A critical evaluation of in vitro cell culture models for high-throughput drug screening and toxicity.
Drug candidate and toxicity screening processes currently rely on results from early-stage in vitro cell-based assays expected to faithfully represent essential aspects of in vivo pharmacology and toxicology. Several in vitro designs are optimized for high throughput to benefit screening efficiencies, allowing the entire libraries of potential pharmacologically relevant or possible toxin molecules to be screened for different types of cell signals relevant to tissue damage or to therapeutic goals. Creative approaches to multiplexed cell-based assay designs that select specific cell types, signaling pathways and reporters are routine. However, substantial percentages of new chemical and biological entities (NCEs/NBEs) that fail late-stage human drug testing, or receive regulatory "black box" warnings, or that are removed from the market for safety reasons after regulatory approvals all provide strong evidence that in vitro cell-based assays and subsequent preclinical in vivo studies do not yet provide sufficient pharmacological and toxicity data or reliable predictive capacity for understanding drug candidate performance in vivo. Without a reliable translational assay tool kit for pharmacology and toxicology, the drug development process is costly and inefficient in taking initial in vitro cell-based screens to in vivo testing and subsequent clinical approvals. Commonly employed methods of in vitro testing, including dissociated, organotypic, organ/explant, and 3-D cultures, are reviewed here with specific focus on retaining cell and molecular interactions and physiological parameters that determine cell phenotypes and their corresponding responses to bioactive agents. Distinct advantages and performance challenges for these models pertinent to cell-based assay and their predictive capabilities required for accurate correlations to in vivo mechanisms of drug toxicity are compared.


Alterations in the shape of the automated perimetric profile arising from cataract.
The attenuation of the perimetric response arising from cataract was investigated and related to the degree of cataract quantified by glare sensitivity. Visual fields were measured with the Octopus and Dicon automated perimeters out to an eccentricity of 30 degrees. Nuclear and non-nuclear cataracts differed in their effect on the perimetric profile. Non-nuclear cataracts exhibited the same qualitative characteristics as a model developed in previous studies, whereby the overall pattern of perimetric attenuation was dependent upon target configuration. For these subjects, perimetric sensitivity was depressed to a greater extent at an eccentricity of 30 degrees compared with fixation when measured with the large projected stimuli, whereas the reverse was true when sensitivity was measured with the small LED stimuli. Conversely, nuclear cataracts depressed perimetric sensitivity to a greater extent at the fovea compared with more peripheral regions for both the large projected and small LED stimuli.


Association between lncRNA H19 rs217727 polymorphism and the risk of cancer: an updated meta-analysis.
We have performed this study to evaluate the association between H19 rs217727 polymorphism and the risk of cancer. An odds ratio (OR) with a 95% confidence interval (CI) was applied to determine a potential association. A total of 17 case-control publications were selected. This meta-analysis showed that H19 rs217727 has a significant increased association with cancer risk in allelic, homozygous, heterozygote, dominant and recessive models (T vs C: OR = 1.16, 95% CI = 1.06-1.27, I2 = 75.7; TT vs CC: OR = 1.29, 95% CI = 1.06-1.56, I2 = 71.6; CT vs CC: OR = 1.15, 95% CI = 1.01-1.31, I2 = 75.4; CT + TT vs CC: OR = 1.20, 95% CI = 1.05-1.36, I2 = 76.5; TT vs CT + CC: OR = 1.22, 95% CI = 1.02-1.45, I2 = 70.6;). In the subgroup analysis of smoking status, both smokers and nonsmokers showed an increase in cancer risk in allelic, homozygous, dominant and heterozygote models. This meta-analysis revealed H19 rs217727 may influence cancer susceptibility.


Profiling the microRNA signature of the peripheral sensory ganglia in experimental autoimmune encephalomyelitis (EAE).
Multiple sclerosis is an autoimmune disease with a distinct female bias, as well as a high prevalence of neuropathic pain in both sexes. The dorsal root ganglia (DRG) contain the primary sensory neurons that give rise to pain, and damage to these neurons may lead to neuropathic pain. Here, we investigate the sex differences of the DRG transcriptome in a mouse model of MS. Next-generation sequencing was used to establish RNA and microRNA profiles from the DRG of mice with MOG35-55-induced EAE, a model of CNS inflammation that mimics aspects of MS. Differential expression and multiple meta-analytic approaches were used to compare expression profiles in immunized female and male mice. Differential expression of relevant genes and microRNAs were confirmed by qPCR. Three thousand five hundred twenty genes and 29 microRNAs were differentially expressed in the DRG of female mice with MOG35-55-EAE, while only 189 genes and 3 microRNAs were differentially expressed in males with MOG35-55-EAE. Genes related to the immune system were uniquely regulated in immunized female mice. Direct comparison of sex within disease indicates significant differences in interferon and phagosomal pathways between the sexes. miR-21a-5p is the primary dysregulated microRNA in both sexes, with females having additional dysregulated microRNAs, including miR-122-5p. This study provides evidence that females are uniquely affected by MOG35-55-EAE and that this difference may result from additional signaling not present in the male. The altered transcriptome of females correlates with other studies finding hyperactivity of pain-sensing neurons and suggests underlying sex-specific pathways for neuropathic pain.


Treated invasive cervical carcinoma. Utility of computed tomography in distinguishing between skeletal metastases and radiation necrosis.
The bony pelvis should be carefully evaluated on computed tomography (CT) scans of the lower abdomen and pelvis performed for staging cervical cancer or for evaluating suspected recurrence. CT provides optimal imaging of the spine and pelvis, frequently providing a clinically relevant supplement to bone scan or plain film information. In a study of eight patients with skeletal metastases from cervical carcinoma and three cases of radiation osteitis, overlap existed in their imaging characteristics. Metastases were always lytic but nearby sclerotic areas from radiation were often present. Radiation osteitis may be lytic, sclerotic, or mixed, and both may avidly accumulate bone-scanning radiotracers. The absence of a soft tissue mass, slow progression, blastic elements, and sharply defined borders on CT suggest radiation necrosis. However, in some lesions within a radiation portal, biopsy or MRI may be required for final diagnosis.


Quantitative Measurement of Dissection Resistance in Intimal and Medial Layers of Human Coronary Arteries.
The left anterior descending (LAD) coronary artery is the most frequently involved vessel in coronary artery dissection, a cause of acute coronary syndrome or sudden cardiac death. The biomechanical mechanisms underlying arterial dissection are not well understood. This study investigated the dissection properties of LAD specimens harvested from explanted hearts at the time of cardiac transplantation, from patients with primary dilated cardiomyopathy (n=12). Using a previously validated approach uniquely modified for these human LAD specimens, we quantified the local energy release rate, G, within different arterial layers during experimental dissection events (tissue tearing). Results show that the mean values of G during arterial dissection within the intima and within the media in human LADs are 20.7±16.5 J/m2 and 10.3±5.0 J/m2, respectively. The difference in dissection resistance between tearing events occurring within the intima and within the media is statistically significant. Our data fall in the same order of magnitude as most previous measurements of adhesive strength in other human arteries, with the differences in measured values of G within the layers most likely due to histologically observed differences in the structure and composition of arterial layers.


QRS-based assessment of myocardial damage and adverse events associated with cardiac sarcoidosis.
Cardiac sarcoidosis (CS) generates myocardial scar and arrhythmogenic substrate. CS diagnosis according to the Japanese Ministry of Health and Welfare guidelines relies, among others, on cardiac magnetic resonance imaging with late gadolinium enhancement (CMR-LGE). However, access to CMR-LGE is limited. The electrocardiography-based Selvester QRS score has been validated for identifying myocardial scar in ischemic/nonischemic cardiomyopathy, but its efficacy has not been tested to evaluate CS. The purpose of this study was to examine whether the QRS score can be applied to CS. CS-associated myocardial scar was assessed by both CMR-LGE and QRS scoring in patients with extra-CS (n = 59). Of 59 patients, 35 (59%) were diagnosed with CS according to the Japanese Ministry of Health and Welfare guidelines. QRS-estimated scar mass positively correlated with that quantified by CMR-LGE (signal intensity ≥2SD above the reference; r = 0.68; P < .001). Receiver operating characteristic curves demonstrated optimal cutoffs of 9% CMR-LGE scar and 3-point QRS score to identify patients with CS. The areas under the curves of CMR-LGE and the QRS score were not significantly different (0.83 and 0.78, respectively; P = .27); both methods demonstrated similar diagnostic performance. A QRS score of ≥3 led to a higher incidence of CS-associated adverse events (death/fatal arrhythmia/heart failure hospitalization) than did a QRS score of <3 (35 ± 21 months of follow-up; P = .01). QRS score was an independent predictor of risk in multivariate analysis (P = .03). The Selvester QRS scoring estimates CS-associated myocardial damage and identifies patients with CS equally well as CMR-LGE. A higher QRS score is also associated with an increased risk of life-threatening events in CS, indicating its potential use as a risk predictor.


Learning as the best medicine: Proposal for SMART schooling for hospitalized children.
This research paper explores learning alternatives for chronically ill students, considering the challenges they encounter in their learning processes due to prolonged or intermittent absences from school. International practices and recent research findings on this topic will be reviewed in the contexts of hospital schools, SMART hospitals, and SMART learning technologies to highlight their primary characteristics. The current situation of hospitalized students, particularly those in Dubai, will be discussed to propose an alternative education program to aid them: the Edu-Med Care Model. This model is built on SMART education and healthcare approaches to support the goal of helping students overcome barriers that prevent them from accessing conventional learning spaces. The strengths and limitations of the Edu-Med Care Model will be evaluated.


A Comparison Study on the Therapeutic Effect of High Protein Diets Based on Pork Protein versus Soybean Protein on Obese Mice.
In this study, an obese C57BL/6J mice model was induced to compare the effect of different high protein diets (soybean protein and pork protein) on obesity. The obese mice were randomly divided into four groups: natural recovery (NR), high-fat diet (HF), high soybean protein diet (HSP), and high pork protein diet (HPP) groups. After 12 weeks of dietary intervention, the obesity-related indexes of mice were measured, such as body weight, fat coefficients, blood lipid indexes and so on. Results showed that HSP and HPP decreased the weight and fat coefficients of mice, the levels of serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and leptin (p < 0.05). Soybean protein was shown to be more effective in reducing the weight and fat mass of obese mice, although pork protein seemed to have a better effect on regulating serum triglyceride (TG). In addition, the two high protein diets both alleviated hepatic fat deposition effectively. Furthermore, HPP and HSP decreased the expression of hepatic peroxisome proliferator-activated receptor-γ (PPAR-γ) and increased the protein expression of phosphorylated AMP-activated protein kinase (pAMPK), phosphorylated acetyl CoA carboxylase (pACC), and uncoupling protein 2 (UCP2) (p < 0.05). In conclusion, the study shows that high protein diets based on both pork protein and soybean protein alleviated abdominal obesity in mice effectively by regulating lipid metabolism, probably via the UCP2-AMPK-ACC signaling pathway.


