Hemispherectomy: historical review and recent technical advances.
The surgical options available for intractable hemispheric epilepsy have evolved since their initial description in the early 20th century. Surgical techniques have advanced, as has the ability to predict good surgical outcomes with noninvasive diagnostics. The authors review the history of hemispherectomy and detail the novel imaging and surgical strategies used to confer seizure freedom.


Behavioral and neurobiological effects of estrogen replacement therapy and a history of triphasic oral contraceptive exposure.
The effects of contraceptive steroids and estrogen replacement therapy on behavior and neuroendocrine function were evaluated in adult female cynomolgus monkeys. During the 'premenopausal' phase of the experiment, the animals were assigned to either treatment with a triphasic oral contraceptive (OC) for 24 months or the untreated control group. The monkeys were then ovariectomized and half of each of the premenopausal groups were randomly assigned to either treatment with conjugated equine estrogens (ERT) or the untreated control group for 12 months (the 'postmenopausal' phase). All evaluations were completed during the postmenopausal phase of the experiment. Both types of exogenous steroid treatments appeared to increase cardiovascular and hypothalamic-pituitary-adrenal responses to stress in socially dominant but not socially subordinate females. A history of triphasic OC administration increased contact aggression received, and reduced the prolactin response to fenfluramine, suggesting reduced serotonergic activity, for at least a year following the cessation of triphasic OC treatment.


Time to think beyond door to balloon time: significance of total ischemic time in STEMI.
Significance of total ischemic time (TIT) in the context of ST-segment elevation myocardial infarction (STEMI) is still controversial. Therefore, in this study, we have evaluate the association of TIT with immediate outcomes in STEMI patients in whom recommended door to balloon (DTB) time of less than 90 min was achieved. A total of 5730 patients were included in this study, out of which 80.9% were male and median age was 55 [61-48] years. The median DTB was observed to be 60 [75-45] min and onset of chest pain to emergency room (ER) arrival time was 180 [300-120] min. Prolonged TIT was associated with poor pre-procedure thrombolysis in myocardial infarction (TIMI) flow grade (p = 0.022), number of diseased vessels (p = 0.002), use of intra-aortic balloon pump (p = 0.003), and in-hospital mortality (p = 0.002). Mortality rate was 4.5%, 5.7%, and 7.8% for the patients with TIT of ≤ 120 min, 121 to 240 min, and > 240 min, respectively. Thirty days' risk of mortality on TIMI score was 4.97 ± 7.09%, 5.01 ± 6.99%, and 7.12 ± 8.64% for the patients with TIT of ≤ 120 min, 121 to 240 min, and > 240 min, respectively. Prolonged total ischemic was associated with higher in-hospital mortality. Therefore, TIT can also be considered in the matrix of focus, along with DTB time and other clinical determinants to improve the survival from STEMI.


A tutorial on the application of ion-selective electrode potentiometry: an analytical method with unique qualities, unexplored opportunities and potential pitfalls; tutorial.
Ion-selective potentiometry enjoys practical utility as a simple analytical technique to measure ionic constituents in complex samples. Advances in the field have improved the selectivity and decreased the detection limit of ion-selective electrodes (ISEs) by orders of magnitude such that trace analysis in micro and nanomolar concentrations is now possible with potentiometric sensors. This tutorial reviews the fundamental principles of ion-selective potentiometry, describes the practical considerations involved in the use of these sensors to measure real samples, and discusses the statistical evaluation of experimental results compared with alternative analytical techniques.


Fatal Microascus trigonosporus (anamorph Scopulariopsis) pneumonia in a bone marrow transplant recipient.
Over the past decade, an increasing number of opportunistic mycelial fungal infections have been reported in immunocompromised patients. Presented here is the first reported case of Microascus trigonosporus pneumonia, which occurred in a 24-year-old-man with a history of allogenic bone marrow transplantation with graft-versus-host disease. Despite the administration of effective antifungal treatment, the patient died after uncontrollable respiratory failure and multiorgan failure developed. This report confirms the results of previous studies that suggested a very poor outcome for bone marrow transplant recipients with non-Aspergillus mould infections.


Evaluation of starches obtained from four Dioscorea species as binding agent in chloroquine phosphate tablet formulations.
Starches obtained from four Dioscorea species namely Dioscorea dumetorum (Bitter), Dioscorea oppositifolia (Chinese), Dioscorea alata (Water), and Dioscorea rotundata (White) have been evaluated as binding agents in chloroquine phosphate tablet formulations in comparison with official corn starch. The compressional properties of the formulations were analyzed using density measurements and the Heckel and Kawakita equations. The mechanical properties of the tablets were assessed using tensile strength, brittle fracture index (BFI), and friability tests while the drug release properties of the tablets were assessed using disintegration and dissolution times. The results indicate that the four starches vary considerably in their physicochemical properties. The ranking for the tensile strength and the disintegration and dissolution times for the formulations was Chinese > Bitter > Corn > White > Water while the ranking was reversed for BFI and friability. The results suggest that Water, White, and Corn could be useful when faster disintegration time of tablets is desired while Chinese and Bitter could be more useful when bond strength is of concern and in minimizing the problems of lamination and capping in tablet formulation.


Sympathetic regulation of coronary circulation during handgrip exercise and isolated muscle metaboreflex activation in men.
What is the central question of this study? What is the role of β- and α-adrenergic receptors in the control of the coronary circulation during handgrip exercise and isolated muscle metaboreflex activation in humans? What is the main finding and its importance? β-Adrenergic receptor, but not α-adrenergic receptor, blockade significantly blunted the increases in coronary blood velocity observed during handgrip. Coronary blood velocity was unchanged from baseline during isolated muscle metaboreflex activation. This highlights the important role of β-adrenergic receptors in the coronary circulation during handgrip in humans, and the more limited involvement of the α-adrenergic receptors. We sought to investigate the role of β- and α-adrenergic receptors in coronary circulation during static handgrip exercise and isolated muscle metaboreflex activation in humans. Seventeen healthy young men underwent two experimental sessions, consisting of 3 min of static handgrip exercise at a target force of 40% maximum voluntary force (not achieved for the full 3 min), and 3 min of metaboreflex activation (post-exercise ischaemia) in two conditions: (1) control and β-blockade (oral propranolol), and (2) control and α-blockade (oral prazosin). In both sessions, coronary blood velocity (CBV, echocardiography) was increased during handgrip (Δ8.0 ± 7.4 cm s-1 ) but unchanged with metaboreflex activation (Δ2.5 ± 3.2 cm s-1 ) under control conditions. β-Blockade abolished the increase in CBV during handgrip, while CBV was unchanged from control with α-blockade. Cardiac work, estimated from rate pressure product (RPP; systolic blood pressure multiplied by heart rate), increased during handgrip and metaboreflex in control conditions in both sessions. β-Blockade reduced RPP responses to handgrip and metaboreflex, whereas α-blockade increased RPP, but the responses to handgrip and metaboreflex were unchanged. CBV and RPP were only significantly correlated during handgrip under control (r = 0.71, P < 0.01) and β-blockade (r = 0.54, P = 0.03) conditions, and the slope of this relationship was unaltered with β-blockade. Collectively, these findings indicate that β-adrenergic receptors play the primary role to the increase of coronary circulation during handgrip exercise, but CBV is unchanged with metaboreflex activation, while α-adrenergic receptor stimulation seems to exert no effect in the control of the coronary circulation during handgrip exercise and isolated muscle metaboreflex activation in humans.


The spiderweb of error-detecting codes in the genetic information.
Nature possesses inherent mechanisms for error detection and correction during the translation of genetic information, as demonstrated by the discovery of a self-complementary circular C3-code called X0 in various organisms such as bacteria, eukaryotes, plasmids, and viruses (Arquès and Michel, 1996; Michel, 2015, 2017). Since then, extensive research has focused on circular codes, which are believed to be remnants of ancient comma-free codes. These codes can be regarded as an additional genetic code specifically optimized for detecting and preserving the proper reading frame in protein-coding sequences. A study by Fimmel et al. in 2014 identified that a total of 216 maximal self-complementary C3-codes can be grouped into 27 equivalence classes with eight codes in each class. In this work, we study how the 27 equivalence classes are related to each other. While the codes in each equivalence class obtained by Fimmel et al. in 2014 are permutations of each other, i.e. one code can be obtained from the other by applying a permutation of the bases, it has not been clear how the equvalence classes are connected. We show that there is an ordering of the equivalence classes such that one gets from one class to the next one by substituting only one pair of codon/anticodon in the corresponding codes, i.e. the corresponding codes have a maximal intersection of 18 codons. To perform this analysis, we define two graphs, G216 and G27, whose vertices are, respectively, all 216 maximal self-complementary C3-codes and 27 equivalence classes. Several properties of the graphs are obtained. Most surprisingly, it turns out that G27 contains Hamiltonian paths of length 27. This fact ultimately leads to a representation of the set of all 216 maximal self-complementary C3-codes as a kind of spider web. Finally, we define dinucleotide cuts of such codes by projecting each codon to its first two bases and show that the paths of lengths 27 in G216 can even be chosen so that all the codes contain a special subset of dinucleotides defined by Rumer's roots. These observations raise a lot of new questions about the biological function of such structures.


Forty-eight single-shot epidural injections on the same patient.
A patient is described who has received 48 single-shot epidurals with plain lignocaine. No complications were encountered at any time. Nuclear magnetic resonance imaging confirmed that no dural damage had occurred.


IRF9 inhibits CyHV-3 replication by regulating the PI3K-AKT signalling pathway in common carp (Cyprinus carpio) epithelial cells.
Interferon regulatory factor 9 (IRF9) is an important transcriptional regulator involved in innate and adaptive immunity. Cyprinid herpesvirus-3 (CyHV-3) is a virus causing widespread death and great economic loss in farmed common carp (Cyprinus carpio). However, the effect of IRF9 on CyHV-3 infection in common carp has not been reported. In this study, during CyHV-3 infection, IRF9 overexpression in common carp fin epithelial (CCF) cells significantly reduced the expression of viral factor thymidine kinase (TK) and open reading frame 72 (ORF72), and knockdown of IRF9 produced the opposite results (p < 0.05). In CCF cells. The IRF9 protein was expression in the nucleus and was rapidly induced in CCF cells by CyHV-3 infection. In addition, several genes associated with virus infection, including type I interferon (IFNI), IFN-stimulated gene 15 (ISG15), myxovirus resistance 1 (Mx1) and Viperin were induced in CCF cells overexpressing IRF9 upon CyHV-3 infection. IRF9 overexpression induced by CyHV-3 infection significantly increased the gene expression of Mx1 and phosphoinositide 3-kinase (PI3K) and the protein expression of protein kinase B (AKT) (p < 0.01). Interestingly, IRF9 did not significantly affect Mx1 gene expression when AKT protein levels remained unchanged during CyHV-3 infection of CCF cells. Furthermore, a significant resistance-related locus was found in the IRF9 sequence in "Longke-11" mirror carp (M11) and Yellow River carp (p < 0.05). These results indicated that IRF9 inhibited viral replication by upregulating the expression of Mx1 via the PI3K-AKT signalling pathway during CyHV-3 infection in CCF cells and provide some basis for the study of the antiviral molecular mechanisms of common carp.


