Reconstruction of the main portal vein for a large saccular aneurysm.
A large aneurysm of the main portal vein is rare, and the appropriate surgical procedure is uncertain. Reconstruction of a main portal vein affected by a large saccular aneurysm is described. Abdominal pain led to the diagnosis of a large saccular aneurysm of the main portal vein in a 58-year-old woman who had undergone cholecystectomy 10 years earlier. At laparotomy a dorsolateral approach to the hepatoduodenal ligament was performed with no attempt at extensive separate exposure of the anatomical structures in the hepatoduodenal ligament, so as to avoid the devascularisation of the common hepatic duct and additional weakening of the portal vein wall. The aneurysm was longitudinally incised, and the portal vein was reconstructed from the walls of the aneurysm with a longitudinal running suture. The rest of the aneurysmal wall was wrapped around the portal vein, leaving it normal in size and contour. Recovery was uneventful. Follow-up CT scan showed a patent portal vein in the region of the former aneurysm. Large saccular aneurysms can rupture, bleed and cause death. The potential hazards of manipulation of large portal vein aneurysms are negligible in comparison with the possible complications of the aneurysm itself. In our opinion the ease with which the main portal vein was dissected and reconstructed make an elective operation in such cases a reasonable approach.


Intrapopulation variation in nectar secretion in Impatiens capensis.
Variation in nectar secretion rates within a population of Impatiens capensis was examined. There was no evidence for phenotypic variation between plants in nectar secretion rates. There was significant daily variation in secretion rates, which appeared to be caused by environmental factors. Individual flowers showed variable rates of secretion over consecutive hours, and these fluctuations in secretion occurred independently among the many flowers on any single plant. Time of day, plant size, and flower age (as indicated by sexual phase) showed no relationship to nectar secretion rates.


Therapeutic application of intrapericardial tissue plasminogen activator in a 4-month-old child with complex fibropurulent pericarditis.
To describe a young child with complex fibropurulent pericarditis who was successfully treated with intrapericardial recombinant tissue plasminogen activator. Individual case report. Pediatric intensive care unit of a tertiary children's hospital. A 4-month-old Asian girl with Staphylococcus aureus septic shock who later developed a loculated fibropurulent pericardial effusion that was refractory to management with a subxiphoid percutaneous pericardial drainage catheter. Three doses of intrapericardial tissue plasminogen activator were administered at 12-hr intervals, allowed to dwell for 2 hrs, and subsequently drained via low continuous suction. Immediately after intrapericardial tissue plasminogen activator was administered via a percutaneous pericardial drainage catheter, the patient had an increase in pericardial fluid drainage and resolution of a complex fibropurulent pericardial effusion. Pericardial fluid drainage ceased and then increased to 122 mL, 270 mL, and 80 mL of fluid, respectively, after each of the three doses of intrapericardial tissue plasminogen activator. Serial echocardiography confirmed the initial presence of the effusion, the subsequent loculated nature of the effusion, and ultimate resolution of the effusion after tissue plasminogen activator. The patient survived to hospital discharge without cardiac dysfunction. The fibrinolytic effect of tissue plasminogen activator therapy promotes the resolution of complex fibropurulent pericardial effusions refractory to traditional pericardial drainage via percutaneous catheter and suction. Use of intrapericardial tissue plasminogen activator may preclude the need for surgical intervention in fibropurulent pericarditis.


Physiological aspects of automatic physical training control by biofeedback in weightlessness.
An automatically regulated biofeedback apparatus "UN-1" is described for enabling astronauts to maintain specified levels of exercise or lower body negative pressure within acceptable limits of cardiac function. The apparatus was also used to assess the workload tolerance of cosmonauts during space flight. Under these conditions the cosmonaut was unable to exercise on the cycloergometer when his heart rate reached 140 beats/minute steady state.


p53-dependent DNA repair during the DNA damage response requires actin nucleation by JMY.
The tumour suppressor p53 is a nuclear transcription factor with key roles during DNA damage to enable a variety of cellular responses including cell cycle arrest, apoptosis and DNA repair. JMY is an actin nucleator and DNA damage-responsive protein whose sub-cellular localisation is responsive to stress and during DNA damage JMY undergoes nuclear accumulation. To gain an understanding of the wider role for nuclear JMY in transcriptional regulation, we performed transcriptomics to identify JMY-mediated changes in gene expression during the DNA damage response. We show that JMY is required for effective regulation of key p53 target genes involved in DNA repair, including XPC, XRCC5 (Ku80) and TP53I3 (PIG3). Moreover, JMY depletion or knockout leads to increased DNA damage and nuclear JMY requires its Arp2/3-dependent actin nucleation function to promote the clearance of DNA lesions. In human patient samples a lack of JMY is associated with increased tumour mutation count and in cells results in reduced cell survival and increased sensitivity to DNA damage response kinase inhibition. Collectively, we demonstrate that JMY enables p53-dependent DNA repair under genotoxic stress and suggest a role for actin in JMY nuclear activity during the DNA damage response.


Side effects of adjuvant chemotherapy and their impact on outcome in elderly breast cancer patients: a cohort study.
Breast cancer patients over the age of 65 are more likely to suffer chemotherapy side effects, with premature discontinuation, which negatively affects survival. We conducted a retrospective cohort study enrolling breast cancer patients; dose reductions or interruptions of chemotherapy have been collected, as well as side effects. Progression-free survival was determined by Kaplan-Meier and evaluated for its association with reduction/suspension. The study included 128 women (median age: 71). Nineteen patients experienced cardiotoxicity, while dosage of chemotherapy was reduced in 23 patients (18.0%), and 14 (10.9%) had premature interruptions. Dose reduction/interruptions were associated with numerically worse progression-free survival (78.2 vs 94.8 months; p = 0.10). Reduction/discontinuation of chemotherapy due to side effects affected nearly 30% of our population, potentially worsening outcomes.


A mutational analysis of the bacteriophage P1 recombinase Cre.
Bacteriophage P1 encodes a 38,600 Mr site-specific recombinase, Cre, that is responsible for reciprocal recombination between sites on the P1 DNA called loxP. Using in vitro mutagenesis 67 cre mutants representing a total of 37 unique changes have been characterized. The mutations result in a wide variety of phenotypes as judged by the varying ability of each mutant Cre protein to excise a lacZ gene located between two loxP sites in vivo. Although the mutations are found throughout the entire cre gene, almost half are located near the carboxyl terminus of the protein, suggesting a region critical for recombinase function. DNA binding assays using partially purified mutant proteins indicate that mutations in two widely separated regions of the protein each result in loss of heparin-resistant complexes between Cre and a loxP site. These results suggest that Cre may contain two separate domains, both of which are involved in binding to loxP.


Abelson murine leukemia virus P120: identification and characterization of tyrosine phosphorylation sites.
Tryptic peptides containing two major in vivo P120gag-abl tyrosine phosphorylation acceptor sites were identified, phosphorylated in vitro, and purified to homogeneity. The tyrosine site in peptide a is localized at a position six residues distal to its trypsin cleavage site, whereas the tyrosine acceptor site in peptide b is at residue seven. A third peptide, c, contains an amino-terminal phosphotyrosine residue: phosphorylation of this latter peptide only occurs to a significant extent in vivo.


Role of skin tissue layers and ultra-structure in transcutaneous electrical stimulation including tDCS.
During transcranial electrical stimulation (tES), including transcranial direct current stimulation (tDCS) and transcranial alternating current stimulation (tACS), current density concentration around the electrode edges that is predicted by simplistic skin models does not match experimental observations of erythema, heating, or other adverse events. We hypothesized that enhancing models to include skin anatomical details, would alter predicted current patterns to align with experimental observations. We develop a high-resolution multi-layer skin model (epidermis, dermis, and fat), with or without additional ultra-structures (hair follicles, sweat glands, and blood vessels). Current flow patterns across each layer and within ultra-structures were predicted using finite element methods considering a broad range of modeled tissue parameters including 78 combinations of skin layer conductivities (S m-1): epidermis (standard: 1.05 × 10-5; range: 1.05 × 10-6 to 0.465); dermis (standard: 0.23; range: 0.0023 to 23), fat (standard: 2 × 10-4; range: 0.02 to 2 × 10-5). The impact of each ultra-structures in isolation and combination was evaluated with varied basic geometries. An integrated final model is then developed. Consistent with prior models, current flow through homogenous skin was annular (concentrated at the electrode edges). In multi-layer skin, reducing epidermis conductivity and/or increasing dermis conductivity decreased current near electrode edges, however no realistic tissue layer parameters produced non-annular current flow at both epidermis and dermis. Addition of just hair follicles, sweat glands, or blood vessels resulted in current peaks around each ultrastructure, irrespective of proximity to electrode edges. Addition of only sweat glands was the most effective approach in reducing overall current concentration near electrode edges. Representation of blood vessels resulted in a uniform current flow across the vascular network. Finally, we ran the first realistic model of current flow across the skin. We confirm prior models exhibiting current concentration near hair follicles or sweat glands, but also exhibit that an overall annular pattern of current flow remains for realistic tissue parameters. We model skin blood vessels for the first time and show that this robustly distributes current across the vascular network, consistent with experimental erythema patterns. Only a state-of-the-art precise model of skin current flow predicts lack of current concentration near electrode edges across all skin layers.


Microbiota dispersion in the Uyuni salt flat (Bolivia) as determined by community structure analyses.
Soil microbial communities are an important component of biological diversity and terrestrial ecosystems which is responsible for processes such as decomposition, mineralization of nutrients, and accumulation of organic matter. One of the factors that provide information on the mechanisms regulating biodiversity is spatial scaling. We characterized the microbial communities using 16S rRNA gene sequences from DNA isolated from halite at various locations and correlated these to geographic distance in the Uyuni salt flat (Bolivia). Sequences from each site were analyzed to determine any spatial patterns of diversity, as well as to describe the microbial communities. Results suggest that different taxa are able to disperse over Uyuni's surface crust regardless of distance. As expected, ubiquitous taxa included members of Halobacteriaceae such as Haloarcula, Halorubrum, Halorhabdus, Halolamina, and halophilic bacteria Salinibacter, Halorhodospira, and unclassified members of the Gammaproteobacteria. Archaeal communities were homogeneous across the salt flat. In contrast, bacterial communities present strong local variations which could be attributed to external factors. Likely sources for these variations are the Rio Grande river influent in the south shore and the Tunupa volcano influencing the northern area.


