[Anti-infective treatment of fungal infections by Candida and Aspergillus].
Invasive fungal infections caused by Candida or Aspergillus are associated with a high mortality. Knowledge about the risk factors, diagnosis and treatment management is crucial for improving the survival of those affected. To give a practical overview about risk factors and treatment management of Candida and Aspergillus infections as well as providing an outlook on new antifungal agents. Summary of the relevant literature and recommendations on candidemia and invasive candidiasis as well as invasive and chronic pulmonary aspergillosis. The first line treatment of candidemia and invasive candidiasis are echinocandins including caspofungin, anidulafungin and micafungin. Regular blood cultures have to be taken to determine the duration of treatment. After the first negative control blood culture treatment should be continued for another 14 days. The first line treatment of invasive pulmonary aspergillosis is azoles including voriconazole and isavuconazole. The duration of treatment depends on disease severity and is recommended for 6-12 weeks. The duration of treatment for chronic pulmonary aspergillosis is 6-12 months. Therapeutic drug monitoring is recommended for voriconazole and for posaconazole. New antifungal agents including olorofim, fosmanogepix, opelconazole, rezafungin or ibrexafungerp will broaden the therapeutic spectrum in the foreseeable future. Knowledge about risk factors and the correct treatment management is crucial for the survival of patients with invasive fungal infections.


The balancing act of dementia care: an ethnographic study of everyday life and relatives' experiences in a Danish nursing home for people living with advanced dementia.
The purpose of this study was to explore how everyday life was organized in a Danish nursing home for people living with advanced dementia and how relatives experienced their family members' everyday lives. Field notes from participant observations (approximately 160 hours) and transcripts from ethnographic interviews with relatives (9) were analysed thematically in accordance with ethnographic principles. The analysis revealed one main theme, 'Enabling a meaningful everyday life in the nursing home' with two corresponding sub-themes: (1) Structures of daily life: Balancing collective and individual activities and (2) Physical togetherness: Balancing being together and being alone. The findings showed that everyday life in the nursing home was organized to support a meaningful life for the residents by providing activities and togetherness on a daily basis. While relatives generally appreciated the everyday life experienced in the nursing home, challenges were encountered in connection with the provision of an appropriate balance between levels and types of activities and togetherness for all residents.


Morphologic, immunologic, enzymehistochemical and chromosomal analysis of a cell line derived from Hodgkin's disease. Evidence for a B-cell origin of Sternberg-Reed cells.
Cell lines derived from Hodgkin's disease may provide a clue to the nature of Sternberg-Reed cells. In the current study, the establishment of an Epstein-Barr-virus-negative lymphoblastoid cell line, derived from the pleural fluid of a patient with the nodular sclerosis type of Hodgkin's disease, is described. The morphologic and immunologic cell marker findings indicate that this cell line is derived from Sternberg-Reed cells. The immunologic findings and a chromosomal analysis are in agreement with a B-lymphocyte origin of these cultured cells. Extrapolation of the results to Hodgkin's disease in vivo would indicate that Hodgkin's disease, like most non-Hodgkin's lymphomas, is the result of B-cell proliferation.


Systolic hypertension: hemodynamic mechanism and choice of antihypertensive treatment.
Arterial compliance and indexes of ventricular ejection were measured in 27 men with systolic hypertension. The patients were separated into two age groups, younger or older than age 35 years, and matched with normotensive control subjects. Arterial compliance was estimated from analysis of the monoexponential blood pressure-time curve during diastole, according to a simple viscoelastic model. In the younger patients, arterial compliance and stroke volume were within normal ranges. Rapid ejection time was significantly reduced (P less than 0.001), indicating an increased venlocity in the first part of ventricular ejection. Systolic pressure decreased significantly after administration of propranolol, which also caused prolongation of rapid ejection time. In the older patients, indexes of ventricular ejection were within normal limits. arterial compliance was significantly reduced (P less than 0.01) and was negatively correlated with the level of systolic pressure (P less than 0.001). Systolic pressure decreased significantly after administration of sodium nitroprusside, which caused an increase in arterial compliance. These findings provide evidence that: (1) the hemodynamic mechanisms of systolic hypertension differ in younger and older patients, and (2) these hemodynamic differences should be taken into account when choosing drugs to decrease systolic pressure.


Asynchronous spatial evolutionary games.
Over the past 50 years, much attention has been given to the Prisoner's Dilemma as a metaphor for problems surrounding the evolution and maintenance of cooperative and altruistic behavior. The bulk of this work has dealt with the successfulness and robustness of various strategies. Nowak and May (1992) considered an alternative approach to studying evolutionary games. They assumed that players were distributed across a two-dimensional (2D) lattice, interactions between players occurred locally, rather than at long range as in the well mixed situation. The resulting spatial evolutionary games display dynamics not seen in their well-mixed counterparts. An assumption underlying much of the work on spatial evolutionary games is that the state of all players is updated in unison or in synchrony. Using the framework outlined in Nowak and May (1992), we examine the effect of various asynchronous updating schemes on the dynamics of spatial evolutionary games. There are potential implications for the dynamics of a wide variety of spatially extended systems in biology, physics and chemistry.


Analysis of a human brain transcriptome map.
Genome wide transcriptome maps can provide tools to identify candidate genes that are over-expressed or silenced in certain disease tissue and increase our understanding of the structure and organization of the genome. Expressed Sequence Tags (ESTs) from the public dbEST and proprietary Incyte LifeSeq databases were used to derive a transcript map in conjunction with the working draft assembly of the human genome sequence. Examination of ESTs derived from brain tissues (excluding brain tumor tissues) suggests that these genes are distributed on chromosomes in a non-random fashion. Some regions on the genome are dense with brain-enriched genes while some regions lack brain-enriched genes, suggesting a significant correlation between distribution of genes along the chromosome and tissue type. ESTs from brain tumor tissues have also been mapped to the human genome working draft. We reveal that some regions enriched in brain genes show a significant decrease in gene expression in brain tumors, and, conversely that some regions lacking in brain genes show an increased level of gene expression in brain tumors. This report demonstrates a novel approach for tissue specific transcriptome mapping using EST-based quantitative assessment.


Spontaneous reanastomosis between lymphatic vessels following syngeneic transplantation of the small intestine in the rat.
Spontaneous lymphvascular reanastomosis (SLR) following small bowel transplantation in rats is of clinical relevance for the resorption of long chain fatty acids. Detailed morphological and molecular data concerning the process of lymphvascular reanastomosis are not available in the literature. In this study SLR was investigated using microradiology and scanning electron microscopy. Between the 8th and 21st postoperative days following transplantation SLR does not occur between the intestinal trunk of the transplant and the thoracic duct of the recipient. Instead, an indirect connection was observed between the inserted advential lymphatic vessels of the mesenteric artery and lymphatic vessels of the aorta or ductus deferens, which are connected with the thoracic duct.


Cilia are at the heart of vertebrate left-right asymmetry.
Handed asymmetry of the shape and position of the internal organs is found in all vertebrates, and is essential for normal cardiac development. Recent genetic and embryological experiments in mouse embryos have demonstrated that left-right asymmetry is established by directional flow of extraembryonic fluid surrounding the node, which is driven by motile monocilia.


Quantification of left ventricular regional myocardial function using two-dimensional speckle tracking echocardiography in healthy volunteers--a multi-center study.
Although two-dimensional speckle tracking (2DST) has been validated in animal and early clinical studies for quantitative evaluation of myocardial motion and contractility, there are only limited measurements in large healthy population to be used as reference data, which severely restricts its clinical application. This study aimed at determining the age-specific normal values of left ventricular (LV) longitudinal, circumferential and radial strain in healthy adults. We studied 228 healthy subjects (109 males, mean age 44 ± 15 years, range 18-78 years). Their LV longitudinal, circumferential and radial strains were measured by 2DST at basal, middle and apical levels of parasternal short-axis and apical 2-, 4- and 3-chamber views. The effects of age, gender and echocardiographic machines (52 patients had measurements obtained by both GE and Philips machines) on these parameters were also evaluated. The longitudinal and circumferential strains were -20.4 ± 3.4% and -22.9 ± 3.1%, respectively with higher values being observed at basal than apical segments. On the contrary, the radial strain which ranged 42.6 ± 12.9% decreased towards apical segments. The longitudinal strain declined, the circumferential strain rose and the radial strain remained similar during aging. Adult females had slightly higher circumferential and longitudinal strains than males (23 ± 3% vs -22 ± 3%, -21 ± 3% vs -20 ± 3% respectively; both p<0.01). Strains measured by the 2 different echo machines had good correlations but Phillips-assessed strains (longitudinal and circumferential) were 10% higher than GE measurements. Inter- and intra-observer variabilities were acceptable. Strain measurements by 2DST echocardiography varies with age, gender and echocardiographic vendors in healthy adults. These findings are important to differentiate between health and disease and to assess the severity of disease.


Age, poverty, acculturation, and gastric cancer.
Gastric cancer is an aggressive disease, and overall changes in incidence rates have been noted. There are conflicting data on whether young patients have worse outcomes than older patients; the roles of tumor biology and access to care are critical to answering this question. Our objectives were to explore how gastric cancer rates, receipt of care, and outcomes are affected by age, poverty, and acculturation. A total of 42,187 patients were identified from the 1980-2009 Surveillance, Epidemiology, and End Results registry. We compared trends in incidence rates between patients <40, 40-64, and ≥65 years using ordinary least-squares regression. Separate multivariate regression models were used to evaluate the impact of age, poverty, and acculturation on receipt of cancer-directed therapy and hazard of mortality. Patients <40 years had stable incidence rates over the 3-decade period compared with decreases for patients 40-64 and ≥65 years. They are also more likely to present with aggressive, advanced disease (P < .0001 for both). On unadjusted and adjusted analyses, patients <40 years were more likely to receive cancer-directed therapies and have better survival than those ≥65 years. Residing in high poverty areas was associated with not receiving appropriate cancer-directed therapy; the adjusted hazard ratio of mortality for surgically resected patients was, however, not affected by poverty. Residing in high immigration areas was associated with a low hazard ratio (HR, 0.74; 95% confidence interval [CI], 0.7-0.79) of mortality. Foreign-born patients also had a low hazard ratio (HR, 0.87; 95% CI, 0.83-0.91) of mortality. Although trends in incidence rates for patients <40 years remain unchanged and their disease is aggressive and advanced at presentation, they do not experience disparities in gastric cancer-directed therapies and survival after resection. For patients residing in impoverished areas or high immigration communities, operative resection and adjustment for appropriate aftercare is associated with comparable or better survival when compared with those living in low poverty or low immigration areas. Disparities remain in receipt of appropriate cancer-directed therapies, and future efforts should focus on decreasing structural variations in care and unconscious biases regarding patients from these vulnerable communities.


