Novel alternative splicing predicts a truncated isoform of the NMDA receptor subunit 1 (NR1) in embryonic rat brain.
The expression of mesencephalic brain derived neurotrophic factor (BDNF) has been shown to be regulated by dopaminergic neuronal functioning and glutamate receptors (GluRs). In turn, BDNF participates in the regulation of mesencephalic GluRs' expression. In the present study we analyzed, using semi-quantitative RT-PCR, the effect of BDNF as well as of the GluRs agonists NMDA and trans-(+/-)-1-Amino-(1S,3R)-cyclopentane dicarboxylic acid (t-ACPD), on the expression levels of the NMDA GluR subunit 1 (NR1) mRNA, using rat cultured mesencephalic neurons. In the course of this study, a novel rat mRNA splice variant of NR1 was identified. This new NR1 mRNA isoform is characterized by the insertion of an 82 base pair intron containing an inframe stop codon, thus predicting the expression of a putative truncated protein of 465 amino acids. The RT-PCR and in situ hybridization reveals that the novel NR1 mRNA is expressed in various brain regions of the rat embryo, whereas no expression was detected in the adult rat brain. The modulation of the novel NR1 mRNA isoform by both BDNF and the metabotropic GluR agonist t-ACPD, suggests that the resulting putative NR1 truncated protein may be relevant in the regulatory network of glutamatergic neurotransmission in the developing central nervous system.


The occipital artery. Anatomy--normal arteriographic aspects--embryological significance.
An anatomical and radioanatomical study of the intracranial branches of the occipital artery is presented and attempt to systematize the muscular branches of the occipital trunk and its vertebral anastomosis. An embryological hypothesis is presented to explain and memorize all the artrial variations of this area.


Non-traditional roles for the Adenomatous Polyposis Coli (APC) tumor suppressor protein.
The Adenomatous Polyposis Coli (APC) tumor suppressor is a multifunctional protein that is mutated in a majority of colon cancers. The role of APC as an antagonist of the Wnt signaling pathway is well known and it is widely accepted that inappropriate activation of this pathway through loss of APC function contributes to the progression of colon cancers. However, a body of evidence is growing to support the idea that APC plays non-traditional functions outside of the Wnt pathway with roles in cell migration, adhesion, chromosome segregation, spindle assembly, apoptosis, and neuronal differentiation. This review highlights the research into alternate functions for APC beyond its role in Wnt signaling and discusses the possible contributions for these non-traditional functions of APC in tumor formation.


Autoimmune phenomena in ocular cicatricial pemphigoid.
Twelve patients with various stages of ocular cicatricial pemphigoid were studied. Tear volumes measured by Schirmer tests and visual acuities were generally reduced in proportion to disease severity. Mannitol-positive staphylococcus was recovered from 67% (16/24) of the eyelids cultured. Immunoglobulins were bound to the basement membrane of clinically involved conjunctivae in 67% of the patients (8/12). Eighty percent (8/10) of the clinically normal conjunctivae had no immunoglobulins bound to the basement membrane or epithelium, further reinforcing the importance of tissue-fixed immunoglobulins in the pathogenesis of this condition. Four of eight patients with immunoglobulins bound to basement membrane also had C3 complement bound to basement membrane. Acute disease may be associated with the presence of complement in the conjunctiva. In addition, three of the eight patients with basement membrane staining, and three without, showed marked epithelial intercellular and intracellular staining for immunoglobulins. Indirect immunofluorescence of patients' sera showed no circulating antibodies to basement membrane, but three patients had circulating antibodies directed to the conjunctival epithelium in an intercellular or intracellular location. No significant association of ocular pemphigoid with other circulating autoantibodies. HLA aantigens, or abnormal serum immunoglobulin levels was realized.


Characterization of Candida famata Isolated from Poultry Feces for Possible Probiotic Applications.
We studied here the yeast content of poultry feces, collected randomly from a French farm located in the north of the country. Thus, 81 yeast colonies were isolated and clustered into 22 distinct groups using the rep-PCR method. A single colony was taken from each group and identified using biochemical (ID 32C system) and molecular (sequencing of the D1/D2 domain of 26S rDNA and ITS1-5.8-ITS2 rDNA region) methods. Both methods led to the identification of Candida famata species. One isolate of C. famata strains, named strain Y5, was further studied for its cytotoxicity, adhesion, and surface properties, hemolytic activity, and its survival in simulated gastric and intestine environments. The data obtained advocate the probiotic potential of this isolate.


Topographic, tomographic, and corneal wavefront asymmetry in keratoconus: towards an eye asymmetry index EASIX.
The study aims to explore the intereye asymmetry in normal and keratoconic individuals and to evaluate the discriminant power of single and combined asymmetry parameters. This is a retrospective designed study including 414 patients who had Pentacam Scheimpflug topographic and tomographic imaging in both eyes: 124 subjects with bilateral normal corneas evaluated for refractive surgery and 290 with keratoconus. All elevation-, pachymetric-, and volumetric-based data (56 parameters) were electronically retrieved and analyzed. Intereye asymmetry was determined by subtracting the lowest value from the highest value for each variable. The degree of asymmetry between each subject's eyes was calculated with intraclass correlation coefficients for all the parameters. Receiver operating characteristic curve was used to determine predictive accuracy and to identify optimal cutoffs of these values and combinations thereof. In the normal/keratoconus subjects the median intereye asymmetries were 0.30/3.45 for K2 (flat) meridian, 0.03/0.25 for BFS front, 1.00/15.00 for elevation back BFS apex, and 7.00/29.00 for pachy min. In addition to Rabinowitz's Kmax intereye asymmetry we propose pachymetric, elevation-based, and high-order corneal wavefront intereye asymmetry parameters to improve the diagnostic armamentarium of keratoconus.


Segmental territories along the cardinal veins generate lymph sacs via a ballooning mechanism during embryonic lymphangiogenesis in mice.
During lymphangiogenesis in the mammalian embryo, a subset of vascular endothelial cells in the cardinal veins is reprogrammed to adopt a lymphatic endothelial fate. The prevailing model of lymphangiogenesis contends that these lymphatic precursor cells migrate away from the cardinal veins and reassemble peripherally as lymph sacs from which a lymphatic vasculature is generated. However, this model fails to account for a number of observations that, as a result, have remained anecdotal. Here, we use optical projection tomography, confocal microscopy and in vivo live imaging to uncover three key stages of lymphatic vascular morphogenesis in the mouse embryo at high resolution. First, we define territories or "pre-lymphatic clusters" of Prox1-positive lymphatic endothelial progenitor cells along the antero-posterior axis of the cardinal veins. Second, these pre-lymphatic clusters undergo progressive extrusion ("ballooning") to generate primitive lymph sacs. Third, lymphatic vessels emerge by a combination of mechanisms including sprouting from the lymph sacs and direct delamination of streams of cells from the cardinal veins. Our data support a new model for lymphatic vascular patterning and morphogenesis, as a basis for identifying the molecular cues governing these processes.


Reduction of Respiratory Motion During PET/CT by Pulsatile-Flow Ventilation: A First Clinical Evaluation.
Respiratory motion negatively affects PET/CT image quality and quantitation. A novel Pulsatile-Flow Ventilation (PFV) system reducing respiratory motion was applied in spontaneously breathing patients to induce sustained apnea during PET/CT. Four patients (aged 65 ± 14 y) underwent PET/CT for pulmonary nodule staging (mean, 11 ± 7 mm; range, 5-18 mm) at 63 ± 3 min after (18)F-FDG injection and then at 47 ± 7 min afterward, during PFV-induced apnea (with imaging lasting ≥8.5 min). Anterior-posterior thoracic amplitude, SUVmax, and SUVpeak (SUVmean in a 1-cm-diameter sphere) were compared. PFV PET/CT reduced thoracic amplitude (80%), increased mean lesion SUVmax (29%) and SUVpeak (11%), decreased lung background SUVpeak (25%), improved lesion detectability, and increased SUVpeak lesion-to-background ratio (54%). On linear regressions, SUVmax and SUVpeak significantly improved (by 35% and 23%, respectively; P ≤ 0.02). PFV-induced apnea reduces thoracic organ motion and increases lesion SUV, detectability, and delineation, thus potentially affecting patient management by improving diagnosis, prognostication, monitoring, and external-radiation therapy planning.


Medial supracondylar stress fracture in an adolescent pitcher/.
We report the occurrence of a medial supracondylar stress fracture in an adolescent pitcher. To our knowledge, this fracture has not been described in the literature, and awareness of this entity allows initiation of therapy and precludes further unnecessary work-up. The radiographic, computed tomography, and magnetic resonance imaging appearances are reviewed and the mechanism of injury is discussed.


Costs, effects and implementation of routine data emergency admission risk prediction models in primary care for patients with, or at risk of, chronic conditions: a systematic review protocol.
Emergency admission risk prediction models are increasingly used to identify patients, typically with one or more chronic conditions, for proactive management in primary care to avoid admissions, save costs and improve patient experience. To identify and review the published evidence on the costs, effects and implementation of emergency admission risk prediction models in primary care for patients with, or at risk of, chronic conditions. We shall search for studies of healthcare interventions using routine data-generated emergency admission risk models. We shall report: the effects on emergency admissions and health costs; clinician and patient views; and implementation findings. We shall search ASSIA, CINAHL, the Cochrane Library, HMIC, ISI Web of Science, MEDLINE and Scopus from 2005, review references in and citations of included articles, search key journals and contact experts. Study selection, data extraction and quality assessment will be performed by two independent reviewers. No ethical permissions are required for this study using published data. Findings will be disseminated widely, including publication in a peer-reviewed journal and through conferences in primary and emergency care and chronic conditions. We judge our results will help a wide audience including primary care practitioners and commissioners, and policymakers. CRD42015016874; Pre-results.


The influence of whey protein and glycomacropeptide on satiety in adult humans.
Protein is often considered the most satiating macronutrient. The objective was to determine the short-term effect of mixtures of whey protein and glycomacropeptide (GMP) versus a carbohydrate control on satiety in healthy adult humans. The study was a randomised crossover Latin Square design. On 4 separate days, fifty healthy subjects (19 males and 31 females) received a subject-specific breakfast (08:00 h), a preload drink (12:00 h) and lunch (12:30 h). The preload drink was presented as a milkshake with either maltodextrin carbohydrate (control), whey protein isolate (WPI) with no GMP, WPI with naturally present 21% GMP or WPI with naturally present 21% GMP plus added GMP. Satiety was assessed using visual analogue scales (VAS) and by determining ad libitum food intake during a cafeteria style meal offered 30 min after the preload. The VAS indicated that the lower GMP treatment induced a greater feeling of fullness immediately after consumption of the preload compared with the other treatments. Energy and macronutrient intake at lunch did not differ significantly (p>0.05) between treatments although subjects chose to eat foods higher in carbohydrate and lower in protein after the protein preloads. Women consumed the least amount of protein after the protein preloads whereas no difference was found in men. There was some evidence that whey proteins and their components enhance satiety over a short-term period compared to carbohydrate but there was no consistent effect of either whey protein alone or glycomacropeptide.


