Teachers' emotions in the time of COVID: Thematic analysis of interview data reveals drivers of professional agency.
We explored two complex phenomena associated with effective education. First, teachers' professional agency, the volitional actions they take in response to perceived opportunities, was examined to consider individual differences in its enactment. Second, "strong" emotions have been proposed as important in teaching and learning, and we wished to clarify which basic emotions might be involved, besides curiosity, which is a known emotional factor in engagement in teaching. We also explored how agency and basic emotions might be related. Thirteen teachers working in Scottish secondary schools were interviewed at the start of the covid pandemic in 2020 to discuss relevant feelings, thoughts and actions arising from unprecedented changes in their lives and professional practices. Thematic analysis was used to identify aspects of agentic behavior and basic emotions expressed. Teacher agency was expressed through adaptability, collective agency, constrained agency, and non-action. Four basic emotion percepts were identified, which we label as "CARE", "CURIOSITY", "COOPERATION", and "CHALLENGE". We extend the definition of agency to include volitional non-action as a response to opportunity. In contrast to prior research emphasizing emotions as an outcome of volitional behavior, we explore emotions preceding agency. We develop four theoretical propositions related to teacher emotions. (1) Four emotion percepts substantially influence teachers' voluntary motivated behavior. (2) The amount and proportion of emotions experienced varies between individual teachers. (3) The four percepts are experienced concurrently or in rapid succession in engaged teaching contexts. (4) Professional experience and specific situational factors also influence teachers' behavioral choices. For future consideration, we suggest that awareness of emotion percepts may encourage both teachers' engagement and their professional agency for the benefit of their pedagogical practice and outcomes for their students.


Post-traumatic stress disorder in an emergency department population one year after Hurricane Katrina.
Hurricane Katrina resulted in a significant amount of injury, death, and destruction. To determine the prevalence of, and risk factors for, symptoms of post-traumatic stress disorder (PTSD) in an emergency department (ED) population, 1 year after hurricane Katrina. Survey data including the Primary Care PTSD (PC-PTSD) screening instrument, demographic data, and questions regarding health care needs and personal loss were collected and analyzed. Seven hundred forty-seven subjects completed the survey. The PC-PTSD screen was positive in 38%. In the single variate analysis, there was a correlation with a positive PC-PTSD screen and the following: staying in New Orleans during the storm (odds ratio [OR] 1.73, 95% confidence interval [CI] 1.28-2.34), having material losses (OR 1.64, 95% CI 1.03-2.60), experiencing the death of a loved one (OR 1.96, 95% CI 1.35-1.87), needing health care during the storm (OR 2.01, 95% CI 1.48-2.73), and not having health care needs met during the storm (OR 2.00, 95% CI 1.26-3.18) or after returning to New Orleans (OR 2.29, 95% CI 1.40-3.73). In the multivariate analysis, the death of a loved one (OR 1.87, 95% CI 1.26-2.78), being in New Orleans during the storm (OR 1.69, 95% CI 1.22-2.33), and seeking health care during the storm (OR 1.69, 95% CI 1.22-2.35) were associated with positive PC-PTSD screens. There was a high prevalence of PTSD in this ED population surveyed 1 year after hurricane Katrina. By targeting high-risk patients, disaster relief teams may be able to reduce the impact of PTSD in similar populations.


De Novo Reconstruction of Adipose Tissue Transcriptomes Reveals Long Non-coding RNA Regulators of Brown Adipocyte Development.
Brown adipose tissue (BAT) protects against obesity by promoting energy expenditure via uncoupled respiration. To uncover BAT-specific long non-coding RNAs (lncRNAs), we used RNA-seq to reconstruct de novo transcriptomes of mouse brown, inguinal white, and epididymal white fat and identified ∼1,500 lncRNAs, including 127 BAT-restricted loci induced during differentiation and often targeted by key regulators PPARγ, C/EBPα, and C/EBPβ. One of them, lnc-BATE1, is required for establishment and maintenance of BAT identity and thermogenic capacity. lnc-BATE1 inhibition impairs concurrent activation of brown fat and repression of white fat genes and is partially rescued by exogenous lnc-BATE1 with mutated siRNA-targeting sites, demonstrating a function in trans. We show that lnc-BATE1 binds heterogeneous nuclear ribonucleoprotein U and that both are required for brown adipogenesis. Our work provides an annotated catalog for the study of fat depot-selective lncRNAs and establishes lnc-BATE1 as a regulator of BAT development and physiology.


Correlates of anxiety in women living with HIV of reproductive age.
Prior investigations suggest that women living with HIV (WLWH) experience higher rates of anxiety compared to the general population. This study investigates correlates of anxiety among 361 WLWH of reproductive age in Ontario, Canada who completed a series of self-reported measures. Anxiety was assessed using the Hospital Anxiety and Depression Scale (HADS-A). Thirty-seven percent of the sample had high anxiety (HADS-A ≥ 11). HIV-related stigma, reproductive health-related worries, having experienced judgment from family and friends for trying to become pregnant and use of antiretrovirals were associated with high anxiety. Being in a romantic/sexual relationship, older age, and undetectable viral load were associated with low anxiety. Findings highlight the importance of HIV-related stigma and having experienced judgment from family and friends for trying to become pregnant as important predictors of anxiety among WLWH of reproductive age. There is a need for appropriate management of anxiety and stigma for WLWH of childbearing age.


A case of anterior persistent hyperplastic primary vitreous associated with morning glory disc anomaly and retinopathy of prematurity like retinopathy in a term-born child.
Association of morning glory disc anomaly (MGDA) with persistent hyperplastic primary vitreous (PHPV) has been reported earlier. Retinopathy of prematurity (ROP) like retinopathy in preterm babies with optic disc anomalies has also been published. Our case is unique in terms of presence MGDA, PHPV, unilateral ROP like retinopathy in a term infant with normal birth weight. A 5-month-old girl, born at term with a birth weight of 3750 g, presented with anterior PHPV, MGDA and ROP like retinopathy. In order to prevent retinal detachment, she received 360 degree barrage laser photocoagulation at the edge of the optic disc excavation of the left eye. In the follow-up a month later, laser scars were found in her left fundus without other complications. PHPV and MGDA with ROP like retinopathy in term and normal weight baby is rare. The peripheral avascular retinal area, caused by the dragging of the defected optic disc, might have been more vulnerable to the oxygen change after birth which resulted in ROP like retinopathy. High sensitivity to oxygen results in a series of changes such as upregulation of VEGF and IGF-1 may cause ROP-like retinopathy.


v-fps protein-tyrosine kinase coordinately enhances the malignancy and growth factor responsiveness of pre-neoplastic lung fibroblasts.
The v-fps oncoprotein was expressed in a pre-neoplastic, growth factor-dependent Chinese hamster lung fibroblast line (CCL39) to study its effect on growth controls and on the induction of malignancy. Two transfectants were characterized which expressed low (39FPS-8) or high (51FPS-6) levels of P130gag-f ps protein-tyrosine kinase activity. 39FPS-8 cells still arrested in quiescence when deprived of growth factors, but developed an increased sensitivity to the mitogenic actions of epidermal growth factor (20-fold) and alpha-thrombin (50-fold), although not to insulin. In contrast, 51FPS-6 cells completely escaped growth controls, divided in serum-free medium, and were insensitive to further growth factor stimulation. Both transfectants produced rapidly growing tumors in nude mice that formed pulmonary metastases from a subcutaneous site, unlike the parental cells which are non-metastatic. 51FPS-6 cells were comparatively more efficient than 39FPS-8 cells in colonizing the lungs after intravenous inoculation. The v-fps tyrosine kinase therefore induces a partial to complete relaxation of growth factor-mediated controls on the CCL39 cell cycle, with the extent of factor independence reflecting the amount of P130gag-f ps synthesized. This reduction in growth factor requirements correlates with the capacity of v-fps to confer the attributes of metastatic tumors upon preneoplastic CCL39 fibroblasts. We speculate that increased sensitivity to growth factor stimulation represents a common mechanism by which tumor cells acquire metastatic properties.


Differential relational encoding of categorical information in memory for action events.
Memory for action phrases is better if the actions are enacted in subject-performed tasks (SPTs) than if they are only listened to in verbal tasks (VTs). This effect is ascribed to better item-specific encoding of SPTs than of VTs. The role of interitem relational information is controversial, and the findings of clustering with categorically structured lists are inconsistent (see Engelkamp, 1998). The present study contributes to clarifying these effects by demonstrating that intentional relational encoding can be used more efficiently in VTs than in SPTs and influences the degree of clustering. If the list structure is not obvious, inducing intentional encoding by presenting the category labels prior to list presentation and asking subjects to use this preinformation increases clustering in VTs but not in SPTs. Without preinformation, clustering scores of VTs and SPTs did not differ, with preinformation, clustering of VTs was stronger than that of SPTs. The authors suggest how the inconsistent findings with regard to clustering effects can be explained.


Plasma lactoferrin measured by an enzyme-linked immunosorbent assay (ELISA). Measurements on adult and infant plasma.
The lactoferrin content of human plasma has been measured by an enzyme-linked immunosorbent assay. In cord blood the level was 0.02-0.3 mg/l, corresponding to 3-44 X 10-(10) mol/l lactoferrin; in plasma 5 d post partum the level had not changed. In adults the level was 0.02-0.2 in 29 out of 30 plasma samples and above 1 mg/l in 1 sample. Similar results were obtained with EDTA, citrate or heparin as anti-coagulant.


Quantitative ultrasound measurements and vitamin D status in the assessment of hip fracture risk in a nationally representative population sample.
Adjusted for age, gender, height and weight, calcaneal quantitative ultrasound (QUS) and serum 25-hydroxyvitamin D (S-25(OH)D) proved to be significant predictors of hip fracture among subjects aged ≥50 years. Even if their contribution to the predictive power was modest, they may be useful in the assessment of hip fracture risk in the elderly. This study assessed calcaneal QUS measurements, S-25(OH)D and several other factors for the prediction of hip fracture risk in a nationally representative population sample. The study population consisted of 3,305 subjects (1,872 women), aged 50 years or over, who had participated in a comprehensive health survey. QUS measurements were made by means of the Hologic Sahara device. S-25(OH)D was measured by radioimmunoassay. Emerging cases of hip fracture were identified from the National Hospital Discharge Register. During a mean follow-up of 8.4 years, 95 subjects sustained a hip fracture. After adjusting for age, gender, height, weight and each other, a 1 standard deviation increment in the quantitative ultrasound index (QUI) (21.7) and in S-25(OH)D (17.5 nmol/L) reduced the risk of hip fracture by 40 % (hazard ratio [HR] = 0.60, 95 % confidence interval [CI] = 0.42-0.86) and by 31 % (HR = 0.69, 95 % CI = 0.55-0.87), respectively. The predictive power of a model including age, gender, height and weight was improved by about 8 % after the addition of QUI and S-25(OH)D. Among subjects aged 75 years or over, the corresponding improvement was about 130 %. QUI and S-25(OH)D were significant and independent predictors of hip fracture. However, their ability to increase the predictive power of a statistical model including readily available simple variables such as age, gender, height and weight was rather modest. Still, our findings suggest that QUI and S-25(OH)D may be of clinical use in the assessment of hip fracture risk particularly in the elderly.


