Mini Nutritional Assessment and functional capacity in community-dwelling elderly in rural Luozi, Democratic Republic of Congo.
Good nutrition is beneficial both for the health and the functional capacity of the elderly. However, malnutrition is a serious health problem among the elderly, particularly the elderly living in rural areas in many developing countries. The aim of the present study was to carry out a cross-sectional study of the elderly in the city of Luozi, Democratic Republic of Congo, through the use of the long and the short forms of the Mini Nutritional Assessment (MNA) scale. We carried out a cross-sectional study in the city of Luozi, a city facing serious socioeconomic problems as a result of wartime conditions in the country. The study included 370 volunteer community-dwelling elderly people aged 65-88 years, both male and female. Investigations took into account the MNA, the activities of daily living, and the instrumental activities of daily living, falls, current diseases and lifestyle. Approximately 57.8% of the participants were at risk of malnutrition, whereas 28.4% were malnourished according to the MNA scale. MNA scores were significantly lower (Student's t-test, P=0.03) in those with a fall history (MNA score 18.3±4.0) compared with those who did not (MNA score, 21.0±2.7). All the participants with malnutrition suffered from at least one chronic disease. The percentage of participants with dependency was significantly higher in the malnourished participants (87.6%) than in well-nourished participants (50.9%). These findings provide information that malnutrition is a serious health concern among elderly people in the city of Luozi, and shows the need for adequate nutrition and social programs for the elderly.


Attachment styles have a modulatory impact on psychophysiological arousal evoked by reciprocated and unreciprocated gaze.
Gaze processing plays an essential role during social interactions. Here, it was investigated whether variations in attachment style (secure, anxious and avoidant) were associated with differential expressions of sympathetic autonomic arousal upon live dyadic gaze interactions. To do so, 47 participants were presented with either reciprocated or unreciprocated eye gaze from a live model and skin conductance responses (SCRs) were collected. In line with previous observations, SCRs and subjective ratings of arousal were higher in response to reciprocated, compared to unreciprocated gaze. In terms of the modulation by attachment style, it was shown that participants with low attachment security and high attachment avoidance displayed overall higher sympathetic arousal upon the presentation of the live dyadic gaze cues, irrespective of whether the observed model showed reciprocal or unreciprocated gaze. Together, these observations indicate that attachment styles have a modulatory effect on individuals' psychophysiological responses to dyadic gaze interactions.


Malaria in UK travellers: assessment, prevention and treatment.
Malaria is the most serious tropical disease. Increasing numbers of people are travelling to tropical destinations where they are at risk of malaria. Nurses need to be aware of the disease risk, prevention of mosquito bites and appropriate chemoprophylaxis to protect the health of travellers. This article describes the malaria lifecycle, bite prevention, chemoprophylaxis, diagnosis and prevention strategies for people travelling to malarious areas. Additional resources are supplied for nurses who want further information.


On the relevance of structure preservation to simulations of muscle actuated movements.
In this work, we implement a typical nonlinear Hill-type muscle model in a structure-preserving simulation framework and investigate the differences to standard simulations of muscle-actuated movements with MATLAB/Simulink. The latter is a common tool to solve dynamical problems, in particular, in biomechanic investigations. Despite the simplicity of the examples used for comparison, it becomes obvious that the MATLAB/Simulink integrators artificially loose or gain energy and angular momentum during dynamic simulations. The relative energy error of the MATLAB/Simulink integrators related to a very low actual muscle work can naturally reach large values, even higher than 100%. But also during periods with large muscle work, the relative energy error reaches up to 2%. Even in simulations with very small time steps, energy and angular momentum errors are still present using MATLAB/Simulink and can (at least partially) be responsible for phase errors in long-term simulations. This typical behaviour of commercial integrators is known to increase for more complex models or for computations with larger time steps, whose use is crucial for efficiency, especially in the context of optimal control simulations. In contrast to that, time-stepping schemes being derived from a discrete variational principle yield discrete analogues of the Euler-Lagrange equations and Noethers theorem. This ensures that the structure of the system is preserved, i.e. the simulation results are symplectic and momentum consistent and exhibit a good energy behaviour (no drift).


Leptin confers protection against TNF-α-induced apoptosis in rat cardiomyocytes.
Leptin, an important adipose-derived hormone, is recognized as a crucial protein in energy homeostasis. Recent studies indicated that leptin is associated with cardiac pathophysiology, however, the role and mechanisms of leptin in cardiomyocytes apoptosis are poorly understood. Here we investigated whether leptin exerted protective effect on cardiomyocytes exposed to tumor necrosis factor-alpha (TNF-α) and the possible mechanisms. Neonatal rat cardiomyocytes were subjected to TNF-α in the presence or absence of leptin. By FITC/Annexin V flow cytometry and Western blot, we noticed that TNF-α increased Annexin V binding and cleaved caspase-3/PARP, which were attenuated by leptin pretreatment. Moreover, leptin protected cardiomyocytes against mitochondrial apoptosis by inhibiting cytochrome C elevation and Bcl-2 decreasing. TNF-α-induced P38 MAPK and NF-κB activation were abolished by leptin addition, and the P38 and NF-κB inhibitor, SB203580 and Bay117082, also mitigated the apoptotic effect of TNF-α, indicating that their activation might be responsible for the apoptosis in TNF-α-treated cardiomyocytes. Therefore, leptin conferred anti-apoptotic effect in cardiomyocytes exposed to TNF-α possibly by inhibiting TNF-α-activated P38 MAPK and NF-κB pathways.


Hand preference influences neural correlates of action observation.
It has been argued that we map observed actions onto our own motor system. Here we added to this issue by investigating whether hand preference influences the neural correlates of action observation of simple, essentially meaningless hand actions. Such an influence would argue for an intricate neural coupling between action production and action observation, which goes beyond effects of motor repertoire or explicit motor training, as has been suggested before. Indeed, parts of the human motor system exhibited a close coupling between action production and action observation. Ventral premotor and inferior and superior parietal cortices showed differential activation for left- and right-handers that was similar during action production as well as during action observation. This suggests that mapping observed actions onto the observer's own motor system is a core feature of action observation - at least for actions that do not have a clear goal or meaning. Basic differences in the way we act upon the world are not only reflected in neural correlates of action production, but can also influence the brain basis of action observation.


The effect of ammonia on cell-type-specific enzyme accumulation in Dictyostelium discoideum.
We have shown that ammonia inhibits stalk cell formation and promotes spore formation during cyclic AMP induced differentiation of monolayers of sporogenous amoebae (Gross, J.D. et al., Nature (London), 303, 244-245, 1983). Here we show that exposure to ammonia favours the accumulation of prespore- over prestalk-specific enzymes and related products. We conclude that ammonia switches cells from the prestalk to the prespore pathway rather than simply inhibiting stalk cell maturation and hence may act as a morphogen during development.


Regression of Epileptogenesis by Inhibiting Tropomyosin Kinase B Signaling following a Seizure.
Temporal lobe epilepsy (TLE) is a devastating disease in which seizures persist in 35% of patients despite optimal use of antiseizure drugs. Clinical and preclinical evidence implicates seizures themselves as one factor promoting epilepsy progression. What is the molecular consequence of a seizure that promotes progression? Evidence from preclinical studies led us to hypothesize that activation of tropomyosin kinase B (TrkB)-phospholipase-C-gamma-1 (PLCγ1) signaling induced by a seizure promotes epileptogenesis. To examine the effects of inhibiting TrkB signaling on epileptogenesis following an isolated seizure, we implemented a modified kindling model in which we induced a seizure through amygdala stimulation and then used either a chemical-genetic strategy or pharmacologic methods to disrupt signaling for 2 days following the seizure. The severity of a subsequent seizure was assessed by behavioral and electrographic measures. Transient inhibition of TrkB-PLCγ1 signaling initiated after an isolated seizure limited progression of epileptogenesis, evidenced by the reduced severity and duration of subsequent seizures. Unexpectedly, transient inhibition of TrkB-PLCγ1 signaling initiated following a seizure also reverted a subset of animals to an earlier state of epileptogenesis. Remarkably, inhibition of TrkB-PLCγ1 signaling in the absence of a recent seizure did not reduce severity of subsequent seizures. These results suggest a novel strategy for limiting progression or potentially ameliorating severity of TLE whereby transient inhibition of TrkB-PLCγ1 signaling is initiated following a seizure. ANN NEUROL 2019;86:939-950.


Can dynamic imaging, using 18F-FDG PET/CT and CT perfusion differentiate between benign and malignant pulmonary nodules?
The aim of the study was to derive and compare metabolic parameters relating to benign and malignant pulmonary nodules using dynamic 2-deoxy-2-[fluorine-18]fluoro-D-glucose (18F-FDG) PET/CT, and nodule perfusion parameters derived through perfusion computed tomography (CT). Twenty patients with 21 pulmonary nodules incidentally detected on CT underwent a dynamic 18F-FDG PET/CT and a perfusion CT. The maximum standardized uptake value (SUVmax) was measured on conventional 18F-FDG PET/CT images. The influx constant (Ki ) was calculated from the dynamic 18F-FDG PET/CT data using Patlak model. Arterial flow (AF) using the maximum slope model and blood volume (BV) using the Patlak plot method for each nodule were calculated from the perfusion CT data. All nodules were characterized as malignant or benign based on histopathology or 2 year follow up CT. All parameters were statistically compared between the two groups using the nonparametric Mann-Whitney test. Twelve malignant and 9 benign lung nodules were analysed (median size 20.1 mm, 9-29 mm) in 21 patients (male/female = 11/9; mean age ± SD: 65.3 ± 7.4; age range: 50-76 years). The average SUVmax values ± SD of the benign and malignant nodules were 2.2 ± 1.7 vs. 7.0 ± 4.5, respectively (p = 0.0148). Average Ki values in benign and malignant nodules were 0.0057 ± 0.0071 and 0.0230 ± 0.0155 min-1, respectively (p = 0.0311). Average BV for the benign and malignant nodules were 11.6857 ± 6.7347 and 28.3400 ± 15.9672 ml/100 ml, respectively (p = 0.0250). Average AF for the benign and malignant nodules were 74.4571 ± 89.0321 and 89.200 ± 49.8883 ml/100g/min, respectively (p = 0.1613). Dynamic 18F-FDG PET/CT and perfusion CT derived blood volume had similar capability to differentiate benign from malignant lung nodules.


Folate metabolism and neural tube defects.
Neural tube defects may due to a number of factors acting on a susceptible embryo. The most widely accepted is a lack of folic acid at a critical time of development. Studies in which folic acid supplements have been given are reviewed. The results of these support the policy of giving folic acid, starting before conception. The metabolism of folate and vitamin B12 is discussed, including specific metabolic disorders; although there is no evidence that these play any part in causing neural tube defects. The special problems that occur among women taking anti-epileptic drugs are also considered. There are slight differences in the recommendations that have been made for supplementation, and further studies are needed before there can be complete agreement.