[Households in the reduction stage of the housing market. Analysis of behavior and prospects for the year 2000].
The aging of the Dutch population will lead to a larger demand for housing for the elderly. But this is not the only effect the aging population will have on the housing market. Till the year 2000 the group of households in the reduction stage will grow substantially. These households experience a reduction in size because children leave their parents' home or one of the partners dies. These households behave quite differently on the housing market than younger households. Simulation models have been developed to analyse both growth and composition of the group of older households and their behaviour on the housing market till the year 2000. The result show that the housing needs of the elderly in the future differ widely from those of the present cohorts.


Ultrasound assisted dialysis of semi-permeable membrane devices for the simultaneous analysis of a wide number of persistent organic pollutants.
A new procedure based on ultrasound assisted dialysis (UAD) for the simultaneous and quantitative extraction of a wide number of persistent organic pollutants (POPs) such as polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls (PCBs) or some other organochlorinated pesticides (OCPs) contained in semi-permeable membrane devices (SPMDs) has been developed. This extraction technique combines the advantages of the organic solvent dialysis (OSD) and the speed of the ultrasound assisted extraction. The extraction was performed in an ultrasound bath for 32 min placing the SPMD in a glass flask covered with 80 mL of hexane. This set-up is able to extract simultaneously up to 8 samples. The proposed method entails good repeatabilities (RSD 2-13%) and recoveries (around 100% for almost every analyte). Limits of detection were at ng SPMD(-1) level and enough for the determination of the target analytes in a slightly polluted aquatic environment, as it was tested by successfully comparing the OSD to the proposed methodology. Therefore, the results obtained show that the UAD can be a good alternative for the extraction of POPs in SPMDs as it requires short extraction times and solvent volumes, and provides a cleaner extract for the subsequent clean-up step. Moreover, it fits better than the OSD to the general requirements of Green Chemistry.


Efficiency of tungsten-polymer composite shields on fetal dose reduction in chest CT scans.
Given their desirable shielding properties, 5 polymer composite shields reinforced with tungsten were selected and their effects as gamma shields on fetal dose reduction were investigated. According to the results, the selected shields reduce the fetus brain, the fetus lungs, the fetus kidneys, and the total fetus dose almost 34.17%-41.19%, 20.47%-25.08%, 9.27%-12.13%, and 15.39%-18.69%, respectively, at tube voltage of 80 kVp. At the higher tube potentials, the values of dose reduction were smaller. Moreover, it was observed that polymers named PHEMA-WO3 and RS-U-30 had an excellent shielding ability among the other studied composites.


Amino-functionalized alginate/graphene double-network hydrogel beads for emerging contaminant removal from aqueous solution.
Inorganic-organic composite hydrogels have attracted much attention in recent years. In this study, an amino-functionalized graphene/alginate double-network hydrogel (NH2-DN) with excellent mechanical and adsorption properties was successfully prepared. Triethylenetetramine (TETA) was used as a crosslinker which promotes random few-layer graphene sheets stacking and resulted in a reduced graphene oxide (rGO) network, containing mesopore and macropore structures on the hydrogel surface. Compared to single network hydrogel, enhanced thermal stability and mechanical properties were achieved in NH2-DN. The elasticity modulus was improved by approximately 3 times due to the formation of the double-network. More importantly, NH2-DN exhibited excellent adsorption properties for typical emerging contaminants (Cu2+ and ciprofloxacin (CIP)). Compared with that of an ordinary graphene/alginate single-network hydrogel (SN), the adsorption capacity of the NH2-DN for Cu2+ and CIP reached 153.91 mg g-1 and 301.36 mg g-1, respectively, which was increased by 130% and 182%, respectively. Adsorption isotherm and kinetic analyses reveal that the adsorption process of CIP onto the NH2-DN was dominated by chemical affinity. Adsorption properties were comprehensively examined, including the effects of the solid-liquid ratios, pH, and ionic strength. NH2-DN retained 94% of its adsorption capacity when the ionic strength was 0.5 mol L-1 and maintained at least 87% of its adsorption capacity in weak acidic and alkaline solutions. This novel amino-functionalized organic-inorganic hydrogel has great potential in environmental applications owing to its outstanding physicochemical, mechanical, and adsorption properties for emerging contaminants in wastewater.


In vivo identification of novel regulators and conserved pathways of phagocytosis in A. gambiae.
Anopheles gambiae uses effective immune responses, including phagocytosis, to fight microbial infection. We have developed a semiquantitative phagocytosis test and used it in conjunction with dsRNA gene silencing to test the in vivo roles of 71 candidate genes in phagocytosis of Escherichia coli and Staphylococcus aureus. Here, we show that inactivation of 26 genes changes the phagocytic activity by more than 45% and that two pathways similar to those that mediate apoptotic cell removal in Caenorhabditis elegans are used in A. gambiae for phagocytosis of microorganisms. Simultaneous inactivation of the identified regulators of phagocytosis and conserved components defining each signaling pathway permitted provisional assignment of the novel regulators to one or the other pathway. Pathway inactivation enhances at least three times the ability of E. coli and S. aureus to proliferate in the mosquito. Interestingly, mosquito survival is not compromised even if both pathways are perturbed simultaneously.


Effect of a multi-modal intervention on immunization rates in obstetrics and gynecology clinics.
There is increasing attention on immunizations by obstetrician-gynecologists and a need to improve vaccination rates for all women. To evaluate the effect of a multimodal intervention on rates of immunization with tetanus, diphtheria, and acellular pertussis (Tdap); human papillomavirus (HPV); and influenza in outpatient obstetrics and gynecology clinics. Immunization rates at 2 clinics were compared pre- and post-implementation of multiple interventions at a public integrated health-care system. Study interventions began on June 6, 2012 and concluded on May 31, 2014; the preimplementation time period used was June 6, 2010 to June 5, 2012. Interventions included stocking of immunizations in clinics, revision and expansion of standing orders, creation of a reminder/recall program, identification of an immunization champion to give direct provider feedback, expansion of a payment assistance program, and staff education. All women aged 15 and older who made a clinic visit during influenza season were included in the influenza cohort; women who delivered an infant during the study time period and had at least 1 prenatal visit within 9 months preceding delivery were included in the Tdap cohort; each clinic visit by a nonpregnant woman aged 15-26 years was assessed and included in the HPV analysis as an eligible visit if the patient was lacking any of the 3 HPV vaccines in the series. The primary outcome was receipt of influenza and Tdap vaccine per current American College of Obstetricians and Gynecologists guidelines and receipt of HPV vaccine during eligible visits. Influenza and Tdap were assessed with overall coverage rates at the institutional level, and HPV was assessed at the visit level by captured opportunities. All analyses included generalized estimating equations and the primary outcome was assessed with time as a covariate in all models. A total of 19,409 observations were included in the influenza cohort (10,231 pre- and 9178 post-intervention), 2741 in the Tdap cohort (1248 pre- and 1493 post-intervention), and 12,443 in the HPV cohort (7966 pre- and 4477 post-intervention). Our population was largely Hispanic, English-speaking, and publicly insured. The rate of influenza vaccination increased from 35.4% pre-intervention to 46.0% post-intervention (P < .001). The overall rate for Tdap vaccination increased from 87.6% pre-intervention to 94.5% post-intervention until the recommendation to vaccinate during each pregnancy was implemented (z = 4.58, P < .0001). The average Tdap up-to-date rate after that recommendation was 75.0% (z = -5.77, P < .0001). The overall rate of HPV vaccination with an eligible visit increased from 7.1% before to 23.7% after the intervention. Using evidence-based practices largely established in other settings, our intervention was associated with increased rates of influenza, Tdap, and HPV vaccination in outpatient underserved obstetrics and gynecology clinics. Integrating such evidence-based practices into routine obstetrics and gynecology care could positively impact preventive health for many women.


Aquasonolysis of thioethers.
The aquasonolytical rate constants and products of diethyl sulfide, diallyl sulfide, dipropyl sulfide, dibutyl sulfide, diethyl disulfide, and dipropyl disulfide have been investigated. The sonolysis for model compounds in aqueous solutions follows the pseudo-first-order kinetics. Disulfides are more rapidly sonicated than sulfides. Neither vapour pressure nor thermostability of thioethers can obviously affect their aquasonolytical rates. Higher Henry's Law constant and hydrophobicity of substrate result in a higher aquasonolytical rate constant. Furthermore, the aquasonolytical rate constant decreases as the initial concentration of dipropyl sulfide increases. CS2, COS, thiols, thiirane, lower sulfides, butenyne, and butadiene are detected as principal very volatile products during ultrasonic irradiations. Thiophene, benzene, 1,5-hexadiene, and cyclopentadiene are additionally obtained during the aquasonolysis of diallyl sulfide. Furthermore, trisulfides, trithiolane, and other cyclic thiolanes as volatile products are observed. These results demonstrate that thioethers undergo thermal decomposition during their aquasonolyses. The transfer process of volatile thioethers between cavitation bubbles and bulk liquid remarkably affect the aquasonolysis, and the hydrophobicity of substrate dominates the transfer process.


Motor patterns and propulsion in the rat intestine in vivo recorded by spatio-temporal maps.
We have used spatio-temporal maps derived from video images to investigate propagated contractions of the rat small intestine in vivo. The abdomen, including an exteriorized segment of jejunum, was housed in a humid chamber with a viewing window. Video records were converted to spatio-temporal maps of jejunal diameter changes. Intraluminal pressure and fluid outflow were measured. Contractions occupied 3.8 +/- 0.2 cm of intestine and propagated anally at 3.1 +/- 0.2 mm s(-1) when baseline pressure was 4 mmHg. Contractions at any one point lasted 8.7 +/- 0.6 s. Contractions often occurred in clusters; within cluster frequencies were 2.28 +/- 0.04 min(-1). Pressure waves, with amplitudes greater than about 9 mmHg, expelled fluid when the baseline pressure was 4 mmHg. In the presence of L-NAME, circular muscle contractions occurred at a high frequency, but they were not propagated. We conclude that video recording methods give good spatio-temporal resolution of intestinal movement when applied in vivo. They reveal neurally-mediated propulsive contractions, similar to those previously recorded from intestinal segments in vitro. The propagated contractions had speeds of propagation that were slower and frequencies of occurrence that were less than speeds and frequencies of slow waves in the rat small intestine.