Extended storage of single-donor apheresis platelets in CLX blood bags: effect of storage on platelet morphology, viability and in vitro function.
A CLX (Cutter Laboratories, Berkeley, Calif.) bag system was evaluated for storage of single-donor apheresis platelets collected with the Haemonetics V-50 blood processor. Concentrates (n = 21) containing 3.9-5.2 x 10(11) platelets in 292 (+/- 41.8) ml were stored in two 1-liter bags for 7 days at 22 degrees C. pH was well maintained, declining from an initial pH of 7.0 (+/- 0.04) to 6.92 (+/- 0.20) after 7 days. Platelet morphology, response to a hypotonic stimulus and aggregation induced by paired agonists (epinephrine and ADP, or collagen) were also well-preserved. Concentrates with a wide variation of platelet yields (2.0 greater than or equal to 5.2 x 10(11), n = 43) also maintained pH (6.96 +/- 0.26), morphology and aggregation when stored for 7 days. All platelet concentrates (n = 64) were sterile at collection. Single-donor apheresis platelets may be stored in this bag system for up to 7 days.


Sediment resuspension due to internal solitary waves of elevation in the Messina Strait (Mediterranean Sea).
By combining real-field observations and theoretical predictions, we describe role and relationships among north-propagating internal solitary waves (ISWs) generated by tidal currents in the Messina Strait (Mediterranean Sea), buoyancy deformation, sediment resuspension, and mixing effects. In particular, our results show that the presence of ISWs traveling along the Gioia Basin (north of the Strait) is not strictly related to seasonality. During winter, when the remote observation of ISWs from satellite is particularly rare due to the weak water column stratification, we observe elevation-type ISWs from hydrographic data. This finding reveals a different scenario with respect to the summer one, when the high stratified water column gives rise to depression-type north-propagating ISWs and the subsequent sea surface manifestations, detectable from satellite imagery. Moreover, our beam transmission observations and theoretical predictions of the induced near-bottom horizontal velocity suggest that these elevation-type ISWs induce sediment resuspension over the seafloor, as well as mixing effects as they break on the frontal slope nearby Capo Vaticano.


Abnormal screening chest radiograph in a 21-year-old male.
A 21-year-old male with a medical history of scoliosis was referred for an abnormal chest radiograph performed on screening (figure 1). He was asymptomatic with good exercise tolerance. Blood pressure and heart rate were normal. The heart sounds were normal. The pulmonary examination was unremarkable. A treadmill test performed 3 years prior for atypical chest pain was normal. An ECG performed was also normal. What abnormality is present in the chest radiograph? DextrocardiaEnlarged right heart borderMediastinal massProminent pulmonary vasculatureSitus inversus.


Effects of the Methanolic Extract of Vitellaria paradoxa Stem Bark Against Scopolamine-Induced Cognitive Dysfunction and Oxidative Stress in the Rat Hippocampus.
Vitellaria paradoxa C.F. Gaertn (Sapotaceae) is a perennial three which naturally grows in the northern part of Cameroon. It has been traditionally used in the Cameroonian folk medicine for treating inflammation and pain. In the present study, we evaluate the possible anti-amnesic and antioxidative effects of the methanolic extract of V. paradoxa stem bark in an Alzheimer's disease (AD) rat model of scopolamine. Rats received a single injection of scopolamine (1.5 mg/kg) before behavioral testing and were treated with the methanolic extract (25 and 50 mg/kg), daily, for eight continuous days. Also, the antioxidant activity in the hippocampus was assessed using the total content of reduced glutathione and malondialdehyde levels. The scopolamine-treated rats exhibited the following: decrease of exploratory time and discrimination index within the novel object recognition test, decrease of spontaneous alternations percentage within Y-maze task, and increase of working memory errors, reference memory errors, and time taken to consume all five baits within radial arm-maze task. Administration of the methanolic extract significantly improved these parameters, suggesting positive effects on memory formation processes and antioxidant potential. Our results suggest that the methanolic extract ameliorates scopolamine-induced memory impairment by attenuation of the oxidative stress in the rat hippocampus.


Catastrophic expenditure and treatment attrition in patients seeking comprehensive colorectal cancer treatment in India: A prospective multicentre study.
Although colorectal cancer is increasing in India, the cost of comprehensive treatment and its consequences for patients and households are unknown. This study aimed to describe catastrophic expenditure and treatment attrition in patients with a treatment plan for colorectal cancer. A prospective, multicentre, cohort study was conducted in five tertiary hospitals in India from December 2020 to March 2022. Consecutive patients with a new treatment plan for colorectal cancer were followed-up for six months. The total cost of treatment was reported, including out-of-pocket payments (OOPP, paid by patients at the time-of-service use) and covered by third parties (insurance, public funds). The primary outcome was catastrophic expenditure, defined as OOPPs greater than 25% of patient's annual household income and the secondary outcome was treatment attrition, defined as unplanned interruption of the treatment course not recommended by the clinical team. Of 226 patients included, 20 died within six months of being offered a treatment plan and four were lost to follow-up. The median total cost of colorectal cancer treatment was 407,508 Indian Rupees (INR/5340 USD), to which the biggest contributor was the patient's OOPP (median 330,277 INR/4328 USD). Surgery and anaesthesia costs (median 85,944 INR/1126 USD) were higher than radiotherapy (median 55,525 INR/728 USD) and chemotherapy (median 14,780 INR/194 USD). The overall catastrophic expenditure rate was 90.1% (182/202) and the treatment attrition rate was 9.4% (19/202). Patients with treatment attrition made lower OOPPs than those who completed treatment (median 205,926 vs 349,398 INR, p < 0.01) but had a similar risk of catastrophic expenditure (OR 0.23, 95%CI 0.03-2.28, p = 0.186). Most treatment costs for colorectal cancer were paid out-of-pocket by patients and catastrophic expenditure was common. Treatment attrition rates at tertiary centres were low, suggesting greater attrition at previous stages of care. Better financial protection may allow more patients to receive comprehensive cancer treatment while avoiding household financial catastrophe. This research was funded by the National Institute for Health Research (NIHR) (NIHR 16.136.79) using UK aid from the UK Government to support global health research, by the India Institute of the University of Birmingham and by the Global Challenges program of the University of Birmingham. The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR or the UK government.


N-(4-Meth-oxy-3-nitro-phen-yl)acetamide.
The title compound, C9H10N2O4, crystallizes with a disordered nitro group in twinned crystals. Both the meth-oxy group and the acetamide groups are nearly coplanar with the phenyl ring, and the C-N-C-O torsion angle [0.2 (4)°] is also insignificantly different from zero. Overall, the 12-atom meth-oxy-phenyl-acetamide group is nearly planar, with an r.m.s. deviation of 0.042 Å. The nitro group is twisted out of this plane by about 30°, disordered into two orientations with opposite senses of twist. In the crystal, the N-H group donates a hydrogen bond to a nitro oxygen atom, generating chains propagating in the [101] direction. The amide carbonyl oxygen atom is not involved in the hydrogen bonding.


Inhibition of nitric oxide and prostaglandin E2 production by pyrrolylated-chalcones: Synthesis, biological activity, crystal structure analysis, and molecular docking studies.
In search of potent anti-inflammatory agents, twenty-four chalcone derivatives including seven new compounds (13 - 17, 21 and 23) containing pyrrole moiety were designed, synthesized, and assessed for their nitric oxide (NO) and prostaglandin E2 (PGE2) suppression ability on IFN-γ/LPS-induced RAW 264.7 macrophage cells. Results showed that none of the synthesized compounds were PAINS-associated molecules, with 3-(2,5-dimethoxyphenyl)-1-(1H-pyrrol-2-yl)-prop-2-en-1-one (compound 16) exhibiting remarkable inhibition activity towards PGE2 and NO production with IC50 values of 0.5 ± 1.5 µM and 12.1 ± 1.5 µM, respectively. Physicochemical and ADMET studies showed that majority of the compounds obey to Lipinski's rule of five (RO5) having high blood brain barrier (BBB) penetration, human intestinal absorption (HIA), P- glycoprotein (PgP) inhibition and plasma binding protein (PPB) inhibition. The obtained atomic coordinates for the single-crystal XRD of 16 were then applied in a molecular docking simulation, and compound 16 was found to participate in a number of important binding interactions in the binding sites of ERK and mPGES-1. Based on these results, we have observed the potential of compound 16 as a new hit anti-inflammatory agent, and these findings could serve as a basis for further studies on its mechanism of action.


Effect of dissociative extraction with 1.5 M calcium chloride on proteoglycans in rat-incisor predentine visualized with cuprolinic blue.
Treatment of rat-incisor predentine for 48 h in a 1.5 M CaCl2 solution halved the number and size of the proteoglycan precipitates visualized using a critical MgCl2 concentration and cuprolinic blue staining. About 75 per cent of the aggregable proteoglycans were extracted; 25 per cent resisted extraction. Treatment with CaCl2 also completely abolished the electron density of the amorphous ground substance, an observation consistent with the possible existence of two classes of proteoglycans in predentine.


Evaluation of warfarin initiation regimens in elderly inpatients.
To compare initial warfarin doses of 5 mg or below and doses above 5 mg in hospitalized elderly. Retrospective review of charts identified from computerized pharmacy records. County teaching hospital. Inpatients aged 65 years or older receiving at least three warfarin doses. We measured the time to first international normalized ratio (INR) of 2.0 or greater, bleeding complications, number of warfarin doses held, and vitamin K use. The average initial low dose (33 patients) was 4.8 +/- 0.8 mg and the average initial high dose (40 patients) was 9.0 +/-1.2 mg. The mean time to first INR of 2.0 or greater was similar, 3.4 and 3.0 days, respectively (p=0.38). The low-dose group had fewer bleeds (7 vs 13, p=0.28) and doses held (11 vs 18 patients, p=0.27, 30 vs 50 doses). Four patients in each group received vitamin K (p=0.8). Forty-four percent of patients with an INR of 4 or above and 48% of patients who had a dose held were on a long-term drug or had a new drug added that could cause a major drug interaction with warfarin. In this pilot study, hospitalized elderly who received a low versus high initial dose of warfarin achieved therapeutic INRs in a similar time and had lower but not significantly different safety outcomes.