Detection of sensitized human blood lymphocytes by agglutination with basic peptides: a possible test for malignant disease.
A simple rapid micro-agglutination test for detecting sensitized lymphocytes from human peripheral blood is described: the poly-L-lysine (PLL) 3400 agglutination test of lymphocytes (PAL test). The incubation of lymphocytes from 30 cancer patients, 30 patients with non-malignant disease and 40 healthy controls with PLL (mol. wt 3400) is evaluated. The test was positive in 83 percent of malignant and 20 percent of non-malignant cases. All healthy controls were negative. Other peptides tested showed no significant difference in reaction between malignant and non-malignant diseases. The mechanism of detection of sensitized lymphocytes from patients with malignant disease through agglutination induced by PLL 3400 is discussed.


Noma in an Afghani child: a case report.
We present a case of Cancrum Oris, also known as Noma, in a child treated by an Otorhinolaryngologist at a United States-led Joint Forces hospital in Afghanistan. Noma is a deadly, necrotizing infection of the face that is rarely seen in wealthy nations but can cause significant morbidity in third world countries. Through a literature review, we report the incidence, risk factors, clinical features, and proposed treatment for this disease.


Understanding the contribution of environmental factors in the spread of antimicrobial resistance.
The overuse and abuse of antibiotics have contributed to the global epidemic of antibiotic resistance. Current evidence suggests that widespread dependency on antibiotics and complex interactions between human health, animal husbandry and veterinary medicine, have contributed to the propagation and spread of resistant organisms. The lack of information on pathogens of major public health importance, limited surveillance, and paucity of standards for a harmonised and coordinated approach, further complicates the issue. Despite the widespread nature of antimicrobial resistance, limited focus has been placed on the role of environmental factors in propagating resistance. There are limited studies that examine the role of the environment, specifically water, sanitation and hygiene factors that contribute to the development of resistant pathogens. Understanding these elements is necessary to identify any modifiable interactions to reduce or interrupt the spread of resistance from the environment into clinical settings. This paper discusses some environmental issues that contribute to antimicrobial resistance, including soil related factors, animal husbandry and waste management, potable and wastewater, and food safety, with examples drawn mainly from the Asian region. The discussion concludes that some of the common issues are often overlooked and whilst there are numerous opportunities for environmental factors to contribute to the growing burden of antimicrobial resistance, a renewed focus on innovative and traditional environmental approaches is needed to tackle the problem.


Reduced myelin density in unmedicated major depressive disorder: An inhomogeneous magnetization transfer MRI study.
To detect the whole-brain reduced myelin density in unmedicated patients with major depressive disorder (MDD) using the inhomogeneous magnetization transfer (ihMT) imaging technology. Compared to other technologies, the ihMT provides high specificity and sensitivity to detect myelin. In this prospective study, fifty unmedicated patients (mean age 25.36 years, 40% men) with MDD and 57 age- and sex-matched healthy controls (HCs) (mean age 25.02 years, 53% men) were recruited between January 2019 and December 2019. All participants underwent ihMT imaging, and pseudo-quantitative ihMT (qihMT) and ihMT ratio (ihMTR) were obtained. The mean values of qihMT and ihMTR extracted from the 50 WM masks (extracted from the International Consortium for Brain Mapping, ICBM-152) in each participant were compared between participants in the MDD and HCs groups. The symptoms of patients were evaluated using the 24-item Hamilton Depression Rating scale (HDRS). Compared with the HC group, the MDD group showed significantly decreased qihMT and ihMTR values in the left inferior fronto-occipital fasciculus (IFOF) (t = -4.057, p < 0.001; t = -3.662, p < 0.001) and the left uncinate fasciculus (UF) (t = -4.776, p < 0.001; t = -3.800, p < 0.001) after Bonferroni correction. The correlation analysis displayed a significant negative correlation between qihMT values of the left IFOF and HDRS total scores in patients with MDD (r = -0.390, p = 0.012). This was a cross-sectional study with a relative small sample. These findings suggest the reduced myelin density in the IFOF and UF in patients with MDD, which might be associated with the pathophysiology of MDD.


P300 subcomponents reflect different aspects of psychopathology in schizophrenia.
The aim of the study was to investigate abnormalities of P300 subcomponents in schizophrenic patients as well as relationships between these subcomponents and positive versus negative schizophrenic symptoms. Nineteen schizophrenic patients and 19 healthy controls were tested with an auditory event-related potential oddball paradigm designed to elicit the P300. The P300 data were analyzed by separating P300 subcomponents with a recently developed dipole source model. Compared to healthy controls, schizophrenic patients showed reduced P300 amplitudes of the temporo-basal dipoles, corresponding mainly to P3b. Positive symptoms of the Positive and Negative Syndrome Scale correlated positively with the temporo-basal but not with temporo-superior dipole P300 activities, whereas negative symptoms correlated positively with the temporo-superior but not with temporo-basal dipole activities. The P300 subcomponents separated with the dipole model are affected in a different manner by positive versus negative symptoms. Furthermore, the positive correlation between the severity of psychopathology and the P300 amplitudes of the different dipole activities appears to be a state-dependent effect, which has to be separated from the P300 amplitude reduction as a trait marker in schizophrenic patients.


Azathioprine desensitizes liver cancer cells to insulin-like growth factor 1 and causes apoptosis when it is combined with bafilomycin A1.
Hepatoblastoma is a primary liver cancer that affects children, due to the sensitivity of this tumor to insulin-like growth factor 1 (IGF-1). In this paper we show that azathioprine (AZA) is capable of inhibiting IGF1-mediated signaling cascade in HepG2 cells. The efficiency of AZA on inhibition of proliferation differs in the evaluated cell lines as follows: HepG2 (an experimental model of hepatoblastoma)>Hep3B (derived from a hepatocellular carcinoma)>HuH6 (derived from a hepatoblastoma)>>HuH7 (derived from a hepatocellular carcinoma)=Chang Liver cells (a non-malignant cellular model). The effect of AZA in HepG2 cells has been proven to derive from activation of Ras/ERK/TSC2, leading to activation of mTOR/p70S6K in a sustained manner. p70S6K phosphorylates IRS-1 in serine 307 which leads to the uncoupling between IRS-1 and p85 (the regulatory subunit of PI3K) and therefore causing the lack of response of HepG2 to IGF-1. As a consequence, proliferation induced by IGF-1 is inhibited by AZA and autophagy increases leading to senescence of HepG2 cells. Our results suggest that AZA induces the autophagic process in HepG2 activating senescence, and driving to deceleration of cell cycle but not to apoptosis. However, when simultaneous to AZA treatment the autophagy was inhibited by bafilomycin A1 and the degradation of regulatory proteins of cell cycle (e.g. Rb, E2F, and cyclin D1) provoked apoptosis. In conclusion, AZA induces resistance in hepatoblastoma cells to IGF-1, which leads to autophagy activation, and causes apoptosis when it is combined with bafilomycin A1. We are presenting here a novel mechanism of action of azathioprine, which could be useful in treatment of IGF-1 dependent tumors, especially in its combination with other drugs.


ConvNets for automatic detection of polyglutamine SCAs from brain MRIs: state of the art applications.
Polyglutamine spinocerebellar ataxias (polyQ SCAs) are a group of neurodegenerative diseases, clinically and genetically heterogeneous, characterized by loss of balance and motor coordination due to dysfunction of the cerebellum and its connections. The diagnosis of each type of polyQ SCA, alongside with genetic tests, includes medical images analysis, and its automation may help specialists to distinguish between each type. Convolutional neural networks (ConvNets or CNNs) have been recently used for medical image processing, with outstanding results. In this work, we present the main clinical and imaging features of polyglutamine SCAs, and the basics of CNNs. Finally, we review studies that have used this approach to automatically process brain medical images and may be applied to SCAs detection. We conclude by discussing the possible limitations and opportunities of using ConvNets for SCAs diagnose in the future.


Cardiac involvement with anti-mitochondrial antibody-positive myositis mimicking cardiac sarcoidosis.
Anti-mitochondrial antibody (AMA)-positive myositis is an atypical inflammatory myopathy characterized by chronic progressive respiratory muscle weakness, muscular atrophy, and cardiac involvement. Arrhythmias, cardiomyopathy, and myocarditis have been reported as cardiac manifestations. Herein, we present the first report of a patient diagnosed with having AMA-positive myositis with cardiac involvement mimicking cardiac sarcoidosis.


Obstructive Sleep Apnoea and Hypertension: the Role of the Central Nervous System.
Obstructive sleep apnoea (OSA) is associated with both nocturnal and daytime hypertensions which increase cardiovascular morbidity and mortality. It is thought that the repeated episodes of hypoxia and hypercapnia during nocturnal airway obstructions that characterise OSA result in increased sympathetic drive that persists during wakefulness. Although the underlying mechanisms responsible for this hypertension remain to be elucidated, several neural and humoral mechanisms have been proposed and recent evidence suggesting changes in the central nervous system may play a significant role. The purpose of this review is to explore recent evidence of central changes associated with elevated sympathetic drive in individuals with OSA. Recent human brain imaging investigations and, in particular, combined microneurography recording of resting sympathetic activity with high-resolution functional magnetic resonance imaging have provided some important insights into changes in brain function and anatomy associated with resting sympathetic activity. Functional and anatomical changes occur in OSA, including in regions of the brainstem circuitry known to be responsible for setting resting sympathetic activity. Furthermore, these changes are reversed following continuous positive airway treatment in concert with reductions in resting sympathetic drive. These resent findings suggest that the central changes may contribute significantly to the hypertension associated with OSA.


Comparative Lipid Profile Analysis of Hermetia illucens Larvae Fed Food Waste at Different Days of Age Using an LC-MS-Based Lipidomics Approach.
A lipidomics approach based on liquid chromatography-tandem mass spectrometry (LC-MS) was applied to analyze the molecular-level mechanism of lipid deposition in Hermetia illucens (H. illucens) larvae fed food waste (FW) at different days of age. The H. illucens larvae reared on FW substrates generally became larger, heavier, and fatter at 5-15 d of age. A large amount of glycerolipids (GL) were deposited, while glycerophospholipids (GP), sphingolipids, and derivatized lipids became relatively less abundant during the growth stage of the larvae. Forty-three subclasses of 3,205 lipid molecules were identified in larvae, and 139 lipids (79 upregulated and 60 downregulated during larval growth and development) were identified as potential biomarkers (variable importance in projection > 1; P < 0.05). The differential lipids were mainly enriched in 19 metabolic pathways, of which 9 metabolic pathways related to lipids, including GL and GP metabolisms. The results demonstrate that the lipid composition and mechanisms changed during the growth and development stage of H. illucens larvae. To the best of our knowledge, this is the first work exploring the molecular-level mechanism of lipid deposition during the growth and development stage of H. illucens larvae. The findings provide novel information for determining and utilizing the nutritional value of H. illucens larvae.


