Prescribing practices in Southeastern Europe - focus on benzodiazepine prescription at discharge from nine university psychiatric hospitals.
There is much concern about the widespread long-term use of benzodiazepines. Our manuscript addressed its use in the region of Southeastern Europe, which seems extensive, but insufficiently explored. At nine university psychiatric hospitals (Croatia, Macedonia and Serbia), we retrospectively analyzed discharge summary documents to find the prevalence of discharge benzodiazepine prescriptions and the prescribed benzodiazepine doses. This study included 1047 adult subjects and showed that 81.9% of them had benzodiazepines prescribed in the discharge summary document, with high mean daily dose of around 5mg lorazepam equivalents. Factors associated with the prescriptions were exclusively clinical factors (diagnosis of schizophrenia spectrum disorders, more lifetime hospitalizations, psychiatric comorbidity, co-prescription of antidepressant or mood stabilizer, shorter duration of the hospitalization), while socio-demographic factors were not found to influence benzodiazepine discharge prescriptions. Similarly, factors which influenced the prescription of higher daily benzodiazepine dose were more lifetime psychiatric hospitalizations and co-prescription of antidepressant or mood stabilizer, as well as the diagnosis of mental/behavioral disorders due to substance use and co-prescribed antipsychotic. Our data are emphasizing an urgent need for guidelines and improved education of both health care professionals and patients, in order to prevent long term benzodiazepine (mis)use and related side-effects.


A comparison of the organization of longitudinal and circular contractions during pendular and segmental activity in the duodenum of the rat and guinea pig.
Little is known of the spatiotemporal organization of pendular duodenal contractions. We used longitudinal and radial spatiotemporal mapping to examine and compare pendular and segmental contractile activity in the proximal duodenum of the rat and guinea pig when the lumen was perfused with saline or micellar decanoic acid. Isolated phasic longitudinal contractions occurred along the rat duodenum with a frequency of 36 ± 2 cpm and strain rate amplitude of 26.8 ± 8.0% s(-1). These contractions occurred at fixed locations along the duodenum forming columns on the longitudinal strain rate map. The strain rate activity had local maxima at 4-6 points spaced at 7.7 ± 4.0 mm intervals along the duodenum and were uncoordinated between neighboring domains. Similarly disposed, less distinct, longitudinal contractions occurred in the guinea pig duodenum at a frequency of 25.2 ± 6.6 cpm with amplitude 6.8 ± 3.6% s(-1) but these were generally accompanied by numerous circular contractions that were distributed over 4-5 fixed locations and occurred with a frequency of 9 ± 3 cpm. Isolated static circular muscle contractions also occurred but at a lower rate in the rat than the guinea pig. Both types of contractions propagated after dosage with tetrodotoxin, lidocaine, atropine, or apamin. Localized contractions during segmental and pendular activity had some features of the spike patches that are normally associated with slow wave propagation. However, the commencement of propagation following administration of neural blocking agents and cholinergic inhibitors indicates their localization is maintained by inhibitory elements of the enteric nervous system.


Modelling the emergence of coordinated collective motion by minimizing dissatisfaction.
Coordinated collective motion (CCM) has been recently studied using agent-based simulations by applying three behavioural rules: repulsion, attraction and alignment. But these rules are so similar to the expected group behaviour that it can hardly be labelled emergent. We developed an agent-based model that produces CCM using a set of low-level dyadic interaction rules. The agents change their positions with regard to other agents in order to minimize their own dissatisfaction with their inter-individual distances. To test the emergence of CCM, several simulation experiments were performed. The results show that the agents were able to achieve CCM after a few thousand time steps, and that the bigger the area perceived by them, the more coordinated and cohesive the group motion became. An increased memory span and capacity to remember other agents' identities improved cohesion and coordination. The relationship with biological referents is discussed.


Spinocerebellar ataxias in Asia: Prevalence, phenotypes and management.
This paper reviews and summarizes three main aspects of spinocerebellar ataxias (SCA) in the Asian population. First, epidemiological studies were comprehensively reviewed. Overall, the most common subtypes include SCA1, SCA2, SCA3, and SCA6, but there are large differences in the relative prevalence of these and other SCA subtypes between Asian countries. Some subtypes such as SCA12 and SCA31 are rather specific to certain Asian populations. Second, we summarized distinctive phenotypic manifestations of SCA patients of Asian origin, for example a frequent co-occurrence of parkinsonism in some SCA subtypes. Lastly, we have conducted an exploratory survey study to map SCA-specific expertise, resources, and management in various Asian countries. This showed large differences in accessibility, genetic testing facilities, and treatment options between lower and higher income Asian countries. Currently, many Asian SCA patients remain without a final genetic diagnosis. Lack of prevalence data on SCA, lack of patient registries, and insufficient access to genetic testing facilities hamper a wider understanding of these diseases in several (particularly lower income) Asian countries.


Suppression of autoimmune thyroid disease by FK 506: influence on thyroid-infiltrating cells, adhesion molecule expression and anti-thyroglobulin antibody production.
Autoimmune thyroid disease was induced in female PVG/c rats by neonatal thymectomy, followed by sublethal, whole body x-irradiation. Disease development, assessed by histological evidence of lymphocytic thyroiditis and circulating levels of anti-thyroglobulin antibodies, was reduced significantly by a 3-week course of FK 506 (0.5 or 1.5 mg/kg per day) commencing after the detection of autoantibody production. Thyroid-infiltrating mononuclear cells (MNC) in untreated rats stained predominantly for CD4+ and MHC class II antigen which was expressed widely on dendritic cells. Fewer infiltrating cells expressed TCR alpha/beta, CD5, CD8 or LFA-1 beta. Intercellular adhesion molecule-1 (ICAM-1) was observed on MNC, vascular endothelial cells and a minority of residual thyroid epithelial cells. FK 506 administration reduced markedly the incidence of infiltrating TCR alpha/beta +, CD5+, CD4+, CD8+, and LFA-1 beta + cells and the expression both of MHC class II antigens and ICAM-1 on MNC, endothelial cells and thyrocytes. Compared with normal PVG/c rats, there were reduced incidences of CD4+ CD8- and CD4- CD8+ lymphocytes and an elevation in the CD4+/CD8+ cell ratio in the spleens of animals with autoimmune thyroiditis. These changes were partially reversed by FK 506. Systemic drug levels estimated by enzyme immunosorbent assay were in excess of those known to blockade cytokine production by CD4+ T lymphocytes in vitro and some evidence of minor renal dysfunction was observed. The results are consistent with a therapeutic effect of FK 506 mediated via interference with CD4+ T lymphocyte function and adhesion molecule-dependent cytotoxic effector mechanisms.


Protective monoclonal antibodies define maturational and pH-dependent antigenic changes in Sindbis virus E1 glycoprotein.
Monoclonal (MC) antibodies specific for either the EI or E2 glycoproteins of Sindbis virus (SIN) were used to probe for differences in the surface topography of SIN epitopes between infected cells and mature virions. Employing an enzyme-linked immunosorbent assay (ELISA) in which binding of individual peroxidase-labeled MC antibodies to immobilized (solid-phase) detergent-disrupted SIN was inhibited specifically by one or more unlabeled antibodies, viral epitopes could be grouped into six spatially distinct antigenic sites--five on E1, designated a through e, and one site on E2. All six sites were represented on the surfaces of SIN-infected cells as shown by the complement (C')-dependent lysis mediated by antibodies of the corresponding epitope specificities. In contrast, virus-neutralizing (NT) activity was restricted to antibodies specific for epitopes on E2 and on site c of E1, irrespective of the presence of added C' and an antiserum against mouse immunoglobulins. That E1 sites a, b, d, and e became inaccessible to antibody binding was shown by a competitive-inhibition ELISA. Whereas all MC antibodies were inhibited from binding to solid-phase SIN when premixed with detergent-treated virions, only those having NT activity could be competitively inhibited by intact virions. Sites E1-d and E1-e could be exposed not only by detergent disruption but also by lowering the virion pH from 7.2 to 6.0. These collective results indicate that a majority of immunologically relevant E1 epitopes present on SIN-infected cell surfaces become cryptic during SIN maturation and, except at low pH, remain undetectable on virion surfaces.


