Prognostic Value of Pretreatment Geriatric Nutrition Risk Index in Lung Cancer Patients: A Meta-Analysis.
To explore the prognostic value of pretreatment Geriatric Nutrition Risk Index (GNRI) in lung cancer patients. The PubMed, EMBASE and Web of Science electronic databases were searched up to October 5, 2021 for relevant studies. The primary and second outcomes were the overall survival (OS) and progression-free survival (PFS) and the hazard ratios (HRs) with 95% confidence intervals (CIs) were combined to assess the association between GNRI and prognosis of lung cancer patients. A total of eight retrospective studies involving 2012 patients were included and all of them were from Asian countries. The pooled results demonstrated that lower pretreatment GNRI was significantly associated with poor OS (HR = 2.01, 95% CI: 1.68-2.42, P < 0.001) and PFS (HR = 1.50, 95% CI: 1.24-1.81, P < 0.001). Subgroup analysis based on the treatment (surgery vs non-surgery) and tumor type (non-small cell lung cancer vs small cell lung cancer) showed similar results. Lower pretreatment GNRI was an independent prognostic risk factor for lung cancer patients and might contribute to the evaluation of prognosis and formulation of therapy strategies in lung cancer.


Cytomegaloviral colitis in HIV positive patients: endoscopic findings.
Diarrhea in seropositive human immunodeficiency virus patients is one of the most important and disabling symptoms, and often decreases their quality of life. Cytomegalovirus colitis is among the principal causes of this symptom and colonoscopy is the gold standard examination to diagnose it. To define the main endoscopic findings in seropositive human immunodeficiency virus patients with cytomegalovirus colitis. Two hundred and forty-three colonoscopies were performed in 200 seropositive human immunodeficiency virus patients with diarrhea associated or not to abdominal pain or gastrointestinal bleeding, over 10-year period, whom 51 patients were diagnosed with cytomegalovirus colitis. Full length colonoscopy with ileum intubation was always tried and multiple biopsies of all segments examined, including endoscopically normal segments, were attempted. All diagnoses were confirmed by histologic and immunohistochemical studies. Total colonoscopy was possible in 98.03% and ileum intubation in 88.23% of these cytomegalovirus colitis patients. At colonoscopy, a heterogeneous ulcerative pattern was presented in 72.54%, an inflammatory process of the mucosa in 21.56% and 5.88% of the patients mucosa was endoscopically normal. Full length colonoscopy with ileum intubation and multiples biopsies of all segments, even when they are endoscopically normal, have always to be attempted in cases of seropositive human immunodeficiency virus patient with diarrhea.


Patient perspectives of 'Watch and Wait' for chronic haematological cancers: Findings from a qualitative study.
Chronic blood cancers are incurable, and characterised by unpredictable, remitting-relapsing pathways. Management often involves periods of observation prior to treatment (if required), and post-treatment, in an approach known as 'Watch and Wait'. This study aimed to explore patient experiences of 'Watch and Wait'. In-depth interviews with 35 patients (10 accompanied by relatives) with chronic lymphocytic leukaemia, follicular lymphoma, marginal zone lymphoma or myeloma. Data were analysed using descriptive qualitative techniques. Patient views of Watch and Wait ranged along a continuum, from immediate acceptance, to concern about treatment deferral. Significant ongoing anxiety and distress were described by some, due to the uncertain pathways associated with Watch and Wait. Infrequent contact with clinical staff was said to exacerbate this, as there was limited opportunity to ask questions and seek reassurance. Patients indicated that the impact of their malignancy could be underestimated by clinicians; possibly due to them comparing chronic and acute subtypes. Most patients lacked knowledge of blood cancers. Support from clinicians was considered greater among treated patients, possibly due to increased contact, and many drew on relatives for aid. Most patients were satisfied with their time-allocation with haematology staff, although experiences could be improved by greater access to clinical nurse specialists, counselling services, and community-based facilities. Experiences varied. Anxiety about unpredictable futures could be more distressing than any physical symptoms and have a greater impact on quality of life. Ongoing assessment could facilitate identification of difficulties, and is particularly important among individuals without supportive networks.


Nuclear factor recognition sites in the gut-specific enhancer region of an Anopheles gambiae trypsin gene.
The major digestive enzyme of Anopheles gambiae is encoded by the trypsin 1 gene. This gene is expressed exclusively in the gut and its mRNA abundance increases after ingestion of a blood meal. Previous experiments with transgenic Drosophila have shown that the enhancer region, from nucleotide -360 bp to -150 bp upstream of the transcription initiation site, is necessary to drive the gut-specific expression of a reporter gene (Skavdis et al., 1996. EMBO J. 15, 344-350). In this study, we defined DNA sequences within this region that are capable of binding nuclear factors from either gut or non-gut tissues. By electrophoretic mobility shift assays, we determined that a gut-specific nuclear factor recognizes and binds to three sites in the enhancer region with a consensus sequence TYCAAGT. Another factor, found in many tissues, recognizes and binds to at least two additional sites with a consensus sequence ACGATA. This study defines for the first time for an insect gut-specific enhancer, specific sequences that interact with nuclear factors.


Acute demyelination mimicking vascular hemicrania.
A 29-year-old woman presented with acute hemicrania, trigeminal neuropathy and posterior fossa dysfunction. The admission differential diagnosis included vertebral artery dissection, posterior circulation aneurysm, vascular malformation and brainstem infarction. However, radiographic and CSF studies indicated demyelination. Acute demyelination should be in the differential diagnosis of vascular hemicrania with signs of posterior fossa dysfunction.


Two isolated cases with symmetrically absent hands and feet.
We describe two unrelated boys with similar bilateral terminal transverse defects of the upper and lower limbs without other anomalies. Review of the literature did not reveal another report of this distinctive type of malformation.


Thymocytes stimulate metabolism of arachidonic acid in rat thymic epithelial cells.
Arachidonic acid metabolites play an important role in the development of T cells in the thymus. In the normal animal, prostaglandin levels in the thymus are significantly higher than in plasma. Herein, we have studied the regulation of arachidonic acid metabolism using the thymic endocrine epithelial cell line, TEA3A1, and thymocytes. We have found that TEA3A1 cells, but not thymocytes, produced prostaglandins and thromboxanes. We have also found that thymocytes could stimulate the production of arachidonic acid metabolites in TEA3A1 cells when both cells were cocultured. The strongest stimulation was observed when TEA3A1 cells were cocultured with thymocyte subpopulations either negative for OX8 or W3/25 functional surface markers (either double-negative or single-positive thymocytes). Furthermore, cell-cell contact seems to be absolutely required for the activation of arachidonic acid metabolism in TEA3A1 cells. The study presented here describes the existence of a novel regulatory mechanism of arachidonic acid metabolism which may play an important role in the development of T cells in the thymus.


Prevalence and Correlates of Intimate Partner Violence Experience Among Partners of Naval Personnel in Lagos, Nigeria.
Military personnel are one of the high risk groups recognized as perpetrators of intimate partner violence (IPV). Little is known about IPV experience of partners of naval personnel. This study determined the prevalence and correlates of IPV experience among partners of naval personnel. A cross-sectional survey of 435 male and female partners of naval personnel selected using the multistage sampling technique from the Navy Barracks in Lagos, Nigeria was conducted. Data were collected using a 40 item interviewer-administered questionnaire between August and September 2017. Univariate, bivariate and multivariate analysis was done to identify the predictors of partners' experience of IPV. Analysis was done at p-value ≤0.05. The mean age of the respondents was 32.7 ± 7.86yrs and 72% were females. The lifetime prevalence of any IPV experience was 40.7% (with 74.4% of this experienced by females, CI: 0.81-1.91). The prevalence of controlling behaviour, psychological, sexual, economic and physical IPV were 31.5%, 16.3% 12.4%, 12.0% and 8.5% respectively. There was a positive association between experience of IPV and respondents' occupational status (p < 0.0001), lifetime experience of physical (p < 0.0001), sexual abuse (<0.0001), and history of childhood abuse (p < 0.0001). After adjustment for confounders, age (AOR = 2.11, CI = 1.07-4.16), occupational status (AOR = 4.56, CI = 2.30-9.02), history of childhood abuse (AOR = 2.10, CI = 1.26-3.49,) and partners' alcohol use (AOR = 3.41, CI = 1.38-8.39) remained significant factors influencing experience of IPV. The prevalence of IPV experience among partners of naval personnel was high. Being unemployed, experience of abuse in childhood and having a partner who consumed alcohol increased partners' vulnerability to IPV. Naval personnel would benefit from marital counseling and training on non-violence conflict resolution strategies.


Effectiveness of cervical cancer screening over cervical cancer mortality among Japanese women.
Various studies have revealed that cervical cancer (CC) screening significantly reduces both CC incidence and mortality in developed countries. Although Japan introduced a nationwide government funded annual CC screening for the women aged 30+ in 1982, the effectiveness of CC screening on CC mortality has not yet been evaluated by any prospective cohort study. Therefore, the present study evaluated the association of CC mortality with self-reported CC screening and some other factors by a nationwide cohort study. Baseline survey of the Japan Collaborative Cohort Study for the enrollment of subjects was completed during 1988-90 and followed until 2003. This study only analyzed 63,541 women, aged 30-79 years, who were free from any cancer history at enrollment. During the follow-up period, 38 CC deaths were identified. The mean age at mortality was 67.0 years, with a mortality rate of 4.2 per 100,000 person-years. Participation rate in CC screening was 46.9%. Age-adjusted Cox model indicated significantly lower CC mortality [hazard ratio (HR) = 0.30, 95% confidence interval (CI) = 0.12-0.74] due to CC screening. Protectiveness remained almost the same (HR = 0.30, 95% CI = 0.12-0.76) when adjusted for age, body mass index and number of deliveries. The results also revealed that CC screening could reduce at least 50% of CC deaths even after excluding the effect of possible self-selection bias. CC screening in Japan may reduce CC mortality significantly for women aged 30-79 years. However, further studies with more CC deaths and increased statistical power are needed to validate the findings.


