Developing a new apathy measurement scale: Dimensional Apathy Scale.
Apathy is both a symptom and syndrome prevalent in neurodegenerative disease, including motor system disorders, that affects motivation to display goal directed functions. Levy and Dubois (2006) suggested three apathetic subtypes, Cognitive, Emotional-affective and Auto-activation, all with discrete neural correlates and functional impairments. The aim of this study was to create a new apathy measure; the Dimensional Apathy Scale (DAS), which assesses apathetic subtypes and is suitable for use in patient groups with motor dysfunction. 311 healthy participants (mean=37.4, S.D.=15.0) completed a 45-item questionnaire. Horn's parallel analysis of principal factors and Exploratory Factor Analysis resulted in 4 factors (Executive, Emotional, Cognitive Initiation and Behavioural Initiation) that account for 28.9% of the total variance. Twenty four items were subsequently extracted to form 3 subscales--Executive, Emotional and Behavioural/Cognitive Initiation. The subscale items show good internal consistency reliability. A weak to moderate relationship was found with depression using Becks Depression Inventory II. The DAS is a well-constructed method for assessing multidimensional apathy suitable for application to investigate this syndrome in different disease pathologies.


Dynamic 13 C MR spectroscopy as an alternative to imaging for assessing cerebral metabolism using hyperpolarized pyruvate in humans.
This study is to investigate time-resolved 13 C MR spectroscopy (MRS) as an alternative to imaging for assessing pyruvate metabolism using hyperpolarized (HP) [1-13 C]pyruvate in the human brain. Time-resolved 13 C spectra were acquired from four axial brain slices of healthy human participants (n = 4) after a bolus injection of HP [1-13 C]pyruvate. 13 C MRS with low flip-angle excitations and a multichannel 13 C/1 H dual-frequency radiofrequency (RF) coil were exploited for reliable and unperturbed assessment of HP pyruvate metabolism. Slice-wise areas under the curve (AUCs) of 13 C-metabolites were measured and kinetic analysis was performed to estimate the production rates of lactate and HCO3- . Linear regression analysis between brain volumes and HP signals was performed. Region-focused pyruvate metabolism was estimated using coil-wise 13 C reconstruction. Reproducibility of HP pyruvate exams was presented by performing two consecutive injections with a 45-minutes interval. [1-13 C]Lactate relative to the total 13 C signal (tC) was 0.21-0.24 in all slices. [13 C] HCO3- /tC was 0.065-0.091. Apparent conversion rate constants from pyruvate to lactate and HCO3- were calculated as 0.014-0.018 s-1 and 0.0043-0.0056 s-1 , respectively. Pyruvate/tC and lactate/tC were in moderate linear relationships with fractional gray matter volume within each slice. White matter presented poor linear regression fit with HP signals, and moderate correlations of the fractional cerebrospinal fluid volume with pyruvate/tC and lactate/tC were measured. Measured HP signals were comparable between two consecutive exams with HP [1-13 C]pyruvate. Dynamic MRS in combination with multichannel RF coils is an affordable and reliable alternative to imaging methods in investigating cerebral metabolism using HP [1-13 C]pyruvate.


Non-destructive assessment of amylose content in rice using a quality inspection system at grain elevators.
Amylose content is an important determinant of rice quality. Its accurate, non-destructive assessment is a challenge to the industry. We examined whether the automatic quality inspection system accurately measured the amylose content. Brown and milled rice models were calibrated with 902 samples produced between 2008 and 2017 in Hokkaido, Japan, and validated individually by samples collected in 2018 (n = 33) and 2019 (n = 71) from several grain elevators within the region. Models were developed by processing the automatic system data comprising of a near-infrared spectrometer, a visible light grain segregator, combined analysis of chemometrics, and by merging low and ordinary amylose variety validation results. The lower standard error of prediction (<0.52%) and a higher ratio of performance deviation (>4.0) in both models enabled accurate non-destructive assessment of amylose content. Hence, the automatic quality inspection system is a useful tool for meeting the demands of higher quality and palatability of rice.


COVID-19 and Fake News in the Dominican Republic.
The first case of novel coronavirus disease (COVID-19) in the Dominican Republic coincided with a period of political crisis. Distrust in governmental institutions shaped the critical phase of early response. Having a weak public health infrastructure and a lack of public trust, the Ministry of Health (MoH) began the fight against COVID-19 with a losing streak. Within 45 days of the first reported case, the political crisis and turmoil caused by "fake news" are limiting the capacity and success of the MoH response to the pandemic.


First record of the genus Phanerotomella (Hymenoptera: Braconidae) from Baltic amber with the description of a new species.
A new but exinct chelonine wasp species, Phanerotomella brevivena Kittel sp. nov. (Braconidae: Cheloninae) of the modern genus Phanerotomella is described from Baltic amber. This new species differs from all other extant Phanerotomella species by having the fore wing vein SR-1 only partially sclerotised. This is the first fossil record of the genus in amber.


The role of an open artificial intelligence platform in modern neurosurgical education: a preliminary study.
The use of artificial intelligence in neurosurgical education has been growing in recent times. ChatGPT, a free and easily accessible language model, has been gaining popularity as an alternative education method. It is necessary to explore the potential of this program in neurosurgery education and to evaluate its reliability. This study aimed to show the reliability of ChatGPT by asking various questions to the chat engine, how it can contribute to neurosurgery education by preparing case reports or questions, and its contributions when writing academic articles. The results of the study showed that while ChatGPT provided intriguing and interesting responses, it should not be considered a dependable source of information. The absence of citations for scientific queries raises doubts about the credibility of the answers provided. Therefore, it is not advisable to solely rely on ChatGPT as an educational resource. With further updates and more specific prompts, it may be possible to improve its accuracy. In conclusion, while ChatGPT has potential as an educational tool, its reliability needs to be further evaluated and improved before it can be widely adopted in neurosurgical education.


The Head and Neck Survivorship Tool (HN-STAR) Trial (WF-1805CD): A protocol for a cluster-randomized, hybrid effectiveness-implementation, pragmatic trial to improve the follow-up care of head and neck cancer survivors.
Survivors of head and neck cancer (HNC) can have multiple health concerns. To facilitate their care, we developed and pilot-tested a clinical informatics intervention, HN-STAR. HN-STAR elicits concerns online from HNC survivors prior to a routine oncology clinic visit. HN-STAR then presents tailored evidence-based clinical recommendations as a clinical decision support tool to be used during the visit where the oncology clinician and survivor select symptom management strategies and other actions. This generates a survivorship care plan (SCP). Online elicitation of health concerns occurs 3, 6, and 9 months after the clinic visit, generating an updated SCP each time. HN-STAR encompasses important methods of improving survivorship care (e.g., needs assessment, tailored interventions, dissemination of guidelines) and will be evaluated in a pragmatic trial to maximize external validity. This hybrid type 1 implementation-effectiveness trial tests HN-STAR effectiveness while studying barriers and facilitators to implementation in community oncology practices within the National Cancer Institute Community Oncology Research Program. Effectiveness will be measured as differences in key survivorship outcomes between HNC participants who do and do not use HN-STAR over one year after the clinic visit. The primary endpoint is HNC-specific quality of life; other outcomes include patient-centered measures and receipt of guideline-concordant care. Implementation outcomes will be assessed of survivors, providers, and clinic stakeholders. The hybrid design will provide insight into a dose-response relationship between the extent of implementation fidelity and effectiveness outcomes, as well as how to incorporate HN-STAR into standard practice outside the research setting.


Recurrent myxoinflammatory fibroblastic sarcoma: a case report.
Myxoinflammatory fibroblastic sarcoma is a rare sarcoma which typically presents in the extremities and is treated by definitive surgery. In recurrent disease, the reported utilization of radiotherapy is increasing, and more modern techniques such as intensity-modulated radiotherapy may be improving long-term outcomes.


Digital dentistry: The new state of the art - Is it disruptive or destructive?
Summarizing the new state of the art of digital dentistry, opens exploration of the type and extent of innovations and technological advances that have impacted - and improved - dentistry. The objective is to describe advances and innovations, the breadth of their impact, disruptions and advantages they produce, and opportunities created for material scientists. On-line data bases, web searches, and discussions with industry experts, clinicians, and dental researchers informed the content. Emphasis for inclusion was on most recent publications along with innovations presented at trade shows, in press releases, and discovered through discussions leading to web searches for new products. Digital dentistry has caused disruption on many fronts, bringing new techniques, systems, and interactions that have improved dentistry. Innovation has spurred opportunities for material scientists' future research. With disruptions intrinsic in digital dentistry's new state of the art, patient experience has improved. More restoration options are available delivering longer lifetimes, and better esthetics. Fresh approaches are bringing greater efficiency and accuracy, capitalizing on the interest, capabilities, and skills of those involved. New ways for effective and efficient inter-professional and clinician-patient interactions have evolved. Data can be more efficiently mined for forensic and epidemiological uses. Students have fresh ways of learning. New, often unexpected, partnerships have formed bringing further disruption - and novel advantages. Yes, digital dentistry has been disruptive, but the abundance of positive outcomes argues strongly that it has not been destructive.


Management of optic pathway and chiasmatic-hypothalamic gliomas in children with radiation therapy.
Optic pathway and chiasmatic-hypothalamic gliomas are rare childhood tumors. This study presents the experience in management of these tumors with radiation therapy. Thirty-three children with the diagnosis of optic pathway and chiasmatic-hypothalamic gliomas were treated with radiation therapy from 1973 through 1994 in the Department of Radiation Oncology at Ankara University Faculty of Medicine. Twenty-four children had optic pathway gliomas and nine had chiasmatic-hypothalamic gliomas. Evidence of neurofibromatosis was present in six children. Subtotal resection was performed in 22 children and a biopsy in seven. The most common prescription for total tumor dose was 50 Gy, delivered in 2 Gy daily fractions. Follow-up ranged from 0.5 to 16.1 years (mean, 13.6 years). Overall, progression-free and cause-specific survival probabilities for the entire group were 93%, 82% and 93%, respectively, at 5 years and 79%, 77% and 88%, respectively, at 10 years. Differences in overall, progression-free and cause-specific survival probabilities between optic pathway and chiasmatic-hypothalamic gliomas were not statistically significant. Absence of evidence of neurofibromatosis correlated with significantly better progression-free and cause-specific survival probabilities. Radiation therapy is effective in stabilization or improvement of vision and prevention of tumor progression in both optic pathway and chiasmatic-hypothalamic gliomas.