Evaluating Auricular Point Acupressure for Chronic Low Back Pain Self-Management Using Technology: A Feasibility Study.
Chronic low back pain, one of the most common reasons for seeking healthcare services, causes significant negative impacts on individuals and society. Nonpharmacologic therapies and self-management are included in practice guidelines, but their implementation is challenging. To assess the feasibility of using an auricular point acupressure (APA) mobile app as a self-guided tool to learn and self-administer APA to manage chronic low back pain (cLBP) and to compare cLBP outcomes between 2 groups (app vs app + telehealth). A 2-phase study design was used. In phase 1, participants (app group, n = 18) had in-person study visits and installed the app to learn and self-administer APA to manage cLBP. In phase 2, all research activities occurred remotely due to the COVID-19 pandemic, so a second group was recruited (app + telehealth, n = 19). The app + telehealth group underwent a virtual session, installed the app, and were provided the opportunity for questions and verification on the accuracy of the self-administered APA. The participants were recruited by distributing study flyers at outpatient clinics and referrals. Participants with chronic low back pain were eliglbe for the study. Using a quasi-experimental design with a mixed methods approach, all participants were instructed to download the APA app, provided an APA kit (includes seeds embedded within pre-cut squares of adhesive tape), and advised to self-administer APA with guidance from the app for 4 weeks to manage their cLBP. Study outcomes were collected at the preintervention time point as well as postintervention and 1-month follow-up. Interviews were also conducted at the postintervention time point. Of the 37 participants enrolled, six dropped out, and the attrition rate was 16%. Adherence to APA practice was high (85%-94%). After 4 weeks of APA treatment, participants in the app + telehealth group experienced a 29% decrease in pain intensity during the postintervention time point and a 35% reduction during the 1-month follow-up. Similar improvements were noted in pain interference (28%) and physical function (39%) for participants in the app + telehealth group at the 1-month follow-up. These changes are slightly higher compared with those in the app group (21% pain intensity reduction, 23% improved pain interferences, and 26% improved physical function) during the 1-month follow-up. Overall, APA was found to be feasible using the app and the qualitative findings showed acceptability of the intervention in both groups. It is feasible to learn and self-administer APA with an app, supplemented with either in-person or telehealth sessions, presenting a promising intervention toward cLBP self-management. Telehealth was found to boost this intervention effectively.


Radioimmunoguided surgery (RIGS), PET/CT image-guided surgery, and fluorescence image-guided surgery: past, present, and future.
(125)I-labeled anti-TAG-72 antibodies were applied in radioimmunoguided surgery (RIGS) to remove gross and occult tumors. It is challenging to handle (125)I-labeled materials. PET/CT image-guided surgery utilizes (18)FDG to monitor the biochemical activity of the tumor and to integrate pre- and postoperative imaging for complete tumor removal. PET/CT image-guided surgery only detects later stage disease. Fluorescence image-guided surgery using anti-TAG-72 antibodies may provide opportunities for intraoperative cancer detection of both gross and occult tumors.


Antidiabetic plants improving insulin sensitivity.
Globally, the prevalence of diabetes mellitus is increasing at an alarming rate. This chronic pathology gravely troubled the human health and quality of life. Both insulin deficiency and insulin resistance are involved in the pathophysiology of diabetes mellitus. Moreover, insulin resistance is being diagnosed nowadays in a growing population of diabetic and obese patients, especially in industrialized societies. There are lots of conventional agents available to control and to treat diabetes, but total recovery from this disorder has not been reported up to this date. Plants provided a potential source of hypoglycemic drugs and are widely used in several traditional systems of medicine to prevent diabetes. A few reviews with less attention paid to mechanisms of action have been published on antidiabetic plants. The present review focuses on the various plants that have been reported to be effective in improving insulin sensitivity associated with diabetes. In this work, an updated systematic review of the published literature has been conducted to review the antidiabetic plants improving insulin sensitivity and 111 medicinal plants have been reported to have a beneficial effect on insulin sensitivity using several in-vitro and in-vivo animal models of diabetes. The different metabolic and cellular effects of the antidiabetic plants improving insulin sensitivity are reported indicating the important role of medicinal plants as potential alternative or complementary use in controlling insulin resistance associated with diabetes mellitus.


Biophysical measures of skin tissue water: variations within and among anatomical sites and correlations between measures.
Biophysical measures to assess that skin water includes stratum corneum hydration via capacitance (SC), dermal water via tissue dielectric constant (TDC), and transepidermal water loss (TEWL). Since skin differs among anatomical sites and tissue depth we sought to determine the site and depth variability of these measures and their relationships. Measurements were done at 17 skin sites from forehead to foot in 32 supine healthy women. Measurements included SC at 1.25 MHz, TDC at 300 MHz to depths of 0.5, 1.5, and 2.5 mm and TEWL. Tissue dielectric constant decreased with increasing depth at forehead, forearm, and calf; increased with depth at palm, thenar eminence and great toe; and was independent of depth at cheek, hand dorsum, thumb pulp, and foot dorsum. SC correlated with TDC at most sites and depths. TEWL correlated with TDC at 2.5 mm only at calf sites and thenar eminence. Results establish parameter ranges for each measure, show that TDC values do not necessarily change with skin depth, and show a significant correlation between TDC and SC values at most sites. These correlations suggest that SC hydration but not TEWL is directly linked to dermal tissue water levels in normal skin.


Extortion - A voracious prosocial strategy.
Recently Press and Dyson have dramatically changed our view on the Prisoner's Dilemma by proposing a new class of strategies that enforce a linear relationship between the two players' scores. Players adopting 'extortion' respond with cooperation to cooperation in most cases, defect in other rounds, but respond to defection with defection. In this way, extortion enforces full cooperation of the partner who accedes to it because he profits from doing so. This unbeatable strategy is nevertheless prosocial because it is mostly cooperative and induces cooperation even though it gains most itself. Experiments show that about 40% of humans choose to use extortion in competitive situations or when they have the power to exchange coplayers. On being punished in egalitarian situations, they use a generous strategy.


Down-regulation of surface fractalkine by RNA interference in B16 melanoma reduced tumor growth in mice.
It is reported that membrane-bound form of CX3CL1/fractalkine (FKN) promotes cell-cell adhesion by binding with its unique receptor CX3CR1, and membrane fractalkine works as an adhesion molecule for the communication between tumor cells and vascular endothelial cells. Here, we show that CX3CL1/fractalkine was expressed on both mouse and human solid tumors, and small interfering RNA-mediated knock down of fractalkine gene inhibited melanoma B16-F0 cells growth in vivo, which was correlated to the decreased angiogenesis around the tumor. Our findings for the first time suggest that membrane fractalkine may possibly promote tumor angiogenesis through its strong cell adhesion function and therefore serves as a potential target of tumors therapy including RNA interference.


Auricular acupuncture diagnosis in patients with lumbar hernia.
Auricular Acupuncture Diagnosis is a diagnostic method which is essential for the topographic identification on the auricle of the anatomical parts of the body carrying a particular ailment or dysfunction. To identify the specific zones related to lumbar hernia in patients treated with a series of epidural infiltrations with corticosteroids. In a consecutive group of thirty patients with lumbar hernia 2 diagnostic methods used in Auricular Acupuncture Diagnosis, Pain Pressure Test and Electric Skin Resistance Test, were applied before the first infiltration (T0), before the second and the third infiltration (T1, T2) and one week after the third infiltration (T3). The parameters, whose variations were analyzed at T0-T3, were the following: the number of points identified; the intensity of pain on a verbal rating scale and the foot-hand distance in cm with bent spine and extended knees. The identified points were reported on the Auricular Sectogram which is a validated graphic system suitable for a correct transcription of the points and indicated for a statistical analysis of their distribution on the different sectors. A significant association was found for some auricular areas, along the series of epidural infiltrations, with a progressive reduction in the number of tender and low electrical resistance points together with a decrease of pain and hand-foot distance. The auricular zones found with Auricular Acupuncture Diagnosis in our group of patients seem of clinical relevance and could be included in the complementary treatment of lumbar-sciatic pain in lumbar hernia.


Inhibitory receptor binding events among the components of complex mixtures contribute to mixture suppression in responses of olfactory receptor neurons of spiny lobsters.
Responses of olfactory receptor neurons of spiny lobsters Panulirus argus to two-component mixtures can be shaped by inhibitory events such as odor-activated hyperpolarizations and inhibition of odor-receptor binding (Daniel et al. 1996). In the current study, we extend this analysis to complex mixtures by examining responses of spiny lobster olfactory receptor neurons to mixtures containing up to seven odorants, consisting of adenosine-5'-monophosphate, ammonium, betaine, L-cysteine, L-glutamate, DL-succinate, and taurine. The response to a mixture was often less than the response to its most excitatory component. The effect of adding an excitatory odorant to a mixture depended on olfactory receptor neuron type, composition of the mixture, and which compound was added. In some cases the added excitatory compound had no effect or even decreased the mixture's response intensity, thus demonstrating nonlinear contributions of the components. Response intensities predicted by a noncompetitive model, which is most representative of these olfactory receptor neurons, were improved when the model included a term for empirical measurements of inhibitory binding interactions, suggesting that inhibitory binding interactions are one mechanism contributing to mixture suppression. This model's predictions were accurate for binary mixtures but not for larger mixtures, suggesting that additional inhibitory mechanisms are needed to account for mixture interactions in complex mixtures.


Chemical shift assignments of zinc finger domain of methionine aminopeptidase 1 (MetAP1) from Homo sapiens.
Methionine aminopeptidase Type I (MetAP1) cleaves the initiator methionine from about 70 % of all newly synthesized proteins in almost every living cell. Human MetAP1 is a two domain protein with a zinc finger on the N-terminus and a catalytic domain on the C-terminus. Here, we report the chemical shift assignments of the amino terminal zinc binding domain (ZBD) (1-83 residues) of the human MetAP1 derived by using advanced NMR spectroscopic methods. We were able to assign the chemical shifts of ZBD of MetAP1 nearly complete, which reveal two helical fragments involving residues P44-L49 (α1) and Q59-K82 (α2). The protein structure unfolds upon complex formation with the addition of 2 M excess EDTA, indicated by the appearance of amide resonances in the random coil chemical shift region of (15)NHSQC spectrum.


