Occurrence and performance of the aspen blotch miner, Phyllonorycter salicifoliella, on three host-tree species.
Larvae of the aspen blotch miner, Phyllonorycter salicifoliella Chambers (Lepidoptera: Gracillariidae), feed within leaves of three host-tree species in north-central Minnesota, USA. Far more individuals occur on Populus tremuloides than on P. balsamifera or P. grandidentata. We tested whether this pattern of host use reflected variable performance among alternative hosts by examining survivorship, sources of mortality, pupal mass, feeding efficiency, and development time of miners on each tree species. We also determined foliar water, nitrogen, condensed tannin, and phenolic glycoside content of host trees to test if host-tree chemical attributes were responsible for differences in performance. There was no significant difference in egg-to-adult survival among miners on different hosts, although dominant sources of mortality did vary. Miners on P. grandidentata suffered less parasitism and more predation than those on the other hosts, even though most parasitoid species attacked miners on all hosts. The other performance parameters varied among host species, but not in a consistent pattern. Pupal mass was greatest on P. tremuloides and P. balsamifera, the hosts with comparatively high foliar nitrogen and low phenolic glycoside concentrations. However, feeding efficiency was greatest and development time shortest for miners on P. grandidentata. Thus, pupal mass was the only index of performance maximized on P. tremuloides, the most commonly used host. Infrequent occurrence of Phyllonorycter salicifoliella on P. grandidentata results in part from phenological differences between this and the other host species. Low oviposition rates on P. balsamifera are correlated with low abundance of this host at the study site and a phenolic glycoside profile different from that of the other host species.


Cell-cycle-dependent expression of the large Ca2+-activated K+ channels in breast cancer cells.
In a previous work, we have reported that the ionic nature of the outward current recorded in MCF-7 cells was that of a K+ current. In this study, we have identified a Ca2+-activated K+ channel not yet described in MCF-7 human breast cancer cells. In cells arrested in the early G1 (depolarized cells), increasing [Ca2+]i induced both a shift in the I-V curve toward more negative potentials and an increase in current amplitude at negative and more at positive potential. Currents were inhibited by r-iberiotoxin (r-IbTX, 50 nM) and charybdotoxin (ChTX, 50 nM). These data indicate that human breast cancer cells express large-conductance Ca2+-activated K+ (BK) channels. BK current-density increased in cells synchronized at the end of G1, as compared with those in the early G1 phase. This increased current-density paralleled the enhancement in BK mRNA levels. Blocking BK channels with r-IbTX, ChTX or both induced a slight depolarization in cells arrested in the early G1, late G1, and S phases and accumulated cells in the S phase, but failed to induce cell proliferation. Thus, the expression of the BK channels was cell-cycle-dependent and seems to contribute more to the S phase than to the G1 phase. However, these K+ channels did not regulate the cell proliferation because of their minor role in the membrane potential.


Editorial Commentary: Proximal Stabilization for Recurrent Patellar Dislocation--Respect the Anatomy and Achieve Excellent Outcomes Regardless of Specific Technique.
In a Level IV evidence systematic review of 13 studies comparing medial patellofemoral ligament reconstruction and medial soft-tissue realignment for recurrent lateral patellar instability without osseous pathology, both techniques showed excellent outcomes with low recurrent dislocation rates (<10% for both) without significant clinical, radiographic, or instability differences between the two groups at minimum 2-year follow-up. As in all well-designed and -conducted systematic reviews, the authors delicately balance study homogeneity (similar patients and surgical procedures-excluding distal osseous realignment and first-time dislocators) and heterogeneity (improved generalizability: dichotomized medial soft-tissue realignment and medial patellofemoral ligament reconstruction).


Extended-spectrum β-lactamase-producing E. coli from retail meat and workers: genetic diversity, virulotyping, pathotyping and the antimicrobial effect of silver nanoparticles.
The spread of extended-spectrum β-lactamases (ESBL) producing E. coli from food animals and the environment to humans has become a significant public health concern. The objectives of this study were to determine the occurrence, pathotypes, virulotypes, genotypes, and antimicrobial resistance patterns of ESBL-producing E. coli in retail meat samples and workers in retail meat shops in Egypt and to evaluate the bactericidal efficacy of silver nanoparticles (AgNPs-H2O2) against multidrug resistant (MDR) ESBL-producing E. coli. A total of 250 retail meat samples and 100 human worker samples (hand swabs and stool) were examined for the presence of ESBL- producing E. coli. Duck meat and workers' hand swabs were the highest proportion of ESBL- producing E. coli isolates (81.1%), followed by camel meat (61.5%). Pathotyping revealed that the isolates belonged to groups A and B1. Virulotyping showed that the most prevalent virulence gene was Shiga toxin 2 (stx2) associated gene (36.9%), while none of the isolates harbored stx1 gene. Genotyping of the identified isolates from human and meat sources by REP-PCR showed 100% similarity within the same cluster between human and meat isolates. All isolates were classified as MDR with an average multiple antibiotic resistance (MAR) index of 0.7. AgNPs-H2O2 at concentrations of 0.625, 1.25, 2.5 and 5 μg/mL showed complete bacterial growth inhibition. Virulent MDR ESBL-producing E. coli were identified in retail meat products in Egypt, posing significant public health threats. Regular monitoring of ESBL-producing E. coli frequency and antimicrobial resistance profile in retail meat products is crucial to enhance their safety. AgNPs-H2O2 is a promising alternative for treating MDR ESBL-producing E. coli infections and reducing antimicrobial resistance risks.


Same-Day Discharge vs Inpatient Robotic-Assisted Radical Prostatectomy: Complications, Time-Driven Activity-Based Costing, and Patient Satisfaction.
Historically, robotic-assisted radical prostatectomy is accompanied by an inpatient hospital admission. The COVID-19 pandemic necessitated a transition to same-day discharge robotic-assisted radical prostatectomy in some centers to free up critically needed inpatient beds. This study aims to compare complications, total health care costs, and patient satisfaction for same-day discharge vs inpatient robotic-assisted radical prostatectomy. We compared 392 consecutive robotic-assisted radical prostatectomies performed as same-day discharge (n = 206) vs inpatient (n = 186) from February 2020 to November 2022 at 2 academic medical centers. We utilized propensity score analysis to assess the impact of same-day discharge vs inpatient robotic-assisted radical prostatectomy on 30-day complications (primary outcome). Time-driven activity-based costing analysis was applied to compare total costs of robotic-assisted radical prostatectomy care, and we administered a validated Patient Satisfaction Outcome Questionnaire to compare satisfaction scores. Inpatient robotic-assisted radical prostatectomy patients were more likely to be older, self-reported Black race or Hispanic ethnicity, and have higher American Society of Anesthesiologists classification. Complication rates were nonsignificantly lower for same-day discharge vs inpatient robotic-assisted radical prostatectomy (OR 0.87, 95% CI 0.35 to 2.21; P = .8). Same-day discharge vs inpatient robotic-assisted radical prostatectomy demonstrated a $2106 (19%) overall cost reduction. Median satisfaction survey scores were similar, and a clinically significant difference can be excluded. Same-day discharge robotic-assisted radical prostatectomy is cost-effective and should be the preferred approach in appropriately selected patients.


Analysis on the temporal and spatial characteristics of the shallow soil temperature of the Qinghai-Tibet Plateau.
Shallow soil refers to the soil layer within the 50 cm depth. Shallow soil temperature (ST) directly or indirectly affects many processes in the soil, such as seed germination, plant growth, and water evaporation. Therefore, the study of shallow ST is of great significance in understanding the surface energy, water cycle, ecology and climate change. This work collected observational data from 141 meteorological stations on the Qinghai-Tibet Plateau from 1981 to 2020 and ERA5 reanalysis data, used the "Moving Surface Spline Interpolation Algorithm Based on Green's Function" and "Fuzzy C-means algorithm", and analyzed the temporal and spatial change characteristics of ST at different levels. The results showed that 1) the temperature increase of 0-20 cm (the surface layer of the shallow soil) was roughly the same. The average annual ST was 9.15-9.57°, and the interdecadal variabilities were 0.49-0.53 K/10a. The average annual ST of 40 cm (the bottom layer) was 8.69°, and the interdecadal variability reached 0.98 K/10a. 2) Considering the 7 regions, the warming trend was obvious, and there were certain regional differences. The average annual ST in different regions ranged from 5.2 (northeastern Plateau) to 17.1 °C (western Sichuan Plateau), with a difference of nearly 12 K. The standard deviation ranged from 0.40 (western Sichuan Plateau) to 0.61 K (Qiangtang Plateau), with a difference of 0.21 K. 3) The errors of the obtained grid data were basically less than 3%, which were much smaller than the errors obtained from the ERA5 reanalysis data. This work is significant for understanding the characteristics of ST evolution and land‒atmosphere interactions on the Qinghai-Tibet Plateau and provides important data support for improving the underlying surface boundary conditions of models.


Risk assessment relationships for evaluating effluents from coal industries.
Public awareness of the risks associated with traditional coal combustion and newer coal gasification and liquefaction industries is increasing. Assessing the health risks for people exposed to effluents from these industries generally involves four major steps: (1) characterizing the pollutant sources, (2) projecting the release and dispersion of toxic substances in workplaces and in the environment, (3) estimating their uptake by people through inhalation and ingestion and their contact with skin, and (4) evaluating their potential for causing health effects. Pollutants of special concern include toxic gases, carcinogenic organic compounds and trace metals. Relationships between the levels of pollutants released to the environment and the magnitudes of human exposures and methods of formulating exposure-dose-effect relationships for use in human risk assessment are discussed.


Automatic accurate non-invasive quantitation of blood flow, cross-sectional vessel area, and wall shear stress by modelling of magnetic resonance velocity data.
To apply a new, automatic and non-invasive method for quantification of blood flow, dynamic cross-sectional vessel area, and wall shear stress (WSS) by in vivo magnetic resonance velocity mapping of normal subjects. Prospective, open study. Six young volunteers. A three-dimensional paraboloid model enabling automatic determination of blood flow, vessel distensibility and WSS was applied to blood velocity determinations in the common carotid artery. Blood flow was also determined by a manual edge detection method. Using the new method, the common carotid mean blood flow was 7.28 (5.61-9.63) (mean (range)) ml/s. By the manual-method blood flow was 7.21 (5.55-9.60) ml/s. Mean luminal vessel area was 26% larger in peak systole than in diastole. Mean/peak WSS was 0.82/2.28 N/m2. Manually and automatically determined flows correlated (r2 = 0.998, p < 0.0001). WSS and peak centre velocity were associated (r2 = 0.805, p < 0.0001). Blood flow, luminal vessel area dilatation, and WSS can be determined by the automatic three-dimensional paraboloid method. The hypothesis of association between peak centre velocity and WSS was not contradicted by the results of the present study.