Can specific preoperative counseling increase the likelihood a woman will choose postmastectomy breast reconstruction?
Low reconstruction rates after mastectomy for breast cancer raise questions about the impact of preoperative education. This study determines whether counseling about reconstruction influences the decision about reconstruction. The study was based on a prospectively collected database of breast cancer surgery. A total of 299 operations for breast cancer were performed. Of 127 mastectomies, 21 (16%) were not candidates. In all, 106 women were specifically educated about reconstruction; 40 (37%) women consulted with a plastic surgeon; and 22 (21%) women ultimately chose reconstruction. Forty women had the option of mastectomy or breast conservation. Twelve (30%) women accepted a consultation with a plastic surgeon. Six of these women (15%) ultimately chose reconstruction. Mastectomy was required in 66 women; 28 (42%) accepted a consultation with a plastic surgeon; 16 (24%) underwent reconstruction; 3 additional women are planning delayed reconstruction (28%). Reconstruction is more likely when mastectomy is required than when it is chosen. Low reconstruction rates reflect patient desire rather than access or education.


[Radiography of the epididymis, vas deferens and vesicle in the investigation of male sterility (author's transl)].
Radiography of the epididymis, vas deferens and vesicle was formed in 72 subjects admitted for sterility. The technique employed, its indications, and the results achieved are discussed. Several examples are presented.


The canal of the posterior ampullar nerve: an important anatomic landmark in the posterior fossa transmeatal approach.
The canal of the posterior ampullar nerve is located between the inferior part of the internal acoustic meatus and ampulla of the posterior semicircular canal. It permits a more accurate localisation of the underlying labyrinth in inner-ear surgery. An anatomical and radiological study was undertaken to determine the importance the relationship between the canal and the labyrinth. Ten dry and 10 cadaveric temporal bone dissections, together with 20 high resolution CT scans of the same temporal bones were studied in an attempt to describe the anatomy of the canal of the posterior ampullar nerve. The length of the canal of the posterior ampullar nerve, the length of internal acoustic meatus, and distances from porus acusticus to the singular foramen and the transverse crest, and from the singular foramen to the vestibule and transverse crest, and from operculum to the sigmoid sinus and to the porus acusticus were measured. During the transmeatal posterior cranial fossa approach using the canal of the posterior ampullar nerve as a landmark enables more bone to be safely removed from the internal acoustic meatus thus preserving hearing.


Phosphomimetic Mutation of Glycine Transporter GlyT1 C-Terminal PDZ Binding Motif Inhibits its Interactions with PSD95.
Even though the abundance of GlyT1 in postsynaptic aspects of forebrain neurons is low, its previously reported interaction with postsynaptic density protein PSD95 represents a prototype of interaction, which might uncover the binding mechanism and regulation of the GlyT1 C-terminal PDZ motif. We used a phosphomimetic approach to mimic the potential phosphorylation of GlyT1 C-terminal serines 640, 643, 644, and 649 of the mouse GlyT1b subtype (mGlyT1b) (Uniprot P28571-2) and its effect on GlyT1-PSD95 PDZ interaction. Among them, only phosphomimetic mutation of serine 649 to aspartate, which resides in the minimal PDZ motif -SRI, significantly eliminated the interaction of the GlyT1 C-terminus with PSD95 PDZ domain 2. The effect was observed with recombinant fusion proteins as well as with GlyT1 and PSD95 expressed in tissue culture. Results indicate that phosphorylation of mouse GlyT1b serine 649 and equivalent serines of GlyT1a and GlyT1c subtypes might regulate the PDZ interaction of the GlyT1 C-terminal PDZ binding motif.


[Clinical case of the month. Anterior mediastinal mass in a patient with acromegaly].
The discovery of an anterior asymptomatic mediastinal mass with acromegaly creates a dilemma for the clinician. As acromegaly can be due to a pituitary tumor but also to an ectopic production of GHRH, the first diagnostic step consists of finding the etiology of the disease in order to use adequate treatment. This can be complicated by the fact that acromegaly can be associated with other tumors (for instance in MEN-1 disease and Carney Complex) and because chronic GH hypersecretion can stimulate tumor overgrowth and perhaps tumor formation. We describe the case of a 44-year-old acromegalic woman with an anterior mediastinal mass. We present the different diagnoses and a review of the literature.


Intracranial germ cell tumour (embryonal carcinoma with teratoma) with complex karyotype including isochromosome 12p.
We report the chromosomal characteristics of a malignant teratoma with embryonal carcinoma component located in the pineal region of a 15-year-old boy. Chromosome analysis showed a near-triploid complex karyotype (62 chromosomes), including two copies of an isochromosome 12p, confirmed by fluorescence in situ hybridization analysis. The present findings indicate that isochromosome 12p formation is probably associated with the development of malignant germ cell tumours.


Different developmental patterns of simple deductive and probabilistic inferential reasoning.
In three studies, we examined simple counterexample-based and probabilistic reasoning in children 6, 7, and 9 years of age. In the first study, participants were asked to make conditional (if-then) inferences under both categorical (certain or uncertain) and probabilistic instructions. Results showed that 6-year-olds respond to both forms of inference in similar ways, but whereas probabilistic conditional inferences showed little development over this period, categorical inferences clearly improved between 6 and 7 years of age. An analysis of the children's justifications indicated that performance under categorical instructions was strongly related to counterexample generation at all ages, whereas this was true only for the younger children for inferences under probabilistic instructions. These findings were replicated in a second study, using problems that referred to concrete stimuli with varying probabilities of inference. A third study tested the hypothesis that children confused probability judgments with judgments of confidence and demonstrated a clear dissociation between these two constructs. Overall, these results show that children are capable of accurate conditional inferences under probabilistic instructions at a very early age and that the differentiation between categorical and probabilistic conditional reasoning is clear by at least 9 years ofage. These results are globally consistent with dual-process theories but suggest some difficulties for the way that the analytic-heuristic distinction underlying these theories has been conceptualized.


Role of the endothelial antigen Eag-1 in the rejection of rat kidney allografts.
The immunogenicity of the minor histocompatibility antigen Eag-1 of the rat kidney endothelium was studied in renal allografts mismatched for antigens of the major histocompatibility complex (MHC). The rejection rates of BN.1L (RT1(1), Eag-1+), (BN.1LXMAXX)F1 (RT1l/n, Eag-1+), and LEW (RT1l, Eag-1-) kidneys transplanted into unsensitized, bilaterally nephrectomized MAXX (RT1n, Eag-1-) recipients were comparable, indicating that incompatibility for Eag-1 has no effect on the survival of MHC-incompatible kidney grafts. Transplantation of BN (RT1n, Eag-1+) and WKY (RT1k, Eag-1+) kidneys into unilaterally nephrectomized MAXX recipients led to a weak and inconsistent antibody response against Eag-1, indicating that MHC incompatibility does not influence the formation of antibodies against Eag-1.


Durability of the first combined antiretroviral regimen in patients with AIDS at a reference center in Belo Horizonte, Brazil, from 1996 to 2005.
Finding a better first antiretroviral regimen is one of the strategies used to improve span and quality of life of HIV/AIDS patients. 891 patients were followed during 24 months or until interruption/abandonment of treatment, changing regimen or death. At the end of 6 months, 69% of the patients were still being treated with the first regimen, 54% at 12 months, 48% at 18 months and 39% at 24 months. AZT-3TC-EFV was the most prescribed regimen and with the lesser discontinuation. NNRTI regimens showed high effectiveness and durability compared to PI regimens. Irregular medication dispensation was the only risk factor for failure/interruption of treatment in multivariate analyses. Intolerance/adverse effects were mainly responsible for first regimen discontinuation, followed by abandonment/non-adherence and virologic failure. Results showed significant difference between causes of interruption of first HAART with higher percentage of intolerance/adverse effects with PI regimens and higher immunologic failure with NNRTI regimens. Even with the availability of more potent and tolerable drugs, lack of adherence to HAART and high level of adverse effects are still the most important barriers to prolonged success of treatment. This study adds relevant information about durability and effectiveness of HAART in the first decade of its use in Brazil.


Estimation of Cognitive Performance Based on Premorbid Intelligence in Parkinson's Disease.
The estimation of premorbid intelligence (PI) is needed for an accurate diagnosis. This study aimed to estimate the cognitive performance taking into account the PI in Parkinson's disease (PD) compared to healthy controls (HC); and to analyze the discrepancies between the current and the predicted cognitive performance based on the PI. Semantic fluency, verbal and visual memory, and executive functions were assessed in 39 PD and 162 HC. A linear regression model was used to analyze the discrepancies between the predicted cognitive performance and the current raw scores through PI variables (Word Accentuation Test (WAT), Pseudo-Words (PW) Reading subtest from PROLEC-R, age, and years of education). ROC analyses were performed to assess their diagnostic properties. Significant differences were found in the raw cognitive scores between patients and HC [semantic fluency (t = 6.07; p < 0.001), verbal memory (t = 6.63; p < 0.001), and executive functions (t = 2.57; p = 0.013), and in visual memory (t = 1.97; p = 0.055 marginally significant)]. Compared to HC, PD patients presented higher discrepancies between the predicted cognitive performance and the raw scores in semantic fluency, verbal memory, visual memory, executive functions (AUC = 0.78, 0.78; 0.64, 0.61, respectively). The magnitude of the discrepancies scores between the current and the predicted cognitive performance based on PI indicates the presence of cognitive decline in the specific cognitive domain in PD patients. This study underlines the usefulness of premorbid measures and variables, such as WAT, PW, age, and years of education, to more accurately estimate the cognitive performance in PD.


Stimulation of benzodiazepine receptors in the dorsal hippocampus and median raphé reveals differential GABAergic control in two animal tests of anxiety.
The effects of pharmacological challenges to the benzodiazepine receptors in the dorsal hippocampus and median raphé nucleus were investigated in the social interaction and the elevated plus-maze tests of anxiety in rats. In the social interaction test, bilateral administration of midazolam (1 and 2 micrograms), into the dorsal hippocampus had anxiolytic effects; flumazenil (500 ng) was silent, but was able to antagonize the anxiolytic effects of midazolam (2 micrograms). In the social interaction test, midazolam was also anxiolytic when infused into the median raphé nucleus; flumazenil (100 and 500 ng) increased locomotor activity, but did not change anxiety measures. As an anatomical control, midazolam (1 and 2 micrograms) was infused into the adjacent pontine reticular nucleus, and was without effect. In contrast to the social interaction test, local infusion of midazolam (1 and 2 micrograms) and flumazenil (100 and 500 ng) into either the dorsal hippocampus or the median raphé nucleus failed to change anxiety measures in the elevated plus-maze (trials 1 and 2). These results show that stimulation of the benzodiazepine receptors in the hippocampus or the median raphé nucleus leads to anxiolytic effects in the social interaction test, but not in the elevated plus-maze. It would therefore appear that the two tests detect different types of anxiety that are differentially modulated by GABAA-benzodiazepine receptors in the dorsal hippocampus and the median raphé nucleus.