Electron spectroscopic tomography of specific chromatin domains.
The eukaryotic genome is packaged within the nucleus as poly-nucleosome 10 nm chromatin fibres. The nucleosome core particle, the fundamental chromatin subunit, consists of a DNA molecule wrapped around a histone octamer. Biochemical modifications of both the DNA and histone proteins have been characterized that influence chromatin structure and function. These modifications include DNA methylation, histone variants and posttranslational modifications of the core histone protein tails. An outstanding area for investigation in the field of nuclear cell biology is the characterization of the functional relation between these biochemical modifications and the underlying chromatin structure and nuclear sub-compartmentalization. Electron spectroscopic tomography is a high-resolution microscopy technique that facilitates visualization of individual 10 nm chromatin fibres in three dimensions. The method, therefore, has a role to play in exploring the relationships of the epigenome and nuclear organization. Correlating immunofluorescence microscopy with electron spectroscopic tomography provides a powerful approach to relate epigenetic marks with high resolution chromatin organization.


Chemoembolization and other ablative therapies for liver metastases of gastrointestinal endocrine tumours.
Hepatic metastases are frequent in patients with gastroentero-pancreatic (GEP) endocrine tumours; their presence significantly influences overall prognosis. Surgery, although the treatment of choice for hepatic metastases, is frequently impossible due to disease extent. Systemic chemotherapy in patients with diffuse and/or progressive liver metastases yields disappointing results especially in patients with metastases from midgut origin. In addition, in patients with carcinoid syndrome, the efficacy of somatostatin analogues wanes due to disease progression and development of tachyphylaxis. Locoregional strategies with vascular occlusion inducing ischemia in these highly vascular GEP tumours are indeed other options and may be performed using either surgical or radiological techniques (e.g. surgical ligation of the hepatic artery, transient hepatic ischemia, or sequential hepatic arterialization). Trans-catheter arterial chemoembolization is efficacious in both the control of hormonal symptoms and yields reliable objective tumour responses. Treatments aimed at regional destruction either alone or in combination with surgery include radiofrequency ablation and cryotherapy and may also be considered in certain circumstances.


A QbD-led simple and sensitive RP-UHPLC method for simultaneous determination of moxifloxacin, voriconazole, and pirfenidone: An application to pharmaceutical analysis.
A novel, quick and precise RP-UHPLC analytical method for the simultaneous determination of moxifloxacin (MFX), voriconazole (VCZ) and pirfenidone (PIR) was developed and validated according to the International Conference on Harmonization guidelines using a QbD-driven response surface Box-Behnken design. The developed method was validated considering the selectivity, sensitivity, linearity, accuracy-precision, robustness, stability, limit of detection and limit of quantification, respectively. Resolution between MFX, VCZ and PIR was achieved using a gradient elution protocol against a Waters Symmetry Shield C18 column (150 × 4.6 mm2 , 5 μm) using an Agilent 1290, Infinity II series LC system. The method was applied to quantitatively estimate proprietary and in-house prepared pharmaceutical topical ophthalmic formulations containing MFX, VCZ and PIR at wavelength (λmax ) of 296, 260 and 316 nm. The method is sensitive enough to detect up to 0.1 ppm of analytes in the formulation. The method was further exploited to study and identify the possible degradation products of the analytes. The proposed chromatographic method is simple, economical, reliable and reproducible. In conclusion, the developed method could be applicable for routine quality control analysis of single or combined MFX, VCZ and PIR-containing units or bulk dosage forms in pharmaceutical industries and research organizations working on drug discovery and development.


Lyotropic liquid crystal behavior of carboxylated cellulose nanocrystals.
In this work, the lyotropic liquid crystal (LC) behavior of carboxylated cellulose nanocrystals (CNs) has been studied for cotton cellulose prepared by TEMPO-mediated oxidation of cellulose nanocrystals (TOCNs). It is found that suspensions of TOCNs at a critical concentration of 4.1wt% form anisotropic phase with clear optical birefringence. Furthermore, fingerprint texture is clearly observed when the concentration is 9.0wt% under a polarizing optical microscope. Fingerprint texture is characteristic of chiral nematic liquid crystal (N*-LC) phase. The band-spacing corresponds to half the helical pitch, and thus, the helical pitch of N*-LCs (9.0wt%) is about 6.0μm. The degree of oxidation (DO) and zeta potential of TOCNs in suspension are 0.15 and -59.5mV, respectively. Relatively larger aspect ratio and higher surface charges density of TOCNs make the critical concentration of LC formation decreased and the helical pitch increased compared to that of the LC prepared by H2SO4 hydrolysis system. The interparticle electrostatic repulsion between CNs with different surface charges influence the helical pitch of N*-LCs.


Regulating riparian forests for aquatic productivity in the Pacific Northwest, USA: addressing a paradox.
Forested riparian buffers isolate streams from the influence of harvesting operations that can lead to water temperature increases. Only forest cover between the sun and stream limits stream warming, but that cover also reduces in-stream photosynthesis, aquatic insect production, and fish productivity. Water temperature increases that occur as streams flow through canopy openings decrease rapidly downstream, in as little as 150 m. Limiting management options in riparian forests restricts maintenance and optimization of various buffer contributions to beneficial uses, including forest products, fish, and their food supply. Some riparian disturbance, especially along cold streams, appears to benefit fish productivity. Options for enhancing environmental investments in buffers should include flexibility in application of water quality standards to address the general biological needs of fish and temporary nature of clearing induced warming. Local prescriptions for optimizing riparian buffers and practices that address long-term habitat needs deserve attention. Options and incentives are needed to entice landowners to actively manage for desirable riparian forest conditions.


Expression of integrin subunits in the human infant breast correlates with morphogenesis and differentiation.
Integrins are widely expressed on normal tissues and their function is considered critical directly or indirectly with the control of cell growth and differentiation. Also, they are likely to play a crucial role in cell-matrix interactions during development. As the human breast develops after birth, it provides a rare opportunity in which to study human organogenesis. We have examined the distribution of integrins in the human infant breast with the aim of elucidating the possible role of these molecules in morphogenesis and differentiation. Necropsy breast specimens from six male and eight female infants, ranging in age from 1 day to 9 months, were used in this study. Cryostat sections were stained by the avidin-biotin complex technique, using a panel of monoclonal antibodies (MAbs) which recognize beta 1, alpha 2, alpha 6, beta 4, alpha v, and alpha v beta 3 integrin chains, which are candidate molecules for a role in mammory morphogenesis. MAbs to beta 1 (DH12) and alpha 2 (HAS3) showed positive membrane and cytoplasmic staining of basal cells and luminal epithelial cells. In addition, positive staining for the beta 1 integrin chain was found on fibroblasts. A MAb which recognizes the alpha 6 chain (MP4F10) showed positive staining of the basal cells and heterogeneous staining of the luminal epithelial cells, whilst beta 4 chain (439-9B) showed positive staining in the basement membrane domain of the basal cells with no staining of the luminal epithelial cells. There was a positive correlation between the intensity of expression and the structural development of the ductal system, with integrin expression reduced or absent in the end buds and lateral buds.(ABSTRACT TRUNCATED AT 250 WORDS)


Percutaneous Axillary Artery Access for Peripheral and Complex Endovascular Interventions: Clinical Outcomes and Cost Benefits.
The aim of this study was to determine the safety, efficacy, and applicability of percutaneous axillary artery (pAxA) access in patients requiring upper extremity large sheath access during complex aortic, cardiac, and peripheral endovascular procedures. We also take this opportunity to address the potential cost-benefits offered by pAxA access compared to open upper extremity access. A total of 26 consecutive patients, between June 2018 and October 2020, underwent endovascular intervention, requiring upper extremity access (UEA). Ultrasound-guided, percutaneous access of the axillary artery was used in all 26 patients with off-label use of pre-close technique with Perclose ProGlide closure devices. Access sites accommodated sheath sizes that ranged from 6 to 14 French (F). End points were technical success and access site-related complications including isolated neuropathies, hematoma, distal embolization, access-site thrombosis, and post-operative bleeding requiring secondary interventions. Technical success was defined as successful arterial closure intraoperatively with no evidence of stenosis, occlusion, or persistent bleeding, requiring additional intervention. Of the 26 patients requiring pAxA access, 15 underwent complex endovascular aortic aneurysm repairs (EVAR) with branched, fenestrated, snorkel, or parallel endografts, 6 underwent peripheral vascular interventions, and 5 underwent cardiac interventions. Fifty-three percent accommodated sheath sizes of 12F or higher. Technical success was achieved in 100% of cases with no major perioperative access complications requiring additional open or endovascular procedures. In our series, we had one post-operative mortality secondary to myocardial infarction in a patient with significant coronary artery disease. Our data again demonstrated the proposed safety and efficacy attributable to pAxA access, while extending its application to wide spectrum of endovascular interventions which included peripheral or coronary vascular in addition to complex EVAR.


Retinoic acid induces gene expression of fibroblast growth factor-9 during induction of neuronal differentiation of mouse embryonal carcinoma P19 cells.
We have found that the gene expression of the ninth member of the fibroblast growth factor (FGF) family, FGF9 was induced during retinoic acid(RA)-induced neuronal differentiation of murine embryonal carcinoma P19 cells. We have reported here the nucleotide sequence of the mouse FGF9 cDNA. The murine cDNA showed 92.4% nucleotide sequence homology to the human FGF9 cDNA and 98.2% homology to that of rats. This mouse FGF9 cDNA encoded a polypeptide consisting of 208 amino acids with amino acid sequence identical to that of rats. Only one amino acid was replaced compared to the human homolog. The highly conserved sequence homology of FGF9 suggests its functional importance. FGF9 was originally isolated from a culture medium of a human glioma cell line as a growth-promoting factor for glial cells [5]. Upon induction of neuronal differentiation by forming cell aggregates with 10(-6) M RA, the gene expression of FGF9 was increased biphasically during the first 96 hours when cells were aggregating and from 168 hours to 192 hours followed by plating onto a tissue culture dish as glia-like cells proliferated. Neither undifferentiated P19 cells nor the cells aggregated without RA remaining undifferentiated expressed FGF9. This indicates that RA regulates the gene expression of FGF9 that may play an important role in neuronal differentiation in both early and late developmental process.


