Potential applications of nanotechnologies to Parkinson's disease therapy.
Nanotechnology will play a key role in developing new diagnostic and therapeutic tools. Nanotechnologies use engineered materials with the smallest functional organization on the nanometre scale in at least one dimension. Some aspects of the material can be manipulated resulting in new functional properties. Nanotechnology could provide devices to limit and reverse neuropathological disease states, to support and promote functional regeneration of damaged neurons, to provide neuroprotection and to facilitate the delivery of drugs and small molecules across the blood-brain barrier. All of them are relevant to improve current therapy of Parkinson's disease (PD).


Traffic noise mapping of the city of Santiago de Chile.
A noise map is a cartographic representation of the noise level distribution in a determined area and period of time. This article presents the most important aspects of the noise mapping project across Santiago, a city of nearly six million inhabitants. The study was performed employing limited information and a low-cost, vehicular traffic noise predictive model. The methodology applied to the Chilean experience can also be used to create noise maps for major cities. An evaluation of noise prediction models, considering simplifications of the modeling environment (buildings) and for the vehicular traffic flow rates attributed to the streets under study, was made. The noise levels were modeled according to recommended exposure values for the above area. The results revealed that the noise levels for the city of Santiago were high in a relevant percentage of the surface.


Difficulties in family therapy evaluation. I. A comparison of insight vs. problem-solving approaches. II. Design critique and recommendations.
In Part 1, an outcome study comparing two methods of family treatment, is reported. Families were randomly assigned to one of two forms of conjoint therapy: an Insight-oriented treatment (N = 10) or a Problem-Solving intervention (N = 10). The results on self-report measures of family functioning indicate that the Problem-Solving intervention produced more favorable changes after three months. Experienced therapists did better than inexperienced therapists in the Insight-treatment condition but level of experience did not make a difference in the Problem-Solving therapy. A group of eight families who dropped out of the Insight-treatment group provided data on correlates of premature termination. In Part II, the study is critically reviewed. The practical obstacles to implementing an experimental design in a clinic setting are considered. Special attention is given to issues involving the selection of treatment and control conditions: sampling and the measurement of outcome. Alternatives to experimental designs are considered.


Seasonal consumption of polyphenol-rich fruits affects the hypothalamic leptin signaling system in a photoperiod-dependent mode.
Leptin has a central role in the maintenance of energy homeostasis, and its sensitivity is influenced by both the photoperiod and dietary polyphenols. The aim of this study was to investigate the effect of seasonal consumption of polyphenol-rich fruits on the hypothalamic leptin signaling system in non-obese and obese animals placed under different photoperiods. Non-obese and diet-induced obese male Fischer 344 rats were placed under either a short-day (SD) or long-day (LD) photoperiod and were supplemented with either 100 mg/kg of lyophilized red grapes or cherries. In non-obese animals, both fruits reduced energy balance independent of the photoperiod to which they were placed. However, the hypothalamic gene expression of Pomc was significantly up-regulated only in the SD photoperiod. In contrast, in obese animals only cherry significantly decreased the energy balance, although both fruits were able to counteract the diet-induced increase in hypothalamic AgRP mRNA levels when consumed during the SD photoperiod. In conclusion, the consumption of rich-polyphenol fruits may increase leptin sensitivity through the modulation of the hypothalamic leptin signal pathway mainly when consumed in the SD photoperiod. Therefore, fruit seasonality should be considered, as it can influence energy homeostasis and obesity.


IGF-1 activates a cilium-localized noncanonical Gβγ signaling pathway that regulates cell-cycle progression.
Primary cilia undergo cell-cycle-dependent assembly and disassembly. Emerging data suggest that ciliary resorption is a checkpoint for S phase reentry and that the activation of phospho(T94)Tctex-1 couples these two events. However, the environmental cues and molecular mechanisms that trigger these processes remain unknown. Here, we show that insulin-like growth-1 (IGF-1) accelerates G1-S progression by causing cilia to resorb. The mitogenic signals of IGF-1 are predominantly transduced through IGF-1 receptor (IGF-1R) on the cilia of fibroblasts and epithelial cells. At the base of the cilium, phosphorylated IGF-1R activates an AGS3-regulated Gβγ signaling pathway that subsequently recruits phospho(T94)Tctex-1 to the transition zone. Perturbing any component of this pathway in cortical progenitors induces premature neuronal differentiation at the expense of proliferation. These data suggest that during corticogenesis, a cilium-transduced, noncanonical IGF-1R-Gβγ-phospho(T94)Tctex-1 signaling pathway promotes the proliferation of neural progenitors through modulation of ciliary resorption and G1 length.


Beta-oxidation of conjugated linoleic acid isomers and linoleic acid in rats.
To assess the oxidative metabolism of conjugated linoleic acid (CLA) isomers, rats were force-fed 1.5-2.6 MBq of [1-14C]-linoleic acid (9c,12c-18:2), -rumenic acid (9c,11t-18:2), or-10trans,12cis-18:2 (10t,12c-18:2), and 14CO2 production was monitored for 24 h. The animals were then necropsied and the radioactivity determined in different tissues. Both CLA isomers were oxidized significantly more than linoleic acid. Moreover, less radioactivity was recovered in most tissues after CLA intake than after linoleic acid intake. The substantial oxidation of CLA isomers must be considered when assessing the putative health benefits of CLA supplements.


Superior perioperative analgesia with combined femoral-obturator-sciatic nerve block in comparison with posterior lumbar plexus and sciatic nerve block for ACL reconstructive surgery.
The purpose of this randomized controlled study is to compare and evaluate the intraoperative and post-operative outcome of PLPS nerve block and that of femoral, obturator and sciatic (FOS) nerve block as a method of anaesthesia, in performing ACL reconstruction. Patients referred for elective arthroscopic ACL reconstruction using hamstring autograft were divided in two groups. The first group received combined femoral-obturator-sciatic nerve block (FOS Group) under dual guidance, whereas the second group received posterior lumbar plexus block under neurostimulation and sciatic nerve block (PLPS Group) under dual guidance. The two groups were comparable in terms of age, sex, BMI and athletic activity. The time needed to perform the nerve blocks was significantly shorter for the FOS group (p < 0.005). Similarly, VAS scores during tourniquet inflation and autograft harvesting were significantly higher (p < 0.005) in the PLPS group and this is also reflected in the intraoperative fentanyl consumption and conversion to general anaesthesia. Finally, patients in this group also reported higher post-operative VAS scores and consumed more morphine. Peripheral nerve blockade of FOS nerve block under dual guidance for arthroscopic ACL reconstructive surgery is a safe and tempting anaesthetic choice. The success rate of this technique is higher in comparison with PLPS and results in less peri- and post-operative pain with less opioid consumption. This study provides support for the use of peripheral nerve blocks as an exclusive method for ACL reconstructive surgery in an ambulatory setting with almost no complications. I.


A Novel Texture-Quantization-Based Reversible Multiple Watermarking Scheme Applied to Health Information System.
The recent innovations in information and communication technologies have appreciably changed the panorama of health information system (HIS). These advances provide new means to process, handle, and share medical images and also augment the medical image security issues in terms of confidentiality, reliability, and integrity. Digital watermarking has emerged as new era that offers acceptable solutions to the security issues in HIS. Texture is a significant feature to detect the embedding sites in an image, which further leads to substantial improvement in the robustness. However, considering the perspective of digital watermarking, this feature has received meager attention in the reported literature. This paper exploits the texture property of an image and presents a novel hybrid texture-quantization-based approach for reversible multiple watermarking. The watermarked image quality has been accessed by peak signal to noise ratio (PSNR), structural similarity measure (SSIM), and universal image quality index (UIQI), and the obtained results are superior to the state-of-the-art methods. The algorithm has been evaluated on a variety of medical imaging modalities (CT, MRA, MRI, US) and robustness has been verified, considering various image processing attacks including JPEG compression. The proposed scheme offers additional security using repetitive embedding of BCH encoded watermarks and ADM encrypted ECG signal. Experimental results achieved a maximum of 22,616 bits hiding capacity with PSNR of 53.64 dB.


The ethics of sustainable genomic research in Africa.
Michael Parker and Dominic Kwiatkowski discuss important ethical considerations for sustainable genomics research in Africa.


Latent class analysis of anxiety and depressive symptoms in referred adolescents.
Comorbidity between anxiety disorders and depressive disorders in adolescents occurs very frequently. The aim of this study was to investigate if anxiety and depression represent distinct disease entities. Two thousand thirty two 11- to 18-year-olds, referred to mental health services, were investigated. Self-reported symptoms of anxiety and depression were analyzed with latent class analysis. The numbers of adolescents with severe depression symptoms, but with less severe, or absent, anxiety symptoms, were negligible. Further, two subgroups could be discerned in those with severe anxiety symptoms: one with severe depressive symptoms, and one with mild depressive symptoms. A self-report questionnaire was used, whereas diagnostic interview information regarding DSM-IV disorders was not available. It seems less useful to develop treatments, or to conduct studies aimed at etiological mechanisms, that are specifically aimed at depression and not at anxiety. Further, it may be relevant to discern specific subgroups of anxious adolescents, with severe versus mild comorbid depression symptoms.


Antigenic heterogeneity among the field isolates of Newcastle disease virus (NDV) in relation to the vaccine strain: 1. Studies on viruses isolated from wild birds in Israel.
In order to reveal the viruses strongly differing from the VH NDV strain used in Israel for poultry vaccination, 54 NDV strains isolated during the last 15 years in Israel from feral birds were studied by means of the panels of 39 monoclonal antibodies. Six isolates were found to have considerable antigenic differences in envelope proteins as compared to the vaccine strain. In four cases, the differences were related mostly to the hemagglutinin-neuraminidase glycoprotein, in one case to the fusion glycoprotein, and in one case to the matrix protein.


Anatomy, histology, and pathology of the major epicardial coronary arteries relevant to echocardiographic imaging techniques.
We are at the threshold of a new era of coronary artery imaging with the use of transthoracic, transesophageal, and intravascular ultrasound. Echocardiographic imaging has the capability of assessing changes of the lumen and walls of major epicardial coronary arteries. This article reviews certain anatomic, histologic, and pathologic observations of the major epicardial coronary arteries relevant to these various echocardiographic imaging techniques.


Recording SOCE Activity in Neurons by Patch-Clamp Electrophysiology and Microfluorometric Calcium Imaging.
Store-operated Ca2+ entry (SOCE) is a Ca2+ influx pathway at the plasma membrane that replenishes intracellular Ca2+ stores in response to depletion of Ca2+ stores. The SOC current, also known as the Ca2+ release-activated Ca2+ current (ICRAC), has a small conductance, which makes selective recording difficult. This challenge may be addressed using techniques based on identification of Ca2+ influx patch-clamp electrophysiological recording and measurement of cytoplasmic Ca2+ accumulation with Ca2+-sensitive fluorophores. Here, we describe specific methods for studying SOCE using these approaches in rat dorsal root ganglion neurons.


