Effect of antihypertensive medication adherence on hospitalization for cardiovascular disease and mortality in hypertensive patients.
Antihypertensive medication treatment is one effective management strategy to prevent cardiovascular disease (CVD) and mortality. However, little research has been conducted on the rates of antihypertensive medication adherence and the effect of antihypertensive medication adherence on health outcomes in South Korea. We searched the Korean National Health Insurance Claims Database for records from 2003 to 2007. Patients in this study were 18 years of age or older and they were diagnosed with hypertension and newly prescribed antihypertensive medication in 2003. Adherence to antihypertensive medication was estimated as the medication possession ratio (MPR). Multivariate Cox regression was used to evaluate the association between medication adherence and adverse health outcomes after adjusting for patient demographics and clinical characteristics. Our study population consisted of 40,408 patients with a mean age of 51 years. Among the patients, 50.3% were men, 4.0% had Medicaid health insurance, 17.8% had diabetes, 20.9% had dyslipidemia and 42.4% were adherent (MPR ≥ 80%). Nonadherent patients (MPR<80%) were younger and more likely to have Medicaid health insurance; they had lower rates of diabetes and dyslipidemia compared with adherent patients. In the Cox multivariate analysis, nonadherence increased the risk of all adverse health outcomes, including all-cause mortality and hospitalization for CVD (hazard ratio: 1.57, confidence interval: 1.40-1.76). In conclusion, our study indicates that medication adherence is important for reducing hospitalization due to CVD and mortality.


Unilateral primitive hydatid cyst with surgical resection of the scrotum: a case report.
Hydatid disease remains a public health problem in many Mediterranean countries. Liver and lung localizations are the most common. Renal hydatid cysts represent 2 percent to 4 percent of the visceral forms of this disease. To the best of our knowledge a scrotal location has only previously been described in five papers in the literature, all being secondary localizations. In this paper, we report a case of a primitive scrotal hydatid cyst. A Moroccan man aged 29 years old presented to our facility with scrotal pain. A clinical examination identified a painless scrotal mass. The results of a scrotal ultrasound showed intra-scrotal cystic formations with different sizes associated with scrotal effusion of average abundance. Chest cavity and abdominal computed tomography scans did not reveal any other localizations. Our patient benefited from surgical protruding dome resection. A partial cysto-pericystectomy was realized. The first stage consisted of injecting a scolicide solution; hydrogen peroxide is the most commonly used agent. This is injected into the cystic cavity and retained for 10 minutes. This process allows for sterilization of the cyst while avoiding the risk of rupture and transmission of the hydatid liquid into the circulation. After 10 minutes, the cystic contents are removed by suction. The cyst is then opened, and the endocyst containing the hydatid membrane and daughter vesicles are removed. It is of note that our patient did not receive any additional medical treatment. Our diagnosis was made using an imaging approach and was confirmed during surgery. Ultrasound is often the key diagnostic approach for cases of a scrotal hydatid cyst. Treatment is primarily surgical, aiming for resection of the protruding dome via a longitudinal scrotectomy.


Self-determination by First Nations Australians in alcohol policy: Lessons from Mbantua/Alice Springs (Northern Territory, Australia).
First Nations Australians have an internationally-recognised right to self-determination - a key social determinant of health. The recognition and application of this right varies within different regions and policy contexts but is currently unknown for First Nations Australians' engagement in alcohol policy development. This study seeks to: explore First Nations Australians' experiences of alcohol policy in Central Australia (Northern Territory); and identify how First Nations Australians' right to self-determination can be recognised and applied in the development of alcohol policy in Mbantua/Alice Springs. Using a blended yarning and appreciative inquiry approach, 24 interviews were conducted. Interviews were thematically coded in multiple stages, using diagrammatic methods. Four key themes emerged: (i) experiences of purchasing alcohol; (ii)communication of the current alcohol policy; (iii) experiences of policy described by participants (and their community); and (iv) self-determination in alcohol policy. Current pathways for contributing to alcohol policy have been ineffective in achieving meaningful engagement with Australia's First Nations community members. This study provides some guidance as to how self-determination can more effectively be incorporated in the development of alcohol policy in the NT.


Synopsis and prospectives on fetal liver transplantation.
Over 300 individuals have received fetal liver transplants for a spectrum of disorders including immunodeficiencies, aplastic anemia, leukemia and genetic disorders. In some instances, the objective has been to reconstitute the immune system from fetal liver-derived lymphoid stem cells. In aplastic anemia and leukemia two distinct approaches have been used: engraftment of fetal liver-derived hematopoietic stem cells or attempts to stimulate recovery of autologous hematopoiesis via factors produced by fetal liver. In genetic disorders, partial engraftment of fetal liver-derived hematopoietic and hepatic cells has been investigated. This report critically reviews data presented at a symposium on fetal liver transplantation in New-Delhi, 1-5 February 1986.


Early and delayed personality changes associated with depression recovery? A one-year follow-up study.
Many studies have shown the state effect of depression on personality. However, the chronology of personality changes associated with depression recovery remains unstudied. The objective of this study is to assess early (first month) and delayed personality changes associated with depression recovery. Fifty-seven depressed inpatients were assessed with the Temperament and Character Inventory (TCI) at admission, 1 month, and 1 year post-treatment. Patients were divided into poor and favorable outcome. No significant personality change was observed in patients with poor depression outcome. Conversely, a favorable outcome of depression was associated with early and delayed personality changes. Early changes were: decrease in Harm avoidance (HA(1):Worry and pessimism), increase in Cooperativeness and Self-directedness (SD(1):Responsibility, SD(4):Self-acceptance, SD(2):Purposefulness and SD(3):Resourcefulness). Delayed changes were changes in character: increase in Self-Directedness (SD(1):Responsibility, SD(4):Self-acceptance, SD(5): Congruent second nature), decrease in Self-transcendence (ST(2):Transpersonal identification). This study shows the different status of personality changes associated with depression recovery, and it contributes to a better knowledge of the state effect and of subtle clinical changes in patients who are recovering from depression. It may also have implications for the prediction of depression outcome.


"In the hospital, there will be nobody to pamper me": a qualitative assessment on barriers to facility-based delivery in post-Ebola Sierra Leone.
Sierra Leone has one of the highest maternal mortality rates in the world. Encouraging the use of skilled birth attendance in health facilities is an important step in the endeavor to increase the number of safe deliveries. However, public trust in health facilities has been greatly damaged during the Ebola epidemic outbreak in Sierra Leone in 2014/2015, and little is known about external and intrinsic barriers to facility-based delivery (FBD) in the country since the end of the Ebola epidemic. We conducted a qualitative study on FBD in Princess Christian Maternity Hospital, Freetown, which is the national referral maternity hospital in Sierra Leone. We performed six focus group discussions with providers, pregnant women and recent mothers surrounding experiences, attitudes and behaviors regarding FBD and potential barriers. Discussions were tape recorded, transcribed and evaluated through content analysis. Women in our study were overall technically aware of the higher safety linked with FBD, but this often diverged from their individual desire to deliver in a supportive and trusted social and traditional environment. Close relatives and community members seemed to be highly influencial regarding birth practices. Many women associated FBD with negative staff attitudes and an undefined fear. Logistic issues regarding transportation problems or late referral from smaller health centers were identified as frequent barriers to FBD. More supportive staff attitudes and acceptance of an accompanying person throughout delivery could be promising approaches to increase women's confidence in FBDs. However, these approaches also imply revising health systems structures, like staff working conditions that are conducive for a friendly atmosphere, sufficient space in delivery wards allowing the women to bring a birth companion, or like the establishment of a reliable peripheral ambulance system to ensure transportation and fast referral.


Cytochalasin B and the structure of actin gels. II. Further evidence for the splitting of F-actin by cytochalasin B.
Cytochalasin B decreased the flow birefringence and s20,w and increased the extinction angle of actin filaments in salt solutions favoring polymerization of the protein. These changes occurred without a detectable increase in the equilibrium actin monomer concentration determined by a radioassay. These results complement earlier observations indicating that cytochalasin B shortens actin filaments without net depolymerization. Analyzed in terms of Flory's classical network theory, this shortening accounts for the marked effect of cytochalasin B in dissolving the gel structure of F-actin crosslinked by actin-binding protein concentrations near the critical concentration for incipient gelation. Cytochalasin B decreased the annealing rate of low concentrations of actin filament fragments prepared by sonic disruption. The result is consistent with the idea that cytochalasin B binds to the ends of actin filaments, and may explain how cytochalasin B causes filament shortening.


Diene chirality and cotton effects of nonhomoannular cisoid conjugated dienes: circular dichroism and crystal structure of a steroidal 19-nor-1(10),9(11)-diene derived from Westphalen's diol diacetate.
Nonhomoannular cisoid conjugated dienes exhibit negative lowest energy pi-->pi* Cotton effects when they have P diene chirality and positive CEs when they have M diene chirality. We investigated this relationship further with a variety of such dienes by MM2 conformational energy-minimization calculations and by an X-ray crystal structure of a steroidal 19 nor 1(10),9(11) diene. CEs are stronger when each double bond of the diene is endocyclic in a different ring and weaker when only one of the double bonds is endocyclic or when neither double bond is endocyclic. They are also stronger when axial allylic and homoallylic substituents with CH/pi interactions are present that exert consignate chirality contributions.


Vinflunine potentiates the activity of cisplatin but not 5-fluorouracil in a transplantable murine adenocarcinoma model.
Vinflunine is a novel Vinca alkaloid currently undergoing Phase II clinical trials, which have previously demonstrated anti-vascular effects in a transplantable murine colon adenocarcinoma model. Previous studies with compounds showing similar effects in combination with standard anti-cancer agents have demonstrated an improved efficacy relative to the standard agents. In this study the synergistic effects of administering vinflunine in combination with either Cisplatin (CPL) or 5-fluorouracil (5-FU) were investigated in a well-differentiated transplantable murine colon adenocarcinoma model (MAC 29). Vinflunine significantly potentiated the anti-tumour effects of CPL, but had little effect in combination with 5-FU. Using Hoescht 33342 dye labelling of the functional vasculature, clear evidence of vascular shutdown was seen for treatment groups including vinflunine. These data demonstrate that the combination of vinflunine and CPL has significant preclinical anti-tumour activity against a transplantable murine adenocarcinoma model that is related to the anti-vascular effects of vinflunine.