Recurrent cortical circuits implement concentration-invariant odor coding.
Animals rely on olfaction to find food, attract mates, and avoid predators. To support these behaviors, they must be able to identify odors across different odorant concentrations. The neural circuit operations that implement this concentration invariance remain unclear. We found that despite concentration-dependence in the olfactory bulb (OB), representations of odor identity were preserved downstream, in the piriform cortex (PCx). The OB cells responding earliest after inhalation drove robust responses in sparse subsets of PCx neurons. Recurrent collateral connections broadcast their activation across the PCx, recruiting global feedback inhibition that rapidly truncated and suppressed cortical activity for the remainder of the sniff, discounting the impact of slower, concentration-dependent OB inputs. Eliminating recurrent collateral output amplified PCx odor responses rendered the cortex steeply concentration-dependent and abolished concentration-invariant identity decoding.


The psychological and psychiatric effects of terrorism: lessons from London.
The 7 July 2005 bombings in London caused heightened levels of distress among some in the general community. This distress was most notable in Muslims and members of ethnic minority groups. These effects were transient for most. An estimated 30% of those who were more affected by the attacks, including victims and witnesses, developed psychiatric disorders as a result. An outreach program was set up to screen those who were exposed to potentially traumatic events and to offer them evidence-based treatment. This article discusses what lessons might be learned from studies of the general community and the screen-and-treat approach.


Mutualism between the territorial intertidal limpet Patella longicosta and the crustose alga Ralfsia verrucosa.
Mutualistic relations between plants and animals are well documented on land but have received less attention in marine systems. This study examined the relationship between the territorial intertidal limpet Patella longicosta and the crustose brown alga Ralfsia verrucosa. Adult Patella are found exclusively in association with Ralfsia, on which they feed, while Ralfsia occurs primarily, but not exclusively, in Patella territories. Ralfsia benefits directly from both the presence and the territorial behaviour of Patella. Algal productivity was assessed by measuring oxygen evolution and utilization in situ and deriving photosynthesis/irradiance curves. Productivity was increased by about 30% by the presence of Patella in both summer (P max of grazed algae 0.0098; ungrazed algae 0.0063 mg C · cm-2 · h-1) and winter (P max grazed algae 0.0081; ungrazed algae 0.0053 mg-2 · C · h-1). Algal growth rates were not significantly increased by the application of limpet mucus in the laboratory. We did not examine nutrient regeneration by the limpet, but the increase in photosynthetic rate may depend on the limpet's grazing pattern which creates secondary sites for growth. Ralfsia also benefited from the territorial behaviour of Patella. The effects of different grazing regimes were investigated in different seasons by removing territorial limpets and either excluding all limpets using copper-based antifouling paint, or allowing access to non-territorial limpets (mostly P. oculus) using partial paint barriers. Exclusion of all limpets resulted in rapid overgrowth of Ralfsia plants by the foliose green alga Ulva sp.. Where non-territorial limpets had access to the plants overgrowth was reduced but Ralfsia plants were entirely removed by destructive grazing. Non-territorial grazers removed 90% of Ralfsia plants within 4 weeks in summer and 60% in winter. In control treatments P. longicosta prevented overgrowth by Ulva and actively excluded vagrant grazers, preventing overgrazing. Based on these findings, the association between the limpet and alga can be regarded as a nonobligate mutualism.


Metabolic and biogeochemical consequences of viral infection in aquatic ecosystems.
Ecosystems are controlled by 'bottom-up' (resources) and 'top-down' (predation) forces. Viral infection is now recognized as a ubiquitous top-down control of microbial growth across ecosystems but, at the same time, cell death by viral predation influences, and is influenced by, resource availability. In this Review, we discuss recent advances in understanding the biogeochemical impact of viruses, focusing on how metabolic reprogramming of host cells during lytic viral infection alters the flow of energy and nutrients in aquatic ecosystems. Our synthesis revealed several emerging themes. First, viral infection transforms host metabolism, in part through virus-encoded metabolic genes; the functions performed by these genes appear to alleviate energetic and biosynthetic bottlenecks to viral production. Second, viral infection depends on the physiological state of the host cell and on environmental conditions, which are challenging to replicate in the laboratory. Last, metabolic reprogramming of infected cells and viral lysis alter nutrient cycling and carbon export in the oceans, although the net impacts remain uncertain. This Review highlights the need for understanding viral infection dynamics in realistic physiological and environmental contexts to better predict their biogeochemical consequences.


Primary cutaneous B-cell lymphoma associated with actinic prurigo.
We describe two patients with a diagnosis of actinic prurigo who subsequently developed cutaneous B-cell lymphoma. This is the first report, to our knowledge, of this association. We propose that chronic antigenic stimulation by ultraviolet radiation, in the context of actinic prurigo, may have been causal in the development of these unusual lymphomas.


Simultaneous impairment of neuronal and metabolic function of mutated gephyrin in a patient with epileptic encephalopathy.
Synaptic inhibition is essential for shaping the dynamics of neuronal networks, and aberrant inhibition plays an important role in neurological disorders. Gephyrin is a central player at inhibitory postsynapses, directly binds and organizes GABAA and glycine receptors (GABAARs and GlyRs), and is thereby indispensable for normal inhibitory neurotransmission. Additionally, gephyrin catalyzes the synthesis of the molybdenum cofactor (MoCo) in peripheral tissue. We identified a de novo missense mutation (G375D) in the gephyrin gene (GPHN) in a patient with epileptic encephalopathy resembling Dravet syndrome. Although stably expressed and correctly folded, gephyrin-G375D was non-synaptically localized in neurons and acted dominant-negatively on the clustering of wild-type gephyrin leading to a marked decrease in GABAAR surface expression and GABAergic signaling. We identified a decreased binding affinity between gephyrin-G375D and the receptors, suggesting that Gly375 is essential for gephyrin-receptor complex formation. Surprisingly, gephyrin-G375D was also unable to synthesize MoCo and activate MoCo-dependent enzymes. Thus, we describe a missense mutation that affects both functions of gephyrin and suggest that the identified defect at GABAergic synapses is the mechanism underlying the patient's severe phenotype.


Regulation of the nitric oxide pathway genes by tetrahydrofurandiols: microarray analysis of MCF-7 human breast cancer cells.
THF-diols (9,12-oxy-10,13-dihydroxyoctadecanoic and 10,13-oxy-9,12-dihydroxyoctadecanoic acids) are endocrine disrupters in rats and mitogens in breast cancer cells. Microarray analyses and real-time PCR analyses on RNA from THF-treated MCF-7 cells revealed a number of genes (caveolin 1, heat shock protein 90 alpha and 90 beta, vascular endothelial growth factor, ATPase, Ca++ transporting, ubiquitous) in the nitric oxide pathway (NOP) were targets for THF-diols. Chromatin immunoprecipitation studies suggest THF-diols modify of histone H4 acetylation at the caveolin 1 promoter via an epigenetic mechanism. These findings are consistent with the well-known involvement of NOP genes in cell proliferation and sexual behavior.


[A quantitative method for the evaluation of keratinophilic fungi of environmental origin].
A tentative quantitative method is proposed to evaluate keratinophilic flora in the environment (soil and sand). It associates the MPN methodology to the "hair bait" technique. The methodology developed on sand samples has been able to detect shores with high amounts of keratinophilic flora (Focene, Torvaianica) besides clean areas.


Periodontal soft tissue increase induced by periodontally accelerated osteogenic orthodontics surgery.
To quantitatively assess periodontal soft tissue changes, including gingival thickness and keratinized gingiva width after periodontally accelerated osteogenic orthodontics (PAOO) surgery by digital measurements. METHODS: This study enrolled 15 maxillaries with 89 anterior teeth and 16 mandibles with 94 anterior teeth from Chinese adult patients with skeletal Angle Class III malocclusion for whom PAOO surgery was proposed during orthodontic treatment. Intraoral scanning and cone beam computed tomography (CBCT) examinations were performed before PAOO surgery and 6 months after the surgery. Keratinized gingiva width was measured on the digital model acquired by intraoral scanning. The gingival thickness was measured using a digital three-dimensional (3D) model based on the combination of digital intraoral scanning and CBCT data. The mean gingival thickness before surgery was 0.91 ± 0.32 mm and 1.21 ± 0.38 mm at 6-month after PAOO. Patients showed periodontal soft tissue increase with a mean gingival tissue gain of 0.30 ± 0.33 mm. At 1 mm, 2 and 3 mm apical to cemento-enamel junction (CEJ) levels, the gingival thickness increase of the mandible was higher than that of the maxilla (0.38 ± 0.30 mm vs. 0.24 ± 0.31 mm, 0.43 ± 0.35 mm vs. 0.26 ± 0.41 mm, 0.36 ± 0.27 vs. 0.25 ± 0.32 mm, respectively, all P < 0.05). Moreover, the sites of gingival thickness ≤ 1 mm before surgery showed more tissue gain than the sites > 1 mm (0.36 ± 0.32 mm vs. 0.18 ± 0.31 mm, P < 0.001). The mean keratinized gingiva width at T0 was 3.88 ± 1.22 mm, and increased 1.05 ± 1.24 mm 6 months after PAOO surgery. Moreover, a digital 3D model for gingival thickness measurement based on the combination of digital intraoral scanning and CBCT displayed high reliability and accuracy with an intra-class correlation coefficient (ICC) of 0.897. PAOO could improve an insufficient quantity of periodontal soft and hard tissues in patients with skeletal Angle Class III malocclusion, including the gingival thickness and keratinized gingiva width. A digital 3D model based on the combination of digital intraoral scanning and CBCT data could provide a new digital measurement of gingival thickness with high accuracy and reliability.


Severe Type of COVID-19: Pathogenesis, Warning Indicators and Treatment.
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2, is a major public health issue. The epidemic is unlikely to be contained until the global launch of safe and effective vaccines that could prevent serious illnesses and provide herd immunity. Although most patients have mild flu-like symptoms, some develop severe illnesses accompanied by multiple organ dysfunction. The identification of pathophysiology and early warning biomarkers of a severe type of COVID-19 contribute to the treatment and prevention of serious complications. Here, we review the pathophysiology, early warning indicators, and effective treatment of Chinese and Western Medicine for patients with a severe type of COVID-19.


