Binucleated cells in a human renal cell carcinoma with 34 chromosomes.
Cytogenetic analysis of a human renal cell carcinoma revealed a near-haploid chromosome number of 34 with the loss of one chromosome #1, #2, #3, #6, #7, #9, #10, #12, #13, #17, #18, and #21. Binucleated cells were observed in histologic, cytologic, as well as in cytogenetic preparations. The paper briefly discusses the binucleation-polyploidization as a possible compensatory mechanism to maintain the genetic balance in near-haploid cells.


Programmed cell death-10 enhances proliferation and protects malignant T cells from apoptosis.
The programmed cell death-10 (PDCD10; also known as cerebral cavernous malformation-3 or CCM3) gene encodes an evolutionarily conserved protein associated with cell apoptosis. Mutations in PDCD10 result in cerebral cavernous malformations, an important cause of cerebral hemorrhage. PDCD10 is associated with serine/threonine kinases and phosphatases and modulates the extracellular signal-regulated kinase pathway suggesting a role in the regulation of cellular growth. Here we provide evidence of a constitutive expression of PDCD10 in malignant T cells and cell lines from peripheral blood of cutaneous T-cell lymphoma (Sezary syndrome) patients. PDCD10 is associated with protein phosphatase-2A, a regulator of mitogenesis and apoptosis in malignant T cells. Inhibition of oncogenic signal pathways [Jak3, Notch1, and nuclear factor-κB (NF-κB)] partly inhibits the constitutive PDCD10 expression, whereas an activator of Jak3 and NF-κB, interleukin-2 (IL-2), enhances PDCD10 expression. Functional data show that PDCD10 depletion by small interfering RNA induces apoptosis and decreases proliferation of the sensitive cells. To our knowledge, these data provide the first functional link between PDCD10 and cancer.


Partial cystectomy for invasive bladder cancer.
Thirty two patients--23 males and 9 females with a mean age of 52.5 years--underwent planned partial cystectomy for histologically proved muscle invasive bladder cancer. Twenty patients had transitional cell carcinoma and 12 had adenocarcinoma of the bladder. One patient had well-differentiated, 18 had moderately differentiated, and 13 had poorly differentiated tumours. The tumour size was < 2 cm in 7 patients, 2-4 cm in 19 patients, and > 4 cm in 6 patients. Patients with single primary muscle invasive tumours situated in the upper half of the bladder were considered eligible for partial cystectomy. The presence of multicentric urothelial disease, of dysplasia, or carcinoma-in-situ in bladder mucosa away from the tumour on multiple random punch biopsies was considered contraindications to partial cystectomy. All patients underwent partial cystectomy with bilateral pelvic lymphadenectomy. The tumour-free margins of resection were confirmed by intraoperative frozen section examination. The bladder was closed primarily in all patients, although three patients required re-implantation of the ureter. No patient received adjuvant radiation or chemotherapy. Five patients had pathological stage B1 (T2), 18 had B2 (T3A), and 9 had C (T3B) disease. No patient had metastatic pelvic lymph nodes. There was one postoperative death due to unrelated medical cause. Five patients had minor complications that resolved with conservative measures. All patients had adequate bladder capacity of > 250 cc at 6 months after surgery, and none had symptoms attributable to reduced bladder capacity. The overall actuarial survival was 80.1% at 5 years.(ABSTRACT TRUNCATED AT 250 WORDS)


Challenges and opportunities for on-line monitoring of chlorine-produced oxidants in seawater using portable membrane-introduction Fourier transform-ion cyclotron resonance mass spectrometry.
The present study reports the first evaluation of a MIMS device equipped with a high-resolution Fourier transform-ion cyclotron resonance mass spectrometer (FT-ICR MS) for comprehensive speciation of chlorine-produced oxidants (CPO) in seawater. A total of 40 model compounds were studied: 4 inorganic haloamines (mono-, di-, and trichloramine and monobromamine), 22 organic N-haloamines, 12 N-haloamino acids, and 2 free oxidants (HOCl/ClO- and HOBr/BrO-). The main key factors influencing the analytes' introduction and their detection were optimized. Under optimized conditions, the rise and fall times of the MIMS signal ranged from 8 to 79 min and from 7 to 73 min, respectively, depending on the compound. Free oxidants and N-haloamino acids, which are ionic or too polar at seawater pH, hardly crossed the membrane, and MIMS analysis was thus unsuitable. Nevertheless, better enrichment and therefore better sensitivity were achieved with organic N-haloamines than with inorganic haloamines. The observed detection limits ranged from tens of μM to sub-μM levels. Oxidant decomposition occurred inside the MIMS device, at a higher rate for N-bromamines than for chlorinated analogues.Graphical abstract.


Myosin light chain phosphorylation during staircase in fatigued skeletal muscle.
It has been reported that the peak of the staircase or the enhanced tension response during low frequency stimulation is delayed in fatigued fast muscle. Our purpose was to determine if the rate and extent of regulatory myosin light chain (P-LC) phosphorylation, a molecular mechanism associated with the positive staircase, are also altered by fatigue. The staircase contractile response, muscle metabolites and phosphate incorporation by the P-LC were assessed at 0, 5, 10 or 20 s of 10-Hz stimulation, in either non-fatigued (control) or fatigued (10 Hz for 5 min, followed by 20 min of recovery) rat gastrocnemius muscle in situ. The concentration of adenosine triphosphate (ATP) in fatigued muscles, 21 +/- 0.9 mmol.kg-1 (dry weight) was significantly lower (P < 0.05) than in the control muscles, 26.1 +/- 1.5 mmol.kg-1. In both groups, ATP content was significantly lower after 20 s of 10 Hz stimulation. The P-LC phosphate content (in mol phosphate.mol-1 P-LC) was 0.10, 0.38, 0.60 and 0.72 after 0, 5, 10 or 20 s of 10 Hz stimulation in control muscles, but only 0.03, 0.08, 0.11 and 0.19 at these times in fatigued muscles. Although the absolute magnitude of tension potentiation was attenuated in proportion to the depressed twitch amplitude, these surprisingly low levels of phosphorylation were associated with 0, 48, 79 and 86% potentiation of the developed tension at these times in contrast with 0, 71, 87 and 49% potentiation in control muscles. These data demonstrate that while the rate and extent of phosphate incorporation is depressed in fatigued muscle, tension potentiation is still evident.(ABSTRACT TRUNCATED AT 250 WORDS)


Organic matter removal and nitrogen transformation by a constructed wetland-microbial fuel cell system with simultaneous bioelectricity generation.
Microbial fuel cells integrated into constructed wetlands have been previously studied. Nevertheless, their application as a suitable treatment for wastewater is still in the developmental stage. In this context, the aim of this study was to evaluate organic matter removal and nitrogen transformation by a microbial fuel cell integrated into a constructed wetland (CWMFC). To accomplish this, three experimental systems were operated under batch-mode conditions over 170 days: i) one was planted with Schoenoplectus californicus (P-CWMFC); ii) another was unplanted (NP-CWMFC); and iii) the third system did not have any electrodes (CW) and was used as a control. Chemical oxygen demand (COD) removal efficiency ranged between 74-87%, 69-81% and 62-72% for the P-CWMFC, NP-CWMFC and CW systems, respectively, with organic loading rates (OLR) ranging from 4.8 to 7.9 g COD/m2 d. NH4+-N removal efficiency exceeded 98%, 90% and 83% for P-CWMFC, NP-CWMFC and CW, respectively. Wastewater treatment performance was improved due to anaerobic oxidation that occurred on the anodes. Organic matter removal was 18% higher in closed-circuit mode than in open-circuit mode in both integrated systems (P-CWMFC and NP-CWMFC), and these differences were significant (p < 0.05). With respect to the performance of microbial fuel cells, the maximum power density (8.6 mW/m2) was achieved at an organic loading rate of 7.9 g COD/m2 d with an internal resistance and coulombic efficiency of 251 Ω and 2.4%, respectively. The results obtained in this work can provide positive impacts on CW development by enhancing anaerobic degradation without forced aeration.


Glucose transporter member 1 is involved in UVB-induced epidermal hyperplasia by enhancing proliferation in epidermal keratinocytes.
Glucose transporter member 1 (GLUT-1) is one of the major facilitated glucose transporters and contributes to the promotion of keratinocyte proliferation in psoriasis and carcinogenic lesions. In this study, we postulate that GLUT-1 is involved in ultraviolet B (UVB)-induced epidermal hyperplasia. The purpose of this study is to investigate the possible role of GLUT-1 in UVB-induced hyperplasia. The effects of UVB on GLUT-1 expression levels were investigated in in vitro and in vivo studies. In addition, the involvement of epidermal growth factor (EGF) and hypoxia inducible factor-1 alpha (HIF-1α), transcriptional factors for GLUT-1, in GLUT-1-related events were investigated. GLUT-1 mRNA and its protein levels were markedly increased by UVB irradiation in HaCaT cells. In in vivo studies, a strong immunofluorescence signal of GLUT-1 was clearly observed around the basal layer of the epidermis, which proliferated excessively by UVB irradiation. In HaCaT cells, EGF mRNA and its protein levels were markedly increased by UVB irradiation, and then the GLUT-1 mRNA level was significantly increased by treatment with EGF. Additionally, the upregulation of GLUT-1 by both UVB irradiation and treatment with EGF was significantly suppressed by transfection with HIF-1α siRNA. We conclude that GLUT-1 is involved in UVB-induced epidermal hyperplasia by enhancing proliferation of epidermal basal cells, and the GLUT-1-related event might be regulated by an increase in HIF-1α stimulated by EGF.


Radioimmunoassay of pyridostigmine in plasma and tissues.
A sensitive and specific radioimmunoassay is reported for the cholinergic agent, pyridostigmine. Antibodies were raised in rabbits against a conjugate of pyridostigmine and bovine serum albumin. The assay can detect as little as 2.5 ng/ml of drug directly in plasma and tissue homogenates. Structurally similar compounds and major metabolites are not recognized by the antibody. The specificity of the antibody has been confirmed by utilizing high pressure liquid chromatography. Plasma concentration-time profiles and tissue distribution of the drug were determined by this method in rat after intramuscular administration of pyridostigmine.


The Crooked Nose.
Correction of a crooked nose is one of the most common requests from patients presenting for rhinoplasty. Both esthetic and functional issues are typically present in patients with this deformity. Rhinoplasty for the crooked nose is particularly challenging because multiple nasal structures, both external and internal, are commonly involved. A major septal deformity is almost always a component of severely deviated noses. The crooked nose results from extrinsic and intrinsic forces that produce distortion of the nasal structures and nasal deviation. The open approach is particularly useful and is the focus of this article.


