Outbreak of human astroviruses 1 and Melbourne 2 in acute gastroenteritis pediatric patients in Japan during the COVID-19 pandemic, 2021.
Human astrovirus (HAstV) infection is one of the leading causes of acute gastroenteritis in young children. The present study reports the outbreak of HAstV in children with acute gastroenteritis in Kyoto, Japan, during the COVID-19 pandemic, 2021. A total of 61 stool samples were collected from children with acute gastroenteritis who visited a pediatric outpatient clinic in Maizuru city, Kyoto, Japan from July to October, 2021. HAstV was screened by RT-PCR, and the genotypes were identified by nucleotide sequence analysis. Of 61 cases of acute gastroenteritis, 20 were mono-infected with HAstV alone. In addition, mixed infection of HAstV and NoV, and HAstV and RVA were also detected in 15 and 1 cases, respectively. Of 36 HAstV strains detected in this outbreak, 29 and 7 were HAstV1 and MLB2 genotypes, respectively. All HAstV1 strains were closely related to the HAstV1 reported from Thailand and Japan in 2021 and all of them belonged to subgenotype HAstV1a. Among MLB2, they were most closely related to the MLB2 strains reported from China in 2016 and 2018. After the kindergartens and schools were re-opened at the middle of 2021 in Japan, an outbreak of HAstV was reported. Control measures against the COVID-19 pandemics might affect the spread of diarrheal virus infection. Here we report the outbreak of HAstV1 and MLB2 in Kyoto, Japan, during COVID-19 pandemic in 2021.


Effects of surfactants on graphene oxide nanoparticles transport in saturated porous media.
Transport behaviors of graphene oxide nanoparticles (GONPs) in saturated porous media were examined as a function of the presence and concentration of anionic surfactant (SDBS) and non-ionic surfactant (Triton X-100) under different ionic strength (IS). The results showed that the GONPs were retained obviously in the sand columns at both IS of 50 and 200mmol/L, and they were more mobile at lower IS. The presence and concentration of surfactants could enhance the GONP transport, particularly as observed at higher IS. It was interesting to see that the GONP transport was surfactant type dependent, and SDBS was more effective to facilitate GONP transport than Triton X-100 in our experimental conditions. The advection-dispersion-retention numerical modeling followed this trend and depicted the difference quantitatively. Derjaguin-Landau-Verwey-Overbeek (DLVO) interaction calculations also were performed to interpret these effects, indicating that secondary minimum deposition was critical in this study.


Effect of anterior chamber depth on predictive accuracy of seven intraocular lens formulas in eyes with axial length less than 22 mm.
This study aimed to evaluate whether different anterior chamber depth (ACD) affects the predictive accuracy of intraocular lens formulas in eyes with axial length (AL) less than 22 mm. Eighty-five eyes of 85 patients with AL less than 22 mm were included in this retrospective study, which were divided into three groups: Group 1, ACD less than 2.4 mm; Group 2, ACD between 2.4 and 2.9 mm; and Group 3, ACD greater than 2.9 mm. Optical biometry with partial coherence interferometry was performed in all cases. The median absolute error (MedAE) was compared by Friedman's test, using the optimized lens constant, among seven formulas (Barrett Universal II, Haigis, Hill-RBF, Hoffer Q, Holladay 1, Holladay 2, and SRK/T) in each group. Friedman's test showed no significant difference in MedAE among all formulas in Groups 1 and 3. However, as the Haigis formula had the highest MedAE and lowest percentage of eyes within ±0.25 Diopter, it is least preferred in Group 1. On the contrary, in Group 3 it fared the best, having the least MedAE and highest percentage of eyes within ±0.25 Diopter. In Group 2, Friedman's test gave significant difference, and post-hoc analysis showed statistical superiority of Haigis over the Holladay 1 (p=0.02), Holladay 2 (p=0.01), Hill-RBF (p=0.04), and SRK/T (p=0.02) formulas. However, there was no statistical difference between the Barrett Universal II, Haigis, and Hoffer Q formulas. Considering the ACD in eyes with AL less than 22 mm, Haigis is the preferred formula while SRK/T proved to be the worst formula in Groups 2 and 3.


Neonatal adenovirus infection: a case report with in situ hybridization confirmation of ascending intrauterine infection.
Adenovirus infection is a rare, but serious infection, during the neonatal period. The actual model of infection at birth is currently unknown, however, several mechanisms have been proposed. We describe a case of fatal neonatal adenovirus pneumonia in a 25-wk gestational age infant. Adenovirus was confirmed by electron microscopy and by in situ hybridization. The maternal cervical/endocervical smear taken prior to the delivery contained epithelial cells with changes suggestive of adenovirus, which was confirmed by in situ hybridization on the smear. These findings suggest that ascending viral infection is a factor in the pathogenesis of neonatal adenovirus infection. The identification and reporting of adenovirus may be important during pregnancy in order to avoid delay in delivery of the fetus once membranes have ruptured.


Change of zonal bile acid processing after partial hepatectomy in the rat.
The aim of this study was to analyze whether partial hepatectomy alters functional liver heterogeneity with respect to bile acid processing. One, 5 and 21 days after liver resection (approximately 80% of liver mass) in male Sprague-Dawley rats (300-400 g), isolated livers were perfused in either the antegrade or the retrograde direction, respectively, with 32 nmol cholate/min per g liver. Uptake, metabolism and biliary secretion kinetics were determined by bolus injection of 14C-cholate. Uptake and biliary recovery (within 30 min) of cholate were > 90% in all groups. One day postresection, liver mass had already doubled and it regenerated to over 80% 5 days after resection. Serum bile acid concentration increased rapidly, peaking 6 h after resection (176.7 +/- 28.5 mumol/l) (mean +/- SEM). Twenty-one days after resection it fell to control values (23.2 +/- 3.8 mumol/l). T25 (T50), the time (min) necessary to excrete 25% (50) of the bile acid load into bile, was strikingly different between periportal and pericentral cells of controls (1.8 vs 5.7 and 3.4 vs 8.1). Five days after resection this difference became smaller (1.4 vs 2.9 and 2.8 vs 5.5) due to accelerated biliary cholate secretion in pericentral cells. Pericentral cells of controls metabolized cholate more extensively to taurocholate (approximately 83%) and glycocholate (approximately 13%) than periportal cells of controls (65%, 10%), leading to a 5-fold higher proportion of unmetabolized cholate in periportal than pericentral cells (25% vs 5%). Five days after resection the percentage of taurocholate decreased significantly at the expense of an increased formation of glycocholate.(ABSTRACT TRUNCATED AT 250 WORDS)


Objective visual field evaluation using multifocal visual evoked potentials in patients with intracranial disease complicated by mental disorders.
We investigated whether visual field defects can be objectively evaluated using multifocal visual evoked potentials (mfVEPs) in patients with intracranial disease complicated by mental disorders. First, to determine the normal pattern of mfVEPs, recordings were performed using a VERIS Junior Science recording apparatus (Mayo, Aichi, Japan) in 40 healthy subjects. Responses from 8 sites in each subject were divided into 4 quadrants (superior and inferior temporal quadrants and superior and inferior nasal quadrants). In each quadrant, two response waves were grouped and averaged, and the peak latency and amplitude were used for assessment. mfVEP recordings were also performed in 3 patients with intracranial disease complicated by mental disorders, in whom dynamic or static perimetry was impossible, or in whom reliable data could not be obtained, and quadrants showing abnormalities were compared with the sites of intracranial lesions observed by imaging techniques. In the 40 normal subjects, no significant differences were observed in the peak latency among the 4 quadrants, but the amplitude was significantly higher in the inferior than in the superior semi-field. mfVEPs in the 3 patients revealed abnormal waves, which corresponded to the lesions observed by imaging techniques. The objective evaluation of visual field defects using mfVEPs may be useful in patients with intracranial disease complicated by mental disorders, in whom kinetic/static perimetry as a subjective examination is difficult.


Classification of EMG signals using PCA and FFT.
In this study, the fast Fourier transform (FFT) analysis was applied to EMG signals recorded from ulnar nerves of 59 patients to interpret data. The data of the patients were diagnosed by the neurologists as 19 patients were normal, 20 patients had neuropathy and 20 patients had myopathy. The amount of FFT coefficients had been reduced by using principal components analysis (PCA). This would facilitate calculation and storage of EMG data. PCA coefficients were applied to multilayer perceptron (MLP) and support vector machine (SVM) and both classified systems of performance values were computed. Consequently, the results show that SVM has high anticipation level in the diagnosis of neuromuscular disorders. It is proved that its test performance is high compared with MLP.


[Balloon catheter arterial occlusion before high-risk splenectomy and nephrectomy].
Balloon catheter occlusion of the splenic or renal artery was undertaken in 10 patients (7 men and 3 women, aged 20-76 years) 30 to 120 min before a splenectomy (n = 8) or nephrectomy (n = 2), for the purpose of preventing a high intra- and post-operative blood loss and facilitating the technical procedure of removing an often markedly enlarged spleen. The operation time after balloon catheter occlusion was only 60-140 min; intra- and post-operative complications did not occur, other than one instance of pneumonia and one of subcutaneous haematoma. This method would seem to be suitable for reducing the operative risk of splenectomy or nephrectomy in the presence of a giant spleen or reduced tolerance of operation.


A generic organ based ontology system, applied to vertebrate heart anatomy, development and physiology.
We present a novel approach to modelling biological information using ontologies. The system interlinks three ontologies, comprising anatomical, developmental and taxonomical information, and includes instances of structures for different species. The framework is constructed for comparative analyses in the field of evolutionary development. We have applied the approach to the vertebrate heart and present four case studies of the functionality of the system, focusing on cross-species comparisons, developmental studies, physiological studies and 3D visualisation.


The effects of thromboxane A2 inhibitors (OKY-046 and ONO-3708) and leukotriene inhibitors (AA-861 and LY-171883) on CCl4-induced chronic liver injury in mice.
The effects of OKY-046, a selective thromboxane A2 (TxA2) synthetase inhibitor, ONO-3708, a novel TxA2 receptor antagonist, AA-861, a selective 5-lipoxygenase inhibitor and LY-171883, a peptide leukotrienes (p-LTs) receptor antagonist on the chronic liver injury were investigated in mice. The chronic liver injury was induced by the injection of carbon tetrachloride (CCl4) two times a week for twelve weeks in mice. In chronic liver injury models, significant histopathological changes in the liver and extensive elevation of glutamate transaminase (GOT and GPT) activity were observed. Administration of OKY-046, ONO-3708, AA-861 and LY-171883 for 12 weeks suppressed the elevation of serum GOT and GPT levels and histopathological changes in CCl4-induced chronic liver injury. These results suggest that TxA2 and LTs inhibitors are effective for the onset and development of chronic liver injury in mice.