Geriatric depression.
Depression in later life can present unique clinical and therapeutic challenges. Phenomenology is often atypical and the concurrence of physical illness can confound both diagnosis and treatment. A review of current knowledge about epidemiology, pathogenesis, clinical features, and therapeutic issues is presented.


The role of NCAM in remyelination.
The neural cell adhesion molecule (NCAM) is expressed by myelinating precursor cells in neonatal mouse spinal cord and by remyelinating cells after chemically induced demyelination in adult mouse. It shows tempting suggestions about its possible involvement in the reparative mechanisms and the remyelination processes that take place in multiple sclerosis (MS). In fact, its levels progressively increase in the cerebrospinal fluid (CSF) of acute MS patients subjected to steroid treatment, paralleling the progressive clinical improvement after the attack. Such an increase is not found in acute MS patients not treated with steroids nor in non-acute patients subjected to the same steroid treatment.


A prospective cohort study of pulmonary function during pregnancy in women with and without asthma.
Pregnancy alters the severity of asthma unpredictably. Uncertainty still exists about longitudinal changes in pulmonary function during pregnancy in both healthy and asthmatic women. This study aimed to compare pulmonary function changes during pregnancy in healthy and asthmatic women and to determine the relationship between pulmonary function and asthma-related quality of life during pregnancy. A secondary aim was to investigate the application of forced expiratory volume in 6 s (FEV6) for monitoring asthma during pregnancy. Pregnant women with (n = 20) and without asthma (n = 20) had pulmonary function tests at 8-20, 21-28 and 29-40 weeks gestation. Those with asthma also completed the Asthma Control Questionnaire (ACQ) and mini Asthma Quality of Life Questionnaire (mAQLQ) at each visit. Pulmonary function declined in both groups at follow-up #1 (more markedly in those with asthma) but then improved at follow-up #2 (more markedly in those with asthma). In those with asthma, ACQ scores increased, while mAQLQ scores declined at follow-up #1; whilst at follow-up #2 these changes were in the opposite direction. FEV6 and forced vital capacity (FVC) were highly correlated (r = 0.88, p < 0.01) in asthmatics. Pulmonary function changes during second and third trimesters were more pronounced in asthmatics than in healthy women. FEV6 monitoring may assist pregnant women and their health professionals in optimizing asthma management. The changes in pulmonary function in women with asthma were not significantly associated with changes in asthma control or asthma-related quality of life.


Molecular study of endo and phytocannabinoids on lipid membranes of different composition.
The discovery of the endocannabinoid system (ECS) dates back only 30 years. Although many research groups have been elucidating its components, location, functions and metabolism, the peculiarities of the compounds considered "neurotransmitters" of ECS generate questions that have not yet been answered or controversies in the literature. In this context, we studied the molecular behaviour of the main endocannabinoid compounds and the main phytocannabinoids in eukaryotic outer and inner model membranes. The high lipophilicity of these compounds gives place to the hypothesis that cannabinoids may reach the molecular targets through the lipid bilayer. This consideration is not only for the cannabinoid receptors but also for other (many) targets that these bioactive molecules modulate (Watkins, 2019; Nelson et al., 2020; Jakowiecki and Filipek, 2016). Given the reported multitarget action of these compounds and the differential behaviour towards the different receptors, studying the properties and dynamics of these cannabinoids in POPC and POPE model membranes become relevant. In this regard, we have studied the differential modulation of the endocannabinoids anandamide and 2-arachidonoyl-glycerol and the phytocannabinoids cannabidiol and trans-Δ9-tetrahydrocannabinol to eukaryotic outer and inner model membranes. Results show that behaviours favour the mobility of the bioactive molecules studied by the external eukaryotic model membrane. As well as, the internal eukaryotic model membrane is less fluid, favouring the stabilisation of folded conformations or the positioning of the molecules in the centre of the bilayer. These results provide relevant evidence that contributes to a deep inside understanding of the behaviour of the primary endogenous ligands of ECS, together with the principal phytocannabinoids of C. sativa.


The myelodysplastic/myeloproliferative neoplasms: myeloproliferative diseases with dysplastic features.
The 2001 World Health Organization (WHO)-sponsored classification of hematopoietic tumors has, for the first time, clearly defined a group of rare myeloid neoplasms termed myelodysplastic/myeloproliferative diseases (MDS/MPDs). This group includes three main entities, chronic myelomonocytic leukemia, atypical chronic myeloid leukemia and juvenile myelomonocytic leukemia, and also several less well defined, 'unclassifiable' disorders with MDS/MPN-like features. In the upcoming fourth edition of the WHO fascicle, due out later this year, the term 'MPD' is replaced by 'myeloproliferative neoplasm (MPN)'. Accordingly, the term MDS/MPD is being replaced by 'MDS/MPN' that will be used in this review. Although much progress has been made in understanding the molecular pathogenesis of myeloid neoplasms, most of the diseases included in the group of MDS/MPN still remain 'clinicopathologically assigned'. In other words, they can only be accurately categorized by a careful multiparametric approach that is based on the integration of bone marrow and peripheral blood morphology with other laboratory and clinical findings. The current 'spotlight' review provides practical guidelines, which should allow for a reproducible classification of these uncommon neoplasms when encountered in clinical practice.


Photodynamic antimicrobial chemotherapy (PACT) using riboflavin inhibits the mono and dual species biofilm produced by antibiotic resistant Staphylococcus aureus and Escherichia coli.
Multispecies biofilms play a significant role in persistent infections. Furthermore, by interspecies transfer of antibiotic resistance genes, multispecies biofilms spread antibiotic resistance. The purpose of this study was to investigate the effect of Photodynamic Antimicrobial Chemotherapy (PACT) using riboflavin on mono and multi species biofilms. For this we used two clinically relevant opportunistic pathogens species E. coli and S. aureus as mono-species and multispecies biofilms. We did broth dilution assay for antibacterial, crystal violet assay for biofilms and fluorometric study for reactive oxygen species (ROS) and extracellular polymeric substance (EPS) production by phenol-HCl method. Antibacterial study revealed that photo-illuminated riboflavin shows bactericidal effect against each bacteria and their mix culture. E. coli was found to be little more resistant than S. aureus. Crystal violet assay revealed photo-illuminated riboflavin shows anti-biofilms activity against both mono and mix species biofilms. But mix species biofilms were more resistant to PACT than mono species biofilms. Further study revealed this may be due to the interaction between different EPS production, hence in mix species biofilms EPS production is less affected after PACT than mono species biofilms. We found photo-illuminated riboflavin increased the intracellular ROS production. Photo-illuminated riboflavin shows bactericidal and anti-biofilms effect against each bacteria and their mix culture. Photo-illuminated increased intracellular ROS production, which may induce the oxidative stress and destroy the respiratory system of bacteria.


Cryoballoon versus radiofrequency ablation for persistent atrial fibrillation: a systematic review and meta‑analysis.
Clinical outcomes of catheter ablation for persistent atrial fibrillation (AF) remain discouraging. This meta‑analysis aimed to compare cryoballoon ablation (CBA) with radiofrequency ablation (RFA) for persistent AF. A systematic search of the PubMed, EMBASE, and Cochrane Library databases was performed for studies comparing the outcomes between CBA and RFA. Seven trials including 934 patients were analyzed. There were no differences between groups in terms of freedom from atrial arrhythmia (risk ratio [RR], 1.04; 95% CI, 0.93-1.15; P = 0.52; I2 = 0%), procedural complications (RR, 0.91; 95% CI, 0.52-1.59; P = 0.74; I2 = 0%), atrial fibrillation or atrial tachycardia relapse during the blanking period (RR, 0.73; 95% CI, 0.50-1.06; P = 0.1; I2 = 9%), repeat ablation (RR, 0.74; 95% CI, 0.45-1.21; P = 0.23; I2 = 62%), and vascular complications (RR, 0.98; 95% CI, 0.42-2.27; P = 0.97; I2 = 0%). Cryoballoon ablation increased the incidence of conversion to sinus rhythm during ablation (RR, 1.69; 95% CI, 1.01-2.83; P = 0.046; I2 = 0%) and phrenic nerve palsy (PNP; RR, 3.05; 95% CI, 0.95-9.8; P = 0.06; I2 = 0%), while RFA increased the risk of cardiac tamponade (RR, 0.27; 95% CI, 0.06-1.25; P = 0.09; I2 = 0%). Subanalyses revealed a lower incidence of recurrent atrial arrhythmia and repeat ablation during CBA without touch‑up RFA in pulmonary vein isolation. CBA provides an alternative technique for persistent AF ablation. It might reduce the risk of repeat ablation and cardiac tamponade but increase the risk of PNP.


Isolation of lung alveolar walls.
Disintegration of peripheral lung tissue followed by filtration through an 80 mesh stainless steel screen yields a filtrate containing tissue particles with properties consistent with their identification as fragments of alveolar walls. Application of this procedure readily yields large quantities of alveolar wall tissue.


Spinal dermoid cysts originating intracranial fat drops causing obstructive hydrocephalus: case reports.
The authors report two cases of spinal dermoid cysts whose rupture originated the migration of free fat drops into the ventricles and intracranial subarachnoid spaces. In both cases the fat drops caused obstructive hydrocephalus, which represents a quite exceptional complication. Moreover, one of the cases is unique, since the finding of intracranial fat causing hydrocephalus considerably preceded the discovery of the spinal neoplasm. The authors suggest that the finding of intracranial fat in the absence of a local source makes the search for a intraspinal dermoid or epidermoid tumor mandatory.


Preparation and characterization of pH-responsive microgel using arabinoxylan from wheat bran for BSA delivery.
Wheat bran arabinoxylan (AX) discard from wheat production was utilized to form pH-responsive microgels. AX was modified by carboxymethylation, and the carboxymethylated arabinoxylans (CMAX) were characterized by FT-IR, NMR, gel permeation chromatography (GPC), and rheological analysis. The CMAX microgel was cross-linked by Fe3+ using an inverse emulsification polymerization. The morphology, particle size, pH sensitivity, and mechanism of cross-linking between COO- and Fe3+ of the CMAX microgel was investigated. The CMAX microgel was used to be an oral protein drug carrier. The CMAX microgel particles exhibited a stable spherical structure. FT-IR spectral analysis of the CMAX microgel indicated that the microgel was crosslinked by bridging Fe3+ and COO- with unidentate binding. The CMAX microgel exhibited good pH sensitivity and high stability in acid condition. Additionally, BSA was used as the embedding protein, and the controlled release effect of CMAX microgel was explored in gastrointestinal tract simulation.


