The examination of physicians' awareness of dementing disorders.
Despite a significant increase in the amount of research being conducted on the etiology, diagnosis, and treatment of Alzheimer's disease and other dementing disorders, there has been little assessment of the utilization of this new wealth of information by the primary care physician. It was hypothesized that there would be a wide variation in physicians' knowledge of dementing disorders and the procedures used to diagnose these disorders. To quantitate the present status of primary care physicians' knowledge of dementing disorders and to investigate possible relationships between this knowledge and different physician and practice characteristics, 50 general internists and family practitioners from Winnebago County, Illinois, were interviewed regarding their recall of causes of dementia, procedures used in diagnosing these diseases, treatment recommendations, and comfort in making a differential diagnosis. Results revealed a wide variation in both physicians' familiarity with the causes of dementia as well as the procedures used in making the diagnosis. Although a majority (80%) of the physicians reported some degree of confidence in making a differential diagnosis of dementing disorders, a significant trend was found between physician age and comfort in making the diagnosis, with age being directly correlated with comfort. This was in spite of a significant negative association between physician age and immediate recall of causes of dementia. These data imply that younger physicians are entering the work force with at least better immediate recall of information on dementing disorders, but they have had little opportunity to become comfortable with that knowledge due to a generally smaller geriatric population in their practice.(ABSTRACT TRUNCATED AT 250 WORDS)


Fighting behavior and winning National Hockey League games: a paradox.
To assess a relationship between fighting behavior and winning games in the National Hockey League (NHL), 4,240 NHL game summaries from five consecutive seasons (1987-88--1991-92) were examined. Analysis of the relation between a team's number of major fighting penalties and final league standings gave four significant negative correlations indicating a substantial inverse relationship, i.e., the larger the number of fights, the lower the final standings tended to be, although one significant positive correlation was obtained for those teams finishing in the bottom half of the standings. The results question the popular belief that fighting and winning NHL games are favorably associated. Explanations are suggested.


Repair of persistent truncus arteriosus with interrupted aortic arch.
The aim of our study was to analyse experience with repair of truncus arteriosus with interrupted aortic arch. Between 1993 and 2004, eight consecutive patients underwent repair of truncus arteriosus with interrupted aortic arch. The median age was 6.5 days (range 1-85 days) and median weight was 3.2 kg (range 2.6-4.8 kg). Five patients had type A and 3 patients had type B aortic arch interruption. The repair was performed in deep hypothermia with circulatory arrest in 4 patients and isolated selective low-flow perfusion of the head and the heart in the last 4 patients. The repair consisted in aortic arch reconstruction by direct anastomosis between descending and ascending aorta, closure of ventricular septal defect and reconstruction of the right ventricular to pulmonary artery continuity using a valved conduit. One (12.5%) patient died from sepsis and hepato-renal failure 18 days after surgery. Seven (87.5%) patients were followed up for 2.0-11.7 years (median 2.6 years). No patient died after the discharge from hospital. In 4 patients 1-3 reinterventions were required 0.6-10.0 years after repair. Reoperations were performed for conduit obstruction in 2 patients, aortic regurgitation in 2 patients, right pulmonary artery stenosis in 2 patients and airway obstruction in 1 patient. In 2 patients concommitant aortic valve and conduit replacement was required. Balloon angioplasty for aortic arch obstruction was necessary in 1 patient, and for bilateral pulmonary branch stenosis in 1 patient. Five (28.6%) surviving patients are in NYHA class I and 2 (71.4%) patients are in NYHA class II. Primary repair of persistent truncus arteriosus with interrupted aortic arch can be done with low mortality and good mid-term results. Aortic arch reconstruction in isolated low-flow perfusion of the head and the heart influences favourably the postoperative recovery. The main postoperative problems are associated with conduit obstruction and aortic insufficiency.


Pathogenesis of Alcohol-Associated Liver Disease.
Excessive alcohol consumption is a global healthcare problem with enormous social, economic, and clinical consequences. While chronic, heavy alcohol consumption causes structural damage and/or disrupts normal organ function in virtually every tissue of the body, the liver sustains the greatest damage. This is primarily because the liver is the first to see alcohol absorbed from the gastrointestinal tract via the portal circulation and second, because the liver is the principal site of ethanol metabolism. Alcohol-induced damage remains one of the most prevalent disorders of the liver and a leading cause of death or transplantation from liver disease. Despite extensive research on the pathophysiology of this disease, there are still no targeted therapies available. Given the multifactorial mechanisms for alcohol-associated liver disease pathogenesis, it is conceivable that a multitherapeutic regimen is needed to treat different stages in the spectrum of this disease.


Sphingosine 1-phosphate receptor-1 specific agonist SEW2871 ameliorates ANIT-induced dysregulation of bile acid homeostasis in mice plasma and liver.
Dysregulated bile acid (BA) homeostasis is an extremely significant pathological phenomenon of intrahepatic cholestasis, and the accumulated BA could further trigger hepatocyte injury. Here, we showed that the expression of sphingosine-1-phosphate receptor 1 (S1PR1) was down-regulated by α-naphthylisothiocyanate (ANIT) in vivo and in vitro. The up-regulated S1PR1 induced by SEW2871 (a specific agonist of S1PR1) could improve ANIT-induced deficiency of hepatocyte tight junctions (TJs), cholestatic liver injury and the disrupted BA homeostasis in mice. BA metabolic profiles showed that SEW2871 not only reversed the disruption of plasma BA homeostasis, but also alleviated BA accumulation in the liver of ANIT-treated mice. Further quantitative analysis of 19 BAs showed that ANIT increased almost all BAs in mice plasma and liver, all of which were restored by SEW2871. Our data demonstrated that the top performing BAs were taurine conjugated bile acids (T-), especially taurocholic acid (TCA). Molecular mechanism studies indicated that BA transporters, synthetase, and BAs nuclear receptors (NRs) might be the important factors that maintained BA homeostasis by SEW2871 in ANIT-induced cholestasis. In conclusion, these results demonstrated that S1PR1 selective agonists might be the novel and potential effective agents for the treatment of intrahepatic cholestasis by recovering dysregulated BA homeostasis.


Structural MRI-Based Measures of Accelerated Brain Aging do not Moderate the Acute Antidepressant Response in Late-Life Depression.
Late-life depression (LLD) is characterized by accelerated biological aging. Accelerated brain aging, estimated from structural magnetic resonance imaging (sMRI) data by a machine learning algorithm, is associated with LLD diagnosis, poorer cognitive performance, and disability. We hypothesized that accelerated brain aging moderates the antidepressant response. Following MRI, participants entered an 8-week randomized, controlled trial of escitalopram. Nonremitting participants then entered an open-label 8-week trial of bupropion. Ninety-five individuals with LLD. A machine learning algorithm estimated each participant's brain age from sMRI data. This was used to calculate the brain-age gap (BAG), or how estimated age differed from chronological age. Secondary sMRI measures of aging pathology included white matter hyperintensity (WMH) volumes and hippocampal volumes. Mixed models examined the relationship between sMRI measures and change in depression severity. Initial analyses tested for a moderating effect of MRI measures on change in depression severity with escitalopram. Subsequent analyses tested for the effect of MRI measures on change in depression severity over time across trials. In the blinded initial phase, BAG was not significantly associated with a differential response to escitalopram over time. BAG was also not associated with a change in depression severity over time across both arms in the blinded phase or in the subsequent open-label bupropion phase. We similarly did not observe effects of WMH volume or hippocampal volume on change in depression severity over time. sMRI markers of accelerated brain aging were not associated with treatment response in this sequential antidepressant trial.


[Is axillary dissection in clinically lymph node-negative breast carcinoma further indicated?].
In the treatment of breast cancer, the indication for adjuvant systemic treatment was extended also to nodal negative tumor stages in the last years. For that reason, the indicator status of axillary dissection lost some of its importance. Therefore, in node negative patients, the necessity of axillary dissection and the use of definitive axillary radiotherapy, which causes less morbidity, may be reconsidered. In a review of the related literature, we present international treatment experiences related to axillary dissection, axillary radiotherapy and "sentinel node dissection" (SLND). In addition, our long-term experiences in 19 patients with clinically negative axillary nodes treated by conservative surgery without axillary dissection but axillary radiotherapy, are reported. The median rate of axillary recurrences with axillary radiotherapy is 2.0%, the regional (supraclavicular and retrosternal) recurrence rate 2.7%. With axillary dissection, axillary recurrences occur in 1 to 2%, in nodal negative stages in 0 to 1%, the median regional recurrence rate is 2.2%. A meta-analysis presented in 1995 by the Early Breast Cancer Study Group showed no significant difference in the regional recurrence rate or the overall survival between axillary dissection and axillary radiotherapy. With SLND, usually only one axillary node is excised. With the help of molecular and immunohistochemical methods, SLND may predict axillary involvement with high precision. Definitive radiotherapy of the axilla is a valid treatment option for patients without palpable axillary nodes with the potential advantage of being less cost intensive and better tolerated. If the indication for systemic therapy is no more dependent on the axillary status, axillary dissection may be replaced by axillary radiotherapy. In small tumors without risk factors and without indication for systemic therapy, SLND seems to be the best treatment option.


Allophilia: Increasing college students' "liking" of older adults with dementia through arts-based intergenerational experiences.
This study evaluates whether an arts-based intergenerational experience, Opening Minds through Art (OMA), increases positive attitudes or allophilia ("liking for the other"-in this case, older adults with dementia) in students who joined the OMA program as compared with the control group. Pre- and posttests of the Allophilia Scale were used to compare 216 students who participated in OMA and 499 students who did not. Hierarchical regression was used to investigate the association between OMA participation and students' Allophilia scores. After one semester, results showed that OMA participation is significantly positively associated with students' affection, comfort, kinship, engagement, and enthusiasm toward older adults living with dementia. We conclude that increasing students' allophilia toward older adults living with dementia is necessary and possible through well-designed intergenerational experiences.