Which Predictor, SctO2 or SstO2, Is more Sensitive for Postoperative Cognitive Dysfunction in Spine Surgery: A Prospective Observational Study?
Patients undergoing spinal surgery in the prone position may experience venous stasis, often resulting in edema in dependent areas of the body, including the head, and increased postoperative cognitive dysfunction (POCD). Not only does POCD present challenges for post-operative care and recovery, it can also cause permanent damage to the patient's brain and increase mortality and social costs. We aimed to clarify the incidence of POCD in patients with hypertension after prone spine surgery and to further determine the association between intraoperative somatic tissue oxygen saturation (SstO2)/cerebral tissue oxygen saturation (SctO2) and POCD. Patients with hypertension scheduled for open prone spine surgery from January 2020 to April 2021 were included in this single-center, prospective, observational study. SctO2 and SstO2 were monitored by near-infrared spectroscopy continuously throughout the surgery. The primary outcome was POCD assessed using the Mini-Mental Status Examination (MMSE). The association of SstO2 and SctO2 with POCD was evaluated with unadjusted analyses and multivariable logistic regression. One hundred and one of 112 identified patients were included, 28 (27.8%) of whom developed POCD. None of the investigated SctO2 indices were predictive of POCD. However, the patients with POCD had greater decreases in intraoperative absolute SstO2 and relative SstO2 than the patients without POCD (P = 0.037, P = 0.036). Moreover, three SstO2 indices were associated with POCD, including a greater absolute SstO2 decrease (P = 0.021), a greater relative SstO2 decrease (P = 0.032), and a drop below 90% of the baseline SstO2 (P = 0.002), independent of ASA III status, preoperative platelets and postoperative sepsis. In addition, there was no correlation between intraoperative SctO2 and intraoperative SstO2 or between their respective absolute declines. Twenty-eight (27.7%) of 101 patients developed POCD in patients with hypertension undergoing prone spine surgery, and intraoperative SstO2 is associated with POCD, whereas SctO2 shows no association with POCD. This study may initially provide a valuable new approach to the prevention of POCD in this population.


High-resolution genome-wide array-based comparative genome hybridization reveals cryptic chromosome changes in AML and MDS cases with trisomy 8 as the sole cytogenetic aberration.
Although trisomy 8 as the sole chromosome aberration is the most common numerical abnormality in acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS), little is known about its pathogenetic effects. Considering that +8 is a frequent secondary change in AML/MDS, cryptic--possibly primary--genetic aberrations may occur in cases with trisomy 8 as the apparently single anomaly. However, no such hidden anomalies have been reported. We performed a high-resolution genome-wide array-based comparative genome hybridization (array CGH) analysis of 10 AML/MDS cases with isolated +8, utilizing a 32K bacterial artificial chromosome array set, providing >98% coverage of the genome with a resolution of 100 kb. Array CGH revealed intrachromosomal imbalances, not corresponding to known genomic copy number polymorphisms, in 4/10 cases, comprising nine duplications and hemizygous deletions ranging in size from 0.5 to 2.2 Mb. A 1.8 Mb deletion at 7p14.1, which had occurred prior to the +8, was identified in MDS transforming to AML. Furthermore, a deletion including ETV6 was present in one case. The remaining seven imbalances involved more than 40 genes. The present results show that cryptic genetic abnormalities are frequent in trisomy 8-positive AML/MDS cases and that +8 as the sole cytogenetic aberration is not always the primary genetic event.


New aspects of technical testing of intravascular stents.
Maximum magnetic resonance artifacts from stents are often determined by the presence of ferromagnetic compounds in the delivery system. We propose a mathematic model describing artifacts caused by nitinol stents. A method for evaluation of critical radial rigidity of the stents was developed.


Vitiligo and melanoma-associated hypopigmentation (MAH): shared and discriminative features.
It is unclear if differences between melanoma-associated hypopigmentation (MAH) and classical vitiligo exist. Hypopigmented areas and associated lesions (halo nevi, hypopigmented scars) in 15 melanoma patients and 31 patients with classical vitiligo were analyzed by digital photography. The activity of the respective lesions was assessed by the vitiligo disease activity (VIDA) score. Associated diseases were recorded by history and serological tests;genotyping of HLA class I antigens as well as histology/immunohistology were performed. MAH were diagnosed in 12 of 15 melanoma patients; mean onset was 4.8 years after the primary diagnosis of the melanoma. Three melanoma patients reported hypopigmentation more than 15 years before diagnosis of melanoma. In the history and family history of vitiligo patients, autoimmune diseases were much more frequent and haplotype HLA-A2 was twice as common compared to MAH patients. MAH lesions were most often distributed in a bilateral symmetrical pattern, corresponding to vitiligo. MAH was less progressive compared to classical vitiligo; however, it was more often associated with other acquired leukodermas. In both groups hypopigmentation spread centripetally to the trunk. Histological and immunohistological differences were not found. Whereas differences exist concerning associated autoimmune diseases, MAH and vitiligo shared many common clinical and histological features. Further studies are needed to assess the clinical relevance of vitiligo-like alterations in melanoma patients.


Consensus Conference on North American Training in Hepatopancreaticobiliary Surgery: A Review of the Conference and Presentation of Consensus Statements.
The findings and recommendations of the North American Consensus Conference on Training in HPB Surgery held October 2014 are presented. The conference was hosted by the Society for Surgical Oncology (SSO), Americas Hepatopancreaticobiliary Association (AHPBA), and the American Society of Transplant Surgeons (ASTS). The current state of training in HPB surgery in North America was defined through three pathways-HPB, Surgical Oncology, and Solid Organ Transplant fellowships. Consensus regarding programmatic requirements included establishment of minimum case volumes and inclusion of quality metrics. Formative assessment, using milestones as a framework and inclusive of both operative and non-operative skills, must be present. Specific core HPB cases should be defined and used for evaluation of operative skills. The conference concluded with a focus on the optimal means to perform summative assessment to evaluate the individual fellow completing a fellowship in HPB surgery. Presentations from the hospital perspective and the American Board of Surgery led to consensus that summative assessment was desired by the public and the hospital systems, and should occur in a uniform but possibly modular manner for all HPB fellowship pathways. A task force comprised of representatives of the SSO, AHPBA, and ASTS are charged with implementation of the consensus statements emanating from this consensus conference.Copyright © 2016 The American Society of Transplantation, the American Society of Transplant Surgeons, and the Society of Surgical Oncology. All rights reserved. No part of this document may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopy, recording, or any information storage and retrieval system, without written permission by The American Society of Transplantation, the American Society of Transplant Surgeons, or the Society of Surgical Oncology.


The health and economic burden of rotavirus disease in Belgium.
For health economic evaluations of rotavirus vaccination, estimates of the health and cost burden of rotavirus are required. Due to differences in health care systems and surveillance organisations, this is difficult to achieve by imputing estimates from one country to others. This study aimed to estimate the burden of rotavirus disease in Belgium. In children younger than 7 years of age, rotavirus is predicted to account annually for about 5,600 hospitalisations (676:100,000 children); 26,800 outpatient, general practitioner and paediatrician visits; and about 44,600 episodes for which no medical care is sought. This burden is estimated to represent direct costs of 7.7 million Euro and indirect costs of 12.8 million Euro. Rotavirus disease causes a substantial health and economic burden in Belgium.


Pulmonary hypoplasia testing in clinical obstetrics.
An ultrasound-based diagnostic test for predicting pulmonary hypoplasia antenatally by measurements of fetal chest circumference was applied prospectively to 45 patients at risk for developing this disorder. The outcome for the newborn infant and the autopsy findings were correlated with the antenatal prediction. The results of this test demonstrated a sensitivity and a specificity of 88% and 96%, respectively. The application of this test to clinical practice is recommended.


Variation in susceptibility of HeLa cell lines to coxsackievirus A9.
In the course of serial passages for several years a line of uncloned HeLa cells (A line) showed a gradual decrease in plaquing efficiency by coxsackievirus A9 (CA9 virus), while subcultures prepared from the same line kept frozen at an early passage level (A original line) did not show any change. However, it was observed later that the plaque-forming ability of the A original line (A orig. line) also decreased after serial passages as was observed with the A line. Comparing the characteristics of the same cell line at two different passage levels, it was found that the efficiency of adsorption of virus to cells was nearly the same, while virus yield at 8 hours after infection was different. The activity of alkaline phosphatase of cells was also different between these two passage levels, suggesting that a high enzymatic activity is associated with the susceptibility of cell cultures to CA9 virus. Magnesium chloride at 25 mM enhanced plaque formation by CA9 virus in highly passaged less susceptible cell cultures, and a possible role of the chemical as a stabilizer of alkaline phosphatase was discussed.


Validation of the International Study Group of Rectal Cancer definition and severity grading of anastomotic leakage.
The International Study Group of Rectal Cancer (ISREC) has proposed a generally applicable definition and severity grading of (AL) after sphincter-preserving resection of the rectum. This work has been carried out to test for validity. A total of 746 patients who were identified from a prospective rectal cancer database underwent sphincter-preserving anterior resection of the rectum between October 2001 and January 2011. The incidence and severity of AL was determined using the criteria established by the ISREC. Patients with AL were categorized according to the ISREC scheme. The clinical outcomes were analyzed and compared between the groups. The overall AL rate was 7.5% (56/746). The 56 patients with AL were distributed among the different groups as follows: Grade A, 16%; grade B, 23%; and grade C, 61%. Compared with the grade A patients, grades B and C patients had significantly elevated serum C-reactive protein levels (P < .01). None of the grade A patients were transferred to the intensive care unit (ICU). Their further hospital stay was uneventful. The length of stay in the ICU was significantly longer for grade C patients compared with grade B patients (P < .001). The median hospital stay of grade C patients was significantly longer than that of grades A and B patients (P < .001). The definition and severity grading of AL after anterior resection of the rectum proposed by the ISREC provides a simple, easily applicable, and valid classification. Using this classification system may facilitate comparison of results from different studies on AL after sphincter-preserving rectal surgery.


