It's right, but risky too: Inclusive behavior as a positive risk in adolescence.
Although adolescent risk-taking is often characterized as negative, more recent work focuses on risk as a spectrum of negative to positive behaviors. We propose inclusive behavior as a new category of positive risk-taking focused on helping and facilitating social belonging for those who are marginalized or excluded. We use a qualitative approach to explore adolescents' perceptions of the risks involved in inclusive behavior and the factors that motivate acting inclusively at school. 30 focus groups were conducted at 16 middle and high schools across the United States. The cross-sectional sample consisted of 194 students in grades 6-12 (11-19 years old). Students were majority female (61%) and self-identified as white (68%). Data were analyzed using qualitative thematic analysis. Students often perceived the decision to act inclusively as risky because it involved weighing uncertain outcomes, including potential costs (e.g. peer rejection) and rewards (e.g. friendship). Students primarily focused on the role of peer group influence, but also discussed how school norms, the identity of the peer they were trying to include, and their own motivations affected the perceived risk involved in acting inclusively. This study provides an exploratory look at adolescents' experiences of inclusive behavior. Findings support the current conceptualization of positive risk-taking behavior and suggest a multi-level framework for inclusive risks. Exploring the factors that make inclusive behavior differentially risky across individuals and contexts is a first step towards understanding how inclusive behavior fits within the positive risk-taking framework and designing interventions to reduce the risks involved.


The chemokinetic response of psoriatic and normal polymorphonuclear leukocytes to arachidonic acid lipoxygenase products.
Polymorphonuclear leukocytes (PMN) from ten patients with chronic stable plaque psoriasis, five of whom had more than 40% skin involvement and five with less than 20% involvement, responded in a dose-related fashion to stimulation with the arachidonic acid lipoxygenase products 5- and 12-hydroxyeicosatetraenoic acid (5- and 12-HETE) and leukotriene B4 (LTB4) in an in vitro chemokinesis assay. There was no significant difference in either the random migration or the chemokinetic response of psoriatic PMN to LTB4 when compared to the responses of PMN from a group of age- and sex-matched healthy controls. Psoriatic PMN migrated further in response to low doses of 5- and 12-HETE although the distance moved after maximal stimulation was no different to that observed in controls. No significant difference was observed in the responses of PMN obtained from patients with less than 20% skin involvement when compared to those with more extensive psoriasis. The small differences measured between the chemokinetic responses of psoriatic and control PMN to the lipoxygenase products tested are unlikely to be of pathogenetic significance.


Vestibular implant: does it really work? A systematic review.
People with vestibular loss present a deficit in the vestibular system, which is primarily responsible for promoting postural control, gaze stabilization, and spatial orientation while the head moves. There is no effective treatment for a bilateral loss of vestibular function. Recently, a vestibular implant was developed for people with bilateral loss of vestibular function to improve this function and, consequently, the quality of life of these patients. To identify in the scientific literature evidence that vestibular implants in people with vestibular deficit improves vestibular function. One hundred and forty six articles were found from five databases and 323 articles from the gray literature mentioning the relationship between vestibular implant and vestibular function in humans. The PICOS strategy (Population, Intervention, Comparison and Outcome) was used to define the eligibility criteria. The studies that met the inclusion criteria for this second step were included in a qualitative synthesis, and each type of study was analyzed according to the bias risk assessment of the Joanna Briggs Institute through the critical assessment checklist Joanna Briggs institute for quasi-experimental studies and the Joanna Briggs institute critical assessment checklist for case reports. Of the 21 articles included in reading the full text, 10 studies were selected for the qualitative analysis in the present systematic review. All ten articles analyzed through the critical assessment checklist Joanna Briggs institute showed a low risk of bias. The total number of samples in the evaluated articles was 18 patients with vestibular implants. Taken together, these findings support the feasibility of vestibular implant for restoration of the vestibulo-ocular reflex in a broad frequency range and illustrate new challenges for the development of this technology.


[Specific features of the clinical picture and difficulties of diagnostics of laryngeal paresis and paralysis in the newborn babies, during breast feeding and early infancy].
The objective of the present study was to compare different methods for the endoscopic examination of the larynx in the newborn babies, during the period of breast feeding and early infancy. Special attention was given to differential diagnostics and the cases of the asymptomatic clinical curse of the disease. Case reports are presented, and the relevant literature data are analysed.


The characteristics and prognostic significance of esophageal squamous cell carcinoma with synchronous multiple lesions: over 10-year experience.
Esophageal squamous cell carcinoma (ESCC) is occasionally observed with synchronous multiple tumor lesions. Our study is aiming to define the clinical and prognostic features of this pathological subtype. This study included a large cohort of 1126 ESCC patients received esophagectomy with systemic lymph-node dissection between 2003 and 2013 in Sun Yat-sen University Cancer Center. The characteristics and prognostic significance of ESCC with multiple lesions were analyzed. The propensity score matching was performed to balance the baseline clinical characteristics. A total of 103 patients (9.1%) with 216 synchronous multiple lesions were identified from postoperative gross samples. Among them, 94 patients had two lesions, and 8 patients had three lesions, while only one patient had four lesions. The consistency of pT stages and histological grade among tumor lesions from the same gross sample were 19.4% (20/103) and 37.9% (39/103), respectively. Additionally, the tumor sites, sizes, and even the pathological subtypes can be variant in one patient. The preoperative upper gastrointestinal endoscopy could only identified 80.1% of the multiple tumor lesions. The male gender (P = 0.012), positive personal cancer history (P < 0.001), and higher pN stages (P < 0.001) were independent risk factors for synchronous multiple lesions. Patients with multiple lesions showed significantly lower survival rate (P = 0.002), and the multiple-lesion was an independently adverse prognostic factor in operable ESCC (P = 0.002). ESCC with multiple lesions had unique clinical features and should not be simply treated as the one-lesion ESCC. Due to its worse prognostic impact, advanced multidisciplinary therapies should be considered for patients with multiple esophageal tumor lesions.


A giant urinary bladder stone in the mummy of Lebanese Maronite Patriarch Joseph Tyan (1760-1820) and its environmental and nutritional implications.
Historical sources and anthropological investigations, with the indispensable support of radiology, bring to light pathological evidence of the past. The purpose of this article is to present the radiological investigation conducted on the mummy of the Maronite Joseph Tyan (1760-1820), a famous patriarch who guided the Lebanese Maronite community during a critical period of its history. The natural mummy of the Patriarch was temporarily removed from its burial site to certify the degree of preservation. Conventional radiography was necessary to determine the state of the internal organs and any physical abnormalities, and to clarify the degree of conservation of the mummy. Radiological analysis uncovered an exceptional case of a large urinary bladder stone. This pathological evidence confirms historical documentary sources that in the last years of his life the Patriarch suffered from abdominal pain and urinary problems. We can suppose that the environment and diet of the Maronite community, limited by restricted agricultural resources, was the possible cause of the urinary bladder stone, as today the epidemiology of these diseases demonstrates links with mainly cereal diets in rural areas.


Estimating tuberculosis incidence from primary survey data: a mathematical modeling approach.
There is an urgent need for improved estimations of the burden of tuberculosis (TB). To develop a new quantitative method based on mathematical modelling, and to demonstrate its application to TB in India. We developed a simple model of TB transmission dynamics to estimate the annual incidence of TB disease from the annual risk of tuberculous infection and prevalence of smear-positive TB. We first compared model estimates for annual infections per smear-positive TB case using previous empirical estimates from China, Korea and the Philippines. We then applied the model to estimate TB incidence in India, stratified by urban and rural settings. Study model estimates show agreement with previous empirical estimates. Applied to India, the model suggests an annual incidence of smear-positive TB of 89.8 per 100 000 population (95%CI 56.8-156.3). Results show differences in urban and rural TB: while an urban TB case infects more individuals per year, a rural TB case remains infectious for appreciably longer, suggesting the need for interventions tailored to these different settings. Simple models of TB transmission, in conjunction with necessary data, can offer approaches to burden estimation that complement those currently being used.


No evidence for triallelic inheritance of MKKS/BBS loci in Amish Mckusick-Kaufman syndrome.
It has been hypothesized that two mutations in one gene are not sufficient and that three mutations between two genes are required for penetrance in some cases of Bardet-Biedl syndrome (the so-called "triallelic inheritance" model). McKusick-Kaufman syndrome (MKS) is allelic to one form of Bardet-Biedl syndrome (BBS). We describe an Amish family with MKS, where three children were affected with homozygous MKKS (BBS6) mutations (H84Y and A242S on both alleles), their father was a carrier, and their mother was homozygous for the same MKKS mutations, but she was non-penetrant. Genotyping and/or sequencing of BBS1, BBS2, BBS3, BBS4, BBS5, BBS7, and BBS8 excluded "triallelic inheritance" for each gene either by an incompatible inheritance pattern or an absence of mutations in the coding region and the intronic splice junctions of these genes. We conclude that the "triallelic" model does not explain the incomplete penetrance of MKS.


Assessment of oral midazolam limited sampling strategies to predict area under the concentration time curve (AUC) during cytochrome P450 (CYP) 3A baseline, inhibition and induction or activation.
A previous study reported a 2- and 3-timepoint limited sampling strategy (LSS) model accurately predicted oral midazolam area under the concentration time curve (AUC), and thus cytochrome P450 (CYP) 3A activity. This study evaluated whether the LSS models predict midazolam AUC during CYP3A baseline, inhibition and induction/activation. Plasma midazolam concentrations from 106 healthy adults from 6 published studies were obtained where oral midazolam was co-administered alone or with ketoconazole, double-strength grapefruit juice, Ginkgo biloba extract, pleconaril, or rifampin. Observed and predicted midazolam AUCs were determined. Bias and precision of the LSS models were determined. Contrasting results were observed for the 2- and 3-timepoint LSS models in accurately predicting midazolam AUC during baseline CYP3A conditions. With the exception of 1 study (single dose, double-strength grapefruit juice), the 2- and 3-timepoint LSS models did not accurately predict midazolam AUC during conditions of CYP3A inhibition and induction/activation. The previously reported 2- and 3-timepoint oral midazolam LSS models are not applicable to the evaluated conditions of CYP3A baseline, inhibition, and induction/ activation.