Tyrosine 729 of the G-CSF receptor controls the duration of receptor signaling: involvement of SOCS3 and SOCS1.
Mutations in the granulocyte-colony stimulating factor receptor (G-CSF-R) gene resulting in carboxy terminal truncation have been associated with acute myeloid leukemia (AML). The truncated G-CSF-R from AML patients mediate enhanced and prolonged activation of signal transducer and activator of transcription 5 (Stat5). It has been shown that Src homology-2 (SH2)-containing tyrosine phosphatase-1 attenuates the intensity of G-CSF-induced Stat5 activation through interacting with the carboxy terminus of the G-CSF-R. Using a series of tyrosine-to-phenylalanine substitution mutants, we show here that tyrosine (Tyr) 729, located in the carboxy terminus of the G-CSF-R, controls the duration of G-CSF-stimulated activation of Stat5, Akt, and extracellular signal-regulated kinase 1/2. It is interesting that activation of these signaling molecules by G-CSF was prolonged by pretreating cells with actinomycin D or cyclohexamide, suggesting that de novo protein synthesis is required for appropriate termination of G-CSF-R signaling. The transcripts for suppressor of cytokine signaling 3 (SOCS3) and SOCS1 were up-regulated rapidly upon G-CSF stimulation. Expression of SOCS3 or SOCS1, but not SOCS2 and cytokine-inducible SH2 domain-containing protein, completely suppressed G-CSF-induced Stat5 activation but had only a weak effect on Stat5 activation mediated by the receptor mutant lacking Tyr 729. SOCS1 and SOCS3 also inhibited G-CSF-dependent cell proliferation, but the inhibitory effect of the two SOCS proteins on cell proliferation was diminished when Tyr 729 of the G-CSF-R was mutated. These data indicate that Tyr 729 of the G-CSF-R is required for SOCS1- and SOCS3-mediated negative regulation of G-CSF-R signaling and that the duration and intensity of G-CSF-induced Stat5 activation are regulated by two distinct mechanisms.


[Identification and characterization of a purple sulfur bacterium from mangrove with rhodopin as predominant carotenoid].
To exploit resources of purple sulfur bacteria in China and further investigate its response mechanism to ecological environment of mangrove. Repeated agar shake dilution method, microscope techniques, UV-Vis absorption spectra, thin layer chromatography, HPLC and MS were used. We isolated a purple sulfur bacterium, designated as strain YL28, from a intertidal sediment sample collected from inshore mangrove near Luoyang Bridge of Quanzhou city, Fujian Province of China. Cells were ovoid to rod shaped, 0.5 microm - 1 microm x 2 microm - 3 microm. Color of cell suspensions was reddish-brown. It possessed vesicular intracytoplasmic membrane structures, contained rhodopin and phytylated bacteriochlorophyll a as well as the other two novel bacteriochlorophyll a intermediates. The optimum growth was at 2% - 3.5% NaCl, pH 5.7 - 6.7 and 20 degrees C - 35 degrees C. Photoautotrophically growth anaerobically in the light with sulphide, sulphur, thiosulfate, sulfite as electron donor. Globules of S(0) distributed inside the cells. Photoheterotrophic growth with various organic substrates, especially citrate, glucose, sucrose, fructose and propanol in the presence of sulfide. Nitrogen sources: ammonium salts, N2, urea, glutamate, nitrate and nitrite. Vitamins were not required. Qualitative assessment of IC50 values of chloromycetin, cefazolin, benzene, hydroxy biphenyl, enrofloxacin, acetamiprid, mercuric chloride and cadmium chloride were 70, 100, 20, 20, 3, 170, 5 mg/L and 25 mg/L, respectively. Based on phenotype characteristics and 16S rRNA gene sequence similarity of 99% to M. gracile, strain YL28 was identified as novel isolate of M. gracile despite its different physiological characteristics with respect to the species of M. gracile. The organism is possessed of slightly acid tolerance, higher amount of carotenoid of rhodopin and tolerance towards certain antibiotics, pesticide as well as heavy metals.


[Evolution of the omnivorous dentition].
Authors deal with the evolution of the omnivorous dentition, specially concerning the "changes" determined in men by different functions.


De novo synthesis of phospholipids is coupled with autophagosome formation.
Autophagy, the process involved in the breakdown of intracellular proteins and organelles, has become an area of great importance in both cell survival and cell death. Despite the abundance of information on this topic, persisting issues remain about the origin and mechanism of formation of the autophagosomal membrane. The endoplasmic reticulum (ER) plays a critical role in the initiation of autophagy, especially in the formation of early lipid particles, termed the phagophores or the isolation membranes. The bulk, if not all of the lipid biosynthetic pathways cease at the level of the ER where the main synthesizing enzymes are resident proteins. We postulate that if the initial isolation membrane is formed from the locally synthesized lipids at the level of the ER, than an increase in the biosynthesis of the bilayer-forming phospholipids (phosphatidylcholine-PC, phosphatidylethanolamine-PE, and phosphatidylserine-PS) would occur simultaneously with induction of autophagy. As part of the isolation membranes, PE conjugates the cytosolic microtubule-associated protein 1 light chain 3 (LC3-I), to form LC3-II, the selective autophagosomal protein. Phosphatidylinositol-3-kinase (PI3K) action on the ER phosphatidylinositol occurs with phospholipid biogenesis, and together they act to contribute to the elongation and assembly of the autophagosomal particle.


Inhibition of Notch 1 receptor influenced the differentiation of Lin-CD45RA-dendritic cell precursors within ovarian carcinoma microenvironment.
Previous evidence suggested that the differentiation of Lin-CD45RA-DC precursors were prior to plasmcytoid dendritic cells (pDCs) than myeloid dendritic cells (mDCs) within ovarian cancer microenvironment. However, the mechanism is still unclear. Therefore, we investigated the function of Notch 1 signal pathway in the differentiation of Lin-CD45RA-DC precursors. The CD34+ hematopoietic stem cells were extracted from umbilical cord blood in term parturition, and Lin-CD45RA-DC precusors were separated and induced mature. Expression of Notch1 receptor and ligands in Lin-CD45RA-DC precusors was detected by Real-time PCR and was down-regulated by shRNA or γ-secretase inhibitor (GSI). Flow cytometry was used to analyze the subset of DCs with or without SKOV3 culture supernatants. IL-12 level was detected by ELISA. Expression of Notch1 receptors and ligands were detected in Lin-CD45RA-DC precursor cells. The Notch1 mRNA in Lin-CD45RA-DC precursors can be down-regulated by shRNA-Notch1 lentivirus transfection and GSI. ShRNA mediated Notch 1 knock-down significantly differentiated less plasmcytoid dendritic cells (pDCs), but generated more myeloid dendritic cells (mDCs), and this would not be influenced by the supernatant of the ovarian carcinoma cell line. GSI had the same effect in the differentiation of pDC. The secretion of IL-12 significantly increased after Notch1 knock-down with or without SKOV3 culture supernatants. Notch1 is an important signaling pathway in the differentiation of Lin-CD45RA-DC precursor cells to plasmcytoid dendritic cells (pDCs). And this would not be affected by the supernatant of the ovarian carcinoma cell line.


Adult attention-deficit/hyperactivity disorder is associated with reduced norepinephrine transporter availability in right attention networks: a (S,S)-O-[11C]methylreboxetine positron emission tomography study.
The norepinephrine transporter (NET) has been suggested to play a critical role in attention-deficit/hyperactivity disorder (ADHD). In this prospective controlled study we tested the a-priori-hypothesis that central NET availability is altered in adult ADHD patients compared to healthy controls. Study participants underwent single positron emission tomography-magnetic resonance imaging (PET-MRI). MRI sequences included high resolution T1-MPRAGE data for regions of interest (ROI) delineation and voxel-based morphometry (VBM) and T2-weighted fluid-attenuated inversion-recovery for detection and exclusion of pathological abnormalities. NET availability was assessed by NET-selective (S,S)-O-[11C]methylreboxetine; regional distribution volume ratios (DVR) were calculated based on individual PET-MRI data co-registration and a multi-linear reference tissue model with two constraints (MRTM2; reference region: occipital cortex). VBM analysis revealed no difference in local distribution of gray matter between the 20 ADHD patients (9 females, age 31.8 ± 7.9 years, 488 ± 8 MBq injected activity) and the 20 age-matched and sex-matched control participants (9 females, age 32.3 ± 7.9 years, 472 ± 72 MBq). In mixed-model repeated-measures analysis with NET availability as dependent and ROI as repeated measure we found a significant main effect group in fronto-parietal-thalamic-cerebellar regions (regions on the right: F1,25 = 12.30, p = .002; regions on the left: F1,41 = 6.80, p = .013) indicating a reduced NET availability in ADHD patients. None of the other investigated brain regions yielded significant differences in NET availability between groups after applying a Benjamini-Hochberg correction at a significance level of 0.05. Overall our findings demonstrate the pathophysiological involvement of NET availability in adult ADHD.


Psychosocial and neurocognitive functioning in unipolar and bipolar depression: a 12-month prospective study.
Previous studies have revealed psychosocial and cognitive impairments in patients during unipolar and bipolar depression, which persist even in subsyndromal and euthymic states. Currently, little is known about the nature and the extent of psychosocial and cognitive deficits during depression. The aim of the present study was to characterize psychosocial and cognitive profiles among unipolar (MDD) and bipolar (BD) patients during a major depressive episode and to compare the profiles of the patient groups. Depressed patients with MDD (n=13) and BD (n=11) were followed over a period of 12 months. Clinical, psychosocial and neuropsychological assessments were conducted at baseline and at 6-week, 4-month, 8-month and 12-month follow-ups. In the case of severe mood disorders, psychosocial and neurocognitive functioning seem similar among MDD and BD patients during a depressive episode. All MDD and BD patients had global psychosocial dysfunction, characterized by occupational and relational impairments. Furthermore, the neurocognitive profile was heterogeneous with regard to the nature and extent of cognitive deficits but attentional processes were frequently compromised. After 1 year of treatment, occupational and relational impairments, as well as neurocognitive dysfunction, persisted sufficiently to alter daily functioning.