Synthesis and binding affinities of new 17 alpha-substituted estradiol-rhenium "n + 1" mixed-ligand and thioether-carbonyl complexes.
The development of technetium and rhenium-based radiotracers for the steroid receptor system requires the use of suitable donor groups on the steroid to provide stable binding sites for the metal. Previous approaches have mainly exploited methods involving various N- and S-coordinating chelate systems or organometallic complexes. In this work, we have prepared several novel chelate systems attached to a series of 17 alpha-substituted estradiol derivatives and examined their binding to the estrogen receptor (ER). The neutral "n + 1" mixed-ligand and dithioether-carbonyl complexes that we prepared contain the metal in three oxidation states, +5, +3 or +1, attached to a 17 alpha-substituted estradiol derivative through a thiol group, an isocyanide group, or a dithioether unit, respectively. In our preliminary investigations, we used rhenium as a nonradioactive analog of the radionuclide technetium. All complexes synthesized were evaluated in a competitive radiometric receptor binding assay at 0 degree C and 25 degrees C to determine their relative binding affinities (RBA) to the ER (relative to 3,17 beta-estradiol, RBA = 100%). The complexes show binding affinities up to 23.4% at 0 degree C and 14.1% at 25 degrees C.


Genetic Identification of Vagal Sensory Neurons That Control Feeding.
Energy homeostasis requires precise measurement of the quantity and quality of ingested food. The vagus nerve innervates the gut and can detect diverse interoceptive cues, but the identity of the key sensory neurons and corresponding signals that regulate food intake remains unknown. Here, we use an approach for target-specific, single-cell RNA sequencing to generate a map of the vagal cell types that innervate the gastrointestinal tract. We show that unique molecular markers identify vagal neurons with distinct innervation patterns, sensory endings, and function. Surprisingly, we find that food intake is most sensitive to stimulation of mechanoreceptors in the intestine, whereas nutrient-activated mucosal afferents have no effect. Peripheral manipulations combined with central recordings reveal that intestinal mechanoreceptors, but not other cell types, potently and durably inhibit hunger-promoting AgRP neurons in the hypothalamus. These findings identify a key role for intestinal mechanoreceptors in the regulation of feeding.


Computed tomography of the nasopharynx and neck.
Computed tomography (CT) is unparalleled for evaluation of the nasopharynx and the neck in comparison with other radiologic modalities. Its ability to demonstrate soft tissue and bone abnormalities has established its role as a primary method of radiologic diagnosis, frequently obviating the need for further radiologic elaboration. Furthermore, in many cases, CT provides distinction among inflammatory, neoplastic, and traumatic conditions.


Occupational diseases associated with animal industry with special reference to the influence of the techniques of animal maintenance.
The health problems which may involve farm workers are discussed and classified as: 1) diseases of mechanical origin; 2) diseases of environmental origin; 3) infection diseases (a) contracted from the environment; (b) contracted from animals); 4) social and psychological problems. The transmission of diseases from farm workers to animals has been outlined. The AA. conclude by stressing that the techniques that assure good farm profit coincide with the prevention of occupational diseases in farm workers.


Environmental Justice and Health Effects of Urban Air Pollution.
Minority communities often bear the burden of "hosting" pollution sources. This report assesses whether there are any health effects from living near such pollution sources and whether health effects of pollution vary by sex, ethnicity, or income. The air pollution emissions from Hartford area, point sources are modeled and exposures are estimated for the residents who participated in a geographically-based health survey. The pollution intensities and other individual and neighborhood characteristics are used to predict an individual's reported respiratory problems. The results indicate that respiratory problems are correlated significantly with pollution levels, especially sulfur dioxide from the local trash-to-energy incinerator-the fifth largest one in the U.S. The effects of a given pollution level tend to be more serious for specific subgroups based upon sex, ethnicity, poverty, and age. Even when controlling for other factors, air pollution levels are significantly correlated with health problems, especially for Hispanics. This air pollution may contribute to health disparities.


Immunological phenotypic pattern of acute lymphoblastic leukaemia in Egypt.
We have performed immunophenotyping studies on 186 untreated cases of acute lymphoblastic leukemia (ALL) in an Egyptian population, using panels of monoclonal antibodies (mAb) and an avidin-biotin-immunoperoxidase detection system. Sixty-two of these cases were tested with a panel of mAb directed against the T-cell markers CD2, CD4, CD8, B-cell markers CD20, kappa and lambda, the common ALL antigen (common ALLa) and class II HLA antigens. The remaining 124 cases were also tested with additional markers of T- and B-cell precursors, namely CD7 and CD19. The common leukocyte antigen, T200, was used to exclude nonhemopoietic neoplasms. Cases that remained unclassifiable were further tested with a wider panel of T-cell markers, including CD1, CD2, CD3 and CD5. In some cases multiple mAb directed against the same antigens were used. The relative frequencies of common ALL and B ALL were calculated from the total number of cases and were found to be 39.2% and 3.2%, respectively. The proportions of T-cell and null leukemias were calculated from the better characterized subgroup of 124 cases, and were found to be 50% and 4.8%, respectively. In our series, the age distribution of common ALL revealed a peak at 2-5 yr, but this was partially obscured in the entire series by the high proportion of T-cell cases, which had an age peak between 4 and 12 yr of age. Our results demonstrate marked differences in the phenotypic pattern of ALL in Egypt compared to Western Countries, the predominant finding being a relative excess of T-cell ALL and a paucity of common ALL cases. At present it is not clear whether this results from an increased incidence of T-cell ALL or a decreased incidence of common ALL.


Intradermal spindle cell/pleomorphic lipoma of the vulva: case report and review of the literature.
Spindle cell/pleomorphic lipoma (SC/PL) is a benign adipose tissue tumor that usually affects the subcutaneous tissues of shoulders, backs, and neck region of middle-aged male patients. Histologically, it is characterized by the presence of primitive CD34-positive spindle cells arranged in short fascicles, bizarre floret-like multinucleated giant cells, mature adipocytes, and a small number of lipoblasts. Recently, an intradermal subset has been described, which mainly affects female patients and presents a wider antomical distribution when compared to the classical variant of SC/PL. We report a case of intradermal SC/PL affecting the labium majus of a 56-year-old female patient. The histological examination disclosed the typical histological features, however the lesion showed poorly demarcated and infiltrative borders, as well as involvement of dermal nerves. The immunohistochemical analysis according to streptovidin-biotin-peroxidase technique showed immunoreactivity for CD34 and vimentin in the spindle cells, as well as S100 protein and vimentin in the adipocytic cells. To the best of our knowledge, this is the first case of intradermal SC/PL affecting the vulvar region. Care must be taken not to misdiagnosis this rare tumor as well-differentiated liposarcoma, cellular angiofibroma, solitary fibrous tumor, and cutaneous neurofibroma.


A novel cascade signal amplification strategy integrating CRISPR/Cas13a and branched hybridization chain reaction for ultra-sensitive and specific SERS detection of disease-related nucleic acids.
The molecular diagnosis of disease by high-sensitively and specifically detecting extremely trace amounts of nucleic acid biomarkers in biological samples is still a great challenge, and the powerful sensing strategy has become an urgent need for basic researches and clinical applications. Herein, a novel one-pot cascade signal amplification strategy (Cas13a-bHCR) integrating CRISPR/Cas13a system (Cas13a) and branched hybridization chain reaction (bHCR) was proposed for ultra-highly sensitive and specific SERS assay of disease-related nucleic acids on SERS-active silver nanorods sensing chips. The Cas13a-bHCR based SERS assay of gastric cancer-related miRNA-106a (miR-106a) can be achieved within 60 min and output significantly enhanced SERS signal due to the multiple signal amplification, which possesses a good linear calibration curve from 10 aM to 1 nM with the limit of detection (LOD) low to 8.55 aM for detecting gastric cancer-related miR-106a in human serum. The Cas13a-bHCR based SERS sensing also shows good specificity, uniformity, repeatability and reliability, and has good practicability for detection of miR-106a in clinical samples, which can provide a potential powerful tool for SERS detection of disease-related nucleic acids and promise brighter prospects in the field of clinical diagnosis of early disease.


Conservative endovascular management of retained placenta accreta with marked vascularity after abortion or delivery.
To report our experience on the value of transcatheter arterial embolization (TAE) or transcatheter arterial chemoembolization (TACE) for the uterus-preserving management of retained placenta accreta with marked vascularity after abortion or delivery. Thirty-eight consecutive women with retained placenta accreta were retrospectively analyzed over a 5-year period. When elevated levels of serum β-hCG (> 25 mIU/mL) were detected, TACE with dactinomycin was chosen for devascularization along with cytotoxic effects on active trophoblasts; in contrast, if the serum β-hCG level was low (≤ 25 mIU/mL), TAE was chosen. After confirming devascularization, the additional need for hysteroscopic resection and systemic methotrexate administration was individually determined. The most frequent sign and symptom in the abortion group was significant hemorrhaging, while a hypervascular mass detected at a regular check-up was the most frequent in the delivery group. The median time elapsed between abortion and endovascular management was 36 days, and the median time elapsed after delivery was 31.5 days. TACE was performed more frequently than TAE in the abortion group, while TAE was the more frequent procedure in the delivery group. In 10 and 11 cases, after abortion and delivery, respectively, hysteroscopic resection was performed. Systemic methotrexate administration was additionally done in three and one cases after abortion and delivery, respectively. Uterine preservation was achieved in all cases. This case series emphasizes that endovascular embolization is an effective key intervention with or without additional therapies for uterus-preserving management of retained placenta accreta with marked vascularity after abortion or delivery.


Identification of hearing loss in infants and young children.
An infant's hearing loss is detectable at any age. In spite of the importance of identifying deafness early, we do a poor job largely because the medical community is neither aware nor convinced that finding hearing loss is worth the trouble. There are two public health strategies for early detection, the high risk register (family history, hyperbilirubinemia, prematurity, rubella, and maxillofacial anomalies) and behavioral screening. The advantages and disadvantages are discussed. The incidence of handicapping hearing loss in newborns is 1 per 380 births and 1 per 61 in babies admitted to an intensive care nursery. This is higher than generally believed and may be one favorable result of using a new automated hearing screening system--the Crib-o-gram. In most deaf babies there is more than one risk factor present. Evaluating a hearing suspect baby demands a high index of suspicion, and taking the parent's suspicions seriously. The chances that a hearing loss exists at one year of age is about 1 in 4 on parental suspicion alone, regardless of what the physician's opinion might be. Immediate referral upon suspicion needs to occur more often than it does.