17β-estradiol rapidly facilitates lordosis through G protein-coupled estrogen receptor 1 (GPER) via deactivation of medial preoptic nucleus μ-opioid receptors in estradiol primed female rats.
In female rats sexual receptivity (lordosis) can be induced with either a single large dose of estradiol benzoate (EB), or a priming dose of EB that does not induce sexual receptivity followed by 17β-estradiol (E2). Estradiol priming initially inhibits lordosis through a multi-synaptic circuit originating in the arcuate nucleus of the hypothalamus (ARH) that activates and internalizes μ-opioid receptors (MOR) in medial preoptic nucleus (MPN) neurons. Lordosis is facilitated when MPN MOR are deactivated after the initial estradiol-induced activation. We tested the hypothesis that E2 given 47.5 h post EB acts rapidly through G protein-coupled estrogen receptor 1 (GPER) in the ARH to deactivate MPN MOR and facilitate lordosis. Ovariectomized Long Evans rats implanted with a third ventricle cannula were primed with 2 μg EB. DMSO control, E2, or G1 (GPER selective agonist) was infused 47.5 h later, and rats were tested for sexual receptivity. E2 and G1 infusions significantly increased levels of sexual receptivity compared to DMSO controls and pretreatment with G15 (GPER antagonist) blocked the facilitation of sexual receptivity. Brains were processed for MPN MOR immunohistochemistry to measure MPN MOR activation levels. E2 and G1 both significantly reduced MPN MOR activation compared to DMSO controls, while pretreatment with G15 blocked MPN MOR deactivation. In another group of EB treated ovariectomized rats, GPER immunofluorescence positive staining was observed throughout the ARH. Together these data indicate that in the 2 μg EB primed rat, E2 rapidly signals through GPER in the ARH to deactivate MPN MOR and facilitate lordosis.


α1,4-Linked N-acetylglucosamine suppresses gastric cancer development by inhibiting Mucin-1-mediated signaling.
Gastric cancer is the second leading cause of cancer deaths worldwide, and more understanding of its molecular basis is urgently needed. Gastric gland mucin secreted from pyloric gland cells, mucous neck cells, and cardiac gland cells of the gastric mucosa harbors unique O-glycans carrying terminal α1,4-linked N-acetylglucosamine (αGlcNAc) residues. We previously reported that αGlcNAc loss correlated positively with poor outcomes for patients with differentiated-type gastric cancer. However, the molecular mechanisms underlying these outcomes remained poorly understood. Here, we examined the effects of upregulated αGlcNAc expression on malignant phenotypes of the differentiated-type gastric cancer cell lines, AGS and MKN7. Upregulation of αGlcNAc following ectopic expression of its biosynthetic enzyme attenuated cell proliferation, motility, and invasiveness of AGS and MKN7 cells in vitro. Moreover, AGS cell tumorigenicity was significantly suppressed by αGlcNAc overexpression in a xenograft model. To define the molecular mechanisms underlying these phenotypes, we investigated αGlcNAc binding proteins in AGS cells and identified Mucin-1 (MUC1) and podocalyxin. Both proteins were colocalized with αGlcNAc on human gastric cancer cells. We also found that αGlcNAc was bound to MUC1 in murine normal gastric mucosa. When we assessed the effects of αGlcNAc binding to MUC1, we found that αGlcNAc blocked galectin-3 binding to MUC1, phosphorylation of the MUC1 C-terminus, and recruitment of Src and β-catenin to that C-terminus. These results suggest that αGlcNAc regulates cancer cell phenotypes by dampening MUC1 signal transduction.


GO based PVA nanocomposites: tailoring of optical and structural properties of PVA with low percentage of GO nanofillers.
Graphene-based polymer composites are gaining interest as a modish class of substance that holds promising angles on diverse applications. In this work, Graphene Oxide (GO) based Polyvinyl Alcohol (PVA) nanocomposites (PVA-GO) have been prepared by employing a facile solution casting method. Low concentrations of GO nanofiller (0.25%, 0.50%, 0.75%, and 1.0%) were used and the result of the use of them over the distinct substantial characteristics of the nanocomposites was evaluated. The different features of the as-synthesized nanocomposites such as optical, structural, chemical, and thermal properties were identified by UV-Vis spectroscopy, X-ray diffraction (XRD), Fourier transform infrared spectra (FTIR), and Thermo-gravimetric analysis (TGA), respectively. From the structural analysis of the crystallinity of the nanocomposite it is evident that a reduction in crystallinity caused by the amalgamation of the GO nanofiller. FTIR study shows improved interaction between the GO nanofiller and PVA matrix. The incorporation of GO was found to reduce the optical band gap of the nanocomposite both for the direct and indirect transition. The Urbach energy of the nanocomposite increases with the increase of the GO concentration suggests the formation of localized states causing a reduction in the optical band gap. PVA-GO nanocomposites with improved and tunable physical properties synthesized from a simple and economic route may pave a new horizon for polymer-based optoelectronic devices.


Diversity and prevalence of ANTAR RNAs across actinobacteria.
Computational approaches are often used to predict regulatory RNAs in bacteria, but their success is limited to RNAs that are highly conserved across phyla, in sequence and structure. The ANTAR regulatory system consists of a family of RNAs (the ANTAR-target RNAs) that selectively recruit ANTAR proteins. This protein-RNA complex together regulates genes at the level of translation or transcriptional elongation. Despite the widespread distribution of ANTAR proteins in bacteria, their target RNAs haven't been identified in certain bacterial phyla such as actinobacteria. Here, by using a computational search model that is tuned to actinobacterial genomes, we comprehensively identify ANTAR-target RNAs in actinobacteria. These RNA motifs lie in select transcripts, often overlapping with the ribosome binding site or start codon, to regulate translation. Transcripts harboring ANTAR-target RNAs majorly encode proteins involved in the transport and metabolism of cellular metabolites like sugars, amino acids and ions; or encode transcription factors that in turn regulate diverse genes. In this report, we substantially diversify and expand the family of ANTAR RNAs across bacteria. These findings now provide a starting point to investigate the actinobacterial processes that are regulated by ANTAR.


Using spatial video geonarratives to improve nursing care for people who use drugs and experience homelessness: A methodology for nurses.
People who are insecurely housed and use drugs are disproportionately affected by drug poisonings. Nurses are uniquely positioned to utilize harm reduction strategies to address the needs of the whole person. Needle debris encompasses drug paraphernalia discarded in public spaces. Studying needle debris provides a strategic opportunity to identify where drugs are being used and target public health strategies accordingly. Our aim in this article is to illustrate how spatial video geonarratives (SVG) combined GPS technology interviews, and videos of locations with needle debris, can elicit valuable data for nursing research. Using SVG required knowledge of how to collect data wearing cameras and practice sessions were necessary. A Miufly camera worn at waist height on a belt provided the stability to walk while interviewing stakeholders. We wore the cameras and conducted go-along interviews with outreach workers, while filming the built environment. Upon completion of data collection, both the interview and GPS information were analysed using Wordmapper software. This methodology resulted in data presented uniquely in both a visual map and narrative. These data were richer than if a single modality had been used. These data highlighted specific contextual factors that were related to the location of needle debris, which created opportunities for nursing interventions to support people experiencing vulnerability.


Clinical significance of thyroid transcription factor-1 in advanced lung adenocarcinoma under epidermal growth factor receptor tyrosine kinase inhibitor treatment.
Thyroid transcription factor 1 (TTF-1) positivity correlates with a higher prevalence of epidermal growth factor receptor (EGFR) mutation in lung adenocarcinoma. It is unknown whether TTF-1 expression affects the clinical outcome of patients with advanced lung adenocarcinoma, who have received EGFR tyrosine kinase inhibitors (TKIs) during the treatment course. This study enrolled patients with advanced lung adenocarcinoma who had results of EGFR mutation analysis and TTF-1 immunostaining. The impact of TTF-1 expression on overall survival (OS) and progression-free survival (PFS) under EGFR TKI treatment was evaluated. Multivariate analyses were done to examine the independent predictors of OS and PFS. Of 496 patients with advanced lung adenocarcinoma, 443 had TTF-1-positive adenocarcinoma. Patients with TTF-1-positive lung adenocarcinoma had longer OS than did those with TTF-1-negative lung adenocarcinoma (median survival, 27.4 vs 11.8 months, P = .001). In patients with EGFR TKI treatment, those with TTF-1-positive lung adenocarcinoma and mutant EGFR had longer OS. In patients with EGFR mutation, those with TTF-1-positive lung adenocarcinoma had longer PFS than did those with TTF-1-negative lung adenocarcinoma (median survival, 8.7 vs 5.7 months, P = .043). Multivariate analysis showed that negative TTF-1 expression is a predictor for shorter OS, and a predictor for shorter PFS under EGFR TKI treatment. TTF-1 shows independent prognostic significance in advanced lung adenocarcinoma. Patients with TTF-1-negative lung adenocarcinoma have not only shorter OS, but also shorter PFS under EGFR TKI treatment, despite the existence of mutant EGFR. Further studies are needed to investigate the optimal treatment of patients with TTF-1-negative lung adenocarcinoma.


The effects of chronic tinnitus caused by acoustic trauma on social behaviour and anxiety in rats.
Tinnitus is associated with significant increases in anxiety disorders in humans, which is thought to affect social interaction; however, there has been only one previous study of the effects of tinnitus on social interaction in animals treated with salicylate and no previous study of the effects of tinnitus on anxiety in animals. In the present study, we used acoustic trauma to induce tinnitus in rats and investigated its effects on social interaction and anxiety in animals confirmed to have tinnitus. When social behaviours were grouped, we found that animals with tinnitus engaged in significantly more aggressive behaviours toward both tinnitus and sham control animals (P=0.03). When individual social behaviours were analysed without considering whether a tinnitus or sham animal was interacting with a member of its own treatment group, tinnitus animals were found to engage in significantly more anogenital investigation (P=0.01) and significantly less social grooming (P=0.003). When the data were analysed according to whether an animal was interacting with a member of its own group, tinnitus animals were found to bite sham animals significantly more than other tinnitus animals (P=0.005). Sham animals also bit tinnitus animals significantly more than other sham animals (P=0.02), as well as climbing away from them more (P=0.04), kicking (P=0.003), nudging them more (P=0.04), and sleeping with them more (P=0.02). By contrast, sham animals sniffed tinnitus animals significantly less than sham animals (P=0.05). There were no significant differences between the sham and tinnitus animals in performance in the elevated plus and elevated T maze tests of anxiety. However, tinnitus animals displayed a slight but significant increase in locomotor activity in the open field (P=0.04). These data suggest that tinnitus results in complex changes in social interaction in rats, which are not due simply to increases in anxiety.


On the rates of enzymatic, protein and model compound reactions: the importance of diffusion control.
A meaningful method of comparison is suggested for saturation kinetics, typical of enzyme-catalyzed reactions, and nonsaturation kinetics, often typical of model compound reactions. True diffusion-controlled reactions do not give saturation behavior; but enzymes may need saturation behavior to attain selectivity and stereospecificity for complicated substrates or for reactions beyond the complexity of electron transfer. However, the diffusion controlled limit provides a better reference point for rate comparisons than does the rate of uncatalyzed reaction. The failure of the Stokes-Einstein equation for small substrates is documented, as are ways of circumventing the problem. Advantages and pitfalls in the use of viscosogens to test for diffusion control are delineated. Finally, the possible advantages of surface diffusion for an enzyme, but lack of experimental evidence, is discussed.