Large-deformation strain energy density function for vascular smooth muscle cells.
Vascular tissue exhibits marked mechanical nonlinearity when exposed to large strains. Vascular smooth muscle cells (VSMCs) are the most prevalent cell type in the artery wall, but it is unclear how much of the vessel nonlinearity is attributable to VSMCs. Here, we used cellular microbiaxial stretching (CμBS) to measure the large-strain mechanical properties of individual VSMCs. We find that the mechanical properties of VSMCs with native-like architectures are highly anisotropic, due to their highly aligned actomyosin cytoskeletons, and that inhibition of actomyosin contraction with rho-associated kinase inhibitor HA-1077 results in nearly isotropic material properties. We further find that when VSMCS are exposed to large strains (up to 60% stretch), the cells' stress-strain behavior is surprisingly linear. Finally, we modified a previously published Holzapfel-Gasser-Ogden type strain energy density function to characterize individual VSMCs, to account for the observed large-deformation linearity. These data have important implications in the development of models of vascular mechanics and mechanobiology.


No place to unload: a preliminary analysis of the prevalence, risk factors, and consequences of ambulance diversion.
To study the prevalence, risk factors, and consequences of ambulance diversion. Observational cohort analysis from January 1, 1986, to December 31, 1989. Population-based study of a large urban region located in Northern California. Individuals transported by ambulance to any of 13 hospitals in the region (n = 153,167). Diversion defined as the patient not being transported to their initially intended hospital because the hospital was unable to accept patients because of temporary emergency department closure. Ambulance run time recorded by radio contact was documented in ambulance registry. "Transport-associated deaths" were measured as any deaths occurring in the field, while en route, or soon after arriving at the ED. During the four-year interval, total diversions increased by 453% (n = 718 in 1986 versus 3,973 in 1989; P < .005), thereby affecting one in nine transports during the last quarter of 1989. Diversion was more common in elderly patients (odds ratio, 1.17; 95% confidence interval, 1.11, 1.23), during the winter (odds ratio, 1.36; 95% confidence interval, 1.31, 1.44), and at night (odds ratio, 1.30; 95% confidence interval, 12.4, 1.37). Compared with their nondiverted counterparts, diverted transports had longer times at the scene (13.5 versus 12.4 minutes; P < .005) and greater transport times (13.3 versus 11.6 minutes; P < .005). We did not find a significant increase in the rate of transport-associated deaths (0.460 deaths per 1,000 population in 1986 versus 0.464 deaths per 1,000 population in 1989; P = NS). Ambulance diversion is a common and increasing event that delays emergency medical care.


Oxidative Bisulfite Sequencing: An Experimental and Computational Protocol.
Bisulfite sequencing (BS-seq) remains the gold standard technique to quantitively map DNA methylation at a single-base resolution. However, BS-seq cannot discriminate between 5-methylcytosine (5mC) and 5-hydroxymethylcytosine (5hmC). Oxidative bisulfite sequencing (oxBS-seq) was one of the first techniques that enabled absolute quantification of 5mC and 5hmC at single-base resolution. OxBS-seq uses chemical oxidation of 5hmC prior to bisulfite treatment to provide a direct readout of 5mC; comparison with BS-seq data can then be used to infer 5hmC levels. Here we describe in detail an updated version of our laboratory's oxBS-seq protocol, which uses potassium perruthenate (KRuO4) as an oxidant. We also describe a bioinformatics pipeline designed to handle Illumina short read sequencing data from whole-genome oxBS-seq.


The half-life of the HSV-1 1.5-kb LAT intron is similar to the half-life of the 2.0-kb LAT intron.
Herpes simplex virus type 1 establishes a latent infection in the sensory neurons of the peripheral nervous system of humans. Although about 80 genes are expressed during the lytic cycle of the virus infection, essentially only one gene is expressed during the latent cycle. This gene is known as the latency-associated transcript (LAT), and it appears to play a role in the latency cycle through an anti-apoptotic function in the 5' end of the gene and miRNA encoded along the length of the transcript which downregulate some of the viral immediate-early gene products. The LAT gene is about 8.3 kb long and consists of two exons separated by an unusual intron. The intron between the exons consists of two nested introns. This arrangement of introns has been called a twintron. Furthermore, the larger (2 kb) intron has been shown to be very stable. In this study, we measure the stability of the shorter 1.5-kb nested intron and find its half-life is similar to the longer intron. This was achieved by deleting the 0.5-kb overlapping intron from a plasmid construct designed to express the LAT transcript from a tet-inducible promoter and measuring the half-life of the 1.5-kb intron in tissue culture cells. This finding supports the hypothesis that it is the common branch-point region of these nested introns that is responsible for their stability.


Characteristics and predictors of women who obtain rescreening for sexually transmitted infections using the www.iwantthekit.org screening programme.
Professional organizations recommend rescreening chlamydia-infected women. The iwantthekit Internet-screening programme offered rescreening opportunities by using iwantthekit. Mailed, home-collected vaginal swabs were tested for chlamydia, gonorrhoea, and trichomoniasis by nucleic acid amplification tests. Demographics and risk behaviours of repeat users were determined from questionnaires. Predictors of repeat users were measured in a matched case-control study. Of 1747 women, 304 (17%), who used iwantthekit, indicated they had used the kit previously. Mean age was 24.7 ± 5.7 years and 69% were African-American. Repeat iwantthekit users were more likely to be aged ≥ 20 years (OR=2.10); were more likely to have been treated for a sexually transmitted infection (OR=2.32); less likely to drink alcohol before sex (OR=0.63); and to never use condoms (OR=0.43). Of repeat users, 84.2% had a negative prior test and 15.8% had a positive. At current test, 13.2% were infected. Previous trichomoniasis was associated with current trichomoniasis (p<0.05). The iwantthekit may offer rescreening opportunities for previously infected women.


Ossifying fibromyxoid tumor of soft parts: a report of 17 cases with emphasis on unusual histological features.
Ossifying fibromyxoid tumor of soft parts is an unusual benign neoplasm, with a tendency for local recurrence. Its typical microscopic appearance is that of a multinodular proliferation of round to spindle shaped cells separated by fibrous bands in which bone formation is often seen. Herein, we present the clinicopathologic features of 17 examples of this tumor with particular emphasis on some unusual histopathologic features that may place pitfalls in the diagnosis of this tumor, including satellite micronodules, mucinous microcysts, absence of myxoid areas, crush artifact, multiple microcalcifications, epidermoid cysts, atypical chondroid differentiation with binucleate lacunar cells, pericytic growth pattern, and malignant change. Awareness of these unusual morphologic features should lead to a search for areas displaying the more typical features of ossifying fibromyxoid tumor to arrive at a correct diagnosis.


Acute Colonic Pseudo-obstruction Following Spinal Fixation for Trauma.
Acute colonic pseudo-obstruction (ACPO) is a potentially highly morbid surgical complication. The incidence of ACPO following spinal trauma is unknown, but is likely higher than after elective spinal fusion. The purpose of this study was to establish the incidence of ACPO in patients with major trauma undergoing spinal fusion for unstable thoracic and lumbar fracture, and secondly, to characterize the nature of ACPO in this group, including treatment and complications. A metropolitan hospital prospective trauma database was utilized to identify all patients from November 2015 to December 2021 meeting major trauma criteria and undergoing thoracic or lumbar spinal fusion for fracture. Individual records were then evaluated for occurrence of ACPO. ACPO was defined as radiologic evidence of colonic dilation without mechanical obstruction in symptomatic patients undergoing dedicated abdominal imaging. After exclusions, 456 patients with major trauma undergoing thoracic or lumbar spinal fusion were identified. ACPO occurred in 34-an incidence rate of 7.5%. There was no evidence of difference in terms of the spinal fracture type, level, surgical approach, or number of segments fused. There were no perforations; only 2 patients required colonoscopic decompression and none required surgical resection. ACPO occurred at a high frequency in this group of patients, although it required relatively simple treatment. High vigilance for ACPO should be maintained in trauma patients requiring thoracic or lumbar fixation, with a view to early intervention. The etiology driving the high rates of ACPO in this cohort is not understood and would benefit from further investigation.


Left main occlusion - a classic electrocardiogram.
Left main occlusion is associated with a dire prognosis, as the left main supplies blood to >75 % of the left ventricle. This is a case showing a classic electrocardiogram (ECG) together with the echocardiogram videos and images from coronary angiography.


A comparison of responses of guinea-pig isolated trachea to six prostaglandins.
Effects of prostaglandins (PG) E1, E2, F2alpha, A1, A2 and B2 were studied on guinea-pig isolated tracheal chains. PGF2alpha, B2 and A2 produced contraction, PGE1 and E2 relaxation of the chain, but A1 produced no response. 1) From the cumulative dose response curves, PGF2alpha was more active in producing contraction than B2 or A2, though its effect was less than that of acetylcholine (ACh). PGE1-induced relaxation was less than the response to isoproterenol. 2) PGE1 and E2 1 microgram/ml caused a 26.1 +/- 3.83% (n=5) or a 9.5 +/- 3.36 (n=6) decrease of ACh (1 microgram/ml)-induced contraction respectively. The degree of relaxation produced by E1 was greater than that by E2 (P less than 0.01). 3) After five minutes preincubation with each of PGA1, A2, B2 and F2alpha in concentrations which did not produce any effect, ACh-induced contraction was augmented only after PGA2 (P less than 0.05).