Biodegradation and metabolic fate of thiamphenicol via Chlorella sp. UTEX1602 and L38.
Thiamphenicol (TAP) is a typical medicament in animal husbandry and aquaculture for treating diverse infections. In this work, thiamphenicol biodegradation performance via microalgae was tested. The cultivation results showed that TAP could be biodegraded via the target algae. Chlorella sp. L38 presented strong adaptive ability to high concentration TAP. Biodegradation, biosorption and bioaccumulation were the dominant metabolic fates. Biodegradation contributed around 97% of the total removal efficiency at the TAP concentration of 46.2 mg·L-1. The removal of TAP by Chlorella L38 and UTEX1602 agreed with the kinetic range of zero-order reaction, and the shortest half-lives were 3.2 d and 5.0 d. Based on the identification of metabolites, the metabolic pathway of TAP by microalgae was proposed, including chlorination, chlorine substitution, dehydration and hydroxylation. Therefore, biological treatment via microalgae has the potential for TAP purification.


MR evaluation of liver iron overload.
Children and young adults with hemolytic anemias requiring frequent transfusions develop increased liver iron content. We evaluated 15 chronically transfused children with sickle cell disease to determine whether spin-echo magnetic resonance (MR) imaging was useful in assessing the degree of iron overload. Quantitative MR parameters were correlated with liver biopsy iron determinations and serum ferritin levels. The best predictor of liver iron was the ratio of the intensities between the liver and paraspinal musculature on somewhat T1 weighted sequence (repetition time 0.5 s, echo time 28 ms), R2 = 0.58. Magnetic resonance was able to separate those patients with liver iron levels greater than 100 micrograms/mg (intensity ratios approximately 0.4), from those with levels less than 100 micrograms/mg (intensity ratios near 1). However, MR was unable to quantitate liver iron in patients with values ranging from 100 to 400 micrograms/mg since similar intensity ratios were present in this range. Thus, MR provides a qualitative rather than quantitative assessment of liver iron overload.


Galectin-3 plasma levels and coronary artery disease: a new possible biomarker of acute coronary syndrome.
Inflammation plays a key role in atherosclerosis. Galectin-3 is a macrophage- and endothelium-derived mediator actively involved in the regulation of many aspects of inflammatory cell behaviour. The aim of this study is to quantify plasma Galectin-3 in patients with coronary artery disease (CAD) and different clinical manifestation at the moment of observation in order to verify whether Galectin-3 could be a useful biomarker of atherosclerotic state. We enrolled 125 patients affected by CAD, angiographically documented (70 stable, 55 unstable). They underwent accurate examinations and anamnestic data was collected. The most important traditional risk factors, such as age, hypertension, and body mass index, were reported. Plasma Galectin-3 was quantified using an ELISA kit. Unstable patients (n = 55) had a higher plasma Galectin-3 levels in respect to the stable subjects (27.75 ng/mL (19.27-39.09) vs 6.48 ng/ml (4.88-8.83), p<0.001. A trend in correlation between plasma Galectin-3 levels and number of vessels compromised seems to be present: CAD patients with three-vessel disease had higher levels of Galectin-3 than patients with one-or two-vessel disease (17.39 ng/ml (10.75-29.82) vs 9.18 ng/ml (5.56-23.22), p= 0.058. The significantly higher plasma Galectin-3 levels in patients with unstable angina in respect to the stable angina confirm the involvement of Galectin-3 in promoting macrophage activation and monocyte attraction. Despite the distribution of CAD in patients with acute and chronic coronary disease being similar, we may hypothesize that Galectin-3 could be a useful biomarker of atherosclerotic plaque and in particular of its destabilization.


Identification of fungal lignocellulose-degrading biocatalysts secreted by Phanerochaete chrysosporium via activity-based protein profiling.
Activity-based protein profiling (ABPP) has emerged as a versatile biochemical method for studying enzyme activity under various physiological conditions, with applications so far mainly in biomedicine. Here, we show the potential of ABPP in the discovery of biocatalysts from the thermophilic and lignocellulose-degrading white rot fungus Phanerochaete chrysosporium. By employing a comparative ABPP-based functional screen, including a direct profiling of wood substrate-bound enzymes, we identify those lignocellulose-degrading carbohydrate esterase (CE1 and CE15) and glycoside hydrolase (GH3, GH5, GH16, GH17, GH18, GH25, GH30, GH74 and GH79) enzymes specifically active in presence of the substrate. As expression of fungal enzymes remains challenging, our ABPP-mediated approach represents a preselection procedure for focusing experimental efforts on the most promising biocatalysts. Furthermore, this approach may also allow the functional annotation of domains-of-unknown functions (DUFs). The ABPP-based biocatalyst screening described here may thus allow the identification of active enzymes in a process of interest and the elucidation of novel biocatalysts that share no sequence similarity to known counterparts.


ICP monitoring--current status and future directions.
Continuous monitoring of intracranial pressure (ICP) is now an accepted part of neurosurgical practice, used in the management of patients with severe head injury, coma-producing subarachnoid haemorrhage, hydrocephalus, intracranial infection and following hypoxic or ischaemic insults to the brain. The pressure is measured from the lateral ventricle or from the subarachnoid space, and each neurosurgical department should establish criteria for determining what level of increased ICP should be acted upon and how it should be managed. This review favours a three stage approach: a) determining that ICP is truly elevated and correcting any immediately remediable causes, such as airway obstruction, then b) first-line measures, which consist of hyperventilation, osmotherapy and controlled CSF drainage, then c) second-line measures, consisting of short-acting anaesthetic agents--thiopentone and gammahydroxybutyrate. Future refinements of ICP monitoring will include improved understanding and better methods of measuring intracranial pressure-volume relationships and more detailed analysis of intracranial pulse pressure and the pressure waveform, its changes with mean ICP and its relationship with the arterial pressure waveform.


Liver pathology in transient neonatal hyperammonemia.
Ultrastructural investigations have been performed on two cases of transient neonatal hyperammonaemia (TNH). This newly recognized metabolic disorder is chiefly characterized by severe hyperammonaemia in the postnatal period, a comatous state, absence of abnormal organic aciduria, normal activity of urea cycle enzymes and, usually, complete recovery. The aetiology is presently unknown. Electron microscopy uncovered rather congruent alterations of hepatocyte structure, with a wide spectrum of mitochondrial lesions, an increase of autophagous bodies with organelle remnants, and changes in the excretory apparatus. Thus, in contrast to some of the hereditary disorders of the urea cycle, no specific structural changes could be found in TNH. This finding is in line with the observation of normal activities of main urea enzymes in these cases, and indicates that a different biochemical system may be pathogenetically involved in TNH.


Plasma cyclic AMP in manic-depressive illness.
The postulated disturbance of cyclic AMP (cAMP) in manic-depressive illness was investigated by using plasma as the biological material. Cyclic AMP was measured by a protein-binding assay, which was found very satisfactory for the purpose of this study. In the drug-free state, depressed patients (n = 28) had significantly lower and manic patients (n = 9) significantly higher plasma concentrations of cAMP than controls. Unmedicated manic-depressive subjects had normal cAMP levels during normothymic phases (n = 7). Cyclic AMP was reduced by neuroleptics in mania and elevated by tricyclics in depression. Lithium exerted a normalizing effect on cAMP in both phases of the illness. It is concluded that manic-depressive illness is associated with a disturbance in the cAMP system. The use of plasma rather than urine for the investigation of the state of cAMP in psychiatric disorders is advocated.


Topography of glycoproteins in the chick synaptosomal plasma membrane.
Chick brain synaptosomes or synaptic subfractions were treated with neuraminidase (EC 126.96.36.199) and/or galactose oxidase (EC 22.214.171.124) preparations in which proteolytic activity was inhibited with phenylmethanesulfonyl fluoride followed, after washing, by reductive incorporation of sodium boro[3H]hydride to identify galactose residues exposed on the synaptosomal external surface. Control experiments to demonstrate restriction of labeling to the external surface involved comparing the radioactivity in synaptoplasmic, soluble polypeptides isolated after labeled, isolated synaptoplasm and examining incorporation into fractions incubated without enzymes. Intactness of the synaptic plasma membrane after labeling was shown by trypsin digestion studies. Polypeptides were separated on sodium dodecyl sulfate polyacrylamide gels and were detected by a liquid scintillation counting procedure. Eleven major radioactive peaks were found after galactose oxidase treatment and reduction of isolated synaptic membranes. When intact synaptosomes were labeled, the same components were detected. When isolated synaptic membranes or intact synaptosomes were treated with neuraminidase before galactose oxidase treatment, three additional components were labeled. These results suggest that (a) chick synaptic membranes have a complex mixture of glycoproteins, (b) all major chick synaptic membrane glycoproteins labeled by galactose oxidase have most or all carbohydrate groups exposed at the exterior surface of the synaptosome, (c) all major, externally-disposed polypeptides of these synaptic membranes are glycoproteins.


Synthesis and preliminary evaluation of (S)-2-(4'-carboxycubyl)glycine, a new selective mGluR1 antagonist.
The synthesis and the pharmacological evaluation at metabotropic glutamate receptors of S-2-(4'-carboxy-cubyl)glycine (ACUDA, 9) are described. S-2-(4'-Carboxy-cubyl)glycine is a structurally novel group I selective antagonist for mGluR1 subtype.


Assessing knowledge and attitudes of owners or managers of hospitality venues regarding a policy banning indoor smoking.
In response to accumulating evidence on the detrimental health effects of second-hand smoke, governments throughout the world have adopted laws prohibiting indoor smoking in public places. Lebanon has recently enacted a law prohibiting indoor smoking in all of its forms, rendered effective as of 3 September 2012. This study examined the knowledge and attitudes of owners/managers of restaurants, cafes, pubs and nightclubs in Beirut towards the ban, three months before it came into effect. Self-administered cross-sectional survey. Data were derived from a self-administered cross-sectional survey conducted in June 2012. In total, 262 hospitality venues (restaurants, cafes, pubs and nightclubs) were sampled at random to participate. The response rate was 74% (194/262). Overall, 84% of owners/managers reported that they were aware of the ban, yet the average knowledge score was only 3.43/10. A general positive attitude was noted towards customer satisfaction (44.8%), law enforcement (61.1%) and employee protection from second-hand smoke (74%), while 55% of owners/managers were concerned that their revenues would decrease. However, 83.3% expressed their willingness to implement the law. This quantitative study is the first to examine the knowledge and attitudes of owners/managers of hospitality venues regarding the indoor smoking ban in Lebanon. Civil society and government bodies should use the findings to develop a campaign to address the knowledge and attitudes of owners/managers of hospitality venues to ensure successful enforcement.