Proteomic analysis of human bladder tissue using SELDI approach following microdissection techniques.
Lysing of a complete biopsy sample results in a mixture of desired and undesired proteins, reflecting the originating cell types. Therefore microdissecting tissue material is mandatory prior to sample lysis and all downstream applications of protein analysis (proteomics). The two most important dissecting methods for bladder tissue specimens are manual microdissection and laser microdissection. Sample transfer can further be separated into manual laser pressure catapulting (LPC) and laser capture microdissection (LCM). One of the possible downstream applications of protein analysis is surface-enhanced laser desorption ionization (SELDI) time-of-flight mass spectrometry. The small quantities of tissue obtained by microdissection are sufficient for use in the SELDI technique.


Vascular Endothelial Growth Factor as Predictive Biomarker for Stroke Severity and Outcome; An Evaluation of a New Clinical Module in Acute Ischemic Stroke.
The need to study prognosis after incidence of acute ischemic stroke (AIS) has fueled researchers to identify predictors apart from neurological, functional, or disability measures. The purpose of this study was to test and validate a newly developed clinico-biomarker assessment module in AIS and also to investigate the role of serum vascular endothelial growth factor (VEGF) after AIS. A randomized controlled study with sample size of 250 patients suffering from AIS within 2 weeks of the index event were conducted and followed up for a period of three months. Age, gender, stroke subtype, previous stroke history, dysarthria, stroke localization, wakeup strokes, and Glasgow Coma Scale (GCS) were dichotomized as present or absent using the National Institute of Health Stroke Scale (NIHSS) which consists of four subcategories. The additional serum VEGF was scored between 1 and 4 (0-200 = 1, 200-300 = 2, 300-400 = 3, and 400-500 = 4). All these were summed under a clinical biomarker (CB) module with highest score of 30. The mean VEGF in 125 patients was 378.4 + 98.9 pg/ml, indicating a moderately high increase with a score of 3 on CB module. Multiple regression analysis revealed that the CB model was fit to predict prognosis and severity [R2 = 0.86, F (23.4, 6);P = 0.001], with NIHSS subscore, prestroke status, and VEGF being very strong predictors. When only the clinical module was tested on all 250 patients, it was found that the NIHSS subscore, time to stroke onset and prestroke functional status were the most common [R2 = 0.79; F (45,9);P = 0.005]. This study demonstrates that VEGF is highly upregulated in AIS with severe disability as compared to healthy controls. This biomarker is a strong predictor of severity and functionality when combined with clinical variables three months post the ishemic event.


MACRONUTRIENTS OF MOTHERS' MILK OF VERY LOW BIRTH WEIGHT INFANTS: ANALYSIS ACCORDING TO GESTATIONAL AGE AND MATERNAL VARIABLES.
To analyze the composition of macronutrients present in the milk of mothers of preterm newborn infants (PTNB) - protein, fat, carbohydrate, and calories - by gestational age (GA), chronological age (CA) and maternal variables. Longitudinal study that analyzed 215 milk samples from the 51 mothers of PTNB admitted in three Neonatal Intensive Care Units of Rio de Janeiro from May/2013-January/2014. Milk collection was performed by pickup pump, on a fixed day of each week until discharge. The spectrophotometric technique with Infrared Analysis (MilkoScan Minor 104) was used for the quantitative analysis. A sample of 7 mL of human milk was taken from the total volume of milk extracted by the mother. The data was grouped by GA (25-27, 28-31, 32-36, 37-40 weeks) and by CA (zero to 4, 5-8, 9-12, 13-16 weeks). Protein, carbohydrate, fat and calories did not show any pattern of change, with no difference among groups of GA. When the macronutrients were analyzed by groups of CA, protein decreased, with significant difference between the first two groups of CA. Carbohydrates, fat and calories presented increasing values in all groups, without significant differences. Weight gain during pregnancy, maternal hypertension and maternal age were associated with changes in fat and calories in the first moment of the analysis of milk. There was a significant decrease in the levels of protein during the first eight weeks after birth. CA may be an important factor in the composition of human milk.


A comparison of the technical sustainability of in situ stabilisation/solidification with disposal to landfill.
Sustainability is becoming a very important issue in contaminated land remediation and should form one of the factors used in future selection of treatment technologies. In situ stabilisation/solidification (S/S) is a remediation technique that is increasingly being applied to the treatment of contaminated sites because of numerous advantages over other remediation techniques. This paper assesses and compares aspects of the technical sustainability of in situ S/S with landfilling. Criteria previously established for the assessment of the technical sustainability of the remediation of contaminated land are employed. The comparison is presented in the form of a case study based on a real remediation project in the UK. The analysis indicated that landfilling had a larger impact than S/S in the majority of areas investigated, such as waste production (1000 kg waste/t soil remediated for landfilling compared to none for S/S), transportation (12.9 km/t for landfilling, 0.4 km/t for S/S) and use of raw materials (1005.5 kg/t for landfilling, 88.9 kg/t for S/S), although S/S had high greenhouse gas emissions (12.6 kg/t for landfilling, 40.9 kg/t for S/S). In addition, a multi-criteria/cost-effectiveness analysis gave cost effectiveness scores of -34.2 to S/S and -138.1 to landfill (where more positive is better).


Exploring Fatigue Sensitivity in terms of Mental Health and Fatigue Severity among a Racially and Ethnically Diverse Sample with Severe Fatigue.
Fatigue sensitivity, or the misattribution that fatigue symptoms will lead to negative personal consequences, is one individual difference factor related to adverse behavioral health consequences. The current study investigated whether fatigue sensitivity was related to panic symptoms, depression, as well as fatigue severity among 166 persons of diverse racial/ethnic backgrounds with severe fatigue. As hypothesized, fatigue sensitivity was statistically significantly related to greater panic symptoms, general depression, and fatigue severity. These results were evident over the variance explained by age, sex, neuroticism, and somatic symptoms. This work is the first to evaluate fatigue sensitivity in terms of behavioral health outcomes among a racial/ethnically diverse sample with severe fatigue.


Mapping the impact of the expanded Mexico City Policy for HIV/ family planning service integration in PEPFAR-supported countries: a risk index.
The previously-named Mexico City Policy (MCP) - which prohibited non U.S.-based non-governmental organizations (NGOs) from receiving U.S. family planning (FP) funding if they advocated, provided, counseled, or referred clients for abortions, even with non-U.S. funds - was reinstated and expanded in 2017. For the first time, the expanded MCP (EMCP) applies to HIV funding through the President's Emergency Plan for AIDS Relief (PEPFAR) in addition to FP funding. Previous, and more limited, iterations of the policy forced clinic closures and decreased contraceptive access, prompting the need to examine where and how the EMCP may impact FP/HIV service integration. The likelihood of FP/HIV service de-integration under the EMCP was quantified using a composite risk index for 31 PEPFAR-funded countries. The index combines six standardized indicators from publically available sources organized into three sub-indexes: 1) The importance of PEPFAR for in-country service delivery of HIV and FP services; 2) The susceptibility of implementing partners to the EMCP; and 3) The integration of FP/HIV funds and programming through PEPFAR and USAID. Countries with the highest overall risk scores included Zambia (3.3) Cambodia (3.2), Uganda (3.1), South Africa (2.9), Haiti (2.8), Lesotho (2.8), Swaziland (2.1), and Burundi (1.5). Zambia's risk score is driven by sub-index 1, having a high proportion of country HIV expenditures provided by PEPFAR (86.3%). Cambodia and Uganda's scores are driven sub-index 3, with both countries reporting 100% of PEPFAR supported HIV delivery sites were providing integrated FP services in 2017. South Africa's risk score is driven by sub-index 2, where roughly 60% of PEPFAR funding is to non U.S.-based NGOs. Of the countries with the highest risk scores, Swaziland, Lesotho, and South Africa, are also in the top quartile of PEPFAR countries for HIV prevalence and unintended pregnancies among young women. This analysis highlights where and why the EMCP may have the greatest impact on FP/HIV service integration. The possible disruption of service integration in countries with generalized HIV epidemics highlights significant risks. Researchers, national governments, and non-U.S. funders can consider these risk factors to help target their responses to the EMCP and mitigate potential harms of the policy.


In vitro generated allospecific cytolytic T lymphocytes injure pancreatic islets.
The role of cytotoxic T lymphocytes in the rejection of pancreatic islet allografts remains poorly defined. The present study was designed to assess the ability of in vitro generated cytolytic T lymphocytes to produce allospecific functional and structural damage of mouse pancreatic islets. A mixed lymphocyte-islet coculture model (MLIC) has been developed, in which islets from DBA/2J mice (H-2d) stimulate the generation of allospecific cytolytic T lymphocytes (C57B1/6, H-2b), as measured by lysis of allospecific chromium-labeled tumor targets. Responder C57B1/6 splenocytes sensitized to DBA/2J islets were harvested from the MLIC on Day 5 and cocultured with either freshly isolated DBA/2J or B10.BR (H-2K) islets. Islet injury was determined by assessment of beta cell function after 8 hr (as measured by insulin release in response to a glucose challenge) and islet destruction after 24 hr of coculture with the sensitized splenocytes. Whereas coculture of third party B10.BR islets with MLIC-sensitized C57B1/6 anti-DBA splenocytes had no effect on insulin release or structure, incubation of allospecific DBA/2J islets with these splenocytes resulted in inhibition of insulin release after 8 hr and disintegration of the islets by 24 hr. The depletion of MLIC-sensitized C57B1/6 anti-DBA splenocytes with anti-Lyt2 monoclonal antibody, but not anti-L3T4 monoclonal antibody, prevented the allospecific destruction of fresh islets by the splenocytes in culture. This study suggests that allospecific, cytotoxic T lymphocytes may play an important role in the effector mechanism of pancreatic islet allograft destruction.