Aggressive control measures for resistant Acinetobacter baumannii and the impact on acquisition of methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus in a medical intensive care unit.
The medical ICU implemented aggressive control measures following an outbreak of multidrug-resistant, clonal Acinetobacter baumannii. Multivariable regression analyses comparing acquisition (6 months preceding to 6 months during or following the outbreak) revealed decreased VRE and MRSA acquisition. Aggressive control measures can reduce VRE, and perhaps MRSA, transmission.


7 g weighted versus unweighted polyurethane nasoenteral tubes--spontaneous transpyloric passage and clinical performance: a controlled randomised trial.
A proportion of patients requiring enteral nutrition is at increased risk of regurgitation or pulmonary aspiration of enteral diet as a result of gastric atony or paresis. The positioning of the distal end of an enteral feeding tube beyond the pylorus into duodenum or jejunum may reduce this risk. It has been postulated that by suitable lengthening of feeding tubes and by altering the distal end tip profile or by the addition of a weight, spontaneous passage of a tube through the pylorus after pernasal insertion may be achieved. In a recent controlled trial we were unable to demonstrate any advantage to a) modifying the tip profile or b) the addition of a 2.4 g weight. This prospective controlled clinical study examined the difference between an unweighted polyurethane tube which had performed optimally in the previous study and a new 7 g weighted tube similar in all other respects. In both cases less than 50% of tubes had passed spontaneously through the pylorus when assessed at 24 h, with no significant difference in performance (p = 0.38). When comparing overall length of time that each tube remained in situ, there was similarly no significant difference between the 7 g weighted and unweighted tubes (p = 0.277). We conclude that the addition of a 7 g weight to a suitably lengthened enteral feeding tube confers no advantage on either incidence of spontaneous transpyloric passage or in prolonging tube usage. If post-pyloric feeding is indicated for a patient, positioning by either fluoroscopic or endoscopic techniques should be undertaken.


Neurological complications after therapy for fetal-fetal transfusion syndrome: a systematic review of the outcomes at 24 months.
The main objective of this study was to review the available scientific evidence about mid-term neurological outcomes in twins after laser therapy for twin-to-twin transfusion syndrome (TTTS). A systematic review of studies on neurodevelopmental outcomes (cognition, motor development, communication skills and cerebral palsy) of twins after laser therapy for TTTS was conducted. Outcomes at 24 months of age and the use of validated scales for assessment were the selected criteria. Electronic and manual research identified 25 studies, and nine of them were eligible for the review. The global mean rate of neurological injury in twins treated with laser was 14.07%. The mean rate of cognitive impairment was 8.41%, 11.14% for motor delay, 16.5% for communication delay and 5.73% for cerebral palsy. These rates were higher than the results found in dichorionic twins, but lower than the results found in twins treated with amnio-reductions or conservative management. Laser therapy is associated with a lower rate of neurological injury at 24 months of age compared to other therapeutic techniques. This tendency was also observed with specific incidences regarding cognition, motor skills and cerebral palsy.


Effects of thermal softening of endotracheal tubes on postoperative sore throat: A randomized double-blinded trial.
Postoperative throat complications after intubation are undesirable but frequent outcomes. A randomized, double-blinded study was performed to determine whether thermal softening of endotracheal tubes reduced throat complications after intubation. Patients (n = 196) undergoing nasal surgery were randomly allocated into the control group and thermal softening groups. Sore throat and hoarseness were evaluated 1 and 24 hours after extubation. The severity of sore throat was evaluated using the numeric rating scale (NRS). The primary outcome was the incidence of sore throat 1 hour after extubation and sore throat was defined as a painful or scratchy feeling in the throat. The secondary outcomes were the incidence of hoarseness 1 hour after extubation, the incidence of sore throat and hoarseness 24 hours after extubation, severity of sore throat, and vocal cord injuries. The incidence of sore throat 1 hour after extubation was lower in the thermal softening group than in the control group (35.1% vs 52.7%, P = .02). Moreover, thermal softening decreased the mean NRS score for sore throat in the thermal softening group by 10% an hour after extubation (thermal softening group, 1.29 [95% CI, 0.88-1.70] vs control group, 2.33 [95% CI, 1.77-2.89]; P < .01). At 24 hours after extubation, the incidence of sore throat (38.3% vs 40.7%, P = .77) and hoarseness (34.0% vs 35.2%, 0.95 [0.52-1.74], P = .74) were comparable between the two groups. Intubation using endotracheal tubes with thermal softening significantly decreased the incidence of sore throat 1 hour after extubation when compared with endotracheal tubes without thermal softening.


Schneiderian first rank symptoms in schizophrenia: A developmental neuroscience evaluation.
Self disorders in schizophrenia have been suggested to have distinct neurobiological underpinnings. Using comprehensive neuro-scientific assessments including a neurophysiological, a neurochemical and a neuropsychological marker, this study assesses disordered-"self" in schizophrenia. Twenty schizophrenia patients with first rank symptoms (FRS;FRS+), 20 patients without FRS (FRS-) and 20 healthy controls (HC) were assessed for psychopathology, especially on specially designed FRS score sheets with a narrow and a broad definition. Resting state electroencephalography was acquired using 256-electrodes; gamma spectral-power was measured in 8 regions of interest. Serum BDNF and self-monitoring were also assessed. Comparative and correlation analysis were conducted in addition to a step-wise discriminant function analysis. FRS+ group with greater positive symptom score and a lower negative symptom score, showed significantly increased gamma spectral power, especially on right hemispheric regions, along with lower BDNF levels and lower scores on self-monitoring compared to FRS- and HC. Serum BDNF levels and gamma spectral power in the region corresponding right inferior parietal lobule were identified as predictors that most accurately classified the defined groups. Schizophrenia patients satisfying the criteria of presence of first rank symptoms represent a distinct neurodevelopmental subgroup with associated features of predominantly positive symptoms, significantly lower neurotrophin levels, aberrant resting state brain activity in the heteromodal association cortex and performing poorer on self-monitoring tasks.


Operando monitoring of thermal runaway in commercial lithium-ion cells via advanced lab-on-fiber technologies.
Operando monitoring of complex physical and chemical activities inside rechargeable lithium-ion batteries during thermal runaway is critical to understanding thermal runaway mechanisms and giving early warning of safety-related failure. However, most existing sensors cannot survive during such extremely hazardous thermal runaway processes (temperature up to 500 °C accompanied by fire and explosion). To address this, we develop a compact and multifunctional optical fiber sensor (12 mm in length and 125 µm in diameter) capable of insertion into commercial 18650 cells to continuously monitor internal temperature and pressure effects during cell thermal runaway. We observe a stable and reproducible correlation between the cell thermal runaway and the optical response. The sensor's signal shows two internal pressure peaks corresponding to safety venting and initiation of thermal runaway. Further analysis reveals that a scalable solution for predicting imminent thermal runaway is the detection of the abrupt turning range of the differential curves of cell temperature and pressure, which corresponds to an internal transformation between the cell reversible and irreversible reactions. By raising an alert even before safety venting, this new operando measurement tool can provide crucial capabilities in cell safety assessment and warning of thermal runaway.


Effectiveness of salvage catheters in home parenteral nutrition: A single-center study and systematic literature review.
There are sparse data regarding the rate of catheter salvage and long-term effectiveness of antibiotic lock treatment outcome after central line-associated bloodstream infections (CLABSI). Objectives were to analyze the effectiveness of central venous catheter (CVC) rescue strategy and its impact on catheter lifespan. Secondary objective included effectiveness of taurolidine+4% citrate in primary prevention, compared to a secondary prevention strategy, by analyzing infection incidence during two successive periods. Real-life 5-year observational study assessing CLABSI occurrence and CVC salvage outcomes in adult patients requiring Home Parenteral Nutrition (HPN) managed in a single-center Intestinal Failure Unit. Over the 5-year period, there were 106 confirmed infections (63/143 patients (44%)). Infection incidence was 0.92/1000 catheter-days. Incidence was 1.02/1000 catheter-days during the taurolidine+4% citrate period while lower at 0.84/1000 catheter-days (p = 0.034) during the systematic taurolidine lock period. Of the total number of infections, 89 CVCs were immediately removed and 17 were salvaged. The success rate of catheter salvage with antibiotic lock was 82.4%, with 53% remaining CLABSI-free at one year. The salvage strategy extended catheter lifespan by a median 165 days (IQR 50-214). However, the rate of new infection was significantly higher in instances of salvage (71.4%) vs. removal (36%). Parenteral Nutrition (PN) ≥12 months (p = 0.002), PN (vs. hydroelectrolytic support) (p = 0.028) and self-management by patients (p = 0.049) were independent risk factors of CLABSI. Catheter salvage appears to be an effective long-term strategy with >50% of CVCs remaining CLABSI-free at one year and a prolonged catheter life, although may expose to a more frequent and earlier infection recurrence. Cohort approved by the French CNIL (National Committee for Data Protection, authorization number CNIL 2015-25). referred to as "observational research", "non-interventional", or « non-RIPH ».


Obstetric and Neonatal Adversities, Parity, and Tourette Syndrome: A Nationwide Registry.
To determine the relationships between parity, obstetric adversities, neonatal factors, and Tourette syndrome in a large nationwide cohort. This nationwide, register-based, nested case-control study identified all children diagnosed with Tourette syndrome born between 1991 and 2010 from the Finnish Hospital Discharge Register (n = 767). Each case was matched to 4 controls. Information on parity, obstetric, and neonatal factors was obtained from the Finnish Medical Birth Register. Conditional logistic regression was used to determine the relationship between parity, obstetric, and neonatal factors, and Tourette syndrome. Nulliparity was associated with increased odds for Tourette syndrome (OR 1.7, 95% CI 1.4-2.2), and 3 or more previous births was associated with decreased odds for Tourette syndrome (OR 0.5, 95% CI 0.3-0.9) compared with parity 1-2. Birth weight 4000-4499 g was associated with decreased odds for Tourette syndrome (OR 0.7, 95% CI 0.5-0.9). Low birth weight, gestational age, weight for gestational age, Apgar score at 1 minute, induced labor, birth type or presentation, neonatal treatment, or maternal blood pressure were not associated with Tourette syndrome. Increasing parity and high birth weight are associated with decreased odds for Tourette syndrome.