Laryngeal Lipoma: A Clinicopathologic Case Report.
Lipoma is not usual in the head and neck and the intrinsic form of isolated laryngeal lipoma is quite rare. Because isolated laryngeal lipoma symptoms are uncharacteristic and often has no systemic manifestation, clinical diagnosis is difficult. We describe an extremely rare case of intrinsic laryngeal lipoma.


A simple method of scalp localization using multiplanar reconstruction of MR images.
Image-based scalp localization methods currently used are complex and not standardized. The authors have developed a simple yet accurate method for craniotomy localization using multiplanar reconstruction (MPR) algorithms. In this method, the goal is to localize a projected point (defined as T) of the center of the lesion on the scalp. An oblique coronal plane is reformatted using a patient's magnetic resonance (MR) images with MPR algorithms to include both the center of the lesion and bilateral external auditory meati. Then the distance between T and the ipsilateral external auditory meatus or sagittal suture (defined as S) is measured along the scalp contour in the plane. The distance between the bregma and S is also measured. These distances are used for scalp localization, using a tape measure in the operating room. We have had successful scalp localization in six clinical cases. It took about 3 min to measure each distance on the MR console. This method for craniotomy planning using MPR algorithms is simple and sufficiently accurate.


Interleukin-6 gene polymorphism (-174 G/C) is associated with toxoplasmic retinochoroiditis.
Experimental data have demonstrated a relevant role for IL-6 in the modulation of acute ocular toxoplasmosis. Therefore, we aim to investigate the possible association between the IL-6 gene polymorphism at position -174 and toxoplasmic retinochoroiditis (TR) in humans. Ninety-seven patients with diagnosed TR were recruited from the Uveitis Section, Federal University of Minas Gerais. For comparison, 83 healthy blood donors with positive serology for toxoplasmosis and without retinal signs of previous TR were included in the study. Genomic DNA was obtained from oral swabs of individuals and amplified using polymerase chain reaction (PCR) with specific primers flanking the locus -174 of IL-6 (-174G/C). PCR products were submitted to restriction endonuclease digestion and analysed by polyacrylamide gel electrophoresis to distinguish allele G and C of the IL-6 gene, allowing the detection of the polymorphism and determination of genotypes. There was a significant difference in the genotype (χ(2) = 12.9, p = 0.001) and allele (χ(2) = 6.62, p = 0.01) distribution between TR patients and control subjects. In a subgroup analysis, there was no significant difference in genotypes and allele frequencies regarding TR recurrence. This study suggests that the genotypes related with a lower production of IL-6 may be associated with the occurrence of TR.


Oxidative stress and antioxidant status in patients undergoing prolonged exposure to hyperbaric oxygen.
To evaluate the condition of oxidative stress in patients undergoing prolonged exposure to hyperbaric oxygen (HBO) and the possible modifications of the antioxidant defense systems in the absence of antioxidant supplementation. Twelve patients exposed to 15 HBO treatments for pathological conditions related to hypoxia were included in the study. Oxidative stress indices as well as plasma and erythrocyte antioxidant levels were measured in blood samples collected both at the 1st and 15th HBO session. The repeated exposures to HBO led to a significant accumulation of plasmatic reactive oxygen metabolites (ROM) and malondialdehyde (MDA). After 15 HBO sessions, no relevant differences were detected for reduced glutathione (GSH), alpha-tocopherol, and retinol plasma levels; however, a significant decrease in erythrocyte superoxide dismutase (SOD) and catalase (CAT) activity was observed when compared to the 1st HBO exposure; glutathione peroxidase (GPx) activity remained almost unchanged. In the absence of antioxidant supplementation, the prolonged HBO treatment leads to a condition of oxidative stress that seems to affect in particular the response of the enzymatic antioxidant defense system; the possible relationship between the chemical modifications of the enzymes caused by oxygen reactive species and the consequent inactivation of the proteins is under investigation.


Accidental reinnervation as a complication of latissimus dorsi free flap to the face and scalp.
Although direct nerve neurotization is well known, accidental full reinnervation of a major muscle following microvascular transfer has not previously been reported. Our patient, who presented with total scalp loss, was initially treated with simple skin grafts. Repeated breakdowns over the years necessitated the use of more durable cover. A free latissimus dorsi muscle flap achieved this objective. Two years post-transfer it became evident that the whole of the latissimus dorsi had become innervated, producing facial and scalp distortion when the patient smiled. Formal exploration and section of both neural trunks to the latissimus dorsi was necessary to abolish this bizarre grimace.


Increasing age at time of pectus excavatum repair in children: emerging consensus?
Advances in surgical technique for pectus excavatum repair continue to change practice patterns. The present study examines trends in operative age in a nationwide administrative database. A cross-sectional descriptive analysis was performed using the Nationwide Inpatient Sample (NIS) and Kids' Inpatient Database (KID) data from 1998 to 2009. Pediatric discharges involving surgical repair of pectus excavatum were selected. Patients were sub-grouped by age at operation and calendar year of repair for further comparison. A total of 5830 elective admissions were identified that met inclusion criteria. Mean age at operation was 13.5 years, and this increased from 11.8 years to 14.4 years over the period studied and was accompanied by narrowing of the interquartile range. Examined over groups of four calendar years, patient age at the time of repair was significantly higher in more recent years in both unadjusted and multivariate analyses (P < .001). The age at operation in this sample has steadily increased, with an accompanying decrease in variability. This is consistent with previous findings and with overall trends in patient selection reported in the literature. This selection pattern may reflect evolving consensus regarding optimal management of pectus excavatum and provide clinical guidance regarding appropriate referral and intervention.


Acute pulmonary oedema and hyperchloraemic metabolic acidosis following operative hysteroscopy using sodium chloride 0.9.
Fluid media including sodium chloride 0.9% are used during operative hysteroscopy to provide uterine distension and aid visualisation. Volume overload is a known complication of their use but is usually associated with long procedures or uterine tissue dissection. A previously well 40-year-old woman presented for hysteroscopy and evacuation of retained products of conception under general anaesthesia. On emergence, she developed respiratory compromise and a hyperchloraemic metabolic acidosis in keeping with acute pulmonary oedema induced by sodium chloride 0.9% fluid overload. Anaesthetists must remain vigilant during operative procedures using distension media. Additionally, they should be familiar with the clinical and metabolic manifestations consistent with systemic transfusion of such media.


Salt-tolerant bacteria enhance the growth of mung bean (Vigna radiata L.) and uptake of nutrients, and mobilize sodium ions under salt stress condition.
Salinity is one of the significant abiotic stresses that exert harmful effects on plant growth and crop production. It has been reported that the harmfulness of salinity can be mitigated by the use of salt-tolerant plant growth-promoting (PGP) bacteria. In this study, four bacteria were selected from a total of 30 cultures, based on salt-tolerant and PGP properties. The isolates were found to produce indole acetic acid (8.49-19.42 μg/ml), siderophore (36.04-61.77%), and solubilize potassium and inorganic phosphate. Identification based on 16S rRNA gene sequencing revealed that the isolates belonged to Cronobacter (two isolates) and Enterobacter (two isolates). Inoculation of PGP bacteria under 2 and 10% salinity stress showed enhanced plant growth parameters in Vigna radiata compared to both salinity and non-salinity control plants. The rate of germination (113.32-206.64%), root length (128.79-525.31%), shoot length (34.09-50.32%), fresh weight, and dry weight were 3-fold higher in bacteria-treated seeds than control plants. The estimation of chlorophyll (1-5-fold), carotenoids (1-4-fold), and proline content (3.65-14.45%) was also higher compared to control plants. Further, the bacterized seeds showed enhanced nitrogen and phosphorous uptake and mobilized sodium ions from roots to leaves. Overall the strains SS4 and SS5 performed well in both 2 and 10% salt-amended soils. These strains could be formulated as a bioinoculant to mitigate the salinity stress in salinized soils.


A Genetically Informed Cross-Lagged Analysis of Autistic-Like Traits and Affective Problems in Early Childhood.
A genetically informed cross-lagged model was applied to twin data to explore etiological links between autistic-like traits and affective problems in early childhood. The sample comprised 310 same-sex twin pairs (143 monozygotic and 167 dizygotic; 53 % male). Autistic-like traits and affective problems were assessed at ages 2 and 3 using parent ratings. Both constructs were related within and across age (r = 0.30-0.53) and showed moderate stability (r = 0.45-0.54). Autistic-like traits and affective problems showed genetic and environmental influences at both ages. Whereas at age 2, the covariance between autistic-like traits and affective problems was entirely due to environmental influences (shared and nonshared), at age 3, genetic factors also contributed to the covariance between constructs. The stability paths, but not the cross-lagged paths, were significant, indicating that there is stability in both autistic-like traits and affective problems but they do not mutually influence each other across age. Stability effects were due to genetic, shared, and nonshared environmental influences. Substantial novel genetic and nonshared environmental influences emerge at age 3 and suggest change in the etiology of these constructs over time. During early childhood, autistic-like traits tend to occur alongside affective problems and partly overlapping genetic and environmental influences explain this association.


Prenatal high salt diet increases blood pressure and salt retention in the spontaneously hypertensive rat.
1. An examination was made of the effect of prenatal, high salt (5% w/w) and low salt (0.1% w/w) diet on the blood pressure and ability to excrete a salt load of mature spontaneously hypertensive rats (SHR) of the Okamoto strain maintained on normal salt (0.8% w/w) diet after weaning. 2. Prenatal high salt diet resulted in a significant exacerbation of the hypertension of 4 month old SHR when compared with animals given prenatal low salt diet. 3. Three month old SHR given prenatal, high salt diet exhibited a significantly reduced Na+ excretion following a single, oral salt load (150 mmol/l, 1% bodyweight) when compared with the low salt group. 4. Thus, prenatal, high salt diet may influence body fluid homeostasis in genetically susceptible individuals later in life.