A computer workstation for clinical medicine.
New computer tools for physicians, nurses, and the medical care team will become common in the 1990s. This paper describes a clinical workstation (CWS) development project that uses new technology that moves the technical support for medical decision making from the computer room to the nursing station. Collection, processing, and display of clinical information including patient identification, laboratory, and radiology results and current medications are carried out in the environment of a multi-windowed computer workstation. Easy access to automated medical literature databases from the workstation is also provided. This pilot project has successfully demonstrated a CWS operating on an acute general neurology and neurosurgical inpatient nursing unit and a critical care unit at The Johns Hopkins Hospital.


Characteristics of particulate and non-particulate corticosteroids. Indications for their use in chronic pain treatments.
Corticosteroids been used frequently in pain treatments since the middle of last century (1952). Due to a review of the complications as a result of their application in epidural injections, the United States of America Food and Drug Administration (FDA) issued an «alert controversy» requesting that a warning label should be added to injectable corticosteroids, where risks must be described (loss of sight, brain damage, paralysis and death) when administering by this route. It must be mentioned that there are different types of corticosteroids with diverse characteristics, which as a result, may produce different side-effects. Due to the aforementioned developments, the controversies that have arisen, and the lack of well-conducted studies on the use of steroids in epidural injections, we must begin by reviewing their indications in different pain conditions.


Autonomous Document Cleaning--A Generative Approach to Reconstruct Strongly Corrupted Scanned Texts.
We study the task of cleaning scanned text documents that are strongly corrupted by dirt such as manual line strokes, spilled ink, etc. We aim at autonomously removing such corruptions from a single letter-size page based only on the information the page contains. Our approach first learns character representations from document patches without supervision. For learning, we use a probabilistic generative model parameterizing pattern features, their planar arrangements and their variances. The model's latent variables describe pattern position and class, and feature occurrences. Model parameters are efficiently inferred using a truncated variational EM approach. Based on the learned representation, a clean document can be recovered by identifying, for each patch, pattern class and position while a quality measure allows for discrimination between character and non-character patterns. For a full Latin alphabet we found that a single page does not contain sufficiently many character examples. However, even if heavily corrupted by dirt, we show that a page containing a lower number of character types can efficiently and autonomously be cleaned solely based on the structural regularity of the characters it contains. In different example applications with different alphabets, we demonstrate and discuss the effectiveness, efficiency and generality of the approach.


China's belt and road initiative (BRI) under the vision of 'maritime community with a shared future' and its impacts on global fisheries governance.
'Maritime Community with a Shared Future' is the broad vision through which China aims to lead the global fisheries governance. This research has been motivated by China's ambition of equating its maritime development goals with sustainable development goal - 14 (Life Below Water). Through this research, the influential role of China in 'global fisheries governance' has been put through an 'ocean governance mechanism at various levels (national, regional, and international). Therefore, China's role in 'global ocean and fisheries' are discussed side-by-side, focusing on and supporting a better understanding of China's potential challenges and opportunities in world fisheries. The role of China in global and regional fisheries governance has been critically analysed throughout the discussion. It is also discussed how China plays its part in Regional Fisheries Management Organisations (RFMOs) and how this role-playing can be utilised through the Belt and Road initiative (BRI) for effective governance, conservation and preservation of marine fisheries. The scope of China's national ocean and fisheries legislation is framed to support China's stance in leading global fisheries governance. The conclusion followed the discussion in descending order suggesting ocean and fisheries governance improvement and appropriate advocacy options available to China.


[Changes in the oxygen transport function in patients with chronic kidney failure during hemodialysis].
Some parameters of oxygen transport blood function have been studied prior to hemodialysis treatment and following 5, 25, 50 and 100 hemodialysis procedures. It has been established that programmed hemodialysis decreases O2 transport and reserve. These changes may be associated with an unfavourable effect of the procedure itself on the body, accompanied by anemia, microthromboembolisms in lung vessels, hypercapnia and arteriovenous blood shunt. Partial compensation of O2 transport decrease is achieved due to cardiac output increase and O2 tissue excretion. These compensatory mechanisms cannot ensure normal values of O2 reserve and transport and are fairly quickly depleted in the course of hemodialysis.


Canine viral enteritis. II. Morphologic lesions in naturally occurring parvovirus infection.
The morphologic lesions associated with naturally occurring canine parvovirus infection are described. The disease is characterized by necrosis of crypt epithelium in the small intestine and of lymphoid tissue in Peyers patches, lymph nodes, spleen and thymus.


Counseling and peer review are key disciplinary procedures.
The best approach to the problem of an employee with a disciplinary problem is not always termination. When performance slips at this hospital, supervisors work closely with the employee to bring about improvement. The secret to the system is early recognition of problems, followed by intense problem solving.


Methods for molecular imaging of brain tumours in a hybrid MR-PET context: Water content, T2∗, diffusion indices and FET-PET.
The aim of this study is to present and evaluate a multiparametric and multi-modality imaging protocol applied to brain tumours and investigate correlations between these different imaging measures. In particular, we describe a method for rapid, non-invasive, quantitative imaging of water content of brain tissue, based on a single multiple-echo gradient-echo (mGRE) acquisition. We include in the processing a method for noise reduction of the multi-contrast data based on Principal Component Analysis (PCA). Noise reduction is a key ingredient to obtaining high-precision water content and transverse relaxation T2∗ values. The quantitative method is applied to brain tumour patients in a hybrid MR-PET environment. Active tumour tissue is identified by means of FET-PET; oedema, white and grey-matter segmentation is performed based on MRI contrasts. Water content information is not only relevant by itself, but also as a basis for correlations with other quantitative measures of water behaviour in tissue and interpreting the microenvironment of water. Water content in active tumour tissue (84%) and oedema (79%) regions is found to be higher than that of normal WM (69%) and close to that of normal GM (83%). Consistent with literature reports, mean kurtosis is measured to be lower in tumour and oedema regions than in normal WM and GM, whereas mean diffusivity is increased. Voxel-based correlations between water content and diffusion indices obtained with diffusion kurtosis tensor imaging, and between quantitative MRI and FET-PET are reported for 8 brain tumour patients. The effective transverse relaxation time T2∗ is found to be the MR parameter showing the strongest correlations with other MR indices derived here and with FET-PET.


Insulin secretagogues: who, what, when, and how?
Sulfonylurea compounds were the first available oral antidiabetic agents and they remain an important tool in our quest for optimal glycemic control. The more recent introduction of meglitinides offers an approach to short-term insulin release with minimal hypoglycemic risk during fasting periods. Published trials suggest that individuals with a hemoglobin A(1c) above 8.5% are unlikely to reach currently recommended targets (6.5% to 7%) without the use of one of these insulin secretagogues. Starting and probable maximally effective doses for glimepiride are 1 to 2 mg initially and 4 mg thereafter. For glyburide and glipizide, these are 2.5 to 5 mg initially, and 10 mg effective at a maximum. The large majority of the effect can be seen within a week, making them very attractive when rapid lowering of glucose is needed. An understanding of the principles will facilitate more effective use of initial and combination therapy.


Risk factors for fatal cardiac complications after allogeneic hematopoietic cell transplantation: Japanese Society for Transplantation and Cellular Therapy transplant complications working group.
Fatal cardiac complications can occur from the early to late phases after hematopoietic cell transplantation (HCT). Herein, the Japanese transplant registry database was used to retrospectively analyze health records of 33,791 allogeneic HCT recipients to elucidate the pathogenesis and risk factors involved. Overall, 527 patients died of cardiac complications at a median of 130 (range 0-3924) days after HCT. The cumulative incidence of fatal cardiac complications was 1.2% (95% confidence interval [CI]: 1.0-1.3) and 1.6% (95% CI: 1.5-1.8) at 1 and 5 years after HCT, respectively. Fatal cardiovascular events were significantly associated with an HCT-specific comorbidity index (HCT-CI) score of ≥1 specific to the three cardiovascular items, lower performance status, conditioning regimen cyclophosphamide dose of >120 mg/kg, and female sex. Cardiovascular death risk within 60 days after HCT was associated with the type of conditioning regimen, presence of bacterial or fungal infections at HCT, and number of blood transfusions. Contrastingly, late cardiovascular death beyond 1 year after HCT was associated with female sex and older age. Lower performance status and positive cardiovascular disease-related HCT-CI were risk factors for cardiac complications in all phases after HCT. Systematic follow-up may be necessary according to the patients' risk factors and conditions.