Expanding the spectrum of ADNP-related disorder-Antenatally diagnosed congenital diaphragmatic hernia and a novel de novo mutation in ADNP gene.
De novo heterozygous ADNP variants have been associated with a complex neurological phenotype characterized primarily by neurodevelopmental delay. Cardiac and renal anomalies have additionally been observed in a few patients. All reported cases to date have been ascertained postnatally. Congenital diaphragmatic hernia (CDH) has been previously observed in one child diagnosed with a de novo ADNP-related neurodevelopmental disorder. We report a fetus who presented with syndromic CDH associated with a de novo heterozygous ADNP variant.


Atherosclerotic calcification and intimal medial thickness of the carotid arteries.
Carotid intimal medial thickness (IMT) is a measure of subclinical atherosclerosis and is predictive of future cardiovascular events. The purpose of this study was to determine the significance and magnitude of association between IMT and atherosclerotic calcification of the carotid arteries. Forty-five subjects underwent electron beam computed tomography of the neck to ascertain the extent of atherosclerotic calcification in the carotid arteries followed by B-mode carotid ultrasonography for IMT. The mean age, BMI and total cholesterol to HDL ratio were 61.4, 26.2 and 4.3, respectively. Forty-one percent were women. The overall mean IMT was 0.91 mm with the mean for the right and left being 0.93 and 0.87 mm, respectively. The median total carotid calcium score (CCS) was 48.4 [range: 0-973]. Age-adjusted correlations were significant between the overall mean IMT and total CCS (r=0.53, p<0.01), mean right IMT and right CCS (0.31, 0.05), mean left IMT and left CCS (0.31, 0.05), right common carotid IMT and right CCS (0.53, <0.01) and left common carotid IMT and left CCS (0.31, 0.05). The mean IMT was 0.14 mm greater in subjects with any carotid calcification adjusted for risk factors. A 0.05 mm increase in the carotid IMT was associated with an approximate 3-fold increase in risk for the presence of atherosclerotic calcification. Carotid IMT is significantly correlated with and predictive of atherosclerotic calcification. Conversely, individuals with any carotid calcification have significantly greater intimal medial thicknesses.


Effects of cysteamine on pain behaviour and on somatostatin- and substance P-like immunoreactivity in the substantia gelatinosa of the rat.
Immunohistochemical studies on rats showed cysteamine to deplete immunoreactive somatostatin, but not substance P, in the substantia gelatinosa of the spinal trigeminal nucleus and spinal cord. The effect of cysteamine treatment on chemical pain was investigated using capsaicin as the pain-producing stimulus. Thermal pain was assessed with a hot plate test after cysteamine treatment. It was found that cysteamine did not alter the hind paw lick latency in the hot plate test or the number of forepaw wipes after application of a drop of capsaicin into the cornea, compared to normal animals. In capsaicin-treated animals a significantly lower number of forepaw wipes were seen after corneal capsaicin application. However, in cysteamine-treated animals slower wiping was observed compared to untreated and capsaicin-treated animals. This suggests that somatostatin may be of importance for the modulation of nociceptive information, although it is not a major pain transmitter.


The effect of carbon dioxide laser on wound contraction and epithelial regeneration in rabbits.
This study was undertaken to compare objectively healing rates (in rabbits) of wounds caused by CO2 laser with those caused by scalpel. The rates of contraction and epithelialisation of standard wounds were determined with daily measurement of wound area from the time of wounding until the wound had healed. Our results demonstrate significant delays in both wound contraction (p = 0.0001) and epithelialisation (p = 0.0001) for CO2 laser-created wounds when compared to those seen in scalpel-created wounds. Normal epithelial regenerative capacities were demonstrated in the laser group despite the slow onset of epithelial migration. The appearance of the healed areas appeared comparable for both modalities.


Development of behavioral and emotional problems in Tourette syndrome.
Tourette syndrome is a movement disorder with multiple neuropsychiatric features. Using the parent form of the Child Behavior Checklist by Achenbach and Edelbrock, we identified behavioral and emotional difficulties in 78 males, 6-16 years of age, with Tourette syndrome. Symptoms most often identified included obsessive-compulsive behavior, aggressiveness, hyperactivity, immaturity, withdrawal, and somatic complaints. Abnormal checklist scores were most prevalent in adolescents with Tourette syndrome. Tic severity was not a statistically significant predictor of behavioral disturbance, although a suggestive relationship between tic severity and behavioral disturbance was observed in the 12- to 16-year-old group. Dividing Tourette syndrome patients into those with or without hyperactivity failed to identify whether hyperactivity had a major impact on abnormal behaviors. Our results illustrate the relative frequency of psychopathology in Tourette syndrome and emphasize the need for a comprehensive approach to this syndrome.


The potential role of miRNAs in the pathogenesis of cardiovascular diseases - A focus on signaling pathways interplay.
For the past two decades since their discovery, scientists have linked microRNAs (miRNAs) to posttranscriptional regulation of gene expression in critical cardiac physiological and pathological processes. Multiple non-coding RNA species regulate cardiac muscle phenotypes to stabilize cardiac homeostasis. Different cardiac pathological conditions, including arrhythmia, myocardial infarction, and hypertrophy, are modulated by non-coding RNAs in response to stress or other pathological conditions. Besides, miRNAs are implicated in several modulatory signaling pathways of cardiovascular disorders including mitogen-activated protein kinase, nuclear factor kappa beta, protein kinase B (AKT), NOD-like receptor family pyrin domain-containing 3 (NLRP3), Jun N-terminal kinases (JNKs), Toll-like receptors (TLRs) and apoptotic protease-activating factor 1 (Apaf-1)/caspases. This review highlights the potential role of miRNAs as therapeutic targets and updates our understanding of their roles in the processes underlying pathogenic phenotypes of cardiac muscle.


Research progress of additives in photobiological hydrogen production system to enhance biohydrogen.
Photosynthetic biohydrogen has the advantages of extensive raw materials, clean and renewable, etc. But, its low substrate utilization rate limit its commercial application. It is reported that the use of additives in the process of biohydrogen by photofermentation is beneficial to increase biohydrogen. However, in practical application, the mechanism of additives in hydrogen production is not understood. This paper, the promotion effect of some additives on biohydrogen by photofermentation was reviewed. Whatever, the existing problems and development trends of various additives are also discussed. It is necessary to select appropriate additives according to the hydrogen-producing characteristics. The use of composite additives may further enhance biohydrogen, but the specific situation needs further exploration. The research results of this paper can help readers to further understand the role of additives in the crouse of photofermentative biohydrogen, provide reference for the research of photofermentative biohydrogen.


[Study on the association between RANTES-403G/A as well as -28C/G gene polymorphism and their susceptibility to the hepatitis B virus infections in Dong and Han ethnicities in Guizhou, China].
To investigate the association between both regulated upon activation normal T cell expressed and secreted (RANTES) -403G/A, -28C/G gene polymorphism and the susceptibilities to hepatitis B virus (HBV) infection, among people with Dong and Han ethnicities, in Guizhou. A total of 229 individuals with HBV persistence infection, 161 HBV clearanced patients and another 200 controls were recruited to conduct a case-control study among residents with Dong or Han ethnicities. Allelic frequencies of both RANTES-403G/A and -28C/G were identified by TaqMan-MGB probe. Both RANTES-403G/A and -28C/G polymorphism in the HBV-persistent group, when compared to the HBV-clearances group, no significant difference was found (P > 0.05). from the univariate analysis showed that subjects carrying -403AG and -28GG genotype had higher risk on the susceptibility to HBV persistence infection. The distributions of RANTES-28C/G gene polymorphism between Dong minority and Han ethnicities regarding HBV persistence showed statistically significant difference (P < 0.05). There was no difference on the distributions of RANTES-403G/A gene polymorphism between Dong minority and Han ethnicities. Patients that carrying both RANTES-403AG and -28GG genotype had higher risk on the persistence to HBV, while RANTES-403A had contributed to the clearance of HBV infection.


Assessing the predictive validity of the RAND/UCLA appropriateness method criteria for performing carotid endarterectomy.
We assessed the predictive validity of an expert panel's ratings of the appropriateness of carotid endarterectomy by comparing ratings to the results of subsequent randomized clinical trials. We found the trials confirmed the ratings for 44 indications (covering almost 30% of operations performed in 1981) and refuted the ratings for none.


Densities of microtime rodents along a pollution gradient from a copper-nickel smelter.
Population densities of microtine rodents were studied along an air pollution gradient in the Kola Peninsula, Russia, by long-term and short-term trapping. The study area is affected by high sulphur dioxide and heavy metal emissions from the Severonikel copper-nickel smelter in Monchegorsk. The density of Clethrionomys rufocanus, the most abundant vole species in the area, was lowest close to the smelter and increased with distance up to the farthest, less polluted trapping sites. Clethrionomys glareolus, C. rutilus and Lemmus lemmus were absent from the most severely damaged area and were also scarce at the moderately polluted area 28 km south of the smelter. Although the population of C. glareolus has previously been cyclic at the moderately polluted area, we were unable to demonstrate any regular cycle. The most likely explanation for the low number of microtine rodents in the damaged and moderately polluted areas in a decrease in the quantity of important food plants: epiphytic lichens for C. glareolus and possibly C. rutilus, mosses for L. lemmus and seed plants, especially Vaccinium myrtillus, for C. rufocanus. Close to the smelter, direct toxic effects of heavy metals may also reduce population densities. The results show that pollutants may change the relative proportions of microtine species.


Short perspective on "NMR population inversion using a composite pulse" by M.H. Levitt and R. Freeman [J. Magn. Reson. 33 (1979) 473-476].
The invention of the composite pulse by Malcolm H. Levitt in 1978 is described from a personal perspective.


The fluorescence intensity of the lipophilic probe N-phenyl-1-naphthylamine responds to the oxidation-reduction state of purified Escherichia coli cytochrome o incorporated into phospholipid vesicles.
N-Phenyl-1-naphthylamine (NPN), a reagent which has been used previously to probe the fluidity or microviscosity of the membrane lipids of intact cells of Escherichia coli, was found to respond to the redox state of purified cytochrome o incorporated into lipid vesicles formed from purified or E. coli phospholipids. NPN was bound to the proteoliposomes to produce a steady-state level of fluorescence intensity. Addition of the substrate ascorbate, in the presence of phenazine methosulfate as an electron donor, did not alter the fluorescence. However, following complete removal of oxygen from the medium by oxidation of the substrate by molecular oxygen catalyzed by cytochrome o, there was an increase in the fluorescence of NPN. This coincided with the reduction of cytochrome o. Reoxidation of the cytochrome by addition of oxygen decreased the fluorescence to steady-state levels until the oxidant had been completely reduced. The fluorescence changes were dependent on the incorporation of cytochrome o into phospholipid vesicles but were insensitive to the state of energization of the vesicle membrane.