The management of dislocated lens material after phacoemulsification.
To determine the visual outcome, prognostic factors, and effect of timing of surgical intervention in patients with retained lens fragments after phacoemulsification. A retrospective review was carried out of the notes of 44 consecutive patients who suffered posterior dislocation of lens fragments during phacoemulsification, of whom 34 underwent vitrectomy. The presence of severe uveitis at presentation was a significant predictor of a final visual acuity of less than 6/60 (p = 0.002). A raised intraocular pressure at presentation (> 29 mmHg) significantly increased the risk of chronic glaucoma (p = 0.0279), but there was no association between glaucoma and delay in vitrectomy. Patients operated on within 1 week of cataract surgery obtained a better visual outcome (64.7%) of patients achieved 6/12 or better visual acuity) than those operated on later than 1 week (41% obtained 6/12), but this difference did not reach statistical significance. The trend towards a better visual outcome with early vitrectomy was not statistically significant. A large prospective trial is indicated to determine the optimum time for vitrectomy in these patients.


Inter- and intra-observer variability of the AO/OTA classification for sternal fractures: a validation study.
Recently, a new classification system for sternal fractures has been published in the Journal of Orthopedic trauma by the Arbeitsgemeinschaft für Osteosynthesefragen (AO) foundation and the Orthopaedic Trauma Association (OTA). The aim of this study was to evaluate inter- and intra-observer variability of the AO/OTA classification for sternal fractures. Twenty multidetector computed tomography (CT) scans of patients with sternal fractures were classified independently by six senior and six junior orthopedic trauma surgeons of two level-1 trauma centers. Assessment was done on two occasions with an interval of 6 weeks. The kappa value was calculated to determine variability. The inter-observer variability of the AO/OTA classification for sternal fractures showed fair-to-moderate agreement (kappa = 0.364). There was no significant difference between junior and senior surgeons. Analyses of the separate components of the classification demonstrated that agreement was lowest for classifying fracture type within the sternal body (kappa = 0.319) followed by manubrium (kappa = 0.525). The intra-observer variability showed moderate agreement with a mean kappa of 0.414. The inter- and intra-observer variability of the AO/OTA classification for sternal fractures shows fair-to-moderate agreement. The overall performance of the classification might be improved with minor modifications. Diagnostic cross-sectional study (level I).


Suboptimal performance on neuropsychological tests in patients with suspected chronic toxic encephalopathy.
Suboptimal performance during neuropsychological testing can seriously complicate assessment in behavioral neurotoxicology. We present data on the prevalence of suboptimal performance in a group of Dutch patients with suspected chronic toxic encephalopathy (CTE) after long-term occupational exposure to solvents. One hundred and forty-five subjects referred to one of two Dutch national assessment centers for CTE were administered the Amsterdam Short-Term Memory Test (ASTM) and the Test of Memory Malingering (TOMM), two tests specifically developed for the detection of suboptimal performance. For both tests, very cautious cut-off scores were chosen with a specificity of 99%. Results indicated that suboptimal performance appears to be a substantial problem in this group of patients with suspected CTE after long-term exposure to organic solvents. Only 54% of our subjects obtained normal scores on both tests of malingering, i.e. at or above cut-off score. The two tests seemed to measure the same concept in that nearly all the subjects with low TOMM scores also had low ASTM scores. However, a higher proportion of subjects scored below the cut-off on the ASTM than on the TOMM.


Oral cancer awareness and knowledge: Survey of dentists in Democratic Republic of the Congo.
Oral cancer (OC) is one of the global diseases that is the eighth rank among different others. Early intervention therapy had a positive impact on increasing the prognosis and the survival rate up to 5 years. The aim of the current study was to evaluate the knowledge, attitude, and practice of dentists about OC in the Democratic Republic of the Congo (DRC). It was a cross-sectional analytical survey conducted in the primary oral health care centers in DR. Congo from February to April 2021. Only dentists working at any of the primary oral health care centers, public or private was included. Data were collected by using a survey of a 33-item questionnaire. The practice level, knowledge, risk factors, diagnosis for OC, attitude, and opinions of the dentists were recorded and evaluated. The SPSS 20 was used for data analysis and P < 0.05 was considered significant. Out of 162 dentists recorded, 65.4% were male and 34.6% were females. Half of the dentists (50.6%) had more than 5-15 years of practical experience, and 81.5% of the participants were general practice dentists. A majority of dentists were not familiar with the proper physical oral examination steps (80.2%). The practice level of the dentists was highly poor. The knowledge level about clinical features and diagnostic procedures (frequent anatomical region, common type of OC, associated factor with OC, frequent stage diagnosis of OC, and condition associated with OC) was very low. The dentists' gender was associated with a poor level of practice (P = 0.009). However, the age experience of work was associated with the high knowledge of the clinical presentation of oral cancer (P = 0.040). The dentists in DRC have obvious problems in the knowledge of OC diagnosis. More continued education and training programs for dentists would serve to address the knowledge deficits and practice shortcomings about oral cancer screening, prevention, and early detection.


Linkage between bacterial community-mediated hydrogen peroxide detoxification and the growth of Microcystis aeruginosa.
Microcystis aeruginosa, an important cyanobloom-forming cyanobacterium, is sensitive to the high light intensity and consequent oxidative stress. Based on our genomic and transcriptomic analyses of H2O2-treated cells, many genes involved in photosynthesis, Calvin cycle, and microcystin synthesis were downregulated, whereas several toxin-antitoxin genes, DNA repair genes, and H2O2-defense systems such as peroxiredoxins and glutathione synthesis were upregulated. Axenic M. aeruginosa was then co-cultured with synthetic bacterial communities collected from 15 different freshwater samples with exhibiting different degrees of H2O2-production and catalase activities. Our analyses indicated that H2O2-resistant bacterial communities favored the growth and photosynthetic activity of M. aeruginosa cells under either H2O2 treatment or high light conditions. Nanopore-based bacterial community analyses indicated that these growth-promoting effects were likely attributable to a high proportion of Alphaproteobacteria (e.g., Brevundimonas and Ochrobactrum species), which protected M. aeruginosa cells from H2O2 toxicity. Further, these bacterial communities exhibited higher catalase activity levels and faster O2 production rates upon H2O2 detoxification. Taken together, our findings newly suggest that the occurrence of catalase-less M. aeruginosa blooms is largely influenced by the surrounding microbiota during high light and organic-rich conditions.


Association of cold receptor TRPM8 gene polymorphism with blood lipid indices and anthropometric parameters in Shorians.
We analyzed single nucleotide polymorphisms of the cold receptor TRPM8 gene as genetic markers of blood serum lipid indices in Shorians. Associations were found between rs11562975 (L250L) TRPM8 gene mononucleotide polymorphism with total cholesterol and LDL cholesterol and between rs28901637 (P249P) and HDL cholesterol. No associations of P249P and L250L with triglyceride level were found. L250L polymorphism was associated with anthropometric parameters characterizing lipid metabolism (hip and waist circumferences). The TRPM8 gene is likely to be involved in the regulation of lipid metabolism.


A mysterious extrafraction in the gamma area of protein electrophoresis in dialysis patients is found to be fibrinogen.
The appearance of a heretofore unnoticed extrafraction in the gamma protein electrophoresis of 17 dialyzed patients was linked to the modified Shaldon dialysis catheter. Medication interference, infection, and immunological or hematological disease as causative factors were ruled out. After initial contradictory results, the extrafraction was determined to be fibrinogen, present because of the slow release of heparin contained in the catheter, so that electrophoresis was performed on plasma instead of on serum.


Generation of hard x rays by femtosecond laser pulse interaction with solid targets in atmosphere.
X ray radiation as high as 50 keV, including K(α) of Ba and Mo, have been observed from a solid target during the interaction of low energy ~0.65 mJ, 1 kHz 40 femtosecond laser pulses focused in air at atmospheric pressure. Energetic electrons generating such x rays are possibly produced when the field strength in laser pulse wake exceeds the runaway threshold in air. Two dimensional particle-in-cell simulations that include optical field ionization of air and elastic collisions support this mechanism.


Selective removal of phosphate from aqueous solution by MIL-101(Fe)/bagasse composite prepared through bagasse size control.
MIL-101(Fe)/sugarcane bagasse (SCB) with high adsorption capacity and selectivity toward phosphate was prepared through in-situ synthesis method. Effects of bagasse size on the morphology and performances of the composites were investigated, and adsorption behavior and mechanism of phosphate on the composite prepared at the optimum bagasse size were studied. Results showed that composite prepared with bagasse size of 200-300 mesh (MIL-101(Fe)/SCB3) showed much higher adsorption capacity than SCB, blank MIL-101(Fe) and the composites prepared with the other bagasse size, which was due to the more positively charged surface and the more exposed adsorption active sites including FeOHx and exchangeable Cl-. Co-ions experimental results illustrated that the as prepared MIL-101(Fe)/SCB3 showed high adsorption affinity toward phosphate, and the common cationic and anionic ions exhibited negligible effects on phosphate adsorption capacity and rate. The optimum pH range for phosphate adsorption on MIL-101(Fe)/SCB3 was from 3.0 to 10.0, and in this range Fe release was less than 0.03%. Adsorption mechanism showed that phosphate was adsorbed mainly through electrostatic force, ion-exchange, and inner-sphere surface complex. Simulated wastewater treatment experiment showed that MIL-101(Fe)/SCB3 could efficiently remove phosphate from aqueous solution.


Cytokinin signaling.
Cytokinins influence many aspects of plant growth and development. The current model for cytokinin signaling is a multi-step phosphorelay similar to the prokaryotic two-component systems that are used in responses to environmental stimuli. Recently, progress has been made in improving our understanding of the molecular mechanism that underlies cytokinin signaling. Molecular and genetic analyses of loss-of-function mutants indicate that the two-component elements that are involved in cytokinin signaling have redundant and overlapping functions. These elements regulate both the shoot and root meristems, are required for the development of fertile flowers, and modulate the response to varying nutrient levels.