Single-Cell and Spatial Transcriptomic Analysis of Human Skin Delineates Intercellular Communication and Pathogenic Cells.
Epidermal homeostasis is governed by a balance between keratinocyte proliferation and differentiation with contributions from cell-cell interactions, but conserved or divergent mechanisms governing this equilibrium across species and how an imbalance contributes to skin disease are largely undefined. To address these questions, human skin single-cell RNA sequencing and spatial transcriptomics data were integrated and compared with mouse skin data. Human skin cell-type annotation was improved using matched spatial transcriptomics data, highlighting the importance of spatial context in cell-type identity, and spatial transcriptomics refined cellular communication inference. In cross-species analyses, we identified a human spinous keratinocyte subpopulation that exhibited proliferative capacity and a heavy metal processing signature, which was absent in mouse and may account for species differences in epidermal thickness. This human subpopulation was expanded in psoriasis and zinc-deficiency dermatitis, attesting to disease relevance and suggesting a paradigm of subpopulation dysfunction as a hallmark of the disease. To assess additional potential subpopulation drivers of skin diseases, we performed cell-of-origin enrichment analysis within genodermatoses, nominating pathogenic cell subpopulations and their communication pathways, which highlighted multiple potential therapeutic targets. This integrated dataset is encompassed in a publicly available web resource to aid mechanistic and translational studies of normal and diseased skin.


Neuromuscular activation analysis of the trunk muscles during hippotherapy sessions.
Hippotherapy allows the development of affective, sensory, motor, and cognitive areas, besides providing the practitioner with several movements and stimuli necessary for therapeutic progress. However, there is a limited amount of scientific evidence regarding the suitability of the mount material, mount type, and hippotherapy session duration, as well as regarding the activation of specific muscle groups during the practice and its applicability to activities of daily living. This study aimed to study the neuromuscular activation behavior of the iliocostalis, longissimus, multifidus, and upper trapezius muscles of children during four hippotherapy session time points using a functional task. It also compared two different mount materials for riding. A total of 30 children were randomly assigned to one of three groups: Saddle Hippotherapy Group, Blanket Hippotherapy Group, and Control Group. Data were collected with an electromyograph in a functional task that comprised trunk movements to pick up an object. Assessments took place at four times during the session. There was a significant increase in the neuromuscular activation of the iliocostalis, longissimus, and multifidus muscles after a 30-min session. The trapezius muscle showed increased neuromuscular activation after only 10 min. It continued to increase (but without a statistical difference) after and 20 and 30 min. Hippotherapy promoted neuromuscular activation of the trunk muscles in children, assessed through a functional task, and was influenced by both session time and mount material. Specifically, the greater neuromuscular performance occurred when an exercise was performed using saddle and stirrup and lasted 30 min.


Pediatric Moyamoya Presenting as a Subarachnoid Hemorrhage from a Ruptured Anterior Cerebral Artery Aneurysm.
The incidence of Moyamoya disease (MMD)-associated intracranial aneurysms ranges from 3% to 14% in adult patients, whereas this complication has rarely been reported in children. We herein report the first case, to our knowledge, of an extremely rare subarachnoid hemorrhage presentation of a child with a ruptured anterior cerebral artery dissecting aneurysm secondary to a newly discovered, unilateral Moyamoya-like pathology. MMD-associated aneurysms are extremely rare in children, and hemorrhage may be the initial presentation of the disease. Prompt intervention is essential to exclude the ruptured aneurysm that is at risk of rebleeding because of persistent hemodynamic stress.


Serum markers of bone formation in parenteral nutrition patients.
Bone gamma-carboxyglutamic acid containing protein (BGP) has been utilized effectively as a serum marker of bone turnover in healthy normals and in individuals with a variety of metabolic bone disorders including postmenopausal osteoporosis and Paget's disease. The utility of this serum marker in other bone disorders, including that associated with the maintenance of patients on long-term parenteral nutrition, still requires definition. Because of our interest in this clinical syndrome and the availability of serum and of bone formation rates (BFR) measured directly from double tetracycline labeling in 11 long-term parenteral nutrition patients, we measured BGP levels in these patients and attempted to correlate this measure with BFR. Serum vitamin D metabolites, immunoreactive parathyroid hormone (PTH), and alkaline phosphatase (alk phos) were also measured. Serum BGP was only weakly and not significantly correlated (r = 0.24, p = NS) with bone formation rate for the group as a whole. However, in a subgroup of 10 patients without hyperparathyroidism, there was strong and significant correlation (r = 0.81, P less than 0.01) between BGP and BFR. There was also a strong correlation between bone formation rate and serum 1,25 dihydroxyvitamin D [1,25(OH)2D] levels (r = 0.89, P less than 0.01, n = 11). The mechanism of this association could not be established. A correlation of borderline significance was observed between bone formation rate and serum alk phos (r = 0.60, P = 0.05, n = 11). The current data suggest that additional studies may help to more fully define the utility of serum measurements in quantifying bone dynamics in parenteral nutrition patients, and that measures of vitamin D metabolites, BGP, and alk phos may prove useful.


DKK3 ameliorates neuropathic pain via inhibiting ASK-1/JNK/p-38-mediated microglia polarization and neuroinflammation.
Neuropathic pain is a common and severely disabling state that affects millions of people worldwide. Microglial activation in the spinal cord plays a critical role in the pathogenesis of neuropathic pain. However, the mechanisms underlying spinal microglial activation during neuropathic pain remain incompletely understood. Here, we investigated the role of Dickkopf (DKK) 3 and its interplay with microglial activation in the spinal cord in neuropathic pain. In this study, we investigated the effects of intrathecal injection of recombinant DKK3 (rDKK3) on mechanical allodynia and microglial activation in the spinal cord after spared nerve injury (SNI) in rats by western blot (WB), immunofluorescence (IF), quantitative polymerase chain reaction (qPCR), and enzyme-linked immunosorbent assay (ELISA). We found that SNI induced a significant decrease in the levels of DKK3, Kremen-1 and Dishevelled-1 (DVL-1) and up-regulated the expression of phosphorylated apoptosis signal-regulating kinase 1 (p-ASK1), phosphorylated c-JUN N-terminal kinase (p-JNK), phosphorylated p38 (p-p38) in the spinal cord. Moreover, our results showed that exogenous intrathecal administration of rDKK3 inhibited expression of p-ASK1, p-JNK, p-p38, promoted the transformation of microglia from M1 type to M2 type, and decreased the production of pro-inflammatory cytokines compared to the rats of SNI + Vehicle. However, these effects were reversed by intrathecal administration of Kremen-1 siRNA or Dishevelled-1 (DVL-1) siRNA. These results suggest that DKK3 ameliorates neuropathic pain via inhibiting ASK-1/JNK/p-38-mediated microglia polarization and neuroinflammation, at least partly, by the Kremen-1 and DVL-1 pathways.


Living and Dying in Malta During the Horrible Summer of 1837.
Cholera reached the Maltese Archipelago for the first time ever in June 1837. It found a poor and destitute population that was not prepared for the epidemic. Many doctors feared contagion while others believed it was contracted from bad air or miasma. The first cases of cholera in Malta broke out at a hospital for the elderly and the infirm, the Ospizio in Floriana on 9th June 1837, reached a peak in the week between 12 July to 18 July and dwindled by the end of August 1837. The epidemic saw a death toll of 4252 from 8785 registered cholera cases when the Maltese population was 120,000. Contemporary foreign residents on the islands witnessed and recorded stories of heartlessness and harshness of terrified people. This degenerative behaviour, however, did not reach the callousness of rioting and murder that were observed in other countries. Also, during this dark time, there were people who showed compassion, kindness and selfless devotion to the sick and the dying. In the chaos that reigned during that summer, the inhabitants of one small town in the north of Malta organized themselves better than the rest with good results.


Disorderly CD44 gene expression in human cancer cells can be modulated by growth conditions.
Disorderly CD44 gene expression is a well-documented characteristic feature of tumour cells from cancers arising in many different organs of the human body. Molecular pathological studies have established that the pattern of the abnormal expression can differ according to the origin and the stage of the tumour. In this investigation it has been demonstrated that in some but not all tumour cell lines, which are undeniably and irreversibly malignant when inoculated in vivo, CD44 gene expression can still be modulated. In two cell lines, the pattern of CD44v expression was found to be affected by cell-to-cell and cell-to-substrate attachment. Expression was up-regulated by cell-substrate interactions, but only until cell-to-cell contact caused subsequent down-regulation of CD44v transcription. This information provides new opportunities for detailed investigation of the mechanisms of abnormal CD44 gene regulation in cancer and for exploring stage-related changes in the expression of this complex gene.


Ultrafast interfacial charge evolution of the Type-II cadmium Sulfide/Molybdenum disulfide heterostructure for photocatalytic hydrogen production.
The interfacial charge dynamics was crucial for semiconductor heterostructure photocatalysis. Through the rational design of the heterostructure interface, heterojunction expressed variable recombination and migration dynamics for excited carriers. Herein, followed by a typical chemical bath strategy with the hexagonal cadmium sulfide (CdS) overlapped on the exfoliated molybdenum disulfide (MoS2) film, we developed a cadmium sulfide/molybdenum disulfide (CdS-MoS2) nano-heterojunction and investigated the interfacial charge dynamics for photocatalytic hydrogen evolution. Photoelectron spectroscopy detected an energetic offset between CdS and MoS2, revealing the formation of an interfacial electric field with efficient charges separation. Through transient absorption spectra, we demonstrated the type-II contact at the CdS-MoS2 interface. Driven by the electric field, the excited carriers separated and rapidly migrated to sub-band defects of CdS within the first 500 fs. The carriers-restricted defects provided catalytic active sites, endowing CdS-MoS2 a highly efficient photocatalytic capability. Consequentially, the CdS-MoS2 achieved an enhanced hydrogen evolution rate of 2.3 mmol·g-1·h-1 with significantly stronger photocurrent density. This work gave an insight to the channel of interfacial separation and migration for excited carriers, which could contribute to the interfacial engineering of advanced heterojunction photocatalysts.


Improved vessel-tissue contrast and image quality in 3D radial sampling-based 4D-MRI.
In radiation treatment planning for thoracic and abdominal tumors, 4D-MRI has shown promise in respiratory motion characterization with improved soft-tissue contrast compared to clinical standard, 4D computed tomography (4D-CT). This study aimed to further improve vessel-tissue contrast and overall image quality in 3D radial sampling-based 4D-MRI using a slab-selective (SS) excitation approach. The technique was implemented in a 3D radial sampling with self-gating-based k-space sorting sequence. The SS excitation approach was compared to a non-selective (NS) approach in six cancer patients and two healthy volunteers at 3T. Improvements in vessel-tissue contrast ratio (CR) and vessel signal-to-noise ratio (SNR) were analyzed in five of the eight subjects. Image quality was visually assessed in all subjects on a 4-point scale (0: poor; 3: excellent). Tumor (patients) and pancreas (healthy) motion trajectories were compared between the two imaging approaches. Compared with NS-4D-MRI, SS-4D-MRI significantly improved the overall vessel-tissue CR (2.60 ± 3.97 vs. 1.03 ± 1.44, P < 0.05), SNR (63.33 ± 38.45 vs. 35.74 ± 28.59, P < 0.05), and image quality score (2.6 ± 0.5 vs. 1.4 ± 0.5, P = 0.02). Motion trajectories from the two approaches exhibited strong correlation in the superior-inferior (0.96 ± 0.06), but weaker in the anterior-posterior (0.78 ± 0.24) and medial-lateral directions (0.46 ± 0.44). The proposed 4D-MRI with slab-selectively excited 3D radial sampling allows for improved blood SNR, vessel-tissue CR, and image quality.