Patient goals after operation in the posterior vaginal compartment.
Success after operation for a pelvic organ prolapse in the posterior vaginal compartment is often related to restoration of anatomy, but success for the patient is linked to achievement of patient-reported goals. We investigated patient-reported goals after an operation in the posterior compartment and to which extent the goals had been achieved. A prospective case series study including 87 women undergoing operation in the posterior compartment at Aalborg University Hospital. The women were asked to list up to three goals they wished to fulfil with the operation. Three months after surgery a telephone interview was conducted in which the women were asked whether each single goal was fulfilled, partly fulfilled or not fulfilled and to estimate the extent to which the goals had been achieved on a VAS scale from 1 to 10. All patient-reported goals were divided into eight groups: 1: bulging, 2: bowel problems, 3: urinary problems, 4: sexual problems, 5: psychological problems, 6: physical activity, 7: pain and 8: others. A total of 233 goals were stated. Most goals were related to bowel problems (37.3%) and bulging (21.0%). Median total VAS score was 9. Overall 58.8% of all goals were categorized as fulfilled and 22.3% as partly fulfilled. Fulfilled goals were 83.7% in the group with bulging problems, sexuality problems 65%, and bowel problems 57.5%. Urinary problems had fewest fulfilled goals (18.5%). Bowel problems were further divided into evacuation problems, incontinence, constipation and others. Goals concerning evacuation problems were most often fulfilled (76.1%), and goals concerning anal incontinence were rarely fulfilled (25.0%). Approximately 80% of the patient-reported goals after posterior compartment operation were fulfilled or partly fulfilled. Most goals were related to bowel problems and bulging. Bowel problems in the form of evacuation problems were more often solved than incontinence and constipation, and women should be advised about this. All goals should be discussed with the patient prior to an operation.


[Induced prescription in primary health care in area Bilbao].
to know the proportion of induced prescription (IP) in Area Bilbao and its source, the proportion of cost IP accounts for, the proportion of IP in the main therapeutic groups, the attitude of GP when requested for prescription and its influence on cost, the proportion of disagreement with requested prescription, the reasons for disagreement, and the proportion with letter from specialist. to know the proportion of IP in the remaining therapeutic groups, in drugs of low clinical value, in generic drugs and in new drugs with low or no therapeutic improvement. A descriptive cross-sectional study.Setting. Primary health care. Drugs prescribable under National Health Service prescribed by and/or requested to GPs. Main results. 7.922 drugs were analysed. Type of prescription: IP, 48.3% (95% CI, 47.2-49.4); GP prescription (GPP), 50.6% (95% CI, 49.5-51.7); unknown source, 1,1% (95% CI, 0.9-1.3). Main source, public specialist (72.2%), private specialist (16.6%). IP accounted for 62.5% of cost. In the most prescribed therapeutic group, central nervous system (24.2%), IP, 39.8%; GPP, 58.9%; in cardiovascular system (19.1%), IP, 56.2%; GPP, 43.1%. 98.4% of requested prescription was actually prescribed, 1.2% was changed and 0.4%, suppressed. Proportion of disagreement, 11%; reasons for disagreement, no need for medical treatment (23.9%), therapeutic group (34.4%), active ingredient (13.2%), brand name (28.5%). There was a 62.4% with letter from specialist. Primary care is not accountable for a substantial proportion of prescription. GP prescribes a considerable proportion of drugs without agreement. It would be necessary a system that allows to separate the cost by care levels and also improve their communication.


Fat distribution in relation to sex and socioeconomic status in children 4-19 years.
Fat distribution was studied in an urban sample of boys and girls 4.5 to 19.5 years from the Basque province of Biscay by means of Principal Component Analysis (PCA) of five skinfolds. The PCA extracted four components, which explained 99.1% of the total variance. The first principal component revealed strong stability across age and sex, and was related to a pattern of central body fat distribution. The three other components, upper-lower trunk fat, lateral-medial trunk fat, and upper-lower extremity fat, showed poor stability due largely to the influence of age and, to a lesser degree, sex. In both sexes, individual scores of the four factors did not show multivariate differences by socioeconomic status when a MANOVA with age, age2 and age3 as covariates was done. Nevertheless, the first factor scores were significantly higher only in the poorer socioeconomic group of girls. The results are explained in the context of either different lifestyles related to socioeconomic status, a protective effect against environmental stress on urban males, or greater plasticity of trunk fat relative to extremity fat in females. Am. J. Hum. Biol. 10:799-806, 1998. © 1998 Wiley-Liss, Inc.


Characterization of differentiation antigens expressed in bovine lymphosarcomas.
To characterize the cell-surface antigens expressed in tumour cells derived from bovine leukosis and to determine their cell lineages, the immunophenotypes of the tumour cells from 13 bovine lymphosarcomas were examined with 13 monoclonal antibodies (mAbs). Of 13 cattle with lymphosarcomas, four were identified clinically as having the thymic-type sporadic bovine leukosis (SBL) and one as having the skin-type; two had enzootic bovine leukosis (EBL) and six were untypable. Flow cytometric analysis revealed that the tumour cells from nine cases were of T-cell lineage (BoCD5+, BoCD2+ or BoCD2-) and two were of B-cell lineage (MHC-II+, BoCD5+, IgM+); there were two bovine leukaemia virus-infected cattle (EBL). T-cell tumours appeared to originate from immature (BoCD4-, BoCD8-) T cells, but there was no significant relationship between clinical type (EBL, calf-, skin- and thymic-type) and tumour-cell immunophenotype.


[Schwannoma of the nasal cavity: a case report].
Schwannomas of the nasal cavity and paranasal sinuses are quite rare, with 4% occurring in this location. Most of them are benign and do not recur when totally removed by surgery. It is very important to distinguish between schwannoma and primary benign neurofibroma. Neurofibromas are lesions having the possibility for malignant transformation and recurrence. A case of schwannoma in the nasal cavity is reported, and the diagnostic and therapeutic procedures, as well as recommendations from the literature, are described. The histological and immunohistochemical features are discussed in detail to draw a distinction between schwannoma and neurofibroma. In cases of intranasal and paranasal lesions, the existence of a schwannoma must be considered. Differentiating between schwannoma and neurofibroma is important for estimating the risk of malignant transformation and recurrence.


Calcium sulfide-organosilicon complex for sustained release of H2S in strongly acidic wastewater: Synthesis, mechanism and efficiency.
Sulfide precipitation is an efficient method to remove Cu(II) and As(III) from strongly acidic wastewater, but the instantaneous release of H2S from traditional sulfuration reagents causes serious H2S pollution. Moreover, the obtained precipitates are mixtures of CuS and As2S3, leading to difficulties in resource recovery. In this study, a calcium sulfide-organosilicon complex (CaS-OSCS), in which CaS was coated into a matrix of {[O1.5Si(CH2)3NH]CS}n (OSCS) via the coordination bonding, was developed. OSCS, as a matrix of CaS-OSCS, can ensure the sustained and stable release of H2S under strongly acidic conditions owing to its low swelling (1.75% swelling ratio) and excellent acid resistance. The release longevity of H2S from CaS-OSCS extended from 5 min up to 50 min compared with that from CaS because the hydrophobic OSCS prevented solution diffusing to the pores of CaS-OSCS and thus slowed down the hydrolysis of CaS in pores. 99% of Cu(II)/As(III) was precipitated without H2S escape, and the dosage of sulfuration reagents was reduced by 30%. In addition, CaS-OSCS improved the selective separation of copper from wastewater, and a separation factor between Cu(II) and As(III) reached 2376. This study provides a potential approach for the elimination of H2S pollution and selective recovery of copper.


The ultrasonic harmonic scalpel for circumcision: experimental evaluation using dogs.
Male circumcision is one of the most commonly performed operations worldwide, and many novel techniques have been developed for better postoperative outcomes. The purpose of this study was to explore the feasibility of applying the ultracision harmonic scalpel (UHS) for circumcision by using dogs. Sixteen adult male dogs were divided into two groups: the UHS group and the control group. The dogs were circumcised with either the UHS or a conventional scalpel. The UHS circumcision procedure and the effects were imaged 1 week after surgery. The two groups were compared with respect to the operative time and volume of blood loss. Postoperative complications, including oedema, infection, bleeding of the incision and wound dehiscence, were recorded for both groups. The mean operative time for the UHS group was only 5.1 min compared with the 35.5 min of the conventional group. The mean blood loss was less than 2 ml for the UHS group and 15 ml for the conventional group. There was only one case of mild oedema in the UHS group, but the postoperative complications in the conventional group included two cases of mild oedema, one infection of the incision and one case of bleeding of the incision. In conclusion, circumcision using UHS is a novel technique to treat patients with phimosis and excessive foreskin, and this method has a short operative time, less blood loss and fewer complications than the conventional scalpel method. This small animal study provides a basis for embarking on a larger-scale clinical trial of the UHS.


Three-Dimensional Heads-Up vs. Standard Operating Microscope for Cataract Surgery: A Systematic Review and Meta-Analysis.
The surgical time duration, the postoperative best-corrected visual acuity (BCVA), and the incidence rate of intraoperative complications, alongside the vision and posturing parameters, were estimated by systematic review and meta-analysis to compare the three-dimensional (3D) heads-up visualization system (HUVS) and standard operating microscope (SOM) in cataract surgery. A literature search was conducted using PubMed, Embase, and Scopus on 26 June 2022. The weighted mean difference (WMD) was used to present postoperative BCVA and the mean surgical time duration, whereas the risk ratio (RR) was used to present the incidence rate of intraoperative complications. Publication bias was evaluated with Egger's test. The Cochrane Collaboration's Tool for randomized clinical trials, the methodological index for non-randomized, and the Newcastle-Ottawa Scale were used to assess the risk of bias. The research has been registered with the PROSPERO database (identifier, CRD42022339186). In the meta-analysis of five studies with 1021 participants, the pooled weighted mean difference (WMD) of the postoperative BCVA showed no significant difference between patients who underwent HUVS versus SOM cataract surgery (WMD = -0.01, 95% confidence interval (CI): -0.01 -0.02). In the meta-analysis of nine studies with 5505 participants, the pooled WMD of mean surgical time duration revealed no significant difference between patients who underwent HUVS versus SOM cataract surgery (WMD = 0.17, 95% CI: -0.43-0.76). In the meta-analysis of nine studies with 8609 participants, the pooled risk RR associated with intraoperative complications was 1.00 (95% CI, 1.00-1.01). 3D HUVS and SOM provide comparable surgical time duration, postoperative BCVA, and incidence rate of intraoperative complications.