The effect of complete carcinogens on intercellular transfer of lucifer yellow in fibroblast culture.
The effect on permeability of gap junctions of complete powerful carcinogens, 3-methylcholanthrene (MC), 7,12-dimethylbenz(a)anthracene (DMBA), ethyl methanesulfonate (EMS), and weak carcinogens, benz(a)anthracene (BA), benzo(e)pyrene (B(e)P) as well as the aryl-hydroxylase inhibitor 7,8-benzoflavone (7,8-BF) has been studied with the use of a dye-coupling technique and transformed Djungarian hamster DM15 fibroblasts. MC, EMS and 7,8-BF were found to exert a strong inhibitory effect on cell-to-cell dye transfer. BA and DMBA had the uncoupling activity only in 2 out of 4 experiments. B(e)P was not shown to affect LY transfer between DM15 cells. The uncoupling effect of MC, 7,8-BF and EMS (only when EMS used at the concentration of 600 micrograms/ml but not 1000 micrograms/ml) appeared reversible. The causes of failure to detect DMBA and B(e)P effects on gap junctions are discussed.


Screening for neuropsychological impairment in children using Reitan and Wolfson's preliminary neuropsychological test battery.
This study examined the efficacy of two screening batteries developed by Reitan and Wolfson [Reitan, R. M., & Wolfson, D. (2006). Issues in neuropsychology: Where have we succeeded? Where have we failed? What are the clinical and forensic implications? Presented at the 26th annual conference of the National Academy of Neuropsychology] for predicting neuropsychological impairment on the Halstead-Reitan Neuropsychological Test Battery for Older Children (ages 9-14) and the Reitan-Indiana Neuropsychological Test Battery (ages 5-8). Sixty-eight subjects were selected from archival data collected from cases in a private practice setting. Using Reitan and Wolfson's recommended screening battery neuropsychological deficit scale score (SBNDS) cut-off of 16/17 correctly classified 82.5% of older children as normal or impaired according to total GNDS scores. The screening battery for young children (n=28) resulted in 100% correct classification using Reitan and Wolfson's recommended SBNDS cut-off of 22/23.


The Importance of Cardiovascular Risk Assessment and Pregnancy Heart Team in the Management of Cardiovascular Disease in Pregnancy.
Pregnancy-related maternal morbidity and mortality is increasing because of complications from cardiovascular disease. Pregnancy results in physiologic changes that can adversely impact the cardiovascular system and lead to adverse pregnancy outcomes. A multidisciplinary pregnancy heart team is essential to safely navigate women with heart disease through pregnancy. This role of the pregnancy heart team is to offer preconception counseling, determine pregnancy risks and educate women about those risks, develop a comprehensive antenatal and delivery plan, and ensure appropriate postpartum follow-up. These steps are important to improve cardiovascular outcomes in pregnancy.


Calcium-entry blockers, vascular smooth muscle and systemic hypertension.
Abnormal narrowing of the arterioles, caused by contraction of arteriolar smooth muscle, contributes to the genesis and the maintenance of the increased peripheral resistance observed in hypertension. Activation of the contractile process in vascular smooth muscle requires an increase in cytoplasmic calcium. In most blood vessels, the activator ion enters the cell through specific membrane channels, which can be inhibited by a chemically heterogeneous group of drugs, the calcium-entry blockers. The antihypertensive effect of these agents is probably explained by their inhibitory effect on (1) alpha-adrenergic activation (the pharmacologic subtype of postjunctional alpha-adrenoceptor does not necessarily determine the importance of calcium entry); (2) activation by nonadrenergic neurohumoral mediators (for example, serotonin); (3) acceleration of calcium entry by metabolites of arachidonic acid formed by lipoxygenase; and (4) inherent myogenic tone.


The translocation of antimony in soil-rice system with comparisons to arsenic: Alleviation of their accumulation in rice by simultaneous use of Fe(II) and NO3.
Antimony (Sb) accumulation in rice grains is a potential risk to human health. This study aims to develop agronomic practices that can reduce the accumulation of Sb in rice grain in contaminated soil. A pot culture experiment was conducted to investigate the effects of co-application of ferrous iron and nitrate (Fe(II) + NO3-) in paddy soils on Sb uptake by rice. The co-application of Fe(II) and NO3- promoted abiotic/biotic Fe(II) oxidation and mineralization in the rhizosphere soil and formation of Fe plaques, consequently, Sb bioavailability was significantly reduced by enhancing Sb immobilization on the newly formed Fe(III) (hydr)oxides. The results were compared with those for arsenic (As) in the same trial and it was shown that the two metalloids have different translocation behavior in the soil-rice plant system. The adsorption of Sb, especially the Sb(V), on Fe(III) (hydr)oxides was more significantly enhanced by the decreased soil pH after the application of Fe(II) + NO3- than that of As. The uptake of Sb by the roots of rice was much more difficult but it was much easier to be transported from the rice straw to the grains compared to As. The differences might be mainly caused by the different uptake mechanisms of Sb and As by rice plants from paddies. The bioavailable As(III) would be much more efficient in entering into the rice roots than Sb(III) through the aquaporin channel due to its much smaller ionic radius; the bioavailable As(V), entering into the rice roots via phosphate transporters, would also be more efficient in taking up by roots than Sb(V), which pathway from soil to rice roots remains unclear. These findings provide new insights into Sb biogeochemical behavior in soil-rice plant systems and demonstrate that co-application of Fe(II) and NO3- could be a promising strategy for safely-utilizing Sb contaminated sites in the future.


The science behind codes and standards for safe pedestrian walkways: lighting and visual cues.
Walkway codes and standards are created through consensus by committees based on a number of factors, including historical precedence, common practice, cost, and, sometimes, empirical data. The authors maintain that codes and standards that can have an impact on human safety and welfare should give consideration in their formulation to the results of pertinent scientific research. This article extends a companion one in examining many elements of common walkway codes and standards related specifically to lighting, warnings and markings. It indicates which elements are based on or supported by empirical data; and which elements could benefit from additional scientific research. This article identifies areas in which additional research leading toward scientific based codes and standards may be beneficial in enhancing the safety of pedestrian walkway surfaces.


Studies of properties and potential applications of some soluble salts of cellulose acetate phthalate. Part 1: rheological behavior and aging effect.
Rheological behaviour for solutions of the sodium, ammonium, and triethanolamie salts of cellulose acetate phthalate was studied. The comparative resistance to microbial growth and to changes in pH values exhibited by these solutions on storage was also investigated. The results indicated that the viscosities of these solutions were temperature and concentration dependent and that increasing the rate of shear produced only a slight increase of viscosity. Solutions of ammonium and the triethanolamine salts did not support any apparent microbial growth during storage at room temperature of three weeks, but the sodium salt appeared to suffer from microbial contamination. However, the use of a mixture of 0.15% methylparaben and 0.05% propylparaben prevented such contamination. The pH values of all the slat solutions studied appeared to decrease on storage.


[Economic and political aspects of prostate cancer prevention].
Deciding on a health policy in practice means dedicating human and financial resources and prioritising spendings. The economic evaluation of prevention strategies attempts to establish a relationship between the medical benefit of prevention and its additional cost (or in some cases cost reduction) compared to no prevention. Decisions on reimbursing drugs, interventions or funding health programmes do not usually follow efficiency criteria which define economic rationality. Politics may for example decide to make prostate cancer a public health priority if mortality in a country or in some regions of the country appears to be excessively high. Economic rationality alone is not an appropriate factor on which to base a decision which may be purely political, reflecting the actual values of the society at a given point in time.


Pulmonary myelolipoma containing osseous tissue: An unexpected finding at autopsy.
Pulmonary myelolipoma is a very rare benign tumor composed of mature adipose tissue and hematopoietic elements such as erythroid, myeloid and megakaryocytic. It usually represents accidental finding during autopsy or chest imaging, since most cases are asymptomatic. Larger masses can lead to hemorrhage, chest pain and chest organ compression. We present a case of incidental finding of pulmonary myelolipoma during the autopsy of an 83- year old woman who died of abdominal aortic rupture. In the right lower lung lobe, solitary, well-circumscribed yellow-brown nodule which was 3 cm in its longest diameter was found. Pathohistological analysis revealed tumor composed of mature adipose tissue and hematopoietic cells (myeloid cells, megakaryocytes, erythroid cells) with fragments of mature bone tissue. Differential diagnosis of pulmonary myelolipoma includes lipoma, liposarcoma, hamartoma, phlebangioma, teratoma and extramedullary hematopoiesis. In majority of cases, tumor removal is not necessary, however, larger lesions should be surgically removed. No cases of malignant transformation or recurrence have so far been reported in the literature.


Improved cross-axis synchronous flow-through coil planet centrifuge for performing counter-current chromatography. I. Design of the apparatus and analysis of acceleration.
A novel design of the cross-axis synchronous flow-through coil planet centrifuge is introduced. The apparatus holds a pair of large coil holders symmetrically, one on each side of the rotary frame, at a lateral position 12.5 cm from the center of the holder shaft held 10 cm from the centrifuge axis. Mathematical analysis of acceleration generated by the planetary motion of the apparatus revealed a unique centrifugal force field which promises high retention of the stationary phase in the multilayer coil to perform efficient preparative-scale counter-current chromatography.


Cigarette abandonment: its significance.
Two hundred and eight interviews with ex-cigarette-smokers in the street and 208 interviews with ex-cigarette-smoker chest patients, all over 45 years of age, gave a composite picture of people commonly smoking until their health is affected. Symptoms were much more important then tobacco tax or propaganda in stopping cigarette-smoking. Of continuing smokers 16% wished that they could stop because of symptoms. Fear of the presence of cigarette-induced disease was thought to explain why some patients gave unconvincing reasons for abandoning cigarettes or had become ex-smokers in the year preceding their examination and many of these had carcinoma of the bronchus. Cigarette abandonment should be accepted as part of the symptomatology of respiratory disease. It sometimes is the first identifiable event in the relevant medical history of chest patients.