A comparative review of the mineralogical and chemical composition of African major bauxite deposits.
Bauxite, which is the main raw material that aluminium is extracted from was discovered in Africa in the early 1900s. Currently, the production and export capacities of the African Bauxite ore are about a third of the World's total capacity. However, the processes leading to the final finished product of; surface mining of the ore, refining ore into alumina and finally extracting the pure aluminium metal in high energy consuming smelters that employ the Hall-Héroult electrolysis process; seldom take place inside Africa. The main goal of this work is to analyse the mineralogical and geochemical characteristics of bauxite deposits from some prominent bauxite producing and exporting countries of Africa in order to fashion out if a trend exist for the type of source rocks. Judging from the data obtained, gibbsite is found to be the main aluminium oxide in all the bauxite deposits with slight occurrence of boehmite in 3 out of the 13 deposits, while goethite is the main oxyhydroxide iron mineral. The compiled results of the various investigations highlighted the fact that the deposits are of diverse qualities with respect to world standard of major element content of bauxite; with average percentage concentration in the ranges as: Al2O3 (43.73-61.25), Fe2O3 (1.55-34.25), SiO2 (0.42-10.84); except two of the deposits with alumina content less than 40%. With evaluated silica moduli less than 8 for only two (2) of the deposits (4.76 and 6.94), the rest have higher moduli that ranges between (14.49 and 75.45). The higher percentage of iron oxide content (>20) in six (6) out of the 13 ore deposits, allowed the deposits to be grouped into three (3) categories of grades; high alumina ore, ferruginous ore, siliceous ore and combination of each. Source rock of the deposits were determined through geochemical and petrographic considerations of laterisation products of the rocks through evaluation of the weathering indices of; Chemical Index of Alteration which was in the range (97.16-99.98) while the Ruxton ratio ranged between (0.0133-0.2100); signifying the parent rock underwent intensive weathering process. This is indicative of the source rocks of the Bauxite deposits being either (i) anorthositic, (ii) argillite and dolerite, (iii) granulite and feldspathic gneiss, and/or, (iv) mafic-basaltic andesite igneous. Awareness of new and yet-to-commence emerging bauxite producing African countries was created, by highlighting the economic impact those respective countries will experience when that mining sector is developed for the aluminum industry at home and world at large.


Jejunal pouch interposition with fundic-like plication after total gastrectomy.
We developed a technique of jejunal pouch interposition with a fundic-like jejunal plication (JPI-FP) for reconstruction after total gastrectomy (TG) for gastric cancer. The aim of this study was to investigate the advantages of JPI-FP over Roux-en-Y reconstruction (R-Y). Twenty-two patients who had undergone TG more than 1 year earlier were classified into two groups according to the method of reconstruction used: Group A (n = 7) underwent R-Y, and group B (n = 15) underwent JPI-FP. Group B was subdivided into two groups to examine the usefulness of additional pylorus preservation: group B1 (n = 8), pylorus (-) and group B2 (n = 7), pylorus (+). Food intake and body weight were significantly higher in group B than in group A (P < 0.05). Reflux esophagitis was diagnosed in two of the group A patients, but in none of the group B patients. Excessive esophageal bile exposure, determined as the fraction time of esophageal bilirubin absorbance over 0.14 > 50%, was significantly higher in group A than in group B (P < 0.05). There was no significant difference in bile exposure in the jejunal pouch between groups B1 and B2. JPI-FP is a superior method of reconstruction after TG to prevent excessive esophageal bile reflux and from a nutritional aspect. The advantage of pylorus preservation remains unconfirmed.


Transient, activity dependent inhibition of transmitter release from low threshold afferents mediated by GABAA receptors in spinal cord lamina III/IV.
Presynaptic GABAA receptors (GABAARs) located on central terminals of low threshold afferent fibers are thought to be involved in the processing of touch and possibly in the generation of tactile allodynia in chronic pain. These GABAARs mediate primary afferent depolarization (PAD) and modulate transmitter release. The objective of this study was to expand our understanding of the presynaptic inhibitory action of GABA released onto primary afferent central terminals following afferent stimulation. We recorded evoked postsynaptic excitatory responses (eEPSCs and eEPSPs) from lamina III/IV neurons in spinal cord slices from juvenile rats (P17-P23, either sex), while stimulating dorsal roots. We investigated time and activity dependent changes in glutamate release from low threshold A fibers and the impact of these changes on excitatory drive. Blockade of GABAARs by gabazine potentiated the second eEPSC during a train of four afferent stimuli in a large subset of synapses. This resulted in a corresponding increase of action potential firing after the second stimulus. The potentiating effect of gabazine was due to inhibition of endogenously activated presynaptic GABAARs, because it was not prevented by the blockade of postsynaptic GABAARs through intracellular perfusion of CsF. Exogenous activation of presynaptic GABAARs by muscimol depressed evoked glutamate release at all synapses and increased paired pulse ratio (PPR). These observations suggest that afferent driven release of GABA onto low threshold afferent terminals is most effective following the first action potential in a train and serves to suppress the initial strong excitatory drive onto dorsal horn circuitry.


Taurine potentiates presynaptic NMDA receptors in hippocampal Schaffer collateral axons.
We have previously shown that activation of presynaptic N-methyl-d-aspartate (NMDA) receptors (NMDAR) enhances the amplitude of the presynaptic fibre volley (FV) evoked in Schaffer collateral axons of rat hippocampal slices, by a mechanism independent of extracellular Ca(2+). Here we compared the pharmacological characteristics of presynaptic NMDARs affecting axon excitability (activated by 10-300 microM NMDA for 10 min), with those mediating field excitatory postsynaptic potentials (NMDA-fEPSP). We found that NMDA-induced potentiation was completely inhibited by NVP-AAM077, an antagonist of NR2A-containing NMDAR, but not by ifenprodil, an NR2B-selective antagonist. The inhibitor of the glycine-binding site in NMDARs, 7-clorokynurenic acid (7-CK), was more potent against NMDA-fEPSP (IC(50) = 6.3 +/- 1.3 microM) than against the NMDA-induced FV potentiation (IC(50) = 26.5 +/- 1.3 microM). Moreover, both post- and presynaptic NMDAR-mediated phenomena were enhanced by glycine and d-serine, but taurine, an endogenous analogue of glycine, only enhanced the latter (EC(50) = 19 microM). Taurine was able to block the inhibitory effect of low doses of 7-CK on NMDA-induced FV potentiation, while glycine and d-serine only reduced the effects of higher concentrations of this drug. Surprisingly, the enhancing effect of taurine on NMDA-induced FV potentiation was blocked when it was co-applied with glycine. Furthermore, the glutamate released synaptically with a train of stimuli also increased FV amplitude by a mechanism dependent on NMDARs; this was potentiated by taurine but not by co-application of taurine and glycine. These results reveal that presynaptic NMDARs have unique properties that mediate the facilitation of axon excitability.


Manganese superoxide dismutase (SOD2) inhibits radiation-induced apoptosis by stabilization of the mitochondrial membrane.
To define the molecular pathways involved in radiation-induced apoptosis and the role of the mitochondria, 32D cl 3 hematopoietic cells and subclones overexpressing either the human manganese superoxide dismutase (SOD2) transgene (1F2 and 2C6) or BCL2L1 (also known as Bcl-xl) transgene (32D-Bcl-xl) were compared for their response to radiation at the subcellular level, comparing nuclear to mitochondrial localized pathways. All cell lines showed complete detectable DNA repair by 30 min after irradiation, and clearly delayed migration of BAX and active stress-activated protein (SAP) kinases MAPK1 (also known as p38) and MAPK8 (also known as JNK1) to the mitochondria at 3 h. Radioresistant clonal lines 1F2, 2C6 and 32D-Bcl-xl showed significant decreases in mitochondrial membrane permeability, cytochrome C release, caspase 3 and poly(adenosine diphosphate-ribose) polymerase (PARP) activation at 6-12 h, and in apoptosis at 24 h. Since the nuclear-to-cytoplasm events preceding the release of cytochrome C were similar in all cell lines, and increased expression of either the SOD2 or the BCL2L1 transgene provided radiation protection, we conclude that events at the level of the mitochondria are critically involved in radiation-induced apoptosis.


Congenital stridor: unusual manifestation of coarctation of the aorta.
Coarctation of the aorta is a relatively common congenital condition. Most infantile presentations of aortic coarctation are related to the associated congenital cardiac abnormalities leading to congestive heart failure or systemic hypoperfusion. We describe a 4-month-old infant who presented with stridor as the sole manifestation of coarctation. Radiologic studies revealed enlarged innominate artery due to the aortic coarctation that resulted in tracheal compression. After surgical correction, respiratory signs and symptoms completely resolved. This case report describes a unique cause of stridor in newborn infants and discusses the potential for vascular anomalies to result in tracheal narrowing.


Bladder cancer risk and personal hair dye use.
Several cohort and case-control studies have found an increased risk of bladder cancer among hairdressers and barbers who are occupationally exposed to hair dyes. However, the carcinogenic risk associated with personal use of hair dyes remains uncertain since several large case-control and cohort studies did not find an association between personal hair dye use and bladder cancer. To address this question, the authors used data collected on 459 bladder cancer cases and 665 controls who were interviewed as part of a case-control study conducted in New Hampshire between 1994 and 1998. Participants underwent a structured personal interview with regard to history of hair dye use and bladder cancer risk factors. Unconditional logistic regression analysis was used to compute odds ratios that were associated with hair dye use, while controlling for potential confounding factors. A history of any hair dye use was inversely associated with bladder cancer incidence in men [adjusted odds ratio (OR) = 0.5; 95% confidence interval (CI)=0.3-0.8], although risk reductions were not statistically significant for individual dye types. In women, use of permanent (adjusted OR = 1.5; 95%CI = 0.8-2.7) and rinse-type hair dye (adjusted OR = 1.7; 95%CI = 0.8-3.6) were associated with a modestly elevated risk of bladder cancer but with limited statistical precision; no association was found with use of semi-permanent dyes (adjusted OR = 0.7; 95%CI = 0.3-1.4). For permanent hair dye use, odds ratios were most pronounced for younger age at first use, higher frequency and prolonged time since first use; however there were no clear trends in risk by these factors. In light of the prevalence of hair dye use, further studies are needed that address the effects of specific colors and types of hair dyes along with the possible role of individual susceptibility.


