Screen printed bipolar electrode for sensitive electrochemiluminescence detection of aflatoxin B1 in agricultural products.
In order to avoid the occurrence of false positives and false negatives caused by improper pretreatment during the detection of aflatoxin B1 by enzyme linked immunosorbent assay (ELISA). In this paper, we developed a screen printed bipolar electrode (BPE) for sensitive electrochemiluminescence (ECL) detection of aflatoxin B1 in agricultural products. The sensor uses a cathode of closed BPE as a functional sensing interface and an anode as a signal collection interface. In this way, the analyte does not need to participate in the ECL reaction of the anode. It avoids direct contact of photoactive molecules with complex reaction systems and greatly broadens the range of applications for ECL. After mixing the test sample with a known fixed concentration of horseradish peroxidase-labeled AFB1 (HRP-AFB1), they compete for binding to monoclonal antibodies. HRP catalyzes the polymerization of aniline to form polyaniline (PANI). Thereby causing a change in the oxidation-reduction potential and the ECL intensity in the electrochemical system, and then achieve the purpose of detecting the AFB1 concentration in the sample. As a result, the sensor has a good analytical performance for AFB1 with a linear range of 0.1-100 ng mL-1 and a detection limit of 0.033 ng mL-1. The sensor avoids the direct contact between the reaction system and the signal measurement system. In recovery experiment for six grains, the results demonstrate that the recovery rate and accuracy of this sensor is better than that of ELISA. This method provides a new idea for the detection of other mycotoxins in grains.


Pathogenic multiple antimicrobial resistant Escherichia coli serotypes in recreational waters of Mumbai, India: a potential public health risk.
Globally, coastal waters have emerged into a pool of antibiotic resistance genes and multiple antibiotic resistant microorganisms, and pathogenicity of these resistant microorganisms in terms of serotypes and virulence genes has made the environment vulnerable. The current study underscores the presence of multiple antibiotic resistant pathogenic serotypes and pathotypes of Escherichia coli, the predominant faecal indicator bacteria (FIB), in surface water and sediment samples of famous recreational beaches (Juhu, Versova, Mahim, Dadar, and Girgaon) of Mumbai. Out of 65 faecal coliforms (FC) randomly selected, 38 isolates were biochemically characterized, serotyped (for 'O' antigen), antibiogram-phenotyped (for 22 antimicrobial agents), and genotyped by polymerase chain reaction (for virulence factors). These isolates belonged to 16 different serotypes (UT, O141, O2, O119, O120, O9, O35, O126, O91, O128, O87, O86, R, O101, O118, and O15) out of which UT (18.4%), O141 (15.7%), and O2 (13.1%) were predominant, indicating its remarkable diversity. Furthermore, the generated antibiogram profile revealed that 95% of these isolates were multiple antibiotic resistant. More than 60% of aminoglycoside-sensitive E. coli isolates exhibited resistance to penicillin, extended penicillin, quinolone, and cephalosporin classes of antibiotic while resistance to other antibiotics was comparatively less. Antibiotic resistance (AR) indexing indicated that these isolates may have rooted from a high-risk source of contamination. Preliminary findings revealed the presence of enterotoxin-encoding genes (stx1 and stx2 specific for enterohaemorrhagic E. coli and Shiga toxin-producing E. coli, heat-stable toxin enterotoxin specific for enterotoxigenic E. coli) in pathogenic serotypes. Thus, government authorities and environmental planners should create public awareness and adopt effective measures for coastal management to prevent serious health risks associated with these contaminated coastal waters.


The influence of maternal respiratory allergy on obstetrics and perinatal outcomes: A nested case-control study.
To evaluate the influence of respiratory allergy on obstetrics and perinatal outcomes. A nested case-control retrospective study on 41 035 pregnant women. Obstetrics and perinatal outcomes of women with or without respiratory allergy were compared. Rates of preterm delivery (<37 weeks of gestation), low birth weight (<2500 g), neonatal acidosis (pH < 7.20), low 5-min APGAR score (<7), cesarean section rate and indications, and perinatal morbidity and mortality were analyzed. Results are expressed as number and percentages. χ2 and Fisher exact tests were used for comparisons. Logistic regression was used. Statistical significance was set at 95% level (P < 0.05). A total of 724 (1.8%) patients had respiratory allergy, and their rates of preterm delivery and low birth weight were significantly higher than those of control women (both P < 0.001). Nevertheless, analyzing the causes, multiple gestation rate was significantly higher in this group, and adjusting by this, no statistical difference was found in any of the perinatal outcomes studied. In addition, in vitro fertilization and sterility were also significantly higher in the respiratory allergy group (both P < 0.001). Women with respiratory allergy are at higher risks of prematurity and low birth weight but these results are mediated by sterility, in vitro fertilization, and multiple gestation rate. Nonetheless, participation of inflammatory mechanisms should be further studied.


Immune system versus tumor: shifting the balance in favor of DCs and effective immunity.
Despite the initial excitement over cancer vaccines, the clinical effectiveness of immunotherapy has been disappointing. The suppressive milieu present within established tumors inhibits effective immune responses, although new strategies are emerging to manipulate the local tumor microenvironment and shift the balance back to a proinflammatory environment, promote DC activation, and enhance tumor immunity.


[Robotic surgery in gynecologic oncology: Retrospective and comparative study with laparotomy and laparoscopy].
To compare robot-assisted laparoscopy with conventional laparoscopy and laparotomy in gynecologic oncology. This is a monocentric retrospective study enrolling 92 patients who underwent a standard or radical hysterectomy (with parametrectomy) with or without pelvic lymphadenectomy between January 2008 and December 2010. All patients were diagnosed for a cervical or endometrial cancer. Laparotomy was performed for 33 patients, conventional laparoscopy for 20 patients, and robot-assisted laparoscopy for 39 patients. The main parameter was the length of hospital stay in the three groups. Length of hospital stay significantly decreased in the robotic group in comparison with the laparotomic group (median 5 and 8 days respectively, P<0.0001), but no differences were found between the robotic and laparoscopic groups (P=0.77). Intraoperative blood loss was lower in the robotic group. Intraoperative complications and lymph nodes removed were equal in the three groups. Regarding the data recorded, there were no significant differences between conventional and robotic laparoscopy. Hysterectomies performed after pelvic radiation, which were all made by laparotomy before the robot's arrival, were all performed with robotic laparoscopy since its arrival. Robotic surgery allows a reduced length of hospital stay and a lower blood loss in comparison with laparotomy, without any worse oncologic results. Robotic surgery changed our practice, especially hysterectomy after pelvic radiation, performed by laparotomy before.


Chronic antihypertensive effects of captopril (SQ 14,225), an orally active angiotensin I-converting enzyme inhibitor, in conscious 2-kidney renal hypertensive rats.
Indirect systolic blood pressure (SBP) was monitored in 9 groups of 15 male conscious 2-kidney renal hypertensive rats (RHR) for over 6 months. Daily oral dosing with captopril (SQ 14,225, D-3-mercapto-2-methylpropanoyl-L-proline, 30 mg/kg), an orally active angiotensin I-converting enzyme inhibitor, lowered SBP 30--50 MM Hg during this period. Withdrawal of captopril for 5 days at 1, 3 and 6 months resulted in gradual return of SBP to control levels without overshoot. Resumption of dosage with captopril again decreased SBP. Daily oral dosing with hydrochlorothiazide (HCTZ, 6 mg/kg/day) alone for 6 months had little or no effect on SBP, but increased the antihypertensive effect of captopril. Daily oral dosing with hydralazine (6 mg/kg) caused an initial marked antihypertensive effect greater than that of captopril but almost complete tolerance developed within 4 weeks of dosing. Highest survival rates occurred in RHR treated with captopril plus HCTZ. In four other similarly treated groups of RHR and normotensive rats (NR), least cardiac hypertrophy and highest plasma renin activity occurred in captopril-treated animals compared with vehicle-treated controls. Plasma renin activity was about 2 to 4 fold higher in the rats dosed with captopril compared with vehicle-treated rats. Heart weight/body weight ratios, initially higher in the two RHR groups compared to NR, decreased only in the captopril treated group to or near those of the NR groups. These results indicate that chronic treatment with captopril decreased SBP and cardiac weights of RHR, and that HCTZ, or possibly other diuretics, can augment the antihypertensive effect of captopril while having little or no effect by themselves.


A complex mutable polymorphism located within the fragile X gene.
While studying founder chromosomes in the fragile X syndrome, we have unexpectedly found linkage equilibrium to FRAXAC2, an Alu-associated microsatellite within the defective gene, FMR-1. DNA sequencing of 265 chromosomes revealed 39 alleles and a complex microsatellite of form (GT)x-C-(TA)y-(T)z. A mutation rate of 3.3% was observed but only among fragile X maternally derived meioses. Finding a second mutable locus within FMR-1 suggests that the target for tandem repeat instability may not be confined to the (CGG)n repeat alone and raises the possibility of an FMR-1 mutation mechanism involving microsatellites.


The process of climate change in mass media discourse using the example of Polish and international editions of "Newsweek" magazine.
The main objective of the article is to conduct a critical media discourse analysis as presented in the Polish and international editions of the "Newsweek" magazine in the years 2001-2006 and 2012-2016; the subject of which was climate change. The introduction provides the definitions of the key terms, such as: the greenhouse effect and critical discourse analysis (CDA). The theoretical part presents the most important assumptions of the CDA and presents a characteristic of the weekly. The results of the conducted quantitative and qualitative analysis partially lead to varying conclusions. Based on the CDA, the hypothesis was assumed that more attention was provided to climate change in the international (English) edition of "Newsweek", than in the Polish-language edition. Rejected in turn was the hypothesis, according to which, more importance to climate change and their repercussions was provided in the discourse within the last 5 years of publication of the weekly than in the discourse from the years 2001-2006. As a result of comparison of both discourses, the disturbing fact that media discourse did not present and encourage among the readers an active stance in favour of the climate was noticed. It is the task of this influential weekly, the message of which reaches many people, not only to provide knowledge and shape specific values or view, but also to encourage and popularise attitudes in favour of the climate. If man wants to continue to live on earth, then one of their goals is to modify the form of discourse by entities responsible for its form.