Modular transient nanoclustering of activated β2-adrenergic receptors revealed by single-molecule tracking of conformation-specific nanobodies.
None of the current superresolution microscopy techniques can reliably image the changes in endogenous protein nanoclustering dynamics associated with specific conformations in live cells. Single-domain nanobodies have been invaluable tools to isolate defined conformational states of proteins, and we reasoned that expressing these nanobodies coupled to single-molecule imaging-amenable tags could allow superresolution analysis of endogenous proteins in discrete conformational states. Here, we used anti-GFP nanobodies tagged with photoconvertible mEos expressed as intrabodies, as a proof-of-concept to perform single-particle tracking on a range of GFP proteins expressed in live cells, neurons, and small organisms. We next expressed highly specialized nanobodies that target conformation-specific endogenous β2-adrenoreceptor (β2-AR) in neurosecretory cells, unveiling real-time mobility behaviors of activated and inactivated endogenous conformers during agonist treatment in living cells. We showed that activated β2-AR (Nb80) is highly immobile and organized in nanoclusters. The Gαs-GPCR complex detected with Nb37 displayed higher mobility with surprisingly similar nanoclustering dynamics to that of Nb80. Activated conformers are highly sensitive to dynamin inhibition, suggesting selective targeting for endocytosis. Inactivated β2-AR (Nb60) molecules are also largely immobile but relatively less sensitive to endocytic blockade. Expression of single-domain nanobodies therefore provides a unique opportunity to capture highly transient changes in the dynamic nanoscale organization of endogenous proteins.


Short interval of biopsy to robotic-assisted laparoscopic radical prostatectomy does not render any adverse effects on the perioperative outcomes.
The aim of our study was to investigate the effects of prostate biopsy on perioperative outcomes of robotic-assisted laparoscopic prostatectomy (RALP).A total of 181 patients who underwent the RALP in our institution have been retrospectively reviewed, patients were divided into different groups according to the interval of biopsy to RALP and core numbers of biopsy. Perioperative outcomes including estimated blood loss (EBL), operative time (OT), surgical margin status, postoperative drainage, hospital stay, and perioperative complications were served as endpoints.Interval of biopsy to RALP was not significantly correlated with any perioperative outcomes, while the biopsy core numbers had significant correlation with the EBL. In logistic regression analysis, the biopsy core numbers were associated with higher risk of positive surgical margins. Body mass index (BMI) was also a significant factor related to OT.Delay of the RALP after biopsy was not applicable in the era of RALP and surgeons could be more freely in selecting the time of RALP. Besides, further studies should focus on how to improve the diagnostic efficiency of prostate cancer without increasing the incidence of surgical complications.


Phylogenetic implications of the microbody-lipid globule complex in zoosporic fungi.
Chytridiomycetous fungal zoospores contain a unique and intricate association of organelles, the 'microbody-lipid globule complex' (MLC). The spatial arrangement of organelles in the MLC appears important in the utilization of lipid globules for energy, but in addition, the structural association of organelles in the MLC reveals phylogenetic trends within this diverse group of organisms. Variations in the structure of the MLC correlate well with current phylogenetic concepts of aquatic fungi, yet suggest new relationships among these posteriorly uniflagellate zoospores. Based upon the organization of organelles in the MLC, 4 basic patterns of MLCs can be recognized, and these correspond to the 4 orders of Chytridiomycetes. The MLC in its simplest form consists of a microbody appressed to the edge of a lipid globule. In more highly organized MLCs, mitochondria subtend the microbody and a cisterna surmounts one side of the lipid globule. The organization and structure is still more complex in other MLCs where ER is elaborated into a tubular network of membranes or where small microbodies or mitochondria fuse into 'giant' organelles. The structural organization of the MLC provides an additional criterion by which the phylogeny of awuatic fungi can be evaluated.


Test system for determination of HIV-1 frameshifting efficiency in animal cells.
We have developed a system in animal cells which allows the quantification of frameshifting determined by specific mRNA sequences. The method is based on the expression of an N-terminally extended firefly luciferase gene which requires frameshifting in order to be translated as a functional enzyme. The systems sensitivity is such that it allows the detection of even low efficiency of frameshifting. Our results show that the HIV-1 frameshift sequence including the 3' located stem-loop structure leads to ribosomal frameshifting at a lower level than that described for in vitro systems when tested in several fibroblastoid cell lines.


[Production of L forms of the plague microbe].
Experiments were conducted in vitro. The process of formation of unstable L-form cultures of Pasteurella pestis under the effect of penicillin was studied. A comparatively high frequency of this phenomenon in various strains was demonstrated. A possible role of the L-transformation process in the persistence of the causative agent in the organism of wild animals in endemic foci of infection is put forward.


Matrix stones.
A scanning electron microscopic examination of matrix stones, which have been obtained from a 27-month-old Japanese boy with congenital hydronephrosis, revealed a rough fibrous net structure with small depositions of calcium phosphate. We believe that fibrous matrix may be the primary constituent and that the matrix stone may be the consequence of calcium deposition to it.


TAHDNet: Time-aware hierarchical dependency network for medication recommendation.
Medication recommendation is a hot topic in the research of applying neural networks to the healthcare area. Although extensive progressions have been made, current researches still face the following challenges: (i). Existing methods are poor at efficiently capturing and leveraging local and global dependency information from patient visit records. (ii). Current time-aware models based on irregularly interval medical records tend to ignore periodic variability in patient conditions, which limits the representational learning capability of these models. Therefore, we propose a Dynamic Time-aware Hierarchical Dependency Network (TAHDNet) for the medication recommendation task to address these challenges. Firstly, we use a Transformer-based model to learn the global information of the whole patient record through a self-supervised pre-training process. Secondly, a 1D-CNN model is used to learn the local dependencies on visitation level. Thirdly, we propose a dynamic time-aware module with a fused temporal decay function to assign different weights among different time intervals dynamically through a key-value attention mechanism. Experimental results on real-world datasets demonstrate the effectiveness of the model proposed in this paper.


Suprasternal approach for impending tracheo-innominate artery fistula.
We report preventive innominate artery division or ligation through a suprasternal approach for impending tracheo-innominate artery fistula (TIF) with recurrent airway oozing in patients with severe neuromuscular disease. Our approach is less invasive and a favorable procedure as preventive surgery for impending TIF.


The fucosyltransferase locus FUT1 maps distal to apolipoprotein loci E and C2 on human chromosome 19.
The location of the fucosyltransferase locus FUT1 relative to the apolipoprotein E/C2 loci on human chromosome 19 has remained unclear. We determined by a combination of physical mapping and fluorescence in situ hybridization that this fucosyltransferase gene maps distal to the apolipoprotein loci.


Axis of preferred motion is a function of bar length in visual cortical receptive fields.
The responses of 82 simple cells and 41 complex cells in area 17 of anesthetized and paralysed cats were examined with light bars of different length. For 84% of the simple cells and 66% of the complex cells the preferred axis of orientation of a stationary flashing long bar (orientational selectivity) and the preferred axis of movement of a small spot were parallel. As a consequence, the axis of maximal response to a moving light spot was mostly orthogonal to the optimal axis of a moving bar. Thus, a single cell responds to two perpendicular axes of preferred movement one for a long bar and one for a light spot, respectively. For both axes independent direction preferences could be distinguished. Additional preferred axes of movement between the two orthogonal extremes could be found with moving bars of intermediate lengths. This can be explained by the fact that cells with a pronounced response to a moving spot showed a strong tendency for intermediate bar length to elicit responses consisting of a superposition of both components. Therefore, decreasing bar length resulted in a gradual rotation of the preferred direction of movement from orthogonal to parallel with respect to the orientational axis, rather than to a mere widening of the tuning curve. Accordingly, the change in orientation selectivity with decreasing bar length is a regular transition from the orientation dependent response to a response type that depends only on the movement axis of the spot. Thus, in a simple model, the resulting response characteristic can be interpreted as an average of both components weighted according to the length of the stimulus.


Influences of noise on the occurrence of period doubling in distributed-feedback laser diodes under direct-current modulation.
The influences of Langevin noise on period doubling (PD) of a strongly modulated distributed-feedback laser have been investigated. The onset of PD was confirmed to be reduced through the use of the rate equations as a model. The threshold values of PD were examined in terms of driving frequency and rf power and have been compared with the measurements of PD.


Effects of hypothyroidism on the karyometric development of pyramidal neurons of the hippocampus (CA1), area 6 and area 17 in the male mouse.
This study has examined the karyometric changes within pyramidal neurons of the hippocampus, motor area 6 and visual area 17 in a hypothyroid group of male mice treated with propylthiouracil, with or without interruption of treatment at the 35th postnatal day. Hypothyroidism resulted in decrease of nuclear size in the three areas before puberty and even after puberty in the hippocampus. Where the treatment was continued throughout the experimental period there was a progressive increase of nuclear size in both visual and motor areas.


"Enactment" in the lives and treatment of Holocaust survivors' offspring.
This paper explores an aspect of "enactment" often seen in Holocaust survivors' offspring: the compulsion to re-create their parents' experiences in their own lives through concrete acts. At the core of this compulsion is a psychic hole, a gap in the child's emotional understanding, stemming from identification with the parents on one hand, and the parents' denial or repression of the trauma on the other. The compulsion to enact can be transformed into a cognitive mode when such offspring are helped to find the meaning of the trauma in their parents' lives, as is illustrated here by clinical examples.


Lumbosacral lipoma causing tethering of the conus: case report.
We report a case of tethered cord syndrome treated surgically. As in many reported cases, the treatment was successful on pain but only partially so on sphincter dysfunction. The most important diagnostic investigation is CT scanning with contrast medium.


The Effects of Hyperbaric Oxygen Therapy on Post-Training Recovery in Jiu-Jitsu Athletes.
The present study aimed to evaluate the effects of using hyperbaric oxygen therapy during post-training recovery in jiu-jitsu athletes. Eleven experienced Brazilian jiu-jitsu athletes were investigated during and following two training sessions of 1h30min. Using a cross-over design, the athletes were randomly assigned to passive recovery for 2 hours or to hyperbaric oxygen therapy (OHB) for the same duration. After a 7-day period, the interventions were reversed. Before, immediately after, post 2 hours and post 24 hours, blood samples were collected to examine hormone concentrations (cortisol and total testosterone) and cellular damage markers [creatine kinase (CK), aspartate aminotransferase (AST), alanine aminotransferase (ALT), and lactate dehydrogenase (LDH)]. Moreover, the rating of perceived exertion (RPE) and recovery (RPR) scales were applied. Final lactate [La] values (control: 11.9 ± 1.4 mmol/L, OHB: 10.2 ± 1.4 mmol/L) and RPE [control: 14 (13-17 a.u.), OHB: 18 (17-20 a.u.)] were not significantly different following the training sessions. Furthermore, there was no difference between any time points for blood lactate and RPE in the two experimental conditions (P>0.05). There was no effect of experimental conditions on cortisol (F1,20 = 0.1, P = 0.793, η2 = 0.00, small), total testosterone (F1,20 = 0.03, P = 0.877, η2 = 0.00, small), CK (F1,20 = 0.1, P = 0.759, η2 = 0.01, small), AST (F1,20 = 0.1, P = 0.761, η2 = 0.01, small), ALT (F1,20 = 0.0, P = 0.845, η2 = 0.00, small) or LDH (F1,20 = 0.7, P = 0.413, η2 = 0.03, small). However, there was a difference between the two experimental conditions in RPR with higher values at post 2 h and 24 h in OHB when compared to the control condition (P<0.05). Thus, it can be concluded that OHB exerts no influence on the recovery of hormonal status or cellular damage markers. Nonetheless, greater perceived recovery, potentially due to the placebo effect, was evident following the OHB condition.