Variations in the TNFα gene and their interactions with the IL4R and IL10 genes in relation to hand osteoarthritis.
The development of osteoarthritis (OA) involves inflammation, but the evidence for participation of genes propagating or inhibiting inflammation in the OA process is inconsistent. We investigated the associations of common variants in the TNFα gene, and their interactions with other cytokine genes, with hand OA among Finnish women. This cross-sectional study was based on bilateral hand radiographs of 542 female dentists and teachers which were classified according to the presence of OA (radiographic K-L score ≥ 2 in ≥ 3 joints) using reference images. The genotypes were determined by PCR-based methods. The degree of pairwise linkage disequilibrium (LD) and haplotypes were constructed and analyzed by the SNPStats software. The associations between four TNFα SNPs and hand OA were tested using logistic regression adjusting for age, occupation, and BMI, and fitting a log-additive model of inheritance. Gene-gene interactions of TNFα SNPs with IL4R and IL10 SNPs were examined by stratified logistic regression analyses. Possible interactions of the TNFα SNPs with variants in the previously reported IL1β and IL6 genes in influencing hand OA were also explored. Two TNFα polymorphisms ("-1031" and "-863") were associated with hand OA (OR = 1.45, 95% CI 1.01-2.07 and 1.55, 1.06-2.25, respectively). These associations retained when adjusting further for IL1β "3954" and IL6 "174". The TNFα G-A-G haplotype was associated with an increased risk of hand OA (1.61, 1.10-2.37, p = 0.01). Interactions were observed between TNFα "-1031" and IL4R Ser503Pro, TNFα "-1031" and IL10 "-1082", and TNFα "-863" and IL10 "-1082" SNPs with regard to hand OA (p = 0.012, p = 0.0068, and p = 0.02, respectively). The carriage of the TNFα "-1031" minor allele doubled the risk (2.01, 1.26 - 3.22) only in women with the IL4R Ser/Ser genotype. Similarly, the TNFα "-1031" and "-863" minor alleles were associated with an increased risk of hand OA only in IL10 G/G or A/A homozygotes (2.54, 1.45-4.47 and 2.60, 1.46-4.62, respectively) but not in heterozygotes (G/A). Our results suggest that the TNFα gene variants play a role in the etiology of hand OA. In addition, the findings are suggestive of a gene-gene interaction of the TNFα with IL4R and IL10 genes.


Metformin impairs growth of endometrial cancer cells via cell cycle arrest and concomitant autophagy and apoptosis.
Effective therapies for early endometrial cancer usually involve surgical excision and consequent infertility Therefore, new treatment approaches that preserve fertility should be developed. Metformin, a well-tolerated anti-diabetic drug, can inhibit cancer cell growth. However, the mechanism of metformin action is not well understood. Here we investigate the roles of autophagy and apoptosis in the anti-cancer effects of metformin on endometrial cancer cells. Ishikawa endometrial cancer cells were treated with metformin. WST-8 assays, colony formation assays, flow cytometry, caspase luminescence measurement, immunofluorescence, and western blots were used to assess the effects of metformin on cell viability, proliferation, cell cycle progression, apoptosis, and autophagy. Metformin-treated cells exhibited significantly lower viability and proliferation and significantly more cell cycle arrest in G1 and G2/M than control cells. These cells also exhibited significantly more apoptosis via both intrinsic and extrinsic pathways. In addition, metformin treatment induced autophagy. Inhibition of autophagy, either by Beclin1 knockdown or by 3-methyladenine-mediated inhibition of caspase-3/7, suppressed the anti-proliferative effects of metformin on endometrial cancer cells. These findings indicate that the anti-proliferative effects and apoptosis caused by metformin are partially or completely dependent on autophagy. We showed that metformin suppresses endometrial cancer cell growth via cell cycle arrest and concomitant autophagy and apoptosis.


Efficacy of Every Four Monthly and Quarterly Dosing of Faricimab vs Ranibizumab in Neovascular Age-Related Macular Degeneration: The STAIRWAY Phase 2 Randomized Clinical Trial.
Faricimab neutralizes angiopoietin-2 and vascular endothelial growth factor A via both simultaneous and independent binding. To evaluate extended dosing with faricimab, the first bispecific antibody designed for intraocular use, in patients with neovascular age-related macular degeneration. This phase 2 randomized clinical trial was a 52-week multicenter, active comparator-controlled, parallel-group study. Study participants were enrolled in 25 sites in the US from January and March 2017 with treatment-naive choroidal neovascularization secondary to neovascular age-related macular degeneration and best-corrected visual acuity (BCVA) Early Treatment Diabetic Retinopathy Study letter score of 73 (approximate Snellen equivalent, 20/40) to 24 (approximate Snellen equivalent, 20/320). Analysis began January 2017 and ended March 2018. Participants were randomized 1:2:2 to receive intravitreal ranibizumab, 0.5 mg, every 4 weeks or faricimab, 6.0 mg, every 12 or 16 weeks. Participants in the faricimab arms initially received 4 monthly injections of faricimab. No rescue injections were allowed. Participants randomized to dosing every 16 weeks were assessed for disease activity at week 24 using prespecified criteria. Those with no active disease continued dosing every 16 weeks through trial end; participants with disease activity continued received dosing every 12 weeks. Mean change in BCVA from baseline at week 40. Of 76 participants enrolled (mean [SD] age, 78.5 [8.5] years; age range, 56-94 years; 41 women [58%]; 69 white [97%]), 16 (21.0%) were randomized to ranibizumab every 4 weeks, 29 (38.2%) to faricimab every 12 weeks, and 31 (40.8%) to faricimab every 16 weeks. At week 24, 12 weeks after their last initiation injection, 65% (36 of 55) of all faricimab-treated participants had no disease activity. At week 40, adjusted mean BCVA gains from baseline (Early Treatment Diabetic Retinopathy Study letters) were +11.4 (80% CI, 7.8-15.0), +9.3 (80% CI, 6.4-12.3), and +12.5 (80% CI, 9.9-15.1) for the ranibizumab every 4 weeks, faricimab every 12 weeks, and faricimab every 16 weeks arms, respectively. Participants received a mean (SD) total of 12.9 (0.25), 6.7 (0.91), and 6.2 (0.93) injections, for the ranibizumab every 4 weeks, faricimab every 12 weeks, and faricimab every 16 weeks arms, respectively, through week 52. The secondary BCVA and anatomical imaging end points supported the primary end point and were comparable with ranibizumab every 4 weeks. No new or unexpected safety signals were identified. At week 52, faricimab dosing every 16 weeks and every 12 weeks resulted in maintenance of initial vision and anatomic improvements comparable with monthly ranibizumab. These results suggest a role for simultaneous neutralization of angiopoietin-2 and vascular endothelial growth factor A in providing sustained efficacy through extended durability, warranting further investigation. ClinicalTrials.gov Identifier: NCT03038880.


Evaluation of intramuscular 15(s)-15-methyl prostaglandin F2 alpha tromethamine salt for induction of abortion, medications to attenuate side effects, and intracervical laminaria tents.
Sixty gravidas 8 to 20 menstrual weeks' gestation were studied to evaluate (1) the efficacy of intramuscularly administered 15(S)-15-methyl prostaglandin F2alpha tromethamine (15(S)-Me-PGF2alpha) as an abortifacient; (2) the effectiveness of prochlorperazine and Lomotil for attenuation of vomiting and diarrhea; and (3) the practicability of augmenting this prostaglandin dose schedule with intracervical laminaria tents. Group I subjects received 250 mug of 15(S)-Me-PGF2alpha intramuscularly every 2 hours for the initial 24 hours and 500 mug for the next 24-hour period. Group II received the same dose schedule of prostaglandin and prearranged doses of prochlorperazine and Lomotil. Group III received the same dose schedule of prostaglandin after intracervical laminaria tents had been inserted, and prochlorperazine and Lomotil were administered by the prearranged dose schedule. It appears that (1) the 15(S)-Me-PGF2alpha was effective in inducing abortion; (2) a significant decrease in body temperature occurred; (3) the abortifacient effectiveness of this prostaglandin dose schedule was not altered by the regimen of prochlorperazine and Lomotil; (4) only diarrhea was significantly attenuated with the regimen of prochlorperazine and Lomotil; and (5) laminaria augmentation was not useful.


Primary hepatic lymphoma diagnosed using endoscopic ultrasound-guided liver biopsy: a case report.
Because of the rarity of primary hepatic lymphomas, diagnosis of this disease entity may often be difficult, and performing a liver biopsy is the only way to establish a definitive diagnosis. Recently, endoscopic ultrasound-guided liver biopsy has emerged as a safe technique for obtaining liver tissue. However, there is no report on the use of endoscopic ultrasound-guided liver biopsy for diagnosing primary hepatic lymphomas. An 85-year-old Asian man was admitted to our hospital because of multiple liver lesions without any identifiable primary tumor or extrahepatic lymphadenopathy. Serum tumor markers, including alpha-fetoprotein, were in the normal range. We provisionally diagnosed the patient with a cancer of unknown primary origin with liver metastases. An endoscopic ultrasound-guided fine needle liver biopsy of the tumor in the left lobe of the liver was performed using a transgastric approach, and histology revealed a primary hepatic lymphoma of a diffuse large B-cell lymphoma type. Primary hepatic lymphomas are quite rare, and diagnosis is often difficult without performing a biopsy. Endoscopic ultrasound-guided liver biopsy is a useful diagnostic modality even in such cases.


Laryngeal complications of COVID-19.
To describe and visually depict laryngeal complications in patients recovering from coronavirus disease 2019 (COVID-19) infection along with associated patient characteristics. Prospective patient series. Tertiary laryngology care centers. Twenty consecutive patients aged 18 years or older presenting with laryngological complaints following recent COVID-19 infection were included. Patient demographics, comorbid medical conditions, COVID-19 diagnosis dates, symptoms, intubation, and tracheostomy status, along with subsequent laryngological symptoms related to voice, airway, and swallowing were collected. Findings on laryngoscopy and stroboscopy were included, if performed. Of the 20 patients enrolled, 65% had been intubated for an average duration of 21.8 days and 69.2% requiring prone-position mechanical ventilation. Voice-related complaints were the most common presenting symptom, followed by those related to swallowing and breathing. All patients who underwent flexible laryngoscopy demonstrated laryngeal abnormalities, most frequently in the glottis (93.8%), and those who underwent stroboscopy had abnormalities in mucosal wave (87.5%), periodicity (75%), closure (50%), and symmetry (50%). Unilateral vocal fold immobility was the most common diagnosis (40%), along with posterior glottic (15%) and subglottic (10%) stenoses. 45% of patients underwent further procedural intervention in the operating room or office. Many findings were suggestive of intubation-related injury. Prolonged intubation with prone-positioning commonly employed in COVID-19 respiratory failure can lead to significant laryngeal complications with associated difficulties in voice, airway, and swallowing. The high percentage of glottic injuries underscores the importance of stroboscopic examination. Otolaryngologists must be prepared to manage these complications in patients recovering from COVID-19. IV.