Integrated pan-cancer gene expression and drug sensitivity analysis reveals SLFN11 mRNA as a solid tumor biomarker predictive of sensitivity to DNA-damaging chemotherapy.
Precision oncology seeks to integrate multiple layers of data from a patient's cancer to effectively tailor therapy. Conventional chemotherapies are sometimes effective but accompanied by adverse events, warranting the identification of a biomarker of chemosensitivity. Identify an mRNA biomarker that predicts chemosensitivity across solid tumor subtypes. We performed a pan-solid tumor analysis integrating gene expression and drug sensitivity profiles from 3 cancer cell line datasets to identify transcripts correlated with sensitivity to a panel of chemotherapeutics. We then tested the ability of an mRNA biomarker to predictive clinical outcomes in cohorts of patients with breast, lung, or ovarian cancer. Expression levels of several mRNA transcripts were significantly correlated with sensitivity or resistance chemotherapeutics in cancer cell line datasets. The only mRNA transcript significantly correlated with sensitization to multiple classes of DNA-damaging chemotherapeutics in all 3 cell line datasets was encoded by Schlafen Family Member 11 (SLFN11). Analyses of multiple breast, lung, and ovarian cancer patient cohorts treated with chemotherapy confirmed SLFN11 mRNA expression as a predictive biomarker of longer overall survival and improved tumor response. Tumor SLFN11 mRNA expression is a biomarker of sensitivity to an array of DNA-damaging chemotherapeutics across solid tumor subtypes.


Probing the Origin of Gold Dissolution and Tunneling Across Ni2P Shell Using in situ Transmission Electron Microscopy.
Hybrid core-shell catalysts possess superior physiochemical properties that are closely related to their atomic structures. Here, we report novel diffusion phenomena in an Au-Ni2P yolk-shell structure using in situ heating transmission electron microscopy (TEM) analysis. The Au yolks can dissolve completely into and diffuse across the Ni2P shell at 500 °C, resulting in an inward volume expansion of the Ni2P shell and shrinkage of the void. The dissolved Au is subsequently segregated, forming a new crystal on the outer layer of the shell. A detailed atomic-scale resolution imaging revealed that the outward Au diffusion and aggregation occur when the Au yolks are epitaxial to the Ni2P shells. Theoretical analysis shows that the outward diffusion and deposition of Au atoms is primarily driven by the excess epitaxial strain energy.


Integrating, Harmonizing, and Curating Studies With High-Frequency and Hourly Physiological Data: Proof of Concept from Seven Traumatic Brain Injury Data Sets.
Research in severe traumatic brain injury (TBI) has historically been limited by studies with relatively small sample sizes that result in low power to detect small, yet clinically meaningful outcomes. Data sharing and integration from existing sources hold promise to yield larger more robust sample sizes that improve the potential signal and generalizability of important research questions. However, curation and harmonization of data of different types and of disparate provenance is challenging. We report our approach and experience integrating multiple TBI data sets containing collected physiological data, including both expected and unexpected challenges encountered in the integration process. Our harmonized data set included data on 1536 patients from the Citicoline Brain Injury Treatment Trial (COBRIT), Effect of erythropoietin and transfusion threshold on neurological recovery after traumatic brain injury: a randomized clinical trial (EPO Severe TBI), BEST-TRIP, Progesterone for the Treatment of Traumatic Brain Injury III Clinical Trial (ProTECT III), Transforming Research and Clinical Knowledge in Traumatic brain Injury (TRACK-TBI), Brain Oxygen Optimization in Severe Traumatic Brain Injury Phase-II (BOOST-2), and Ben Taub General Hospital (BTGH) Research Database studies. We conclude with process recommendations for data acquisition for future prospective studies to aid integration of these data with existing studies. These recommendations include using common data elements whenever possible, a standardized recording system for labeling and timing of high-frequency physiological data, and secondary use of studies in systems such as Federal Interagency Traumatic Brain Injury Research Informatics System (FITBIR), to engage investigators who collected the original data.


Haematologic parameters as risk factors for cardiac infarction, in an occupational health care setting.
It is still controversial, whether moderately high haematocrit (Ht) and haemoglobin (Hb) values are risk factors for coronary heart disease. Using the computerized data-system of the Periodical Medical Examination (PME) of Phillips' International Electrical Company, a case-control study was carried out. Cases were male workers (n = 104, from 50 to 60 years of age) who had suffered a first, non-fatal myocardial infarction, and who had had a PME prior (on the average 16 months) to the occurrence of infarction. For each case two age-matched healthy controls were selected from the PME-attendancy list (= 208). For each subject information was abstracted from the PME-records about haematologic parameters and covariates (smoking, cholesterol, blood pressure, pulse-rate, weight, height, FEV5, consumption of antihypertensive agents). After dichotomizing the haematocrit and haemoglobin values at their whole sample means (0.46 l/l and 9.7 mmol/l respectively) in "low" (lower than or equal to the mean) and "high" (greater than the mean), crude odds-ratio's of 2.7 (95% CI: 1.6-4.6) and 2.1 (95% CI: 1.2-3.6) were found for Ht and Hb respectively, when comparing "high" with "low" levels. The associations between Ht and Hb, and the occurrence of myocardial infarction were still present after controlling for covariates using multiple logistic regression models, entering the continuous variables with their exact values. After adjustment, mean corpuscular volume (MCV) also appeared to be correlated with infarction. Our results confirm the hypothesis that moderately high haematocrit and--to a lesser extent--haemoglobin and MCV-values are risk factors for the occurrence of myocardial infarction.


Twitch mouth pressure for detecting respiratory muscle weakness in suspicion of neuromuscular disorder.
Twitch mouth pressure using magnetic stimulation of the phrenic nerves and an automated inspiratory trigger is a noninvasive, non-volitional assessment of diaphragmatic strength. Our aims were to validate this method in patients with suspected neuromuscular disease, to determine the best inspiratory-trigger pressure threshold, and to evaluate whether twitch mouth pressure decreased the overdiagnosis of muscle weakness frequently observed with noninvasive volitional tests. Maximal inspiratory pressure, sniff nasal pressure, and twitch mouth pressure were measured in 112 patients with restrictive disease and suspected neuromuscular disorder. Esophageal and transdiaphragmatic pressures were measured in 64 of these patients to confirm or infirm inspiratory muscle weakness. Magnetic stimulation was triggered by inspiratory pressures of -1 and -5 cmH2O. The -5 cmH2O trigger produced the best correlation between twitch mouth pressure and twitch esophageal pressure (R2 = 0.86; P <0.0001). The best association of noninvasive tests to predict inspiratory muscle weakness was sniff nasal pressure and twitch mouth pressure. Below-normal maximal inspiratory pressure and sniff nasal pressure values suggesting inspiratory muscle weakness were found in 63/112 patients. Only 52 of these 63 patients also had abnormal twitch mouth pressure. In conclusion twitch mouth pressure measurement is a simple, noninvasive, nonvolitional technique which may help to select patients with suspected neuromuscular disorder for invasive inspiratory-muscle investigation.


The arteriovenous fistula and the history of a forgotten pioneer.
The radiocephalic arteriovenous fistula (AVF), first introduced by Dr Kenneth Charles Appell, allowed for the provision of hemodialysis for patients with chronic kidney disease (CKD) and remains a reliable method for vascular access today. The purpose of this study is to review the contributions that led to the development of the AVF. We describe the work of Dr Appell, whose procedure bypassed the need for repeated cannulation in achieving vascular access, transforming the management of patients with dialysis-dependent CKD. A literature search was conducted by searching "arteriovenous fistula," "history of surgery," "hemodialysis," "vascular access," "chronic kidney disease," "repeated cannulation," and "Kenneth Charles Appell" on PubMed, Embase, and Web of Science. Only articles written in English were considered. Before the arteriovenous fistula, glass cannulae were used for vascular access, beginning with Abel's "vividiffusion" apparatus in animals and Haas's experimental dialysis on humans. The use of glass cannulae was continued by Kolff, who transitioned from venipuncture needles to glass cannulae. However, these attempts were complicated by thrombosis, excessive bleeding related to heparin use, and damage to vascular access sites from repeated cannulation. Arteriovenous shunts, using polytetrafluoroethylene tubing, were an improvement from previous attempts at vascular access, but were prone to local bleeding, shunt occlusion, phlebitis, cellulitis, and rarely lasted more than a few months. To address these challenges, Dr Appell created an upper extremity AVF, allowing for the provision of maintenance dialysis without externalized devices, repeated cannulation, and extensive anticoagulant administration. Despite Dr Appell's vision and pioneering contributions to vascular surgery, he has received little credit for his work. The enormous contribution by Dr Appell in the development of the AVF that transformed the modern management of patients with CKD is recognized in this review of the history of vascular access surgery for hemodialysis.


Treatment options and pregnancy management for patients with PV and ET.
Polycythemia vera (PV) and essential thrombocythemia (ET) are the two most common subtypes of Philadelphia chromosome-negative myeloproliferative neoplasm (MPN). PV results in erythrocytosis and ET in thrombocytosis. The discovery of JAK2 mutations in the majority of patients with MPN over the last 2 decades has led to the development of JAK inhibitors. Because PV and ET progress relatively slowly, the main treatment strategy for these two diseases is to prevent thrombotic complications. The first-line agent for both PV and ET is hydroxyurea, although some patients are intolerant or refractory to this compound and need other treatment options. Notably, hydroxyurea is contraindicated during pregnancy. In addition to JAK inhibitors, several new agents, such as HDAC inhibitors, LSD1 inhibitors, MDM2 inhibitors and hepcidin mimetics, have been developed as treatment options. Classical agents, such as busulfan and interferon, are still used to treat patients with PV or ET as well. Based on this context, treatment options and pregnancy management for patients with PV or ET are discussed in this review.