Validation of the Mini-OAKHQOL for use in patients with osteoarthritis in Spain.
The Mini-Osteoarthritis Knee and Hip Quality of Life (Mini-OAKHQOL) questionnaire osteoarthritis is specific to individuals with knee or hip osteoarthritis. The objective of this study was to perform a validation of the Mini-OAKHQOL for use in Spain in terms of its psychometric properties of reliability, validity and responsiveness. Patients with osteoarthritis from the waiting list for a joint replacement completed the OAKHQOL, Short Form 36 Health Survey and Western Ontario and McMaster Universities Osteoarthritis Index. Reliability was assessed in terms of internal consistency and test-retest data, and convergent validity using Spearman's correlation coefficient. Structural validity was investigated by confirmatory factor analysis, and Rasch analysis was used to examine the unidimensionality of the scales. Responsiveness was assessed by calculating effect sizes. Confirmatory factor analysis confirmed the five-factor model, and the results of the Rasch analyses supported the unidimensionality assumption, with infit and outfit statistics. Cronbach's alpha ranged from 0.76 to 0.89 for all except the social dimensions. Statistically significant differences were observed between patients with different degrees of disease severity on all dimensions. There was convergent validity among dimensions expected to be correlated. The OAKHQOL questionnaire showed good responsiveness, with large changes for all dimensions apart from the two social dimensions, which had small effect sizes. Results of the study support the view that the Spanish version of the Mini-OAKHQOL questionnaire is a valid instrument to measure health-related quality of life in patients with osteoarthritis of the lower limb.


Hippocampal 'zipper' slice studies reveal a necessary role for calcineurin in the increased activity of L-type Ca(2+) channels with aging.
Previous studies have shown that inhibition of the Ca(2+)-/calmodulin-dependent protein phosphatase calcineurin (CN) blocks L-type voltage sensitive Ca(2+) channel (L-VSCC) activity in cultured hippocampal neurons. However, it is not known whether CN contributes to the increase in hippocampal L-VSCC activity that occurs with aging in at least some mammalian species. It is also unclear whether CN's necessary role in VSCC activity is simply permissive or is directly enhancing. To resolve these questions, we used partially dissociated hippocampal "zipper" slices to conduct cell-attached patch recording and RT-PCR on largely intact single neurons from young-adult, mid-aged, and aged rats. Further, we tested for direct CN enhancement of L-VSCCs using virally mediated infection of cultured neurons with an activated form of CN. Similar to previous work, L-VSCC activity was elevated in CA1 neurons of mid-aged and aged rats relative to young adults. The CN inhibitor, FK-506 (5muM) completely blocked the aging-related increase in VSCC activity, reducing the activity level in aged rat neurons to that in younger rat neurons. However, aging was not associated with an increase in neuronal CN mRNA expression, nor was CN expression correlated with VSCC activity. Delivery of activated CN to primary hippocampal cultures induced an increase in neuronal L-VSCC activity but did not elevate L-VSCC protein levels. Together, the results provide the first evidence that CN activity, but not increased expression, plays a selective and necessary role in the aging-related increase in available L-VSCCs, possibly by direct activation. Thus, these studies point to altered CN function as a novel and potentially key factor in aging-dependent neuronal Ca(2+) dysregulation.


Accuracy of imaging modalities for adnexal torsion: a systematic review and meta-analysis.
Adnexal torsion (AT), a serious gynaecological emergency, often presents with non-specific symptoms leading to delayed diagnosis. To compare the test accuracy of ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI) to diagnose AT. We searched EMBASE, MEDLINE and Cochrane CENTRAL until December 2019. Studies reporting on the accuracy of any imaging modality (Index Test) in female patients (paediatric and adult) suspected of AT compared with surgical diagnosis and/or standard clinical/radiological follow-up period until resolution of symptoms (Reference Standard). We assessed study quality using QUADAS-2. We conducted test accuracy meta-analysis using a univariate model or a hierarchical model. We screened 3836 citations, included 18 studies (1654 women, 665 cases), and included 15 in the meta-analyses. Ultrasound pooled sensitivity (n = 12, 1187 women) was 0.79 (95% CI 0.63-0.92) and specificity was 0.76 (95% CI 0.54-0.93), with negative and positive likelihood ratios of 0.29 (95% CI 0.13-0.66) and 4.35 (95% CI 2.03-9.32), respectively. Using Doppler with ultrasound (n = 7, 845 women) yielded similar sensitivity (0.80, 95% CI 0.67-0.93) and specificity (0.88, 95% CI 0.72-1.00). For MRI (n = 3, 99 women), the pooled sensitivity was 0.81 (95% CI 0.63-0.91) and specificity was 0.91 (95% CI 0.80-0.96). A meta-analysis for CT was not possible with two case-control studies and one cohort study (n = 3, 232 women). Its sensitivity range was 0.74-0.95 and specificity was 0.80-0.90. Ultrasound has good performance as a first-line diagnostic test for suspected AT. Magnetic resonance imaging could offer improved specificity to investigate complex ovarian morphology, but more evidence is needed. To investigate adnexal torsion, ultrasound is a good first-line diagnostic test with a pooled sensitivity of 0.79 and specificity of 0.76.


Postnatal development of the dopaminergic system of the striatum in the rat.
The dopaminergic innervation of the developing caudate-putamen (patches and matrix) and nucleus accumbens (shell and core) of the rat was examined with light and electron microscope immunocytochemistry, using antibodies against dopamine. Light microscopic analysis showed, in accordance with previous studies, that early in life, dopaminergic fibers were relatively thick and present throughout the striatum. Their distribution was heterogeneous, showing dense aggregations, the so-called dopamine islands. The pattern of innervation became more uniform during the third postnatal week with most of the dopamine islands no longer detectable. For electron microscopic analysis, parts of the caudate-putamen containing dopamine islands or matrix, and of the nucleus accumbens, from the shell and the core of the nucleus, were selected. This analysis revealed that symmetrical synapses between immunoreactive profiles and unlabeled dendritic shafts predominated throughout development but, at the late stages, symmetrical axospinous synapses also became a prominent feature. These findings indicate that: (1) although the caudate-putamen and the nucleus accumbens have different connections and functions, they exhibit similar types of dopaminergic synapses, and (2) the relatively late detection of dopaminergic axospinous synapses suggests that the development of the dopaminergic system in the striatum is an active process, which parallels the morphological changes of striatal neurons and may contribute to their maturation.


Evaluation of Touch and Durability of Cotton Knit Fabrics Treated with Reactive Urethane-Silicone Softener.
A new reactive urethane-silicone softener was developed to provide a soft touch to cotton knit fabrics with improved durability to washing and dimensional stability. The reactive urethane-silicone softener consisted of an amino silicone softener and a blocked isocyanate, which can crosslink and react with cellulose surfaces. The activated isocyanate from the blocked isocyanate reacted with the amino silicone softener by heat treatment at 150 °C for 30 min. The mechanical properties of the cotton knit fabrics treated with the urethane-silicone softener were evaluated using a Kawabata Evaluation System-Fabrics (KES-FB) system. The cotton knit fabrics treated with the urethane-silicone softener showed excellent elasticity, flexibility and shear recovery as well as excellent recovery against bending deformation, and soft and smooth surface characteristics with a small coefficient of friction that were maintained even after washing 20 times.


Taxes, institutions, and innovation: Theory and international evidence.
We develop an international model of the design of institutions for regulating innovative activities of private corporations. Informational limitations faced by the social planner preclude complete contracting with private firms. Corporate innovation creates positive and negative externalities. The social planner in each country takes into account the legal system in place, and designs an umbrella of institutions that include a menu of organizational forms, liability structures, corporate taxes, and subsidies. We show that limited liability may be accompanied by excessive innovation. However, when the nonmonetized benefits are very high, private firms may be too conservative in innovation policies. Firms choose their organizational form and level of innovation consistent with private optimality. With the optimal institutional design for each country, we demonstrate that private innovation choices are aligned with social optimality. In particular, we show that the optimally designed corporate tax rate in each country is a decreasing function of its legal effectiveness. Using data from 63 countries over 2003-2018, we document supporting evidence. MNCs can take advantage of differential liability and corporate tax structures across national boundaries to circumvent institutional design constraints. However, when MNCs generate positive externalities to host countries, their governments may provide subsidies and incentives.


Cytogenetic components of reproductive isolation in Trimerotropis thalassica and T. occidentalis.
The grasshopper Trimerotropis thalassica (Bruner) has a diploid count of 2n=23 male (XO), 24 female (XX). The two largest autosomes pairs are regularly metacentric, a consequence of fixed pericentric inversions. The X-chromosome is also a fixed metacentric. The remaining nine pairs of autosmes are polymorphic for floating percentric inversions so that the complement consists of a mixture of telocentric and metacentric members. Trimerotropis occidentalis (Bruner) is polymorphic for comparable inversions in only two of its autosome pairs and has a telocentric X. It is however, unique among the species of the genus Trimerotropis in having only 21 chromosomes in its male diploid set in all the populations so far studied. A single male found in a mixed population of these two species at Jasper Ridge, Stanford University, was characterized by the count 2n=22 male. In both this respect of and in its phenotype it was intermediate in character, representing a natural F1 hybrid between the two species. Cytogenetic analysis of this hybrid male indicated that occidentalis is differentiated from thalassica only is respect of a single tandem translocation. This has involved two of the telocentric elements of thalassica which have fused into a single composite telocentric partly homologous with each of the smaller progenitors. Although potentially capable of forming a multiple of three, one or other of the progenitor chromosomes regularly fails to pair with the tandem product in the hybrid so that one or more univalents invariably occur. These, by lagging, prevent cytokinesis and subsequently lead to the formation of macrospermatids which inevitably produce a measure of sterility. It is argued that this sterility provides a basis of reproductive isolation.


Retracted: Implementation of a System for Assessing the Quality of Spoken English Pronunciation Based on Cognitive Heuristic Computing.
[This retracts the article DOI: 10.1155/2022/5239375.].


Tissue inhibitor of metalloproteinases-3 (TIMP-3) is an extracellular matrix-associated protein with a distinctive pattern of expression in mouse cells and tissues.
We have isolated cDNA clones corresponding to a novel mouse metalloproteinase inhibitor. Five overlapping cDNA clones contain most of the information for a prominent 4.5-kilobase transcript that was detected in RNA from mouse fibroblasts and adult tissues. Sequence analysis revealed an open reading frame (ORF) for a protein of 212 amino acids that is 80% identical to chicken inhibitor of metalloproteinases-3 (ChIMP-3). The 3'-untranslated sequence also showed remarkable conservation with the chicken gene. The ORF directed the expression of a 24-kDa protein in COS-1 cells that localized to the extracellular matrix (ECM). On the basis of these similarities we propose to identify the new gene as murine tissue inhibitor of metalloproteinases-3 (TIMP-3). Mouse C3H 10T1/2 fibroblasts produced a 24-kDa metalloproteinase inhibitor that also localized to the ECM and was recognized by a polyclonal antibody to ChIMP-3. Like TIMP-1, TIMP-3 was highly inducible in mouse C3H 10T1/2 fibroblasts by phorbol ester (PMA), epidermal growth factor (EGF), and transforming growth factor-beta 1, but nuclear run-on assays showed that the on/off transcription kinetics were faster for TIMP-3 than TIMP-1. A major difference in vitro was the stimulation of expression of TIMP-3 by dexamethasone which inhibits EGF- and PMA-induced TIMP-1 transcription. Also, TIMP-3 showed a distinctive pattern of expression in adult tissues with abundant transcripts detected in kidney, lung, and brain but only low levels detected in bone, a prominent location of TIMP-1 transcripts. We propose that TIMP-3 functions in a tissue-specific fashion as part of an acute response to remodeling stimuli.