Early events in the DNA damage response.
The ability to sense DNA damage and activate response pathways that coordinate cell cycle progression and DNA repair is essential for the maintenance of genomic integrity and the viability of organisms. During the last couple of years, several proteins have been identified that participate very early in the DNA damage response. Here we review the current understanding of the mechanisms by which mammalian cells detect DNA lesions, especially double-strand breaks, and mediate the signal to downstream transducers.


Quantitative and Qualitative Analysis of Exogenous Gene Expression by the S1 Nuclease ProtectionAssay.
The Sinuclease protection procedure allows the precise definition of the beginning and end of gene transcripts as well as the position of intron/ exon boundaries in a gene. Alternatively, when these parameters are already known, the technique can be used to quantify transcript levels in a variety of expression systems.


Nursing students' attitude and preparedness for nurse prescribing and its relationship with self-efficacy.
The number of countries where nurses are allowed to prescribe has increased over the past two decades. Nursing students' self-efficacy has the main impact on their clinical and cognitive skills. The aim of this study is to determine nursing students' attitudes and preparedness for nurse prescribing and its relationship with their perceived self-efficacy. The descriptive-correlational study METHODS: This study was conducted at five Nursing and Midwifery schools of Tabriz, Ardebil, Ilam, Ramsar, and Mashhad, Iran from March to July 2018. Through random sampling 250 undergraduate nursing students from the different geographical areas of Iran were selected. The research tool consisted of three parts including demographic information, nurse prescribing questionnaire, and a questionnaire on self-efficacy in patient care. Nursing students had a positive attitudes and relatively high levels of preparedness for nurse prescribing. However, near to half of the participants (48.4%) mentioned that they have not good knowledge of pharmacology. Also there was a significant positive correlation between the students' self-efficacy and their attitudes and preparedness to nurse prescribing (p < 0.001, rs= 0.467;p = 0.00, rs= 0.633). Given the nursing students' positive attitude to and their preparedness for nurse prescribing, it is possible to make them more prepared for this new role by increasing their pharmacological knowledge and improving their accountability, management, and leadership skills.


Superior human leukocyte reconstitution and susceptibility to vaginal HIV transmission in humanized NOD-scid IL-2Rγ(-/-) (NSG) BLT mice.
Humanized Bone marrow/Liver/Thymus (BLT) mice recapitulate the mucosal transmission of HIV, permitting study of early events in HIV pathogenesis and evaluation of preexposure prophylaxis methods to inhibit HIV transmission. Human hematopoiesis is reconstituted in NOD-scid mice by implantation of human fetal liver and thymus tissue to generate human T cells plus intravenous injection of autologous liver-derived CD34(+) hematopoietic stem cells to engraft the mouse bone marrow. In side-by-side comparisons, we show that NOD-scid mice homozygous for a deletion of the IL-2Rγ-chain (NOD-scid IL-2Rγ(-/-)) are far superior to NOD-scid mice in both their peripheral blood reconstitution with multiple classes of human leukocytes (e.g., a mean of 182 versus 14 CD4(+) T cells per μl 12 weeks after CD34(+) injection) and their susceptibility to intravaginal HIV exposure (84% versus 11% viremic mice at 4 weeks). These results should speed efforts to obtain preclinical animal efficacy data for new HIV drugs and microbicides.


Oxaliplatin-based adjuvant chemotherapy rather than fluorouracil-based chemotherapy in rectal cancer is more efficient to decrease distant metastasis and increase survival after preoperative chemoradiotherapy and surgery: a meta-analysis.
The standard treatment of stage II-III rectal cancer is preoperative chemoradiotherapy (CRT), followed by total mesorectal excision (TME). However, the rate of metastasis is still high following this treatment. Therefore, several adjuvant chemotherapy studies have been conducted on reducing subsequent metastases and increasing survival, although there are still no definite conclusions. We searched for published prospective randomized controlled trials comparing adjuvant chemotherapy regimens following standard preoperative CRT and curative surgery in stage II-III rectal cancer. We systematically searched Medline, Embase, and the Cochrane Library for relevant trials done from January 2004 to January 2021. Review Manager (RevMan, version 5.3) was used to analyze the data. We initially searched 1955 studies. We screened and carefully selected four randomized controlled trials with 2897 patients. Compared to the 5-FU-based regimen group, the oxaliplatin-added regimen group attained a higher 3-year locoregional control rate (relative risk [RR] of 0.64, 95% confidence interval [CI], 0.48-0.86; p = 0.003) and 3-year distant metastasis control rate (RR of 0.82, 95% CI, 0.71-0.95; p = 0.007). The oxaliplatin-added regimen group had significantly increased 3-year disease-free survival with a hazard ratio (HR) of 0.85 (95% CI: 0.74-0.97, p = 0.020), but not overall survival (p = 0.740). Grade 3 or higher acute toxicity rates did not differ between the two groups (p = 0.190). The addition of oxaliplatin to adjuvant therapy for stage II-III rectal cancer following preoperative CRT and TME may increase disease-free survival without significant increases in toxicity, but not overall survival.


[Study on the mechanism of oocyte aneuploidy by spectral karyotyping].
To establish the method of detecting oocyte aneuploidy by spectral karyotyping (SKY). The unfertilized oocytes were fixed 1-2 days after oocyte retrieval. Spectral karyotyping was performed according to the protocol. 64% of oocytes were normal, 36% of oocytes were aneuploidy, of which 22% were due to nondisjunction and 14% unbalanced predivision. SKY is an effective method for detecting oocyte aneuploidy. Both nondisjunction and unbalanced predivision are involved in oocyte aneuploidy formation.


Open palm technique for Dupuytren's contracture.
A study of the pre-operative condition of seventy-five hands afflicted with Dupuytren's contracture is followed by an analysis of the results of limited fasciectomy approached by midlateral digital and transverse palmar excisions. The palmar wounds were left open and healing occurred with minimal complications. The correction of contractures compares favourably with that achieved using other techniques of access and wound closure.


Experience with heat-killed antigens of L. longbeachae serogroups 1 and 2, and L. jordanis in the indirect fluorescence antibody test.
Sera from 1384 individuals were examined with a trivalent antigen composed of Legionella longbeachae serogroups 1 and 2 and L. jordanis. One hundred and twenty nine (9.3%) showed a reaction on screening. Thirty-six (2.6%) had a titre of greater than or equal to 64 with monovalent antigens. Ten (0.7%) had a high (greater than or equal to 256) or greater than or equal to fourfold rising titre of antibody to one or more antigens and six of these patients had a severe chest infection. No correlation was apparent between the presence of low level antibodies and disease.


Psychological benefits of prostate cancer screening: the role of reassurance.
The role of reassurance in decision-making about screening for health problems is largely unknown. We examined the reassurance value of prostate cancer screening in primary care patients. One hundred and sixty eight men, aged 45-70 years, who had no history of prostate cancer, from three family medicine practices in southeast Texas. A hypothetical scenario was developed where men were asked to assume they did not have prostate cancer, and then to rank three predefined screening states with regard to reassurance value: (A) unknown (no screening), (B) normal by screening [a prostate-specific antigen (PSA) test and a digital rectal examination (DRE)] and (C) normal by biopsy (abnormal PSA test and DRE results but a negative ultrasound-guided prostate biopsy). Most of the men (96.8%) associated some reassurance value with screening, considering health state A to be the worst possible health state. Results from a multivariate analysis showed that preference for screening state C was associated with a family history of prostate cancer and perceived greater risk for prostate cancer compared with other men. These findings suggest that prostate cancer screening may have some reassurance value for men, and that increased risk status may explain why some men prefer the added reassurance afforded by screening.


Clinicopathologic Features and Genetic Alterations in Mixed-Type Ampullary Carcinoma.
Mixed-type ampullary carcinoma is a subtype that combines intestinal-type (I-type) and pancreatobiliary-type (PB-type) lesions, but few studies have examined its clinicopathologic features and genetic alterations. The differences in genetic alterations between mixed type and other subtypes, as well as the genetic differences between I-type and PB-type lesions in the mixed type, remain unclear. In this study, we compared the clinicopathologic features and prognosis of 110 ampullary carcinomas classified by hematoxylin and eosin and immunohistochemical staining as follows: 63 PB-type, 35 I-type, and 12 mixed-type carcinomas. A comparative analysis of genetic mutations by targeted sequencing of 24 genes was also performed in 3 I-type cases, 9 PB-type cases, and I and PB-type lesions of 6 mixed-type cases. The mixed subtype had a poorer prognosis than the other subtypes, and there was also a similar tendency in the adjuvant group (n = 22). A total of 49 genetic mutations were detected in all 18 lesions for which genetic alteration was analyzed. No genetic mutations specific to the mixed type were found, and it was not possible to determine genetically whether the mixed type had originally been I or PB type. However, 5 of 6 cases had mutations common to both I and PB-type lesions, and additional mutations were found only in either I or PB-type lesions. In support of this, the mixed type more frequently exhibited genetic heterogeneity intratumorally than the other subtypes. Mixed-type tumors are histologically, immunohistochemically, and genetically heterogeneous, and this heterogeneity is associated with poor prognosis and may affect treatment resistance.


Metalloendoprotease cleavage triggers gelsolin amyloidogenesis.
Amyloid diseases like Alzheimer's disease and familial amyloidosis of Finnish type (FAF) stem from endoproteolytic cleavage of a precursor protein to generate amyloidogenic peptides that accumulate as amyloid deposits in a tissue-specific manner. FAF patients deposit both 8 and 5 kDa peptides derived from mutant (D187Y/N) plasma gelsolin in the extracellular matrix (ECM). The first of two aberrant sequential proteolytic events is executed by furin to yield a 68 kDa (C68) secreted fragment. We now identify the metalloprotease MT1-matrix metalloprotease (MMP), an integral membrane protein active in the ECM, as a protease that processes C68 to the amyloidogenic peptides. We further demonstrate that ECM components are capable of accelerating gelsolin amyloidogenesis. Proteolysis by MT1-MMP-like proteases proximal to the unique chemical environment of the ECM offers an explanation for the tissue-specific deposition observed in FAF and provides critical insight into new therapeutic strategies.