Effects of aging and lifelong aerobic exercise on basal and exercise-induced inflammation.
Age-associated chronic basal inflammation compromises muscle mass and adaptability, but exercise training may exert an anti-inflammatory effect. This investigation assessed basal and exercise-induced inflammation in three cohorts of men: young exercisers [YE; n = 10 men; 25 ± 1 yr; maximal oxygen consumption (V̇o2max), 53 ± 3 mL·kg-1·min-1; quadriceps area, 78 ± 3 cm2; means ± SE], old healthy nonexercisers (OH; n = 10; 75 ± 1 yr; V̇o2max, 22 ± 1 mL·kg-1·min-1; quadriceps area, 56 ± 3 cm2), and lifelong exercisers with an aerobic training history of 53 ± 1 yr (LLE; n = 21; 74 ± 1 yr; V̇o2max, 34 ± 1 mL·kg-1·min-1; quadriceps area, 67 ± 2 cm2). Resting serum IL-6, TNF-α, C-reactive protein, and IGF-1 levels were measured. Vastus lateralis muscle biopsies were obtained at rest (basal) and 4 h after an acute exercise challenge (3 × 10 repetitions, 70% 1-repetition maximum) to assess gene expression of cytokines [IL-6, TNF-α, IL-1β, IL-10, IL-4, interleukin-1 receptor antagonist (IL-1Ra), and transforming growth factor-β (TGF-β)], chemokines [IL-8 and monocyte chemoattractant protein-1 (MCP-1)], cyclooxygenase enzymes [cyclooxygenase-1 and -2 (COX-1 and COX-2, respectively), prostaglandin E2 synthases [microsomal prostaglandin E synthase 1 (mPGES-1) and cytosolic prostaglandin E2 synthase (cPGES)] and receptors [prostaglandin E2 receptor EP3 and EP4 subtypes (EP3 and EP4, respectively), and macrophage markers [cluster of differentiation 16b (CD16b) and CD163], as well as basal macrophage abundance (CD68+ cells). Aging led to higher (P ≤ 0.05) circulating IL-6 and skeletal muscle COX-1, mPGES-1, and CD163 expression. However, LLE had significantly lower serum IL-6 levels (P ≤ 0.05 vs. OH) and a predominantly anti-inflammatory muscle profile [higher IL-10 (P ≤ 0.05 vs. YE), TNF-α, TGF-β, and EP4 levels (P ≤ 0.05 vs. OH)]. In OH only, acute exercise increased expression of proinflammatory factors TNF-α, TGF-β, and IL-8 (P ≤ 0.05). LLE had postexercise gene expression similar to YE, except lower IL-10 (P ≤ 0.10), mPGES-1, and EP3 expression (P ≤ 0.05). Thus, although aging led to a proinflammatory profile within blood and muscle, lifelong exercise partially prevented this and generally preserved the acute inflammatory response to exercise seen in young exercising men. Lifelong exercise may positively impact muscle health throughout aging by promoting anti-inflammation in skeletal muscle.NEW & NOTEWORTHY This study assessed a unique population of lifelong aerobic exercising men and demonstrated that their activity status exerts an anti-inflammatory effect in skeletal muscle and circulation. Furthermore, we provide evidence that the inflammatory response to acute exercise is dysregulated by aging but preserved with lifelong exercise, which might improve skeletal muscle resilience to unaccustomed loading and adaptability into late life.


Production and characterization of a generic antibody against group A trichothecenes.
An antibody against group A trichothecenes was produced after immunization of rabbits with an immunogen prepared by conjugation of T-2 toxin to bovine albumin at the C-8 position. T-2 toxin was first converted to 3-acetylneosolaniol (3-Ac-NEOS) and then to its hemisuccinate (HS) before conjugation to the protein. The rabbits showed a quick immune response after immunization of the new conjugate. The antibody produced bound with tritiated T-2 toxin, T-2 tetraol tetraacetate, and diacetoxyscirpenol (DAS) and showed good cross-reactivities with most of the group A trichothecenes. The concentrations causing 50% inhibition of binding of 3H-T-2 toxin to the new antibody by unlabeled T-2, acetyl-T-2, 3'-OH-T-2, DAS, 3-Ac-NEOS-HS, 3'-OH-Ac-T-2, T-2 tetraol tetraacetate, iso-T-2, 3-Ac-NEOS, Ac-DAS, and 3,4,15-triacetyl-7-deoxynivalenol were found to be 0.34, 0.34, 0.6, 2.5, 4, 10, 18, 24, 100, 200, and 300 ng/assay, respectively; for HT-2, T-2 triol, and T-2 tetraol, the concentration was greater than 1000 ng/assay. Nivalenol, deoxynivalenol (DON), 15-acetyl-DON, and triacetyl-DON, did not inhibit the binding at 1000 ng/assay. The practical application of using this new antibody for radioimmunoassay (RIA) of trichothecene was tested by spiking T-2 toxin to corn. T-2 toxin was then extracted with acetone, subjected to a simple Sep-Pak C-18 reversed-phase treatment, and analyzed by RIA. The overall recovery for 18 samples spiked with 10 to 50 ppb of T-2 toxin was 94.22%.


[Current management of nonvariceal upper gastrointestinal bleeding in Spain].
Mortality related to nonvariceal upper gastrointestinal bleeding (NVUGIB) has not changed. More information is needed to improve the management of this entity. The aims of this study were: a) to determine the characteristics of bleeding episodes, b) to describe the clinical approaches routinely used in NVUGIB, and c) to identify adverse outcomes related to endoscopic or medical treatments in Spain. The European survey of nonvariceal upper GI bleeding (ENERGiB) was an observational, retrospective cohort study on NVUGIB with endoscopic evaluation carried out across Europe. The present study focused on Spanish patients in the ENERGiB study. The patients were managed according to routine care. The mean and standard deviation were calculated for quantitative variables and absolute and relative frequencies were calculated for categorical variables. Patients (n=403) were mostly men (71%), with a mean age of 65 years, and co-morbidities (62.5%). Most of the patients were managed by gastroenterologists (57.1%) or internal medicine teams (25.1%). A proton pump inhibitor was used empirically in 80% before endoscopy. Bleeding persistence occurred in 6.4% and recurrence in 6.7%. The mortality rate at 30 days was 3.5%. This study contributes to the characterization of Spanish patients and NVUGIB episodes in a real clinical setting and identifies the routine management of this entity, which is in line with the standards proposed by recent clinical practice guidelines. A notable finding was that age and the number of comorbidities in NVUGIB patients were increasing. These factors could explain the persistent mortality rate, despite the evident advances in the management of this entity.


A hierarchical assembly pathway directs the unique subunit arrangement of TRiC/CCT.
How the essential eukaryotic chaperonin TRiC/CCT assembles from eight distinct subunits into a unique double-ring architecture remains undefined. We show TRiC assembly involves a hierarchical pathway that segregates subunits with distinct functional properties until holocomplex (HC) completion. A stable, likely early intermediate arises from small oligomers containing CCT2, CCT4, CCT5, and CCT7, contiguous subunits that constitute the negatively charged hemisphere of the TRiC chamber, which has weak affinity for unfolded actin. The remaining subunits CCT8, CCT1, CCT3, and CCT6, which comprise the positively charged chamber hemisphere that binds unfolded actin more strongly, join the ring individually. Unincorporated late-assembling subunits are highly labile in cells, which prevents their accumulation and premature substrate binding. Recapitulation of assembly in a recombinant system demonstrates that the subunits in each hemisphere readily form stable, noncanonical TRiC-like HCs with aberrant functional properties. Thus, regulation of TRiC assembly along a biochemical axis disfavors the formation of stable alternative chaperonin complexes.


Effects of fluid, electrolyte and substrate ingestion on endurance capacity.
The availability of carbohydrate (CHO) as a substrate for the exercising muscles is known to be a limiting factor in the performance of prolonged cycle exercise, and provision of exogenous CHO in the form of glucose can increase endurance capacity. The present study examined the effects of ingestion of fluids and of CHO in different forms on exercise performance. Six male volunteers exercised to exhaustion on a cycle ergometer at a workload which required approximately 70% of Vo2max. After one preliminary trial, subjects performed this exercise test on six occasions, one week apart. Immediately before exercise, and at 10-min intervals throughout, subjects ingested 100 ml of one of the following: control (no drink), water, glucose syrup, fructose syrup, glucose-fructose syrup or a dilute glucose-electrolyte solution. Each of the syrup solutions contained approximately 36 g CHO per 100 ml; the isotonic glucose-electrolyte solution contained 4 g glucose per 100 ml. A randomised Latin square order of administration of trials was employed. Expired air samples for determination of Vo2, respiratory exchange ratio and rate of CHO oxidation were collected at 15-min intervals. Venous blood samples were obtained before and after exercise. Subjects drinking the isotonic glucose-electrolyte solution exercised longer (90.8 (12.4) min, mean (SEM] than on the control test (70.2 (8.3) min; p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)


Submucosal Fecalith Presenting as a Submucosal Cecal Mass.
A wide variety of benign and malignant submucosal lesions may arise from the wall of the large intestine. They can originate in the submucosa or in the muscular propia; furthermore, they can be caused by compression of extrinsic structures.1,2 We report a case of a submucosal mass identified as a fecalith protruding into the cecum.


Postoperative ileus: a review.
Postoperatively, some patients experience a prolonged inhibition of coordinated bowel activity, which causes accumulation of secretions and gas, resulting in nausea, vomiting, abdominal distension, and pain. This prolonged inhibition can take days or weeks to resolve and often is referred to as postoperative paralytic ileus lasting more than three days after surgery. This article reviews the etiology, pathophysiology, and treatment options of postoperative ileus. The relevant literature from 1965 to 2003 was identified and reviewed using MEDLINE database of the U.S. Medical Library of Medicine. Both retrospective and prospective studies were included in this review. The pathophysiology of postoperative ileus is multifactorial. The duration of postoperative ileus correlates with the degree of surgical trauma and is most extensive after colonic surgery. However, postoperative ileus can develop after all types of surgery including extraperitoneal surgery. A variety of treatment options have been used to decrease the duration of postoperative ileus. However, it is difficult to compare these studies because of small sample sizes and differences in operations performed, anesthesia protocols provided both intraoperatively and postoperatively, patient comorbidities, and in the measured end points, such as the time to the presence of bowel sounds, flatus, or bowel movements, tolerance of solid food, or discharge from the hospital. However, despite these drawbacks, some conclusions can be made. Paralytic postoperative ileus continues to be a significant problem after abdominal and other types of surgery. The etiology is multifactorial and is best treated with a combination of different approaches. Currently, the important factors that could effect the duration and recovery from postoperative ileus include limitation of narcotic use by substituting alternative medications such as nonsteroidals and placing a thoracic epidural with local anesthetic when possible. The selective use of nasogastric decompression and correction of electrolyte imbalances also are important factors to consider.