Retrospective study of risk factors for mortality in human avian influenza A(H7N9) cases in Zhejiang Province, China, March 2013 to June 2014.
The influenza A(H7N9) virus causes a serious disease that threatens human health. Fatalities associated with human infections caused by this virus are of great public health concern; however, the possible risk factors are not yet fully known. A stratified sampling method, incorporating household income levels and a random number table method, was used to select laboratory-confirmed A(H7N9) cases for this study. Eighty-five patients were selected randomly from 139 laboratory-confirmed A(H7N9) cases occurring in Zhejiang Province between March 1, 2013 and June 30, 2014. Data were collected using a standard method. To test the statistical significance among discrete variables, univariate analyses were used to compare two groups. The Kaplan-Meier product-limit method was used to analyze the patient survival fraction. The Cox proportional hazards regression model was used to analyze all variables with p ≤ 0.05 in the univariate analysis. Lastly, a stepwise procedure was used to construct a final model with a significance level of p > 0.10 for removal and p<0.05 for re-entry. A total of 85 patients with H7N9 virus infection were identified. Among these, 30 (35.29%) died. In the univariate analysis, the following factors were associated with a high risk of influenza A(H7N9) case fatality: age ≥ 60 years (p=0.008), low education level (p=0.030), chronic diseases (p=0.029), poor hand hygiene (p=0.010), time from illness onset to the first medical visit (p=0.029) and to intensive care unit admission (p=0.008), an incubation period of ≤ 5 days (p=0.039), a peak C-reactive protein ≥ 120 mg/l (p=0.012), increased initial neutrophil count (p=0.020), decreased initial lymphocyte count (p=0.021), and initial infection of both lungs (p=0.003). Multivariate analysis confirmed that the independent predictors of H7N9 virus infection mortality in Zhejiang, China were hand hygiene (hazard ratio (HR) 5.163, 95% confidence interval (CI) 1.164-22.661), age (HR 1.042, 95% CI 1.007-1.076), and peak CRP (HR 1.009, 95% CI 1.002-1.016). Improvements in immunity, early case identification and treatment, and personal protection measures are key to addressing the high human avian influenza A(H7N9) case fatality rate.


Pregnancy- and lactation-associated vertebral compression fractures: MRI prevalence and characteristics.
The frequency of pregnancy- and lactation-associated vertebral compression fractures (PLVCFs) is not known. This study showed that MRI prevalence of PLVCFs was approximately 0.5% in females ≥ 15 and < 40 years of age over a 48-month period. PLVCFs did not display MRI features distinguishing them from other vertebral insufficiency fractures. We aimed to investigate the MRI prevalence and characteristics of pregnancy- and lactation-associated vertebral compression fractures (PLVCFs). This retrospective cross-sectional observational study included all thoracic, lumbar, or thoracolumbar MRI examinations performed in our hospital (or at outside centers and referred to us for consultation) of females ≥ 15 and < 40 years of age during a 48-month period. Two radiologists independently reviewed all images for vertebral compression fractures and their disagreement was resolved by a third blinded senior radiologist with 24 years of dedicated musculoskeletal radiology experience. MRI features of PLVCFs (early/late stage, height loss, endplate involvement, retropulsion) were noted. A total of 1484 MRI examinations-including 50 consultations from outside centers-of 1260 females (mean age, 27.7 years; range, 15-39) were included. Interobserver agreement of the two junior radiologists was substantial (κ = 0.607; 95% CI, 0.545-0.669). Vertebral compression fractures were identified in 177 of thoracic (n = 210), lumbar (n = 900), or thoracolumbar MRI (n = 374) examinations. Six women (7 MRI examinations; 4.0% of MRIs with vertebral fractures) had PLVCFs diagnosed on MRI (prevalence, 0.47%; mean age, 31 years; age range, 25-37). Number of fractured vertebrae in cases with PLVCF ranged between 1 and 11 (mean, 5.6). DEXA, available in all patients with PLVCFs, verified osteopenia/osteoporosis in four of six patients. PLVCFs have an MRI prevalence of approximately 0.5% in the target population and do not display distinguishing features from other insufficiency type vertebral compression fractures.


Additional Queen Square (QS) screening items improve the test accuracy of the Montreal Cognitive Assessment (MoCA) after acute stroke.
The Montreal Cognitive Assessment (MoCA) is a popular cognitive screening tool used in stroke, but lacks sensitivity for detecting impairment in stroke-relevant domains of processing speed, non-verbal memory and executive functions. Our aim was to assess whether the test accuracy of the MoCA can be improved with additional tailored screening items targeting these three domains. We included 196 patients admitted to an acute stroke unit at the National Hospital for Neurology and Neurosurgery, Queen Square (QS), London. Participants completed the MoCA as well as a series of additional QS-screening items designed to assess speed of processing, non-verbal memory and executive functions. Performance on the MoCA and QS screening items was compared with performance on "gold standard" neuropsychological assessment. In our sample, 22% of patients were classified as "cognitively intact" on the traditional MoCA alone (≥ 25). However, when tested on the QS-screening items, 40% of these patients failed on speed of processing, 56% failed on non-verbal memory and 26% failed on executive functions. Compared with neuropsychological assessment, the QS-screening items had good sensitivity (QS-Speed: 0.85; QS-Vis: 0.71; QS-EF: 0.73) and modest specificity (QS-Speed: 0.59; QS-Vis: 0.39; QS-EF: 0.54), regardless of stroke lateralisation. Additional screening items detected impairments in speed of processing, non-verbal memory and executive functions over and above those captured using the standard MoCA. The use of these QS-screening items improves the detection of post-stroke cognitive deficits in domains not adequately covered by the standard MoCA.


Pooled analysis of elderly patients with non-small cell lung cancer treated with front line docetaxel/gemcitabine regimen: the Hellenic Oncology Research Group experience.
Thirty to 40% of patients with non-small cell lung cancer (NSCLC) are older than 70 years and rarely are enrolled in clinical trials. Moreover, in clinical practice, > 75% of patients older than 65 years with metastatic NSCLC never receive any kind of chemotherapy. To retrospectively evaluate the impact of age on efficacy and toxicity of chemotherapy regimens in patients with advanced NSCLC treated with the docetaxel-gemcitabine combination. Pooled data from six clinical trials of the Hellenic Oncology Research Group were analyzed. According to their age, patients were divided into two groups: those with age < 70 years and those with > or = 70 years. A total of 858 patients were included in this analysis. Six hundred sixty-six (77.6%) patients were younger than 70 years, whereas 192 (22.4%) patients where > or = 70-year-old. Overall response rate was 30.3% and 30.2% for patients < 70 years and > or = 70 years, respectively (p = 0.974). The median time to tumor progression was 4.1 and 4.5 months for patients < 70 years and > or = 70 years, respectively (p = 0.948). Median overall survival was 9.9 and 9.2 months for patients < 70 and > or = 70, respectively (p = 0.117). The multivariate analysis revealed performance status (PS) (p = 0.0001) and stage (p = 0.0001) as independent factors with significant impact on the hazard of death. Chemotherapy was well tolerated, but the incidence of grade III/IV mucositis was significantly higher in elderly patients (0.2% versus 1.5% for patients < 70 versus > or = 70 years, respectively; p = 0.011). The docetaxel/gemcitabine regimen has a comparable efficacy and tolerance in young (< 70 years) and elderly (> or = 70 years) patients.


Ultrastructural alteration in the rat liver produced by benzyl viologen.
This report presents qualitative data of the effects of a free radical generator (benzyl viologen) on rat liver. Rats were administered benzyl viologen (0.825 mg per kg of body weight) or saline solution (controls) intraperitoneally, in single daily dosage for 15 days. For microscopic examination animals were killed after 3 or 15 days of treatment. In the control animals, liver ultrastructure remained normal throughout the experiment. But in rats with benzyl viologen it was possible to observe important morphological alterations essentially in mitochondria, frequently forming ring-like bodies. Endoplasmic reticulum was observed as concentric patterns which cover the mitochondria and, on occasion, the lipid droplets within the cell. Increased number of dense granular lysosomes were observed in the apical cytoplasm mainly close to the bile canaliculus. A large quantity of lipid inclusions and cellular degeneration of the liver of treated rats showed a marked dose-response relationship.


Formation of polyelectrolyte multilayers on fibres: influence on wettability and fibre/fibre interaction.
Polydimethyldiallylammonium chloride (PDADMAC) and polystyrene sulfonate (PSS) have been used to build-up polyelectrolyte multilayers (PEMs) on chemical soft wood fibres and on SiO2 at various electrolyte concentrations. Adsorption onto SiO2 was studied using a stagnation point adsorption reflectometer (SPAR), and the adsorbed amount of PDADMAC and PSS on the fibres was determined using nitrogen analysis and Schöniger burning, respectively. The adsorption onto the two substrates was then compared. Paper testing showed that the tensile index (TI) increased by about 90% when 11 layers had been adsorbed, and that there was a correlation between the adsorbed amount and the increase in TI. It was also shown that the particular polymer present in the outermost layer significantly influenced the TI, and that PDADMAC produced a higher TI. A correlation between the adsorbed amount and the TI was also found. Individual fibres were partly treated with a PEM and analysed using a dynamic contact angle analyser (DCA) and environmental scanning electron microscopy (ESEM).