The Inhibitory Activity of Natural Products to Xanthine Oxidase.
The natural products have a new chemical structure and biological active diversity, so they are favored by scientific researchers. Gout is a high incidence and high-risk disease, and the current treatments are not satisfactory. Xanthine oxidase (XO) is a key enzyme responsible for the development and progression of various metabolic and oxidative stress-related diseases. Excessive activity of XO leads to elevated serum urate levels, which in turn leads to the development of hyperuricemia. This review mainly introduces the recent progress of the new research on the anti-gout activity of natural products that could provide new treatment methods for gout and information for the discovery and development of new anti-gout drugs.


pepFunk: a tool for peptide-centric functional analysis of metaproteomic human gut microbiome studies.
Enzymatic digestion of proteins before mass spectrometry analysis is a key process in metaproteomic workflows. Canonical metaproteomic data processing pipelines typically involve matching spectra produced by the mass spectrometer to a theoretical spectra database, followed by matching the identified peptides back to parent-proteins. However, the nature of enzymatic digestion produces peptides that can be found in multiple proteins due to conservation or chance, presenting difficulties with protein and functional assignment. To combat this challenge, we developed pepFunk, a peptide-centric metaproteomic workflow focused on the analysis of human gut microbiome samples. Our workflow includes a curated peptide database annotated with Kyoto Encyclopedia of Genes and Genomes (KEGG) terms and a gene set variation analysis-inspired pathway enrichment adapted for peptide-level data. Analysis using our peptide-centric workflow is fast and highly correlated to a protein-centric analysis, and can identify more enriched KEGG pathways than analysis using protein-level data. Our workflow is open source and available as a web application or source code to be run locally. pepFunk is available online as a web application at https://shiny.imetalab.ca/pepFunk/ with open-source code available from https://github.com/northomics/pepFunk. email@example.com. Supplementary data are available at Bioinformatics online.


Regulation of expression of the gene for vitamin B12 receptor cloned on a multicopy plasmid in Escherichia coli.
The btuB gene of Escherichia coli codes for a protein (BtuB) located in the outer membrane. BtuB is the receptor for vitamin B12 (cyanocobalamin). We have cloned the btuB gene into pUC8 using transposon Tn5 as the marker to first isolate several parts of the relevant DNA fragment from the specialized transducing phage lambda darg13. After reconstitution of the gene, Tn5 was removed by selecting for spontaneous excision. The partial nucleotide sequence and transcriptional start of the btuB gene were determined. The BtuB+ plasmid allowed a large amplification of the synthesis of BtuB, resulting in a 65-fold increased level of vitamin B12 binding. The level of vitamin B12 binding was reduced by a factor of 22 when cells were grown in the presence of high concentrations of vitamin B12. The regulation of the gene was studied in more detail by the use of a protein fusion between the extreme amino-terminus of BtuB and beta-galactosidase of E. coli. The kinetics of repression and derepression were consistent with the presence in the cells of a large amount of a regulatory molecule exhibiting an apparent Km for vitamin B12 of 3 microM.


Targeting p53 for enhanced radio- and chemo-sensitivity.
p53 acts as a central mediator of the cellular response to stressful stimuli. The growth-suppressive function of p53 is lost with mutation and this occurs commonly in human cancer. In addition to suppressing cancer development and progression, wild-type p53 further confers chemo-sensitivity and radio-sensitivity upon tumor cells. Accumulated evidence over the last two decades that wild-type p53 activity is required for the efficacy of radiation and chemotherapy has led to considerable interest in development of strategies to restore normal p53 function in tumors with defective p53-dependent signaling. A number of promising discoveries, based on the knowledge of structural and functional basis of p53 mutation, p53 degradation by MDM2 and p53 family proteins, provide a foundation for future drug design. Here we review the role of p53 in enhancing the sensitivity from radiation and chemotherapy and discuss current progress on therapies targeting p53.


Developmental effects of coumarin and the anticoagulant coumarin derivative warfarin on zebrafish (Danio rerio) embryos.
Coumarin and warfarin, two substances which are intensively metabolized in animals and humans, were tested for teratogenicity and embryo lethality in a 3-day in vitro assay using zebrafish embryos. Warfarin is a coumarin derivative, but in contrast to the mother substance warfarin has anticoagulant properties. Both substances produced teratogenic and lethal effects in zebrafish embryos. The LC(50) and EC(50) values for coumarin are 855 μM and 314 μM, respectively; the corresponding values for warfarin are 988 μM and 194 μM. For coumarin, three main or fingerprint endpoints (malformation of head, tail and growth retardation) were identified, whereas malformation of tail was the only fingerprint endpoint of warfarin. The analysis of the ratios between the zebrafish embryo effect concentrations of both substances and human therapeutic plasma concentrations confirmed the teratogenic potential of warfarin, as well as the equivocal status of coumarin.


Are booster shots coming?
Vaccine top-ups might boost immune systems and block new coronavirus variants, but there are many unknowns, reports Graham Lawton.


Second-line treatment of pediatric patients with relapsed rhabdomyosarcoma adapted to initial risk stratification: Data of the European Soft Tissue Sarcoma Registry (SoTiSaR).
Outcome of relapsed disease of localized rhabdomyosarcoma remains poor. An individual treatment approach considering the initial systemic treatment and risk group was included in the Cooperative Weichteilsarkom Studiengruppe (CWS) Guidance. Second-line chemotherapy (sCHT) ACCTTIVE based on anthracyclines (adriamycin, carboplatin, cyclophosphamide, topotecan, vincristine, etoposide) was recommended for patients with initial low- (LR), standard- (SR), and high-risk (HR) group after initial treatment without anthracyclines. TECC (topotecan, etoposide, carboplatin, cyclophosphamide) was recommended after initial anthracycline-based regimen in the very high-risk (VHR) group. Data of patients with relapse (n = 68) registered in the European Soft Tissue Sarcoma Registry SoTiSaR (2009-2018) were retrospectively analyzed. Patients of initial LR (n = 2), SR (n = 16), HR (n = 41), and VHR (n = 9) group relapsed. sCHT consisted of ACCTTIVE (n = 36), TECC (n = 12), or other (n = 15). Resection was performed in 40/68 (59%) patients and/or radiotherapy in 47/68 (69%). Initial risk stratification, pattern/time to relapse, and achievement of second complete remission were significant prognostic factors. Microscopically incomplete resection with additional radiotherapy was not inferior to microscopically complete resection (p = .17). The 5-year event-free survival (EFS) and overall survival (OS) were 26% (±12%) and 31% (±14%). The 5-year OS of patients with relapse of SR, HR, and VHR groups was 80% (±21%), 20% (±16%), and 13% (±23%, p = .008), respectively. Adapted systemic treatment of relapsed disease considering the initial risk group and initial treatment is reasonable. New treatment options are needed for patients of initial HR and VHR groups.


Hospitalized stroke surveillance in the community of Durango, Mexico: the brain attack surveillance in Durango study.
Vascular conditions are becoming the greatest cause of morbidity and mortality in developing countries. Few studies exist in Latin America. We aimed to perform a rigorous stroke surveillance study in Durango, Mexico. Active and passive surveillance were used to identify all patients with potential stroke presenting to Durango Municipality hospitals from August 2007 to July 2008. Exclusion criteria were subjects younger than 25 years old, stroke attributable to head trauma, and non-Durango Municipality residents. Brain Attack Surveillance in Durango-trained neurologists validated cases as stroke using source documentation. Stroke hospitalization rates were defined to include patients examined in the emergency department or admitted to the hospital. Abstractors identified 435 potential cases; 309 (71%) were validated as stroke. Of the validated stroke cases, the median age was 71 and 49% were female. Subtypes were 61.5% ischemic stroke, 20.7% intracerebral hemorrhage, 7.4% subarachnoid hemorrhage, and 10.4% undetermined. Overall initial NIHSS was a median of 11 (interquartile range, 7-17); in-hospital mortality was 39%. When adjusted to the world population, the age-adjusted hospitalization rate of first-ever stroke was 118.2 per 100 000; rates by type were: ischemic stroke, 69.1 (95% CI, 57.5-80.7); intracerebral hemorrhage, 26.7 (95% CI, 19.6-33.8); subarachnoid hemorrhage, 9.5 (95% CI, 5.3-13.8); and unknown, 12.3 (95% CI, 7.4-17.3). Of 190 patients with validated ischemic stroke, 44.2% received lipid testing and 7.4% received carotid imaging and echocardiography; 1.1% received tissue plasminogen activator. To our knowledge, this is the first estimate of stroke hospitalization rates in a Mexican community and it provides information important for design of interventions to prevent and treat stroke. This information is critical to reduce Mexico's stroke burden.


Interactive effects of oxygen, carbon dioxide and flow on photosynthesis and respiration in the scleractinian coral Galaxea fascicularis.
Rates of dark respiration and net photosynthesis were measured for six replicate clonal fragments of the stony coral Galaxea fascicularis (Linnaeus 1767), which were incubated under 12 different combinations of dissolved oxygen (20%, 100% and 150% saturation), dissolved carbon dioxide (9.5 and 19.1 µmol l-1) and water flow (1-1.6 versus 4-13 cm s-1) in a repeated measures design. Dark respiration was enhanced by increased flow and increased oxygen saturation in an interactive way, which relates to improved oxygen influx into the coral tissue. Oxygen saturation did not influence net photosynthesis: neither hypoxia nor hyperoxia affected net photosynthesis, irrespective of flow and pH, which suggests that hyperoxia does not induce high rates of photorespiration in this coral. Flow and pH had a synergistic effect on net photosynthesis: at high flow, a decrease in pH stimulated net photosynthesis by 14%. These results indicate that for this individual of G. fascicularis, increased uptake of carbon dioxide rather than increased efflux of oxygen explains the beneficial effect of water flow on photosynthesis. Rates of net photosynthesis measured in this study are among the highest ever recorded for scleractinian corals and confirm a strong scope for growth.


Placental miRNAs Targeting Cellular Stress Response Pathways Are Highly Expressed in Non-Hispanic Black People.
Non-Hispanic Black (NHB) people have a 2.5-fold higher risk of maternal mortality when compared to non-Hispanic White (NHW) people. Neonates of NHB people are more likely to be born preterm and small for gestational age, which may be driven by structural racism. The placenta is very sensitive to the maternal environment and may play a critical role in the translation of environmental stressors to pregnancy outcomes. Our aim was to assess the placental miRNA expression profile in both NHB and NHW people and the association between differentially expressed miRNAs and pregnancy outcomes. Placentas were collected from 50 NHB and 74 NHW people with a normal singleton pregnancy undergoing elective cesarean section at term prior to the onset of labor. Placental miRNA expression was measured via whole-genome small RNA-sequencing in a subset of 77 placentas. Fifteen miRNAs were more highly expressed in the placentas of NHB people. Several of these miRNAs were associated with cellular stress response pathways, suggesting that they may be responding to environmental stressors. Placental miR-192-5p expression was lower among NHB people and was positively associated with neonatal adiposity, suggesting it may be sensitive to structural racism with potential impacts on fetal growth.