Pediatric oncology and the future of oncological imaging.
The future of pediatric oncology will be influenced by changes in drug design and treatment strategy, with genomic medicine and molecular-based diagnostics and therapeutics playing increasingly important roles. The role of imaging as a means of measuring response to therapy has also evolved, with the development of new technologies and higher sensitivity means of detecting tumors. Conventional anatomical imaging techniques are being increasingly supplemented with functional techniques, including FDG-PET imaging and diffusion-weighted MR imaging. The risk-adapted treatment regimens of the past, which led to improved event-free and overall survival in many pediatric cancers, have paved the way for new response-based treatment paradigms. Response-based approaches seek to identify patients with a high likelihood of cure, treating them less aggressively, while those not responding to therapy are identified early and redirected into more aggressive therapeutic regimens. These advances will require concurrent development of imaging biomarkers as surrogates of early response to therapy. Incorporating these techniques into new response-directed treatment algorithms will be crucial as personalized medicine and molecular-targeted, tumor-specific therapies gain acceptance for the treatment of children with cancer.


Evaluation of urinary enzymes in newborns treated with gentamicin.
In recent years, there has been an increasing amount of study on early diagnosis of kidney injury through sensitive and specific biomarkers. We examined the practical applicability of the urinary levels of NAG (N-acetyl-β-D-glucosaminidase), AP (alkaline phosphatase), and LDH (lactate dehydrogenase) as renal dysfunction screening biomarkers in full and pre-term newborns treated with gentamicin. Fourteen pre-term and fifteen full-term newborns who received gentamicin for suspected infections were enrolled. Serum and urine specimens were obtained before the zero days and after gentamicin infusion on the 1st, 3rd, and 5th days of treatment. In full-term newborns a significant increase in urinary NAG, LDH, AP after 5 days of gentamicin administration compared with control group was noted (P<0.05, P<0.001 and P<0.01; respectively). Our findings indicate that urinary enzymes may be useful in full-term newborns as a non-invasive method for evaluation of tubular function.


Factors influencing the attainment of major motor milestones in CDKL5 deficiency disorder.
This study investigated the influence of factors at birth and in infancy on the likelihood of achieving major motor milestones in CDKL5 Deficiency Disorder (CDD). Data on 350 individuals with a pathogenic CDKL5 variant was sourced from the International CDKL5 Disorder Database. A first model included factors available at birth (e.g., sex, variant group and mosaicism) and the second additionally included factors available during infancy (e.g., age at seizure onset, number of anti-seizure medications used, experience of a honeymoon period and formal therapy). Cox regression was used to model the time to achieve the milestones. The probability of attaining the outcomes at specific ages was estimated by evaluating the time-to-event function at specific covariate values. Independent sitting and walking were achieved by 177/350 and 57/325 children respectively. By seven years of age, 67.1% of females but only 37.3% of males could sit independently. About a quarter each of females and males achieved independent walking by eight and six years, respectively. When observed from birth, female gender, a late truncating variant and mosaicism impacted most positively on the likelihood of independent sitting. When observed from one year, later seizure onset and experiencing a honeymoon period also improved the likelihood of independent sitting. Factors that favoured sitting (except gender) also improved walking. Having a truncating variant between aa178 and aa781 reduced the likelihood of achieving independent sitting and walking. It is possible to utilise factors occurring early in life to inform the likelihood of future motor development in CDD.


Differentiation of Swertia Mussotii Franch from Artemisiae Capillaris Herba by capillary electrophoresis with electrochemical detection.
A high-performance capillary electrophoresis (CE) with electrochemical detection (ED) method is developed for differentiation of Swertia Mussotii Franch from Artemisiae Capillaris Herba in this work. Swertia Mussotii Franch contains a great deal of swertiamarin and mangiferin that are not present in Artemisiae Capillaris Herba, whereas Artemisiae Capillaris Herba consists of abundant chlorogentic acid. Therefore, determining their swertiamarin, mangiferin and chlorogentic acid contents can differentiate these two crude herbs. Operated in a wall-jet configuration, a 300 microm diameter carbon-disk electrode was used as the working electrode, which exhibits good response at +1000 mV (versus SCE) for the three analytes. With a separation voltage of 14 kV, the three analytes were separated within 14 min in a 52 cm length capillary in 50 mmol/l borax buffer (pH 9.2). The system was demonstrated good stability and reproducibility with an R.S.D. of less than 5% for both migration time and peak current. This method was successfully used to analyze and identify the crude herbs with satisfactory assay results.


Factors Governing the Propagation Direction and Spin-Rotation Plane of Noncollinear Magnetic Structures: A Helix vs Cycloid in Doubly Ordered Perovskites NaYMnWO6 and NaYNiWO6.
The magnetic structure of NaYMnWO6 was determined by neutron powder diffraction measurements. Below 9 K, the magnetic structure is a helix to wave vector k = (0, 0.447, 1/2), in contrast with NaYNiWO6, which shows a transverse spin density wave with k = (0.47, 0, 0.49). By analyzing the differences in the spin exchanges of NaYMnWO6 and NaYNiWO6, and in the magnetic anisotropies of the Mn2+ (d5, S = 5/2) and the Ni2+ (d2, S = 1) ions, we show what factors govern the propagation direction of a noncollinear magnetic structure and whether it becomes a helix or a cycloid.


Association between snoring and depressive symptoms in adolescents.
While previous studies have suggested that snoring may be associated with depressive symptoms and suicidality in adults and preschool children, there have been no investigations in non-clinical adolescent populations. This study aimed to demonstrate the association between snoring and depressive symptoms/suicidality in adolescents. This survey study recruited 8530 students (grades 7-11) and examined depressive symptoms, suicidality, snoring frequency, daytime sleepiness, sleep duration, and presence of insomnia by questionnaires. Correlation analyses, multiple linear regression analyses and mediation analyses were performed to determine the association between snoring frequency and depressive symptoms/suicidality. The study population included 8080 students (16.73 ± 1.09 years old). Snoring frequency was positively correlated with depressive symptoms and suicidality. Snoring frequency was associated with depressive symptoms and suicidality when adjusted for age and sex, and the association remained significant after additionally adjusting for sleep duration, insomnia, and daytime sleepiness. When depressive symptoms were included as a predictor of suicidality, snoring frequency showed no significant predictive value. Mediation analysis confirmed that depressive symptoms mediate the association between snoring frequency and suicidality. Our findings suggest that self-reported complaints of snoring are associated with increased depressive symptoms and suicidality in adolescents independently of sleep duration, insomnia, and daytime sleepiness, and the connection between snoring and suicidality is mediated by depressive symptoms. These data underscore the importance of identifying snorers among adolescents and screening for depression and suicidal ideation in this population.


Degradation of chlorophenols using pentachlorophenol-degrading bacteria Sphingomonas chlorophenolica in a batch reactor.
Chlorophenols are common environmental contaminants that have been used as the major component in wide-spectrum biocides in industry and agriculture. Many chlorophenols tend to persist in the environment and may become public health hazards. This research studied the ability of the pentachlorophenol (PCP)-degrading bacterium Sphingomonas chlorophenolica to degrade and dechlorinate other chlorophenols. In addition, the characteristics of S. chlorophenolica were also investigated. When S. chlorophenolica cells were preincubated with PCP, the lag phase PCP degradation periods became shorter and the PCP concentrations that could be removed became higher. S. chlorophenolica was able to completely degrade 2,3,6-trichlorophenol (2,3,6-TCP), 2,4,6-trichlorophenol (2,4,6-TCP), 2,3,4,6-tetrachlorophenol (2,3,4,6-TeCP), and PCP within 38.1, 15.1, 11.8, and 11.8 h, and to release concentrations of 50.1, 60.9, 63.7, and 58.5 mg/L chloride at the same period of time. In the presence of supplementary carbon sources, the PCP removal efficiency increased with the presence of glucose or pyruvate. However, the removal efficiency of 75 mg/L 2,4-dichlorophenol did not increase with supplemental carbon sources.


Adjuvant effects of TLR agonist gardiquimod admixed with Leishmania vaccine in mice model of visceral leishmaniasis.
Tropical and subtropical areas of the world are affected by leishmaniasis, which is caused by Leishmania spp. It has been categorized as an NTD (neglected tropical disease) because of its negligence. The sand fly of genus Phlebotomus acts as the vector for the transmission of the promastigote form of this protozoan parasite to the mammalian host where it converts to amastigote form in the macrophages. Visceral form of leishmaniasis (VL) is a deadly infection in the endothelial system of the human and other mammals. Only a few chemotherapeutic agents are available for the treatment of this infectious disease whereas no vaccine is available for the control of leishmanial infection. Therefore in the current study, we have tested the effects of gardiquimod (a TLR agonist) as an adjuvant in combination with the formalin-killed antigen of L. donovani as a vaccine. The mice were vaccinated thrice at an interval of 2 weeks and challenged with L. donovani promastigotes after 2 weeks of the last vaccination. We assessed the parasite load, delayed-type hypersensitivity (DTH) responses, humoral and cell-mediated immune response in BALB/c mice before and after challenge infection with L. donovani. Immunized mice were found to have the least parasite load, high DTH response, elevated levels of Th1 cytokines, IgG2a, and nitric oxide than non-immunized and infected control mice. The efficacy of the vaccine was boosted with the use of adjuvant gardiquimod that depicts its potential as an adjuvant in this study. Our study is reporting the adjuvant effects of gardiquimod for the first time. Further studies using other Leishmania species can be performed to signify its role.


Serological monitoring of a Toxoplasma infection after hematopoietic stem cell transplantation.
We report a primary response to Toxoplasma gondii following a hematopoietic stem cell transplantation in a patient with multiple myeloma. The primary response to T. gondii was supported by IgM, IgG and IgA seroconversion. The patient was promptly treated and there were no complications related to toxoplasmosis in the subsequent months.


Inhibin/activin expression in human and rodent liver: subunits α and βB as new players in human hepatocellular carcinoma?
Activins and inhibins belong to the TGFβ-superfamily, which controls cell proliferation and differentiation in many organs. Activin A, the dimer of inhibin βA subunit, acts strongly anti-proliferative in hepatocytes. Little is known on the other activin/inhibin subunits in human liver and hepatocellular carcinoma (HCC). We studied the expression of the complete inhibin family α, βA, βB, βC, βE in normal liver, tumour-adjacent and HCC tissue, 12 additional organs and rodent liver. A total of 16 HCC and 10 disease-free livers were analysed. Expression of inhibin subunits was determined by qRT-PCR, normalised to RNA input and by geNorm algorithm, and confirmed by immunohistochemistry. Remarkably, βA expression was not decreased in HCC. Similarly, βC and βE exhibited no major changes. In contrast, inhibin α, barely detectable in normal liver, was strongly increased in tumour-adjacent liver and dramatically enhanced in HCC. βB was strongly enhanced in some HCC. At variance with human liver, rodent liver showed higher inhibin α and βC expression, but βA was somewhat, and βB dramatically lower. Upregulation of inhibin α - and possibly of βB - may shield HCC cells from anti-proliferative effects of activin A. Dramatic variations between humans and rodents may reflect different functions of some inhibins/activins.