Post-traumatic morbidity is frequent in children with frontobasilar fractures.
Frontobasilar fractures are potentially life-threatening injuries also in pediatric populations, often due to associated intracranial trauma. This retrospective study was performed at a tertiary care university hospital to evaluate the management and outcome of pediatric frontobasilar fractures. The secondary aim was to re-evaluate the computerized tomography images to reveal all the skull base fracture sites predicting morbidity. A retrospective analysis of all the 20 consecutive pediatric patients diagnosed with and treated for a frontobasilar fracture at the Turku University Hospital, Turku, Finland during 1995-2010 was performed. The referral area of this tertiary care university hospital covers 750,000 inhabitants of whom approximately 20% are 18 years or younger. The mean annual incidence of frontobasilar fractures was 1.1 per 100,000 children aged 18 years and under. A road traffic accident was the most common etiological factor. Other factors included being hit by a heavy object, falling from a height, and falling to the ground. The mean Glasgow Coma Scale score was 10 and loss of consciousness was initially detected in 15 (75%) patients in the emergency unit. Twelve (60%) patients had an intracranial injury, 17 (85%) had facial bone fractures, and 15 (75%) had a fracture of the anterior cranial base. The middle cranial fossa and sella were affected in five (25%) of the patients. There seem to be no long-term neuroendocrine sequelae following brain injury, not even when the sella or the hypophyseal area was affected. Twelve (60%) patients were treated operatively. One patient died after one week of intensive care treatment. Only four (20%) patients had no post-traumatic implications, eight (40%) suffered from various long-term sequelae, and five (25%) had permanent neurological or neuropsychological sequelae. Frontobasilar fractures in childhood are rare and often associated with intracranial trauma and long-term morbidity. However, according to this study, 75% of the patients showed no permanent neurological or neuropsychological sequelae.


Determination of lipid bilayer/water partition coefficient of new phenothiazines using the second derivative of absorption spectra method.
The partition coefficients (K(p)) between lipid bilayer of phosphatidylcholine (PC) vesicles and buffer for five new phenothiazines were determined using the second derivatives of ultraviolet absorption spectra. The lambda(max) of absorption band for each of the investigated phenothiazine derivatives (PDs) was shifted to the longer wavelengths in the presence of PC vesicles with increasing of lipid concentration. As a result of light scattering in liposome suspension no isosbestic point could be observed in absorption spectra. However, the background signal could be eliminated using the method of second derivative of absorption spectra. In the second derivative of absorption spectra two isosbestic points were observed. Changes of intensity (Delta D) of second derivative of absorption spectra at the lambda(max) (wavelength of absorption maximum for drug in buffer) caused by the increase in lipid concentration were measured for set of phenothiazine derivatives. K(p) for these drugs were calculated from the relationship between Delta D and lipid concentration. The K(p) values for all studied phenothiazine derivatives are in the order of magnitude of 10(5) and they increase about 1.7-fold when length of the alkyl phenothiazine chain was enhanced by addition of the each next one (-CH(2)) group. Substitution of -H atom by -CF(3) group at position 2 of phenothiazine ring results in 3.5-fold increase in K(p) values.


Assessment and treatment of substance use in adults with ADHD: a psychological approach.
Over half of young people and adults diagnosed with Attention Deficit Hyperactivity Disorder [ADHD] also have substance use disorder [SUD]. Their use of substances may arise from an attempt to self-medicate and/or to cope with their difficulties. This manuscript reviews key research in the literature and identifies that traditional SUD psychological interventions are an effective treatment for those presenting with a dual diagnosis of ADHD and SUD. However, typically, this is only available to those presenting to specialist SUD services for treatment of harmful use and/or dependency. This misses an opportunity to intervene much earlier, before drug use escalates to these levels. The manuscript aims to provide practical guidance for healthcare practitioners, by detailing a psychological framework for earlier assessment and intervention of problematic drug use in young people and adults with ADHD. Specific techniques are outlined drawing on psychoeducation, motivational interviewing and cognitive behavioural therapy in a phased approach to address factors that motivate initial use of substances and those that maintain use.


Anticipatory guidance for the adolescent. Parents' concerns.
Parents' opinions regarding anticipatory guidance for adolescents have not been adequately investigated. In this study, 932 parents of adolescents completed a computerized questionnaire listing 30 common psychosocial-medical concerns of adolescence. Respondents were asked how important it is for private pediatricians to discuss these topics with their teenagers during regular checkups. Ten items were rated important by > or = 90% of parents, 22 items by > or = 80%, and 29 items by > or = 66%. Heeding parents' expectations and concerns, pediatricians should incorporate discussions of psychosocial-medical issues as a meaningful component of routine adolescent health care.


Nursing education in South Africa.
Basic nursing education in South Africa has recently changed from a series of single registrations to a 4 year integrated programme. Diploma nursing education has also been moved into the mainstream of post-secondary education by the establishment of Nursing Colleges affiliated to Universities. These structural changes have put nursing education on a healthy footing, which should serve it well for the next decade.


Nuclear fragmentation in colon carcinoma cells.
The nuclei of the epithelial cells of well differentiated adenocarcinoma of the large intestine show characteristic appendages, the nucleotesimals, connected with the main nucleus by lamellar bridges. We interpret this phenomenon as being the result of a hitherto unknown type of amitosis that permits rapid cancer growth in spite of a low mitotic index.


Anterior Capsular Reconstruction for Irreparable Subscapularis Tears.
Chronic anterior shoulder instability due to structural failure of the subscapularis muscle and the anterior capsule is a rare and challenging diagnosis for surgeons to manage because poor-quality capsular, labral, and rotator cuff tissue often limits effective treatment options. If primary repair is not possible because of retraction and poor tissue quality, reconstruction with an allograft or autograft may be the only joint-preserving option. The purpose of this article is to describe a surgical technique for anterior capsular reconstruction using a human acellular dermal allograft for the treatment of irreparable subscapularis tears.


Malignant lesions on mammography: accuracy of two different computer-aided detection systems.
We retrospectively compared the accuracy of two computer-aided detection (CAD) systems for the detection of malignant breast lesions on full-field digital mammograms. Mammograms of 326 patients were analyzed (117 patients with breast cancer, 209 negative cases), and each set of cases was read by two CAD systems (Second Look versus AccuDetect Galileo). True-positive fractions per image and case for soft densities, microcalcifications, and total cancers were assessed. Study results showed better overall performance of AccuDetect Galileo (when compared to Second Look) in detecting masses, microcalcifications, and all cancer types, especially in extremely dense breast parenchyma.


Implementing telemedicine in urogynecology: A feasibility study.
Telemedicine has been recommended for the management of urogynecological conditions during the coronavirus (COVID 19) pandemic. This study aimed to evaluate the feasibility of telemedicine for urogynecology at a Brazilian public hospital. A descriptive observational study was performed at a urogynecology outpatient clinic. The primary outcome was the desire to continue with telemedicine. Secondary outcomes were appointment resolvability, technical aspects of the appointment, and patient satisfaction. The participants had in-person appointments that were canceled because of the COVID-19 pandemic. We collected data on sociodemographic characteristics and clinical and technical aspects of the appointments. The participants responded to satisfaction questionnaires 7-15 days post-procedure. The categorical variables were evaluated based on absolute and relative frequency. The continuous variables were described as the mean and standard deviation. A chi-square test was performed to determine the association between variables. In total, 225 patients had appointments canceled due to the COVID-19 pandemic, of which 171 were eligible for the study. Telemedicine appointments were agreed upon by 48% of the participants and 85.5% responded to the satisfaction survey. We found that 57.7% of the participants desired to continue with telemedicine. The appointment resolvability rate was 76.1%, 63.4% of the appointments met the technical criteria, and the satisfaction rate was 93%. The only variable associated with the desire to continue telemedicine was overall patient satisfaction (p=0.02). Telemedicine in urogynecology is feasible and can be implemented in the studied population. However, actions are essential to adequately support patient preference and improve the acceptance of telemedicine.


Incidence of and Risk Factors for Incisional Hernia After Hepatectomy for Colorectal Liver Metastases.
Incisional hernia (IH) is common after major abdominal surgery; however, the incidence after hepatectomy for cancer has not been described. We analyzed incidence of and risk factors for IH after hepatectomy for colorectal liver metastases (CLM). Patients who underwent open hepatectomy with midline or reverse-L incision for CLM at a single institution between 2010 and 2018 were retrospectively analyzed. Postoperative CT scans were reviewed to identify IH and the time from hepatectomy to hernia. Cumulative IH incidence was calculated using competing risk analysis. Risk factors were assessed using Cox proportional hazards model analysis. The relationship between IH incidence and preoperative body mass index (BMI) was estimated using a generalized additive model. Among 470 patients (median follow-up: 16.9 months), IH rates at 12, 24, and 60 months were 41.5%, 51.0%, and 59.2%, respectively. Factors independently associated with IH were surgical site infection (HR: 1.54, 95% CI 1.16-2.06, P = 0.003) and BMI > 25 kg/m2 (HR: 1.94, 95% CI 1.45-2.61, P < 0.001). IH incidence was similar in patients undergoing midline and reverse-L incisions and patients who received and did not receive a bevacizumab-containing regimen. The 1-year IH rate increased with increasing number of risk factors (zero: 22.2%; one: 46.8%; two: 60.3%; P < 0.001). Estimated IH incidence was 10% for BMI of 15 kg/m2 and 80% for BMI of 40 kg/m2. IH is common after open hepatectomy for CLM, particularly in obese patients and patients with surgical site infection. Surgeons should consider risk-mitigation strategies, including alternative fascial closure techniques.