Transglutaminase-mediated crosslinking of Bambara groundnut protein hydrogels: Implications on rheological, textural and microstructural properties.
Interest in plant protein-based hydrogels with desirable strength has been increasing in recent years. In this study, Bambara groundnut protein isolate (BPI) was crosslinked with transglutaminase (TGase) (0 - 25 U/g protein) during gelation and rheological, textural and microstructural properties of the resulting hydrogels were investigated. Treatment with TGase up to 15 U/g protein resulted in the formation of hydrogels with small pores and an organised homogeneous network. G' of TGase-treated BPI hydrogels was more than ten-fold higher than G" throughout the frequency range of 0-100 rad/s, suggesting dominance of the elastic like behaviour. BPI hydrogel with the highest G' (6967 Pa) and hardness (5.60 N) was formed at 15 U/g protein of TGase activity. The hydrogel had a high distribution β-sheets (53.52%) and α-helixes (26.17%) as compared to the β-turns and random coils. However, a further increase in TGase activity did not improve the hydrogel properties. Transglutaminase mediated crosslinking of BPI hydrogel was demonstrated by the reduction in amine and thiol groups and the formation of a new protein band (56 kDa) in crosslinked hydrogels. Overall, TGase promoted the formation of a strong gel with an organised network.


The clinical entity of adult respiratory distress syndrome. Definition, prediction, and prognosis.
This article discusses the clinical entity of the adult respiratory distress syndrome (ARDS), its manifestations, and its natural history. The problems of defining the syndrome and its associated risk factors are delineated. In addition, the article reviews the experimental, retrospective, and prospective studies of ARDS risk factors, as well as the clinical correlations with mortality.


Multivariate measures of similarity and niche overlap.
Niche overlap measures are used to assess the similarity in resource use by two species. Recently researchers have used niche overlap measures as summary measures and for making inferences, typically about competition for resources. The problem of estimating niche overlap when the niches are multivariate normal distributions with equal covariance matrices has previously been studied. In this work, the assumption of equal covariance matrices is relaxed. Two general measures of similarity are evaluated assuming general multivariate normal distributions. Commonly used measures of overlap are given as special cases of these two general measures. The question of bias in estimating these measures is discussed and shown to be a potential problem, especially when there are many redundant variables or if sample sizes are small.


A Rare Pathology: Low-Grade Fibromyxoid Sarcoma of the Maxilla.
Low-grade fibromyxoid sarcoma (LGFMS) is a rare tumor with a benign histologic appearance and fully malignant behavior. To date, only 5 cases of LGFMS in the maxillofacial region have been reported. This report describes the case of a 16-year-old boy who was referred to the authors' hospital with an intraosseous myxofibroblastic tumor, probably of the LGFMS type, of the right maxilla. Radical resection with wide safe margins and secondary reconstruction with a free forearm flap were performed. Six-month follow-up showed no sign of recurrence or metastasis. The authors review the scientific literature and discuss different tumor locations and treatment strategies for those in the maxillofacial region. The present case is the sixth reported case of LGFMS in the maxillofacial region (intraosseous LGFMS of the maxilla), adding another facet to the literature regarding this rare soft tissue tumor.


Initial toxicity, quality-of-life outcomes, and dosimetric impact in a randomized phase 3 trial of hypofractionated versus standard fractionated proton therapy for low-risk prostate cancer.
Randomized evidence for extreme hypofractionation in prostate cancer is lacking. We aimed to identify differences in toxicity and quality-of-life outcomes between standard fractionation and extreme hypofractionated radiation in a phase 3 randomized trial. We analyzed the results of the first 75 patients in our phase 3 trial, comparing 38 Gy relative biologic effectiveness (RBE) in 5 fractions (n = 46) versus 79.2 Gy RBE in 44 fractions (n = 29). Patients received proton radiation using fiducials and daily image guidance. We evaluated American Urological Association Symptom Index (AUASI), adverse events (AEs), and Expanded Prostate Index Composite (EPIC) domains. The primary endpoint of this interim analysis was the cumulative incidence of grade 2 (G2) or higher AEs. The randomized patient allocation scheme was a 2:1 ratio favoring the 38 Gy RBE arm. The median follow-up was 36 months; 30% of patients reached 48-month follow-up. AUASI scores differed <5 points (4.4 vs 8.6; P = .002) at 1 year, favoring the 79.2 Gy arm. Differences in AUASI were not significant at ≥18 months. EPIC urinary symptoms favored the 79.2 Gy arm at 1 year (92.3 vs 84.5; P = .009) and 18 months (92.3 vs 85.3; P = .03); bother scores were not significant at other time points. Cumulative ≥G2 genitourinary toxicity was similar between the 79.2 Gy and 38 Gy arms (34.5% vs 30.4%; P = .80). We found no differences in the EPIC domains of bowel symptoms, sexual symptoms, or bowel ≥G2 toxicities. Bladder V80 (79.2 Gy arm; P = .04) and V39 (38 Gy arm; P = .05) were predictive for cumulative G2 genitourinary AEs. Low AE rates were seen in both study arms. Early temporary differences in genitourinary scores disappeared over time. Bladder constraints were associated with genitourinary AEs.


Genome-wide analysis of the IQD gene family in maize.
IQD gene family plays important roles in plant developmental processes and stress responses. To date, no systematic characterization of this gene family has been carried out in maize. In this study, 26 IQD genes, from ZmIQD1 to ZmIQD26, were identified using Blast search tools. The phylogenetic analysis showed these genes were divided into four subfamilies (IQD I-IV) and members within the same subfamily shared conserved exon/intron distribution and motif composition. The 26 ZmIQD genes are distributed unevenly on 8 of the 10 chromosomes, with 9 segmental duplication events, suggesting that the expansion of IQDs in maize was due to the segmental duplication. The analysis of Ka/Ks ratios showed that the duplicated ZmIQDs had primarily undergone strong purifying selection. In addition, the 26 ZmIQDs displayed different expression patterns at different developmental stages of maize based on transcriptome analysis. Further, quantitative real-time PCR analysis showed that all 26 ZmIQD genes were responsive to drought treatment, suggesting their crucial roles in drought stress response. Yeast two-hybrid assay proved that ZmIQD2 and ZmIQD15 can interact with ZmCaM2 and IQ or I in IQ motif is required for ZmIQD15 to combine with CaM2. Our results present a comprehensive overview of the maize IQD gene family and lay an important foundation for further analysis aimed at uncovering the biological functions of ZmIQDs in growth and development.


Effect of the New Nordic Diet compared with usual care on glucose control in gestational diabetes mellitus: Study protocol for the randomized controlled trial intervention with new Nordic DIet in women with GestatiOnal diabetes mellitus (iNDIGO).
Gestational diabetes mellitus (GDM) is a pregnancy complication associated with short- and long-term health consequences for mother and child. First line treatment is diet and exercise but there is a recognized knowledge gap as to what diet treatment is optimal. A healthy Nordic diet has been associated with improved health but no studies in women with GDM exist. The New Nordic Diet (NND) is an initiative with the purpose to develop a healthy Nordic diet including foods with the potential to grow in Nordic countries; including fruit, berries, vegetables, whole-grain cereal products, nuts, fish, and rapeseed oil. The purpose of the intervention with new Nordic DIet in women with GestatiOnal diabetes mellitus (iNDIGO) is to test if the NND compared with usual care improves glucose control in women with GDM. The iNDIGO study is a randomized parallel controlled trial where 50 women with GDM will be randomized to either an NND or usual care for 14 days (30-32 weeks of gestation). Participants in the NND group will receive menus and food bags containing foods to be consumed. Primary outcome is glycemic control (time in target) measured using continuous glucose monitoring. Compliance to the dietary intervention will be tested using dietary biomarkers and adherence questionnaires. Diet treatment represents first line treatment in GDM but it remains unclear what type of diets are effective. iNDIGO is an efficacy study and will provide evidence as to whether a healthy Nordic diet can improve glucose control in women with GDM. ClinicalTrials.gov registration Number: NCT04169243. Registered 19 November 2019, https://clinicaltrials.gov/ct2/show/NCT04169243.


Tissue response to porous hydroxyapatite ceramic in the human femoral head.
We describe pathohistological findings of the human femoral head after it was grafted with hydroxyapatite (HA) and allogenic bone. The femoral head was removed because of the recurrence of a giant cell tumor 15 months after the graft. Histological investigation revealed that the entire surface of the HA granules was completely surrounded by the bone in the periphery of the grafted area; in some areas granules were partly in contact with the existing bone, and the rest were surrounded by fibrous tissue. There was no intervening layer of fibrous tissue between the granule surface and the bone where they were in direct contact. Pores were completely filled with fibrous tissue, partially filled with bone in the periphery of the pores, or completely filled with bone. Undecalcified histology revealed the formation of osteoid and ossification at the site where fibrous tissue infiltrated the pores. These findings indicated continued ingrowth of new bone into the HA pores. Under a scanning electron microscope, the surfaces of the granules showed clear demarcation in vitro, but it became less smooth, indicating in vivo changes. Although no foreign body reaction to the HA was noted anywhere, the HA surface appeared to be subject to a biodegradation process.


3D T1-weighted contrast-enhanced brain MRI in children using a fat-suppressed golden angle radial acquisition: an alternative to Cartesian inversion-recovery imaging.
T1-weighted post-contrast MRI is essential in brain protocols. We demonstrate the feasibility and utility of a 3D non-Cartesian radial acquisition in children. To compare bulk motion artifacts, image quality, and lesion conspicuity in 3D T1-weighted post-contrast brain MRI between a new fat-suppressed radial gradient-echo and a traditional non-fat-suppressed inversion-recovery Cartesian gradient-echo sequence. Images from 53 patients acquired at 3 Tesla were compared. Three radiologists rated the images in three categories, including the presence of bulk motion and whether it impacted diagnosis, whether one sequence was preferred over the other in overall image quality and conspicuity of vascular structures and lesions, and whether diagnosis was possible if only the new fat-suppressed radial acquisition was obtained. The Fleiss' kappa for inter-rater agreement was 0.67 for bulk motion and 0.54 for sequence preference. Of the 53 cases, 56% were identified to have significant motion on conventional imaging, while only 13% had motion artifacts on the radial acquisition (p < 0.05). There were no cases where motion was seen on the radial acquisition but not on conventional imaging. Both sequences were equally preferred in 87% of the cases. All radiologists agreed that the radial approach had lower gray-white matter contrast than the conventional inversion-recovery method, but preferred the former for making diagnosis in uncooperative patients. We demonstrate the potential utility of a fat-suppressed 3D T1-weighted post-contrast brain gradient-echo sequence in children. The technique is useful in non-sedate pediatric imaging due to its reduced sensitivity to bulk motion.