Sonographic evaluation of the spleen among sickle cell disease patients in a teaching hospital in Nigeria.
Regional variations in size and parenchyma echo-texture of the spleen among sickle cell disease (SCD) patients have been documented in various publications. The objectives of this study were to assess the size and parenchyma echo-texture of the spleen of SCD patients and ascertain the relationship of age, height and weight with the spleen sizes. This was a cross sectional study involving 103 each of SCD and age matched control subjects. Aloka ST- 550 -3500 ultrasound machine with 3.5 and 5 MHz convex transducers was used to scan the subjects over a 15 months period (September, 2012 to November, 2013). The age, height and weight of each subject were recorded. The spleen sizes of SCD patients were generally larger than those of the controls (p < 0.05). Abnormal spleen parenchyma of varied appearances was found among the SCD subjects. There were negative correlations between mean spleen sizes and height, weight and age in SCD patients but positive correlations were found between them in the controls. Routine sonographic assessment of spleen size and echo-texture is useful in the management of SCD patients.


Structural Features that Distinguish Inactive and Active PI3K Lipid Kinases.
PI3K lipid kinases signal through the PI3K/Akt pathway, regulating cell growth and proliferation. While the structural features that distinguish between the active and inactive states of protein kinases are well established, that has not been the case for lipid kinases, and neither was the structural mechanism controlling the switch between the two states. Class I PI3Ks are obligate heterodimers with catalytic and regulatory subunits. Here, we analyze PI3K crystal structures. Structures with the nSH2 (inactive state) are featured by collapsed activation loop (a-loop) and an IN kinase domain helix 11 (kα11). In the active state, the a-loop is extended and kα11 in the OUT conformation. Our analysis suggests that the nSH2 domain in the regulatory subunit regulates activation, catalysis and autoinhibition through the a-loop. Inhibition, activation and catalytic scenarios are shared by class IA PI3Ks; the activation is mimicked by oncogenic mutations and the inhibition offers an allosteric inhibitor strategy.


Nursing care for patients with Kounis syndrome.
Kounis syndrome (KS) is defined as the occurrence of a coronary event secondary to a severe allergic reaction. This syndrome is described as poorly known, underdiagnosed and with a low prevalence whose aetiology is difficult to know due to the large number of causative agents. The objective is to create an individualized care plan for a patient with Kounis syndrome. The nursing assessment was performed on admission using Virginia Henderson's need theory. A care plan was developed following the NANDA-NOC-NIC taxonomy. After the planning and execution phase, the proposed activities were evaluated, thus verifying that the objectives had been achieved.


Complex cervical spondylotic myelopathy: a report of two cases and literature review.
A report of two cases with complex cervical spondylotic myelopathy (CSM) and review of the literature. To describe two unique patients with complex CSM due to simultaneous anomalies as anteroposterior compressions of the spinal cord in both upper and lower cervical spine, caused by hypertrophic transverse ligament of atlas (TLA), dysplasia of the posterior arch of atlas, disc herniation, hypertrophic ligamentum flavum and osteophytes. We present such two cases with clinical, imageological presentations, and describe the surgical procedure, to which both patients responded favorably. The neurological functions of both patients gradually improved according to the JOA scores and VAS scores in preoperative clumsiness and gait disturbance during the mean follow-up period lasted for 18 months. The latest plain radiographs and computed tomography (CT) revealed good fusion without instrumental failure and magnetic resonance imaging (MRI) showed good decompression of C1-7 spinal cord of both patients. Both patients are progressively followed-up. Posterior surgical approach as C1-7 laminectomy with fixations or occipital-cervical fusions may obtain better reconstructions of the cervical spine and good neurological recovery for the patients with complex CSM we present. However, the incidence and ethnic predisposition for the patients with complex CSM are still unclear.


Amplification of serotonin-induced contractions of isolated porcine coronary arteries after pretreatment with therapeutic doses of beta-methyldigoxin.
The present experiments demonstrate that after pretreatment of isolated porcine coronary arteries with therapeutic (2.5 X 10(-9) M) was well as with toxic (10(-6) M) doses of beta-methyldigoxin the serotonin-induced contractions were significantly amplified. Since serotonin released from destroyed thrombocytes may be one of the triggering factors eliciting coronary spasms, caution must be taken in the use of digitalis in coronary disease of spastic origin.


Hepatic cancers and their response to chemoembolization therapy. Quantitative image-guided 31P magnetic resonance spectroscopy.
Hepatic embolization combined with intra-arterial administration of cytostatic drugs (chemoembolization) is frequently used to treat primary and metastatic cancers to the liver. Quantitative phosphorus-31 magnetic resonance spectroscopy (31P MRS) was used to assess the metabolic state of hepatic cancers and their metabolic response to chemoembolization. Fifteen localized 31P MRS studies were performed on five patients with liver tumors. Thirteen healthy volunteers served as controls. Metabolite ratios and molar metabolite concentrations were calculated. Untreated hepatic tumors, relative to normal controls, showed elevated phosphomonoester/adenosine triphosphate (PME/ATP) ratios, reduced concentrations of ATP and inorganic phosphate (Pi), and normal phosphodiester (PDE) concentrations. As an acute response to chemoembolization, ATP, PME, and/or PDE concentrations diminished, whereas Pi concentrations increased or stayed relatively constant. Long-term follow-up after chemoembolization showed decreased PME/ATP and increased ATP concentrations in the absence of changes on standard magnetic resonance and computed tomographic images. These preliminary spectroscopic data suggest that quantitative 31P MRS can be successfully used to monitor directly metabolic response to hepatic chemoembolization.


Adherence to prescribed medications for chronic illnesses among older adults in a rural community, Karnataka, India.
To assess adherence to prescribed medications for chronic illnesses and to identify factors associated with it among rural older adults. A cross-sectional study was carried out from September to November 2011 in three subcenters in Lakkur PHC, Kolar District, India. All older adults were listed, and those suffering from chronic non-communicable diseases were included in the study. A structured interview schedule comprising of 48 items was used to measure adherence, and to identify factors associated with adherence in the domains of socioeconomic status, therapy, health systems, patient behavior and physical factors. Of the 184 older adults included in the study, 63.6% were fully adherent to their medication. Non-adherence to medication showed a statistically significant relationship with the absence of a medical store within their village, non-availability of drugs at the nearest medical store, inability to understand the doctor's language, failure to explain the consequences of not taking medicines by the healthcare provider, self-alteration of medicine dosage, fear that medicines will lead to the development of dependence to medicines and difficulty in swallowing. Those who led busy lives, those who had been prescribed three or more types of medicines prescribed per day, those who required special skills to take medicines (injections, inhalers), those who had made adjustments to their usual lifestyle to take medicines and those who had knowledge that medicines need to be taken lifelong were more likely to be adherent to their medications. Four factors, namely, the doctor explaining the consequences of not taking medicines, altering the dosage of the medicines by the patients themselves, the number of medicines prescribed per day and having the knowledge that medicines need to be taken lifelong, were critical determinants of adherence to medications. Geriatr Gerontol Int 2016; 16: 1339-1345.


Patterns of recurrent preterm birth in Western Australia: A 36-year state-wide population-based study.
It is known that a previous preterm birth increases the risk of a subsequent preterm birth, but a limited number of studies have examined this beyond two consecutive pregnancies. This study aimed to assess the risk and patterns of (recurrent) preterm birth up to the fourth pregnancy. We used Western Australian routinely linked population health datasets to identify women who had two or more consecutive singleton births (≥20 weeks gestation) from 1980 to 2015. A log-binomial model was used to calculate risk ratios (RRs) and 95% confidence interval (CIs) for preterm birth risk in the third and fourth deliveries by the combined outcomes of previous pregnancies. We analysed 255 435 women with 651 726 births. About 7% of women had a preterm birth in the first delivery, and the rate of continuous preterm birth recurrence was 22.9% (second), 44.9% (third) and 58.5% (fourth) deliveries. The risk of preterm birth at the third delivery was highest for women with two prior indicated preterm births (RR 12.5, 95% CI: 11.3, 13.9) and for those whose first pregnancy was 32-36 weeks gestation, and second pregnancy was less than 32 weeks gestation (RR 11.8, 95% CI: 10.3, 13.5). There were similar findings for the second and fourth deliveries. Our findings demonstrate that women with any prior preterm birth were at greater risk of preterm birth in subsequent pregnancies compared with women with only term births, and the risk increased with shorter gestational length, and the number of previous preterm deliveries, especially sequential ones.


A quality assessment of genetic association studies supporting susceptibility and outcome in acute lung injury.
Clinical observations and animal models provide evidence that the development of acute lung injury (ALI), a phenomenon of acute diffuse lung inflammation in critically ill patients, is influenced by genetic factors. Association studies are the main tool for exploring common genetic variations underlying ALI susceptibility and/or outcome. We aimed to assess the quality of positive genetic association studies with ALI susceptibility and/or outcome in adults in order to highlight their consistency and major limitations. We conducted a broad PubMed literature search from 1996 to June 2008 for original articles in English supporting a positive association (P < or = 0.05) of genetic variants contributing to all-cause ALI susceptibility and/or outcome. Studies were evaluated based on current recommendations using a 10-point quality scoring system derived from 14 criteria, and the gene was considered as the unit of replication. Genes were also categorized according to biological processes using the Gene Ontology. Our search identified a total of 29 studies reporting positive findings for 16 genes involved mainly in the response to external stimulus and cell signal transduction. The genes encoding for interleukin-6, mannose-binding lectin, surfactant protein B, and angiotensin-converting enzyme were the most replicated across the studies. On average, the studies had an intermediate quality score (median of 4.62 and interquartile range of 3.33 to 6.15). Although the quality of association studies seems to have improved over the years, more and better designed studies, including the replication of previous findings, with larger sample sizes extended to population groups other than those of European descent, are needed for identifying firm genetic modifiers of ALI.