Influence of hyperalimentation on rat hepatic microsomal fluidity and function.
Total parenteral nutrition with an amino acid-glucose solution has previously been shown to decrease rat hepatic drug metabolism compared with drug metabolic activity observed in rats receiving the same solution enterally and chow-fed animals. Because changes in membrane fluidity and lipid composition are reported to influence activity of a number of liver enzymes, effects of parenteral and enteral nutrition on hepatic microsomal membrane fluidity and lipid composition were assessed and compared with hepatic mixed-function oxidase activity. Both parenteral and enteral hyperalimentation produced a significant decrease in microsomal membrane fluidity (fluorescence anisotropy = 0.155 +/- 0.003 in both experimental groups versus 0.129 +/- 0.003 for microsomes from chow-fed animals). However, meperidine demethylase activity was significantly decreased compared with chow-fed experiments only in hepatic microsomes from parenterally hyperalimented animals, whereas ethoxyresorufin deethylase activity was significantly reduced only in the enteral-nutrition group. Inclusion of lipid in the parenterally administered hyperalimentation solution normalized microsomal membrane fluidity and lipid profile to those of chow-fed animals but did not increase hepatic meperidine demethylation. Both parenteral and enteral nutrition produce significant changes in physical state and lipid composition of rat hepatic microsomal membranes, but these changes are not responsible for the altered hepatic drug metabolism observed during hyperalimentation.


The role of upstream stimulatory factor 1 in the transcriptional regulation of the human TBX21 promoter mediated by the T-1514C polymorphism associated with systemic lupus erythematosus.
T-bet is a key regulator for the lineage commitment in CD4+ T helper (Th) 1 cells by activating the hallmark production of interferon-γ. Previously, two single nucleotide polymorphisms (SNPs) in the TBX21 promoter, T-1993C and T-1514C, have been shown by statistic studies to associate with systemic lupus erythematosus (SLE). The effect of -1993 SNP on the Yin Yang 1 transcription factor-mediated promoter activity has been already indicated. This study aimed to investigate roles of the T-1514C SNP on TBX21 transcription and its functional effect by luciferase reporter, electrophoretic mobility shift assay (EMSA), chromatin immunoprecipitation (ChIP) assay, and flow cytometric analysis of intracellular T-bet, IFN-γ, and IL-4 expression in activated CD4+ T cells. The TBX21 promoter carrying -1514C possessed significantly lower transcriptional activity than that of -1514T and was markedly downregulated by the overexpression of upstream stimulatory factor 1 (USF-1) when compared with the promoter carrying -1514T. EMSA indicated that the transcription factor USF-1 was bound to the -1514C allele probe with the affinity higher than that to the -1514T allele probe. ChIP assay suggested that USF-1 bound around -1514 of TBX21 genomic DNA in vivo in the human T cell line Jurkat with -1514C/T. The individuals carrying -1514C allele were determined to have significantly diminished expression of T-bet and IFN-γ and increased IL-4 production in CD4+ T cells compared with those of -1514T allele. The findings demonstrate that the T-1514C polymorphism affects TBX21 gene expression and Th1 cytokine production by binding USF-1 to the SNP site.


Biodiversity conservation: an example of a multidisciplinary approach to marine dispersal.
The general aim of this paper is to present a possible multidisciplinary approach to the problem of connectivity among marine protected areas (MPAs) describing some of the mechanisms and vectors that control the dispersal of propagules among spatially distributed marine communities of MPAs in the Southern Adriatic Sea. A joint approach is described that focuses on (a) measurements of surface water current and model data integrated with a dedicated software (LAVA, LAgrangian Variational Analysis), (b) measurements of rafting objects and their evaluation as an alternative way to species dispersal, and (c) a tool to automatically monitor propagules and plankton species in the water column. Studies on the dynamics of water currents demonstrated that the Gargano area has the potential to supply dispersal propagules to the Southern Adriatic both along the Italian coastline and offshore across the basin, thus providing important services to the dispersal processes and the connectivity routes among MPAs. The natural dispersion is however enhanced by floating objects, on which entire marine communities are living and travelling. The number of these objects has greatly increased with the introduction of human litter: in the Adriatic, man-made litter composes nowadays the majority (79 %) of all floating objects, with this corresponding to an almost fourfold increase in the abundance of floating objects since pre-industrial times. Such enhanced dispersion may benefit transmission of propagules from MPAs along biodiversity corridors, but may also enhance the arrival of invasive species. The direct observation of organisms can provide information on the species distribution and mobility. New technology (GUARD-1 system) has been developed to automatically identify spatial or temporal distributions of selected species in the water column by image analysis. The system has so far successfully detected blooms of ctenophores in the water column and is now being tested for identification of other zooplankton groups, such as copepods, as well as marine litter. This low-cost, long-lasting imaging system can be hosted on mobile devices such as drifters, which makes it very suitable for biological dispersal studies.


Anesthesia for ophthalmic surgery in the elderly: the effects of clonidine on intraocular pressure, perioperative hemodynamics, and anesthetic requirement.
The effects of clonidine on intraocular pressure and perioperative cardiovascular variables were studied by a randomized double blind design in 80 elderly patients (ASA physical status I-III) scheduled for elective ophthalmic surgery under general anesthesia (GA) and local anesthesia (LA). Group 1 (n = 40), the control group, received diazepam po (0.1 mg.kg-1) 90-120 min prior to arrival to the operating room. Group 2 (n = 40) received clonidine po approximately 5 micrograms.kg-1 po at the same time. Each group was divided into subgroups of 20 patients each to be managed with GA (GA subset) or LA (LA subset). Ninety to 120 minutes after the premedication, a large decrease in IOP from 20 +/- 3 to 12 +/- 3 mmHg (P less than 0.01) and a small but significant reduction of both systolic and diastolic BP and HR were observed in patients receiving clonidine, while no changes occurred in controls. In the patients managed with GA, clonidine effectively prevented IOP rise and attenuated the associated cardiovascular response (P less than 0.01) following laryngoscopy and tracheal intubation, and significantly reduced intraoperative cardiovascular lability and anesthetic requirement for isoflurane (P less than 0.05) and for fentanyl (P less than .001). In patients managed with LA, intraoperative systolic (P less than 0.01) and diastolic BP and HR variability (P less than 0.05) were significantly lower in patients receiving clonidine as compared to controls. Intraoperatively, a significantly higher incidence of hypertension (P less than 0.01) and tachycardia (P less than 0.05) were respectively observed in the LA subset and GA subset of the controls when contrasted with the corresponding subset of those receiving clonidine. Moreover, clonidine was more effective than diazepam as a premedication; in fact, satisfactory intraoperative sedation and cardiovascular stability were observed in 85% of the patients who received clonidine, and in 50% of those patients who did not receive clonidine (P less than 0.01). Thus, clonidine may represent a useful adjunct in the management of the aged patient in the setting of ophthalmic surgery.


Stability of the bacterial communities supported by a seven-stage biological process treating pharmaceutical wastewater as revealed by PCR-DGGE.
The stabilities of the bacterial community structures supported by seven full-scale biological reactors treating pharmaceutical wastewater were investigated by denaturing gradient gel electrophoresis (DGGE) of polymerase chain reaction (PCR) amplified 16S rRNA gene fragments. Effluent quality from this treatment process was consistently high with respect to BOD5 (<30 mgl(-1)), soluble COD (<500 mgl(-1)), and total ammonia (< 5 mgl(-1) as N) concentrations. Long-term community structure stability was studied by comparing the similarity of PCR-DGGE fingerprints from samples collected 87 days apart between which the influent wastewater characteristics were relatively stable. The Dice index (Cs) of similarity was moderately high for the first four reactors (Cs = 0.61-0.77) and very high for the last three reactors (Cs = 0.89-0.91). Short-term community structure stability was studied by comparing PCR-DGGE fingerprints from samples collected 15 days apart between which the influent wastewater characteristics changed significantly, while the effluent quality remained consistently high. The bacterial community composition of each of the seven bioreactors showed a moderate community shift (Cs = 0.70-0.76). Short-term variability in influent wastewater composition, therefore, affected a greater community shift than did long-term operation treating a wastewater of relatively consistent composition. These results indicate that functionally stable wastewater treatment bioreactors have stable microbial community structures under normal operating conditions but are able to adapt in response to perturbations to sustain high effluent quality.


Amikacin therapy of gram-negative bacteremia.
Treatment with amikacin was evaluated in 15 patients with gram-negative bacteremia. The sources of sepsis were urinary tract (in six patients), abdomen (in five) and miscellaneous sites (in four). Sixteen bacterial pathogens were recovered, including three gentamicin-resistant organisms. All isolates were susceptible to amikacin. Eleven of the 14 patients who could be evaluated fulfilled the criteria for cure, including the three patients with gentamicin-resistant organisms. Three patients failed to respond to amikacin therapy. Monitoring untoward effects revealed eighth nerve toxicity in one patient and nephrotoxicity in one patient. These results indicate that amikacin is effective in the treatment of patients with gram-negative bacteremia, even when caused by gentamicin-resistant bacteria.


Downregulation of Low-density lipoprotein receptor-related protein 1B (LRP1B) inhibits the progression of hepatocellular carcinoma cells by activating the endoplasmic reticulum stress signaling pathway.
Hepatocellular carcinoma (HCC) has a high recurrence rate and mortality rate even after surgery. Low-density lipoprotein receptor-related protein 1B (LRP1B) has proven to be involved in tumor development and progression of multiple malignancies. However, the function of LRP1B in HCC progression has not been fully elucidated. Thus, we conducted this study to explore the relationship between LRP1B and HCC. Bioinformatic analyses implied that LRP1B was highly expressed in HCC tissues. High LRP1B expression was shown to be related to poor outcomes and the determination of HCC patients' tumor stage. LRP1B deletion impeded the proliferation, migration, and invasion of HCC cells. Further investigation demonstrated that silencing LRP1B expression enhanced the sensitivity of HCC cells to doxorubicin. LRP1B deletion inhibited HCC progression by regulating the PERK-ATF4-CHOP signaling pathway. Additionally, we probed the genomic alterations of LRP1B in HCC and the impact on the prognosis of patients. Collectively, our results suggest that LRP1B plays an essential role in the promotion of HCC progression by regulating the PERK-ATF4-CHOP signaling pathway, which is a potential prognostic biomarker and a promising therapeutic target of HCC.