Aqua-(3-fluoro-benzoato-κO)(3-fluoro-benzoato-κO,O')(1,10-phenanthroline-κN,N')cobalt(II).
In the title compound, [Co(C(7)H(4)FO(2))(2)(C(12)H(8)N(2))(H(2)O)], the Co(II) ion is coordinated by two O atoms from one 3-fluoro-benzoate (fb) ligand and one O atom from another fb ligand, two N atoms from the 1,10-phenanthroline ligand and a water mol-ecule in a distorted octa-hedral geometry. An intra-molecular O-H⋯O hydrogen bond occurs. Inter-molecular O-H⋯O hydrogen bonds link pairs of mol-ecules into centrosymmetric dimers. Weak inter-molecular C-H⋯O and C-H⋯F hydrogen bonds and π-π inter-actions between the aromatic rings [shortest centroid-centroid distance = 3.4962 (2) Å] further stabilize the crystal packing.


Thermographic mapping of the skin surface in biometric evaluation of cellulite treatment effectiveness.
Cellulite is one of the worst tolerated aesthetic imperfections. Edema that accompanies cellulite causes disorders of blood flow what may be observed as changes in the skin surface temperature. The aim of this paper was to develop a new method based on the analysis and processing of thermal images of the skin for biometric evaluation of severity of cellulite and monitoring its treatment. The observations of the treatment effects were conducted on 10 females (33.4 ± 6.4 years). Thermal images of the volunteers' thighs were captured before starting the therapy (T0 ). In the following stages: T1 , T2 , and T3 , thermal images were captured 2 weeks after the first, second and third Alidya treatment administration, respectively. Profiled algorithms were developed to determine the mean Grey Level Co-occurrence Matrix (GLCM) contrast in the acquired thermograms. The mean GLCM contrast for the phase T0 was 70.91, and for the stages T1 , T2 , and T3 : 57.78, 41.80, and 38.53, respectively. The use of proposed method (GLCM contrast) enables biometric evaluation of the effectiveness of cellulite treatment. Traditionally used parameters of infrared analysis such as local points of the maximum and minimum temperature or the median temperatures are not useful in thermal, biometric evaluation of anti-cellulite preparations.


What the Phage: a scalable workflow for the identification and analysis of phage sequences.
Phages are among the most abundant and diverse biological entities on earth. Phage prediction from sequence data is a crucial first step to understanding their impact on the environment. A variety of bacteriophage prediction tools have been developed over the years. They differ in algorithmic approach, results, and ease of use. We, therefore, developed "What the Phage" (WtP), an easy-to-use and parallel multitool approach for phage prediction combined with an annotation and classification downstream strategy, thus supporting the user's decision-making process by summarizing the results of the different prediction tools in charts and tables. WtP is reproducible and scales to thousands of datasets through a workflow manager (Nextflow). WtP is freely available under a GPL-3.0 license (https://github.com/replikation/What_the_Phage).


Critical features of a curriculum in health care quality and resource management.
In response to mounting demands for quality and accountability in health care, a science of health care quality and resource management (QRM) has evolved, but too slowly and without the academic base needed to prepare practitioners to assume new roles and fulfill requirements to regulate their practice. To develop such a base, The University of Houston and The University of Texas Health Science Center sponsored a needs assessment survey to identify areas of knowledge and skills to be included in a master's degree curriculum in QRM. The study used a three-cycle Focus Delphi technique to secure experts' refinement of the survey instrument and consensus among participants, who included practitioner-members of the National Association of Quality Assurance Professionals (NAQAP), of health care administration educational program directors, and hospital administrators. Starting with a listing based on a competency outline obtained from NAQAP, the study identified critical learning needs and elaborated a framework with 12 broad categories and 108 specific knowledge and skill areas.


Increased expression of ICAM-1 among symptomatic neurocysticercosis.
Neurocysticercosis (NCC) is a common parasitic infection of the central nervous system (CNS) caused by larvae of Taenia solium. Most infected individuals remain asymptomatic while few develop symptoms i.e. seizures. Integrity or disruption of blood brain barrier plays an important role in CNS infection and inflammatory response. Therefore, we studied the induction of Th1 (TNF-alpha, IFN-gamma, IL-1beta and IL-2), Th2 (IL-4), IL-10 cytokines and adhesion molecule sICAM-1 in the lymphocytes isolated from symptomatic and asymptomatic NCC cases by stimulating them with Taenia solium cyst fluid antigens. The expression of TNF-alpha, IFN-gamma, IL-1beta and sICAM-1 was significantly higher only in symptomatic NCC cases. Our study highlights the role of adhesion molecules in the development of symptoms in NCC.


[Clinical and etiological aspects of intertrigos caused by fungal infections in Abidjan (Cote d'Ivoire)].
Epidemiology of these disorders, mainly caused by mycosis, is little known in the Ivory Coast. The aim of this study was to determine the different clinical aspects of intertrigos caused by fungal infections. We conducted a cross-sectional study in the Department of Clinical Dermatology at the University Hospital in Yopougon (Abidjan, Ivory Coast) from April to October 2012. The study involved the patients come to consultation with lesions in the folds suggesting a mycosis. Samples of serous fluid by swabbing or of scales by scrape cutting with the scalpel blade were performed at the level of the lesions. The fungal agents responsible for these lesions were identified after biological culture. A total of 200 patients had lesions suggesting intertrigo caused by fungal infection. The average age of patients was 29.8 years (with a standard deviation of 11.1 years). Mycosis-related intertrigos accounted for 6.7% of reasons for consultation. A female predominance was observed (76.7%). Lesions mainly occurred in the groin area (40.8%) and in the intergluteal clefts (36.9%). The most observed symptoms were maceration (52.4%) followed by burning (18.4%). In 89.3% of cases, intertrigos were caused by yeasts, including Candida albicans (33%), and Candida parapsilosis(19.4%) which were predominant. Mycosis-related intertrigos mainly affect the young adults of female sex. Lesions mainly occur at the level of the inguinal folds and intergluteal clefts. The main etiological agents are yeasts (Candida).


Arsenic trioxide initiates ER stress responses, perturbs calcium signalling and promotes apoptosis in human lens epithelial cells.
Identification of novel agents to eradicate the residual lens cell population following cataract surgery provides one mode of preventing PCO formation. The present study investigated the biological mechanism of As(2)O(3) cytotoxicity in a human lens cell line and capsular bag system. FHL 124 cell survival was assessed by quantification of total protein content, a cell population measure. Gene changes were detected by Real-time PCR; apoptosis by TUNEL assays. Intracellular calcium was measured by real-time fluorimetric single-cell digital imaging techniques after Fura-2 incorporation. In vitro human capsular bags were generated from donor eyes, which involved sham cataract surgery then use of the Perfect Capsule device to form a closed system to deliver As(2)O(3) for 2min. On-going observations were by phase-contrast microscopy. Cellular architecture was examined by fluorescence immunocytochemistry. FHL 124 cells demonstrated a dose-dependent sensitivity to As(2)O(3) exposure. A 2min exposure of As(2)O(3) to cells within the capsular bag, using the perfect capsule system, resulted in total cell death when used at 100mM. As(2)O(3) provoked an ER stress response identified through an upregulation of known genes. As(2)O(3) depleted the calcium store and consequently lead to reduced calcium signalling. As(2)O(3) increased rates of apoptosis. Arsenic trioxide provokes ER stress that leads to down-regulation of calcium signalling resulting in apoptosis. The application of As(2)O(3) to cells within the capsular bag for a 2min window using the Perfect Capsule system predicts putative therapeutic benefit in vivo.


Stereoselective reduction of ketones by Daucus carota hairy root cultures.
Reduction of acetophenone by Daucus carota hairy root cultures afforded (S)-phenylethanol in high yield (96%) and excellent enantiomeric excess (ee>or=98%). Aromatic ketones, keto esters, and a simple aliphatic ketone were reduced with good stereoselectivity (ee=62-98%) and moderate to high chemical yields (25-90%).


Obstetrician-gynecologist physicians' beliefs about emergency contraception: a national survey.
Although emergency contraception (EC) is available without a prescription, women still rely on doctors' advice about its safety and effectiveness. Yet little is known about doctors' beliefs and practices in this area. We surveyed 1800 US obstetrician-gynecologists. Criterion variables were doctors' beliefs about EC's effects on pregnancy rates, and patients' sexual practices. We also asked which women are offered EC. Predictors were demographic, clinical and religious characteristics. Response rate was 66% (1154/1760). Most (89%) believe EC access lowers unintended pregnancy rates. Some believe women use other contraceptives less (27%), initiate sex at younger ages (12%) and have more sexual partners (15%). Half of physicians offer EC to all women (51%), while others offer it never (6%) or only after sexual assault (6%). Physicians critical of EC, males and religious physicians were more likely to offer it never or only after sexual assault (odds ratios 2.1-12). Gender, religion and divergent beliefs about EC's effects shape physicians' beliefs and practices.


Computational modeling and biological validation of novel non-steroidal ligands for the cholesterol recognition/interaction amino acid consensus (CRAC) motif of the mitochondrial translocator protein (TSPO).
Mitochondria play a critical role in the physiological homeostasis of the cell, contributing to numerous cellular processes, including bioenergetics, metabolism and cell life and death. Owing to their keystone role, mitochondria have gained much attention as pharmacological targets. The outer mitochondrial integral membrane translocator protein (TSPO) has attracted a significant degree of pharmacological interest owing to its ability to bind a number of classes of drugs with high affinity and specificity. In addition to its well-characterized drug binding site, TSPO possess an additional high-affinity ligand binding site, originally identified for its ability to bind the lipid cholesterol, which was named the cholesterol recognition/interaction amino acid consensus (CRAC) motif. Previous investigations from our laboratory identified additional ligands targeted to TSPO's CRAC motif which are able to potently inhibit mitochondrial cholesterol transport and steroid biosynthesis, processes for which TSPO has been well-characterized. However, all of these compounds possessed the steroidal backbone common to cholesterol and steroid hormones. In our efforts to expand our understanding of TSPO's CRAC motif, we performed studies aimed at identifying non-steroidal ligands for this motif. Molecular modeling and in silico screening of large chemical libraries identified a panel of compounds which were subsequently screened for bioactivity in a number of steroidogenic model systems. These efforts identified a family of non-steroidal CRAC ligands able to potently inhibit steroidogenesis, and at higher concentrations, promote apoptosis. In addition, the best candidate in this family was able to suppress testosterone synthesis when administered to rats, indicating that this novel family of non-steroidal CRAC ligands may serve as prototypes for the development of drugs useful for treatment of diseases of steroid overproduction, such as Cushing's syndrome and steroidogenic cell tumors in humans and animals.