Is it necessary to diagnose levator avulsion on pelvic floor muscle contraction?
Avulsion of the levator ani muscle commonly occurs at vaginal birth. This condition is usually diagnosed by translabial ultrasound (TLUS) during pelvic floor muscle contraction (PFMC). Some patients are unable to achieve a satisfactory PFMC and in these cases avulsion is assessed at rest. The aim of this study was to validate the diagnosis of levator avulsion by means of TLUS at rest. This was a retrospective study of 233 women seen at a tertiary urogynecological center. All women underwent four-dimensional TLUS in the supine position and after voiding. Volumes were obtained on maximal PFMC and at rest. Analysis of the volumes was performed with the observer blinded against all clinical data. Avulsion was defined as an abnormal levator ani muscle insertion that was visible in at least three consecutive axial plane slices, at and above the level of minimal hiatal dimensions, at 2.5-mm intervals. We examined the correlation between both assessment methods using Cohen's kappa coefficient and tested the association of each method with female pelvic organ prolapse on clinical examination, organ descent on ultrasound and hiatal ballooning. In total, datasets from 202 women were available for analysis. The correlation between a diagnosis of avulsion in volumes obtained at rest and those on PFMC was moderate, with a kappa value of 0.583 (95% CI, 0.484-0.683). Agreement for defects visualized on single slices was moderate, with a kappa value of 0.556 (95% CI, 0.520-0.591). When avulsion diagnoses at rest and on PFMC were tested against symptoms of prolapse, and prolapse on clinical examination and on ultrasound, neither of the two methods was superior. Although tomographic ultrasound imaging during PFMC enhances tissue discrimination, this may not translate to superior diagnostic performance. Hence, volumes obtained at rest may be used in women unable to contract their pelvic floor. The diagnosis of levator avulsion by tomographic pelvic floor ultrasound is equally valid when performed at rest or on PFMC. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.


Periodontitis prevalence and severity in an African population: A cross-sectional study in the Greater Accra Region of Ghana.
Periodontitis is a major public health problem affecting many adults, with considerable variation in its prevalence and severity worldwide. There is little data on its prevalence or associated risk factors in Ghana making development of evidence based preventive programs challenging. This study assessed the prevalence, severity, extent, and associated risk factors of periodontitis in an adult Ghanaian population. A population based cross-sectional study involving adults aged ≥25 years in the Greater Accra Region (GAR) of Ghana. A random stratified two-stage sampling method was used to select participants from rural and urban communities. Data on sociodemographic and risk factors were collected using a semi-structured questionnaire. A full-mouth periodontal examination was performed to diagnose and describe the severity of periodontitis following the CDC-AAP case definition. A total of 729 participants were included in the study, with a mean age of 43.9 ± 14.6 years and 61% being female. Majority (84.8%) presented with gingivitis, 46.7% had periodontitis with 41.8% having both, and 13.9% had severe periodontitis. The mean clinical attachment loss (AL) was 1.36 ± 0.67 mm and 1.41 ± 0.57 mm for probing depth (PD). Factors associated with periodontitis included, increasing age, smoking, and alcohol use; being Muslim provided lower odds of disease. Older people, former smoking, being underweight and not having health insurance were associated with severe periodontitis. This study shows a high burden of periodontitis with comparatively more severe disease. Existing sociodemographic disparities in disease burden highlights the need of developing targeted population based preventive programs.


Arthroscopic Bankart repair with peeling osteotomy of the anterior glenoid rim preserves glenoid morphology.
A decrease in the glenoid size after arthroscopic Bankart repair (ABR) was common in shoulders without osseous fragments compared with those with osseous fragments. For cases of chronic recurrent traumatic anterior glenohumeral instability without osseous fragments, we have performed ABR with peeling osteotomy of the anterior glenoid rim (ABRPO) to make an intentional osseous Bankart lesion. The aim of this study was to compare the glenoid morphology after ABRPO with it after simple ABR. The medical records of patients who underwent arthroscopic stabilization for chronic recurrent traumatic anterior glenohumeral instability were retrospectively reviewed. Patients with an osseous fragment, with revision surgery and without complete data were excluded. Patients were assigned to 1 of 2 groups: Group A, ABR without peeling osteotomy procedure or Group B, with ABRPO procedure. Computed tomography was performed preoperatively and 1 year after surgery. The size of the glenoid bone loss was investigated by the assumed circle method. The following formula was used to calculate the decreased size of the glenoid: (Δ) = (postoperative size of the glenoid bone loss) - (preoperative size of the glenoid bone loss). The size of the glenoid 1 year after surgery was assessed to determine if it had decreased (Δ > 0%) or not decreased (Δ ≤ 0%) relative to the preoperative size. This study evaluated 39 shoulders divided into 2 groups: 27 shoulders in Group A and 12 shoulders in Group B. In Group A, postoperative glenoid bone loss was significantly greater than preoperative glenoid bone loss (7.8 ± 6.2 vs. 5.5 ± 5.3, respectively, P = .02). In Group B, postoperative glenoid bone loss was significantly lower than preoperative glenoid bone loss (5.6 ± 5.4 vs. 8.7 ± 4.0, respectively, P = .02). The P value for the interaction of group (A or B) × time (preoperative or postoperative) was 0.001. The decreased size of the glenoid was significantly larger in Group A than in Group B (2.1 ± 4.2 vs. -3.1 ± 4.5, respectively, P = .001). The rate of shoulders in which the size of the glenoid decreased 1 year after surgery relative to the preoperative size was significantly higher in Group A than in Group B (63% [17/27] vs. 25% [3/2], respectively, P = .04). The study showed that ABRPO preserved the glenoid size better than simple ABR without a peeling osteotomy procedure.


Primary essential cutis verticis gyrata--a case report.
Cutis verticis gyrata (CVG) is a skin deformity characterised by excessive growth of the skin of the scalp, resulting in furrows and folds which are similar to gyri of the brain cortex. CVG can be classified into two forms: 'primary' (essential and non-essential) and 'secondary'. The primary non-essential type is associated with the neurological and ophthalmological changes, while the primary essential form does not present any other disorder except for the cutaneous alterations. Secondary forms of CVG are much more frequent and accompany other pathologies. The treatment consists of local hygiene and surgical resection of skin excess. This study reports a case of CVG of the primary essential type in a male patient, who was referred to us for a surgical treatment.


Proposal for a Lorenz qubit.
Nonlinear qubit master equations have recently been shown to exhibit rich dynamical phenomena such as period doubling, Hopf bifurcation, and strange attractors usually associated with classical nonlinear systems. Here we investigate nonlinear qubit models that support tunable Lorenz attractors. A Lorenz qubit could be realized experimentally by combining qubit torsion, generated by real or simulated mean field dynamics, with linear amplification and dissipation. This would extend engineered Lorenz systems to the quantum regime, allowing for their direct experimental study and possible application to quantum information processing.


The uncertainty of UTCI due to uncertainties in the determination of radiation fluxes derived from numerical weather prediction and regional climate model simulations.
In this study we examine the determination accuracy of both the mean radiant temperature (Tmrt) and the Universal Thermal Climate Index (UTCI) within the scope of numerical weather prediction (NWP), and global (GCM) and regional (RCM) climate model simulations. First, Tmrt is determined and the so-called UTCI-Fiala model is then used for the calculation of UTCI. Taking into account the uncertainties of NWP model (among others the HIgh Resolution Limited Area Model HIRLAM) output (temperature, downwelling short-wave and long-wave radiation) stated in the literature, we simulate and discuss the uncertainties of Tmrt and UTCI at three stations in different climatic regions of Europe. The results show that highest negative (positive) differences to reference cases (under assumed clear-sky conditions) of up to -21°C (9°C) for Tmrt and up to -6°C (3.5°C) for UTCI occur in summer (winter) due to cloudiness. In a second step, the uncertainties of RCM simulations are analyzed: three RCMs, namely ALADIN (Aire Limitée Adaptation dynamique Développement InterNational), RegCM (REGional Climate Model) and REMO (REgional MOdel) are nested into GCMs and used for the prediction of temperature and radiation fluxes in order to estimate Tmrt and UTCI. The inter-comparison of RCM output for the three selected locations shows that biases between 0.0 and ±17.7°C (between 0.0 and ±13.3°C) for Tmrt (UTCI), and RMSE between ±0.5 and ±17.8°C (between ±0.8 and ±13.4°C) for Tmrt (UTCI) may be expected. In general the study shows that uncertainties of UTCI, due to uncertainties arising from calculations of radiation fluxes (based on NWP models) required for the prediction of Tmrt, are well below ±2°C for clear-sky cases. However, significant higher uncertainties in UTCI of up to ±6°C are found, especially when prediction of cloudiness is wrong.


3-D Ultrasound Imaging Reliability of Measuring Dysplasia Metrics in Infants.
Developmental dysplasia of the hip is a hip abnormality that ranges from mild acetabular dysplasia to irreducible femoral head dislocations. While 2-D B-mode ultrasound (US)-based dysplasia metrics or disease metrics are currently used clinically to diagnose developmental dysplasia of the hip, such estimates suffer from high inter-exam variability. In this work, we propose and evaluate 3-D US-derived dysplasia metrics that are automatically computed and demonstrate that these automatically derived dysplasia metrics are considerably more reproducible. The key features of our automatic method are (i) a random forest-based learning technique to remove regions across the coronal axis that do not contain bone structures necessary for dysplasia-metric extraction, thereby reducing outliers; (ii) a bone segmentation method that uses rotation-invariant and intensity-invariant filters, thus remaining robust to signal dropout and varying bone morphology; (iii) a novel slice-based learning and 3-D reconstruction strategy to estimate a probability map of the hypoechoic femoral head in the US volume; and (iv) formulae for calculating the 3-D US-derived dysplasia metrics. We validate our proposed method on real clinical data acquired from 40 infant hip examinations. Results show a considerable (around 70%) reduction in variability in two key 3-D US-derived dysplasia metrics compared with their 2-D counterparts.


Feeding intolerance in the preterm infant.
Feeding intolerance (FI), defined as the inability to digest enteral feedings associated to increased gastric residuals, abdominal distension and/or emesis, is frequently encountered in the very preterm infant and often leads to a disruption of the feeding plan. In most cases FI represents a benign condition related to the immaturity of gastrointestinal function, however its presentation may largely overlap with that of an impending necrotizing enterocolitis. As a consequence, individual interpretation of signs of FI represents one of the most uncontrollable variables in the early nutritional management of these infants, and may lead to suboptimal nutrition, delayed attainment of full enteral feeding and prolonged intravenous nutrition supply. Strategies aimed at preventing and/or treating FI are diverse, although very few have been validated in large RCT and systematic reviews. The purpose of this paper is to summarize the existing information on this topic, spanning from patho-physiological and clinical aspects to the prevention and treatment strategies tested in clinical studies, with specific attention to practical issues.