MRI in the workup of biliary tract filling defects.
Recent advances in magnetic resonance imaging (MRI) have made imaging the biliary tract faster while providing excellent anatomic reproduction of this duct system. MRI/MR-cholangiopancreatography (MRCP) has now become the first-line imaging procedure for many biliary tract problems. This work briefly discusses the MR techniques for biliary tree imaging and reviews MRI's role in the numerous diagnoses of filling defects in the biliary tract.


Perception of urinary biomarker tests among patients referred with suspected urological malignancy.
To determine the acceptability of a non-invasive urinary biomarker test in place of conventional flexible cystoscopy for the diagnosis of bladder cancer in patients referred to a Rapid Access Haematuria Clinic (RAHC) with suspected urological malignancy. Patients attending a RAHC were recruited to a prospective observational study evaluating a novel urinary biomarker (URO17™) for the detection of bladder cancer and invited to complete a two-part structured questionnaire. Questions related to demographics, attitudes towards conventional cystoscopy and the minimal acceptable sensitivity (MAS) at which a urinary biomarker would be considered an alternative to flexible cystoscopy both before and after undergoing the procedure. A total of 250 patients completed the survey; the majority of whom were referred with visible haematuria (75.2%). One hundred seventy-one (68.4%) would be willing to accept a urinary biomarker in place of cystoscopy, with 59 (23.6%) expressing preference for the biomarker with a MAS as low as 85%. Conversely, 74 patients (29.6%) would not be willing to accept a urinary biomarker, regardless of its sensitivity. A significant number of patients reported a change in MAS after undergoing cystoscopy, with 80 (32.0%) and 16 (6.4%) increasing and decreasing the required value respectively (P = 0.001). The greatest increase was seen in the proportion of patients unwilling to accept a urinary biomarker regardless of its sensitivity, rising from 29.6% to 38.4%. Although many patients attending a RAHC would be willing to accept a urinary biomarker test in place of conventional flexible cystoscopy for the detection of bladder cancer, effective patient, public and clinician engagement will be necessary at all stages of implementation if it is to become an established component of the diagnostic pathway.


Electrochemical removal of gaseous benzene using a flow-through reactor with efficient and ultra-stable titanium suboxide/titanium-foam anode at ambient temperature.
Catalytic oxidation technology is currently considered as a feasible approach to degrade and mineralize volatile organic compounds (VOCs). However, it is still challenging to realize efficient removal of VOCs through catalytic oxidation at room temperature. In our study, a novel flow-through electrocatalytic reactor was designed, composed of porous solid-electrolyte, gas-permeable titanium sub-oxides/titanium-foam (TiSO/Ti-foam) as anode and platinum coated titanium foam (Pt/Ti-foam) as cathode. This device could oxidize nearly 100% of benzene (10 ppm) to carbon dioxide at a current density of 1.2 mA/cm2 under room temperature. More importantly, the device maintained excellent stability over 1000 h. Mechanism of benzene mineralization was discussed. Hydroxyl radicals generated on the TiSO/Ti-foam anode played a crucial role in the oxidation of benzene. This study provides a promising prototype of the electrochemical air purifier, and may find its application in domestic and industrial air pollution control.


Effects of open burning of rice straw on concentrations of atmospheric polycyclic aromatic hydrocarbons in central Taiwan.
The sizes and concentrations of 21 atmospheric polycyclic aromatic hydrocarbons (PAHs) were measured at Jhu-Shan (a rural site) and Sin-Gang (a town site) in central Taiwan in October and December 2005. Air samples were collected using semi-volatile sampling trains (PS-1 sampler) over 16 days for rice-straw burning and nonburning periods. These samples were then analyzed using a gas chromatograph with a flame-ionization detector (GC/FID). Particle-size distributions in the particulate phase show a bimode, peaking at 0.32-0.56 microm and 3.2-5.6 microm at the two sites during the nonburning period. During the burning period, peaks also appeared at 0.32-0.56 microm and 3.2-5.6 microm at Jhu-Shan, with the accumulation mode (particle size between 0.1 and 3.2 microm) accounting for approximately 74.1% of total particle mass. The peaks at 0.18-0.32 microm and 1.8-3.2 microm at Shin-Gang had an accumulation mode accounting for approximately 70.1% of total particle mass. The mass median diameter (MMD) of 3.99-4.35 microm in the particulate phase suggested that rice-straw burning generated increased numbers of coarse particles. The concentrations of total PAHs (sum of 21 gases + particles) at the Jhu-Shan site (Sin-Gang site) were 522.9 +/- 111.4 ng/ml (572.0 +/- 91.0 ng/ml) and 330.1 +/- 17.0 ng/ml (or 427.5 +/- 108.0 ng/ml) during burning and nonburning periods, respectively, accounting for a roughly 58% (or 34%) increase in the concentrations of total PAHs due to rice-straw burning. On average, low-weight PAHs (about 87.0%) represent the largest proportion of total PAHs, followed by medium-weight PAHs (7.1%), and high-weight PAHs (5.9%). Combustion-related PAHs during burning periods were 1.54-2.57 times higher than those during nonburning periods. The results of principal component analysis (PCA)/absolute principal component scores (APCS) suggest that the primary pollution sources at the two sites are similar and include vehicle exhaust, coal/wood combustion, incense burning, and incineration emissions. Open burning of rice straw was estimated to contribute approximately 5.0-33.5% to the total atmospheric PAHs at the two sites.


Apps and gaps in bipolar disorder: A systematic review on electronic monitoring for episode prediction.
Long-term clinical monitoring in bipolar disorder (BD) is an important therapeutic tool. The availability of smartphones and wearables has sparked the development of automated applications to remotely monitor patients. This systematic review focus on the current state of electronic (e-) monitoring for episode prediction in BD. We systematically reviewed the literature on e-monitoring for episode prediction in adult BD patients. The systematic review was done according to the guidelines for reporting of systematic reviews and meta-analyses (PRISMA) and was registered in PROSPERO on April 29, 2020 (CRD42020155795). We conducted a search of Web of Science, MEDLINE, EMBASE, and PsycINFO (all 2000-2020) databases. We identified and extracted data from 17 published reports on 15 relevant studies. Studies were heterogeneous and most had substantial methodological and technical limitations. Models varied widely in their performance. Published metrics were too heterogeneous to lend themselves to a meta-analysis. Four studies reported sensitivity (range: 0.21 - 0.95); and two reported specificity for prediction of mood episodes (range: 0.36 - 0.99). Two studies reported accuracy (range: 0.64 - 0.88) and four reported area under the curve (AUC; range: 0.52-0.95). Overall, models were better in predicting manic or hypomanic episodes, but their performance depended on feature type. Our conclusions are tempered by the lack of appropriate information impeding our ability to synthesize the available evidence. Given the clinical variability in BD, predicting mood episodes remains a challenging task. Emerging e-monitoring technology for episode prediction in BD requires more development before it can be adopted clinically.


Differential responses of leaf photosynthesis to insect and pathogen outbreaks: A global synthesis.
Outbreak of insects or pathogens (referred to as biotic disturbance), which is projected to continually increase in a warmer climate, may profoundly affect plant photosynthesis and production. However, the response of plant photosynthesis to biotic disturbance remains unclear, especially differences in response between insects and pathogens, which hinders the prediction of plant productivity in future climate. In this study, a meta-analysis approach was used to examine effects of insects and pathogens on photosynthetic rate per unit leaf area (Pn) and the associated characteristics from 115 studies. Our results showed that biotic disturbance significantly decreased Pn by 34.8% but increased Rd by 26.2%. Most of parameters associated with Pn were significantly reduced by biotic disturbance, including gs, Tr, photosynthetic pigments (e.g., a+b, a, and b), and chlorophyll fluorescence properties (Fv/Fm, qp). The disturbance type (insects vs pathogens) was the most important factor affecting the response of Pn, with a greater decrease in Pn by pathogens (-37.5%) than insects (-28.0%). The response ratio of Pn was positively correlated with that of gs and Tr for both insects and pathogens, while negatively with Ci and positively with Chl a+b, ΦPSII, and qp for only pathogens. In addition, the higher sensitivity of Pn to biotic disturbance in crop than non-crop plants poses a great challenge to agricultural system in the future. The weighted response ratio of Pn and relationships of Pn with other associated paramerters under insect and pathogen disturbance will facilitate vegetation models to integrate the effects of biotic disturbance on primary production, improving predicition of the ecosystem carbon cyling in combining with leaf area measurement.


Structure of cellulose in birch phloem fibres in tension wood: an X-ray nanodiffraction study.
To gain a better understanding of bark layer structure and function, especially of the phloem fibres and their contribution to the posture control of trees, it is important to map the structural properties of these cells. The role of bark can also be linked to the reaction wood formation and properties which are essential when it comes to studying the questions related to tree growth. To offer new insights into the role of bark in the postural control of trees, we studied the micro- and nanoscale structures of the phloem and its nearest layers. This study is the first time, in which phloem fibres in trees have been extensively examined using X-ray diffraction (XRD). We determined the orientation of cellulose microfibrils in phloem fibres of Silver birch saplings by using scanning synchrotron nanodiffraction. The samples consisted of phloem fibres extracted from tension, opposite and normal wood (TW, OW, NW). Using scanning XRD, we were able to obtain new information about the mean microfibril angle (MFA) in cellulose microfibrils in phloem fibres connected to reaction wood. A slight but consistent difference was detected in the average MFA values of phloem fibres between the TW and OW sides of the stem. Using scanning XRD, different contrast agents (intensity of the main cellulose reflection or calcium oxalate reflection, mean MFA value) were used to produce 2D images with 200 nm spatial resolution. Based on our results, the tension wood formation in the stem might be related to the structure and properties of phloem fibres. Thus, our results suggest that the nanostructure of phloem fibres is involved in the postural control of trees containing tension and opposite wood.