Thyroidectomy and parathyroid hormone: tracing hypocalcemia-prone patients.
The aim of this prospective study was to identify patients at high risk of developing hypocalcemia after thyroidectomy on the basis of the parathyroid hormone (PTH) level on the first postoperative day. We included 160 patients undergoing total thyroidectomy in a period of 6 months by the same surgical team in this study. In all patients the PTH level was measured before surgery on the day of surgery (PTH1), and on the first postoperative day (PTH2), whereas serum calcium level was measured daily until discharge. Patients were classified as hypocalcemic if they had a serum calcium level less than the normal range on the first postoperative day, independently of symptoms of hypocalcemia. At an average follow-up period of 5.9 months (range, 4-9 mo), 66 patients were considered hypocalcemic, 57 patients (35.6%) had a transient hypocalcemia, and 9 patients (5.6%) required calcium-vitamin D supplementation for persistent hypocalcemia. The mean PTH1 value was 54.4 +/- 17.2 pg/mL (median, 53.85 pg/mL), the mean PTH2 value was 22.8 +/- 13.3 pg/mL (median, 21 pg/mL). The mean PTH decrease in value was 51.54% +/- 27.4% (median, 51.83%; range, 4%-94%) and 43.7% of patients presented a PTH decrease of more than 50%. The presence of a postoperative hypocalcemia was statistical correlated both with the PTH2 level and with the PTH drop percent value (P < .001 and P = .002, respectively). With the use of the receiver operating characteristic curve, the maximum sum of the sensitivity and specificity for the correlation of PTH2 levels and hypocalcemia occurred at a PTH2 level of 9.6 pg/mL. The PTH measurement on the first postoperative day may be considered a useful method to predict postthyroidectomy hypocalcemia, thus avoiding prolonged hospitalization. Moreover, PTH dosage at first postoperative day is more reliable and less expensive than intraoperative quick PTH assay.


New records and descriptions of digeneans from the Magellanic penguin Spheniscus magellanicus (Forster) (Aves: Sphenisciformes) on the coast of Brazil.
Five species of digeneans parasitic in the Magellanic penguin Spheniscus magellanicus (Forster) from off the Brazilian coast of the western Atlantic are reported for the first time from this host and described. These are Mesostephanus odhneri (Travassos, 1924) Lutz, 1935, Posthodiplostomum macrocotyle Dubois, 1937, Stephanoprora uruguayensis Holcman-Spector & Olagüe, 1989, Ascocotyle (Phagicola) longa Ransom, 1920 and Ascocotyle (Phagicola) sp. One other digenean, Cardiocephaloides physalis (Lutz, 1926) Sudarikov, 1959, was also recorded. The taxonomy of the species and available data on their life-cycles are commented upon in relation to the possible origins of digenean infections of the Magellanic penguin.


Risk factors for hospital acquired venous thromboembolism in congenital heart disease patients: A report from the children's hospital acquired thrombosis (CHAT) consortium.
The incidence of pediatric hospital-acquired venous thromboembolism (HA-VTE) has increased over time. Congenital heart disease (CHD) as a co-morbidity has been demonstrated to significantly increase HA-VTE risk among hospitalized children. To identify specific risks factors for the development of HA-VTE in hospitalized children with CHD. This retrospective case-control study included hospitalized participants aged 0-21 years within the Children's Hospital Acquired Thrombosis (CHAT) Consortium Registry with a co-morbidity of CHD. Participants with HA-VTE and non-VTE controls with a past medical history of CHD were selected from the CHAT Registry and data regarding multiple clinical variables were extracted. These variables were then analyzed to assess their association with HA-VTE development. Three hundred and thirty-three participants with a co-morbidity of CHD were identified, comprising 275 HA-VTE cases and 58 controls. Median age for HA-VTE cases was 0.4 (IQR = 0-2.6) years compared to 3.4 (IQR = 0.7-6.5) for controls. Male participants were predominant in both groups (57.5 % HA-VTE cases vs 51.7 % controls). Multivariable analysis identified prior recent hospitalization (OR = 4.12, 95%CI = 1.66-10.24), intensive care unit (ICU) admission (OR = 3.29, 95 % CI = 1.15-9.40), and CVC placement (OR = 9.14, 95 % CI = 3.38-24.72) as significant risk factors for HA-VTE in subjects with CHD. ICU admission, CVC placement, and prior hospitalization were identified as statistically significant predictors associated with HA-VTE development in hospitalized children with history of CHD. Prospective studies are needed to validate these results and help develop strategies to mitigate HA-VTE development in these patients.


Thyrotropin receptor processing and interaction with thyrotropin.
In vitro transcription/translation, using rat thyrotropin receptor cDNA, results in the formation of nonglycosylated proteins able to bind thyrotropin, one of which approximates the 87 Kd size predicted for the receptor. In the presence of canine pancreatic microsomal membranes, putative glycosylation sites are modified as evidenced by digestion with endoglycosidase H. Using a deletion mutant, the presence of a hydrophobic peptide after the initiation signal is established as a signal peptide critical to post translational processing by the canine pancreatic membranes but not to binding thyrotropin.


Abbreviated MRI protocol for colorectal liver metastases: How the radiologist could work in pre surgical setting.
MRI is the most reliable imaging modality that allows to assess liver metastases. Our purpose is to compare the per-lesion and per-patient detection rate of gadoxetic acid-(Gd-EOB) enhanced liver MRI and fast MR protocol including Diffusion Weighted Imaging (DWI) and T2-W Fat Suppression sequence in the detection of liver metastasis in pre surgical setting. One hundred and eight patients with pathologically proven liver metastases (756 liver metastases) underwent Gd-EOBMRI were enrolled in this study. Three radiologist independently graded the presence of liver lesions on a five-point confidence scale assessed only abbreviated protocol (DWI and sampling perfection with application-optimized contrasts using different flip angle evolution (SPACE) fat suppressed sequence) and after an interval of more than 2 weeks the conventional study (all acquired sequences). Per-lesion and per-patient detection rate of metastases were calculated. Weighted к values were used to evaluate inter-reader agreement of the confidence scale regarding the presence of the lesion. MRI detected 732 liver metastases. All lesions were identified both by conventional study as by abbreviated protocol. In terms of per-lesion detection rate of liver metastasis, all three readers had higher detection rate both with abbreviated protocol and with standard protocol with Gd-EOB (96.8% [732 of 756] vs. 96.5% [730 of 756] for reader 1; 95.8% [725 of 756] vs. 95.2% [720 of 756] for reader 2; 96.5% [730 of 756] vs. 96.5% [730 of 756] for reader 3). Inter-reader agreement of lesions detection rate between the three radiologists was excellent (k range, 0.86-0.98) both for Gd-EOB MRI and for Fast protocol (k range, 0.89-0.99). Abbreviated protocol showed the same detection rate than conventional study in detection of liver metastases.


A generalized plotting program, written in BASIC for scientific data.
A software package for the hardcopy graphic display of two-dimensional data had been developed. It is written in BASIC and is compatible with a microcomputer interfaced to an intelligent digital plotter. The core of the package is a plotting program. It features a command menu that displays 15 user-controllable parameters. Most of these parameters are automatically tabulated and can be changed in an interactive manner. The data which is plotted is either entered by hand or read from pre-existing data files. The package has several other important features. One subroutine within the plotting program determines and draws the best fit of a curve through a set of points. Using another program, the user can edit and manipulate the information contained in data files. All the program commands are written in simple and precise language, therefore the user needs no previous experience with computers. Furthermore the programs can be easily modified to suit personalized needs.


Clinical experience with Donepezil (Aricept) in the UK.
Experience of the use of Donepezil (Aricept) in the UK since licensing is discussed. The results of a 30 week double blind parallel group study in the US of Donepezil 5 or 10 mg versus placebo show statistically significant improvements in cognitive and clinical global assessments. Beneficial effects were demonstrated in the absence of significant adverse effects on physical or laboratory values. The guidelines for use adopted in the UK are discussed with the emphasis on identifying non-cognitive behaviours, as significant improvements in these have been found and often have more impact on quality of life than cognitive improvements alone.


Tracing Pb and Possible Correlated Cd Contamination in Soils by Using Lead Isotopic Compositions.
Concentrations of Pb and Cd in topsoil from 24 locations along the Baguan River near a smelting dump in west Panzhihua were measured using ICP-MS to examine the spatial distributions of these toxic heavy metals. Twenty-one profile samples, 7 from each of 3 locations down to 80 cm, were also analyzed to establish background levels and Pb - Cd correlations. Lead isotopic ratios in all 45 samples and potential sources of soil contamination were determined using MC-ICP-MS. Contamination levels of Pb and Cd in soils from both sides of the river ranged from low to moderate, and the concentrations of Pb and Cd exhibited highly correlated behavior. Results of an isotope-tracer technique determined the number of end-member contaminants and background compositions contributing to the compositions of topsoils. Results of a binary mixing model indicated that contaminants in upslope soils from relatively higher elevations were coal and derivative products, and that these soils are isotopically distinct from downslope soils. Contaminants in downslope soils were slag and derivative products from V processing. Results demonstrate the use of Pb isotopic tracers in low-to-moderate contaminant levels to predict potential sources and Pb is a viable surrogate to trace potential Cd contamination in Panzhihua region.


Long-term outcomes of laparoscopic sleeve gastrectomy: a Lebanese center experience.
Long-term data of laparoscopic sleeve gastrectomy (LSG) are still scarce in the Middle East. The aim of this study was to assess the efficacy and safety at 5 years and beyond. Tertiary referral hospital between April 2007 and March 2015. A retrospective review of 76 patients who underwent LSG at the senior author's institution between April 2007 and March 2010. Mean preoperative body mass index (BMI) was 42.8±7.1 kg/m2. Follow-up rates were 90.4%, 86.3%, and 77.8% at 5, 6, and 7 years, respectively. Percentage of excess weight loss (%EWL) was 69.8%±28.7% at 5 years, 70.6%±32.7% at 6 years, and 76.6%±21.2% at 7 years, respectively. Mean total weight loss was 26.5%±8.7%, 24.9%±8.8%, and 26.6%±6.0% at 5, 6, and 7 years, respectively. %EWL at 5-years was significantly higher for patients with a preoperative BMI<45 kg/m2 (83.1% versus 46.3%, P<.0001). LSG improved or resolved diabetes, hypertension, and asthma in 87.5%, 68%, and 81.7% of patients, respectively. New onset gastroesophageal acid reflux disease developed in 21.2% of patients. Long-term complications included hiatal hernias necessitating repair (1.4%), incisional hernias (2.7%), and symptomatic gallstones (9.6%), as well as depression necessitating admission (4.1%). In the present patient population, LSG resulted in satisfactory %EWL and co-morbidity resolution after 5 years. The results were excellent for patients with a BMI<45 kg/m2. De novo acid reflux symptoms developed in 1 of 5 patients. Cholelithiasis necessitating cholecystectomy was the most common long-term complication.