Extended release potassium salts overdose and endoscopic removal of a pharmacobezoar: A case report.
Reported cases of potassium overdoses have shown that this condition could generate several morbidities, mainly related to cardiac dysrhythmias even with fatal outcomes in some cases. Potassium salts in extended release tablets could form pharmacobezoars if a large amount is ingested. In relation to the above, when the patient has a pharmacobezoar, clinical findings may be delayed and may persist. The techniques available for removal of a pharmacobezoar are whole bowel irrigation (WBI), endoscopy or in some surgery [1]. Endoscopy as a decontamination method has shown promising results. A 42 year old woman, who intentionally ingested 100 tablets of extended release potassium chloride, 50 mg of clonazepam and an undisclosed amount of ethanol, presented with metabolic acidosis, hyperlactatemia and sinus tachycardia 2 h after ingestion. Gastric lavage and activated charcoal were applied initially, specific measures were not necessary. However, a transcutaneous pacemaker was placed. Because of her background, we considered a pharmacobezoar and an endoscopy were performed to remove 99 tablets of potassium that were isolated or forming concretions. The readily available techniques to remove a pharmacobezoar are whole bowel irrigation (WBI) and endoscopy; nevertheless there is not a consensus about their relative merits. Our patient was treated by endoscopy because we found on the X-ray a conglomerate of radiopaque images suggesting a pharmacobezoar. In this case we did not have any adverse effect. We consider that endoscopy could be an effective and safe method to remove a drug bezoar from the stomach in uncomplicated patients.


Epigenetic alteration of microRNAs in feces of colorectal cancer and its clinical significance.
MicroRNAs regulate target gene expression through translation repression or mRNA decay, and they are emerging as important modulators in cellular pathways. Previous studies have shown the occurrence of epigenetically modified miRNAs in colorectal cancer (CRC), identifying these miRNA methylation signatures may provide candidate markers for the detection of malignant colonocytes. Fecal-based tests are widely adopted as noninvasive methods for CRC diagnosis, thus several studies have attempted to use miRNAs from feces as CRC markers. This article evaluates a recently published study investigating the usefulness of epigenetically silenced miRNAs in fecal specimens, including miR-34b/c and miR-148a, as potential markers for CRC screening and prognosis.


Cancer information needs of people with intellectual disability: a review of the literature.
The lifespan of people with an intellectual disability has increased significantly in recent years; however, this has resulted in a rising incidence of age-related illnesses including cancer. The World Health Organisation has expressed concern as evidence suggests prevalence rates for cancer are increasing for this group. The needs of people with a cancer diagnosis and an intellectual disability are beginning to be highlighted; however, there appears to be a substantial dearth of services including appropriate cancer information. This presents alarming obstacles and barriers to high-quality cancer care impacting on treatment, management and overall survival rates for this client group. Furthermore, a number of policy and research reports directed at the health needs of people with an intellectual disability have continually highlighted the need for accessible information and effective communication. Having access to cancer information should be considered a crucial part of providing optimum holistic care for this client group. Cancer professionals should assess the unique information needs of people with an intellectual disability as mainstream information does not meet their requirements. Furthermore, health professionals working in intellectual disability settings must also address their knowledge and information deficits in this regard. This paper presents a review of the literature with a specific focus on the cancer information needs of people with an intellectual disability.


Mechanisms involved in xyloglucan catabolism by the cellulosome-producing bacterium Ruminiclostridium cellulolyticum.
Xyloglucan, a ubiquitous highly branched plant polysaccharide, was found to be rapidly degraded and metabolized by the cellulosome-producing bacterium Ruminiclostridium cellulolyticum. Our study shows that at least four cellulosomal enzymes displaying either endo- or exoxyloglucanase activities, achieve the extracellular degradation of xyloglucan into 4-glucosyl backbone xyloglucan oligosaccharides. The released oligosaccharides (composed of up to 9 monosaccharides) are subsequently imported by a highly specific ATP-binding cassette transporter (ABC-transporter), the expression of the corresponding genes being strongly induced by xyloglucan. This polysaccharide also triggers the synthesis of cytoplasmic β-galactosidase, α-xylosidase, and β-glucosidase that act sequentially to convert the imported oligosaccharides into galactose, xylose, glucose and unexpectedly cellobiose. Thus R. cellulolyticum has developed an energy-saving strategy to metabolize this hemicellulosic polysaccharide that relies on the action of the extracellular cellulosomes, a highly specialized ABC-transporter, and cytoplasmic enzymes acting in a specific order. This strategy appears to be widespread among cellulosome-producing mesophilic bacteria which display highly similar gene clusters encoding the cytosolic enzymes and the ABC-transporter.


The RNA helicase RHAU (DHX36) unwinds a G4-quadruplex in human telomerase RNA and promotes the formation of the P1 helix template boundary.
Human telomerase RNA (hTR) contains several guanine tracts at its 5'-end that can form a G4-quadruplex structure. Previous evidence suggests that a G4-quadruplex within this region disrupts the formation of an important structure within hTR known as the P1 helix, a critical element in defining the template boundary for reverse transcription. RNA associated with AU-rich element (RHAU) is an RNA helicase that has specificity for DNA and RNA G4-quadruplexes. Two recent studies identify a specific interaction between hTR and RHAU. Herein, we confirm this interaction and identify the minimally interacting RNA fragments. We demonstrate the existence of multiple quadruplex structures within the 5' region of hTR and find that these regions parallel the minimal sequences capable of RHAU interaction. We confirm the importance of the RHAU-specific motif in the interaction with hTR and demonstrate that the helicase activity of RHAU is sufficient to unwind the quadruplex and promote an interaction with 25 internal nucleotides to form a stable P1 helix. Furthermore, we have found that a 5'-terminal quadruplex persists following P1 helix formation that retains affinity for RHAU. Finally, we have investigated the functional implications of this interaction and demonstrated a reduction in average telomere length following RHAU knockdown by small interfering RNA (siRNA).


Modification mechanism of sesbania gum, and preparation, property, adsorption of dialdehyde cross-linked sesbania gum.
This paper studied the modification mechanism of Sesbania gum (SG) by means of the variations in the numbers of surface hydroxyl groups on the granules, Schiff's agent coloration of aldehyde groups, Fourier transform infrared spectroscopy (FTIR) and X-ray diffraction (XRD), energy dispersive spectrum (EDS), etc., and also examined the preparation, property and adsorption of dialdehyde cross-linked sesbania gum (DCLSG). The results showed that the surface hydroxyl numbers of cross-linked sesbania gum (CLSG) decreased with increasing the cross-linking degree. The distribution of the aldehyde groups on the DCLSG particles was nonuniform because most of aldehyde groups mainly located on the edge of particles. The cross-linking occurred only on the surface of SG particles. The oxidization occurred not only on the surface of SG particles, but also in the interior of particles. The cross-linking or oxidization changed the thermal properties, and reduced the swelling power, viscosity, alkali and acid resistance of SG.


Drugs that alter the hemostatic mechanism.
This article offers a brief review of antiplatelet drugs, anticoagulants, fibrinolysins, and antifibrinolysins. Aspirin and heparin are discussed in detail. Warfarin, streptokinase, urokinase, and tissue-type plasminogen activator are also considered. Indications for use, mechanism of action, monitoring therapy, and current investigational studies are discussed.


Are Two-Dimensional Morphometric Measures Reflective of Disease Severity in Adult Chiari I Malformation?
Two-dimensional (2D) morphometric measures have been previously used to diagnose Chiari I malformation (CMI) and distinguish patients from healthy subjects. There is, however, a paucity of literature regarding whether morphometric differences exist across the range of CMI disease severity. We evaluated whether 2D morphometrics demonstrate significant changes across standardized grades of CMI severity in adults. This retrospective observational study comprised 76 patients with symptomatic CMI with or without syringomyelia. Patients matched for age, sex, and body mass index were selected from each of the 3 severity grades of the Chiari Severity Index (CSI). The study used 17 2D craniocervical and posterior fossa morphometric variables that were previously found to differentiate patients with CMI from healthy subjects. The measurements were performed on midsagittal T1-weighted magnetic resonance imaging sequences using 2 custom in-house software tools, MorphPro and CerePro, and compared across CSI grades. Analysis of variance showed that none of the 17 morphometric variables were significantly different across the 3 CSI grades (P > 0.003). Bayes factor 10 scores ranged from 0.11 to 0.82. Of variables, 9 had Bayes factor 10 scores between 0.10 and 0.30, while 8 had scores between 0.30 and 1. None of the Bayes factor 10 scores provided support for the alternative hypothesis that the morphometric measures differed across the CSI grades. Our study indicated that 2D morphometrics are not reflective of CMI disease severity as indicated by the CSI grading system. The findings of our study support the need for further investigation into whether non-2D morphometric variables can be used as markers of disease severity.


Transcatheter aortic valve implantation after branched thoracic endovascular aortic repair in zone 0.
An 83-year-old woman who underwent emergent hemi-arch replacement for acute aortic dissection (Stanford Type A) and staged branched thoracic endovascular aortic repair in zone 0 was admitted for severe aortic stenosis. We performed transfemoral transcatheter aortic-valve implantation with an SAPIEN 3 valve. The interference between the stent frames of the valve and the stent grafts in the aortic arch was concerning. However, using the SAPIEN 3 valve's flex system, the valve was successfully delivered through the complex structure in the aortic arch without any aggravation. The patient's postoperative course was uneventful.


A comparative study of neurogenesis in the retinal ciliary marginal zone of homeothermic vertebrates.
The retina of many fish and amphibians grows throughout life, roughly matching the overall growth of the animal. The new retinal cells are continually added at the anterior margin of the retina, in a circumferential zone of cells, known as the ciliary marginal zone, or CMZ. Recently, Fischer and Reh [Dev. Biol. 220 (2000) 197] have found that new neurons are added to the retina of the chicken via proliferation and subsequent differentiation of neurons and glia at the retinal margin in a zone highly reminiscent of the CMZ of lower vertebrates. In addition, other groups have reported that putative retinal stem cells could be isolated from the ciliary margin of the adult mouse. In light of these findings, we have re-investigated the eyes of three additional species to determine whether other homeothermic vertebrates also possess CMZ cells and whether we could detect evidence for addition of neurons at the retinal margin in mature animals. We examined one additional avian species, the quail, one marsupial, the opposum, and one mammal, the mouse. We find that the CMZ cells have been gradually diminished during vertebrate evolution. The quail has a reduced CMZ as compared to the chicken, while the opposum has only a few cells likely related to the CMZ and we failed to find evidence of CMZ cells at the margin of the mouse retina.


Enhancement of nitroblue tetrazolium dye reduction by leucocytes exposed to a factor released from sensitised lymphocytes.
Leucocytes from purified protein derivative (PPD) skin test positive individuals, after exposure to PPD in vitro, show a significant increase in nitroblue tetrazolium (NBT) dye reduction when compared to leucocytes from PPD negative donors. The active principle was shown to be soluble, and was released from lymphocytes after a rapid, immunologically specific interaction with the sensitising antigen.