High level of lncRNA NR2F1-AS1 predict the onset and progression of diabetic retinopathy in type 2 diabetes.
This study aimed to investigate whether dysregulation of NR2F1-AS1 is associated with the T2D onset and DR progression. A total of 269 individuals diagnosed with T2D were recruited in this study, including 111 individuals with uncomplicated T2D and 158 individuals with nonproliferative diabetic retinopathy (NPDR). A total of 48 among the NPDR individuals developed into proliferative diabetic retinopathy (PDR), excepting that 6 individuals were dropped out. RT-qPCR was used to determine the expression of NR2F1-AS1 level in blood. The correlations between NR2F1-AS1 expression and other parameters were tested by Pearson correlation. Receiver operating characteristic (ROC) curves were plotted for evaluating the diagnostic value of NR2F1-AS1 as a biochemical indicator detecting T2D and PDR. Kaplan-Meier method and Cox multivariable analysis was used to evaluate the predictive power of NR2F1-AS1 for incidence of PDR. A significant increase in blood NR2F1-AS1 in uncomplicated T2D, NPDR, and PDR patients was found when compared to healthy subjects. Significant correlations between NR2F1-AS1 expression and the level of fasting glucose, 2-h postprandial blood glucose, and HbA1c were revealed. Furthermore, NR2F1-AS1 represented distinguishing ability in T2D individuals from healthy subjects and PDR individuals from NPDR individuals. NR2F1-AS1 also showed strong predictive ability for PDR. The examination of blood NR2F1-AS1 may be used as a noninvasive biomarker for screening of T2D and early diagnosis of DR. NR2F1-AS1 may also be used as a promising novel biomarker for prediction PDR. NR2F1-AS1 may play a role in the progression of DR by moderating EndMT.


[Comparison of MR cholangiopancreatography and surgical diagnosis of extrahepatic bile duct carcinoma].
This work was done to compare the validity of various imaging methods, e.g. ultrasonography (US), computed tomography (CT), endoscopic retrograde cholangiopancreatography (ERCP), percutaneous transhepatic cholangiography (PTC), and, especially, magnetic resonance cholangiopancreatography (MRCP) for extrahepatic bile duct carcinoma. Sixty-five such patients who were operated and confirmed by pathology were used. Sixty patients had been examined by US; 52 by CT; 20 by ERCP; 9 by PTC and 20 by MRCP. The results of these imaging methods were compared with those of operative and pathological findings. The diagnostic accuracy rates of site location were US 81.7%, CT 84.6%, ERCP 75.0%, PTC 88.9% and MRCP 100%, respectively. The quality diagnostic accuracy rates were US 73.3%, CT 82.7%, ERCP 75.0%, PTC 88.9% and MRCP 95.0%, respectively. MRCP is superior to US, CT, ERCP and PTC not only in demonstrating the position but also the nature of extrahepatic bile duct carcinoma.


Modified Charlson comorbidity index as a survival prediction tool for older patients after liver transplantation.
An increasing number of older patients now undergo liver transplantation (LT). Although the overall outcomes in older patients are not different from those of younger patients, there is no tool to predict LT prognosis in older patients. We hypothesized that a modified Charlson comorbidity index (mCCI) and 5-factor modified frailty index (mFI-5) can predict outcomes in older patients after LT. This retrospective study included 155 patients (aged >65 years) who underwent LT at Seoul National University Hospital. The recipients were subcategorized into 2 groups based on the mCCI score and mFI-5: the low (0-1) and high (2-5) mCCI groups, and low (≤0.4) and high (>0.4) mFI-5 groups. The independent effect of each variable on post-LT survival was determined using the mCCI subgroup, age at transplantation, sex, Child-Turcotte-Pugh score, model for end-stage liver disease (MELD) score, and mFI-5 subgroup. The high-mCCI group (41 patients) showed significantly lower 1- and 3-month and 1-, 3-, and 5-year survival than the low-mCCI group. Using the Cox regression model, the mCCI, sex, and MELD score remained significant. The mFI-5 was not a significant factor to predict patients' survival. The mCCI and MELD scores could be used to predict post-LT survival in older patients.


Ipsilateral ureteroureterostomy and pyeloureterostomy: a review of 15 years of experience with 25 patients.
We reviewed our 15-year experience with pyeloureterostomy and ureteroureterostomy in 25 children with ureteral duplication. Pyeloureterostomy was performed in 5 patients, including 4 with reflux and 1 with upper pole obstruction. The results were good in 4 and in 1 patient postoperative anastomotic obstruction developed. Ipsilateral ureteroureterostomy was performed in 20 patients, including 8 with reflux into 1 or both ipsilateral ureters, 7 with obstructed ectopic upper pole ureters without ureterocele, 4 with ectopic ureteroceles and 1 with incomplete ureteral duplication and obstruction of the common distal ureteral segment. At followup, which ranged from 3 months to 6 years, 17 patients had good postoperative results as demonstrated by improved upper tract drainage and absence of reflux. Of 6 patients who underwent simultaneous ipsilateral ureteral reimplantation at the time of ureteroureterostomy postoperative reflux was noted in 1, necessitating a second procedure. Ureteral stumps were left in 13 patients. Postoperative urinary infection occurred in only 3 of these patients, all as single episodes and 2 associated with persistent contralateral reflux. Significant luminal disparity at the time of ureteroureterostomy was noted in 18 patients and did not adversely affect results.


Discovery of Conservation and Diversification of miR171 Genes by Phylogenetic Analysis based on Global Genomes.
The microRNA171 (miR171) family is widely distributed and highly conserved in a range of species and plays critical roles in regulating plant growth and development through repressing expression of SCARECROW-LIKE (SCL) transcription factors. However, information on the evolutionary conservation and functional diversification of the miRNA171 family members remains scanty. We reconstructed the phylogenetic relationships among miR171 precursor and mature sequences so as to investigate the extent and degree of evolutionary conservation of miR171 in Arabidopsis thaliana (L.) Heynh. (ath), grape (Vitis vinifera L.) (vvi), poplar (Populus trichocarpa Torr. & A.Gray ex Hook.) (ptc), and rice (Oryza sativa L.) (osa). Despite strong conservation of over 80%, some mature miR171 sequences, such as ptc-miR171j -l, and -m and osa-miR171g, -h, and -i, have undergone critical sequence variation, leading to functional diversification, since they target non-SCL gene transcript(s). Phylogenetic analyses revealed a combination of old ancestral relationships and recent lineage-specific diversification in the miR171 family within the four model plants. The cis-regulatory motifs on the upstream promoter sequences of miR171 genes were highly divergent and shared some similar elements, indicating their possible contribution to the functional variation observed within the miR171 family. This study will buttress our understanding of the functional differentiation of miRNAs and the relationships of miRNA-target pairs based on the evolutionary history of miRNA genes.


Alveolar macrophage-epithelial cell interaction following exposure to atmospheric particles induces the release of mediators involved in monocyte mobilization and recruitment.
Studies from our laboratory have shown that human alveolar macrophages (AM) and bronchial epithelial cells (HBEC) exposed to ambient particles (PM10) in vitro increase their production of inflammatory mediators and that supernatants from PM10-exposed cells shorten the transit time of monocytes through the bone marrow and promote their release into the circulation. The present study concerns co-culture of AM and HBEC exposed to PM10 (EHC-93) and the production of mediators involved in monocyte kinetics measured at both the mRNA and protein levels. The experiments were also designed to determine the role of the adhesive interaction between these cells via the intercellular adhesion molecule (ICAM)-1 in the production of these mediators. AM/HBEC co-cultures exposed to 100 microg/ml of PM10 for 2 or 24 h increased their levels of granulocyte-macrophage colony-stimulating factor (GM-CSF), M-CSF, macrophage inflammatory protein (MIP)-1beta, monocyte chemotactic protein (MCP)-1, interleukin (IL)-6 and ICAM-1 mRNA, compared to exposed AM or HBEC mono-cultures, or control non-exposed co-cultures. The levels of GM-CSF, M-CSF, MIP-1beta and IL-6 increased in co-cultured supernatants collected after 24 h exposure compared to control cells (p < 0.05). There was synergy between AM and HBEC in the production of GM-CSF, MIP-1beta and IL-6. But neither pretreatment of HBEC with blocking antibodies against ICAM-1 nor cross-linking of ICAM-1 on HBEC blocked the PM10-induced increase in co-culture mRNA expression. We conclude that an ICAM-1 independent interaction between AM and HBEC, lung cells that process inhaled particles, increases the production and release of mediators that enhance bone marrow turnover of monocytes and their recruitment into tissues. We speculate that this interaction amplifies PM10-induced lung inflammation and contributes to both the pulmonary and systemic morbidity associated with exposure to air pollution.


Sensation and perception of sucrose and fat stimuli predict the reinforcing value of food.
Chronic overeating can lead to weight gain and obesity. Sensory system function may play a role in the types of foods people select and the amount of food people eat. Several studies have shown that the orosensory components of eating play a strong role in driving food intake and food selection. In addition, previous work has shown that motivation to get food, or the reinforcing value of food, is a predictor of energy intake. The purpose of this study was to test the hypothesis that higher detection thresholds and lower suprathreshold intensity ratings of sweet and fat stimuli are associated with greater reinforcing value of food. In addition, we sought to determine if the sensory ratings of the stimuli would differ depending on whether they were expectorated or swallowed. The reinforcing value of food was measured by having participants perform operant responses for food on progressive ratio schedules of reinforcement. Taste detection thresholds and suprathresholds for solutions containing varied concentrations of sucrose and fat were also measured in two different Experiments. In Experiment 1, we found that sucrose, but not fat, detection predicted the reinforcing value of food with the reinforcing value of food increasing as sucrose detection threshold increased (indicating poorer detection). In Experiment 2, we found that lower suprathreshold ratings of expectorated fat and sucrose predicted greater reinforcing value of food. In addition, higher detection thresholds for fat stimuli (indicating poorer detection) were associated with greater reinforcing value of food. When taken together, these studies suggest that there is a relationship between taste detection and perception and reinforcing value of food and that these relationships vary based on whether the stimulus is swallowed or expectorated.


Morphology and function of Bast's valve: additional insight in its functioning using 3D-reconstruction.
The utriculo-endolymphatic valve was discovered by Bast in 1928. The function of Bast's valve is still unclear. By means of orthogonal-plane fluorescence optical sectioning (OPFOS) microscopy 3D-reconstructions of the valve and its surrounding region are depicted. The shape of the duct at the utricular side is that of a flattened funnel. In the direction of the endolymphatic duct and sac this funnel runs into a very narrow duct. The valve itself has a rigid 'arch-like' configuration. The opposing thin, one cell-layer thick, utricular membrane is highly compliant. We propose that opening and closure of the valve occurs through movement of the flexible base/utricular membrane away from and toward the relatively rigid valve lip.