Order in cellulosics: Historical review of crystal structure research on cellulose.
The structure determination of cellulose represents a significant part in the history of polymer science. On one side, cellulose as a natural and renewable material has valuable physical properties which can be improved with detailed knowledge of the structure. On the other side, it is produced by nature as fibers, e.g. ramie, cotton etc., most suitable for structural studies by X-ray diffraction after their discovery in 1912 and was regarded by scientists as predestined for such an undertaking. The progress utilizing appropriate methods and models will be pursued in this investigation from the beginning of the structural research in 1913 till the proposal of realistic structures of cellulose in the 1970s. Different basic units of the crystal structure are discussed. Many structural models for native cellulose have been suggested over times with parallel or antiparallel running chains in the fibers and supported or abandoned. In this historical review on order in cellulosics, the crystal structure research throughout the times will be critically evaluated and the improvements in experiments and methods discussed. This subject is not restricted to cellulose rather can be extended to further polymer fibers.


The glittering prizes.
The Nobel Prizes will be announced at the beginning of October. Is there a possibility that immunology might make the list?


Making fire work: pyrotechnics and natural philosophy.
Everyone is familiar with fireworks, common to festivals and celebrations across the world. At first glance, the history of science might appear to have little to do with the history of these explosive devices. However, fireworks were an important element of court culture in Europe, which relied on spectacle and festival to manifest the power of princes. From the fifteenth century, courts regularly set off fireworks around elaborate theatrical scenery and ephemeral temples, fascinating audiences with a variety of exotic motions and effects exploding in the night sky. Fireworks also intrigued natural philosophers, and over several centuries there were diverse interactions among the sciences and pyrotechny.


Myocardial perfusion studies--direct imaging of acute myocardial injury with 99mTc-pyrophosphate.
Imaging of acute myocardial injury is possible with a large number of agents. All of these agents share similar patterns of uptake in acutely injured myocardial tissue. The technique appears to be a reliable way of ruling in or out the diagnosis of acute myocardial infarction.


Exploring the efficacy of herbal medicinal products as oral therapy for inflammatory bowel disease.
Inflammatory bowel disease (IBD) encompasses a collection of idiopathic diseases characterized by chronic inflammation in the gastrointestinal (GI) tract. Patients diagnosed with IBD often experience necessitate long-term pharmacological interventions. Among the multitude of administration routes available for treating IBD, oral administration has gained significant popularity owing to its convenience and widespread utilization. In recent years, there has been extensive evaluation of the efficacy of orally administered herbal medicinal products and their extracts as a means of treating IBD. Consequently, substantial evidence has emerged, supporting their effectiveness in IBD treatment. This review aimed to provide a comprehensive summary of recent studies evaluating the effects of herbal medicinal products in the treatment of IBD. We delved into the regulatory role of these products in modulating immunity and maintaining the integrity of the intestinal epithelial barrier. Additionally, we examined their impact on antioxidant activity, anti-inflammatory properties, and the modulation of intestinal flora. By exploring these aspects, we aimed to emphasize the significant advantages associated with the use of oral herbal medicinal products in the treatment of IBD. Of particular note, this review introduced the concept of herbal plant-derived exosome-like nanoparticles (PDENs) as the active ingredient in herbal medicinal products for the treatment of IBD. The inclusion of PDENs offers distinct advantages, including enhanced tissue penetration and improved physical and chemical stability. These unique attributes not only demonstrate the potential of PDENs but also pave the way for the modernization of herbal medicinal products in IBD treatment.


[Epidemiological study of conditions causing miscarriage].
The results of a population survey of the causes of spontaneous abortion are reported. A total of 328 female residents of the Cheremushki district in Moscow were investigated, using a retrospective epidemiologic method and 2 kinds of specifically-elaborated questionnaires. Mathematical analysis of the data has identified meaningful risk factors of spontaneous abortion.


Trajectories of target reaching arm movements in individuals with spinal cord injury: effect of external trunk support.
Deficits in trunk control due to spinal cord injury (SCI) lead to slower target-reaching movements of the hand. We investigated whether the movement path is also affected, and whether providing external support for the trunk can abolish the kinematic differences. To compare movement trajectories between individuals with SCI and neurologically normal individuals, with and without external trunk support. Neural Control/Biomechanics Laboratory, University of Illinois, Chicago, USA. Five subjects with levels of injury between C7 and T4 were tested 3-8 years post-injury, and compared with five control subjects. Two targets were employed. Trajectories were recorded by a motion-capture system using infrared emitting markers. Peak speed and path curvature were calculated for the fingertip and for the acromion. Compared with control subjects, the subjects with SCI exhibited lower peak speed of the fingertip but not of the acromion, and less straight paths for both. When the trunk was supported externally, the difference in fingertip speed persisted. The support abolished the difference in path curvature for the fingertip but accentuated that for the acromion. The slower hand movements of individuals with SCI are not simply time-scaled versions of those of normal subjects, and the provision of trunk support does not erase the kinematic differences between the reaching movements of the two groups.


The evaluation of accuracy of serial rapid HIV test algorithm in the diagnosis of HIV antibodies among pregnant women in south east Nigeria.
Accurate HIV testing in pregnancy is critical to the prevention of mother to child transmission of HIV infection and linkages to other preventive strategies. This study determined the sensitivity, specificity negative and positive predictive value of serial rapid testing of HIV among pregnant women in Nnewi, south east Nigeria. This was a comparative descriptive study conducted over a 4-month period. Serial rapid testing algorithm was compared with conventional ELISA testing after obtaining informed consents from the pregnant women. All positive and discordant results were confirmed with western blot HIV test. Participants also completed a questionnaire. Data analysis was done using SPSS version 20. A total of 166 pregnant women participated in this study. The mean age of the participants was 29 ± 4.3 years. The HIV prevalence was highest in the 25-29 years category. This was also the modal age category. Majority of the women were multiparous. The prevalence of HIV infection was 12 %. The sensitivity, specificity, negative and positive predictive value of serial rapid HIV testing was 95, 100, 99.3 and 100 % respectively. The sensitivity of the serial rapid test algorithm was high but still lower than the WHO recommended 99 % and above. The 100 % specificity and positive predictive value makes it a good diagnostic test strategy. There is need for regular review of HIV test kits and policy.


Capsular bag implantation of the hydrogel lens.
Fifty hydrogel lenses were implanted in the capsular bag. Six months after surgery, 96% of eyes had visual acuities of 20/30 and 40% had acuities of 20/15. The age range of patients was 65 to 92 years (mean 76 years). Such visual satisfaction is rarely achieved in this age group and appeared to be related to the low incidence of uveitis and capsular fibrosis associated with these lenses. Excellent lens centration was maintained in 82% of eyes. Despite the small number of cases and short follow-up, these preliminary results merit attention from the medical profession.


Reporting sample size calculations for randomized controlled trials published in nursing journals: A cross-sectional study.
Prior sample size calculation is essential to ensure that a randomized controlled trial (RCT) has enough power to detect any statistical differences between two groups while not over-recruiting participants. However, the compliance among RCTs published in nursing field is unknown. To describe the reporting of sample size methodology and parameters used in RCTs published in nursing journals. A cross-sectional database search of all RCTs published in nursing journals was conducted. 116 journals in the category of nursing. Not applicable. A database search was conducted to identify all RCTs published in nursing journals from January 2016 to December 2016. Two-arm RCTs were reviewed to see if sample size estimation was mentioned in the text and if the parameters were sufficient for the estimation. For RCTs with effect size, sample sizes were recomputed and compared with the reported size. Two hundred and twenty-three RCTs were included in this study, and 143 (64.1%) studies mentioned how they obtained their sample sizes. Among these 143 studies, 132 (92.3%), 133 (93.0%), 33 (23.1%), and 84 (58.7%) specified their levels of significance (α), powers, tails of the test, and effect size related information, respectively. Only 22 (15.4%) provided all the necessary parameters to compute their sample sizes. Out of the 84 RCTs with effect size information, 49 (58.3%) had a relative difference of less than 25%. Around 36% of the RCTs published in nursing journals did not report how they reached their sample sizes. For those that had reported, only 15% provided all the necessary parameters to re-compute their sizes. It is concluded that the methodology and parameters used for sample size determination are inadequately reported in RCTs published in nursing journals.


Effect of alkaline electrolyzed water on physicochemical and structural properties of apricot protein isolate.
In this current study, comparative study between the effect of electrolyzed water and ultrapure water on the extraction of apricot protein was conducted. The results revealed that under the condition of same pH (pH = 9.5), the extraction efficiency of electrolyzed water on apricot protein was superior to that of ultrapure water. Moreover, apricot protein (EAP) extracted by electrolyzed water displayed preferable foaming capacity and emulsion stability. The foaming capacity and emulsion stability of EAP were 11.17% and 36.33 min, for UAP, only 4.75% and 23.88 min, respectively. Meanwhile, compared to UAP, the secondary structure of EAP was more orderly, in which the orderly structures of α-helix and β-sheet were 7.5 and 60.2%, while the disorderly structures of β-turn and random coil were 8.4 and 23.8%. This work provided a novel extraction strategy, which could improve the extraction rate and minimize the destruction of the structure and functional properties of apricot protein.


Arthritis patterns in familial Mediterranean fever patients and association with M694V mutation.
Familial Mediterranean fever (FMF) is an autosomal recessive disorder characterized by recurrent attacks of febrile peritonitis, pleuritis and synovitis. Arthritis is a common and important feature of FMF. The clinical spectrum of arthritis in 71 FMF patients was retrospectively investigated. Mutations in the familial Mediterranean (MEFV) gene were screened. Unlike the previous reports on arthritis of FMF, most of the FMF patients (59%) in this study had symmetric two-joint arthritis whereas monoarticular, oligoarticular and polyarticular arthritis was presented in 20, 8 and 10% of the patients, respectively. Knees were affected in 45 (63%) patients, ankles in 30 (42%), elbows in 11 (15%), wrists in 12 (17%), hips in 12 (17%), small joints of the hands 7 (10%), small joints of the feet 2 (3%) and sacroiliac in 1 (1%). Destruction of the hip was observed in 2 (3%) patients and required hip replacement. Amyloidosis developed in 2 (3%) of our patients. Mutations in the MEFV gene were identified in 50 (71%) patients and the most dominant mutation detected was M694V (64%). Since FMF can be diagnosed by a simple DNA mutation analysis, all arthritis patients of certain origins (Arabs, Turks, Armenians and Jews) should be tested for FMF in order to prevent the complications (amyloidosis and protracted arthritis) by introducing colchicine which is the treatment of choice for FMF.