Lymphotoxin-β receptor in microenvironmental cells promotes the development of T-cell acute lymphoblastic leukaemia with cortical/mature immunophenotype.
Lymphotoxin-mediated activation of the lymphotoxin-β receptor (LTβR; LTBR) has been implicated in cancer, but its role in T-cell acute lymphoblastic leukaemia (T-ALL) has remained elusive. Here we show that the genes encoding lymphotoxin (LT)-α and LTβ (LTA, LTB) are expressed in T-ALL patient samples, mostly of the TAL/LMO molecular subtype, and in the TEL-JAK2 transgenic mouse model of cortical/mature T-ALL (Lta, Ltb). In these mice, expression of Lta and Ltb is elevated in early stage T-ALL. Surface LTα1 β2 protein is expressed in primary mouse T-ALL cells, but only in the absence of microenvironmental LTβR interaction. Indeed, surface LT expression is suppressed in leukaemic cells contacting Ltbr-expressing but not Ltbr-deficient stromal cells, both in vitro and in vivo, thus indicating that dynamic surface LT expression in leukaemic cells depends on interaction with its receptor. Supporting the notion that LT signalling plays a role in T-ALL, inactivation of Ltbr results in a significant delay in TEL-JAK2-induced leukaemia onset. Moreover, young asymptomatic TEL-JAK2;Ltbr(-/-) mice present markedly less leukaemic thymocytes than age-matched TEL-JAK2;Ltbr(+/+) mice and interference with LTβR function at this early stage delayed T-ALL development. We conclude that LT expression by T-ALL cells activates LTβR signalling in thymic stromal cells, thus promoting leukaemogenesis.


Comment on "No consistent ENSO response to volcanic forcing over the last millennium".
Dee et al (Reports, 27 March 2020, p. 1477) claimed that large volcanic eruptions do not produce a detectable El Niño response. However, they come to the wrong conclusion because they have ignored the fundamental climate response to large volcanic eruptions: Volcanic eruptions cool the surface, thus masking the relative El Niño warming.


Mutational Analysis of Prostate-Specific Antigen Defines the Intrinsic Proteolytic Activity of the proPSA Zymogen.
Prostate-specific antigen (PSA) is an important prostate cancer biomarker. It is also a protease expressed at high concentrations by the normal and malignant prostate. PSA is secreted as a zymogen (proPSA) with an inhibitory prodomain that must be removed for full activity. ProPSA variants, assumed to be inactive, are found in the blood of prostate cancer patients, and are indicative of poor clinical outcome. Despite the abundance of clinical reports, our understanding of PSA's enzymology is limited, in part due to a lack of appropriate experimental systems. We sought to develop a series of PSA-derived mutants that would help to enhance our understanding of the gene. Sixteen rPSA variants were generated and characterized by a variety of biochemical methods. The wildtype cDNA (WT) provided the template for generating a panel of recombinants. These included variants that abolished removal of the prodomain (R24A), disabled its enzymatic activity (S213A), and/or facilitated a cell-based conversion to the active conformation (FR). The purified variants' proteolytic activity was examined using a fluorogenic substrate, known PSA-cleavable proteins, and physiologically relevant inhibitors. Upon demonstrating our successful generation and purification of the PSA variants, we characterized proPSA activity, describing cleavage of synthetic and biologic substrates, but not serum protease inhibitors. This finding was exploited in the development of a self-activating mutant (PSA_QY) that exhibited the greatest enzymatic activity of all the variants. The system described herein will prove useful for varied applications. ProPSA is partially functional with relatively high activity compared to the mature enzyme. In demonstrating the zymogen's intrinsic activity, we suggest that the proPSA in prostate cancer patient serum is not inert. This may have implications for our understanding of the disease. Prostate 76:1203-1217, 2016. © 2016 Wiley Periodicals, Inc.


Orofacial presentations of sarcoidosis--a case series and review of the literature.
Sarcoidosis is a multi-system disease of unknown aetiology characterised by the presence of non-caseating granulomas, the lungs and lymph nodes being the most affected sites. Orofacial manifestations of the condition are increasingly recognised, with several recent case reports where the initial presentation of the disease is in the region. Here, we report six cases of orofacial sarcoidosis which help to illustrate the wide spectrum of the condition.


[Geriatric multimorbidity in claims data - part 2 : diagnoses of hospitals and diagnoses from physicians in the ambulatory setting].
Due to demographics, characteristic multimorbidity in geriatric patients is resulting in increased social, medical, and healthcare challenges. Geriatric multimorbidity (GM) can be defined as the simultaneous occurrence of at least two diseases that require medical care with an interdisciplinary focus on independence in activities of daily living. Typical conditions of GM are, e.g., incontinence, cognitive impairment, frailty, and decubitus. Part 2 of this study is based on claims data of 240,502 AOK insurants (AOK is one of the major health insurance companies of the German statutory health insurance system) aged ≥ 60 years with at least one admission to a hospital with a geriatric ward. Geriatric conditions (GCs) were ascertained in two ways: diagnoses from physicians in the ambulant care setting and diagnoses in a hospital setting in 2008. A total of 15 GC were assessed using diagnoses based on ICD-10 codes (as per suggestion from scientific geriatric societies). An insurant was defined as a person with GM, if he/she had at least two GCs. The proportion of GCs in ambulant or inpatient diagnoses of 240,502 insurants varied significantly in most cases. For specific GCs, considerably higher proportions of ambulant diagnoses (e.g., pain, impairment of vision, or hearing) or for inpatient diagnoses (e.g., electrolyte or fluid metabolism disorders, malnutrition, incontinence) were identified. Only on rare occasions were small differences observed comparing the proportions of specific GCs in the diagnoses of the two different care sectors. This finding reduces considerably the accordance between the two care sectors with reference to the presence or absence of a GC for ambulant or inpatient diagnoses. The main agreement was with the non-coding of specific GCs, not with ambulant or inpatient diagnoses. Insurants with a geriatric hospital admission or certain care level (level ≥ 1) generally had higher proportions for specific GCs for inpatient and ambulant diagnoses than non-geriatric treated insurants or insurants without a certain care level. Of the geriatric treated insurants and those with certain care levels, 90% were characterized by the presence of GM for both ambulant or inpatient diagnoses. This percentage is remarkably higher than for patients who featured no geriatric treatment or had no certain care level. The inclusion of ambulant diagnoses in addition to inpatient diagnosis offers comprehensive possibilities to identify insurants with GM in claims data. The contribution of the diagnoses of both care sectors for the identification of GC and GM varies with regard to attribute and insurant orientation. Furthermore, significant attribute-oriented overlap of insurants claiming geriatric treatments and insurants with certain care levels became visible, which can open new possibilities for simpler identification of a portion of patients with GM.


The Rise of Dementia With Lewy Bodies: Nursing Interventions and Implications.
Age and dementia with Lewy bodies (DLB) are highly associated. As the elderly population in the United States increases, so will the incidence of DLB. Nurses increasingly can expect to care for this population. This article will examine and explain the current literature describing the state of DLB as well as best practices for nursing care of physical, psychosocial, and educational needs of DLB patients, families, and caregivers. CINAHL Complete and Google Scholar were used to search for relevant literature within the last 6 years. The following keywords were used alone or in combination: "Lewy," "Lewy body," "dementia," "aging," "caregiver," "support," and "nursing." Eighty articles were reviewed and 26 were chosen, along with 1 government website, for this review article. Dementia with Lewy bodies is defined, and the presentation is described. Behavioral and psychological, motor, autonomic, and cognitive symptoms most common and those considered to be hallmarks are explained. Diagnosis and both pharmacologic and nonpharmacologic treatments, along with nursing implications and interventions, are provided. Early recognition of signs and symptoms of DLB helps to provide timely diagnosis and appropriate treatment. The importance of knowledge acquisition for nurses to better care for DLB patients and their families is addressed throughout the article.


Prevalence in digital panoramic radiographs of carotid area calcification among Iraqi individuals with stroke-related disease.
The purpose of this study was to determine the prevalence of carotid calcification on digital dental panoramic tomography in a group of the Iraqi population who have some stroke-related vascular and or metabolic disease. Digital dental panoramic tomographic images of 157 adult patients of age range 40-80 years having chronic illnesses such as coronary heart diseases, hypertension, type 2 diabetes, and hyperlipidemia and of 43 control subjects (age range 40-71 years, free of systemic diseases) were made and examined for the presence of carotid artery calcification adjacent or just below the intervertebral space between C3, C4, and C5 on both sides of patient's neck. The study group was subclassified into vascular, metabolic, and vascular-metabolic groups. Determinations were made of the prevalence, number, and distribution of carotid area calcifications. Forward stepwise logistic regression analysis was used to determine which risk factor is more liable to develop carotid artery area calcification. The statistical difference between patients with stroke-related diseases (vascular, metabolic, and vascular-metabolic groups) versus patients in the control group was highly significant concerning the prevalence of carotid area calcifications (P < .01). Carotid area calcification was identified in 38.8% of the study group. Bilateral calcifications were observed more than unilateral calcification for both genders (26.6% vs. 13.9% for men; 24.4% vs. 12.8% for women). People with stroke-related vascular and/or metabolic diseases have greater prevalence of calcified area calcifications seen on panoramic radiographs than people who are otherwise healthy.


Isozyme specificity of testosterone 7 alpha-hydroxylation in rat hepatic microsomes: is cytochrome P-450a the sole catalyst?
In the present study we show that monospecific antibody against cytochrome P-450a completely inhibits testosterone 7 alpha-hydroxylation in hepatic microsomes of untreated male or female rats or rats of either sex treated with dexamethasone. These data are in contrast with those of K. Nagata et al. (1987, J. Biol. Chem. 262, 2787-2793) who recently reported that an antibody prepared against cytochrome P-450a completely inhibited testosterone 7 alpha-hydroxylase activity in microsomes from untreated or 3-methylcholanthrene-treated rats but only inhibited 50% of the activity in microsomes from dexamethasone-treated rats. They proposed that dexamethasone treatment of rats induced another testosterone 7 alpha-hydroxylase in rat liver. The discrepancy in the two sets of data was due, at least in part, to the use of a chromatography system by Nagata et al. that is incapable of resolving a number of testosterone metabolites. Dexamethasone treatment of rats leads to a marked increase in the production of several testosterone metabolites, including 15 beta-hydroxytestosterone which is cochromatographic with 7 alpha-hydroxytestosterone in their chromatography system. Our results indicate that cytochrome P-450a accounts for all of the testosterone 7 alpha-hydroxylase activity in microsomes from dexamethasone-treated rats, and that testosterone 7 alpha-hydroxylation continues to be a useful marker for monitoring cytochrome P-450a in rat hepatic microsomes.