A multicenter cohort study on the association of the one-abutment one-time concept with marginal bone loss around bone level implants.
To investigate the association of the one-abutment one-time concept with marginal bone loss (MBL) around bone-level implants in relation to other factors. Records from patients treated by four experienced implant surgeons between January 2016 and July 2019 were scrutinized. Subjects treated with two bone-level implant types with varying machined collar (subgroups: 0.5 and 0.8 mm) were considered, receiving a healing abutment (HA cohort) or a permanent abutment at the time of surgery (OT cohort). The primary outcome was MBL registered at 3 months and the longest follow-up. A clustered two-part regression model for semicontinuous data was used. Data pertaining to 160 patients (92 females, mean age 54) and 344 implants (125 in HA cohort, 219 in OT cohort) were available for evaluation. Mean MBL amounted to 0.52 mm (SD 0.68) after a mean follow-up of 20 (SD 9.2) months, with 33.8% of the implants showing complete bone preservation and 5.0% demonstrating >2mm MBL. OT was not related to the presence of MBL using MBL as dependent binary variable (0: no MBL; 1: MBL irrespective of its magnitude). However, OT significantly reduced the magnitude of MBL with 0.300mm when compared to HA (p = .023) in the cases where MBL was detected. Subgroup (p = .212), smoking (p = .789), history of periodontitis (p = .839), type of edentulism (p = .054), implant surgeon (p = .079), patient compliance (p = .617), and follow-up (p = .443) failed to show a significant association with MBL in the regression model. Ninety-eight % of the implants survived. Within the limitations of a cohort study, the one-abutment one-time concept was associated with a decrease in MBL at implant sites with bone loss. Therefore, the placement of a permanent abutment at the time of surgery seems relevant to limit marginal bone-level alterations.


Autoregulatory patterns in the arteriolar network of cat mesentery.
The purpose of this study was to examine the distribution and extent of autoregulatory behavior among arterioles in the arcade network of the cat mesentery. We found that 71% of 169 arterioles studied dilated and 63% showed blood flow autoregulation with arterial pressure reduction to 55-60 mm Hg. There appeared to be a direct relation between the degree of dilation and the degree of autoregulation when individual vessels were compared (r = 0.71). The dilation of individual arterioles was also correlated with the degree of autoregulation of other vessels in the same field (r = 0.51). To a lesser extent, the degree of dilation of individual arterioles was correlated with the degree of dilation of other vessels in the same field (r = 0.30). In comparing vessels which dilated, the largest average response was found in preparations where all vessels dilated. On a percentage basis the small arterioles located distally in the network dilated more than the large arterioles located proximally. In preparations having both reactive and nonreactive arterioles to pressure reduction, the nonreactive vessels were usually located geographically in proximity to each other. The flow distribution in the arteriolar network remained relatively stable on pressure reduction; the total tissue area perfused by a first-order arteriole shifting by 3% on the average.


Neural respiratory drive measured during inspiratory threshold loading and acute hypercapnia in healthy individuals.
Understanding the effects of respiratory load on neural respiratory drive and respiratory pattern are key to understanding the regulation of load compensation in respiratory disease. The aim of the study was to examine and compare the recruitment pattern of the diaphragm and parasternal intercostal muscles when the respiratory system was loaded using two methods. Twelve subjects performed incremental inspiratory threshold loading up to 50% of their maximal inspiratory pressure, and 10 subjects underwent incremental, steady-state hypercapnia to a maximal inspired CO2 of 5%. The diaphragmatic electromyogram (EMGdi) was measured using a multipair oesophageal catheter, and the parasternal intercostal muscle EMG (sEMGpara) was recorded from bipolar surface electrodes positioned in the second intercostal space. The EMGdi and sEMGpara were analysed over the last minute of each increment of both protocols, normalized using the peak EMG recorded during maximal respiratory manoeuvres and expressed as EMG%max. The EMGdi%max and sEMGpara%max increased in parallel during the two loading methods, although EMGdi%max was consistently greater than sEMGpara%max in both conditions, inspiratory threshold loading [bias (SD) 9 (3)%, 95% limits of agreement 4-15%] and hypercapnia [bias (SD) 6 (3)%, 95% limits of agreement -0.05 to 12%]. Inspiratory threshold loading resulted in more pronounced increases in mean (SD) EMGdi%max [10 (7)-45 (28)%] and sEMGpara%max [5.3 (3.1)-40 (28)%] from baseline compared with EMGdi%max [7 (4)-21 (8)%] and sEMGpara%max [4.7 (2.3)-10 (4)%] during hypercapnia, despite comparable levels of ventilation. These data support the use of sEMGpara%max, as a non-invasive alternative to EMGdi%max recorded with an invasive oesophageal electrode catheter, for the quantification of neural respiratory drive. This technique should make evaluation of respiratory muscle function easier to undertake and therefore more readily acceptable in patients with respiratory disease, in whom transduction of neural respiratory drive to pressure generation can be compromised.


Clinical Outcomes and Prognostic Factors in Complex, High-Risk Indicated Procedure (CHIP) and High-Bleeding-Risk (HBR) Patients Undergoing Percutaneous Coronary Intervention with Sirolimus-Eluting Stent Implantation: 4-Year Results.
We aimed to characterize the performance and safety of percutaneous coronary intervention (PCI) in complex, high-risk indicated procedure (CHIP) and high-bleeding-risk (HBR) patients at a 4-year follow up. We included all consecutive patients who underwent PCI with the sirolimus-eluting coronary stent Alex Plus (Balton, Poland) between July 2015 and March 2016. We analyzed various baseline demographic and clinical characteristics, laboratory data, and clinical outcomes. We enrolled 232 patients in whom 282 stents were implanted, including 81 patients meeting the CHIP criteria and 76 patients meeting the HBR criteria. In the whole population, the mean age was 68 ± 11 years, and 23.7% were females. Most procedures were performed from radial access (83.2%) using a 6F guiding catheter (95.7%). The lesions were mostly predilated (61.6%), and postdilatation was performed in 37.9%. The device success was 99.6% (in one case, a second stent was required due to heavy calcifications). Additional stents were deployed in 39% of cases due to edge dissection (6.9%), side branch stenting (5.2%), or diffuse disease (26.9%). Myocardial infarction (MI) type 4a was revealed in 2.2% of cases. At 4 years, the MACE rates for the whole population and for CHIP and HBR patients were 23.3%, 29.6%, and 27.6%, respectively. CHIP patients had a higher risk of MACEs (29.6% vs. 19.9%, HR 1.69, p = 0.032) and cardiac death (11.1% vs. 4.6%, HR 2.50, p = 0.048). There were no differences for MI (7.4% vs. 6.6%, p = 0.826) and TLR (18.5% vs. 12.6%, p = 0.150). HBR patients were also characterized by a higher risk of MACEs (27.6% vs. 21.2%, HR 1.84, p = 0.049) and cardiac death (17.1% vs. 1.9%, HR 9.61, p < 0.001). There were no differences for MI (7.9% vs. 6.4%, p = 0.669) and TLR (11.8% vs. 16.0%, p = 0.991). PCI in CHIP and HBR patients is feasible with a low rate of periprocedural complications. Nevertheless, CHIP and HBR patients are at a high risk of future adverse events and require strict surveillance to improve outcomes.


NiCo2O4 nano-needles as an efficient electro-catalyst for simultaneous water splitting and dye degradation.
Developing an efficient and non-precious bifunctional catalyst capable of performing water splitting and organic effluent degradation in wastewater is a great challenge. This article reports an efficient bifunctional nanocatalyst based on NiCo2O4, synthesized using a simple one-pot co-precipitation method. We optimized the synthesis conditions by varying the synthesis pH and sodium dodecyl sulfate (SDS) concentrations. The prepared catalyst exhibited excellent catalytic activity for the electrochemical oxygen evolution reaction (OER) and simultaneous methylene blue (MB) dye degradation. Among the catalysts, the catalyst synthesized using 1 g SDS as a surfactant at 100 °C provided the highest current density (658 mA cm-2), lower onset potential (1.34 V vs. RHE), lower overpotential (170 mV @ 10 mA cm-2), and smallest Tafel slope (90 mV dec-1) value. Furthermore, the OH˙ radicals produced during the OER electrochemically degraded the MB to 90% within 2 hours. The stability test conducted at 20 mA cm-2 showed almost negligible loss of the electrochemical response for OER, with 99% retention of the original response. These results strongly suggest that this catalyst is a promising candidate for addressing the challenges of wastewater treatment and energy generation.


Symptom resolution of bile reflux gastritis after transoral gastric outlet reduction in a patient with Billroth II anastomosis.
Endoscopic transoral outlet reduction (TORe) utilizing a full thickness endoscopic suturing device is a minimally invasive therapeutic option in bariatric surgery patients who have experienced weight gain, but also can be used in patients who underwent Billroth II (B-II) procedure with biliary reflux symptoms.


Regulatory long non-coding RNA and its functions.
The discovery of large numbers of long non-coding RNAs (lncRNAs) has been driven by genome-wide transcriptional analyses. Compared to small ncRNAs, lncRNAs have been shown to harbor biological activities, but the functions of the great majority of lncRNAs are not known. There is growing evidence that lncRNAs can regulate gene expression at epigenetic, transcription, and post-transcription levels and widely take part in various physiological and pathological processes, such as participating in cell development, immunity, oncogenesis, clinical disease processes, etc. Here, the current research efforts on the function of lncRNA in recent years were summarized.


Management of Grave's disease is improved by total thyroidectomy.
A retrospective analysis was performed on 267 consecutive patients with Graves' disease (GD). The principal aim of this study was to evaluate the risk for recurrence and complications when changing the surgical method from subtotal (ST) to total thyroidectomy (TT). Information from 267 consecutive patients operated on for GD between 2000 and 2006 was collected at Uppsala University Hospital (143) and Falun County Hospital (128). There were 229 women and 38 men. Four patients were operated on twice. A total of 40 STs and 229 TTs were performed. Results were compared to those of a previous cohort from the same hospital, with a majority of STs (157/176) performed from 1980 to 1992. The risk for relapse of GD was reduced from 20 to 3.3 % after the shift from ST to TT. In terms of surgical complications, 2.2 % demonstrated permanent vocal cord paralysis and 4.5 % had persistent hypocalcemia, not significant when compared to the previous cohort. In spite of TT, there were four recurrences, all due to remnant thyroid tissue high up at the hyoid bone. Changing the surgical method did not affect postoperative progression of dysthyroid ophthalmopathy (DO, 7.0 vs. 7.5 %). There were no differences in outcome with respect to which hospital the patients had their operation. Change from ST to TT dramatically reduced the risk for recurrence of GD without increasing the rate of complications. TT is not more effective than ST in hampering progression of DO as has been advocated by some. Careful surgical dissection up to the hyoid bone is necessary to avoid recurrence.