Wounds traversing two or more cardiac chambers. Case presentation of two survivors and review of the literature.
A review of the literature on patients who have survived wounds traversing two or more cardiac chambers is presented and two further cases are documented. The inital management of the patient should be directed toward control of hemorrhage or treatment of cardica tamponade or both. Cardiopulmonary bypass is helpful in repair of many intracardiac defects but is not absolutely essential for survival. Surface myocardial wounds should be sutured during the initial procedure to allow for immediate survival. A subsequent procedure may be indicated to correct intracardiac defects. Repair of injuries to the mitral and aortic valves should be directed at an attempt to reconstruct the damaged valve. If this is impossible, a prosthetic valve should be inserted. Injuries to the tricuspid and pulmonic valves probably warrant a conservative approach. Septal defects can be treated easily with Dacron patches or primary suture closure. Postoperative complications include all of those commonly seen with thoracic procedures, but infection is less prominent than one would anticipate, even when prostheses have been implanted. With early, aggressive management it is anticipated that more survivors of these serious wounds will be recorded.


Mutagenicity of glyceryl trinitrate (nitroglycerin) in Salmonella typhimurium.
The recent finding that the clinical nitrovasodilator, glyceryl trinitrate (GTN), is mutagenic in Salmonella typhimurium strain TA1535 has been examined in closer detail, with emphasis on its mechanism of action. GTN increased the number of His+ revertants to a maximum of 4 times over background at a GTN dose of 5 mumol/plate. Hamster liver S9 depressed the toxicity of high GTN doses and increased the maximum number of revertants to 5 times over background at 10 mumol/plate. GTN did not cause significant reversion in any of the six other S. typhimurium strains tested (TA1975, TA102, TA1538, TA100, TA100NR, YG1026), although signs of toxicity were observed. Therefore, the mutagenicity of GTN was manifest only in the repair-deficient (uvrB and lacking in pKM101) strain which is responsive to single base changes. Oligonucleotide probe hybridization of TA1535 revertants showed that virtually all of the GTN-induced mutants contained C-->T transitions in either the first or second base of the hisG46 (CCC) target codon, with a preference for the latter. A similar mutational spectrum was seen previously with a complex of spermine and nitric oxide (NO) which releases nitric oxide. This suggests that NO, which can be derived from GTN via metabolic reduction, may be responsible for GTN's mutagenic action. The known NO scavenger oxymyoglobin did not substantially alter the dose response of GTN, indicating that extracellular NO was not mediating reversion. The data are consistent with the hypothesis that intracellular nitric oxide is responsible for the observed mutations.


Decreasing the overall environmental impact of the Dutch diet: how to find healthy and sustainable diets with limited changes.
To find diets optimised on nutrition and environmental impact close to the current Dutch diet and to identify the most effective and acceptable options for mitigating environmental impact. Linear programming was used to optimise diets of Dutch men and women aged 9-69 years, divided into ten age-gender groups. The analysis included nutrient composition, a metric for popularity and life cycle assessments of 207 food products. Greenhouse gas emissions, fossil energy use and land occupation were used to calculate a weighted score for the overall environmental impact. Optimised diets were solutions that minimised changes to the current diet while satisfying all nutritional constraints, with stepwise reductions in environmental impact. The Netherlands. Dutch children and adults aged 9-69 years. Meat was always reduced. Vegetable, fruit and dairy contents remained similar, while bread, fatty fish and legumes increased. The extent of changes depended on age and gender. Beverages were not heavily reduced. Nutrients critical for the outcome were α-linoleic acid, retinol, Ca, Na, Se, dietary fibre, SFA, thiamin and Fe (women of childbearing age). Total protein, essential amino acids and carbohydrates were not critical. Reducing meat is the most effective option for lowering the environmental impact of diets in all age-gender groups. Reducing alcoholic and non-alcoholic beverages is another option. Leaving out fish and dairy products are not. The differences in nutritional requirements related to age and gender have a significant effect on the composition of the optimised diets.


ATP-mediated increase in H+ flux from retinal Müller cells: a role for Na+/H+ exchange.
Small alterations in extracellular H+ can profoundly alter neurotransmitter release by neurons. We examined mechanisms by which extracellular ATP induces an extracellular H+ flux from Müller glial cells, which surround synaptic connections throughout the vertebrate retina. Müller glia were isolated from tiger salamander retinae and H+ fluxes examined using self-referencing H+-selective microelectrodes. Experiments were performed in 1 mM HEPES with no bicarbonate present. Replacement of extracellular sodium by choline decreased H+ efflux induced by 10 µM ATP by 75%. ATP-induced H+ efflux was also reduced by Na+/H+ exchange inhibitors. Amiloride reduced H+ efflux initiated by 10 µM ATP by 60%, while 10 µM cariporide decreased H+ flux by 37%, and 25 µM zoniporide reduced H+ flux by 32%. ATP-induced H+ fluxes were not significantly altered by the K+/H+ pump blockers SCH28080 or TAK438, and replacement of all extracellular chloride with gluconate was without effect on H+ fluxes. Recordings of ATP-induced H+ efflux from cells that were simultaneously whole cell voltage clamped revealed no effect of membrane potential from -70 mV to 0 mV. Restoration of extracellular potassium after cells were bathed in 0 mM potassium produced a transient alteration in ATP-dependent H+ efflux. The transient response to extracellular potassium occurred only when extracellular sodium was present and was abolished by 1 mM ouabain, suggesting that alterations in sodium gradients were mediated by Na+/K+-ATPase activity. Our data indicate that the majority of H+ efflux elicited by extracellular ATP from isolated Müller cells is mediated by Na+/H+ exchange.NEW & NOTEWORTHY Glial cells are known to regulate neuronal activity, but the exact mechanism(s) whereby these "support" cells modulate synaptic transmission remains unclear. Small changes in extracellular levels of acidity are known to be particularly powerful regulators of neurotransmitter release. Here, we show that extracellular ATP, known to be a potent activator of glial cells, induces H+ efflux from retinal Müller (glial) cells and that the bulk of the H+ efflux is mediated by Na+/H+ exchange.


Pathogenesis of Aerosolized Ebola Virus Variant Makona in Nonhuman Primates.
Highly pathogenic filoviruses such as Ebola virus (EBOV) hold capacity for delivery by artificial aerosols, and thus potential for intentional misuse. Previous studies have shown that high doses of EBOV delivered by small-particle aerosol cause uniform lethality in nonhuman primates (NHPs), whereas only a few small studies have assessed lower doses in NHPs. To further characterize the pathogenesis of EBOV infection via small-particle aerosol, we challenged cohorts of cynomolgus monkeys with low doses of EBOV variant Makona, which may help define risks associated with small particle aerosol exposures. Despite using challenge doses orders of magnitude lower than previous studies, infection via this route was uniformly lethal across all cohorts. Time to death was delayed in a dose-dependent manner between aerosol-challenged cohorts, as well as in comparison to animals challenged via the intramuscular route. Here, we describe the observed clinical and pathological details including serum biomarkers, viral burden, and histopathological changes leading to death. Our observations in this model highlight the striking susceptibility of NHPs, and likely humans, via small-particle aerosol exposure to EBOV and emphasize the need for further development of diagnostics and postexposure prophylactics in the event of intentional release via deployment of an aerosol-producing device.


Accurate, rapid measurement of the fraction of unbound estradiol and progesterone in small volumes of undiluted serum at 37 degrees C by miniature steady-state gel filtration.
A method is described for the accurate, rapid measurement of the unbound fractions of estradiol and of progesterone in small volumes of plasma or serum at 37 degrees C by a miniature method of steady-state gel filtration. There is minimal perturbation of the equilibrium between bound and free hormone and no derived kinetic parameters are required. The method has been used to measure the unbound fraction of progesterone in plasma from women during the second and third trimesters of pregnancy and of estradiol in sera of developing female rats.


H2-antagonists in the treatment of recurrent ulceration after vagotomy.
Twenty-two patients with recurrent ulceration following vagotomy with and without a drainage procedure have been treated with histamine H2-antagonists and followed for up to 3 years. Four of a group of 6 patients responded to a single therapeutic course. Ten of 16 patients assigned to long term maintenance treatment remain symptom-free. Cimetidine may be an alternative to further surgery in the treatment of some patients with recurrent ulceration after vagotomy.


Edible and medicinal termites: a global overview.
Termites are mainly known for damage caused to human beings, both in urban and rural areas. However, these insects play an important role in the decomposition of organic matter in tropical regions and are important natural resources, which are widely used in traditional medicine and are also consumed by human populations in several parts of the world. This study aimed to catalogue termite species used worldwide through a literature review, characterizing them by its human populations' use. The results showed that at least 45 species of termites, belonging to four families, are used in the world, with 43 species used in human diet and/or in livestock feeding. Nine termite species are used as a therapeutic resource. There is an overlapping use of seven species. The use of termites was registered in 29 countries over three continents. Africa is the continent with the highest number of records, followed by America and Asia. The results suggest that, in addition to their ecological importance, termites are a source of medicinal and food resources to various human populations in various locations of the world, showing their potential for being used as an alternative protein source in human or livestock diets, as well as a source for new medicines.


Genetic analysis of a red tilapia (Oreochromis spp.) population undergoing three generations of selection for increased body weight at harvest.
Quantitative genetic analysis was performed on 10,919 data records collected over three generations from the selection programme for increased body weight at harvest in red tilapia (Oreochromis spp.). They were offspring of 224 sires and 226 dams (50 sires and 60 dams per generation, on average). Linear mixed models were used to analyse body traits (weight, length, width and depth), whereas threshold generalised models assuming probit distribution were employed to examine genetic inheritance of survival rate, sexual maturity and body colour. The estimates of heritability for traits studied (body weight, standard length, body width, body depth, body colour, early sexual maturation and survival) across statistical models were moderate to high (0.13-0.45). Genetic correlations among body traits and survival were high and positive (0.68-0.96). Body length and width exhibited negative genetic correlations with body colour (- 0.47 to - 0.25). Sexual maturity was genetically correlated positively with measurements of body traits (weight and length). Direct and correlated genetic responses to selection were measured as estimated breeding values in each generation and expressed in genetic standard deviation units (σG). The cumulative improvement achieved for harvest body weight was 1.72 σG after three generations or 12.5% per generation when the gain was expressed as a percentage of the base population. Selection for improved body weight also resulted in correlated increase in other body traits (length, width and depth) and survival rate (ranging from 0.25 to 0.81 genetic standard deviation units). Avoidance of black spot parent matings also improved the overall red colour of the selected population. It is concluded that the selective breeding programme for red tilapia has succeeded in achieving significant genetic improvement for a range of commercially important traits in this species, and the large genetic variation in body colour and survival also shows that there are prospects for future improvement of these traits in this population of red tilapia.


