Wind and power density data of strategic offshore locations in the Colombian Caribbean coast.
The high potential of wind speed in the Colombian Caribbean coast is an opportunity to develop offshore wind energy technology. This article contains the wind speed and wind power density in four strategic locations in Colombia (Cartagena, Barranquilla, Santa Marta and La Guajira) at different elevations. The dataset from this study is related to the research paper "Renewables energies in Colombia and the opportunity for the offshore wind technology published in Journal of Cleaner Production (Rueda-Bayona et al.) [1]. Reading and processing numerous files stored in databases could be challenging because it demands software programming to do so, what could difficult the access to valuable data for the community. Also, high compressed files such as NetCDF formats demand specialised software which is not easy obtaining and utilising because it requires skills in a programming language. Then, this study used the NARR-NOAA database [2] and generated local wind and power density data stored in Excel sheets to ease their utilisation.


Effect of anti-interferon serum of influenza virus infection in mice.
Mice were infected by an aerosol of influenza virus Type A (0.5 LD50) and subsequently treated with 4 intranasal instillations of anti-interferon antiserum over a period of 72 h. All the mice treated with antiserum died within 7 days post-infection, whilst the mice in the control groups survived. In mice that did not receive the antibody, virus titers in the lung peaked on day 3 and then decreased again. Also, interferon was detectable both in lung homogenates and serum. In mice treated with antiserum, no interferon was detectable and the virus concentrations in the lung increased until death. These results suggest that interferon produced in the respiratory tract plays an important role in the early stages of influenza virus infection.


Changes in hippocampal AMPA receptors and cognitive impairments in chronic ketamine addiction models: another understanding of ketamine CNS toxicity.
Ketamine has been reported to impair human cognitive function as a recreational drug of abuse. However, chronic effects of ketamine on central nervous system need to be further explored. We set out to establish chronic ketamine addiction models by giving mice a three or six month course of daily intraperitoneal injections of ketamine, then examined whether long-term ketamine administration induced cognition deficits and changed hippocampal post-synaptic protein expression in adult mice. Behavior tests results showed that mice exhibited dose- and time-dependent learning and memory deficits after long-term ketamine administration. Western blot results showed levels of GluA1, p-S845 and p-S831 proteins demonstrated significant decline with ketamine 60 mg/kg until six months administration paradigm. But levels of p-S845 and p-S831 proteins exhibited obvious increase with ketamine 60 mg/kg three months administration paradigm. NR1 protein levels significantly decrease with ketamine 60 mg/kg three and six months administration paradigm. Our results indicate that reduced expression levels and decreased phosphorylation levels of hippocampal post-synaptic membrane GluA1- containing AMPA receptors maybe involved in cognition impairment after long-term ketamine administration. These findings provide further evidence for the cognitive damage of chronic ketamine addiction as a recreational drug.


Sex Differences in Symptom Phenotypes Among Older Patients with Acute Myocardial Infarction.
Clinicians make a medical diagnosis by recognizing diagnostic possibilities, often using memories of prior examples. These memories, called "exemplars," reflect specific symptom combinations in individual patients, yet most clinical studies report how symptoms aggregate in populations. We studied how symptoms of acute myocardial infarction combine in individuals as symptom phenotypes and how symptom phenotypes are distributed in women and men. In this analysis of the SILVER-AMI Study, we studied 3041 patients (1346 women and 1645 men) 75 years of age or older with acute myocardial infarction. Each patient had a standardized in-person interview during the acute myocardial infarction admission to document the presenting symptoms, which enabled a thorough examination of symptom combinations in individuals. Specific symptom combinations defined symptom phenotypes and distributions of symptom phenotypes were compared in women and men using Monte Carlo permutation testing and repeated subsampling. There were 1469 unique symptom phenotypes in the entire SILVER-AMI cohort of patients with acute myocardial infarction. There were 831 unique symptom phenotypes in women, as compared with 819 in men, which was highly significant, given the larger number of men than women in the study (P < .0001). Women had significantly more symptom phenotypes than men in almost all acute myocardial infarction subgroups. Older patients with acute myocardial infarction have enormous variation in symptom phenotypes. Women reported more symptoms and had significantly more symptom phenotypes than men. Appreciation of the diversity of symptom phenotypes may help clinicians recognize the less common phenotypes that occur more often in women.


Right ventricle-to-aorta conduit in pulmonary atresia with intact ventricular septum and coronary sinusoids.
A 20-month-old girl with pulmonary atresia, intact ventricular septum, and ventriculocoronary connections underwent successful interposition of a right ventricle-to-aorta conduit and Fontan operation. The patient initially had a modified Blalock-Taussig shunt at birth and subsequently a bidirectional Glenn shunt at 8 months of age. After Fontan and right ventricle-to-aorta conduit placement, the suprasystemic right ventricular pressure dropped to systemic levels without causing myocardial injury. Additionally, the right ventricular cavity enlarged. We believe that the use of a right ventricle-to-aorta conduit should provide a valuable alternative and improve the outlook of certain patients with pulmonary atresia, intact ventricular septum, and ventriculocoronary connections.


Interaction of the human papillomavirus type 16 E6 oncoprotein with wild-type and mutant human p53 proteins.
The E6 oncoproteins encoded by the cancer-associated human papillomaviruses (HPVs) can associate with and promote the degradation of wild-type p53 in vitro. To gain further insight into this process, the ability of HPV-16 E6 to complex with and promote the degradation of mutant forms of p53 was studied. A correlation between binding and the targeted degradation of p53 was established. Mutant p53 proteins that bound HPV-16 E6 were targeted for degradation, whereas those that did not complex HPV-16 E6 were not degraded. Since the HPV-16 E6-promoted degradation involves the ubiquitin-dependent proteolysis pathway, specific mutations were made in the amino terminus of p53 to examine whether the E6 targeted degradation involved the N-end rule pathway. No requirement for destabilizing amino acids at the N terminus of p53 was found, nor was evidence found that HPV-16 E6 could provide this determinant in trans, indicating that the N-terminal rule pathway is not involved in the E6-promoted degradation of p53.


Desmutagenic activity of natural humic acids: inhibition of mitomycin C and maleic hydrazide mutagenicity.
Humic acids are natural components of organic matter widespread in the environment. In spite of the incomplete knowledge about their composition, increasing interest in humic acid activity is justified by their ubiquity. Four different humic acids have been tested in Chinese hamster ovary cells in vitro, both alone and in combination with two well-known mutagens (mitomycin C and maleic hydrazide). Data about sister-chromatid exchanges, mitotic and proliferation indices were collected. Our results, on the whole, indicate: (i) a slight mutagenicity and toxicity of tested humic acids, probably due to chlorination during sample preparation; (ii) a desmutagenic rather than antimutagenic activity of the tested humic acids.


C-Terminal region of 48-kDa rhoptry protein for serological detection of Babesia caballi antibodies in horses.
A recombinant C-terminal antigen derived from Babesia caballi 48-kDa rhoptry protein (rBc48/CT) was made for the development of a serologically diagnostic test. Antiserum raised against the rBc48/CT reacted specifically with the corresponding native protein by Western blotting and the indirect fluorescent antibody test (IFAT). Next, an indirect enzyme-linked immunosorbent assay (Bc48/CT-ELISA) and an immunochromatographic test based on the Bc48/CT (Bc48/CT-ICT) were constructed and employed for the detection of an antibody to B. caballi in a variety of equine sera. The results of Bc48/CT-ELISA and Bc48/CT-ICT were highly concordant with those of IFAT and ELISA, with full-length protein of Bc48 used as the reference tests. Our results demonstrate the success of Bc48/CT as antigen for the serological diagnosis of B. caballi infection in horses.


Characterising neurological time series data using biologically motivated networks of coupled discrete maps.
Artificial biochemical networks (ABNs) are a class of computational dynamical system whose architectures are motivated by the organisation of genetic and metabolic networks in biological cells. Using evolutionary algorithms to search for networks with diagnostic potential, we demonstrate how ABNs can be used to carry out classification when stimulated with time series data collected from human subjects with and without Parkinson's disease. Artificial metabolic networks, composed of coupled discrete maps, offer the best recognition of Parkinsonian behaviour, achieving accuracies in the region of 90%. This is comparable to the diagnostic accuracies found in clinical diagnosis, and is significantly higher than those found in primary and non-expert secondary care. We also illustrate how an evolved classifier is able to recognise diverse features of Parkinsonian behaviour and, using perturbation analysis, show that the evolved classifiers have interesting computational behaviours.


The contribution of executive processes to deceptive responding.
We measured behavioral responses (RT) and recorded event-related brain potentials (ERPs) when participants made truthful and deceptive responses about perceived and remembered stimuli. Participants performed an old/new recognition test under three instructional conditions: Consistent Truthful, Consistent Deceptive and Random Deceptive. Compared to Consistent Truthful responses, Consistent Deceptive responses to both perceived and remembered stimuli produced the same pattern of less accurate, slower and more variable responses and larger medial frontal negativities (MFN). The MFN is thought to reflect activity in anterior cingulate cortex, a brain area involved in monitoring actions and resolving conflicting response tendencies. The Random Deceptive condition required participants to strategically monitor their long-term response patterns to accommodate a deceptive strategy. Even compared to the Consistent Deceptive condition, RTs in the Random Deceptive condition were significantly slower and more variable and MFN activity increased significantly. MFN scalp distribution results revealed the presence of three different patterns of brain activity; one each for truthful responses, deceptive responses and strategic monitoring. Thus, the data indicate that anterior cingulate cortex plays a key role in making deceptive responses.


Clonality and Antimicrobial Susceptibility of Burkholderia cepacia complex Isolates Collected from Cystic Fibrosis Patients during 1998-2013 in Bern, Switzerland.
For the first time, we analyzed the clonality and susceptibility of Burkholderia cepacia complex isolates (n=55) collected during 1998-2013 from 44 Swiss cystic fibrosis (CF)-patients. B. cenocepacia (n=28) and B. multivorans (n=14) were mainly of sequence type (ST) 833 and ST874, respectively; B. contaminans isolates were of ST102. Overall, the following MIC50/90s (mg/l) were obtained: piperacillin/tazobactam (≤ 4/≥ 128), ticarcillin/clavulanate (≥ 256/≥256), ceftazidime (2/≥ 32), aztreonam (16/≥ 32), meropenem (2/8), tobramycin (8/≥ 16), minocycline (≤ 1/16), levofloxacin (≤ 0.5/≥ 16), and trimethoprim/sulfamethoxazole (≤ 0.5/4). This is the first survey providing information on the clonality of Bcc detected in Switzerland. Species identification and antimicrobial susceptibility tests should always be routinely performed to adapt more targeted therapies.