Concordance study between one-step nucleic acid amplification and morphologic techniques to detect lymph node metastasis in papillary carcinoma of the thyroid.
Tumor resection in papillary thyroid carcinoma (PTC) is often accompanied by lymph node (LN) removal of the central and lateral cervical compartments. One-step nucleic acid amplification (OSNA) is a polymerase chain reaction-based technique that quantifies cytokeratin 19 (CK19) messenger RNA copies. Our aim is to assess the value of OSNA in detection of LN metastases in PTC, in comparison with imprints and microscopic analysis of formalin-fixed, paraffin-embedded (FFPE) tissue. A total of 387 LNs from 37 patients were studied. From each half LN, 2 imprints were taken and analyzed with hematoxylin and eosin (H&E) and CK19 immunostaining. One half of the LN was submitted to OSNA and one half to FFPE processing and H&E and CK19 staining. For concordance analysis, every single LN was considered as a case. A group of 11 cases with discordant results between OSNA and H&E/CK19 FFPE sections were subjected to additional FFPE serial sectioning and H&E and CK19 staining. We found a high degree of concordance between the assays used, with sensitivities ranging from 0.81 to 0.95, and specificities ranging from 0.87 and 0.98. OSNA allowed upstaging of patients from pN0 to pN1, in comparison with standard pathologic analysis. Identification of a metastatic LN with more than 15000 CK19 messenger RNA copies predicted the presence of a second LN with macrometastasis (<5000 copies). In summary, the study shows that OSNA application in sentinel or suspicious LN may be helpful in assessing nodal status in PTC patients.


Aesthetic and hearing rehabilitation in patients with bilateral microtia-atresia.
To evaluate the safety and efficacy of auricle reconstruction and active transcutaneous bone-conduction implantation in patients with bilateral microtia-atresia. Patients were chosen prospectively, with each being his/her own control. The setting was a tertiary referral center. Twelve patients, aged 6-18 years, with bilateral microtia-atresia suffering from bilateral conductive hearing loss. All had an upper bone conduction threshold limit of 45 dB HL at frequencies of 0.5-4 kHz. Patient satisfaction with the reconstructed auricle was rated as highly satisfactory, basically satisfactory, or unsatisfactory. Mean pure-tone thresholds and speech audiometry test results were compared among patients unaided, with a soft-band Bonebridge, and with an implanted Bonebridge. Subjective satisfaction was analyzed using three questionnaires: the Abbreviated Profile of Hearing Aid Benefit (APHAB), the Glasgow children's benefit inventory (GCBI), and the International Outcome Inventory for Hearing Aids (IOI-HA). All patients who underwent auricle reconstruction expressed satisfaction with their appearance. The mean pure-tone thresholds of unaided patients and those with soft-band and implanted Bonebridge were 55.25 ± 3.43 dBHL, 31.37 ± 3.03 dBHL, and 21.25 ± 2.16 dBHL, respectively. The mean speech discrimination scores measured in a sound field with a presentation level of 65 dB SPL under these three conditions were 46.0 ± 0.11%, 80.0 ± 0.09%, and 94.0 ± 0.02%, respectively. Questionnaires demonstrated patients' benefits and satisfaction with this surgery. The surgical procedure involving auricle reconstruction and Bonebridge implantation was safe and effective for patients with bilateral microtia-atresia, solving both appearance and hearing problems.


Cholesterol-lowering activity of adzuki bean (Vigna angularis) polyphenols.
Adzuki beans (ABs; Vigna angularis) were reported to show potential for prevention of cholesterol absorption and lowering of the blood cholesterol level. However, the main active compounds and some cellular effects remain unknown. In this study, we evaluated the potential cholesterol-lowering effects of (+)-catechin 7-O-β-D-glucopyranoside (C7G) and (+)-epicatechin 7-O-β-D-glucopyranoside (E7G), identified as abundant polyphenols in ABs. To investigate the cholesterol-lowering activity in vitro, cholesterol micelles, bile acids, and Caco-2 cells as an intestinal model were used in the study. C7G and E7G each inhibited micellar solubility in a dose-dependent manner, and their inhibitory activity was as strong as that of (+)-catechin (IC50 values: C7G, 0.23 ± 0.03 mg/ml; E7G, 0.22 ± 0.02 mg/ml; (+)-catechin, 0.26 ± 0.11 mg/ml). The AB polyphenols showed binding activity toward bile acids and changed them into an insoluble form. When Caco-2 cells were treated with C7G or E7G, the amount of incorporated cholesterol was significantly decreased compared with vehicle-treated control cells, and no cytotoxicity was observed under the experimental conditions used. Meanwhile, quantitative real-time PCR revealed that the mRNA level of the cholesterol transporter NPC1L1 remained unchanged in the treated cells. Taken together, the present findings suggest that C7G and E7G are the main active compounds in ABs, and have the ability to inhibit micellar solubility, bind to bile acids, and suppress cholesterol absorption. The present study supports the health benefits of ABs as a medicinal food and the application of AB polyphenols as medicinal supplements to suppress cholesterol elevation.


Long-term melatonin treatment for the sleep problems and aberrant behaviors of children with neurodevelopmental disorders.
Clinical evidence is required about the long-term efficacy and safety of melatonin treatment for sleep problems in children with neurodevelopmental disorders (NDDs) who underwent adequate sleep hygiene interventions. We conducted a 26-week, multicenter, collaborative, uncontrolled, open-label, phase III clinical trial of melatonin granules in children 6 to 15 years of age who had NDDs and sleep problems. The study consisted of the 2-week screening phase, the 26-week medication phases I and II, and the 2-week follow-up phase. Children received 1, 2, or 4 mg melatonin granules orally in the medication phases. Variables of sleep status including sleep onset latency (SOL), aberrant behaviors listed on the Aberrant Behavior Check List-Japanese version (ABC-J), and safety were examined. The primary endpoint was SOL in the medication phase I. Between June 2016 and July 2018, 99 children (80 males and 19 females, 10.4 years in mean age) were enrolled at 17 medical institutions in Japan-74, 60, 22, 9, 6, and 1 of whom had autism spectrum disorder, attention-deficit/hyperactivity disorder, intellectual disabilities, motor disorders, specific learning disorder, and communication disorders, respectively, at baseline. Fifteen children received the maximal dose of 4 mg among the prespecified dose levels. SOL recorded with the electronic sleep diary shortened significantly (mean ± standard deviation [SD], - 36.7 ± 46.1 min; 95% confidence interval [CI], - 45.9 to - 27.5; P < 0.0001) in the medication phase I from baseline, and the SOL-shortening effect of melatonin persisted in the medication phase II and the follow-up phase. Temper upon wakening and sleepiness after awakening improved significantly (P < 0.0001 each) in the medication phase I from baseline and persisted in the follow-up phase. The following subscales of the ABC-J improved significantly: stereotypic behavior (P = 0.0322) in the medication phase I; and irritability, hyperactivity, and inappropriate speech (P < 0.0001) in the medication phase II. Treatment-emergent adverse events did not occur subsequent to week 16 after medication onset, and NDDs did not deteriorate in the follow-up phase. Long-term melatonin treatment in combination with adequate sleep hygiene interventions may afford clinical benefits to children with NDDs and potentially elevates their well-being. ClinicalTrils.gov , NCT02757066 . Registered April 27, 2016.


Assessment of Patient Reported Outcomes (PROs) in Outpatients Taking Oral Anticancer Drugs Included in the Real-Life Oncoral Program.
Background In previous studies, patient-reported outcomes (PROs) have been shown to improve survival in cancer patients. The aim of the present study was to assess symptoms potentially related to adverse events experienced by cancer outpatients treated by oral anticancer agents (OAAs) using PROs. Methods Between September 2018 and May 2019, outpatients starting OAAs were included in a 12-week follow-up to assess 15 symptoms listed in the National Cancer Institute PRO Common Terminology Criteria for Adverse Events, using a 5-point scale of severity or frequency. Patients were requested to alert a referral nurse or pharmacist when they self-assessed high-level (level 3 or 4) symptoms. Results 407 questionnaires were completed by 63 patients in which 2333 symptoms were reported. Almost three-quarters (74.6%) reported at least one high-level symptom. The symptoms that were most commonly experienced were fatigue (>9 in 10 patients; 13.2% of symptoms declared), various psychological disorders (>9 in 10 patients; 28.6% of symptoms declared) and general pain (>8 in 10 patients; 9.4% of symptoms declared). Conclusion PROs are appropriate to detect potential adverse events in cancer outpatients treated by OAAs. This study is the first step for integrating the patient's perspective in a digital e-health device in routine oncology care.


[Age-related characteristics of cholinergic regulation of the biomechanical function of the rat heart in hypoxia].
Hypoxia is shown to decrease chronotropic and inotropic responses of the isolated heart of mature rats to stimulation of M-choline receptors. In aged tissue hypoxia has no influence on the inotropic response to carbocholine effect. The results permit a conclusion to be made on the higher resistance of cholinergic mechanisms that regulate the cardiac function to hypoxic effects in aged animals.


The lager yeast Saccharomyces pastorianus removes and transforms Fusarium trichothecene mycotoxins during fermentation of brewer's wort.
An investigation was conducted to determine the fate of deoxynivalenol, deoxynivalenol-3-glucoside, HT-2 toxin and T-2 toxin, during a four-day fermentation with the lager yeast Saccharomyces pastorianus. The influence of excessive mycotoxin concentrations on yeast growth, productivity and viability were also assessed. Mycotoxins were dosed at varying concentrations to 11.5° Plato wort. Analysis of yeast revealed that presence of the toxins even at concentrations up to 10,000 μg/L had little or no effect on sugar utilisation, alcohol production, pH, yeast growth or cell viability. Of the dosed toxin amounts 9-34% were removed by the end of fermentation, due to physical binding and/or biotransformation by yeast. Deoxynivalenol-3-glucoside was not reverted to its toxic precursor during fermentation. Processing of full-scan liquid chromatography-quadrupole time-of-flight-mass spectrometry (LC-QTOF-MS) data with MetaboLynx and subsequent LC-QTOF-MS/MS measurements resulted in annotation of several putative metabolites. De(acetylation), glucosylation and sulfonation were the main metabolic pathways activated.


Syndromes of congenital bowing of the long bones.
Ten patients with congenital bone disease in whom bowing of the long bones was the predominant or only sign are described. The group was composed of three patients with Campomelic dwarfism, one with long bones bowing of Caffey's type, four with femoral bowing (two of them familial), one with bowing of the long bones of the lower limbs and one with bowing of the forearm bones.