Physicians who experience sickness certification as a work environmental problem: where do they work and what specific problems do they have? A nationwide survey in Sweden.
In a recent study, 11% of the Swedish physicians below 65 years dealing with sickness certification tasks (SCT) experienced SCT to a great extent as a work environment problem (WEP). This study aimed at exploring which SCT problems those physicians experienced and if these problems varied between general practitioners (GPs), psychiatrists, orthopaedists and physicians working at other types of clinics. A cross-sectional nationwide questionnaire study. All physicians working in Sweden in 2008. The 1554 physicians <65 years old, working in a clinical setting, having SCT and stating SCT to a great extent being a WEP. Frequency of possibly problematic situations or lack of time, reasons for sickness certifying unnecessarily long, experience of difficulties in contacts with sickness insurance offices, and severity of experienced problems. In all, 79% of this group of physicians experienced SCT as problematic at least once weekly, significantly higher proportion among GPs (p<0.001) and psychiatrists (p=0.005). A majority (at most 68.3%) experienced lack of time daily, when handling SCT, the proportion being significantly higher among orthopaedists (p=0.003, 0.007 and 0.011 on three respective items about lack of time). Among psychiatrists, a significantly higher proportion (p<0.001) stated wanting a patient coordinator. Also, GPs agreed to a higher extent (p<0.001) to finding 14 different SCT tasks as 'very problematic'. The main problem among physicians who experience SCT to a great extent as a WEP was lack of time related to SCT. The proportion of physicians experiencing problems varied in many aspects significantly between the different work clinics; however, GPs were among the highest in most types of problems. The results indicate that measures for improving physicians' sickness certification practices should be focused on organisational as well as professional level and that the needs in these aspects differ between specialties.


A modified juvenile arthritis damage index to improve articular damage assessment in juvenile idiopathic arthritis--enthesitis-related arthritis (JIA-ERA).
Juvenile arthritis damage index (JADI) consists of two parts which measure articular (JADI-A) and extra-articular (JADI-E) damage in patients with juvenile idiopathic arthritis (JIA). It does not include assessment of cardiac dysfunction and joint areas commonly affected in enthesitis-related arthritis (ERA) category of JIA. We have tried to study if modification of JADI will improve its performance in JIA-ERA. We studied 101 consecutive patients of JIA-ERA. JADI-A was modified (JADI-AM) to include damage assessment of tarsal joints and lumbar spine. JADI-E was modified (JADI-EM) to include assessment of symptomatic cardiac dysfunction. The performances of the modified and standard JADI were compared. Ninety-seven patients were male. The median age was 18 years (9-36). At a median disease duration of 6 years (1-24), joint damage was observed in 47 as assessed by JADI-A. JADI-AM could identify 11 more patients (N = 58) with articular damage. JADI-AM had good correlation with number of joints with limitation of movement (Spearman's [rS] = 0.9) and low to moderate correlation (rS < 0.7) with measures of disease activity and functional status. JADI-AM discriminated well among patients with different disability levels. Extra-articular damage was observed in 35, and modification of JADI-E with inclusion of cardiac dysfunction did not identify any additional patient. Thus, we propose a modification of the JADI-A (JADI-AM). In JIA-ERA, modification of JADI-A improves its ability to identify articular damage. Modification of the JADI-E may not be needed as symptomatic cardiac involvement is rare.


Penetrating trauma to the kidney and Meckel's Diverticulum in a patient with unilateral renal agenesis.
Emergency laparotomy for abdominal gunshot wounds is frequently performed in South Africa and remains associated with significant morbidity and mortality. The occurrence of congenital anomalies during surgery is an unexpected finding and presents a major challenge. The successful management of a haemodynamically unstable 26-year-old man with unilateral renal agenesis, concomitant right renal and hepatic injuries, and a transected Meckel's Diverticulum following an abdominal gunshot wound is presented. Intraoperative decision-making is difficult when congenital visceral anomalies form part of the injury complex in trauma. Basic principles of damage control surgery that include initial exploration, secondary resuscitation and definite operation must be adhered to. Repair of complex injuries are delayed until the definitive laparotomy. The presence of one congenital anomaly should alert the surgeon to the possibility of further anomalies. Although congenital visceral anomalies are spectacular findings at laparotomy, they should not distract the trauma surgeon. Adhering to damage control surgery principles and careful inspection of the peritoneal cavity for further abnormalities remain the mainstay of successful management.


Summer-winter differences of PM2.5 toxicity to human alveolar epithelial cells (A549) and the roles of transition metals.
Atmospheric fine particulate matters (PM2.5) induce adverse human health effects through inhalation, and the harmful effects of PM2.5 are determined not only by its air concentrations, but also by the particle components varied temporally. To investigate seasonal differences of the aerosol toxicity effects including cell viability and membrane damage, cell oxidative stress and responses of inflammatory cytokines, the human lung epithelial cells (A549) were exposed to PM2.5 samples collected in both summer and winter by the in vitro toxicity bioassays. Toxicological results showed that, the PM2.5 led to the cell viability decrease, cell membrane injury, oxidative stress level increase and inflammatory responses in a dose-dependent manner. Temporally, the cytotoxicity of winter PM2.5 was higher than summer of this studied industrial area of Nanjing, China. According to the different contents of heavy metals accumulated in PM2.5, the transition metals such as Cu might be an important contributor to the aerosol cell toxicity.


Quantum mechanical description of the interactions between DNA and water.
In recent years, a lot of attention has been focused on the electronic properties of DNA. With recent advances in linear scaling quantum mechanics there are now new tools available to enhance our understanding of the electronic properties of DNA among other biomolecules. Using both explicit solvent models and implicit (continuum) solvent models, the electronic characteristics of a dodecamer duplex DNA have been fully studied using both divide and conquer (D&C), semi-empirical quantum mechanics and non-D&C semi-empirical quantum mechanics. According to the AM1 Hamiltonian, approximately 3.5 electrons (approximately 0.3 electron/base pair) are transferred from the duplex to the solvent. According to the density of state (DOS) analysis, in vacuo DNA has a band gap of approximately 1 eV showing that in the absence of solvent, the DNA may exhibit similar properties to those of a semiconductor. Upon increasing solvation (2.5-5.5 A), the band gap ranges from approximately 3 eV to approximately 6 eV. For the implicit solvent model, the band gap continues this widening trend to approximately 7 eV. Therefore, upon solvation and in the absence of dopants, the DNA should begin to loose its conductive properties. Finally, when one considers the energy and localization of the frontier orbitals (HOMO and LUMO), solvent has a stabilizing effect on the DNA system. The energy of the HOMO drops from approximately 15 eV in vacuo to approximately 2 eV for 5.5 A of water to approximately -8 eV for the implicit solvent model. Similarly, the LUMO drops from approximately 16 eV for in vacuo to approximately 9 eV for 5.5 A of water to approximately -1 eV for the implicit model. Beyond the importance of the computed results on the materials properties of DNA, the present work also shows that the behavior of intercalators will be affected by the electronic properties of DNA. This could have an impact on our understanding of how DNA based drugs interact with DNA and on the design of new DNA based small molecule drugs.


Need to Bring Family to the Heart of Healthcare as it is Home, not a Hospital, Where Healthcare Begins and Ends.
Today the patients and their families are 'powerless' recipients of healthcare services. The healthcare services are siloed and fragmented and getting worse with an increasing array of specialists and subspecialists who "patch up" patients and send them back home. It is important for healthcare providers to become involved in the process of health promotion, prevention, and recovery. For successful implementation of this family-level care needs to be recognized and integrated into all policies, guidelines of the government, and healthcare providers reoriented through in-service and basic training.


Effects of laminectomy and facetectomy on the stability of the lumbar motion segment.
A ligamentous, nonlinear, sliding contact, three-dimensional finite element (FE) model of L2-L3 complex was developed to investigate the biomechanical effect of laminectomy with and without facetectomy. The L2-L3 FE model was validated against experimental study under various physiological loadings and found to match well with the experimental data. Four iatrogenic models (unilateral laminectomy, unilateral laminectomy with unilateral facetectomy, unilateral laminectomy with bilateral facetectomy and total bilateral laminectomy) were evaluated under flexion, extension, torsion, lateral bending, anterior and posterior shear load vectors to determine alterations in kinematics and annulus stress. Results show that total laminectomy with facetectomy induces considerable increase in motion and annulus stress, except for lateral bending, whereas unilateral laminectomy shows the least increases.


Surfactant replacement therapy in neonatal respiratory distress syndrome. A multi-centre, randomized clinical trial: comparison of high- versus low-dose of surfactant TA.
We conducted a prospective, randomized, controlled trial comparing the efficacy of two doses of a reconstituted bovine surfactant (Surfactant TA) in premature infants requiring mechanical ventilation shortly after birth for respiratory distress syndrome. Forty-six infants weighting 1000-1499 g were randomized into two groups: a low-dose group (23 infants given a single dose of 60 mg surfactant lipid/kg) and a high-dose group (23 infants given a single dose of 120 mg/kg). The mean (SD) age at which surfactant was given was 5.5 (+/- 1.2) h in the low-dose group and 6.0 (+/- 1.5) h in the high dose group. Both treatments improved oxygenation (increased arterial-alveolar PO2 ratio) with decreased mean airway pressure, the high-dose surfactant having a more beneficial effect in prolonging the response. Infants in the high-dose group had significantly less (P less than 0.05) incidence of both intraventricular haemorrhage and bronchopulmonary dysplasia. This prospective trial documents that a greater benefit can be obtained by increasing the dose of surfactant (120 mg/kg) beyond 60 mg/kg treatment of premature infants with severe respiratory distress syndrome (RDS).


Parsley (Petroselinum crispum Mill.): A source of bioactive compounds as a domestic strategy to minimize cholesterol oxidation during the thermal preparation of omelets.
This study evaluated the protective effect of parsley (Petroselinum crispum Mill.) against lipid and cholesterol oxidation in omelets prepared by air frying, pan frying, and microwaving. The bioactive composition and in vitro antioxidant capacity of parsley extract was characterized. Compounds such as phenolic acids and their derivatives (p-coumaric acid, p-coumaric acid 4-O-hexoside) and flavonoids (apigenin 7-glucoside, quercetin-O-pentosyl-hexoside) were identified in parsley by UHPLC-ESI-MS. Moreover, the presence of these bioactive constituents was investigated in omelets. Cooking induced lipid oxidation and increased the level of cholesterol oxidation products (COPs) in control omelets, which was more pronounced after air frying and microwaving. The total content of COPs increased from 40.69 ± 2.26 μg/g (raw) to 821.05 ± 13.77 μg/g (air frying), 805.21 ± 14.50 μg/g (microwaving), and 311.07 ± 13.84 μg/g (pan frying). The addition of parsley proved to be effective reducing COPs formation, mainly in air-fried samples with 0.75% parsley (81.73% of protection). Chromatographic analyses revealed the thermo-degradation of parsley compounds, since only two flavonoids detected in parsley were found in omelets containing the herb after cooking. Nonetheless, these findings indicate the potential application of parsley as a natural inhibitor of cholesterol and lipid oxidation in food systems such as omelets.