Estrogen does not prevent endothelial dysfunction caused by cigarette smoking.
Estrogen favors endothelial function while acute tobacco use provokes dysfunction. Previous studies have not examined the effect of smoking one cigarette at different stages of the menstrual cycle. Favorable actions of estrogen on endothelial function are transitorily abolished by smoking one cigarette. Brachial artery endothelium-dependent dilation was measured noninvasively before, 10 min, and 1 h after smoking in 17 healthy premenopausal women. Studies were done in the first 3 days (early stage) and repeated between Days 9 and 13 of the menstrual cycle (middle stage). Estradiol was measured after each study. At basal conditions, women in the middle stage of their cycles, when estradiol was 20 times higher than in the early stage, had significantly more endothelial-dependent brachial dilatation. No difference in the marked depression caused by cigarette smoking was found between the two stages. One h recuperation was complete in both phases. Cigarette smoking abolishes the protection of circulating estrogen on endothelial function.


Zn-doped Bi2MoO6 supported on reduced graphene oxide with increased surface active sites for degradation of ciprofloxacin.
The reduced graphene oxide supported Zn-doped Bi2MoO6 nanocomposites (ZnxBi2-xMoO6/RGO) are synthesized by an easy one-step solvothermal method for the rapid degradation of ciprofloxacin (CIP). Characterization analyses show that Bi2MoO6 nanosheets are uniformly supported on RGO, for which the agglomeration of Bi2MoO6 is effectively inhibited, leading to more exposure of surface active sites. The degradation rate of Zn0.1Bi1.9MoO6/RGO5 on CIP reached 90% after 120 min of visible light irradiation, which was 10.4 times the rate of unsupported Bi2MoO6. Zn doping and RGO loading synergistically reduce the recombination rate of photogenerated electron-hole pairs and result in the enhanced photocatalytic performance. Compared with previously reported catalysts, Zn0.1Bi1.9MoO6/RGO5 can get higher degradation efficiency with shorter time and less dosage. In addition, after five cycles, the degradation efficiency is maintained at about 85%, showing perfect cycling stability of Zn0.1Bi1.9MoO6/RGO5. Photocatalytic mechanism suggests that the photogenerated •O2- and h+ are main species for degrading CIP based on ZnxBi2-xMoO6/RGO complex.


DMP8 and 9 regulate HAP2/GCS1 trafficking for the timely acquisition of sperm fusion competence.
Sexual reproduction involves the fusion of two gametes of opposite sex. Although the sperm-expressed fusogen HAPLESS 2 (HAP2) or GENERATIVE CELL SPECIFIC 1 (GCS1) plays a vital role in this process in many eukaryotic organisms and an understanding of its regulation is emerging in unicellular systems [J. Zhang et al., Nat. Commun. 12, 4380 (2021); J. F. Pinello et al. Dev. Cell 56, 3380-3392.e9 (2021)], neither HAP2/GCS1 interactors nor mechanisms for delivery and activation at the fusion site are known in multicellular plants. Here, we show that Arabidopsis thaliana HAP2/GCS1 interacts with two sperm DUF679 membrane proteins (DMP8 and DMP9), which are required for the EGG CELL 1 (EC1)-induced translocation of HAP2/GCS1 from internal storage vesicle to the sperm plasma membrane to ensure successful fertilization. Our studies in Arabidopsis and tobacco provide evidence for a conserved function of DMP8/9-like proteins as HAP2/GCS1 partner in seed plants. Our data suggest that seed plants evolved a DMP8/9-dependent fusogen translocation process to achieve timely acquisition of sperm fusion competence in response to egg cell-derived signals, revealing a previously unknown critical step for successful fertilization.


Antituberculosis agents.
Tuberculosis, once considered a problem solved, is now dramatically on the rise. New approaches to chemotherapy will hopefully help to control this again serious problem. This article reviews the current status of tuberculosis chemotherapy, including the management of drug-resistant cases.


Improved detection of recurrent laryngeal tumor after radiotherapy using (18)FDG-PET as initial method.
Timely detection of recurrent laryngeal tumor after radiation is an important predictive factor for curation as well as preservation of laryngeal function. Direct laryngoscopy under general anesthesia with taking of biopsies is the standard diagnostic procedure to detect recurrence when suspicion is raised. This, however, is an invasive and potentially damaging technique. Hence, a non-invasive diagnostic procedure, such as (18)FDG-PET to stratify patients for direct laryngoscopy could be useful. (18)FDG-PET is interpreted visually so that observer variation may affect clinical practice. In the present study, we therefore investigated this aspect of reproducibility. Thirty consecutive patients suspected of recurrent laryngeal carcinoma after radiotherapy underwent (18)FDG-PET and direct laryngoscopy under general anesthesia with taking of biopsies. (18)FDG-PET scans were reported by nine nuclear medicine physicians and residents, using a three-point scaling system. The reference was the absence or appearance of a local recurrence in the 12 months following (18)FDG-PET. Eight patients had biopsy proven recurrent laryngeal carcinoma. Sensitivity of (18)FDG-PET was 88% (95% CI 53-98%) and specificity was 82% (95% CI 62-93%). The observers had a moderate to reasonable agreement (weighted kappa 0.45 (95% CI 0.20-0.69)) vs. the clinical gold standard and interobserver kappa was 0.54 (95% CI 0.40-0.69). (18)FDG-PET seems to be a promising technique to detect recurrent laryngeal carcinoma after radiotherapy, and selecting patients for direct laryngoscopy. This will avoid futile invasive procedures. Interobserver agreement and variability is reasonable using this technique, but training is necessary. Studies comparing different strategies to select patients for direct laryngoscopy in case of suspected recurrence are warranted.


Comparative efficiency of a laboratory and examining room assay for therapeutic drug monitoring of theophylline in ambulatory patients.
The total clinical personnel time for therapeutic drug monitoring of theophylline with a non-instrumented disposable examining room assay was 446 seconds. For a traditional assay, 1115 seconds of clinical personnel time was required to obtain the sample, send it to the laboratory, and subsequently act on the results. The corresponding costs for time, materials, and laboratory charges were +18.02 and +37.25, respectively.


A generalized extraction-TLC procedure for identification of drugs.
A combination of liquid-liquid extraction and thin-layer chromatography permits rapid identification of a large variety of drugs in pharmaceutical or street dosage forms, or in biological materials. The system utilizes selective pH extraction combined with internal standards. Limits of sensitivity are in the submicrogram level. The procedure is rapid and requires minimal equipment and training of personnel. It can be supplied in toxicology involving both clinical and forensic demands.


Author Correction: Distribution pattern of leftventricular myocardial strain analyzed by a cine MRI based deformation registration algorithm in healthy Chinese volunteers.
An amendment to this paper has been published and can be accessed via a link at the top of the paper.


Inflammatory Bowel Disease Presentation and Diagnosis.
A full understanding of the presentation and work-up of inflammatory bowel disease is necessary to ensure appropriate treatment of this complex disease. Crohn's disease and ulcerative colitis share many common clinical features but are treated very differently. This article covers the factors which contribute to IBD pathogenesis and presentation as well as the methods of diagnosis and work-up to ensure that the appropriate diagnosis is reached. This article also serves as a basis of understanding for the more complex aspects of the disease to be discussed in subsequent articles.


Simple Things Are Not Simple: Pulsatile Tinnitus due to Tortuous Occipital Artery.
Pulsatile tinnitus is often a chronic and debilitating condition and normally has a vascular origin. We describe a case of pulsatile tinnitus due to an aberrant branch of the external carotid artery (ECA), which has not been reported previously. A 67-year-old female with chronic unilateral pulsatile tinnitus, which could be controlled completely with direct pressure on a small tortuous superficial branch behind her left ear. This was confirmed with doppler to be an unusually tortuous occipital branch of the ECA. Under local anesthesia, this vessel was identified with intraoperative doppler and ligated. Complete resolution of tinnitus immediately, with consistent results 3 months postoperatively. Pulsatile tinnitus due to aberrances in the occipital ECA branch is rare, and in this case, was successfully treated with minor surgery.


Civil commitment in Turkey: reflections on a bill drafted by psychiatrists.
Involuntary hospitalization of the mentally ill has been an issue that still remains outside the judicial system in Turkey. Despite the new Turkish Civil Code, which includes several articles relevant to involuntary psychiatric hospital admissions, there still appears to be a need for a comprehensive mental health law to address specific issues concerning civil commitment of the mentally ill. As a result of the lack of specific statutory regulation, an insufficient number of psychiatric hospital beds and limited appreciation of the safety risks involved in untreated mental illness, involuntary hospitalization remains an underutilized option by psychiatrists and the courts alike. In response to its concerned members, the Psychiatric Association of Turkey has appointed a task force to draft a proposed mental health law, entitled the "Psychiatric Patients' Bill of Rights." Although the draft suggests a model with emphasis on the right to psychiatric treatment, it also recommends close judicial oversight to prevent potential abuses of discretion by the system. However, this might present logistic problems in a country with already overburdened courts. Authors discuss the highlights of the draft within the context of Turkey's current cultural, social and judicial structure, and compare it to similar laws of other countries.


Heteromultivalent liposomal nanoconstructs for enhanced targeting and shear-stable binding to active platelets for site-selective vascular drug delivery.
Activated platelets play multiple roles in vascular diseases. Hence, a delivery vehicle that can specifically target activated platelets and stay retained under a hemodynamic environment can potentially enhance the efficacy of vehicle-encapsulated vascular drug by protecting it from rapid plasma deactivation, reducing its systemic non-specific side-effects, and increasing its therapeutic index at disease sites undergoing platelet hyperactivity. We rationalized that liposomal nanoconstructs surface-modified with two kinds of peptide that simultaneously bind integrin α(IIb)β(3) and P-selectin on activated platelets can provide synergistic mechanisms for enhanced selectivity to vascular disease sites. We further hypothesized that dual-receptor targeting will enhance binding strength and retention under flow. We tested this using fluorescently-labeled liposomes, surface-modified by an RGD peptide targeted to active α(IIb)β(3) and an EWVDV peptide targeted to P-selectin. The liposomes were studied for their platelet-specific interactions inside a parallel plate flow chamber at low-to-high shear stresses. The interaction specificity was further confirmed by flow cytometry. Our results indicate that liposomes surface-modified with both RGD and EWVDV simultaneously have higher selectivity as well as retention to activated platelets under flow compared to liposomes bearing any one peptide type. These results establish the potential of our nanoconstructs for enhanced site-selective drug delivery in vascular diseases.