Panitumumab: human monoclonal antibody against epidermal growth factor receptors for the treatment of metastatic colorectal cancer.
Panitumumab, formerly known as ABX-EGF, was the first recombinant human immunoglobulin G2 monoclonal antibody approved by the US Food and Drug Administration for the treatment of patients with epidermal growth factor receptor-expressing metastatic colorectal cancer (mCRC) refractory to fluoropyrimidine-, oxaliplatin-, and/or irinotecan-containing chemotherapeutic regimens. The purpose of this review was to evaluate the pharmacokinetic and pharmacodynamic properties, clinical efficacy, and safety profile of panitumumab in the treatment of metastatic colorectal cancer. Computerized searches of MEDLINE and International Pharmaceutical Abstracts from 1985 to August 15, 2007, were performed with the search terms panitumumab, ABX-EGF, EGFr, and colorectal cancer. All available clinical trials and ongoing trials were included in this review. Relevant abstracts presented at the annual meetings of the American Society of Clinical Oncology, American Association for Cancer Research, and Gastrointestinal Cancer Symposium (1999-2007) also were reviewed and included. Preclinical and clinical studies have established a role for panitumumab in mCRC refractory to multiple chemotherapeutic regimens. In a Phase III trial of panitumumab plus best supportive care (BSC) versus BSC alone in patients with refractory mCRC, panitumumab was found to have efficacy in time-related end points, such as progression-free survival. In the panitumumab group, a significant (46%) reduction in tumor progression rate was reported compared with BSC (hazard ratio, 0.54; 95% CI, 0.44-0.66; P < 0.001). At the present time, the use of panitumumab as first-line treatment for mCRC with standard chemotherapy and bevacizumab is not indicated due to increased toxicity with no advantage in efficacy. The efficacy of panitumumab is being evaluated in other solid tumors, such as lung, breast, ovarian, bladder, and head and neck cancers. Panitumumab appears to have relatively acceptable tolerability and is now available as an additional option for patients with mCRC refractory to multiple chemotherapeutic regimens.


Effects of statins on C-reactive protein and interleukin-6 (the Ludwigshafen Risk and Cardiovascular Health study).
This report provides preliminary evidence that statins may lower C-reactive protein levels by interfering with the generation and/or release of C-reactive protein in the liver rather than by modulating inflammatory processes in the vessel wall.


Integrated fermentation and anaerobic digestion of primary sludges for simultaneous resource and energy recovery: Impact of volatile fatty acids recovery.
This research assessed the impact of volatile fatty acids (VFA) recovery and biomethane potential in an integrated fermentation-digestion process with a single stage digestion of primary and rotating belt filtration (RBF) sludges. Implementing semi-continuous fermentation at 1, 2, and 4 days solids retention time (SRT) showed a direct impact on the hydrolysis and VFA recovery which increased as SRT increased, while also improving the dewaterability by reducing the concentrated sludge volume index of the processed sludge. pH-controlled fermentation was effective improving the VFA yields by up to 93% and 72% at pH 9 (relative to no pH control), for RBF and primary sludges, respectively; although fermentation at pH 6 (optimum) showed promise for enhancing VFAs while lowering the required chemicals significantly. Although cellulose constituted only 21.0% and 29.5% of the TSS in primary and RBF sludges, it contributed 38-41% of the methane production for the two sludges, respectively. Experimental results of integrated fermentation-digestion and single stage digestion processes were incorporated in techno-economic analysis. Results confirmed the economic viability of fermentation with payback periods of 2.7 ± 1.1 years (RBF), and 3.6 ± 2.7 years (PS), while also revealed that VFA recovery could save up to 7.2 ± 2.0% (RBF), and 7.6 ± 2.7% (PS) of the respective total sludge handling and disposal costs, despite an average of 12.7% and 8.4% decrease in biogas production due to VFA extraction in the integrated systems of RBF and primary sludges, respectively. Overall, the integrated fermentation-digestion system economically outperformed the single stage digestion for both sludge types under all studied scenarios.


Clarifying the effect of facial emotional expression on inattentional blindness.
Conscious perception often fails when an object appears unexpectedly and our attention is focused elsewhere (inattentional blindness). While various factors have been identified as determinants of inattentional blindness, the influence of an unexpected object́s semantic value remains ambiguous. This is also true for the supposedly evolutionary meaning of faces; some studies found higher detection rates for faces while others did not or used control conditions that differed in physical aspects of the stimulus as well. In the proposed studies we aim to replicate and clarify the effect of the semantic value of faces on inattentional blindness in a controlled and systematic manner.


Comparable survival for pediatric acute myeloid leukemia with poor-risk cytogenetics following chemotherapy, matched related donor, or unrelated donor transplantation.
We sought to better define the role of hematopoietic cell transplantation (HCT) in first remission (CR1) for high-risk pediatric acute myeloid leukemia (AML). Outcomes were compared among patients aged less than 21 years with cytogenetically defined poor-risk AML treated with chemotherapy, matched related (MRD), or unrelated donor (URD) transplantation in CR1. Poor-risk cytogenetics was defined as monosomy 7/del7q, monosomy 5/del 5q, abnormalities of 3q, t(6;9)(p23;q34), or complex karyotype. Included are patients treated on Children's Oncology Group trials or reported to the Center for International Blood and Marrow Transplant Research from 1989 to 2006. Of the 233 patients, 123 received chemotherapy, 55 received MRD HCT, and 55 received URD HCT. The 5-year overall survival from the time of consolidation chemotherapy or transplant conditioning was similar: chemotherapy (43% ± 9%), MRD (46% ± 14%), or URD (50% ± 14%), P = 0.99. Similarly, multivariate analysis demonstrated no significant differences in survival [(reference group = chemotherapy); MRD HR 1.08, P = 0.76; URD HR 1.13, P = 0.67] despite lower relapse risk with URD HCT (HR = 0.43, P = 0.01). Our findings do not provide support for the preferential use of HCT over chemotherapy alone for children with cytogenetically defined poor-risk AML in CR1.


Nondestructive quantification of the soluble-solids content and the available acidity of apples by fourier-transform near-infrared spectroscopy.
This research evaluated the feasibility of using Fourier-transform near-infrared (FT-NIR) spectroscopy to quantify the soluble-solids content (SSC) and the available acidity (VA) in intact apples. Partial least-squares calibration models, obtained from several preprocessing techniques (smoothing, derivative, etc.) in several wave-number ranges were compared. The best models were obtained with the high coefficient determination (r2) 0.940 for the SSC and a moderate r2 of 0.801 for the VA, root-mean-square errors of prediction of 0.272% and 0.053%, and root-mean-square errors of calibration of 0.261% and 0.046%, respectively. The results indicate that the FT-NIR spectroscopy yields good predictions of the SSC and also showed the feasibility of using it to predict the VA of apples.


Novel approaches to mitigate primer interaction and eliminate inhibitors in multiplex PCR, demonstrated using an assay for detection of three strawberry viruses.
Multiplex PCR is an important technique for detecting a variety of pathogens simultaneously in a single assay. Previous research has focused on optimising the factors affecting reliable multiplex PCR, including primer design, PCR components and conditions, and inhibitors in samples. In this study, the interaction of primers to form complex secondary structures including visible dimers and invisible "primer clusters", a novel form of primer secondary structure found during this research, were shown to be the most important factors affecting successful multiplex PCR. Approaches to mitigate primer interaction and eliminate inhibitors were tested, including: reduction of primer concentrations especially those with preferential amplification; decrease of PCR extension temperature; increase of extension time and PCR cycles; and addition of bovine serum albumin. Based on these approaches, a multiplex RT-PCR with sensitivity comparable to the simplex PCR for individual viruses was developed for the detection of Raspberry ringspot virus, Strawberry latent ringspot virus and Tomato bushy stunt virus. A plant internal amplification control was also included. These approaches may be useful as a guideline for the development of multiplex PCR protocols for the detection of other pathogens or organisms associated with plants, humans, animals and the environment.


[Vascular injuries associated with dislocation of the knee: diagnosis protocol].
Knee dislocation is an unusual condition, and can have catastrophic consequences, such as vascular and neurological complications, in addition to the ligament injuries. The aim of this study is to analyse the effectiveness of a protocol of early diagnosis of vascular injuries associated with knee dislocations. A retrospective study was conducted which included acute knee dislocations treated in our institution, with a minimum of 12 months follow-up, between 1999-2010. A diagnostic protocol based on physical examination and ankle-brachial index was used in order to detect vascular injuries. Ten dislocations, 30% with popliteal artery injury, were diagnosed early and received emergency treatment within 8 hours. There were associated neurological injuries in two patients. There were no amputations. The systematic use of this protocol has avoided consequences of late diagnosis and has drastically reduced the abusive use of invasive tests, such as arteriography.


Fecal shedding of foodborne pathogens by Florida-born heifers and steers in U.S. beef production segments.
The objective in this study was to assess breed effects in fecal prevalence of Escherichia coli O157:H7 in heifers on a development program in Florida and in their steer half siblings in stocker and feedlot phases in Oklahoma. A secondary objective was to characterize fecal shedding of Campylobacter and Salmonella in subsets of the same samples. After weaning, heifers (n = 501; purebreds and F1 crosses of Angus, Brahman, and Romosinuano) were preconditioned and placed in a local development program. Steers (n = 481) were transported to Oklahoma, where they grazed wheat for 6 months and then were placed in feedlot pens. Fecal samples were obtained at least every 28 days for 12 months on most animals. None of the 10,982 samples tested positive for E. coli O157:H7. Overall fecal prevalences of Campylobacter and Salmonella in heifers were 1.7 and 0.04%, respectively. Corresponding overall prevalences in steer samples were 27.2 and 0.6%. Campylobacter isolates were mostly C. jejuni and were tetracycline resistant. Eight Salmonella isolates were Salmonella Typhimurium that were either quad or penta resistant, most often to ampicillin, chloramphenicol, sulfamexathole, and tetracycline. Feedlot steers had greater odds of positive detection of Campylobacter (odds ratio, 8.5; confidence interval, 3.7, 19.5) than when grazing winter wheat. No breed effect was detected for fecal prevalence of these pathogens.