Effects of Radix aconiti lateralis preparata and Rhizoma zingiberis on energy metabolism and expression of the genes related to metabolism in rats.
To study the influence of Radix aconiti lateralis preparata and Rhizoma zingiberis, two species of Chinese medicinal herbs with hot property, on energy metabolism and gene expression spectrum, and to analyze the possible mechanism of their effects. Forty-eight specific pathogen free Wistar rats were randomly divided into a Radix aconiti lateralis preparata group, a Rhizoma zingiberis group, and a control group. They were intragastrically treated with concentrated decoction of Radix aconiti lateralis preparata, Rhizoma zingiberis and normal saline respectively for 20 days. Toe temperature (TT), energy intake (EI), digestible energy (DE), and metabolizable energy (ME) were measured. The content of adenosine triphosphate (ATP) and energy charge (EC) in hepatic tissue were measured with high performance liquid chromatography (HPLC). The activity of ATPase and succinate dehydrogenase (SDH) in the liver were detected with chemical colorimetry. The gene expression in the liver was detected with Illumina's rat Ref-12 gene array. The differential expression genes were selected, annotated and classified based on Gene Ontology (GO). Real-time quantitative reverse-transcriptase PCR (Q-RT-PCR) was used to test the accuracy of results. Compared with the control group, the TT on the 10(th) day after the beginning of administration and ATP in the Radix aconiti lateralis preparata and Rhizoma zingiberis groups increased significantly (P<0.05). EI/body mass (BM), DE/BM, ME/BM, the hepatic EC and the activity of Na(+)-K(+)-ATPase, Ca(2+)-Mg(2+)-ATPase and SDH of liver increased significantly only in the Radix aconiti lateralis preparata group (P<0.05). There were 592 differential expression genes in the Radix aconiti lateralis preparata group and 1 159 in the Rhizoma zingiberis group compared with the control group. Among the differential expression genes, genes related to metabolic processes were the most significant based on GO analysis. There were 337 strips of gene differential expression in common in both Radix aconiti lateralis preparata and Rhizoma zingiberis groups compared with the control group. Herbs with hot property such as Radix aconiti lateralis preparata and Rhizoma zingiberis could improve the energy metabolism in rats, through influencing the metabolic process of sugar, lipid, and amino acid. It could also promote the production, storage, and utilization of energy by regulating the gene expression related to metabolism, which may be the main molecular mechanism of warming yang and dispelling cold for the treatment of the cold syndrome according to Chinese medicine theory.


Counseling Latina mothers of preschool children about weight issues: suggestions for a new framework.
To assess Latina mothers' health beliefs and attitudes regarding early childhood weight issues and to use the information to update current nutrition education methods. Data were collected in eight focus group sessions using a semistructured questionnaire. Forty-three Latina mothers (and grandmothers) with children aged 2 to 5 years were recruited at five different Special Supplemental Nutrition Program for Women, Infants, and Children sites in California. Transcripts of focus groups were imported into QSR NUD*IST software, facilitating in-depth iterative analysis of emergent themes. Fifteen emergent themes were identified and organized into four functional domains relevant to nutrition education: health beliefs surrounding weight, impact and cause of overweight, life values and concerns, and strategies for making changes in children's eating and activity patterns. Information from this qualitative study demonstrates that the traditional nutrition counseling paradigm may not be effective with Latina mothers. In addition, cultural beliefs can be barriers to successful prevention and treatment of overweight. To ensure that culturally competent services are provided, educators must be prepared to adjust education approaches according to the cultural background of the clients. Key among the issues was mothers' difficulty acknowledging overweight among their children and their perception that health and weight were poorly associated. Certain cultural values were identified as barriers to adopting healthful behaviors. Mothers were able to identify specific ways in which nutrition education could be improved. Our findings suggest that nutrition education efforts targeting Latina mothers of young children can be reframed to better address the belief system and cultural framework of the population, like identifying positive eating behaviors rather than focusing on a child's weight.


Congenital coronary arteriovenous fistula: a diagnostic challenge.
This report describes a case of coronary arteriovenous (A-V) fistula involving both the right and the left coronary arteries. The venous component of the two circulations combines into a single channel that empties into the left ventricle just below the mitral valve.


Alcohol and nicotine co-Administration during pregnancy and lactation periods alters sensory discrimination of adult NMRI mice offspring.
The present study investigated the impacts of alcohol, nicotine, and their co-administration during pregnancy and lactation on sensory information processing including visual, tactile, and auditory discrimination in adult NMRI mice offspring. Pregnant mice were injected with saline or 20% alcohol (3 g/kg), or nicotine (1 mg/kg) or their co-administration alcohol+nicotine, intraperitoneally until the end of lactation. The offspring were separated from their mothers after lactation period on postnatal day (PND) 28. The locomotor activity, novel object recognition-dependent on visual system (NOR-VS), novel texture discrimination- dependent on somatosensory system (NTR-SS), and acoustic startle reflex were evaluated in PND90. The results revealed no statistical significance for locomotor activity of alcohol, nicotine, and co-administration alcohol+nicotine groups compared to the saline group in the open field task. The results, however, showed a significant decline in the ability of novel object discrimination in the nicotine and co-administration alcohol + nicotine groups compared to the saline group (P < 0.05) in the NOR-VS task. In the NTR-SS and acoustic startle reflex tasks, texture discrimination and the prepulse inhibition abilities in the offspring administered with nicotine and alcohol alone were reduced when compared to the saline group. Also, co-administration of alcohol+nicotine groups showed a decline in the aforementioned tests compared to the saline group (P <0.05). Administration of alcohol and nicotine during fetal and postpartum development disrupts sensory processing of inputs of visual, tactile, and auditory systems in adult mice.


Crateva adansonii DC, an African ethnomedicinal plant, exerts cytotoxicity in vitro and prevents experimental mammary tumorigenesis in vivo.
Crateva adansonii DC is a plant traditionally used in Cameroon to treat constipation, asthma, snakebites, postmenopausal complaints and cancers. The anticancer potential of the dichloromethane/methanol extract of C. adansonii stem barks was investigated using human breast cancer cell and 7,12 dimethylbenz(a)anththracene (DMBA)-induced mammary tumorigenesis model in rats. The cytotoxicity of C. adansonii extract was assessed in vitro towards breast carcinoma (MCF-7 and MDA-MB-231) and non-tumoral cell lines (NIH/3T3 and HUVEC) by Alamar Blue assay. Furthermore, in vivo studies were performed on female Wistar rats treated either with C. adansonii extract at a dose of 75 or 300mg/kg body weight or with tamoxifen (3.3mg/kg body weight), starting 1 week prior DMBA treatment and lasted 12 weeks. The investigation focused on tumour burden, tumour DNA fingerprint, morphological, histological, hematological, and biochemical parameters. CC50 values for the in vitro assays were 289µg/mL against MCF-7 cells and >500µg/mL in others cells, leading to a selectivity index ≥1.73. C. adansonii extract significantly (p<0.001) revealed in vivo the reduction of the cumulative tumour yield (87.23%), total tumour burden (88.64%), average tumour weight (71.11%) and tumour volume (78.07%) at the dose of 75mg/kg as compared to DMBA control group. A weak effect was also observed at 300mg/kg. This extract showed a moderate hyperplasia at the dose of 75mg/kg while at 300mg/kg no significant change was noted as compared to DMBA group. It protected rats from the DNA alteration induced by DMBA and increased antioxydant enzymes activities in mammary gland tissue homogenates. In addition, Ultra-High Performance Liquid Chromatography/ESI-QTOF-Mass Spectrometry analysis of C. adansonii extract detected structure-related of many well-known anticancer agents such as flavane gallate, flavonol, phenylpropanoïds, sesquiterpene derivatives, gallotannins and lignans. The LD50 of C. adansonii was estimated to be greater than 5000mg/kg. These aforementioned results suggest that the C. adansonii extract may possess antitumor constituents, which could combat breast cancer and prevent chemically-induced breast cancer in rats.


Surgical skills training restructured for the 21st century.
Few if any medical schools have a comprehensive surgical skills program taking medical students from learning basic knot tying and surgical skills to performing these skills at a level adequate for function during a primary care, surgical, or subspecialty residency. We have designed and continue to refine a program, which consists of five workshops focused on basic surgical skills, which are applicable to all medical and surgical disciplines. During the first workshop students learn how to tie both one- and two-handed surgical knots. The second workshop involves teaching students differences in suture type and use, instrument handling, and suturing techniques. The third workshop is used to address problems and refine techniques previously learned in the first two sessions. The fourth workshop comprises a final examination to evaluate suture and knot tying skills. The fifth session is a voluntary knot tying and suturing competition with awards for speed, finesse, aesthetics, and the watertightness of a vascular surgical repair. Surgical faculty and house staff are present at each workshop to provide direction and constructive criticism. Fifty-seven third-year medical students have completed the surgical skills curriculum. Statistical analysis demonstrates significant improvement in both knot tying and suturing (P < 0.05) for these students. Forty-four percent of students have successfully sewn a watertight anastomosis. We hypothesize that this curriculum will produce medical students with basic surgical skills, appreciation of surgical technique, and the confidence to perform basic surgical skills at completion of the curriculum.


Technology-aided programs for assisting communication and leisure engagement of persons with amyotrophic lateral sclerosis: two single-case studies.
Technology-aided programs for assisting communication and leisure engagement were assessed in single-case studies involving two men with amyotrophic lateral sclerosis (ALS). Study I involved a 51-year-old man with a virtually total loss of his motor repertoire and assessed a technology-aided program aimed at enabling him to (a) write and send out text messages and have incoming messages read to him and (b) establish videophone connections with his children (i.e., establish video contact and communicate with them). Study II involved a 66-year-old man with virtually no motor behavior and apparent depression and assessed a technology-aided program aimed at enabling him to (a) engage in leisure activities and make requests for basic needs and (b) use a low-demand messaging system. The results of both studies were highly encouraging. The participant of Study I could use the technology-aided program for effective communication and social interaction with multiple partners as well as for family interaction. The participant of Study II could use the technology-aided program for leisure engagement, requests, and basic family contacts/communication. The implications of technology for helping persons with severe ALS levels maintain an active and constructive role are discussed.


[Is there a hepatogenic ulcer? Prospective study of the incidence of peptic ulcer in portal hypertension].
During a 7 years study, the endoscopically determined prevalence and incidence of peptic gastroduodenal ulcer in 305 patients with portal hypertension (72% alcoholic cirrhosis, 21.3% non-alcoholic cirrhosis, 6.7% non-cirrhotic portal hypertension) were 4.3% and 3.9% per year, respectively. The yearly risk per patient of suffering from peptic ulcer was 7.4% if both, first and recurrent ulcers (total: 49) were considered. No association was disclosed of peptic ulcer with sex, age, etiology or severity of liver disease. Although an adequate control group was not yet available for comparison, the data do not support the previously postulated relationship between liver cirrhosis and peptic ulcer.


Molecular taxonomy and biodiversity of rock fungal communities in an urban environment (Vienna, Austria).
The diversity of fungal communities on three different historical monuments in the city of Vienna (Austria) was analyzed and compared to the fungal diversity of microfungi on rock in the original quarry located in a rural area (Zogelsdorf, Austria). The fungal strains isolated were characterized by morphology and the complete rock fungal community was identified based on molecular data, that is, by sequencing parts of the small ribosomal subunit (18S) and internal transcribed spacer region 1 (ITS1). The genera Coniothyrium, Epicoccum and Phoma were found to be dominant on monument and rock surfaces. Additionally, black yeasts such as Exophiala species and microcolonial fungi like Sarcinomyces and Coniosporium which hitherto were regarded as typical rock inhabitants in semi-arid environments are frequently found on all rock surfaces in Vienna. The biodiversity of the fungi in the urban environment was much higher than on the same rock type in a rural environment, this difference can be attributed to the elevated organic pollution in the city.