The outcome of infliximab dose doubling in 157 patients with ulcerative colitis after loss of response to infliximab.
Optimising infliximab therapy is recommended in inflammatory bowel disease (IBD) patients who lose response to infliximab; however, there are no data on the outcome of ulcerative colitis (UC) patients after doubling the dose. To determine the efficacy and safety of infliximab dose doubling in UC patients with a loss of response to infliximab. From January 2006 to May 2013, we retrospectively reviewed the outcome of the consecutive UC patients who were treated with infliximab dose doubling (10 mg/kg) for loss of response in four French academic centres. The clinical response and remission were assessed. A composite event-free survival analysis was performed using the log-rank test and the Cox model. One hundred and fifty-seven patients [84 males; median age 37. 6 (IQR 28.2-49.4) years] were included. The median follow-up after infliximab dose doubling was 1.8 (1.0-3.1) years. At weeks 8 and 24, 55% and 43% of the patients achieved a clinical response respectively. The probabilities of the event-free survival were 71%, 61% and 55% at 6 months, 1 year and 2 years respectively. In the multivariate analysis, the predictors of infliximab dose doubling failure were the absence of the introduction of an immunomodulator concomitantly to dose doubling, a partial Ulcerative Colitis Disease Activity Index >6, a C-reactive protein level >10 mg/L, a leucocyte count >8000/mm(3) and a haemoglobin level <12.5 g/dL. Adverse events were reported in 12 patients (8%). Infliximab dose doubling led to short- and long-term event-free survival in UC patients, who had a loss of response to infliximab, in greater than 50% of the cases. The benefits of such a strategy were significantly improved by adding a concomitant immunomodulator.


Are fatigue and disturbances in pre-programmed activity of pelvic floor muscles associated with female stress urinary incontinence?
To investigate whether there is a difference between a continent versus a stress urinary incontinent group of women regarding: (i) fatigue in pelvic floor muscles, and (ii) pre-activation times between pelvic floor and abdominal muscles during coughing. Twenty-six continent and 20 stress urinary incontinent parous women were examined. Fatigue was measured with an intravaginal device. Time to 10% decline of the initial reference force (RF) was defined as time-to-fatigue. Simultaneous recordings of force developed in levator ani muscle and electromyographic activity in the external oblique abdominal muscle were performed to determine whether contraction of pelvic floor muscles precedes activity in abdominal muscles during coughing. Time-to-fatigue was identical in the two groups (10.5 sec in the continent and 11.5 sec in the incontinent group, median values). Normalized force was significantly reduced in the incontinent group. The pelvic floor muscles contracted 160 msec before the abdominal muscles in both groups. In 24% of the continent and in 30% of the incontinent women, however, abdominal muscle activity preceded activity of pelvic floor muscles. Muscular fatigue, defined as rate of force loss, does not seem to be associated with urinary stress incontinence. Moreover, muscular activity recruitment patterns were equal in both groups suggesting that other factors than disturbances of ordered muscle recruitment, that is, pelvic floor followed by abdominal muscles, may be responsible for stress urinary incontinence. It is likely that reduced normalized force, as found in the incontinent group, is an important contributing factor.


Usefulness of Antibodies to Oxidized Low-Density Lipoproteins as Predictors of Morbidity and Prognosis in Heart Failure Patients Aged ≥65 Years.
Elevated level of antibodies to oxidized low-density lipoproteins (OxLDL-Ab) was shown to reliably predict morbidity and mortality in patients with heart failure (HF). Two hundred and eleven patients aged ≥65 years treated at the Heart Failure Unit, Tel Aviv-Sourasky Medical Center, were included in this retrospective study. The end points were time to the first hospitalization (morbidity), all-cause mortality, and a combination of the two (composite outcome). HF duration ranged from 8 to 10.5 years. Mean follow-up was 5.2 ± 1.9 years. The mean number of clinical visits was 18.3 ± 2.4. Participants were divided according to OxLDL-Ab level. Group 1 had Ox LDL-Ab level <200 arbitrary U/ml. Group 2 had OxLDL-Ab level ≥200 arbitrary U/ml. The mean time to the first hospitalization was 25.8 ± 17.0 months. The mortality rate was 44.1%. Combined mortality and hospitalization rate was 58.8%. Adjusted hazard ratios of OxLDL-Ab for hospitalization were 3.16, p <0.001, 95% confidence interval 1.740 to 5.736 and for composite outcome 2.67, p <0.001, 95% confidence interval 1.580 to 4.518. In conclusion, OxLDL-Ab level was the best predictor for both hospitalization and composite outcome. It may, thus, serve as a useful clue for early and more accurate detection of poorly controlled HF and as a marker for imminent exacerbations of thereof.


Analysis of silent information regulator 1 (SIRT1) gene polymorphisms in antituberculosis- drug-induced hepatotoxicity in a prospective cohort study.
Antituberculosisdrug-induced hepatotoxicity (ATDH) is a common and sometimes serious side effect related to tuberculosis (TB) treatment. A number of risk factors and host genetics contribute to the development of ATDH. However, genetic factors of ATDH remain to be identified. Silent Information Regulator 1 (SIRT1), an essential metabolism gene, was proved to be involved in ATDH in mice. The aim of this investigation was to study the association between ATDH and tag-single nucleotide polymorphisms (tag-SNPs) of the SIRT1 gene in a prospective cohort study in patients with TB. 280 newly diagnosed TB patients were recruited in this study before starting first line anti-TB treatment and were followed up for 3 months after initiating anti-TB therapy. The tag-SNPs were selected by using Haploview 4.2 based on the HapMap database of Han Chinese Beijing. Genotyping was performed by polymerase chain reaction (PCR) and the Sequenom MassARRAY iPLEX platform. 24 (9.8%) of the 245 patients included in the final analysis developed hepatotoxicity during the following up period. No significant differences in the allele, genotype, or haplotype frequency distributions of the tag- SNPs (rs7069102, rs2273773, rs4746720) of the SIRT1 gene were identified between the ATDH and non-ATDH groups (all p > 0.05). The SIRT1 gene may not contribute to the risk for developing hepatotoxicity during anti-TB treatment in the Han Chinese population.


Genomic characterization, molecular cloning and expression analysis of two terpene synthases from Thymus caespititius (Lamiaceae).
The identification, isolation and functional characterization of two genes encoding two monoterpene synthases-γ-terpinene synthase (Tctps2) and α-terpineol synthase (Tctps5)-from three chemically distinct Thymus caespititius (Lamiaceae) genotypes were performed. Genomic exon-intron structure was also determined for both terpene synthase genes, revealing an organization with seven exons and six introns. The cDNA of Tctps2 was 2,308 bp long and had an open reading frame of 1,794 bp encoding for a protein with 598 amino acids. Tctps5 was longer, mainly due to intron sequences, and presented high intraspecific variability on the plants analyzed. It encoded for a protein of 602 amino acids from an open reading frame of 1,806 bp comprising a total of 2,507 bp genomic sequence. The amino acid sequence of these two active Tctps genes shared 74 % pairwise identity, ranging between 42 and 94 % similarity with about 50 known terpene synthases of other Lamiaceae species. Gene expression revealed a multi-product Tctps2 and Tctps5 enzymes, producing γ-terpinene and α-terpineol as major components, respectively. These enzymatic results were consistent with the monoterpene profile present in T. caespititius field plants, suggesting a transcriptional regulation in leaves. Herewith reported for the first time for this species, these two newly characterized Tctps genes improve the understanding of the molecular mechanisms of reaction responsible for terpene biosynthesis and chemical diversity found in T. caespititius.


Development of dual toxoid-loaded layersomes for complete immunostimulatory response following peroral administration.
Present study reports the development of divalent vaccine with enhanced protection, permeation and presentation following peroral immunization. Layersomes were prepared by layer-by-layer tuning of polyelectrolytes on liposomes template. The developed system was evaluated for in vitro stability of antigen and layersomes, cell-based assays and immunization experiments in mice. Layersomes exhibited enhanced stability in simulated biological fluids, still preserving the integrity, biological activity and conformational stability of toxoids. Layersomes also exhibited complete and protective (>0.1 IU/ml) immunostimulatory response include serum IgG titer, mucosal sIgA titer and cytokines (IL-2 and IFN-γ) levels following peroral administration. The positive findings of proposed strategy are expected to contribute significantly in the field of stable liposomes technology and peroral immunization.


Identification of non-volatile compounds and their migration from hot melt adhesives used in food packaging materials characterized by ultra-performance liquid chromatography coupled to quadrupole time-of-flight mass spectrometry.
The identification of unknown non-volatile migrant compounds from adhesives used in food contact materials is a very challenging task because of the number of possible compounds involved, given that adhesives are complex mixtures of chemicals. The use of ultra-performance liquid chromatography coupled to quadrupole time-of-flight mass spectrometry (UPLC-MS/QTOF) is shown to be a successful tool for identifying non-targeted migrant compounds from two hot melt adhesives used in food packaging laminates. Out of the seven migrants identified and quantified, five were amides and one was a compound classified in Class II of the Cramer toxicity. None of the migration values exceeded the recommended Cramer exposure values.


Antimicrobial peptides with atypical structural features from the skin of the Japanese brown frog Rana japonica.
Japonicin-1 (FFPIGVFCKIFKTC) and japonicin-2 (FGLPMLSILPKALCILLKRKC), two peptides with differential growth-inhibitory activity against the Gram-negative bacterium, Escherichia coli and the Gram-positive bacterium Staphylococcus aureus, were isolated from an extract of the skin of the Japanese brown frog Rana japonica. Both peptides show little amino acid sequence similarity to previously characterized antimicrobial peptides isolated from the skins of Ranid frogs. Circular dichroism studies, however, demonstrate that japonicin-2 adopts an alpha-helical conformation in 50% trifluoroethanol in common with many other cationic antimicrobial peptides synthesized in amphibian skin. Peptides belonging to the brevinin-1, brevinin-2, and tigerinin families, previously identified in the skins of Asian Ranid frogs, were not detected but a temporin-related peptide (ILPLVGNLLNDLL.NH(2); temporin-1Ja), that atypically bears no net positive charge, was isolated from the extract. The minimum inhibitory concentrations (MICs) of the peptides against E. coli were japonicin-1, 30 microM; japonicin-2, 12 microM; and temporin-1Ja > 100 microM. The MICs against S. aureus were japonicin-1, > 100 microM; japonicin-2, 20 microM; and temporin-1Ja, > 100 microM.


Timing and Persistence of Material Hardship Among Children in the United States.
Screening for social determinants of health (SDH) has been widely adopted to identify child health risks associated with exposure to material hardship. Whereas SDH screening typically addresses a 12-month span, we sought to compare the prevalence of exposure to present (within the past year) as compared to recent (2-4 years ago) hardship among children in the United States. We analyzed the 2014 Survey of Income and Program Participation, a nationally representative survey that interviewed participating households annually between 2014 and 2017. We included data from households with children in all waves. As of 2017, households were categorized as (1) experiencing present hardship (within the last year); (2) experiencing recent but not present hardship (any year between 2014 and 2016); and (3) experiencing no hardship over the 4-year period. Of 2422 households, 27% experienced present hardship and 29% experienced recent but not present hardship. Households presently experiencing hardship were more likely to have Medicaid insurance, less likely to be married, and had more children than families who had experienced recent hardship. However, these groups were similar on caregivers' educational attainment, race/ethnicity, language spoken in the home, and age of the youngest child. Our results suggest that clinical screening tools for SDH that use a 12-month time frame risk missing many children who have recently (within the past 4 years) experienced material hardship and may benefit from interventions to improve social support; a longer time frame could provide clinicians with valuable information for understanding social factors that impact child health and development.