Acupuncture as an adjunct to standard treatment for pelvic girdle pain in pregnant women: randomised double-blinded controlled trial comparing acupuncture with non-penetrating sham acupuncture.
To investigate whether acupuncture has a greater treatment effect than non-penetrating sham acupuncture in women with pelvic girdle pain (PGP) during pregnancy. Randomised double-blinded controlled trial. East Hospital, Gothenburg, and 25 antenatal primary care units in the region of Västra Götaland, Sweden. A total of 115 pregnant women with a clinical diagnosis of PGP who scored > or =50 on a 100-mm visual analogue scale (VAS). Women were randomly allocated to standard treatment plus acupuncture or to standard treatment plus non-penetrating sham acupuncture for 8 weeks. Main outcome measure was pain. Secondary outcomes were frequency of sick leave, functional status, discomfort of PGP, health-related quality of life and recovery of severity of PGP as assessed by the independent examiner. After treatment, median pain decreased from 66 to 36 in the acupuncture group and from 69 to 41 in the non-penetrating sham group (P = 0.493) as assessed on a VAS. Women in the acupuncture group were in regular work to a higher extent than women in the sham group (n = 28/57 versus 16/57, P = 0.041). The acupuncture group had superior ability to perform daily activities measured with the disability rating index (DRI) (44 versus 55, P = 0.001). There were no significant differences in quality of life, discomfort of PGP and recovery from severity of PGP between the groups. Acupuncture had no significant effect on pain or on the degree of sick leave compared with non-penetrating sham acupuncture. There was some improvement in performing daily activities according to DRI. The data imply that needle penetration contributes to a limited extent to the previously reported beneficial effects of acupuncture.


A porcine model of postoperative hemi-diaphragmatic paresis to evaluate a unilateral diaphragmatic pacemaker.
Unilateral phrenic nerve damage is a dreaded complication in congenital heart surgery. It has deleterious effects in neonates and children with uni-ventricular circulation. Diaphragmatic palsy, caused by phrenic nerve damage, impairs respiratory function, especially in new-borns, because their respiration depends on diaphragmatic contractions. Furthermore, Fontan patients with passive pulmonary perfusion are seriously affected by phrenic nerve injury, because diaphragmatic contraction augments pulmonary blood flow. Diaphragmatic plication is currently employed to ameliorate the negative effects of diaphragmatic palsy on pulmonary perfusion and respiratory mechanics. This procedure attenuates pulmonary compression by the abdominal contents. However, there is no contraction of the plicated diaphragm and consequently no contribution to the pulmonary blood flow. Hence, we developed a porcine model of unilateral diaphragmatic palsy in order to evaluate a diaphragmatic pacemaker. Our illustrated step-by-step description of the model generation enables others to replicate and use our model for future studies. Thereby, it might contribute to investigation and advancement of potential improvements for these patients.


Involvement of spinal PKA/CREB signaling pathway in the development of bone cancer pain.
It has been shown that spinal PKA/CREB signaling pathway is involved in neuropathic and inflammatory pain, but its effects on bone cancer pain have not previously been investigated. The aim of this study was to examine the potential role of the spinal PKA/CREB signaling pathway in the development of bone cancer pain. A bone cancer pain model was made by inoculation of Walker 256 cells into the intramedullary space of rat tibia. Western blot analysis examined the expression of PKAca (PKA catalytic subunit) and phospho-CREB (p-CREB) protein levels. The authors further investigated effects of intrathecal treatment with H-89 (a PKA inhibitor, 8 nmol) or forskolin (a PKA agonist, 10 nmol) on nociceptive behavior and the expression of PKAca and p-CREB. On days 6, 9, and 15 after inoculation, the expression of PKAca and p-CREB protein levels were higher in the bone cancer pain rats compared to the sham rats. On day 9, intrathecal administration of H-89 significantly attenuated bone cancer-induced mechanical allodynia as well as upregulation of PKAca and p-CREB protein levels. These effects were completely abolished by intrathecal pretreatment with the PKA agonist forskolin. The results suggest that the spinal PKA/CREB signaling pathway may participate in the development of bone cancer pain. The findings of this study may provide an evidence for developing novel analgesics to block bone cancer pain.


Investigation of pathology associated with Chlamydia pecorum infection in the male reproductive tract, and the effect on spermatogenesis and semen quality in the koala (Phascolarctos cinereus).
There is growing evidence that Chlamydia pecorum infection of the male koala reproductive tract causes inflammation and pathology of the urogenital tract. Previous studies have revealed that male koalas exhibiting severe clinical signs of urogenital chlamydial disease had an increased incidence of sperm DNA fragmentation and abnormal sperm morphology, suggestive of chronic exposure to C. pecorum infection and/or inflammation in the testis and epididymis, with residual pathology and lesions disrupting spermatogenesis and maturation of spermatozoa. This study specifically aimed to determine whether pathology associated with chlamydial infection in different regions of the male koala reproductive tract had an adverse effect on classical seminal parameters, sperm DNA quality and endocrine function (testosterone secretion) of naturally infected males. Semen from 58 sexually mature male koalas deemed not suitable for rehabilitation or treatment was assessed, in addition to undertaking a GnRH challenge to determine the androgenic capacity of the testis. Following euthanasia, tissue samples from testes, epididymis and prostate were evaluated for histopathology and real time polymerase chain reaction (qPCR). A significant difference in sperm concentration was observed between males with unilateral and bilateral testicular atrophy and C. pecorum infection (P = 0.011); and between males with unilateral atrophy and C. pecorum infection in one testis and bilateral normal testes with no C. pecorum infection (P = 0.008). No significant association was found for any other semen parameters when categorised by histopathology and C. pecorum tissue presence within the testes, epididymis and prostate. Plasma testosterone concentrations did not significantly differ between testicular histopathology diagnosis and/or C. pecorum infection status. This study suggests Chlamydia infection and inflammation may not be the predominant reason of disruption to spermatogenesis in the wild koala but rather testicular degeneration and atrophy, irrespective of Chlamydia infection, appears to be the primary reason of decreased sperm concentration.


Direct wet mounts versus concentration for routine parasitological examination: are both necessary?
The authors evaluated the usefulness of direct wet mount microscopic examination of stool samples for routine parasitologic diagnosis compared with formalin-ethyl acetate concentration detection. Over a three-year period, there were no instances in which an intestinal parasite was detected only by the direct wet mount examination. Elimination of routine direct wet mount examinations can reduce laboratory cost and save significant technologist time without decreasing the sensitivity of microscopic examinations for common parasitic agents.


[The enzymatic linkage of fibrinogenesis and fibrinolysis (author's transl)].
The coagulation cascade can be triggered by an extrinsic or intrinsic signal. The response is a highly complex activation sequence of several serine proteases. This physiological event of hemostasis comprises the activation of the kinin system as well as other plasma constituents. As an expression of the dynamic balance between fibrinogenesis and fibrinolysis plasminogen is activated either by proteases deriving from the blood clotting cascade or by its linkage to the kallikrein kinin system. Inhibitors of the fibrinolytic events have to be directed specifically against serine proteases or they may be used to interact with the substrate fibrin thus its degradation is delayed.


Location of paramagnetic defects in detonation nanodiamond from proton spin-lattice relaxation data.
We developed an approach for determining location of intrinsic paramagnetic defects in nanodiamonds from the data of proton spin-lattice relaxation of the surface hydrogen atoms. The approach was applied to the detonation nanodiamond (DND) of the diameter of 5 nm. We found that dangling bonds with unpaired electron spins are located within the near-surface belt at the distance of 0.3-0.9 nm from the DND surface. The NMR data are compared with the results of EPR measurements.


Enhancement of bile tolerance in lactococci by Tween 80.
The aim of this study is to clarify the effect of Tween 80 on bile tolerance of lactococci. Four out of the six strains of lactococci could grow in broth containing 0.3% bile in the presence of 1% Tween 80, but grew slightly or not at all in the absence of Tween 80. Growing with Tween 80 altered the fatty acid composition of all three strains tested, but it is not clear which fatty acid influences bile tolerance. Material that absorbed light at 260 nm leaked from the cells tested with bile, but the leakage was decreased by addition of 1% Tween 80. Coincidentally, the decrease in the cell count by exposure to bile was suppressed by addition of Tween 80. Tween 80 enhances bile tolerance of some strains of lactococci. It is clarified that Tween 80 in the broth contributes to the bile tolerance of lactococci by reducing the cellular leakage caused by bile.


Cardioprotective effect of transcutaneous electric acupoint stimulation in the pediatric cardiac patients: a randomized controlled clinical trial.
Acupuncture pretreatment exerts neuroprotective and cardioprotective effects in animal models and in adult patients underwent cardiac surgery; however, data in pediatric patient are unavailable. To investigate the effects of transcutaneous electric acupoint stimulation (TEAS) on acute myocardial injury from pediatric open-heart surgery. Children, aged 2-12 years, with congenital heart defects scheduled for surgical repair were enrolled. They were randomized to TEAS (administrated at bilateral P6 acupoint for 30 min after basal anesthesia) and control (an electrode was placed on the arm without stimulus) groups. The primary end point was serum cardiac troponin I (cTnI) over 24 h after aortic unclamping. Furthermore, clinical outcome and serum cytokine and C-reactive protein concentrations were evaluated. Seventy eligible children were analyzed, 36 in controls and 34 in TEAS group. Compared with controls, the mean cTnI levels were significantly lower in TEAS group at 8 h (P = 0.043) and 24 h (P = 0.046) after aortic unclamping. The duration of ventilation (P = 0.004) and length of ICU stay (P = 0.032) was significantly longer in controls than in TEAS group. There was a significant difference in the release of C-reactive protein at 8 h (P = 0.039) between two groups, whereas the values for cytokines were not significant. Transcutaneous electric acupoint stimulation on the bilateral P6 acupoint is effective for attenuation myocardial injury in children undergoing cardiac surgery. The beneficial effects may be partially associated with reduction in cTnI and C-reactive protein level in the early postoperative period.


NKG2D blockade significantly attenuates ischemia-reperfusion injury in a cardiac transplantation model.
NKG2D (natural killer group 2 member D), are activating or coactivating receptor on NK cells, γδ T, and CD8(+) T cells, stimulates cytokine secretion by the former two and plays a costimulatory role for the last CD8(+) T cells. Male Lewis rat hearts were flushed and stored in cold Bretschneider preservation solution for 8 hours. Anti-NKG2D monoclonal antibody (mAb) was administered before transplantation into syngeneic recipients. Expressions of Troponin-T, myeloperoxidase (MPO), tumor necrosis factor (INF), (ICAM) and interleukin (IL)-17 were examined on days 1, 3, and 7 after reperfusion. We observed that isografts from anti-NKG2D mAb-treated animals showed decreased cardiac troponin-T, low expression of MPO, TNF, and ICAM, and superior cardiac output. Furthermore, blockade of NKG2D significantly reduced the number of γδ T cells, which are the main source of IL-17 production. Blockade of NKG2D significantly attenuated ischemia-reperfusion injury in a cardiac transplantation model. The effect coincided with a low expression of TNFα, ICAM and a reduced number of infiltrating IL-17-producing γδ T cells.