Use of over-the-counter medications during pregnancy.
The most common medications used in pregnancy are nonprescription or over-the-counter medications, although there has been little research on their risks or safety. We describe the patterns of over-the-counter medication use among pregnant women. Data were collected in 2 case-control studies of birth defects: the Slone Epidemiology Center Birth Defects Study (BDS) and the National Birth Defects Prevention Study (NBDPS). Among 7563 mothers of malformed and nonmalformed offspring in the Slone Epidemiology Center Birth Defects Study and 2970 mothers of nonmalformed offspring in the National Birth Defects Prevention Study, acetaminophen, ibuprofen, and pseudoephedrine were used by at least 65%, 18%, and 15%, respectively. Among women in the Slone Epidemiology Center Birth Defects Study, the use in pregnancy of aspirin and chlorpheniramine decreased from 1976 to 2004 and of ibuprofen, pseudoephedrine, diphenhydramine, dextromethorphan, and guaifenesin increased. Among women in the National Birth Defects Prevention Study, the use of acetaminophen, pseudoephedrine, diphenhydramine, and guaifenesin was higher during pregnancy than before pregnancy. Findings show that over-the-counter medications are used by most pregnant women. Studies that examine specific over-the-counter medications in relation to specific birth defects are necessary to better inform pregnant women about risks and safety.


Standard fractionation low-dose proton radiotherapy for diffuse choroidal hemangiomas in pediatric Sturge-Weber syndrome.
Sturge-Weber syndrome is a nonhereditary congenital neurocutaneous syndrome characterized by leptomeningeal angiomatosis, facial nevus flammeus, and diffuse choroidal hemangioma, which when complicated by total retinal detachment, portend a poor prognosis. Management is often limited to salvage external beam irradiation. We present a modified proton therapy technique for young children with total bullous retinal detachments that uses standard fractionation low-dose proton radiotherapy to decrease the risk of radiation complications. Treatment techniques for young children who cannot cooperate with conventional radiation protocols are also described.


Gut feelings about diabetes.
Studies of patients going into diabetes remission after gastric bypass surgery have demonstrated the important role of the gut in glucose control. The improvement of type 2 diabetes after gastric bypass surgery occurs via weight dependent and weight independent mechanisms. The rapid improvement of glucose levels within days after the surgery, in relation to change of meal pattern, rapid nutrient transit, enhanced incretin release and improved incretin effect on insulin secretion, suggest mechanisms independent of weight loss. Alternatively, insulin sensitivity improves over time as a function of weight loss. The role of bile acids and microbiome in the metabolic improvement after bariatric surgery remains to be determined. While most patients after bariatric surgery experienced sustained weight loss and improved metabolism, small scale studies have shown weight regain and diabetes relapse, the mechanisms of which remain unknown.


Cocrystal and Salt Forms of an Imidazopyridazine Antimalarial Drug Lead.
Cocrystallization and salt formation were used to produce new multicomponent forms of a novel antimalarial imidazopyridazine drug lead (MMV652103) that displayed improved physicochemical properties. The drug lead had earlier shown good in vitro potency against multidrug resistant (K1) and sensitive (NF54) strains of the human malaria parasite Plasmodium falciparum, and high in vivo efficacy in both Plasmodium berghei and Plasmodium falciparum mouse models. A major drawback of MMV652103 is its limited aqueous solubility. Various new supramolecular products, including several multicomponent solid forms, are reported here, namely 3 cocrystal forms with the dicarboxylic acid coformers adipic acid, glutaric acid, and fumaric acid, and a salt form with malonic acid. These were characterized by thermal methods and their structures elucidated by single-crystal X-ray diffraction. A customized solubility experiment was performed in fasted-state simulated intestinal fluid for comparison of the solubility behavior of each new form of the drug lead with that of the untreated starting material. All of the multicomponent forms showed an improvement in the maximum concentrations (Cmax) attained by the drug lead and the rate at which it dissolved. The recorded Cmax values exceeded the concentration of the untreated compound by factors in the range 4.6-5.6.


Uptake of 67Cu by ceruloplasmin in vitro.
Solutions of human ceruloplasmin, in Tris buffer at pH values between 6 and 7.5, readily took up carrier-free 67Cu2+, but only when the substrate, rho-phenylenediamine, was added.


The relation between physical activity, fitness, and fatness in adolescents: A mediation analysis.
To investigate the total, direct and mediated (by fatness) association of physical activity (PA) with fitness. Body fat percentage (%Fat), maximal oxygen uptake (VO2max ) and PA were measured directly in 18-year-olds (n=202) and their association analyzed with a linear regression-based mediation analysis after controlling for sex. The total association between PA and VO2max was significant (c=0.66, P<0.001) and was significantly mediated by %Fat (ab=0.25, 95% CI: 0.04-0.49). The direct association was also significant (ć=0.41, P<0.001). Physical activity is associated with VO2max in 18-year-old adolescents but a little over a third of that association is mediated by %Fat. Regardless of fatness, PA is important for fitness in this age group. Am. J. Hum. Biol. 28:584-586, 2016. © 2015 Wiley Periodicals, Inc.


Electrosorptive desalination by carbon nanotubes and nanofibres electrodes and ion-exchange membranes.
A novel membrane capacitive deionization (MCDI) device, integrating both the advantages of carbon nanotubes and carbon nanofibers (CNTs-CNFs) composite film and ion-exchange membrane, was proposed with high removal efficiency, low energy consumption and low cost. The CNTs-CNFs film was synthesized by low pressure and low temperature thermal chemical vapor deposition. Several experiments were conducted to compare desalination performance of MCDI with capacitive deionization (CDI), showing that salt removal of the MCDI system was 49.2% higher than that of the CDI system. The electrosorption isotherms of MCDI and CDI show both of them follow Langmuir adsorption, indicating no change in adsorption behavior when ion-exchange membranes are introduced into CDI system. The better desalination performance of MCDI than that of CDI is due to the minimized ion desorption during electrosorption.


Time-limited trials in the ICU: a mixed-methods sequential explanatory study of intensivists at two academic centres.
To understand intensivist perceptions of the appropriateness of time-limited trials (TLTs)-a strategy to align life-sustaining care with patient goals and values in the midst of clinical uncertainty. We conducted a mixed-methods sequential explanatory study of intensive care unit (ICU) intensivists regarding appropriateness of utilising TLTs in three vignettes centred on invasive mechanical ventilation (IMV); continuous renal replacement therapy (CRRT); and heated high-flow nasal cannula (HHFNC). Semistructured interviews were conducted using the Tailored Implementation of Chronic Diseases framework. Data were analysed using thematic and matrix analysis. Two academic medical centres in the USA participated in the randomised surveys and one centre participated in the semistructured interviews. Pulmonary and critical care intensivists and fellows. To understand intensivists perceptions of the appropriateness in using TLTs. Of 115 physicians surveyed, 71 initiated the survey and 44 completed the entire survey with a response rate of 38% (N=44/115) and a completion rate of 62% (N=44/71). While 35% (N=23/66) of intensivists had never heard of a TLT, of the intensivists who had heard of a TLT, 77% (N=33/43) had participated in one. In response to the vignettes, appropriateness of using a TLT varied (IMV: 74% (N=46/62); CRRT 78% (N=49/63); HHFNC 92% (N=56/61) as did the durations of the TLT. Semistructured interviews with 11 intensivists revealed having clarity about patient goals and clinical endpoints facilitated successful TLTs while lack of an evidenced-based framework was a barrier. More than half of the physicians who responded had conducted or participated in a TLT. To increase the use of TLTs in the ICU, clinicians desire a more robust, evidence-based framework on how to conduct TLTs.


Determination of energy minima and saddle points using multireference configuration interaction methods in combination with reduced gradient following: the S(0) surface of H(2)CO and the T(1) and T(2) surfaces of acetylene.
The implementation of the reduced gradient following (RGF) method into the COLUMBUS quantum-chemical program system is reported using the newly developed analytic MR-CISD/AQCC gradient feature. By this combination a very useful tool has been developed for general searches of stationary points on ground- and excited-state energy surfaces. This procedure is applied to the S(0) surface of H(2)CO and the T(1) and T(2) surfaces of acetylene. For H(2)CO we investigated three minima (formaldehyde, s-trans, and s-cis hydroxycarbene) and five saddle points. For the T(1) and T(2) states of acetylene the cis- and trans-minima and the planar and nonplanar saddle points were computed.


Non-invasive 19F-NMRS of 5-fluorouracil in pharmacokinetics and pharmacodynamic studies.
Knowledge of the exact dose and rate at which an antitumor agent is delivered to its target site is postulated to be crucial to proper patient management. It is now possible to obtain such information using non-invasive 19F-NMRS (nuclear magnetic resonance spectroscopy) following the administration of 5-fluorouracil (5-FU). We have performed such studies in 103 patients with breast, colorectal and other tumors. Measurable 19F signals were detected in 99 of these patients (92.5%). Estimation of the tumoral t1/2 of 5-FU in these patients revealed that 51 of them (51.5%) exhibited a tumoral t1/2 greater than 20 min, a value we had characterized as indicating drug trapping in the tumor. Of these patients, 46 who received regimen bolus 5-FU 600 mg/m2 with leucovorin for their treatment have been evaluated. In these patients, the association between trapping and response remains very high (p<.000001). None of the non-trappers responded to chemotherapy, whereas 70% of the evaluable trappers responded. Details are presented here on the methodology of NMRS data acquisition and on their pharmacokinetic analysis. The potential mechanisms underlying the trapping effect appear to be predicated primarily on transport processes. Suggestions are presented on how such pharmacokinetic imaging studies may extend both our understanding of the mechanism of action of 5-FU, and how they could be used to optimize patient treatment.