Haplotype analysis of Lrrk2 R1441H carriers with parkinsonism.
The Roc domain of the Lrrk2 protein harbors two pathogenic mutations which cause autosomal dominant parkinsonism (R1441C and R1441G). A third putatively pathogenic variant (R1441H) has been identified in four probands of diverse ethnicity with parkinsonism. Herein we show that the R1441H substitutions lie on different haplotypes within our patients, confirming this codon as a mutational hotspot. The absence of this variant in control subjects and the presence of two other pathogenic variants at this amino acid position collectively support the contention that R1441H is a pathogenic substitution.


Developmental changes in rabbit juxtamedullary proximal convoluted tubule acidification.
The transporters responsible for apical proton secretion were examined in neonatal and adult proximal convoluted tubules (PCT). Transporter activity was assayed from the rate of recovery of cell pH after cell acidification following exposure to NH4Cl. Cell pH was monitored in in vitro perfused tubules using the pH sensitive dye 2',7'-bis(carboxyethyl)-5,6-carboxyfluorescein. Recovery from an acid load in adult PCT occurred at 0.52 +/- 0.09 pH units/min in the presence of sodium and 0.25 +/- 0.05 in the absence of sodium (p less than 0.05). One mmol/L N-ethylmaleimide, an inhibitor of the H(+)-ATPase, inhibited the sodium-independent pH recovery from an acid load consistent with a H(+)-ATPase on the apical membrane. In neonatal PCT, recovery from an acid load was 0.39 +/- 0.08 pH units/min in the presence of sodium and only 0.08 pH units/min in the absence of sodium (p less than 0.05). Studies using 4 mmol/L luminal amiloride, an inhibitor of the Na+/H+ antiporter, were consistent with a larger fraction of pH recovery from an acid load in neonatal PCT being due to the Na+/H+ antiporter compared with adult PCT. Thus, maturation of the PCT involves an increase in activity of a sodium-independent proton secretory mechanism, presumably the H(+)-ATPase.


Parietal cell density during gastric ulcer healing in the rat.
During the healing of gastric ulcers, extensive changes take place in the structure and proportion of the parietal cells in the ulcer margin. We aimed to determine whether these changes are influenced by compounds or by procedures that may promote or delay gastric ulcer healing. Acetic acid ulcers were produced in the rat gastric corpus; control rats were non-operated or sham-operated. All rats were provided with an osmotic minipump releasing 3H-thymidine for determination of the labelling index (LI). The rats were given omeprazole, gastrin or indomethacin, infected with Helicobacter pylori, or subjected to anterior vagotomy. They were killed after 1, 2, 6 or 13 days, and the ulcer margin and undamaged corpus wall were excised for histology. The proportion of parietal cells was calculated in relation to the total number, and the total volume, of the epithelial cells. The parietal cells averaged 16%-21% of the number and 30%-32% of the volume of the epithelial cells in the unoperated control rats, but considerably less in the ulcer margin. This reduction was partially prevented by indomethacin. In the undamaged, dorsal epithelium the parietal cells increased to 23%-26% of the number, and 41%-47% of the volume, of the epithelial cells, both in the ulcer rats and in the sham-operated rats. The LI of the parietal cells was 6% in the undamaged epithelium of the 13-day ulcer rats, but close to 0% in all other groups examined. Indomethacin prevents much of the loss of parietal cells in the ulcer margin. In the undamaged epithelium of the ulcer rats there is an increased proportion of parietal cells. The new parietal cells are not formed directly from dividing cells, but are probably recruited from existing precursor cells.


Autoradiographic comparison of [125I]LSD-labeled 5-HT2A receptor distribution in rat and guinea pig brain.
Although the density and distribution of 5-HT2A (5-hydroxytryptamine-2A) receptors is well established for rat brain, the 5-HT2A receptor distribution and density in guinea pig brain has not been extensively studied. In the present in vitro study, we have utilized 125I-lysergic acid diethylamide ([125I]LSD) to quantify and compare 5-HT2A receptor density in coronal sections of rat and guinea pig brain. Spiperone (1 microM) and sulpiride (1 microM) were used to displace [125I]LSD binding from 5-HT2A and D2 binding sites, respectively. Ligand binding was quantified by computer-aided image analysis densitometry (MCID). Similar to the rat, areas of highest specific 5-HT2A receptor binding (fmol/mg protein) in guinea pig brain included the claustrum and Layer 4 of the cerebral cortex. Significant binding was also found in remaining neocortical layers, islands of Calleja, caudate putamen, olfactory bulb, nucleus accumbens, and choroid plexus. While the rat brain exhibited a high level of specific binding in the tenia tecta and mammillary nuclei, little binding was observed in these regions in the guinea pig. In both rat and guinea pig, low specific binding was found in amygdaloid, thalamic, or cerebellar areas. These studies indicate a general similarity between 5-HT2A binding site distribution and relative density in guinea pig and rat brain but point to a few brain regions where significant differences exist.


Pd-Catalyzed Tandem Pathway for Stereoselective Synthesis of (E)-1,3-Enyne from β-Nitroalkenes by Using a Sacrificial Directing Group.
The involvement of nitroalkenes instead of minimal one alkyne motif for (E)-1,3-enynes synthesis through a palladium catalyzed stereoselective bond forming pathway at room temperature is presented. Implication of nitro group as a sacrificial directing group, formation of magical alkyne on a newly developed Csp 3 -Csp 3 bond with initial palladium-MBH adduct make this methodology distinctive. This protocol features an unprecedented sequential acetate addition, carbon-carbon bond formation, isomerization of double bond and nitromethane degradation in a tandem catalytic walk via dancing hybridization. Mechanistic understanding through identification of intermediates and computational calculations furnishes complete insight into the tandem catalytic pathway. Broad substrates scope and functional groups tolerance make this synthetic methodology magnificent and dynamic. This represents the first example of stereoselective 1,3-enyne synthesis exclusively from alkene substrates by introducing the concept of sacrificial directing group.


Import of host delta-aminolevulinate dehydratase into the malarial parasite: identification of a new drug target.
The parasite Plasmodium berghei imports the enzyme delta-aminolevulinate dehydratase (ALAD), and perhaps the subsequent enzymes of the pathway from the host red blood cell to sustain heme synthesis. Here we have studied the mechanism of this import. A 65-kDa protein on the P. berghei membrane specifically bound to mouse red blood cell ALAD, and a 93-amino-acid fragment (ALAD-DeltaNC) of the host erythrocyte ALAD was able to compete with the full-length enzyme for binding to the P. berghei membrane. ALAD-DeltaNC was taken up by the infected red blood cell when added to a culture of P. falciparum and this led to a substantial decrease in ALAD protein and enzyme activity and, subsequently, heme synthesis in the parasite, resulting in its death.


Complete intraventricular migration of ventriculo-peritoneal shunt: A rare case report.
A ventriculoperitoneal (VP) shunt is a cerebral shunt used to treat hydrocephalus. This is used to remove the excessive accumulation of cerebrospinal fluid inside the ventricles. We are reporting a rare case of complete intracranial migration of a ventriculoperitoneal shunt, a potentially fatal complication, presenting to us with hydrocephalous. The baby was taken up for surgery with endoscopic assisted shunt removal and shunt revision. Ventriculoperitoneal shunt is one of the common procedures used in infants and children, however, it is used in all age groups for hydrocephalous. The shunt is associated with multiple large number of complications like obstruction, infection, migration, and separation from the connected site. Etc. Shunt migration is a less common complication of which cranial migration is still less common. Optimum creation of the sub-galeal space for the shunt chamber, a smaller burr hole, a smaller dural opening, and proper anchorage of the chamber to the pericranium, are some of the measures that may be useful in obviating this complication.


An object-oriented approach to data display and storage: 3 years experience, 25,000 cases.
Object-oriented programming techniques were used to develop computer based data display and storage systems. These have been operating in the 8 anaesthetising areas of the Adelaide Children's Hospital for 3 years. The analogue and serial outputs from an array of patient monitors are connected to IBM compatible PC-XT computers. The information is displayed on a colour screen as wave-form and trend graphs and digital format in 'real time'. The trend data is printed simultaneously on a dot matrix printer. This data is also stored for 24 hours on 'hard' disk. The major benefit has been the provision of a single visual focus for all monitored variables. The automatic logging of data has been invaluable in the analysis of critical incidents. The systems were made possible by recent, rapid improvements in computer hardware and software. This paper traces the development of the program and demonstrates the advantages of object-oriented programming techniques.


The effect of probiotics on faecal microbiota and genotoxic activity of faecal water in patients with atopic dermatitis: a randomized, placebo-controlled study.
Colonic microbiota is involved in the etiology of colon cancer according to several reports. Studies also indicate that the microbiota differs between atopic patients and healthy subjects. To evaluate whether a probiotic mix containing Lactobacillus paracasei Lpc-37, Lactobacillus acidophilus 74-2, and Bifidobacterium animalis subsp. lactis DGCC 420 can affect the microbiota and its genotoxic activity in healthy subjects and patients with atopic dermatitis (AD). A placebo-controlled cross-over study was conducted. Fifteen healthy adults and 15 adult AD patients consumed 2×100 ml/d of either a probiotic or a placebo drink for 8 weeks followed by a wash out period of 2 weeks before crossing the intervention. Faecal water was isolated from stool samples collected at the end of each period. HT29c19a cells incubated with faecal water were measured for DNA damage using single-cell gel electrophoresis ("comet assay"). Bacterial species were determined by qPCR and concentrations of short-chain fatty acids were measured by means of gas chromatography. Probiotic supplementation resulted in a significant increase in lactobacilli, whereas numbers of Bifidobacteria and Bacteroidetes remained unchanged. Clostridium perfringens cluster I-II was significantly reduced in healthy subjects. Genotoxic potential (expressed as tail intensity) of faecal water, was not affected. However, tail intensity decreased significantly in the probiotic period compared to placebo (23.5 vs. 16.7%) in AD patients. Although faecal concentrations of short-chain fatty acids were not affected, faecal pH was significantly reduced (7.0 vs. 6.6) in AD patients after probiotics. The results indicate that probiotics lower the genotoxic potential of faecal water in AD patients. The faecal C. perfringens cluster I-II levels remained unaffected suggesting either a change in their activity, or the fact that other bacterial species are responsible for the reduced genotoxic activity of faecal water.


Control of communication networks: welfare maximization and multipath transfers.
We discuss control strategies for communication networks such as the Internet. We advocate the goal of welfare maximization as a paradigm for network resource allocation. We explore the application of this paradigm to the case of parallel network paths. We show that welfare maximization requires active balancing across paths by data sources, and potentially requires implementation of novel transport protocols. However, the only requirement from the underlying 'network layer' is to expose the marginal congestion cost of network paths to the 'transport layer'. We further illustrate the versatility of the corresponding layered architecture by describing transport protocols with the following properties: they welfare maximization, each communication may use an arbitrary collection of paths, where paths may be from an overlay, and paths may be combined in series and parallel. We conclude by commenting on incentives, pricing and open problems.