IL-17 increases cadherin-11 expression in a model of autoimmune experimental arthritis and in rheumatoid arthritis.
IL-17 plays important roles in synovial inflammation and bone destruction in the mouse model of autoimmune arthritis and in rheumatoid arthritis (RA). Cadherin-11 determines the behavior of synovial cells in their proinflammatory and destructive tissue response in inflammatory arthritis, and promotes the invasive behavior of fibroblast-like synoviocytes (FLS). The purpose of this study was to examine the effect of IL-17 on the expression of cadherin-11 in autoimmune experimental arthritis and in RA synovium. The severity of synovial inflammation and bone destruction were examined in IL-17-injected knee joints of mice with collagen-induced arthritis (CIA). Cadherin-11 expression was examined in the synovium of mice with CIA, of IL-1 receptor antagonist (IL-1Ra)-deficient mice and of patients with RA and osteoarthritis (OA). Cadherin-11 expression was also examined in the synovium of IL-17 injected knee joints from CIA mice and in IL-17-stimulated FLS of CIA mice and RA patients. IL-17 aggravated synovial inflammation and bone destruction in CIA. By immunohistochemistry, cadherin-11 expression was increased in the synovium of mice with CIA and IL-1Ra-deficient mice and in patients with RA. Synovial cadherin-11 expression in IL-17-injected knee joints, measured by real-time RT-PCR, Western blot and immunohistochemistry, was increased in CIA. Cadherin-11 expression was significantly increased by IL-17 in cultured FLS of CIA mice and RA patients, and these increases were blocked by NF-κB inhibitors. IL-17 increased the expression of cadherin-11 in vivo and in vitro, which implies that an IL-17-induced increase of cadherin-11 is involved in IL-17-induced aggravation of joint destruction and inflammation.


Getting on top of sleep: Research begins to unravel the molecular mechanisms that link sleep and health.
There is no doubt that sleep is good for health. Yet, understanding how sleep exerts its healing effects has been a formidable challenge.


Comparative acceptability of transnasal esophagoscopy and esophageal capsule esophagoscopy: a randomized, controlled trial in veterans.
EGD screening for Barrett's esophagus (BE) is costly, with insufficient evidence to support its effectiveness. To compare acceptance and tolerability of 2 novel, office-based, endoscopic screening techniques done on nonsedated patients. Randomized block study design with allocation concealment. Outpatient clinic setting at a Veterans Affairs medical center. A total of 184 veterans with or without GERD symptoms. Transnasal esophagoscopy (TNE) or esophageal capsule esophagoscopy (ECE). Acceptance and tolerability of TNE and ECE and effectiveness of BE screening. Esophageal screening was accepted by 184 of 1210 (15.2%) veterans. The majority were men (96%) and African American (58%), with a mean (± standard deviation) age of 58.9 (± 8.1) years. Five TNE participants (5%) and 2 ECE participants (2%) refused the assigned procedure after randomization (P = .25). Eleven patients (12.6%) randomized to TNE crossed the minimal clinically important threshold for overall procedure tolerability, as opposed to no patients randomized to ECE (P = .001). Effectiveness of BE screening was not significantly different in both procedures (TNE vs ECE = 3.2% vs 5.4%; P = .47). Overall, BE was present in 8 of 75 white participants (10.6%) and in 0 of 107 African American participants (P < .001). The general veteran population may not reflect the screening population for BE. Despite a small proportion of veterans expressing interest in esophageal screening, both TNE and ECE were feasible in the outpatient clinic setting and were accepted by >95% of participants who did express an interest. Screening was effective only in white participants. Moderate differences in tolerability between TNE and ECE notwithstanding, cost considerations along with availability of equipment and trained personnel should guide the modality to be used for BE screening.


Systems biology approaches to abscisic acid signaling.
Recent advances in our understanding of abscisic acid (ABA) signaling have identified a core pathway consisting of receptors (PYR/PYL/RCAR), protein phosphatases (PP2C), protein kinases (SnRK2), and several downstream factors that will lead to the next stage of ABA research. Systems biology will be an important concept for further understanding ABA responses in plants. In this review, two practical approaches of systems biology to ABA signaling are presented: the one is 'transcriptome analysis', which covers coding genes as well as unannotated transcripts, and the other is 'phosphoproteomics'. The latter technology will offer an unprecedented overview of the regulatory networks involved in ABA signaling because protein phosphorylation/dephosphorylation is a major center of such regulation. Systematic studies will contribute to our understanding of the network structure and dynamics of ABA signaling; moreover, systems biology will facilitate ABA signaling studies as well as future biotechnological applications in crops or trees.


miRNA-128 and miRNA-223 regulate cholesterol-mediated drug resistance in breast cancer.
Breast cancer is the second most common malignancy worldwide and 70% of all breast cancer cases are estrogen receptor-positive (ER+). Endocrine therapy, Tamoxifen (TAM), is a popular treatment for ER+ breast cancer patients; however, despite its success in reducing breast cancer mortality, cancer drug resistance remains a significant challenge. A major contributor to this resistance is the dysregulation of cholesterol homeostasis, where breast cancer cells have elevated cholesterol levels. MicroRNAs (miRNAs) are master regulators of cholesterol-related and cancer drug resistance pathways, and their aberrant expression often confers resistance. Therefore, we aimed to investigate the roles of miRNA-128 and miRNA-223 in cholesterol-mediated TAM resistance. Three breast cancer cell lines were treated with a combination of 1 μM TAM and 10 μM of a cholesterol depleting agent (Acetyl Plumbagin: AP) following transfection with a miR-128 inhibitor or a miR-223 mimic. Cell viability and cholesterol levels were assessed using an MTT assay and fluorescence staining, respectively. In addition, expression levels of several genes and proteins involved in cancer drug resistance and cholesterol homeostasis were also assessed using RT-qPCR and western blotting. The combination treatment with altered miRNA expression led to reduced cell viability due to a reduction in free cholesterol and lipid rafts in MCF-7, MDA-MB-231, and long-term estrogen-deprived cells (resistant breast cancer cells). Moreover, reduced miR-128 expression was favoured in all breast cancer cell lines as this alteration lowered the expression of genes involved in cholesterol synthesis and transport, drug resistance, and cell signalling. Investigating the gene expression profiles in different breast cancer cell lines was important to elucidate further the molecular mechanisms involved in miRNA-regulated cholesterol homeostasis and cancer drug resistance. Therefore, our findings demonstrated that miR-128 and miR-223 could be potential targets in reducing TAM resistance through the depletion of excess cholesterol.


[Radiation exposure in diagnostic nuclear medicine: risk comparisons on the basis of effective doses].
The hypothetical risk of medical radiation exposure is often extrapolated to large population groups using arbitrary assumptions. To assess risk and benefit of diagnostic nuclear medicine and roentgenology, estimation of individual loss of life expectancy should be preferred. Employing ICRP 60 figures, diagnostic medical radiation exposure yields effective doses which commonly lie below or within the range of annual exposure from natural radiation (1-6 mSv). On an average, the individual medical exposure in Germany is estimated to be between 1 and 2 mSv which--extrapolated to total lifespan--leads to a hypothetical loss of life expectancy of 20-40 days. In the light of the rapid increase of life expectancy due to progresses in medical diagnostics and treatment after the introduction of X-rays, this figure is negligibly small.


βIII-tubulin enhances efficacy of cabazitaxel as compared with docetaxel.
Cabazitaxel is a novel taxane approved for treatment of metastatic hormone-refractory prostate cancer in patients pretreated with docetaxel. Cabazitaxel, docetaxel, and paclitaxel bind specifically to tubulin in microtubules, disrupting functions essential to tumor growth. High levels of βIII-tubulin isotype expression are associated with tumor aggressivity and drug resistance. To understand cabazitaxel's increased efficacy, we examined binding of radio-labeled cabazitaxel and docetaxel to microtubules and the drugs' suppression of microtubule dynamic instability in vitro in microtubules assembled from purified bovine brain tubulin containing or devoid of βIII-tubulin. We found that cabazitaxel suppresses microtubule dynamic instability significantly more potently in the presence of βIII-tubulin than in its absence. In contrast, docetaxel showed no βIII-tubulin-enhanced microtubule stabilization. We also asked if the selective potency of cabazitaxel on βIII-tubulin-containing purified microtubules in vitro extends to cabazitaxel's effects in human tumor cells. Using MCF7 human breast adenocarcinoma cells, we found that cabazitaxel also suppressed microtubule shortening rates, shortening lengths, and dynamicity significantly more strongly in cells with normal levels of βIII-tubulin than after 50% reduction of βIII-tubulin expression by siRNA knockdown. Cabazitaxel also more strongly induced mitotic arrest in MCF7 cells with normal βIII-tubulin levels than after βIII-tubulin reduction. In contrast, docetaxel had little or no βIII-tubulin-dependent selective effect on microtubule dynamics or mitotic arrest. The selective potency of cabazitaxel on purified βIII-tubulin-containing microtubules and in cells expressing βIII-tubulin suggests that cabazitaxel may be unusual among microtubule-targeted drugs in its superior anti-tumor efficacy in tumors overexpressing βIII-tubulin.


Tetra-aqua-(nitrato-κO,O')bis-(pyridinium-4-carboxyl-ate-κO)europium(III) dinitrate.
The asymmetric unit of the title compound, [Eu(NO(3))(C(6)H(5)NO(2))(2)(H(2)O)(4)](NO(3))(2), consists of one-half of the C(2) symmetric coordination cation and one nitrate anion. The eight-coordinated Eu(III) atom is in a distorted dodeca-hedral coordination environment. The coordination cations and nitrate anions are connected via O-H⋯O and N-H⋯O hydrogen bonds into a three-dimensional network.


Neobacillus massiliamazoniensis sp. nov., a new bacterial species isolated from stool sample of an inhabitant of the Amazon region.
Using a culturomics approach, a strain was isolated, identified and characterised following the taxonogenomics concept. Neobacillus massiliamazoniensis sp. nov., strain LF1T (=CSURP1359) was isolated from human stool. The 16S rRNA gene sequence analysis of strain LF1T (accession number: LK021124) exhibits 98.32% similarity levels with Neobacillus bataviensis strain IDA1115 (accession number: NR_036766.1), the phylogenetically closest related species with standing in nomenclature. The draft genome size of strain LF1T (accession number: CVRB00000000) is 4.6 Mbp with a G+C content of 34.1 mol%. Analysis of phylogenic tree, genomic analysis and phenotypic criteria described here sufficiently prove that this bacterium is different from previously known bacterial species with standing in nomenclature and represents a new Neobacillus species belonging to Firmicutes phylum.