Alcohol-induced myocardial fibrosis in metallothionein-null mice: prevention by zinc supplementation.
Alcohol-induced cardiomyopathy including fibrosis has been recognized clinically for a long time, but its pathogenesis is incompletely understood. Studies using experimental animals have not fully duplicated the pathological changes in humans, and animal models of alcoholic cardiac fibrosis are not available. In the present study, we have developed a mouse model in which cardiac hypertrophy and fibrosis were produced in metallothionein-knockout (MT-KO) mice fed an alcohol-containing liquid diet for 2 months. The same alcohol feeding did not produce cardiac fibrosis in the wild-type (WT) control mice, although there was no difference in the alcohol-induced heart hypertrophy between the WT controls and the MT-KO mice. Zinc supplementation prevented cardiac fibrosis but did not affect heart hypertrophy in the alcohol-fed MT-KO mice, suggesting a specific link between zinc homeostasis and cardiac fibrosis. Serum creatine phosphokinase activity was significantly higher in the alcohol-administered MT-KO mice than in the WT mice, and zinc supplementation decreased serum creatine phosphokinase activities and eliminated the difference between the groups. Thus, disturbance in zinc homeostasis due to the lack of MT associates with alcohol-induced cardiac fibrosis and more severe cardiac injury, making the MT-KO mouse model of alcohol-induced cardiac fibrosis a useful tool to investigate specific factors involved in the alcoholic cardiomyopathy.


Improving acetabular cup orientation in total hip arthroplasty by using smartphone technology.
Acetabular cup placement in total hip arthroplasty is often difficult to assess, especially in the lateral position and using the posterior approach. Conventional techniques and computer-assisted surgery are the 2 most popular methods for proper placement of the acetabular cup in Lewinnek's safe zone of orientation (anteversion 15° ± 10° and lateral inclination 40° ± 10°). We developed a system that uses the accelerometer and camera function of the iPhone. A level indicator application and protractor application were downloaded to the iPhone and used to improve acetabular cup placement. This system has proven to be accurate and quick. Our series of 50 prospective cases showed good results with all our acetabular cups being placed within a narrow range in the safe zone and with less than 5% difference between the preoperative, intraoperative, and postoperative acetabular inclinations.


NF-κB in liver cancer: the plot thickens.
The role of the NF-κB signaling pathway in liver cancer is complex. While some evidence suggests that in the liver, like in many other organ systems, NF-κB is oncogenic, there is strong evidence showing that in certain liver cancer models NF-κB suppresses tumorigenesis. These contrasting findings cannot be dismissed on technicalities and are likely due to the complex nature of the NF-κB response. Similar contrasting findings regarding NF-κB activity are revealed in skin cancer models. Thus, it is possible that the contradictory role of NF-κB in tumorigenesis is a general phenomenon and not an oddity related solely to the liver. Further studies are indicated to decipher the underlying molecular mechanisms. Revealing these mechanisms may facilitate the identification of patient subgroups and specific situations in which NF-κB inhibition will be a preferred therapeutic option. Moreover, it is possible that specific interventions could boost the tumor suppressor functions of NF-κB in tumors that harbor mutations that render this pathway constitutively active.


Endometriosis of bladder.
A case is described of endometriosis of the bladder in a postmenopausal patient who had gross hematuria and pelvic mass. Medical treatment with progestins was unsuccessful, and a partial cystectomy was performed.


Microfluidic biosensing of circulating tumor cells (CTCs): Recent progress and challenges in efficient diagnosis of cancer.
Cancer metastasis is one of the foremost causes of cancer incidence and fatality in the whole of the world. Circulating tumor cells (CTC) have been confirmed to be among the most significant stimuli of metastasis in recent years and presently are the subject of extensive research aiming to be accurately identified by using biological and physical properties. Among the various studies conducted for isolation, identification, and characterization of CTCs, microfluidic systems have aroused great attention owing to their unique advantages such as low-cost, simplicity, reduction in reagent consumption, miniaturization, fast and precise control. The purpose of this review is to provide an overview of current state of the microfluidic biosensors for the screening of CTCs. Additionally, given the recent progress in this field, future outlook for the development of the microfluidics biosensing is briefly discussed.


Pancreatic neuroendocrine tumor: added value of fusion of T2-weighted imaging and high b-value diffusion-weighted imaging for tumor detection.
To investigate the added value of fusion of high b-value diffusion-weighted images (DWI) and T2-weighted (T2) MR images for the detection of pancreatic neuroendocrine tumors (PNT). 18 patients with 18 histologically proven PNT were included. Two radiologists independently and retrospectively reviewed four randomized images sets (T2+T1, DWI, T2+DWI, and DWI+T2 fusion). Lesion detection confidence level was assessed using a three grade score (no lesion; uncertain lesion and certain lesion); lesion size and signal intensity were recorded. Apparent diffusion coefficients (ADC) of tumor and adjacent pancreas were measured. Readers 1 and 2 respectively detected 14/18 and 16/18 lesions on T2+T1, 13/18 and 12/18 on DWI, 16/18 and 15/18 on T2+DWI and 17/18 and 16/18 on DWI+T2 fusion. Lesion median size was 16 mm (range: 7 mm-40 mm), 22% were hyperfunctioning (all insulinomas) and 72% were low-grade (Rindi 1). All tumors except one (with cystic component) showed lower ADC than adjacent pancreatic parenchyma. Fusion imaging had significantly better detection score by both authors (p<0.005) and provided the higher inter-reader agreement (kappa 0.7). DWI alone had the worst score for both readers. Fusion images improve the detection of PNT, especially in patients with small isointense lesions on conventional MR sequences.


Occurrence and spatial distribution of perfluorinated compounds in groundwater receiving reclaimed water through river bank infiltration.
Perfluorinated compounds (PFCs) in groundwater are of widespread concern due to their potential toxicity to human health and ecological systems. PFCs in rivers can infiltrate into groundwater through riverbank infiltration, potentially endangering the safety of drinking water and causing a deterioration in the groundwater environment. This study investigated the occurrence of PFCs in rivers and riverside groundwater from 2014 to 2017 in a city in north China. PFCs were detected in most of the groundwater samples, ranging from not detected to 64.8 ng L-1. The predominant PFCs in both river and groundwater samples were perfluorooctane sulfonate, perfluorooctanoic acid, perfluorobutane sulfonate and perfluorobutanoic acid. The PFC concentrations and major compounds were consistent in both the river and riverside groundwater samples at each site, suggesting that the adjacent river was the source of the PFCs in the riverside groundwater. The spatial distribution of the PFCs in the riverside groundwater was affected by the hydraulic connection between the groundwater and the river, the lithology of the aquifer and the properties of the compounds. The results indicated that PFCs were attenuated during riverbank infiltration and the ability of different riverbank lithologies to remove PFCs was in the order sandy clay > fine sand > sandy gravel. Perfluorooctane sulfonate concentrations decreased sharply with increasing distances from river, whereas perfluorooctanoic acid, perfluorobutane sulfonate and perfluorobutanoic acid could by transported for greater distances in riverside groundwater. This study provides valuable information on PFCs in riverside groundwater affected by riverbank infiltration.


Insular thyroid cancer: a population-level analysis of patient characteristics and predictors of survival.
Insular thyroid cancer (ITC) is an uncommon, poorly differentiated thyroid malignancy. To date, there have been no population-level studies of the characteristics and outcomes of patients with ITC. The authors used the Surveillance, Epidemiology, and End Results (SEER) database from 1999 to 2007 to compare the characteristics and prognosis of patients who had ITC with those of patients who had well differentiated thyroid cancer (WDTC) and anaplastic thyroid cancer (ATC). Data analyses were performed using chi-square tests, analyses of variance, log-rank tests, and multivariate regression. There were 114 patients with ITC, 497 patients with ATC, and 34,021 patients with WDTC. The mean age of patients with ITC was 62.1 years versus 48.1 years for patients with WDTC and 69.5 years for patients with ATC (P < .001). The mean ITC tumor size was 5.9 cm versus 2.0 cm for WDTC and 6.4 cm for ATC (P < .001). Distant metastasis occurred in 31% of patients with ITC versus 4.5% of patients with WDTC and 59.1% of patients with ATC (P < .001). Insular histology was associated independently with compromised survival in the overall study sample (hazard ratio [HR], 2.1; P = .001). The 5-year disease-specific survival rate was 72.6%, 97.2%, and 9.1% for patients with ITC, WDTC, and ATC, respectively (P < .001). After adjustment, radioiodine therapy (HR, 0.15; 95% confidence interval, 0.04-0.5) and distant metastasis (HR, 15.3; 95% confidence interval, 3.7-62.2) were associated independently with ITC survival. The mortality rate was 7.1%, 12%, and 54.3% for patients with localized, regional, and distant stage ITC, respectively (P < .001). For patients who had ITC with distant metastasis, thyroidectomy and radioiodine therapy independently improved survival. ITC is rare and aggressive. The current results indicated that its treatment should include total thyroidectomy and high-dose radioiodine for all patients and neck dissections for patients with lymph node disease. Early diagnosis and close surveillance are essential in the management of patients with ITC.


Synthesis, Biological Evaluation and Molecular Docking Studies of Piperidinylpiperidines and Spirochromanones Possessing Quinoline Moieties as Acetyl-CoA Carboxylase Inhibitors.
Acetyl-coenzyme A carboxylases (ACCs) play critical roles in the regulation of fatty acid metabolism and have been targeted for the development of drugs against obesity, diabetes and other metabolic diseases. Two series of compounds possessing quinoline moieties were designed, synthesized and evaluated for their potential to inhibit acetyl-CoA carboxylases. Most compounds showed moderate to good ACC inhibitory activities and compound 7a possessed the most potent biological activities against ACC1 and ACC2, with IC50 values of 189 nM and 172 nM, respectively, comparable to the positive control. Docking simulation was performed to position compound 7a into the active site of ACC to determine a probable binding model.


Menopausal symptoms after cessation of hormone replacement therapy.
To determine the prevalence of recurrent menopausal symptoms among post-menopausal women who discontinued hormone replacement therapy (HRT) after the publication of the women's health initiative (WHI) study and to describe the therapeutic strategies employed to address these symptoms. Retrospective analysis of 1000 post-menopausal women seen consecutively at an internal medicine practice from January 2004 to May 2004. Among 1000 post-menopausal women, 205 (21%) had discontinued HRT due to the WHI results. Menopausal symptoms were present in 91/205 (44%) women, with 52/205 (25%) having vasomotor symptoms, 51/205 (25%) urogenital complaints, and 10/205 (5%) mood-related symptoms. Out of the 91 symptomatic women, only 55 (60%) received therapy to relieve their symptoms. The most commonly employed treatments were topical estrogen in 33/91 (36%) women, complementary therapies in 18/91 (20%) women, and venlafaxine in 13/91 (14%) women. Among complementary therapies, the most frequent were black cohosh used by 8/91 (9%) women and soy by 7/91 (8%) women. Many post-menopausal women developed typical menopausal symptoms after discontinuation of HRT, with vasomotor and urogenital complaints being the most commonly reported. Topical estrogen, complementary therapies, and venlafaxine were the most usual treatments for menopausal symptoms. However, a large number of symptomatic women remained untreated.