Tumor Vascular Morphology Undergoes Dramatic Changes during Outgrowth of B16 Melanoma While Proangiogenic Gene Expression Remains Unchanged.
In established tumors, angiogenic endothelial cells (ECs) coexist next to "quiescent" EC in matured vessels. We hypothesized that angio-gene expression of B16.F10 melanoma would differ depending on the growth stage. Unraveling the spatiotemporal nature thereof is essential for drug regimen design aimed to affect multiple neovascularization stages. We determined the angiogenic phenotype-represented by 52 angio-genes-and vascular morphology of small, intermediate, and large s.c. growing mouse B16.F10 tumors and demonstrated that expression of these genes did not differ between the different growth stages. Yet vascular morphology changed dramatically from small vessels without lumen in small to larger vessels with increased lumen size in intermediate/large tumors. Separate analysis of these vascular morphologies revealed a significant difference in αSMA expression in relation to vessel morphology, while no relation with VEGF, HIF-1α, nor Dll4 expression levels was observed. We conclude that the tumor vasculature remains actively engaged in angiogenesis during B16.F10 melanoma outgrowth and that the major change in tumor vascular morphology does not follow molecular concepts generated in other angiogenesis models.


Visual features influence thought content in the absence of overt semantic information.
It has recently been shown that the perception of visual features of the environment can influence thought content. Both low-level (e.g., fractalness) and high-level (e.g., presence of water) visual features of the environment can influence thought content in real-world and experimental settings where these features can make people more reflective and contemplative in their thoughts. It remains to be seen, however, if these visual features retain their influence on thoughts in the absence of overt semantic content, which could indicate a more fundamental mechanism for this effect. In this study, we removed this limitation by creating scrambled edge versions of images, which maintain edge content from the original images but remove scene identification. Nonstraight edge density is one visual feature that has been shown to influence many judgements about objects and landscapes and has also been associated with thoughts of spirituality. We extend previous findings by showing that nonstraight edges retain their influence on the selection of a Spiritual & Life Journey topic after scene-identification removal. These results strengthen the implication of a causal role for the perception of low-level visual features on the influence of higher order cognitive function, by demonstrating that in the absence of overt semantic content, low-level features, such as edges, influence cognitive processes.


Diagnostic accuracy of prehospital electrocardiograms interpreted remotely by emergency physicians in myocardial infarction patients.
Prehospital 12‑lead electrocardiogram (ECG) is the most widely used screening tool for recognition of ST-segment elevation myocardial infarction (STEMI). However, prehospital diagnosis of STEMI based solely on ECGs can be challenging. To evaluate the ability of emergency department (ED) physicians to accurately interpret prehospital 12‑lead ECGs from a remote location. All suspected prehospital STEMI patients who were transported by EMS and underwent angiography between 2006 and 2014 were included. We reviewed prehospital ECGs and grouped them based on: 1) presence or absence of a culprit artery lesion following angiography; and 2) whether they met the 3rd Universal Definition of Myocardial Infarction. We also described characteristics of ECGs that were misinterpreted by ED physicians. A total of 625 suspected STEMI cases were reviewed. Following angiography, 94% (590/625) of patients were found having a culprit artery lesion, while 6% (35/625) did not. Among these 35 patients, 24 had ECGs that mimicked STEMI criteria and 9 had non-ischemic signs. Upon ECG reinterpretation, 92% (577/625) had standard STEMI criteria while 8% (48/625) did not. Among these 48 patients, 35 had ischemic signs ECGs and 13 did not. Characteristics of misinterpreted ECGs included pericarditis, early repolarization, STE > 1 mm (1‑lead only), and negative T-wave. Remote interpretation of prehospital 12‑lead ECGs by ED physicians was a useful diagnostic tool in this EMS system. Even if the rate of ECG misinterpretation is low, there is still room for ED physicians operating from a remote location to improve their ability to accurately diagnose STEMI patients.


Estimating survival and clinical outcome in advanced non-small cell lung cancer with bone-only metastasis using molecular markers.
This retrospective study investigated prognostic factors in advanced non-small cell lung cancer (NSCLC) with bone-only metastasis, and developed a graded prognostic assessment (GPA) model to estimate patient survival. The primary endpoint was overall survival. We investigated the patients with advanced NSCLC with bone-only metastasis at the initial diagnosis and diagnosed between 2013 and 2019 in our hospital. A log-rank test and Cox proportional hazards model were used to examine factors. A GPA model was developed in the training set based on the factors that were determined significant according to their hazard ratios and verified by the validation set. We finally included 220 patients for analysis. These patients were divided into two groups, 147 cases for the training cohort and 73 for the validation cohort. The following were significant independent prognostic factors, and were included in the GPA model: smoking; EGFR (epidermal growth factor receptor) sensitive/ALK (anaplastic lymphoma kinase) mutations; loss of weight; hypoalbuminemia; and primary site treated by surgery or radiotherapy. GPA score of nil was assigned to smoking, without sensitive mutations, loss of weight, hypoalbuminemia, and without local treatment of primary site; the corresponding superior alternatives were scored 1.5, 2.0, 1.5, 1.5, and 1.5, respectively. The median survival times of patients with GPA scores of nil to 3.0, 3.5 to 6.0, and 6.5 to 8.0 were 14.2, 29.5, and 56.6 months in the training set (P < 0.001) and 15.2, 31.2, and 54.0 months in the validation set (P < 0.001). The survival time of patients with NSCLC with bone-only metastasis was dramatically influenced by the presence of the determined prognostic factors. The GPA model developed in this study may be a useful clinical tool to estimate the life expectancy of these patients, and guide treatment.


Conversion to complete resection with mFOLFOX6 with bevacizumab or cetuximab based on K-ras status for unresectable colorectal liver metastasis (BECK study).
Patients with colorectal liver metastasis (CRLM) might be down-staged by chemotherapy from an initially unresectable stage to a resectable stage. Because the tumor response to preoperative chemotherapy has been correlated with resection rate, the improved efficacy from the concept that only the patients without K-ras mutations receive an anti-EGFR antibody might be expected to increase the conversion rate. The purpose of this study is to evaluate the conversion rate from unresectable CRLM to complete resection. We conducted a multi-institutional phase II trial for unresectable CRLM. Patients received mFOLFOX6 with either bevacizumab (bev) or cetuximab (cet) based on K-ras status (UMIN000004310). Planned treatment was for six cycles during which tumors were assessed for resectability every three cycles. Patients whose disease was unresectable after six cycles switched their chemotherapy regimen from mFOLFOX6 to FOLFIRI. The primary endpoint was R0 resection rate. Thirty-five patients with unresectable CRLM were enrolled. A total of 22/12 patients with K-ras wild-type/mutant (wt/mt) were treated with mFOLFOX6 plus cet/bev, respectively. The overall response rate was 64.7% (wt/mt; 77.3%/41.7%, P = 0.04). In 20 patients (58.8%), hepatectomy was performed according to protocol treatment, and the conversion rate was 72.7%/33.3% in wt/mt patients, respectively (P = 0.03). Finally, 23 patients (67.6%) underwent hepatectomy, and the conversion rate was 77.2%/50.0% in wt/mt patients (P = 0.09). The overall R0 resection rate was 47.1% (wt/mt; 50.0%/41.7%, P = 0.36). This prospective study showed that combined chemotherapy based on K-ras status can facilitate conversion to resection in patients with unresectable CRLM.


Determining minimal clinically important difference estimates following surgery for degenerative conditions of the lumbar spine: analysis of the Canadian Spine Outcomes and Research Network (CSORN) registry.
There is significant variability in minimal clinically important difference (MCID) criteria for lumbar spine surgery that suggests population and primary pathology specific thresholds may be required to help determine surgical success when using patient reported outcome measures (PROMs). The purpose of this study was to estimate MCID thresholds for 3 commonly used PROMs after surgical intervention for each of 4 common lumbar spine pathologies. Observational longitudinal study of patients from the Canadian Spine Outcomes and Research Network (CSORN) national registry. Patients undergoing surgery from 2015 to 2018 for lumbar spinal stenosis (LSS; n = 856), degenerative spondylolisthesis (DS; n = 591), disc herniation (DH; n = 520) or degenerative disc disease (DDD n = 185) were included. PROMs were collected presurgery and 1-year postsurgery: the Oswestry Disability Index (ODI), and back and leg Numeric Pain Rating Scales (NPRS). At 1-year, patients reported whether they were 'Much better'/'Better'/'Same'/'Worse'/'Much worse' compared to before their surgery. Responses to this item were used as the anchor in analyses to determine surgical MCIDs for benefit ('Much better'/'Better') and substantial benefit ('Much better'). MCIDs for absolute and percentage change for each of the 3 PROMs were estimated using a receiving operating curve (ROC) approach, with maximization of Youden's index as primary criterion. Area under the curve (AUC) estimates, sensitivity, specificity and correct classification rates were determined. All analyses were conducted separately by pathology group. MCIDs for ODI change ranged from -10.0 (DDD) to -16.9 (DH) for benefit, and -13.8 (LSS) to -22.0 (DS,DH) for substantial benefit. MCID for back and leg NPRS change were -2 to -3 for each group for benefit and -4.0 for substantial benefit for all groups on back NPRS. MCID estimates for percentage change varied by PROM and pathology group, ranging from -11.1% (ODI for DDD) to -50.0% (leg NPRS for DH) for benefit and from -40.0% (ODI for DDD) to -66.6% (leg NPRS for DH) for substantial benefit. Correct classification rates for all MCID thresholds ranged from 71% to 89% and were relatively lower for absolute vs percent change for those with high or low presurgical scores. Our findings suggest that the use of generic MCID thresholds across pathologies in lumbar spine surgery is not recommended. For patients with relatively low or high presurgery PROM scores, MCIDs based on percentage change, rather than absolute change, appear generally preferable. These findings have applicability in clinical and research settings, and are important for future surgical prognostic work.


Effects of a major structural change to the intensive care unit on the quality and outcome after intensive care.
Changes in structure may affect outcome after intensive care in various ways. Both closed (as opposed to open) units and the number of nurses have been shown to affect outcome. To study the effects of temporarily moving an intensive care unit (ICU) on various indicators of outcome and quality of care. Because of rebuilding, over a period of 8 months our ICU was moved to an adjacent postoperative area. The 12 month periods immediately before and after the rebuilding were chosen as reference periods. Routinely collected data such as length of stay, ventilator time, readmission rate, severity score (SAPS II), and observed mortality were used for comparison. Using variable life adjusted display (VLAD), an increase in hospital mortality was observed during the 8 month rebuilding period. This was also found using Kaplan-Meier estimates of survival and standardised mortality ratio. Structural change to our ICU was probably the major cause for the observed change in mortality.