Macrophage proinflammatory response to Francisella tularensis live vaccine strain requires coordination of multiple signaling pathways.
The macrophage proinflammatory response to Francisella tularensis (Ft) live vaccine strain (LVS) was shown previously to be TLR2 dependent. The observation that intracellular Ft LVS colocalizes with TLR2 and MyD88 inside macrophages suggested that Ft LVS might signal from within the phagosome. Macrophages infected with LVSDeltaiglC, a Ft LVS mutant that fails to escape from the phagosome, displayed greatly increased expression of a subset of TLR2-dependent, proinflammatory genes (e.g., Tnf) but decreased expression of others (e.g., Ifnb1). This latter subset was similarly mitigated in IFN-beta(-/-) macrophages indicating that while Ft LVS-induced TLR2 signaling is necessary, cytosolic sensing of Ft to induce IFN-beta is required for full induction of the macrophage proinflammatory response. Although LVSDeltaiglC greatly increased IL-1beta mRNA in wild-type macrophages, protein secretion was not observed. IL-1beta secretion was also diminished in Ft LVS-infected IFN-beta(-/-) macrophages. rIFN-beta failed to restore IL-1beta secretion in LVSDeltaiglC-infected macrophages, suggesting that signals in addition to IFN-beta are required for assembly of the inflammasome and activation of caspase-1. IFN-beta plays a central role in controlling the macrophage bacterial burden: bacterial recovery was greater in IFN-beta(-/-) than in wild-type macrophages and treatment of Ft LVS-infected macrophages with rIFN-beta or 5,6-dimethylxanthenone-4-acetic acid, a potent IFN-beta inducer, greatly decreased the intracellular Ft LVS burden. In toto, these observations support the hypothesis that the host inflammatory response to Ft LVS is complex and requires engagement of multiple signaling pathways downstream of TLR2 including production of IFN-beta via an unknown cytosolic sensor and activation of the inflammasome.


Carcinogenic potential of hycanthone in mice and hamsters.
Hycanthone was administered to Schistosoma mansoni-infected and non-infected Syrian golden hamsters and Swiss mice by intraperitoneal and intramuscular injection of amounts up to the maximum tolerated dose. No tumors attributable to treatment were observed in hamsters. In infected mice, the overall incidence of hepatomas and hepatocellular carcinomas increased from 3.4% in untreated mice to 10.6% in those treated with hycanthone. Non-infected control mice developed 0.8% of these tumors compared to 10.2% in mice treated with hycanthone. Despite the use of high dose levels of hycanthone, statistical significance was attained only with non-infected female mice injected intraperitoneally and intramuscularly with hycanthone and then only at confidence levels of 92 and 95% respectively.


Digital Problem-Based Learning in Health Professions: Systematic Review and Meta-Analysis by the Digital Health Education Collaboration.
The use of digital education in problem-based learning, or digital problem-based learning (DPBL), is increasingly employed in health professions education. DPBL includes purely digitally delivered as well as blended problem-based learning, wherein digital and face-to-face learning are combined. The aim of this review is to evaluate the effectiveness of DPBL in improving health professionals' knowledge, skills, attitudes, and satisfaction. We used the gold-standard Cochrane methods to conduct a systematic review of randomized controlled trials (RCTs). We included studies that compared the effectiveness of DPBL with traditional learning methods or other forms of digital education in improving health professionals' knowledge, skills, attitudes, and satisfaction. Two authors independently screened studies, extracted data, and assessed the risk of bias. We contacted study authors for additional information, if necessary. We used the random-effects model in the meta-analyses. Nine RCTs involving 890 preregistration health professionals were included. Digital technology was mostly employed for presentation of problems. In three studies, PBL was delivered fully online. Digital technology modalities spanned online learning, offline learning, virtual reality, and virtual patients. The control groups consisted of traditional PBL and traditional learning. The pooled analysis of seven studies comparing the effect of DPBL and traditional PBL reported little or no difference in postintervention knowledge outcomes (standardized mean difference [SMD] 0.19, 95% CI 0.00-0.38). The pooled analysis of three studies comparing the effect of DPBL to traditional learning on postintervention knowledge outcomes favored DPBL (SMD 0.67, 95% CI 0.14-1.19). For skill development, the pooled analysis of two studies comparing DPBL to traditional PBL favored DPBL (SMD 0.30, 95% CI 0.07-0.54). Findings on attitudes and satisfaction outcomes were mixed. The included studies mostly had an unclear risk of bias. Our findings suggest that DPBL is as effective as traditional PBL and more effective than traditional learning in improving knowledge. DPBL may be more effective than traditional learning or traditional PBL in improving skills. Further studies should evaluate the use of digital technology for the delivery of other PBL components as well as PBL overall.


N-β-Methylamino-L-Alanine and Its Naturally Occurring Isomers in Cyanobacterial Blooms in Lake Winnipeg.
Cyanobacterial blooms have affected Lake Winnipeg since the mid-1990s due to an increased phosphorus loading into the lake, which has been exacerbated by stressors such as climate change and eutrophication. Aquatic ecosystems involving cyanobacteria have been found to contain N-β-methylamino-L-alanine (BMAA) and 2,4-diaminobutyric acid (DAB), non-protein amino acids that are associated with neurodegenerative disease, as well as two of the naturally occurring isomers, N-2(amino)ethylglycine (AEG) and β-amino-N-methylalanine (BAMA). We hypothesized that the cyanobacterial bloom in Lake Winnipeg produces BMAA and/or its naturally occurring isomers. Samples of cyanobacteria were collected by the Lake Winnipeg Research Consortium from standard sampling stations and blooms in July and September of 2016 and were analyzed for BMAA, DAB, AEG, and BAMA using previously published validated analytical methods. BMAA and BAMA were found in the highest concentration in the center of the north basin, the deepest and lowest-nitrogen zone of the lake, at an average concentration of 4 μg/g (collected in July and September 2016) and 1.5 mg/g (collected in July 2016), respectively. AEG and DAB were found in the highest concentration in cyanobacterial blooms from the nearshore region of the north basin, the slightly shallower and more nitrogen-rich zone of the lake, at 2.1 mg/g (collected in July 2016) and 0.2 mg/g (collected in July and September 2016), respectively. These findings indicate that the production of non-protein amino acids varies with the depth and nutrient contents of the bloom. It is important to note that we did not measure food or water samples directly and further study of the Lake Winnipeg food web is required to determine whether BMAA bioaccumulation represents an increased risk factor for neurodegenerative disease in the region.


Salivary Duct Carcinoma: An Update on Morphologic Mimics and Diagnostic Use of Androgen Receptor Immunohistochemistry.
More than 15 years ago, seminal studies by Dr. E. Leon Barnes and colleagues transformed our understanding of salivary duct carcinoma (SDC) and, in doing so, paved the way for contemporary diagnostic and therapeutic approaches to this aggressive salivary adenocarcinoma. In particular, attention to the apocrine phenotype of SDC and expression of androgen receptor (AR) by immunohistochemistry has improved the diagnostic accuracy and showed how SDC can be reliably distinguished from its morphologic mimics (i.e., other salivary gland carcinomas with high grade transformation, low grade cribriform cystadenocarcinoma, and squamous cell carcinomas involving parotid). Furthermore, the observation that SDC shares AR expression with prostate cancer and apocrine breast cancer foresaw the discovery of common molecular alterations between SDC and these tumor types and draw attention to androgen deprivation therapy for SDC patients.


Osteochondral lesions of the lateral trochlear ridge: a rare, subtle but important finding on advanced imaging in patients with elbow pain.
To characterize the radiographic, CT, and MRI appearance of clinically and/or surgically proven osteochondral lesions of the lateral trochlear ridge. Ten years of medical charts with elbow radiographic, CT, and MRI studies were retrospectively reviewed. Patients with pathology isolated to the lateral trochlear ridge were included. Studies were reviewed by two radiologists. Identifiable pathology on each type of study was noted and characterized. Ten elbow studies were included, all from males aged 15 to 58 years (mean 29 years). Five elbow radiographs were normal, one showed mixed lucency and sclerosis of the lateral trochlear ridge, and four demonstrated small osseous fragments adjacent to the ridge. In all cases, CT demonstrated focal lucency at the cortical surface of the lateral trochlear ridge; 8 contained small osseous fragments, axial plane maximum width ranged from 5 to11 mm, depth from 1 to 2 mm. Focal bone marrow edema in the subchondral lateral trochlear ridge was found in the 6 cases with MR images. Two demonstrated linear high signal underlying the in situ osseous fragment, faintly visible on MRI. In 9 cases, arthroscopy was performed within 3 months of imaging. The remaining patient was treated conservatively with casting. Osteochondral lesions of the lateral trochlear ridge are rare but important, as these patients go on to arthroscopy at a high rate. If an abnormality of the lateral trochlear ridge is seen or suspected, we recommend CT as the best imaging study to define these lesions.


Reduction of amyloid load and cerebral damage in a transgenic mouse model of Alzheimer's disease by treatment with a beta-sheet breaker peptide.
Genetic, neuropathological, and biochemical studies have provided strong evidence for a central role of amyloid in the pathogenesis of Alzheimer's disease (AD). We have proposed previously that peptides designed as beta-sheet breakers may be useful in preventing the formation of amyloid plaques. In this study, we describe a modified beta-sheet breaker peptide with improved pharmacological properties, a high rate of penetration across the blood-brain barrier, and the ability to induce a dramatic reduction in amyloid deposition in two different transgenic AD models. In addition, we report for the first time a significant increase in neuronal survival and a decrease in brain inflammation associated with the reduction of amyloid plaques. These results demonstrate that the process of amyloid deposition is one of the causes of neurodegeneration in AD. Moreover, our findings indicate that beta-sheet breaker peptides provide a valuable tool for evaluating further the importance of amyloid in the etiology of AD and suggest that these peptides or some of their derivatives might be good candidates for AD treatment.


The effects of kainic acid on the cochlear ganglion of the rat.
The effects of locally applied kainic acid on cells and fibers in the rat cochlea were examined in a quantitative and ultrastructural study. Doses of 5 nM per microliter of artificial perilymph destroyed part of the spiral ganglion type I cell population, with no ototoxic effects on cochlear hair cells or supporting cells. Type II cells also appeared unaffected. A quantitative evaluation of the cell loss with the 5 nM dosage showed that 34% of spiral ganglion neurons were lost 10 days after treatment. Doses of 20 nM per microliters and 40 nM per microliters did not result in increasing neuronal loss. This differential toxicity could reflect the presence of a sub-population of spiral ganglion cells with an increased number of KA receptors.