Modification of polyacrylonitrile-derived carbon nanofibers and bacteriophages on screen-printed electrodes: A portable electrochemical biosensor for rapid detection of Escherichia coli.
A facile method was developed for fabricating a disposable phage-based electrochemical biosensor for the detection of Escherichia coli. Bare screen-printed electrodes (SPEs) were modified using a two-step drop-casting method, in which polyacrylonitrile-derived electrospun carbon nanofibers (CNFs) were deposited, followed by E. coli bacteriophage immobilization. The deposition of CNFs increased the surface area for bacteriophage immobilization while maintaining a conductive link for ferro/ferricyanide redox transitions. Cyclic voltammetry and electrochemical impedance spectroscopy confirmed that the CNF modification increased the electron-transfer rate, whereas bacteriophages and E. coli blocked electron transfer at the electrode. The biosensor achieved a response within 10 min and a linear response in the E. coli concentration range of 102-106 CFU/mL. A limit of detection (LOD) of 36 CFU/mL in phosphate-buffered saline was achieved, which is the lowest LOD reported thus far for phage-based disposable SPE sensors. The biosensor exhibited recovery rates between 106 % and 119 % for E. coli detection in apple juice. The proposed fabrication method allowed electrodes to be obtained from different production batches with remarkable consistency and reproducibility, and they remained stable at room temperature for one month. Thus, a phage-based disposable SPE that can be used for bacterial detection was developed for the first time.


Tyrosinase activity and abundance in Cloudman melanoma cells.
Rabbit anti-tyrosinase antibodies were used to study the abundance, processing, and degradation of tyrosinase in murine (Cloudman) melanoma cells. The polyclonal antibodies precipitated low-molecular-weight (68,000 and 70,000) and high-molecular-weight (78,000 and 80,000) tyrosinases that had a precursor-product relationship. Cells with high basal tyrosinase activity had high levels of newly synthesized tyrosinase. Cells with low tyrosinase activity synthesized less tyrosinase and degraded the enzyme at a faster rate than cells with high tyrosinase activity. Melanotropin (melanocyte stimulating hormone), dibutyryl cyclic adenosine monophosphate, and isobutylmethylxanthine caused an increase in the abundance of newly synthesized tyrosinase that was directly proportional to the increase in enzyme activity. This enzyme was not a phosphoprotein. Other changes in the culture conditions that increased the level of tyrosinase activity increased the abundance of newly synthesized enzyme. It is thus concluded that the level of tyrosinase activity in Cloudman melanoma cells is a direct reflection of the abundance of enzyme protein.


Measurement of chest wall motion using a motion capture system with the one-pitch phase analysis method.
Spirometry is a standard method for assessing lung function. However, its use is challenging in some patients, and it has limitations such as risk of infection and inability to assess regional chest wall motion. A three-dimensional motion capture system using the one-pitch phase analysis (MCO) method can facilitate high precision measurement of moving objects in real-time in a non-contacting manner. In this study, the MCO method was applied to examine thoraco-abdominal (TA) wall motion for assessing pulmonary function. We recruited 48 male participants, and all underwent spirometry and chest wall motion measurement with the MCO method. A significant positive correlation was observed between the vital capacity (Spearman's ρ = 0.68, p < 0.0001), forced vital capacity (Spearman's ρ = 0.62, p < 0.0001), and tidal volume (Spearman's ρ = 0.61, p < 0.0001) of spirometry and the counterpart parameters of MCO method. Moreover, the MCO method could detect regional rib cage and abdomen compartment contributions and could assess TA asynchrony, indicating almost complete synchronous movement (phase angle for each compartment: - 5.05° to 3.86°). These findings suggest that this technique could examine chest wall motion, and may be effective in analyzing chest wall volume changes and pulmonary function.


Morphological parameter variations between sister chromatids by electron microscopy.
Five morphological parameters of sister chromatids, viz radius, length, centromeric index, volume and centromere width, were studied by electron microscopy, from 140 human number 1 chromosomes, and 122 human number 2 chromosomes. The degree of variation obtained ranged from 0.277 +/- 0.003% and 0.286 +/- 0.005% for the centromeric index of chromosomes 1 and 2, respectively, to 9.835 +/- 0.933% and 13.472 +/- 1.461% for centromere width.


Stimuli, reinforcers, and the persistence of behavior.
This article reviews evidence from basic and translational research with pigeons and humans suggesting that the persistence of operant behavior depends on the contingency between stimuli and reinforcers, and considers some implications for clinical interventions.


Carotid ultrasound is useful for the cardiovascular risk stratification of patients with rheumatoid arthritis: results of a population-based study.
To determine if the use of carotid ultrasonography (US) may improve the stratification of the cardiovascular (CV) risk in rheumatoid arthritis (RA). A set of 370 consecutive patients without history of CV events were studied to assess carotid intima-media thickness (cIMT) and plaques. As previously proposed, CV risk was calculated according to the modified EULAR systematic coronary risk evaluation (mSCORE) for RA that was adapted by the application of a multiplier factor of 1.5 in those patients fulfilling ≥ 2 of 3 specific criteria. The mean disease duration was 9.8 years, 250 (68%) had rheumatoid factor/anticyclic citrullinated peptide positivity and 61 (17%) extra-articular manifestations. 43 were excluded because they had type 2 diabetes mellitus or severe chronic kidney disease. CV risk was categorised in the remaining 327 RA patients according to the mSCORE: mild (96 cases; 29.3%), moderate (201; 61.5%) and high/very high risk (30; 9.2%). Only five patients were reclassified as having high/very high CV risk when the mSCORE was applied. Severe carotid US abnormalities (cIMT >0.90 mm and/or plaques) were uncommon in patients with low mSCORE (13%). Nevertheless, in patients with moderate mSCORE, severe carotid US abnormalities were observed in 63% of cases. A model that included a chart mSCORE risk ≥ 5% plus the presence of severe carotid US findings in patients with moderate mSCORE risk (≥ 1% and <5%) yielded high sensitivity for high/very high CV risk (93 (95% CI 88 to 96)). Our results support the use of carotid US in the assessment of CV risk in patients with RA.


Direct Observation of One-Dimensional Peierls-type Charge Density Wave in Twin Boundaries of Monolayer MoTe2.
One-dimensional (1D) metallic mirror-twin boundaries (MTBs) in monolayer transition-metal dichalcogenides exhibit a periodic charge modulation and provide an ideal platform for exploring collective electron behavior in the confined system. The underlying mechanism of the charge modulation and how the electrons travel in 1D structures remain controversial. Here, for the first time, we observed atomic-scale structures of the charge distribution within one period in MTB of monolayer MoTe2 by using scanning tunneling microscopy/spectroscopy. The coexisting apparent periodic lattice distortions and U-shaped energy gap clearly demonstrate a Peierls-type charge density wave (CDW). Equidistant quantized energy levels with varied periodicity are further discovered outside the CDW gap along the metallic MTB. Density functional theory calculations are in good agreement with the gapped electronic structures and reveal that they originate mainly from a Mo 4d orbital. Our work presents hallmark evidence of the 1D Peierls-type CDW on the metallic MTBs and offers opportunities to study the underlying physics of 1D charge modulation.


Treatment patterns and bleeding outcomes in persons with severe hemophilia A and B in a real-world setting.
The current standard of care treatment for severe hemophilia A and B (SHA and SHB) is the prophylactic intravenous replacement of coagulation factor VIII or IX (FVIII/FIX) to prevent spontaneous bleeding. Persons with hemophilia without prophylactic treatment receive therapy in case of bleeding, i.e., on demand. To assess treatment patterns, utilization of products, and bleeding outcomes in a real-world cohort of persons with SHA and SHB, defined as FVIII or FIX activity < 1%, data was retrospectively collected from hemophilia-specific patient diaries used for home treatment, medical records, and entries into the Austrian Hemophilia Registry from the year 2012 to 2017. Fifty-three male persons with SHA (n = 47) and SHB (n = 6) were included; 26 with SHA and 5 with SHB were on prophylaxis, 8 and 1 switched therapy regimen, and 13 and 0 received on-demand therapy. Persons on prophylaxis used a mean factor FVIII or FIX dose of 71.7 and 40.1 IU/kg/week. Median (IQR) annualized bleeding rates (ABR) in SHA were 28.0 (23.4-31.3) in the on-demand, 4.9 (1.6-13.5) in the prophylaxis group, and 3.0 (2.0-6.8) in the prophylactic group of SHB. Three persons with SHA had zero bleeds during the observation period. On-demand therapy and hepatitis B and C were associated with higher ABR but not age, weight, and HIV positivity. Bleeding rates and the proportion of on-demand therapy in persons with hemophilia were high in our real-world cohort. Further improvement is needed, which might be facilitated with the advent of factor products with extended half-life or non-factor therapies.


Prevalence, motives and patterns of anticipated radiograph ordering by nurses in accident and emergency departments in France.
Although common in many countries, anticipated ordering of radiographs by nurses in Accident and Emergency Departments (AEDs) remains illegal in France. Despite this, some evidence suggests that it is implemented in a number of AEDs. To describe the current state of the practice of anticipated ordering of radiographs by nurses in France. Despite a low response rate (21.2%), the findings (prevalence and implementation patterns) stress the urgency of a broad review of this issue in France.


Acute and chronic radiation injury.
Although all areas of the body are susceptible to radiation injury, different tissues have varying tolerances for radiation exposure. The goal of this summary is to introduce basic concepts of radiation biology and discuss the effects of radiation on various tissues. Reference texts and literature were reviewed to summarize key points in radiation biology and the direct and indirect cell damage caused by radiation. The most prevalent factor for injury is long exposure time, which can be an issue in lengthy peripheral vascular or aortic interventions. Several key maneuvers can help decrease exposure for both the patient and the physician. Radiation induces tissue injury at the cellular level. The use of good fluoroscopic technique is imperative for physician and patient protection.


Parasympathomimetic effects of mono sodium glutamate.
The effects of Mono sodium glutamate on smooth muscles were studied using the guinea-pig isolated ileum. Mono sodium glutamate produced spasmogenic effect. Atropine blocked the contractile response elicited by Mono sodium glutamate whereas mepyramine and hexamethonium failed to do so. These findings suggest a cholinergic involvement at post ganglionic site of action.