Overall and relapse-free survival in oropharyngeal and hypopharyngeal squamous cell carcinoma are associated with genotypes of T393C polymorphism of the GNAS1 gene.
In previous studies, we have shown that the T allele of a specific single-nucleotide polymorphism (SNP) in the Galphas gene (T393C) correlates with increased Galphas expression and hence apoptosis. The T allele was associated with a favorable outcome in a variety of human cancers, e.g., carcinoma of the urinary bladder, kidney, and colorectum. The prognostic value of the T393C SNP was evaluated in an unselected series of patients treated with curative intent for oropharyngeal and hypopharyngeal squamous cell carcinomas, including all tumor stages with different therapeutic regimens. Genotype analysis was done using DNA from paraffin-embedded tissue samples from 202 patients (162 men, 40 women) with a median follow-up of 38 months (1-133 months). The various genotypes were correlated with relapse-free and overall survival. GNAS1 393C homozygous patients displayed a higher risk for disease progression than T393 homozygous patients (hazard ratio CC versus TT, 1.9; 95% confidence interval, 1.1-3.2; P = 0.019). The same genotype effect was observed for overall survival with CC genotypes at higher risk for death compared with TT genotypes (hazard ratio, 1.7; 95% confidence interval, 1.1-2.9; P = 0.015). Multivariate analysis showed that, besides American Joint Committee on Cancer stage, tumor localization, and gender, the T393C polymorphism was an independent prognostic factor for disease progression and death. The T393C SNP could be considered as a genetic marker to predict the clinical course of patients suffering from oropharyngeal and hypopharyngeal cancer.


Development of a novel high volume band compression injector for the analysis of complex samples like toxaphene pesticide.
A new type of injector has been developed for gas chromatographic analysis. The injector has high volume and band compression (HVBC) capabilities useful for the analysis of complex samples. The injector consists essentially of a packed liner operated at room temperature while a narrow heated zone is used to axially scan the liner selectively desorbing the compounds of interest. The scanning speed, distance and temperature of the zone are precisely controlled. The liner is connected to an interface which can vent the solvent or any undesirable compounds, and transfer the analytes to an analytical column for separation and quantification. The injector is designed to be compatible with injection volumes from 1 to more than 250microL. At a low sample volume of 1microL, the injector has competitive performances compared to those of the "on-column" and "split/splitless" injectors for the fatty acid methyl esters and toxaphene compounds tested. For higher volumes, the system produces a linear response according to the injected volume. In this explorative study, the maximum volume injected seems to be limited by the saturation of the chromatographic system instead of being defined by the design of the injector. The HVBC injector can also be used to conduct "in situ" pretreatment of the sample before its transfer to the analytical column. For instance, a toxaphene sample was successively fractionated, using the HVBC injector, in six sub-fractions characterized by simpler chromatograms than the chromatogram of the original mixture. Finally, the ability of the HVBC injector to "freeze" the separation in time allowing the analyst to complete the analysis at a later time is also discussed.


Advances in ophthalmic ultrasound.
New ultrasound technologies, including three-dimensional imaging, tissue characterization, and very high frequency (50 MHz) ultrasound, have become available recently. We demonstrate how these technologies can be used alone and together to improve the use of ultrasound for diagnosis of ocular pathology.


Persisting symptoms common but inability to work rare: a one-year follow-up study of Finnish hospitalised COVID-19 patients.
Difficulties in recovery persisting for months have been reported in patients with severe COVID-19. Our aim was to investigate respiratory and overall recovery one year after hospital discharge. Finnish patients hospitalised due to COVID-19 during the first wave of the pandemic were recruited to a survey of symptoms, quality of life (RAND-36), work status, and health care use one year after hospital discharge. Patients with lung function test and chest x-ray results available from 3-6 months after hospital discharge underwent spirometry and a chest x-ray at one year. Ninety-six patients responded to the one-year survey, 32 underwent spirometry and 32 a chest x-ray. Of those working full-time before COVID-19, median duration of sick leave was 40 days and 10% had not returned to work at one year. Health-care service use related to COVID-19 after discharge was reported by 79%, 50% using primary care, 34% occupational health care and 32% specialist care, respectively. Tiredness, fatigue, and physical difficulties increased in follow-up (p = 0.022-0.033). Quality of life did not change. Chest x-ray abnormalities decreased in follow-up, with an abnormal chest x-ray in 58% at 3-6 months and 25% at one year. A restrictive spirometry pattern was more common at one year (16 vs. 34%, p = 0.014). Prolonged symptoms are common, some patients have decreased lung function, and a small minority of patients still have not returned to work one year after severe COVID-19. This calls for further research into the underlying causes and risk factors for prolonged recovery.


[Ultrasonographic diagnosis of Fournier's gangrene].
The usefulness of ultrasound in the detection of Fournier's gangrene in the early stages is described herein. We discuss the clinical course of the patient with scrotal inflammation of a torpid course suspected as Fournier's gangrene on the ultrasound findings. The use of ultrasound in cases with acute scrotal inflammation of a torpid course as in this case, permits early detection of Fournier's gangrene, a fulminant condition. A review of the literature has shown that the findings described herein have been infrequently reported.


Predictive models to estimate the risk of glaucoma development and progression.
In this chapter, we review the motivations and steps involved in the construction and validation of predictive models for the development and progression of glaucoma. We start with a critical review of the literature on the risk factors that have been identified as associated with development and progression of the disease. Subsequently, we review the steps necessary to build and validate a predictive model containing risk factors. We analyze the current models that have been proposed to assess risk of glaucoma development in patients with ocular hypertension and we discuss the potential for creating models to assess risk of progression in patients already diagnosed with the disease. Finally, we discuss some of the limitations of currently available models and the perspectives on this area.


Keratin 8 phosphorylation regulates its transamidation and hepatocyte Mallory-Denk body formation.
Mallory-Denk bodies (MDBs) are hepatocyte inclusions that are associated with poor liver disease prognosis. The intermediate filament protein keratin 8 (K8) and its cross-linking by transglutaminase-2 (TG2) are essential for MDB formation. K8 hyperphosphorylation occurs in association with liver injury and MDB formation, but the link between keratin phosphorylation and MDB formation is unknown. We used a mutational approach to identify K8 Q70 as a residue that is important for K8 cross-linking to itself and other liver proteins. K8 cross-linking is markedly enhanced on treating cells with a phosphatase inhibitor and decreases dramatically on K8 S74A or Q70N mutation in the presence of phosphatase inhibition. K8 Q70 cross-linking, in the context of synthetic peptides or intact proteins transfected into cells, is promoted by phosphorylation at K8 S74 or by an S74D substitution and is inhibited by S74A mutation. Transgenic mice that express K8 S74A or a K8 G62C liver disease variant that inhibits K8 S74 phosphorylation have a markedly reduced ability to form MDBs. Our findings support a model in which the stress-triggered phosphorylation of K8 S74 induces K8 cross-linking by TG2, leading to MDB formation. These findings may extend to neuropathies and myopathies that are characterized by intermediate filament-containing inclusions.


Active Surveillance for Prostate Cancer under the Patient Protection and Affordable Care Act.
Active surveillance is the standard alternative to immediate curative intervention in men with low risk prostate cancer. It avoids unnecessary treatments while allowing for curative intervention in cases that progress with time and it has added total cost savings without compromising outcomes compared to immediate treatment. The 3 foci of the PPACA are to increase access to health care, improve quality of health care delivery and decrease costs. Multiple aspects of the PPACA are likely to impact the choice and delivery of active surveillance for prostate cancer management. Programs including value based purchasing, episode based payments and accountable care organizations as well as increasing use of electronic health records may help promote the delivery of quality, efficient care for Americans. Active surveillance fits well in this model and becomes an attractive option for managing prostate cancer in the new health care environment.


Lipoprotein signal peptides are processed by Lsp and Eep of Streptococcus uberis.
Lipoprotein signal peptidase (lsp) is responsible for cleaving the signal peptide sequence of lipoproteins in gram-positive bacteria. Investigation of the role of Lsp in Streptococcus uberis, a common cause of bovine mastitis, was undertaken using the lipoprotein MtuA (a protein essential for virulence) as a marker. The S. uberis lsp mutant phenotype displayed novel lipoprotein processing. Not only was full-length (uncleaved) MtuA detected by Western blotting, but during late log phase, a lower-molecular-weight derivative of MtuA was evident. Similar analysis of an S. uberis double mutant containing insertions disrupting both lsp and eep (a homologue of the Enterococcus faecalis "enhanced expression of pheromone" gene) indicated a role for eep in cleavage of lipoproteins in the absence of Lsp. Such a function may indicate a role for eep in maintenance of secretion pathways during disruption of normal lipoprotein processing.


Identification of non-fatal myocardial infarction through hospital discharge data in Western Australia.
The validity of identifying incident cases of non-fatal acute myocardial infarction (AMI) between 1971 and 1982 in Western Australia from routine hospital records was assessed in ages 25-64 years, according to the WHO criteria defined in 1970 and 1983. This was done by reviewing original data sources and by using the Perth Coronary Register of 1971 as an external reference. Events with a coded discharge diagnosis of acute or subacute ischemic heart disease were found to be highly sensitive (97%) for cases of "definite" AMI (WHO 1983 criteria). The specificity of such events was lower (positive predictive value of about 70%) and validation of these events would be necessary for studies requiring high specificity. The sensitivity and specificity of these events for "definite" AMI seemed quite stable over time with similar values being observed in 1971 and 1978. Although the situation for "possible" AMI (non-fatal) is less clear, certainly many more records would need to be reviewed to validate this diagnosis.


Biomechanical evaluation of augmentation of suture-bridge supraspinatus repair with additional anterior fixation.
Studies have recently focused on evaluating the ability of the supraspinatus repair to withstand rotational loads. Other studies have focused on the importance of minimizing gap formation to avoid decreased healing and failure of repair. The objective of this study was to use a loading model that incorporates external rotation to biomechanically evaluate augmenting a suture-bridge technique for supraspinatus repair with an additional anterior fixation. Eight matched cadaveric shoulder pairs were randomized to 2 different types of repairs after a simulated supraspinatus tear. One group received a standard suture-bridge technique, and the other underwent a suture-bridge repair with an additional anterior fixation consisting of a 4.5-mm suture anchor. A custom apparatus was used to test all specimens, allowing for dynamic external rotation from 0° to 30° during loading. Cyclic loading was performed for 30 cycles from 0 to 90 N, followed by load to failure using a materials-testing machine. No differences were found in linear stiffness, yield load, ultimate load, and energy absorbed for load to failure between the 2 groups (P > .05). There was a reduction in anterior gapping at ultimate load between the anterior augmentation repair group (6.4 ± 3.1 mm) and the standard suture bridge (9.4 ± 2.8 mm; P = .037). There does not appear to be a biomechanical advantage with the addition of an anterior suture augmentation of a suture bridge for a supraspinatus repair. However, using an anterior augmentation for a suture bridge prevents gap formation at ultimate load in a biomechanical, dynamic external rotation model.