The measurement properties of mentoring relationship quality scales for mentoring programs.
The measurement properties of two new scales designed to measure global and engagement mentoring relationship quality (Global Mentoring Relationship Quality Scale and Quality of Mentoring Relationship Engagement Scale) were examined among 272 mentors, 491 children, and 554 parents participating in Big Brothers Big Sisters community mentoring programs across Canada. Results demonstrated their unidimensionality, moderate convergent validity, good external validity, and weak-to-moderate reporter concordance. Longitudinal analyses demonstrated good predictive validity of mentor and parent mentoring relationship quality scales with respect to predicting mentoring relationship status.


Assessment of the predictive potential of cognitive scores from retinal images and retinal fundus metadata via deep learning using the CLSA database.
Accumulation of beta-amyloid in the brain and cognitive decline are considered hallmarks of Alzheimer's disease. Knowing from previous studies that these two factors can manifest in the retina, the aim was to investigate whether a deep learning method was able to predict the cognition of an individual from a RGB image of his retina and metadata. A deep learning model, EfficientNet, was used to predict cognitive scores from the Canadian Longitudinal Study on Aging (CLSA) database. The proposed model explained 22.4% of the variance in cognitive scores on the test dataset using fundus images and metadata. Metadata alone proved to be more effective in explaining the variance in the sample (20.4%) versus fundus images (9.3%) alone. Attention maps highlighted the optic nerve head as the most influential feature in predicting cognitive scores. The results demonstrate that RGB fundus images are limited in predicting cognition.


Gaucher disease mouse models: point mutations at the acid beta-glucosidase locus combined with low-level prosaposin expression lead to disease variants.
Gaucher disease is a common lysosomal storage disease caused by a defect of acid beta-glucosidase (GCase). The optimal in vitro hydrolase activity of GCase requires saposin C, an activator protein that derives from a precursor, prosaposin. To develop additional models of Gaucher disease and to test in vivo effects of saposin deficiencies, mice expressing low levels (4--45% of wild type) of prosaposin and saposins (PS-NA) were backcrossed into mice with specific point mutations (V394L/V394L or D409H/D409H) of GCase. The resultant mice were designated 4L/PS-NA and 9H/PS-NA, respectively. In contrast to PS-NA mice, the 4L/PS-NA and 9H/PS-NA mice displayed large numbers of engorged macrophages and nearly exclusive glucosylceramide (GC) accumulation in the liver, lung, spleen, thymus, and brain. Electron microscopy of the storage cells showed the characteristic tubular storage material of Gaucher cells. Compared with V394L/V394L mice, 4L/PS-NA mice that expressed 4--6% of wild-type prosaposin levels had approximately 25--75% decreases in GCase activity and protein in liver, spleen, and fibroblasts. These results imply that reduced saposin levels increased the instability of V394L or D409H GCases and that these additional decreases led to large accumulations of GC in all tissues. These models mimic a more severe Gaucher disease phenotype and could be useful for therapeutic intervention studies.


Computed Tomographic 3-Dimensional Virtual Dissection Aiding in Diagnosis and Surgical Planning of a Rare Form of Obstructed Supracardiac Total Anomalous Pulmonary Venous Connection With an Unusual Scimitar-Like Arrangement.
We present a case of a newborn with a rare presentation of obstructed supracardiac total anomalous pulmonary venous connection who required emergent cannulation to extracorporeal membrane oxygenation (ECMO). Computed tomographic angiography of the heart was performed and using novel virtual dissection techniques aided in surgical planning and guidance. Computed tomographic angiography can be successfully performed in neonates with complex congenital heart disease on ECMO without adjustment of flows to aid in surgical management and novel virtual dissection techniques aid in complex anatomical delineation and spatial orientation with noncardiac structures. The preoperative imaging in this case allowed for appropriate and detailed presurgical planning and contributed to the excellent outcome of this patient.


Large scale purification and biochemical characterization of T7 primase/helicase proteins. Evidence for homodimer and heterodimer formation.
A rapid purification procedure produces milligram amounts of the T7 gene 4A' primase/helicase, 4B helicase, and the wild-type 4AB proteins expressed from the clones described in the accompanying paper (Rosenberg, A. H., Patel, S. S., Johnson, K. A., and Studier, F. W. (1992) J. Biol. Chem. 267, 15005-15012). Purified 4A' protein (in which the wild-type methionine at amino acid 64 has been replaced by leucine to eliminate the 4B initiation codon) appears to be equivalent to the wild-type 4A protein in primase, helicase, and NTPase activities. Gel filtration chromatography and polyacrylamide gel electrophoresis of native proteins indicate that the 4A' and 4B proteins form homodimers and heterodimers in solution. Heterodimer formation presumably accounts for an observed 3-fold increase in the primase activity of 4A' upon addition of 4B that lacks primase activity of its own. Steady-state k(cat) and Km values for hydrolysis of the nucleoside triphosphates ATP, dATP, dTTP, and dGTP were measured for 4A', 4B, 4A'B (1:1), and wild-type 4AB (1:2) proteins. The dependence of the dNTPase activities on the concentration was hyperbolic, suggesting single or noncooperative binding sites, whereas ATPase activity was sigmoidal, suggesting more than one ATP binding site. The k(cat)/Km ratios for hydrolysis of the dNTPs by the four protein preparations were within a factor of 6 of each other. The 1:1 mixture of 4A'B had the highest k(cat)/Km ratios, with a preference for dATP and dTTP.


Minimally Invasive Pulmonary Fibroelastoma Resection.
Pulmonary fibroelastomas are a rare primary cardiac tumor with less than 50 cases reported in the literature to date. We performed a minimally invasive valve-sparing tumor resection through a left anterior mini-incision (LAMI). The procedure was performed without cardiac arrest or aortic cross clamp, expediting postoperative recovery and allowing for an uncomplicated discharge on postoperative day 5. LAMI is a safe and reliable alternative to median sternotomy for patients requiring interventions on the right ventricular outflow tract and main pulmonary artery, including pulmonary fibroelastoma resection and pulmonary valve replacement when needed.


Fluorescent conjugated block copolymer nanoparticles by controlled mixing.
Monitoring of the formation of stable fluorescent nanoparticles from controlled mixing of a THF solution of poly(fluorene ethynylene)-block-poly(ethylene glycol) in a microfluidic laminar flow crossjunction by spatially resolved fluorescence spectroscopy reveals the time scale of particle formation as well as incorporation of small molecule guests and the role of solvent mixing.


Near-infrared spectroscopy to indicate selective shunt use during carotid endarterectomy.
This study assessed the value of cerebral near-infrared spectroscopy (NIRS) and transcranial Doppler (TCD) in relation to electroencephalography (EEG) changes for the detection of cerebral hypoperfusion necessitating shunt placement during carotid endarterectomy (CEA). This was a prospective cohort study. Patients with a sufficient TCD window undergoing CEA from February 2009 to June 2011 were included. All patients were continuously monitored with NIRS and EEG. An intraluminal shunt was placed, selectively determined by predefined EEG changes in alpha, beta, theta, or delta activity. Relative changes in regional cerebral oxygen saturation (rSO2) in the frontal lobe and mean blood flow velocity (Vmean) 30 seconds before carotid cross-clamping versus 2 minutes after carotid cross-clamping were related to shunt placement. Receiver operating characteristic curve analysis was performed to determine the optimal thresholds. Diagnostic values were reported as positive and negative predictive value (PPV and NPV). Of a cohort of 151 patients, 17(11%) showed EEG changes requiring shunt placement. The rSO2 and Vmean decreased more in the shunt group than in the non-shunt group (mean ± standard error of the mean) 21 ± 4% versus 7 ± 5% and 76 ± 6% versus 12 ± 3%, respectively (p < .005), Receiver operating characteristic curve analysis revealed a threshold of 16% decrease in rSO2 (PPV 76% and NPV 99%) and 48% decrease in Vmean (PPV 53% and NPV 99%) as the optimal cut-off value to detect cerebral ischemia during CEA under general anesthesia. Compared with EEG, we found moderate PPV but high NPV for NIRS and TCD to detect cerebral ischemia during CEA under general anesthesia, meaning that both techniques independently may be suitable to exclude patients for unnecessary shunt use and to direct the use of selective shunting. However, the optimal thresholds for NIRS remain to be determined.


Osteomalacia and celiac disease: response to 25-hydroxyvitamin D.
In this 54 year old woman with celiac disease, osteomalacia developed while she was on a gluten-free diet which had caused regression of her steatorrhea. She was not responsive to large doses of parenterally administered dihydrotachysterol and calcium, but she was responsive to the oral administration of 25-hydroxyvitamin D3 (25-OHD3). The data suggest that 25-OHD3 is the treatment of choice for patients with vitamin D deficiency due to intestinal malabsorption.


Optimization of protein purification and characterization using Thermofluor screens.
The efficient large scale production of recombinant proteins depends on the careful conditioning of the protein as it is isolated and purified to homogeneity. Low protein stability leads to low purification yields as a result of protein degradation, precipitation and folding instability. It is often necessary to go through several iterations of trial-and-error to optimize the homogeneity, stability and solubility of the protein sample. We have set up Thermofluor assays to identify customized protocols for the preparation and characterization of individual protein constructs. We apply a two-step approach: we first screen for global parameters, followed by a search for protein-specific additives. The first screen has been designed in such a way, that it is possible to discern global stability trends according to pH, salt concentration, buffer type and concentration. The second screen contains small molecules that can affect the folding, aggregation state and solubility of the protein construct and also includes small molecules that specifically bind and stabilize proteins. The screens are designed to evaluate purification and storage protocols, and aim to provide hints to optimize these protocols. The home-made screens have been tested on more than 200 different protein constructs at the Sample Preparation and Characterization (SPC) facility at EMBL Hamburg. We describe which RT-PCR machines can be adapted to perform Thermofluor assays, what are the necessary experimental conditions to set up a screen, some leads on how to interpret the data and we give several examples of Thermofluor applications beyond stability screens.