The value of bronchoalveolar lavage for discrimination between healthy and diseased individuals.
Bronchoalveolar lavage (BAL) is standard diagnostic procedure. Procedural recommendations have been made by pneumological societies including normal values for interpretation of BAL cytology. These normal values derive from small studies in healthy volunteers and have never been analysed for their sensitivity and specificity. This study aims to analyse sensitivity and specificity of these normal values by assessing lavage cell composition in healthy and diseased individuals. More than 6000 BAL were retrospectively analysed for their cellular distribution including BALs of 250 healthy individuals. All BALs were obtained under similar conditions. Bronchoalveolar lavage cytology of healthy individuals mirrors data from previous studies with smoking being the most important manipulator of BAL cytology. Analyses of proposed normal values demonstrate specificity between 80% and 95%, whereas sensitivity ranges between 35% and 65%. Using different mathematical models, a value summing up the differences to ATS-proposed normal values of the cytological pattern was found to best discriminate between healthy and diseased individuals with a sensitivity of nearly 60% with a predefined specificity of 95%. In summary, our analysis confirmed prior results for healthy volunteers and enlarged these findings by analysing sensitivity and specificity of lavage results in an independent validation cohort of diseased individuals. Thereby, the study may influence the acceptance of BAL in the diagnostic workup of individuals with pulmonary diseases. Additionally, the study proposes a novel value that facilitates lavage interpretation and may therefore be useful in further studies.


Analysis of two capreomycin-resistance determinants from Streptomyces capreolus and characterization of the action of their products.
Two genes encoding capreomycin (Cp)-modifying enzymes have been isolated from the producing organism Streptomyces capreolus. Cp acetyltransferase (CAC), encoded by cac, is active against all four components of the Cp complex, whereas Cp phosphotransferase (CPH), the product of cph, is active against Cp components IA and IIA (and also the related antibiotic, Vm) but not against Cp IB or Cp IIB.


Comparative biochemistry and pharmacology of salivary gland secretions. III. Chromatographic isolation of a myocardial depressor protein (MDP) from the venom of Crotalus atrox.
A protein has been isolated from the venom of the western diamondback rattlesnake (Crotalus atrox) which induces acute myocardial depression when administered to experimental animals. Purification was achieved by gel filtration on Sephadex G-100, DEAE- and CM-cellulose ion-exchange chromatography, ultra-filtration, and adsorption chromatography on hydroxyapatite. Amino acid analysis of the highly purified protein indicated N-terminal isoleucine and C-terminal tyrosine residues, and the absence of free sulfhydryl groups. Rabbits were immunized against the myocardial depressor protein (MDP) and a highly specific antiserum prepared which made it possible to study other snake venoms for the presence or absence of MDP. All of the North American Crotalid species of snakes contain MDP in varying degrees of concentration, but none of the Asiatic snake venoms tested reacted with the antiserum to the myocardial depressor protein. Intravenous administration of MDP to experimental animals (dogs, cats) produces an immediate and profound decrease in the cardiac output, the left ventricular systolic and mean pressures, the velocity of shortening of the contractile element, the systemic arterial pressure and an elevation in the left ventricular end-diastolic and pulmonary wedge pressures. These hemodynamic changes indicate that MDP administration induces an acute myocardial failure which is does dependent. The potential use of this protein for the reproducible causation of left ventricular failure, obviating the need for the more commonly used surgical ligation of the coronary arteries, warrants a full investigation into its structure, active site and its mechanism of action on the myocardial cell.


Molecular analysis of the cytosolic and glycosomal glyceraldehyde-3-phosphate dehydrogenase in Leishmania mexicana.
Glyceraldehyde-3-phosphate dehydrogenase (GAPDH) activity was detected in two cell compartments of Leishmania mexicana promastigotes. These activities could be attributed to two different isoenzymes, one residing in glycosomes, the other in the cytosol. We have cloned and sequenced the genes for both isoenzymes. The glycosomal enzyme is encoded by two tandemly linked genes of identical sequence and contains features frequently found in glycosomal enzymes: the presence of peptide insertions, a small carboxy-terminal extension with a potential glycosomal targeting signal (-SKM) and an excess of positively charged residues (net charge +7). Only one open reading frame was detected for the cytosolic enzyme. The amino acid sequences of the two proteins are only 55% identical. We discuss some evolutionary aspects of the observed organization of the GAPDH genes in the Trypanosomatidae and the role of the two isoenzymes in the metabolism of these organisms. The possibility to develop GAPDH-specific inhibitors that will be effective against the enzyme of various parasitic members of this family is explored.


Mucin expression profile of benign and malignant cervical tissues and correlation with clinical-pathologic parameters.
To detect the expression of mucins in diverse benign and malignant cervical tissues of cervical disease. 158 cases of cervical tissues were collected. Sections were stained with monoclonal antibodies against MUC1, MUC2, MIUC4, MUC5AC, and MUC20 by immunohistochemistry. Normal cervical epithelium showed high expr ession of MUC1I, MUC4, and MUC5AC, partial expression of MUC20, and no MUC2. With the development from chronic cervicitis, cervical intraepithelial neoplasia (CI7N) to cervical squamous cell carcinoma (SCC), the expression of MUC1, NMUC4, and MUC20 was statistically significant. The expression of MUCl was related with the depth of invasion and clinical stage of SCC. The positive rates of MUC4 and MUC20 were associated with the degree of differentiation and clinical stage of SCC. There was a correlation between the expression of MUC4, MUC 1, and MUC20 in cervical squamous lesions. Mucins may be involved in the development of cervical cancer.


Suramin. A potent inhibitor of melanoma heparanase and invasion.
Suramin, a polysulfonated naphthylurea, has anti-reverse transcriptase and anti-proliferative activities and inhibits the binding of various growth factors to their cell surface receptors. This drug is used in the treatment of acquired immunodeficiency syndrome and several types of cancers. Increased levels of circulating glycosaminoglycans have been observed in suramin-treated cancer patients, suggesting that it may inhibit glycosaminoglycan catabolism. Melanoma-derived heparanase, a heparan sulfate-specific endo-beta-D-glucuronidase that plays an important role in metastatic melanoma cell invasion through basement membranes, is inhibited by suramin in a dose-dependent manner: 100% inhibition was observed at a concentration of approximately 100 microM. Structurally related polysulfonated compounds, such as trypan blue and Evans blue, had lower heparanase inhibitory activities: the concentrations required for 50% heparanase inhibition (ID50) were 310-320 microM and six times higher than for suramin (ID50 = 46 microM). Oversulfated heparin tetrasaccharide, whose average molecular size is similar to suramin, had also much lower heparanase inhibitory activity than suramin. The inhibition constants (Ki) for suramin and oversulfated heparin tetrasaccharide were 48 and 290 microM, respectively. Suramin had a remarkable inhibitory activity against B16 melanoma cell invasion through reconstituted basement membranes (ID50 less than 10 microM). The inhibitory effects of suramin on melanoma heparanase and cell invasion appeared to be completely independent of its antiproliferative activity, because significant effects on melanoma cell growth were not observed at the concentrations of suramin used in this study. The results suggest that the antimetastatic effects of suramin may be due to its antiinvasive rather than antiproliferative activities.


Infant colic: the effect of serotonin and melatonin circadian rhythms on the intestinal smooth muscle.
It is hypothesized that in the evening, peak serotonin concentration causes intestinal cramps associated with colic because serotonin increases intestinal smooth muscle contractions. Melatonin has the opposite effect of relaxing intestinal smooth muscles. Both serotonin and melatonin exhibit a circadian rhythm with peak concentrations in the evening. However, serotonin intestinal contractions are unopposed by melatonin during the first 3 months because only serotonin circadian rhythms are present at birth. Melatonin circadian rhythms appear at 3 months of age. The cramps of colic disappear at 3 months of age.


Rejuvenation remodels transcriptional network to improve rhizogenesis in mature Juglans tree.
Adventitious rooting of walnut species (Juglans L.) is known to be rather difficult, especially for mature trees. The adventitious root formation (ARF) capacities of mature trees can be significantly improved by rejuvenation. However, the underlying gene regulatory networks (GRNs) of rejuvenation remain largely unknown. To characterize such regulatory networks, we carried out the transcriptomic study using RNA samples of the cambia and peripheral tissues on the bottom of rejuvenated and mature walnut (Juglans hindsii × J. regia) cuttings during the ARF. The RNA sequencing data suggested that zeatin biosynthesis, energy metabolism and substance metabolism were activated by rejuvenation, whereas photosynthesis, fatty acid biosynthesis and the synthesis pathways for secondary metabolites were inhibited. The inter- and intra-module GRNs were constructed using differentially expressed genes. We identified 35 hub genes involved in five modules associated with ARF. Among these hub genes, particularly, beta-glucosidase-like (BGLs) family members involved in auxin metabolism were overexpressed at the early stage of the ARF. Furthermore, BGL12 from the cuttings of Juglans was overexpressed in Populus alba × P. glandulosa. Accelerated ARF and increased number of ARs were observed in the transgenic poplars. These results provide a high-resolution atlas of gene activity during ARF and help to uncover the regulatory modules associated with the ARF promoted by rejuvenation.


Hormonal and morphologic effects of bromocriptine on normal rat pituitary and GH3 tumor cells.
Bromocriptine in concentrations up to 5 X 10(-4) mol/L was studied for any deleterious effects upon normal rat pituitary cells, as well as on the rat GH3 cell line. Normal rat pituitary glands were obtained by decapitation from 50-day-old female Wistar rats and dispersed with 0.25% trypsin. The cells (10(5) per plate) were then incubated in 60 by 15 mm plates (Falcon) that contained 3 ml of Dulbecco's modified Eagle's medium with 10% fetal calf serum. GH3 cells were plated in a similar fashion. Bromocriptine was added in concentrations of 5 X 10(-4) to 5 X 10(-9) mol/L, and aliquots of medium were obtained at 6, 24, and 48 hours for the determination of growth hormone and prolactin. Cell counts were performed at 24 and 48 hours. A significant reduction in concentrations of growth hormone and prolactin was observed with concentrations of bromocriptine of 5 X 10(-5) and 5 X 10(-4) mol/L at 24 and 48 hours (p less than 001). Although no significant changes in cell counts were observed in the normal rat pituitary cells, the GH3 cells showed complete disruption at 48 hours only in the plates that contained the highest concentrations of bromocriptine. Electron microscopy of normal rat cells and GH3 demonstrated selective cytotoxic effects only on the GH3 cells. In conclusion, bromocriptine has been demonstrated to have a direct effect on hormone release and on the morphologic characteristics of tumor cells but not normal pituitary cells.