A Rapid Method for the Detection of Diarrhetic Shellfish Toxins and Azaspiracid Shellfish Toxins in Washington State Shellfish by Liquid Chromatography Tandem Mass Spectrometry.
Diarrhetic shellfish toxins (DSTs) in domestic shellfish and azaspiracids (AZAs) in imported products are emerging seafood safety issues in the United States. In addition to causing gastrointestinal illnesses, some of these toxins are also carcinogenic and genotoxic. Efficient analytical strategies are needed for their monitoring in U.S. domestic and imported shellfish. In the US, DSTs and AZAs are the only lipophilic shellfish toxins addressed in regulations. Streamlining of existing methods for several classes of lipophilic toxins, based on liquid chromatography coupled with triple quadrupole mass spectrometry, was pursued. The resulting simplified LC-MS/MS method is focused on the separation and detection of just the AZAs and total DSTs using a C18 Hypersil gold column. Filter vials are used to expedite and simplify sample handling. The method has a run time of 7.25 min. LOQs for the AZAs and DSTs in shellfish were 0.3-0.4 µg/kg. Recoveries (AZAs and total DSTs) for three spiking levels in three matrixes ranged from 68 to 129%. Trueness was established using certified reference materials. Method equivalence was established using shellfish provided blind by the Washington State Department of Health Public Health Laboratory (WA DOH PHL). Data obtained from these samples agreed well with data from another LC-MS/MS method used in harvest control by WA DOH PHL (R = 0.999; P < 0.0001). The LC-MS/MS method described offers more rapid sample handling and has excellent sensitivity, linearity, and repeatability.


Ultraviolet B irradiation increases endothelin-1 and endothelin receptor expression in cultured human keratinocytes.
The effect of ultraviolet B (UVB) irradiation on endothelin-1 (ET-1) and ET receptor expression was examined using cultured normal human keratinocytes. Keratinocytes secreted ET-1 in the medium at a level of 2.1 pg/day/10(5) cells. UVB irradiation up to 10 mJ/cm2 increased ET-1 secretion 3-fold, and potentiated expression of mRNA for ET-1. Both ETA and ETB receptor mRNAs were detected in keratinocytes, and their expression was up-regulated by 5 mJ/cm2 UVB irradiation.


The impact of medical informatics on patient satisfaction: a USA-based literature review.
Patient satisfaction is increasingly recognized as an important component of quality. The expansion of health information technologies (HIT) might have an impact on patient satisfaction - either positively or negatively. We conducted a literature review to explore the impact of these technologies on patient satisfaction. The database of PubMed was searched from inception through May 2010, using the MeSH terms "Medical Informatics" and "Patient Satisfaction". We included all original interventional studies regardless of their study design that were published in English and were evaluating HIT impact on patient satisfaction. Studies were categorized by technology type according to the American Medical Informatics Association framework and by study design. The major outcome of interest was the HIT impact on patient satisfaction. Of 1293 citations reviewed, 56 studies met our inclusion criteria. Design of these studies included mostly randomized controlled trials (RCTs) (n=20, 36%), cross-sectional surveys (n=17, 30%), and a pre and post studies (n=14, 25%). Overall, 54% (n=30) of the studies demonstrated a positive effect of HIT on patient satisfaction, 34% (n=19) failed to show any effect, 11% (n=6) had inconclusive results, and 2% (n=1) revealed a negative effect. Of the 20 RCTs, 40% (n=8) showed a positive effect of HIT on patient satisfaction, 50% (n=10) failed to show any effect, and 10% (2) had inconclusive results. Analysis suggested that while there is some evidence that HIT improves patient satisfaction, studies in this literature review, and in particularly RCTs, were not consistent in their findings. Although HIT may be a promising tool to improve patient satisfaction, more well-designed research studies are needed in order to get a better understanding of this domain and accordingly find new opportunities to improve quality of care.


Prevalence of premenstrual syndrome and premenstrual dysphoric disorder in a population-based sample in China.
To investigate the prevalence of premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD), and the frequency and severity of the symptoms in a population-based sample of Chinese women of reproductive age. Women aged 18-45 years were screened for suspected PMS and PMDD based on the ACOG recommendations for a diagnosis of PMS and diagnostic and statistical manual of mental disorders, fourth edition (DSM-IV). For those who were consistent with PMS diagnostic criteria, the daily record of severity of problems (DRSP) questionnaire was used to assess the symptoms prospectively over 2 months. Participants were then categorized as having no perceived symptoms, mild PMS, moderate PMS, and PMDD, based on a validated algorithm. Among the study group, the incidence of PMDD was 2.1% and PMS was 21.1%. The most common symptoms were irritability (91.21%), breast tenderness (77.62%), depression (68.31%), abdominal bloating (63.70%) and angry outbursts (59.62%). The prevalence of PMS/PMDD and the frequency and severity of the symptoms have their own characteristics in Chinese women.


Spatially multiplexed dark-field microspectrophotometry for nanoplasmonics.
Monitoring the effect of the substrate on the local surface plasmon resonance (LSPR) of metallic nanoparticles is key for deepening our understanding of light-matter interactions at the nanoscale. This coupling gives rise to shifts of the LSPR as well as changes in the scattering pattern shape. The problem requires of high-throughput techniques that present both high spatial and spectral resolution. We present here a technique, referred to as Spatially Multiplexed Micro-Spectrophotometry (SMMS), able to perform polarization-resolved spectral and spatial analysis of the scattered light over large surface areas. The SMMS technique provides three orders of magnitude faster spectroscopic analysis than conventional dark-field microspectrophotometry, with the capability for mapping the spatial distribution of the scattered light intensity with lateral resolution of 40 nm over surface areas of 0.02 mm(2). We show polarization-resolved dark-field spectral analysis of hundreds of gold nanoparticles deposited on a silicon surface. The technique allows determining the effect of the substrate on the LSPR of single nanoparticles and dimers and their scattering patterns. This is applied for rapid discrimination and counting of monomers and dimers of nanoparticles. In addition, the diameter of individual nanoparticles can be rapidly assessed with 1 nm accuracy.


Biorefining and biotechnology prospects of low-cost fish feed on Red tilapia production with different feeding regime.
This study aimed to decrease the production cost and increase tilapia yield with a feeding regime. The trial was divided into four treatments with three replications followed by the feeding frequency in monosex male Nile tilapia with an average initial weight of 17.86-18.40 g/fish cultured on a net cage in the earth pond for three months. Fish fed with 18% protein supplemented with 5% protein concentrate. The first month was used by 32% protein feed twice per day (T1, control), fish were fed twice per day every other week (T2), fish were fed twice per day per week (T3), and fish were fed twice per day per week (T3). Fish fed twice per day per week are now fed twice per day (T4). These results revealed that T2 fish had the highest growth performance and most protein consumption (P < 0.05). Moreover, fish in T2 has the lowest production cost and highest benefit-cost ratio (B/C ratio) (P < 0.05). The highest percentage of edible meat in T2 was P < 0.05, but the proximate analysis was close for all three groups (P > 0.05). As a result, it is necessary to ensure that Nile Tilapia culture has sufficient protein and nutrition control. This will allow for both high growth and low cost. Fish health and quality were positively affected by a perfect protein-containing feeding regimen. In fish fed with 18% protein and 5% protein concentrate for the first month, followed by 32% protein feed twice every other day and then with 18% protein.


Disparities in mortality by disability: an 11-year follow-up study of 1 million individuals.
This longitudinal study examines to what extent the risk of mortality-all-cause, natural death, suicide, and unintentional injury mortality-differs by types and severity of disabilities as well as disability status. Data were the National Sample Cohort of 1,025,340 individuals in South Korea followed from 2002 to 2013. Cox regression with time-variant variables was used to estimate the hazard ratio of mortality by disability. Individuals with disabilities had a higher risk of mortality compared to those without (HR 1.84, 95% CI 1.80-1.88 for natural death; HR 1.83, 95% CI 1.64-2.03 for suicide; HR 1.54, 95% CI 1.38-1.71 for unintentional injury). All types of disability were associated with an increased risk of natural death. Individuals with mental disability were the highest risk group for suicide (HR 7.14, 95% CI 5.31-9.60). People defined as having severe disability had an elevated risk for all categories of mortality. Disabilities are important markers of high risk of mortality. Findings call for actions to reduce mortality risk of people with disabilities, including preventing suicidal behaviors of those with mental disability.


Dydrogesterone increases serum lactalbumin concentration in the puerperium.
Eight women taking oral dydrogesterone 10 mg twice daily for the first 10 d of the puerperium, had significantly (P less than 0.01) greater levels of serum lactalbumin than controls (n = 9), from day 4. No difference was observed in prolactin concentrations between groups.


New strategies in the treatment of T-cell lymphoma.
A Review of Selected Presentations From the 43rd American Society of Clinical Oncology Annual Meeting, June 1-5, 2007, Chicago, Illinois.


High-sensitivity C-reactive protein and atherosclerotic disease: from improved risk prediction to risk-guided therapy.
There is compelling experimental and clinical evidence suggesting a crucial role for inflammation in the initiation and also the progression of atherosclerosis. Numerous biomarkers involved at various levels of the inflammation cascade have been shown to be associated with adverse cardiovascular outcomes. Yet, to date, it is not clear whether inflammation simply accompanies the atherosclerotic process or represents a major driver. Among all blood biomarkers, C-reactive protein (CRP), the classical acute phase reactant that can be measured with high-sensitivity (hs) assays seems to be the most promising candidate. It has already found its way into the guidelines in primary prevention. Hs-CRP can also be used to identify a high-risk group for recurrent events in patients with manifest atherosclerosis. Several post hoc analyses of large-scale randomized clinical trials testing various statins have indicated that, besides low density lipoprotein (LDL) cholesterol, hs-CRP levels might also further aid in tailoring statin treatment. The large JUPITER trial has prospectively confirmed these findings in primary prevention in patients with elevated hs-CRP but normal LDL cholesterol levels. Still, statin therapy is not a specific anti-inflammatory regime acting on the inflammation cascade. Thus, to directly test the inflammation hypothesis, a novel, more proximally located cytokine-based approach is needed. Canakinumab, a fully human monoclonal antibody against interleukin-1β, might represent a promising compound in this regard and provide a proof of concept. If successful, this may become a novel strategy to treat high-risk patients with stable atherosclerotic disease to prevent recurrent events on top of standard medical care.


Assessment of the biological stability of human thyroid stimulating hormone prepared by immunoaffinity chromatography.
This paper reports a comprehensive study of the biological stability of an immunoaffinity purified preparation of human thyroid stimulating hormone (TSH) and provides a reference against which future natural or synthetic preparations may be compared. The stability of the hormone preparation was investigated using the accelerated degradation method. The bioassay of the TSH was carried out in mice using a modified McKenzie method. Analysis of the results showed that the preparation was as stable as other TSH preparations purified by conventional methods.