Optimisation of the DNA dipstick as a rapid extraction method for Schistosoma japonicum in infected mice samples and spiked human clinical samples.
Schistosomiasis remains a public health issue and the need for accurate and affordable diagnostics is crucial in the elimination of the disease. While molecular diagnostics are highly effective, they are expensive, with the main costs been associated with DNA extraction. The DNA dipstick is a rapid, affordable and simple purification method that allows DNA to be extracted from diagnostic samples within 30 s. We aimed to optimise the DNA dipstick method for samples from mice and egg-spiked human samples. Urine, blood and faeces were collected from mice exposed to Schistosoma japonicum infection at weekly intervals from Day 0 to Day 42. Urine and faecal samples were also collected from volunteer, uninfected humans and spiked with S. japonicum eggs. All samples were subject to several optimisation procedures and DNA extracted with the DNA dipstick. Amplification of the target DNA was carried out using LAMP and visualised using agarose gel electrophoresis and flocculation. The DNA dipstick successfully identified S. japonicum from infected mice and human clinical samples spiked with cracked eggs or genomic DNA from S. japonicum. Amplification was observed from week 4 post infection in infected mice. For human samples, amplification was observed in sieved faecal samples, filtered urine samples heated at 95 °C for 30 min, and sera samples heated at 95 °C for 30 min. The DNA dipstick combined with LAMP has huge potential in providing cost-effective, simple and accurate detection of schistosomiasis infection in endemic regions. This will allow for rapid treatment, tracking outbreaks-such as occur after typhoons, leading to better health outcomes and contributing to control and eventual elimination of schistosomiasis.


Effects of hypoxia on megakaryocytopoiesis and granulopoiesis.
Previous studies have reported that exposure of mice to hypoxic conditions results in a decrease in blood platelets. To further explore the effect of hypoxia on megakaryocytopoiesis, megakaryocytes and their progenitor cells (CFU-M) were studied in hypoxic mice. Mice were exposed to hypoxia by enclosure in cages covered with dimethyl-silicone rubber membranes for up to 10 d. At various times during the hypoxic and ex-hypoxic periods the total megakaryocytes and CFU-M were determined in the humerus and spleen. CFU-M were assayed in the soft gel colony forming assay using pokeweed mitogen-stimulated spleen cell conditioned medium (PWCM) as a source of colony stimulating activity. After 10 d of hypoxia, packed red cell volume (PRCV) increased to 148% of control levels and blood platelets decreased to 40% of controls. Total megakaryocytes and CFU-M per humerus decreased to 18% and 50% of controls respectively. 4 d into the ex-hypoxic phase, PRCV was still increased at 128% of controls while marrow megakaryocytes and CFU-M increased to normal levels. Platelet recovery was somewhat slower, returning to normal by d 6. In contrast to the findings in the marrow, total spleen megakaryocytes and CFU-M increased to about 3- and 5-fold of control levels respectively by 6 d of hypoxia. During the exhypoxic phase, CFU-M decreased to normal on d 4, followed by a rebound of 3-fold control values on d 8. Spleen megakaryocytes decreased more slowly, returning to normal by d 10. A marked granulocytosis was observed during the hypoxic phase.(ABSTRACT TRUNCATED AT 250 WORDS)


Capturing forest dependency in the central Himalayan region: Variations between Oak (Quercus spp.) and Pine (Pinus spp.) dominated forest landscapes.
Our study explores the nexus between forests and local communities through participatory assessments and household surveys in the central Himalayan region. Forest dependency was compared among villages surrounded by oak-dominated forests (n = 8) and pine-dominated forests (n = 9). Both quantitative and qualitative analyses indicate variations in the degree of dependency based on proximity to nearest forest type. Households near oak-dominated forests were more dependent on forests (83.8%) compared to households near pine-dominated forests (69.1%). Forest dependency is mainly subsistence-oriented for meeting basic household requirements. Livestock population, cultivated land per household, and non-usage of alternative fuels are the major explanatory drivers of forest dependency. Our findings can help decision and policy makers to establish nested governance mechanisms encouraging prioritized site-specific conservation options among forest-adjacent households. Additionally, income diversification with respect to alternate livelihood sources, institutional reforms, and infrastructure facilities can reduce forest dependency, thereby, allowing sustainable forest management.


Scleroderma and the Esophagus.
The gastrointestinal tract is the second largest organ system in the body and is often affected by connective tissue disorders. Scleroderma is the classic rheumatologic disease affecting the esophagus; more than 90% of patients with scleroderma have esophageal involvement. This article highlights esophageal manifestations of scleroderma, focusing on pathogenesis, clinical presentation, diagnostic considerations, and treatment options. In addition, this article briefly reviews the esophageal manifestations of other key connective tissue disorders, including mixed connective tissue disease, myositis, Sjogren syndrome, systemic lupus erythematosus, fibromyalgia, and Ehlers-Danlos syndrome.


Combined terminal ileoscopy and biopsy is superior to small bowel follow-through in detecting terminal ileal pathology.
Several studies have compared small bowel barium examination with ileoscopy in assessment of terminal ileal disease. Some suggest that ileoscopy is superior in detection of terminal ileal disease whereas others suggest similar disease detection rates for both techniques. The aim of this retrospective study was to determine if small bowel follow-through and ileoscopy with terminal ileum biopsy compare favourably at detecting pathology in the terminal ileum. All colonoscopies with terminal ileoscopy performed over a 16-month period were reviewed. We determined which of these patients had also had small bowel follow-through studies within 2 weeks of colonoscopy. We compared the diagnoses of terminal ileum pathology using ileoscopy with terminal ileal biopsy versus small bowel follow-through. Forty-six patients had both terminal ileoscopy with biopsy and small bowel follow-through. In 19 patients, the terminal ileum was abnormal at ileoscopy and/or biopsy but normal at small bowel follow-through. In 27 patients, terminal ileum findings at small bowel follow-through and at ileoscopy and/or biopsy were compatible. This study suggests that examination of the terminal ileum by combined ileoscopy and biopsy may be superior to small bowel follow-through at detecting terminal ileal pathology. In our series, many patients received effective treatment that otherwise would not have been offered based on the small bowel follow-through results alone. Using combined ileoscopy and biopsy, microscopic inflammatory changes, otherwise missed without biopsy, can be detected. Retrograde ileoscopy is recommended in patients with a clinical history of organic diarrhoea and/or abdominal pain even in the presence of a normal small bowel follow-through.


Genetic predisposition to acute kidney injury induced by severe sepsis.
The aim of this study was to demonstrate that candidate gene polymorphisms are associated with an increased risk of acute kidney injury (AKI). Patients admitted to the intensive care unit with the diagnosis of severe sepsis and an expected intensive care unit length of stay more than 48 hours were included. Genetic polymorphisms studied included angiotensin-converting enzyme insertion/deletion (polymerase chain reaction); tumor necrosis factor α -376, - 308, and -238; interleukin-8 -251; vascular endothelial growth factor (VEGF) +405 and +936; and pre-B-cell colony-enhancing factor -1001 (TaqMan SNP genotyping assay, Life Technologies, Grand Island, NY). Acute kidney injury was defined as the risk, injury, and failure categories, as per the RIFLE (risk, injury, failure, loss, end-stage kidney disease) classification. One hundred thirty-nine patients were included, 65 of whom developed AKI. In univariate analysis, the VEGF +936 CC and the pre-B-cell colony-enhancing factor -1001 GG genotypes were associated with AKI. In multivariate analysis, Simplified Acute Physiology Score II score (odds ratio [95% confidence interval], 1.06 [1.03-1.09]), chronic arterial hypertension (3.15 [1.39-7.15]), and the presence of the VEGF +936 CC genotype (3.41 [1.19-9.79]) were associated with AKI. This is the first study demonstrating an association between the VEGF +936 CC genotype and the risk to develop AKI in patients with severe sepsis.


Recruiting family dyads facing thoracic cancer surgery: Challenges and lessons learned from a smoking cessation intervention.
Persistent smoking after a cancer diagnosis has adverse effects. Most smoking cessation interventions focus on individual behaviors; however, family members who smoke are major barriers to success. This article describes challenges and lessons learned related to recruitment and retention to a longitudinal, dyadic-centered smoking cessation intervention study for individuals confronting a new diagnosis of thoracic cancer and their family members who smoke. A prospective, one-group repeated measures, mixed-method feasibility study measured recruitment, retention, adherence, and acceptability over a 6-month period in a thoracic surgery clinic at a university cancer center. A multidisciplinary, multi-component decision aid-"Tobacco Free Family"-was used to intervene with the dyads. Study recruitment occurred preoperatively with a thoracic surgery team member assessing smoking status. During the 6-month recruitment period, 50 patients who smoked were screened, and 18 eligible families were approached to participate. Sixteen participants (8 dyads) enrolled. Patients were all male, and participating family members were all female-either spouses or long-term girlfriends. Others types of family members declined participation. Recruitment was lower than anticipated (44%), retention was high (100%), and maximizing convenience was the most important retention strategy. Oncology nurses can assess the smoking status of patients and family members, facilitate understanding about the benefits of cessation, refer those willing to stop to expert resources, and help motivate those unwilling to quit. Research is needed to continue developing strategies to help patients with thoracic cancer and their families facing surgery as an impetus for stopping smoking. Novel intervention delivery and communication need further exploration.


A simple method for high resolution light microscopy of nervous tissue.
A simple method for high resolution light microscopy of nervous tissue is described. Tissue perfused with glutaraldehyde and formaldehyde and postfixed with osmium tetroxide is embedded in HistoResin (LKB Bromma), a new glycol methacrylate based embedding medium, and sectioned (2 microns) on a standard microtome. The method gives excellent preservation of tissue structure, which is far superior to that in paraffin sections and in fact resembles that in epoxy resin-embedded material. It does not, however, require the time, expertise and ultramicrotome needed to cut epoxy resin sections. This technique is particularly useful for assessing demyelination.