Stereological study of the zona fasciculata of the adrenal cortex in stress situations (hypothermia, catabolism).
The ultrastructure of the rat fasciculata cells in stress situations, such as catabolism and hypothermia was compared descriptively and quantitatively by stereological methods with that of the nonstimulated rat fasciculata cell. The volume and surface densities are expressed per cm3 of cytoplasm, mitochondria and smooth endoplasmic reticulum. Furthermore, absolute values are given. In both stress situations the volume density of the mitochondria compared to the controls is enlarged significantly (H: 37% CA: 50%). The significant increase of the average single mitochondrium of the fasciculata cell (H: 58% CA: 58%) shows a real growth of the mitochondria in these stress situations. Also the surface density of the mitochondrial inner membranes--the mitochondrial enzymes for steroid genesis are partly located in these membranes--shows a significant increase (H: 31%, CA: 84%). Whereas the volume density of the smooth endoplasmic reticulum remains unchanged, the surface density is significantly raised (H: 44%, CA: 60%). An attempt was made to draw up a relationship between stereological and known biochemical data of steroid genesis within the fasciculata cell. An activation in both stress situations could be observed. The stereological data reflect a subcellular reaction pattern, which is similar to exogenous ACTH administration, thus indicating an endogenous ACTH liberation due to these stress conditions.


Numerical analysis of water based CNTs flow of micropolar fluid through rotating frame.
In this article, the nanomaterial flow of micropolar fluid in rotating frame is considered. The SWCNT and MWCNT with base fluid namely pure water is also taken into account to analyze the flow behavior over stretching surface. Mathematical model have been constructed under the nanomaterial of micropolar fluid. The governing equations have been developed in the form of system of partial differential equations. The partial differential equations are transformed into ordinary differential equations using similarity transformations. The transformed system has been solved through MAPLE software. The physical parameters like as thermal slip effects, velocity slip effects and magnetic hydrodynamics on the micropolar nanofluid are presented by tables and graphs. Surprisingly in the rotating parameter, F''(0) and - θ'(0) increases for higher values of the rotating parameter while opposite to be noted for G''(0). The Nusselt number and skin friction increases for higher values of micropolar parameter but MWCNT achieves higher heat transfer as associated to SWCNT.


Crowd physiology: the 'penguin effect'.
The effects of heat retention on an individual in a crowd situation (the 'penguin effect') is introduced and described, with implications for the emergency services and the potential casualties themselves discussed. Management of anyone who collapses in the core of a crowd should involve much more than first-aid treatment for fainting. Some people may die from the effect.


Efficacy and Feasibility of Chhattisgarh Balloon and Conventional Condom Balloon Tamponade: A 2-Year Prospective Study.
To evaluate the clinical efficacy of two types of condom uterine balloon tamponade systems, namely Chhattisgarh condom balloon device "CG balloon (CGB)" having a central drainage channel as well as indigenous tying system to fasten condom to the catheter and conventional condom uterine balloon device (C-UBT) as a second-line intervention in post-partum haemorrhage (PPH). The present non-randomised prospective case series was carried out from December 2014 to September 2016 and included 60 women having PPH which was refractory to first-line management and who were treated with either of the two condom balloon tamponade devices prepared on spot. Women with allergy to latex, retained placenta, uterine rupture, anomaly, genital infection and/or malignancy were excluded. Case report forms were filled for all participants and analysed. Primary outcome was arrest of haemorrhage, and one of the secondary outcomes was cost and consistency of the devices. CGB was used in 46 and C-UBT in 14 women. The overall success rate was 98.33%. The mean blood loss was 1417 mL. Women of C-UBT group had greater blood loss, higher inflation volume and delays due to technical issues (OR 7.6). CGB was cheaper and more consistent than C-UBT by omitting the use of suture material. CGB and conventional condom balloon tamponade both are easy to use, feasible and efficacious for control of PPH, but CGB condom balloon device has the advantage of a central drainage lumen for real-time assessment of blood loss and therefore early corrective action.


Two roles of Ca2+ in agonist stimulated Ca2+ oscillations.
We propose a mechanism for agonist-stimulated Ca2+ oscillations that involves two roles for cytosolic Ca2+: (a) inhibition of inositol-1,4,5-trisphosphate (IP3) stimulated Ca2+ release from the endoplasmic reticulum (ER) and (b) stimulation of the production of IP3 through its action on phospholipase C (PLC), via a Gq protein related mechanism. Relying on quantitative experiments by Parker, I., and I. Ivorra (1990. Proc. Natl. Acad. Sci. USA. 87:260-264) on the inhibition of Ca2+ release from the ER using caged-IP3, we develop a kinetic model of inhibition that allows us to simulate closely their experiments. The model assumes that the ER IP3 receptor is a tetramer of independent subunits that can bind both Ca2+ and IP3. Upon incorporation of the action of Ca2+ on PLC that leads to production of IP3, we observe in-phase-oscillations of Ca2+ and IP3 at intermediate values of agonist stimulation. The oscillations occur on a time scale of 10-20 s, which is comparable to the time scale for inhibition in Xenopus oocytes. Analysis of the mechanism shows that Ca(2+)-inhibition of IP3-stimulated Ca2+ release from the ER is an essential step in the mechanism. We also find that the effect of Ca2+ on PLC can lead to an indirect increase of cytosolic Ca2+, superficially resembling "Ca(2+)-induced Ca(2+)-release." The mechanism that we propose appears to be consistent with recent experiments on REF52 cells by Harootunian, A. T., J. P. Y. Kao, S. Paranjape, and R. Y. Tsien. (1991. Science [Wash. DC]. 251:75-78.) and we propose additional experiments to help test its underlying assumptions.


A study of evening primrose seed oil in atopic asthma.
It has shown recently that Evening Primrose Oil (Efamol) produces a significant clinical improvement in atopic eczema. Efamol contains gamma-linolenic acid which is a precursor to PGE1 a more consistent bronchodilator than PGE2. We have conducted a double blind placebo controlled study in atopic asthmatics given Efamol for an eight week period looking at the control of asthma, including histamine challenge tests. We have found no effect on the asthma or challenge tests although Efamol produced an alteration in fatty acid profile. The patients showed an abnormal fatty acid profile. We speculate that such fatty acid abnormalities could be important in the aetiology of asthma.


Incidence of thyroid disorders in Connecticut.
A prospective study involving 1,544 patients who had annual physical examinations during a one-year period was conducted to determine the incidence of htyroid abnormalities in a practice of general internal medicine. A total of 5.8% abnormalities were found including nodular disease, thyroiditis, Graves' disease, hypothyroidism, simple goiter, and iatrogenic hyperthyroidism. No thyroid cancer was detected.


High performance aqueous zinc battery enabled by potassium ion stabilization.
Aqueous zinc ion batteries (AZIBs) are highly competitive in the energy storage systems due to their feature with operation safety and environmental friendliness. However, the sluggish diffusion kinetics of Zn2+ and inferior cathode circulation hinder their widespread application. Herein, we assemble a highly durable zinc ion battery by intercalating K+ into V2O5 nanolayers. The K+ pre-intercalation can buffer the lattice expansion of the electrode materials and reduce the internal stress. In addition, the stable K+ acts as a "pillar" to protect the layered structure of V2O5 materials from collapse during operation cycling. It delivers a reversible capacity of 479.8 mAh g-1 at 0.2 A g-1 and achieves excellent cyclic stability with a retention rate of 91.3% (10 A g-1) after 3000 cycles. The cell still maintains excellent specific capacity at high work temperature.


Tobacco amblyopia: the effect of treatment on the electroretinogram.
In seven recently diagnosed and untreated patients with tobacco amblyopia the light and dark adapted electroretionograms were recorded together with visual acuity, central fields and the Farnsworth-Munsell 100-Hue test. After 3 months treatment with injections of hydroxocobalamin all these tests were repeated. An improvement in visual acuity resulted in all cases. A significant reduction in the Farnsworth-Munsell total error score of the seven patients was noted (p less than 0.01). A significant increase in the amplitude of the light adapted b-wave of the ERG was found (0.01 less than p less than 0.02) following the course of hydroxocobalamin injections. No other significant changes in the ERG were demonstrated. It is suggested that the ERG changes demonstrated an improvement in an abnormal biochemical state in those bipolar and perhaps Müller cell of the inner nuclear layer of the retina which make electrophysiological connnections chiefly with foveal cones.


Polyvinyl alcohol film with chlorine dioxide microcapsules can be used for blueberry preservation by slow-release of chlorine dioxide gas.
Chlorine dioxide (ClO2) is a safe and efficient bactericide with unique advantages in reducing foodborne illnesses, inhibiting microbial growth, and maintaining the nutritional quality of food. However, gaseous ClO2 is sensitive to heat, vibration, and light, which limits its application. In this study, a ClO2 precursor-stabilized ClO2 aqueous solution was encapsulated by the double emulsion method, and a high-performance ClO2 self-releasing polyvinyl alcohol (PVA) film was prepared to investigate its performance and effect on blueberry quality during storage. The self-releasing films had the best overall performance when the microcapsule content was 10% as the film's mechanical properties, thermal stability, and film barrier properties were significantly improved. The inhibition rates of Listeria monocytogenes and Escherichia coli were 93.69% and 95.55%, respectively, and the mycelial growth of Staphylococcus griseus was successfully inhibited. The resulting ClO2 self-releasing films were used for blueberry preservation, and an experimental study found that the ClO2 self-releasing antimicrobial film group delayed the quality decline of blueberries. During the 14-day storage period, no mold contamination was observed in the ClO2 self-releasing film group, and blueberries in the antibacterial film group had higher anthocyanin accumulation during the storage period. Research analysis showed that films containing ClO2 microcapsules are promising materials for future fruit and vegetable packaging.