Towards a genomics approach to tick (Acari: Ixodidae) control in cattle: a review.
Ticks and tick-borne disease (TBD) are major challenges to cattle production in the tropics and subtropics. Economic losses associated with ticks amount to billions of dollars annually. Although efforts to eradicate ticks and TBD using chemical control strategies have been implemented in many developing countries for decades, these acaricides are costly, and cattle susceptibility to ticks remains unchanged. Traditional breeding methods, where the farmer selected animals using records to improve the host genetic resistance to ticks (HGRT), are less than fully effective and time consuming. The HGRT has been reported in literature. To date, solutions to fight ticks and TBD are still unclear. Development of single-nucleotide polymorphism (SNP) technologies has created an opportunity to estimate breeding values of animals from DNA samples. The use of SNP technology for genomic selection allows information retrieval from the genotype even before the gene is expressed; thus potentially giving farmers the ability to make selection decisions on HGRT at an earlier age. This review discusses factors that affect HGRT, breeding selection, immunology, and genomic approaches and their application to improve HGRT in order to enhance livestock production.


Growth factor and small molecule influence on urological tissue regeneration utilizing cell seeded scaffolds.
Regenerative medicine strategies combine various attributes from multiple disciplines including stem cell biology, chemistry, materials science and medicine. The junction at which these disciplines intersect provides a means to address unmet medical needs in an assortment of pathologies with the goal of creating sustainable, functional replacement tissues. Tissue damage caused by trauma for example, requires rapid responses in order to mitigate further tissue deterioration. Cell/scaffold composites have been utilized to initiate and stabilize regenerative responses in vivo with the hope that functional tissue can be attained. Along with the gross reconfiguration of regenerating tissues, small molecules and growth factors also play a pivotal role in tissue regeneration. Several regenerative studies targeting a variety of urological tissues demonstrate the utility of these small molecules or growth factors in an in vivo setting.


The effect of a low-load plyometric running intervention on leg stiffness in youth with cerebral palsy: A randomised controlled trial.
To determine whether a running intervention utilising plyometric activities improved leg stiffness in youth with cerebral palsy (CP), GMFCS levels I and II. This stratified randomised controlled trial examined the lower limb kinetics and kinematics of a sample of youths with CP during sub-maximal hopping and running, prior to and immediately following a 12-week running intervention that incorporated low load plyometric training. Included participants were 13 in the control group (mean age 13 years 2 months [SD 2 years 7 months]; six males; nine GMFCS level I; six unilateral) and 18 in the intervention group (mean age 12 years 9 months [SD 2 years 10 months]; 13 males; 11 GMFCS level I; nine unilateral). Derived variables included three-dimensional leg stiffness as well as resultant ground reaction force and change in leg length. Generalised linear mixed models were developed for statistical analysis. At follow-up the intervention group had greater leg stiffness than the control group during submaximal hopping (Intervention median = 3278Nm-1; Control median = 1556Nm-1; p < 0.01). At follow-up, participants in the intervention group in GMFCS Level I had greater leg stiffness than the control group during jogging (Intervention mean=38.84 (SD=25.55); Control mean=29.38 (SD=11.11); t = 2.61 p = 0.01). A running training intervention which includes plyometric activities can improve leg stiffness in young people with CP, especially those in GMFCS level I.


Aqueous drainage device surgery in refractory pediatric glaucomas: I. Long-term outcomes.
To determine the long-term outcomes and complications of aqueous drainage device surgery in children with congenital and aphakic glaucoma. Chart review of consecutive children treated with aqueous drainage device surgery at Duke University Eye Center from 1995 to 2006, recording demographic, glaucoma-related, and anterior segment examination findings. Included are 30 children (38 eyes) with congenital glaucoma and 32 children (41 eyes) with aphakic glaucoma. Median follow-up was 5.5 years (0.5-10.5) in the congenital glaucoma group and 3.5 years (0.5-13.8) in the aphakic glaucoma group. Pre-aqueous drainage device median intraocular pressure (IOP) was 29 mmHg in the congenital glaucoma group and 36 mmHg in the aphakic glaucoma group. Post-aqueous drainage device median IOP was 14 and 15 mmHg in the congenital and aphakic glaucoma group, respectively (p < 0.0001 vs pre-aqueous drainage device IOP). Post-aqueous drainage device pupil abnormalities were noted in 16% and 7% of eyes in the congenital glaucoma and aphakic glaucoma groups, respectively, and cataract occurred in 20% of phakic eyes in the congenital glaucoma group. Reoperation was necessary in 26% and 22% of eyes in the congenital glaucoma and aphakic glaucoma groups, respectively. One-year Kaplan-Meier success was 92% and 90% in the congenital and aphakic glaucoma groups, respectively, but fell by 10 years to 42% and 55%, respectively. Vision-threatening complications occurred in 10% of eyes overall. Aqueous drainage device surgery is moderately successful in children with refractory congenital and aphakic glaucoma. Common complications include corneal touch and cataract; iris abnormalities occur less commonly.


Centrins in unicellular organisms: functional diversity and specialization.
Centrins (also known as caltractins) are conserved, EF hand-containing proteins ubiquitously found in eukaryotes. Similar to calmodulins, the calcium-binding EF hands in centrins fold into two structurally similar domains separated by an alpha-helical linker region, shaping like a dumbbell. The small size (15-22 kDa) and domain organization of centrins and their functional diversity/specialization make them an ideal system to study protein structure-function relationship. Here, we review the work on centrins with a focus on their structures and functions characterized in unicellular organisms.


[Compression of the celiac trunk (author's transl)].
Besides the vascular changes caused by arteriosclerosis the compression stenosis is the most frequent form of the isolated restriction of the arteria coeliaca. The compression of the arteria coeliaca, caused by the ligamentum arcuatum medianum or a fribromatous ganglion tissue, can cause complaints similar to the symptoms of angina abdominalis: pains in the epigastrium, postprandial pains, loss of weight, nausea/vomiting, diarrhea, 93% of the patients with severe vascular compression have an abdominal vascular murmur. Of 31 patients with angiographically proved compression stenosis, 11 patients suffering from occlusion or intense stenosis had to be operated because of heavy complaints. The angiographic and intraoperative findings allow the conclusion that there is a connection between the extent of the stenosis and the clinical appearance. The decompression of the arteria coeliaca, in other words the detachment of the compressing tissue leads to total complaintlessness in 83% of the patients. If the arteria coeliaca is hypoplastic a vessel widening or a bypass operation is necessary to establish normal blood circulation in the epigastric organs.


Risk stratification and beneficiary selection among elderly nasopharyngeal carcinoma patients from concurrent chemoradiotherapy combined with induction chemotherapy.
This study aims to evaluate the risk stratification among elderly Nasopharyngeal carcinoma (NPC) patients (≥60 years old) and select the beneficiaries from concurrent chemotherapy (CCRT) combined with induction chemotherapy (IC). A total of 909 elderly non-metastatic NPC patients treated with cisplatin-based CCRT or IC + CCRT between January 2007 and December 2016 were included. Prognostic nomograms were generated according to clinical characteristics and serum biomarkers. The survival outcomes of patients treated with CCRT versus IC + CCRT were compared in three well-matched risk groups (high, medium, and low risk) after PSM analysis. Benefit of IC in people older or younger than 70 years and effect of different IC regimens and cycles on prognosis were analyzed. Nomograms of overall survival (OS) (C-index: 0.64, 95% CI, 0.61-0.89) and disease special survival (DSS) (C-index: 0.65, 95% CI, 0.62-0.71) showed good prognostic accuracy. The nomogram for DSS included variables of age, gender, ACE, EBV DNA, N stage, and T stage. OS included variables of age, smoking history, ACE, ALB, EBV DNA, N stage, and T stage. The corresponding 5-year OS rates of high, medium and low risk groups were 87.4%, 82.2%, and 60.9%, respectively (p < 0.001), while the 5-year DSS rates were 92.2%, 84.3%, and 69.0%, respectively (p < 0.001). In the high risk group, IC + CCRT led to significantly higher 5-year OS and DSS rate compared with CCRT (5-year OS rate, 73.5% versus 51.8%, p = 0.006; 5-year DSS rate, 81.4% versus 61.3%, p = 0.002). While in the medium and low risk groups, OS and DSS were not significantly different (OS: p = 0.259, 0.186; DSS: p = 0.29, 0.094). Subgroup analysis showed in the high risk group, only people younger than 70 years old could benefit from IC. TPF and IC cycles of three could lead to the best survival results. Compared with CCRT, OS, and DSS among high risk elderly patients were significantly improved by the addition of IC in patients younger than 70 years old. TPF and three IC cycles were recommended.


Risk Factors for Melioidosis Mortality and Epidemics: A Multicentre, 10-Year Retrospective Cohort Study in Northern Hainan.
Burkholderia pseudomallei is a gram-negative environmental bacterium and aetiological agent of melioidosis, a tropical infectious disease with diverse clinical presentations. We aimed to describe the epidemiological and clinical characteristics of melioidosis in northern Hainan and to determine the meteorological factors affecting its morbidity. We conducted a retrospective, multicentre, observational cohort study of 90 patients with melioidosis admitted to four general hospitals in northern Hainan from 2010 to 2020. Epidemiological, clinical presentation, laboratory and treatment outcome data were collected and analysed. The monthly incidence of melioidosis and meteorological data, including precipitation, temperature, humidity, air pressure and wind speed, for the same period were collected to analyse the relationship between meteorological factors and the incidence of melioidosis. Of the 90 patients included in the study, 79 (87.78%) were male. Patient age ranged from 10 to 81 years old, but most patients, namely, 78 (86.67%), were middle-aged and elderly people aged 41-81 years old. Forty-six patients (51.11%) were farmers. The number of cases increased significantly after 2014, with the highest numbers occurring in 2014 and 2016. The highest number of cases occurred in summer and autumn and were associated with abundant rainfall, and 58 cases (64.44%) occurred from July to December. The patients showed diverse presentations and abnormal laboratory parameters: 69 patients (76.67%) had a history of diabetes mellitus; bacteremia was present in 50 patients (55.56%), sepsis was present in 39 patients (43.33%) and pneumonia in 19 patients (21.11%). An average high-sensitivity C-reactive protein (hs-CRP) level of 149.57 ± 13.65 mg/L and a median procalcitonin (PCT) level of 1.31 (0.39, 6.21) ng/mL were observed. Among all the cases, 21 (23.33%) were identified as acute infections, 51 (56.67%) as subacute infections and 18 (20.00%) as chronic infections. Six patients (6.67%) died of illness; five of these patients were male, and five of these patients were middle-aged and elderly patients. The monthly average precipitation was significantly positively correlated with the monthly average incidence of melioidosis (r = 0.74, P < 0.01). Male patients, farmers and especially middle-aged and elderly individuals with a history of diabetes mellitus accounted for most of the patients. The majority of cases were concentrated in coastal areas. Most cases of melioidosis occurred during the rainy seasons, and the monthly average precipitation was an independent factor affecting the average monthly incidence of melioidosis.