The enteric nervous system in tissue culture. III. Studies on neuronal survival and the retention of biochemical and morphological differentiation.
The maintenance of differentiated properties and survival rates of enteric neurons, grown in explant cultures for periods of up to 3 weeks, was studied. Using catecholamine fluorescence, immunohistochemistry and autoradiography, it was found that adrenergic neurons, VIP-containing neurons and putative GABAergic neurons, which constitute small subpopulations of guinea pig myenteric neurons in vivo, were all represented in plexus explants after maintenance in culture for 2-3 weeks. The pattern of expression of the transmitter-related enzymes, acetylcholinesterase and monoamine oxidase, paralleled that found in in situ studies. Investigation of neuronal structure by intracellular injection of horseradish peroxidase revealed that the cultured neurons continue to express the wide diversity in gross morphology which characterizes these cells in vivo. Employing autoradiography following uptake of [3H]GABA to label putative GABAergic neurons, their survival rate from days 1 to 15 of culturing was determined. No neuronal death was detected between days 1 and 5, while the number of neurons decreased between days 5 and 15. These observations suggest that enteric neurons maintained in explant cultures survive well and maintain to a high degree their histochemical and morphological properties.


The origin of ferroelectricity in magnetoelectric YMnO3.
Understanding the ferroelectrocity in magnetic ferroelectric oxides is of both fundamental and technological importance. Here, we identify the nature of the ferroelectric phase transition in the hexagonal manganite, YMnO(3), using a combination of single-crystal X-ray diffraction, thorough structure analysis and first-principles density-functional calculations. The ferroelectric phase is characterized by a buckling of the layered MnO(5) polyhedra, accompanied by displacements of the Y ions, which lead to a net electric polarization. Our calculations show that the mechanism is driven entirely by electrostatic and size effects, rather than the usual changes in chemical bonding associated with ferroelectric phase transitions in perovskite oxides. As a result, the usual indicators of structural instability, such as anomalies in Born effective charges on the active ions, do not hold. In contrast to the chemically stabilized ferroelectrics, this mechanism for ferroelectricity permits the coexistence of magnetism and ferroelectricity, and so suggests an avenue for designing novel magnetic ferroelectrics.


Abbreviated MR Imaging for Breast Cancer.
Breast MR imaging is the most sensitive imaging method for the detection of breast cancer and detects more aggressive malignancies than mammography and ultrasound examination. Despite these advantages, breast MR imaging has low use rates for breast cancer screening. Abbreviated breast MR imaging, in which a limited number of breast imaging sequences are obtained, has been proposed as a way to solve cost and patient tolerance issues while preserving the high cancer detection rate of breast MR imaging. This review discusses abbreviated breast MR imaging, including protocols, multicenter clinical trial results, clinical workflow implementation challenges, and future directions.


Cholesterol ester hydrolase in human red blood cells.
1. Cholesterol ester hydrolytic activity (sterol-ester hydrolase EC 18.104.22.168) was detected in human red blood cells. Enzyme activity appeared confined to the cell membrane and was most marked in washed preparations of red cell ghosts. 2. Hydrolytic activity was stimulated by the anti-oxidants D-alpha-tocopherol and butylated hydroxytoluene. Marked inhibition was produced by erythrocyte hemolysate, sodium taurocholate, and Triton X-100. 3. Optimal pH for the reaction was 5.4--5.7. 4. Because red cell cholesterol is all unesterified, it is speculated that the hydrolase serves to maintain the erythrocyte membrane free of esterified cholesterol.


Incidence and Outcomes of Delayed Targeted Therapy After Cytoreductive Nephrectomy for Metastatic Renal-Cell Carcinoma: A Nationwide Cancer Registry Study.
The optimal timing of targeted therapy (TT) initiation for metastatic renal-cell carcinoma (mRCC) is not clear. We used a nationwide cancer registry to determine clinical and social factors associated with delayed TT and to evaluate the association of a delayed approach with overall survival (OS). We performed a retrospective observational study utilizing the National Cancer Data Base from 2006 to 2012 for patients diagnosed with mRCC (clear-cell histology) treated with cytoreductive nephrectomy and TT. Time to initiation of TT was defined as early (within 2 months), moderately delayed (2-4 months), delayed (4-6 months), and late (> 6 months). Of the 2716 patients included in the analysis, the median (interquartile range) time from diagnosis to initiation of TT was 2.1 (1.3-3.23) months. A total of 1255 patients (46.2%) had early TT, 1072 patients (39.5%) had moderately delayed TT, 284 patients (10.5%) had delayed TT, and 105 patients (3.9%) had late TT. Delay in TT initiation was not independently associated with OS in multivariable analysis. The time interval from diagnosis to TT initiation was not correlated with time from initiation of TT to death (r = 0.04, P = .08). We found that delayed initiation of TT was not an independent predictor of worse OS. Although this study is subject to limitations of observation study design and selection bias, the results are consistent with the notion that in carefully selected patients, outcomes might not be compromised with initial observation.


A small-area index of socioeconomic deprivation to capture health inequalities in France.
In the absence of individual data, ecological or contextual measures of socioeconomic level are frequently used to describe social inequalities in health. This work focuses on the methodological aspects of the development and validation of a French small-area index of socioeconomic deprivation and its application to the evaluation of the socioeconomic differentials in health outcomes. This index was derived from a principal component analysis of 1999 national census data from the Strasbourg metropolitan area in eastern France, at the census block level. Composed of 19 variables that reflect the multiple aspects of socioeconomic status (income, employment, housing, family and household, and educational level), it can discriminate disadvantaged urban centres from more privileged rural and suburban areas. Several statistical tests (Cronbach's alpha coefficient, convergent validity tests with other deprivation indices from the literature) provided internal and external validation. Its successful application to another French metropolitan area (Lille, in northern France) confirmed its transposability. Finally, its capacity to capture the social inequalities in health when applied to myocardial infarction data shows its potential value. This study thus provides a new tool in French public health research for characterising neighbourhood deprivation and detecting socioeconomic disparities in the distribution of health outcomes at the small-area level.


Effects of malnutrition on the acute phase response of plasma proteins in patients undergoing total gastrectomy.
The serum level of six acute phase proteins (APP) has been evaluated preoperatively and for a few days in the postoperative period. Thirty patients undergoing total gastrectomy for gastric cancer have been studied in two subgroups according to their nutritional status. Those with gastric cancer had significantly higher baseline serum levels of alpha 1 acid glycoprotein (alpha1AGP) and C-reactive protein (CRP) than a control group. Malnourished patients also had reduced acute phase response for alpha1AGP and alpha 1 antitrypsin (alpha1AT) a higher increase of CRP and fibrinogen, and a lower decrease for transferrin and retinol binding protein (RBP).


Copper-Catalyzed Electrophilic Cyclization of N-Propargylamines with Sodium Sulfinate for the Synthesis of 3-Sulfonated Quinolines.
A convenient and effective protocol for the synthesis of 3-sulfonated quinolines via copper-catalyzed electrophilic cyclization of N-propargylamines has been developed, in which cheap and stable sodium sulfinates were utilized as green sulfonylation reagents. This cascade transformation involves radical addition, cyclization and dehydrogenative aromatization processes in a one-pot reaction under mild conditions.


Use of recombinant human erythropoietin and risk of severe retinopathy in extremely low-birth-weight infants.
To evaluate the frequency and severity of retinopathy of prematurity in extremely low-birth-weight (ELBW) infants who received recombinant human erythropoietin (rHuEPO), and to compare the frequency of blood cell transfusions these infants required with a matched control group who did not receive rHuEPO. Retrospective cohort analysis. Level III neonatal intensive care unit in a large academic medical center. One hundred thirty-eight ELBW infants who received rHuEPO and 138 ELBW infants who did not (control group) but who were matched by birth weight, gestational age, sex, and year of birth and who survived to the first ophthalmologic examination. The rHuEPO was started before the 8th day of life in 115 (83%) of the 138 infants. Stages III-V retinopathy of prematurity occurred with similar frequency in both groups of infants (rHuEPO group 19% [26 infants] vs control group 20% [27 infants], p>0.05). Infants in the rHuEPO group received fewer transfusions on average during their hospitalization compared with those in the control group (4.2 vs 6.1 transfusions, p<0.01). Use of rHuEPO for prevention or treatment of anemia of prematurity in ELBW infants does not increase the frequency of severe retinopathy of prematurity and reduces the number of transfusions.


Adult-onset cerebral folate deficiency.
To report new manifestations of cerebral folate deficiency, a rare metabolic autoimmune syndrome,in an adult. Case report. University teaching hospital. A 58-year-old woman with progressive memory loss and myoclonus presented for medical attention. Results of cerebral spinal fluid analysis showed low levels of tetrahydrobiopterin and 5-methyltetrahydrofolate. The patient's serum folate level was normal. Serum contained folate receptor 1 blocking and binding antibodies. The patient was treated successfully with folinic acid supplementation, and after 6 months of treatment,clinical symptoms had resolved. To our knowledge, we report the first case of adult-onset cerebral folate deficiency. Furthermore, this condition could represent a treatable form of early-onset dementia.


Outcome of prenatally diagnosed fetal hydronephrosis.
To demonstrate the postnatal investigation, treatment and outcome of infants with hydronephrosis prenatally diagnosed by ultrasound between 1994 and 1996. In a two-year period we studied 20 infants who presented with hydronephrosis diagnosed by prenatal ultrasound and confirmed by postnatal ultrasound. Unilateral hydronephrosis was diagnosed in 17 infants and bilateral hydronephrosis in 3. An anteroposterior renal pelvic diameter > 7 mm after 33 weeks of pregnancy was used to predict abnormal outcomes. In the postnatal follow-up period, the infants were followed with sequential ultrasound and urinalysis. 99mTc-diethylene triamine pentaacetic acid scan, intravenous pyelography and voiding cystourethrography were performed in selected cases. Pyeloplasty was performed only if there was evidence of renal compromise. A male predilection was found. The left kidney was more commonly involved. Ultrasonic follow-up of the 20 infants showed that hydronephrosis resolved in 9, who were all in the unilateral hydronephrosis group. The range of fetal renal pelves on prenatal ultrasound was 7-15 mm in the resolution group. Pyeloplasty was performed in three unilateral hydronephrosis infants. Follow-up ranged from 36 to 72 months. When the fetal renal pelvis was < 15 mm on prenatal ultrasound, it never progressed. Prenatally diagnosed hydronephrosis may be safely observed, and surgical correction should be performed only if renal compromise occurs.


pH-balanced tampons: do they effectively control vaginal pH?
To determine if tampons lubricated with pH-balanced gel are effective at maintaining normal vaginal pH. Randomised controlled trial. Urban family planning clinic and teaching hospital. Healthy volunteers using the combined oral contraceptive pill. Women were randomised to use an existing lubricating gel (pH 5.1) or a lactic acid-buffered gel (pH 3.8-4.2) with regular size, non-applicator tampons. In the preceding control cycle, women used identical tampons without gel. Vaginal pH < or = 4.5, microbiology (candida and bacterial vaginosis [BV]) and colposcopic appearance within 72 hours of tampon use, subject acceptability and symptoms. Eighty-one out of 98 (83%) women completed the study. No significant difference was observed between tampons with the standard gel formulation, the pH-balanced gel and nonlubricated tampons in terms of vaginal pH, microbiological evidence of candida or BV, or colposcopic appearance. Acceptability scores were significantly higher for lubricated tampons compared with nonlubricated tampons (P < 0.05), although there was no difference in reported symptoms. Tampons lubricated with pH-balanced gel do not control vaginal pH. There was no evidence of measurable health benefits of lubricated tampons, but women preferred tampons with [corrected] lubrication.