CYP1B1 promotes tumorigenesis via altered expression of CDC20 and DAPK1 genes in renal cell carcinoma.
Cytochrome P450 1B1 (CYP1B1) has been shown to be up-regulated in many types of cancer including renal cell carcinoma (RCC). Several reports have shown that CYP1B1 can influence the regulation of tumor development; however, its role in RCC has not been well investigated. The aim of the present study was to determine the functional effects of CYP1B1 gene on tumorigenesis in RCC. Expression of CYP1B1 was determined in RCC cell lines, and tissue microarrays of 96 RCC and 25 normal tissues. To determine the biological significance of CYP1B1 in RCC progression, we silenced the gene in Caki-1 and 769-P cells by RNA interference and performed various functional analyses. First, we confirmed that CYP1B1 protein expression was significantly higher in RCC cell lines compared to normal kidney tissue. This trend was also observed in RCC samples (p < 0.01). Interestingly, CYP1B1 expression was associated with tumor grade and stage. Next, we silenced the gene in Caki-1 and 769-P cells by RNA interference and performed various functional analyses to determine the biological significance of CYP1B1 in RCC progression. Inhibition of CYP1B1 expression resulted in decreased cell proliferation, migration and invasion of RCC cells. In addition, reduction of CYP1B1 induced cellular apoptosis in Caki-1. We also found that these anti-tumor effects on RCC cells caused by CYP1B1 depletion may be due to alteration of CDC20 and DAPK1 expression based on gene microarray and confirmed by real-time PCR. Interestingly, CYP1B1 expression was associated with CDC20 and DAPK1 expression in clinical samples. CYP1B1 may promote RCC development by inducing CDC20 expression and inhibiting apoptosis through the down-regulation of DAPK1. Our results demonstrate that CYP1B1 can be a potential tumor biomarker and a target for anticancer therapy in RCC.


"The impact of statins addind to the fixed combination antihypertensive therapy on the arterial stiffness in patients with moderate and severe hypertension".
The objective of this study was the evaluation of the arterial stiffness, which changed after adding statins to the guidelines recommended dual or triple fixed combination antihypertensive therapy in patients with moderate to severe arterial hypertension. It was included 99 patients in total being diagnosed with moderate and severe arterial hypertension (2nd and 3rd stages of arterial hypertension) without diabetes. Those patients were divided into 2 groups. The first group (n = 59) was assigned to the dual or triple fixed combination antihypertensive therapy plus including statins.Patients in the second group (n = 40) received only the dual or triple fixed combination antihypertensive treatment following the recommended guidelines without any statins. The CAVI index was performed in order to measure in all participants before and at the end of the follow-up period. Furthermore, the Office (Clinic BP) Blood Pressure (BP) was monitored in assigned participants as well as the Ambulatory Blood Pressure Monitoring (ABPM). The laboratory investigations also took place such as the standard blood test, the urine and biochemistry analysis and the estimated Carotid Intima-Media Thicknesses with Ultrasound. The study-duration was 6 months. Office BP and ABPM had decreased significantly and equally in both treatment groups. The total cholesterol (TC) and LDL cholesterol had decreased significantly in the statin group on 1,76 mmol/l (30%, p < 0,05) and 1,51 mmol/l (41%, p < 0,05) respectively. In the group without statin therapy, there was no changes in the level of TC and LDL cholesterol. In the group without statins, it was noted a significant decrease in the level of BP, however, the CAVI index level was shown the growth to +0,9 units on the right side and +1,0 units on the left.In the group without statin's treatment, the CAVI index was changed from 7.73 ± 0.17/7.62 ± 0.19 units to 8.63 ± 0.22/8.62 ± 0.12 units on the right/left site after treatment (p < 0,05). It means there was an increase in the stiffness of the arterial wall in terms of cardio-vascular index CAVI in the group without added statin after 6 months of the therapy. In the group with added statin after 6 months of the therapy, the CAVI had not have any changes. It can be seen from the observed figures: the CAVI on the right/left site was 8.32 ± 0.16/8.33 ± 0.19 initially and 8.44 ± 0.16/8.24 ± 0.15 units treatment (p > 0,05) afterwards.We did not note any impact of statin therapy on the BP level. However, a significant correlations was found between the CAVI index with age and the serum level of blood Triglycerides before treatment, including LDL Cholesterol and HDL Cholesterol, duration of hypertension, the blood glucose level, the Potassium level and the Maximum Thickness of Intima-Media of Carotid Arteries in the statins group. The adding of the statin to the current fixed dual or triple combination of the antihypertensive therapy could prevent the progression of arterial stiffness in patients with 2nd and 3rd stages of arterial hypertension.


Treatment of dorsally dislocated distal radius fractures with individualized 3D printed bracing: an exploratory study.
The aim of this work was to develop a three-dimensionally (3D) printed brace for the acute treatment of dorsally dislocated and correctly reduced distal radius fractures (DRF). The hypothesis was that a brace shaped to the mirror image of the contralateral (non-fractured) wrist will have an optimal anatomical fit, resulting in improved comfort and lower rates of secondary fracture displacement. Validation: the circumference of both wrists and comfort of the brace were studied in healthy volunteers and effectiveness of the brace was evaluated in an ex vivo fracture model. Clinical study: the brace was tested for comfort and effectiveness in patients with a well reduced unstable DRF. Validation: the circumference of both wrists may be different, the brace retained the reduction in the ex vivo fracture model and was well tolerated in the volunteers. Clinical study: in DRF patients comfort scores were lower and pain scores higher compared to the healthy volunteers. After 3 and 5 weeks all patients were independent in ADL according to the Katz-index. Posttraumatic swelling subsided in the first week. In two of the five patients secondary fracture dislocation occurred. Treatment of a dislocated DRF in the acute setting (day one) with a custom-made 3D printed brace, anatomically modelled from a 3D scan of the contralateral wrist, is possible. Difference between both wrists and posttraumatic swelling must be adapted for. The high rate of secondary fracture displacement led to early discontinuation of the study and a small sample size. Name of the registry: ClinicalTrials.Gov Trial registration number: NCT03848702 Date of registration: 02/21/2019, retrospectively registered.


Structure of a NEMO/IKK-associating domain reveals architecture of the interaction site.
The phosphorylation of IkappaB by the IKK complex targets it for degradation and releases NF-kappaB for translocation into the nucleus to initiate the inflammatory response, cell proliferation, or cell differentiation. The IKK complex is composed of the catalytic IKKalpha/beta kinases and a regulatory protein, NF-kappaB essential modulator (NEMO; IKKgamma). NEMO associates with the unphosphorylated IKK kinase C termini and activates the IKK complex's catalytic activity. However, detailed structural information about the NEMO/IKK interaction is lacking. In this study, we have identified the minimal requirements for NEMO and IKK kinase association using a variety of biophysical techniques and have solved two crystal structures of the minimal NEMO/IKK kinase associating domains. We demonstrate that the NEMO core domain is a dimer that binds two IKK fragments and identify energetic hot spots that can be exploited to inhibit IKK complex formation with a therapeutic agent.


Phytosociology and antioxidant profile study for selecting potent herbs for phytoremediation of crude oil-contaminated soils.
Crude oil exploration activities affect the surrounding vegetation. The present investigation deals with the study of phytosociology and biochemical profiles of the herbaceous community in the active and abandoned oil drilling sites of crude oil-explored area. For comparison, a similar investigation was also carried out in control sites where oil exploration activities were not evident. At first, a phytosociological investigation was carried out and based on the results obtained antioxidant enzyme profiles of dominant herbs were studied to understand their defense mechanism to crude oil-associated stress. A total of 69 plant species belonging to 20 families were recorded in the studied sites and the family Cyperaceae was the most dominant in the crude oil-contaminated sites. The results revealed that the plants growing near the oil-explored-contaminated sites exhibit a higher level of DPPH and H2O2 radical scavenging activities as compared to control plant samples. For DPPH assay, the lowest IC50 value was exhibited by Cyperus rotundus which was recorded to be 31.49 and 55.31 respectively for the samples of contaminated and control sites. Again, in the case of H2O2 scavenging activity assay, Parthenium hysterophorus showed the lowest IC50 values of 27.48 and 63.07 for the samples of contaminated and control sites respectively. As a whole, the findings confirm the superior defense mechanism of some dominant herbs of the contaminated sites that include Torenia flava, Croton bonplandianus, Eclipta alba, Cyperus rotundus, Cyperus brevifolius, and Parthenium hysterophorus and their suitability for use in phytomanagement practices.


Ion exchange paper adsorption and thin-layer chromatography for detection of chloroquine in urine for the study of chemosensitivity of Plasmodium falciparum.
With a view to determining the chemosensitivity of Plasmodium falciparum to chloroquine, two qualitative tests for the detection of this antimalarial agent in urine were compared in Central African schoolchildren: the test of Dill and Glazko and a thin-layer chromatography technique involving ion exchange and extraction. Results obtained with 149 subjects showed the marked superiority in specificity and sensitivity of the chromatography test. This is of particular interest when selecting subjects before a therapeutic trial is undertaken. After administration of a single dose of chloroquine (10 mg kg-1) to 14 schoolchildren, both urinary detection tests gave positive results at 24 and 48 hours. However, on day 7 all results with the chromatography test were positive, while 57% of false negatives were recorded by the Dill and Glazko test.


RNF20 controls astrocytic differentiation through epigenetic regulation of STAT3 in the developing brain.
Astrocyte has crucial roles in the central nervous system and accumulating evidence has shown its core function for brain complexity, plasticity and cognition. However, the essential key factors in the precise regulation of astrocytic differentiation remain largely uncharacterized. Here, we identified that RNF20, an E3 ligase of H2BK120 in the mammalian system, regulates astrocyte production from neural precursor cells. RNF20 deficiency by shRNA knockdown or deletion in conditional knockout mice impairs the astrocytic differentiation. Overexpression of RNF20 promotes astrocytic differentiation and can rescue the astrocyte production deficiency caused by RNF20 disruption. Furthermore, we demonstrate that RNF20 functions cooperatively with acetyltransferase MOF to promote astrocytic generation. RNF20-mediated H2Bub1 cooperating with MOF-mediated H4K16ac activates the transcription of Stat3. Together, these data indicate RNF20 is a critical regulator of astrocytic production, which may contribute to the understanding of neurological disorders with glial dysgenesis.


Opinions of Brazilian resuscitation instructors regarding resuscitation in the delivery room of extremely preterm newborns.
To describe the opinions of pediatricians who teach resuscitation in Brazil on initiating and limiting the delivery room resuscitation of extremely preterm infants. Cross-sectional study with electronic questionnaire (Dec/2011-Sep/2013) sent to pediatricians who are instructors of the Neonatal Resuscitation Program of the Brazilian Society of Pediatrics, containing three hypothetical clinical cases: (1) decision to start the delivery room resuscitation; (2) limitation of neonatal intensive care after delivery room resuscitation; (3) limitation of advanced resuscitation in the delivery room. For each case, it was requested that the instructor indicate the best management for each gestational age between 23 and 26 weeks. A descriptive analysis was performed. 560 (82%) instructors agreed to participate. Only 9% of the instructors reported the existence of written guidelines at their hospital regarding limitations of delivery room resuscitation. At 23 weeks, 50% of the instructors would initiate delivery room resuscitation procedures. At 26 weeks, 2% would decide based on birth weight and/or presence of fused eyelids. Among the participants, 38% would re-evaluate their delivery room decision and limit the care for 23-week neonates in the neonatal intensive care unit. As for advanced resuscitation, 45% and 4% of the respondents, at 23 and 26 weeks, respectively, would not apply chest compressions and/or medications. Difficulty can be observed regarding the decision to not resuscitate a preterm infant with 23 weeks of gestational age. At the same time, a small percentage of pediatricians would not resuscitate neonates of unquestionable viability at 26 weeks of gestational age in the delivery room.