Clinical presentation at first heart failure hospitalization does not predict recurrent heart failure admission.
There are limited data on whether clinical presentation at first heart failure (HF) hospitalization predicts recurrent HF events. We aimed to assess predictors of recurrent HF hospitalizations in mild HF patients with an implantable cardioverter defibrillator or cardiac resynchronization therapy with defibrillator. Data on HF hospitalizations were prospectively collected for patients enrolled in MADIT-CRT. Predictors of recurrent HF hospitalization (HF2) after the first HF hospitalization were assessed using Cox proportional hazards regression models including baseline covariates and clinical presentation or management at first HF hospitalization. There were 193 patients with first HF hospitalization, and 156 patients with recurrent HF events. Recurrent HF rate after the first HF hospitalization was 43% at 1 year, 52% at 2 years, and 55% at 2.5 years. Clinical signs and symptoms, medical treatment, or clinical management of HF at first HF admission was not predictive for HF2. Baseline covariates predicting recurrent HF hospitalization included prior HF hospitalization (HR = 1.59, 95% CI: 1.15-2.20, P = 0.005), digitalis therapy (HR = 1.58, 95% CI: 1.13-2.20, P = 0.008), and left ventricular end-diastolic volume >240 mL (HR = 1.62, 95% CI: 1.17-2.25, P = 0.004). Recurrent HF events are frequent following the first HF hospitalization in patients with implanted implantable cardioverter defibrillator or cardiac resynchronization therapy with defibrillator. Neither clinical presentation nor clinical management during first HF admission was predictive of recurrent HF. Prior HF hospitalization, digitalis therapy, and left ventricular end-diastolic volume at enrolment predicted recurrent HF hospitalization, and these covariates could be used as surrogate markers for identifying a high-risk cohort.


Comprehensive evaluation of aroma and taste properties of different parts from the wampee fruit.
Wampee is a tropical fruit having high medicinal value. To fully realize the fruit's potential, it is essential to reveal the flavor characteristics. In this study, a comprehensive analysis of the aroma and taste profiles of different parts from the wampee fruit was conducted. The aroma profile was analyzed by E-nose, and 67 volatile components were identified through HS-SPME-GC-MS. Among them, 11 were considered as crucial compounds. Additionally, 42 volatile components were identified by HS-GC-IMS, with 22 compounds showing a variable importance in projection scores greater than 1.0. Moreover, the taste profile and representative compounds were analyzed by E-tongue and HPLC, and 12 compounds were considered as important taste contributors based on taste activity value. These findings shed light on the various compounds responsible for the unique aroma and taste of the wampee fruit, providing theoretical foundation for exploring ways for its comprehensive utilization and development.


Compensatory articulatory mechanisms preserve intelligibility in prodromal Parkinson's disease.
Dysarthria is highly prevalent in patients with Parkinson's disease (PD) and speech changes have already been detected in patients with prodromal PD on the acoustic level. However, the present study directly tracks underlying articulatory movements with electromagnetic articulography to investigate early speech alterations on the kinematic level in isolated REM sleep behavior disorder (iRBD) and compares them to PD and control speakers. Kinematic data of 23 control speakers, 22 speakers with iRBD, and 23 speakers with PD were collected. Amplitude, duration, and average speed of lower lip, tongue tip, and tongue body movements were analyzed. Naive listeners rated the intelligibility of all speakers. Patients with iRBD produced tongue tip and tongue body movements that were larger in amplitude and longer in duration compared to control speakers, while remaining intelligible. Compared to patients with iRBD, patients with PD had smaller, longer and slower tongue tip and lower lip movements, accompanied by lower intelligibility. Thus, the data indicate that the lingual system is already affected in prodromal PD. Furthermore, lower lip and especially tongue tip movements slow down and speech intelligibility decreases if motor impairment is more pronounced. Patients with iRBD adjust articulatory patterns to counteract incipient motor detriment on speech to maintain their intelligibility level.


Angiographic CT with intravenous contrast agent application for monitoring of intracranial flow diverting stents.
Intracranial flow diverting devices are increasingly used to treat cerebral aneurysms. A reliable, non-invasive follow-up modality would be desirable. Our aim was to compare intra-arterial digital subtraction angiography (ia DSA) to angiographic computed tomography with intravenous contrast agent application (iv ACT) in the visualisation of flow diverting devices and aneurysm lumina. Follow-up monitoring by iv ACT (n = 36) and ia DSA (n = 25) in 14 patients treated with flow diverting devices for intracranial aneurysms was evaluated retrospectively. Images were evaluated by two neuroradiologists in anonymous consensus reading regarding the device deployment, wall apposition, neck coverage of the aneurysm, opacification of the vessel and device lumen, as well as the degree of aneurysm occlusion. Corresponding ia DSA and iv ACT images were scored identically in all patients regarding the stent deployment, wall apposition and neck coverage, as well as the degree of aneurysm occlusion and patency status of the device and parent artery. Opacification of the parent vessel lumen and perfused parts of the aneurysm was considered slightly inferior for iv ACT in comparison with ia DSA (seven of 36 cases), without impact on diagnosis. We demonstrated the feasibility and diagnostic value of iv ACT in follow-up imaging of intracranial flow diverting devices. Due to its high spatial resolution and non-invasive character, this novel technique might become a valuable imaging modality in these patients.


Vertebral osteomyelitis caused by non-tuberculous mycobacteria: case reports and review.
There are currently few reports of vertebral osteomyelitis caused by non-tuberculous mycobacteria. To date, only 38 cases, excluding human immunodeficiency virus patients, have been reported. We describe 3 patients with vertebral osteomyelitis caused by Mycobacterium avium-intracellulare complex or Mycobacterium kansasii, and review previous reports of vertebral osteomyelitis caused by non-tuberculous mycobacteria. Case 1 is a 50-year-old man who presented with lower back pain. Radiologic examination revealed L1-L5 enhancement and paravertebral abscess. The surgical specimen was positive for Mycobacterium avium-intracellulare complex. The patient was successfully treated by surgical excision and antibiotic administration. Case 2 is a 68-year-old woman who presented with upper back pain. Spine MRI revealed multiple lesions at T9-T12, L2, L4, and L5. Her back pain worsened, and repeated MRI revealed extensive bone lesions. Mycobacterium kansasii was isolated from a T5 vertebral body specimen. Surgery was not performed. Case 3 is a 38-year-old woman who had been taking prednisolone for systemic lupus erythematosus. We diagnosed her condition as suppurative knee arthritis caused by M. avium-intracellulare complex. Vertebral MRI revealed T9 vertebral body enhancement and a paravertebral abscess at T8-T9. Tissue culture of a T9 specimen yielded M. avium-intracellulare complex. Her clinical condition improved following posterior thoracic spinal fusion. In conclusion, vertebral osteomyelitis caused by non-tuberculous mycobacteria should be included in the differential diagnosis, even in immunocompetent patients.


The association between autistic traits and serum testosterone, oxytocin, and androstenedione levels in prepubertal male drug naive children with attention-deficit/hyperactivity disorder.
Children with attention-deficit/hyperactivity disorder (ADHD) might have similar problems as in autism spectrum disorder (ASD) and show impairment in social behaviour. Also, there is a relationship between social relationship skills and ToM (theory of mind) skills of children with ADHD. Besides, ASD is associated with prenatal exposure to high levels of androgens, and oxytocin plays a role in the modulation of emotions, coping with stress, and social behaviour like ASD. In this study, the relationship between autistic traits and serum oxytocin, testosterone, and androstenedione levels in prepubertal male drug naive children with ADHD has been investigated. Eighty-three prepubertal children, who were diagnosed with ADHD between the ages of 6-10 years old, are included in the study. For the study, intelligence levels were evaluated by using WISC-4, and autistic traits were measured by using both social responsiveness scale and theory of mind tests. In addition, serum oxytocin, testosterone, and androstenedione levels were measured by using ELISA. It has been found that serum testosterone levels of patients with lower autistic traits are significantly lower than those with moderate and severe autistic traits, while the serum oxytocin levels are significantly higher. Also, patients with severe autistic traits have had significantly higher serum androstenedione levels than those with lower and moderate autistic traits. This study suggests that patients who have higher autistic traits have elevated testosterone and androstenedione levels and lower serum oxytocin levels. Further studies are needed to clarify this relationship.


Epithelial-myoepithelial carcinoma with multiple recurrences: An unusual presentation.
Epithelial-myoepithelial carcinoma (EMC) is a type of malignant salivary gland tumors that is extremely rare. EMC primarily affects major salivary glands, particularly the parotid gland, but minorsalivary glands are also affected. It contributes less than 0.5-1% of all salivary gland neoplasms. Multiple recurrences are relatively rare with EMC. There have been very few reports of multiplerecurrences in the literature. Biphasic tubular structures composed of externalclear cells and inner ductal cells are the distinguishing histopathological feature. However, histological variation is prevalent, making a precise diagnosis challenging. We present a case of EMC that had multiple recurrences during a six-year period.


Delineating the geographic context of physical activities: A systematic search and scoping review of the methodological approaches used in social ecological research over two decades.
The social ecological approach suggests that the spatial context among other factors influence physical activity behavior. Ample research documents physical environmental effects on physical activity. Yet, to date inconsistent associations remain, which might be explained by conceptual and methodological challenges in measuring the spatial dimensions of health behavior. We review methods applied to measure the spatial contexts in the social ecological physical activity literature. Online databases and selected reviews were used to identify papers published between 1990 and 2020. A total of 2167 records were retrieved, from which 412 studies that used physical activity as a primary outcome variable, included measures of the physical environment and applied the main principles of the social ecological approach, were included. Subjective approaches were the dominant method to capture the spatial context of physical activities. These approaches were applied in 67% (n=279) of the studies. From the objective approaches an administrative unit was most prevalent and was applied in 29% (n=118) of the studies. The most comprehensive objective spatial methods that capture the true environmental exposure, were used only in 2% (n=10) of the studies. Current social ecological physical activity research applies simple conceptualizations and methods of the spatial context. While conceptual and methodological concerns have been repeatedly expressed, no substantive progress has been made in the use of spatial approaches. To further our understanding on place effects on health, future studies should carefully consider the choice of spatial approaches, and their effect on study results.