Case Report: Microscope-assisted surgery of C7 nerve root cyst with neurological symptoms.
Cervical nerve root cysts are rare and easily missed or misdiagnosed in clinical practice. Although conventional surgery is effective for cervical nerve root cysts, it is limited by the small surgical field of view and operating range, relatively difficult procedure, and incomplete cyst resection. Microscope-assisted magnification of the surgical field of vision reduces the difficulty and ensures complete cyst resection. A 58-year-old male patient was diagnosed with a cervical nerve root sleeve cyst on the right C7 vertebra with neurological symptoms. Microscope-assisted surgery was used as treatment. The cyst was completely removed by the microscope-assisted surgery, with satisfactory patient recovery. The surgery did not produce complications, such as spinal cord neurovascular injury, and the patient's symptoms disappeared quickly after surgery. During the 2-year follow-up, there was no complication and no recurrence. Microscope-assisted surgery in treatment of the C7 nerve root cyst could achieve a complete resection.


Defining professionalism in anaesthesiology.
The Royal College of Physicians and Surgeons of Canada, through the CanMEDS 2000 project has identified the role of professional as 1 of 7 roles for which physicians are expected to be accountable when dealing with patients. Each specialty is responsible for defining this role relative to their specialty. The qualities of professionalism for anaesthesiology were defined through a Delphi process involving Canadian anaesthesiology educators. The panellists took part in 3 rounds that identified qualities in 3 distinct areas of professionalism - humanistic qualities, personal development qualities and anaesthesiology meta-competences. A total of 23 of 29 anaesthesiologists responded (79%) in round 1, with response rates to rounds 2 and 3 being 72% and 69%, respectively. Of the original 36 qualities, some were combined, definitions were changed in 23, 11 qualities were added and 4 were deleted, leaving a list of 40 qualities. There is considerable interest in this issue among the Canadian educators in postgraduate anaesthesiology. Consensus on important professional qualities for anaesthesiologists was obtained through the Delphi technique. These qualities will form the basis of identifiable professional behaviours to which anaesthesiologists should aspire.


Expression of proto-oncogenes in xenografts of human renal cell carcinomas.
In a recent paper, we described the expression pattern of proto-oncogenes in primary human renal cell carcinoma [12]. To test the possibility of using xenografts as a useful alternative for such studies, we analyzed xenografts of a number of human renal cell carcinomas in nu/nu mice. Xenografts included RC2, RC14, RC21, RC43 and NC65. Northern blot analysis indicated that c-Ras was expressed in all these xenografts. The identity of the ras transcripts in the individual xenografts was further specified as c-Ha-ras, c-Ki-ras or N-ras. Expression of c-myc and the p53 gene was also found in a number of these tumors. Only RC21 failed to express the c-myc or the p53 gene. In all xenografts, a 3.0 kb c-fes/fps mRNA was present. In RC2, RC14, RC21 and RC43, low levels of the 4.8 kb ab 1 transcript were detectable. Transcripts of myb and sis could not be detected in any of the xenografts. The results indicated that the expression pattern of a variety of proto-oncogenes in xenografts of human renal cell carcinomas was similar to that in the primary tumors.


Enhanced growth and fatty acid accumulation of microalgae Scenedesmus sp. LX1 by two types of auxin.
Microalgae are potential candidates for the production of valuable products, such as renewable biodiesel, health products and pigments. However, low biomass productivity has restricted their large-scale applications. In this study, the effects of two auxins (one natural type of indole-3-acetic acid (IAA) and the other synthetic type of 2,4-dichlorophenoxyacetic acid (2,4-D)) on the growth and fatty acid methyl esters (FAMEs) production of a freshwater microalgae Scenedesmus sp. LX1 were investigated. Both auxins showed a "low dosage-promotion and high dosage-inhibition" effect on the growth and FAMEs accumulation. The optimum dosage of IAA and 2,4-D were 1mgL-1 and 0.1mgL-1, respectively. Moreover, the IAA could increase the monounsaturated fatty acid content. The auxins may promote the growth by enhancing the photosynthetic activity through increasing chlorophyll contents. Therefore, auxin significantly enhanced microalgal growth and FAMEs accumulation, and has a potential for application in developing efficient microalgal cultivation.


Avoidance of routine endotracheal intubation and general anesthesia for primary closure of gastroschisis: a systematic review and meta-analysis.
Over the last few decades, several articles have examined the feasibility of attempting primary reduction and closure of gastroschisis without general anesthesia (GA). We aimed to systematically evaluate the impact of forgoing routine intubation and GA during primary bedside reduction and closure of gastroschisis. The primary outcome was closure success. Secondary outcomes were mortality, time to enteral feeding, and length of hospital stay. 12 studies were included: 5 comparative studies totalling 192 patients and 7 descriptive case studies totalling 56 patients. Primary closure success was statistically equivalent between the two groups, but trended toward improved success with GA/intubation (RR = 0.86, CI 0.70-1.03, p = 0.08). Mortality was equivalent between groups (RR = 1.26, CI 0.26-6.08, p = 0.65). With respect to time to enteral feeds and length of hospital stay, outcomes were either equivalent between the two groups or favored the group that underwent primary closure without intubation and GA. There are few comparative studies examining the impact of performing primary bedside closure of gastroschisis without GA. A meta-analysis of the available data found no statistically significant difference when forgoing intubation and GA. Foregoing GA also did not negatively impact time to enteral feeds, length of hospital stay, or mortality.


Functional increases in cerebral blood volume over somatosensory cortex.
We have examined the relationship between cerebral blood volume (CBV) and electrophysiology over primary somatosensory cortex (S-I) in the rat. We did this by comparing the spatial characteristics and time course of activity-related changes in plasma fluorescence, intrinsic optical reflectance signals, and single unit electrophysiology in S-I to identical stimuli. S-Is of urethane-anesthetized male Sprague-Dawley rats were exposed, and fluorescent Texas Red dextran dye (MW 70,000) was administered intravenously. Subsequently, foredigit electroshock or vibrissal deflection was associated with fluorescence increases over contralateral forelimb or posteromedial barrel subfield cortex. Fluorescence was delayed and prolonged, indicating that CBV increases at 1-1.5 s and peaks 2-2.5 s after the onset of stimulation in both regions. When stimulus intensity was adjusted to produce barely detectable fluorescence foci (10% above back-ground), significant electrophysiologic spiking was seen. At these parameters, fluorescence change overlay areas of increased cortical layer III cell firing on single unit recordings. However, surface boundaries of the smallest observable fluorescence foci at their peak spatial extents consistently overspilled electrophysiologic center receptive fields. Corresponding intrinsic optical reflectance decreases were seen at 610 and 850 nm, exhibiting similar timing and colocalizing closely with fluorescence increase at both wavelengths after identical stimuli. These signals similarly overspilled electrophysiologic activity. Thus, we observed delayed increases in vascular fluorescence (related to CBV) over activated cortex. The smallest detectable fluorescence changes overspilled the center receptive field boundaries and were associated with appreciable electrophysiologic firing. In addition, the striking spatial and temporal similarity between intrinsic optical reflectance and fluorescence activity suggests that changes in intrinsic cortical reflectance are strongly related to changes in CBV.


Determination of the molecular mass and dimensions of membrane proteins by size exclusion chromatography.
Size exclusion chromatography is an established technique for the determination of hydrodynamic volumes of proteins or protein complexes. When applied to membrane proteins, the contribution of the detergent micelle, which is required to keep the protein soluble in the aqueous phase, needs to be determined to obtain accurate measurements for the protein. In a detergent series, in which the detergents differ only by the length of the alkyl chain, the contribution of the detergent micelle to the hydrodynamic volume is variable, whereas the contribution of the protein is constant. By using this approach, several parameters of membrane proteins can be estimated by extrapolation, such as the radius at the midpoint of the membrane, the average radius, the Stokes radius, and the excluded volume. The molecular mass of the protein can be determined by two independent measurements that arise from the behaviour of the free detergent micelle and protein-detergent micelle during size exclusion chromatography and the determination of the detergent-protein ratio. Determining the dimensions of protein-detergent micelles may facilitate membrane protein purification and crystallization by defining the accessibility of the protein surface.


Bilateral internal thoracic artery coronary grafting: risks and benefits in elderly patients.
Whether bilateral internal thoracic artery (BITA) grafting benefits elderly patients in coronary artery bypass grafting (CABG) remains unclear since they tend to have a limited life expectancy and severe comorbidities. We aim to evaluate the outcomes of BITA vs. single internal thoracic artery (SITA) grafting in elderly patients. A meta-analysis was performed by database searching until May 2021. Studies comparing BITA and SITA grafting among elderly patients were included. One randomized controlled trial, nine propensity score matching, and six unmatched studies were identified, with a total of 18 146 patients (7422 received BITA grafting and 10 724 received SITA grafting). Compared with SITA grafting, BITA grafting had a higher risk of deep sternal wound infection (DSWI) [odds ratio: 1.67; 95% confidence interval (CI): 1.22-2.28], and this risk could not be significantly reduced by the skeletonization technique. Meanwhile, BITA grafting was associated with a higher long-term survival [hazard ratio: 0.83; 95% CI: 0.77-0.90], except for the octogenarian subgroup. Reconstructed Kaplan-Meier survival curves revealed 4-year, 8-year, and 12-year overall survival rates of 85.5%, 66.7%, and 45.3%, respectively, in the BITA group and 79.3%, 58.6%, and 34.9%, respectively, in the SITA group. No significant difference was observed in early mortality, perioperative myocardial infarction, perioperative cerebral vascular accidents, or re-exploration for bleeding. Compared with SITA grafting, BITA grafting could provide a long-term survival benefit for elderly patients, although this benefit remained uncertain in octogenarians. Meanwhile, elderly patients who received BITA were associated with a higher risk of DSWI and such a risk could not be eliminated by the skeletonization technique.


Gel immersion endoscopy: a novel method to secure the visual field during endoscopy in bleeding patients (with videos).
It is difficult to secure the visual field during endoscopy for GI bleeding or colonoscopy without preparation because the injected water is rapidly mixed with fresh blood or stool. We developed a novel method to secure the visual field in these situations. Clear gel with the appropriate viscosity to prevent rapid mixing is injected through the accessory channel, instead of water. A vinyl tube was used as an in vitro GI bleeding model. After filling the lumen with indigo carmine dye, air insufflation and water injection are not effective for securing the visual field. However, after gel injection, the bleeding source is observed clearly in the space occupied by the gel. The efficacy of this method was evaluated subjectively in clinical use. From February 2014 until June 2015, gel immersion was used in 17 consecutive patients when the visual field could not be secured with routine insufflation. Of these 17 patients, gel injection was very effective in 10, effective in 5, slightly effective in 1, and not effective in 1. There were no adverse events associated with this method. Gel immersion endoscopy is safe and effective for securing the visual field, creating a space for endoscopic visualization and treatment in otherwise difficult situations.