Spinal segmental and supraspinal mechanisms underlying the pain-relieving effects of spinal cord stimulation: an experimental study in a rat model of neuropathy.
Spinal cord stimulation (SCS) may alleviate certain forms of neuropathic pain; its mechanisms of action are, however, not fully understood. Previous studies have mainly been focused onto segmental spinal mechanisms, though there is evidence indicating a supraspinal involvement. This study aims to evaluate the relative importance of segmental and supraspinal mechanisms related to the activation of the dorsal columns (DCs). Rats were used to induce the spared nerve injury neuropathy and simultaneously subjected to chronic bilateral DC lesions at the C6-C8 level. Two pairs of miniature electrodes were implanted in each animal, with a monopolar system placed in the dorsal epidural space at a low thoracic level (below lesion) and a bipolar system placed onto the dorsal column nuclei (above lesion). Stimulation (50 Hz, 0.2 ms, 2-4V, 5 min) was applied via either type of electrodes, and tests for sensitivity to tactile and thermal stimuli were used to assess its inhibitory effects. Various receptor antagonists {bicuculline (GABA(A)), saclofen (GABA(B)), ketanserine (5HT(2)), methysergide (5HT(1-2)), phentolamine (α-adrenergic), propranolol (β-adrenergic), sulpiride (D(2)/D(3) dopamine) or saline were injected prior to the SCS. Rostral and caudal stimulations produced a comparable inhibition of neuropathic manifestations, and these effects were attenuated by about 50% after DC lesions. Pretreatment with the various receptor antagonists differentially influenced the effects of rostral and caudal stimulation. Our findings suggest that both supraspinal and segmental mechanisms are activated by SCS, and that in this model with DC lesions, rostral and caudal stimulations may activate different synaptic circuitries and transmitter systems.


Does ambient temperature interact with air pollution to alter blood pressure? A repeated-measure study in healthy adults.
Both low temperature and high air pollution have been associated with an increased risk of cardiovascular events, which could be predicted by increased arterial blood pressure (BP) within short periods. However, whether exposures to temperature and air pollution simultaneously may have interactive effects on BP has been unknown. We investigated this potential interaction during 460 repeated visits in 39 healthy university students in the context of traffic-related air pollution. Study participants in the Healthy Volunteer Natural Relocation study underwent repeated BP measurements for 12 occasions under three exposure scenarios in Beijing, China, in 2010-2011. We used generalized linear mixed-effects models to estimate exposure effects. Decreasing temperature was associated with significant increases in BP. There were significant interactions between temperature and traffic-related air pollutants (particulate matter with an aerodynamic diameter ≤2.5 μm, organic carbon, elemental carbon and nitrogen dioxide) on BP (P < 0.05 for all interaction tests). The estimated increases in SBP and DBP were 4.9 mmHg [95% confidence interval (CI) 2.9-6.8] and 3.7 mmHg (95% CI 2.3-5.1) at high elemental carbon level (≥median), and were -1.3 mmHg (95% CI -6.3 to 3.6) and 0.7 mmHg (95% CI -2.8 to 4.2) at low elemental carbon level (<median) per 10°C decrease in daily minimum temperature. We also found stronger air pollution effects on BP at low temperature levels (<median) than at high temperature levels (≥median). Low temperature and high air pollution may act synergistically to increase BP in healthy adults. Our findings may have potential implications for prevention of cardiovascular events associated with increased BP among high-risk individuals.


Page kidney phenomenon in kidney allograft following peritransplant lymphocele.
A case of kidney allograft dysfunction in a recipient with a prior lymphocele is described. We attribute it to a Page kidney phenomenon caused by a constrictive pericapsular fibrosis. Surgical exploration and excision of the fibrotic tissue were followed by the recovery of renal transplant function. To our knowledge, only 1 case of Page kidney in renal allograft due to peritransplant hematoma has been described in the literature.


Earthworm toxicity during chemical oxidation of diesel-contaminated sand.
An ecotoxicity test with Eisenia fetida was performed to monitor the removal of diesel and toxicity variation during the ozonation process. The three-dimensional (3-D) cell test was introduced for the monitoring of the ozonation process, and the removal rate based on total petroleum hydrocarbons (TPHs) mass was about 95% near the ozone inlet ports. This high removal rate might be caused by the low soil organic matter (SOM) content and low water content of sand. The use of a fiber-optic transflection dip probe (FOTDP) demonstrated that more than half of the injected ozone was consumed by reactions with diesel or natural ozone-consuming materials. The earthworm toxicity test using Eisenia fetida demonstrated that diesel concentrations in soil exceeding 10,000 mg/kg caused a dose-dependent weight loss in earthworms and increased mortality. Toxic effects were reduced greatly or eliminated after ozonation, and the degradation products of the ozonation were not toxic to the earthworms at the concentrations tested. One specific result was that the sublethal test on the earthworm might be more sensitive for the evaluation of the quality of contaminated soil, for some samples, which did not result in mortality and produced an adverse effect on weight.


Indoor air particles and bioaerosols before and after renovation of moisture-damaged buildings: the effect on biological activity and microbial flora.
Many building-related health problems coincide with moisture damage and mold growth within a building. Their elimination is assumed to improve indoor air quality. The aim of this study was to follow the success of remediation in two individual buildings by analyzing the microbial flora and immunotoxicological activity of filter samples. We compare results from samples collected from indoor air in the moisture-damaged buildings before and after renovation and results from matched reference buildings and outdoor air. The microbial characteristics of the samples were studied by analyzing ergosterol content and determining the composition of fungal flora with quantitative polymerase chain reaction (QPCR). In addition, the concentrations of particles were monitored with optical particle counter (OPC). The immunotoxicological activity of collected particle samples was tested by exposing mouse macrophages (RAW264.7) for 24 h to particle suspension extracted from the filters, and measuring the viability of the exposed cells (MTT-test) and production of inflammatory mediators (nitric oxide, IL-6 and TNF*) in cell culture medium by enzyme-linked immunoassay (ELISA). The results show that for Location 1 the renovation decreased the immunotoxicological activity of the particles collected from damaged building, whereas no difference was detected in the corresponding samples collected from the reference building. Interestingly, only slight differences were seen in the concentration of fungi. In the Location 2, a decrease was seen in the concentration of fungi after the renovation, whereas no effect on the immunotoxicological responses was detected. In this case, the immunotoxicological responses to the indoor air samples were almost identical to those caused by the samples from outdoor air. This indicates that the effects of remediation on the indoor air quality may not necessarily be readily measurable either with microbial or toxicological parameters. This may be associated with different spectrum of harmful agents in different mold and moisture-damaged buildings.


Techno-functional characterization of indigenous Lactobacillus isolates from the traditional fermented foods of Meghalaya, India.
The rural tribal people of Meghalaya depend mostly on their ethnic fermented foods as a part of their regular diet and these fermented foods are considered to be a hub of healthy microorganisms. However, the efficacy of probiotic microorganisms is considered to be population-specific because of gut microflora variation in food habits and specific host-microbial interactions. Hence, a strong need for exploring novel indigenous microorganisms with rich probiotic potentiality is required. A few indigenous Lactobacillus isolates (from traditional fermented foods of Meghalaya) were studied extensively for its technological and probiotic attributes. The isolates could survive at pH 2-3 (L. fermentum K16 showed high cell count: pH 2-5.12 log CFU/ml; pH 3-5.76 log CFU/ml), against bile salts (L. fermentum K7 showed high cell count-5.36 log CFU/ml), gastric juices (pepsin and trypsin), and intestinal juice (pancreatin). The isolates showed α-galactosidase activity from 0.104-0.412 μM/ml and β-glucosidase activity ranging from 0.122-0.409 μM/ml. Exopolysaccharide production was in between 410 and 950 mg/L. Cell surface hydrophobicity was 71.57% (L. rhamnosus K4E) and auto-aggregation was 83% (L. fermentum K16) during the study. Highest proteolytic activity (0.671 nm) and cholesterol assimilation (52.57%) was exhibited by L. fermentum K16. The isolates showed high free radical scavenging activity by ABTS method up to 80.78% by isolate L. fermentum K7. Antibacterial activity and co-aggregation efficacy was also tested against B. cereus, E. faecalis, S. dysenteriae, S. aureus, E. coli, L. monocytogenes, S. typhi. These indigenous Lactobacillus isolates with high probiotic potentials could be exploited in the development of the traditional fermented foods of Meghalaya.


Inputs from the nucleus of the solitary tract to subfornical organ neurons projecting to the paraventricular nucleus in the rat.
Extracellular single-unit activity was recorded from 26 subfornical organ (SFO) neurons antidromically identified as projecting to the hypothalamic paraventricular nucleus (PVN) in urethane-anesthetized male rats. Of these identified SFO neurons, 10 displayed an inhibitory response and 2 exhibited an excitatory response in neuronal excitability following electrical stimulation of the nucleus of the solitary tract (NTS), while the remaining neurons were unresponsive. Eight out of 10 SFO neurons that demonstrated the inhibitory response to NTS stimulation also displayed a reduction in ongoing activity in response to activation of peripheral baroreceptors, achieved by rising arterial blood pressure with an intravenous administration of the alpha-agonist metaraminol, whereas the remaining responsive neurons to NTS stimulation were ineffective. These results show that a part of SFO neurons projecting to the PVN may receive inhibitory inputs from the peripheral baroreceptors through NTS neurons.


In vitro production studies with a wild-type Helicoverpa baculovirus.
The potential use of a wild-type Helicoverpa baculovirus as a biopesticide, using insect cell culture for its production, has been investigated. A Helicoverpa zea cell line was adapted to grow in suspension culture using a serum-free medium, SF900II and serum supplemented SF900II. The serum supplemented cells were infected with a wild-type nuclear polyhedrosis virus of Helicoverpa armigera (HaNPV), at different stages of growth, in conditioned and tresh medium, to determine the effect of cell density on polyhedra production. Cultures infected at low cell densities, produced similar yields of virus (20-40 PIB/cell), irrespective of medium conditions. However, in infections which occurred at high cell densities, there was a 16-fold improvement in cell specific yields, when the spent medium was renewed with fresh medium prior to infection. Results indicated that only 60-70% of the viable cells in a culture produced polyhedra as a result of infections.