"Occult" papillary carcinoma of the thyroid: a questionable entity.
A series of 72 cases of "occult" thyroid papillary cancer, i.e. tumours of less than 1.5 cm in diameter, was analysed. The patients--26 males and 46 females--were treated surgically, 25 by lobectomy and isthmusectomy and 47 by total thyroidectomy. In 51 cases nodal neck dissection was performed, bilateral in 2 cases. 9 thyroidectomised patients received radiometabolic therapy. Hormone therapy (T4) was continuously administered to 57 patients. The median duration of follow-up was 99 months (60-189). All the patients were alive (except one who died from other causes) and free of disease at last control. No relapses in the thyroid were observed in the conservatively treated patients. 2 patients of the 47 radically operated upon subsequently presented nodal metastasis and underwent neck dissection. The so-called "occult" thyroid papillary cancer does not differ from other papillary cancers with respect to morphological, clinical and prognostic factors--it differs only in size. Considering occult papillary tumours as an entity is questioned in this paper.


Pulmonary Hypertension in Apparently Healthy Children in Southern Nigeria.
To determine the severity and prevalence of pulmonary hypertension and its relationship with age and body mass index (BMI) in healthy children. Observational study. University of Nigeria Teaching Hospital Ituku-Ozalla Enugu, Lagos State University Teaching Hospital, Niger Delta University Teaching Hospital, Bayelsa and Blessed Children Hospital Enugu from January 2010 to December 2019. Four hundred and seventy (470) apparently healthy children aged 1 to 17 years underwent Doppler echocardiographic studies. Their tricuspid regurgitation velocity (TRV) was measured with continuous wave Doppler. Pulmonary artery systolic pressure (PASP) was estimated using the Bernoulli equation. Elevated PASP were determined at PASP ≥35/mmHg. Values were compared against age and BMI. The mean age was 7.9 ± 3.3 years. Four hundred and fifty-nine subjects (97.7%) had normal PASP while 11 (2.3%) had elevated PASP. Those with elevated PASP had a significantly higher mean TRV of 2.7 ± 0.22 cm/s (95% CI; 2.55-2.85) vs TRV of 1.56 ± 0.43cm/s (95% CI; 1.52-1.60) and higher mean PASP of 39.27±4.89 mmHg (95% CI; 35.99-42.56) vs 20.45 ± 5.34 mHg (95% CI; 19.96-20.94) (p=0.001). Though majority of the children had appropriate weight for ages, those with elevated PASP had a significantly greater weight than those with normal PASP (p<0.001). There was a weak positive correlation of PASP with age (r=0.16) and BMI in normal weight (r=0.08). Obese children had a negative correlation value(r=-0.13). A weak negative correlation of PASP with BMI was seen in underweight (r=-0.17 and overweight (r=-0.73) children (p>0.05). The mean pulmonary artery systolic pressure in the studied apparently healthy Nigerian children was 20.45± 5.34/ mmHg. The frequency of elevated PASP was 2.3%, commoner in children with higher BMI. Age and body mass index are not optimal predictors of PASP. Key Words: Pulmonary artery systolic pressure, Children, Pulmonary hypertension, Echocardiography.


Trophospongium-like structures in an insect eye: response of retinula cells of Papilio xuthus (Lepidoptera) to irradiation with ultraviolet light.
Presumably, as a consequence of a 3-h exposure to light of 350-nm wavelength (1.5 X 10(15) photons/cm2 sec) followed by a period of 20 h of rest in the dark, the four smaller retinula cells in each ommatidium of the eye of the butterfly Papilio xuthus contain a structure in the peripheral regions of their cytoplasm that resembles a portion of a rhabdom. Evidence for and against the view that this unusual, highly ordered arrangement of membranes represents a trophospongium is presented. In view of the fact that the structure in question only occurred at the same time when rhabdomeres were in a process of disintegration or reformation, the authors conclude that the structure in question is involved in the supply or removal of substances during a period of considerable activity of the retinula cell.


Fertilizer-dependent efficiency of Pseudomonads for improving growth, yield, and nutrient use efficiency of wheat (Triticum aestivum L.).
Acquisition of nutrients by plants is primarily dependent on root growth and bioavailability of nutrients in the rooting medium. Most of the beneficial bacteria enhance root growth, but their effectiveness could be influenced by the nutrient status around the roots. In this study, two 1-aminocyclopropane-1-carboxylate (ACC)-deaminase containing plant-growth-promoting rhizobacteria (PGPR), Pseudomonas fluorescens and P. fluorescens biotype F were tested for their effect on growth, yield, and nutrient use efficiency of wheat under simultaneously varying levels of all the three major nutrients N, P, and K (at 0%, 25%, 50%, 75%, and 100% of recommended doses). Results of pot and field trials revealed that the efficacy of these strains for improving growth and yield of wheat reduced with the increasing rates of NPK added to the soil. In most of the cases, significant negative linear correlations were recorded between percentage increases in growth and yield parameters of wheat caused by inoculation and increasing levels of applied NPK fertilizers. It is highly likely that under low fertilizer application, the ACC-deaminase activity of PGPR might have caused reduction in the synthesis of stress (nutrient)-induced inhibitory levels of ethylene in the roots through ACC hydrolysis into NH(3) and alpha-ketobutyrate. The results of this study imply that these Pseudomonads could be employed in combination with appropriate doses of fertilizers for better plant growth and savings of fertilizers.


Myocardial depressant effects of sodium acetate.
Sodium acetate produced a direct, dose-related decrease in myocardial contractile force in the dog and isolated rabbit papillary muscle. In the dog, there was also a decrease in blood pressure which was attributed primarily to the fall in contractile force. However, sodium acetate was found to have weak vasodilator properties as shown by the decreases in hind-limb perfusion pressure.


Synergistic interactions of saponins and monoterpenes in HeLa cells, Cos7 cells and in erythrocytes.
In phytomedicine complex extracts consisting of phenolics, monoterpenes or saponins are traditionally used. It is often impossible to attribute the biological activity of an extract to one or few compounds. As an explanation of the superior activity of extracts, a synergistic effect of combinations of active compounds has been suggested. Since lipophilic monoterpenes or saponins targeting the biomembrane usually accompany polar polyphenols in phytomedical preparations, we decided to investigate their effect as single substances and in combination to gain further insight into potential synergistic effects of herbal medicine. Combinations of the monoterpenes α-pinene, thymol and menthol with the monodesmosidic saponins digitonin, aescin, glycyrrhizic acid and Quillaja saponin demonstrated strong synergistic activity. The IC(50) of haemolysis was lowered by a factor of 10-100 from 316μg/ml to 2μg/ml for aescin, 157μg/ml to 11μg/ml for Quillaja saponins and 20μg/ml to 3μg/ml for digitonin when combined with thymol. A similar significant synergistic cytotoxicity occurred both in HeLa and Cos7 cells by combining the α-pinene, thymol and menthol with the saponins. The IC(50) of glycyrrhizic acid was lowered by a factor 100 from around 300μg/ml to around 1-10μg/ml and the IC(50) of aescin, digitonin and Quillaja saponins about the factor 10. Monoterpenes and monodesmosidic saponins have a common target, the biomembrane, which is present in all animal, fungal and bacterial cells. Disturbance of membrane fluidity and permeability is the mode of action. This activity is non-specific which makes it extremely difficult for bacteria and fungi to develop resistance. This explains the overall success of these molecules as defence chemicals in the plant kingdom. The synergistic effect of combinations of saponins with monoterpenes opens a complete new field of possible applications in medicine to overcome resistance in multidrug resistant microbial and human cell.


Enhancement of ERK phosphorylation and photic responses in Vc/C1 neurons of a migraine model.
Although it is well known that migraine pain is enhanced by photic stimulation of the eye, the mechanisms underlying this response are not yet understood. Noxious stimulation to the dura is known to activate trigeminal spinal subnucleus caudalis and upper cervical spinal cord (Vc/C1) neurons, causing migraine pain. Intense photic stimulation to the eye is also known to activate certain Vc/C1 neurons, thus increasing migraine pain. In this study, we hypothesized that Vc/C1 neurons receiving noxious dural input would be further activated by intense photic stimulation, resulting in the enhancement of migraine pain. However, mechanisms underlying the interactions between dural and photic sensory information in Vc/C1 neurons is unknown. To evaluate the above hypothesis, we studied phosphorylated extracellular signal-regulated kinase (pERK) -immunoreactive (IR) cells in Vc/C1 in dural mustard oil (DMO)-administrated rats. The change in neuronal excitability of Vc/C1 nociceptive neurons receiving input from the dura in DMO rats was examined and tested if those neurons were modulated by intense flush light stimulation. There were many pERK-IR cells in the lateral portion of Vc/C1 after MO administration to the dura. Flashlight presentation to the eye in DMO rats caused an enhancement of ERK phosphorylation in Vc/C1 neurons and pERK-IR cells were significantly suppressed after intracisternal administration of MEK1 inhibitor PD98059. Dura-light sensitive (DL) neurons were recorded in the lateral portion of Vc/C1 and photic responses of DL neurons were significantly enhanced following dural MO administration. These findings indicate that DL Vc/C1 neurons in DMO rats intensified their responses to intense photic stimulation and that ERK phosphorylation in Vc/C1 neurons receiving noxious dural input increased with intense photic stimulation, suggesting that Vc/C1 nociceptive neurons are involved in the enhancement of dural nociception associated with intense light stimulation.