Ventilatory effects accompanying spontaneous movement in the suckling opossum.
To determine whether spontaneous movement was associated with an organized respiratory response during early stages of mammalian development, we studied immature suckling opossums (Didelphis virginiana) between 30 and 60 days of age. Rate and depth of breathing were measured using pressure plethysmography and movement was assessed using electromyography of neck muscles. During air-breathing as well as during ventilatory chemostimulation with hypoxic, hypercapnic, and asphyxiant test gases, the onset of spontaneous movement was often marked by an increase in minute-ventilation, dominated by an increase in breathing frequency. In the absence of respiratory irregularities, ventilation and breathing frequency remained elevated throughout an episode of movement. After decerebration at the midcollicular level, the onset of spontaneous movement was accompanied by respiratory effects similar to those found in the intact preparation. The ventilation response with spontaneous movement contrasted to results during venilatory chemostimulation at rest, where increases in breathing resulted primarily from increases in tidal volume. It is concluded that a hyperpnea with spontaneous movement is present in the suckling opossum, and that the effect is primarily organized in the lower brainstem.


[Bleeding origin, patient-related risk factors, and prognostic indicators in patients with acute gastrointestinal hemorrhages requiring intensive care treatment. A retrospective analysis from 1999 to 2010].
Gastrointestinal bleeding (GIB) is a common problem in elderly patients involving severe comorbidities and concomitant antiplatelet or anticoagulatory therapy. The risk factors and prognostic indicators of patients with severe GIB requiring intensive care medical treatment have not been well evaluated. A retrospective analysis of 7,376 patients from the medical intensive care unit (ICU) at the University Hospital Aachen was carried out between 1999 and 2010. Of 614 patients admitted to the ICU because of acute GIB, 463 (75%) presented with upper GIB (UGIB) and 151 (25%) with lower GIB (LGIB). Despite early endoscopic intervention and ICU treatment, UGIB had a mortality rate of 16%, whereas LGIB showed a significantly better prognosis (mortality <5%) in the ICU setting. Risk factors for OGIB-related mortality were hemodynamic instability, organ failure, comorbidities (especially liver cirrhosis), and rebleeding. In total, 218 patients (36%) were treated with antiplatelet or anticoagulatory drugs, which were associated with a favorable prognosis in the UGIB group. Elevated serum lactate levels upon admission were superior in predicting mortality than established indicators of prognosis such as the Rockall or the Glasgow-Blatchford score. Despite successful endoscopic intervention, severe acute UGIB is associated with a significant mortality rate of 16% in the ICU setting, determined by hemodynamic failure, organ dysfunction, and comorbidities. The serum lactate levels of patients with GIB on the day of admission to the ICU are prognostic.


Midterm ultrasound biomicroscopy findings in eyes with successful viscocanalostomy.
To show tissue changes using ultrasound biomicroscopy (UBM) in eyes with controlled intraocular pressure (IOP) after viscocanalostomy. Consultores Oftalmológicos, Fundación Oftalmológica Argentina Jorge Malbran and Hospital Santa Lucía, Buenos Aires, Argentina. This retrospective noncomparative case series comprised 23 eyes of 19 patients with uncontrolled open-angle glaucoma who had viscocanalostomy and UBM and a mean follow-up of 20 months +/- 5.9 (SD) (range 12 to 30 months). The UBM measurements were taken a mean of 6.8 +/- 5.9 months (range 3 to 14 months) after the viscocanalostomy. In 7 eyes, UBM was again performed a mean of 7.8 +/- 4.6 months (range 7 to 9 months) after the first study. All patients had preoperative and postoperative IOP measurements. The mean IOP at last examination was 13.3 +/- 2 mm Hg (range 8 to 17 mm Hg). One eye had evidence of a subconjunctival bleb. All eyes had a nonreflective scleral chamber and posterior to it, a hyporeflective zone. In 7 eyes in which 2 UBMs were performed, the scleral chamber was unchanged 7 to 9 months after the first study. The presence of a scleral chamber and absence of a subconjunctival filtering bleb are the usual UBM findings in eyes with adequate control of IOP several months after viscocanalostomy. These findings suggest that viscocanalostomy is successful when a continuous aqueous flow through the trabeculo-Descemet's membrane is present, maintaining a scleral chamber.


Dorsal acoustic windows may ameliorate liver ultrasound in patients with chronic liver disease and meteorism/obesity/ascites.
To identify dorsal acoustic windows (DAWs) for the study of the liver and to investigate whether they could improve the visualization of the liver in patients with chronic liver disease and ascites, meteorism, and/or obesity. The study was based on a single ultrasound examination and divided into three successive stages. Firstly, we performed a preliminary study involving 10 cirrhotic patients to identify new DAWs. Inter-observer reproducibility of measurements obtained through the DAWs was then assessed in another 29 cirrhotic patients. Finally, in 50 patients with chronic hepatitis/cirrhosis, we employed the DAWs when ascites, meteorism or obesity hampered the conventional ultrasound examination. With patients sitting, we found three new DAWs, by the combined use of which it was possible to explore the liver, spleen, and their vascular structures, and which provided reproducible measurements. In the clinical setting, we found 11 of 50 patients in whom the addition of the new DAWs led to better results in terms of successful visualization/Doppler measurements for portal vein (ratio = 100 % vs 27 %, p = 0.001), hepatic artery (ratio = 90 % vs 27 %, p = 0.004), and hepatic veins (mean number = 2.4 ± 0.2 vs 1.0 ± 0.2, p = 0.01). Among these 11 patients, in one case the addition of DAWs led to visualization of hepatic focal lesions in the right lobe, not previously displayed through conventional ultrasound. These DAWs may be an additional tool that improves the accuracy of ultrasound examinations in patients with meteorism, ascites, or obesity.


Open and Closed Rhinoplasty.
Most surgeons recognize the broad utility of both endonasal and external rhinoplasty approaches. Most understand that there are situations when a given approach offers advantages and may be considered preferable. In this article, the anatomy, incisions, and approaches that are available to the surgeon are reviewed. General indications are discussed for the external and endonasal approaches. The pros and cons of each approach are discussed, and further thoughts on the decision-making process are provided.


A protocol for determination of anticardiolipin antibodies by ELISA.
The anticardiolipin (aCL) test has been widely used by physicians since the mid-1980s for diagnosing patients with antiphospholipid syndrome (APS). Establishment of this diagnosis has enabled effective management of patients with recurrent thrombosis or recurrent pregnancy losses. The test was first established in 1983 as a radioimmunoassay and soon thereafter converted into ELISA. There have been numerous efforts to standardize the aCL test, but precise reproducible measurement of aCL levels is difficult and the use of semiquantitative measurements (high, medium and low) is recommended as this is probably sufficient for clinical diagnosis. Using validated ELISAs for measuring aCL Abs offers greater reproducibility, would reduce interlaboratory variations and limit discrepancies in results between different laboratories. This article details a procedure that takes approximately 2 h and summarizes the information available on the aCL ELISA test.


Antimüllerian hormone, antral follicle count and ovarian volume predict menstrual cycle length in healthy women.
Although menstrual cycle length is one of the main concerns of women and may have important health consequences, little is known about its predictors. The aim of this study was to identify predictors of menstrual cycle length variability in healthy women. Prospective cross-sectional study. Two hundred healthy women aged 21-45. A questionnaire was administered to determine lifestyle factors. Ovarian parameters, metabolic parameters, pituitary hormones, sex steroids and antimüllerian hormone (AMH) were measured. Women with long (≥35 days) and normal (25-34 days) menstrual cycles had >5-fold and >2-fold higher serum AMH levels, respectively, compared to those with short cycles (<25 days). Menstrual cycle length was associated with age but not lifestyle factors. Only one factor group (AMH, antral follicle count [AFC], ovarian volume, testosterone and LH) was significantly associated with menstrual cycle length. Within this factor group, only the ovarian parameters (AMH, AFC, ovarian volume) predicted menstrual cycle length. Each SD increase in AMH (32·9 pmol/l) and ovarian volume (2·29 cm(3) ) was associated with 2·80-fold (95% CI: 1·67-4·69) and 1·62-fold (95% CI: 1·08-2·43) increased risks, respectively, for longer menstrual cycles. AMH, AFC and ovarian volume are positively associated with menstrual cycle length in healthy women. Our identification of AMH as an independent predictor of menstrual cycle length puts forth a new notion of utilizing menstrual cycle length to predict possible AMH-dependent/-associated outcomes. In addition, this novel relationship may facilitate the interpretation of AMH levels and its clinico-pathological significance across different centres.


Loss of Penumbra by Impaired Oxygen Supply? Decreasing Hemoglobin Levels Predict Infarct Growth after Acute Ischemic Stroke: Stroke: Relevant Impact of Hemoglobin, Hematocrit and Transfusion (STRAIGHT) - An Observational Study.
The association of mortality and poor outcome with reduced levels of hemoglobin (Hb) and hematocrit (Hct) in patients admitted for ischemic stroke was recently demonstrated. The mechanisms behind this have remained unclear. Here, we aimed to investigate a putative association between low Hb and Hct levels and infarct growth. All consecutive patients who received intravenous thrombolysis based on multimodal magnetic resonance imaging during the years 1998-2009 were screened. Laboratory data as well as admission magnetic resonance images and follow-up computed tomography scans of 257 patients were assessed. Overall, data of 100 patients were of sufficient quality and further analyzed. Decrease in Hb and Hct as well as perfusion-weighted imaging volume, mismatch volume, and final infarct size on follow-up computed tomography were associated with infarct growth. A linear regression model revealed Hb decrease (β = 0.23, p = 0.02) to be a predictor of infarct growth, independent of mismatch volume (β = 0.27, p = 0.004) and minimum sodium (β = -0.21, p = 0.03), and adjusted to the non-predicting variables age, National Institute of Health Stroke Scale score, maximum leucocytes and C-reactive protein, blood glucose, and Hct decrease. Hb levels that decrease after admission independently predict infarct growth in thrombolyzed stroke patients. The clinical implications of this relationship remain to be investigated.