Drugs interacting with organic anion transporter-1 affect uptake of Tc-99m-mercaptoacetyl-triglycine (MAG3) in the human kidney: therapeutic drug interaction in Tc-99m-MAG3 diagnosis of renal function and possible application of Tc-99m-MAG3 for drug development.
Renal uptake of Tc-99m-MG3 involves organic anion transporter (OAT). Treatment with drugs showing OAT affinity might interfere with renal uptake of Tc-99m-MAG3, leading to misinterpretation in Tc-99m-MAG3. This study was conducted to discuss a possible drug interference with Tc-99m-MAG3 diagnosis on OAT sites. Renal uptake and plasma clearance of Tc-99m-MAG3 were analyzed in healthy volunteers under control and OAT1 and OAT3 related drug treatment conditions. An in vitro uptake study using OAT1 or OAT3 expressing cells was also conducted. Both PAH and probenecid treatment induced delays in Tc-99m-MAG3 clearance from blood, and reductions in the renal uptake clearance. As a result, the normalized effective renal plasma flow estimated from Tc-99m-MAG3 clearance was significantly underestimated, whereas the glomerular filtration rate estimated from plasma creatinine levels was unchanged. The transport activity of Tc-99m-MAG3 was higher in OAT1-expressing cells than in OAT3-expressing cells. Drugs with OAT1 affinity affect the renal uptake of Tc-99m-MAG3 and blood clearance. This might cause misinterpretation of functional diagnosis of the kidney using Tc-99m-MAG3.


Factors affecting the toxicity of rotting carcasses containing Clostridium botulinum type E.
Mice killed shortly after receiving c. 2000 spores of a type E strain of Clostridium botulinum per os were incubated at one of five chosen temperatures together with bottles of cooked meat medium seeded with a similar inoculum. After incubation the rotting carcasses were homogenized. Sterile membrane filtrates of the homogenates (10%, w/v) and pure cultures were then titrated for toxicity. Some of the main findings were confirmed with two further type E strains. Toxicity produced at 37 degrees C was poor in both carcasses and cultures (200-20,000 mouse intraperitoneal LD/g or ml). It was good in both systems at 30 and 23 degrees C, usually reaching 20,000-200,000 LD/g or ml, and in carcasses occasionally more; at 30 degrees C maximal toxicity was reached more quickly in carcasses than in cultures. Prolonged incubation (36-118 days) at 30 or 23 degrees C resulted in complete loss of toxicity in virtually all carcasses but not in cultures. At 16 degrees C the development of toxicity in carcasses was strikingly greater than in cultures. At 9 degrees C neither system produced more than slight toxicity after prolonged incubation. Trypsinization increased the toxicity of cultures but not usually of carcasses. Unfiltered carcass homogenate (10%, w/v) with maximal intraperitoneal toxicity was harmless for mice by mouth in doses of 0.25 ml. These findings differed in important respects from those made earlier with a type C strain.


Novel tissue-pressure sensing technology using a wide-band dielectric imaging system: An in vivo study.
A novel dielectric wide-band imaging system with tissue pressure (TP) technology provides real-time contact force (CF) monitoring using non-CF catheters. This study sought to investigate the feasibility, safety, and efficacy of ablation with TP technology. Eighty-five patients with supraventricular tachycardia (SVT) were ablated with real-time monitoring of CF by TP technology and compared with 85 patients who underwent ablation with a conventional non-TP approach. Baseline characteristics, procedural data, and TP data were analyzed in the study. Ablation applications in the TP group were then subdivided into good contact and poor contact groups according to the TP level for analysis. The TP group had a significantly shorter procedural time (16.2 ± 6.9 min vs. 19.9 ± 10.0 min, p = 0.033), shorter ablation time (334.6 ± 166.9 s vs. 391.3 ± 195.7 s, p = 0.049), and fewer mean numbers of radiofrequency catheter ablation (RFCA) deliveries (6.2 ± 3.2 vs. 7.6 ± 5.2, p = 0.047) than the non-TP group. The achieved average percentage of TP >3 g was significantly higher in the good-contact group (97.94% vs. 15.48%, p < 0.001). The median impedance decreases during RFCA in the good contact group and poor contact group were 4.10 (0.30-6.88) Ω and 2.60 (-0.05-4.98) Ω at 10 s, 4.45 (0.58-8.25) Ω and 2.88 (0.23-5.70) Ω at 20 s, and 4.67 (1.95-9.08) Ω and 2.97 (-0.26-6.33) Ω at 30 s, respectively (p < 0.05 for comparisons between categories). All patients achieved acute success, and no complications were observed. Two patients in the TP group and one patient in the non-TP group experienced recurrence during follow-up. TP-technology guided ablation of SVT is feasible, efficient, and safe.


A Ready-to-Use Purified Exosome Product for Volumetric Muscle Loss and Functional Recovery.
Large skeletal muscle defects owing to trauma or following tumor extirpation can result in substantial functional impairment. Purified exosomes are now available clinically and have been used for wound healing. The objective of this study was to evaluate the regenerative capacity of commercially available exosomes on an animal model of volumetric muscle loss (VML) and its potential translation to human muscle injury. An established VML rat model was used. In the in vitro experiment, rat myoblasts were isolated and cocultured with 5% purified exosome product (PEP) to validate uptake. Myoblast proliferation and migration was evaluated with increasing concentrations of PEP (2.5%, 5%, and 10%) in comparison with control media (F10) and myoblast growth medium (MGM). In the in vivo experiment, a lateral gastrocnemius-VML defect was made in the rat hindlimb. Animals were randomized into four experimental groups; defects were treated with surgery alone, fibrin sealant, fibrin sealant and PEP, or platelet-rich plasma (PRP). The groups were further randomized into four recovery time points (14, 28, 45, or 90 days). The isometric tetanic force (ITF), which was measured as a percentage of force compared with normal limb, was used for functional evaluation. Florescence microscopy confirmed that 5% PEP demonstrated cellular uptake ∼8-12 h. Compared with the control, myoblasts showed faster proliferation with PEP irrespective of concentration. PEP concentrations of 2.5% and 5% promoted myoblast migration faster compared with the control (<0.05). At 90 days postop, both the PEP and fibrin sealant and PRP groups showed greater ITF compared with control and fibrin sealant alone (<0.05). At 45 days postop, PEP with fibrin sealant had greater cellularity compared with control (<0.05). At 90 days postop, both PEP with fibrin sealant and the PRP-treated groups had greater cellularity compared with fibrin sealant and control (<0.05). PEP promoted myoblast proliferation and migration. When delivered to a wound with a fibrin sealant, PEP allowed for muscle regeneration producing greater functional recovery and more cellularity in vivo compared with untreated animals. PEP may promote muscle regeneration in cases of VML; further research is warranted to evaluate PEP for the treatment of clinical muscle defects.


Impacts of operating conditions on efficiency of electrokinetically enhanced filtration for de-watering of orange juice and malt extract.
The effects of operational factors an on an electrokinetic-enhanced filtration (EKEF) application to dewater orange juice (OJ) and malt extract (ME) was investigated. EKEF improved dewatering of both foodstuffs and resulted in net dewatering efficiencies of 7.4% and 4.9% for OJ and 10.7% and 6.3% for ME after 5.5 h processing under 30 V and 15 V, respectively. Dry matter content was increased by 19.2% and 15.6% for OJ after 5.5 h and 14.8% and 12.8% for ME after 3.5 h under 30 V and 15 V, respectively, compared with 14.9% and 10.3% under the control conditions for OJ and ME, respectively. The EKEF process effectively improved dewatering of high moisture-content foods with positive impacts on process efficiency by increased voltage, pressure, and the pore size of filters. The initial distance between electrodes had a negative impact as the distance increased. EKEF is a useful adjunct to improve high pressure filtration of foodstuffs.


Ehrlichiosis and Anaplasmosis: An Update.
Canine ehrlichiosis and anaplasmosis are zoonotic tick-borne diseases with broad distribution. Advances in diagnostics have enhanced our understanding of the species of rickettsial organisms involved, their expanding geographic distribution, and their impact on the health of dogs, cats, and people. While clinical remission can be achieved with appropriate antimicrobial therapy, optimal treatment modalities for the elimination of infection remain somewhat uncertain. Protection through vaccines for ehrlichiosis or anaplasmosis remains elusive. This review provides practicing veterinarians with the most current information about the transmission, diagnosis, and management of ehrlichiosis and anaplasmosis in dogs and cats.


Men Who Specifically Seek Unprotected Sex Partners via the Internet: Whose Profiles Are the Most Searched for by Other Site Users?
Men who have sex with men (MSM) account for the largest number of persons diagnosed with AIDS in the United States, with higher than-average rates of drug use and unprotected sex being cited as the principal reasons underlying their high rates of HIV infection. Recent evidence has suggested that the use of Web sites specifically designed to promote unsafe sexual practices may be particularly common among MSM, therebyfostering their risky behaviots. In light of these findings, the present study which compares HIV risk behaviors sought by men whose profiles are among the most frequently brought up in searches to those whose profiles ate not aspopular with other site users, is based on a content analysis of 1,316 ads/profiles posted on one of the most popular MSM Web sites that specifically fosters unprotected sex. Ads/profiles were selected randomly based on the American ZIP code of residence. Data were collected between September 2006 and January 2007. Rates of advertised-for high-risk sexual behaviots were very high both for men whose profiles were among the most popular and those whose profiles were not, particularly for oral sex involving ejaculation into the mouth, anal sex involving ejaculation into the anus, multiple partner sex, and fetching. Analytical comparisons of these groups showed that the most searched for profiles weæ thosepromoting the highest levels ofrisky behaviors and the greatest propensity toward wanting to engage in high-risk activities. Ihe HIV intenention-related implications of these findings are discussed.


LXR agonists: new potential therapeutic drug for neurodegenerative diseases.
Liver X receptors (LXRs) are nuclear receptors involved in the regulation of lipid metabolism and inflammatory responses in the central nervous system. Defects in cholesterol homeostasis contribute to the pathogenesis of neurodegenerative diseases, such as Alzheimer's disease, Parkinson's disease, multiple sclerosis, and Huntington's disease. Inflammatory responses could enhance the neurodegenerative process or act independently. The natural and synthetic LXR agonists induce the transcriptional activity of LXR target genes, thus attenuate the imbalance of cholesterol metabolism and overactivation of microglia and astrocytes in inflammation and are widely used in a variety of neurodegenerative diseases animal models. By developing more specific, potent, penetrable, and functional LXR agonist may lead to a better curative effect for neurodegenerative diseases and avoidance of potentially deleterious side effects. Here, we focus on recent advances in our understanding of the role of LXRs and their agonists in cholesterol homeostasis, inflammation, and the potential therapeutic effects in neurodegenerative diseases.