The position of the ZEBRA activation domain does not influence its biological activity.
Epstein-Barr virus (EBV) is a human herpesvirus which latently infects B lymphocytes. EBV encodes a unique transcriptional activator, known as ZEBRA, which can disrupt viral latency in B cells and induce lytic viral replication. Furthermore, ZEBRA has been shown to bind at the EBV origin of lytic replication, and is necessary for viral DNA replication to occur. Previously we demonstrated that heterologous activation domains can fully substitute for the ZEBRA activation domain. Here we extend those results by showing that the position of the ZEBRA activation domain or a heterologous replacement domain does not influence its ability to function in the disruption of EBV latency. In this study three novel clones were constructed in which the ZEBRA activation region was repositioned to the carboxy terminus of the protein. These mutants were used to demonstrate that the ability of ZEBRA's wild type domain to function in the complex biological process of virus activation is not compromised by altering its position within the protein.


Lipid deposition at the limbus.
Lipid deposition at the limbus is a feature of familial and non-familial dyslipoproteinemias and can also occur without apparent accompanying systemic abnormality. Hyperlipoproteinemia, most notably type II hyperlipoproteinemia, is frequently associated with bilateral corneal arcus, with less common association in types III, IV and V. Diffuse bilateral opacification of the cornea with accentuation towards the limbus is a feature of HDL deficiency syndromes and LCAT deficiency. Whereas the lipid accumulation of hyperlipoproteinemia may be representative of excessive insudation of lipoprotein from plasma into the cornea that of hypolipoproteinemia is more likely to be a consequence of defective lipid clearance. The situation is yet further complicated by the modifying influences of secondary factors, both local and systemic.


Multi-center, multi-vendor validation of deep learning-based attenuation correction in SPECT MPI: data from the international flurpiridaz-301 trial.
Although SPECT myocardial perfusion imaging (MPI) is susceptible to artifacts from soft tissue attenuation, most scans are performed without attenuation correction. Deep learning-based attenuation corrected (DLAC) polar maps improved diagnostic accuracy for detection of coronary artery disease (CAD) beyond non-attenuation-corrected (NAC) polar maps in a large single center study. However, the generalizability of this approach to other institutions with different scanner models and protocols is uncertain. In this study, we evaluated the diagnostic performance of DLAC compared to NAC for detection of CAD as defined by invasive coronary angiography (ICA) in a large multi-center trial. During the phase 3 flurpiridaz multi-center diagnostic clinical trial, conducted over 74 international sites, patients with known or suspected CAD who were referred for a clinically indicated ICA were enrolled. Using receiver operating characteristic (ROC) analysis, we evaluated the detectability of obstructive CAD, defined by quantitative coronary angiography by a core laboratory, using total perfusion deficit (TPD) as an integrated measure of defect extent and severity on DLAC polar maps compared to NAC polar maps. This was also compared against the visual scoring of three expert core lab readers. Out of 755 patients, 722 (69% male) had evaluable SPECT and ICA for this study. ROC analysis demonstrated significant improvement in detecting per-patient obstructive CAD with DLAC over NAC with area under the curve (AUC) of 0.752 (95% CI: 0.711-0.792) for DLAC compared to 0.717 (0.675-0.759) for NAC (p value = 0.016). Compared to the consensus of expert readers AUC = 0.743 (0.701-0.784), DLAC was comparable (p value = 0.913), whereas NAC underperformed (p value = 0.051). DL-based attenuation correction improves diagnostic performance of SPECT MPI for detecting CAD in data from a large multi-center clinical trial regardless of SPECT camera model or protocol. A Phase 3 Multi-center Study to Assess PET Imaging of Flurpiridaz F 18 Injection in Patients With CAD, ClinicalTrials.gov Identifier: NCT01347710, registered on 4 May 2011. https://clinicaltrials.gov/ct2/show/study/NCT01347710.


An overview of viruses discovered over the last decades and drug development for the current pandemic.
Since the discovery of the yellow fever virus in 1901, thus far, two hundred nineteen viral species are recognized as human pathogens. Each year, the number of viruses causing infections in humans increases, triggering epidemics and pandemics, such as the current COVID-19 pandemic. Pointing to bats as the natural host, in 2019, a genome highly identical to a bat coronavirus (COVID-19) spread all over the world, and the World Health Organization (WHO) officially confirmed it as a pandemic. The virus mainly spreads through the respiratory tract, uses angiotensin-converting enzyme 2 (ACE2) as a receptor, and is characterized by symptoms of fever, cough, and fatigue. Antivirals and vaccines have provided improvements in some cases, but the discovery of a new and diverse variety of viruses with outbreaks has posed a challenge in timely treatments for medical scientists. Currently, few specific antiviral strategies are being used, and many of the effective antiviral drugs and reported active molecules are under vital exploration. In this review, with the details of viral diseases, we summarize the current attempts in drug development, epidemiology, and the latest treatments and scientific advancements to combat the COVID-19 epidemic. Moreover, we discuss ways to reduce epidemics and pandemics in the near future.


Psychosocial and economic issues related to physical health in psychiatric illness.
As well as the obvious medical consequences associated with physical health problems in individuals with schizophrenia, physical health problems lead to a number of psychosocial consequences--further contributing to the existing burden of schizophrenia itself. Weight gain can seriously impair quality of life through decreased functioning, social stigmatization, discrimination and potential financial consequences. However, patients with schizophrenia may be less capable of managing their weight via exercise and dietary interventions compared with the general population, and may, therefore, be more prone to non-compliance with a medication that induces weight gain. This may lead to exacerbation of the mental illness. Patients' perceptions and experience of antipsychotic treatments are also important as these can further impact on overall patient wellbeing. It is hoped that by increasing awareness of the psychosocial consequences of physical health impairment, we can move towards reducing the burden that patients face.


A rabbit model to study regression of ventricular hypertrophy.
The purpose of this study is to develop and characterise a reproducible rabbit model of LVH regression following pressure-induced myocardial hypertrophy. Without endotracheal intubation and mechanical ventilation, a median sternotomy was performed. The median incision was made exactly along the midline of the sternum. Ascending aortic diameter was reduced 50% above the aortic valve, which lead to an approximate 75% reduction in crosssectional area. The sham-operated rabbits underwent the same procedures without actual ligation of the aorta. The animals of early DB group and late DB group were subjected to the second operation for removing the ligation eight weeks or 16 weeks after the initial banding surgery, respectively. Echocardiography, haemodynamic assessment, histology, and electron microscopy were used to assess functional and structural aspects of myocardial hypertrophy at each time point. The pressure overload resulted in robust LVH assessed by echocardiography, haemodynamic assessment, LV weight/body weight ratios, histology, and electron microscopy. Ascending aortic debanding completely or partially reversed LVH. The degree of LVH regression was association with the duration of pressure overload, proved by the fact that restoration of LV structure and function was complete in animals subjected to eight weeks of aortic banding but incomplete in animals subjected to 16 weeks of aortic banding. The animals did not experience severe mechanical ventilatory impairment. These results demonstrate an efficient and reproducible method of promoting LVH regression in rabbits without endotracheal intubation and mechanical ventilation.


Preparation and Anti-Tumour Activity of Some Arylbismuth(III) Oxine Complexes.
New arylbismuth(lll) oxinates, PhBi(MeOx)(2), (p-MeC(6)H(4))Bi(Ox)(2), (p-MeC(6)H(4))Bi(MeOx)(2), (p-ClC(6)H(4))Bi(Ox)(2), and (p-ClC(6)H(4))Bi(MeOx)(2) (Ox(-) = quinolin-8-olate and MeOx(-)=2-methylquinolin-8-olate) have been prepared by reaction of the appropriate diarylbismuth chlorides with Na(Ox) or Na(MeOx) in the presence of 15-crown-5. An X-ray crystallographic study has shown PhBi(MeOx)(2) to be a five coordinate monomer with distorted square pyramidal stereochemistry. Chelating MeOx ligands have a cisoid arrangement in the square plane and the phenyl group is apical. The lattice is stabilised by significant pi-pi interactions between centrosymmetric molecules. A range of these complexes has been shown to have high in vitro biological activity (comparable with or better than cisplatin) against L1210 leukaemia, the corresponding cisplatin resistant line, and a human ovarian cell line, SKOV-3. However, initial in vivo testing against a solid mouse plasmacytoma (PC6) and P388 leukaemia has not revealed significant activity.


Validation of a cardiology subspecialty examination by faculty ratings of competencies: a multivariate approach.
This study investigated the relationships between assessments of competence as supplied by clinical faculty and examination performance on the 1975 Cardiovascular Disease subspecialty examination. Canonical correlation analysis showed the existence of two factors, which accounted for 36% of the variance in common.


Arsenocholine-O-sulfate: A novel compound as major arsenic species in the parasitic mushroom Tolypocladium ophioglossoides.
The As concentrations, along with 34 other elements, and the As speciation were investigated in wild-grown samples of the parasitic mushroom Tolypocladium ophioglossoides with inductively coupled plasma mass spectrometry (ICPMS) and high performance liquid chromatography coupled to ICPMS. The As concentrations were 0.070-3.44 mg kg-1 dry mass. More remarkable was the As speciation, where up to 56% of the extracted As were found to be an unknown As species, which was marginally retained under anion- and also cation-exchange conditions. After testing several different chromatographic settings, the compound was finally isolated and identified as 2-(sulfoxyethyl) trimethylarsonium ion (in short: arsenocholine-O-sulfate) with high resolution mass spectrometry. The compound was synthesized and further quantified in all investigated samples via ion-pair chromatography coupled to ICPMS. In addition to the high abundance of arsenocholine-O-sulfate in T. ophioglossoides, small amounts of this As species were also detected in one sample of the host mushroom, Elaphomyces asperulus. In a sample of another parasitic mushroom, Ophiocordyceps sinensis, arsenocholine-O-sulfate could not be detected, but the main species was another unknown compound that was oxidized to inorganic As(V) with hydrogen peroxide. This is the first discovery of arsenocholine-O-sulfate in nature. It is possible that it is present in many other organisms, at least in low concentrations, and just has not been detected there yet because of its unusual chromatographic behavior. The existence of arsenocholine-O-sulfate brings up questions again about the biotransformation pathways of As in the environment and the specific behavior of fungi.