[Results of voluntary and mandatory statistics 1986/87--including a comparison with the preliminary study 1984/85. Scope of the topic: experiences after 2.5 years of the federal directive on operating cost rates of 1985].
The absolute necessity of checking documentation received was reported on, as well as the fact that the legislature cannot assume that one can draw conclusions from one year about the following year. It was shown that the introduction of new methods can considerably affect diagnosis statistics, and pointed out that easier research into complications was one positive effect of the--externally induced--more detailed formulation of medical reports. Since, in our 10,000-patient orthopedic-traumatologic clinic, we had to state every fourth ICD-9 figure including the V-classification, it would not be possible in our case to cover the entire hospital with just a few code numbers. Furthermore, it has so far proved right, in spite of the stipulation to use ICD-9, to perform basic documentation using our in-house code. This appears indispensable to us, particularly considering the error rate when decoding ICD-9 data.


Comparison of viable and nonviable tumor uptake of Sc-46, Mn-54, Zn-65, In-111 and Au-195 with Ga-67 citrate in a hepatoma model.
The tissue distribution of Sc-46, Mn-54, Zn-65, In-111 and Au-195 were studied in a rat hepatoma model at various time intervals over a 96 h period. The tumor localizing properties of these isotopes were evaluated by examining their incorporation and clearance from viable and nonviable tumor tissue and determining the critical tissue ratios formed with blood and muscle. In general, the results showed greater uptake in viable than nonviable tumor tissue at early time periods (4-24 h). By 96 h, however, the activity remaining in the nonviable tumor tissue exceeded the quantity in viable tumor tissue. This trend was previously noted for Ga-67. When compared with Ga-67, only Mn-54 among the isotopes studied showed remarkably higher viable tumor/blood ratios (4-24 h, 45:1-83:1 respectively). Manganese-54 also showed highly significant accumulation in cardiac muscle with a heart/blood ratio at 4 h superior to comparable values previously reported for Cs-137 and Tl-201. It is suggested that tumor and heart imaging may be feasible utilizing radioactive manganese (Mn-51 or Mn-52) with the new positron imaging systems.


Significantly different expression levels of microRNAs associated with vascular invasion in hepatocellular carcinoma and their prognostic significance after surgical resection.
Although gross vascular invasion (VI) has prognostic significance in patients with hepatocellular carcinoma (HCC) who have undergone hepatic resection, few studies have investigated the relationship between gross VI and aberrant expression of microribonucleic acids (miRNAs and miRs). Thus, the objective of this study was to identify miRNAs selectively expressed in HCC with gross VI and investigate their prognostic significance. Eligible two datasets (accession number: GSE20594 and GSE67140) were collected from the National Center for Biotechnology Information's (NCBI) Gene Expression Omnibus (GEO) database to compare miRNAs expression between HCC with and without gross VI. Differentially expressed miRNAs were externally validated using expression data from The Cancer Genome Atlas (TCGA) database. Prognostic significance and predicted functions of selected miRNAs for HCC were also investigated. Thirty-five miRNAs were differentially expressed between HCC with and without gross VI in both datasets. Among them, three miRNAs were validated using TCGA database. miR-99a, miR-100, and miR-148a were downregulated to a greater extent in patients with HCC and gross VI than in those with HCC but no gross VI. Receiver operating characteristic (ROC) curve analysis showed discriminatory power of these miRNAs in predicting gross VI. Multivariate survival analysis revealed that types of surgery, advanced tumor node metastasis (TNM) stage, and low expression of miR-100-5p were independently associated with tumor recurrence. It also revealed that types of surgery, advanced TNM stage, low expression of miR-100-5p and miR-148a-3p were independent risk factors for overall survival (OS) after hepatic resection for HCC. A text mining analysis revealed that these miRNAs were linked to multifaceted hallmarks of cancer, including "invasion and metastasis." Low expressions of miR-100-5p and miR-148a-3p were associated with gross VI and poor survival of patients after hepatic resection for HCC.


[Burn injuries during surgery (author's transl)].
The simultaneous use of high frequency apparatuses and a heated water bed may, in certain unfavourable circumstances result in burn injuries.


Placental teratoma or acardius amorphus with amniotic band syndrome.
The differential diagnosis between placental teratoma and fetus acardius may be difficult. Both are rare conditions and show a variable degree of organisation. Important diagnostic features are the presence or absence of an umbilical cord and craniocaudal development. The presence of an umbilical cord and obvious craniocaudal development is highly indicative of fetus acardius. A fetus acardius is a malformed member of a monochorial twin. An acardius is probably caused by overpowering of the heart of the fetus acardius by that of the normal sibling or primary agenesis of the heart. Our case illustrates the difficulties in making the right diagnosis. Careful analysis showed that most probably amniotic rupture followed by formation of amniotic bands had resulted in the development of a fetus acardius.


Quality of Life and Its Association with Level of Functioning in Young Children with Cerebral Palsy.
Quality of life (QOL) in older children, adolescents, and adults with cerebral palsy (CP) is significantly impaired. Level of functioning is one of the probable determinants of impairment in QOL. However, such studies in young children with CP are scarce in the literature. Parents of all consecutive children aged between 1 and 4 years with a confirmed diagnosis of CP completed the Infant Toddler Quality of Life (ITQOL) questionnaire. Total and individual subdomain scores of ITQOL were examined for association with the level of functioning measured by Gross Motor Function Classification System-Expanded & Revised (GMFCS E&R), Mini-Manual Ability Classification System (Mini-MACS), Communication Function Classification System (CFCS), and Eating and Drinking Ability Classification System (EDACS), with/without adjustment to probable confounding variables. One hundred three children with CP (74 boys, mean age: 2.6 ± 0.9 years, 49% lower and 39% middle socioeconomic status) were enrolled. All four scales (GMFCS, Mini-MACS, CFCS, and EDACS) describing levels of functioning had significant association with ITQOL total score (β= -0.19, -0.15, -0.11, -0.09, respectively), which persisted even after adjusting for confounding variables (p = 0.004, 0.01, 0.03, and 0.046, respectively). Among the confounding variables, uncontrolled seizures, significant vision impairment, lower socioeconomic status, type of CP, and institution of comprehensive rehabilitation measures for ≥6 months had a significant association with ITQOL score (p = 0.03, 0.04, 0.02, 0.02, and 0.01, respectively). Level of functioning as measured by GMFCS, Mini-MACS, EDACS, and CFCS is independent predictors of impairment in QOL in young children with CP.


Integrating eDNA and citizen science observations to model distribution of a temperate freshwater turtle near its northern range limit.
To determine species distributions and the factors underlying them, reliable occurrence data are crucial. Assembling such data can be challenging for species with cryptic life histories or that occur at low densities. We developed species-specific eDNA protocols, from sampling through data interpretation, to detect the common musk turtle (Sternotherus odoratus) and tested whether eDNA occurrences change our understanding of the species distribution and the factors that shape its northern range limit. We used Species Distribution Models (SDMs) with full parameter optimization on citizen science observations of S. odoratus in Southern Ontario alone and together with eDNA occurrences. Our eDNA protocol was robust and sensitive. SDMs built from traditional observations and those supplemented with eDNA detections were comparable in prediction accuracy. However, models with eDNA detections suggested that the distribution of S. odoratus in Southern Ontario is underestimated, especially near its northern range limit, and that it is shaped by thermal conditions, hydrology, and elevation. Our study underscores the promise of eDNA for surveying cryptic aquatic organisms in undocumented areas, and how such insights can help us to improve our understanding of species distributions.


Value of two-dimensional echocardiography, electrocardiography, and clinical signs in detecting right ventricular infarction.
Noninvasive tests for the diagnosis of right ventricular (RV) infarction--two-dimensional echocardiography (2DE), ST elevation in V4R, and clinical parameters--were compared with equilibrium gated blood pool study (GBPS) in 50 patients after acute inferior myocardial infarction. Twenty-two of 50 patients had RV wall motion abnormalities on GBPS and 20 of 50 on 2DE. Sensitivity and specificity of 2DE was 82% and 93%, ST elevation in V4R was 50% and 71%, elevation of venous pressure was 77% and 85%, and a positive Kussmaul's sign was found in 59% and 89% for the detection of RV infarction compared to GBPS. Patients with RV infarction had higher peak creatine kinase levels and lower left ventricular ejection fractions than patients without RV infarction. Three patients died and all had significant left ventricular damage. At 20 weeks' follow-up, two thirds of the patients had no residual RV wall motion abnormalities, and all but two patients showed some recovery.


Pairwise interact-and-imitate dynamics.
This paper introduces and studies a class of evolutionary dynamics-pairwise interact-and-imitate dynamics (PIID)-in which agents are matched in pairs, engage in a symmetric game, and imitate the opponent with a probability that depends on the difference in their payoffs. We provide a condition on the underlying game, named supremacy, and show that the population state in which all agents play the supreme strategy is globally asymptotically stable. We extend the framework to allow for payoff uncertainty, and check the robustness of our results to the introduction of some heterogeneity in the revision protocol followed by agents. Finally, we show that PIID can allow the survival of strictly dominated strategies, leads to the emergence of inefficient conventions in social dilemmas, and makes assortment ineffective in promoting cooperation.


Molecular Recognition in Asymmetric Counteranion Catalysis: Understanding Chiral Phosphate-Mediated Desymmetrization.
We describe the first theoretical study of a landmark example of chiral anion phase-transfer catalysis: the enantioselective ring-opening of meso-aziridinium and episulfonium cations promoted by asymmetric counteranion-directed catalysis (ACDC). The mechanism of ion-pairing, ring-opening, and catalyst deactivation have been studied in the condensed phase with both classical and quantum methods using explicitly and implicitly solvated models. We find that the stability of chiral ion-pairs, a prerequisite for asymmetric catalysis, is dominated by electrostatic interactions at long range and by CH···O interactions at short range. The decisive role of solvent upon ion-pair formation and of nonbonding interactions upon enantioselectivity are quantified by complementary computational approaches. The major enantiomer is favored by a smaller distortion of the substrate, demonstrated by a distortion/interaction analysis. Our computational results rationalize the stereoselectivity for several experimental results and demonstrate a combined classical/quantum approach to perform realistic modeling of chiral counterion catalysis in solution.


Frequent loss of heterozygosity in the β2-microglobulin region of chromosome 15 in primary human tumors.
Downregulation or total loss of HLA class I expression on tumor cells is known as a mechanism of cancer immune escape. Alterations of the HLA phenotype are frequently due to mutations affecting genes encoding the HLA class I heavy chains located on chromosome 6p21 or the β2-microglobulin (β2m) gene encoding the light chain of the HLA complex located on chromosome 15q21. Frequently irreversible total loss of HLA class I molecules is due to the coincidence of two molecular events, the mutation of one β2m gene and the loss of the second copy. The latter is detectable as loss of heterozygosity (LOH) of microsatellite markers in the β2m region on chromosome 15q21 (LOH-15q21). Thus, LOH-15q21 might be an important event in the processes of HLA class I downregulation and total loss. Here we studied the frequency of LOH-15q21 in tumor tissues of different entities. By determining the status of heterozygosity of two microsatellite markers we detected LOH-15q21 in 44% of bladder carcinomas (n = 69), in 35% of colon carcinomas (n = 95), in 16% of melanomas (n = 70) but only in 7% of renal cancers (n = 45). Moreover, we observed a frequent coincidence of LOH-15q21 and LOH-6p21 in colorectal carcinoma, bladder carcinoma and melanoma, but not for renal carcinoma. We believe that the high incidence of LOH-15q21 in some malignancies and especially the coincidence of LOH-15q21 and LOH-6p21 might have a strong impact on tumor immunogenicity and on the efficiency of cancer immunotherapy.