Genetic variability of Echinococcus granulosus complex in various geographical populations of Iran inferred by mitochondrial DNA sequences.
To investigate the genetic variability and population structure of Echinococcus granulosus complex, 79 isolates were sequenced from different host species covering human, dog, camel, goat, sheep and cattle as of various geographical sub-populations of Iran (Northwestern, Northern, and Southeastern). In addition, 36 sequences of other geographical populations (Western, Southeastern and Central Iran), were directly retrieved from GenBank database for the mitochondrial cytochrome c oxidase subunit 1 (cox1) gene. The confirmed isolates were grouped as G1 genotype (n=92), G6 genotype (n=14), G3 genotype (n=8) and G2 genotype (n=1). 50 unique haplotypes were identified based on the analyzed sequences of cox1. A parsimonious network of the sequence haplotypes displayed star-like features in the overall population containing IR23 (22: 19.1%) as the most common haplotype. According to the analysis of molecular variance (AMOVA) test, the high value of haplotype diversity of E. granulosus complex was shown the total genetic variability within populations while nucleotide diversity was low in all populations. Neutrality indices of the cox1 (Tajima's D and Fu's Fs tests) were shown negative values in Western-Northwestern, Northern and Southeastern populations which indicating significant divergence from neutrality and positive but not significant in Central isolates. A pairwise fixation index (Fst) as a degree of gene flow was generally low value for all populations (0.00647-0.15198). The statistically Fst values indicate that Echinococcus sensu stricto (genotype G1-G3) populations are not genetically well differentiated in various geographical regions of Iran. To appraise the hypothetical evolutionary scenario, further study is needed to analyze concatenated mitogenomes and as well a panel of single locus nuclear markers should be considered in wider areas of Iran and neighboring countries.


Relationships Between Different Dimensions of Social Support and Suicidal Ideation in Young People with Major Depressive Disorder.
Suicidal ideation (SI) is a common feature of depression and is closely associated with suicidal behaviour. Social support is implicated as an important determinant of suicide, but it is unclear how different social support dimensions influence SI in young people with depression. This study examines relationships between social support dimensions and SI in young people with major depressive disorder (MDD). 283 Australians aged 15-25, diagnosed with MDD, were recruited from two clinical trials conducted in youth-specific outpatient mental health services. The Multidimensional Scale of Perceived Social Support (MSPSS) was used to evaluate perceived support from Family, Friends, and a Significant Other. Suicidal ideation was assessed using the Suicidal Ideation Questionnaire (SIQ). Hierarchical regression was used to explore associations between social support and SI, controlling for demographics and depression severity. A hierarchical regression model predicted 9% of the variability in SI, with depression severity being the most significant predictor. Family Support was inversely related to SI and uniquely contributed 2% of the variance; β = -0.15 (95% CI -0.27 - -0.02) p < .05. Demographics and support from Friends or a Significant Other were not significantly associated with SI. Findings are correlational; it cannot be determined that increasing family support would decrease SI severity. Perceived Family Support was negatively associated with SI in young people with MDD. This suggests that family members might play important roles in suicide prevention efforts. More work is needed exploring ways to empower families to develop adaptive family functioning and support.


Photo-Induced Black Phase Stabilization of CsPbI3 QDs Films.
α-CsPbI3 quantum dots (QDs) show outstanding photoelectrical properties that had been harnessed in the fabrication of perovskite QDs solar cells. Nevertheless, the stabilization of the CsPbI3 perovskite cubic phase remains a challenge due to its own thermodynamic and the presence of surface defects. Herein, we report the optimization of the CsPbI3 QDs solar cells, by monitoring the structure, the morphology and the optoelectronic properties after a precise treatment, consisting of the conventional solvent washing with a time limited ultraviolet (UV) exposure combination, during the layer-by-layer deposition. The UV treatment compensates the defects coming from the essential but deleterious washing treatment. The material is stable for 200 h and the PCE improved by the 25% compared with that of the device without UV treatment. The photo-enhanced ion mobility mechanism is discussed as the main process for the CsPbI3 QDs and solar cell stability.


Are American Indian/Alaska Native Adolescent Health Behaviors Different? A Review of AI/AN Youth Involved in Native STAND Curriculum, 2014-2017 United States.
To explore health behavior profiles of AI/AN youth involved in native students together against negative decisions (STAND), a national culture-based curriculum. We analyzed data from 1236 surveys conducted among AI/AN youth at 40 native STAND implementation sites located in 16 states throughout the US from 2014 to 2017. Health profiles included demographics, sexual orientation, sexual activity, STI testing, cigarette use, and suicide attempts in the past 12-months. We used t-tests and chi square tests of independence to compare risk behavior prevalence among the sample. Health behavior profiles of AI/AN youth indicate that 45.6% of youth did not use condoms the last time they had sex, and 82.7% have never been tested for STIs. Differences in cigarette smoking were observed in questioning youth (questioning: 80.3%, straight/heterosexual: 63.8%, LGBTQ2S + : 49.9%, p = 0.03). Health behaviors related to sex, substance, violence and self-harm, are at least as common for AI/AN youth as those observed in other US teens. Future research should consider similarities and differences in health profiles of AI/AN youth when designing interventions that affect them. Further, our findings underscore the need for culturally-relevant curricula like native STAND, not because their health behavior is different, but because their socio-ecologic environment is different.


Rapid fingerprinting of sterols and related compounds in vegetable and animal oils and phytosterol enriched- margarines by transmission mode direct analysis in real time mass spectrometry.
Plant-derived sterols, often referred to as phytosterols, are important constituents of plant membranes where they assist in maintaining phospholipid bilayer stability. Consumption of phytosterols has been suggested to positively affect human health by reducing cholesterol levels in blood via inhibition of its absorption in the small intestine, thus protecting against heart attack and stroke. Sterols are challenging analytes for mass spectrometry, since their low polarity makes them difficult to ionize by both electrospray ionization (ESI) and matrix-assisted laser desorption ionization (MALDI), typically requiring derivatization steps to overcome their low ionization efficiencies. We present a fast and reliable method to characterize the composition of phytosterols in vegetable oils and enriched margarines. The method requires no derivatization steps or sample extraction procedures thanks to the use of transmission mode direct analysis in real time mass spectrometry (TM-DART-MS).


Radio frequency identification (RFID) of dentures in long-term care facilities.
The difficulty of identifying the ownership of lost dentures when found is a common and expensive problem in long term care facilities (LTCFs) and hospitals. The purpose of this study was to evaluate the reliability of using radiofrequency identification (RFID) in the identification of dentures for LTCF residents after 3 and 6 months. Thirty-eight residents of 2 LTCFs in Switzerland agreed to participate after providing informed consent. The tag was programmed with the family and first names of the participants and then inserted in the dentures. After placement of the tag, the information was read. A second and third assessment to review the functioning of the tag occurred at 3 and 6 months, and defective tags (if present) were reported and replaced. The data were analyzed with descriptive statistics. At the 3-month assessment of 34 residents (63 tags) 1 tag was unreadable and 62 tags (98.2%) were operational. At 6 months, the tags of 27 of the enrolled residents (50 tags) were available for review. No examined tag was defective at this time period. Within the limits of this study (number of patients, 6-month time span) RFID appears to be a reliable method of tracking and identifying dentures, with only 1 of 65 devices being unreadable at 3 months and 100% of 50 initially placed tags being readable at the end of the trial.


Comparing the properties of neuronal culture systems: a shopping guide for the cell biologist.
Cell biologists of many stripes may find that their question of interest can be studied to advantage in neurons. However, they will also find that "neurons" include many and diverse cell types among which perhaps just one or a few may be ideal for a particular experiment. This chapter discusses the properties, relative complexity, and cost of primary neurons and neuronal cell types from different species and parts of the nervous system and compares their utility for different kinds of cell biological experiments.


Intravenous exposure to di(2-ethylhexyl)phthalate (DEHP): metabolites of DEHP in urine after a voluntary platelet donation.
In this study we investigated human metabolism and excretion of DEHP after intravenous exposure. For this purpose we determined the five major DEHP metabolites in urine samples of a volunteer before and after a platelet donation (dual-needle technique). Plateletpheresis procedures are known to cause a significant DEHP exposure. We observed a sharp increase in urinary DEHP metabolite concentrations after the procedure. Maximum concentrations of 5OH-MEHP, 5oxo-MEHP, 5cx-MEPP and MEHP observed 4 h after the procedure were 822, 729, 577 and 388 microg/l respectively. 2cx-MMHP was excreted at highest concentrations after 8 h (201 microg/l). Due to longer elimination half-times, 5cx-MEPP and 2cx-MMHP were the major metabolites excreted in urine 24 h after the exposure. The 24-h-cumulative excretion of 363 microg 5cx-MEPP, 353 microg 5OH-MEHP, 309 microg 5oxo-MEHP, 178 microg MEHP and 133 microg 2cx-MMHP indicates an absolute exposure of our volunteer of about 2.6 mg DEHP. Related to the body weight this equals a dose of 31.6 microg/kg body weight/day. This indicates that current risk or preventive limit values for DEHP such as the RfD of the US EPA (20 microg/kg/day) and the TDI of the European Union (20-48 microg/kg/day) can be exceeded on the day of the plateletpheresis. The amount of the dose excreted in urine, distribution of the metabolites in urine and all other elimination characteristics after intravenous DEHP exposure are comparable to oral exposure. There are no indications that toxicokinetic behaviour and the toxicity of DEHP are fundamentally different after the two routes of exposure. Therefore, toxicological endpoints observed for DEHP after oral application should also be considered relevant for medical procedures causing intravenous DEHP exposure, like apheresis procedures. Especially women in their reproductive age need to be protected from DEHP exposures exceeding the above mentioned preventive limit values.


The prognostic value of immediate post-TAVI hemodynamic evaluation is superior to aortography and transoesophageal echocardiography in predicting patient survival.
Although post-TAVI PAR is commonly seen, its exact evaluation, grading and the true impact on patients' survival are still debated. This single center study aimed to evaluate the effect of post transcatheter aortic valve implantation (TAVI) paravalvular aortic regurgitation (PAR) on patients' survival. The outcome was evaluated by the three most commonly used techniques just after TAVI in the interventional arena. 201 high risk patients with severe symptomatic aortic stenosis underwent TAVI with the self-expandable system. The severity of post-TAVI PAR was prospectively evaluated by aortography and transesophageal echocardiography (TEE) using a four-class scheme and hemodynamic evaluation by calculation of the regurgitation index (RI). Median follow up time was 763 days. Post-TAVI PAR results of the three different modalities were concordant with each other (all p < 0.001). Patients with grade 0-I PAR by aortography had better long term outcomes compared to those who had grade II-III PAR (unadjusted HR 1.77 [95% CI, 1.04-3.01], p = 0.03). Although in multivariate analysis neither aortography nor TEE were shown to be significant predictors of survival, hemodynamic assessment using the exact RI result was a significant predictor of survival and its effect was found to be linear (adjusted HR 0.72 [95% CI, 0.52-0.98] for 10% point increase in RI, p = 0.03595). Among the three modalities that are frequently used to evaluate the outcome, post-TAVI RI showed the highest added predictive value for survival.