Electronic Implementation of Integrated End-of-life Care: A Local Approach.
The Liverpool Care Pathway for the Dying Patient is an instrument to deliver integrated care for patients in their last hours of life. Originally a paper-based system, this study investigates the feasibility of an electronic version. An electronic Liverpool Care Pathway was implemented in a specialized palliative care unit of a German university hospital. Its use is exemplified by means of auditing and analysis of the proportion of recorded items. In the years 2013 and 2014 the electronic Liverpool Care Pathway was used for the care of 159 patients. The uptake of the instrument was high (67%). Most items were recorded. Apart from a high usability, the fast data retrieval allows fast analysis for auditing and research. The electronic instrument is feasible in a computerized ward and has strong advantages for retrospective analysis. Internal Clinical Trial Register of the Medical Faculty, Heinrich Heine University Düsseldorf, No. 2015124683 (7 December 2015).


Patterns and preferences of antidiabetic drug use in Turkish patients with type 2 diabetes - A nationwide cross-sectional study (TEMD treatment study).
The treatment preferences in type 2 diabetes (T2DM) are affected by multiple factors. This survey aims to find out the profiles of the utilization of antidiabetics and their determinants. The nationwide, multicenter TEMD survey consecutively enrolled patients with T2DM (n = 4678). Medications including oral antidiabetics (OAD) and injectable regimens were recorded. Multiple injectable regimens with or without OADs were defined as complex treatments. A total of 4678 patients with T2DM (mean age: 58.5 ± 10.4 years, 59% female) were enrolled. More than half of patients (n = 2372; 50.7%) were using injectable regimens with or without OADs, and others (n = 2306, 49.3%) were using only OADs. The most common OADs were metformin (93.5%), secretagogues (40.1%), and DPP-4 inhibitors (37.2%). The rates of the use of basal, basal-bolus and premix insulin were 26.5%, 39.5% and 22.4%, respectively. Patients using OADs achieved better glycemia, blood pressure and weight control (p < 0.001 for all) but poorer LDL-C control (p < 0.001). The independent associates of complex treatments were diabetes duration, obesity, eGFR, glycated haemoglobin, macro and microvascular complications, education level, and self-reported hypoglycemia. This study is the first nationwide report to show that almost half of the patients with T2DM are using injectable regimens in Turkey.


Long-term outcomes of a dual-mobility cup and cementless triple-taper femoral stem combination in total hip replacement: a multicenter retrospective analysis.
The separate design concepts of dual-mobility cups and triple-taper femoral stems were developed to improve survivorship following total hip replacement (THR) by reducing instability/dislocation and enabling enhanced fixation. Successful outcomes at over two decades have been reported with earlier-generation devices based on these concepts. The current study aimed to provide the first long-term results with a unique pairing of later-generation dual-mobility cup and triple-taper cementless femoral stem after a decade of use in patients undergoing THR. In this retrospective analysis, records were reviewed for all subjects implanted with this dual-mobility cup/cementless femoral stem combination at three centers between 2002 and 2005. Any subject who had not already had follow-up visit beyond 10 years, was not previously revised, and still living were invited for a single follow-up visit consisting of Merle d'Aubgine Scores, the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index, and standard radiographs. There were 244 THRs available for analysis. At a mean follow-up of 11.9 years, the Kaplan-Meier survivorship (endpoint: revision for any reason) was 99.1% (95% CI, 97.6-99.7) for the stem and 95.9% (95% CI, 93.1-97.6) for the cup. Merle d'Aubigne Scores were significantly improved from baseline and WOMAC scores were in the satisfactory range at the final follow-up. Radiographic analysis revealed no cases of stem subsidence, no cases of bone hypertrophy, 1 (0.4%) case of bone atrophy, and 3 (1.2%) cases of osteolysis around the stem. No subjects had radiolucent lines greater than 1 mm in any femoral Gruen zone. Evidence of cup migration was seen in 1 (0.4%) subject and 1 (0.4%) subject had evidence of osteolysis that was seen in Gruen zones I, II, IV, and V. This combination of a later-generation dual-mobility cup and cementless triple-taper stem was associated with excellent survivorship and satisfactory functional outcomes at over 10 years follow-up. ClinicalTrials.gov, NCT02648152. Date of registration: January 6, 2016. Retrospectively registered.


Controlled fetal blood-letting of the recipient twin as a new method for the treatment of severe twin-twin transfusion syndrome: preliminary results.
To investigate the feasibility of withdrawal of blood from the recipient twin as a new method for the treatment of severe twin-twin transfusion syndrome. Seven consecutive monozygotic monochorionic twin pregnancies affected by severe twin-twin transfusion syndrome were treated. Fetal blood was withdrawn from the recipient twin using cordocentesis. The volume of blood to be removed was determined using the formula for intrauterine blood transfusion of anemic fetuses. Fetal outcome was evaluated in relation to changes in the amniotic fluid and in growth curves (comparing the differences between the centiles of the estimated fetal weight before the procedure and the centiles of weight at birth), fetal mortality, gestational age at delivery, neonatal weight and neurological damage. Overall, seven of the 14 (50%) fetuses survived; at least one fetus survived in five (71%) pregnancies, both fetuses survived in two (29%) pregnancies, while in two (29%) pregnancies there were no survivors. No maternal complications were observed. At follow-up, one (14%) baby had minor neurological damage. Withdrawal of blood from the recipient twin in the treatment of severe twin-twin transfusion syndrome was associated with survival similar to that of the alternative techniques of serial amniodrainage and fetoscopic laser surgery, with some possible advantages such as reduced neurological damage compared with serial amniodrainage. It is also less invasive compared with fetoscopic laser surgery.


Three-Dimensional Microsurgical Anatomy of the Choroid Plexus Using the Volume Rendering Technique.
The choroid plexus (CP) is a specific anatomical structure producing cerebrospinal fluid into the ventricular space. The three-dimensional anatomical structure of the choroid plexus located within the lateral ventricle may be evaluated by using the three dimensional volume rendering technique (3D-VRT) from acquired two-dimensional contrast enhanced computerized tomographic images. The raw data of Three-dimensional Computerized Tomography Angiography (3D-CTA) were transferred into the computer and recorded in a software program. These images were evaluated in terms of anatomical shape, borders, extensions length and dimensions. The patient group consisted of 57 (27 female and 30 male) patients. The mean age of the patients was 55±9 years. In male individuals, the distance of the superior tip from Frazier's point was 7.96±0.71 centimeters at the right side. In males, the distance of the inferior tip of the CP was estimated as 1.93±0.26 centimeters posterior-lateral from the anterior clinoid process, 1.64±0.23 centimeters posterior-lateral from the bifurcation of internal carotid artery, and 2.86±0.23 centimeters posterior-medial from the bifurcation of middle cerebral artery on the right side. The results of this study showed us that this technique could be used in the three-dimensional evaluation of some anatomical structures such as the choroid plexus.


Molecular forms of the estrogen receptor in breast cancer.
Estrogen receptors (ERs) of which two isoforms have been identified (alpha and beta) are subjected to phosphorylation, glycozylation, ubiquitination and other post-transcriptional conformational changes giving rise to a very high molecular heterogeneity. Partial proteolysis of these receptors, as well as their high tendency to associate within oligomeric structures, reinforces this property. Investigations demonstrated that this heterogeneity is not a biochemical artefact suggesting some biological relevance. Our purpose was to review this topic, especially with regard to ERalpha from breast cancers.


Genetic diversity of Mycobacterium tuberculosis clinical isolates from HIV-TB patients from two public hospitals at Bogotá, Colombia.
The co-infection of TB/HIV is an increasing problem for public health worldwide. In Colombia, of 13.871 confirmed cases of TB in 2016 (prevalence of 0,028%) 14% correspond to HIV co-infection. However, we have scarce information regarding genetic diversity of strains infecting HIV patients. In this study, we carried-out an active search of cases of TB in 356 HIV-infected individuals, who were enrolled in two Public Hospitals at Bogotá-Colombia, between 2014 and 2015. We found 49 patients with HIV-TB co-infection. Genetic characterization of Mycobacterium tuberculosis (Mtb) isolates from these patients showed a predominance of three major sub-lineages: Haarlem (n = 26), LAM (n = 12) and T (n = 11). Remarkably, the most predominant pattern in the present study (SIT62/H1, n = 11) is very specific to this country. Indeed, taking in account distribution in countries with at least 3% of SIT62/H1, 36% of all such patterns collected worldwide were from Colombia. Furthermore, Colombia alone is responsible for almost all the SIT62/H1 strains in South America, suggesting a successful transmission of this genotype inside TB/HIV population from Colombia.


Carbon tetrachloride induction of rapid changes in liver nuclear protein factors capable of sequence-specific binding to regulatory elements in the long terminal repeat of polytropic-class endogenous murine leukemia virus-related proviruses.
Treatment of mice with hepatic carcinogens, including CCl4, has been shown to rapidly enhance the transcription of endogenous murine leukemia virus-related proviral sequences in the liver. To understand the mechanism for this transcriptional stimulation, we used nuclear protein preparations from mouse livers to perform DNase I protection analyses and identified nuclear protein binding on approximately 20 individual sequences within the regulatory regions of the long terminal repeat (LTR) of a polytropic-class endogenous provirus clone. From 3 to 144 h after treatment with CCl4, the livers of FVB/N mice were analyzed for specific nuclear protein binding to the LTR DNA. Three to nine hours after CCl4 treatment, decreased protection was seen at potential regulatory cis-elements throughout the LTR, including specific sites within the putative negative regulatory element (located 5' of the consensus enhancer sequences) and the 3' terminal portion of the polytropic class-specific enhancer-like inserted sequence element and around the CCAA(C/T) box in the promoter region. In addition, by 3-6 h after treatment, a transient increase in protection activity for the transcription initiation site occurred. The loss of cis-element protection expanded to other binding sites and became most marked by 48 h after treatment. As the regenerating liver recovered, the nuclear protein binding activities for these LTR sequences also recovered, but protection at the TATAA and transcription initiation sites remained deprotected at 144 h after treatment. Nuclear protein protection of other sites, particularly in the conserved LTR enhancer sequences, was minimally affected by CCl4 treatment. Three nuclear protein binding sites that showed rapid CCl4-induced kinetic changes were homologous to the consensus sequence for the binding of the transcription factor families MEF-2, HNF-1, and C/EBP. The complex kinetic changes in factors that may contribute to the rapid and transient induction of endogenous retroviral gene expression in the liver after CCl4 exposure are discussed.