Molecular Diagnostics of Plasma Cell Neoplasms.
Genetic characterization of myeloma at diagnosis by interphase fluorescence in situ hybridization and next-generation sequencing (NGS) can assist with risk stratification and treatment planning. Measurable residual disease (MRD) status after treatment, as evaluated by next-generation flow cytometry or NGS on bone marrow aspirate material, is one of the most important predictors of prognosis. Less-invasive tools for MRD assessment such as liquid biopsy approaches have also recently emerged as potential alternatives.


Identification and characterization of muscarinic cholinergic receptors in the human urinary bladder and parotid gland.
The binding characteristics of [3H]quinuclidinyl benzilate (QNB) to muscarinic sites in isolated plasma membrane fractions of the human urinary bladder and parotid gland were studied. QNB binding to both preparations was of high affinity and low capacity. Mean values for the apparent dissociation constants (Kd) for binding to membrane preparations from the urinary bladder and parotid glands were 22 and 34 pM and the Bmax values 234 and 456 fmol/mg protein, respectively. Significance of difference between Kd and Bmax values from the two tissues was at the level of P less than 0.005 and P less than 0.05, respectively. QNB binding was inhibited by muscarinic receptor antagonists with varying degree of effectiveness. The mean values for the inhibition constant (Ki) were significantly lower for oxybutynin, amitriptyline, and pirenzepine but higher for secoverine in preparations of the urinary bladder than of the parotid gland. The mean Ki values for quinidine and verapamil were lower in the urinary bladder than that in the parotid gland. Carbachol exhibited a marked selectivity for the urinary bladder (about 30-fold) compared with the parotid gland. The present data obtained in two human tissues that are highly cholinergic in their innervation give support to the argument for heterogeneity of the muscarinic cholinergic receptors.


Aerophagia in adolescents is associated with exposure to adverse life events and psychological maladjustment.
Aerophagia is a common childhood functional gastrointestinal disorder. We studied the association between adverse life events (ALEs), psychological maladjustment, somatization, and aerophagia (AP) in adolescents. We also assessed the impact of AP on their health-related quality of life (HRQoL). A cross-sectional survey was conducted on 2500 subjects of 13-18 years in 8 randomly selected schools in Sri Lanka. Translated, validated, and self-administered questionnaires were used to collect data. Aerophagia was diagnosed using Rome III criteria. A total of 2453 questionnaires were analyzed (males 1200 [48.9%], mean age 14.8 years, SD 1.6 years). Of them, 371 adolescents had AP (15.1%). Aerophagia was associated with exposure to physical abuse (20.4% vs. 12.7% in controls, P < .0001), emotional abuse (20.3% vs. 8.2% in controls, P < .0001), and other ALEs (22% vs. 10.2% in controls, P < .001). One hundred and ninety (51.2%) adolescents with AP and 775 (37.2%) controls had a personality score above the international cutoff value of 105, indicating psychological maladjustment (odds ratio 1.77, 95% confidence interval 1.42-2.21, P < .0001). Those with AP had higher somatization (16.4 vs. 8.9) and lower overall HRQoL scores (77.0 vs. 85.1, P < .0001). HRQoL scores of adolescents with AP were lower in all domains, namely, physical (80.6 vs. 86.9), emotional (69.1 vs. 80.3), social (83.8 vs. 90.5), and school (72.6 vs. 82.5) functioning (P < .0001). Aerophagia was associated with exposure to ALEs and psychological maladjustment. Affected teenagers suffer from more somatic symptoms and has a poor HRQoL.


Postdiagnosis BMI Change Is Associated with Non-Small Cell Lung Cancer Survival.
Body mass index (BMI) change after a lung cancer diagnosis has been associated with non-small cell lung cancer (NSCLC) survival. This study aimed to quantify the association based on a large-scale observational study. Included in the study were 7,547 patients with NSCLC with prospectively collected BMI data from Massachusetts General Hospital and Brigham and Women's Hospital/Dana-Farber Cancer Institute. Cox proportional hazards regression with time-dependent covariates was used to estimate effect of time-varying postdiagnosis BMI change rate (% per month) on overall survival (OS), stratified by clinical subgroups. Spline analysis was conducted to quantify the nonlinear association. A Mendelian Randomization (MR) analysis with a total of 3,495 patients further validated the association. There was a J-shape association between postdiagnosis BMI change and OS among patients with NSCLC. Specifically, a moderate BMI decrease [0.5-2.0; HR = 2.45; 95% confidence interval (CI), 2.25-2.67] and large BMI decrease (≥2.0; HR = 4.65; 95% CI, 4.15-5.20) were strongly associated with worse OS, whereas moderate weight gain (0.5-2.0) reduced the risk for mortality (HR = 0.78; 95% CI, 0.68-0.89) and large weight gain (≥2.0) slightly increased the risk of mortality without reaching statistical significance (HR = 1.10; 95% CI, 0.86-1.42). MR analyses supported the potential causal roles of postdiagnosis BMI change in survival. This study indicates that BMI change after diagnosis was associated with mortality risk. Our findings, which reinforce the importance of postdiagnosis BMI surveillance, suggest that weight loss or large weight gain may be unwarranted.


Colloidal Oatmeal (Avena Sativa) Improves Skin Barrier Through Multi-Therapy Activity.
Oats (Avena sativa) are a centuries-old topical treatment for a variety of skin barrier conditions, including dry skin, skin rashes, and eczema; however, few studies have investigated the actual mechanism of action for the skin barrier strengthening activity of colloidal oatmeal. Four extracts of colloidal oatmeal were prepared with various solvents and tested in vitro for skin barrier related gene expression and activity. Extracts of colloidal oatmeal were found to induce the expression of genes related to epidermal differentiation, tight junctions and lipid regulation in skin, and provide pH-buffering capacity. Colloidal oatmeal boosted the expression of multiple target genes related to skin barrier, and resulted in recovery of barrier damage in an in vitro model of atopic dermatitis. In addition, an investigator-blinded study was performed with 50 healthy female subjects who exhibited bilateral moderate to severe dry skin on their lower legs. Subjects were treated with a colloidal oatmeal skin protectant lotion. Clinically, the colloidal oatmeal lotion showed significant clinical improvements in skin dryness, moisturization, and barrier. Taken together, these results demonstrate that colloidal oatmeal can provide clinically effective benefits for dry and compromised skin by strengthening skin barrier.

 J Drugs Dermatol. 2016;15(6):684-690.


Determining the position of a fish passage facility entrance based on endemic fish swimming abilities and flow field.
Hydropower development can significantly mitigate climate change and reduce carbon emissions, but it can also have substantial negative impacts on river environments and fish biodiversity. Fish passage facilities are built to ensure sustainable hydropower development and the biodiversity of fish populations. The locations of the entrances to these facilities play a key role in their efficiency. This study presents a reliable approach that combines the swimming ability of fish and a numerical flow field simulation to determine the optimal location for a fish passage facility entrance. In this study, we used the Gujun Reservoir upstream of the Yangtze River as a case study. A field experiment was conducted, and the swimming abilities of eight endemic fish species in the upstream region of the Yangtze River were measured. Among the tested species, the fastest induced swimming speed (0.14 m/s) was achieved by Glyptothorax sinense, while the slowest critical swimming speed (0.30 m/s) was observed for Paracobitis potanini. We propose that the velocity near the fish passage facility entrance should be higher than the maximum induced swimming speed and lower than the minimum critical swimming speed, making the suitable range between 0.14 and 0.30 m/s. On this basis, velocity fields 500 m downstream of the dam of the Gujun Reservoir under 4 operating conditions with discharge flows of 5.7 m3/s, 23.3 m3/s, 32.5 m3/s, and 41.1 m3/s were calculated. The results showed that the flow field variation downstream of the dam was between 0.1 and 0.9 m/s. After comparing the suitable areas for the target species, the left bank at location 2 was recommended as the optimal location for the fish passage facility entrance in the Gujun Reservoir.


The "Under, Over" Technique for Repair of a Peripheral Bucket-Handle Meniscus Tear With Circumferential Compression Stitches.
The benefits of preserving the meniscus are well-established. Several arthroscopic meniscal repair techniques have been described, such as the inside-out, outside-in, and all-inside. All-inside self-retrieving suture devices can be used to repair vertical, horizontal, and radial tears. However, this technique becomes difficult with large tears, as the jaw of the device cannot reach the peripheral edge of the meniscal tear. We present an all-inside technique using circumferential compression stitches to address large peripheral meniscus tears.


Myelin-associated glycoprotein activation triggers glutamate uptake by oligodendrocytes in vitro and contributes to ameliorate glutamate-mediated toxicity in vivo.
Myelin-associated glycoprotein (MAG) is a key molecule involved in the nurturing effect of myelin on ensheathed axons. MAG also inhibits axon outgrowth after injury. In preclinical stroke models, administration of a function-blocking anti-MAG monoclonal antibody (mAb) aimed to improve axon regeneration demonstrated reduced lesion volumes and a rapid clinical improvement, suggesting a mechanism of immediate neuroprotection rather than enhanced axon regeneration. In addition, it has been reported that antibody-mediated crosslinking of MAG can protect oligodendrocytes (OLs) against glutamate (Glu) overload by unknown mechanisms. To unravel the molecular mechanisms underlying the protective effect of anti-MAG therapy with a focus on neuroprotection against Glu toxicity. MAG activation (via antibody crosslinking) triggered the clearance of extracellular Glu by its uptake into OLs via high affinity excitatory amino acid transporters. This resulted not only in protection of OLs but also nearby neurons. MAG activation led to a PKC-dependent activation of factor Nrf2 (nuclear-erythroid related factor-2) leading to antioxidant responses including increased mRNA expression of metabolic enzymes from the glutathione biosynthetic pathway and the regulatory chain of cystine/Glu antiporter system xc- increasing reduced glutathione (GSH), the main antioxidant in cells. The efficacy of early anti-MAG mAb administration was demonstrated in a preclinical model of excitotoxicity induced by intrastriatal Glu administration and extended to a model of Experimental Autoimmune Encephalitis showing axonal damage secondary to demyelination. MAG activation triggers Glu uptake into OLs under conditions of Glu overload and induces a robust protective antioxidant response.