Diastolic function and insulin resistance in essential hypertension.
We studied the relationship of insulin metabolism to diastolic function in 41 hypertensive patients and 24 healthy subjects. They underwent a 75-g oral glucose tolerance test. Integrated response of insulin to the glucose load was calculated as the area under the curve of insulin (AUC-I) and glucose (AUC-G). The ratio AUC-I/AUC-G was taken as an index of insulin resistance. Echocardiographic examination was performed to measure left ventricular mass. We used pulsed Doppler technique to assess the ratio of early to late transmitral peak velocity (E/A). The hypertensives had higher fasting insulin concentrations, insulin levels at 60 min and at 120 min after oral glucose load. They had higher AUC-I and higher index of insulin resistance compared to normotensives. Patients with hypertension had a lower E/A ratio in comparison to normotensive volunteers. In all subjects, the E/A ratio was negatively correlated with fasting insulin and insulin concentrations at 30, at 60 and at 120 min, AUC-I and insulin resistance index. Multiple regression analysis was performed to evaluate the above relationships, when the effects of confounding factors such as age, heart rate and systolic blood pressure were taken into account. We found that E/A ratio is negatively correlated to insulin concentrations at 120 min and to AUC-I in hyperinsulinemic subgroup of subjects (fasting insulin> 10). We conclude, that insulin metabolism and E/A ratio, which reflects diastolic function of the left ventricle, are related in hypertension.


Effects of moguisteine on the cough reflex induced by afferent electrical stimulation of the superior laryngeal nerve in guinea pigs.
The study aimed to further demonstrate the peripheral antitussive properties of moguisteine. Firstly, the antitussive effect of moguisteine on the cough reflex induced by inhalation of citric acid aerosol was evaluated in conscious guinea pigs. Secondly, the effects of both moguisteine and codeine on the centrally mediated cough reflex induced by afferent electrical stimulation of the superior laryngeal nerve were investigated in anesthetized guinea pigs. Moguisteine (2.5-10 mg/kg, intravenously, i.v.) reduced the cough reflex induced by 7.5% citric acid aerosol in a dose-dependent manner, with an ED50 value of 0.55 mg/kg. Both i.v. (0.5-4 mg/kg) and intracerebroventricular (i.c.v., 5-20 microg) injection of codeine dose dependently inhibited the cough reflex induced by afferent electrical stimulation of the superior laryngeal nerve; the ED50 values were 0.91 mg/kg and 7.90 microg, respectively. The inhibitory effect of codeine (4 mg/kg i.v.) was abolished by pretreatment with naloxone (2 mg/kg intraperitoneally). In contrast to codeine, neither i.v. (4 and 20 mg/kg) nor i.c.v. (20 microg) injection of moguisteine affected the cough reflex. These results suggest that the antitussive effect of codeine is mediated by central opioid mechanisms, whereas the antitussive effect of moguisteine is mediated by peripheral mechanisms.


Molecular keypad controlled circuit for Ce(iii) and NO3 - ions recognition by μw synthesized silicon-embedded organic luminescent sensor.
This report demonstrates the mimicking of an electronic circuit diagram towards Ce(iii) ion sensing response supported by molecular keypads. The probe naphthyl based triazole linked silatrane (NTS) was efficiently synthesized using a series of microwave mediated reactions. The luminescent sensor NTS was explored for the ion sensing response towards Ce(iii) ions using DMSO and DMSO : H2O 4 : 1 (v/v) as solvent media, respectively. The role of water in Ce(iii) ion sensing was detected as 'turn-off' response that contradicts the 'turn-on' with DMSO. Further, the sensing of NO3 - ions by NTS-Ce(iii) ensemble was associated with blue shift on absorption maxima. These mimicking response studies were sketched as circuit diagrams assisted by molecular keypad behaviour as IMPLICATION output logic gate.


[The anti-allergic activity and mechanism of action of gamma-carboline derivatives].
The antianaphylactic effect of new antihistaminic agents by derivatives of gamma-carboline dimebon and meraboin was studied by the method of passive cutaneous anaphylaxis. It was found that the agents in a dose amounting to 10% of LD50 possessed a high anaphylactic activity which did not correlate with the degree of their antihistaminic effect. During in vitro experiments the mechanism of action of dimebon and meraboin can be conditioned also by their ability to decrease histamine release from mast cells and to reduce the activity of cAMP-dependent phosphodiesterase.


Rabbit manure compost as a peat substitute for compound growing media: Proportioning optimization according to physiochemical characteristics and seedling effects.
A large amount of rabbit manure is produced with the development of the rabbit industry, which will cause environmental pollution without proper treatment. Rabbit manure compost may be suitable for seedling cultivation, considering its low moisture, low heavy metal, high lignocellulose, and good fertilizer effect. In this study, a pre-proportioning test of growing media was conducted to optimize the ratio of perlite and vermiculite with peat/rabbit manure compost according to their physicochemical properties. Then, based on the results of the first proportioning optimization, the mixing ratio of rabbit manure compost and peat was further optimized using a bioassay. In this bioassay, salt-tolerant calendula (Calendula officinalis L.) and salt-intolerant cucumber (Cucumis sativus L.) were selected as test plants. The seedling effects (e.g., seedling emergence percentage, plant growth parameters, plant biomass, and nutrient effects) were evaluated. It was shown in the results that the rabbit manure compound growing media could be used for the seedlings, and suitable seedling performance was obtained with the increase of the total porosity (5.0%-61.2%), organic matter content (8.3%-39.9%), and nutrient elements from the rabbit manure compost. From the perspective of seedling emergence, there was no significant difference between rabbit manure compound media and peat treatment, in which the highest emergence percentages were >90%. At the same time, the nutrient performance of plant aboveground was significantly increased in rabbit manure compound growing media compared to peat treatment. In particular, the contents of P and Mg were increased by 31%-141.4% and 80.4%-107.8% for calendula and by 82.6%-117.4% and 35.1%-67.6% for cucumber, respectively. It was indicated in the two-step optimization that the rabbit manure compost proportion of 30%-50% (that is, 60%-100% instead of peat) was more suitable. Additionally, the greenhouse gas emission could be reduced by using rabbit manure compost replacing peat, and the greenhouse gas emission reduction potential would be 3.65 × 105-4.06 × 108 kg CO2-equivalent/year in China, which has important ecological significance.


Regulation of bile acid pool size and plasma lipid levels in the SHR/N-corpulent rat: influence of the level of caloric intake.
In the obese progeny of the SHR/N-cp strain of the rat the bile acid pool was at least twice as large as that in their lean littermates even when only 6 weeks old. The composition of the pool remained unchanged in the obese females, but in their male counterparts the proportion of cholic acid was significantly increased. Cholestyramine feeding reduced the pool size by 26% in the obese rats, but a similar effect also occurred in the lean animals. The obese rats consumed about 60% more food per day than their lean littermates. When obese females were pair-fed to the intake of their lean controls from 6 to 11 weeks of age, the bile acid pool remained significantly enlarged, although not to the same extent as in the obese rats fed ad lib. Plasma cholesterol levels were reduced but remained significantly higher than the levels in the lean animals. The marked hypertriglyceridemia exhibited by the obese rats fed ad libitum did not develop in their pair-fed counterparts. In contrast, there was a comparatively smaller reduction in plasma cholesterol and triglyceride levels in the obese rats fed cholestyramine. Hepatic steatosis persisted in the pair-fed animals as well as in those given cholestyramine. Restricting caloric intake significantly reduced the body weight gain of the obese rats but had little effect on the extent of their corpulence. These studies show that at least some of the characteristics of this congenic strain, including hypertriglyceridemia and hepatic and intestinal hypertrophy, are due mainly to excess dietary intake.(ABSTRACT TRUNCATED AT 250 WORDS)


Two bioluminescent diptera: the North American Orfelia fultoni and the Australian Arachnocampa flava. Similar niche, different bioluminescence systems.
Orfelia fultoni is the only bioluminescent dipteran (Mycetophilidae) found in North America. Its larvae live on stream banks in the Appalachian Mountains. Like their Australasian relative Arachnocampa spp., they build sticky webs to which their bioluminescence attracts flying prey. They bear two translucent lanterns at the extremities of the body, histologically distinct from the single caudal lantern of Arachnocampa spp., and emit the bluest bioluminescence recorded for luminescent insects (lambda(max) = 460 nm versus 484 nm from Arachnocampa). A preliminary characterization of these two bioluminescent systems indicates that they are markedly different. In Orfelia a luciferin-luciferase reaction was demonstrated by mixing a hot extract prepared with dithiothreitol (DTT) under argon with a crude cold extract. Bioluminescence is not activated by adenosine triphosphate (ATP) but is strongly stimulated by DTT and ascorbic acid. Using gel filtration, we isolated a luciferase fraction of approximately 140 kDa and an additional high molecular weight fraction (possibly a luciferin-binding protein) that activated bioluminescence in the presence of luciferase and DTT. The Arachnocampa luciferin-luciferase system involves a 36 kDa luciferase and a luciferin soluble in ethyl acetate under acidic conditions; the bioluminescence is activated by ATP but not by DTT. The present findings indicate that the bioluminescence of O. fultoni constitutes a novel bioluminescent system unrelated to that of Arachnocampa.


Induced hypotension in orthognathic surgery: a comparative study of 2 pharmacological protocols.
The objective of this comparative study was to report on the use of 2 different pharmaceutical protocols involving 2 different anesthetic techniques (IV and balanced) to induce hypotension in patients submitted to orthognathic surgery by assessing the patients' intra- and postoperative physiologic response and hemodynamic stability. Twenty ASA I patients, between 17 and 44 years of age who had dental and skeletal deformities were subdivided into 2 groups: group I (clonidine associated to remifentanil), and group II (dexmedetomidine associated to isoflurane), in addition, other drugs were common to both groups. The following responses were assessed: arterial blood pressure, heart rate, temperature during intra- and postoperative periods, incidence of nausea and vomiting, postoperative pain, awakening time, extubation time, and postanesthetic recovery time. The results of the study using Repeated Measures Test statistical analysis showed that there were no significant differences between the 2 groups in respect to physiologic responses or surgery time. Both protocols tried in this study proved to be effective and safe, and they seem to be interesting alternatives in longer orthognathic surgeries with the expectation of an important blood loss. The choice for either protocol should be based on the inherent risks involved in their use and their cost-benefit ratio.