Reduction of intimal hyperplasia with Re-188-labeled stents in a rabbit model at 7 and 26 weeks: an experimental study.
The aim of this study was to analyze the feasibility of (188)Re-labeled stents to reduce neointimal formation in a rabbit atherosclerosis model and to test the long-term effects at 7 and 26 weeks. Fifty-nine male New Zealand White rabbits were fed a 0.5% cholesterol diet for 4 weeks before balloon angioplasty and insertion of Palmaz stents in the infrarenal aorta. The animals were sacrificed 7 and 26 weeks after stent implantation. Control stents were compared with (188)Re stents: (dose 1) 11.3 +/- 1.8 MBq; (dose 2) 37.3 +/- 4.2 MBq, and (dose 3) 80.1 +/- 7.8 MBq. Each activity group consisted of a short-term (7 weeks) and a long-term group (26 weeks), resulting in a total of eight study groups. No thrombotic occlusion was observed. The neointimal formation in the control group was 2.11 [95% confidence interval (CI): 0.68--6.52] mm(2) at 7 weeks and 2.10 (0.62--7.11) at 26 weeks. In the treatment groups, neointima reduction was detectable at 7 weeks [dose 1: 0.33 (0.09--1.22) mm(2); dose 2: 0.17 (0.05--0.57) mm(2); dose 3: 0.03 (0.01--0.13) mm(2)]. After 26 weeks, a catch-up of neointimal formation in the radioactive groups was most obvious in the low-dose group [dose 1: 0.80 (0.28--2.29) mm(2); dose 2: 0.18([0.06--0.52) mm(2); dose 3: 0.50 (0.17--1.42) mm(2)]. Compared to the long-term control group, neointimal reduction was still >60%. No induction of neointimal formation was observed at the edges of the stents. Radiation resulted in delayed re-endothelialization. (188)Re stents were capable to reduce intimal hyperplasia and did not cause thrombosis. The edge effect, which was the major limitation of (32)P stents, was not observed in (188)Re stents.


A Finger in the Game: Sport-Specific Finger Strength Training and Onset of Injury.
Strength training has proved to be an effective way to prevent injuries, but the evidence of the impact of strength training on finger injuries is lacking. A fingerboard is a sport-specific tool used by climbers for strength training of fingers. In this study, we searched for associations between fingerboard training and finger injuries in climbers with different lengths of climbing experience and levels of performance. A web-based survey was used to collect information on self-perceived pain or injury in fingers (SPIIF) and regular fingerboard training (RFT). The survey was administered to the Finnish climbing community. Data were analyzed using contingency tables; chi-square was used to evaluate statistical significance. No significant correlations between SPIIF and RFT were found when analyzing all the participants (n=434) together. In climbers with 6 y or more in the sport, SPIIF was not common and RFT was negatively associated with SPIIF (χ2 [1, n=200]=4.57; P=0.03). In contrast to this, in male climbers who had been climbing for less than 6 y and had advanced to 7a level or higher (French lead/Font bouldering), SPIIF was common and RFT was positively associated with SPIIF (χ2 [1, n=75]=4.61; P=0.03). We suggest that doing RFT may prevent SPIIF in climbers with a long background in the sport as fingerboard training can help build stronger fingers and thereby stronger tendons and ligaments. Climbers with fewer years in the sport and less adaptation to the fingers should be cautious with their training loads and RFT to avoid finger injuries and pain.


Association between higher systemic immune inflammation index (SII) and deep vein thrombosis (DVT) in patients with aneurysmal subarachnoid hemorrhage (aSAH) after endovascular treatment.
Inflammation contributes to deep vein thrombosis (DVT) formation in patients with aSAH after endovascular treatment. The relationship between systemic immune-inflammatory index (SII) as an inflammatory marker and DVT formation remains unclear. Thus, this study aims to evaluate the association between SII and aSAH-associated DVT following endovascular treatment. We enrolled 562 consecutive patients with aSAH after endovascular treatment at three centers from January 2019 to September 2021. The endovascular treatments included simple coil embolization and stent-assisted coil embolization. Deep venous thrombosis (DVT) was assessed by Color Doppler ultrasonography (CDUS). Multivariate logistic regression analysis was used to establish the model. We assessed the association of the SII, neutrophil-to-lymphocyte ratio (NLR), the systemic inflammatory response index (SIRI), platelet-lymphocyte ratio (PLR), and DVT by using restricted cubic spline (RCS). ASAH-associated DVT was found in 136 (24.20%) patients. Based on the multiple logistic regression analysis, the correlation was found between aSAH-associated DVT and elevated SII (fourth quartile) (adjusted odds ratio = 8.20 [95% confidence interval, 3.76-17.92]; p < 0.001 [p for trend < 0.001]), elevated NLR (fourth quartile) (adjusted odds ratio = 6.94 [95% confidence interval, 3.24-14.89]; p < 0.001 [p for trend < 0.001]), elevated SIRI (fourth quartile) (adjusted odds ratio = 4.82 [95% confidence interval, 2.36-9.84]; p < 0.001 [p for trend < 0.001]), and elevated PLR (fourth quartile) (adjusted odds ratio = 5.49 [95% confidence interval, 2.61-11.57]; p < 0.001 [p for trend < 0.001]). The increased SII was correlated with the formation of aSAH-associated DVT after endovascular treatment.


The correlation between sexual dysfunction and intimate partner violence in young women during pregnancy.
Sexual function is one of the main aspects of life. Pregnancy affects sexual function. The aim of this study was to determine the sexual dysfunction in young pregnant women and its correlation with intimate partner violence (IPV). This cross-sectional study was conducted using two-stage cluster sampling method. The data were collected using a socio-demographic questionnaire, Female Sexual Function Index (FSFI), and Conflict Tactics Scale (CTS2). Multivariate logistic regression was used to determine the relationships between sexual dysfunction with IPV and socio-demographic factors. The results of this study on 346 pregnant women aged 18-29 years showed that mean (SD = standard deviation) of the total sexual function score was 25.4 (5.9), within a possible score range of 2 to 36. About 66% of the young pregnant women had a sexual dysfunction. The lowest and the highest prevalence of sexual dysfunction were in sub domains of sexual satisfaction and sexual desire, respectively. The prevalence of overall IPV against young women was 63%. The most common type of IPV experienced by women was psychological aggression (56.6%). There were statistically significant relationships between sexual dysfunction and IPV (OR (Odds Ratio) = 0.4, 95% Confidence Interval = 0.2 to 0.6, p < 0.001), sufficiency of income for expenses (0.2, 0.1 to 0.6, p = 0.005), husband educational level (0.5, 0.3 to 0.9, p = 0.028) and marriage duration (1.9, 1.0 to 3.7, p = 0.044). Sexual dysfunction has a high prevalence in young pregnant women and IPV had correlation with sexual dysfunction. The routine screening for sexual dysfunction and IPV is recommended during pregnancy for detection and consulting.


Should gastric carcinoid tumors associated with pernicious anemia be treated aggressively?
Two patients with pernicious anemia developed gastric carcinoid, one 20 years and the other 1 year after diagnosis of pernicious anemia. One of the patients underwent successful resection of the tumor, while the second, with diffuse gastric carcinoid, was managed conservatively. She is well and asymptomatic 32 months after the diagnosis. We discuss the dilemma in management of gastric carcinoid associated with pernicious anemia.


Silencing the odorant coreceptor (Orco) disrupts sex pheromonal communication and feeding responses in Blattella germanica: toward an alternative target for controlling insect-transmitted human diseases.
The German cockroach, Blattella germanica, is one of the most severe pests of urban and rural areas. High-throughput genetic screening approaches indicate that the olfactory system of this pest is extremely powerful because it has an extensive array of olfactory receptor genes compared with many other insect species. Several of these genes have been identified previously, but their functions have not yet been characterized. This study describes the sequence of five transcriptomes of B. germanica adult male antennae, female antennae, maxillary palps, legs, and fifth-instar nymph antennae to investigate expression patterns of odorant receptors (ORs). Approximately 90% of ORs were found to be the most highly expressed genes in adult or nymph antennae. Additionally, every OR requires an odorant co-receptor (Orco) to become fully functional, and this was selected and successfully inhibited by injection of the corresponding double-stranded (ds)RNA targeting the Orco. A strong RNA interference (RNAi) effect was observed in which > 75% of Orco messenger RNA (mRNA) was clearly suppressed after 72 h of treatment. Olfactory behavioral assays showed that Orco-impaired B. germanica respond more slowly and show less attraction to one volatile sex pheromone and food resources compared with a control group. The results show that Orco plays a pivotal role in both sex pheromone and food-seeking olfactory processes, and provide an alternative genetic technique for controlling this urban pest species by olfactory disruption. © 2020 Society of Chemical Industry.


Impulsivity and negative emotionality associated with substance use problems and Cluster B personality in college students.
The co-occurrence of personality disorders (PDs) and substance use disorders (SUDs) can be partially attributed to shared underlying personality traits. This study examined the role of negative emotionality (NEM) and impulsivity in 617 university students with self-reported substance use problems and Cluster B PD symptoms. Results indicated that NEM was significantly associated with drug and alcohol use problems, antisocial PD, borderline PD, and narcissistic PD. Impulsivity was significantly associated with drug use problems, antisocial PD, and histrionic PD. Only NEM mediated the relationship between alcohol use problems and symptoms of each of the Cluster B PDs while impulsivity mediated only the relationship between drug use problems and histrionic PD. These results suggest that NEM may be more relevant than impulsivity to our understanding of the co-occurrence between substance use problems and Cluster B PD features.


A brief survey of mRNA surveillance.
Defective mRNAs are degraded more rapidly than normal mRNAs in a process called mRNA surveillance. Eukaryotic cells use a variety of mechanisms to detect aberrations in mRNAs and a variety of enzymes to preferentially degrade them. Recent advances in the field of RNA surveillance have provided new information regarding how cells determine which mRNA species should be subject to destruction and novel mechanisms by which a cell tags an mRNA once such a decision has been reached. In this review, we highlight recent progress in our understanding of these processes.


Medical management for the prevention and treatment of diabetic macular edema.
Recent clinical trials have changed the management paradigm for diabetic macular edema (DME). There is an urgent need to identify the most effective ways of preventing retinopathy or intervening at an early, asymptomatic stage in order to preserve vision. The rise in the incidence of diabetes is a serious public health concern. Grading and screening programmes help to identify sight threatening diabetic retinopathy in the community early and facilitate timely referral to an ophthalmologist. Systemic therapies for DME target the key modifiable risk factors: metabolic and blood pressure control. There may also be a role for modification of the renin-angiotensin system and for lipid lowering agents. Improved glycemic and blood pressure control remain the most effective ways of reducing morbidity from DME. Fenofibrate also has beneficial effects, but the mechanism for this remains unclear. Multiple new treatments are in the pipeline, and these are expected to change our approach to DME for the first time in 30 years.