Interleukin-10 in the Vasculature: Pathophysiological Implications.
Interleukin-10 (IL-10) is an important immunomodulatory cytokine, initially characterized as an anti-inflammatory agent released by immune cells during infectious and inflammatory processes. IL-10 exhibits biological functions that extend to the regulation of different intracellular signaling pathways directly associated with vascular function. This cytokine plays a vital role in vascular tone regulation by changing important proteins involved in vasoconstriction and vasodilation. Numerous investigations covered here have shown that therapeutic strategies inducing IL-10 exert anti-inflammatory, anti-hypertrophic, anti-hyperplastic, anti-apoptotic and antihypertensive effects. This non-systematic review summarizes the modulating effects mediated by IL-10 in vascular tissue, particularly on vascular tone, and the intracellular pathway induced by this cytokine. We also highlight the advances in IL-10 manipulation as a therapeutic target in different cardiovascular pathophysiologies, including the physiological implications in animals and humans. Finally, the review illustrates current and potential future perspectives of the potential use of IL-10 in clinical trials based on the clinical evidence.


Oxidation of 15-hydroxyeicosatetraenoic acid and other hydroxy fatty acids by lung prostaglandin dehydrogenase.
The oxidation of the 15-hydroxy group of prostaglandins of the A, E, and F series by the NAD+-dependent prostaglandin dehydrogenase (PGDH) has been well documented. In addition to prostaglandins, we have observed that the purified lung PGDH also will oxidize 15-HETE to a novel metabolite that was isolated by reverse-phase HPLC and identified by gas chromatography-mass spectrometry as the 15-keto-5,8,11-cis-13-trans-eicosatetraenoic acid (15-KETE). The Km for 15-HETE was 16 microM, which was 2.5 times lower than the value obtained for PGE1. In addition to 15-HETE, 5,15-diHETE and 8,15-diHETE also were substrates for the lung PGDH with Km values of 138 and 178 microM, respectively. Other hydroxy derivatives of eicosatetraenoic acid that did not have a hydroxy group at carbon atom 15 did not support the PGDH-mediated reduction of NAD+. In addition to the 15-hydroxy derivatives of eicosatetraenoic acid, 12-HHT also was a substrate for the lung enzyme with a Km of 12 microM. These data indicate that omega 6-hydroxy fatty acids, in addition to prostaglandins, are also substrates of the lung NAD+-dependent PGDH and that the enzyme does not require the cyclopentane ring of prostaglandins.


Long-term stable and energy-neutral mixed biofilm electrode for complete nitrogen removal from high-salinity wastewater: Mechanism and microbial community.
The steady mixed biofilm electrode (MBE) was investigated for the removal of nitrogen from mustard tuber wastewater. Results showed that complete nitrogen removal occurred over a wide initial chemical oxygen demand (COD)/total nitrogen (TN) ratio ranging from 2.8 to 9.8 using MBE. MBE revealed broad-spectrum applicability for the treatment of high-salinity wastewater containing different forms of nitrogen. Bio-electrochemical process, in-situ heterotrophic nitrogen reduction, ammonia stripping, nitrogen assimilation, and endogenous denitrification coexisted for the removal of nitrogen. Batch activity tests and functional microorganism analysis confirmed that autotrophic/heterotrophic nitrification, anoxic/aerobic denitrification, and nitrogen bio-electrochemical reduction cooperated to achieve efficient nitrogen conversion. More importantly, the analysis of the preliminary energy balance demonstrated that MBE was self-sustaining. The long-term operation stability of MBE was of great importance for its practical application. The results provided herein offer new insights into bioelectrochemical nitrogen removal and resource treatment of high-salinity wastewater.


A computerised quality control testing system for B-mode ultrasound.
Current methods of ultrasound (US) imaging quality control involve an observer taking a series of measurements on test object images. This process is very labour-intensive, rapidly becoming more so as the complexity of US scanners increases. Also, many of the measurements are based on the subjective judgement of the operator and are, therefore, prone to an undesirable level of intraobserver and interobserver variation. We have developed a suite of programs to analyse captured US images to estimate a number of performance parameters, including resolution, high- and low-contrast penetration depths and high- and low-contrast sensitivity. In this system, images of the ATS Laboratories Multipurpose Phantom Model 539 are acquired on a PC with a video capture card, and analysed using the software developed. Automated tests have been developed for resolution, low- and high-contrast penetration and low- and high-contrast sensitivity. A preliminary validation of the system was carried out using images from two curvilinear probes and a linear-array probe operating at 5 MHz, 7.5 MHz and 10 MHz, respectively. The 95% confidence intervals ranged from +/- 17% to +/- 21% for resolution measurements and from 0% to +/- 1.5% for low-contrast penetration. The system provides an index of visibility for high- and low-contrast targets, as compared to the coarse visual assessment of a human observer, with 95% confidence intervals ranging from +/- 6% to +/- 13% for low-contrast sensitivity and from +/- 3% to +/- 25% for high-contrast sensitivity. Advantages of the system over the human observer include improved reproducibility and increased information regarding visibility of targets. A more detailed multicentre validation is currently being undertaken.


Psychotic and nonpsychotic depressions: II. Platelet MAO activity, plasma catecholamines, cortisol, and specific symptoms.
Preliminary data are presented on levels of plasma cortisol, dopamine (DA), epinephrine (EPI), and norepinephrine (NE) before and after dexamethasone in 22 depressed patients (of whom 4 were psychotic). Platelet monoamine oxidase (MAO) activity, determined in 19 of the depressed patients, was significantly higher in the 4 psychotic patients than it was in the 15 nonpsychotic patients. Positive correlations were observed before and after dexamethasone among cortisol, DA, EPI, and platelet MAO. After dexamethasone, plasma NE correlated negatively with DA, EPI, and cortisol. The various correlations were due largely to the inclusion of the psychotic depressive subgroup. Data are also presented on the relationships between these biological measures and specific signs and symptoms.


Atomically Dispersed Zinc(I) Active Sites to Accelerate Nitrogen Reduction Kinetics for Ammonia Electrosynthesis.
Developing highly active and stable nitrogen reduction reaction (NRR) catalysts for NH3 electrosynthesis remains challenging. Herein, an unusual NRR electrocatalyst is reported with a single Zn(I) site supported on hollow porous N-doped carbon nanofibers (Zn1 N-C). The Zn1 N-C nanofibers exhibit an outstanding NRR activity with a high NH3 yield rate of ≈16.1 µg NH3 h-1 mgcat -1 at -0.3 V and Faradaic efficiency (FE) of 11.8% in alkaline media, surpassing other previously reported carbon-based NRR electrocatalysts with transition metals atomically dispersed and nitrogen coordinated (TM-Nx ) sites. 15 N2 isotope labeling experiments confirm that the feeding nitrogen gas is the only nitrogen source in the production of NH3 . Structural characterization reveals that atomically dispersed Zn(I) sites with Zn-N4 moieties are likely the active sites, and the nearby graphitic N site synergistically facilitates the NRR process. In situ attenuated total reflectance-Fourier transform infrared measurement and theoretical calculation elucidate that the formation of initial *NNH intermediate is the rate-limiting step during the NH3 production. The graphitic N atoms adjacent to the tetracoordinate Zn-N4 moieties could significantly lower the energy barrier for this step to accelerate hydrogenation kinetics duing the NRR.


Susceptibility to apoptosis is differentially regulated by c-myc and mutated Ha-ras oncogenes and is associated with endonuclease availability.
Oncogenes and oncosuppressors can deregulate cell replication in tumours, and recently have been shown to influence the probability of apoptosis. The effects of human c-myc and mutated (T24) Ha-ras oncogenes on susceptibility to apoptosis were investigated by introducing them into immortalised rat fibroblasts. The resulting family of transfectants showed closely similar measures of proliferation, but widely divergent rates of apoptosis, differing by up to fifteen-fold, that correlated inversely with population expansion rates in vitro. T24-ras transfectants with moderate or high p21ras expression showed reduced apoptosis, and this was reversed by pharmacological inhibition of membrane localisation of p21ras by mevinolin. In contrast, c-myc stimulated apoptosis, and this was further enhanced by serum deprivation. Inducibility of effector proteins represents one possible mechanism of genetic control of the susceptibility to apoptosis, and its investigation showed that c-myc was associated with expression by viable cells of latent calcium/magnesium sensitive endonuclease activity characteristic of apoptosis. In contrast, endonuclease activity was not detected in viable cells of a T24-ras transfectant expressing high levels of p21ras. Thus, there appeared to be differential regulation of susceptibility to apoptosis, positively by c-myc and negatively by activated ras, and this was associated with availability of endonuclease activity. Genetic modulation of apoptosis in human neoplasms is likely to influence net growth rate, retention of cells acquiring new mutations and response to certain chemotherapeutic agents.


Clinical outcomes of arthroscopic rotator cuff repair: a retrospective comparison of double-layer, double-row and suture bridge methods.
The suture-bridge (SB) method has recently become the mainstream means of repairing full-thickness rotator cuff tears. However, in some patients the deep and superficial layers have moved in different directions because of delamination of their rotator cuffs. In such cases, a simple suture (double-layer, double-row [DD] method) is used to repair the superficial and deep layers separately. The purpose of this study was to analyze the clinical outcomes and re-tear rates of the DD and SB methods, with patients selected according to the condition of their torn cuffs. We retrospectively registered 74 patients with full-thickness rotator cuff tears that had been repaired arthroscopically, 35 shoulders by the DD and 39 by the SB method. Mean ages were 66.1 years in the DD and 62.9 years in the SB group. We evaluated clinical status before and after surgery (Japanese Orthopedic Association [JOA] scores) and re-tear rate. The Wilcoxon signed-ranks test was used to compare JOA scores and active ROM between before and after surgery in each group. Mann-Whitney's U test was used for comparing JOA scores, active ROM, re-tear rates, size of tear, duration of follow-up, sex, and presence of subscapular muscle repair between the DD and SB groups. A hazard ratio of less than 5% was considered to denote significance. JOA scores improved significantly in the DD and SB groups from preoperative means of 63.4 and 63.3 points, respectively, to postoperative means of 91.8 and 92.1 points, respectively. The active flexural ROM improved significantly from means of 110.1° and 100.0°, respectively, to postoperative means of 142.3° and 142.7°, respectively; the differences between groups were not significant. Re-tear occurred in 5.9% of the DD (two of 34 shoulders) and 7.9% of the SB group (three of 38 shoulders); its incidence did not differ significantly between the two groups. Both the DD and SB methods achieve satisfactory clinical outcomes that do not differ significantly. Our results suggest that careful selection of operative method on the basis of the delamination pattern in patients undergoing RCT may reduce the re-tear rate after utilizing the SB method.