The evolution of pollution profile and health risk assessment for three groups SVOCs pollutants along with Beijiang River, China.
Three important groups of semi-volatile organic compounds (SVOCs), polycyclic aromatic hydrocarbons (PAHs), organic chlorinated pesticides (OCPs) and phthalate esters (PAEs), were produced by various human activities and entered the water body. In this study, the pollution profiles of three species including 16 PAHs, 20 OCPs and 15 PAEs in water along the Beijiang River, China were investigated. The concentrations of Σ16PAHs in the dissolved and particulate phases were obtained as 69-1.5 × 102 ng L-1 and 2.3 × 103-8.6 × 104 ng g-1, respectively. The levels of Σ20OCPs were 23-66 ng L-1 (dissolved phase) and 19-1.7 × 103 ng g-1 (particulate phase). Nevertheless, higher levels of PAEs were found both in the dissolved and particulate phases due to abuse use of plastic products. Furthermore, non-cancer and cancer risks caused by these SVOCs through the ingestion absorption and dermal absorption were also assessed. There was no non-cancer risk existed through two kinds of exposure of them at current levels, whereas certain cancer risk existed through dermal absorption of PAHs in the particulate phase in some sampling sites. The results will show scientific insights into the evaluation of the status of combined pollution in river basins, and the determination of strategies for incident control and pollutant remediation.


Electrochemical conversion of chromium from tannery effluents for potential reuse in industrial applications.
Electrochemical oxidation of trivalent chromium from leather tanning mud waste leachates (containing ca 6 g.L-1 Cr(III)) to its hexavalent form was carried out using a PbOx/Pb anode electrode in a prototype small (0.4 L) cylindrical batch electrochemical reactor. The PbOx/Pb anode was prepared by electrochemical anodization at constant current (75 mA cm-2 for 30 min) in a sulfuric acid solution and characterized by the cyclic voltammetry technique to investigate the effect of pH on the process. It was found that at pH = 3, Cr(III) oxidation prevails over the competing water oxidation-oxygen evolution reaction (OER), hence increasing the efficiency of the process. A detailed study of pH (0-3), current density (12-24 mA cm-2), and cell type (divided-undivided) effects on bulk electrolysis of Cr(III) leachates in the batch prototype reactor resulted in process optimization. At pH = 3, 12 mA cm-2 and a cathode inserted in a porous diaphragm envelope, nearly 70% conversion was achieved at a nearly 60% current efficiency, among the highest in the previously reported literature. The method (further optimized with an ion-selective membrane separator) could offer an attractive route for tannery Cr(III) conversion to Cr(VI) for reuse as an etchant or electroplating agent.


Comparing Survival in Patients With Lung Cancer With and Without a History of Common Autoimmune Disease.
Autoimmune disease has both a predisposing and a protective effect toward malignancy. Though studies have investigated the risk of malignancy in patients with autoimmune disease, there is limited research on how autoimmunity affects survival. This study compared survival in patients with lung cancer with and without autoimmune disease. Patients with lung cancer were culled from the Surveillance, Epidemiology, and End Results Medicare databases (2007-2014), and autoimmune diseases were identified using diagnosis codes. The overall prevalence of investigated autoimmune diseases among the 112,445 patients was 22.7%. Overall survival (OS) (p < 0.0001) was longer and cancer-specific mortality (CSM) (p < 0.0001) reduced among patients with autoimmune disease. Median OS was 5 months higher. Improved OS and CSM were also apparent in disease stages 1, 3, and 4 in the NSCLC and SCLC subgroups (p < 0.0001) and across most specific autoimmune diseases. After adjusting for the effects of age, sex, race, disease stage, and chronic kidney disease, autoimmune disease was still predictive of higher OS (hazard ratio = 1.23, 95% confidence interval: 1.21-1.25, p < 0.0001) and reduced CSM (hazard ratio = 1.16, 95% confidence interval: 1.14-1.18, p < 0.0001). The prevalence of rheumatoid arthritis, inflammatory bowel disease, and systemic lupus erythematous was highly enriched compared with the general population. The improvement in OS and CSM was larger in NSCLC than in SCLC, suggesting a larger role for the immune system in NSCLC. Alternate explanations for the improved survival include lead time bias, better access to health care, and a survival or autoimmunity-inducing genetic factor.


Novelty determines the effects of olfactory enrichment on memory and neurogenesis through noradrenergic mechanisms.
Commonly used experimental paradigms of environmental enrichment combine increased social interactions and sensory inputs and renewal of the objects present in the environment. However, the specific contribution of novelty to the effects of enrichment is unclear. Here, we show that repeated daily exposure to single novel odorants and not to an enriched but stable olfactory environment improves short-term olfactory memory and neurogenesis in the mouse olfactory bulb. In addition, these positive effects are mediated by noradrenalin as they are blocked by a noradrenergic receptor antagonist. These data suggest that novelty recognition and noradrenergic mechanisms are crucial in mediating neural plasticity induced by olfactory enrichment.


Cross-national difference in the prevalence of depression caused by the diagnostic threshold.
According to published reports, the prevalence rates of major depressive disorder (MDD) in East-Asian countries are lower than in the West, but the reasons for this difference have not been fully investigated. This study compared the Korean Epidemiologic Catchment Area study (KECAS) sample with the National Comorbidity Survey (NCS, USA) sample. In total, this study included 5349 participants in KECAS and 7423 in NCS aged 18-54 years. The Composite International Diagnostic Interview (CIDI) assessed for MDD. Analysis of the individual symptoms of MDD was completed. Diagnostic threshold of MDD was higher in KECAS participants than in NCS participants. Koreans diagnosed with MDD showed more work impairment than Americans with MDD. Koreans were more likely to express the symptoms like "low energy" and "concentration difficulty," but less to the symptoms like "depressed mood" and "thoughts of death" during an episode of MDD. The Diagnostic and Statistical Manual of Mental Disorders (DSM) framework was the basis for the majority of the comparisons made in this study. Various depressive symptoms not included in the DSM framework were unlikely to be detected. Cross-cultural differences in rates of MDD are attributable to diagnostic thresholds. Symptom patterns and forms of depression in Korea, as defined by the DSM framework, are not identical to those in the U.S.


Rare/cryptic Aspergillus species infections and importance of antifungal susceptibility testing.
The number of patients infected with Aspergillus rose dramatically in recent years. However, studies on the clinical spectrum and antifungal susceptibilities of non-classical (non-fumigatus, non-flavus, non-niger and non-terreus) pathogenic Aspergillus species are very limited. We examined the clinical spectrum and antifungal susceptibilities of 34 non-duplicated, non-classical Aspergillus isolates collected from Hong Kong, Shenzhen and Shanghai. The Aspergillus isolates were identified by internal transcribed spacer, partial BenA and partial CaM sequencing and phylogenetic analyses. Susceptibility testing against eight antifungals was performed following the European Committee for Antimicrobial Susceptibility Testing's methodology. The 34 Aspergillus isolates were identified as 14 different rare/cryptic species of four sections (Flavi [n = 8], Nidulantes [n = 8], Nigri [n = 17] and Restricti [n = 1]). Except for one patient whose clinical history could not be retrieved, 72.7% of the remaining patients had underlying conditions predisposing them to Aspergillus infections. The most common diseases were pulmonary infections (n = 15), followed by skin/nail infections (n = 6), chronic otitis externa and/or media (n = 5), wound infections (n = 2) and mastoiditis/radionecrosis (n = 1), while three were colonisations. Five patients succumbed due to the infections during the admission, and another two died 5 years later because of chronic pulmonary aspergillosis. Antifungal susceptibility testing showed that they possessed different susceptibility profiles compared to the classical Aspergillus species. The majority of isolates characterised were sensitive or wild-type to amphotericin B. The minimum effective concentrations for all the three echinocandins were also low. Susceptibility testing should be performed for infections due to these rare/cryptic Aspergillus species to guide proper patient management.


BMP signaling in the intestinal epithelium drives a critical feedback loop to restrain IL-13-driven tuft cell hyperplasia.
The intestinal tract is a common site for various types of infections including viruses, bacteria, and helminths, each requiring specific modes of immune defense. The intestinal epithelium has a pivotal role in both immune initiation and effector stages, which are coordinated by lymphocyte cytokines such as IFNγ, IL-13, and IL-22. Here, we studied intestinal epithelial immune responses using organoid image analysis based on a convolutional neural network, transcriptomic analysis, and in vivo infection models. We found that IL-13 and IL-22 both induce genes associated with goblet cells, but the resulting goblet cell phenotypes are dichotomous. Moreover, only IL-13-driven goblet cells are associated with classical NOTCH signaling. We further showed that IL-13 induces the bone morphogenetic protein (BMP) pathway, which acts in a negative feedback loop on immune type 2-driven tuft cell hyperplasia. This is associated with inhibiting Sox4 expression to putatively limit the tuft cell progenitor population. Blocking ALK2, a BMP receptor, with the inhibitor dorsomorphin homolog 1 (DMH1) interrupted the feedback loop, resulting in greater tuft cell numbers both in vitro and in vivo after infection with Nippostrongylus brasiliensis. Together, this investigation of cytokine effector responses revealed an unexpected and critical role for the BMP pathway in regulating type 2 immunity, which can be exploited to tailor epithelial immune responses.