Key Considerations and Recommended Strategies for Conducting a School-Based Longitudinal RE-AIM Evaluation: Insights From a 28-School Cluster Randomized Trial.
RE-AIM is an implementation science framework that provides a structure to promote data collection and analysis in the domains of Reach, Efficacy/Effectiveness, Adoption, Implementation, and Maintenance. The RE-AIM approach promotes more data collection and reporting than typical evaluations so potential adopters can determine the potential program fit for their setting. RE-AIM has been used to evaluate a variety of programs; however, there are few resources that provide strategies for conducting a RE-AIM evaluation in the school setting. The purpose of this article is to inform future studies by elucidating experiences conducting a large, complex, multisite, longitudinal RE-AIM evaluation in schools in partnership with the state's Departments of Education and Health, and to share strategies for overcoming obstacles. With the long-term goal of facilitating the translation of school-based intervention research into practice, we provide key considerations and recommend strategies for school-based RE-AIM evaluation success.


Evidence for different mechanisms of 'unhooking' for melphalan and cisplatin-induced DNA interstrand cross-links in vitro and in clinical acquired resistant tumour samples.
DNA interstrand cross-links (ICLs) are critical lesions produced by several cancer chemotherapy agents including platinum drugs and nitrogen mustards. We have previously shown in haematological (multiple myeloma) and solid tumours (ovarian cancer) that clinical sensitivity to such agents can result from a defect in DNA ICL processing leading to their persistence. Conversely, enhanced repair can result in clinical acquired resistance following chemotherapy. The repair of ICLs is complex but it is assumed that the 'unhooking' step is common to all ICLs. Using a modification of the single cell gel electrophoresis (Comet) assay we measured the formation and unhooking of melphalan and cisplatin-induced ICLs in cell lines and clinical samples. DNA damage response in the form of γ-H2AX foci formation and the formation of RAD51 foci as a marker of homologous recombination were also determined. Real-time PCR of 84 genes involved in DNA damage signalling pathways was also examined pre- and post-treatment. Plasma cells from multiple myeloma patients known to be clinically resistant to melphalan showed significant unhooking of melphalan-induced ICLs at 48 hours, but did not unhook cisplatin-induced ICLs. In ovarian cancer cells obtained from patients following platinum-based chemotherapy, unhooking of cisplatin-induced ICLs was observed at 48 hours, but no unhooking of melphalan-induced ICLs. In vitro, A549 cells were proficient at unhooking both melphalan and cisplatin-induced ICLs. γ-H2AX foci formation closely followed the formation of ICLs for both drugs, and rapidly declined following the peak of formation. RPMI8226 cells unhooked melphalan, but not cisplatin-induced ICLs. In these cells, although cross-links form with cisplatin, the γ-H2AX response is weak. In A549 cells, addition of 3nM gemcitabine resulted in complete inhibition of cisplatin-induced ICL unhooking but no effect on repair of melphalan ICLs. The RAD51 foci response was both drug and cell line specific. Real time PCR studies highlighted differences in the damage response to melphalan and cisplatin following equi-ICL forming doses. These data suggest that the mechanisms by which melphalan and cisplatin-induced ICLs are 'unhooked' in vitro are distinct, and the mechanisms of clinical acquired resistance involving repair of ICLs, are drug specific.


[Adaptation and validation in Chile of the patient identification instrument needing palliative care: NECPAL-CCOMS-ICO 3.1©].
Adapt and validate the NECPAL instrument in Chile. Prospective, longitudinal, analytical study for validation of the instrument in 5 stages: cultural adaptation, content validation, pilot test, application, and statistical analysis. Four primary care centers of the South East Metropolitan Health Service, in Santiago, Chile. Primary health care physicians and nurses for cultural adaptation and application, and palliative care experts for content validation. Cultural adaptation was carried out through cognitive interviews. Content validity was measured using Delphi method and the Lawshe content validity ratio (CVR) was obtained. In the pilot test, we measured stability (test-retest), inter judge harmony and application time in 14 chronic advanced patients (CAP). The test was applied to this same group, calculating the sample according to Nunally's recommendation. A sample of 118 CAP was obtained. The CVR was 0.75 and the average testing time was 6.7 min (SD = 4.01). The test-retest obtained a Kappa test concordance index between 0.632 and 1.0; and the interjudge harmony agreement between 0.192 and 0.692. The surprise question (PS) was positive in 20.3% of the sample. The main conditions associated with the disease-specific severity item, were fragility (23.7%), chronic heart disease (21.2%) and chronic lung disease (12.7%). The demand group and specific severity indicators obtained a greater predictive capacity of PS+, with an area under the curve of 0.808 (95% CI: 0.697-0.918). NECPAL is feasible to be used in Chile, has adequate psychometric properties and will allow early detection of patients in need of palliative care.


Oxidative stress by monoamine oxidase mediates receptor-independent cardiomyocyte apoptosis by serotonin and postischemic myocardial injury.
Serotonin (5-hydroxytryptamine [5-HT]), released by activated platelets during cardiac ischemia, is metabolized by the mitochondrial enzyme monoamine oxidase A (MAO-A). Because hydrogen peroxide is one of the byproducts of 5-HT degradation by MAO-A, we investigated the potential role of reactive oxygen species generated by MAOs in 5-HT-dependent cardiomyocyte death and post-ischemia-reperfusion cardiac damage. Treatment of isolated adult rat cardiomyocytes with 5-HT induced intracellular oxidative stress and cell apoptosis. The apoptotic cascade triggered by 5-HT involves release of cytochrome c, upregulation of proapoptotic Bax protein, and downregulation of antiapoptotic Bcl-2 protein. These effects were prevented by inhibition of amine transporter or MAO, antioxidants, or iron chelation. In contrast, cardiomyocyte apoptosis was only slightly affected by the 5-HT(2B) receptor antagonist SB 206553. In vivo, inhibition of MAO-A largely reduced myocardial ultrastructural damage induced by 30 minutes of ischemia followed by 60 minutes of reperfusion in the rat heart. Cardioprotective effects of MAO inhibitors were associated with the prevention of postischemic oxidative stress, neutrophil accumulation, and mitochondrial-dependent cell death and were not reverted by SB 206553. Administration of MAO-A inhibitors during ischemia was still effective in preventing cardiac damage. Our results supply the first direct evidence that oxidative stress induced by MAO is responsible for receptor-independent apoptotic effects of 5-HT in cardiomyocytes and postischemic myocardial injury. These findings provide new insight into the mechanisms of 5-HT action in the heart and may constitute the basis for novel therapies.


HIV-related stigma in the UK then and now: to what extent are we on track to eliminate stigma? A qualitative investigation.
The introduction of effective antiretroviral treatment in the late 1990s led to the perception that HIV was a chronic but manageable condition. Nevertheless, stigma remains one of the major hurdles for people living with HIV (PLWH) to accessing healthcare and biomedical preventions. Thus, Fast Track Cities has set a target of zero HIV discrimination by 2030 as part of its strategy to end HIV transmission. Fifty-three participants from the United Kingdom, including PLWH (n = 21, 40%), health and social care workers (n = 24, 45%), and charity workers and activists (n = 13, 25%), were recruited. Semi-structured interviews investigated stigma and discrimination, focusing on both before and after the widespread use of effective antiretroviral treatment in the late 1990s. Data were analysed using a thematic approach. Before effective antiretroviral treatment narratives were shaped by two main themes: 1) the media's role in influencing public opinion and contributing to misunderstandings of HIV transmission; and 2) personal experiences of HIV-related stigma, which for PLWH included incidents of physical violence and aggression, as well as fears of their HIV status being publicised. Contemporary narratives on stigma experiences were organised around four themes: 1) discrimination in healthcare settings; 2) stigma amongst men who have sex with men (MSM); 3) stigma towards African and Afro-Caribbean PLWH; and 4) the limits of change in public HIV-related knowledge and attitudes. Contemporary narratives indicated a reduction in enacted stigma, but continued anticipation of discrimination and self-reported shame, particularly in MSM and African and Afro-Caribbean PLWH. The nature of stigma against those with HIV has evolved. The intersection of PLWH and minority groups (e.g. MSM and African and Afro-Caribbean persons) may enhance anticipatory and internalised stigma, with some suggestion that this may contribute to reduced engagement in HIV care and prevention services. Our findings indicate the need for further research in this area, as well as proactive interventions with community groups to enhance knowledge of HIV.


[Comparative evaluation of the action of prostanoid inhibitors on uterine contractile function].
Indomethacin and substance BW-755C in experiments on isolated myometrium striae of pregnant white rats exert an inhibiting effect on the contractile uterus function due to inhibition of cyclooxygenase or lipoxygenase ways of the arachidonic acid transformation. Prostaglandin F2 alpha is sensitive to functioning of the cyclooxygenase and lipoxygenase ways of the arachidonic acid transformation, while oxytocin--only lipoxygenase one. Conclusions rest on results from multiparametric analysis of the contractile uterus function suggested by authors and confirmed by the pattern recognition method--the Karunen-Loev orthogonal decomposition.


Indocyanine green is a sensitive adjunct in the identification and surgical management of local and metastatic hepatoblastoma.
Hepatoblastoma is the most common primary pediatric liver malignancy. Indocyanine green (ICG) has been described as an adjunct to resection in small series. Its utility remains undefined in larger cohorts. Records for 29 patients diagnosed with hepatoblastoma who received ICG prior to surgical resection from 2017 to 2020 at a single institution were retrospectively reviewed. The primary outcome was correlation between intraoperative ICG-avidity and histologic presence of hepatoblastoma. A secondary outcome included the histologic margin designation for resected liver specimens. ICG sensitivity was 91% for 120 resected thoracic specimens from 21 patients. Specificity was 57%. In 10% of operations, HB-positive specimens were resected solely on ICG-avidity. In an additional 40% of cases, ICG assisted in localizing a preoperatively diagnosed lesion. ICG sensitivity during thoracotomy and thoracoscopic surgery was 95 and 74%, respectively; primary and relapsed disease demonstrated sensitivity of 94 and 73%, respectively. Sensitivity was 92% for 25 resected liver specimens from nine patients with all parenchymal margins grossly negative for disease. Four multifocal lesions were identified with two resected solely by ICG-avidity. ICG is a sensitive adjunct for identifying local and metastatic hepatoblastoma, including lesions not visualized on preoperative imaging, and delineating margins during liver resection. False positives limit specificity; however, there were no adverse outcomes from additional resections. We noted that thoracoscopic surgery can be completed safely in patients with less significant disease burden, and conversion to thoracotomy, if necessary, is straightforward.