Correlation between microbial communities and key flavors during post-fermentation of Pixian broad bean paste.
Pixian broad bean paste (PBP) is a traditional Chinese condiment, famous for its distinctive flavor. Microbial communities play a vital role in producing the unique flavor of PBP, and a significant accumulation of these volatile flavors occurs during the post-fermentation stage of its production. However, little is known about the relationship between the microbes and flavor compounds in PBP. In this study, high-throughput sequencing (HTS) analysis revealed that Leuconostoc (8.30%), Lactobacillus (7.05%), Weissella (5.80%) and Staphylococcus (4.03%) were the dominant bacterial genera, while the most prevalent yeast genera were Zygosaccharomyces (41.45%) and Pichia (5.83%). Gradual accumulations of free amino acids (glutamic acid and asparagine), organic acids (malic acid and tartaric acid), and unique volatiles (aldehydes, phenols and pyrazines) were evident throughout the post-fermentation process. Analysis of the Pearson's correlation coefficients between 66 key microbes and the key flavors was investigated. Nine core microbes were identified based on the linear discriminant analysis (LDA) scores ≥ 4 (or an average abundance >0.1%) and a high correlation with at least two flavor categories (P < 0.05, |ρ| > 0.8), namely Kosakonia, Kazachstania, Debaryomyces, Lactobacillus, Myroides, Stenotrophomonas, Ochrobactrum, Wohlfahrtiimonas, and Lactococcus genera. These results provide a clearer insight into microbial succession during PBP post-fermentation, thereby contributing to further quality improvement of PBP.


Type 2 diabetes is independently associated with all-cause mortality secondary to ventricular tachyarrhythmias.
The study sought to assess the prognostic impact of type 2 diabetes in patients presenting with ventricular tachyarrhythmias on admission. Data regarding the prognostic outcome of diabetics presenting with ventricular tachyarrhythmias is limited. A large retrospective registry was used including all consecutive patients presenting with ventricular tachycardia (VT) and fibrillation (VF) on admission from 2002 to 2016. Patients with type 2 diabetes (diabetics) were compared to non-diabetics applying multivariable Cox regression models and propensity-score matching for evaluation of the primary prognostic endpoint of long-term all-cause mortality at 2 years. Secondary prognostic endpoints were cardiac death at 24 h, in-hospital death at index, all-cause mortality at 30 days, all-cause mortality in patients surviving index hospitalization at 2 years (i.e. "after discharge") and rehospitalization due to recurrent ventricular tachyarrhythmias at 2 years. In 2411 unmatched high-risk patients with ventricular tachyarrhythmias, diabetes was present in 25% compared to non-diabetics (75%). Rates of VT (57% vs. 56%) and VF (43% vs. 44%) were comparable in both groups. Multivariable Cox regression models revealed diabetics associated with the primary endpoint of long-term all-cause mortality at 2 years (HR = 1.513; p = 0.001), which was still proven after propensity score matching (46% vs. 33%, log rank p = 0.001; HR = 1.525; p = 0.001). The rates of secondary endpoints were higher for in-hospital death at index, all-cause mortality at 30 days, as well as after discharge, but not for cardiac death at 24 h or rehospitalization due to recurrent ventricular tachyarrhythmias. Presence of type 2 diabetes is independently associated with an increase of all-cause mortality in patients presenting with ventricular tachyarrhythmias on admission.


Total Pancreatectomy with Islet Auto-Transplantation: Surgical Procedure, Outcomes, and Quality of Life.
Chronic pancreatitis is a progressive and irreversible process of pancreatic inflammation and fibrosis that can lead to intractable abdominal pain and severely impaired quality of life (QoL). Often patients are refractory to standard medical or endoscopic treatments. Total pancreatectomy (TP) and islet auto-transplantation (TP-IAT) can offer pain relief to patients by removing the entire pancreas and the auto-transplant component ameliorates the resulting diabetes. QoL is significantly improved after TP-IAT when insulin independence is present. Recent data support offering TP-IAT rather than TP alone and treating with exogenous insulin for patients with debilitating chronic pancreatitis.


Failure of diterpenes from Jatropha curcas to induce mutation in Salmonella typhimurium TA98 and TA100.
No mutagenicity of five diterpenes isolated from the roots of Jatropha curcas was detected by Ame's test using both TA98 and TA100 tester strains with or without S-9 fraction from livers of rats treated with polychlorinated biphenyl.


Contribution of Larvae Developing on Corn and Dry Beans to the Adult Population of Western Bean Cutworm in Michigan.
The western bean cutworm, Striacosta albicosta (Smith) (Lepidoptera: Noctuidae), is historically a pest of both corn (Zea mays L. (Poales: Poaceae)) and dry beans (Phaseolus sp. L. (Fabales: Fabaceae)) in the western Great Plains. However, it has recently undergone an eastward range expansion establishing itself across the Corn Belt in 25 states and 4 Canadian provinces. To mitigate the effects of infestation in Michigan, foliar insecticides are used in dry beans, whereas management of the pest in corn relies more heavily on the use of Bt-expressing hybrids. In this study stable carbon isotope analysis was used to determine what crop adult moths developed on as larvae with analysis showing that very few of the adult moths developed on dry beans. These results suggest that beans and corn are not suitable as co-refuges and that mainly adults which developed on corn are contributing to the next generation of western bean cutworm in Michigan.


AMPA and NMDA glutamate receptor trafficking: multiple roads for reaching and leaving the synapse.
Glutamate receptor trafficking in and out of synapses is one of the core mechanisms for rapid changes in the number of functional receptors during synaptic plasticity. Recent data have shown that the fast gain and loss of receptors from synaptic sites are accounted for by endocytic/exocytic processes and by their lateral diffusion in the plane of the membrane. These events are interdependent and regulated by neuronal activity and interactions with scaffolding proteins. We review here the main cellular steps for AMPA and NMDA receptor synthesis, traffic within intracellular organelles, membrane exocytosis/endocytosis and surface trafficking. We focus on new findings that shed light on the regulation of receptor cycling events and surface trafficking and the way that this might reshape our thinking about the specific regulation of receptor accumulation at synapses.


Psychoanalysing the 21st Century: Introduction.
The purpose of this introduction is to sketch out the value of psychoanalysis for the twenty-first century and in particular the ways in which analysis might enable us to move beyond the crisis of the post-Cold War symbolic order.


Overexpression of lung-resistance protein and increased P-glycoprotein function in acute myeloid leukaemia cells predict a poor response to chemotherapy and reduced patient survival.
We investigated the role of the drug resistance-related proteins LRP, MRP and Pgp and the apoptotic suppressor, bcl-2, in relation to other clinical characteristics, with respect to response and survival in 91 patients with newly diagnosed AML, treated with standard chemotherapy. Multivariate analysis showed that poor response to chemotherapy was associated with increasing age (P=0.0004), LRP expression (P=0.0001) and Pgp function (P=0.015). The significant predictors of both leukaemia-free survival (LFS) and overall survival (OS) were LRP (LFS, P=0.01; OS, P=0.0001), Pgp function (LFS, P=0.0001; OS, P=0.0003) and cytogenetic abnormalities (LFS, P=0.0001; OS. P=0.0005). Patients with the lowest expression of LRP and Pgp function and favourable karyotype (group I) had an LFS of 30.2 months compared to 8 5 months in the group with the highest expression of LRP and Pgp and poor prognosis karyotype (group III, P=0.002). OS decreased from 75.4 months in group I to 7.9 months in group III patients (P <0.0001). Neither MRP nor bcl-2 were significantly associated with chemotherapy response and survival. Correlations were found between increasing expression of LRP and older age (P=0.05) and an unfavourable karyotype (P=0.005), but these variables were independent of each other in analysis of treatment response and patient survival. Our findings suggest that both LRP and Pgp are clinically relevant drug-resistance proteins and it may be necessary to modulate both LRP and Pgp functions in order to reverse the multidrug resistance phenotype in AML.


Becker's naevus of the thigh with lipoatrophy: report of two cases.
Although Becker's naevus is most common in males, cases with associated lipoatrophy are more frequently reported in women. Two women are described in whom Becker's naevus of the thigh was associated with localized lipoatrophy. Neither had any bony abnormality or functional deficit.


Does the intestinal microenvironment have an impact on the choleretic effect of inchinkoto, a hepatoprotective herbal medicine?
The choleretic effects of inchinkoto (ICKT), a hepatoprotective herbal medicine, are variable among patients. This study sought to investigate the correlation between the choleretic effects of ICKT and the intestinal microenvironment in patients with biliary obstruction. Patients with biliary obstruction who underwent external biliary drainage were enrolled. The concentrations of total bilirubin and bile acid in the bile, and genipin, a major active ingredient of ICKT, in the bloodstream before and after ICKT treatment were measured. Feces were collected from the patients to determine bacterial count and organic acid concentrations. Samples from 37 patients were collected and analyzed. The serum concentration of genipin increased 3 h after ICKT treatment and showed a positive correlation with the percent changes of biliary concentrations of bile acid, total bilirubin, and direct bilirubin. Serum genipin concentration also showed a positive correlation with the fecal concentrations of representative obligate anaerobes such as the Clostridium leptum subgroup, Bacteroides fragilis group, Bifidobacterium, and the Atopobium cluster. In sharp contrast, so-called harmful bacteria such as Clostridium difficile, Enterobacteriaceae, and Enterococcus showed a negative correlation with the concentration of genipin. Genipin concentration after ICKT administration showed a positive correlation with the fecal concentration of short chain fatty acids such as propionic acid and butyric acid, and a negative correlation with the fecal concentration of lactic acid. The absorption of genipin was variable among patients. This variability may be associated with the fecal microenvironment profile and partly explain the variable choleretic effects of ICKT among patients.


Acetoacetyl-CoA ligase activity in the isolated rat hepatocyte: effects of 25-hydroxycholesterol and high density lipoprotein.
The activity of acetoacetyl-CoA (AcAc-CoA) ligase (E.C.18.104.22.168) in hepatocytes from rats was shown to be the same as the activity in homogenates of their livers. In hepatocytes treated with 25-hydroxycholesterol, AcAc-CoA ligase, 3-hydroxy-3-methyl-glutaryl-CoA (HMG-CoA) reductase and rates of sterol synthesis were substantially decreased. Hepatocytes treated with high density lipoprotein (HDL) exhibited a 2 to 4 fold induction of HMG-CoA reductase activity; however an accompanying increase in AcAc-CoA ligase activity and the rate of cholesterol synthesis was not observed. We conclude (a) that increases in the activity of HMG-CoA reductase when mediated by HDL in hepatocytes do not result in a corresponding change in the capacity for sterol synthesis and (b) that changes in the activity state of HMG-CoA reductase can be dissociated from that of AcAc-CoA ligase.


Mobilization of arachidonic acid from diacyl and ether-linked phospholipids in FMLP stimulated alveolar macrophages.
Exposure of [1 14C]AA labeled guinea-pig alveolar macrophages to FMLP for 15 min induced an extensive mobilization of AA from phospholipids. PC and PI mainly contributed to the AA release, and labeled PE remained unchanged. Analysis of ether-linked phospholipids showed a significant breakdown of labeled diacyl and alkyl-acyl PC and an increase in labeled alkenyl-acyl PE.