Close association of polarization and LC3, a marker of autophagy, in axon determination in mouse hippocampal neurons.
The autophagy-lysosome pathway is a cellular clearance system for intracellular organelles, macromolecules and microorganisms. It is indispensable for cells not only to maintain their homeostasis but also to achieve more active cellular processes such as differentiation. Therefore, impairment or disruption of the autophagy-lysosome pathway leads to a wide spectrum of human diseases, ranging from several types of neurodegenerative diseases to malignancies. In elongating axons, autophagy preferentially occurs at growth cones, and disruption of autophagy is closely associated with incapacity for axonal regeneration after injury in the central nervous system. However, the roles of autophagy in developing neurons remain elusive. In particular, whether autophagy is involved in axon-dendrite determination is largely unclear. Using primary cultured mouse embryonic hippocampal neurons, we here showed the polarized distribution of autophagosomes among minor processes of neurons at stage 2. Time-lapse observation of neurons from GFP-LC3 transgenic mice demonstrated that an "LC3 surge"-i.e., a rapid accumulation of autophagic marker LC3 that continues for several hours in one minor process-proceeded the differentiation of neurons into axons. In addition, pharmacological activation and inhibition of autophagy by trehalose and bafilomycin, respectively, accelerated and delayed axonal determination. Taken together, our findings revealed the close association between LC3, a marker of autophagy, and axon determination in developing neurons.


Topography and age mediate the growth responses of Smith fir to climate warming in the southeastern Tibetan Plateau.
The Tibetan Plateau holds some of the world's highest undisturbed natural treelines and timberlines. Such extreme environments constitute potentially valuable monitoring sites of the effects of climate warming on high-elevation forests. Here, we analyze a network of 21 Smith fir forests situated in the Sygera Mountains, southeastern Tibetan Plateau, using tree-ring width (TRW) and basal area increment (BAI) chronologies. Sampled sites encompassed a wide elevation gradient, from 3600 to 4400 m, including some treeline sites and diverse aspects and tree ages. In comparison with TRW series, BAI series better capture the long-term warming signal. Previous November and current April and summer temperatures are the dominant climatic factors controlling Smith fir radial growth. The mean inter-series correlations of TRW increased upwards, but the forest limit presented the highest potential to reconstruct past temperature variability. Moreover, the growth responses of young trees were less stable than those of trees older than 100 years. Climate warming is accelerating radial growth of Smith fir forest subjected to mesic conditions. Collectively, these findings confirm that the effects of site elevation and tree age should be considered when quantifying climate-growth relationships. The type of tree-ring data (BAI vs. TRW) is also relevant since BAI indices seem to be a better climatic proxy of low-frequency temperature signals than TRW indices. Therefore, site (e.g., elevation) and tree (e.g., age) features should be considered to properly evaluate the effects of climate warming on growth of high-elevation forests.


Metaphyeal and Diaphyseal Dysplasia of the Third Cervical Vertebra Secondary to Physeal Necrosis in a Quarter Horse Foal.
Ischaemia-induced physeal injury has not been described previously in the horse. A 1-month-old Quarter horse foal was submitted for necropsy examination due to an acute onset of ataxia followed by a 4-week history of progressive decline. Focal narrowing of the spinal canal due to ventral compression by the rotation of the cranial aspect of the third cervical vertebra (C3) was observed. The metaphysis and diaphysis of C3 were markedly shortened and white-tan in colour. Microscopically, there was complete loss of the dorsal compact bone of C3 and replacement of 80% of the physis that runs parallel to the vertebral canal with fibrous tissue and thickened viable trabecular bone. Both cranial and caudal physes of C3 showed widespread bands of coagulative necrosis of the hypertrophic and calcifying zones. Marked bone marrow hypoplasia with slight fibrosis was observed in the metaphyses and diaphysis. There was no evidence of fracture or inflammation. The epiphyses were microscopically unremarkable. It was hypothesized that a regional transient incomplete and possibly multiphasic ischaemia involving the nutrient artery caused necrosis of the physes, resulting in dysplasia of the bone. Ischaemic injury to the physis should be considered in the pathogenesis of focal bone dysplasia in horses.


Comparison between MDCK and MDCK-SIAT1 cell lines as preferred host for cell culture-based influenza vaccine production.
To evaluate MDCK and MDCK-SIAT1 cell lines for their ability to produce the yield of influenza virus in different Multiplicities of Infection. Yields obtained for influenza virus H1N1 grown in MDCK-SIAT1 cell was almost the same as MDCK; however, H3N2 virus grown in MDCK-SIAT1 had lower viral titers in comparison with MDCK cells. The optimized MOIs to infect the cells on plates and microcarrier were selected 0.01 and 0.1 for H1N1 and 0.001 and 0.01 for H3N2, respectively. MDCK-SIAT1 cells may be considered as an alternative mean to manufacture cell-based flu vaccine, especially for the human strains (H1N1), due to its antigenic stability and high titer of influenza virus production.


LINC00641/miR-582-5p mediate oxaliplatin resistance by activating autophagy in gastric adenocarcinoma.
The poor prognosis of gastric adenocarcinoma is partly due to chemotherapy failure, especially the oxaliplatin-based chemotherapy. However, the specific mechanism of oxaliplatin resistance is unclear. We aim to find the roles that LINC00641 and miR-582-5p play in regulating oxaliplatin resistance. Quantitative reverse transcriptase-PCR was used to evaluate the expression of LINC00641 and microRNA-582-5p (miR-582-5p) in gastric cancer both in vivo and in vitro. Transwell and CCK-8 assays were performed; and LC3 I/II and p62 were detected by western blot to evaluate the activation of autophagy. LINC00641 expression was associated with prognosis and oxaliplatin resistance in patients with gastric adenocarcinoma. The expression of LINC00641 was higher in gastric cancer tissues; whereas miR-582-5p was down-regulated in gastric cancer tissues. Moreover, LINC00641 was highly expressed in oxaliplatin-resistant cell lines and miR-582-5p was down-regulated. In addition, LINC00641 negatively regulated the expression of miR-582-5p. With regard to biological functions, down-regulation of LINC00641 suppressed cell migration and proliferation. Further experiments indicated that down-regulation of LINC00641 inhibited the autophagy process, making gastric cancer cells more sensitive to oxaliplatin. LINC00641 and miR-582-5p are biomarkers for predicting overall survival, as they were involved in regulating oxaliplatin resistance by altering autophagy in gastric adenocarcinoma.


Monitoring of the insecticide trichlorfon by phosphorus-31 nuclear magnetic resonance (31P NMR) spectroscopy.
Trichlorfon is an organophosphorus insecticide, which is extensively being used for protection of fruit crops. Trichlorfon is a thermal labile compound, which cannot be easily determined by gas chromatography (GC) and has no suitable group for sensitive detection by high performance liquid chromatography (HPLC). In this study, a 31P nuclear magnetic resonance (31P NMR) has been described for monitoring of trichlorfon without any separation step. The quantitative works of 31P NMR spectroscopy has been performed in the presence of an internal standard (hexamethylphosphoramide). Limit of detection (LOD) for this method has been found to be 55 mg L(-1), without any sample preparation, and the linear working range was 150-5500 mg L(-1). Relative standard deviation (R.S.D.%) of the method for three replicates within and between days was obtained < or =9%. The average recovery efficiency was approximately 99-112%. This method was applied for monitoring trichlorfon in a commercial insecticide sample and tomato sample.


The use of bacillus Calmette-Guerin in the therapy of bladder carcinoma in situ.
Intravesical instillations of Tice strain bacillus Calmette-Guerin were given to 33 patients with biopsy proved carcinoma in situ. An induction phase consisting of 12 weekly instillations was followed by a maintenance phase of instillations bimonthly for 3 months and then monthly for 18 months. A total of 6 patients did not complete the induction phase because of adverse reactions but 4 were rendered free of tumor and have had no recurrence. Of the remaining 27 patients 18 became free of tumor after 12 weeks of therapy (3 had recurrences during the maintenance period), 6 after 18 weeks (with 1 recurrence) and 3 after 24 weeks. Thus, 31 of 33 patients (94 per cent) were rendered free of carcinoma in situ. There were 4 recurrences in these patients (13 per cent). The 27 patients who have remained free of disease have been followed for 1.75 to 8.5 years, with an average of 5.25 years. Side effects, principally bladder irritability, were a problem early in the study. With the use of isoniazid, nonsteroidal anti-inflammatory agents and bladder antispasmodics, the treatment has been safe and tolerated well. The study indicates that bacillus Calmette-Guerin is effective in eliminating carcinoma in situ in most patients, although prolonged treatment may be necessary. Maintenance therapy appears to be of value in reducing the incidence of recurrent tumor.


The detection of human sapoviruses with universal and genogroup-specific primers.
Sapovirus (SV) causes gastroenteritis in humans and comprises genetically divergent viruses. A nested reverse transcription-polymerase chain reaction (RT-PCR) targeting the capsid-protein-coding region was developed using universal and genogroup-specific primer sets. The universal primers were capable of detecting human SV genogroups I, II, IV and V. Genetic analysis of the amplified products enabled us to phylogenetically determine the genotypes of the viruses. In addition, genogroup-specific primers that amplified different lengths of the amplicon depending on the genogroup were developed. These genogroup-specific primers were also used as inner primers for the nested PCR. These two simple RT-PCR methods are powerful tools for both detection and epidemiological studies of human SV.


[Recombinant human pigment epithelium-derived factor inhibits the proliferation of the endothelial cells from blood vessels].
To express and purify the recombinant human pigment epithelium-derived factor (PEDF) which inhibits the proliferation of the endothelium cells from blood vessel in E.coli. PEDF gene was inserted into the prokaryotic expression vector pGEX-4T-2. The recombinant protein PEDF was expressed in E.coli BL-21, and purified by the GST Sepharose 4B affinity column. The recombinant human PEDF protein was identified by Western blot and mass spectrum. The biological activity of the recombinant human PEDF protein was measured by using MTT. The 46 kDa recombinant human PEDF protein was obtained. It significantly inhibited the proliferation of the human umbilical vein cell line HUVEC. The recombinant human PEDF with anti-angiogenesis activity protein may be successfully purify through prokaryotic expression.