Clinical outcomes in patients with metastatic castrate-resistant prostate cancer treated with abiraterone with or without ongoing androgen deprivation therapy: A retrospective case-control study.
Abiraterone and concurrent androgen deprivation therapy (ADT) are used in the treatment of patients with metastatic castration-resistant prostate cancer. Recently, it has been suggested that the use of abiraterone alone (without ADT) may have comparable efficacy to abiraterone with ongoing ADT. Here, we sought to assess the impact of ADT cessation in patients beginning abiraterone for castration-resistant prostate cancer. We identified 39 patients at our institution who received abiraterone alone (with discontinuation of ADT) between 2011 and 2022. We then procured a comparable group of 39 patients (matched by age, Gleason score, and prostate-specific antigen [PSA] level) who received abiraterone with ongoing ADT during the same period. We assessed and compared clinical outcomes in the two groups (abiraterone-alone vs. abiraterone-ADT) with respect to PSA response rates, PSA progression-free survival, and overall survival. Results were adjusted using Cox proportional-hazards multivariable models. The median PSA before treatment initiation was 12.7 (range: 0.2-199) ng/mL in the abiraterone-alone group and 15.5 (range: 0.6-212) ng/mL in the abiraterone-ADT group. Use of abiraterone alone adequately suppressed testosterone levels in 35/37 (94.6%) patients. Patients receiving abiraterone alone had a median PSA reduction of 80.2% versus 79.5% in patients receiving abiraterone plus ADT. The median PSA progression-free survival in patients receiving abiraterone alone was 27.4 versus 25.8 months in patients receiving abiraterone plus ADT (hazard ratio [HR] 1.10; 95% confidence interval [CI] 0.65-1.71; p = 0.82). In addition, abiraterone alone was associated with an overall survival of 3.6 versus 3.1 years in patients receiving abiraterone plus ADT (HR 0.90; 95% CI 0.50-1.62; p = 0.72). There were no differences in PFS or OS between groups after performing Cox multivariable regression analyses. Use of abiraterone alone was associated with comparable clinical outcomes to patients who received abiraterone together with ADT. Further prospective studies are warranted to evaluate the impact of abiraterone alone on treatment outcomes and cost savings.


Gas phase chemistry of Li+ with amides: the observation of LiOH loss in mass spectrometry.
Collision-induced dissociation (CID) of Li(+) adducts of three sets of compounds that contains an amide bond, including 2-(4, 6-dimethoxypyrimidin-2-ylsulfanyl)-N-phenylbenzamide, its derivatives and simpler structures was investigated by electrospray ionization tandem mass spectrometry (ESI-MS/MS). Observed fragment ions include those that reflect loss of LiOH. Other product ions result from the Smiles rearrangement and direct C-S bond cleavage. MS/MS of H/D exchange products demonstrated occurrence of a 1,3-H shift from the amide nitrogen atom to the phenyl ring of these compounds. The LiOH loss from Li(+) adducts of amides was further examined by CID of [M + Li](+) ions of N-phenylbenzamide and N-phenylcinnamide. Loss of LiOH was essentially the sole fragmentation reaction observed for the former. For the latter, both losses of LiOH and H(2)O were discovered. The presence of electron-donating substituents of the phenyl ring of these compounds was found to facilitate elimination of LiOH, while that loss was retarded by electron-withdrawing substituents. Proposed fragment ion structures were supported by elemental compositions deduced from ultrahigh resolution Fourier transform ion cyclotron resonance tandem mass spectrometry (FTICR-MS/MS) m/z value determinations. Density functional theory-based (DFT) calculations were performed to evaluate potential mechanisms for these reactions.


Characterizing Off-center MRI with ZTE.
To maximize acquisition bandwidth in zero echo time (ZTE) sequences, readout gradients are already switched on during the RF pulse, creating unwanted slice selectivity. The resulting image distortions are amplified especially when the anatomy of interest is not located at the isocenter. We aim to characterize off-center ZTE MRI of extremities such as the shoulder, knee, and hip, adjusting the carrier frequency of the RF pulse excitation for each TR. In ZTE MRI, radial encoding schemes are used, where the distorted slice profile due to the finite RF pulse length rotates with the k-space trajectory. To overcome these modulations for objects far away from the magnet isocenter, the frequency of the RF pulse is shifted for each gradient setting so that artifacts do not occur at a given off-center target position. The sharpness of the edges in the images were calculated and the ZTE acquisition with off-center excitation was compared to an acquisition with isocenter excitation both in phantom and in vivo off-center MRI of the shoulder, knee, and hip at 1.5 and 3T MRI systems. Distortion and blurriness artifacts on the off-center MRI images of the phantom, in vivo shoulder, knee, and hip images were mitigated with off-center excitation without time or noise penalty, at no additional computational cost. The off-center excitation allows ZTE MRI of the shoulder, knee, and hip for high-bandwidth image acquisitions for clinical settings, where positioning at the isocenter is not possible.


Potential of extension workshops to change farmers' knowledge and awareness of IPM.
Farmers' knowledge of IPM has been considered, as prerequisites to IPM adoption. In Iran the most prevalent extension method for training farmers in different fields like IPM is extension workshops. The main purpose of this study was to investigate workshop effectiveness to change farmer's knowledge of IPM through assessing and comparing farmer's knowledge of IPM. A survey was conducted among 90 farmers in Karaj City in 2007--08 that included 30 workshop participants, 30 farmers who had exposed to workshop participants, and 30 randomly selected farmers, which were outside of this community. A questionnaire including open and close ended questions was designed. Data was collected through personal structured interviews with respondents at their farms. The study found that workshop participants (10.38) had significantly higher knowledge scores than their non workshop counterparts (5.90). Data also showed very little diffusion of workshop-acquired knowledge from workshop participants to other community members.


[Diagnosis and treatment of dysphagia].
Most swallowing problems can be treated, although the treatment depends on the type of dysphagia. A multidisciplinary team of surgeons, phoniatrists, and speech-language therapists is necessary to develop the appropriate treatment strategy. A thorough medical history, clinical investigation of the swallowing muscles, and fiberoptic endoscopic evaluation of swallowing with foods of different consistencies help to decide whether swallowing exercises alone are sufficient, or whether an additional pharmacologic or surgical treatment is needed to prevent aspiration, malnutrition, and dehydration.


A WAP-Based Concept Acquisition Teaching Model in Cleft Lip and Palate Phenotype and Embryonic Development: Functionality and Usability Study.
Taking advantage of the broad coverage of Wireless Application Protocol (WAP), we developed a Content Management System (CMS)-programmed mobile learning application. This application can help the undergraduate to obtain a comprehensive understanding of concepts in Cleft lip and palate Phenotype, and Embryonic development (CPE). The present study aims to evaluate the feasibility and efficacy of the concept acquisition teaching model on the basis of WAP in a practical undergraduate course of CPE. The concept acquisition teaching model based on WAP was programmed by CMS, covering definitions of various cleft lip and palate, the mechanisms underlying the phenotypes, practical medical cases, as well as corresponding tests after learning. The CPE concept acquisition teaching model was distributed to a total of 524 undergraduate students and 46 tutors participated in CPE teaching from seven highly ranked schools of stomatology in China since April 2022. 524 undergraduate students and 46 tutors from seven highly ranked schools of stomatology in China. The CPE concept acquisition teaching model. The effectiveness of the CPE teaching model. The response rate to the survey was 100%. The grading of the questionnaires indicated that the students were satisfied with the usability, practicality, and outcome, whereas the tutors were more positive with the contents, cooperation, and outcome. The present study demonstrated the feasibility and efficacy of the WAP-based concept acquisition teaching model of CPE and a high level of satisfaction among undergraduate students and tutors who major in Stomatology.


The fate of amalgam implanted in soft tissues -- an experimental study.
The soft tissue reaction to amalgam depended on whether it was finely ground or a solid mass. Finely ground amalgam was actively digested within macrophages and giant-cells with loss of mercury and the formation of the fine particles of silver and sulphur. Larger masses became surrounded by a fibrous capsule.


Retraction: Recommended protocol and technique for doing oral fundus fluorescein angiography for adults and children.
[This corrects the article DOI: 10.4103/ijo.IJO_1220_22].


Modeling assessment of groundwater vulnerability to contamination risk in a typical basement terrain using TOPSIS-entropy developed vulnerability data mining technique.
This study involved a comparative analysis in the groundwater vulnerability domain, which is a crucial component of groundwater management decision support systems (DSS). This was achieved by creating models that covered the range of algorithms from the subjective to the data-driven. The study was conducted in a basement complex area. Databases of climatic, remote sensing, and geophysical datasets were created using varieties of data acquisition techniques. The datasets included in this assessment were: rainfall (R), land use (LU), bedrock topography (BT), recharge rate (Re), and slope (S). The slope and rainfall were determined to have the highest (0.78) and lowest (0.01) weighted factors, respectively, using the entropy method. For the development of the TOPSIS-Entropy model algorithm, the weights results were combined with the TOPSIS outranking method. To generate the Groundwater Vulnerability Model map of the study area, the hybrid model was applied to griddled raster layers of the factors. Also, the TOPSIS and Entropy-WLA model algorithms were also explored and used to generate groundwater vulnerability maps. The TOPSIS-Entropy algorithms produced an accuracy of 70%, while TOPSIS and Entropy-WLA produced accuracy of 50 and 47%, respectively. The resulting model maps were validated by using correlation technique on the produced map and the longitudinal conductance map of the study area. The TOPSIS-Entropy, which followed an object-oriented model pattern, demonstrates greater accuracy and has the potential to provide appropriate insights and alternatives to decision-making in the field of groundwater hydrology in the study area and other regions of the world with comparable geology.