Regeneration of afferent axons into discrete tracts within peripheral nerves in the leech.
We have analyzed the pathway followed by regenerating afferent axons in peripheral nerves of the leech Hirudo medicinalis by anterograde labeling with horseradish peroxidase. We show that axons are able to reestablish appropriate pathways following a lesion (crush) which greatly disrupts the organization of the nerves. Our results are consistent with a pathway selection mechanism involving axon surface markers which are retained on the distal stumps of crushed axons.


Translabial ultrasound evaluation after tension-free transobturator tape technique: Outcomes based on the tape's position.
The purpose of this study was to evaluate the feasibility and accuracy of postoperative translabial ultrasound to assess the position of the tape implanted with the tension-free transobturator tape technique. We enrolled women with clinically and urodynamically proven type I or II stress urinary incontinence who were referred for transobturator tape treatment. A total of 50 women underwent a transobturator tape procedure and were included in the analysis. We divided the patients into two study groups (group A and group B), characterized by normal and obstructed flow at least 30 days after the surgical procedure visit, respectively. We performed a translabial ultrasound evaluation to assess the suburethral localization of the sling. On the longitudinal scan, the distance between the bladder neck and the suburethral sling was >10 mm in all patients in group A (16.7 ± 1.6). On the contrary, the values in group B were ≤10 mm (5.3 ± 4.8). Our findings highlight the role of a skilled sonographic operator performing translabial ultrasound as a first-line method for evaluating postoperative transobturator tape procedure and sling positioning. Moreover, translabial ultrasound could be helpful to determine a "cutoff" of the bladder neck to sling distance, as this is related to the onset of the obstruction.


Hand dermatitis: a review of clinical features, prevention and treatment.
Hand dermatitis is a socially significant health problem. This review provides a discussion on the clinical features and patterns as well as the differential diagnosis of hand dermatitis, because these are essential for proper diagnosis in clinical practice. The morphology, however, is poorly related to the etiology in chronic cases. In all cases of chronic hand dermatitis, a full diagnostic examination should be undertaken and the etiology should be clarified and addressed in the treatment concept, instead of just moving directly from a morphological diagnosis to therapy. Preventive measures should be included in the treatment concept according to etiology. A stepwise approach for escalating therapy is advised, including basic topical therapy, topical corticosteroids, calcineurin inhibitors, as well as phototherapy and systemic therapy with corticosteroids, alitretinoin, cyclosporine, methotrexate, azathioprine, and others.


Inhibition of IL-1beta-dependent prostaglandin E2 release by antisense microsomal prostaglandin E synthase 1 oligonucleotides in A549 cells.
The metabolism of arachidonic acid through the cyclooxygenase pathway is a highly regulated cellular process that results in the formation of PGH2. This unstable intermediate can be enzymatically metabolized to PGE2 by the actions of a microsomal 17 kDa PGE synthase (mPGES1). Treatment of A549 cells with IL-1beta for 24 h resulted in a twofold increase in mPGES1 mRNA, protein expression, and PGES specific activity. To understand the relationship between expression of mPGES1 and PGE2 formation, IL-1beta treated cells were incubated with increasing concentrations of antisense oligonucleotides (ASO) and their effects compared to cells treated with reverse sense oligonucleotides (RSO) designed against the ATG translation initiation codon of mPGES1. Incubation with ASO resulted in a 44% reduction in mRNA expression level as compared to RSO-treated cells. Microsomal preparations isolated from ASO- and RSO-treated cells were analyzed for their ability to convert PGH2 to PGE2 in the presence 2.5 mM reduced glutathione. An approximate 50% reduction (ASO: 1.8 nmol/min/mg, RSO: 3.7 nmol/min/mg) in PGES activity, protein expression by immunodetection, and extracellular PGE2 release was detected in these samples. As a control in these studies, the protein levels of COX2 and secreted IL-8 were quantified; no change in these levels was observed. These results demonstrate the direct association between mPGES1 expression, its enzymatic activity, and total PGE2 production following an inflammatory stimulus.


Research on super-hydrophobic surface of biodegradable magnesium alloys used for vascular stents.
Micro-nanometer scale structure of nubby clusters overlay was constructed on the surface of an AZ31 magnesium alloy by a wet chemical method. The super-hydrophobicity was achieved with a water contact angle of 142° and a sliding angle of about 5°. The microstructure and composition of the super-hydrophobic surface were characterized by SEM and FTIR. Potentiodynamic polarization and electrochemical impedance spectroscopy were used to evaluate the corrosion behavior, and the hemocompatibility of the super-hydrophobic surface was investigated by means of hemolytic and platelet adhesion tests. Results showed that the super-hydrophobic treatment could improve the corrosion resistance of magnesium alloys in PBS and inhibit blood platelet adhesion on the surface, which implied excellent hemocompatibility with controlled degradation.


Comparative recruitment patterns of two non-pioneer canopy tree species in French Guiana.
A comparative study was conducted on the recruitment patterns of two non-pioneer tree species, one dispersed by arboreal mammals and birds (Virola michelii, Myristicaceae) and the other by rodents (Moronobea coccinea, Clusiaceae). These species differ in fruiting phenology, seed size, dispersal distance, germination time and seed nutrient exhaustion. In both species, establishment patterns were consistent with the escape hypothesis and the Janzen-Connell model. Virola seeds need not be buried to survive and germinate, and may produce a seedling carpet beneath the parent. Moronobea seedlings only establish from seeds buried by scatterhoarding rodents in the surrounding understory. One-year survival of Virola seedlings was 47.8% and was greater >10 m than < 10 m from the largest parent tree. In contrast, survival of Moronobea seedlings was 56% 3 years after seed dispersal. Survival of juveniles was greater in gaps than in the understory for Virola but not for Moronobea. Moronobea survival was greater than Virola survival in both microhabitats. Both species establish in the understory, yet both grew faster in gaps. Virola appeared to be more gap-dependent than Moronobea which may persist several years in the understory until a gap occurs. Virola and Moronobea illustrate two intermediate recruitment patterns along an hypothetical continuum of nonpioneer species replacement (Bazzaz and Pickett 1980; Swaine and Whitmore 1988).


Pharmacological, toxicological and neuronal localization assessment of galantamine/chitosan complex nanoparticles in rats: future potential contribution in Alzheimer's disease management.
Nasal galantamine hydrobromide (GH)/chitosan complex nanoparticles (CX-NP2) could have an improved therapeutic potential for managing Alzheimer's disease (AD). The current study aimed to investigate if the complexation reaction between GH and chitosan altered the pharmacological and toxicological profiles of the parent drug; GH. The nasal administration of CX-NP2 to male Wistar rats for 12 consecutive days was compared to negative control group, and oral and nasal GH solutions treated groups in 3 mg/kg daily GH dose. Brain acetylcholinesterase (AChE) protein level and activity were assessed. The in vivo toxicity of CX-NP2 was evaluated via monitoring the clinical signs throughout the study. Histopathological examination of brain sections was performed. The intracellular localization of CX-NP2 within brain neurons was investigated using transmission electron microscopy. GH/chitosan complexation did not negatively alter the pharmacological efficiency of GH. Intriguingly, nasal CX-NP2 exhibited a significant decrease of AChE protein level and activity in rat brains compared to the oral and nasal GH solutions. No toxicity signs or histopathological manifestations were noticed. The nanoparticles were found intracellularly in the brain neurons. The pharmacological efficacy and in vivo safety of nasal CX-NP2 confirm their promising potential to contribute to the management of AD intranasally.


Implications of the anatomy of papillary muscle connections for mapping and ablation of focal ventricular arrhythmias.
Ventricular arrhythmias (VAs) originating from papillary muscles (PAPs) can be challenging when targeted with catheter ablation. Reasons may include premature ventricular complex pleomorphism, structurally abnormal PAPs, or unusual origins of VAs from PAP-myocardial connections (PAP-MYCs). The purpose of this study was to correlate PAP anatomy with mapping and ablation of PAP VAs. In a series of 43 consecutive patients with frequent PAP arrhythmias referred for ablation, the anatomy and structure of PAPs and VA origins were analyzed using multimodality imaging. Successful ablation sites were analyzed for location on the PAP body or a PAP-MYC. In a total of 17 of 43 patients (40%), VAs originated from a PAP-MYC (in 5 of 17 patients, the PAP inserted into the mitral valve anulus); and in 41 patients, VAs originated from a PAP body. VAs from a PAP-MYC more often had delayed R-wave transition than did other PAP VAs (69% vs 28%; P < .001). Patients with failed procedures had more PAP-MYCs (24.8 ± 8 PAP-MYCs per patient vs 16 ± 7 PAP-MYCs per patient; P < .001). Multimodality imaging identifies anatomic details of PAPs that facilitate mapping and ablation of VAs. In more than a third of patients with PAP VAs, VAs originate from connections between PAPs and the surrounding myocardium or between other PAPs. VA electrocardiographic morphologies are different when VAs originate from PAP-connection sites as compared with VAs originating from the PAP body.


Bloodstream gram-negative bacterial infections in adult patients with leukemia: A retrospective review of medical records in a tertiary care hospital in Western Saudi Arabia.
Patients with neutropenic cancers are at high risk of acquiring infections, especially if on chemotherapy. Gram-negative bacterial infections are associated with high mortality. This study aimed to assess clinical characteristics, outcomes, and epidemiology of gram-negative bacterial (GNB) bloodstream infections (BSI) in adult patients with leukemia. This single-center, retrospective study included 102 adult patients diagnosed with leukemia between 2017 and 2019. The patients' demographics, infection diagnosis, leukemia diagnosis, comorbidities, and infection outcomes were collected from electronic medical records. The most common GNB were Klebsiella pneumoniae (33.3 %), Pseudomonas aeruginosa (23.5 %), and Escherichia coli (17.6 %). Additionally, 36.7 % of infections were multidrug resistant. The most common comorbidities were cardiovascular diseases (36.7 %), diabetes mellitus (33.3 %), and liver diseases (24.1 %). GNB-infected patients had a higher mortality than noninfected patients (35.3 % and 11.8 %, respectively, p = 0.005). In a multivariable analysis, patients with acute myeloid leukemia and acute lymphoid leukemia were significantly more likely to acquire GNB BSI (p = 0.01), while patients with chronic myelogenous leukemia and chronic lymphocytic leukemia had a lower likelihood of developing GNB BSI. In addition, low hemoglobin level was an independent risk factor of GNB BSI (p = 0.001). Chemotherapeutic agents showed an association with increased risk of GNB BSI. Patients with acute leukemia and low hemoglobin levels have increased risk of GNB BSI, which was associated with increased mortality. Prospective studies are needed to further assess the effect of co-morbidities and chemotherapy medications on the occurrence of GNB BSI according to the type of leukemia.