Biliary Leakage After Hepatobiliary and Pancreatic Surgery: A Classification System to Guide the Proper Percutaneous Treatment.
To investigate the effectiveness of percutaneous approaches to treat bile leak and to propose an anatomical classification of biliary fistula to guide the most appropriate percutaneous approach. Fifty-six patients with bile leakage after hepatobiliary surgery were included. Based on preoperative images and postoperative fistulogram images, three categories of bile leakage were defined. Every category was treated with non-surgical approaches (internal-external percutaneous drainage, percutaneous/endoscopic biliodigestive anastomosis with rendez-vous technique and biliodigestive percutaneous anastomosis with totally radiologic rendez-vous). In 44/56 (78%) patients, anatomical conformation was "direct communication" (bile ducts upstream from the leak present a direct communication with downstream ducts) and their treatment was conventional percutaneous drainage. In 5/56 (9%), anatomical conformation was "indirect communication" (bile ducts upstream from the leak communicate with downstream ducts through a bile collection) and treatment was percutaneous/endoscopic rendez-vous technique. In 7/56 (12%), anatomical conformation was "no communication" (ducts upstream from the leak are completely excluded from ducts downstream) and treatment was totally radiologic rendez-vous. In 54/56 (96%) during the follow-up, cholangiography revealed complete resolution of the leak without residual stenosis and drains were removed. Complications occurred in 12/56 (21%). Procedure-related mortality was 0%. Ten patients, after > 6 months from resolution of their fistula and drain removal, died due to cancer recurrence. Currently, 44/56 patients (77%) at long-term follow-up (> 12 months) are alive, without bile leak. Our classification helps to choose the most proper percutaneous approach in all kinds of bile leakage, even in severe cases; these are safe techniques with a high success rate.


Temperature and humidity dynamics of cutaneous and respiratory evaporation in pigeons, Columba livia.
Using a two-compartment metabolism chamber, we measured oxygen consumption simultaneously with evaporative water loss (EWL) separately from the skin and respiratory tract of pigeons exposed to various air temperatures and humidities. Both respiratory (REWL) and cutaneous (CEWL) water loss increased markedly with increasing air temperature, and latent heat loss through both routes dissipated large fractions of internal heat production during mild heat stress. CEWL as a percentage of total EWL significantly exceeded REWL (60 +/- 1.5%) at thermoneutral air temperatures, and was also a substantial fraction of total EWL at lower and higher temperatures. Both REWL and CEWL were inverse functions (apparently linear) of ambient humidity at 20 and 30 degrees C. These observations verify suggestions by other investigators that CEWL in birds plays a greater role in water balance and in counteracting heat stress than was previously believed.


Laying the foundation for an International Classification of Functioning, Disability and Health Core Set for community-dwelling elderly adults in primary care: the clinical perspective identified in a cross-sectional study.
Having more information about the biopsychosocial functioning of their geriatric patients might help physicians better balance medical interventions according to patients' needs. For this reason, we aimed to develop an easy-to-handle International Classification of Functioning, Disability and Health (ICF) Core Set for community-dwelling geriatric patients aged 75 and older in primary care. In this empirical study, we describe the functioning and health of community-dwelling patients aged 75 and older in primary care in Germany and identify the most common problems encountered by these individuals when using the ICF. In this exploratory, cross-sectional study, a health professional conducted semi-structured interviews. Community-dwelling older adults aged 75 and older in Germany. 65 participants (mean age=80.2, SD=3.6). Extended ICF Checklist V.2.1a, patients prioritised chapters of the 'activities and participation' component. The three most common impairments for 'body functions' were visual system functions (ICF-code b210; 89%), blood pressure functions (b420; 80%) and sensations associated with hearing and vestibular functions (b240; 59%). For 'body structures', they were eyes, ears and related structures (s2; 81%), structure of mouth (s320; 74%) and structures related to the digestive, metabolic and endocrine systems (s5; 49%). For the 'activities and participation' component, adequate aids compensated for activity limitations to a certain degree. Still, after having adequate aids, the category in which the participants had the most difficulty was walking (d450; 35%). Participants rated the 'mobility' chapter as the most important of all chapters. 'Environmental factors' were facilitators of participants' functioning. This empirical study provides a list of ICF categories relevant to older adults from the clinical perspective. Along with lists from the other three preparatory studies, it will form the basis for the development of an ICF Core Set for community-dwelling older adults in primary care. The trial is registered in ClinicalTrials.gov (NCT03384732).


Appropriateness of gastrointestinal prophylaxis use during hospitalization in patients with acute myocardial infarction: Analysis from the China Acute Myocardial Infarction Registry.
The current status of gastrointestinal prophylaxis (GIP) usage and its effects on hospitalized acute myocardial infarction (AMI) patients is not clear. We investigate the appropriateness of GIP usage and its relationship with clinical events in China. Appropriate use of GIP is not associated with increased adverse outcomes. From January 2013 to September 2014, a total of 24 001 consecutive patients from 108 hospitals with AMI in China Acute Myocardial Infarction (CAMI) registry were analyzed. The appropriateness of GIP was evaluated using the current American College of Cardiology Foundation/American Heart Association (ACCF/AHA) and European Society of Cardiology (ESC) guidelines. The primary endpoint was in-hospital gastrointestinal bleeding (GIB), while the secondary endpoints were in-hospital and 2-year follow-up net adverse cardiovascular and cerebrovascular events (NACCE). Multivariate logistic regression analysis and Cox proportional hazard models were used to assess the effect of appropriate GIP. There were 16 413 (68.38%) AMI patients co-medicated with GIP. Among 108 involved hospitals, only 35 (32.4%) hospitals prescribed more than 50% appropriate GIP. Totally, 59.7% (14 340) AMI patients received inappropriate GIP. Inappropriate GIP use was independently associated with use of GPIIb/IIIa receptor inhibitor and primary percutaneous coronary intervention (PCI). Moreover, appropriate GIP use was associated with decreased GIB risk (OR: 0.692, 95% CI: 0.507-0.944, P = .0202) during hospitalization, while not with increased in-hospital and 2-year follow-up NACCE. The use of GIP is prevalent in patients with AMI in China but only 40% of hospitalized patients received appropriate GIP. Appropriate prophylactic therapy was associated with decreased GIB risk during hospitalization.


Multifunctionality of PIWI proteins in control of germline stem cell fate.
PIWI proteins interacting with specific type of small RNAs (piRNAs) repress transposable elements in animals. Besides, they have been shown to participate in various cellular processes: in the regulation of heterochromatin formation including telomere structures, in the control of translation and the cell cycle, and in DNA rearrangements. PIWI proteins were first identified by their roles in the self-renewal of germline stem cells. PIWI protein functions are not limited to gonadogenesis, but the role in determining the fate of stem cells is their specific feature conserved throughout the evolution of animals. Molecular mechanisms underlying these processes are far from being understood. This review focuses on the role of PIWI proteins in the control of maintenance and proliferation of germinal stem cells and its relation to the known function of PIWI in transposon repression.


Cellular and subcellular organization of pathways of ammonia assimilation and ureide synthesis in nodules of cowpea (Vigna unguiculata L. Walp.).
Fractionation of cell organelles of nitrogen-fixing nodules of cowpea (Vigna unguiculata L. Walp) by discontinuous and continuous sucrose density centrifugation indicated that starch-containing plastids possessed the complete pathway for purine nucleotide synthesis together with significant activities of some other enzymes associated with the provision of substrates in purine synthesis; triosephosphate isomerase (EC 126.96.36.199), NADH-glutamate synthase (EC 220.127.116.11), aspartate aminotransferase (EC 220.127.116.11), phosphoglycerate oxidoreductase (EC 188.8.131.52), and methylene tetrahydrofolate oxidoreductase (EC 188.8.131.52). Enzymes of purine oxidation, xanthine oxidoreductase (EC 188.8.131.52), and urate oxidase (EC 22.214.171.124) were recovered in the soluble fraction; glutamine synthetase (EC 126.96.36.199) occurred in bacteroids and in the cytosol. Intact, infected (bacteroid-containing) and uninfected cells were prepared by enzymatic maceration of the central zone of the nodule and partially separated by centrifugation on discontinuous sucrose gradients. Glutamine synthetase was largely restricted to infected cells whereas plastid enzymes, de novo purine synthesis, and urate oxidase were present in both cell types. Although the levels of all enzymes assayed were higher in infected cells, both cell types possessed the necessary enzyme complement for ureide formation. A model for the cellular and subcellular organization of nitrogen metabolism and the transport of nitrogenous solutes in cowpea nodules is proposed.


Characterization of a New Antienterovirus D68 Compound Purified from Avocado.
One of the major challenges in development of antienterovirus (EV) drugs is in the safety of the drug. Here, we attempted to identify anti-EV compounds from an edible plant extract library and found potent antienterovirus D68 (EV-D68) activity in avocado (Persea americana). The purified identity is determined as 2R,4R-(12Z,15Z)-heneicosa-12,15-diene-1,2,4-triol, named avoenin. Avoenin shows an EC50 of 2.0 μM for EV-D68 (Fermon) infection with CC50 of >150 μM in RD cells by targeting the uncoating step of EV-D68 infection. Resistant mutations of EV-D68 (VP3-V24I, S173P, and S180G) to avoenin confer cross-resistance to pleconaril, an uncoating inhibitor of EV-D68. The inhibitory effect of avoenin is substantially specific to EV-D68 among the EVs. This work reveals avoenin as the identity of anti-EV-D68 activity in avocado and offers insights into development of a novel and effective strategy to overcome EV-D68 infection and its related respiratory diseases.


Polycyclic aromatic hydrocarbons in coarse particles (PM10) over the coastal urban region in Poland: Distribution, source analysis and human health risk implications.
In this study, the results of PM10-bound PAH measurements were subjected to positive matrix factorization (PMF) approach and diagnostic ratios to investigate their levels, seasonal variability, impact of primary anthropogenic sources, and human health risk via the inhalation route. Daily ground-based observations were carried out at a representative coastal site in Gdynia (northern Poland), from April to December 2019. The concentrations of Σ13PAHs in PM10 varied between 0.45 ng m-3 and 54.02 ng m-3, with a mean of 5.22 ± 8.67 ng m-3. A clear seasonality and distribution profiles of PM10-bound PAHs were observed as a result of local/remote sources and meteorological conditions. The highest Σ13PAH concentration was found in December (18.56 ± 16.45 ng m-3) and the lowest values were observed between June and September (3.89 ± 0.52 ng m-3). The PMF-based analysis revealed five factors, suggesting the importance of primary anthropogenic sources of PAHs, i.e. coal combustion, biomass burning, gasoline/diesel vehicles, industrial and shipping activities as well as natural gas combustion. In summer, PAH levels were mostly controlled by local shipping emissions as well as traffic-related and non-combustion sources such as photochemical decomposition. The winter PAH maxima were attributed to a strong increase in residential coal combustion. A Spearman's rank correlation and multilinear regression analysis showed that ambient temperature and NO× had a significant impact on intra-annual variability in PM10-bound PAH transformation in this region. PAH congeners in coarse-size fraction were positively correlated with SO2, indicating their shared anthropogenic sources. The annual mean of epidemiologically based ILCR value was 6.6 × 10-5. This work indicates a potential carcinogenic risk for the local population and a significant difference in BaPeq levels between the individual seasons in this region.