Catalytic co-pyrolysis of herb residue and polypropylene for pyrolysis products upgrading and diversification using nickel-X/biochar and ZSM-5 (X = iron, cobalt, copper).
It is very important to find cheap and efficient catalysts for catalytic co-pyrolysis. Catalytic co-pyrolysis of herb residue (HR) and reused polypropylene (PP) using Ni-X/biochar and ZSM-5 (X = Fe, Co, Cu) was performed to produce pyrolysis oil, pyrolysis gas and carbon nanotubes (CNTs) in a two-stage fixed bed reactor. Bimetallic biochar catalysts exhibited higher catalytic activity due to their higher specific surface area (SBET) and more strong acid sites. NiCu/biochar significantly increased the yield of pyrolysis oil by enhancing Fischer-Tropsch synthesis. In addition, the stronger secondary cracking capacity of NiCu/biochar resulted in the highest content of hydrocarbons (80.47%) and C6-C11(61.10%), while the availability of higher content of carbon source gas also facilitated the formation of CNTs and H2 at back-end. The cheap and efficient NiCu/biochar catalyst has great potential in the application of catalytic pyrolysis, which is conducive to the large-scale promotion of biomass pyrolysis technology.


Low-dose glucocorticoid can lead to hypokalemic paralysis.
Glucocorticoids are widely used in clinical practice, and a rare adverse effect of glucocorticoid administration is hypokalemic paralysis. Recently, we experienced two cases of hypokalemic paralysis after low-dose glucocorticoid administration for urticaria in healthy men. Excluding possible endocrinologic disorders, we concluded that hypokalemic paralysis could be attributed to glucocorticoid administration in our patients. Only few cases of hypokalemic paralysis induced by relatively high glucocorticoid dose are reported. In our cases, we suggest that a very low dose of glucocorticoid injection results in hypokalemic paralysis, even in healthy individuals. Clinicians should be aware that a very low dose of glucocorticoid can cause hypokalemic paralysis. Furthermore, when evaluating patient complaints of muscle weakness with hypokalemia, history of glucocorticoid administration should be thoroughly reviewed.


An integrated process for conversion of spent coffee grounds into value-added materials.
Spent coffee grounds (SCG) are inexpensive materials with a complex composition that makes them promising feedstocks for a biorefinery.Here, conversion of SCG into a wide range of high value-added products (coffee oil, bio-ethanol, D-mannose, manno-oligosaccharide (MOS), cafestol and kahweol) using a novel integrated system was evaluated. The process involves oil extraction, MOS production by mannanase obtained from Penicillium purpurogenum, NaOH (Na) and hydrogen peroxide (HP) pretreatment for the degradation of lignin and phenolic compounds, diterpenes extraction, enzymatic hydrolysis, and fermentation, which can be performed using environmentally friendly technologies. Approximately 97 mL of coffee oil, 164 g of D-mannose, 102 g of MOS, 99 g of bioethanol and a dash of cafestol/kahweol were produced from 1 kg of dry SCG. Producing high-value co-products from SCG using an integrated approach as demonstrated here may be an efficient strategy to reduce waste generation, while improving the economics of the biorefinery production process.


Thoracic Diseases With Musculoskeletal Manifestations and Vice Versa: A Review.
The purpose of this article is to review several thoracic conditions that are associated with certain musculoskeletal radiological abnormalities using imaging of patients with concomitant chest and musculoskeletal manifestations as illustrative examples. Radiologic findings of many thoracic diseases are often nonspecific. When standing alone, their interpretation commonly results in long differential diagnosis. However, in certain instances, a reasonably accurate diagnosis can be made based on imaging findings alone.


Production and characterization of antibodies against the cross-reacting determinant of glycosyl-phosphatidylinositol-anchored acetylcholinesterase.
Dimeric acetylcholinesterase is anchored in the cell membrane by a glycosyl-phosphatidylinositol attached to the C-terminus of the protein. The complex glycan contains an antigenic epitope, the cross-reacting determinant (CRD), which is only revealed after removal of the diradylglycerol by phosphatidylinositol-specific phospholipase C (PI-PLC) but is cryptic in the amphiphilic form. Polyclonal antibodies were raised against the CRD of vertebrate acetylcholinesterase. The purified anti-CRD antibodies recognized only the PI-PLC treated hydrophilic forms of acetylcholinesterase from bovine erythrocytes and Torpedo, and of variant surface glycoprotein from trypanosomes but not the corresponding amphiphilic proteins. Competition experiments showed that inositol-1,2-cyclic phosphate and glucosamine inhibited the binding of the antibodies to the CRD. Furthermore, binding of the anti-CRD antibodies to acetylcholinesterase containing N-methylated glucosamine was markedly reduced. The amphiphilic N-methylated enzyme is less sensitive to digestion with PI-PLC than the non-methylated form. From our results we conclude that inositol-1,2-cyclic phosphate and glucosamine, especially the free amine group of this residue, contribute significantly to the epitope recognized by the anti-CRD antibodies.


The effect of thalidomide on neovascularization in a mouse model of retinopathy of prematurity.
Abnormal angiogenesis is the hallmark feature of retinopathy of prematurity (ROP), and contributes to the severe visual loss that accompanies this disease. Thalidomide is a well-known anti-angiogenic drug. We tested the assumption that injection of intraperitoneal thalidomide could reduce the severity of oxygen-induced retinopathy (OIR) in a mouse model. Forty-three baby wild type mice were used in this study. The mouse model of oxygen-induced retinopathy consisted of a 5-day exposure to 75% oxygen from postnatal day 7 to 12 (P12) followed by 5 days in room air (relative hypoxia). Control mice were those with normally developing retinal vasculature exposed to room air from birth until postnatal day 17 (P17). Thalidomide (200 mg/Kg) was administered daily intraperitoneally to control and ROP mice in two protocols: (1) from P12 to P16, and (2) from P11 to P15 . Fluorescein-conjugated dextran angiography of retinal vasculature was performed on P17, and retinal whole mounts were prepared to score features of retinopathy. The parameters that were scored in a masked fashion included blood vessel growth, blood vessel tufts formation, extra retinal neovascularization, degree of central constriction, and tortuosity of vessels. These parameters constitute the Modified Retinopathy Scoring System (MRSS). In addition, quantification of the number of blood vessel tufts was performed in a masked fashion with hematoxylin & eosin (H&S) staining of paraffin-embedded eye sections. The retinopathy score by MRSS in the thalidomide treated mice was similar to that of untreated mice that were exposed to oxygen (9.3 +/- 1.9 vs 10.15 +/- 1.6; p = 0.21). The neovascularization count was also similar between the two groups (10.4 +/- 5.6 vs 9.6 +/- 4.8; p = 0.56). In the control group left in the room air, the retinopathy score was 0.19 +/- 0.37 (p = 0) and the neovascularization count was also very low (2.92 +/- 2.14; p = 0). Although thalidomide might have a proven anti-angiogenic and anti-inflammatory effect, our model did not show a significant effect on the retinopathy. The reason might be an ineffective level of the drug in the retina due to ineffective metabolism of the drug, or due to blockage of the drug by the blood-retina barrier, or the involvement of other factors besides those influenced by thalidomide in the process.


Injection of Steroid in Nasal Polyps: A Systematic Review.
Chronic rhinosinusitis (CRS) is a common chronic condition classically divided into two phenotypes according to the presence or absence of nasal polyps. The effects of both medical and surgical treatment are often temporary, encouraging research into new treatment options. We performed a systematic review related to dosages, effects, side effects, and safety of intrapolyp steroid injection in patients with nasal polyps. We identified five studies with a total of 386 patients and 2490 intrapolyp steroid injections. Treatment with intrapolyp steroid injection leads to a decrease in the Total Nasal Polyps Score (TNPS), Total Nasal Symptom Score (TNSS), and Lund-Mackay Score. The dosage regimens vary from 10 to 40 mg triamcinolone acetonide. Only two cases of temporary visual complications were reported. This review found that intrapolyp steroid injection may be an effective and safe treatment for patients with nasal polyps. However, there exist no large, randomized, clinical trials. We found no association between dose and effect, or dose and the risk of visual complications.


Autocrine biological effects of glycosyl inositol phosphate produced by reconstituted pig thyroid follicles: role of pertussis toxin sensitive G proteins.
We examine the autocrine activity of glycosyl inositol phosphate (InP-gly) on thyroid metabolism. The cAMP accumulation promoted by thyrotropin (TSH) or forskolin was modulated by InP-gly, stimulated by the lowest tested concentration (10(-8) M) and progressively inhibited by higher concentrations. Iodide uptake and iodine organification were decreased in a concentration-dependent manner by InP-gly alone, or in the presence of TSH. The IAP component of pertussis toxin blocked the inhibitory action of InP-gly on cAMP accumulation by reconstituted thyroid follicles (RTF), suggesting the participation of Gi protein. But the same treatment with IAP was without effect on iodine metabolism, suggesting that there is a second target for InP-gly, more distal than Gi protein, or coupled to another G protein which is insensitive to the toxin.


Metabolic alterations in different developmental stages of Pilocarpus microphyllus.
Pilocarpine is an imidazole alkaloid that has been used for more than a century in glaucoma treatment. It is present in several species of the Pilocarpus genus (jaborandi), with its highest concentrations in P. microphyllus. In addition to pilocarpine, pilosine--an imidazole alkaloid without pharmacological use--is produced in high concentrations in mature plants. A metabolomic study was carried out on juvenile and mature plants to obtain information about pilocarpine metabolism at different developmental stages. Methanol-water and alkaloid extracts were analyzed by ¹H NMR and ESI-MS. Metabolic profiles from both techniques showed clear differences between various developmental stages. Intense signals in the aromatic region of the ¹H NMR spectrum and ions from pilosine and related alkaloids by ESI/MS were found only in extracts from mature plant. Two new imidazole alkaloids were identified by MS(n). Our results suggest that pilosine is produced exclusively in mature developmental stage, and juvenile plant material seems to be appropriate for further studies on pilocarpine biosynthesis.