In vivo activation of CFTR-dependent chloride transport in murine airway epithelium by CNP.
Inhibitors of guanosine 3',5'-cyclic monophosphate (cGMP)-inhibited phosphodiesterases stimulate Cl- transport across the nasal epithelia of cystic fibrosis mice carrying the delta F508 mutation [cystic fibrosis transmembrane conductance regulator (CFTR) (delta F/delta F)], suggesting a role for cGMP in regulation of epithelial ion transport. Here we show that activation of membrane-bound guanylate cyclases by C-type natriuretic peptide (CNP) stimulates hyperpolarization of nasal epithelium in both wild-type and delta F508 CFTR mice in vivo but not in nasal epithelium of mice lacking CFTR [CFTR(-/-)]. With the use of a nasal transepithelial potential difference (TEPD) assay, CNP was found to hyperpolarize lumen negative TEPD by 6.1 +/- 0.6 mV in mice carrying wild-type CFTR. This value is consistent with that obtained with 8-bromoguanosine 3',5'-cyclic monophosphate (6.2 +/- 0.9 mV). A combination of the adenylate cyclase agonist forskolin and CNP demonstrated a synergistic ability to induce Cl- secretion across the nasal epithelium of CFTR(delta F/delta F) mice. No effect on TEPD was seen with this combination when used on CFTR(-/-) mice, implying that the CNP-induced change in TEPD in CFTR(delta F/delta F) mice is CFTR-dependent.


The effectiveness of permethrin-treated deer stations for control of the Lyme disease vector Ixodes scapularis on Cape Cod and the islands: a five-year experiment.
The use of animal host-targeted pesticide application to control blacklegged ticks, which transmit the Lyme disease bacterium between wildlife hosts and humans, is receiving increased attention as an approach to Lyme disease risk management. Included among the attractive features of host-targeted approaches is the reduced need for broad-scale pesticide usage. In the eastern USA, one of the best-known of these approaches is the corn-baited "4-poster" deer feeding station, so named because of the four pesticide-treated rollers that surround the bait troughs. Wildlife visitors to these devices receive an automatic topical application of acaricide, which kills attached ticks before they can reproduce. We conducted a 5-year controlled experiment to estimate the effects of 4-poster stations on tick populations in southeastern Massachusetts, where the incidence of Lyme disease is among the highest in the USA. We deployed a total of forty-two 4-posters among seven treatment sites and sampled for nymph and adult ticks at these sites and at seven untreated control sites during each year of the study. Study sites were distributed among Cape Cod, Martha's Vineyard, and Nantucket. The density of 4-poster deployment was lower than in previous 4-poster studies and resembled or possibly exceeded the levels of effort considered by county experts to be feasible for Lyme disease risk managers. Relative to controls, blacklegged tick abundance at treated sites was reduced by approximately 8.4%, which is considerably less than in previous 4-poster studies. In addition to the longer duration and greater replication in our study compared to others, possible but still incomplete explanations for the smaller impact we observed include the lower density of 4-poster deployment as well as landscape and mammalian community characteristics that may complicate the ecological relationship between white-tailed deer and blacklegged tick populations.


The influence of the enantiomeric ratio of an organic ligand on the structure and chirality of metal-organic frameworks.
We have prepared three distinct polyamino acid-based metal-organic frameworks (MOFs) with different chiralities and porosities using the same chemistry, by simply modifying the enantiomeric ratio of the chiral organic ligand used.


Interannual and between species comparison of the lipids, fatty acids and sterols of Antarctic krill from the US AMLR Elephant Island survey area.
Antarctic euphausiids, Euphausia superba, E. tricantha, E. frigida and Thysanoessa macrura were collected near Elephant/ Island / during 1997 and 1998. Total lipid was highest in E. superba small juveniles (16 mg g(-1) wet mass), ranging from 12 to 15 mg in other euphausiids. Polar lipid (56-81% of total lipid) and triacylglycerol (12-38%) were the major lipids with wax esters (6%) only present in E. tricantha. Cholesterol was the major sterol (80-100% of total sterols) with desmosterol second in abundance (1-18%). 1997 T. macrura and E. superba contained a more diverse sterol profile, including 24-nordehydrocholesterol (0.1-1.7%), trans-dehydrocholesterol (1.1-1.5%), brassicasterol (0.5-1.7%), 24-methylenecholesterol (0.1-0.4%) and two stanols (0.1-0.2%). Monounsaturated fatty acids included primarily 18:1(n-9)c (7-21%), 18:1(n-7)c (3-13%) and 16:1(n-7)c (2-7%). The main saturated fatty acids in krill were 16:0 (18-29%), 14:0 (2-15%) and 18:0 (1-13%). Highest eicosapentaenoic acid [EPA, 20:5(n-3)] and docosahexaenoic acid [DHA, 22:6(n-3)] occurred in E. superba (EPA, 15-21%; DHA, 9-14%), and were less abundant in other krill. E. superba is a good source of EPA and DHA for consideration of direct or indirect use as a food item for human consumption. Lower levels of 18:4(n-3) in E. tricantha, E. frigida and T. macrura (0.4-0.7% of total fatty acids) are more consistent with a carnivorous or omnivorous diet as compared with herbivorous E. superba (3.7-9.4%). The polyunsaturated fatty acid (PUFA) 18:5(n-3) and the very-long chain (VLC-PUFA), C(26) and C(28) PUFA, were not present in 1997 samples, but were detected at low levels in most 1998 euphausiids. Interannual differences in these biomarkers suggest greater importance of dinoflagellates or some other phytoplankton group in the Elephant Island area during 1998. The data have enabled between year comparisons of trophodynamic interactions of krill collected in the Elephant Island region, and will be of use to groups using signature lipid methodology.


Association of untrained labor companion with operative delivery rate: retrospective study of 2247 women.
Support of a pregnant woman during labor by her partner is widely accepted, but the effect of the presence of the partner on delivery outcome is unknown. We conducted a retrospective cohort study to evaluate delivery outcome, defined as spontaneous delivery vs. vaginal-operative delivery or cesarean section, in patients with a singleton pregnancy between 38 weeks and 0 days of gestation (38/0) and 41 weeks and 6 days of gestation (41/6), who planned a vaginal delivery at the Department of Obstetrics, Medical University of Vienna, between January 2007 and December 2009, with respect to the presence of the father in the delivery room compared to the presence of an untrained female supportive companion or no companion. Univariate and multivariate logistic regression analyses were used to assess delivery outcome with respect to clinical variables, such as patient age, parity, body mass index (BMI), induction of labor, fetal birth weight, and years of education of the parturient. The study included 2247 women; 212 (9%, group I) were accompanied by a female supportive companion, 1396 (62%, group II) were accompanied by a male supportive companion, and 639 women (29%, group III) were accompanied by no supportive companion. The vaginal-operative and cesarean delivery rates were not significantly different among the three groups (19% in group I vs. 17% in group II vs. 18% in group III, p=0.5). In a multivariate analysis, operative delivery outcome was significantly associated with higher maternal age (p<0.001), lower parity (p<0.0001), and labor induction (p=0.001) but not with gender of the supportive companion (male vs. no companion: p=0.11; female vs. no companion: p=0.90; male vs. female companion: p=0.23). Parity, maternal age, and labor induction but not the presence or the gender of the supportive companion are associated with the rate of operative deliveries.


Heterogeneity of human colony-forming cells (CFU-C): differences in size, rate of colony formation, and responsiveness to colony-stimulating factor.
Human bone marrow cells have been fractionated by velocity sedimentation at unit gravity. Fractions were analyzed for cell morphology, number of nucleated cells and myeloid colony-forming cells (CFU-C's). Colony formation was assayed with the following CSF preparations: serum-free HLCM and two electrophoretically distinct CSF fractions (CSF-A and CSF-B) purified from the same source. Two distinct CFU-C populations were found. One, a rapidly sedimenting (7.2 to 8.0 mm/hr), population exhibited colonies after 7 days of culture in response to HLCM and CSF-A only. The second, a more slowly sedimenting (6.5 mm/hr) CFU-C peak, did not exhibit colonies until 11 days of culture and did so in response to all three CSF's tested. The results indicate that human bone marrow CFU-C's are heterogeneous and that the two purified CSF fractions from human lung have different CFU-C specificity.


The biological activity of interferon alpha is influenced by two distinct regions in the protein.
With the aim to assign differences in activity between murine interferon-alpha 1 and -alpha 4 to specific amino acids, we have constructed hybrid genes and analysed the antiviral properties of the corresponding hybrid proteins. The hybrid genes were constructed by means of homologous recombination between the alpha 1 and alpha 4 genes in Escherichia coli. Hybrids in which the N-terminal part is derived from alpha 1 show that two regions have a major effect on the activity: amino acid 10-20 and 55-67. When comparing hybrids with N-terminal alpha 4 sequences, transitions in activity are found in the same regions. Interestingly, the curves for the two sets of hybrids are exactly each others mirror image.


Combination therapy in inflammatory bowel disease - from traditional immunosuppressors towards the new paradigm of dual targeted therapy.
Combining immunosuppressors has been proposed as a strategy to enhance treatment efficacy in Inflammatory Bowel Disease (IBD). To summarize current evidence on combinations of targeted therapies with traditional immunosuppressors or with other targeted therapies. A literature search on PubMed and Medline databases was performed to identify relevant articles. Current evidence supports that the combination of infliximab and thiopurines is more effective than monotherapy with both agents in inducing remission in Crohn's Disease and Ulcerative colitis. Data on other combinations of other biologics and traditional immunosuppressors is lacking or show conflicting results. Vedolizumab seems a potentially effective maintenance regimen after calcineurin inhibitors-based rescue therapy in acute severe ulcerative colitis, as an alternative to thiopurines. Dual Targeted Therapy, which is the combination of 2 targeted therapies, might be a reasonable choice in patients with concomitant IBD and extraintestinal manifestations, or in patients with medical-refractory IBD who lack valid alternatives. Combinations with thiopurines are associated with an increased risk of infections and lymphoma. Data on other combinations is scarcer, but no specific safety issue has emerged so far. Combination therapies seem to be effective in selected patients, with an overall acceptable safety profile.