Biliary epithelial cell antibodies induce expression of toll-like receptors 2 and 3: a mechanism for post-liver transplantation cholangitis?
Studies to determine the role of preformed antibodies to biliary epithelial cells (BECs) in liver transplant rejections have been initiated. However, the clinical importance of these antibodies in the posttransplantation period still remains to be elucidated. Reactivity to BECs isolated from a normal healthy liver was investigated in sera of 56 patients before and after liver transplantation (LTX) using flow cytometry. Functional capacity of BEC antibodies was determined by the ability to induce expression of Toll-like receptors (TLRs) on BECs. Cytokine and chemokine production induced by BEC antibodies was determined by enzyme-linked immunosorbent assay. In all, 7 patients (13%) had BEC antibodies only pre-LTX, 14 (25%) only after LTX, 18 (32%) both before and after LTX, and 17 (30%) had no detectable antibodies. Presence of preformed BEC antibodies correlated with acute rejections (P < 0.03). Deposition of immunoglobulins in bile ducts was detected in biopsies of patients during rejections. Significantly higher numbers of patients with post-LTX antibodies (9 of 32) developed cholangitis, compared with 0 of 17 without antibodies (P < 0.02). Specificity studies indicated that these antibodies were both non-HLA- and HLA-specific. Normal BECs expressed mRNA but not the proteins for the TLRs. However, treatment with F(ab')2 fragments of BEC antibodies induced protein expression of TLRs 2 and 3 and significantly high production of interleukin (IL)-6, monocyte chemoattractant protein (MCP)-1, macrophage inflammatory protein (MIP)-1alpha, epithelial neutrophil activating peptide (ENA)-78, and IL-8. In conclusion, BEC antibodies via induction of TLR2 and TLR3 expression, as well as inflammatory cytokine and chemokine production may induce epithelial cell inflammatory responses to bacterial components and contribute to posttransplantation cholangitis.


Quantifying the impact of the Philips recall on patients with sleep apnea and clinicians.
Philips Respironics issued a voluntary recall of positive airway pressure devices used to treat obstructive sleep apnea in June 2021. We surveyed sleep medicine clinicians from the American Academy of Sleep Medicine membership to assess the impact of the recall on clinicians and patients. One hundred thirty-six clinicians participated between June 2022 and November 2022. Participants reported their treatment recommendations for patients affected by the recall, their patients' behaviors regarding the recall, the recall's impact on them as clinicians and on their patients, and the approximate time their patients were waiting for a replacement device. Clinicians most commonly reported first learning about the recall from Philips (25.0%), and patients most commonly first heard about the recall from news sources (34.5%). Most clinicians (62.4%) reported that they recommended patients continue using a recalled device. In comparison, only 9.3% of clinicians reported encouraging patients to stop using their recalled device. Clinicians reported that 59.9% of patients continued treatment with their recalled device, whereas 26.5% stopped treatment. Clinicians reported that over one-third of their patients were still waiting for a replacement machine. Most (86.8%) clinicians reported their stress levels were affected due to the recall, and 91.5% of clinicians reported the recall affected their patients' health and well-being. Most (83.3%) clinicians reported the recall affected their patients' trust in medicine. Clinicians reported that the Philips recall impaired the vast majority of their patients' health and trust in medicine and that many patients were still waiting for replacement devices. Robbins R, Epstein LJ, Pavlova MK, et al. Quantifying the impact of the Philips recall on patients with sleep apnea and clinicians. J Clin Sleep Med. 2023;19(9):1677-1683.


Prevalence of preoperative deep vein thrombosis in long bone fractures of lower limbs: a systematic review and meta-analysis.
There is a paucity of data regarding the prevalence of preoperative deep vein thrombosis (DVT) in patients with long bone (including femur, tibia and fibula) fractures of the lower limbs. We performed a meta-analysis to address the issue. Electronic databases, including PubMed, EMBASE, the Web of Science, the Cochrane Library, the VIP database, CNKI, and the Wanfang database, were systematic searched for original articles that reported the prevalence of preoperative DVT in long bone fractures of the lower limbs from January 2016 to September 2021. The prevalence of preoperative DVT was pooled using random-effects models, and subgroups were established according to study type, detection method, sample size and fracture site. Twenty-three articles reporting on 18,119 patients were eligible. The overall pooled preoperative DVT prevalence was 24.1% (95% CI 19.3-28.8%). In different subgroups, the preoperative DVT prevalences were 18.2-27.3%, 15.2-28.6%, 23.1-24.9%, 18.2-26.0% and 23.2-23.4% for different study designs, sample sizes, age groups, detection methods and fracture sites, respectively. Despite the heterogeneity among studies, this systematic review suggests that the prevalence of preoperative DVT, which may seriously affect the prognosis of patients, is high. Therefore, greater efforts should be devoted to the improvement of screening and prevention strategies for preoperative DVT in lower-extremity long bone fractures. Level III. Trial Registration The study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database with the registration number CRD42022324706.


Bleachability and characterization by Fourier transform infrared principal component analysis of Acetosolv pulps obtained from sugarcane bagasse.
Sugarcane bagasse Acetosolv pulps were bleached by xylanase and the pulps classified by using Fourier transform infrared (FTIR) spectroscopy and principal component analysis (PCA). Pulp was treated with xylanase for 4-8 hwith stirring at 30 degrees C. Some samples were further extracted with NaOH for 1 h at 65 degrees C. FTIR spectra were recorded directly from the dried pulp samples by using the diffuse reflectance technique. Reduction in kappa number of 69% was obtained after sequence xylanase (4 h)-alkaline extraction. During bleaching the viscosity decreased only 12%. FTIR-PCA showed that the first three principal components (PCs) explained more than 90% of the total variance of the pulp spectra. PC2 x PC1 plot showed that the points related to pulps from sequence xylanase (4 h)-alkaline extraction are different from the other. This group is enlarged by plotting PC3 x PC1 or PC3x PC2 containing all pulps submitted to alkaline extraction. PC2 and PC3 are the principal factor for differentiation of the pulps. These PCs suffer influence of the ester bands (1740 and 1244 cm(-1)). On the other hand, the pulps bleached only with xylanase could not be differentiated from the nonbleached pulps.


Functional and nutritional state in elderly men with compensated hypogonadism.
There are few data investigating the relationship between compensated hypogonadism and functional and nutritional status of elderly individuals. Impairment of functional and nutritional status of elderly men with compensated hypogonadism needs to be investigated. In this study, we tried to evaluate the association of functional and nutritional status with testosterone and LH levels in elderly with compensated hypogonadism. A cross-sectional study was performed. A total of 1124 patients older than 70 years were screened. A total of 250 patients (patient group) with compensated hypogonadism and 250 subjects (control group) with normal hormone levels were allocated in the study. All parameters were compared in patient and control groups. The correlations between hormone levels and activities of daily living (ADL), instrumental activities of daily living (IADL), Mini Mental State Examination (MMSE), Mini Nutritional Assessment (MNA), and Geriatric Depression Scale (GDS) were evaluated. ADL, IADL, MMSE, and MNA scores were significantly lower in the patient group. Testosterone and LH levels were correlated with ADL (R = 0.221 and R = -0.262), IADL (R = 0.210 and R = -0.277), MMSE (R = 0.331 and R = -0.341), MNA (R = 0.211 and R = -0.297), and GDS (R = -0.214 and R = -0.211) in the patient group independently from age and body mass index. Our study showed that geriatric men with compensated hypogonadism had worse functionality, cognitive function, nutritional status, and mood compared with healthy controls.


Role of interleukin-6 and insulin resistance as screening markers for metabolic syndrome in patients of chronic obstructive pulmonary disease. A hospital-based cross-sectional study.
Chronic obstructive pulmonary disease (COPD) is usually associated with various extra-pulmonary manifestations. Metabolic syndrome (MetS) is one such entity that has been scarcely studied in Indian patients. The availability of a good screening marker may help in the timely detection of this co-morbidity in COPD patients. We conducted a cross-sectional study to evaluate the prevalence of MetS among COPD patients and the role of Interleukin-6 and insulin resistance (as measured by HOMA-IR) as screening markers for MetS in COPD. One hundred stable COPD patients were evaluated for MetS using US National Cholesterol Education Program Adult Treatment Panel III (2005) guidelines. Interleukin-6 and HOMA-IR (for insulin resistance) were measured and compared between COPD patients with and without MetS. ROC analysis was done to find both the molecules' best cut-off value and sensitivity and specificity in detecting MetS. In the results, the mean age of the study cohort was 59.9±8.7yrs (males=93). Forty-five COPD patients (45%) fulfilled the criteria for MetS. Patients with MetS were comparatively younger (57.9+9.5 v/s 61.6+7.8 years; p=0.037) but had a longer duration of preceding COPD (9.9±2.8 v/s 6.0±2.2 years; p<0.001) as compared to those without MetS. Both IL-6 and HOMA index were statistically higher (p<0.05) in COPD-MetS patients compared to the other group. A cutoff value of 36.3 pg/ml for IL-6 and 1.61 for HOMA index, IL-6 and HOMA-IR had sensitivity of 91.1% and 82.2%, respectively in detecting MetS among COPD patients. To conclude, metabolic syndrome is common comorbidity seen in COPD patients. Interleukin-6 has a better sensitivity than HOMA-IR in screening MetS among COPD patients.