White matter development and tobacco smoking in young adults: A systematic review with recommendations for future research.
Adolescence and young adulthood are critical vulnerability periods for initiation of tobacco smoking. White matter development is ongoing during this time and may be influenced by exposure to nicotine. Synthesis of findings from diffusion tensor imaging (DTI) studies of adolescent and young adult smokers may be helpful in understanding the relationship between neurodevelopment and initiation and progression of tobacco-use behaviors and in guiding further research. A systematic literature review was conducted to identify DTI studies comparing adolescent and young adult (mean age <30 years) smokers versus nonsmokers. A total of 5 studies meeting inclusion criteria were identified. Primary study findings are reviewed and discussed within the context of neurodevelopment and in relation to findings from adult studies. Directions for further research are also discussed. All identified studies reported increases in fractional anisotropy (FA) among adolescent/young adult smokers in comparison to non-smokers. Increased FA was most frequently reported in regions of the corpus callosum (genu, body and spenium), internal capsule and superior longitudinal fasciculus. Findings of increased FA among adolescent/young adult smokers are contrary to those from most adult studies and thus raise the possibility of differential effects of nicotine on white matter across the lifespan. Further research including multiple time points is needed to test this hypothesis. Other areas warranting further research include DTI studies of e-cigarette use and studies incorporating measures of pubertal stage.


Intraruminal controlled release of cyromazine for the prevention of Lucilia cuprina myiasis in sheep.
The efficacy of cyromazine, continuously released from intraruminal capsules at dose rates from 0.5 to 2 mg kg-1 d-1, was evaluated against implants of eggs and first instar larvae of Lucilia cuprina on Merino sheep. Estimates from the non-linear relationship between the success of implants and plasma concentrations showed that 95 per cent protection of sheep could be achieved at a mean release rate of 1.39 mg kg-1 d-1 cyromazine which gave rise to a mean plasma concentration of 0.26 mg litre-1. Present formulations allowed protection for about 90 days in a 40 kg sheep. The 'square wave' type of release profile provided negligible suboptimal dosing thus limiting the potential for selection of resistance. Systemic application of cyromazine provides control of covert and overt strike among sheep and could be used in ecologically based strategies for the control of L. cuprina populations.


RADS and its variants: asthma by another name.
This article describes the different clinical variants of irritant-induced asthma, specifically focusing on high-dose irritant-induced asthma and irritant-induced work-exacerbated asthma, as well as reviews known causes, addresses the often adverse medical and socioeconomic outcomes of this complex condition, and considers issues of causation from an occupational and environmental medicine perspective.


Bloodless aortic dissection.
"Bloodless aortic dissection" is a rare cause of sudden death due to an aortic dissection without intimal tears and with no blood present within the dissected aortic wall. The first case was described in 1993. Death was considered to be caused by acute myocardial ischemia from dissection involving the left coronary artery. Further cases have been described where death was thought to originate from increasing hypertension during progressive extension of the dissection followed by a sudden irritation of the subendothelially localized conduction system of the heart. The presented case involves a rapidly fatal aortic dissection in a 64 year old man without any intimal tears and no blood in the dissected aortic wall, although the dissection involved the entire aorta. Death was considered due to myocardial ischemia since the dissection had reached the aortic root and the origins of the coronary arteries.


Chemorepulsion: Moving away from improper attractions.
Eukaryotic cells can undergo chemorepulsion, but the molecular mechanisms behind this phenomenon have remained unclear. Using Dictyostelium cells, a new study shows that competition of two ligands for the same receptors results in chemorepulsion, thus revealing a simple rule for eukaryotic cells to achieve negative chemotaxis.


Reactivity of methemoglobin immobilized on TiO2 nanoparticle films.
Facile demetallation occurs upon contact of the methemoglobin with a mesoporous TiO2 host in phosphate buffer media at pH 5.5 but not in acetate buffer media. As a result, voltammetric signals previously attributed to hemoglobin-based redox processes have to be re-interpreted.


A Brazilian multicentre study evaluating pregnancies induced by cabergoline in patients harboring prolactinomas.
To evaluate the maternal-fetal outcomes of CAB-induced pregnancies in patients with prolactinoma in a large cohort. The prevalence of tumor growth, miscarriage, preterm, low birth weight, congenital malformations and impairment in neuropsychological development in children among women treated with CAB were assessed in a Brazilian multicentre retrospective observational study, RESULTS: We included 194 women with a mean age of 31 (17-45) years, 43.6% presenting microadenomas and 56.4% macroadenomas, at prolactinoma diagnosis. In 233 pregnancies, CAB was withdrawn in 89%, after pregnancy confirmation. Symptoms related to tumor growth occurred in 25 cases, more frequently in macroadenomas. The overall miscarriage rate was 11%, although higher in the subgroup of patients with CAB maintainance after pregnancy confirmation (38% vs. 7.5%). Amongst the live-birth deliveries, preterm occurred in 12%, low birth weight in 6% and congenital malformations in 4.3%. Neuropsychological development impairment was reported in 7% of cases. Our findings confirm previous results of safety in maternal and fetal outcomes in CAB-induced pregnancies; nevertheless, CAB maintenance after pregnancy confirmation was associated with higher miscarriage rate; result that must be further confirmed.


The treatment of the hepatorenal syndrome with intra-renal administration of prostaglandin E1.
Three patients with the hepatorenal syndrome were treated with prostaglandin E1 administered through a selective renal arterial catheter. Prostaglandin E1 was given in progressively increasing doses (2 to 100 ng/kg/min) over a 60-minute period. Control plasma prostaglandin E levels were elevated in all three patients, 0.98, 0.91, and 0.83 ng/ml, respectively. At the end of the infusion, plasma prostaglandin E levels had risen to 10.4, 2.63, and 10.3 ng/ml in the three patients respectively. Plasma renin activity increased during the course of the infusion in two of the patients. The plasma aldosterone concentration did not change during the prostaglandin E1 infusion. Intrarenal prostaglandin E1 failed to increase urine volume or urinary sodium concentration in three patients with the hepatorenal syndrome.


Using formal concept analysis for microarray data comparison.
Microarray technologies, which can measure tens of thousands of gene expression values simultaneously in a single experiment, have become a common research method for biomedical researchers. Computational tools to analyze microarray data for biological discovery are needed. In this paper, we investigate the feasibility of using formal concept analysis (FCA) as a tool for microarray data analysis. The method of FCA builds a (concept) lattice from the experimental data together with additional biological information. For microarray data, each vertex of the lattice corresponds to a subset of genes that are grouped together according to their expression values and some biological information related to gene function. The lattice structure of these gene sets might reflect biological relationships in the dataset. Similarities and differences between experiments can then be investigated by comparing their corresponding lattices according to various graph measures. We apply our method to microarray data derived from influenza-infected mouse lung tissue and healthy controls. Our preliminary results show the promise of our method as a tool for microarray data analysis.


Gene-environment interaction between interleukin-4 promoter and molds in childhood asthma.
To assess the role of gene-environment interaction between interleukin (IL)-4 promoter and mold exposure on the development of asthma. We conducted a cohort-based, incident, case-control study. The case group consisted of 188 children with new asthma and the control group (n = 376) was matched for age and gender. The outcome of interest was the development of asthma over the 6-year study period. The studied determinants were three polymorphisms of IL-4 promoter (TT, CT, and CC) and three indicators of exposure including histories of water damage, presence of visible molds, and perceived mold odor in the home. Apparent joint effects between IL-4 promoter and mold exposure were observed on both additive and multiplicative scales. Specially, the risk of asthma was significantly associated with children carrying the CT genotype and visible mold exposure comparing with those carrying the TT genotype without any exposure indicator (adjusted odds ratio [OR], 2.14; 95% confidence interval [CI], 1.05-4.34; modified Rothman synergy index for directly use of odds and OR [s] = 1.41; P for interaction = .03). A similar tendency was found (s = 1.30; P for interaction = .04) for children who were exposed to mold odor and carried CT genotype (adjusted OR, 1.99; 95% CI, 1.03-4.41). The results of this study suggest that gene-environment interactions between the IL-4 promoter and an indoor mold problem may play an important role in childhood asthma.


Generating dynamic carbon-dioxide traces from respiration-belt recordings: Feasibility using neural networks and application in functional magnetic resonance imaging.
In the context of functional magnetic resonance imaging (fMRI), carbon dioxide (CO2) is a well-known vasodilator that has been widely used to monitor and interrogate vascular physiology. Moreover, spontaneous fluctuations in end-tidal carbon dioxide (PETCO2) reflects changes in arterial CO2 and has been demonstrated as the largest physiological noise source for denoising the low-frequency range of the resting-state fMRI (rs-fMRI) signal. However, the majority of rs-fMRI studies do not involve CO2 recordings, and most often only heart rate and respiration are recorded. While the intrinsic link between these latter metrics and CO2 led to suggested possible analytical models, they have not been widely applied. In this proof-of-concept study, we propose a deep-learning (DL) approach to reconstruct CO2 and PETCO2 data from respiration waveforms in the resting state. We demonstrate that the one-to-one mapping between respiration and CO2 recordings can be well predicted using fully convolutional networks (FCNs), achieving a Pearson correlation coefficient (r) of 0.946 ± 0.056 with the ground truth CO2. Moreover, dynamic PETCO2 can be successfully derived from the predicted CO2, achieving r of 0.512 ± 0.269 with the ground truth. Importantly, the FCN-based methods outperform previously proposed analytical methods. In addition, we provide guidelines for quality assurance of respiration recordings for the purposes of CO2 prediction. Our results demonstrate that dynamic CO2 can be obtained from respiration-volume using neural networks, complementing the still few reports in DL of physiological fMRI signals, and paving the way for further research in DL based bio-signal processing.


Association of treatment delay and stage with mortality in breast cancer: a nationwide cohort study in Taiwan.
Breast cancer is the fifth leading cause of cancer death globally. In this retrospective study, we investigated the effects of the diagnosis-to-first-treatment interval (DFTI) and other related factors on cancer-specific survival in patients with breast cancer. We included 49,426 patients newly diagnosed as having breast cancer during 2011-2017. The Cox proportional hazards model was used to analyze the hazard ratio (HR) for mortality with various DFTIs; the HRs of the 31-60-, 61-90-, and ≥ 91-day DFTI groups did not differ significantly compared with the reference group (DFTI ≤ 30 days). After stratifying the patients according to initial tumor stage and age, we found that patients aged 55-64 and ≥ 65 years with stage II breast cancer treated ≥ 91 days after diagnosis had a 3.34- and 2.93-fold higher mortality risk (95% confidence intervals [CIs] 1.29-8.69 and 1.06-8.10, respectively). Patients aged ≥ 65 years with stage IV breast cancer treated within 61-90 or ≥ 91 days after diagnosis had a 7.14- and 34.78-fold higher mortality risk (95% CIs 1.28-39.82 and 3.08-393.32, respectively). In conclusion, DFTI is associated with mortality in patients with stage II and IV breast cancer, especially at an older age.