Drug-templated mesoporous silica nanocontainers with extra high payload and controlled release rate.
The possibility of one-step creating of pH-sensitive mesostructured silica-based nanocontainers with exceptionally high payload using associates of two antiseptics (including hydrolyzable one) as templates is demonstrated. The effects of the template nature and the conditions of the sol-gel process on the porous structure of silica nanocontainers are studied and discussed. The kinetics of the templating drug release from such containers is studied and some features of this process are analyzed. It is shown that the drug release rate can be tuned by varying the medium pH. The bactericidal activity of two encapsulated antiseptics against the Staphylococcus aureus is evaluated in vitro by agar diffusion method with replacement of agar with agarose. The diameters of the inhibition zones for silica-based containers loaded with antiseptics increased with the pre-diffusion time at 4 °C. At the same time, empty containers (after elimination of antiseptics by etching) did not reveal any bactericidal properties.


Effects of Sedentary Behavior on the Complications Experienced by Pregnant Women: A Systematic Review.
Pregnant women are encouraged to reduce sitting time and replace it with physical activity. Complications arising during pregnancy include gestational hypertension, preeclampsia, gestational diabetes mellitus (GDM), and prenatal and postpartum depression. In this systematic review, we examined effects of sedentary behavior on the health of pregnant women. We conducted a systematic review with PubMed from year 2000 to identify the relationship between a sedentary lifestyle and psychological effects, occurrence of GDM, gestational hypertension, and preeclampsia. Data extracted included sedentary time of pregnant women, psychological effects, occurrence of GDM, gestational hypertension, and preeclampsia as outcomes. Among the 200 studies retrieved, 11 were finally included after screening. The mean age of eligible pregnant women ranged from 28.5 to 32.9 years. Five studies were extracted with outcomes of psychological effects on the mother, five with GDM, and one with gestational hypertension/preeclampsia. Longer sedentary time was associated with increased risks of prepartum/postpartum depression in three of five studies and GDM in three of five studies. No association was found between sedentary behavior and the risk for gestational hypertension/preeclampsia. Higher sedentary behavior in the second trimester of pregnancy was likely to be associated with postpartum depression. Longer sitting time may increase the risk of prenatal or postnatal depression and GDM, but no relationship was proven for gestational hypertension and preeclampsia in one study. High sedentary behavior in the second trimester may have psychological impacts. The number of studies was small and further research is needed to statistically evaluate impacts of sedentary behavior during pregnancy.


The metabolic clearance of insulin and the feedback inhibition of insulin secretion are altered with aging.
Elevated basal and stimulated insulin levels have been previously demonstrated in elderly human subjects. To see whether these elevated insulin levels are due to alterations in either the metabolic clearance rate (MCR) for insulin or the feedback inhibition of insulin secretion, we have studied 14 elderly and 19 nonelderly subjects, mean age 70 +/- 2 and 35 +/- 2 yr, respectively. Fasting serum insulin and C-peptide levels were elevated in the elderly compared with the nonelderly, 17 +/- 2 versus 11 +/- 1 microU/ml, P less than 0.01 and 0.95 +/- 0.12 versus 0.47 +/- 0.07 pmol/ml, P less than 0.001. Euglycemic hyperinsulinemia created by insulin infusion rates of 15, 40, and 1200 mU/m2/min with glucose held constant resulted in steady-state serum insulin levels of 65 +/- 4, 109 +/- 8, and 11,316 +/- 890 versus 34 +/- 2, 96 +/- 5, and 11,083 +/- 1079 microU/ml in the elderly and nonelderly subjects, respectively. The MCR of insulin was decreased by 46% in the elderly compared with the nonelderly (10.1 +/- 0.7 versus 18.7 +/- 1.4 ml/kg/min) at the insulin infusion rate of 15 mU/m2/min with no difference observed between the two groups at the higher insulin infusions. Steady-state suppression of C-peptide by exogenous insulin was similar, 73 +/- 2% versus 72 +/- 2% and 70 +/- 3% versus 64 +/- 5% in the nonelderly and elderly groups during the 15 and 40 mU/m2/min insulin infusions, respectively. However, 50% suppression was achieved within 30 min in the nonelderly group compared with 70 min in the elderly group during the low-dose infusion.(ABSTRACT TRUNCATED AT 250 WORDS)


Human T cell clones specific for tetanus toxoid: characterization of antigen specificity and HLA restriction.
T cell blasts isolated from six-day cultures of peripheral blood mononuclear cells stimulated with tetanus toxoid (TT) were cloned in a two-layer agar system in the presence of autologous irradiated PBM (iPBM) and TT. Colonies were individually isolated and expanded in interleukin 2-containing medium. The antigen specificity of three T cell clones was attested by their capacity to proliferate under restimulation by TT and not by an unrelated antigen. The clones were specific for either the alpha or the beta chain of the toxin. T cells from these clones expressed Ia determinants and antigens of the helper/inducer T cell subset as defined by anti-T monoclonal antibodies. In the case of the alpha chain-specific clone MA 11 from the donor MA, allogeneic iPBM from HLA-compatible unrelated donors, including seven donors sharing one HLA DR specificity with MA, were found inefficient as antigen-presenting cells. A familial study, however, demonstrated that antigen presentation could be obtained using nonautologous cells. The presenting capability of cells from relatives of the donor MA segregated in association with the HLA-DRw6-bearing maternal haplotype present in MA. Results suggest that MA 11 cells recognized the antigen in the context of a surface determinant closely linked to HLA-DRw6.


A comprehensive modular map of molecular interactions in RB/E2F pathway.
We present, here, a detailed and curated map of molecular interactions taking place in the regulation of the cell cycle by the retinoblastoma protein (RB/RB1). Deregulations and/or mutations in this pathway are observed in most human cancers. The map was created using Systems Biology Graphical Notation language with the help of CellDesigner 3.5 software and converted into BioPAX 2.0 pathway description format. In the current state the map contains 78 proteins, 176 genes, 99 protein complexes, 208 distinct chemical species and 165 chemical reactions. Overall, the map recapitulates biological facts from approximately 350 publications annotated in the diagram. The network contains more details about RB/E2F interaction network than existing large-scale pathway databases. Structural analysis of the interaction network revealed a modular organization of the network, which was used to elaborate a more summarized, higher-level representation of RB/E2F network. The simplification of complex networks opens the road for creating realistic computational models of this regulatory pathway.


N6-substituted 9-methyladenines: a new class of adenosine receptor antagonists.
A series of 15 N6-substituted 9-methyladenines have been assessed as antagonists of A2-adenosine receptor-mediated stimulation of adenylate cyclase in membranes of human platelets and rat PC12 cells and of A1-adenosine receptor-mediated inhibition of adenylate cyclases in membranes of rat fat cells and as inhibitors of binding of N6-R-[3H]phenylisopropyladenosine to A1-adenosine receptors in rat brain membranes. N6 substitution can markedly increase the potency of 9-methyladenine at A1 receptors, while having lesser effects or even decreasing potency at A2 receptors. Effects of N6 substituents on adenosine receptor activity of the 9-methyladenines are reminiscent of effects of N6 substituents on activity of adenosine, suggesting that N6 substituted 9-methyladenines bind to adenosine receptors in the same orientation as do N6-substituted adenosines. N6-Cyclopentyl-9-methyladenine with Ki values at the A1 receptors of 1.3 microM (fat cells) and 0.5 microM (brain) is at least 100-fold more potent than 9-methyladenine (Ki 100 microM, both receptors), while at the A2 receptors KB values of 5 microM (platelets) and 25 microM (PC12 cells) make it 5-fold more potent and equipotent, respectively, compared to 9-methyladenine (KB 24 microM, both receptors). N6-Cyclopentyl and several other N6-alkyl and N6-cycloalkyl analogs are selective for A1 receptors while 9-methyladenine is the most A2 receptor selective antagonist. The N6-R- and N6-S-(1-phenyl-2-propyl)-9-methyladenines, analogous to N6-R- and N6-S-phenylisopropyladenosines, exhibit stereoselectivity at both A1 and A2 receptors. Marked differences in potency of certain N6-substituted 9-methyladenines at the A2 receptors of human platelets and rat PC12 cells provide evidence that these are not identical receptors.


Excessive IL-15 promotes cytotoxic CD4 + CD28- T cell-mediated renal injury in lupus nephritis.
Patients with systemic lupus erythematosus (SLE) are highly susceptible to infection and cardiovascular events, suggesting that chronic antigenic stimulation may accelerate premature aging in SLE patients. Premature aging in SLE is often accompanied with the expansion of cytotoxic CD4 + CD28-T cells. Damage caused by CD4 + CD28- T cells enhances the progressive aging of the tissue function and loss of organism's fitness. The high serum level of IL-15 has been implicated in the pathogenesis of SLE, but its role in CD4 + CD28-T cell-mediated cytotoxicity in nephritic SLE remains unclear. The aim of this study was to investigate the effect of IL-15 on functional properties and associated renal damage of cytotoxic CD4 + CD28- T cell in lupus nephritis (LN). Flow cytometry showed that the number of circulating innate-like CD4 + CD28- T cells was increased in patients with nephritic SLE. Immunofluorescence showed CD4 + CD28- T cell infiltration in the kidney of LN patients, which was correlated with multiple clinicopathological features including estimated glomerular filtration rate (eGFR), proteinuria, the proportion of glomerulosclerosis and the degree of renal chronicity. In addition, a high level of IL-15 and IL15-expressing macrophage infiltration was detected in the periglomerular and intraglomerular tissues of LN patients, which enhanced the innate features, cytokine secretion and migratory capability of CD4 + CD28- T cells, and finally exerted direct TCR-independent cytotoxicity on glomerular endothelial cells in an IL-15-dependent manner in vitro. Our study demonstrated that excessive IL-15 potentially promoted cytotoxic CD4 + CD28- T cell-mediated renal damage in LN. This finding may provide new insights into the potential association of premature aging and tissue damage in LN.


A qualitative study of life with a left ventricular assist device as a bridge to transplant: A new normal.
To explore the lived experiences of individuals with a left ventricular assist device (LVAD) as a bridge to transplant. A qualitative descriptive study of ten patients in the Midwestern United States between 30 and 60 years, with a device implanted between six and 18 months were interviewed. A semi-structured interview guide was utilized to elicit a detailed account of individuals living with an LVAD. Content analysis with an inductive coding approach was used to analyze the interview transcripts. Three major themes, encompassing several sub themes emerged from the data. (1) physical adjustments (reality shock, carrying the batteries, a new routine, showering, and sleep) (2) emotions (decision making, attitude, gratitude, and uncertainty) (3) psychosocial aspects (intimacy adaptations, self-perception, and perception by others) CONCLUSION: The reality of living with a device was 'not normal' but with time it became their new normal. Findings from this study will inform healthcare professionals (HCP) on the lived experience of patients with LVADs. This new knowledge will assist HCPs to engage in realistic discussions with patients contemplating an LVAD implant. Sharing the challenges of patients with LVADs will help future transplant recipients to be better prepared for their new lifestyle.