Survey of Minnesota parent attitudes regarding school-based depression and suicide screening and education.
School-based depression screening and education programs are recommended for addressing the high rates of children's mental illness. The objectives of this study were to (1) identify Minnesota parent attitudes regarding the provision of school-based depression and suicide screening and education and (2) identify predictors of parent support for these school-based programs. A random sample of 1,300 Minnesota households with children ages 5-18 years was surveyed by mail. Chi-square tests and regression analyses were used to detect differences in parent support for depression and suicide screening and education across demographic categories, and parent beliefs and knowledge about depression and suicide. The response rate of eligible households was 43 % (N = 511). Overall, 84-89 % of parents supported school-based depression and suicide screening and education. After adjusting for all variables, parent support for depression screening was associated with greater knowledge [OR 8.48, CI(1.30-55.21)] and fewer stigmatizing beliefs [OR 0.03, CI(0.01-0.12)]. Support for suicide screening was associated with fewer stigmatizing beliefs [OR 0.03, CI(0.01-0.10)]. Support for depression education was associated with fewer stigmatizing beliefs [OR 0.32, CI(0.10-1.00)] and lower educational attainment [OR 0.59, CI(0.40-0.89)]. Support for suicide education was associated with greater knowledge [OR 7.99, CI(1.02-62.68)], fewer stigmatizing beliefs [OR 0.26, CI(0.07-0.92)], and lower educational attainment [OR 0.60, CI(0.38-0.94)]. Parent support for school-based depression and suicide screening and education was high. Parent education to decrease stigmatizing beliefs and increase knowledge about depression and suicide may increase support among the minority of parents who do not endorse such programs.


Formation of the sea urchin male pronucleus in vitro: membrane-independent chromatin decondensation and nuclear envelope-dependent nuclear swelling.
We demonstrate that complete sea urchin male pronuclear development in vitro is a two-step process involving membrane-independent chromatin decondensation and nuclear envelope-dependent pronuclear swelling. In the absence of cytoplasmic membrane vesicles (MVs), permeabilized sperm chromatin decondenses into a spherical nucleus of approximately 4 microns in diameter. Pronuclear swelling to approximately 7 microns requires an intact nuclear envelope, and the degree of swelling is limited by the amount of MVs assembled on the chromatin. Furthermore, after a nuclear envelope is formed, swelling can occur in the absence of additional cytoplasmic MVs. Nuclear swelling also requires ATP hydrolysis, Ca2+ and cytosolic factors, some of which are sensitive to heat and to the sulfhydryl alkylating agent, N-ethylmaleimide. The requirement for a nuclear envelope and the rate of pronuclear swelling are consistent with previous in vivo observations.


Antithrombin III, C1 inhibitor, methylglyoxal, and polymorphonuclear leukocytes in the development of vascular complications in diabetes mellitus.
Under conditions closely approximating those in vivo (100 mM sodium carbonate pH 7.3 with 0.9% NaCl, 37 degrees C), antithrombin III (AT III) and the C1 inhibitor (C1-INH) are inactivated by methylglyoxal (MG) with pseudofirst-order kinetics and second-order rate constants of 25.2 and 7.8 M-1 min-1, respectively. A study of the functional status of neutrophils from patients with diabetes mellitus (DM) prompts an idea that under hyperglycemia in the diabetic organism the polymorphonuclear leukocytes (PML) endure 'arousal' that is identical or analogous to their activation. Indeed, nonstimulated PML from DM patients display (i) an almost sixfold higher luminol-dependent chemiluminescence and (ii) a double rate of oxygen uptake as compared with those from healthy donors, and (iii) are capable of MG formation in the presence of acetoacetate, which in vivo may be an additional source of this inactivator of AT III and C1-INH in diabetic patients. Conditions leading to ketosis or lactic acidosis are discussed, and a probable scenario is proposed for the organismic deterioration in DM.


Adaptation and validation of the Spanish version of the Strauss and Carpenter Prognostic Scale for Schizophrenia.
The aim of this study was to validate the Spanish version of the Strauss and Carpenter Prognostic Scale for Schizophrenia (Strauss and Carpenter, 1977). We performed a multicenter, longitudinal, descriptive study. Forward and backtranslation of the original scale was performed. The sample was composed of persons diagnosed with schizophrenia aged between 18 and 65 years. We calculated interrater reliability, construct validity according to the Global Assessment Scale (GAS), Satisfaction with Life Domains Scale (SLDS), the Global Clinical Impression-Schizophrenia (GCI) scale, The World Health. Organization Short Disability Assessment Schedule (WHO-DAS) and the Positive and Negative Syndrome Scale (PANSS), and predictive validity at the 1-year follow-up using three criterion measures of the GCI, WHO-DAS and GAS scales. The internal consistency coefficient (Cronbach's alpha) was 0.70. The intraclass correlation coefficient ranged from 0.54 to 0.99, except for item 5 (resources for the current treatment), which was -0.13. The correlation between the distinct scales (measuring construct validity) was significant, with a p-value of < 0.01, except for the SLDS, which showed a higher p-value (p<0.05). The Strauss-Carpenter score correlated with all three scores at 1 year (GCI, GAS and WHO-DAS) with an alpha of less than 0.01, showing good predictive validity. The Spanish adaptation of the Strauss and Carpenter prognostic scale is reliable and valid and allows a more severe disease course to be predicted.


Explant cultures of teleost spinal cord: source of neurite outgrowth.
The source of neurite outgrowth in explant cultures of normal adult Apteronotus spinal cord was examined. Explants which contained the central region of spinal cord, including ependyma, showed neurite outgrowth in culture. Explants which did not contain ependyma showed no neurite outgrowth. It is concluded that the ependymal region is necessary for neurite outgrowth in these cultures of adult teleost spinal cord. In addition, our failure to observe axon outgrowth clearly attributable to fluorescently back-labeled electromotor neurons in these cultures suggests that the exuberant neurite outgrowth in vitro is most probably due to cells other than the electromotor neurons. This explant culture system provides a unique opportunity to study neuronal differentiation, regeneration, and neurogenesis in vitro.


Diagnostic inflation in the DSM: A meta-analysis of changes in the stringency of psychiatric diagnosis from DSM-III to DSM-5.
It is often argued that successive editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM) have relaxed diagnostic criteria and thereby inflated rates of diagnosis. This claim has yet to be examined systematically. We quantitatively reviewed 123 studies in which one sample was concurrently diagnosed using two consecutive DSM editions (i.e., DSM-III & DSM-III-R, DSM-III-R & DSM-IV, or DSM-IV & DSM-5). Meta-analysis of 476 risk ratios enabled 123 comparisons of diagnostic rates for specific disorders. Comparisons demonstrating diagnostic inflation (i.e., higher diagnostic rate in the later edition) did not exceed those demonstrating deflation. The average risk ratio was 1.00, indicating no overall change in diagnostic stringency from DSM-III to DSM-5, and there were no reliable tendencies for particular DSM revisions to be more inflationary or deflationary than others. Specific disorders showing reliable evidence of diagnostic inflation or deflation were identified. Notable examples of diagnostic inflation included Attention-Deficit/Hyperactivity Disorder (ADHD), autism, eating disorders, and substance dependence. Although serious concerns have been raised about diagnostic inflation or "concept creep" in the DSM, these concerns may have been overstated.


Millennial-scale hydroclimate control of tropical soil carbon storage.
The storage of organic carbon in the terrestrial biosphere directly affects atmospheric concentrations of carbon dioxide over a wide range of timescales. Within the terrestrial biosphere, the magnitude of carbon storage can vary in response to environmental perturbations such as changing temperature or hydroclimate1, potentially generating feedback on the atmospheric inventory of carbon dioxide. Although temperature controls the storage of soil organic carbon at mid and high latitudes2,3, hydroclimate may be the dominant driver of soil carbon persistence in the tropics4,5; however, the sensitivity of tropical soil carbon turnover to large-scale hydroclimate variability remains poorly understood. Here we show that changes in Indian Summer Monsoon rainfall have controlled the residence time of soil carbon in the Ganges-Brahmaputra basin over the past 18,000 years. Comparison of radiocarbon ages of bulk organic carbon and terrestrial higher-plant biomarkers with co-located palaeohydrological records6 reveals a negative relationship between monsoon rainfall and soil organic carbon stocks on a millennial timescale. Across the deglaciation period, a depletion of basin-wide soil carbon stocks was triggered by increasing rainfall and associated enhanced soil respiration rates. Our results suggest that future hydroclimate changes in tropical regions are likely to accelerate soil carbon destabilization, further increasing atmospheric carbon dioxide concentrations.


Role of risk scoring systems in predicting life expectancy after carotid endarterectomy in asymptomatic patients.
The aim of this study is to compare and to test the performance of all available risk scoring systems (RSSs) designed to predict long-term survival rate in asymptomatic candidate patients for carotid endarterectomy (CEA) for significant carotid artery stenosis. Data on asymptomatic patients who underwent CEA in three high-volume centers were prospectively recorded. Through literature research using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations, six RSSs were identified for the intent of the study. Primary endpoints were 3- and 5-year survival rates after CEA. All items used as variables to compose multiple RSSs were applied to every patient in the study population. The 3- and 5-year mortality prediction rates for each score were assessed by sensitivity, specificity, and predictive negative and positive value calculation, as well as univariable Cox proportional hazard models with the Harrell C index. During the study period, 825 CEAs in 825 asymptomatic patients were analyzed. All items used in RSSs were available in the dataset, with some concerns regarding their definition and application among RSSs. The 3- and 5-year survival rates of the study cohort were 94.5% and 90.3%, respectively. Among the six RSSs analyzed, no RSS demonstrated optimal results in terms of mortality rate prediction accuracy, although some scores had good diagnostic and risk of death precision. RSSs, when used alone, fail to optimally detect postoperative life expectancy in asymptomatic CEA patient candidates. Further prospective controlled studies are needed to compose and validate RSSs with better calibration to predict outcomes.


Synthesis, Characterization, and Applications of Nanomaterials for Energy Conversion and Storage.
Ever since the commencement of the Industrial Revolution in Great Britain in the mid-18th century, the annual global energy consumption from various fossil fuels, encompassing wood, coal, natural gas, and petroleum, has demonstrated an exponential surge over the past four centuries [...].