The cellular senescence of leukemia-initiating cells from acute lymphoblastic leukemia is postponed by β-Arrestin1 binding with P300-Sp1 to regulate hTERT transcription.
Although we previously reported that the self-renewal of leukemia-initiating cells of B-lineage acute lymphoblastic leukemia (B-ALL LICs) was regulated by β-Arrestin1, a multiple-function protein, the cellular senescence is critical for LICs fate and leukemia progress, and worthy for further investigation. Here we found that depletion of β-Arrestin1 extended the population doubling time and the percentage of senile cells, the signatures of cellular senescence, of B-ALL LICs. Moreover, lack of β-Arrestin1 enhanced the expression of proteins (CBX, HIRA) and genes (P53, P16) related to senescence in leukemic Reh cells and B-ALL-LICs-derived leukemic mice. Further results showed that loss of β-Arrestin1 induced senescence of Reh cells through mediating hTERT-telomerase-telomere axis, which was reversed by BIBR1532, the telomerase activity inhibitor. Importantly, depletion of β-Arrestin1 decreased the binding of Sp1 to hTERT promoter at the region of -28 to -36 bp. The anti-sense oligonucleotide of this key region downregulated the transcription of hTERT and aggravated the senescence of Reh cells. Further data demonstrated that the depleted β-Arrestin1 reduced the interaction of P300 with Sp1, thus to reduce Sp1 binding to hTERT promoter, downregulate hTERT transcription, decrease telomerase activity, shorten telomere length, and promote Reh cell senescence. Interestingly, the percentage of senile cells in B-ALL LICs was decreased, which was negatively correlated to good prognosis and β-Arrestin1 mRNA expression in childhood B-ALL patients. Our study shed a light on the senescence of B-ALL LICs and is regulated by β-Arrestin1, providing the potential therapeutic target of leukemia by promoting cellular senescence with a key region of hTERT promoter.


[Enhancement of coagulation caused by transfusion of artificial plasma-replacement solutions].
To investigate hemostasis disorders caused by massive blood transfusions of artificial plasma replacing solutions (PRS). Two groups of patients were examined: 7 healthy volunteers without blood loss (group 1) and 11 healthy donors of bone marrow with intraoperative blood loss 1-2 l (group 2). Five patients of group 1 received transfusion of 12 ml/kg hydroxyethyl starch (HES) 130/0.4, two patients of group 1 received transfusion of modified gelatine solution (gelofusin). All of them received infusions (1-1.5 l) of crystalloid PRS (1-2 l) and infusion of one of colloid PRS (6-HES, 5--gelofusin). Estimated hemodilution in group 1 was 1.17 +/- 0.01 times, in group 2 it varied from 1.3 to 2.7 times (mean 1.78 +/- 0.4 times). Hemostasis was studied by clot growth rate (for groups 1 and 2), endogenic thrombin potential and parameters of thromboelastography (for group 2) in plasm samples obtained before, 2.24 and 48 hours after infusion of colloid PRS. For both groups spatial clot growth rate 2 hours after hemodilution was high. Then it fell and reached baseline level 48 hours after PRS infusion. Endogenic thrombin potential and thromboelastography data (for group 2) changed by the same pattern. A hypercoagulation effect of gelofusin on parameters of thromboelastography and clot growth rate was higher than of HES 130/04. Moderate hemodilution with PRS in vivo causes hypercoagulation which persisted longer than volemic effect of PRS.


Survival time with pacemaker implantation for dogs diagnosed with persistent atrial standstill.
To evaluate survival time in dogs with persistent atrial standstill after pacemaker implantation and to compare the survival times for cardiac-related vs. non-cardiac deaths. Secondary objectives were to evaluate the effects of breed and the presence of congestive heart failure (CHF) at the time of diagnosis on survival time. Twenty dogs with persistent atrial standstill and pacemaker implantation. Medical records were searched to identify dogs diagnosed with persistent atrial standstill based on electrocardiogram that underwent pacemaker implantation. Survival after pacemaker implantation was analyzed using the Kaplan-Meier method. The median survival time after pacemaker implantation for all-cause mortality was 866 days. There was no significant difference (p=0.573) in median survival time for cardiac (506 days) vs. non-cardiac deaths (400 days). The presence of CHF at the time of diagnosis did not affect the survival time (P=0.854). No difference in median survival time was noted between breeds (P=0.126). Dogs with persistent atrial standstill have a median survival time of 866 days with pacemaker implantation, though a wide range of survival times was observed. There was no difference in the median survival time for dogs with cardiac-related deaths and those without. Patient breed and the presence of CHF before pacemaker implantation did not affect median survival time.


Multidimensional fatigue inventory and post-polio syndrome - a Rasch analysis.
Fatigue is a common symptom in post-polio syndrome (PPS) and can have a substantial impact on patients. There is a need for validated questionnaires to assess fatigue in PPS for use in clinical practice and research. The aim with this study was to assess the validity and reliability of the Swedish version of Multidimensional Fatigue Inventory (MFI-20) in patients with PPS using the Rasch model. A total of 231 patients diagnosed with PPS completed the Swedish MFI-20 questionnaire at post-polio out-patient clinics in Sweden. The mean age of participants was 62 years and 61% were females. Data were tested against assumptions of the Rasch measurement model (i.e. unidimensionality of the scale, good item fit, independency of items and absence of differential item functioning). Reliability was tested with the person separation index (PSI). A transformation of the ordinal total scale scores into an interval scale for use in parametric analysis was performed. Dummy cases with minimum and maximum scoring were used for the transformation table to achieve interval scores between 20 and 100, which are comprehensive limits for the MFI-20 scale. An initial Rasch analysis of the full scale with 20 items showed misfit to the Rasch model (p < 0.001). Seven items showed slightly disordered thresholds and person estimates were not significantly improved by rescoring items. Analysis of MFI-20 scale with the 5 MFI-20 subscales as testlets showed good fit with a non-significant x (2) value (p = 0.089). PSI for the testlet solution was 0.86. Local dependency was present in all subscales and fit to the Rasch model was solved with testlets within each subscale. PSI ranged from 0.52 to 0.82 in the subscales. This study shows that the Swedish MFI-20 total scale and subscale scores yield valid and reliable measures of fatigue in persons with post-polio syndrome. The Rasch transformed total scores can be used for parametric statistical analyses in future clinical studies.


Meta-analysis of randomized trials of angioedema as an adverse event of renin-angiotensin system inhibitors.
Angioedema is a rare, potentially life-threatening adverse event of renin-angiotensin system inhibitors. The objective of the present study was to determine the risk of angioedema from randomized clinical trials. A PubMed/CENTRAL/EMBASE search was made for randomized clinical trials from 1980 to October 2011 in patients on angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), or direct renin inhibitor (DRI). Trials with a total number of patients ≥100 and a duration of ≥8 weeks were included for analysis. Incidence of angioedema was pooled by weighing the incident rate of each trial by the inverse of the variance. Twenty-six trials with 74,857 patients in the ACE inhibitor arm with 232,523 person-years of follow-up, 19 trials with 35,479 patients on ARB with 122,293 person-years of follow-up, and 2 trials with 5,141 patients on DRI with 1,735 person-years of follow-up met the inclusion criteria and were included in the analysis. In head-to-head comparison in 7 trials, risk of angioedema with ACE inhibitors was 2.2 times higher than with ARBs (95% confidence interval [CI] 1.5 to 3.3). With ACE inhibitors and ARBs, incidence of angioedema was higher in heart failure trials compared to hypertension or coronary artery disease trials without heart failure (p <0.0001). Weighted incidence of angioedema with ACE inhibitors was 0.30% (95% CI 0.28 to 0.32) compared to 0.11% (95% CI 0.09 to 0.13) with ARBs, 0.13% (95% CI 0.08 to 0.19) with DRIs, and 0.07% with placebo (95% CI 0.05 to 0.09). In conclusion, incidence of angioedema with ARBs and DRI was <1/2 than that with ACE inhibitors and not significantly different from placebo. Incidence of angioedema was higher in patients with heart failure compared to those without heart failure with ACE inhibitors and ARBs.


Bioconcentration, metabolism and the effects of tetracycline on multiple biomarkers in Chironomus riparius larvae.
The antibiotic tetracycline (TC) is widespread in surface waters, but few data are available regarding its adverse effects on aquatic insects. In this study, we investigated the bioconcentration, metabolism, and effects of TC on Chironomus riparius larvae exposed to different concentrations of TC (1.83, 18.5 and 174 μg L-1) for 48 h. The bioconcentration factors were 3.65, 0.74 and 0.23 in larvae with exposure to 1.83, 18.5 and 174 μg L-1 TC, respectively. High concentration ratios of the metabolites anhydrotetracycline (0.56-0.60), 4-epitetracycline (0.43-0.69), and 4-epianhydrotetracycline (0.50-0.55) to the unmetabolized compound were found. Additionally, the activities of superoxide dismutase and glutathione S-transferase were markedly inhibited with a significant increase in malondialdehyde contents at high exposure concentrations of TC (18.5 and 174 μg L-1). Moreover, significant up-regulation of heat shock genes (hsp70 and hsp27), the ecdysone receptor gene, and the E74 early ecdysone responsive gene was observed at all exposure concentrations except for hsp70 at 1.83 μg L-1. Collectively, these results suggested that TC was quickly absorbed and metabolized by C. riparius and resulted in molecular and biochemical disturbances.


Demand for illicit drugs among pregnant women.
We use postpartum survey data linked to medical records and city-level drug prices to estimate the demand for illicit drugs among pregnant women. We find that a $10 increase in the retail price of a gram of pure cocaine decreases illicit drug use by 12-15%. The estimated price effects for heroin are lower than for cocaine and are less robust across alternative model specifications. This study provides the first estimates of the effects of drug prices on prenatal drug use and yields important information about the potential of drug enforcement as a tool for reducing illicit drug use among pregnant women.


Functional analysis of mutations in UDP-galactose-4-epimerase (GALE) associated with galactosemia in Korean patients using mammalian GALE-null cells.
Galactosemia is caused by defects in the galactose metabolic pathway, which consists of three enzymes, including UDP-galactose-4-epimerase (GALE). We previously reported nine mutations in Korean patients with epimerase-deficiency galactosemia. In order to determine the functional consequences of these mutations, we expressed wild-type and mutant GALE proteins in 293T cells. GALE(E165K) and GALE(W336X) proteins were unstable, had reduced half-life, formed aggregates and were partly degraded by the proteasome complex. When expressed in GALE-null ldlD cells GALE(E165K), GALE(R239W), GALE(G302D) and GALE(W336X) had no detectable enzyme activity, although substantial amounts of protein were detected in western blots. The relative activities of other mutants were lower than that of wild-type. In addition, unlike wild-type, GALE(R239W) and GALE(G302D) were not able to rescue galactose-sensitive cell proliferation when stably expressed in ldlD cells. The four inactive mutant proteins did not show defects in dimerization or affect the activity of other mutant alleles identified in patients. Our observations show that altered protein stability is due to misfolding and that loss or reduction of enzyme activity is responsible for the molecular defects underlying GALE-deficiency galactosemia.