Toxicity study of the main alkaloids of Datura ferox in broilers.
Seeds of the weed Datura ferox are frequent contaminants of raw materials used for animal feed. These seeds produce various toxic effects and contain mainly the alkaloids scopolamine and hyoscyamine. In this 3-month toxicity study, a mixture of scopolamine and hyoscyamine (98:2) was incorporated at four total alkaloid levels (1.5, 15, 75 or 150 mg/kg feed) into a control diet fed to 100 broilers. Alkaloid feeding caused significant reductions in the body weight gain of birds, especially of those fed a dose of 150 mg alkaloid/kg feed. Growth-retarding effects, however, were transient, as no changes in body weight gain were noted after 52 days of alkaloid feeding. Alkaloid-treated broilers showed no significant differences from controls with respect to the cardiac rate and breathing frequency nor in relation to plasma aspartate aminotransferase, alanine aminotransferase and alkaline phosphatase activities. In contrast, plasma leucine aminopeptidase activity was significantly reduced after 3 months in all alkaloid-fed birds. Autopsy and histological examination of tissues by light and electron microscopy revealed no pathological changes associated with alkaloid feeding. Broilers appeared generally healthy and behaved normally throughout. These data should be considered in the formulation of new, improved regulations defining the maximum allowable alkaloid content of D. ferox seeds contaminating raw materials destined for use as broiler feed.


Value of contrast-enhanced arterial phase imaging in addition to portovenous phase in CT evaluation of blunt abdominopelvic trauma.
Compare the diagnostic performance of the arterial phase plus portovenous phases (AP + PVP) of abdominopelvic CT (CT) with PVP alone in the detection and characterization of traumatic vascular injury and the effects on radiologists' confidence. CT of 103 consecutive inpatients (median 36 years, 83 males) with blunt abdominopelvic injuries were retrospectively included if performed within 24 h after trauma and before definitive management. Images were re-reviewed by two blinded radiologists with disagreements resolved by the third radiologist. Sixty vascular injuries (liver 23, spleen 15, kidneys 9, pancreas 2, adrenals 3, mesentery, and pelvis 4 each) were found with 4 injuries (liver 2, spleen, and kidneys 1 each) not detected at initial CT. Nineteen (liver 6, spleen 10, kidneys 2, adrenal 1) were visualized only on AP. The sensitivity and accuracy of AP + PVP were 89.58-91.67% and 94.44-95.15%, compared to 61.67-62.50% and 77.67-80.00% of PVP alone. The agreements on the types of injury with final diagnoses were higher for AP + PVP than for PVP alone (78.69% vs. 44.26%). The mean diagnostic radiologist confidence ((1 = 25%, 2 = 50%, 3 = 75%, 4 > 90%) increased significantly in the detection (from 3.38 to 3.71) and characterization (from 2.46 to 3.67) of vascular injuries with AP + PVP compared to PVP alone. For 19 lesions detected only on AP, 11 (spleen 8, liver 2, adrenal 1) received nonoperative management; others had transarterial embolization or surgery. The addition of AP improves the detection and characterization of vascular injuries in CT evaluation of blunt abdominopelvic trauma. • AP+PVP was more sensitive and precise than PVP alone in the detection of traumatic vascular abdominopelvic injuries. • AP+PVP improved the characterization of traumatic abdominopelvic vascular injuries. • When all abdominopelvic vascular injuries were considered, AP increased radiologists' diagnostic confidence in the detection and characterization of vascular injuries.


Brain oscillations evoked by the face of a loved person.
Previous studies have shown a close interrelation between emotional processing and memory processes using facial stimuli and applying the concept of oscillatory brain dynamics. Amending prior findings the influence of neural correlates related to the emotional state termed "romantic love" was investigated. Specifically, the effect of feelings of love on face perception was of interest. Pictures of a "loved person" were presented to female subjects and the elicited responses were compared with responses to pictures showing faces of a "known and appreciated person" or an "unknown person" during EEG recordings (n=20 females). As a control condition light stimulation was employed. The sequence of faces shown was presented in random and block-design. EEG data was analyzed considering maximum amplitudes and topographical differences within the conventional frequency bands of delta, theta, alpha, beta and gamma. Differences between light and face stimuli were found in the delta and theta bands and differences between the face types and the two designs were found in the delta band. The delta response to the picture of the "loved person" showed significantly higher amplitude values, not only in comparison with the "unknown person", but also with the picture of the "appreciated person". Frontal lobes appear to react to different types of facial stimuli with specific increases in delta responses. The difference between the response to the "loved person" and of the "known and appreciated person" reflects the component of the emotion denoted as love. The findings and their interpretations are discussed within the framework of event-related oscillations and complex stimulus processing emphasizing the concept of dynamic localization.


Chromium Methionine and Ractopamine Supplementation in Summer Diets for Grower-Finisher Pigs Reared under Heat Stress.
This study aimed to determine the effects of the dietary supplementation of chromium methionine (CrMet) and ractopamine (RAC) on pigs in the growing-finishing stage under heat stress. The parameters evaluated included productive behavior, blood components, carcass characteristics, organ weight, and meat quality. This study was conducted during the summer season in Sonora, Mexico. The treatments included: (1) control diet (CON), a base diet (BD) formulated to satisfy the nutritional requirements of pigs; (2) RAC, BD plus 10 ppm RAC supplemented during the last 34 days of the study; (3) CrMet-S, BD supplemented with 0.8 ppm of Cr from CrMet during the last 34 days; and (4) CrMet-L, BD supplemented with 0.8 ppm of Cr from CrMet for an 81 d period. RAC supplementation improved the productive behavior and main carcass characteristics of the pigs compared with CON. However, RAC and CrMet supplementation during the last 34 days showed similar results in terms of weight gain, carcass quality, blood components, organ weight, and meat quality. The addition of CrMet-S had a moderate (although not significant) increase in productive performance and carcass weight. These findings are encouraging, as they suggest that CrMet may be a potential alternative for growth promotion. However, more research is needed.


[Adamantiades-Behçet's disease. Clinical review].
Behçet's disease is a chronic relapsing systemic vasculitis of unknown etiology, affecting predominantly oral and genital mucocutaneous tissues and also the eyes. The disease is spread worldwide with a higher prevalence rate in countries along the ancient Silk Route, but it is rare (1-10/100,000) in Central and Northern Europe. Genetic, environmental, immunologic, inflammatory and rheologic factors are involved in the pathogenesis and the course of the disease. Any vascularized organ may be affected. Eye involvement is frequent, and may eventually result in loss of vision. Further important complications are cerebral manifestations, thrombotic syndromes, and arterial aneurysms with a high risk of rupture. Diagnosis and therapy of Behçet's disease are best managed by an interdisciplinary team. Skin lesions may be controlled by systemic treatment with colchicine, alternatively with dapsone, and in severe cases with thalidomide. Active systemic disease should be treated more aggressively using immunosuppressants. Despite advances in treatment relapses are still frequent, and systemic disease remains associated with an adverse prognosis.


[Utilization of technology and communication technologies (TIC) in public health].
The development of information and communications technologies (ICT) and Internet offers public health practitioners new tools to fulfill their missions of monitoring public health, health promotion and disease prevention, and public health protection. In recent years, new applications and practices in public health using these technologies have emerged, particularly in the area of communication among practitioners and transmission of information to the population. This article aims to give an overall view of the use of ICT in public health and to discuss the impact of these technologies on public health practices. The discussion is centred around the implications of using these new technologies: implications with regard to the new possibilities provided by these technologies, but also with regard to the difficulties involved in their use as well as issues related to unequal access and ethics. Finally, the question of the evaluation of these technologies and of their impact on public health is discussed.


Hypercholesterolemia as a risk factor for depressive disorder?
Epidemiological findings demonstrated that increased plasma cholesterol levels are frequently observed in depressive patients. In this regard, there is enhancing evidence that hypercholesterolemia is associated with impairment of brain function. Recently, we demonstrated that low-density lipoprotein receptor knockout (LDLr(-/-)) mice- a widely used rodent model of familial hypercholesterolemia - exhibited memory deficits and cortico-cerebral mitochondrial dysfunction. In this study, we aimed to assess the hypercholesterolemic mice in predictive tasks for depressive-like behavior. Adult wild type C57BL/6 and LDLr (-/-) mice were evaluated in two tests for depressive like behavior, the splash test and forced swimming test. In addition, the activity of monoamine oxidase isoforms and the mRNA levels of hemeoxygenase-1 were assessed in the hippocampus and cerebral cortex of C57BL/6 and LDLr (-/-) mice. Finally, the blood-brain-barrier (BBB) permeability was investigated using the AQP-4 immunofluorescence staining in the mice hippocampus. The LDLr (-/-) mice showed a significant reduction in the grooming time in the splash test and increased immobility time in the forced swimming test, and both parameters were reversed by fluoxetine antidepressant treatment (10mg/kg, 7 days, o.g.). Interestingly, the depressive like behavior of LDLr (-/-) mice was associated with increased activity of monoamine oxidase A, decreased hemeoxygenase-1 mRNA levels and increase of BBB permeability in the hippocampus. Overall, these data provide new evidence that hypercholesterolemia could trigger brain alterations involved in depressive disorders.


Molecular phylogeny of two Rhinoxenus species (Monogenea: Dactylogyridae) from the nasal cavities of serrasalmids (Characiformes: Serrasalmidae) from Brazil.
The dactylogyrid genus Rhinoxenus (Monogenea: Dactylogyridae) is composed of specialized monogeneans infecting the nasal cavities of freshwater fishes from the Neotropical region. This taxon currently comprises 11 species and is easily distinguished from other monogeneans by the absence of the dorsal bar, ventral anchor with inconspicuous roots covered by a sclerotized cap, dorsal anchor greatly modified into a needle-like shape, and hook pair 2 located into bilateral lobes of the trunk. Specimens of Rhinoxenus euryxenus and Rhinoxenus paranaensis were found infecting the nasal cavities of Serrasalmus marginatus and Serrasalmus maculatus, respectively, from the Paraná River basin in Brazil. For the first time, molecular data of Rhinoxenus spp. were obtained and used as a basis for phylogenetic analyses of the genus. Furthermore, our findings represent the first record of R. paranaensis in Brazil.