Effect of Metoclopramide on the Incidence of Early Postoperative Aspiration Pneumonia in Dogs with Acquired Idiopathic Laryngeal Paralysis.
Evaluate the effect of a perioperative intravenous continuous rate infusion (CRI) of metoclopramide on the incidence of aspiration pneumonia in the short term postoperative period in dogs undergoing unilateral arytenoid lateralization. Prospective, randomized, multi-center clinical trial. 61 client-owned dogs with idiopathic laryngeal paralysis and normal preoperative thoracic radiographs. All dogs underwent unilateral arytenoid lateralization with a uniform anesthetic, analgesic, and management protocol. Dogs in the treatment group received an intravenous CRI of metoclopramide for 24 hours perioperative. All dogs were assessed for clinical signs of aspiration pneumonia based on the results of physical examination and owner interview up to the point of suture removal (10-14 days postoperative). Any dog with suspected aspiration pneumonia had thoracic radiographs performed. Six dogs developed aspiration pneumonia in the short term postoperative period (2/28 control dogs and 4/33 treated dogs), accounting for an overall frequency of 10% with no significant difference between control and treated dogs. No variables measured in the study were significantly different between control and treated dogs. Perioperative metoclopramide, at the doses used in this study, did not affect the incidence of aspiration pneumonia in the short term postoperative period in dogs with idiopathic laryngeal paralysis undergoing unilateral arytenoid lateralization.


Response of T lymphocyte populations in prostate cancer patients undergoing radiotherapy: influence of neoajuvant total androgen suppression.
This study sought to better define the immunological impact of combining neoadjuvant total androgen suppression (TAS) with radiotherapy (xRT) in treating prostate cancer. Subjects selected (n = 37) were stage I-II prostate cancer patients meeting the eligibility requirements for RTOG protocols 94-08 or 94-13. Flow cytometric monitoring of circulating T helper (Th), T suppressor/cytotoxic (Ts), natural killer (NK) and B lymphocytes was performed weekly. Significant reduction of all lymphocyte subsets occurred as a result of xRT. Comparison between treatment groups demonstrated that the B lymphocyte and NK lymphocyte radioresponse was not influenced by TAS, but the Th and Ts lymphocyte response was, with addition of TAS leading to less radiation-induced decline. The basis for this T cell response is unclear, but may involve a TAS-induced reduction of testosterone's immunomodulation of T cell proliferation and apoptosis and/or a direct, TAS-induced thymic stimulation. Our data suggest that addition of TAS to xRT appears to have no detrimental effects on lymphocyte subsets, and, indeed, may have favorable effects on T cells.


Third-order nonlinear optical properties of molecules containing aromatic diimides: effects of the aromatic core size and a redox-switchable modification.
The third-order nonlinear optical (NLO) properties of aromatic diimide molecules have been studied for the first time using density functional theory (DFT) with a finite field (FF). This study shows that the size of the aromatic core can affect the static second hyperpolarizability (γ). Increasing the number of benzenes along the longitudinal axis can effectively improve the γ values because the degree of charge transfer along the longitudinal direction increases, whereas an increase in the number of benzenes along the perpendicular axis does not enhance the γ values. Furthermore, the NLO responses of the reduced form radical anions 1(-), 5(-) and 6(-), which were obtained by a reversible redox process, are discussed. The results show that the γ values of the radical anions are changed by the redox process. For the reduced form radical anion 6(-), the γ value is -1906.71×10(-36)esu, and its absolute value is ∼7.3 times larger than that of its neutral parent. An analysis of the BLA values demonstrates that the γ value is closely related to the conjugation of the aromatic core used in the redox process.


Analysis of long- and short-term biometeorological conditions in the Republic of Serbia.
Long- and short-term biometeorological conditions in the Republic of Serbia were analyzed using official meteorological data from numerous weather stations located across the country. Selected biometeorological indices HUMIDEX, Physiologically Equivalent Temperature (PET), and Universal Thermal Climate Index (UTCI) are calculated based on air temperature, relative humidity, wind speed, and cloudiness data from the meteorological stations on annual and summer level as well as during selected heat wave periods during 2000-2020. Application of different biometeorological indices provides similar but somewhat different results. For example, average annual HUMIDEX and UTCI values indicate no thermal stress and no discomfort at all stations, while PET indicates the occurrence of slight to moderate cold stress at all stations. Average summer PET and UTCI indicate the occurrence of slight to moderate heat stress throughout the country, while HUMIDEX indicates no discomfort. Trends of biometeorological indices on annual and summer level show a general increase throughout the country. Furthermore, heat wave analysis indicated that the most populated cities of Serbia are under dangerous and extreme heat stress during these extreme temperature events, which can influence human health and well-being. The obtained biometeorological information can be used for the preparation of climate adaptation strategies that consider the human biometeorological conditions, with a special focus on developing climate-sensitive and comfortable cities.


Interpregnancy Weight Change Among Mothers of a Child with a Major Congenital Anomaly: A Danish Nationwide Cohort Study.
The mother of an infant with a major congenital anomaly is at a higher risk of premature cardiometabolic disease, possibly from chronic caregiver stress and distraction from self-care, including maintaining a healthy lifestyle and body weight. To compare the interpregnancy weight gain in women whose first infant had a major congenital anomaly vs those without an affected child. Multivariable linear regression compared women whose infant had an anomaly vs those whose infant did not, adjusting for interpregnancy time interval, demographics, smoking and health status at the first pregnancy. Of the 199,536 women who had two consecutive singleton births, 4035 (2.0%) had a child with an anomaly at the first birth. The mean (SD) maternal BMI at the start of the first pregnancy was 24.1 (4.7) and 23.7 (4.4) kg/m2 in women with, and without, an anomaly-affected newborn. By the start of the second pregnancy, 3 years later, they had gained a mean (SD) of 2.2 (5.5) and 1.8 (5.2) kg, respectively - an adjusted absolute higher gain of 0.26 kg (95% CI 0.10 to 0.42) in women with an anomaly-affected first-born infant compared to those with an unaffected pregnancy. The adjusted interpregnancy weight gain difference was greatest in women whose first-born infant had a multi-organ anomaly at 0.59 kg (95% CI 0.02 to 1.16). The adjusted odds ratio of moving from a normal BMI category of 18.5-24.9 kg/m2 in the first pregnancy, to an overweight or obese BMI category of 25+ kg/m2 in the second, was 1.18 (95% CI 1.06 to 1.32) comparing mothers with vs without an anomaly-affected child in the first pregnancy. Mothers of an infant with a major congenital anomaly have a modestly higher interpregnancy weight gain and tend to climb to a higher BMI category. The long-term implications of this greater weight trajectory require further study.


Internet-delivered cognitive-behavioral therapy for social anxiety disorder in Romania: a randomized controlled trial.
Internet-based cognitive-behavioral therapy (iCBT) for social anxiety disorder has been found effective, as attested by independently conducted randomized controlled trials in four languages. The study aim is to test the efficacy of an iCBT program in a culture where it was not tested before (i.e. Romania). Participants (n = 76) were recruited, screened and randomized to either a nine-week guided iCBT or a wait-list control group in April and May 2012. Self-report measures were collected before (April 2012) and after the intervention (July 2012), as well as six months later (January 2013). Although social anxiety was assessed with multiple measures, the Liebowitz Social Anxiety Scale - Self Report version (LSAS-SR) and Social Phobia Inventory (SPIN) were used as the primary outcome measures. A significant difference with a large between-group effect size in favor of iCBT was found (Cohen's d = 1.19 for LSAS-SR and d = 1.27 for SPIN). Recovery rates show that 36.8% (n = 14) in the treatment group score below the SPIN clinical cut-off compared to only 2.6% (n = 1) in the wait-list control group. Post-intervention clinical interviews also revealed that 34.2% (n = 13) of the treatment group was completely recovered (full remission) while additionally 36.8% (n = 14) retained some social anxiety symptoms (partial remission). However, an important study limitation is that post-intervention interviewers were not blinded to the study conditions. The program also effectively reduced depression and dysfunctional thinking (between-group Cohen's d = 0.84 for depression and d = 0.63 for dysfunctional thinking). Moreover, the iCBT intervention appears to have a long-term impact for participants' functioning, as the treatment gains were maintained six months later. Internet-delivered interventions display a high potential to quickly and widely disseminate effective evidence-based programs around the world. This study provides support for guided iCBT as a promising treatment approach in Romania. ClinicalTrials.gov NCT01557894.


7 Tesla MRI with a transmit/receive loopless antenna and B1-insensitive selective excitation.
Use of external coils with internal detectors or conductors is challenging at 7 Tesla (T) due to radiofrequency (RF) field (B1 ) penetration, B1 -inhomogeneity, mutual coupling, and potential local RF heating. The present study tests whether the near-quadratic gains in signal-to-noise ratio and field-of-view with field-strength previously reported for internal loopless antennae at 7T can suffice to perform MRI with an interventional transmit/receive antenna without using any external coils. External coils were replaced by semi-rigid or biocompatible transmit/receive loopless antennae requiring only a few Watts of peak RF power. Slice selection was provided by spatially selective B1 -insensitive composite RF pulses that compensate for the antenna's intrinsically nonuniform B1 -field. Power was adjusted to maintain local temperature rise ≤1°C. Fruit, intravascular MRI of diseased human vessels in vitro, and MRI of rabbit aorta in vivo are demonstrated. Scout MRI with the transmit/receive antennae yielded a ≤10 cm cylindrical field-of-view, enabling subsequent targeted localization at ∼100 μm resolution in 10-50 s and/or 50 μm MRI in ∼2 min in vitro, and 100-300 μm MRI of the rabbit aorta in vivo. A simple, low-power, one-device approach to interventional MRI at 7T offers the potential of truly high-resolution MRI, while avoiding issues with external coil excitation and interactions at 7T.