Reduction of adverse drug reactions by computerized drug interaction screening.
Computerized drug-interaction screening systems (CDISS) have been developed as a tool to help decrease the enormous morbidity and expense related to adverse drug interactions. In previous studies the CDISS was used primarily by pharmacists in hospital settings to screen for interactions after the prescription had been written. This study tests the feasibility of family physicians using CDISS before writing the prescription to allow for changes in the prescription while the patient is still in the office. In a 30-day period, 103 patients were screened by family physicians for potential drug-drug, drug-alcohol, and drug-food interactions. Potential drug interactions of varying clinical significance were detected for 71 patients (68.9 percent). The prescription plan was changed for 16 patients (15.5 percent) as a result of using the CDISS. Participating physicians reported that they gained new information in 45.8 percent of the patient encounters, that their awareness of the potential for drug interactions was heightened by participation in this study, and that their exposure to the CDISS was worthwhile as an educational tool. While a few problems, mainly logistic, were noted with the CDISS as used in this study, the authors conclude that with modifications a CDISS can be of great educational and clinical value to the family physician and his or her patients.


Host DNA Demethylation Induced by DNMT1 Inhibition Up-Regulates Antiviral OASL Protein during Influenza a Virus Infection.
Influenza A virus (IAV) is a leading cause of human respiratory infections and poses a major public health concern. IAV replication can affect the expression of DNA methyltransferases (DNMTs), and the subsequent changes in DNA methylation regulate gene expression and may lead to abnormal gene transcription and translation, yet the underlying mechanisms of virus-induced epigenetic changes from DNA methylation and its role in virus-host interactions remain elusive. Here in this paper, we showed that DNMT1 expression could be suppressed following the inhibition of miR-142-5p or the PI3K/AKT signaling pathway during IAV infection, resulting in demethylation of the promotor region of the 2'-5'-oligoadenylate synthetase-like (OASL) protein and promotion of its expression in A549 cells. OASL expression enhanced RIG-I-mediated interferon induction and then suppressed replication of IAV. Our study elucidated an innate immunity mechanism by which up-regulation of OASL contributes to host antiviral responses via epigenetic modifications in IAV infection, which could provide important insights into the understanding of viral pathogenesis and host antiviral defense.


The oldest psyllipsocid booklice, in Lower Cretaceous amber from Lebanon (Psocodea, Trogiomorpha, Psocathropetae, Psyllipsocidae).
Libanopsyllipsocus alexanderasnitsynigen. et sp. n., of Psyllipsocidae is described and figured from the Lower Cretaceous amber of Lebanon. The position of the new taxon is discussed and the fossil is compared to other psyllipsocids. The species represents the earliest record of the family Psyllipsocidae.


Controlled-cycle counter-current chromatography.
The application of the technique of controlled-cycle operation to counter-current chromatography is suggested and evaluated. The operating cycle as applied to a chromatographic column would consist of two individually timed periods: (1) Flow period: a specified volume of mobile phase is fed into one end of the column, conveyed through it, and discharged out of the other end of the column. (2) Delay period: an equilibrium concentration distribution between the phases is allowed to be reached. Mathematical description of controlled-cycle chromatography, using an idealized model, is given and theoretical chromatograms of three-component samples for conventional continuous and controlled-cycle operations are compared. It is shown that for certain conditions the controlled-cycle operation could provide by an order of magnitude greater efficiencies (measured with number of theoretical plates) than conventional operation of a chromatographic column.


Brain responses to glucose ingestion are greater in children than adults and are associated with overweight and obesity.
This study investigated whether brain regions involved in the regulation of food intake respond differently to glucose ingestion in children and adults and the relationship between brain responses and weight status. Data included 87 children (ages 7-11 years) and 94 adults (ages 18-35 years) from two cohorts. Healthy weight, overweight, and obesity were defined by Centers for Disease Control and Prevention criteria. Brain responses to glucose were determined by measuring cerebral blood flow using arterial spin labeling magnetic resonance imaging in brain regions involved in the regulation of eating behavior. Children showed significantly larger increases in brain responses to glucose than adults in the dorsal striatum (p < 0.01), insula (p < 0.01), hippocampus (p < 0.01), and dorsal-lateral prefrontal cortex (p < 0.01). Responses to glucose in the dorsal striatum (odds ratio [OR] = 1.52, 95% CI 1.05-2.20; p = 0.03), hippocampus (OR = 1.51, 95% CI: 1.02-2.22; p = 0.04), insula (OR = 1.64, 95% CI: 1.11-2.42; p = 0.01), and orbitofrontal cortex (OR = 1.63 95% CI: 1.12-2.39; p = 0.01) were positively associated with overweight or obesity, independent of age group. Children have greater brain responses to glucose ingestion than adults in regions involved in eating behavior, and these responses are associated with weight status.


[Resurfacing arthroplasty for treatment of avascular necrosis of femoral head in young and middle-aged patients].
To investigate the early clinical effect of resurfacing arthroplasty on the treatment of avascular necrosis of the femoral head in the young and middle-aged patients. Eleven patients with avascular necrosis of the femoral head in Ficat Stages III -IV (14 hips) were treated by femoral head resurfacing operations. Of 11 cases, there were 7 males and 4 females. With an age range of 35 to 49 years. While 13 patients with avascular necrosis of the femoral head in Ficat Stages III - IV (16 hips) were treated by total hip resurfacing arthroplasty of 13 cases there were 8 males and 5 females. With an age range of 23 to 48 years. The prostheses were improved in light of the anatomic features of the Chinese. These patients treated by femoral head resurfacing operations were followed up for 1 to 5 years. The average Harris hip score was increased from 39 points preoperatively to 91 points postoperatively. These patients treated by total hip resurfacing operations were followed up for 6 to 40 months. The average Harris hip score was increased from 30 points preoperatively to 93 points postoperatively. Hip resurfacing operations may be the most effective treatment for avascular necrosis of the femoral head in the young and middle aged patients.


Contribution from motor vehicle exhaust to the mutagenic activity of airborne particles.
Samples of urban airborne particles have been collected simultaneously at street level and at roof top level in a street canyon of Oslo during two summer months. Extracts of the samples were tested for mutagenicity in the Ames Salmonella/microsome assay. The results are discussed in relation to traffic intensity, to meteorological parameters and to results from a similar study performed in the winter. The results indicated that vehicle exhaust was the main source of mutagens at both sampling sites and both seasons. Some additional activity from other sources may be detected in roof level winter samples. The results indicated further that some of the mutagens present at street level had been transformed to more polar compounds before reaching roof level.


NEWS for Africa: adaptation and reliability of a built environment questionnaire for physical activity in seven African countries.
Built environment and policy interventions are effective strategies for controlling the growing worldwide deaths from physical inactivity-related non-communicable diseases. To improve built environment research and develop African specific evidence, it is important to first tailor built environment measures to African contexts and assess their psychometric properties across African countries. This study reports on the adaptation and test-retest reliability of the Neighborhood Environment Walkability Scale in seven sub-Saharan African countries (NEWS-Africa). The original NEWS comprising 8 subscales measuring reported physical and social attributes of neighborhood environments was systematically adapted for Africa through extensive input from physical activity and public health researchers, built environment professionals, and residents in seven African countries: Cameroon, Ghana, Kenya, Mozambique, Nigeria, South Africa and Uganda. Cognitive testing of NEWS-Africa was conducted among diverse residents (N = 109, 50 youth [12 - 17 years] and 59 adults [22 - 67 years], 69 % from low socioeconomic status [SES] neighborhoods). NEWS-Africa was translated into local languages and evaluated for 2-week test-retest reliability in adult participants (N = 301; female = 50.2 %; age = 32.3 ± 12.9 years) purposively recruited from neighborhoods varying in walkability (high and low walkable) and SES (high and low income) and from villages in six of seven participating countries. The original 67 NEWS items was expanded to 89 scores (76 individual NEWS items and 13 computed scales). Several modifications were made to individual items, and some new items were added to capture important attributes in the African environment. A new scale on personal safety was created, and the aesthetics scale was enlarged to reflect African specific characteristics. Over 95 % of all NEWS-Africa scores (items plus computed scales) demonstrated evidence of "excellent" (ICCs > .75 %) or "good" (ICCs = 0.60 to 0.74) reliability. Seven (53.8 %) of the 13 computed NEWS scales demonstrated "excellent" agreement and the other six had "good" agreement. No items or scales demonstrated "poor" reliability (ICCs < .40). The systematic adaptation and initial psychometric evaluation of NEWS-Africa indicates the instrument is feasible and reliable for use with adults of diverse demographic characteristics in Africa. The measure is likely to be useful for research, surveillance of built environment conditions for planning purposes, and to evaluate physical activity and policy interventions in Africa.


Field studies of the relationship between herbivore damage and tannin concentration in bracken (Pteridium aquilinum Kuhn).
The acceptance of secondary plant metabolites as herbivore deterrents rests primarily on their deleterious effects on herbivores. Efforts to demonstrate differential fitness in natural plant populations with varying concentrations of tannin have failed, since coevolved plant predators may physiologically or behaviorally circumvent the defense, which results in apparently equal amounts of damage to defended and undefended individuals. In this study, two approaches were used to overcome this difficulty. 1) Theoretically, more energy should be allocated to the defense of parts which contribute more heavily to the plant's fitness. Bracken fern clones produce fronds throughout the growing season. Fronds which are produced early should be more heavily defended than late-emerging fronds which will return less photosynthate per unit cost of production. The results of this study do not support this prediction; it appears that the production of tannin is more closely linked to environmental factors such as water stress than to date of frond emergence. Fronds which emerged in August contained as much tannin as fronds which emerged in May. 2) By recording the temporal occurrence of herbivore damage in bracken ferns, it was found that in fronds which escaped attack until after reaching maturity there was a significant negative correlation between tannin concentration in the frond and the amount of damage experienced. This result supports the generally accepted assumption that herbivory has been a selective force in the evolution of tannin as a defensive substance.