Symptoms of rhinosinusitis in patients with unexplained chronic fatigue or bodily pain: a pilot study.
Recent otolaryngologic studies document significant fatigue and bodily pain (BP) in patients with chronic rhinosinusitis. Studies of general medical patients are lacking. A case-control study of 297 consecutive general medical outpatients. Sixty-five patients noted unexplained chronic fatigue (UCF), 33 reported BP, and 26 had both. Compared with 232 patients without UCF, patients with UCF more frequently had the following rhinosinusitis symptoms: facial pressure (odds ratio [OR], 9.7; 95% confidence interval [CI], 5.2-18.2), heavy-headedness (OR, 21.9; 95% CI, 10.9-44.0), nasal obstruction (OR, 4.3; 95% CI, 2.3-7.9), frontal headache (OR, 13.6; 95% CI, 6.5-28.5), postnasal drip (OR, 2.8; 95% CI, 1.6-5.0), sore throat (OR, 3.1; 95% CI, 1.5-6.6), and tender cervical lymph nodes (OR, 9.2; 95% CI, 4.3-19.7). A similar predominance of rhinosinusitis symptoms was noted in patients with BP and in 15 patients with UCF who had chronic fatigue syndrome. No increased prevalence of pollen allergy was noted in association with UCF, BP, or chronic fatigue syndrome. Gastrointestinal, sleep, and psychiatric problems were similar between patients with UCF and 38 patients with explained fatigue. Rhinosinusitis symptoms, however, were more common in UCF. There is an increased prevalence of rhinosinusitis symptoms but not pollen allergy among general medical outpatients with UCF, BP, or both. Rhinosinusitis symptoms are at least as common as gastrointestinal complaints, sleep disturbance, and psychiatric problems (previously well documented complaints associated with UCF and BP). Rhinosinusitis symptoms, furthermore, are more common in UCF than in fatigue explained by a physical or mental illness.


Measuring stillbirth and perinatal mortality rates through household surveys: a population-based analysis using an integrated approach to data quality assessment and adjustment with 157 surveys from 53 countries.
In most low-income and middle-income countries (LMICs), national surveys are the main data source for stillbirths and perinatal mortality. Data quality issues such as under-reporting and misreporting have greatly limited the usefulness of such data. We aimed to enhance the use of mortality data in surveys by proposing data quality metrics and exploring adjustment procedures to obtain the best possible measure of perinatal mortality. We performed a population-based analysis of data from 157 demographic and health surveys (DHSs) from 1990 to 2020, with reproductive calendar and birth history data from 53 LMICs. Pregnancies terminated before 7 months' gestation were excluded. We examined data quality and compared survey values with reference values obtained from a literature review to assess misreporting of the age at early neonatal death, omission and transference of stillbirths, and very early neonatal deaths. Real cohort life-table rates of stillbirth, early neonatal, and perinatal mortality per 1000 births were calculated. The underlying risks of stillbirth and daily deaths were modelled using modified Gompertz-Makeham models. Data for 2 008 807 pregnancies of ≥7 months' gestational age were extracted from the reproductive calendar for the analysis period. Age heaping at day 7 occurred in most surveys. The median value for the heaping index of deaths at day 7 was 2·05 (IQR 1·36-2·87). The median ratio of stillbirths to deaths on days 0-1 was 1·15 (0·86-1·51). Of the 157 surveys, 23 (15%) were considered to have plausible ratios, 71 (45%) had probable ratios, and 63 (40%) had improbable ratios. The ratio of deaths on days 0-1 to deaths on days 2-6 varied considerably between surveys and 119 surveys (76%) had ratios of less than 2·4, indicative of under-reporting of very early neonatal deaths in most surveys. The fully adjusted model increased the median stillbirth rates from 12·2 (9·4-15·9) to 25·6 (18·0-33·4) per 1000 births, with a median relative increase of 95·0% (56·6-136·6). The median perinatal mortality rate also increased from 32·6 (23·6-38·3) to 44·8 (32·8-58·0) per 1000 births, with a median relative increase of 47·8% (6·9-61·0). A simultaneous focus on stillbirths and early neonatal mortality facilitates a comprehensive assessment of inaccurate reporting in household surveys and allows for better use of surveys in planning and monitoring of efforts to reduce stillbirths and early neonatal mortality. None.


Ureaplasma urealyticum and male infertility: an animal model: II. Morphologic changes of testicular tissue at light microscopic level and electron microscopic findings.
Testicular biopsies were obtained from Wistar rats that had been infected artificially with Ureaplasma urealyticum, serotype 3. Approximately 50% of the biopsy specimens obtained 3 and 6 months after infection showed degeneration of the germinal epithelium, giant cell formation and Leydig cell hyperplasia. Electron microscopic studies revealed striking alterations of Sertoli cells, germ cells, and Leydig cells as well as ureaplasma organisms inside the seminiferous tubules. The changes noted in the ertoli cells were apparent as early as one week after infection.


"Foam Cone" exuding from the mouth and nostrils following heroin overdose.
A "foam cone" exuding the mouth and nostrils is a recognized consequence of anoxia following pulmonary edema. In this report, we illustrate and explain this phenomenon in victims of heroin overdose.


[Prediction of the changes of immunological status and psychopathological data in HIV-infected schizophrenia patients].
To predict the immunological status in HIV-infected patients with schizophrenia based on a set of clinical and psychopathological characteristics of the endogenous process. The study included 28 patients with confirmed diagnosis of schizophrenia and HIV status. Authors used psychopathological method, along with psychometric scales (PANSS), in patients with schizophrenia and an immunological method for the determination of HIV-associated status and viral load. Affective syndromes with severe depressive symptoms, volitional impairment, high impulsivity and social features of autism can be prognostically favorable factors for the immune status of HIV-infected patients with schizophrenia that obviously indicates an acute psychotic state. Negative (deficit) symptoms were prognostically unfavorable for the immune status of HIV-infected patients with schizophrenia and for psychosis course. Favorable immune status corresponds to acute psychosis whereas the forms with severe deficit are associated with immunosuppression in HIV-infected patients.


Effect of radiographic abnormalities on rate of bone loss from the spine.
When measured by dual-photon absorptiometry (DPA), the adjusted annual rate of change in bone mineral density (BMD) of the lumbar spine was 0.11 +/- 0.51 (SE)% in 44 healthy postmenopausal women with radiographic abnormalities in the scan field and -0.97 +/- 0.26% in 249 women with normal lateral lumbar radiographs (p = 0.046). Rates of loss of BMD from the radius were similar in the 2 groups. Spurious rates of loss of spine BMD are likely to be found in subjects with calcification of the aorta, osteophytes or other abnormalities in the spine scan field. This should be kept in mind when serial spine scans are being considered in these subjects.


Impact of moderate-to-severe psoriasis on quality of life in China: a qualitative study.
Psoriasis is a serious health problem. Since limited research has investigated the impact of psoriasis on the quality of life of patients with moderate-to-severe psoriasis, this study aimed to explore this issue. A qualitative study was conducted with 22 psoriasis patients from two cities in Shandong province of eastern China participating in one-to-one semi-structured in-depth interviews. Thematic analysis generated five major themes: (1) Symptoms, symptoms management and pain; (2) Functioning and activities of daily living (ADLs); (3) Psychological impact; (4) Social impact; (5) Employment and finances. Our study detailed the effects of psoriasis on patients' symptoms, symptoms management and pain, functioning and activities of daily living (ADLs), psychological impact, social impact, employment and finances. These data can provide a reference for studying the quality of life in patients with psoriasis.


Intensive fattening of beef cattle by stall feeding on the Lilongwe Plain, Malawi. III. Comparative productivity of Malawi zebu and Friesian X Malawi zebu steers.
Beef fattening experiments were undertaken on the Lilonge Plain with Malawi zebu (Mz) and Friesian X Malawi zebu (F X Mz) steers. Animals were fattened under various dietary regimes based on either green forage crops or crop residues supplemented with concentrate rations of local origin. Mz steers consumed less feed and liveweight gain was approximately 75 per cent that of the F X Mz. Measurement of the efficiency parameters of feed conversion, gain and carcass yield per unit of liveweight revealed no significant differences between the two breed types. Slaughter observations indicated better fat distribution in the F X Mz and a significantly higher proportion of hindquarter. The significance of the results is discussed.


[Cutaneous hemangiomas and vascular malformations and associated pathology (Pascual-Castroviejo type II syndrome). Study of 41 patients].
To describe the clinical, diagnostic and therapeutic features of this angiomatous neurocutaneous syndrome, which is the most frequent one, and to report a personal series of 41 patients. Forty one patients--31 females and 10 males--were studied during childhood and then, several patients were followed during many years, which allowed us to learn about the evolution of the abnormalities. The cutaneous lesions were classified as hemangiomas in 30 patients (73%) and as vascular malformations in 11 patients (27%). A cerebellar anomaly (unilateral hemispheric hypoplasia and Dandy-Walker malformation) was seen in 13 patients (31.5%) cerebral cortical dysplasia in 4 patients (10%), aortic arch coarctation in 6 patients (15%), and congenital cardiopathy in 5 patients (12%). The most frequent abnormalities were intracranial and/or extracranial vascular malformations. Persistence of the trigeminal artery was observed in 7 patients (17%), absence or severe hypoplasia of an internal carotid artery in 13 patients (32%), absence of a vertebral artery in 7 patients (17%), hypoplasia of intracranial arteries in 6 patients (15%) and aneurysmal enlargement of carotid or vertebral arteries in 5 patients (12%). Also were observed 4 patients (10%) with intracranial hemangioma, 2 (5%) with hemangioma in mediastinum, and 3 (7.5%) with intestinal hemangioma, all of which disappeared during the first years of life. Aneurysmal enlargement of the carotid and vertebral arteries and intracranial branches also disappeared after a process of progressive narrowing of the arterial lumen that caused complete obstruction of these arteries. At the same time the cutaneous hemangioma regressed. During this process, collateral vascularization through branches of the external carotid artery and of the non-affected branches of the contralateral intracranial arteries developed. This neurocutaneous syndrome is the most frequent one and it is associated with several types of vascular and non-vascular abnormalities which can involve any organ of the body. Internal and external hemangiomas and hemangiomatous lesions progress and tend to regress concomitantly.


A template for change and response to work hour restrictions.
Surgical program directors are seeking how to best meet the work hour restrictions recently mandated by the American College of Graduate Medical Education. Implementation of an 80-hour work week forces major change to graduate medical education, especially surgical education. Creative restructuring of surgical training is necessary to ensure compliance. Developing an innovative solution to meet these requirements must consider programmatic needs, requiring commitment to a change process. The Department of Surgery at Eastern Virginia Medical School experienced a 5-month strategic planning process that generated the Mendoza plan. This plan uses an every third night call model and a night float model to meet site-specific needs. The specifics of the Mendoza plan protect the cornerstone of surgical education, which is continuity of patient care and resident education. The Mendoza plan, and the process leading to its development, may provide insightful information for other surgical residency programs planning to meet work hour guidelines.