Somatic symptoms in multiple personality disorder.
A structured interview, the Dissociative Disorders Interview Schedule, was administered to 20 patients with multiple personality disorder, 20 with panic disorder, 20 with eating disorders, and 20 with schizophrenia. The frequencies of somatization disorder and of individual somatic symptoms in the four groups were compared. The multiple-personality patients reported more somatic symptoms than the other groups. Of the 20 multiple-personality patients, seven met the criteria for somatization disorder. The average number of somatic symptoms per multiple-personality patient was 13.5.


Multidrug resistance proteins in tuberous sclerosis and refractory epilepsy.
Tuberous sclerosis is an autosomal dominant syndrome characterized by seizures that are refractory to medication in severely affected individuals. The mechanism involved in drug resistance in tuberous sclerosis is unknown. The proteins MDR-1 (multidrug resistance) and MRP-1 (multidrug resistance-associated protein-1) are linked to chemotherapy resistance in tumor cells. However, the relationship between refractoriness to antiepileptic drugs and MDR-1 or MRP-1 brain expression has been poorly studied. We have previously described a case of tuberous sclerosis with refractory epilepsy that expressed multidrug resistance gene (MDR-1) in tuber cells from epileptogenic brain lesion. In this retrospective study, we describe the expression of MDR-1 and MRP-1 in the epileptogenic cortical tubers of three pediatric patients with tuberous sclerosis and refractory epilepsy surgically treated. Monoclonal antibodies for MDR-1 and MRP-1 proteins were used for immunohistochemistry. In epileptogenic cortical tuber brain specimens, MDR-1 and MRP-1 proteins were strongly immunoreactive in abnormal balloon cells, dysplastic neurons, astrocytes, microglial cells, and some blood-brain vessels. A more extensive MDR-1 immunoreactivity was observed. These data suggest that refractory epilepsy phenotype in tuberous sclerosis can be associated with the expression of both multidrug resistance MDR-1 and MRP-1 transporters in epileptogenic cortical tubers.


Sexual and reproductive health services use among adolescents in pastoralist settings, northeastern Ethiopia.
Adolescents have special sexual and reproductive health (ASRH) needs and are susceptible to poor health outcomes. The global burden of ill sexual health includes a significant proportion of Adolescents. The existing ASRH services in Ethiopia and particularly in the Afar region are currently not well suited to meet the needs of pastoralist adolescents. This study assesses the level of ASRH service utilization among pastoralists in Afar regional state, Ethiopia. A community based cross-sectional study was conducted from January to March 2021 in four randomly chosen pastoralist villages or kebeles of Afar, Ethiopia. A multistage cluster sampling procedure was used to select 766 volunteer adolescents aged 10-19. SRH services uptake was measured asking whether they had used any SRH service components during the last year. Data was collected through face-to-face interviews with a structured questionnaire; data entry was done with Epi info 3.5.1. Logistic regression analyses was used to assess associations with SRH service uptake. SPSS version 23 statistical software package was used for advanced logistic regression analyses to assess the associations between dependent and predictor variables. The study revealed that two-thirds or 513 (67%) of the respondents are aware of ASRH services. However, only one-fourth (24.5%) of the enrolled adolescents used at least one ASRH service in the past twelve months. ASRH services utilization was significantly associated with gender (being female [AOR = 1.87 (CI 1.29-2.70)], being in school [AOR = 2.38(CI: 1.05-5.41), better family income [AOR = 10.92 (CI; 7.10-16.80)], prior discussions of ASRH issues [AOR = 4.53(CI: 2.52, 8.16)], prior sexual exposure [AOR = 4.75(CI: 1.35-16.70)], and being aware of ASRH services [AOR = 1.96 (CI: 1.02-3.822)]. Being pastoralist, religious and cultural restrictions, fear of it becoming known by parents, services not being available, income, and lack of knowledge were found to deter ASRH service uptake. Addressing ASRH needs of pastoralist adolescents is more urgent than ever, sexual health problems are increasing where these groups face broad hurdles to SRH service uptake. Although Ethiopian national policy has created an enabling environment for ASRH, multiple implementation issues require special attention to such neglected groups. "Gender-culture-context-appropriate" interventions are favorable to identify and meet the diverse needs of Afar pastoralist adolescents. Afar regional education bureau and concerned stakeholders need to improve adolescent education to overcome social barriers (e.g. humiliation, disgrace, and deterring gender norms) against ASRH services through community outreach programs. In addition, economic empowerment, peer education, adolescent counseling, and parent-youth communication will help address sensitive ASRH issues.


Anionic sites on the envelope of Salmonella typhimurium mapped with cationized ferritin.
Binding of either ferritin (F) or cationized ferritin (CF) was employed to indicate the surface charge of the envelope of mainly two Salmonella typhimurium strains (395 MR10, a Rd-mutant, and LT2-M1, a UDP-galactose-4-epimerase-less mutant). Lowering the pH from 7 to 4 decreased binding of CF, but increased binding of F. At low concentrations, the distribution of CF on S. typhimurium 395 MR10 was in general random, with individual ferritin molecules often forming clusters of two or three particles. At ionic strengths of 0.25M NaCl, ferritin produced distinctive, larger clusters at relatively few sites (10-50/cell). Addition of galactose to cultures of growing S. typhimurium, LT2-M1 reduced the binding of CF in 1-10 min, and numerous ferritin-free areas became visible. Possibly this is caused by a pluri-focal reduction in the negative cell surface charge that was generated at the multiple sites of export of new, smooth-type lipopolysaccharide, which either exhibits lesser charge or masks a preexisting surface charge. Dividing cells may show unequal charges on the prospective daughter cells, and the difference in the capacity for ferritin adsorption of both daughter cells is sharply separated at the division site.


Track It to Crack It: Dissecting Processing Stages with Finger Tracking.
A central goal in cognitive science is to parse the series of processing stages underlying a cognitive task. A powerful yet simple behavioral method that can resolve this problem is finger trajectory tracking: by continuously tracking the finger position and speed as a participant chooses a response, and by analyzing which stimulus features affect the trajectory at each time point during the trial, we can estimate the absolute timing and order of each processing stage, and detect transient effects, changes of mind, serial versus parallel processing, and real-time fluctuations in subjective confidence. We suggest that trajectory tracking, which provides considerably more information than mere response times, may provide a comprehensive understanding of the fast temporal dynamics of cognitive operations.


Comparison of optical low-coherence reflectometry and applanation ultrasound biometry on intraocular lens power calculation.
The aim of the study was to determine whether the innovative non-contact optical low-coherence reflectometry method utilized by the Lenstar LS 900® agrees sufficiently with applanation ultrasound A-scan technique in routine biometric measurement and intraocular lens power calculation to replace it. Twenty-two patients hospitalized at our eye clinic undergoing cataract surgery were assigned to have five consecutive measurements of axial length by two examiners in a single session using applanation ultrasound and the Lenstar. The applanation ultrasound intraocular lens power calculation was based on automated keratometry and applanation ultrasound axial length measurements. The Lenstar intraocular lens power calculation was based on its measurement of keratometry and axial length. Bland-Altman analysis was used to assess interobserver repeatability of applanation ultrasound and the Lenstar as well as agreement between the Lenstar and applanation ultrasound for axial length measurement and intraocular lens power calculation. Thirty-two eyes of 22 patients were analyzed. In 95% of the observations, predicted refractive error corresponded to -0.26 ± 0.62 D and 0.01 ± 0.20 D obtained with applanation ultrasound and the Lenstar, respectively. Based on excellent repeatability of the Lenstar and acceptable repeatability of applanation ultrasound, two techniques may be used interchangeably. The predicted refractive error of ± 0.20 D in 95% of the observations has never been achieved. Optical low-coherence reflectometry might become a new standard method for biometric measurement needed for intraocular lens-power calculation in patients with cataract.


An introduction to dyskinesia--the clinical spectrum.
The term movement disorder is used to describe a variety of abnormal movements, and may involve an excess or paucity of movement. Careful characterization of phenomenology is an essential component of diagnosis. Factors such as speed, amplitude, duration, distribution, rhythmicity, suppressibility and pattern of movement provide valuable information to guide the clinician in their assessment of the movement disorder. In this chapter, the clinical spectrum and phenomenology of dyskinesias will be reviewed.


Self-exclusion and breaching of self-exclusion from gambling: a repeated survey study on the development of a nationwide self-exclusion service.
Voluntary self-exclusion from gambling is a common harm reduction tool in individuals with a gambling disorder. Previous data have demonstrated that many gamblers breach their own self-exclusion, typically through other online services outside the jurisdiction in which they are self-excluded. The present study aimed to carry out a new follow-up measure-similar to previous studies in the same setting-of self-exclusion and its breaching in Sweden, in order to allow for the follow-up assessment of a nationwide, multi-operator self-exclusion system introduced in Sweden in 2019. A web survey to the web panel of a market survey company addressed 1505 past-year gamblers, who responded to a number of questions about gambling habits, including screening for gambling problems using the Problem Gambling Severity Index and self-exclusion-related items corresponding to previous studies. Nine percent of past-year gamblers had self-excluded using the Spelpaus service. In logistic regression, self-exclusion was significantly associated with gambling problems, past-year online casino gambling, and absence of online poker gambling. Among self-excluders, 49 percent had ever gambled despite being self-excluded. Among those breaching their self-exclusion, the most common gambling types during self-exclusion were online casino (82 percent), sports betting (47 percent) and lotteries (43 percent). Self-exclusion remains a popular harm reduction tool against problem gambling, more common than in previous studies, mostly in individuals with recent gambling problems and in online casino gamblers. However, breaching self-exclusion is somewhat more common than in previous research. Online casino represents the most common means of self-exclusion breaching. Policy-making in the area needs to further address the risk of breaching one's self-exclusion and may further address the risk of overseas gambling.


Assessment and hormonal treatment of the luteal phase of in vitro fertilization cycles.
Luteal phase lengths and hormonal profiles (progesterone, oestradiol-17 beta, beta HCG and prolactin) have been documented in 77 cases derived from a series of patients undergoing IVF. Nineteen pregnancies were generated during this series and 12 healthy infants have already been delivered. Luteal phase lengths were 14.5 +/- 0.5 days with 14.3% demonstrating mid-luteal progesterone levels of less than 31 nmols/l, considered to be low for successful conception. A random study of luteal support regimens comparing HCG or medroxyprogesterone acetate (MPA) with nil therapy was studied in a series of 44 consecutive embryo transfers during which 10 pregnancies were achieved. No difference was noted in the pregnancy rates for the 3 groups but the pregnancy outcome was better in those who had HCG support and this was more apparent in the overall series of 19 pregnancies. A significant luteotrophic effect was noted with HCG support regimens whilst MPA appeared to have a luteal suppressant action. Six pregnancies which aborted with blighted ova were derived from cycles in which the luteal phase progesterone levels were low raising the possibility that a poor hormonal environment may predispose to blighted ova.