[Phenotypical features of a heterogeneous group of frequently ill children].
The most high morbidity in a group of frequent ailing with acute respiratory diseases was peculiar to the children with phenotype B RH+, with haptoglobin N 1-1, to nonsecretors of antigens ABO'(H) and to individuals, who were born from heterospecific pregnancy on antigens ABO(H) and Rhesus.


Experimental bioprosthetic reconstruction of the trachea.
We removed the tracheas from sacrificed laboratory animals and subjected this tissue to multi-step chemical processing. This method allowed us to preserve the cartilage and reduce its antigenicity, thus creating a bioprosthesis very similar to the host tissue. By using allogeneic and xenogeneic prostheses so prepared, no signs of immune rejections were seen following heterotopic or orthotopic implantations. The transplanted cartilage remained stable for periods ranging up to 21 weeks in recipient rats, while partial morphologic integrity of the cartilage was seen up to 1 year in pigs. Reepithelialization of the transplant with ciliated epithelium was completed in all specimens 12-24 weeks following surgery. Segmental replacement of up to one third of the whole trachea was possible in rats, whereas similar segmental replacements failed in pigs. We also found that successful reconstruction of window-shaped defects was possible. We consider our tracheal bioprosthesis to be superior to cialit-preserved grafts and also to most other biological reconstruction procedures.


Editorial Commentary: Psoas Tenotomy in the Setting of a Borderline Dysplastic Hip Risks Iatrogenic Instability: Be Extremely Cautious and Particularly in Athletes.
Successful outcomes after psoas tenotomies have been reported and proposed in the setting of recalcitrant internal snapping and psoas impingement. However, case reports citing hip flexion weakness and iatrogenic instability created concern regarding the role for psoas tenotomies. Despite these concerns, some recent studies reporting improved outcomes after endoscopic psoas tenotomies breathe further life into this controversial topic. Psoas tenotomy in the setting of a borderline dysplastic hip likely carries an even greater risk for iatrogenic instability. It might be critical to evaluate for clinical signs and symptoms of instability in addition to radiographic parameters to avoid this potentially devastating complication. In addition, the traditional definition of borderline dysplasia is based on lateral acetabular coverage that might be less important than anterior acetabular coverage and femoral version when contemplating psoas tenotomies on the basis of the dynamic anterior stabilizing effect of the iliopsoas myotendinous unit. Surgeons should also be extremely cautious when considering psoas tenotomy in an athletic population with the potential for persistent weakness and limited data hinting at inferior sports specific outcomes. In the end, it is not clear whether the psoas tenotomy "drives" the improvements seen in some studies, or whether many of these patients ultimately battle their way into a minimally clinically important difference "despite" the psoas tenotomy.


The therapeutic effect of clinical trials: understanding placebo response rates in clinical trials--a secondary analysis.
Placebo response rates in clinical trials vary considerably and are observed frequently. For new drugs it can be difficult to prove effectiveness superior to placebo. It is unclear what contributes to improvement in the placebo groups. We wanted to clarify, what elements of clinical trials determine placebo variability. We analysed a representative sample of 141 published long-term trials (randomized, double-blind, placebo-controlled; duration > 12 weeks) to find out what study characteristics predict placebo response rates in various diseases. Correlational and regression analyses with study characteristics and placebo response rates were carried out. We found a high and significant correlation between placebo and treatment response rate across diseases (r = .78; p < .001). A multiple regression model explained 79% of the variance in placebo variability (F = 59.7; p < 0.0001). Significant predictors are, among others, the duration of the study (beta = .31), the quality of the study (beta = .18), the fact whether a study is a prevention trial (beta = .44), whether dropouts have been documented (beta = -.20), or whether additional treatments have been documented (beta = -.17). Healing rates with placebo are lower in the following diagnoses; neoplasms (beta = -.21), nervous diseases (beta = -.10), substance abuse (beta = -.14). Without prevention trials the amount of variance explained is 42%. Medication response rates and placebo response rates in clinical trials are highly correlated. Trial characteristics can explain some portion of the variance in placebo healing rates in RCTs. Placebo response in trials is only partially due to methodological artefacts and only partially dependent on the diagnoses treated.


Effect of sucralfate and its components on taurocholate-induced damage to rat gastric mucosal cells in tissue culture.
The present study evaluated the effect of sucralfate and its components, sucrose octasulfate and aluminum hydroxide, on: (1) damage to rat cultured gastric mucosal cells induced by sodium taurocholate in a neutral environment and in conditions independent of systemic factors, (2) prostaglandin E2 and on 6-keto prostaglandin F1 alpha release by cultured cells, and (3) sulfhydryl content of cultured cells. Cell damage was quantitated by chromium-51 release assay. Prostaglandin E2 and 6-keto prostaglandin F1 alpha were measured by radioimmunoassay. Total sulfhydryl content of cultured cells was determined calorimetrically. Microscopically, sucralfate was found to adhere tightly to epithelial cell surfaces despite frequent washings. Sucralfate 2 mg/ml and 5 mg/ml significantly decreased taurocholate-induced damage, reducing taurocholate-induced specific 51Cr release by 11.8 points (equal to 29% decrease in cell damage, P less than 0.01) and 22.9 points (equal to 56% decrease in cell damage, P less than 0.001), respectively. Sucrose octasulfate and aluminum hydroxide did not exert significant protection against damage induced by sodium taurocholate. The protective effect of sucralfate was not prevented by indomethacin, nor was it counteracted by the sulfhydryl blocker, iodoacetamide. Sucralfate, but not its components, significantly and dose-dependently stimulated prostaglandin E2 (r = 0.94, P less than 0.05) and 6-keto prostaglandin F1 alpha (r = 0.89, P less than 0.05) production by cultured cells. Neither sucralfate nor its components affected sulfhydryl content of cultured cells. In conclusion, sucralfate, but not its components, (1) protects rat gastric mucosal cells against taurocholate-induced damage in conditions independent of systemic factors and in a neutral environment and (2) significantly stimulates prostaglandin production by cultured cells. (3) The protection by sucralfate in vitro does not seem to depend on its stimulatory effect on endogenous prostaglandin synthesis.


The telephone in primary care.
This paper presents a review of the use of the telephone in primary care medicine. The telephone is available to a large majority of United States citizens, a situation that is unusual in other countries. Between 15 and 20% of all primary medical contacts in the United States occur on the telephone. Approximately 40% of routine office telephone contacts are administrative in nature, the remainder involving direct requests for advice or treatment. After office hours, requests for immediate medical advice constitute almost all of the calls (for both daytime and after hours calls). Close to 70% of the medical calls are managed solely by use of telephone. Although the telephone is effectively used for medical consultation, teaching and survey purposes, it has been shown that health professionals are protocols or specific training tends to improve performance, but such programs are not a regular part of medical education.


Comparison of conventional socket attachment and bone-anchored prosthesis for persons living with transfemoral amputation - mobility and quality of life.
For patients with transfemoral amputation experiencing issues with their sockets, bone-anchored prosthesis systems are an alternative and sometimes the only way to be mobile and independent. The present cross-sectional study aimed to investigate the gait performance and quality of life of a group of patients treated with bone-anchored systems compared to those of participants treated with a conventional socket-suspended prosthesis. A total of 17 participants with a socket-suspended and 20 with a bone-anchored prosthesis were included. Gait patterns were examined for symmetry, and performance was assessed using the six-minute walk test and the timed "Up & Go" test. Magnetic resonance imaging was performed to detect signs of osteoarthritis in both hips. Mobility in everyday life and quality of life were assessed using questionnaires. There were no differences between the groups regarding the quality of life, daily mobility, and gait performance. The step width was significantly higher for the patients using socket-suspended prosthesis. The socket-suspended group showed a significant asymmetry regarding the step length. In the socket-suspended group, the prosthetic leg showed significantly higher cartilage abrasion than the contralateral leg did. Large differences in the measured outcomes in both groups illustrate the very different capabilities of the individual participants, which is apparently not primarily determined by the type of treatment. For patients who are satisfied with the socket treatment and perform well, bone-anchored prosthesis systems may not necessarily improve their functional capabilities and perceived quality of life.


[Finger injuries with a focus on ligamentous structures].
Ligamentous lesions of the fingers are common everyday injuries and usually the result of distortion or overloading. Numerous examination methods are available for dedicated radiological diagnosis of sometimes complex injury patterns. To review radiological diagnosis of the ligamentous structures of the finger joints including the presentation of anatomical, biomechanical and therapeutic aspects. Presentation of the anatomy and biomechanics as well as the most common trauma mechanisms of the ligamentous structures. Review of the literature, discussion of recent work and diagnostic expert recommendations. The most relevant ligamentous structures are collateral ligaments, pulley ligaments, volar plates and tendons. The goal of radiologic diagnosis is to accurately define the injury pattern and to differentiate between simple and complicated ligamentous lesions. In unclear cases, magnetic resonance imaging (MRI) has become standard for further diagnostics, which may allow depiction of ligamentous structures in submillimetre resolution. Today, differential diagnosis includes all radiological modalities, which ensures the determination of an adequate therapy and prevention of sequel at a high standard.


Periodontal therapy: a novel acute inflammatory model.
We designed a clinical trial at the Eastman Dental Hospital with the objective of developing a novel in vivo inflammatory model. We recruited 55 subjects suffering from severe periodontitis. Participants received intensive periodontal therapy. Blood samples were collected at baseline and 1 and 7 and 30 days after treatment and processed for a series of biomarkers (TNF-alpha, IL-6, CRP and Fibrinogen) by high-sensitivity assays and differential blood counts (standard laboratory procedures). TNF-alpha levels were significantly raised only after 1 day of therapy (P<0.01) whereas IL-6 (P<0.01), CRP (P<0.001) and Fibrinogen (P<0.001) concentrations peaked 24 hrs after and returned to baseline values within one month following therapy. Mild neutrophilia, monocytosis and lymphopenia were also observed. Intensive periodontal therapy induces a one week moderate inflammatory response and therefore it is proposed as a novel therapeutic and reliable non drug-induced in vivo model of acute inflammation.


Hepatitis B virus-host interactions and novel targets for viral cure.
Chronic infection with HBV is a major cause of advanced liver disease and hepatocellular carcinoma. Nucleos(t)ide analogues effectively control HBV replication but viral cure is rare. Hence treatment has often to be administered for an indefinite duration, increasing the risk for selection of drug resistant virus variants. PEG-interferon-α-based therapies can sometimes cure infection but suffer from a low response rate and severe side-effects. CHB is characterized by the persistence of a nuclear covalently closed circular DNA (cccDNA), which is not targeted by approved drugs. Targeting host factors which contribute to the viral life cycle provides new opportunities for the development of innovative therapeutic strategies aiming at HBV cure. An improved understanding of the host immune system has resulted in new potentially curative candidate approaches. Here, we review the recent advances in understanding HBV-host interactions and highlight how this knowledge contributes to exploiting host-targeting strategies for a viral cure.