"Virtual stent" - clinical evaluation and user experience of on-the-fly stent simulation in treatment of cerebral aneurysms.
Predicting final stent position can be challenging when treating cerebral aneurysms. Third-Party software proved helpful in selecting proper stents in treatment planning. Recent angiographic systems provide basic stent simulation capabilities integrated in the post-processing software to simulate stent position. Goal of this analysis was to evaluate the simulation process and correlation with definite stent position. Thirty-three datasets with fusiform (n = 10) and saccular (n = 23) aneurysms, treated with stent or flow-diverter, were processed. A "virtual stent" of the same (nominal) size was simulated and its position was compared to the treatment result. Simulated length was rated in five grades (too short, shorter, equal, longer, too long), with regard to side-branches, anchoring zone etc. Simulation quality (centerline recognition/adherence to vessel margins) was rated in three grades (no, minor or major corrections required). Simulation was successful in 32/33 cases (97%), with one abortive attempt (3%). In 27/33 simulations (82%), there was no need for centerline refinement. Minor corrections were necessary in four and major corrections in two cases. Simulated nominal length was rated "equal" in 14/33 (42%) cases and "shorter" or "longer" - but within acceptable range - in each 9/33 (27%) cases. Basic stent simulation tools available with genuine angiographic workplace software can provide good simulation capabilities without need for third-party equipment. They can facilitate treatment planning and help to avoid shortage of devices. Yet, lack of calculation of foreshortening in large vessel diameters leaves the user to rely on their experience to account for device-specific properties.


Epidemiology of Neck Pain and Its Impact on Quality-of-Life-A Population-Based, Cross Sectional Study in Singapore.
Cross-sectional, epidemiological study. This study aims to describe the prevalence, risk factors, disability, and quality of life (QoL) burden of neck pain. Neck pain is an increasingly common symptom that results in significant disability and loss of QoL to the individual, and imposes a considerable economic burden to developed countries. A cross-sectional, questionnaire-based study was conducted via multistage random sampling of public households in Singapore on individuals aged 21 and older. Questionnaires were administered face-to-face by trained interviewers. Data analyzed included the prevalence and characteristics of neck pain, its relationship with sociodemographic factors, and its association on QoL and disability via validated questionnaires: EQ5D questionnaire and Neck Disability Index (NDI), respectively. A total of 626 individuals with a median age of 52.0 years (interquartile range 37.0-67.0), and even sex distribution of males (54.0%) and females (46.0%) were included in this study. A total of 144 individuals reported neck pain over the past 6 months, giving a 6-month period prevalence of 23.0%. Among them, nine (6.3%) had chronic, whereas 12 (8.3%) had severe neck pain. Female sex was the only significant risk factor for neck pain on multivariate analysis, with a risk ratio of 1.34 (95% confidence interval [CI] 1.00-1.80, P = 0.049). Individuals with neck pain had mean raw NDI scores of 4.91 ± 6.25, with higher disability seen with increasing pain duration and intensity (P < 0.001 and P = 0.002 respectively). Compared to individuals without neck pain, those with neck pain had poorer QoL with lower EQ5D-Index scores (0.84 ± 0.25 vs. 0.93 ± 0.15; 95% CI 0.046-0.132, P < 0.001) and EQ5D-VAS scores (68.76 ± 14.59 vs. 73.86 ± 13.64; 95% CI 2.510-7.697, P < 0.001). Our findings show that neck pain is a prevalent condition with chronicity and severity of symptoms associated with reduced QoL and increased disability. Population sample health scores can serve as potential reference targets in disease management and aid national health care policy-making.Level of Evidence: 3.


Outcomes of Reoperation After Acute Type A Aortic Dissection: Implications for Index Repair Strategy.
The optimal surgical approach for management of acute type A aortic dissection remains controversial. This study aimed to assess outcomes of reoperation after acute type A dissection repair to help guide decision making around index operative strategy. All aortic reoperations (n=129) at a single referral institution from August 2005 to April 2016 after prior acute type A dissection repair were reviewed. The primary outcome was 30-day or in-hospital mortality. Secondary outcomes included organ-specific morbidity and 1- and 5-year outcomes as estimated using the Kaplan-Meier method. The majority of initial reoperations were proximal aortic (aortic valve, aortic root, or ascending) or aortic arch procedures (62.5%, n=55); most initial reoperations were performed in the elective setting (83.1%, n=74). Additional nonstaged second or more reoperations were required in 21 patients (23.6%) after the initial reoperation, during a median follow-up of 2.5 years after the initial reoperation. Thirty-day or in-hospital mortality for all reoperations was 7.0% (elective: 6.3%; nonelective: 11.1%) with acceptable rates of organ-specific morbidity, given the procedural complexity. One- and 5-year overall survival after initial reoperation was 85.9% and 64.9%, respectively, with aorta-specific survival of 88% at 5 years. Reoperation after acute type A aortic dissection repair is associated with low rates of mortality and morbidity. These data support more limited index repair for acute type A dissection, especially for patients undergoing index repair in lower volume centers without expertise in extensive repair, because reoperations, if needed, can be performed safely in referral aortic centers.


Increased canine jejunal absorption of water, glucose, and sodium with intestinal pacing.
Our aim was to determine if pacing a segment of jejunum backwards with electrical stimuli could increase absorption from it. In four dogs, 75-cm loops of jejunum were isolated from the intestinal stream. After recovery, fluid was infused into the proximal stoma of the loop and effluent collected from the distal stoma for three consecutive 30-min periods. In the second period electrical stimuli were applied to the distal end of the loop to drive the pacesetter potentials of the loop, hence its contractions, backwards. The output of water, glucose, and sodium from the loop was decreased, and the transit of content through the loop was slowed during backward pacing. We conclude that pacing a segment of jejunum backwards with electrical stimuli enhances absorption of water, glucose, and sodium from that segment.


Waist-hip ratio measurement location influences associations with measures of glucose and lipid metabolism. The San Luis Valley Diabetes Study.
The ratio of waist to hip circumference is widely used to characterize fat distribution patterns but the locations for measurement are not standardized. Between 1986 and 1988, we measured two waist and two hip circumferences on 616 Hispanic and non-Hispanic white subjects, aged 30 to 74 years. Intraclass correlation coefficients, based on repeat measurements of 38 subjects, showed that minimum waist and maximum hip circumferences attained or exceeded the level of repeatability seen with the landmark-based circumference measures. Sex-specific partial correlation coefficients, adjusted for age and body mass index, indicated wide variation in the magnitudes of associations of the two waist-hip ratios with measures of insulin, high-density-lipoprotein cholesterol, triglycerides, and diastolic blood pressure. Models with simple waist circumference generally produced partial correlation coefficients of equal or greater magnitude compared to the coefficients seen with the waist-hip ratio.


Renewable and optically transparent electroactive indium tin oxide surfaces for chemoselective ligand immobilization and biospecific cell adhesion.
In this report, we show the successful transfer of a sophisticated electroactive immobilization and release strategy to an indium tin oxide (ITO) surface to generate (1) optically transparent, robust, and renewable surfaces, (2) inert surfaces that resist nonspecific protein adsorption and cell attachment, and (3) tailored biospecific surfaces for live-cell high-resolution fluorescence microscopy of cell culture. By comparing the surface chemistry properties on both ITO and gold surfaces, we demonstrate the ITO surfaces are superior to gold as a renewable surface, in robustness (durability), and as an optically transparent material for live-cell fluorescence microscopy studies of cell behavior. These advantages will make ITO surfaces a desired platform for numerous biosensor and microarray applications and as model substrates for various cell biological studies.


Pediatric Medical Device Consortia: A Novel Pathway for Pediatric Device Development for Pediatric Urologists and Other Pediatric Specialists.
A great need currently exists for medical devices designed specifically for children. This gap is most likely a result of economic, clinical and regulatory challenges as well as a lack of established mechanisms for joining pediatric device ideas with qualified individuals/programs and industry partners. We describe our experience with forming a pediatric medical device consortium that originated from the pediatric urology division and the technology transfer office of a university affiliated children's hospital. We reviewed the developmental history of a pediatric medical device consortium at a university affiliated children's hospital from March 2011 to June 2013 with emphasis on the organizational aspects of the consortium. A pediatric medical device consortium was formed with the assistance of university seed funding to encourage faculty collaboration across multiple campuses. The consortium continued its progress as a resource for pediatric device projects to become a Food and Drug Administration supported pediatric device consortium in 2013. This allows the consortium to expand its activities through the P50 PDC Grant Program. Pediatric urologists can have a major role in organizing pediatric device consortia. Consortia can combine academic centers with the local business, investment, higher education and philanthropic communities to rapidly advance pediatric medical device projects. Novel approaches are necessary for pediatric device projects to overcome current barriers to commercialization, including an extended stay in the academic setting.


Prognosis of zirconia ceramic fixed partial dentures: a 7-year prospective study.
The aim of this study was to evaluate the time-dependent clinical efficacy of anterior and posterior zirconia fixed partial dentures (FPDs). A convenience sample of 28 patients, each wearing 1 FPD, was recalled annually throughout a 6-year follow-up period (mean: 6.5 years). Four patients did not participate in the study (dropouts), and 24 FPDs were in use during the observation period. The cumulative survival and success rates were 88.9% and 81.8%, respectively. Fixed prostheses with zirconia frameworks may be regarded as acceptable alternatives to metal-ceramic anterior and posterior FPDs.


Non-circadian direct effects of light on sleep and alertness: lessons from transgenic mouse models.
Light exerts a strong non-visual influence on human physiology and behavior. Additionally light is known to affect sleep indirectly through the phase shifting of circadian rhythms, and directly, promoting alertness in humans and sleep in nocturnal species. Little attention has been paid to the direct non-image-forming influence of light until recently with the discovery and emerging knowledge on melanopsin, a photopigment which is maximally sensitive to the blue spectrum of light and expressed in a subset of intrinsically photosensitive retinal ganglion cells. Indeed, the development of transgenic mouse models targeting different phototransduction pathways has allowed researchers to decipher the mechanisms by which mammals adapt sleep to their light environment. This review summarizes the novel concepts and discrepancies from recent publications relating to the non-circadian effects of light on sleep and waking. Specifically, we discuss whether darkness, in addition to light, affects their quality. Furthermore, we seek to understand whether longer sustained periods of light exposure can influence sleep, if the direct photic regulation depends on time of day, and whether this affects the homeostatic sleep process. Moreover, the neural pathways by which light exerts a direct influence on sleep will be discussed including the respective role of rods/cones and melanopsin. Finally, we suggest that light weighs on the components of the flip-flop switch model to induce respectively sleep or waking, in nocturnal and diurnal animals. Taking these data into account we therefore propose a novel model of sleep regulation based on three processes; the direct photic regulation interacting with the circadian and homeostatic drives to determine the timing and quality of sleep and waking. An outlook of promising clinical and non-clinical applications of these findings will be considered as well as directions for future animal and human research.