Polarization optical investigation by topo-optical reactions of various blood platelet aggregates.
Phases I and II (early and advanced) of platelet aggregation could readily be followed and studied by various topo-optical reactions. Our studies indicate that in the early stage (monitored by an aggregometer) aggregates show no alteration in membrane structure of platelet. In the advanced stage (phase II), in addition to membrane alteration, platelets 2-3 times larger than in the control were observed. These were stained selectively in the pH 1-2 range with thiazine dyes. After hyaluronidase digestion they lost the ability to stain and became birefringent. The elucidation of this phenomenon requires further study.


Social inequalities in adolescent human papillomavirus (HPV) vaccination: a test of fundamental cause theory.
A unique contribution of the fundamental cause theory of health disparities is its ability to account for the persistence of disparities in health and mortality, despite changes in the mechanisms that are relevant at any given time. Few studies, however, have investigated how such mechanisms are created or operate. Examining the introduction of the human papillomavirus (HPV) vaccine for adolescents-a treatment aimed at preventing cervical and other cancers that typically emerge in mid- to late-adulthood-we empirically trace such a disparity-generating mechanism that is in the process of being latently created, testing whether socioeconomic status (SES) and racial/ethnic disparities exist for several facets of vaccination receipt: knowledge about the vaccine, receipt of a health professional recommendation to vaccinate, and initiation and completion of the three-shot vaccination series. Analyses of 2008, 2009, and 2010 United States National Immunization Survey-Teen data (n = 41,358) reveal disparities consistent with fundamental cause theory, particularly for vaccine knowledge and receipt of a health professional recommendation. While parental knowledge is a prerequisite to adolescent vaccine uptake, low SES and racial/ethnic minority parents have significantly lower odds of knowing about the vaccine. Receipt of a health professional's recommendation to vaccinate is strongly associated with vaccine uptake, however the odds of receiving a recommendation are negatively associated with low SES and black racial/ethnic status. Our findings inform fundamental cause theory by illustrating how disparities in distinct stages of the uptake of new treatments may contribute to reproducing existing health disparities-and, in this case of adolescent HPV vaccination, may maintain future disparities in cervical cancer among adult populations.


Crystallization of the Euplotes raikovi mating pheromone Er-1.
A protein mating pheromone Er-1 from the ciliate Euplotes raikovi has been crystallized from (NH4)2SO4 in two forms. Both are suitable for structural studies to at least 2.8 A resolution. Both unit cell sizes are consistent with a tetramer of molecular weight 17,640 in the asymmetric unit.


Correction to Kasibhatla et al. How much radiation is the chemotherapy worth in advanced head and neck cancer? (Int j radiat oncol biol phys 2007;68:1491-1495).
To correct several elementary radiobiologic errors in the otherwise admirable article by Kasibhatla, Kirkpatrick, and Brizel (2007) on estimating the equivalent radiation effect of the concomitant chemotherapy in head-and-neck chemoradiotherapy. (1) Their equation was wrong because it omitted the lag or onset time of repopulation in tumors, Tk. Instead of zero days this should be 18-35 days. (2) Instead of a doubling time of 5 days, at most 3 days should be used for head-and-neck tumors. (3) Their slope "S" (the gamma-50 slope) for head-and-neck tumors should be 1.7, not 1.1. The same percentages of increased locoregional control as quoted by Kasibhatla et al. are used. The average time-corrected biologically effective dose for the 16 schedules listed should be 72.4 instead of 63.1 Gy(10). The average gains in locoregional tumor control are the equivalent of 8.8 Gy(10), not 10.6 Gy(10) (p = 0.05). The equivalent number of 2-Gy fractions of concomitant chemotherapy as used in the 16 listed schedules is 3.6 (95% confidence interval, 2.7-4.1), not 5 as claimed by Kasibhatla et al. The difference is statistically significant (p < 0.001).


Biodegradation of fipronil by Paracoccus sp. in different types of soil.
In the present studies potential of microorganisms isolated from the cotton fields was explored for the bioremediation of fipronil contaminated soils. The cultures of microbes were grown in Luria broth as shake culture maintained at 28°C. After that Dorn's broth enrichment culture supplemented with fipronil was used and isolated two bacterial cultures viz. Paracoccus sp. and Gamma Proteobacteria. The performance of both bacteria was evaluated for degradation of fipronil in soil. Paracoccus sp. was found better than the Gamma Proteobacteria as far as degradation of fipronil in soil is concerned. The samples of soil were extracted and cleaned up by following a standardized methodology. Fipronil was quantified by gas liquid chromatography and confirmed by gas chromatography mass spectrometer. The limit of quantification of fipronil was worked out to be 10 μg kg(-1). By using this methodology, the mean recoveries of fipronil in different types of soil were found to be more than 85%. The residues of fipronil were found to persist only up to 10 days in soils fortified with fipronil @ 20 μg kg(-1) and amended with Paracoccus sp. while in the soils fortified @ 80 μg kg(-1) fipronil, residues persisted up to 20, 30 and 30 days in loamy sand, sandy loam and clay loam, respectively. Therefore, the use of Paracoccus sp. can further be explored for the bioremediation of fipronil contaminated soils.


Vanillin and 4-hydroxybenzyl alcohol promotes cell proliferation and neuroblast differentiation in the dentate gyrus of mice via the increase of brain-derived neurotrophic factor and tropomyosin-related kinase B.
4-Hydroxy‑3-methoxybenzaldehyde (vanillin) and 4-hydroxybenzyl alcohol (4-HBA) are well‑known phenolic compounds, which possess various therapeutic properties and are widely found in a variety of plants. In the present study, the effects of vanillin and 4‑HBA were first investigated on cell proliferation, as well as neuronal differentiation and integration of granule cells in the dentate gyrus (DG) of adolescent mice using Ki‑67, doublecortin (DCX) immunohistochemistry and 5‑bromo‑2'‑deoxyuridine (BrdU)/feminizing Locus on X 3 (NeuN) double immunofluorescence. In both the vanillin and 4‑HBA groups, the number of Ki‑67+ cells, DCX+ neuroblasts and BrdU+/NeuN+ neurons were significantly increased in the subgranular zone of the DG, as compared with the vehicle group. In addition, the levels of brain‑derived neurotrophic factor (BDNF) and tropomyosin‑related kinase B (TrkB), a BDNF receptor, were significantly increased in the DG in the vanillin and 4‑HBA groups compared with the vehicle group. These results indicated that vanillin and 4‑HBA enhanced cell proliferation, neuroblast differentiation and integration of granule cells in the DG of adolescent mice . These neurogenic effects of vanillin and 4‑HBA may be closely associated with increases in BDNF and TrkB.


Trace metal pollution and its influence on the community structure of soft bottom molluscs in intertidal areas of the Dar es Salaam coast, Tanzania.
The influence of trace metal pollution on the community structure of soft bottom molluscs was investigated in intertidal areas of the Dar es Salaam coast. Significant enrichment of As, Mn, Mo, Sb, and Zn in sediments was recorded. Redundancy analysis indicated that trace metal pollution contributed 68% of the variation in community structure. Monte Carlo permutation test showed that As and Sb contributed significantly to variation in species composition. T-value biplots and van Dobben circles showed that the gastropods Acteon fortis, Assiminea ovata, and Littoraria aberrans, were negatively affected by As and Sb, while the bivalve Semele radiata and the gastropod Conus litteratus were only negatively affected by As. Bioaccumulation of As, Cd, Cu, Mo and Zn occurred in the bivalve Mactra ovalina and the gastropod Polinices mammilla. This calls for regular monitoring and management measures.


Par-4/THAP1 complex and Notch3 competitively regulated pre-mRNA splicing of CCAR1 and affected inversely the survival of T-cell acute lymphoblastic leukemia cells.
Although the intensification of therapy for children with T-cell acute lymphoblastic leukemia (T-ALL) has substantially improved clinical outcomes, T-ALL remains an important challenge in pediatric oncology. Here, we report that the cooperative synergy between prostate apoptosis response factor-4 (Par-4) and THAP1 induces cell cycle and apoptosis regulator 1 (CCAR1) gene expression and cellular apoptosis in human T-ALL cell line Jurkat cells, CEM cells and primary cultured neoplastic T lymphocytes from children with T-ALL. Par-4 and THAP1 collaborated to activate the promoter of CCAR1 gene. Mechanistic investigations revealed that Par-4 and THAP1 formed a protein complex by the interaction of their carboxyl termini, and THAP1 bound to CCAR1 promoter though its zinc-dependent DNA-binding domain at amino terminus. Par-4/THAP1 complex and Notch3 competitively bound to CCAR1 promoter and competitively modulated alternative pre-mRNA splicing of CCAR1, which resulted in two different transcripts and played an opposite role in T-ALL cell survival. Despite Notch3 induced a shift splicing from the full-length isoform toward a shorter form of CCAR1 mRNA by splicing factor SRp40 and SRp55, Par-4/THAP1 complex strongly antagonized this inductive effect. Our finding revealed a mechanistic rationale for Par-4/THAP1-induced apoptosis in T-ALL cells that would be of benefit to develop a new therapy strategy for T-ALL.


Promotion of Pasteurella haemolytica infection in mice by iron.
Mice given 60 micrograms iron, as aqueous ferric ammonium citrate, intravenously were more susceptible than untreated controls to intraperitoneal infection with T serotypes of Pasteurella haemolytica as shown by significant reductions in LD50 values. Iron injection has advantages over administration of bacteria suspended in mucin for studies of P haemolytica infection in mice.


Pregnancy registries: strengths, weaknesses, and bias interpretation of pregnancy registry data.
The chronic nature of epilepsy treatment, as well as the peak in incidence in children and adolescents, makes it likely that women of childbearing age will be exposed to antiepileptic drugs (AEDs). This has led to the establishment of several pregnancy registries to monitor the safety of anticonvulsants in terms of the risk of major birth defects following in utero exposure. Many registries are now approaching their second decade of data collection. With the release of substantial information on a range of AEDs (both older and newer generation drugs), it becomes increasingly important to understand how the methodological variations between cohorts may affect the risks of major birth defects being reported. This chapter explores the key methodological elements of these registries in terms of patient enrolment, the source of exposure and outcome information, outcome definition and ascertainment and comparator groups and how these elements may influence the reported risk estimates. With multiple registries collecting and releasing substantial data on AED safety in pregnancy, the chapter also reflects on how an increasing number of "signals" around increased risk of specific birth defects is likely. Possible methods for interpreting such signals, that the registries were not originally designed to detect and interpret, are also discussed.