[Effect of the technological and culinary preparation on vitamin preservation in fish and in nonfishery products].
The content of vitamins A, E, C, B6, thiamine, riboflavin, niacin and folacin was studied comparatively in some fish species during their preservation as frozen, salt and smoked products. The thiamine content was found to decrease during preservation of frozen and salt fish, while in smoked fish it preserved better. The uncut salt and smoked fish showed an increased content of vitamin A in its edible part at the expense of redistribution together with fat from the internal organs. The boiling of fish and non-fishery products changed the content of some vitamins. Vitamin losses were due both to their destruction at boiling and passage into the broth.


Tuftsin, a natural activator of phagocytic functions including tumoricidal activity.
Some of the properties of the tetrapeptide tuftsin, Thr-Lys-Pro-Arg, are discussed. We describe three phases of tuftsin activation of the macrophage. Tuftsinyltuftsin, the octapeptide Thr-Lys-Pro-Arg-Thr-Lys-Pro-Arg, was synthesized with a view of minimizing the formation of Lys-Pro-Arg, from tuftsin by tissue aminopeptidases. The tripeptide is a tuftsin inhibitor. The octapeptide proved to be quite effective in prolonging the life of syngeneic mice injected with L1210 leukemia cells. Its effect in our laboratory, was considerably better than we could obtain with tuftsin. A simple method for purifying tuftsin by high performance liquid chromatography is described using 0.75% trifluoroacetic acid in water. The tuftsin sequence Thr-Lys-Pro-Arg is present in P12 protein of Rausher murine leukemia virus. A close analog Thr-Arg-Pro-Lys appears in yet another virus protein the haemagglutinin of influenza virus. A second close analog Thr-Arg-Pro-Arg forms the penultimate carboxyterminal of a pancreatic polypeptide found in human and several animals.


Congenital orbital sudoriferous cyst: radiological findings.
We report an extremely unusual case of a 4-month-old boy who presented with a sudoriferous gland cyst of the orbit. Congenital sudoriferous cyst is extremely rare in both the adult and pediatric populations. The CT and MRI findings are presented and the pertinent literature reviewed.


Assessment and Prediction of Cardiovascular Contributions to Severe Maternal Morbidity.
Severe maternal morbidity (SMM) refers to any unexpected outcome directly related to pregnancy and childbirth that results in both short-term delivery complications and long-term consequences to a women's health. This affects about 60,000 women annually in the United States. Cardiovascular contributions to SMM including cardiac arrest, arrhythmia, and acute myocardial infarction are on the rise, probably driven by changing demographics of the pregnant population including more women of extreme maternal age and an increased prevalence of cardiometabolic and structural heart disease. The utilization of SMM prediction tools and risk scores specific to cardiovascular disease in pregnancy has helped with risk stratification. Furthermore, health system data monitoring and reporting to identify and assess etiologies of cardiovascular complications has led to improvement in outcomes and greater standardization of care for mothers with cardiovascular disease. Improving cardiovascular disease-related SMM relies on a multipronged approach comprised of patient-level identification of risk factors, individualized review of SMM cases, and validation of risk stratification tools and system-wide improvements in quality of care. In this article, we review the epidemiology and cardiac causes of SMM, we provide a framework of risk prediction clinical tools, and we highlight need for organization of care to improve outcomes.


Indirect calorimetry in cardiac patients.
Nineteen patients following open heart surgery were studied for the influence of cardiac function on metabolism. Diminished cardiac index was associated with the following changes in metabolism: lowering of the energy expenditure, an increase in respiratory quotient and conversion from fat to carbohydrate metabolism. Protein metabolism remained unaltered. The changes are attributed to decreased oxygen transport to the cell ('stagnant hypoxia'). For the estimation of energy expenditure without calorimetry assessment of cardiac function is essential. A formula for predicting resting energy expenditure is given.


[Double pylorus. Description of two new cases and survey of the literature].
Double pylorus is an extremely rare pathology: it can be an acquired or congenital lesion. Two new cases complicating a peptic ulcer are reported and the clinical appearance and evolution of the different etiological type are described.


Attenuation of leptin action and regulation of obesity by protein tyrosine phosphatase 1B.
Common obesity is primarily characterized by resistance to the actions of the hormone leptin. Mice deficient in protein tyrosine phosphatase 1B (PTP1B) are resistant to diabetes and diet-induced obesity, prompting us to further define the relationship between PTP1B and leptin in modulating obesity. Leptin-deficient (Lep(ob/ob)) mice lacking PTP1B exhibit an attenuated weight gain, a decrease in adipose tissue, and an increase in resting metabolic rate. Furthermore, PTP1B-deficient mice show an enhanced response toward leptin-mediated weight loss and suppression of feeding. Hypothalami from these mice also display markedly increased leptin-induced Stat3 phosphorylation. Finally, substrate-trapping experiments demonstrate that leptin-activated Jak2, but not Stat3 or the leptin receptor, is a substrate of PTP1B. These results suggest that PTP1B negatively regulates leptin signaling, and provide one mechanism by which it may regulate obesity.


From the use of exposure index in quality control testing to the use of exposure index for quality control of clinical images.
The exposure index (EI) is used in routine quality control (QC) tests performed in the radiographic equipment installed in our hospitals. This study aimed at investigating the factors affecting the calculation of EI in QC and clinical images, and the implementation of target EI (EIT) and deviation index (DI) in clinical practice. The EI is 100 times the incident air kerma (IAK) in μGy on the image receptor, using the RQA-5 X-ray beam quality. Conformance to this relationship was investigated in QC images and clinical images acquired using anthropomorphic phantom body parts and different examination protocols, tube potential settings and radiation field sizes. Furthermore, a survey on EIT and DI data from clinical images was performed. Though automatic exposure control (AEC) systems have been adjusted for an IAK of 2.5 μGy, for most anthropomorphic phantom images the EIs were far from 250, depending on the manufacturer, the anatomy imaged, and the examination protocol. Regarding the survey results, DI calculation was feasible in only 38 % of the systems, since for the rest EIT values have not been set. However, the rationale based on which EIT have been selected is unclear. Some systems use only one while others many different EIT values. Before using EI for quality control of clinical images image all receptors and AEC systems should be properly calibrated. Then, the methodology of selecting appropriate EIT should be refined, since the EI calculation may vary, depending on the manufacturer, the anatomy imaged, and the examination protocol.


In vitro percutaneous penetration and metabolism of [3H]T-2 toxin: comparison of human, rabbit, guinea pig and rat.
The purpose of this research was to determine which species of laboratory animal provided the best approximation of in vitro percutaneous penetration and metabolism of T-2 in humans. The [3H]T-2 which penetrated discs of skin after 48 hr (expressed as per cent of dose, 581 ng/cm2) was 1.0, 1.4, 2.8 and 9.7% for the human, rabbit, guinea pig and rat when the vehicle was methanol. The penetration was 29.2, 19.6, 51.9 and 52.6% for the human, rabbit, guinea pig and rat when the vehicle was DMSO. When 2 concentrations were compared, 79 ng/cm2 and 581 ng/cm2 (the vehicle was methanol), the higher dose caused a significant (P less than 0.05) increase in the per cent of dose which penetrated human and guinea pig skin. Metabolism was extensive in the human, rabbit, and rat, with the main metabolite being HT-2 toxin. Previous studies comparing human to monkey indicated penetration in these 2 species was different when methanol was the vehicle. This study indicates that the rabbit provides the best approximation of human skin, both in terms of penetration kinetics and metabolic activity.


[Chronic sclerosing osteomyelitis (so-called Garré's). Review of 12 cases].
This study reports 12 cases of chronic sclerosing osteomyelitis in children. The authors recall the past history of this disease and describe the clinical, radiological and pathological picture found nowadays. They insist upon the salient features that allow to differentiate this lesion from other types of infectious osteomyelitis and osteoid osteoma.


Tauopathies.
Tauopathies are neurodegenerative disorders characterized by the deposition of abnormal tau protein in the brain. The spectrum of tau pathologies expands beyond the traditionally discussed disease forms like Pick disease, progressive supranuclear palsy, corticobasal degeneration, and argyrophilic grain disease. Emerging entities and pathologies include globular glial tauopathies, primary age-related tauopathy, which includes neurofibrillary tangle dementia, chronic traumatic encephalopathy (CTE), and aging-related tau astrogliopathy. Clinical symptoms include frontotemporal dementia, corticobasal syndrome, Richardson syndrome, parkinsonism, pure akinesia with gait freezing and, rarely, motor neuron symptoms or cerebellar ataxia. Some disorders show specific neuroimaging features, while examination of the cerebrospinal fluid awaits markers for in vivo stratification of cases. The possibility of cell-to-cell propagation is a novel aspect of the pathogenesis of tauopathies, which is partly reflected by the hierarchic involvement of anatomic regions. This concept might have relevance for the development of therapies. For cost-effective screening for tau pathologies in neuropathologic practice, examination of the hippocampus, amygdala, and basal ganglia is recommended. Uncommon morphologies or unusually extensive forms of tau pathologies should raise the suspicion of a genetic background. Ongoing multidisciplinary studies are needed to understand the whole spectrum and significance of tau pathologies.


Physical therapy: exercises and the modalities: when, what, and Why?
This article reviews the evidence for using modalities and/or exercise treatment in patients with nonspecific low back pain. Poor evidence of efficacy exists for the use of modalities in this patient group. Exercises are beneficial for patients with subacute and chronic nonspecific low back pain. Further studies are needed for type, frequency, duration, and intensity of exercises.


Nurse confidence in gynaecological oncology practice and the evaluation of a professional development module.
A tertiary-based education program on gynaecological oncology was attended by 62 registered nurses (RN). The program aimed to update nurses' knowledge, improve skills and ability to manage common situations and to assess program efficacy. Evaluation framework with specifically designed pre-post questionnaire about program content and nurse confidence. RN interested in gynaecological oncology were invited to attend. Nurses rated their confidence about gynaecological oncology skills one week prior to the program, immediately post-course, 3 months post and 12 months post. Speaker presentations were evaluated immediately post-course. Participants indicated improved confidence immediately after participating in the course (z = -6.515, p < .001); whilst confidence subsequently declined and stabilised up to 12 months post-course, it still remained significantly higher than before the course: 3 months post- (z = -5.284, p < .001) and 12 months post- (z = -4.155, p < .001). Results support the value of continuing professional education for improving nurse confidence in the gynaecological oncology setting.