Clinical features of 8 cases of orbital sparganosis in southern China.
To describe clinicoradiologic characteristics of orbital sparganosis. Retrospective case series. We studied 8 patients diagnosed with orbital sparganosis at Zhongshan Ophthalmic Center between 1999 and 2011. A thorough review of clinical and imaging manifestations. The primary clinical manifestations were redness and edema of the eyelids and conjunctivas (100%); proptosis (mild in 87.5% of cases and severe in 12.5%); subconjunctival yellow-white granulomatous lesions (75.0%); and migratory hyperemic masses of the eyelid or conjunctiva (50.0%). Of the patients, 6 had diffuse orbital or nodular masses on computed tomography imaging, 2 had the "tunnel sign" on magnetic resonance imaging, and 1 had subconjunctival tubular lesions on ultrasound biomicroscopy imaging. Subconjunctival yellow-white granulomatous lesions, migratory hyperemic masses, and the tunnel sign on magnetic resonance imaging are characteristic clues to preoperative diagnosis of orbital sparganosis.


[Dichotic speech recognition with cochlear implants].
Dichotic speech recognition of side-separated speech stimuli requires their central nervous processing and has been used since the 1950s in a variety of clinical settings. The objective of this study was to investigate the dichotic speech recognition of normal-hearing (NH) subjects, cochlear implant (CI) recipients with single-sided deafness (SSD), and bilateral CI (BilCI) recipients with the dichotic discrimination test according to Feldmann. The speech recognition of ten adult NH subjects, ten SSD CI recipients, and ten BilCI recipients was determined at 65 dB SPL or 65 dB SPL equivalent for monotic presentation of trisyllabic nouns of the Feldmann test (NH subjects: better ear, poorer ear; SSD CI recipients: NH ear, CI; BilCI recipients: better CI, poorer CI) and for dichotic, i.e., simultaneous side-separated, presentation. The NH subjects showed significantly poorer speech recognition for dichotic presentation than for monotic presentation. Speech recognition of SSD CI recipients was significantly worse with the CI than with the NH ear for both monotic and dichotic presentation. For both presentation conditions, BilCI recipients obtained significantly lower speech recognition with the poorer CI compared to the better CI. With each of the two CI, BilCI recipients had significantly worse speech recognition for dichotic presentation than for monotic presentation. All three study groups-NH subjects, SSD CI recipients, and BilCI recipients-were able to recognize dichotically presented speech with both ears. For SSD CI recipients, there was no negative effect of the CI on speech recognition with the NH ear for dichotic presentation.


Humeral retroversion and its relationship to glenohumeral rotation in the shoulder of college baseball players.
Previous studies have documented changes in musculature, bony anatomy, and glenohumeral rotation in the dominant shoulder of baseball players. In a group of asymptomatic college baseball players the total range of motion in the dominant and nondominant shoulders will be similar. Any measured increase in external rotation and decrease in internal rotation occurring between the two sides will be consistent and directly correlate with an increased angle of humeral retroversion in the dominant extremity. Descriptive anatomic study. Fifty-four asymptomatic college baseball players were examined. Standard measurements of glenohumeral range of motion were made and humeral retroversion was determined radiologically. Total rotational motion, measured at 90 degrees of glenohumeral abduction, was 159.5 degrees for the dominant shoulders and 157.8 degrees for the nondominant shoulders. Mean differences in external and internal rotation in the dominant versus nondominant extremities were 9.7 degrees and 8.2 degrees, respectively. Humeral retroversion measured 36.6 degrees +/- 9.8 degrees in the dominant and 26 degrees +/- 9.4 degrees in the nondominant extremity. The mean difference in retroversion correlated significantly by Pearson's product moment with the difference in external (P = 0.001) and internal (P = 0.003) rotation measurements. There is a pattern of increased external rotation and decreased internal rotation in the dominant extremity that significantly correlates with an increase in humeral retroversion. The loss of internal rotation and gains in external rotation may be more strongly related to adaptive changes in proximal humeral anatomy than to changes in the soft tissues.


Difficulties and strategies in the control of schistosomiasis in the Philippines.
Schistosomiasis japonica continues to remain a public health problem in the Philippines affecting 10 out of 16 regions with 6.7 million people at risk mostly farmers and fisher folks. Early efforts focused on snail control in the absence of an effective drug against the disease. Discovery of praziquantel shifted control focus from the expensive snail control to a more manageable one involving case detection and treatment. At present, the government's objective is to reduce morbidity by chemotherapy and supplemented with environmental sanitation, health education, and mollusciciding. In the past, external funds infused into government control programs helped a lot in bringing down prevalence rates of the disease in many highly endemic areas. The end of this foreign assistance has expectedly affected implementation of the programs bringing fears of a possible resurgence in many endemic areas. Such anxiety is also founded on the perennial problems of low disease awareness among people at risk, aggravated security problem, poverty and the negative effects of a devolved set-up in the health care delivery system. Experts suggest that the national health department should be more aggressive in dealing with the disease in terms of ensuring implementation and of continuously searching for better and more improved methods of control. Any new strategy should always consider the devolved set up of the health department.


Complications Are Infrequent After Humeral Shaft Fractures Due to Low-Energy Gunshot Injuries.
To describe humerus shaft fractures after low-energy gunshot wound (GSW) and compare with blunt injuries. We hypothesized that nerve injury, infection, and fracture union would be similar. Retrospective. Urban Level 1 trauma center. Four hundred three patients were treated for a humeral shaft fracture over 18 years. Sixty-two patients sustained injury due to GSW. Primary open reduction and internal fixation was pursued in 59%, including 32% after GSW. Rates of nerve injury, infection, and fracture union. Patients with GSW were younger with a mean age of 30 years, more likely male (90%), with isolated injuries (84%), and less likely to have simple fractures (84%). Both groups experienced high rates of union (98% of GSW fractures vs. 99% of closed high-energy fractures). Deep infection occurred in 1 patient (1.6%) after GSW. Rates of deep infection in the closed and open blunt trauma fracture groups were similarly low at 1% and 4.5%, respectively. Nerve injury on presentation after GSW was more common than after low-energy and high-energy closed fractures (47% vs. 13% and 27%), but similar to blunt open fracture (52%). Despite higher rates of nerve injury, nerve recovery occurred at similarly high rates after both GSW and blunt injuries (78% vs. 86%). Nerve injuries are more common after GSW, but most recover without intervention. Infection is uncommon after GSW, and secondary unplanned operations are rare. Initial nonoperative care of most GSW humerus fractures, even with radial nerve injury at the time of presentation, seems appropriate. Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.


Effects of antibacterial photodynamic therapy on salivary mutans streptococci in 5- to 6-year-olds with severe early childhood caries.
Antibacterial photodynamic therapy (A-PDT) has been shown to kill oral bacteria in the planktonic culture, dental plaque, and biofilm. This study sought to assess the antimicrobial effect of A-PDT with toluidine blue O (TBO) and diode laser on salivary mutans streptococci in 5-6-year-olds with severe early childhood caries (SECC). This case-control study was conducted on 56 children with SECC divided into four groups, namely 0.1 mg/mL TBO, diode laser (633 nm, 20 mW, 6 J/cm2), combination of the two, and no intervention control group. A-PDT was performed on days 1 and 3. Salivary samples were collected before and after A-PDT on days 1 and 3, and 1 and 2 weeks after the second intervention (day 3). Samples were cultured on mitis salivarius agar, and after incubation, the colonies were counted. Data were subjected to repeated measures ANOVA, ANCOVA, and paired comparisons with least square difference and Tukey's test. Bacterial count significantly decreased on days 1 and 3, and 1 and 2 weeks after the second intervention. Bacterial count also decreased following the use of TBO and laser separately, but these reductions were not significant (P > 0.05). Within the limitations of this study, antimicrobial efficacy of TBO + laser was higher than that of diode laser or TBO alone. Durability of treatment increased with double-dose therapy. This modality may be used to decrease the colony count of salivary mutans streptococci in children with SECC.


Adenosine and its receptor agonists potentiate nitric oxide synthase expression induced by lipopolysaccharide in RAW 264.7 murine macrophages.
The effect of adenosine and its agonists on nitric oxide synthase (NOS) activity and the production of nitrite induced by lipopolysaccharide (LPS) in RAW 264.7 cells were investigated. Nitrite production and NOS activity in the RAW 264.7 cells were increased up to 2.5 fold after co-exposure of the cells to LPS and adenosine or its agonists, as compared to LPS alone. Adenosine and its agonists had no effect on NOS activity when incubated alone with RAW 264.7 cells. Enhancement caused by adenosine or its agonists was dose-dependent but the effect was neither A1 nor A2 receptor specific. These findings suggest that during pathological conditions such as inflammation or trauma, the significant amounts of cellular adenosine which are released may increase the production of NO by macrophages.


The effectiveness of the installation of a mobile voice communication system in a university hospital.
In large hospitals, collaborative clinical practice is currently emphasized, with members of various departments expected to work as a team. The importance of accurate communication among the team members is of utmost importance. To improve such communication, the introduction of mobile voice communication systems has received much attention in Japan. Shimane University Hospital also introduced a Personal Handy-phone System (PHS) for doctors. In the traditional setting, much time was wasted searching for doctors through multiple calls on fixed-line telephones. In order to measure the effectiveness of our system, the change in the number of calls made on fixed-line telephones before and after PHS installation was compared. The total number of calls was reduced by more than 35%, and the number of calls to the wards on weekdays was reduced by half. Mobile telecommunication systems with small output power, such as PHS, are known to cause little interference with medical devices which makes it possible to use mobile voice communication safely in hospitals. The improvement in communication by this systems resulted in an improvement in labor efficiency.


Peri-Lead Edema After Deep Brain Stimulation Surgery: A Poorly Understood but Frequent Complication.
Postoperative peri-lead edema (PLE) is a poorly understood complication of deep brain stimulation (DBS), which has been described sporadically in patients presenting with profound and often delayed symptoms. We performed a prospective evaluation of patients undergoing DBS to determine the frequency of and identify risk factors for PLE. Patients underwent DBS electrode placement by a single physician. Postoperative magnetic resonance imaging (MRI) was performed approximately 6 weeks after the operation in asymptomatic subjects and analyzed for presence of PLE. All symptomatic subjects underwent MRI at the time of presentation. Data regarding index disease, preoperative medical issues, operative technique, and intraoperative variables were collected and statistically analyzed. A total of 191 leads were placed in 102 subjects; 15 patients (14.7%) demonstrated PLE. Seven patients (6.9%) presented with symptoms related to PLE, most often altered mental status or neurologic deficit. Many of the MRI findings were profound, with PLE sometimes several centimeters in diameter. No statistically significant difference was found between PLE-positive and normal subjects when analyzing multiple variables, including presence of vascular disease, hypertension, anticoagulant/antiplatelet use, electrode target, index disease, unilateral versus bilateral lead placement, number of brain penetrations, and presence or absence of microelectrode recording. Patients with postoperative PLE can present with severe symptoms or can be asymptomatic and go undiagnosed. Because of the delayed-onset potential, PLE may be more common than previously reported. No clear risk factors have been identified; therefore, further studies and increased clinical vigilance are paramount for improving comprehension and possible prevention of PLE.