Osteoma of Mastoid Bone; A Rare Presentation: Case Report.
Mastoid osteomas are benign, slow growing tumours arising in temporal bone. These are rare; few cases reported till date. Normally are asymptomatic, may present with cosmetic deformity, pain and hearing loss. These are readily excised. Recurrence is rare.


Connecting Heat Tolerance and Tenderness in Bos indicus Influenced Cattle.
Bos indicus cattle are widely utilized in tropical and subtropical climates. Their heat tolerance and parasite resistance are integral for beef production in these regions; however, a reputation for excitable temperaments, slower growth, and variation in tenderness has limited their use in commercial beef production. This suggests that there is antagonism between heat tolerance and meat production traits. Meat quality characteristics are determined by the properties of skeletal muscle as well as conditions during slaughter and processing. Thus, it is possible that adaptations related to heat tolerance in the living animal affect tenderness and other meat quality attributes. Since muscle represents a large proportion of body mass, relatively small changes at the cellular level could impact overall heat production of the animal. Specifically, protein degradation and mitochondria function are aspects of organ and cellular metabolism that may help limit heat production and also have a connection to tenderness. Protein degradation postmortem is critical to structural changes that enhance tenderness whereas mitochondria may influence tenderness through their roles in energy metabolism, calcium regulation, cell death signaling, and oxidative stress. This review explores potential relationships between cellular metabolism in vivo and beef quality development in Bos indicus and Bos indicus influenced cattle.


NFκB (RelA) mediates transactivation of hnRNPD in oral cancer cells.
Heterogeneous Ribonucleoprotein D (hnRNPD) is an RNA binding protein involved in post-transcriptional regulation of multiple mediators of carcinogenesis. We previously demonstrated a strong association of hnRNPD over expression with poor outcome in Oral Squamous Cell Carcinoma (OSCC). However, hitherto the precise molecular mechanism of its overexpression in oral cancer was not clear. Therefore, in an attempt to elucidate the transcriptional regulation of hnRNPD expression, we cloned 1406 bp of 5' flanking region of human hnRNPD gene along with 257 bp of its first exon upstream to promoterless luciferase reporter gene in pGL3-Basic. Transfection of the resulting construct in SCC-4 cells yielded 1271 fold higher luciferase activity over parent vector. By promoter deletion analysis, we identified a canonical TATA box containing 126 bp core promoter region that retained ~ 58% activity of the full length promoter. In silico analysis revealed the presence of four putative NFκB binding motifs in the promoter. Sequential deletion of these motifs from the full-length promoter reporter construct coupled with luciferase assays revealed an 82% decrease in promoter activity after deletion of the first (-1358/-1347) motif and 99% reduction after the deletion of second motif (-1052/-1041). In-vivo binding of NFκB (RelA) to these two motifs in SCC-4 cells was confirmed by ChIP assays. Site directed mutagenesis of even one of these two motifs completely abolished promoter activity, while mutagenesis of the remaining two motifs had marginal effect on the same. Consistent with these findings, treatment of SCC-4 cells with PDTC, a known inhibitor of NFκB dramatically reduced the levels hnRNPD mRNA and protein. Finally, the expression of hnRNPD and NFκB in clinical specimen from 37 oral cancer patients was assessed and subjected to Spearmen's Correlation analysis which revealed a strong positive correlation between the two. Thus, results of the present study for the first time convincingly demonstrate NFκB (RelA) mediated transcriptional upregulation of hnRNPD expression in oral cancer.


Fungal community associated with adults of the chestnut gall wasp Dryocosmus kuriphilus after emergence from galls: Taxonomy and functional ecology.
The diversity of the fungal community associated with adults of Dryocosmus kuriphilus following emergence was examined using HTS analysis. Ascomycota dominated the fungal core-biome community. The functional guilds of the 90 taxa forming the core-biome were assessed, demonstrating three main groups: saprotrophs, plant pathogens and entomopathogens. Twenty-nine OTUs out of 90 were resolved to species level identifying 26 different fungal species. Among these species, many were cosmopolitan or previously recorded in Europe. Ten taxa were previously recorded on chestnut, including some recognized plant pathogens associated with foliage and green tissues such as Epicoccum nigrum, Gnomoniopsis castanea, Colletotrichum acutatum, Stromatoseptoria castaneicola, Ramularia endophylla. Beauveria bassiana; within the core microbiome, Fusarium larvarum represented the most abundant entomopathogenic species. Some of these species are known to impact directly or indirectly the vitality of the insects in the galls. The chestnut blight pathogen, Cryphonectria parasitica, was never found associated with D. kuriphilus. Based on the present study, an active role for D. kuriphilus as a vector of chestnut fungal endophyte/pathogens cannot be demonstrated but neither ruled out.


Association between dexamethasone treatment and the host response in COVID-19 patients admitted to the general ward.
Dexamethasone improves clinical outcomes in COVID-19 patients requiring supplementary oxygen. We investigated possible mechanisms of action by comparing sixteen plasma host response biomarkers in general ward patients before and after implementation of dexamethasone as standard of care. 48 patients without and 126 patients with dexamethasone treatment were sampled within 48 h of admission. Endothelial cell and coagulation activation biomarkers were comparable. Dexamethasone treatment was associated with lower plasma interleukin (IL)-6 and IL-1 receptor antagonist levels, whilst other inflammation parameters were not affected. These data argue against modification of vascular-procoagulant responses as an early mechanism of action of dexamethasone in COVID-19.


Photochemistry in Real Space: Batho- and Hypsochromism in the Water Dimer.
The development of chemical intuition in photochemistry faces several difficulties that result from the inadequacy of the one-particle picture, the Born-Oppenheimer approximation, and other basic ideas used to build models. It is shown herein how real-space approaches can be efficiently used to gain valuable insights in photochemistry through a simple example of red and blue shift effects: the double hypso- and bathochromic shifts in the low-lying valence excited states of (H2 O)2 . It is demonstrated that 1) the use of these techniques allows the perturbative language used in the theory of intermolecular interactions, even in the strongly interacting short-range regime, to be maintained; 2) one and only one molecule is photoexcited in each of the addressed excited states and 3) the electrostatic interaction between the in-the-cluster molecular dipoles provides a fairly intuitive rationalisation of the observed batho- and hypsochromism. The methods exploited and illustrated herein are able to maintain the individuality and properties of the interacting entities in a molecular aggregate, and thereby they allow chemical intuition in general states, at any geometry and using a broad variety of electronic structure methods to be kept and built.


Differentiation of mouse embryonic stem cells into endothelial cells: genetic selection and potential use in vivo.
Embryonic stem (ES) cells are pluripotent cells derived from blastocyst-stage embryos. They are characterized by their infinite self-renewal capacity and their ability to differentiate into many cell types in vitro as well as in vivo. The present protocol describes culture conditions that allow efficient differentiation of mouse ES cells toward the endothelial lineage, both in two-dimensional cultures and in three-dimensional, multicellular embryoid bodies. We also provide a protocol for establishing recombinant ES cell clones, giving the example of cells expressing green fluorescent protein and an antibiotic resistance gene under the control of an endothelial-specific promoter. These transgenes allow the visualization and the genetic selection of endothelial cells from a heterogeneous population of differentiating ES cells. Potential applications for these differentiation models are given, including the study of the endothelial cell lineage and its derivatives, the testing of molecules involved in angiogenesis, and the potential use of selected endothelial cells in vivo.


Description of Rhopalum (s. str.) gulmargense n. sp. with a key to the Indian species of the subgenus Rhopalum Stephens, 1829 s. str. (Hymenoptera: Crabronidae: Crabronini).
A new species of the genus Rhopalum is described from India: Rhopalum (s. str.) gulmargense Saini Dey. A key to the Indian species of the subgenus Rhopalum s. str. and a checklist of all Indian Rhopalum are provided.


MR Imaging of Pulmonary Nodules: Detection Rate and Accuracy of Size Estimation in Comparison to Computed Tomography.
The aims of this study were to assess the sensitivity of various magnetic resonance imaging (MRI) sequences for the diagnosis of pulmonary nodules and to estimate the accuracy of MRI for the measurement of lesion size, as compared to computed tomography (CT). Fifty patients with 113 pulmonary nodules diagnosed by CT underwent lung MRI and CT. MRI studies were performed on 1.5T scanner using the following sequences: T2-TSE, T2-SPIR, T2-STIR, T2-HASTE, T1-VIBE, and T1-out-of-phase. CT and MRI data were analyzed independently by two radiologists. The overall sensitivity of MRI for the detection of pulmonary nodules was 80.5% and according to nodule size: 57.1% for nodules ≤4mm, 75% for nodules >4-6mm, 87.5% for nodules >6-8mm and 100% for nodules >8mm. MRI sequences yielded following sensitivities: 69% (T1-VIBE), 54.9% (T2-SPIR), 48.7% (T2-TSE), 48.7% (T1-out-of-phase), 45.1% (T2-STIR), 25.7% (T2-HASTE), respectively. There was very strong agreement between the maximum diameter of pulmonary nodules measured by CT and MRI (mean difference -0.02 mm; 95% CI -1.6-1.57 mm; Bland-Altman analysis). MRI yielded high sensitivity for the detection of pulmonary nodules and enabled accurate assessment of their diameter. Therefore it may be considered an alternative to CT for follow-up of some lung lesions. However, due to significant number of false positive diagnoses, it is not ready to replace CT as a tool for lung nodule detection.


Hybrid differential equations: Integrating mechanistic and data-driven techniques for modelling of water systems.
Mathematical modelling is increasingly used to improve the design, understanding, and operation of water systems. Two modelling paradigms, i.e., mechanistic and data-driven modelling, are dominant in the water sector, both with their advantages and drawbacks. Hybrid modelling aims to combine the strengths of both paradigms. Here, we introduce a novel framework that incorporates a data-driven component into an existing activated sludge model of a water resource recovery facility. In contrast to previous efforts, we tightly integrate both models by incorporating a neural differential equation into an existing mechanistic ODE model. This machine learning component fills in the knowledge gaps of the mechanistic model. We show that this approach improves the predictive capabilities of the mechanistic model and is able to extrapolate to unseen conditions, a problematic task for data-driven models. This approach holds tremendous potential for systems that are difficult to model using the mechanistic paradigm only.