Entropic particle transport in periodic channels.
The dynamics of Brownian motion has widespread applications extending from transport in designed micro-channels up to its prominent role for inducing transport in molecular motors and Brownian motors. Here, Brownian transport is studied in micro-sized, two-dimensional periodic channels, exhibiting periodically varying cross-sections. The particles in addition are subjected to an external force acting alongside the direction of the longitudinal channel axis. For a fixed channel geometry, the dynamics of the two-dimensional problem is characterized by a single dimensionless parameter which is proportional to the ratio of the applied force and the temperature of the particle environment. In such structures entropic effects may play a dominant role. Under certain conditions the two-dimensional dynamics can be approximated by an effective one-dimensional motion of the particle in the longitudinal direction. The Langevin equation describing this reduced, one-dimensional process is of the type of the Fick-Jacobs equation. It contains an entropic potential determined by the varying extension of the eliminated channel direction, and a correction to the diffusion constant that introduces a space dependent diffusion. Different forms of this correction term have been suggested before, which we here compare for a particular class of models. We analyze the regime of validity of the Fick-Jacobs equation, both by means of analytical estimates and the comparisons with numerical results for the full two-dimensional stochastic dynamics. For the nonlinear mobility we find a temperature dependence which is opposite to that known for particle transport in periodic potentials. The influence of entropic effects is discussed for both, the nonlinear mobility and the effective diffusion constant.


[Fatal poisoning by protriptyline and haloperidol following an extreme overdose].
In this paper the authors report on a case of lethal suicidal toxification with protriptyline and haloperidol after oral ingestion. Gas chromatographic and radioimmunologic investigations were used for quantitative determination of protriptyline and haloperidol in blood, urine, and tissues. The highest concentrations were found in lung and liver. These concentrations are discussed with reference to the cause of death.


Increased fermentable carbohydrate intake alters colonic mucus barrier function through glycation processes and increased mast cell counts.
Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder for which dietary interventions can be a useful treatment. In recent years, the low-FODMAP approach is gaining traction in this regard. The fermentation of these non-absorbed carbohydrates by the gut microbiota can generate toxic glycating metabolites, such as methylglyoxal. These metabolites can have harmful effects by their role in the generation of advanced glycation end products (AGEs), which activates Receptor for AGEs (AGER). Mast cells can be stimulated by AGEs and play a role in IBS. We have treated mice with lactose or fructo-oligosaccharides (FOS), with or without co-administration of pyridoxamine and investigated the colonic mucus barrier. We have found that an increased intake of lactose and fructo-oligosaccharides induces a dysregulation of the colonic mucus barrier, increasing mucus discharge in empty colon, while increasing variability and decreasing average thickness mucus layer covering the fecal pellet. Changes were correlated with increased mast cell counts, pointing to a role for the crosstalk between these and goblet cells. Additionally, AGE levels in colonic epithelium were increased by treatment with the selected fermentable carbohydrates. Observed effects were prevented by co-treatment with anti-glycation agent pyridoxamine, implicating glycation processes in the negative impact of fermentable carbohydrate ingestion. This study shows that excessive intake of fermentable carbohydrates can cause colonic mucus barrier dysregulation in mice, by a process that involves glycating agents and increased mucosal mast cell counts.


The dynamics of circulating tumour DNA (ctDNA) during treatment reflects tumour response in advanced melanoma patients.
Despite the introduction of targeted (BRAFi/MEKi) and immune checkpoint inhibitors (ICIs) has significantly reduced the recurrence rate and improved the overall survival (OS) of patients with Stage III and IV melanoma, only a percentage will benefit of durable disease control. The aim of this study was to examine whether the levels of circulating tumour DNA (ctDNA) in plasma of advanced melanoma patients undergoing BRAFi/MEKi or ICIs vary according to the patients' survival outcomes (i.e. progression-free survival (PFS) and OS) and disease progression. Plasma samples of Stage III-IV melanoma patients were collected at baseline (treatment initiation) and thereafter every 3 months. Circulating BRAFV600E/K and NRASQ61R/K mutations were analysed through droplet digital PCR (ddPCR, Bio-Rad) in a total of 177 plasma samples from 48 melanoma patients (19 Stage III, 29 Stage IV). Baseline ctDNA concentration was significantly associated with OS (HR = 1.003, 95% CI = 1.000-1.006, p = 0.043) and PFS (HR = 1.004, 95% CI = 1.000-1.007, p = 0.029) independent of clinical-prognostic confounders. For each unit increase in the ∆ctDNA (concentration difference between the last follow-up and baseline) there was a 24% increased risk of disease progression, irrespective of treatment type and stage at diagnosis (OR = 1.24, 95% CI = 1.03-1.49, p = 0.020, AUC = 0.93). Patients with reduction of ctDNA level from baseline to the last follow-up had longer OS (HR = 0.14; 95% CI = 0.05-0.44, p = 0.001) and PFS (HR = 0.08; 95% CI = 0.03-0.27, p < 0.0001) compared to patients with increased ctDNA, including adjustment for confounding factors. Our findings suggest that variation of ctDNA over time during melanoma treatment reflects the clinical outcome and tumour response to therapy and might be helpful in clinical monitoring.


A multi-marker integrative analysis reveals benefits and risks of bariatric surgery.
Bariatric surgery (BS) is an effective intervention for severe obesity and associated comorbidities. Although several studies have addressed the clinical and metabolic effects of BS, an integrative analysis of the complex body response to surgery is still lacking. We conducted a longitudinal data study with 36 patients with severe obesity who were tested before, 6 and 12 months after restrictive BS for more than one hundred blood biomarkers, including clinical, oxidative stress and metabolic markers, peptide mediators and red blood cell membrane lipids. By using a synthetic data-driven modeling based on principal component and correlation analyses, we provided evidence that, besides the early, well-known glucose metabolism- and weight loss-associated beneficial effects of BS, a tardive, weight-independent increase of the hepatic cholesterol metabolism occurs that is associated with potentially detrimental inflammatory and metabolic effects. Canonical correlation analysis indicated that oxidative stress is the most predictive feature of the BS-induced changes of both glucose and lipids metabolism. Our results show the power of multi-level correlation analysis to uncover the network of biological pathways affected by BS. This approach highlighted potential health risks of restrictive BS that are disregarded with the current practice to use weight loss as surrogate of BS success.


Correlations between carbon isotope ratio and microhabitat in desert plants.
Water is usually considered to be the key limiting factor for growth of desert plants, yet there is little information available of the water-use efficiency of species within a desert community. Leaf carbon isotope ratios, an indicator of long-term intercellular carbon dioxide concentrations and thus of water-use efficiency in C3 plants, were measured on species occurring within a Sonoran Desert community, consisting of wash, transition and slope microhabitats. Along a soil moisture gradient from the relatively wetter wash to the relatively drier slope, leaf carbon isotope ratios increased in all species, indicating that water-use efficiency increased as soil water availability decreased. Leaf carbon isotope ratios of long-lived perennials were substantially more positive than in short-lived perennials, even though plants were growing adjacent to each other. Leaf carbon isotope ratio and leaf duration (evergreen versus deciduous) were not correlated with each other. The results are discussed in terms of how the efficiency of water use may affect community structure and composition.


Association between quality of life and sleep time among community-dwelling stroke survivors: Findings from a nationally representative survey.
This study aimed to examine the association between quality of life and sleep time among adult stroke survivors. This cross-sectional study used nationally representative data from the Korea National Health and Nutrition Examination Survey (2010-2013), and analyzed data on 504 adult stroke survivors. Findings showed that stroke survivors' daily sleep time significantly varied by sex (P < 0.001), education (P = 0.006) and body mass index (P = 0.012). The EuroQOL-5 Dimension index (P < 0.001), and its dimensions of mobility (P = 0.011), usual activities (P < 0.001) and pain/discomfort (P = 0.005) showed significant differences among people with different sleep times. In the final model, after adjusting for covariates, respondents who slept ≤5 h had odds ratios of 1.82 (95% confidence interval 1.05-3.16) for usual activities and 1.95 (95% confidence interval 1.16-3.27) for pain/discomfort compared with respondents who slept 6-8 h. Respondents who slept ≥9 h had an odds ratio of 3.03 (95% confidence interval 1.43-6.43) for usual activities compared with those who slept 6-8 h. Adjusted means for the EuroQOL-5 Dimension index showed significant differences: 0.76 for ≤5 h, 0.85 for 6-8 h and 0.75 for ≥9 h (P = 0.001). Our findings show an association between quality of life and sleep time among adult stroke survivors. Sleep time should be considered in efforts to improve stroke survivors' quality of life, including education and interventions that encourage 6-8 h of sleep. Geriatr Gerontol Int 2019; 19: 1226-1230.


Blood bank programs and transfusion sustainability. A serial mediating model.
Researchers establish that the current challenges of blood safety and shortage are based on relationship between master production scheduling and blood transfusion sustainability of blood banks. The objective of this study is to evaluate program relationship between master production scheduling and blood transfusion sustainability through total quality management and blood production. A survey questionnaire was adopted with staff from regional and government university teaching hospital blood banks. Simple random sampling was used to collect data from respondents. Preliminary and main data analysis was done using SPSS AMOS23. The results revealed that master production scheduling influence blood transfusion sustainability when serially mediated by total quality management and blood production with 34% variation change at 95% confidence interval. Again, the results obtained show that master production scheduling influence total quality management significantly. Furthermore, total quality management influence blood production significantly. Finally, blood production influence blood transfusion sustainability significantly. Master production scheduling program actions has a positive significant relationship with blood transfusion sustainability through total quality management and blood production programs as serial mediators. This research contributes to the management of blood banks and suggests to have a greater relational management of total quality management, blood production and master production scheduling program actions in order to achieve high levels of blood transfusion sustainability, and in general, a greater benefit for society.