Relationship between gluten availability and celiac disease prevalence: A geo-epidemiologic systematic review.
Celiac disease is a global disease requiring genetic susceptibility and gluten exposure to trigger immune-mediated enteropathy. The effect of the degree of gluten-containing grain availability on celiac disease prevalence is unknown. Our objective was to compare country-based gluten availability to celiac prevalence using a systematic literature review. We searched MEDLINE, Embase, Cochrane, and Scopus until May 2021. We included population-based serum screening with confirmatory testing (second serological study or small intestine biopsy) and excluded specific, high-risk, or referral populations. We determined country-specific gluten availability using the United Nations food balance for wheat, barley, and rye. Human leukocyte antigen (HLA) frequencies were obtained from allelefrequencies.net. The primary outcome was association between gluten-containing grain availability and celiac disease prevalence. Generalized linear mixed models method with Poisson's link was used for analysis. We identified 5641 articles and included 120 studies on 427 146 subjects from 41 countries. Celiac disease prevalence was 0-3.1%, median 0.75% (interquartile range 0.35, 1.22). Median wheat supply was 246 g/capita/day (interquartile range 214.8, 360.7). The risk ratio (RR) for wheat availability on celiac disease was 1.002 (95% confidence interval [CI]: 1.0001, 1.004, P = 0.036). A protective association was seen with barley, RR 0.973 (95% CI: 0.956, 0.99, P = 0.003), and rye, RR 0.989 (95% CI: 0.982, 0.997, P = 0.006). The RR for gross domestic product on celiac disease prevalence was 1.009 (95% CI: 1.005, 1.014, P < 0.001). The RR for HLA-DQ2 was 0.982 (95% CI: 0.979, 0.986, P < 0.001), and that for HLA-DQ8 was 0.957 (95% CI: 0.950, 0.964, P < 0.001). In this geo-epidemiologic study, gluten-containing grain availability showed mixed associations with celiac disease prevalence.


Grafting of a synthetic heparinoid polyelectrolyte onto silicone rubber.
Using a [3H]-labelled polyelectrolyte as a tracer, the 60Co grafting of a synthetic heparinoid polyelectrolyte onto silicone rubber was studied. The polyelectrolyte was labelled by the coupling of a radioactive amine to carboxylate groups of the polyelectrolyte. The amount of grafted polyelectrolyte was found to be dependent on the radiation dose.


Comparison of Short-Term Outcomes of Geriatric Distal Femur and Femoral Neck Fractures: Results From the NSQIP Database.
To compare and contrast postoperative complications in the geriatric population following open reduction and internal fixation (ORIF) for (DF) fractures relative to femoral neck (FN) fractures. Patients aged 65 years and older in the American College of Surgeons National Surgical Quality Improvement Program database who underwent ORIF for FN fractures or DF fractures from 2005 to 2012 were identified. Differences in rates of any adverse events (AAEs), serious adverse events (SAEs), infectious complications, and mortality between groups were explored using univariate and multivariate analyses. The DF cohort had a higher proportion of females (81.95% vs 71.35%, P < .001), were younger (79.41 ± 7.93 vs 82.11 ± 7.26 years old, P < .001), and had a lower age adjusted modified Charlson comorbidity index score (4.22 ± 1.32 vs 4.49 ± 1.35, P = .02). Cases with DF and FN did not differ in AAE (20.05% vs 20.20%, P = .94), SAE (12.03% vs 13.19%, P = .51), infectious complication (4.26% vs 4.22%, P = .97), hospital length of stay (7.32 ± 6.73 days vs 7.02 ± 10.67 days, P = .59), or mortality rates (4.51% vs 5.99%, P = .23). Multivariate analyses revealed that fracture type did not impact AAE (P = .28), SAE (P = .58), infectious complications (P = .83), or mortality (P = .85) rates. Postoperative morbidity and mortality of geriatric patients who sustain DF and FN fractures treated operatively were comparable. This information can be used when risk stratifying and prognosticating for elderly patients undergoing these procedures.


Dielectric spectroscopy of concentrated colloidal suspensions.
A comparison between experimental measurements and theoretical calculations of the permittivity and conductivity of concentrated colloidal suspensions is presented. Dielectric spectroscopy measurements for 100nm and 200nm diameter polystyrene spheres at volume fractions between ϕ=0.01-0.18 and electrolyte concentrations 0.01-1mM KCl (P.J. Beltramo, E.M. Furst, Langmuir 28 (2012) 10703-10712) are compared to cell-model calculations that account for the hydrodynamic and electrokinetic interactions between particles (F. Carrique, F.J. Arroyo, M.L. Jimenez, A.V. Delgado, J. Chem. Phys. 118 (2003) 1945-1956). Under most conditions, there is good agreement between experiment and theory. At low ionic strengths, the dielectric increment exhibits a low-frequency plateau in the experimental spectroscopy and cell model calculations. However, at the highest ionic strengths, the cell model predicts a low frequency plateau that is not observed experimentally. The conductivity increments qualitatively agree over all volume fractions, ionic strengths and frequencies.


Proteinase 3 associated with Wegener's granulomatosis.
Wegener's granulomatosis (WG) is a form of systemic vasculitis characterized by granulomatous inflammation of the upper and lower airways, vasculitis, and necrotizing glomerulonephritis. It is strongly associated with anti-neutrophil cytoplasmic antibodies against proteinase 3 (PR3-ANCAs). Various in vitro observations provided strong evidence that autoimmune PR3-ANCAs are directly involved in glomerular and vascular inflammation. However, little is known about the pathogenic significance of PR3-ANCAs in vivo. Therefore, the generation of animal models helped to validate the suggested autoimmune origin and pathophysiology in WG. To characterize and improve the models, numerous studies were carried out to elucidate the effect of mouse/rat PR3-ANCAs on neutrophil function as well as the role of CD4/CD8 in T and B cells and antibodies in the pathogenesis of the disease. Understanding the pathogenesis is therefore critical to relate these models to human studies hoping that they will be useful for better insight of WG and the development of specific therapies for the disease.


Sensitivity to larval density in populations of Drosophila mojavensis: Influences of host plant variation on components of fitness.
Chromosomally polymorphic populations of Drosophila mojavensis from Baja California feed and breed on agria cactus, Stenocereus gummosus; whereas, monomorphic Arizona populations are associated exclusively with organ pipe cactus, S. thurberi. The effects of this host plant shift in expanding the kinds of feeding and breeding sites were assessed by manipulating larval density and recording differences in egg to adult development time and viability, and adult thorax size in both populations on artificially rotted substrates of both cactus species. Older agria rots increased development time but had no effect on viability. Organ pipe rots were qualitatively poorer substrates than agria rots for both monomorphic and polymorphic populations of D. mojavensis, especially at higher larval densities causing longer egg to adult development times, lower viabilities, and smaller thorax sizes than agria.The Baja population expressed shorter development times, higher viabilities, and smaller thorax sizes than the Arizona population on both cactus substrates. No evidence for cactus host race formation was found. The Baja population was less sensitive to increasing larval densities for all fitness characters studied on both cactus substrates indicating greater developmental homeostasis than in the monomorphic Arizona population. These data support the hypothesized central-marginal population structure within this species coincident with the distribution of host plants and lend insight into the process of adaptive divergence at different life history stages caused by host plant shifts.


A case of an intraventricular inflammatory pseudotumor presumably caused by Epstein-Barr virus infection.
Inflammatory pseudotumor primarily affecting the CNS is an extremely rare lesion with uncertain etiology in most cases. A 67-year-old man developed involuntary movement disorder of the left upper extremity. On MRI, a solid homogeneously-enhanced tumor was noted in the right lateral ventricle adjacent to the thalamus. He had histories of right thalamic hypertensive hemorrhage and recurrent chronic nasal sinusitis associated with an orbital mass lesion, presumably an IP. Partial removal of the tumor yielded a diagnosis of IP associated with EBV infection. The simultaneous occurrence of multiple IPs was presumably because of an exaggerated immune process after EBV infection. Inflammatory pseudotumor should be considered in any case of intraventricular mass lesion.


Memory distortion for orthographically associated words in individuals with depressive symptoms.
While major depressive disorder has been associated with increased veridical memory for negative information, prior false memory literature has linked high depressive symptoms to increased false memory for negative information. We tested whether these contradictory findings may be due to semantic and emotional cohesion inflating false alarm rates in the most commonly used false memory paradigm - the Deese-Roediger-McDermott (DRM). In Experiment 1, healthy controls and depressive participants completed two emotional false memory tasks: the DRM, using semantically associated words, and an adaptation using orthographically associated words. Participants encoded words associated with neutral or negative critical lures. During subsequent recognition memory testing, errors were greater for negative than neutral semantic critical lures, but the opposite pattern was observed for orthographic critical lures. These findings support that orthographically associated stimuli provide a non-confounded method to test emotional false memory. In Experiment 2, we deployed the orthographic paradigm with simultaneous electroencephalography (EEG) and a state measure of negative mood (Positive and Negative Affective Scale) to better understand neurocognitive components of emotional false memory. Replicating Experiment 1, we found fewer false alarms for negative than neutral novel orthographically associated words. The EEG data showed significant differences in two memory-related event-related potentials: the familiarity-related N400, and the recollection-related late positive component (LPC). N400 amplitudes were larger for true versus false endorsements. For LPC, increasing depressive symptoms predicted greater amplitude differences for true versus false negative items and reduced differences for neutral items. However, increasingly negative mood predicted reduced amplitude differences for negative items, and greater amplitude differences for neutral items. Although depressive symptoms and negative mood state are highly correlated, they may inform differentially influence shifts in memory retrieval strategies, with depressive symptoms predicting reduced false alarms for negative information, and negative mood state predicting increased recollection errors for negative information.


Conformational motions regulate phosphoryl transfer in related protein tyrosine phosphatases.
Many studies have implicated a role for conformational motions during the catalytic cycle, acting to optimize the binding pocket or facilitate product release, but a more intimate role in the chemical reaction has not been described. We address this by monitoring active-site loop motion in two protein tyrosine phosphatases (PTPs) using nuclear magnetic resonance spectroscopy. The PTPs, YopH and PTP1B, have very different catalytic rates; however, we find in both that the active-site loop closes to its catalytically competent position at rates that mirror the phosphotyrosine cleavage kinetics. This loop contains the catalytic acid, suggesting that loop closure occurs concomitantly with the protonation of the leaving group tyrosine and explains the different kinetics of two otherwise chemically and mechanistically indistinguishable enzymes.


Autoregulation of the yeast copper metallothionein gene depends on metal binding.
The yeast CUP1 gene product, copper metallothionein, acts to repress the basal transcription of its own structural gene. By creating a series of truncation and amino acid substitutions in CUP1, we show that the ability of the protein to autoregulate is directly correlated to its ability to bind and detoxify copper. These results support a model in which metallothionein controls the level of free intracellular copper available to interact with positive transcription factors. In addition, mutations in chemically equivalent cysteine residues were functionally dissimilar, suggesting that partial sites in the molecule are critical for the formation of the sulfur-metal cluster.


Proofreading, NTPases and translation: constraints on accurate biochemistry.
Two accurate individual reactions can work together as a more accurate overall mechanism. This is straightforward for a transient reaction, but the same accuracy in the steady state (termed proofreading) requires many preconditions. The preconditions for proofreading can be summarized as four statements, which allow experimental identification and subsequent confirmation of proofreading mechanisms.