Characterizing Attention Resource Capacity in Autism: A Multiple Object Tracking Study.
The extant literature aimed at characterizing attentional capability in autistics has presented inconsistent findings. This inconsistency and uncertainty may be the product of different theoretical and methodological approaches used to define attention in autism. In the current study, we investigate whether the allocation of attentional resources to task demands, and attention resource capacity, differs between autistics with no comorbid attention-deficit diagnosis (n = 55) and age-matched neurotypicals (n = 55). We compared differences in capacity and the allocation of resources by manipulating attentional load in a Multiple Object-Tracking (MOT) task, a robust, versatile, and ecological measure of selective, sustained, and distributed attention. While autistics demonstrated lower MOT performance, this difference disappeared when we accounted for fluid reasoning intelligence. Additionally, the similarity in the trend of MOT performance at increasing levels of attentional load between autistics and neurotypicals suggests no differences in the allocation of attentional resources to task demands. Taken together, our study suggests that higher-order cognitive abilities, such as intelligence, should be considered when characterizing attention across the autistic population in research. Similarly, our findings highlight the importance of considering cognitive competence when assessing attentional capabilities in autistic individuals, which could have significant implications for clinical diagnosis, treatment, and support.


Response of tussock tundra to elevated carbon dioxide regimes: analysis of ecosystem CO2 flux through nonlinear modeling.
The response of tussock tundra to elevated atmospheric concentrations of CO2 was measured at Toolik Lake, Alaska in the summer of 1983. Computer-controlled greenhouses were used to determine diurnal ecosystem flux of CO2 under four treatments: 340 ppm, 510 ppm, and 680 ppm CO2, as well as 680 ppm CO2 with a four degree centrigrade increase in temperature. For the seven days of data analyzed, net daily CO2 flux was significantly different between treatments. Net uptake was positively correlated with CO2 concentration in the chamber and negatively correlated with temperature. A nonlinear model was used to analyze this data set and to determine some of the reasons for different net CO2 flux. This model allowed an estimation of light utilization efficiency, total conductance of CO2, and a comparable measure of total respiration. From this analysis we conclude that nutrient limitations in the arctic decrease the capacity of tundra plants to make use of elevated CO2 concentrations. The plants respond by decreasing conductance in the presence of elevated CO2, which results in approximately equal gross uptake rates for the three CO2 treatments. Apparent changes in system respiration result in higher net uptake under elevated CO2 but this may be due to biases in the data. The treatment with increased temperature exhibited higher conductances and, consequently, higher gross uptake of CO2 than the other treatments. Higher temperatures, however, also increase respiration with the result being lower net uptake than would be expected in the absence of temperature inscreases.


Primary Aneurysmal Bone Cyst of the Thoracic Spine: A Pediatric Case Report.
To date, only a few documented cases exist of complete or near-complete paraplegia of the lower extremities following collapse of a vertebral body secondary to an aneurysmal bone cyst. We describe the preceding symptoms associated with this catastrophic event along with surgical management and recovery. A previously healthy, 13-year-old girl had experienced months of ongoing back pain with associated posture change. After collapsing at home in the bathroom, she was brought in by emergency medical services and presented to the neurosurgery service with an American Spinal Injury Association A spinal cord injury. Imaging revealed a collapsed T4 vertebral body including expanded and fluid-filled posterior elements and severe kyphotic spine angulation resulting in cord compression corresponding to her sensory and motor deficits. She underwent emergent surgery for spinal cord decompression with a T2-T4 laminectomy, transpedicular tumor resection, and T1-7 instrumented fusion. The patient tolerated the procedure well postoperatively. At 9 months after the event, she is ambulating independently without the use of crutches or a cane and has regained full strength for all muscle groups of her lower extremities. The unique combination of back pain and posture change symptoms in an otherwise healthy pediatric patient should heighten clinical suspicion for a possible aneurysmal bone cyst of the spine when formulating a differential diagnosis. Additionally, despite the clinical severity at presentation, patients may still experience significant recovery following expeditious surgical intervention.


Unusual abdominal aneurysms in a patient after kidney transplantation treated by endovascular technique.
While abdominal aortic aneurysms are quite common, visceral aneurysms are a seldomly diagnosed vascular pathology. Aneurysms of renal arteries, abdominal aorta and iliac arteries seem to be very rare. We present a patient after renal transplantation with aneurysms of both stumps of the renal arteries, abdominal aortic aneurysm and aneurysms of common iliac arteries. Because of the symptomatic course, the patient required urgent treatment. A successful endovascular procedure was performed. Follow-up imaging did not reveal any complications.


Resistance exercise training enhances sympathetic nerve activity during fatigue-inducing isometric handgrip trials.
Muscle sympathetic nerve activity (MSNA) was investigated 1 week before (pre-training), 1 week after, and 4-6 weeks after strength training using fatigue-inducing handgrip exercises and post-exercise forearm occlusion. Eighteen volunteers underwent forearm training, which consisted of 30 maximal effort, 10-s-duration static handgrips, 4 days per week for 4 weeks. A second group of 18 volunteers served as a control. MSNA was recorded from the tibial nerve by microneurography. Maximal handgrip force increased at 1 week post-training. The MSNA response during fatigued handgrip also increased at 1 week post-training, as compared to pre-training (52.6 +/- 5.8 vs. 40.6 +/- 4.4 bursts min(-1) (mean +/- SEM), respectively). However, at 4 weeks post-training, MSNA activity returned to the pre-training level (44.0 +/- 5.2 bursts min(-1); p < 0.0001 by ANOVA), while the control group showed no changes throughout this period. The MSNA response during post-exercise forearm occlusion was constant throughout the experiment in both groups. Our results indicate that an increased MSNA response after strength training is likely to be the result of central neural factors rather than the muscle metaboreflex.


Potential years of life lost due to PM2.5-bound toxic metal exposure: Spatial patterns across 60 cities in China.
To clarify the spatial patterns of disease burden caused by toxic metals in fine particulate matter (PM2.5) across China, annual concentration levels of typical toxic metals in PM2.5 over 60 cities of China were retrieved. Then, potential years of life lost (PYLL) attributable to toxic metal (As, Cd, Cr (VI), Mn, and Ni) exposure was calculated from health risk assessments and lifetable estimates. The results show that Cr(VI) and As were the most polluted metals and greatly exceeded the recommended annual values in the National Ambient Air Quality Standard of China. PYLL for each death (mean ± standard deviation) of 19.8 ± 4.5 years was observed for lung cancer, followed closely by COPD and pneumonia. Furthermore, the PYLL rate (years per 100,000 people) attributable to exposure to these toxic metals was 457 (male: 505, female: 402) years for different cities; therein, Cr(VI) contributed the highest PYLL among these toxic metals, with a proportion of 72.7% (male: 75.3%, female: 69.5%), followed by As of 16.4% (male: 13.8%, female: 19.8%). The concentration level and PYLL both showed large spatial variability, of which the top-ranking cities were observed to be affected by well-developed metal-related industries and coal-powered industrial sectors.


A comparative study of drug metabolizing enzymes in adrenal glands and livers of rats and chickens.
1. Drug metabolizing enzymes (cytochrome P450, glutathione-S-transferase, carboxylesterase) were compared in livers and adrenal glands from rats and chickens. 2. Quantities of cytochrome P450 in chicken liver and adrenal glands were less than in rat liver and adrenals. 3. Activities of carboxylesterase and of glutathione-S-epoxide transferase were similar in livers of rats and chickens. 4. In the chicken, activities of carboxylesterase and of glutathione-S-epoxide transferase were less in adrenal glands than in livers. 5. Carboxylesterase enzyme activities in adrenal glands of chickens were more sensitive to inhibition by antiesterase agents than were carboxylesterase enzyme activities in liver.


Assessing the general public's view of direct-to-consumer (DTC) genetic testing and their interpretation of DTC website disclaimer messages.
The general public continues to show increased interest and uptake of Direct-to-Consumer (DTC) genetic testing. We conducted an online survey (N = 405) to assess genetics knowledge, interest, and outcome expectancy of DTC genetic testing before and after exposure to a sample DTC disclaimer message. Descriptive statistics were used to analyze the relationship between previous genetic knowledge, attitudes and self-reported systematic processing of a sample DTC disclaimer message, outcome expectancies, and interest to pursue DTC genetic testing. Increased genetic knowledge and more positive attitudes towards DTC genetic testing were associated with increased self-reported systematic processing of the DTC disclaimer message. Further, self-reported systematic processing of the DTC disclaimer message was associated with greater interest in pursuing DTC genetic testing but did not predict outcome expectancies. As DTC genetic testing continues to gain in popularity and usage, additional research is imperative to better understand participants' motivations and processing of the DTC disclaimer messages to improve the user experience.


Personalized exercise for adolescents with diabetes or obesity.
This study examined adherence to a personalized, community-based exercise intervention by sedentary adolescents with type 1 or type 2 diabetes or those with obesity. We conducted a pretest-posttest investigation to explore the application of an individualized exercise prescription based upon current fitness level for 39 adolescents (20 with type 1 diabetes, 9 with type 2 diabetes, and 10 obese) over 16 weeks in community settings. Subjects were recruited from a university-based pediatric endocrinology clinic in the southwestern United States. Adherence to the exercise prescription was monitored using accelerometers over the entire intervention period. Moderate-to-vigorous physical activity (MVPA) levels significantly increased over sedentary baseline values (p < .001), but the average of 42.5 ± 22.1 min/day of MVPA determined at the end of the study was still less than the recommended 60 min/day. Perceptions of health were significantly increased for the total group following the intervention (p = .008). For those with type 1 diabetes, there was a significant association between MVPA duration and percentage change in HbA1c (r = -.526, p = .02). Recruitment and retention of adolescent participation in daily exercise is challenging. Personalized approaches that include adolescent choices with family support and ongoing motivation can improve individual exercise adherence and a sense of personal health.


Ecological momentary assessment of temptation and lapse in dieting.
Although some research attention has been given to the factors associated with temptation and lapse in dieting, the majority of research has focused on individuals in weight loss clinical trials and relied heavily on retrospective self-report data. The present study sought to overcome these limitations by using ecological momentary assessment (EMA) techniques to examine situations of dietary temptation, lapse, and minimal dietary consequence with a sample of overweight dieters (N=30) attempting to lose weight on their own. Results support and extend previous research findings on dietary temptation and lapse. In general, results indicate that recent consumptive activity, location, mood state, type of activity, and abstinence violation effects were related to moments of temptation and/or lapse. Education on the factors associated with dietary temptation and lapse and strategies for addressing these factors is imperative for both dieters in formal programs and those attempting to lose or maintain weight on their own.


The ontogeny of the metabolic and endocrine stress response in the human fetus, neonate and child.
Evidence of an endocrine and metabolic response to stress is evident from the mid trimester of fetal life. The ontogeny of this response is seen in the different patterns of response evident in the fetus, neonate, infant and child. These data raise important issues concerning the management of pain and stress in early life.