The correlation of common carotid arterial diameter with atherosclerosis and diabetic retinopathy in patients with type 2 diabetes mellitus.
The clinical significance of the diameter of the common carotid artery (CCA) measured ultrasonographically in diabetic practice has not been sufficiently established. The objective of this study was to investigate the relationship of the ultrasonic CCA diameter with atherosclerotic measures and diabetic retinopathy as a microvascular complication in patients with type 2 diabetes mellitus (T2DM). This hospital-based cross-sectional study included 102 patients with T2DM (men: 65%, mean age: 57 years) who had no apparent carotid arterial stenosis and no history of cardiovascular or severe renal disease. The current smoking status, body mass index, blood pressure, hemoglobin A1c, serum low-density lipoprotein cholesterol, and ultrasonic measures of carotid arteries (CCA diameter, intima-media thickness (IMT), plaque score) were measured. The cardio-ankle vascular index (CAVI) and the presence of diabetic retinopathy were also assessed. The CCA diameter showed a significant positive correlation with the mean IMT or plaque score. The CAVI had a significant positive correlation with the mean IMT, plaque score, and CCA diameter, while diabetic retinopathy had a significant positive correlation with the CCA diameter, but not the mean IMT or plaque score. These results were unaltered after adjusting for multiple confounders. The CCA diameter may serve as a useful marker for atherosclerosis and diabetic retinopathy, and in particular, may be a marker associated with diabetic retinopathy more clearly than the carotid IMT and plaque score, in patients with T2DM.


Combinatory high-resolution microdissection/ultra performance liquid chromatographic-mass spectrometry approach for small tissue volume analysis of rat brain glycogen.
Cyto-architectural diversity of brain structures emphasizes need for analytical tools for discriminative investigation of distinctive neural structures. Glycogen is the major energy reserve in the brain. There is speculation that brain utilization of this fuel source may affect detection of hypoglycemia. To evaluate sex-specific regulation of glycogen mass and mobilization in the glucose-sensory ventromedial hypothalamic nucleus (VMN), current research coupled UHPLC-electrospray ionization mass spectrometric (LC-ESI-MS) analysis capabilities with novel derivatization protocols for high-sensitivity measurement of glucose and glycogen in small-volume neural tissue samples. This work also sought to demonstrate utility of pairing this approach with optimized Western blot methods for measurement of glycogen metabolic enzyme protein expression. Here, high-resolution micropunch dissection tools for discriminative isolation of VMN tissue were used in conjunction with newly developed glycogen analytical methods and an experimental treatment paradigm for intra-cranial hindbrain-targeted administration of estrogen receptor-alpha (ERα) or -beta (ERβ) receptor antagonists to address the hypothesis that estradiol activates one or both hindbrain ER populations to exert sex-specific regulatory effects on VMN glycogen mass and hypoglycemia-associated mobilization. Outcomes validate a novel multi-analytical platform for investigation of in vivo sex-dimorphic regulation of glycogen metabolism in precisely-defined brain elements under conditions of energy balance versus imbalance. This combinatory approach will facilitate ongoing efforts to elucidate effects of acute versus chronic hypoglycemia on glycogen metabolism in characterized brain glucose-sensory loci and determine effects local glycogen mass and/or mobilization adaptions on sensory monitoring and signaling of recurring hypoglycemia in each sex.


Effects of age on nutrient requirements.
The effects of age on nutrient requirements are difficult to quantify for older adults because there is great variability in aging. There are trends in changes that have been identified through longitudinal studies that indicate that, although there is a decrease in energy requirement with advancing age, there is not a parallel decrease in the need for most other nutrients. In fact, protein requirements per kilogram of body weight may increase; increases for certain vitamins may be due to their unique absorptive and metabolic processes that may be affected by chronic conditions. There is little evidence to support changes in mineral needs unless there is an association with the management of a chronic condition. Fluid requirements to prevent dehydration must be addressed in elderly people.


Conservation of Imprinting and Methylation of MKRN3, MAGEL2 and NDN Genes in Cattle.
Genomic imprinting is the epigenetic mechanism of transcriptional regulation that involves differential DNA methylation modification. Comparative analysis of imprinted genes between species can help us to investigate the biological significance and regulatory mechanisms of genomic imprinting. MKRN3, MAGEL2 and NDN are three maternally imprinted genes identified in the human PWS/AS imprinted locus. This study aimed to assess the allelic expression of MKRN3, MAGEL2 and NDN and to examine the differentially methylated regions (DMRs) of bovine PWS/AS imprinted domains. An expressed single-nucleotide polymorphism (SNP)-based approach was used to investigate the allelic expression of MKRN3, MAGEL2 and NDN genes in bovine adult tissues and placenta. Consistent with the expression in humans and mice, we found that the MKRN3, MAGEL2 and NDN genes exhibit monoallelic expression in bovine somatic tissues and the paternal allele expressed in the bovine placenta. Three DMRs, PWS-IC, MKRN3 and NDN DMR, were identified in the bovine PWS/AS imprinted region by analysis of the DNA methylation status in bovine tissues using the bisulfite sequencing method and were located in the promoter and exon 1 of the SNRPN gene, NDN promoter and 5' untranslated region (5'UTR) of MKRN3 gene, respectively. The PWS-IC DMR is a primary DMR inherited from the male or female gamete, but NDN and MKRN3 DMR are secondary DMRs that occurred after fertilization by examining the methylation status in gametes.


Assessing the relevant time frame for temperature acclimation of leaf dark respiration: A test with 10 boreal and temperate species.
Plants often adjust their leaf mitochondrial ("dark") respiration (Rd ) measured at a standardized temperature such as 20°C (R20 ) downward after experiencing warmer temperatures and upward after experiencing cooler temperatures. These responses may help leaves maintain advantageous photosynthetic capacity and/or be a response to recent photosynthate accumulation, and can occur within days after a change in thermal regime. It is not clear, however, how the sensitivity and magnitude of this response change over time, or which time period prior to a given measurement best predicts R20 . Nor is it known whether nighttime, daytime, or 24-hour temperatures should be most influential. To address these issues, we used data from 1620 Rd temperature response curves of 10 temperate and boreal tree species in a long-term field experiment in Minnesota, USA to assess how the observed nearly complete acclimation of R20 was related to past temperatures during periods of differing lengths. We hypothesized that R20 would be best related to prior midday temperatures associated with both photosynthetic biochemistry and peak carbon uptake rates that drive carbohydrate accumulation. Inconsistent with this hypothesis, prior night temperatures were the best predictors of R20 for all species. We had also hypothesized that recent (prior 3-10 days) temperatures should best predict R20 because they likely have stronger residual impacts on leaf-level physiology than periods extending further back in time, whereas a prior 1- to 2-day period might be a span shorter than one to which photosynthetic capacity and Rd adjust. There was little to no support for this idea, as for angiosperms, long time windows (prior 30-60 nights) were the best predictors, while for gymnosperms both near-term (prior 3-8 nights for pines, prior 10-14 nights for spruce/fir) and longer-term periods (prior 45 nights) were the best predictors. The importance of nighttime temperatures, the relatively long "time-averaging" that best explained acclimation, and dual peaks of temporal acclimation responsiveness in some species were all results that were unanticipated.


Effects of the addition of insulin-transferrin-selenium (ITS) and/or metformin to the in vitro maturation of porcine oocytes on cytoplasmic maturation and embryo development.
One of the main problems of porcine in vitro maturation (IVM) is incomplete cytoplasmatic maturation. Nuclear and cytoplasmic maturation will determine the future success of fertilisation and embryo development. Insulin-transferrin-selenium (ITS) has insulin-like and antioxidant effects, and metformin (M) is an insulin-sensitiser and antioxidant drug. To assess the effects of adding ITS and/or M in porcine IVM media on cytoplasmic maturation and early embryo development. Cumulus -oocyte complexes (COC) were IVM with M (10-4 M), ITS (0.1% v/v), M+ITS or no adding (Control). ITS increased glucose consumption compared to Control and M (P <0.01), and M+ITS did not differ from ITS or Control. Redox balance: M, ITS and M+ITS increased glutathione (P <0.01) and decreased lipid peroxidation (P <0.005). The viability of cumulus cells by flow cytometry increased with M (P <0.005) and decreased with ITS (P <0.001); M+ITS did not differ from Control. After IVF, M increased penetration and decreased male pronucleus (P <0.05). Embryo development: cleavage increased with M (P <0.05), and blastocysts increased with ITS and M+ITS (P <0.05). The number of blastocyst cells increased with ITS (P <0.05). Adding ITS and M+ITS to porcine IVM media benefits embryo development to blastocysts, but ITS alone has better effects than M+ITS. ITS is an excellent tool to improve IVM and embryo development after IVF in pigs.


Control of bleeding in extrahepatic portal hypertension--the reverse splenorenal shunt and portal-azygos disconnection.
Variceal bleeding in children with extrahepatic portal hypertension is best controlled by an effective decompressive shunt. Both the standard and central splenorenal shunts require splenectomy which is undesirable in childhood, and alternative shunts such as the mesocaval shunt and the distal splenorenal shunt are also technically difficult with a similar risk of shunt thrombosis. The reverse splenorenal shunt first described in 1962 by Erlik uses the proximal portion of the left renal vein which was initially anastomosed to the portal vein. It can be anastomosed to any of the major tributaries of the portal system. In the technique described, the proximal end of the renal vein is joined to the side of the splenic vein continuity. It is preferable for this to be done as an elective planned procedure. Massive continuing haemorrhage which is not responding to conservative management can be controlled by portal-azygos disconnection with gastric transection. This procedure will control major variceal haemorrhage for several years and allow a decompressive shunt to be performed under optimal conditions and after appropriate preoperative investigations.


Treatment of an elderly patient with acute abdominal pain with traditional Korean medicine.
Abdominal pain in elderly patients leads to challenge due to diagnostic difficulty and high incidence of complications. This case report presents an elderly patient with acute and severe abdominal pain, who did not respond to Western treatments. The patient was diagnosed to have abdominal pain by Yang deficiency of spleen (脾陽虛). Acupuncture (mainly at LI4 and LR3), indirect moxibustion (CV4 and CV8), and a herbal drug [DaehwangBuja-Tang (大黃附子湯)] were given to the patient; the abdominal pain and related symptoms disappeared completely within 3 days. This study proved the potential use of traditional Korean medicine for treating abdominal pain in elderly patients.