A comparative study of the expression of monoamine oxidase-A and -B mRNA and protein in non-CNS human tissues.
The distributions of monoamine oxidase (MAO)-A and -B proteins and mRNAs in human heart, lung, liver, duodenum, kidney and vasculature were compared using immunohistochemistry and cRNA in situ hybridisation. MAO-A and -B mRNA were detected in all tissues, to differing extents, but particularly in glomeruli, hepatocytes, and the crypts, muscularis mucosa and muscularis externa of duodenum. Renal proximal and distal tubules and loops of Henle had more intense labelling for mRNA of MAO-B than MAO-A; this was reflected in MAO protein expression. Little immunoreactivity was detected in glomeruli. Hepatocytes expressed MAO-A moderately, but MAO-B strongly. In lungs, similar moderately intense labelling for both MAO mRNAs and immunoreactivities was evident in pneumocytes, and epithelial and smooth muscle cells. Cardiomyocytes contained both MAO isoforms, but with more, albeit moderate, labelling for MAO-A. Both isoforms were expressed equally in duodenal villi, crypts, muscularis externa and mucosa; lower level expression occurred in mucosal and submucosal cells. MAO-A and -B mRNA were detected in endothelia, adventitia and media of a renal interlobular artery, but protein immunoreactivities were chiefly in the adventitia. The data reveal widespread tissue distribution of MAO mRNAs and proteins, but indicate that presence of MAO mRNAs does not invariably reflect quantitatively its protein expression.


Residual hip dysplasia in children: osseous and cartilaginous acetabular angles to guide further treatment-a pilot study.
In case of residual hip dysplasia (RHD) in children, pelvic radiographs are sometimes insufficient to precisely evaluate the entire coverage of the femoral head, when trying to decide on the need for further reconstructive procedures. This study retrospectively compares the bony and the cartilaginous acetabular angle of Hilgenreiner (HTE) of 60 paediatric hips on pelvic MRI separated in two groups. Group 1 included 31 hips with RHD defined by a bony HTE > 20°. Group 2 included 27 hips with a HTE < 20°. They were compared by introducing a new ratio calculated from the square of cartilaginous HTE above the bony HTE on frontal MRI. The normal upper limit for this acetabular angle ratio was extrapolated from the published normal values of cartilaginous HTE and bony HTE in children. The acetabular angle ratio was statistically significantly increased in the hips with RHD with a mean value of 7.1 ± 4.7 compared to the hips in the control group presenting a mean value of 2.1 ± 1.9 (p < 0.00001). This newly introduced ratio seems to be a helpful tool to orientate the further treatment in children presenting borderline RHD.


Impact on quality of life after pancreatoduodenectomy: a prospective study comparing preoperative and postoperative scores.
Few studies compare the direct impact of pancreatoduodenectomy (PD) on the patient's quality of life (QOL). The effect of PD in QOL, comparing the preoperative vs. postoperative status, was analyzed. A prospective single-center study was performed. PD patients in a 2-year period were included. A general QOL instrument was applied preoperative, 1, 3, 6, and 12 months after surgery and compared with national norms. Thirty-seven patients were recruited. Twenty of 37 were female. Ampullary carcinoma 14/37, ductal adenocarcinoma in 9/37, and other malignant neoplasms 14/37 were diagnosed. Mortality was absent; 48.6% had complications, 13.5 % required reoperation. Three (median) and 4 (mode) questionnaires were answered per individual. 85 % answered the last questionnaire. 4/37 had cancer related death before a year. Median follow-up was 29 (3-72) months. QOL diminished a month after surgery, physical function (67 vs 40, p<0.0001) and emotional role (37 vs 17, p<0.032) did so significantly. Three months after surgery QOL improved yet not significantly. Six and 12 months postoperatively, physical role (9 vs 49, p=0.001), physical pain (51 vs 71, p=0.01), social function (52 vs 63, p=0.014), vitality (54 vs 64, p=0.018), and emotional role (41 vs 69, p=0.006) improved significantly. PD has a favorable impact in quality of life as demonstrated by the improvement of most parameters assessed in the postoperative period.


Multivariate methods and artificial neural networks in the assessment of the response of infaunal assemblages to sediment metal contamination and organic enrichment.
A 4-year annual sediment survey was conducted in an organically enriched tidal channel to compare the performance of univariate community descriptors, traditional multivariate techniques (TM) and artificial neural networks (AANs), in the assessment of infaunal responses to moderate levels of sediment metal contamination. Both TM approaches and the SOM ANN revealed spatiotemporal patterns of environmental and biological variables, suggesting a causal relationship between them and further highlighting subsets of taxa and sediment variables as potential main drivers of those patterns. Namely, high values of non-natural metals and organic content prompted high abundances of opportunists, while high values of natural metals yielded typical tolerant assemblages of organically enriched areas. The two approaches yielded identical final results but ANNs showed the following advantages over TM: ability to generalise results, powerful visualization tools and the ability to account simultaneously for sediment and faunal variables in the same analysis. Therefore, the SOM ANN, combined with the K-means clustering algorithm, is suggested as a promising tool for the assessment of the ecological quality of estuarine infaunal communities, although further work is needed to ensure the accuracy of the method.


Influence of continuous edge-line delineation on drivers' lateral positioning in curves: a gaze-steering approach.
Recent research indicates that installing shoulders on rural roads for safety purposes causes drivers to steer further inside on right bends and thus exceed lane boundaries. The present simulator study examined whether continuous rather than broken edge-line delineation would help drivers to keep their vehicles within the lane. The results indicated that continuous delineation significantly impacts the drivers' gaze and steering trajectories. Drivers looked more towards the lane centre and shifted their steering trajectories accordingly. This was accompanied by a significant decrease in lane-departure frequency when driving on a 3.50-m lane but not on a 2.75-m lane. Overall, the findings provide evidence that continuous delineation influences steering control by altering the visual processes underlying trajectory planning. It is concluded that continuous edge-line delineation between lanes and shoulders may induce safer driver behaviour on right bends, which has potential implications for preventing run-off-road crashes and cyclist safety.Practitioner summary: This study examined how continuous and broken edge lines influence driving behaviour around bends with shoulders. With continuous delineation, drivers gazed and steered in the bend further from the edge line and thus had fewer lane departures. Continuous marking can therefore help prevent run-off-road crashes and improve cyclists' safety.


Mutations in LPL, APOC2, APOA5, GPIHBP1 and LMF1 in patients with severe hypertriglyceridaemia.
The severe forms of hypertriglyceridaemia (HTG) are caused by mutations in genes that lead to the loss of function of lipoprotein lipase (LPL). In most patients with severe HTG (TG > 10 mmol L(-1) ), it is a challenge to define the underlying cause. We investigated the molecular basis of severe HTG in patients referred to the Lipid Clinic at the Academic Medical Center Amsterdam. The coding regions of LPL, APOC2, APOA5 and two novel genes, lipase maturation factor 1 (LMF1) and GPI-anchored high-density lipoprotein (HDL)-binding protein 1 (GPIHBP1), were sequenced in 86 patients with type 1 and type 5 HTG and 327 controls. In 46 patients (54%), rare DNA sequence variants were identified, comprising variants in LPL (n = 19), APOC2 (n = 1), APOA5 (n = 2), GPIHBP1 (n = 3) and LMF1 (n = 8). In 22 patients (26%), only common variants in LPL (p.Asp36Asn, p.Asn318Ser and p.Ser474Ter) and APOA5 (p.Ser19Trp) could be identified, whereas no mutations were found in 18 patients (21%). In vitro validation revealed that the mutations in LMF1 were not associated with compromised LPL function. Consistent with this, five of the eight LMF1 variants were also found in controls and therefore cannot account for the observed phenotype. The prevalence of mutations in LPL was 34% and mostly restricted to patients with type 1 HTG. Mutations in GPIHBP1 (n = 3), APOC2 (n = 1) and APOA5 (n = 2) were rare but the associated clinical phenotype was severe. Routine sequencing of candidate genes in severe HTG has improved our understanding of the molecular basis of this phenotype associated with acute pancreatitis and may help to guide future individualized therapeutic strategies.


Impact of the Heartfulness program on loneliness in high schoolers: Randomized survey study.
High levels of loneliness are prominent in teenagers ranging from ages 14-19. The 4-week Self-Care program, offered by the Heartfulness Institute, is designed to develop social-emotional skills and self-observation. This study examined the impact of the Self-Care program on loneliness in high school students in the United States in a randomized, wait-list control trial with baseline and postintervention assessments. High school participants, aged 14-19, were randomized into a control-wait-listed group (n = 54) and a Heartfulness group (n = 54). Both the groups completed the intervention and the presurveys and postsurveys online, assessing their loneliness with the UCLA Loneliness Scale. The initial analysis noted the baseline equivalence of the data. A repeated measures ANOVA found a significant time * group interaction, with a significant decrease in loneliness reported in the Heartfulness Intervention group but no significant pre-post difference in the control group. In summary, the short online intervention program consisting of self-care tools decreased loneliness scores in the participants. This study opens up a new valley of possibilities, apart from existing research, and demonstrates that the online intervention used might be helpful to decrease loneliness levels in teens.


Micro-topographic assessment of rill morphology highlights the shortcomings of current protective measures in loess landscapes.
Due to urban expansion and the rapid development of infrastructure in the loess area of China, artificial earth-fill embankments and excavated slopes are increasingly widespread in recent years. Erosion is typical in such loess slopes; however, quantitative statistical analyses of various counter-measures that affects rill erosion are still lacking. Here, we quantified rill morphology and rill erosion development in two newly constructed slopes with different engineering protection measures. We used high-resolution digital surface models (DSMs) acquired using an Unmanned Aerial Vehicle (UAV) to analyze the case areas during two-time periods. Our results from centimeter accuracy differential DSMs demonstrated that rapid rill erosion is prevalent in the study area, expressed as rill density varying between 2.03 km-2 and 8.81 km-2 at different slope surfaces (viz., erosion protected slopes [EPS], landslide protected slopes [LPS], and unprotected slopes [US]). The slope gradient responsible for rill erosion of the EPS, LPS and US are obviously different, and such information is essential for planning preventive measures in each slope type. At the EPS, the severity of erosion is maximum at the top of the ridges, whereas the gap between reinforced concrete lattice and loess deposits are of serious concern at the LPS. The current engineering measures employed in the study area are thus found ineffective for protection against rill erosion. We therefore propose an improved design by implementing an intercepting drain to the existing design for preventing further erosion.