Mortality after the death of a parent in adulthood: a register-based comparison of two ethno-linguistic groups.
Most research on parental bereavement and health have analysed health consequences of parental loss in childhood, while collateral health in adulthood has been less studied. Using register-based population data from Finland, we analyse adult offspring aged 18-50 years with discrete-time hazard models that adjust for offspring and parental socioeconomic and demographic characteristics. In focus are adult children whose parents were alive and lived together at the beginning of the observation period. We compare two culturally distinct but otherwise similar ethno-linguistic groups, Finnish speakers and Swedish speakers. The results suggest that bereaved men have an approximately 30% higher death risk than non-bereaved men, while there is practically no difference in women. Associations between parental and child deaths are, as expected, stronger for concordant causes of death than for discordant causes of death. However, some associations for discordant causes of death remain, which may indicate causality. Among Swedish speakers, who have notably higher family stability than Finnish speakers, the death of one or both parents shows a stronger association with own mortality. The estimated associations found are generally larger than in the neighbouring country Sweden, which may be due to a stronger obedience to traditional family values and patriarchal family roles in Finland. These findings suggest that the association between parental death and mortality in adult offspring may depend on the societal context as well as on cultural practices. These factors should be increasingly acknowledged in future studies on collateral health.


Contact Sensitization in Pediatric Population With Atopic Dermatitis: A Retrospective Study of 80 Patients.
This study aimed to evaluate the frequency of allergic contact dermatitis among children with atopic dermatitis (AD), the most common sensitizer, and the associated risk factors. This retrospective study included children with AD who underwent patch testing at our dermatology department between 2005 and 2021. Eighty patients were included. The average age was 77.6 months (4 months-17 years), divided as follows: children (76.3%), infants (11.3%), and teenagers (10%). The sex ratio (M/F) was 1.35. Thirty-two patients (40%) had positive patch test results. Allergic contact dermatitis was significantly more frequent among patients with severe AD (40.6%) than among those with moderate or mild AD (16.7%, P = 0.017). The most frequent allergens were nickel sulfate (23.7%), cobalt chloride (12.5%), potassium dichromate (8.7%), textile dyes (6.2%), and lanolin (5%). Contact allergies are a common problem in children with AD. They seem to be at risk of sensitization to certain allergens mainly metals and components of skincare products. Patch testing should be performed whenever allergic contact dermatitis is suspected and in cases of severe AD.


4D nucleome Analysis Toolbox: analysis of Hi-C data with abnormal karyotype and time series capabilities.
The availability of powerful analysis tools will further understanding of genome organization and its relationship to phenotype in dynamical settings. The 4D Nucleome Analysis Toolbox (NAT) is a user-friendly and powerful MATLAB toolbox for time series analysis of genome-wide chromosome conformation capture (Hi-C) data and gene expression (RNA-seq). NAT can load and normalize data, define topologically associating domains, analyse translocations, produce visualization, and study time course data. We provide examples that include time series data sets and karyotypically abnormal cell lines demonstrating the flexibility of NAT. https://github.com/laseaman/4D_Nucleome_Analysis_Toolbox. email@example.com.


Human monoclonal antibodies to myelin-associated glycoprotein. Comparison of specificity and use for immunocytochemical localisation of the antigen.
Recent reports demonstrate that a population of patients with gammopathy and demyelinating neuropathy have monoclonal antibodies to myelin-associated glycoprotein. Using the immunoblotting technique we compared the species specificity: human monoclonal antibodies to myelin-associated glycoprotein reacted with human, monkey, calf, dog, rabbit and guinea pig myelin, but not with rat or mouse. On the immunoblot myelin-associated glycoprotein consistently stained as a diffuse band with an apparent molecular weight ranging from 90-100 X 10(3) dalton. Experiments showed that when human CNS myelin had been incubated at 37 degrees C before gel electrophoresis, there was a general shift of staining towards the lower end of the molecular weight range. This low molecular weight myelin-associated glycoprotein, when released from the membrane, contains the antigenic determinant. Peptide mapping by limited proteolysis reveals that the antigenic determinants for 4 different monoclonal antibodies appear to lie very close together in the molecule. The distribution of the antigen was studied in nervous tissue with the unlabelled peroxidase-antiperoxidase method. The results obtained are in close agreement with the localization reported with polyclonal antisera to myelin-associated glycoprotein.


Infected primary intramuscular echinococcosis of thigh.
An unusual case of infected primary echinococcosis involving quadriceps muscles of the thigh and presenting as a cystic mass in a child is being reported. The diagnosis was made preoperatively with ultrasound examination and serology. After a cover of medical treatment the cyst was excised. Various clinical possibilities and management strategies are discussed.


Papillomatosis cutis lymphostatica and 'Ski-Jump' nails.
Papillomatosis cutis lymphostatica is an uncommon condition usually associated with lymphedema. "Ski-jump" nails are upward sloping concave nails that can be an important diagnostic sign which may be overlooked in the setting of lymphedema. A diagnosis of papillomatosis cutis lymphostatica should be suspected in patients presenting with persistent, bland papilliform plaques, supported by the additional presence of "ski-jump" nails.


The live attenuated chimeric vaccine rWN/DEN4Δ30 is well-tolerated and immunogenic in healthy flavivirus-naïve adult volunteers.
WNV has become the leading vector-borne cause of meningoencephalitis in the United States. Although the majority of WNV infections result in asymptomatic illness, approximately 20% of infections result in West Nile fever and 1% in West Nile neuroinvasive disease (WNND), which causes encephalitis, meningitis, or flaccid paralysis. The elderly are at particular risk for WNND, with more than half the cases occurring in persons older than sixty years of age. There is no licensed treatment for WNND, nor is there any licensed vaccine for humans for the prevention of WNV infection. The Laboratory of Infectious Diseases at the National Institutes of Health has developed a recombinant live attenuated WNV vaccine based on chimerization of the wild-type WNV NY99 genome with that of the live attenuated DENV-4 candidate vaccine rDEN4Δ30. The genes encoding the prM and envelope proteins of DENV-4 were replaced with those of WNV NY99 and the resultant virus was designated rWN/DEN4Δ30. The vaccine was evaluated in healthy flavivirus-naïve adult volunteers age 18-50 years in two separate studies, both of which are reported here. The first study evaluated 10³ or 10⁴ PFU of the vaccine given as a single dose; the second study evaluated 10⁵ PFU of the vaccine given as two doses 6 months apart. The vaccine was well-tolerated and immunogenic at all three doses, inducing seroconversion to WNV NY99 in 74% (10³ PFU), 75% (10⁴ PFU), and 55% (10⁵ PFU) of subjects after a single dose. A second 10⁵ PFU dose of rWN/DEN4Δ30 given 6 months after the first dose increased the seroconversion rate 89%. Based on the encouraging results from these studies, further evaluation of the candidate vaccine in adults older than 50 years of age is planned.


Smoking and wound healing.
The association between cigarette smoking and delayed wound healing is well recognized in clinical practice, although extensive controlled studies have yet to be performed. The documented effects of the toxic constituents of cigarette smoke--particularly nicotine, carbon monoxide, and hydrogen cyanide--suggest potential mechanisms by which smoking may undermine expeditious wound repair. Nicotine is a vasoconstrictor that reduces nutritional blood flow to the skin, resulting in tissue ischemia and impaired healing of injured tissue. Nicotine also increases platelet adhesiveness, raising the risk of thrombotic microvascular occlusion and tissue ischemia. In addition, proliferation of red blood cells, fibroblasts, and macrophages is reduced by nicotine. Carbon monoxide diminishes oxygen transport and metabolism, whereas hydrogen cyanide inhibits the enzyme systems necessary for oxidative metabolism and oxygen transport at the cellular level. Slower healing has been observed clinically in smokers with wounds resulting from trauma, disease, or surgical procedures. The reduced capacity for wound repair is a particular concern in patients undergoing plastic or reconstructive surgery. Compared with nonsmokers, smokers have a higher incidence of unsatisfactory healing after face-lift surgery, as well as a greater degree of complications following breast surgery. Smokers should be advised to stop smoking prior to elective surgery or when recovering from wounds resulting from trauma, disease, or emergent surgery.


Spontaneous expulsion of three large fibroids after uterine artery embolization.
To report a case of uneventful expulsion of huge fibroids after uterine artery embolization. Case report. The Department of Obstetrics and Gynaecology of a university hospital. A 45-year-old woman who underwent uterine artery embolization for fibroids. Transfemoral selective bilateral uterine artery catheterization and injection of 500-700 microm polyvinyl alcohol particles. Recovery of the patient. The spontaneous expulsion of three fibroids on three different occasions over several months resulted in a significant reduction in menstrual loss and dysmenorrhea. Delivering fibroids or sections of fibroids may be a natural process after uterine artery embolization, therefore it is essential to warn women about the possible risk. Close follow-up is also essential. The size of the fibroids discharged did not require hysterectomy. Adequate antibiotic cover may be necessary to prevent sepsis.


Post-operative intracranial foreign body granuloma: a case report.
The authors report and discuss some clinical, radiological, histological and ultrastructural aspects of an intracranial foreign body granuloma. This granuloma, which simulated a cavernoma, was due to a surgical swab forgotten during a previous neurosurgical evacuation of an intracerebral hematoma.


Crystal structures of three sterically congested disilanes.
In the three sterically congested silanes, C24H38Si2 (1) (1,1,2,2-tetra-isopropyl-1,2-di-phenyl-disilane), C24H34Br4Si2 (2) [1,1,2,2-tetra-kis-(2-bromo-propan-2-yl)-1,2-di-phenyl-disilane] and C32H38Si2 (3) (1,2-di-tert-butyl-1,1,2,2-tetra-phenyl-disilane), the Si-Si bond length is shortest in (1) and longest in (2), with (3) having an inter-mediate value, which parallels the increasing steric congestion. A comparison of the two isopropyl derivatives, (1 and 2), shows a significant increase in the Si-C(ipso) distance with the introduction of bromine. Also, in the brominated compound 2, attractive inter-molecular Br⋯Br inter-actions exist with Br⋯Br separations ca 0.52 Å shorter than the sum of the van der Waals radii. In compound 2, one of the bromo-isopropyl groups is rotationally disordered in an 0.8812 (9):0.1188 (9) ratio. Compound 3 exhibits 'whole mol-ecule' disorder in a 0.9645 (7):0.0355 (7) ratio with the Si-Si bonds in the two components making an angle of ca 66°.