Inherited thrombocytopenia caused by ANKRD26 mutations misdiagnosed and treated as myelodysplastic syndrome: report on two cases.
Essentials Thrombocytopenia 2 (THC2) is an inherited thrombocytopenia (IT) with dysmegakaryopoiesis. Physicians often do not suspect the genetic origin of thrombocytopenia in patients with THC2. We report two THC2 patients misdiagnosed with myelodysplasia and treated with chemotherapy. IT should be always considered in patients with isolated thrombocytopenia and dysmegakaryopoiesis. Thrombocytopenia 2 (THC2) is an autosomal-dominant disorder caused by point substitutions in the 5'UTR of the ANKRD26 gene. Patients have congenital thrombocytopenia, normal platelet morphology and function, and dysmegakaryopoiesis. Thrombocytopenia is frequently discovered only in adulthood and physicians often do not suspect its genetic origin. We describe two unrelated patients referred to two different institutions for investigation of thrombocytopenia. Based on the finding of dysmegakaryopoiesis at bone marrow examination, patients were diagnosed with myelodysplastic syndrome (MDS) (refractory thrombocytopenia) and treated with several courses of 5-azacytidine. Subsequently, demonstration of thrombocytopenia in their relatives eventually led to molecular diagnosis of THC2 in both families. These cases highlight that patients with THC2 are at risk of being misdiagnosed with MDS and receiving undue myelosuppressive treatments. Because dysmegakaryopoiesis is a feature also of other forms of inherited thrombocytopenia, a genetic disorder must always be considered when a patient presents with isolated thrombocytopenia and dysmegakaryopoiesis.


Reversal and nonreversal shifts in autistic children.
Reversal and nonreversal shifts in nineteen 2- to 14-year-old autistic children were studied. Each child was taught both a reversal and nonreversal shift discrimination task. The reversal shift condition entailed teaching the child to respond to one (the S+) of a pair of stimuli during training and subsequently reversing the S+ during testing. The nonreversal shift condition consisted of teaching the child two unrelated discriminations during training and testing. The results indicated that the older autistic children did better on reversal shifts than younger children who did better on nonreversal shifts. These findings are consistent with those for normal children.


Special health care needs explains the effect of extremely low birth weight on math but not language achievement.
Extremely low birth weight (ELBW; <1kg) adolescents are at risk for special health care needs (SHCN) and poor math achievement compared to normal birth weight (NBW) peers. SHCN are associated with poor academic achievement among NBW children. We hypothesize that SHCN explain the effect of ELBW on math achievement. We compared age 14 Woodcock-Johnson Calculation standard scores between 181 ELBW infants and 115 NBW controls. Persistent SHCN included: 1) prescription medication or equipment use, 2) subspecialty or therapeutic service use, or 3) hospitalization. We used nonlinear marginal effects models to decompose the total effect of ELBW on math into the following 4 components: the effect of ELBW controlling for SHCN, the effect of SHCN controlling for ELBW, effect modification by SHCN, and mediated interaction where SHCN is both causal mediator and effect modifier. Models were adjusted for sociodemographic factors. ELBW adolescents had lower mean math scores than NBW peers (81.3 vs. 96.4). SHCN were more common among ELBW adolescents (54.1% vs. 27%). The total effect of ELBW on math scores was -15.7 points (95% CI -21.0, -10.5). The effect of birth weight alone was -7.6 points (95% CI -13.7, -1.4); the effect of SHCN alone was negligible. SHCN interaction and mediated interaction effects each accounted for 25% of the total effect. Birth weight alone explains only half of the effect of ELBW on math achievement. We found evidence of effect modification and mediation by SHCN. Understanding these explanatory pathways may lead to targeted interventions for improved outcomes.


Testosterone-associated blood pressure dysregulation in women with androgen excess polycystic ovary syndrome.
We tested the hypothesis that hyperandrogenemia in androgen excess polycystic ovary syndrome (AE-PCOS) is a primary driver in blood pressure (BP) dysregulation via altered sympathetic nervous system activity (SNSA), reduced integrated baroreflex gain and increased renin-angiotensin system (RAS) activation. We measured resting SNSA (microneurography), integrated baroreflex gain, and RAS with lower body negative pressure in obese insulin-resistant (IR) women with AE-PCOS [n = 8, 23 ± 4 yr; body mass index (BMI) = 36.3 ± 6.4 kg/m2] and obese IR controls (n = 7, control, 29 ± 7 yr; BMI = 34.9 ± 6.8 kg/m2), at baseline (BSL), after 4 days of gonadotropin-releasing hormone antagonist (ANT, 250 μg/day) and 4 days of ANT + testosterone (ANT + T, 5 mg/day) administration. Resting BP was similar between groups for systolic blood pressure (SBP; 137 ± 14 vs. 135 ± 14 mmHg, AE-PCOS, control) and diastolic BP (89 ± 21 vs. 76 ± 10 mmHg, AE-PCOS, control). BSL integrated baroreflex gain was similar between groups [1.4 ± 0.9 vs. 1.0 ± 1.3 forearm vascular resistance (FVR) U/mmHg], but AE-PCOS had lower SNSA (10.3 ± 2.0 vs. 14.4 ± 4.4 burst/100 heartbeats, P = 0.04). In AE-PCOS, T suppression increased integrated baroreflex gain, which was restored to BSL with ANT + T (4.3 ± 6.5 vs. 1.5 ± 0.8 FVR U/mmHg, ANT, and ANT + T, P = 0.04), with no effect in control. ANT increased SNSA in AE-PCOS (11.2 ± 2.4, P = 0.04). Serum aldosterone was greater in AE-PCOS versus control (136.5 ± 60.2 vs. 75.7 ± 41.4 pg/mL, AE-PCOS, control, P = 0.04) at BSL but was unaffected by intervention. Serum angiotensin-converting enzyme was greater in AE-PCOS versus control (101.9 ± 93.4 vs. 38.2 ± 14.7 pg/mL, P = 0.04) and reduced by ANT in AE-PCOS (77.7 ± 76.5 vs. 43.4 ± 27.3 µg/L, ANT, and ANT + T, P = 0.04) with no impact on control. Obese, IR women with AE-PCOS showed decreased integrated baroreflex gain and increased RAS activation compared with control.NEW & NOTEWORTHY Here we present evidence for an important role of testosterone in baroreflex control of blood pressure and renal responses to baroreceptor unloading in women with a common, high-risk androgen excess polycystic ovary syndrome (AE-PCOS) phenotype. These data indicate a direct effect of testosterone on the vascular system of women with AE-PCOS independent of body mass index (BMI) and insulin-resistant (IR). Our study indicates that hyperandrogenemia is a central underlining mechanism of heightened cardiovascular risk in women with PCOS.


Cecal duplication cyst mimicking intussusception in a female: A case report.
Cecal duplication cysts occur only in 0.4% of all the gastrointestinal tract duplication cysts. More than 80% cases present in the first two years of life. However, asymptomatic individuals may also present in adult life. A female patient of 42 years presented with generalized abdominal pain and multiple episodes of vomiting from one day. A vague tender mass was palpable in the left lumber region, firm in consistency with ill-defined borders and not moving with respiration. Ultrasound shows mild free fluid with internal debrinous echoic area noted in lower abdomen and pelvis along with fatty hepatomegaly. CeCT scan of the abdomen and pelvis shows twisted appearance of the gut and mesentery in right sub-hepatic region. Complete resection and Ileocolic anastomosis was done along with right hemicolectomy. Based on radiological, surgical and pathological findings, the final diagnosis was enteric duplication cyst. Based on their location, terminal ileum and ileocecal junction are the most common sites (53 %) with colonic duplication second to it (13%). However, cecal duplication cysts remain the least common with incidence of 0.4 % only. Females are more common than males. However, their exact cause is not known. Possible causes are defective recanalization, fusion of embryonal longitudinal folds, persistant diverticulae of embryonic life and uterine vascular anomalies. Enteric duplication cysts most commonly presenting with palpable abdominal mass, pain mimicking appendicitis & bleeding per-rectum. The treatment of choice is resection and ileocolic anastomosis with overall good prognosis. The delay in the diagnosis can lead to high mortality.


Biocatalytic production of the antibiotic aurachin D in Escherichia coli.
Aurachin D is a potent inhibitor of cytochrome bd oxidases, which are potential targets in the treatment of infectious diseases. In this study, our aim was to improve the biocatalytic production of aurachin D from a quinolone precursor molecule with recombinant Escherichia coli cells expressing the biosynthesis enzyme AuaA. In order to achieve a high-level production of this membrane-bound farnesyltransferase in E. coli, the expression of the auaA gene was translationally coupled to an upstream cistron in accordance with a bicistronic design (BCD) strategy. Screening of various BCD elements led to the identification of optimized auaA expression cassettes, which increased the aurachin D titer in E. coli up to 29-fold in comparison to T7-mediated expression. This titer could be further raised by codon optimization of auaA and by introducing the mevalonate pathway into the production strain. The latter measure was intended to improve the availability of farnesyl pyrophosphate, which is needed as a cosubstrate for the AuaA-catalyzed reaction. In sum, the described efforts resulted in a strain producing aurachin D with a titer that is 424 times higher than that obtained with the original, non-optimized expression host.


A molecular detection approach for a cotton aphid-parasitoid complex in northern China.
Aphid-parasitoid interactions have been widely used as a model system in research studies on the structure and functions of arthropod food web. Research on aphid-parasitoid food webs is hindered by their micromorphological characteristics and the high amount of labor associated with their development. Species-specific primers for cotton aphids and their parasitoids were designed and integrated into two multiplex PCRs and six singleplex PCRs, and all PCRs were optimized to achieve high specificity and sensitivity (100-10,000 DNA copies). One cotton aphid (Aphis gossypii) as well as three primary parasitoid and seven hyperparasitoid species or genera were detected using this molecular approach. This group comprises all the primary parasitoids and 97.2-99.6% of the hyperparasitoids reported in cotton fields in northern China. A tritrophic aphid-primary parasitoid-hyperparasitoid food web was then established. The described method constitutes an efficient tool for quantitatively describing the aphid-primary parasitoid-hyperparasitoid food webs and assessing the efficiency of the biological control of parasitoids in cotton fields in northern China.