HB vaccination in the prevention of viral reactivation in allogeneic hematopoietic stem cell transplantation recipients with previous HBV infection.
Hepatitis B virus (HBV)-reverse seroconversion (RS) following allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a frequent late-onset complication in recipients with previous HBV infection. We followed 38 allo-HSCT recipients with previous HBV infection, and conducted posttransplant HB vaccine intervention in 13 recipients. First, we followed the recipients without any intervention (historic control) until 2003; hence, we commenced HB vaccination. Out of the patients who underwent transplantation after 2003, 13 recipients were immunized by a standard three-dose regimen after immunosuppressant cessation (vaccine group), whereas 12 recipients were observed without any intervention (nonvaccine group). Eight of the 13 historic control group recipients and 3 of the 12 nonvaccine group recipients, but none of the 13 vaccine group recipients, suffered HBV-RS. Cumulative risks of HBV-RS at 3 years post-HSCT in the historic control, nonvaccine and vaccine groups were 41%, 39%, and 0% respectively (P=.022). We therefore conclude that intervention with HB vaccines is significantly effective in preventing post-HSCT HBV-RS.


Use of complementary and alternative medicine in an urban county hospital epilepsy clinic.
We examined self-reported complementary and alternative medicine (CAM) use among a largely indigent population with epilepsy. Overall CAM use was 70%, with the most frequently reported complementary and alternative medicines (CAMs) being medical marijuana (33%), prayer/spirituality (31%), meditation (19%), vitamins (19%), and stress management (16%). Forty-four percent of patients reported improved seizure control with CAMs. Stress management accounted for perceived seizure reduction in 74%, followed by marijuana (54%), prayer (49%), and yoga (42%). Among the most commonly used and helpful CAMs, stress management was not associated with specific demographic or clinical variables; marijuana use was significantly associated with lower age (users=35.2±10 years vs. nonusers=41.6±12; p<0.01) and lower income (under $15,000 40% use vs. 14% over $15,000; p<0.05); and prayer was significantly associated with female gender (male=21% vs. female=45%; p<0.01) and Black ethnicity (Black=55% vs. Hispanic=30% vs. White=23%; p<0.05). Taken together, our study was notable for the high rate of CAM utilization in a largely indigent population, with high rates of perceived efficacy among several CAM modalities.


Automated elaborate resection planning for bone tumor surgery.
Planning for bone tumor resection surgery is a technically demanding and time-consuming task, reliant on manual positioning of planar cuts in a virtual space. More elaborate cutting approaches may be possible through the use of surgical robots or patient-specific instruments; however, methods for preparing such a resection plan must be developed. This work describes an automated approach for generating conformal bone tumor resection plans, where the resection geometry is defined by the convex hull of the tumor, and a focal point. The resection geometry is optimized using particle swarm, where the volume of healthy bone collaterally resected with the tumor is minimized. The approach was compared to manually prepared planar resection plans from an experienced surgeon for 20 tumor cases. It was found that algorithm-generated hull-type resections greatly reduced the volume of collaterally resected healthy bone. The hull-type resections resulted in statistically significant improvements compared to the manual approach (paired t test, p < 0.001). The described approach has potential to improve patient outcomes by reducing the volume of healthy bone collaterally resected with the tumor and preserving nearby critical anatomy.


The nonstructural proteins of Nipah virus play a key role in pathogenicity in experimentally infected animals.
Nipah virus (NiV) P gene encodes P protein and three accessory proteins (V, C and W). It has been reported that all four P gene products have IFN antagonist activity when the proteins were transiently expressed. However, the role of those accessory proteins in natural infection with NiV remains unknown. We generated recombinant NiVs lacking V, C or W protein, rNiV(V-), rNiV(C-), and rNiV(W-), respectively, to analyze the functions of these proteins in infected cells and the implications in in vivo pathogenicity. All the recombinants grew well in cell culture, although the maximum titers of rNiV(V-) and rNiV(C-) were lower than the other recombinants. The rNiV(V-), rNiV(C-) and rNiV(W-) suppressed the IFN response as well as the parental rNiV, thereby indicating that the lack of each accessory protein does not significantly affect the inhibition of IFN signaling in infected cells. In experimentally infected golden hamsters, rNiV(V-) and rNiV(C-) but not the rNiV(W-) virus showed a significant reduction in virulence. These results suggest that V and C proteins play key roles in NiV pathogenicity, and the roles are independent of their IFN-antagonist activity. This is the first report that identifies the molecular determinants of NiV in pathogenicity in vivo.


Behavioral and electrophysiological effects of pallidal GABAB receptor activation and blockade on haloperidol-induced akinesia in rats.
The globus pallidus plays an important role in movement regulation. Morphological studies have revealed GABA(B) receptor expression in the globus pallidus. To investigate the behavioral and electrophysiological effects of pallidal GABA(B) receptors on haloperidol-induced akinesia, microinjection and extracellular recordings were performed in the present study. Unilateral microinjection of GABA(B) receptor agonist, baclofen, into globus pallidus produced ipsilateral dystonic posturing in haloperidol-induced akinesia rats. However, microinjection of GABA(B) receptor antagonist, CGP55845, induced contralateral dystonic posturing, suggesting the tonic activity of pallidal GABAergic neurotransmission. Micro-pressure ejection of baclofen into globus pallidus decreased the spontaneous firing of pallidal neurons. Furthermore, local administration of CGP55845 alone induced a weak but consistent increase in the frequency of pallidal firing. The presence of CGP55845 prevented baclofen-induced effects completely. From the present in vivo findings it may be concluded that pallidal GABA(B) receptors may contribute to the therapy of parkinsonian akinesia by modulating the activity of globus pallidus.


Monitoring of veterinary drug residues by a combination of continuous flow techniques and column-switching high-performance liquid chromatography. I. Sulphonamides in egg, meat and milk using post-column derivatization with dimethylaminobenzaldehyde.
By using a combination of a low-pressure continuous flow module and a column-switching high-performance liquid chromatographic system, procedures have been developed for the automated residue analysis of sulphonamides and selected other drugs in meat, egg and milk. Aqueous extracts are purified by on-line dialysis and subsequent trace enrichment on a short column containing silica-based or polymer material. After backflush to the analytical column, detection is performed either at 280 nm or, after post-column derivatization with p-dimethylaminobenzaldehyde, at 450 nm. With these procedures the fully automated determination of both polar and apolar sulphonamides and dapsone above 5-20 micrograms/kg is possible. Coefficients of variation are 4-10%, recoveries compared to standards are 85-90%. The methods developed were tested in routine veterinary drug control.


Apparent and Actual Trajectory Control Depend on the Behavioral Context in Upper Limb Motor Tasks.
A central problem in motor neuroscience is to understand how we select, plan, and control motor actions. An influential idea is that the motor system computes and implements a desired limb trajectory, an intermediary control process between the behavioral goal (reach a spatial goal) and motor commands to move the limb. The most compelling evidence for trajectory control is that corrective responses are directed back toward the unperturbed trajectory when the limb is disturbed during movement. However, the idea of trajectory control conflicts with optimal control theories that emphasize goal-directed motor corrections. Here we show that corrective responses in human subjects can deviate back toward the unperturbed trajectory, but these reversals were only present when there were explicit limits on movement time. Our second experiment asked whether trajectory control could be generated if the trajectory was made an explicit goal of the task. Participants countered unexpected loads while reaching to a static goal, tracking a moving target, or maintaining their hand within a visually constrained path to a static goal. Corrective responses were directed back toward the constrained path or to intercept the moving target. However, corrections back to the unperturbed path disappeared when reaching to the static target. Long-latency muscle responses paralleled changes in the behavioral goal in both sets of experiments, but goal-directed responses were delayed by 15-25 ms when tracking the moving goal. Our results show the motor system can behave like a trajectory controller but only if a "desired trajectory" is the goal of the task. Significance statement: One of the most influential ideas in motor control is that the motor system computes a "desired trajectory" when reaching to a spatial goal. Here we revisit the experimental paradigm from seminal papers supporting trajectory control to illustrate that corrective responses appear to return to the original trajectory of the limb, but only if there is an imposed timing constraint. We then provide direct evidence that the human motor system can behave like a trajectory controller, and return the limb to its original trajectory when a specified trajectory is the goal of the task. Our results show that the motor system is capable of a spectrum of corrective responses that depend on the behavioral goal of the motor task.


Comparison study of intraarticular and intravenous gadolinium-enhanced magnetic resonance imaging of cartilage in a canine model.
Magnetic resonance (MR) imaging and measurement of glycosaminoglycan (GAG) have potential for characterization of hyaline articular cartilage. Recently, some reports have demonstrated the potential of direct administration of contrast media for MR imaging of cartilage. To prove the feasibility of intraarticular gadolinium-enhanced MR imaging of cartilage (iGEMRIC) and T1 relaxation mapping of the articular cartilage in vivo with intraarticular injection of Gd-DTPA2-. Five healthy beagle dogs underwent MR imaging and T1 relaxation mapping of the knee joints of both hind legs. The delayed gadolinium-enhanced MR imaging of cartilage (dGEMRIC) and iGEMRIC techniques were interchanged with MR imaging. For dGEMRIC, a double routine dose of Gd-DTPA2- (0.2 mM/kg) was administered intravenously. For iGEMRIC, 2.5 and 1.25 mmol/l saline-diluted Gd-DTPA2- solutions were separately injected into the right and left knee joints, respectively, prior to MR imaging. Color-coded T1 maps of 20 femoral condyles were obtained from the dGEMRIC and iGEMRIC images. The signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and glycosaminoglycan (GAG) delineation of articular cartilage were compared between the dGEMRIC and iGEMRIC techniques. The mean SNR was higher with dGEMRIC than with iGEMRIC, but the difference was not statistically significant (P=0.174). The mean (+/-SD) CNR was higher with iGEMRIC (-11.6+/-3.4) than with dGEMRIC (-16.7+/-4.0; P=0.000), although the absolute value of the CNR was higher with dGEMRIC. The layering and gradient distribution of GAG were more clearly visualized on the iGEMRIC images. The mean scores of GAG delineation with dGEMRIC and iGEMRIC were 0.7+/-0.6 and 2.2+/-1.7, respectively. The iGEMRIC method better visualized GAG distribution (P=0.001). Although the SNR did not differ significantly between the iGEMRIC and dGEMRIC techniques, the color-coded T1 map produced with iGEMRIC allowed better cartilage evaluation. Thus, iGEMRIC exhibits the useful features of both MR arthrography and dGEMRIC, and provides a color-coded T1 map that is useful for diagnosing early articular cartilage damage.