Time course of degeneration of the visual system induced by spontaneous glaucoma in the albino quail (Coturnix coturnix japonica).
The retinal projection of an imperfect albino quail mutant with a sex-linked recessive gene was examined 2 weeks-16 months post-hatch using various histological methods. During the first weeks the visual system was normal. Initial signs of buphthalmos, a form of spontaneous glaucoma, appeared between the 3d and 5th months. Its development induced a degeneration of the retinal projections according to a relatively precise sequence progressing from the mesencephalic tegmentum to the optic tectum, then from the pretectum to the thalamus. The data suggest that the degeneration of the optic axons results from their mechanical compression due to the increased intraocular pressure.


Predictors of health-harming and health-protective behaviors in adolescents with cancer.
Given adolescent cancer survivors' increased susceptibility to late effects, it is imperative that we understand factors that influence their engagement in healthy and unhealthy behaviors. The purpose of this exploratory study was to identify significant predictors of health-harming and health-protective behaviors in adolescent cancer patients. Forty-two adolescents (ages 12-19 years) currently on-treatment for cancer and their parents were recruited from outpatient pediatric cancer clinics. Adolescents completed a battery of questionnaires that assessed their health-behaviors, quality of life, and psychological distress, while parents completed a demographic questionnaire. Regression analyses indicated that specific demographic, illness, and psychosocial variables significantly predicted health-harming and health-protective behaviors. Older adolescent age and unmarried parent status emerged as the best predictors of adolescent health-harming behaviors, whereas married parent status, increased adolescent time since diagnosis, increased adolescent-rated quality of life, and increased distress emerged as the best predictors of health-protective behaviors. Demographic, illness, and psychosocial variables may help inform the development of interventions designed to promote the initiation and/or maintenance of good health practices among adolescents on-treatment for cancer. Interventions are needed that target health behaviors while adolescents are approaching treatment completion, in order to help facilitate the practice of good health practices in survivorship.


Isolated prehospital hypotension after traumatic injuries: a predictor of mortality?
In patients with traumatic injuries, prehospital hypotension that resolves by Emergency Department (ED) arrival is of uncertain significance. We examined the impact of prehospital hypotension (PH) in normotensive ED patients with traumatic injuries on predicting mortality and chest/abdominal operative intervention. A retrospective cohort study was conducted of consecutive patients undergoing helicopter transport to two trauma centers between 1993 and 1997. Outcomes were mortality and chest or abdominal operative intervention. Of 545 scene transports, 55 (10.1%) patients were hypotensive on ED arrival, leaving 490 normotensive ED patients. Of 490 patients, 35 (7%) had PH and 455 (93%) had no PH. Multiple logistic regression showed the PH group to have a relative risk for death of 4.4 (95% CI: 1.2-16.6, p < 0.03) and for chest or abdominal operative intervention of 2.9 (1.1-7.6, p < 0.03). In this study of normotensive trauma center patients, prehospital hypotension was associated with increased risk of mortality and significant chest or abdominal injury.


When do dry cows get heat stressed? Correlations of rectal temperature, respiration rate, and performance.
Previous studies have documented the negative effects of heat stress during the dry period on dairy cow performance during the next lactation, but an easy method to assess heat stress for dry cow management is lacking. In an effort to determine a threshold for heat stress based on the physiological response of respiration rate, an easily measured variable, an analysis including data collected from 6 different studies (n = 144 cows) was performed to summarize the correlations among rectal temperature (RT) and respiration rate (RR) during the dry period, milk production during the first 8 wk of lactation (MK), calf birth weight (CW), body weight at calving (BW), gestation length (GL), and dry matter intake (DMI) pre- and postpartum. Studies were conducted in Florida during the summer, and dry cows were assigned to 2 treatments: heat stress (only shade; HT, n = 75 cows) and cooling (shade, fans, and soakers; CL, n = 69 cows). Average RT (0.3°C) and RR [26 breaths per min (bpm)] of HT cows increased compared with CL. In addition, the CL group produced more milk (2.8 kg/d) during the first 8 wk of the subsequent lactation relative to HT. Correlation analysis indicated that RR of HT was negatively correlated with MK and GL. Within HT, RT was also negatively correlated with MK and GL and tended to be negatively correlated with CW. In addition to being negatively correlated with RT and RR, HT MK was positively correlated with CW, GL, and DMI postpartum. In CL, no correlations were observed for RR, but RT was positively correlated with BW, and MK was positively correlated with DMI postpartum and tended to be positively correlated with GL. Moreover, the overall RT was 39.1 ± 0.48°C and RR was 61 ± 19.5 bpm, which indicates that RR over 61 bpm is an indicator of heat stress in cows during the dry period and can be easily assessed at the cow level. In summary, the more heat load a cow carries in the dry period, the greater the negative effects are on subsequent milk production, which may suggest a threshold for the effects of heat stress. Also, variation among cows within the HT group indicates that cows with longer gestation length have heavier calves, eat more postpartum, and produce more milk, but not as much as CL cows.


Failure of methyclothiazide to lower home blood pressure level in "essential" hypertensive and normotensive young men, despite significant plasma volume contraction.
Home blood pressure measurements were used to assess the effect of methyclothiazide in young essential hypertensive and normotensive males. Although plasma volume was reduced by approximately 10 percent, blood pressure was not reduced in either group. The lack of effect on blood pressure was probably not attributable to dosage employed, as doubling the dose (5 to 10 mg) in the normal subjects (who were equilibrated on constant diet) did not significantly increase changes in plasma volume, plasma renin activity, aldosterone excretion, urine sodium or blood pressure. The higher dose did result in greater changes in plasma potassium and uric acid. Homeostatic mechanisms which limit the volume mediated and other antihypertensive effects of methyclothiazide apparently achieved complete compensation in these young males. This suggests that thiazide diuretics may not be the drug of first choice in the treatment of hypertension in young adults. Further studies with other diuretics are clearly necessary before the significance of these findings can be fully assessed.


[Adenocarcinoma of small bowel. An underdiagnosed disease].
Small bowel adenocarcinoma is a rare disease. The diagnosis is often disguised by nonspecific and varied presenting symptoms. Adenocarcinoma of the small bowel is typically detected at a late stage and with a poor prognosis. The records of 42 patients with small bowel adenocarcinomas diagnosed in 2 surgical clinics between 1995 and 2009 were reviewed for patient and tumor characteristics, treatment effects and survival. The tumor locations were the duodenum (50%), jejunum (38%) and ileum (12%). In comparison to patients seen before 2004 the observed frequency of emergency operations or palliative procedures as well as stage distribution did not change. The median overall survival was 19 months with a 5-year overall survival of 20%. For patients with resections, reduced performance status, higher stage and residual disease after resection predicted decreased overall survival in univariate analysis. Residual disease and pT category were predictive of survival in multivariate analysis. Complete resection provides the only means of a cure. In cases where curative resection cannot be performed the prognosis remains poor. Further study on the methods for early detection and effective adjuvant chemotherapy should be investigated, however, the available data are limited.


Intraoperative Ultrasound Guidance With an Ultrasound-Visible Clip: A Practical and Cost-effective Option for Breast Cancer Localization.
In partial mastectomy (PM) or lumpectomy, ultrasound (US) localization avoids discomfort and additional procedures associated with wire localization. The purpose of this study was to evaluate the association between ultrasound-visible clip (UVC) use at the time of biopsy and US use during resection, hypothesizing that UVCs facilitate US localization and reduce costs compared with traditional radiopaque clips or no clip placement. The study population consisted of adult female patients with breast cancer undergoing PM or lumpectomy at our institution between 2014 and 2016. The core biopsy clip type and localization method during PM were characterized as wire localization versus US localization, and associations were estimated with multivariable regression models. For the cost evaluation, breast biopsy data were obtained from the Department of Radiology. Among 674 patients, 490 had data on localization and the clip type. Ultrasound-visible clip placement at biopsy increased US use during resection by 13% (95% confidence interval, 6%-21%). There was no difference in the total specimen weight with US versus wire localization. The cost savings for using UVCs for the 2209 patients who underwent breast biopsy from 2014 to 2016 was $36,000. This study demonstrates that US localization for PM is feasible at a single institution and cost-effective when facilitated by UVCs. Placement of a UVC at the time of biopsy is recommended, as it is cost-effective and avoids the discomfort and inconvenience of wire localization.


Deregulation of translational control of the 65-kDa regulatory subunit (PR65 alpha) of protein phosphatase 2A leads to multinucleated cells.
Efficient translation of the mRNA encoding the 65-kDa regulatory subunit (PR65 alpha) of protein phosphatase 2A (PP2A) is prevented by an out of frame upstream AUG and a stable stem-loop structure (delta G = -55.9 kcal/mol) in the 5'-untranslated region (5'-UTR). Deletion of the 5'-UTR allows efficient translation of the PR65 alpha message in vitro and overexpression in COS-1 cells. Insertion of the 5'-UTR into the beta-galactosidase leader sequence dramatically inhibits translation of the beta-galactosidase message in vitro and in vivo, confirming that this sequence functions as a potent translation regulatory sequence. Cells transfected or microinjected with a PR65 alpha expression vector lacking the 5'-UTR, express high levels of PR65 alpha, accumulating in both nucleus and cytoplasm. PR65 alpha overexpressing rat embryo fibroblasts (REF-52 cells) become multinucleated. These data and previous results (Mayer-Jaekel, R. E., Ohkura, H., Gomes, R., Sunkel, C. E., Baumgartner, S., Hemmings, B. A., and Glover, D. M. (1993) Cell 72, 621-633) suggest that PP2A participates in the regulation of both mitosis and cytokinesis.


Hyper-branched poly(poly(ethylene glycol)methacrylate)-grafted surfaces by photo-polymerization with iniferter for bioactive interfaces.
A new hyper-branched surface in which three species of architectures were constructed as stem chain, branched stem and twig chain-grafted branched chain of poly(poly(ethylene glycol)methacrylate) (poly(PEGMA)) by photo-polymerization using dithiocarbamyl group (DC) as iniferter was prepared and characterized. For these surfaces, radical copolymerization of styrene and an iniferter-activated chain that was previously synthesized was performed for using as base materials for surface coating. On a DC-activated surface, hyper-branched poly(PEGMA) was introduced by photo-polymerization and dithiocarbamylation. All modified surfaces were analyzed by X-ray photoelectron spectroscopy (XPS) and water contact angle measurements. Our results demonstrated that a highly hyper-branched graft architecture of poly(PEGMA) can be constructed on PU surface by photo-polymerization using dithiocarbamyl group as iniferter, in which first, second and third generation gave stem chain, branched chain and twig chain of poly(PEGMA), respectively. Our hyper-branched surfaces could be regulated by photo-irradiation time and might be controlled by feed amounts or other reaction conditions. This highly dense architecture of PEG chain with hydrophilicity and chain mobility, grafted on surface, is expected to be effectively utilized in bio-implantable substrates or micro- or nano-patterned surfaces for immobilization of bioactive molecules in biomedical fields.