Are myelodysplastic children receiving sufficient health care in Turkey? An analysis of the problems in primary management and their impact on neuro-urological outcome.
To investigate the problems in the primary care of children with spina bifida and to analyze their impact on neuro-urological outcome in Turkey. Information from mothers about the disease, difficulties in getting medical services, availability and efficacy of prenatal ultrasound, and folic acid intake was also assessed. A retrospective review of 476 children registered in the pediatric urology section of our institutional multidisciplinary spina bifida clinic between 1996 and 2005 was made. All children were assessed for the time of primary repair, time to first neuro-urological visit, and compliance to follow up. A phone interview was made with 166 mothers to obtain data regarding their educational status, supplementary folic acid intake before/during gestation, compliance to obstetric follow up, prenatal diagnosis and counseling, information about the importance of neuro-urological surveillance, and difficulties in neuro-urological follow up. Two-thirds of the mothers had an educational status of elementary school or lower. Phone interviews revealed inadequate obstetric follow up in 42% and a low prenatal diagnosis rate (49%) in those under regular follow up. Chart review revealed a significant delay in timing of primary surgical closure (mean 3 months and 2.9 years for open and closed lesions, respectively) and first neuro-urological follow-up visit (mean 1.8 years and 9.7 months after primary repair for open and occult lesions, respectively). Reasons for delayed closure were misguided advice of the nurse/midwife involved in delivery and inability to obtain tertiary health care. Socioeconomic inadequacy of the families and inefficacy of the health insurance system were the most important factors impairing follow up. Serious problems exist in the prevention, prenatal diagnosis and primary management of children with myelodysplasia in Turkey. As a consequence, neuro-urological follow up starts relatively late, which adversely affects the urological prognosis.


Backscatter evaluation of myocardial functional and textural findings in children with right ventricular pressure and/or volume overload.
Integrated backscatter (IBS) analysis represents a recent echocardiographic technique for evaluating the textural and functional state of the right ventricular (RV) myocardium. We undertook our study to (1) define the potential impact of age or morphometric parameters (height, weight, and body surface area) on RV IBS indexes, and (2) compare RV IBS data among normal subjects and children with different conditions of RV overload. We studied 34 patients (mean age 14.6 +/- 4.7 years) divided into 3 groups: 14 patients with RV volume overload related to moderate to large atrial septal defect (group I); (2) 10 patients with RV pressure overload due to transposition of the great arteries after the Mustard procedure (group II); and (3) 10 patients with RV volume and pressure overload due to pulmonary regurgitation and stenosis after corrective surgery for tetralogy of Fallot (group III). In addition, 20 children with structurally normal hearts were enrolled as the control group. The 4 groups were comparable with regard to age and morphometric parameters. IBS parameters were assessed as the magnitude of cyclic variation, determined as the difference between peak and nadir IBS values and the averaged myocardial IBS intensity. In the control group and group I, IBS parameters did not change significantly with age, height, weight, and body surface area. In contrast, in groups II and III, a significant correlation was found between cyclic variation and age at the study (p = 0.021, r = -0.71, and p = 0.006, r = -0.79, respectively). Furthermore, compared with the control group, cyclic variation and IBS intensity were significantly different only in groups II (p = 0.01 and p = 0.006, respectively) and III (both p <0.0001) but not in group I (p = 0.23 and p = 0.38, respectively). The lowest values of cyclic variation and the highest values of intensity were detected in group III patients. Thus, our data suggest that (1) in normal subjects, there is no correlation between RV IBS indexes and age or any morphometric parameters, and (2) IBS analysis is able to noninvasively detect differences in myocardial functional and textural properties in the presence of different conditions of RV overload.


Early amplitude-integrated EEG correlates with cord TNF-alpha and brain injury in very preterm infants.
To investigate if the early electroencephalogram (EEG) and amplitude-integrated EEG (aEEG) in very preterm infants is affected by perinatal inflammation and brain injury, and correlates with long-term outcome. Sixteen infants born at 24-28 gestational weeks (median 25.5) had continuous EEG/aEEG during the first 72 h of life. Minimum and maximum EEG interburst intervals (IBI), and aEEG amplitudes were semi-automatically quantified and averaged over the recording period. Neonatal brain injury was diagnosed with repeated cranial ultrasound investigations. Nine cytokines from four time-points were analyzed during the first 72 h (umbilical cord blood, 6, 24 and 72 h), and outcome was assessed at 2 years of corrected age. Infants with neonatal brain injury (n=9) had prolonged IBI, 11.8 (9.6-23.2) sec versus 8.2 (7.1-11.6) sec in infants (n=7) without brain damage (p=0.005). Handicap at 2 years (n=8, including two infants without neonatally diagnosed brain injury) was associated with prolonged neonatal IBI and lower aEEG amplitudes. Also aEEG amplitudes were decreased in infants with neonatal brain injury. There was a significant positive correlation between the averaged IBI and cord blood TNF-alpha (rs=0.595, p=0.025). Early EEG depression is associated with increased cord blood TNF-alpha, neonatal brain damage and handicap at 2 years.


Assessment of liver fibrosis in primary biliary cholangitis: Comparison between indirect serum markers and fibrosis morphometry.
The accuracy of non-invasive methods for the quantification of liver fibrosis in primary biliary cholangitis (PBC) is still debated. To determine the histo-morphometric measurement of fibrotic tissue and to explore the possible association between indirect markers (APRI, FORNS, FIB-4, and Lok) and morphometry. Retrospective analysis of medical data from patients with PBC, on whom needle liver biopsy was performed as part of the diagnostic assessment. One section of each biopsy stained with Sirius red was used for calculating the percentage of collagen. Quantitative measure of fibrotic tissue (fibrosis morphometry) was calculated as a percentage of collagen content by digital image analysis. Morphometry results were divided into four groups reflecting Ludwig's staging and compared with values for indirect serum markers. 50 PBC patients were enrolled (86% females, mean age 57 ± 12.30 years), 19 were Ludwig's stage I (38%), 14 stage II (28%), 12 stage III (24%), and five stage IV (10%). Morphometry results were significantly different among Ludwig stages (p<0.05). No significant differences were found for indirect serum markers. A significant correlation was found between morphometry results and indirect serum markers tested (p<0.05). In our cohort, the histo-morphometric values of fibrotic tissue increased progressively with Ludwig's stages of PBC, while non-invasive markers did not.


Coping with stress: the effectiveness of different types of music.
Listening to classical and self-selected relaxing music after exposure to a stressor should result in significant reductions in anxiety, anger, and sympathetic nervous system arousal, and increased relaxation compared to those who sit in silence or listen to heavy metal music. Fifty-six college students, 15 males and 41 females, were exposed to different types of music genres after experiencing a stressful test. Several 4 x 2 mixed design analyses of variance were conducted to determine the effects of music and silence conditions (heavy metal, classical, or self-selected music and silence) and time (pre-post music) on emotional state and physiological arousal. Results indicate listening to self-select or classical music, after exposure to a stressor, significantly reduces negative emotional states and physiological arousal compared to listening to heavy metal music or sitting in silence.


Purification of squid synaptic vesicles and characterization of the vesicle-associated proteins synaptobrevin and Rab3A.
Two proteins associated with mammalian synaptic vesicles, the integral membrane protein synaptobrevin and the GTP-binding protein rab3A, are identified in squid nervous tissue using Western blotting and subcellular fractionation of synaptosomes. They both copurify with synaptic vesicles prepared from squid optic lobe. Synaptobrevin (18.1 kDa) is present at high levels in synaptic terminals but at very low levels in axon. Rab3A (27.5 kDa) is a member of the rab family of low-molecular weight GTP-binding proteins which regulates vesicle traffic in secretory and endocytic processes. As resolved with 2-dimensional gels, squid neurons contain at least 16 GTP-binding species (19-29 kDa), and most of these are present in both soluble and particulate fractions. The 24 kDa class of GTP-binding proteins is highly enriched in axonal transport organelles. The characterization of synaptobrevin and rab3A in squid synaptic vesicles extends their known distributions to invertebrates and points to a fundamental importance of these proteins in neurotransmitter release.


A decade of living donor transplantation in North American children: the 1998 annual report of the North American Pediatric Renal Transplant Cooperative Study (NAPRTCS).
This report of the North American Pediatric Renal Transplant Cooperative Study (NAPRTCS) covers the years 1987-1997, and analyzes data on 2,904 living donor (LD) transplants performed in 2,779 patients. Since 1991, approximately 300 LD transplants have been performed each year at the participating centers of the NAPRTCS. Caucasian children account for 72% of all LD recipients while African-American children constitute only 11%. There has been a gradual decline in the number of transplants performed in children under the age of 6 years from a peak of 30% in 1987, to 21% in 1997. Preoperative calcineurin inhibitor therapy has dropped from 71% in 1987 to 38% in 1997. Through 1996, at six months post-transplant 97% of recipients were receiving prednisone, 88% were maintained on cyclosporin A, and 79% were receiving azathioprine. Of patients transplanted in 1997, 47% are maintained on mycophenolate and 10% are maintained on tacrolimus. By day 15, 20% of index transplant patients have had an acute rejection and by the end of the first year 47% have had a rejection episode. Among patients transplanted in 1995-1996, 40% had a rejection in the first year. Nine per cent of rejection episodes are irreversible in children under 2 years of age and 5% of the episodes are irreversible in 25-year-old children. Estimated graft survival probability at 1 year is 91%, at 3 years it is 84% and at 5 years it is 78.5%. Rejection accounts for 33% of graft loss and recurrence constitutes another 10%. Influential prognostic variables for graft survival are race (African-American vs. others, relative risk (RR) = 2.0, p < 0.001), > 5 random transfusions (RR = 1.6, p < 0.001, T cell induction therapy (RR = 0.78, p = 0.01), and later year of entry (1989-1990 vs. 1994-1995, RR = 0.95, p = 0.04). Patient survival at 1 and 3 years was 97% and 96.5%, respectively, however, the 3-year patient survival of children under 2 years was 89%. The mean height deficit baseline (n=2,677) was -1.86, at 1 year post-transplant (n=1,459) it was -1.80, and at 5 years post-transplant (n=592) it was -2,06. This report, devoted specifically to LD pediatric transplants, raises the issues regarding the use of immunosuppression such as preoperative calcineurin inhibitors and T-cell antibodies. Studies to address the high incidence of chronic rejection and recurrence of original disease are necessary. Additional areas of concern are the high infant mortality and continued growth retardation post-transplantation.


The effects of Pilates training on static and dynamic balance of female deaf students: A randomized controlled trial.
To evaluate the effect of Pilates training on static and dynamic balance of deaf female. This study is a randomized, controlled trial with concealed randomization and blinded assessments. 19 female deaf students participated in this study and were randomly assigned into experimental (EXP, n = 9) and control (CON, n = 10) groups. Static balance was examined by Balance Error Scoring System (BESS), and dynamic balance was examined by Y balance test (YBT). The experimental group performed a Pilates training program for 8 weeks (three sessions of 60 min). The findings showed that experimental group showed a significant change in static balance (with open eye and close eye) and dynamic balance (dominant limb and non-dominant limb) after 8 weeks Pilates training (p < 0.05). The control also showed no significant changes after training duration (p > 0.05). This study showed that Pilates training significantly improve balance in female deaf students.