Occult cardiac tamponade detected by transesophageal echocardiography.
Transesophageal echocardiography is a safe, minimally invasive procedure that should be considered when the diagnosis of cardiac tamponade is a possibility and when conventional methods fail to provide conclusive diagnostic information. In this report, we describe a 74-year-old man in the intensive-care unit whose condition was unstable postoperatively because of an occult loculated pericardial effusion and cardiac tamponade. Routine noninvasive and invasive monitoring, including hemodynamic monitoring and transthoracic echocardiography, failed to confirm definitively the suspected diagnosis of cardiac tamponade. In addition, because of the hemodynamic instability of the patient, transporting him for definitive tests (such as fast computed tomographic scanning of the mediastinum, which could not be performed at the bedside) for assessment of cardiac tamponade was relatively contraindicated. In our patient, the diagnostic information obtained by transesophageal echocardiography may have been lifesaving.


Therapeutic protocol using growth factors in electrocution wounds--case reports and review of the literature.
Injuries by high voltage electrocution represent rare and very complex accidents. In order to provide support to surgical therapy, to limit the extension of injuries or to support the natural process of tissue repair, we oriented towards the use of two growth factors, insulin and platelet-enriched plasma (PRP) administered locally, on the injury site. The therapeutic protocol was applied on three cases of electrocution with promising results in reducing the duration of surgical and pharmacological treatment and of time of hospitalization. The influence of growth factors on healing wounds, the mechanism of action and recent therapeutic applications are also discussed.


Prognostic factors for survival in patients with T3 laryngeal carcinoma.
In a total of 511 patients with T3,N0-3,M0 laryngeal carcinoma, 24 possible prognostic factors were analyzed retrospectively. The factors were age, sex, mode of treatment, duration of several clinical symptoms, the presence of sore throat, otalgia, dyspnea, and dysphagia, previous tracheotomy, tumor extension, lymph node status (five items), histologic grading, smoking habits, and alcohol intake. For 300 patients in whom surgery was part of the primary treatment, pathologic staging of the primary tumor and of lymph nodes in neck dissection specimens, cartilage invasion, radicality of the operation, differentiation grade, and subglottic extension ware also evaluated. In a univariate analysis for the whole group, tumor extension (limited to the glottic region), lymph node status (clinically palpable lymph nodes, cytologically confirmed positive lymph nodes), level of lymph node metastasis (high and midjugular site), histologic grading (poor differentiation grade), and treatment modality (planned combined therapy) were considered to be prognostic factors of corrected actuarial survival. In the group that underwent surgery, all factors derived from specimens of the larynx and neck dissections had prognostic significance. Multivariate analysis revealed that the glottic site of the tumor, the presence of cyto- and histopathologically proven metastatic lymph nodes, pretreatment tracheotomy, positive resection margins, and planned combined treatment had a significant influence on corrected actuarial survival.


Evidence for a catecholaminergic projection to area X in the zebra finch.
In the zebra finch (Poephila guttata), horseradish peroxidase injected into or near Area X of the lobus parolfactorius (LPO) is transported to cell bodies in ipsilateral hyperstriatum ventrale pars caudale (HVc), area ventralis of Tsai (AVT), and nucleus tegmenti pedunculo-pontinus, pars compacta (TPc). Area X, LPO, and paleostriatum augmentatum (PA) all contain a dense network of catacholamine-containing axons and nerve terminals, as determined in histofluorescence studies. Cell bodies in AVT and TPc contain catacholamines; lesions of TPc greatly reduce or abolish catacholamine fluorescence in PA, and a lesion of AVT eliminates histofluorescence in LPO, icluding Area X. The anatomical location and catecholaminergic projection from AVT suggest that LPO-Area X may be the avian homolog of the mammalian nucleus accumbens, olfactory tubercle, and/or rostromedial caudate.


Comparison of Continuous Adductor Canal and Femoral Nerve Blocks for Analgesia and Return of Quadriceps Function After Anterior Cruciate Ligament Reconstruction in Adolescent Patients.
To compare early pain relief and late quadriceps function after anterior cruciate ligament reconstruction (ACLR) with hamstring autograft in adolescent patients treated with either a continuous femoral nerve block (cFNB) or continuous adductor canal block (cACB). We retrospectively reviewed a consecutive series of adolescent patients who underwent ACLR and received either a cACB or cFNB for postoperative pain management. Over a 1-year period, all patients underwent ACLR with cFNBs. Over the subsequent 9 months, all patients underwent their ACLR with cACBs. Patient demographics, postoperative pain scores, opioid consumption, satisfaction and complications, and dates and results of quadriceps function derived at the Return to Sports evaluation were compared. Ninety-one patients (53 cFNB, 38 cACB) were reviewed. There were no differences in the demographics of the 2 groups. There were no statistically significant differences between groups in variations in postoperative pain scores (P = .21), or satisfaction with the blocks (P = .93). Patients in the cFNB group consumed a greater number of opioid doses on postoperative day 3 (2.2 ± 2.1 doses cFNB, 1.1 ± 1.6 doses cACB, P = .03) and a greater number of opioid doses overall for postoperative days 1 to 3 (mean 6.8 ± 5.3 doses cFNB, 3.8 ± 2.1 doses cACB, P = .03). There was no difference in time to return of acceptable quadriceps strength and function when comparing the 2 groups (30.9 ± 7.7 weeks cFNB, 28.9 ± 6.6 weeks cACB, P = .087). We found few differences in postoperative analgesic requirements when comparing patients who underwent ACLR with hamstring autograft with a cACB to those who underwent a similar procedure with a cFNB. Return of quadriceps strength and function by six months did not appear to vary with regional technique, either cACB or cFNB, employed at surgery. III, Retrospective comparative study.


Prevalence of temporomandibular dysfunction in orthodontic treatment.
The aim of our study was to investigate the prevalence of temporomandibular dysfunction (TMD) during orthodontic treatment. the study investigated all the patients receiving orthodontic treatment in the dentofacial orthopedic department in Casablanca in the course of the different stages of treatment over a 4-month period. We looked for a possible association between the presence of at least one sign of TMD, the Helkimo anamnesis index, the clinical Helkimo index and the following factors: age, gender, extractions, or not, of premolars, duration, type and stage of orthodontic treatment, molar and canine class, crowding, overjet, overbite and unilateral crossbite. Data were analysed using Epi-info 6.0.fr software. The analysis of the results was done using the Chi(2) test (P<0.05). no statistically significant association could be established between TMD and the various factors under investigation with the exception of the association between gender and the Helkimo anamnesis index, stage of treatment and the Helkimo anamnesis index and the Angle molar class and the Helkimo clinical index.


Thrombocytosis in patients with malignant pleural mesothelioma.
Thrombocytosis above 40.0 X 10(4)/mm3 occurred in five of six (83%) patients with malignant mesothelioma. In contrast, the incidence of thrombocytosis was 7.5% in patients with lung adenocarcinoma, 12.5% in squamous cell carcinoma, 5.1% in small cell carcinoma, and 41.7% in large cell carcinoma, respectively. The platelet count in large cell carcinoma was significantly higher than that in other cell types of lung cancer; however, the platelet count in malignant mesothelioma was much higher than that in large cell carcinoma. These results show that the incidence of thrombocytosis seems to be high in malignant mesothelioma, although the mechanism is thus far unknown.


Induction of filamin-C and its involvement in the regulation of cellular senescence and apoptosis in Huh-7 hepatoma cells during arsenic trioxide exposure.
Arsenic trioxide (ATO) is one of the most toxic inorganic arsenic compounds. In this study, we examined the effects of long-term (7 days) exposure to low dose (5 μM) ATO on a human hepatocellular carcinoma cell line, Huh-7. Along with apoptosis accompanied by secondary necrosis though GSDME cleavage, we observed enlarged and flattened cells adhering to the culture dish and surviving even after exposure to ATO. An increase in cyclin-dependent kinase inhibitor p21 levels as well as positive staining for senescence-associated β-galactosidase activity were observed in ATO-treated cells, indicating cellular senescence. Screening for both ATO-inducible proteins by MALDI-TOF-MS analysis and ATO-inducible genes by DNA microarray analysis showed a marked increase in filamin-C (FLNC), an actin cross-linking protein. Interestingly, the increase in FLNC was observed in both dead and surviving cells, suggesting that the upregulation of FLNC by ATO occurs in both apoptotic and senescent cells. Small interference RNA-mediated knock down of FLNC resulted in not only a reduction of senescence-associated enlarged morphology of the cells, but also an exacerbation of cell death. Taken together, these results suggest a regulatory role of FLNC in the execution of senescence as well as apoptosis during ATO exposure.


Anticoagulant Use and Bleeding Risk in Central European Patients with Idiopathic Pulmonary Fibrosis (IPF) Treated with Antifibrotic Therapy: Real-World Data from EMPIRE.
Nintedanib, a tyrosine kinase receptor inhibitor, may be associated with increased bleeding risk. Thus, patients with an inherited predisposition to bleeding, or those receiving therapeutic doses of anticoagulants or high-dose antiplatelet therapy, have been excluded from clinical trials of nintedanib in idiopathic pulmonary fibrosis (IPF). Our objective was to examine real-world bleeding events in patients with IPF treated with antifibrotics, including those receiving anticoagulants and/or antiplatelet therapy. The European MultiPartner IPF Registry (EMPIRE) enrolled 2794 patients with IPF: group A (1828: no anticoagulant or antiplatelet treatment), group B (227: anticoagulant treatment), group C (659: antiplatelet treatment), and group D (80: anticoagulant and antiplatelet treatment). Overall, 673 (24.1%) received nintedanib and 933 (33.4%) received pirfenidone. Bleeding events and their relationship to antifibrotic and anticoagulation treatment were characterized. Group A patients, versus those in groups B, C, and D, were typically younger and generally had the lowest comorbidity rates. A higher proportion of patients in groups A and C, versus group B, received nintedanib. Pirfenidone, most common in group D, was more evenly balanced across groups. In patients with reported bleeding events, seven of eight received nintedanib (groups A, C, and D). Bleeding incidence was 3.0, 0, 1.3, and 18.1 per 10,000 patient-years (groups A, B, C, and D, respectively). Real-world data from EMPIRE showed that patients on anticoagulant medications received nintedanib less frequently, perhaps based on its mechanism of action. Overall, bleeding incidence was low (0.29%: nintedanib 0.25%; pirfenidone 0.04%) and irrespective of anticoagulant or antiplatelet therapy received (P = 0.072).