Effect of damped sine-wave shocks on catheter dielectric strength.
This study evaluated the ability of 24 new standard tripolar and quadripolar U.S. Catheter Instruments catheters to withstand a single damped sinusoidal shock delivered by a standard defibrillator. The schema for energy delivery was meant to simulate possible clinical practices. Delivered peak voltage and current were measured during each shock. Each electrode was examined for pitting and changes in line resistance as a consequence of the shock. Electrode pitting occurred on all selected anodal poles. However, it also was found on "unsolicited" electrodes from 7 catheters, indicating that current had followed unanticipated routes. Electrode line resistance was unmeasurable in 6 of these 7 inappropriately pitted electrodes. Delivered peak voltage and postshock catheter dielectric strength depended on the manner of energy delivery. To simulate a posterior septal accessory pathway ablation procedure, a shock was delivered to 2 proximal (anodal) poles in 16 quadripolar catheters (8 received 200 J and 8 received 360 J). Delivered peak voltage was 3,125 +/- 362 V for the 200-J shock and 4,100 +/- 160 V for the 360-J shock. Postshock catheter dielectric strength for the 200- and 360-J shock was 1,425 +/- 826 V and 601 +/- 707 V, respectively. This was significantly lower than peak delivered voltage (p less than 0.001 for either energy). To simulate His bundle or ventricular tachycardia focus ablation, 8 tripolar catheters each received a single 200-J shock to the tip electrode. This resulted in a delivered peak voltage of 2,900 +/- 351 V, compared with a postshock dielectric strength of 1,325 +/- 1,320 V (p less than 0.002).(ABSTRACT TRUNCATED AT 250 WORDS)


In vitro immunoglobulin production by mononuclear cells in rheumatoid arthritis.
Since patients with rheumatoid arthritis (RA) exhibit serum hypergammaglobulinemia and autoantibody (rheumatoid factor) production, we compared elaboration and control of in vitro RA mononuclear cell (MNC), Ig assayed by enzyme-linked immunoassays or by hemolytic plaque formation, in 37 RA patients and 17 normal subjects. We found (1) RA spontaneous plaque-forming cells were significantly reduced (RA 344 vs normal 627 PFC/10(6) MNC, P less than 0.002); (2) RA spontaneous IgG and IgM (but not IgA) elaboration was significantly diminished (IgG RA 339, normal 776; IgM RA 255, normal 869 ng/ml, P less than 0.001; IgA RA 87, normal 124); (3) RA stimulated IgG and IgM production (but not IgA) was also decreased (IgG RA 2434, normal 3862, P less than 0.06; IgM RA, 1676, normal 3323, P less than 0.005; IgA RA 1859, normal 2315); (4) reduced RA Ig elaboration was not clearly due to altered numbers of T or non-T cells, age, medications, clinical features of disease, or response kinetics; (5) relative improvement of RA in vitro IgG, but not usually IgM, secretion followed removal of adherent cells, addition of indomethacin or addition of mitomycin C-treated T cells; (6) MNC from synovial fluids, but not bone marrows, exhibited spontaneous Ig production in excess of stimulated synovial fluid cellular or peripheral blood Ig elaboration. These observations indicate selective impairment of peripheral blood MNC IgG and, particularly, IgM secretion in RA. This defect appears to reflect accessory cell influences which differ from normal as well as the sequestration of primed or activated cells in the synovial fluid.


Ischemia modifies protein distribution in gerbil brain subcellular fractions.
This work deals with changes in sedimentation of proteins in subcellular fractions isolated from the ischemic brain of Mongolian gerbils. We analysed protein content and the activity of marker enzymes in P2, S2, M and S3 subfractions isolated after 10 min ischemia, ischemia combined with apnea or 1 h later, after recirculation. On the basis of protein balance, the distribution of marker enzymes and electrophoretic analysis of proteins in brain subfractions it was shown that in ischemia some fraction of proteins which are normally cytosolic and microsomal, cosediment with the crude mitochondrial pellet. This effect, aggravated in ischemia complicated by apnea, is reversible and after 1 h recirculation the protein distribution in the brain normalizes completely.


Lipomatous Solitary Fibrous Tumors Harbor Rare NAB2-STAT6 Fusion Variants and Show Up-Regulation of the Gene PPARG, Encoding for a Regulator of Adipocyte Differentiation.
Solitary fibrous tumors (SFTs) harbor activating NAB2-STAT6 gene fusions. Different variants of the NAB2-STAT6 gene fusion have been associated with distinct clinicopathologic features. Lipomatous SFTs are a morphologic variant of SFTs, characterized by a fat-forming tumor component. Our aim was to evaluate NAB2-STAT6 fusion variants and to further study the molecular genetic features in a cohort of lipomatous SFTs. A hybrid-capture-based next-generation sequencing panel was employed to detect NAB2-STAT6 gene fusions at the RNA level. In addition, the RNA expression levels of 507 genes were evaluated using this panel, and were compared with a control cohort of nonlipomatous SFTs. Notably, 5 of 11 (45%) of lipomatous SFTs in the current series harbored the uncommon NAB2 exon 4-STAT6 exon 4 gene fusion variant, which is observed in only 0.9% to 1.4% of nonlipomatous SFTs. Furthermore, lipomatous SFTs displayed significant differences in gene expression compared with their nonlipomatous counterparts, including up-regulation of the gene peroxisome proliferator activated receptor-γ (PPARG). Peroxisome proliferator activated receptor-γ is a nuclear receptor regulating adipocyte differentiation, providing a possible explanation for the fat-forming component in lipomatous SFTs. In summary, the current study provides a possible molecular genetic basis for the distinct morphologic features of lipomatous SFTs.


Quantification and Selection of Ictogenic Zones in Epilepsy Surgery.
Network models of brain dynamics provide valuable insight into the healthy functioning of the brain and how this breaks down in disease. A pertinent example is the use of network models to understand seizure generation (ictogenesis) in epilepsy. Recently, computational models have emerged to aid our understanding of seizures and to predict the outcome of surgical perturbations to brain networks. Such approaches provide the opportunity to quantify the effect of removing regions of tissue from brain networks and thereby search for the optimal resection strategy. Here, we use computational models to elucidate how sets of nodes contribute to the ictogenicity of networks. In small networks we fully elucidate the ictogenicity of all possible sets of nodes and demonstrate that the distribution of ictogenicity across sets depends on network topology. However, the full elucidation is a combinatorial problem that becomes intractable for large networks. Therefore, we combine computational models with a genetic algorithm to search for minimal sets of nodes that contribute significantly to ictogenesis. We demonstrate the potential applicability of these methods in practice by identifying optimal sets of nodes to resect in networks derived from 20 individuals who underwent resective surgery for epilepsy. We show that they have the potential to aid epilepsy surgery by suggesting alternative resection sites as well as facilitating the avoidance of brain regions that should not be resected.


A 2-year follow-up study of alcohol consumption and risk of dementia.
This report focused on investigating the relationship between alcohol consumption and dementia in elderly people through prospective studies. We conducted a 2-year follow-up study of elderly people from six communities in Chongqing, China. Dementia was detected using the Mini-Mental State Examination (MMSE) and the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R). The relationship between alcohol consumption and dementia was investigated using multiple logistic regression models, adjusting for the potential confounders age, sex, educational level and cigarette smoking. Light-to-moderate drinking was associated with a significantly lower risk of dementia compared with non-drinking. Excessive drinking was related to a higher risk of dementia. The effect of light-to-moderate drinking seemed most prominent among vascular dementia, 0.63 (0.55-0.72) for Alzheimer's disease, 0.31 (0.19-0.51) for vascular dementia and 0.45 (0.12-1.69) for other dementia. In a model adjusting for confounding variables, a light-to-moderate intake of beer was associated with a significantly higher risk of dementia than a non-drinker of beer. For wine, a significantly lower risk of dementia existed for a light-to-moderate drinker. Light-to-moderate drinking was associated with a significantly lower risk of dementia compared with a non-drinker.


Molecular approach in spider mites (Acari: Tetranychidae): preliminary data on ribosomal DNA sequences.
DNA sequence data were used to examine phylogenetic relationships between six species of economically important Tetranychidae mites: Eotetranychus carpini (Oudemans), E. pruni (Reck), Tetranychus pacificus McGregor, T. mcdanieli McGregor, T. turkestani Ugarov & Nikolski and T. urticae Koch. With primers directed toward conserved elements flanking the target region, the Polymerase Chain Reaction was used to amplify the ITS2 spacer of the ribosomal DNA molecule. The nucleotide sequence of a 300-bp fragment of the ITS2 was determined by direct sequencing and nucleotide divergence used for intra-generic comparison in mites. The resulting phylogenetic tree expressing interspecific relationships in genus Tetranychus agrees with morphological data. The study demonstrates the usefulness of the approach in the assessment of the systematics and evolution of the group.


Expression of FRS2 in atypical lipomatous tumor/well-differentiated liposarcoma and dedifferentiated liposarcoma: an immunohistochemical analysis of 182 cases with genetic data.
The fibroblast growth factor receptor substrate 2 (FRS2) gene is located close to MDM2 and CDK4 within the 12q13-15 chromosomal region. FRS2 gene was recently found to be consistently amplified in atypical lipomatous tumor (ALT)/well-differentiated liposarcoma (WDL) and dedifferentiated liposarcoma (DDL), suggesting the detection of FRS2 amplification could be a diagnostic tool for ALT/WDL/DDLs. However, the expression of FRS2 protein and diagnostic value of FRS2 immunohistochemistry (IHC) has not been evaluated in a large cohort of ALT/WDL/DDLs. A SNOMED search of hospital surgical pathology files from January 2007 to July 2020 identified 182 ALT/WDL/DDLs with available materials. FRS2 fluorescence in situ hybridization (FISH) and IHC were performed on 182 ALT/WDL/DDLs and 64 control samples. The expression of FRS2 was also compared with that of classic immunomarkers (MDM2 and CDK4) of this tumor entity. This study included 91 ALT/WDLs and 91 DDLs. The FISH results showed 172 of 182 (94.5%) cases were FRS2-amplified, and 10 cases were FRS2-nonamplified. Immunostaining results showed 171 (94.0%) ALT/WDL/DDLs were positive for FRS2 and 11 cases (6.0%) were FRS2-immunonegative. In 172 FRS2-amplified cases, 166 (96.5%) were FRS2-immunopositive, and 6 (3.5%) were negative. Among 10 FRS2-nonamplified ALT/WDL/DDL cases, 5 cases were FRS2-immunonegative, and 5 tumors displayed 1+ staining for this marker. In 64 control cases, none of them exhibited FRS2 amplification. Forty-seven (73.5%) control cases were negative for FRS2 immunostaining, while 17 cases (26.5%) were FRS2-immunopositive. Fifteen of these false positive samples (15/17, 88.2%) showed 1+ positivity and only 2 cases (2/17, 11.8%) displayed 2+ positivity. In ALT/WDL/DDLs, the sensitivity of FRS2 immunostaining was slightly lower than MDM2 (FRS2 vs. MDM2: 94.0% vs 100.0%) and CDK4 (FRS2 vs. CDK4: 94.0% vs 97.0%). However, the specificity of FRS2 (73.5%) was slightly higher than that of MDM2 (67.8%) and CDK4 (64.4%). This study indicated that FRS2 IHC had relatively good consistency with FRS2 FISH, suggesting that FRS2 immunostaining could be utilized as an additional screening tool for the diagnosis of ALT/WDL/DDL. It must be emphasized that MDM2/CDK4/FRS2 especially MDM2 FISH remains the gold standard and the most recommended method to diagnose this entity.