Synthesis and properties of Au-Fe3O4 heterostructured nanoparticles.
Au-Fe(3)O(4) composite nanoparticles have received much research interest due to their promising biomedical applications. In this work, Au-Fe(3)O(4) composites with well-defined dimer-like nanostructure were synthesized via thermal decomposition route. The surfactant 1,2-hexandicandiol has proved to be critical for the formation of the Au-Fe(3)O(4) hetero-dimers. The hetero-dimers production yield could be significantly improved to be 90% when the 1,2-hexandicandiol concentration was optimized at 0.6 M. The obtained Au-Fe(3)O(4) hetero-dimers possess dual-functionalities of plasmon resonance and magnetization. Moreover, the Fe(3)O(4) domain of the hetero-dimers can be tuned readily by adjusting the molar ratio between Fe and Au sources. Furthermore, it was demonstrated that these Au-Fe(3)O(4) hetero-dimers could be further developed into star-like Au-Fe(3)O(4) nanoparticles which showed plasmon absorption at NIR region.


Development and validation of a UPLC-MS/MS method for simultaneous detection of doxorubicin and sorafenib in plasma: Application to pharmacokinetic studies in rats.
An ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) was developed for the simultaneous quantitation of doxorubicin (DOX) and sorafenib (SOR) in rat plasma. Chromatographic separation was performed using a reversed-phase column C18 (1.7 μm, 1.0 × 100 mm Acquity UPLC BEH™). The gradient mobile phase system consisted of water containing 0.1% acetic acid (mobile phase A) and methanol (mobile phase B) with a flow rate of 0.40 mL/min over 8 min. Erlotinib (ERL) was used as an internal standard (IS). The quantitation of conversion of [M + H]+, which was the protonated precursor ion, to the corresponding product ions was performed using multiple reaction monitoring (MRM) with a mass-to-charge ratio (m/z) of 544 > 397.005 for DOX, 465.05 > 252.03 for SOR, and 394 > 278 for the IS. Different parameters were used to validate the method including accuracy, precision, linearity, and stability. The developed UPLC-MS/MS method was linear over the concentration ranges of 9-2000 ng/mL and 7-2000 ng/mL with LLOQ of 9 and 7 ng/mL for DOX and SOR, respectively. The intra-day and inter-day accuracy, expressed as % relative standard deviation (RSD%), was below 10% for both DOX and SOR in all QC samples that have drug concentrations above the LLOQ. The intra-day and inter-day precision, expressed as percent relative error (Er %), was within the limit of 15.0% for all concentrations above LLOQ. Four groups of Wistar rats (250-280 g) were used to conduct the pharmacokinetic study. Group I received a single intraperitoneal (IP) injection of DOX (5 mg/kg); Group II received a single oral dose of SOR (40 mg/kg), Group III received a combination of both drugs; and Group IV received sterile water for injection IP and 0.9% w/v sodium chloride solution orally to serve as a control. Non-compartmental analysis was used to calculate the different pharmacokinetic parameters. Data revealed that coadministration of DOX and SOR altered some of the pharmacokinetic parameters of both agents and resulted in an increase in the Cmax and AUC and reduction in the apparent clearance (CL/F). In conclusion, our newly developed method is sensitive, specific, and can reliably be used to simultaneously determine DOX and SOR concentrations in rat plasma. Moreover, the results of the pharmacokinetic study suggest that coadministration of DOX and SOR might cause an increase in exposure of both drugs.


The relative frequency of periapical lesions in teeth with root canal-retained posts.
This study was concerned with the relation between technical quality of root filling seal in teeth with posts and radiographic status of the periapical tissues. Full-mouth series from 298 randomly chosen patients were examined by two observers. Endodontic treatment had been performed in 852 roots and posts were observed in 424 of these. Periapical radiolucencies were judged to be present in 16% of roots with posts and in 13% of roots without posts. Roots with posts in which the remaining root filling was shorter than 3 mm showed a statistically significant higher frequency of periapical radiolucencies (p less than 0.01). It was found that an improper seal was more unfavorable in roots with posts (p less than 0.05). The findings in this study indicate that the placement of a post will not per se decrease the probability of periapical healing. It also suggests that the remaining root filling must not be shorter than 3 mm.


Characterization of the groove binding between di-(2-ethylhexyl) phthalate and calf thymus DNA.
In this study, the interaction between di-(2-ethylhexyl) phthalate (DEHP) and calf thymus DNA (ctDNA) was investigated by a combination of multispectroscopic methods, chemometrics algorithm, cyclic voltammetry and molecular simulation. The concentration profiles of the components obtained from resolving the UV-vis absorption data by multivariate curve resolution-alternating least-squares (MCR-ALS) provided a basic evidence for the formation of DEHP-ctDNA complex. Furthermore, the groove binding of DEHP to ctDNA was evidenced by the results from iodide quenching effect, single-stranded DNA quenching effect, melting studies, viscosity measurements and cyclic voltammetry. The binding constant of the complex was in the order of magnitudes of 104Lmol-1, and hydrophobic forces were inferred to drive the binding process. Analysis of Fourier transform infrared spectra suggested that DEHP preferentially bound to A-T rich region of ctDNA in the minor groove, and these results further confirmed by molecular docking. The circular dichroism spectra indicated that DEHP induced a decrease in base stacking degree and an increase in right-handed helicity of ctDNA, but did not cause a significant damage in DNA. This study may improve the understanding of interaction between DEHP and ctDNA and help evaluate the toxicological effect of DEHP.


Engineering life.
A selection strategy to produce ribosome.mRNA pairs that operate independently of the natural cellular machinery in Escherichia coli could be used for the creation of complex artificial networks in cells.


Update on apraxia.
Apraxia is classically defined as difficulty performing learned, skilled gestures. In this review, we describe the range of motor impairments classified as apraxia, focusing on ideomotor limb apraxia. We present several prominent models of praxis to explain the variety of difficulties seen in patients with apraxia. We also discuss the large-scale frontal-parietal-basal ganglia network thought to underlie praxis. In this context, we highlight the common occurrence of limb apraxia in corticobasal degeneration, a neurodegenerative condition characterized by frontal, parietal, and basal ganglia disease.


Facilitation of avoidance behaviour in mice chronically treated with heroin or methadone.
Although the repercussion of chronic treatment with large amounts of opioids on cognitive performance is a matter of concern, the effects of opioid drugs on passive avoidance learning have been scarcely studied. Here, we analyzed the effects of prolonged administration of heroin and methadone, as well as the impact of suffering repeated episodes of withdrawal on fear-motivated learning using the passive avoidance test. Mice received chronic treatment (39 days) with methadone (10 mg/kg/24 h), associated or not with repeated withdrawal episodes, or with heroin (5 mg/kg/12 h). Our results show that, regardless of the type of treatment received, all mice displayed similar basal thermal nociceptive thresholds during 25 days of treatment. In the hot plate test, both methadone and heroin induced antinociception 30 min after drug administration. The analgesic effect was absent when measured 4 h after heroin and 12 h after methadone. Pain behavioural responses elicited by growing intensities of electric shock, applied on day 28th of treatment, were similar in all groups of mice. Our results indicate that chronic opioid treatment had promnesic effects on passive avoidance behaviour in mice, unrelated to changes in the nociceptive state.


The safety of a novel single-drape cover for sterile back tables in the operating room compared to the standard two-drape method: an experimental study.
Covering the prepared sterile back tables (PSBTs) during periods of nonuse and during active surgeries may decrease contamination of sterile surgical instruments that have direct contact to surgical wound. The Association of periOperative Registered Nurses (AORN) declared that an easy method for covering and removing the drape will ultimately be most effective (e.g. standard two-drape method). Hence, this study was designed to test the hypothesis that using a novel single-drape cover had more efficiency and safety in decreasing airborne bacteria-carrying particles (ABCPs) settling on the PSBTs during static and dynamic periods than the standard two-drape method. This experimental study was conducted with using 918 agar plates to detect contamination of the PSBTs with ABCPs on two conditions (static and dynamic) at an academic medical center in Kashan, Iran, from September 25, 2021, to January 20, 2022. The contamination of PSBTs was evaluated by 6 agar settle plates (n = 918 in total) on each PSBT in static and dynamic operating room (OR) conditions. At each time-point, this set-up was repeated on two occasions else during data collection, establishing 81 PSBTs in total. Tested groups included the PSBTs covered with the standard two-drape method, the novel single-drape cover, or no cover. The plates were collected after 15, 30, 45, 60, 120, 180, 240 min and 24 h. The primary outcome measured was comparison of mean bioburden of ABCPs settling on covered PSBTs on two conditions by using agar settle plates. The secondary outcomes measured were to determine the role of covering in decreasing contamination of PSBTs and the estimation of time-dependent surgical instrument contamination in the uncovered PSBTs on two conditions by using agar settle plates. Covering the PSBTs during static and dynamic OR conditions lead to a significantly decreased bioburden of ABCPs on them (P < 0.05). No differences were seen between the standard two-drape method and the novel single-drape cover (P > 0.05). We found that there is no preference for using the novel single-drape cover than the standard two-drape method. Our results showed a significant decrease in bioburden of ABCPs on the PSBTs when those were covered during static and dynamic OR conditions, indicating the efficiency for covering the PSBTs during periods of nonuse and during active surgery.


Molecular characterization of ataxia telangiectasia T cell clones. III. Mapping the 14q32.1 distal breakpoint.
To delimit the 14q32.1 recurrent breakpoint of ataxia telangiectasia clones, we performed an in situ hybridization study with various probes located on the 14q32 band. We thus mapped this breakpoint between the D14S1 and Pi loci. Furthermore, an interstitial duplication including D14S1 and a part of the IgH locus was demonstrated on a t(14;14) clone.


Mechanisms of Oral Tolerance.
Oral tolerance is an active process of local and systemic immune unresponsiveness to orally ingested antigens such as food. The gut immune system must balance responses to commensal bacteria (microbiome), innocuous antigens, and pathogens. Although it is clear that specialized populations of immune cells and lymph nodes create a unique environment in the gut, there remains evidence to suggest that systemic effector sites also are critical to establishing and maintaining oral tolerance.