Ezrin expression as a prognostic marker in colorectal adenocarcinoma.
Ezrin protein acts in the regulation of cytoskeletal and directly influences survival and tumor progression; there is an increase in its expression in metastatic cells and tissues in several types of cancer including colorectal cancer. 250 Patients with colorectal cancer submitted to surgery from 1995 to 2002. Protein expression was carried through by Tissue Micro Array immunohistochemical tests of paraffined neoplasic tissues and associated with clinical variables. Differentiation degree, lymph node invasion, metastasis at diagnosis, and palliative surgery were associated to a higher expression of the protein and survival. Higher expression of the Ezrin correlates with tumor aggressiveness and worse prognosis for colorectal cancer.


Genitourinary imaging in the emergency department.
The emergency medicine (EM) specialist has a wide-ranging armamentarium of imaging modalities available for use in the patient with genitourinary complaints. This article covers the various imaging options, with a discussion of the advantages and disadvantages of each of these different modalities. Special emphasis is placed on point-of-care EM ultrasound performed by the EM specialist at the patient bedside.


Achilles tendon ruptures in diabetic patients.
The aim of this study is to evaluate the results of percutaneous repair of an acute AT rupture in diabetic patients. The study included 39 subjects who were operated at our institution. We performed pre-operative evaluations the day of surgery, and report the results of post-operative evaluation at the final follow-up. The Achilles tendon total rupture score had a post-operative average rating of 70.4 ± 13 (range 55-92). All patients were able to fully weight bear on the operated limb by the end of the eighth post-operative week. Eight patients suffered from a superficial infection of the surgical wound. In conclusion, percutaneous repair of the AT is a viable option for diabetic patients.


Beneficial actions of prostacyclin in traumatic shock.
Prostacyclin (PGI2) infused at a rate of 350 ng/kg/min significantly increased survival time in rats subjected to Noble-Collip drug trauma from 2.7 +/- 0.3 to 4.6 +/- 0.2 h (p less than 0.01) compared with traumatized rats given only the vehicle (Tris buffer). Moreover, PGI2 treated rats exhibited significantly lower circulating cathepsin D and myocardial depressant factor (MDF) activities, indicative of lower lysosomal disruption and lower toxic factor formation. PGI2 induced vasodilation in rats as well as these other protective effects.


Changes in body composition during and after inpatient rehabilitation in people with recent spinal cord injury.
Prospective cohort study. To investigate changes in body composition parameters in people with recent spinal cord injury (SCI) during their first inpatient rehabilitation and up to 1 year after discharge and whether those potential changes over time varied between different personal and lesion characteristics groups. Rehabilitation center, the Netherlands. People with recent SCI (≥18 years; n = 53) were tested around admission (T0) and discharge (T1) of inpatient rehabilitation. A sub-group (n = 19) was measured 1 year after discharge (T2). Personal and lesion characteristics were registered at T0. Anthropometry (height, body mass, body mass index, and waist circumference) was performed at T0, T1, and T2. Bioelectrical impedance analysis (BIA) was measured at T0 and T1. During inpatient rehabilitation, no significant changes in all body composition parameters were found. During the first year after discharge, body mass index (26.8 kg/m2) significantly increased compared with the level at both admission (25.4 kg/m2; p = 0.01, 95% CI: 0.32-2.52) and discharge (25.1 kg/m2; p = 0.02, 95% CI: 0.26-3.00). People with paraplegia showed an increase in absolute waist circumference (6.5%) compared with people with tetraplegia who showed a net decrease (-5.5%) in the year after discharge (p = 0.047, 95% CI: 0.27-33.62). A stable body composition during inpatient rehabilitation is followed by an increased BMI in the year after discharge in people with recent SCI. People with paraplegia showed an increase in absolute waist circumference compared with people with tetraplegia who showed a net decrease in the year after discharge.


Trazodone-induced transient hypomanic symptoms and their management.
Transient trazodone-induced hypomanic symptoms occurred in three depressed patients. Trazodone therapy was continued or reinstated shortly after the hypomanic episode without further evidence of hypomania.


Nonoperative Treatment of the Biceps-Labral Complex.
The long head of the biceps and superior labrum should be evaluated as an interdependent functional unit. A focused patient history and physical examination including multiple provocative tests should be performed alongside advanced imaging studies to obtain an accurate diagnosis. Nonoperative treatment modalities including nonsteroidal anti-inflammatory drugs, glucocorticoid injections, and a standardized physical therapy regimen should be exhausted before operative intervention. Significant improvements in pain, functional outcomes, and quality of life are achieved in patients treated nonoperatively. Although these outcomes are less consistent for overhead athletes, return to play and performance metrics seem comparable to those who undergo surgery.


Corrigendum: Untreated depression and anxiety in patients with common skin diseases: a cross-sectional study in China.
[This corrects the article DOI: 10.3389/fpsyg.2023.1150998.].


Deoxynivalenol aggravates the immunosuppression in piglets and PAMs under the condition of PEDV infection through inhibiting TLR4/NLRP3 signaling pathway.
Mycotoxins are toxic metabolites produced by fungi, which are ubiquitous in cereals and feed worldwide and threaten human and animal health. Deoxynivalenol (DON) is one of the most prevalent mycotoxins and causes a series of toxicities, especially enterotoxicity and immunotoxicity. Porcine epidemic diarrhea virus (PEDV) is a destructive enteropathogenic animal coronavirus, is often accompanied with DON contamination in the swine herd. Previous studies have shown that PEDV infection leads severe immunosuppression in pigs. However, whether DON exposure aggravates the PEDV-induced immunosuppression remains unclear. In this study, weaned piglet and porcine alveolar macrophage cell (PAM) models were established to explore the effects of DON on the PEDV-induced immunosuppression and to clarify its underlying mechanism. The in vivo results showed that 2.25 mg/kg feed DON significantly exacerbated the immunosuppressive effects on the PEDV-infected piglets, as demonstrated by the decreases in growth performance, the numbers of goblet cells and CD3+T cells, as well as the protein expressions of ZO-1, Claudin1 and Muc2, in addition to the increases in anti-inflammatory factors levels and the intestinal injury. Similarly, the in vitro results demonstrated that 3-4 μM DON markedly aggravated apoptosis, enhanced the expressions of anti-inflammatory factors, but reduced the migration and phagocytosis abilities of the PEDV-infected PAMs. Furthermore, DON significantly suppressed the expressions of TLR4/NLRP3 in vivo and in vitro. To contrast, lipopolysaccharide (LPS), the corresponding activator, obviously alleviated the DON-exacerbated immunosuppression. Our findings suggest that DON could aggravate host immunosuppression under the condition of PEDV infection through inhibiting TLR4/NLRP3 signaling pathway, and provide novel theoretical insights into the further studies on the immunotoxicity of DON contamination and PEDV-induced immunosuppression.


Crystallographic and functional analysis of the ESCRT-I /HIV-1 Gag PTAP interaction.
Budding of HIV-1 requires the binding of the PTAP late domain of the Gag p6 protein to the UEV domain of the TSG101 subunit of ESCRT-I. The normal function of this motif in cells is in receptor downregulation. Here, we report the 1.4-1.6 Å structures of the human TSG101 UEV domain alone and with wild-type and mutant HIV-1 PTAP and Hrs PSAP nonapeptides. The hydroxyl of the Thr or Ser residue in the P(S/T)AP motif hydrogen bonds with the main chain of Asn69. Mutation of the Asn to Pro, blocking the main-chain amide, abrogates PTAP motif binding in vitro and blocks budding of HIV-1 from cells. N69P and other PTAP binding-deficient alleles of TSG101 did not rescue HIV-1 budding. However, the mutant alleles did rescue downregulation of endogenous EGF receptor. This demonstrates that the PSAP motif is not rate determining in EGF receptor downregulation under normal conditions.


Role of maintenance oral dexamethasone in prophylaxis of delayed emesis caused by moderately emetogenic chemotherapy.
Although usually a problem of cisplatin-based chemotherapy, delayed emesis can cause severe distress in patients treated with cyclophosphamide. Dexamethasone has been shown to be effective in the control of cisplatin-induced delayed emesis, but its role against the delayed problem in patients treated with cyclophosphamide has not been demonstrated. Our study was conducted to evaluate the effect of dexamethasone in delayed emesis induced by cyclophosphamide. Ninety-eight patients were given i.v. granisetron and i.v. dexamethasone before chemotherapy, and randomised to receive either oral dexamethasone 4 mg twice daily as maintenance or no maintenance. Ninety-four patients were evaluable. Of those given maintenance oral dexamethasone, 57% had complete and 30% had major control of delayed emesis, versus 33% and 15%, respectively, of patients who did not receive maintenance. Side effects are mainly constipation and headache. The results shows that oral dexamethasone is an effective agent against cyclophosphamide-induced delayed emesis.


Properties of multilamellar liposomes containing 99mTcO4-: effect of distearoylphosphatidylcholine to sphingomyelin ratio.
Multilamellar liposomes composed of eight different mixtures of distearoylphosphatidylcholine (DSPC) and sphingomyelin (SM) were prepared containing [99mTc]pertechnetate. The in vitro permeability of the liposome preparations in buffer and serum were measured by both dialysis and direct exposure. Liposomes composed of 25-33% SM were least permeable exhibiting leakage half-times of approximately 70 h in buffer and 52 h in serum. Pertechnetate-containing liposomes of three different lipid compositions were injected into mice and the biodistribution of 99mTc activity was determined. All preparations were taken up primarily by the lungs and liver. The half-time for clearance of 99mTc activity ranged from 24.8 to 30.6 h for the liver and 25.3 to 33.0 h for the lungs.


Self-perceived competence of dental students regarding the management of orofacial pain: a cross-sectional study.
There is limited data on Pakistani dental students perceived competence in managing orofacial pain (OFP). This study aims to evaluate dental students self-perceived competence regarding the management of orofacial pain. This cross-sectional study was conducted in Karachi at randomly selected two public and four private dental schools. This survey was conducted online from November 2020 to December 2020 in six dental schools. A questionnaire link was sent to the 475 students. A chi-square test and independent-sample t-test were conducted to assess the frequency distribution and compare mean scores of knowledge, diagnosis, and management parameters. Of the 475 students, 280 students filled the online survey leaving a response rate of 59%. A significant number of fourth-year students, 65 (51%, p = 0.005), feels knowledgeable regarding neuropathic pain compared to third-year students. The majority of the fourth-year students, 100 (78%, p = 0.010), feel comfortable managing intraoral pain. Almost all the students reported thinking that they need more knowledge related to five types of OFP. The fourth-year students had high mean scores related to knowledge, comfort in diagnosing and managing OFP categories. This study found that dental students perceived competence regarding orofacial pain management varies in relation to specific categories, being lowest for psychogenic pain.


Therapeutic modalities and procedures. Part III: Kinetic procedures, surgical considerations, direct and alternating currents.
Among the topics discussed in this article are kinetic procedures such as massage, manipulation, vibration, traction, and exercise; electrosurgery with high-frequency currents; and electrical stimulation.