Essential Training, Resources, and Skills of First-Year and Junior Pharmacy Practice Faculty Needed in the Development of an Individual Research Program.
To describe types of current training/support received and elicit opinions on the level of importance of specific skills and resources needed to build confidence in conducting research for early-career pharmacy practice faculty. A survey instrument regarding available resources, levels of importance of resources, and skills needed to improve research confidence was sent to all new early-career practice faculty members with 3 or less years of experience in academia at 129 US colleges and schools of pharmacy. Few respondents indicated a formal research training existed at their institution. Overall, a majority of respondents identified at least 14 specific developmental areas as moderately to very important in building confidence. Over 75% of respondents rated 15 basic skills as moderately to very important in successfully starting an individual research program. Although different types of research training programs are available, confidence in conducting research in both informal and formal ones is low. Both groups of respondents identified similar important developmental research areas that would increase their confidence and skills in achieving their early research goals.


Simultaneous atrial and ventricular anti-tachycardia pacing as a novel method of rhythm discrimination.
To evaluate a new discrimination algorithm for supraventricular (SVT) and ventricular (VT) tachycardias, based on the response to simultaneous (A+V) atrial (A) and ventricular (V) anti-tachycardia pacing (ATP). Patients undergoing electrophysiological testing or dual-chamber implantable cardioverter-defibrillator (ICD) implantation were enrolled (N = 32) and underwent A+V ATP through a Marquis ICD with investigational software. If persisting after ATP, the rhythm was classified as VT if the first electrical event was sensed on the V channel and as an SVT otherwise. Arrhythmia sequences (N = 275; 53 VT; 222 SVT) were analyzed in 26 patients (age = 51 +/- 17 years, 13 men, LVEF = 0.49 +/- 0.14). In response to A+V ATP, 55% of SVT versus 41% of VT episodes were terminated (P = NS). Termination of VT but not of SVT was more likely with faster (50% at ATP/arrhythmia cycle length (CL) = 0.81 vs 8% at ATP/arrhythmia CL = 0.88, P = 0.02) but not with longer ATP bursts (P = NS). Of the 115 arrhythmias that persisted after A+V ATP, the algorithm correctly classified 24 of 24 VT (GEE-adjusted sensitivity = 100%) and 85 of 91 SVT (GEE-adjusted specificity = 93%). Proarrhythmia was noted after two A+V ATP, in the form of atrial fibrillation induction and VT acceleration. We describe a new algorithm that can discriminate between SVT and VT with a high sensitivity and specificity. This form of ATP can terminate 55% of SVT sequences. The performance of this new algorithm merits further testing in a large population of dual-chamber ICD patients.


Evaluating the procedural validity of the multilingual computer assisted self interview (MultiCASI) in a refugee population.
Multimedia-based administration of questionnaires, presenting items both in writing and spoken word, offers numerous potential benefits in transcultural psychiatry, such as improved comprehension of each question, ease of administration, prevention of missing or arbitrary responses, and obviating subsequent data entry. The concept has become known as "Computer-Assisted Self Interviewing" (CASI), and while preliminary results are promising, previous studies have not directly compared CASI to paper-and-pen administration in a large and representative sample of refugees. The aim of this study was to evaluate the procedural validity of multilingual CASI in comparison to paper-based-administration. The Hopkins Symptom Checklist-25 anxiety and depression subscales were administered in both modalities with a total of N = 281 participants from sites in Australia, New Zealand, and Denmark. We evaluated potential deviations in both the raw item and scale scores in each modality, while psychometric properties of each subscale were compared for an Arabic-speaking subsample (n = 125). Results showed no significant differences between raw item- or scale score across the two modalities, nor between the level of construct validity. In conclusion, this study supports a wider adaptation of multilingual CASI in the context of transcultural psychiatry, both for purposes of screening and treatment evaluation.


A Prospective Trial to Access the Optimal Circumference of Resection in Antireflux Mucosectomy for Treatment-refractory GERD.
There is still no gold standard regarding the optimal circumference of antireflux mucosectomy (ARMS) in patients with treatment-refractory gastroesophageal reflux disease (GERD). The aim of this study is to assess the safety and effectiveness of resection procedures when the circumferences are different. Thirty-two patients with treatment-refractory GERD were allocated into group A (16 cases) and group B (16 cases) by randomization. In group A and group B, a 2/3 and 1/2 circumference, 1.5 cm wide mucosal resection of the gastric cardia was performed. Health-related quality of life (HRQOL), frequency scale for the symptoms of GERD (FSSG), DeMeester scores and acid exposure time (AET) were accessed at baseline and at 24 months after treatment. Physical component summaries (PCS), mental component summaries (MCS), and RE-specific summary (RES) scores were calculated. All patients had successful surgical procedures and no bleeding, perforation, or dysphagia occurred. The PCS, MCS, and RES scores of post-ARMS were higher than those of pre-ARMS in groups A and B, and the FSSG, DeMeester scores and AET decreased after ARMS in both groups, with differences that were statistically significant (P<0.05). The changes in PCS, MCS, RES, FSSG, DeMeester scores, and AET were greater in group A than in group B, with significant differences in PCS, MCS, RES, and FSSG scores (P<0.05), but no significant differences in, DeMeester scores and AET (P>0.05). ARMS is an effective treatment for treatment-refractory GERD. Moreover, we recommend the 2/3 circumference, 1.5 cm wide mucosal resection of the gastric cardia.


In vitro release profile of anti-ulcer drug rabeprazole from biocompatible psyllium-PVA hydrogels.
The present article discusses the synthesis, characterization and haemocompatibility behaviour of the psyllium-PVA hydrogels prepared by chemical method in the presence of N,N'-methylenebisacrylamide. These hydrogels have been characterized by Fourier Transform infrared spectroscopy, thermo gravimetric analysis, swelling and drug release studies. The release of model drug rabeprazole sodium from the drug loaded hydrogels occurred through non-Fickian diffusion mechanism. Psyllium itself acts as anti-ulcer agent and release of rabeprazole from the drug loaded hydrogels may enhance the curing potential of the drug delivery device. The haemocompatibility was evaluated by studying the blood interactions with hydrogels with reference to thrombogenicity and haemolytic potential. Thrombogenicity results indicate that hydrogels are non-thrombogenic as the weight of clot formed and thrombus percentage for hydrogels was less than the positive control. The haemolytic index has been observed <5%. These observations indicate that these hydrogels are haemo-compatible and hence could be used for oral administration of antiulcer drugs.


Implications of nasopharynx-associated lymphoid tissue (NALT) in the development of allergic responses in an allergic rhinitis mouse model.
Nasopharynx-associated lymphoid tissue (NALT) serves as an important inductive site for mucosal immunity in the upper respiratory tract. Despite its importance in the mucosal immune system, little is known regarding the role of NALT in airway allergic immune responses. We aimed to elucidate the role of NALT in the induction of upper airway allergic responses in a mouse model. Inhibitor of DNA binding/differentiation 2 (Id2)(-/-) and Id2(+/-) mice was exposed to the ovalbumin (OVA)-induced allergic rhinitis model, because the former resulted in the NALT deficiency. The allergic parameters, such as allergic symptoms, serum OVA-specific immunoglobulin E (IgE) levels, eosinophil infiltration, and cytokine profiles in the nasal mucosa, were compared between Id2(-/-) and Id2(+/-) groups. NALT-null, Id2(-/-) mice displayed significantly lower allergic responses compared with Id2(+/-) mice, as demonstrated by lower levels of allergic symptoms, serum OVA-specific IgE, eosinophilic infiltration, and local Th2 cytokine transcriptions. To determine which of two factors, that is, the absence of NALT or the alteration of immunocompetent cell populations caused by the Id2 deficiency, has a larger effect on the attenuated allergic immune responses in Id2(-/-) mice, lethally irradiated Id2(-/-) mice were engrafted with C57BL/6 wild-type bone marrow cells and showed still significantly lower allergic immune responses compared with equally treated Id2(+/-) mice. In addition, IgE class switch recombination-associated molecules, such as ε immunoglobulin heavy-chain germline gene transcript, ε mRNA, and activation-induced cytidine deaminase mRNA, were detected in NALT from OVA-sensitized wild-type mice. These results show the critical role of NALT for the induction of allergic responses in the upper airway at least in part by means of class switching to IgE in situ.


Perioperative Outcomes of Patients Undergoing Lobectomy on Clopidogrel.
Perioperative management of antiplatelet therapy for patients undergoing pulmonary resection must balance the risk of cardiovascular events with that of hemorrhage. An optimal approach has not been defined in this population. We sought to characterize outcomes of patients undergoing pulmonary lobectomy on antiplatelet therapy with clopidogrel. A prospective institutional database was retrospectively reviewed to identify all patients undergoing pulmonary lobectomy from 2007 to 2015 who received perioperative clopidogrel. Patients were grouped according to the timing of clopidogrel discontinuation before operation: group I, 5 days or less; group II, 6 to 14 days; and group III, more than 14 days. Analyses were performed to assess the effect of timing of discontinuation on adverse events. Sixty-two patients were identified and included in the analysis. The indication for clopidogrel was coronary artery disease in 44 patients (71%), 35 (56%) of whom had prior stent placement. The overall incidences of transfusion and major cardiovascular events were 16% (10 of 62) and 6.5% (4 of 62), respectively. Non-ST elevation myocardial infarctions occurred in 4 patients. Three were in patients with stents, all placed more than 1 year before the operation. There were no significant differences identified in estimated blood loss, operative duration, or perioperative deaths. No significant outcome differences in perioperative cardiovascular or hemorrhagic events were identified among the groups. Although these findings suggest that clopidogrel may be discontinued shortly before the operation with limited risk of bleeding, we also found that holding therapy for more than 14 days preoperatively may be safe in appropriately selected patients.


Biological information processing: the use of information for the support of function.
In biological systems, the processing and use of information has evolved out of the need for survival in the face of an uncertain environment. As a consequence, the information-function relationship in these systems is shaped by their adaptability characteristics. In contrast, the information-function relationship in man-designed, goal-oriented organizational systems depends on the ability of the information processing system to support the achievement of the organization's goals. In this paper we use results from adaptability theory in the analysis of control-related aspects of the information-function relationship in man-designed organizational systems. In particular, we use a conceptual model of organizational control to characterize features of functional and control structures and their effect on the adaptability of these systems. The concept of implicit control and a design principle for adaptability-enhancing information systems are derived for this analysis.