Interplay between innate immunity and iron metabolism after acute pancreatitis.
Emerging evidence shows that chronic low-grade inflammation and changes in markers of innate immunity are implicated in a range of metabolic abnormalities following an episode of acute pancreatitis. Also, deranged iron metabolism has been linked to type 2 diabetes mellitus, gestational diabetes, and new-onset diabetes after pancreatitis - the conditions characterized by high haemoglobin glycation index (HGI). This study aimed to investigate the associations between markers of innate immunity and iron metabolism in individuals after acute pancreatitis. Fasting blood samples were collected to analyse lipopolysaccharide binding protein (LBP), interleukin (IL)-6, tumor necrosis factor-α, hepcidin, ferritin, soluble transferrin receptor, HbA1c, and glucose. Participants were categorized into two groups: low HGI and high HGI. Linear regression analyses were conducted, and potential confounders (age, sex, ethnicity, body mass index, diabetes mellitus status, smoking status, aetiology of pancreatitis, duration, recurrence, and severity of pancreatitis) were adjusted for in 5 statistical models. A total of 93 patients following an episode of acute pancreatitis were included, of who 40 (43%) had high HGI. In the overall cohort, LBP was significantly associated with hepcidin and ferritin, and IL-6 was significantly associated with hepcidin, consistently in all the models. Further, LBP contributed to 7.7% and 9.5% of variance in hepcidin and ferritin levels, respectively, whereas IL-6 contributed to 5.3% of hepcidin variance. Upon subgroup analysis, the observed LBP associations were maintained in the high HGI subgroup only and the IL-6 association in the low HGI subgroup only. No consistently significant associations were found between any of the other markers. The interplay between LBP, IL-6, hepcidin, and ferritin characterizes metabolic derangements after acute pancreatitis and may play a role in the pathogenesis of new-onset diabetes after pancreatitis.


Stability of laser epithelial keratomileusis with and without mitomycin C performed to correct myopia in thin corneas: a 15-month follow-up.
To study the stability of the refraction 15 months after myopic laser epithelial keratomileusis (LASEK) performed in thin corneas with and without adjuvant mitomycin C (MMC). Retrospective review. One hundred and thirty-six consecutive eyes that had undergone LASEK to correct their myopia and that had a preoperative central corneal thickness (CCT) of <500 microm at Vissum Madrid, Spain, were included. Intraoperative MMC was applied when the ablation depth exceeded 50 microm (49 eyes). We compared the residual refraction between the three- and 15-month examinations to detect a possible myopic change that would suggest secondary corneal ectasia. Mean preoperative CCT +/- standard deviation (SD) was 484.4 +/- 11.8 microm (range, 440 to 499 microm). Mean CCT +/- SD three months after surgery was 417.9 +/- 32.1 microm (range, 339 to 473 microm). Mean preoperative spherical refraction +/- SD was -3.49 +/- 2.10 diopters (D). Mean preoperative cylinder +/- SD was -0.87 +/- 1.20 D. The mean residual sphere +/- SD was 0.15 +/- 0.40 D three months after surgery and 0.11 +/- 0.60 D 15 months after surgery (P = .45). The mean cylinder +/- SD was -0.13 +/- 0.30 D and -0.25 +/- 0.50 D, respectively (P = .06). Both the uncorrected visual acuity (UCVA) and the best-spectacle corrected visual acuity (BSCVA) showed statistically significant improvement on the 15-month examination (P = .01 and P = .0001, respectively). When analyzed separately, the subgroup treated with intraoperative MMC also showed stability of the refraction and a statistically significant improvement both in UCVA and in BSCVA. Topography showed no signs of ectasia in any case. Myopic LASEK performed on thin corneas, regardless of the use of intraoperative MMC, seems to obtain stable refractive results, with no sign of ectasia during a 15-month follow-up.


Antitumor and apoptotic effects of 5-methoxypsoralen in U87MG human glioma cells and its effect on cell cycle, autophagy and PI3K/Akt signaling pathway.
The main purpose of the current study was to investigate the antitumor effects of 5-methoxypsoralen in U87MG human glioma cells along with studying its effects on cell cycle progression, autophagy and the PI3K/Akt signaling pathway. The cytotoxic effects of the drug were demonstrated by the MTS cell viability assay while its effects on cellular morphology associated with cell apoptosis were evaluated by phase contrast and fluorescence microscopic techniques. Effects of 5-methoxypsoralen on the cell cycle were studied by flow cytometry while effects on PI3K/Akt proteins were evaluated by western blot assay. The results indicate that 5-methoxypsoralen led to time-dependent as well as dose-dependent inhibitory effects on U-87MG human glioma cells. 5-Methoxypsoralen led to a substantial decrease of cell count along with distorted cell morphology. The molecule also led to DNA ladder formation which increased with increasing doses of 5-methoxypsoralen. 5-methoxypsoralen also led to dose-dependent G2/M phase cell cycle arrest. 5-Methoxypsoralen-treated cells also exhibited altered cell ultrastructure with the appearance of autophagic vacuoles and the number of these vacuoles increased with increasing drug dose. In brief, the results indicate that 5-methoxypsoralen exerted potent anticancer and apoptotic effects in U-87MG human glioma cells along with inducing cell cycle arrest, autophagy and m-TOR/PI3K/Akt signaling pathway inhibition.


Clinical implications of Y chromosome microdeletions among infertile men.
Male factor infertility contributes significantly to couples facing difficulty achieving a pregnancy. Genetic factors, and specifically those related to the Y chromosome, may occur in up to 15% of men with oligozoospermia or azoospermia. A subset of loci within the Y chromosome, known as the azoospermia factors (AZFa, AZFb, and AZFc), have been associated with male infertility. Emerging evidence has demonstrated that microdeletions of at least a subset of these regions may also have impacts on systemic conditions. This review provides a brief review of male infertility and the structure of the Y chromosome, and further highlights the role of Y chromosome microdeletions in male infertility and other systemic disease.


The enhancement of radiosensitivity in human esophageal squamous cell carcinoma cells by zoledronic acid and its potential mechanism.
Esophageal squamous cell carcinoma (ESCC) has a low 5-year patient survival rate. Radiotherapy, as a preoperative or postoperative treatment of surgery, has a crucial role in improving local control and survival of ESCC. Various chemotherapeutic and biologic agents have been used as radio-sensitizers in combination with radiotherapy. Here, we demonstrate that zoledronic acid (ZOL) has a radio-sensitizing effect on ESCC cells. Exposure of ESCC cancer cells to ZOL plus radiation resulted in increased cell death through arresting the cell cycle between S and G2/M phases. ZOL appeared to inhibit proliferation, tube formation and invasion of endothelial cells. These anti-angiogenetic effects were more marked concurrently with irradiation. In addition, synergistic suppressive effects on VEGF expression were observed after combined treatment. Our data suggest that the combination of ZOL and radiation is a promising therapeutic strategy to enhance radiation therapy for ESCC patients.


Investigating the relationship between COMT polymorphisms and working memory performance among childhood brain tumor survivors.
Survivors of childhood brain tumors are at increased risk for neurocognitive impairments, including deficits in abilities supported by frontal brain regions. Catechol-O-methyltransferase (COMT) metabolizes dopamine in the prefrontal cortex, with the Met allele resulting in greater dopamine availability and better performance on frontally mediated tasks compared to the Val allele. Given the importance of identifying resiliency factors against the emergence of cognitive late effects, the current study examined the relationship between COMT genotype and working memory performance among childhood brain tumor survivors. Children treated for a brain tumor with conformal radiation therapy (N = 50; mean age at irradiation = 7.41 ± 3.41; mean age at assessment = 13.18 ± 2.88) were administered two computerized measures of working memory (self-ordered search verbal and object tasks). Buccal (cheek) swabs were used to provide tissue from which DNA was extracted. Findings revealed an association between COMT genotype and performance on the self-ordered verbal (P = 0.03) but not object task (P = 0.33). Better performance was found for the Met/Val group compared to either Met/Met or Val/Val. COMT may indicate a potential resiliency factor against neurocognitive effects of cancer and its treatment; however, there is a need for replication with larger samples of childhood brain tumor survivors.


Urethane and hydroxyurethane induce sister-chromatid exchanges in cultured human lymphocytes.
Both urethane and hydroxyurethane induced sister-chromatid exchanges (SCE) in cultured human lymphocytes. Aroclor-induced rat-liver microsome fraction deactivated rather than activated these two agents in the lymphocyte system.


Immunocytochemical evidence of SV 40-related T antigen in two human brain tumours of ependymal origin.
A series of thirty-time human brain tumours has been screened for the presence or absence of SV 40-related T antigen by the direct and indirect immunoperoxidase techniques. Two tumours (an ependymoma and a choroid plexus papilloma) of ependymal origin revealed markedly positive nuclear staining for T antigen both in in vivo and in vitro. The possible viral etiology of these human brain tumours is discussed in relation to recent human papovavirus isolates.


Premenstrual syndrome and premenstrual dysphoric disorder: definitions and diagnosis.
Because of the prevalence, chronicity and distress caused by premenstrual symptoms (PMS), diagnosis and effective treatments are important information for clinicians. The DSM-IV requires at least five specified symptoms for premenstrual dysphoric disorder (PMDD), a severe dysphoric form of PMS, while the ICD-10 requires only one distressing symptom for a diagnosis of PMS. Many women who seek treatment fall between these two diagnostic approaches, and standard diagnostic criteria for clinically significant PMS are needed. A diagnosis of PMS consists of determining the timing of the symptoms in relation to menses, meaningful change between post- and premenstrual symptom severity and a clinically significant severity of the symptoms. A differential diagnosis to distinguish PMS from other medical and psychiatric conditions is important for appropriate treatment. No hormone or laboratory test indicates a PMS diagnosis. The current diagnostic standard requires confirmation of subjective symptom reports by prospective daily diaries. Diagnostic criteria for PMS must recognize the broad range of symptoms, the temporal pattern of the symptoms and the critical issue of symptom severity, which differentiates clinically significant PMS from normal menstrual cycle changes.


Influence of different molar concentrations of acid on morphological, physicochemical and pasting properties of Pakistani Basmati and Irri rice starches.
Starches extracted from two dominant varieties of rice, Basmati and Irri were subjected to acid hydrolysis by preparing starch slurry of 35% (w/v) in HCl solutions of concentrations 0.1M, 0.3M and 0.8M. The scanning electron micrographs showed that granular morphology of starches significantly changed after acid hydrolysis. Acid thinning improved the solubility of starches whereas decline was observed in swelling power and water retention capacity. Paste clarity of both acid treated Basmati and Irri rice starches reduced gradually upon cold storage. Also reduction in values of pasting, peak viscosity, hot paste viscosity, cold paste viscosity and set back were observed in acid thinned Basmati and Irri rice starches. The DE values increased with the increase in HCl concentration for both Basmati and Irri starch. The hardness of 0.8M HCl treated Basmati starch gel was found significantly lower than all treated and untreated starches. The gelatinization enthalpy for Basmati starch significantly reduced after acid hydrolysis with 0.1M, 0.3M and 0.8M HCl solutions at p <0.05.