Prognostic relevance of insulin resistance on disease-free survival in head and neck squamous cell carcinomas: Preliminary results.
The primary purpose of this study was to investigate the significance of pretreatment glycemic parameters in the prognosis of head and neck squamous cell carcinoma (HNSCC). Plasma samples of 71 patients with untreated HNSCC were obtained at the time of diagnosis. The prognostic value of fasting insulin, glucose, glycosylated hemoglobin levels, and the homeostatic model of risk assessment-insulin resistance (HOMA-IR) was evaluated toward disease-free survival. High HOMA-IR levels were associated with poor disease-free survival in intermediate-advanced stage tumors. Kaplan-Meier curves showed lower disease-free survival rates in patients with high HOMA-IR than in patients with low levels. In patients with intermediate-advanced stage tumors, multivariate analysis revealed that those with an HOMA-IR >2.974 presented a 2.7 times higher risk of poor outcome (95% confidence interval [CI] 1.023-7.341; P = .045). The HOMA-IR is independently associated with disease-free survival in patients with HNSCC. We found an optimal HOMA-IR cutoff value for disease-free survival in patients with intermediate-advanced HNSCC.


[A potentiometric sensor designed on the basis of urease immobilized in polyelectrolyte microcapsules].
A potentiometric biosensor has been designed on the basis of glass pH-electrode with a sensing device of the microcellular polyelectrolytic coating containing urease. The polymeric walls of the coating are readily permeable for low-molecular weight compounds, including urea, but are impermeable for macromolecules. The main characteristics of the biosensor in various experimental solutions containing urea, low-molecular-weight salt, and buffer have been obtained. The sensor has been shown to be stable for at least three weeks. The standard curves of the sensor are linear in the range of urea concentrations from 0.2 to 20 mM.


The adaptive significance of insect gall distribution: survivorship of species in xeric and mesic habitats.
We studied the relationship between habitat moisture and gall-forming insect populations. Population sizes for most galling taxa were significantly larger in xeric habitats compared with mesic habitats. Our results indicate that the differential abundance of galling insects in these habitats is due primarily to differential mortality and survivorship. Mortality factors acting upon eight insect galling species (belonging to eight genera and four families) were measured on six species (five genera and five families) of host plants. Survival was significantly higher for galling populations inhabiting xeric habitats compared with mesic habitats. Parasitism was higher in mesic habitats in seven of eight habitats and fungus-induced diseases were higher in five of seven habitats. Mortality due to predation and other (unknown) factors showed no clear trends. Overall, there was a tendency towards lower mortality and consequently higher survival for populations inhabiting xeric habitats. We hypothesize that reduced mortality caused by natural enemies and endophytic fungi has contributed to the speciation and radiation of galling insects in apparently harsh environments.


Clinical and economic outcomes associated with National Kidney Foundation guideline-concordant oral antidiabetic drug treatment among type 2 diabetes patients with chronic kidney disease.
To assess outcomes associated with oral anti-diabetic drug (OAD) treatment concordant with guidelines from the National Kidney Foundation (NKF) among type 2 diabetes mellitus (T2DM) patients with chronic kidney disease (CKD). Electronic health record data between 1/1/2005 and 10/31/2010 provided by an integrated health system were analyzed. T2DM patients were selected based on diagnosis from the health record. Patients with stages 3-5 CKD based on diagnosis or lab results were further identified with the date of first indicated CKD set as index date. Patients who had a medication order of OADs within three months of the index date were included. Patients were considered non-guideline-concordant if prescribed OADs that were recommended to be avoided or if they required dosage adjustment, but were unadjusted. Glycemic control, hospital admissions, and costs of encounters were assessed over a 12-month post-index period, and hypoglycemic events were evaluated until loss of follow-up. Regression analyses were performed, adjusting for patient demographic and clinical characteristics. Among 6058 patients (mean age: 70; 42% male), 45% were not [corrected] guideline-concordant. After adjusting for patient characteristics, guideline-concordant patients had a lower risk for hypoglycemic events (HR: 0.72; 95% CI: 0.62-0.83), were less likely to have a hospital admission (OR: 0.87; 95% CI: 0.77-0.98), and more likely to have glycemic control (OR: 1.64, 95% CI: 1.46-1.84). Non-guideline-concordant patients had annual encounter costs of 1.10 times those of guideline-concordant patients (marginal cost = $731; P = 0.04). Unobservable confounders may still exist and bias the results; therefore, findings should be interpreted as associations instead of causations. Findings were based on a single integrated health system and may not be generalizable to larger populations. The findings of this exploratory study suggest that guideline-concordant treatment may yield better clinical and economic outcomes. Future research with a better controlled design is warranted to confirm these preliminary findings.


The effects of freshwater to seawater transfer on circulating levels of angiotensin II, C-type natriuretic peptide and arginine vasotocin in the euryhaline elasmobranch, Carcharhinus leucas.
This study examined the effect of transfer to increased environmental salinity on the circulating levels of angiotensin II (ANG II), C-type natriuretic peptide (CNP), and arginine vasotocin (AVT) in the euryhaline elasmobranch, Carcharhinus leucas. Plasma levels of ANG II and CNP were significantly increased in C. leucas chronically acclimated to seawater (SW) in comparison to freshwater (FW) acclimated fish. There was no difference in plasma AVT levels. Acute transfer of FW fish to 75% SW induced an increase in plasma ANG II levels within 12 h, and subsequent transfer from 75 to 100% SW further increased plasma ANG II levels at both 24 and 72 h. No change in plasma CNP was observed during acute transfer to increased salinity. However, a significant increase in plasma AVT levels was observed following 96 h in 75% SW and 24 h in 100% SW. In chronically SW acclimated C. leucas plasma osmolality, sodium, chloride, and urea were all significantly higher than FW acclimated fish but there was no difference in haematocrit. Acute transfer of C. leucas to 75% SW induced a significant increase in plasma osmolality, sodium and urea concentrations within 96 h of transfer. Subsequent transfer from 75 to 100% SW induced a further increase in these variables within 24 h in addition to a significant increase in plasma chloride above control levels. Haematocrit did not differ between the experimental and control groups throughout the acute study. Circulating levels of ANG II were significantly correlated to plasma, sodium, chloride, and urea concentrations during acclimation to SW. Conversely, circulating levels of CNP and AVT did not correlate to plasma osmolytes, however, CNP was significantly correlated to haematocrit during acclimation to seawater.


Ganglion cyst of the spinoglenoid notch: comparison between SLAP repair alone and SLAP repair with cyst decompression.
Some authors have described the ganglion cyst of the spinoglenoidal notch as related to repetitive overhead activities and labral tear caused by trauma, while others have explained lesions of the capsulolabral complex and ganglion cysts to have separate pathologies. The purpose of this study is to compare clinical and radiological outcomes between 2 groups: 1 with superior labrum anterior and posterior (SLAP) repair only and the other with SLAP repair and cyst decompression prospectively. From August 2000 to March 2007, 28 patients matching the inclusion criteria were selected for the study. They were divided into 2 groups: 1 who received SLAP repair and the other with concomitant SLAP repair and cyst decompression. A visual analogue scale (VAS) and Rowe and Constant scores were used to make evaluation. Preoperative magnetic resonance images (MRIs) of 2 patient groups were compared with 2 follow-up MRIs taken 3 months after the operation and at final follow-up. Mean VAS and Constant and Rowe scores in groups I and II improved significantly from mean preoperative score compared to last follow-up score; however, there was no statistically significant difference between the 2 groups (P > .05). Preoperative MRI and arthroscopy revealed type II SLAP lesions and a type V lesion, respectively, as accompanying lesions in 24 cases. The hypothesis stating 1-way valve mechanism of SLAP lesion as an initial cause of ganglion cysts has been proved indirectly in this study. Furthermore, direct decompression of the cyst does not lead to different results.


Imaging in orbital trauma.
Orbital trauma is one of the most common reasons for ophthalmology specialty consultation in the emergency department setting. We survey the literature from 1990 to present to describe the role of computed tomography (CT), magnetic resonance imaging (MRI) and their associated angiography in some of the most commonly encountered orbital trauma conditions. CT orbit can often detect certain types of foreign bodies, lens dislocation, ruptured globe, choroidal or retinal detachments, or cavernous sinus thrombosis and thus complement a bedside ophthalmic exam that can sometimes be limited in the setting of trauma. CT remains the workhorse for acute orbital trauma owing to its rapidity and ability to delineate bony abnormalities; however MRI remains an important modality in special circumstances such as soft tissue assessment or with organic foreign bodies.


Taurolidine, an antilipopolysaccharide agent, has immunoregulatory properties that are mediated by the amino acid taurine.
Taurolidine has bactericidal and antilipopolysaccharide properties. It is broken down into the amino acid taurine, which has been shown to modulate intracellular calcium activity, a critical component in the priming and activation of macrophages and polymorphonuclear leukocytes. We hypothesized that taurolidine may function to enhance immune activity in these cells. The aim of this study was to investigate the immunological effects of taurolidine and correlate findings with survival after a septic challenge in a murine model. Study 1: CD-1 mice underwent cecal ligation and puncture, were randomized to receive taurolidine (200 mg/kg body weight/i.p.) or saline control, and studied for end point survival. Study 2: CD-1 mice were randomized to receive taurolidine (200 mg/kg body weight/i.p.) or saline control. Peritoneal macrophages (PM luminal diameters) were assessed for O2-, NO, tumor necrosis factor-alpha (TNF-alpha), CD11b, phagocytosis, and PMN influx. O2-, TNF-alpha, CD11b expression, and phagocytosis were significantly increased in the taurolidine group. Study 3: PM luminal diameters were cultured in vitro +/- 0.5 mg/ml taurolidine and PM luminal diameter antimicrobial function assessed (O2-, NO, TNF-alpha, and phagocytosis). O2-, TNF-alpha, and phagocytosis were significantly increased, whereas NO was reduced. Study 4: PM luminal diameters were also cultured with taurine (0.5 mg/ml). Similar increase in O2-, TNF-alpha, and phagocytosis were identified. Intracellular PM luminal diameter [Ca2+] was also assessed and increases in free, unbound intracellular [Ca2+] occurred after taurine culture. Thus, in addition to its bactericidal and antilipopolysaccharide activity, taurolidine primes PM luminal diameters for enhanced antimicrobial activity and these effects appear mediated by the amino acid taurine.


The Net Effect of Functional Traits on Fitness.
Generalizing the effect of traits on performance across species may be achievable if traits explain variation in population fitness. However, testing relationships between traits and vital rates to infer effects on fitness can be misleading. Demographic trade-offs can generate variation in vital rates that yield equal population growth rates, thereby obscuring the net effect of traits on fitness. To address this problem, we describe a diversity of approaches to quantify intrinsic growth rates of plant populations, including experiments beyond range boundaries, density-dependent population models built from long-term demographic data, theoretical models, and methods that leverage widely available monitoring data. Linking plant traits directly to intrinsic growth rates is a fundamental step toward rigorous predictions of population dynamics and community assembly.