Percaruncular single injection peribulbar anaesthesia in patients with axial myopia for phacoemulsification.
Myopia has been identified as a risk factor for globe perforation during regional anaesthesia for cataract surgery. We conducted this study to evaluate efficacy of single injection percaruncular peribulbar anaesthesia for phacoemulsification in patients with axial myopia. Eighty patients with axial myopia received percaruncular peribulbar anaesthesia and were evaluated for incidence of major or minor complications. Also surgeon and patients' satisfaction and their comment on operative conditions were noted. Of the 80 patients 51 patients had posterior staphylomas. About three quarters of the patients developed adequate akinesia in 10 min. Remaining 25% received second injection with the same technique but with less volume after which the percent of patients with adequate akinesia rose to 91%. Adequate analgesia developed in almost all patients and only in one patient, intravenous analgesia was necessary to complete the operation. All operations were completed uneventfully. No perforations or penetrations were recorded and no other major complications were encountered. About 97% of the surgeons and 96% of the patients found the operative conditions satisfactory. Using single injection percaruncular peribulbar local anaesthesia for phacoemulsification in patients with axial myopia is an effective technique.


[Incorporating narratives and perceptions into local health diagnoses: the case of Bilbao].
The subjectivity of a multitude of dimensions that affect health requires systemic approaches, study designs that integrate population health data and the narratives of the population, as well as specific methodological approaches that allow the capture of evidence from social and community processes. The use of participatory methodologies in urban health diagnoses is key to capturing the different perspectives and knowledge of the local context, contributing to a more complete analysis of reality. This methodological note presents the development of the participatory process carried out as part of the Bilbao health diagnosis; the identification of participating agents and selection criteria, the invitation to participate and the dynamics developed. Sharing experiences that have incorporated participatory processes is necessary to foster its methodological development, and thus, to promote it practice.


The serum levels of testosterone and prolactin in patients with prostatic carcinoma treated with various doses of Fostrolin and bromocriptin.
In 45 patients with newly diagnosed carcinoma of the prostate, 1509 radioimmunological assays (RIA) were done for serum testosterone (T), prolactin (PRL) and growth hormone (GH). The patients were divided into 4 groups and treated with gradually lowered doses of Fostrolin and bromocriptin. It was noted that after high doses of Fostrolin, T levels did not markedly decrease, and PRL concentrations increased manifold. Small doses of Fostrolin, however, caused a drop in T and PRL levels. In the light of the results of up-to-date investigations and of the role played by PRL in a higher incidence of prostatic tumours, employment of bromocriptin, a prolactin antagonist, in the treatment of prostatic cancer seems to be justified. Reduction of T concentration below castration level and attainment of trace PRL levels in response to small doses of Fostrolin and bromocriptin had a favourable effect on the clinical course of the malignant disease.


Half-life measurements at the National Institute of Standards and Technology.
For nearly half a century the half-lives of many radionuclides have been measured with increasing precision. The results of these measurements for many long-lived radionuclides, such as 60Co, 137Cs, 85Kr, 133Ba, 207Bi, 152Eu, 154Eu, and 155Eu, have been updated recently by the Radioactivity Group of NIST. These long-lived radionuclides are used extensively to calibrate various nuclear counting and monitoring systems. The long-term precision of these calibrations can be greatly affected by the uncertainties in the calibrant half-lives. Results for the half-lives of many radionuclides measured over the last four decades are tabulated. In addition, values of the half-lives of several short-lived radionuclides used in nuclear medicine are addressed, which are critical in determining the correct dosage given in patient treatment, are addressed. Comparisons with the recommended values from the International Atomic Energy Agency Coordinated Research Program and the Evaluated Nuclear Structure Data File from Brookhaven National Laboratory are presented and any apparent disagreements noted.


Detection and classification of allexiviruses from garlic in China.
Degenerate primers for RT-PCR were designed and used to amplify genome fragments ( c. 750 nt in the coat protein-ORF6 region) of allexiviruses from a total of 28 garlic samples from 24 provinces in China. Many samples contained more than one distinct sequence. A total of 60 different sequences were obtained. Phylogenetic analysis and two-way comparisons were used to assess the status of the sequences and to re-examine the criteria for distinguishing species within the genus. Most of the sequences could be allocated to either Garlic virus D or Garlic virus X on the basis of sequence similarity but some appeared to be intermediate between existing species. There were no sequences of Garlic virus C or Shallot virus X. A comparison with the related genera Carlavirus, Foveavirus and Potexvirus suggests that the published allexivirus species demarcation criteria may have been drawn too tightly and should be re-examined.


Contribution of take-out food consumption to socioeconomic differences in fruit and vegetable intake: a mediation analysis.
Lower fruit and vegetable (F/V) intake among socioeconomically disadvantaged groups has been well documented, and may be a consequence of a higher consumption of take-out foods. This study examined whether, and to what extent, take-out food consumption mediated (explained) the association between socioeconomic position and F/V intake. A cross-sectional postal survey was conducted among 1,500 randomly selected adults aged 25 to 64 years in Brisbane, Australia, during 2009 (response rate 63.7%, N=903). A food frequency questionnaire assessed usual daily servings of F/V (0 to 6), overall take-out consumption (times per week), and the consumption of 22 specific take-out items (never to once per day or more). These specific take-out items were grouped into "less healthy" and "healthy" choices and indexes were created for each type of choice (0 to 100). Socioeconomic position was ascertained by education. The analyses were performed using linear regression, and a bootstrap resampling approach estimated the statistical significance of the mediated effects. Mean daily servings of F/V were 1.89±1.05 and 2.47±1.12, respectively. The least educated group members were more likely to consume fewer servings of fruit (β= -.39, P<0.001) and vegetables (β= -.43, P<0.001) compared with members of the highest educated group. The consumption of "less healthy" take-out food partly explained (mediated) education differences in F/V intake; however, no mediating effects were observed for overall and "healthy" take-out consumption. Regular consumption of "less healthy" take-out items may contribute to socioeconomic differences in F/V intake, possibly by displacing these foods.


Stabilizing and color tuning pyrazine radicals by coordination for photochromism.
With the help of theoretical predictions, we have found, from the [donor-metal-acceptor] system, the first photochromic pyrazine-based compound that can undergo photoinduced charge separation and yield stable pyrazine radicals.


Proportional versus projected glucose tolerance values: a quality control program.
The objective of this study was to improve the reproducibility of the oral glucose tolerance test (OGTT). Ten patients were used to demonstrate the difference between proportional and projected values in an OGTT. A procedure that plots data points at their actual time of collection, producing an accurate graph, that can predict a proportional glucose value at the intersection of the curve with the two-hour specified collection time, was developed. The efficacy of this procedure was demonstrated by clinical trials on a second group of ten patients. Hospital outpatient clinic for the first group of ten patients since heparin lock was not required; Columbia Medical Center, Ormond Beach, FL for the second group since heparin lock was required. All subjects in the first group were referred to the clinic by their family physician for an OGTT. Subjects in the second group were selected to meet the following criteria: no overt symptoms of diabetes, but with at least two high risk factors for Type 2 diabetes. A glucose load was given to each patient after a fasting sample blood sugar was analyzed. The recommended OGTT procedure for obtaining accurate predicted proportional two hour plasma glucose (2hPG) values requires a three hour OGTT with 1/2 hourly mid-test samples. A sample collection form was used to record all pertinent aspects of the test, time of first swallow, amount ingested in five minutes and the exact times of sample collections. A digital clock, located in the phlebotomist's view, was used to accurately establish all time intervals, including zero time. The study demonstrated that inspection of the OGTT curve and calculated values provide additional useful information. It also identified five impaired glucose tolerance (IGT) subjects, one gestational diabetes mellitus (GDM) patient, thirteen normal subjects, and one flat curve. Accurate time intervals are not necessary since 2hPG can be accurately expressed as a predicted proportional value if the true intervals are recorded and used to calculate the glucose level at the desired time interval(s).


Web-based delivery of a preventive parent training intervention: a feasibility study.
Low enrollment and participation are common in face-to-face parenting interventions. Developing innovative delivery methods is one way to address participation barriers. The purpose of this study was to test the feasibility of a Web-based delivery model for an evidence-based behavioral parent training program. Parents (n = 9) completed two Web-based prototype sessions of the Chicago Parent Program delivered on an Android tablet over 2 weeks, and then participated in a post-intervention focus group. Quantitative and qualitative data were collected. The Web-based delivery adaptation was feasible and useful for low-income urban parents. Our preliminary findings suggest that Web-based delivery is a feasible approach to integrating mental health prevention into systems of care. Translating interventions to alternative delivery platforms is promising for nursing to increase access to evidence-based interventions.


Withdrawing and withholding treatment: policies in long-term care facilities.
The Task Force on Life and the Law conducted a survey of nursing homes in New York State in 1986 and 1988. The survey examined the existence of policies on decisions about life-sustaining treatment, the process to determine which residents have decision-making capacity, the prevalence of ethics committees or other vehicles to resolve disputes, and policies on advance directives such as living wills and durable powers of attorney. Comparison of responses in 1986 and 1988 shows an increase in the number of facilities that have established explicit policies and institutional vehicles to address the dilemmas associated with decisions to withdraw or withhold life-sustaining treatment.


The human flavoproteome.
Vitamin B2 (riboflavin) is an essential dietary compound used for the enzymatic biosynthesis of FMN and FAD. The human genome contains 90 genes encoding for flavin-dependent proteins, six for riboflavin uptake and transformation into the active coenzymes FMN and FAD as well as two for the reduction to the dihydroflavin form. Flavoproteins utilize either FMN (16%) or FAD (84%) while five human flavoenzymes have a requirement for both FMN and FAD. The majority of flavin-dependent enzymes catalyze oxidation-reduction processes in primary metabolic pathways such as the citric acid cycle, β-oxidation and degradation of amino acids. Ten flavoproteins occur as isozymes and assume special functions in the human organism. Two thirds of flavin-dependent proteins are associated with disorders caused by allelic variants affecting protein function. Flavin-dependent proteins also play an important role in the biosynthesis of other essential cofactors and hormones such as coenzyme A, coenzyme Q, heme, pyridoxal 5'-phosphate, steroids and thyroxine. Moreover, they are important for the regulation of folate metabolites by using tetrahydrofolate as cosubstrate in choline degradation, reduction of N-5.10-methylenetetrahydrofolate to N-5-methyltetrahydrofolate and maintenance of the catalytically competent form of methionine synthase. These flavoenzymes are discussed in detail to highlight their role in health and disease.