CLU: a new algorithm for EST clustering.
The continuous flow of EST data remains one of the richest sources for discoveries in modern biology. The first step in EST data mining is usually associated with EST clustering, the process of grouping of original fragments according to their annotation, similarity to known genomic DNA or each other. Clustered EST data, accumulated in databases such as UniGene, STACK and TIGR Gene Indices have proven to be crucial in research areas from gene discovery to regulation of gene expression. We have developed a new nucleotide sequence matching algorithm and its implementation for clustering EST sequences. The program is based on the original CLU match detection algorithm, which has improved performance over the widely used d2_cluster. The CLU algorithm automatically ignores low-complexity regions like poly-tracts and short tandem repeats. CLU represents a new generation of EST clustering algorithm with improved performance over current approaches. An early implementation can be applied in small and medium-size projects. The CLU program is available on an open source basis free of charge. It can be downloaded from http://compbio.pbrc.edu/pti.


[Long-term outcome after dialysis-dependent renal failure on the intensive care unit].
Acute kidney injury (AKI) is a common and serious complication of acute life-threatening diseases. The aim of this study was to investigate the effect of acute renal failure on mortality in intensive care patients, the need for renal replacement therapy at discharge, and the effect on long-term mortality. Evaluation of 118 patient cases with dialysis-dependent acute renal failure between November 2016 and December 2017 admitted to a medical intensive care unit (ICU) at the University Hospital Tübingen, Germany. Dialysis at discharge and 1‑year mortality were defined as the primary endpoints. The secondary endpoint was need for continuous renal replacement after 18 months. In 118 patients, renal replacement modality by means of hemodialysis became necessary. A mortality rate of 45.8% (54/118) was found in patients requiring dialysis. Of the 64 surviving dialysis-dependent patients, 35.9% were still dependent on renal replacement therapy at the time of discharge. The 1‑year mortality rate was significantly higher in patients that still required dialysis at the time of discharge (p = 0.004). At 18-month follow-up, seven patients (10.9%) were still on renal replacement therapy. At this time, dialysis was significantly more frequent in patients with dialysis at the time of discharge than in dialysis-free patients (7.1% vs. 71.4%, p = 0.001). Severe episodes of AKI requiring renal replacement therapy in the setting of an ICU are associated with increased mortality 1 year after discharge and an increased requirement for renal replacement 18 months after discharge.


Lipidomic-based investigation into the therapeutic effects of polyene phosphatidylcholine and Babao Dan on rats with non-alcoholic fatty liver disease.
In recent years, with the improvement of people's living standards, non-alcoholic fatty liver disease (NAFLD) has become the most common chronic liver disease in the world. In this paper, the metabolic disorders in Sprague Dawley (SD) rats were induced by a choline-deficient, l-amino acid-defined (CDAA) diet. The therapeutic effects of polyene phosphatidylcholine (PPC) and Babao Dan (BBD) on NAFLD were observed. Lipidomic analysis was performed using ultra-high-performance liquid chromatography-Orbitrap MS, and data analysis and lipid identification were performed using the software LipidSearch. Both PPC and BBD can reduce lipid accumulation in the liver and improve abnormal biochemical indicators in rats, including reduction of triglycerides, total cholesterol, alanine transaminase and aspartate transaminase in serum. In addition, lipids in rat serum were systematically analyzed by lipidomics. The lipidomic results showed that the most obvious lipids with abnormal metabolism in CDAA diet-induced rats were glycerides (triglycerides and diacylglycerols), phospholipids and cholesterol esters. Both BBD and PPC partly reversed the disturbance to lipids induced by the CDAA diet. PPC may be more effective than BBD in alleviating NAFLD because it has a better effect on inhibiting the abnormal accumulation of lipids and reducing the inflammatory reaction in the body.


Adrenal and gonadal hormone variations during a febrile attack in a woman with tumor necrosis factor receptor-associated periodic syndrome.
TNF-receptor-associated periodic syndrome (TRAPS) is a hereditary fever syndrome that results from mutations in the TNF-receptor superfamily 1A gene (TNFRSF1A). It is characterized by periodic fever, arthralgia, abdominal pain, myalgia, headache, and skin lesions. Because adrenal and gonadal hormone cascades are modulated by TNF, this study aimed to investigate specific hormones and enzyme steps during an attack phase in a woman with TRAPS. Morning blood samples were taken from a 38-yr-old woman before, during, and after the febrile episode in the late luteal, menstrual, and early follicular phase of the menstrual cycle, respectively. Serum cortisol levels were markedly increased throughout the entire observation period and demonstrated a dip during the attack phase. In contrast, serum levels of dehydroepiandrosterone and 17-hydroxyprogesterone demonstrated a sharp rise during the febrile episode. Dehydroepiandrosterone in relation to androstenedione or cortisol was increased. Indicative of aromatase activation, estrone and 17beta-estradiol demonstrated a marked increase during the attack phase. This study suggests that some important steroid hormone-conversion steps are activated (aromatase) and inhibited (second step of the P450c17 and the 3beta-hydroxysteroid dehydrogenase) during the inflammatory attack phase in a TRAPS patient. These changes of enzyme pathways are typical on the basis of increased TNF signaling.


Mapping causal functional contributions derived from the clinical assessment of brain damage after stroke.
Lesion analysis reveals causal contributions of brain regions to mental functions, aiding the understanding of normal brain function as well as rehabilitation of brain-damaged patients. We applied a novel lesion inference technique based on game theory, Multi-perturbation Shapley value Analysis (MSA), to a large clinical lesion dataset. We used MSA to analyze the lesion patterns of 148 acute stroke patients together with their neurological deficits, as assessed by the National Institutes of Health Stroke Scale (NIHSS). The results revealed regional functional contributions to essential behavioral and cognitive functions as reflected in the NIHSS, particularly by subcortical structures. There were also side specific differences of functional contributions between the right and left hemispheric brain regions which may reflect the dominance of the left hemispheric syndrome aphasia in the NIHSS. Comparison of MSA to established lesion inference methods demonstrated the feasibility of the approach for analyzing clinical data and indicated its capability for objectively inferring functional contributions from multiple injured, potentially interacting sites, at the cost of having to predict the outcome of unknown lesion configurations. The analysis of regional functional contributions to neurological symptoms measured by the NIHSS contributes to the interpretation of this widely used standardized stroke scale in clinical practice as well as clinical trials and provides a first approximation of a 'map of stroke'.


Successful reversal of threatening carotid artery occlusion in HIV-associated non-aneurysmal vasculitis.
We report a case of HIV-associated carotid vasculitis, causing cerebral infarction. Immediate corticosteroid treatment was followed by improvement, with radiological documentation of reversal of the vasculitic changes, preventing arterial occlusion. Vasculitis should be considered as a diagnosis in stroke in HIV and steroid treatment considered as a potentially life-saving intervention.


Simultaneous determination of 5-fluorouracil and uracil by high-performance liquid chromatography using four serial columns.
A sensitive assay was developed for the quantitation of 5-fluorouracil (5-FU) and uracil using liquid-liquid extraction (LLE) and HPLC with UV detection. Analyses were performed with four microBondapak C18 columns connected in series using 20 mM acetic acid with 1% ACN as mobile phase. The calibration curves were linear across the range of 26-1000 ng ml(-1) (0.21-7.8 microM) for 5-FU and 1.0-14.0 microg ml(-1) (0.01-110 microM) for uracil. This assay has been implemented to determine the plasma concentrations for pharmacokinetic studies for 5-FU and uracil in conjunction with clinical trials.


Hierarchical porous structure formation mechanism in food waste component derived N-doped biochar: Application in VOCs removal.
Nitrogen-doped (N-doped) hierarchical porous carbon was widely utilized as an efficient volatile organic compounds (VOCs) adsorbent. In this work, a series of N-doped hierarchical porous carbons were successfully prepared from the direct pyrolysis process of three food waste components. The porous biochar that derived from bone showed a high specific surface area (1405.06 m2/g) and sizable total pore volume (0.97 cm3/g). The developed hierarchical porous structure was fabricated by the combined effect of self-activation (Carbon dioxide (CO2) and water vapor (H2O)) and self-template. The emission characteristics of activation gas analyzed by Thermogravimetric-Fourier transform infrared spectrometer (TG-FTIR) and the transformation of ash composition in the biochar help to illustrate the pore-forming mechanism. Calcium oxide (CaO) and hydroxylapatite were confirmed as the major templates for mesopores, while the decomposition processes of calcium carbonate (CaCO3) and hydroxylapatite provided a large amount of activation gas (CO2 and H2O) to form micropores. The materials also obtained abundant N-containing surface functional groups (up to 7.84 atomic%) from pyrolysis of protein and chitin. Finally, the porous biochar showed excellent performance for VOCs adsorption with a promising uptake of 288 mg/g for toluene and a high adsorption rate of 0.189 min-1. Aplenty of mesopores distributed in the materials effectively improved the mass transfer behaviors, the adsorption rate got a noticeable improvement (from 0.118 min-1 to 0.189 min-1) benefited from mesopores. Reusable potentials of the hierarchical porous carbons were also satisfying. After four thermal regeneration cycles, the materials still occupied 84.8%-87.4% of the original adsorption capacities.


Performance on the African neuropsychology battery using the learning ratio in a sample of healthy Congolese.
Using the African Neuropsychology Battery (ANB), we seek to develop normative data by examining the demographic effects for two learning process scores: initial learning (Trial One) and learning ratio (LR, the percentage of items learned relative of to-be-learned material following Trial 1). Healthy participants from the Democratic Republic of Congo completed the four memory tests of the ANB: the African Story Memory Test (ASMT), African List Memory Test (ALMT), African Visuospatial Memory Test (AVMT), and African Contextual Visuospatial Memory Test (ACVMT). We developed indices of learning for each subtest, as well as aggregate learning indices for Trial 1 and LR, and composite indices examining verbal, visual, contextual, and noncontextual learning, and grand indices comprising all four subtests. Trial 1 and LR scores each demonstrated acceptable intercorrelations across memory tests. We present normative data for Trial 1 and LR by age and education. These data provide normative standards for evaluating learning in Sub-Saharan Africa.