Macrophages-induced IL-18-mediated eosinophilia promotes characteristics of pancreatic malignancy.
Reports indicate that accumulated macrophages in the pancreas are responsible for promoting the pathogenesis of chronic pancreatitis (CP). Recently, macrophage-secreted cytokines have been implicated in promoting pancreatic acinar-to-ductal metaplasia (ADM). This study aims to establish the role of accumulated macrophage-activated NLRP3-IL-18-eosinophil mechanistic pathway in promoting several characteristics of pancreatic malignancy in CP. We report that in a murine model of pancreatic cancer (PC), accumulated macrophages are the source of NLRP3-regulated IL-18, which promotes eosinophilic inflammation-mediated accumulation to periductal mucin and collagen, including the formation of ADM, pancreatic intraepithelial neoplasia (PanINs), and intraductal papillary mucinous neoplasm. Most importantly, we show improved malignant characteristics with reduced levels of oncogenes in an anti-IL-18 neutralized and IL-18 gene deficient murine model of CP. Last, human biopsies validated that NLRP3-IL-18-induced eosinophils accumulate near the ducts, showing PanINs formation in PC. Taken together, we present the evidence on the role of IL-18-induced eosinophilia in the development of PC phenotype like ADM, PanINs, and ductal cell differentiation in inflammation-induced CP.


Gender differences in clinical presentation and surgical outcome of aortic stenosis.
Little is known about the gender differences of patients undergoing aortic valve replacement (AVR) for isolated severe aortic stenosis. 408 consecutive patients (215 women and 193 men; p=0.9) were analysed. At presentation, women were older (73.7+/-9.3 years vs men 66.5+/-11.5 years; p<0.001), more symptomatic (New York Heart Association (NYHA) class: women 2.3+/-0.7 vs men 2.0+/-0.65; p<0.001), and presented with smaller valve areas (women 0.6+/-0.2 cm(2) vs men 0.7+/-0.2 cm(2); p<0.001) and higher mean pressure gradients (women 67.3+/-19.2 mm Hg vs men 62.2+/-20.0 mm Hg, p=0.001). Despite older age and more advanced disease in women, operative mortality did not differ. Survival after AVR by Kaplan-Meier analysis tended to be even better in women (92.8%, 89.8%, 81.4% vs men 89.1%, 86.6%, 76.3% at 1, 2 and 5 years, p=0.31). After division into age quintiles, the outcome of women was significantly better in patients older than 79 years (p=0.005). After adjustment for clinical characteristics, gender did not predict operative mortality and late outcome. Despite physical improvement in both groups after surgery, women remained more symptomatic (NYHA class: women 1.6+/-0.7 vs men 1.3+/-0.4; p=0.001). Although women referred to AVR are older and more symptomatic, operative and long-term mortality are not increased. In the oldest age group of 79 years and older, women even have a better outcome, presumably due to a longer mean life expectancy.


Kinetically distinct processing pathways diversify the CD8+ T cell response to a single viral epitope.
The source proteins from which CD8+ T cell-activating peptides are derived remain enigmatic. Glycoproteins are particularly challenging in this regard owing to several potential trafficking routes within the cell. By engineering a glycoprotein-derived epitope to contain an N-linked glycosylation site, we determined that optimal CD8+ T cell expansion and function were induced by the peptides that are rapidly produced from the exceedingly minor fraction of protein mislocalized to the cytosol. In contrast, peptides derived from the much larger fraction that undergoes translocation and quality control are produced with delayed kinetics and induce suboptimal CD8+ T cell responses. This dual system of peptide generation enhances CD8+ T cell participation in diversifying both antigenicity and the kinetics of peptide display.


Practical approaches to the evaluation of signal-to-noise ratio performance with parallel imaging: application with cardiac imaging and a 32-channel cardiac coil.
In this work, two practical methods for the measurement of signal-to-noise-ratio (SNR) performance in parallel imaging are described. Phantoms and human studies were performed with a 32-channel cardiac coil in the context of ultrafast cardiac CINE imaging at 1.5 T using steady-state free precession (SSFP) and TSENSE. SNR and g-factor phantom measurements using a "multiple acquisition" method were compared to measurements from a "difference method". Excellent agreement was seen between the two methods, and the g-factor shows qualitative agreement with theoretical predictions from the literature. Examples of high temporal (42.6 ms) and spatial (2.1x2.1x8 mm3) resolution cardiac CINE SSFP images acquired from human volunteers using TSENSE are shown for acceleration factors up to 7. Image quality agrees qualitatively with phantom SNR measurements, suggesting an optimum acceleration of 4. With this acceleration, a cardiac function study consisting of 6 image planes (3 short-axis views, 3 long-axis views) was obtained in an 18-heartbeat breath-hold.


Immunohistochemical demonstration of melatonin in the female mink harderian gland.
In the Harderian gland of the female mink, either intact or killed after a bilateral ablation of the cervical superior ganglion, almost all of the cells of the alveoli were immunolabeled with anti-melatonin antiserum. Animals were killed during the day or during the night. The immunolabelling was observed only in the cytoplasm, while the nucleus remained unstained. Using successive dilutions of the antiserum on serial sections of the Harderian gland to qualitate the melatonin content, a circadian rhythm of melatonin immunoreactivity was observed. The intensity of immunofluorescence labelling was higher in intact animals killed during the day than in those killed during the night. These results could be explained by the inhibitory or stimulatory influence of pineal melatonin released during the night on melatonin synthesis or release in the Harderian gland, respectively. In the Harderian gland of ganglionectomized animals, the intensity of melatonin immunofluorescence was lower than in intact animals killed during the day. It is concluded that the Harderian gland might be involved in the perception of the day/night cycle and that melatonin synthesis/secretion was likely controlled by the cervical superior ganglion in this organ.


A systematic review of placebo-controlled randomized clinical trials of treatments used in oral lichen planus.
Oral lichen planus (OLP) is one of the commoner conditions seen in oral medicine clinics. Current treatments are palliative rather than curative. Numerous treatments have been tried but many have not been evaluated in randomized controlled trials (RCTs). To review the effectiveness and safety of any therapy compared with placebo for the treatment of symptomatic OLP. A systematic review of 11 RCTs, totalling 223 patients was done. The main outcome measures used were improvement of signs (erythema, reticulation, ulceration) and symptoms (pain, discomfort) usually after 8 weeks of therapy. Eleven interventions were grouped into four therapeutic classes (topical ciclosporins, topical or systemic retinoids, topical steroids and phototherapy) for comparison. No therapy was replicated exactly. Trials recording the same outcomes in each therapeutic class were pooled. The largest number of pooled trials was four. Small odds ratios with very wide confidence intervals indicating statistically significant but imprecisely known treatment benefits were seen in all but one trial. Only systemic agents were associated with treatment toxicities; all other side-effects were mild and mainly local. The results are tempered by the small study sizes, lack of replication, lack of standardized outcome measures and the very high likelihood of publication bias. Therefore this review provides only circumstantial evidence for the superiority of the assessed interventions over placebo for the palliation of symptomatic OLP. There is a need for larger placebo-controlled RCTs with carefully selected and standardized outcome measures.


Ultra-Low Energy Cycled Burst Spinal Cord Stimulation Yields Robust Outcomes in Pain, Function, and Affective Domains: A Subanalysis From Two Prospective, Multicenter, International Clinical Trials.
DeRidder's burst stimulation design has become a key spinal cord stimulation (SCS) waveform because it reduces the intensity of pain as well as its associated emotional distress. The brain pathways underlying these outcomes may also allow for the effects of stimulation to carry over after stimulation is turned off, making it amenable to intermittent application. Here, the utility of intermittently cycled burst was evaluated using data from two large real-world prospective studies (TRIUMPH, REALITY). Subjects used intermittent dosing in a 1:3 ratio (30 sec on, 90 sec off; N = 100) in TRIUMPH and 1:12 ratio in REALITY (30-sec on, 360-sec off; N = 95) for six months. Pain intensity (0-10 numeric rating scale), pain-related emotions on the pain catastrophizing scale (PCS), and physical function on PROMIS questionnaires were compared with preimplant baseline ratings and by group. In both groups, mean pain intensity decreased by nearly 50% relative to baseline, PCS scores significantly decreased, and physical function improved. Importantly, no differences between the 1:3 and 1:12 groups were identified. A high proportion, 80% and 77% of the 1:3 and 1:12 groups, respectively, were considered responders on a multiple measures. No adverse events were associated with intermittent stimulation. Intermittent cycling of burst SCS lowers the overall electric charge delivered to the spinal cord and preserves battery consumption, without compromising pain relief and associated symptoms.


The mood-induced activation of implicit alcohol cognition in enhancement and coping motivated drinkers.
In two experiments, we investigated whether different mood states activate specific types of implicit alcohol cognition among undergraduates classified as enhancement (EM) or coping (CM) motivated drinkers. Participants completed a Stroop task in Experiment 1 (n=81), and an Extrinsic Affective Simon Task (EAST; [De Houwer, J. (2003). The Extrinsic Affective Simon Task. Experimental Psychology, 50, 77-85.]) in Experiment 2 (n=79) following random assignment to listen to positive or negative musical mood induction procedures (MMIP). Consistent with hypotheses, only EM, and not CM, drinkers displayed an activation of implicit attention to alcohol cues (Experiment 1) and reward-alcohol implicit associations (Experiment 2) following exposure to positive MMIP. Contrary to hypotheses for CM drinkers, none of the groups, in either experiment, showed an activation of implicit alcohol processing following exposure to negative MMIP. Confidence that positive mood activates implicit alcohol cognition among EM drinkers is increased since this result emerged across two studies involving quite different methodologies. This research has implications for experimental cognitive research and it highlights the potential utility of treatment matching according to drinking motives (e.g., EM) to improve clinical outcomes.