Genome-wide analysis of fatty acid desaturase genes in chia (Salvia hispanica) reveals their crucial roles in cold response and seed oil formation.
Chia (Salvia hispanica) is a functional food crop with high α-linolenic acid (ALA), the omega-3 essential fatty acid, but its worldwide plantation is limited by cold-intolerance and strict short-photoperiod flowering feature. Fatty acid desaturases (FADs) are responsible for seed oil accumulation, and play important roles in cold stress tolerance of plants. To date, there is no report on systemically genome-wide analysis of FAD genes in chia (ShiFADs). In this study, 31 ShiFAD genes were identified, 3 of which contained 2 alternative splicing transcripts, and they were located in 6 chromosomes of chia. Phylogenetic analysis classified the ShiFAD proteins into 7 groups, with conserved gene structure and MEME motifs within each group. Tandem and segmental duplications coursed the expansion of ShiFAD genes. Numerous cis-regulatory elements, including hormone response elements, growth and development elements, biotic/abiotic stress response elements, and transcription factor binding sites, were predicted in ShiFAD promoters. 24 miRNAs targeting ShiFAD genes were identified at whole-genome level. In total, 15 SSR loci were predicted in ShiFAD genes/promoters. RNA-seq data showed that ShiFAD genes were expressed in various organs with different levels. qRT-PCR detection revealed the inducibility of ShiSAD2 and ShiSAD7 in response to cold stress, and validated the seed-specific expression of ShiSAD11a. Yeast expression of ShiSAD11a confirmed the catalytic activity of its encoded protein, and its heterologous expression in Arabidopsis thaliana significantly increased seed oleic acid content. This work lays a foundation for molecular dissection of chia high-ALA trait and functional study of ShiFAD genes in cold tolerance.


Multimodal Medical Image Fusion using Rolling Guidance Filter with CNN and Nuclear Norm Minimization.
Medical image fusion is very important for the diagnosis and treatment of diseases. In recent years, there have been a number of different multi-modal medical image fusion algorithms that can provide delicate contexts for disease diagnosis more clearly and more conveniently. Recently, nuclear norm minimization and deep learning have been used effectively in image processing. A multi-modality medical image fusion method using a rolling guidance filter (RGF) with a convolutional neural network (CNN) based feature mapping and nuclear norm minimization (NNM) is proposed. At first, we decompose medical images to base layer components and detail layer components by using RGF. In the next step, we get the basic fused image through the pretrained CNN model. The CNN model with pre-training is used to obtain the significant characteristics of the base layer components. And we can compute the activity level measurement from the regional energy of CNN-based fusion maps. Then, a detail fused image is gained by NNM. That is, we use NNM to fuse the detail layer components. At last, the basic and detail fused images are integrated into the fused result. From the comparison with the most advanced fusion algorithms, the results of experiments indicate that this fusion algorithm has the best effect in visual evaluation and objective standard. The fusion algorithm using RGF and CNN-based feature mapping, combined with NNM, can improve fusion effects and suppress artifacts and blocking effects in the fused results.


A new integrated circular economy index and a combined method for optimization of wood production chain considering carbon neutrality.
The wood industry is potentially advantageous to applying the concepts of circular economy for sustainable development and can contribute to the commitment of carbon neutrality. This study developed an integrated circular economy index based on five different quantitative indicators for assessment of the wood production chain: heat recovery rate, CO2 sequestration rate, fossil fuel substitution rate, renewable electricity usage rate, and revenue increase from the by-products. A combination of best-worst method (BWM) and linear goal programming (LGP) techniques was investigated to develop an optimal circular economy model of wood processing chain for reduction in CO2 emission. The integrated circular economy index and the combined method were tested in a case-study of a rubberwood processing chain in Vietnam. The proposed model suggests that the woodchips and biomass from the harvesting and processing of rubberwood could be collected and treated using microwave thermolysis techniques; the enzyme hydrolysis technique is appropriate for bioethanol and biomethane recovery from the sawdust; and the hot air technique is preferable in the drying process. The proposed model could result in a significant reduction of the total net carbon emission from +552,750 tons CO2eq to -1,145,940 tons CO2eq per year. This could support the achievement of Vietnam's zero CO2 emission goal and hopefully contribute to the country's commitment to carbon emission neutrality by the year 2050.


Lesion Size May Predict Return to Play in Young Elite Athletes Undergoing Microfracture for Osteochondral Lesions of the Talus.
To evaluate the clinical and sports-related outcomes of arthroscopic microfracture (MFx) for osteochondral lesion of the talus (OLT) in elite athletes. The athletes who underwent arthroscopic MFx for OLTs at our institution between January 2011 and September 2015 with minimum 2 years of follow-up were reviewed. The Foot and Ankle Outcome Score, American Orthopaedic Foot & Ankle Society, and visual analog scale pain score, time and rate of "return-to-competition" (RTC, return to an official match for at least 1 minute after treatment), and rate of "return-to-play" (RTP, participation in at least 2 entire seasons after treatment) were used to evaluate the outcomes. We compared athletes who were able to RTP with those who were not. In total, 41 patients (mean age 19.34 ± 3.76 years) were included. The mean follow-up was 54.9 ± 13.72 months. In total, 36 patients had medial lesions, and 5 patients had lateral lesions. All subscales of preoperative Foot and Ankle Outcome Score were significantly improved at the final follow-up. The mean preoperative American Orthopaedic Foot & Ankle Society score of 74.46 ± 8.10 improved to 91.62 ± 2.99 (P < .001) at the final follow-up. The mean preoperative visual analog scale pain score of 5.44 ± 1.57 improved to 2.66 ± 1.04 (P < .001). All patients achieved RTC (100%) at mean time of 5.45 ± 3.18 months, and 74.4% of patients were able to RTP. The RTP-group showed significantly smaller lesions compared to the No-RTP group (71.52 ± 43.29 vs 107.00 ± 45.28 mm2, P = .009). The cut-off OLT size for predicting RTP was 84.0 mm2, with a sensitivity of 90.0% and specificity of 75.9%. All athletes were able to RTC at average of 5.45 months after MFx for OLTs with minimal subchondral involvement, and 74.4% were able to RTP. The only prognostic variable for RTP was lesion size, and its predictive cut-off was 84.0 mm2. IV, Case series.


Use of bone morphogenic protein-7 as a treatment for osteoarthritis.
Osteoarthritis is a degenerative disorder resulting from breakdown of articular cartilage. Previous work has shown bone morphogenic protein-7 has a potential protective effect on cartilage during the development of osteoarthritis. The purpose of this study was to determine whether bone morphogenic protein-7 could decrease the amount of cartilage degradation in preexisting osteoarthritis. The rabbit ACLT model was used as a model of osteoarthritis. Bone morphogenic protein-7 was delivered via Alzet osmotic pump to the joint 4 weeks after anterior cruciate ligament transection; thus cartilage injury was preexisting. The experimental group showed less cartilage degradation than the controls, with an average Outerbridge score of 1.9 versus 2.6 for the controls. Histomorphometry showed a trend toward less cartilage degradation in the bone morphogenic protein-7 group when compared with controls. Semiquantitative real-time polymerase chain reaction showed a considerably greater expression of aggrecan in the bone morphogenic protein-7-treated cartilage when compared with controls and less expression of matrix metalloproteinase-3 and matrix metalloproteinase-13, important catabolic mediators. The synovial tissue of the experimental group also showed considerably less expression of matrix metalloproteinase-3, matrix metalloproteinase-13, and aggrecanase. These results indicate bone morphogenic protein-7 may reduce degradation of articular cartilage in osteoarthritis.


The election and the nation's fiscal plight aim the spotlight again on Medicare.
The candidates' differing prescriptions for what ails Medicare mask real uncertainties about the effectiveness of proffered solutions.


Dichotic listening revisited: trial-by-trial ERP analyses reveal intra- and interhemispheric differences.
The dichotic listening (DL) paradigm is often used to assess brain asymmetries at the behavioral level. The aim of this study was to evaluate the dynamic temporal and topographical characteristics of event related potentials (ERPs) obtained with diotic and dichotic consonant-vowel (CV) stimuli from the same subjects. We used a novel approach in which we concurrently analyzed on a trial-by-trial basis ERP parameters during trials that resulted in a right ear advantage (REA) or left ear advantage (LEA) or that were presented under diotic (homonymous) conditions. CV syllables were used as auditory stimuli (/ba/, /da/, /ga/, /ka/, /pa/, /ta/). The EEG measurements were performed with 64 channels by mainly focusing on the N1P2, N2P3 and late negativity (LN) components. Overall, behavioral data revealed a clear REA. The central area showed higher amplitudes than the other locations for N1P2 responses. Additionally, responses were faster for the diotic, compared to the dichotic conditions. The LN had shorter latencies in trials resulting in a REA, compared with those producing a LEA. This result makes it likely that the overall REA is a time-bound effect, which can be explained by the structural theory of Kimura. Furthermore, the results demonstrated a specific spatiotemporal shift from central to frontal areas between N1P2 and LN that was pronounced in dichotic trials. This shift points towards the involvement of frontal areas in resolving conflicting input.


Development of gravitropic response: unusual behavior of flax phloem G-fibers.
The major mechanism of gravitropism that is discussed for herbal plants is based on the nonuniform elongation of cells located on the opposite stem sides, occurring in the growing zone of an organ. However, gravitropic response of flax (Linum usitatissimum L.) is well-pronounced in the lower half of developing stem, which has ceased elongation long in advance of plant inclination. We have analyzed the stem curvature region by various approaches of microscopy and found the undescribed earlier significant modifications in primary phloem fibers that have constitutively developed G-layer. In fibers on the pulling stem side, cell portions were widened with formation of "bottlenecks" between them, leading to the "sausage-like" shape of a cell. Lumen diameter in fiber widening increased, while cell wall thickness decreased. Callose was deposited in proximity to bottlenecks and sometimes totally occluded their lumen. Structure of fiber cell wall changed considerably, with formation of breaks between G- and S-layers. Thick fibrillar structures that were revealed in fiber cell wall by light microscopy got oblique orientation instead of parallel to the fiber axis one in control plants. The described changes occurred at various combinations of gravitational and mechanical stimuli. Thus, phloem fibers with constitutively formed gelatinous cell wall, located in nonelongating parts of herbal plant, are involved in gravitropism and may become an important element in general understanding of the gravity effects on plants. We suggest flax phloem fibers as the model system to study the mechanism of plant position correction, including signal perception and transduction.


Anaesthetic breathing systems in the accident and emergency department.
We report two cases where patients with an acute head injury developed hypercapnia as a result of the inappropriate use of the Magill breathing circuit. The Magill circuit is inefficient when used for controlled ventilation because the patient is ventilated with his own expired gas and develops hypercapnia. The suitability of alternative breathing systems are discussed.