Fulminant Anti-Myelin Oligodendrocyte Glycoprotein-Associated Cerebral Cortical Encephalitis: Case Series of a Severe Pediatric Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease Phenotype.
We describe a cohort of children with severe myelin oligodendrocyte glycoprotein (MOG)-IgG-associated cerebral cortical encephalitis (CCE), manifesting with bilateral cortical cytotoxic edema and critical neurological illness. We retrospectively reviewed our pediatric MOG antibody-associated disease (MOGAD) database and identified patients with specific radiographic pattern of bilateral, multifocal cortical cytotoxic lesions. We collected demographic, clinical, and outcomes data from these patients and compared select variables with radiographically distinct cerebral MOGAD syndromes (case-control analysis). We assessed the correlation of quantitative clinical variables with severity/outcomes measures using simple linear regression. Sixty-five of 88 total MOGAD cases had cerebral disease, and six of 88 met inclusion criteria for fulminant CCE (f-CCE). Age range was 2 to 7 years; five of six were male. Six of six were critically ill with severe encephalopathy and seizures, two of six required barbiturate coma, and two of six required invasive intracranial pressure monitoring. Six of six required treatment escalation beyond steroids. Four of six had favorable outcome; two of six had moderate-severe disability. Compared with other cerebral MOGAD cases (n = 59), children with f-CCE were more likely to have critical illness and poor neurological outcomes scores. Neurofilament light chain and treatment latency positively correlated with intensive care unit length of stay and outcomes scores; cerebrospinal fluid (CSF) white blood cell count and neutrophil-to-lymphocyte ratio did not. Pediatric CCE with bilateral cytotoxicity is associated with more fulminant disease and worse outcomes than other cerebral MOGAD syndromes.


On hermetic reading abilities.
A review of the literature on hyperlexia suggests that the disorder is frequently associated with autism, that hermetic readers reach the lexicon via both the phonological and orthographic routes, and that the children derive meaning from print (notably, single words). In hyperlexia, as in other savant syndromes, the skills seemingly arise without a practice period and are not integrated with other areas of knowledge. A theory was advanced to account for the findings: Savants have dysfunctional procedural memory systems, though their declarative memories are relatively intact. The deficit in procedures is reflected in the difficulties savants have with routinized activities and in a dissociation of accessible knowledge from action. A disconnected declarative system manifests itself in the savant skill.


Analysis of deoxynivalenol and zearalenone: State-of-the-art in Europe.
The aim of this study was to investigate the state-of-the-art in the analysis of deoxynivalenol (DON) and zearalenone (ZON) in cereals and to support a knowledge and experience exchange between the laboratories working in the field of Fusarium mycotoxin analysis. For that purpose the results obtained in recent intercomparisons and two Standards, Measurements and Testing (SMT) projects of the European Commission dealing with the determination of DON and ZON are discussed. The experiences gained during these studies clearly show the need for further improvements in DON and ZON determination to obtain more accurate and comparable results.


PCR-RFLP genotyping for exon 1 and promoter region mutations of the human mannose binding lectin (MBL-2) gene.
The Mannose Binding Lectin (MBL) plays an important role in innate immunity and its genetic deficiencies are associated with frequent and prolonged infections. Serum MBL determination may not accurately detect acute phase protein levels and it is also difficult to detect dysfunctional protein. Genotyping of the exon 1 and promoter regions in the MBL gene will provide useful information on the presence of deficiencies in patients. A reproducible PCR-RFLP method is described to accurately detect genotypes of exon 1 and polymorphic haplotypes of the promoter region in the MBL gene.


Identification of promising methionine aminopeptidase enzyme inhibitors: A combine study of comprehensive virtual screening and dynamics simulation study.
Methionine aminopeptidase (MetAP) enzymes play a critical role in bacterial cell survival by cleaving formyl-methionine initiators at N-terminal of nascent protein, a process which is vital in proper protein folding. This makes MetAP an attractive and novel antibacterial target to unveil promising antibiotics. In this study, the crystal structure of R. prowazekii MetAP was used in structure-based virtual screening of drug libraries such as Asinex antibacterial library and Comprehensive Marine Natural Products Database (CMNPD) to identify promising lead molecules against the enzyme. This shortlisted three drug molecules; BDE-25098678, BDE-30686468 and BDD_25351157 as most potent leads that showed strong binding to the MetAP enzyme. The static docked conformation of the compounds to the MetAP was reevaluated in molecular dynamics simulation studies. The analysis observed the docked complexes as stable structure with no major local or global deviations noticed. These findings suggest the formation of strong intermolecular docked complexes, which showed stable dynamics and atomic level interactions network. The binding free energy analysis predicted net MMGBSA energy of complexes as: BDE-25098678 (-73.41 kcal/mol), BDE-30686468 (-59.93 kcal/mol), and BDD_25351157 (-75.39 kcal/mol). In case of MMPBSA, the complexes net binding energy was as; BDE-25098678 (-77.47 kcal/mol), BDE-30686468 (-69.47 kcal/mol), and BDD_25351157 (-75.6 kcal/mol). Further, the compounds were predicted to follow the famous Lipinski rule of five and have non-toxic, non-carcinogenic and non-mutagenic profile. The screened compounds might be used in experimental test to highlight the real anti- R. prowazekii MetAP activity.


Complementary and alternative medicine use among infertile women attending infertility specialty clinics in South Korea: does perceived severity matter?
Complementary and alternative medicine (CAM) use among infertile women is popular in many countries, including Korea. Previous research has repeatedly found more than half of infertile women surveyed use CAM therapies for fertility enhancement and overall well-being. However, there is currently little evidence to support this practice, and this raises the question of infertile women's experiences in the uptake of those modalities and sociodemographic and psychological factors associated with CAM use. Thus, this study aims to explore the perceptions and experiences of infertile women with regard to their use of CAM in Korea. A cross-sectional study was conducted using data from 263 infertile women attending infertility specialty clinics in Seoul, Korea, in June 2012. The survey instrument included 47 questions on the use of CAM, demographic characteristics, health status, and infertility related factors such as duration and type of infertility, experience and satisfaction of conventional treatment, and self-perceived severity of infertility condition. Chi-square test and logistic regression were used for data analysis. Among 286 respondents (response rate, 95.3%), a total of 263 women were included in the final analysis. 63.5% of respondents used one or more types of CAM modalities during infertility treatment. The utilization of CAM was associated with employment status, duration of infertility treatment, and self-perceived severity of the disease. The most commonly used CAM modalities were multivitamin and herbal medicine, and differences in types of CAM modalities used were found between the group with a higher rating of self-perceived disease severity and the lower perceived severity group. High prevalence of CAM use among infertile women was observed in Korea. Our findings support that infertile women's own understanding of their illness and physical condition influences self-care behavior such as CAM use. This calls for an urgent need for further in-depth study of the clinical effects of popular CAM modalities among infertile women when used in conjunction with conventional treatment.


Composite follicular lymphoma and "early" (in situ and mantle zone growth pattern) mantle cell neoplasia: A rare entity with peculiar cytogenetic and clinical features.
Composite follicular lymphoma (FL) and mantle cell lymphoma (MCL) is rare and not fully characterized from a genetic and clinicopathological point of view. We report a composite lymphoma (CL) in which a G1-2 FL was associated with an in situ mantle cell neoplasia (ISMCN) and a mantle zone growth pattern (MZGP) MCL, followed-up for six years after the first diagnosis, until the exitus of the patient. We performed a comprehensive immunohistochemical study and a detailed cytogenetic analysis, including conventional karyotyping, SKY FISH, FISH on metaphases and interphasic separated nuclei, and FISH on histological sections. The study was completed by the review of the 13 published composite FL and MCL. Our results show that this entity generally behaves like an indolent lymphoma, with the outcome of patients driven by the progression of the FL component. The MCL component generally does not evolve in an aggressive disease. Indeed, half of the cases present exclusively ISMCN. In our case, mantle cell neoplasia at diagnosis was represented by ISMCN and MZGP MCL and it was characterized by a simple karyotype, with t(11;14) as the sole cytogenetic abnormality. This cytogenetic aspect well correlates with the indolent behavior of the mantle cell component. Conversely, the complex karyotype of the FL component was associated with disseminated disease that influenced patient's outcome. Finally, we suggest that not only ISMCN, but also isolated MZGP MCL, may be considered as lesions with low potential of transformation in an aggressive MCL.


Male reproductive effort and breeding system in an hermaphroditic plant.
Male reproductive effort was estimated from flower, seed and fruit biomass data in populations of the self-compatible plant Gilia achilleifolia that differ in genetically estimated selfing rate. Male reproductive effort decreases with increased rate of selfing, a finding that is consistent with theoretical arguments pertaining to the allocation of resources to male and female reproductive functions in hermaphroditic organisms.


[Biochemical-immunological comparison of the lymphoid cells of tonsils and adenoids (author's transl)].
We compared human lymphoid cells isolated from faucial and palatine tonsils by means of 9 different biochemical-immunological parameters. The cell populations were identical in all values. Evidence as to the biological equivalence of the tissues is disclosed.


Validation of a tool for determining the clinical utility of stillbirth investigations.
Up to 20% of all stillbirths and 45% of term stillbirths are currently classified as unexplained. Many of these stillbirths do not undergo currently recommended investigations. This may leave questions unanswered and not identify stillbirths with a recurrence risk in subsequent pregnancies. To validate a new tool (Stillbirth Investigation Utility Tool) to identify the clinical utility of investigations in stillbirth and the inter-rater agreement on cause of stillbirth using the Perinatal Society of Australia and New Zealand-Perinatal Death Classification (PSANZ-PDC). Thirty-four stillbirths were randomly selected for inclusion, each assessed independently by five blinded assessors. The investigations were grouped into three categories: clinical and laboratory; placental pathology; and autopsy examination. The cause of death was assigned at the end of each group. Outcome measures were clinical utility of investigations measured by assessor rated usefulness and inter-rater agreement on the assigned cause of death. Comprehensive maternal history, maternal full blood count, maternal blood group and screen and placenta histopathology were useful in all cases. Clinical photographs were not performed and should have been performed in 50% of cases. The inter-rater agreement on cause of death assigned after all investigation results was 0.93 (95% CI 0.87-1.0). The new Stillbirth Investigation Utility Tool showed very good agreement in assigning the cause of death using PSANZ-PDC. Four investigations were useful in all cases. Minor refinements will be made based on feedback to enhance usability for wider implementation in research studies to assess the yield of investigations in stillbirths.