Dynamics of the leukocytic response of Biomphalaria glabrata during the larval development of Schistosoma mansoni and Echinostoma liei.
The daily evolution of the number of hemocytes in Biomphalaria glabrata was ascertained under three conditions: uninfected snails, snails infected with Schistosoma mansoni, and snails infected with Echinostoma liei. The Results show differences between the three experiments as well as in the average hemocyte density over the whole experimental period, as in the temporal dynamics of circulating hemocyte number. Specifically, it appears that the development of E. liei in B. glabrata induces a density of circulating hemocytes greater than that in uninfected B. glabrata or in snails infected with S. mansoni. The hemocyte dynamics observed in both experimental groups might best be interpreted by taking into account differences in the immunogenic stimulating capacity of the two trematodes and different physiological functions of the hemocytes brought into play during the infection: wound repair, nutrient digestion and transport, and excretion.


Variable interpretation of ultrasonograms may contribute to variation in the reported incidence of white matter damage between newborn intensive care units in New Zealand.
The incidence of cerebral white matter damage reported to the Australian and New Zealand Neonatal Network (ANZNN) varies between neonatal intensive care units (NICUs). Differences in the capture, storage, and interpretation of the cerebral ultrasound scans could account for some of this variation. A total of 255 infants of birth weight <1500 g and gestation <32 weeks born between 1997 and 2002 and drawn equally from each of the six NICUs in New Zealand were randomly selected from the ANZNN database. Half had early cerebral ultrasound scans previously reported to ANZNN as normal, and half had scans reported as abnormal. The original scans were copied, anonymised, and independently read by a panel of three experts using a standardised method of reviewing and reporting. There was considerable variation between NICUs in methods of image capture, quality, and completeness of the scans. There was only moderate agreement between the reviewers' reports and the original reports to the ANZNN (kappa 0.45-0.51) and between the reviewers (kappa 0.54-0.64). The reviewers reported three to six times more white matter damage than had been reported to the ANZNN. Some of the reported variation in white matter damage between NICUs may be due to differences in capture and interpretation of cerebral ultrasound scans.


Lessons Learned from Infants with Late Detection of Critical Congenital Heart Disease.
Late detection of critical congenital heart disease (CCHD) is multifactorial and ill defined. We investigated the results of pulse oximetry screening (POS) and points in the care chain that contribute to delayed detection of CCHD. The medical records of 13 infants with delayed detection at a single pediatric cardiac center between 2013 and 2016 were identified and reviewed. Left heart obstructive lesions were the most common diagnosis (n = 8; 62%) and included coarctation of the aorta (n = 6), interrupted aortic arch with ventricular septal defect (n = 1), and critical aortic stenosis (n = 1). Tetralogy of Fallot (TOF) (n = 2), truncus arteriosus (n = 1), pulmonary atresia with ventricular septal defect (n = 1), and total anomalous pulmonary venous drainage (n = 1) made up the remainder of the conditions. Routine prenatal care was reported in most infants (10/13). Infants with late detection had either a true negative POS (10/13 infants) or no POS performed (3/13 infants). At the time of detection, 5/6 (83%) infants with coarctation had normal pulse oximetry values, whereas 6/7 (86%) infants with other CCHD developed abnormal pulse oximetry values. At diagnosis, 11/13 (85%) infants had significant signs or symptoms of clinical deterioration; only 2 infants were completely asymptomatic. Late detection of CCHD is uncommon and multifactorial. Eliminating late detection is dependent upon improving detection on screening obstetrical ultrasounds, enforcement of universal POS, and attention to the neonatal physical exam.


Expression cloning of an insect diuretic hormone receptor. A member of the calcitonin/secretin receptor family.
Insect diuretic hormones and their receptors regulate fluid and ion secretion and thus are attractive targets for the design of novel insect control agents. A complementary DNA clone encoding a corticotropin-releasing factor-related diuretic hormone receptor from the tobacco hornworm Manduca sexta was isolated by expression cloning in COS-7 cells. The receptor consists of 395 amino acids and contains seven putative transmembrane domains. The expressed receptor binds M. sexta diuretic hormone, as well as several related insect diuretic peptides with high affinity. Furthermore, each of these peptides stimulate adenylate cyclase in COS-7 cells transfected with the receptor. The M. sexta diuretic hormone receptor is homologous to the receptors for calcitonin, secretin, vasoactive intestinal peptide, parathyroid hormone, glucagon-like peptide 1, growth hormone-releasing hormone, pituitary adenylate cyclase-activating polypeptide, and glucagon. The M. sexta diuretic hormone receptor is the first nonmammalian member of this family to be identified.


Making the transition from student to newly qualified vascular sonographer: An exploration of the domains of professionalism.
Rapid increases in the utility of vascular ultrasound combined with increasing expectations from reporting physicians have required a shift to a more defined professional role for the vascular sonographer in Australia. This has created increasing pressure on newly qualified sonographers to be more job-ready and better able to navigate the challenges of the clinical workplace early in their career. There is a distinct lack of structured strategies that newly qualified sonographers can utilise to assist their transition from student to employee. In our paper, we aimed to answer the question of 'What makes a sonographer a Professional?' with the view to extending understanding of how a structured framework can assist the development of a professional identity and can encourage participating in Continuing Professional Development by the newly qualified sonographer. The authors reviewed their own clinical experiences and the current literature to source tangible and practical strategies that can be easily enacted by newly qualified sonographers to motivate their continuing growth. Through this review, the 'Domains of Professionalism in the role of the sonographer' framework was developed. In this framework, we describe the various domains of professionalism and their associated dimensions, making it specific to the discipline of sonography and to the point of view of a newly qualified sonographer. Our paper contributes to the discussion on Continuing Professional Development using a purposeful and targeted approach to support newly qualified sonographers across all discipline areas of ultrasound specialisation to navigate the often challenging pathway to becoming a professional.


RIFM fragrance ingredient safety assessment, ethyl lactate, CAS registry number 97-64-3.
The existing information supports the use of this material as described in this safety assessment. Ethyl lactate was evaluated for genotoxicity, repeated dose toxicity, reproductive toxicity, local respiratory toxicity, phototoxicity/photoallergenicity, skin sensitization, and environmental safety. Data on ethyl lactate show that ethyl lactate is not genotoxic and provided a calculated Margin of Exposure (MOE) > 100 for the repeated dose toxicity, reproductive toxicity, and local respiratory endpoints. Data from ethyl lactate and additional material ethyl (L)-lactate (CAS # 687-47-8) show that there are no safety concerns for ethyl lactate for skin sensitization under the current declared levels of use. The phototoxicity/photoallergenicity endpoints were evaluated based on ultraviolet (UV) spectra; ethyl lactate is not expected to be phototoxic/photoallergenic. The environmental endpoints were evaluated; ethyl lactate was found not to be Persistent, Bioaccumulative, and Toxic (PBT) as per the International Fragrance Association (IFRA) Environmental Standards, and its risk quotients, based on its current volume of use in Europe and North America (i.e., Predicted Environmental Concentration/Predicted No Effect Concentration [PEC/PNEC]), are <1.


Investigation of health literacy level and its effect on quality of life in patients with spinal cord injury.
To determine the health literacy (HL) level in patients with traumatic spinal cord injury (SCI) and evaluate the relationship between HL and the quality of life (QoL). Cross-sectional study. Ankara Physical Medicine and Rehabilitation Education and Research Hospital, Turkey. A total of 77 patients with traumatic SCI aged 15-65 years where the trauma had occurred at least a month ago before data collection and who were attending the rehabilitation program at the hospital as inpatients we included in the study. The European Health Literacy Questionnaire Turkish Adaptation (HLS-TR) was used for the evaluation of the HL level, and the Short Form-36 was used for the evaluation of the QoL. The HL level was inadequate in 32.5%, problematic-limited in 40.3%, sufficient in 19.5%, and excellent in 7.8% of the patients. The vitality and mental health subdimensions of the QoL were found to be statistically significantly better in participants with excellent, sufficient or problematic-limited HL compared to those with an inadequate level. According to our results, the HL level of the majority of patients with SCI who are hospitalized in our hospital is low, and there is a relationship between HL and QoL. In conclusion, steps need to be taken to increase the HL levels of patients to improve their QoL, taking into account the important effect of HL on the QoL.


Human T-cell leukemia virus-I and hematologic malignancies in Panama.
Serum samples were obtained in a 2-year period (November 1, 1984-December 31, 1986) from 136 Panamanian patients with hematologic malignancies identified by a population-based registry designed for studies investigating human T-cell lymphotropic virus (HTLV)-I. Only three patients had clinical and serologic findings of HTLV-I-associated adult T-cell leukemia/lymphoma (ATLL). The authors conclude that although classical HTLV-I-associated ATLL occurs in the Panamanian population, it is not as prevalent as in other Caribbean populations.


Perceptions of weight status and energy balance behaviors among patients with non-alcoholic fatty liver disease.
Weight loss through behavioral modification is central to treating non-alcoholic fatty liver disease (NAFLD). To achieve this, patients need to accurately self-perceive their health behaviors. We aimed to identify predictors of concordance between self-perception and objective measures of body weight, physical activity (PA) and dietary behaviors. We used data from the Harris County NAFLD Cohort, an ongoing prospective study in a regional safety-net healthcare system. Patients completed self-administered baseline questionnaires on demographics, diet, PA, and self-perceptions. We assessed concordance between actual and self-perceived body weight and energy-balance behaviors. Multivariable logistic regression identified predictors of concordance. Patients (n = 458; average age 46.5 years) were 90% Hispanic and 76% female. PA and fruit/vegetable intake guidelines were met among 37% and 9%, respectively. Most (89%) overweight/obese patients accurately perceived themselves as such. However, 41% of insufficiently-active and 34% of patients not meeting fruit/vegetable intake guidelines inaccurately self-perceived their behaviors as "just right". Women were 3 times more likely to accurately self-perceive weight status (adjusted odds ratio [AOR] 3.24; 95% CI 1.68-6.25) but 51% less likely to accurately self-perceive PA levels than men (AOR 0.49; 95% CI 0.29-0.81). Lower acculturation was associated with higher odds of accurate PA self-perception. Patients with prediabetes or diabetes vs normoglycemia were more likely to accurately self-perceive their fruit/vegetable intake. Most NAFLD patients accurately self-perceived their body weight. A third or more of those not meeting fruit/vegetable intake or PA guidelines had inaccurate perceptions about their behaviors. Our findings highlight key areas to target in NAFLD-specific behavioral modification programs.


Familial recurrent dislocation of patella with autosomal dominant mode of inheritance.
Recurrent dislocation of the patella is considered to be a manifestation of generalized joint laxity. An autosomal dominant mode of inheritance was previously suggested in a few instances; however, male-to-male transmission has not yet been reported. We report a recurrent dislocation of the patella occurring in five generations of one family with male-to-male transmission and without generalized joint laxity.