[Cyclosporine eye drops: A 4-year retrospective study (2009-2013)].
The University Hospitals Paris Centre Pharmacy compounds three concentrations of cyclosporine eye drops: 20mg/mL (=2%); 5mg/mL (=0.5%) and 0.5mg/mL (=0.05%). Cyclosporine A 2% drops were developed in 1995 to prevent the rejection of high-risk cornea transplants after failure of topical steroids. The other concentrations of eye drops were developed for the treatment of various immune or inflammatory diseases of the cornea, conjunctiva and uvea. These eye drops are dispensed with a physician's prescription to hospitalized or ambulatory patients. A retrospective study over 4 years (2009-2013) was conducted to analyze the details of prescription and possible adverse events. Dispensations made from January 1st, 2009 through December 31st, 2013 were studied, including patient age, dose of cyclosporine and practice location of prescribing physician. We also recorded the indications for cyclosporine eye drops in a sample of ambulatory patients. The analysis of local tolerability and the effect on visual comfort was based on questionnaires sent to the patients on cyclosporine 2% over a period of 2 months. Cyclosporine eye drops prescription grew continuously from 2009 through 2013 for all concentrations. In 2013, 5,859 patients were treated, among which 3,616 patients with topical cyclosporine 2%, 1,681 patients with 0.5%, and 562 patients with 0.05%. In total, this represents 62,621 eye drops. Treated patients ranged from 1 week to 100 years old. Topical 2% cyclosporine is indicated in 61% of cases to prevent high-risk corneal graft rejection. Other indications are corneal ulcer (6%), atopic keratoconjunctivitis (5%), vernal keratoconjunctivitis (5%) and herpetic keratitis (4%). Topical 0.5% cyclosporine is prescribed primarily for dry eye syndrome (20%) and to prevent rejection of high-risk corneal transplantation (11%), to treat ocular rosacea (10%), vernal keratoconjunctivitis (10%), atopic keratoconjunctivitis (8%) and Sjögren's syndrome (7%). Topical 0.05% cyclosporine is prescribed primarily for dry eye syndrome resistant to conventional treatment (47%) and Sjögren's syndrome (21%). Local tolerability of topical cyclosporine was evaluated in 388 patients. The majority of patients (63%) did not experience any adverse effects. The main side effects are redness, burning sensation and itching. Prescription of various formulations of topical cyclosporine is current practice for surgical indications: rejection of high-risk corneal transplantation; or medical indications: vernal or atopic keratoconjunctivitis and dry eye syndrome. Further prospective randomized studies would be necessary to validate formulations, doses and indications of cyclosporine eye drops.


Capillary pH and blood gas determinations in asthmatic children.
Earlobe capillary pH and blood gases in asthmatic children were compared to arterial values. Hyperemia of the earlobe was produced by applying thurfyl nicotinate (Trafuril). Approximately 15 min later capillary blood was obtained simultaneously with a radial arterial sample. Earlobe capillary PO2, PO2, and pH correlated well with arterial values. This technique is simple, safe, and appears to be a satisfactory substitute for arterial blood in normotensive asthmatic children.


α-Melanocyte stimulating hormone attenuates dexamethasone-induced osteoblast damages through activating melanocortin receptor 4-SphK1 signaling.
Long-term glucocorticoid (GC) usage may cause non-traumatic femoral head osteonecrosis. Dexamethasone (Dex) is shown to exert potent cytotoxic effect to osteoblasts. Here, we investigated the potential activity of α-melanocyte stimulating hormone (α-MSH) against the process. Our data revealed that pretreatment of α-MSH significantly inhibited Dex-induced apoptosis and necrosis in both osteoblastic-like MC3T3-E1 cells and primary murine osteoblasts. Melanocortin receptor 4 (MC4R) acts as the receptor of α-MSH in mediating its actions in osteoblasts. The MC4R antagonist SHU9119, or shRNA-mediated knockdown of MC4R, almost abolished α-MSH-induced activation of downstream signalings (Akt and Erk1/2) and its pro-survival effect in osteoblasts. Further studies showed that α-MSH activated MC4R downstream sphingosine kinase 1 (SphK1) and increased cellular sphingosine-1-phosphate (S1P) content in MC3T3-E1 cells and primary murine osteoblasts, which were blocked by SHU9119 or MC4R shRNAs. SphK1 inhibition by the its inhibitor N,N-dimethylsphingosine (DMS), or SphK1 knockdown by targeted-shRNAs, largely attenuated α-MSH-mediated osteoblast protection against Dex. Together, these results suggest that α-MSH alleviates Dex-induced damages to cultured osteoblasts through activating MC4R-SphK1 signaling.


The role of soap and nutrition in producing human diseases I.
Direct clinical observation gives insight to the hypothesis of daily soaping by humans as the cause of arteriosclerosis. The constant resupply to sebaceous glands by hepatic synthesis of cholesterol and lipid compounds raises plasma concentrations and accordingly these compounds plaque out of suspension onto arteriolar intimal surfaces.


Immunosuppressive treatment in myocarditis.
Twenty patients (13 males and seven females) with a biopsy-proven diagnosis of myocarditis underwent a period of treatment with prednisone and azathioprine. The primary objective of the study was the observation of histologic changes which occur during treatment and after treatment withdrawal. The secondary objective was the detection, if any, of changes in left ventricular ejection fraction. Multiple endomyocardial biopsies were obtained and the treatment was adjusted in order to achieve complete disappearance of the myocardial inflammation. The histologic status was improved in all patients, although complete disappearance of the signs of active disease was seen in 15 patients only. Two patients died during the observation period. A clear relationship between histologic status and immunosuppression was established in some patients (50% of all cases showed a worsening after withdrawal from the treatment). An overall improvement of the ejection fraction was observed (from 0.37 +/- 0.14 to 0.46 +/- 0.17), but a direct effect of the treatment on the recovery of ventricular function cannot be stated. In some patients, however, a direct relationship between the histological changes and the changes in ejection fraction was seen. These data suggest that treatment with prednisone and azathioprine may be beneficial in some patients with biopsy-proven myocarditis and depressed ventricular function.


Deciphering the role of Sodium Lignosulfonate against Candida spp. as persuasive anticandidal agent.
In spite of therapeutic development against life threatening fungal pathogens like Candida albicans, the repertoire of effective antifungal drugs is lagging. The emergence and persistence of azole/echinocandin resistance and other cases of multi-drug resistance have led to the failure of the antifungal treatment regime. This troublesome scenario has steered a need for the development of novel leads. Computer aided in-silico drug design using virtual screening, molecular docking, drug likeness, absorption, distribution, metabolism, excretion, and toxicity analysis for the identification of lead compounds for further in-vitro analysis is a cost effective and time-saving strategy. The present study used these strategies to discover novel lead antifungal from the pool of second largest occurring natural compound lignin. After the virtual screening of lignin derivatives, Sodium lignosulfonate (LIG) was identified as the best lead for further analysis. After this vigorous in-silico analysis, LIG was then tested in-vitro against 5 different Candida species. MIC value of LIG against Candida spp. was found to be 64-128μg/ml. The study is revealing LIG as a potent and persuasive antifungal agent. In the race of Candida therapeutics, the revelation of the antifungal potential of such natural compounds might impact and diversify the discovery and development of novel antifungal agent.


Evolution of active host-attraction strategies in the freshwater mussel tribe Lampsilini (Bivalvia: Unionidae).
Most freshwater mussels (Bivalvia: Unionoida) require a host, usually a fish, to complete their life cycle. Most species of mussels show adaptations that increase the chances of glochidia larvae contacting a host. We investigated the evolutionary relationships of the freshwater mussel tribe Lampsilini including 49 of the approximately 100 extant species including 21 of the 24 recognized genera. Mitochondrial DNA sequence data (COI, 16S, and ND1) were used to create a molecular phylogeny for these species. Parsimony and Bayesian likelihood topologies revealed that the use of an active lure arose early in the evolution of the Lampsiline mussels. The mantle flap lure appears to have been the first to evolve with other lure types being derived from this condition. Apparently, lures were lost independently in several clades. Hypotheses are discussed as to how some of these lure strategies may have evolved in response to host fish prey preferences.


The isotopic composition of evaporating waters - review of the historical evolution leading up to the Craig-Gordon model.
Attempts to explain the variations in the abundance of heavy isotopic species of water throughout the hydrologic cycle solely by means of the classical equilibrium-fractionation processes could not be reconciled with measured abundances of the isotopic species in residues of "evaporation systems". Focusing on the evaporation of surface waters, the paper follows the evolution of the concepts during the 1950-ties and early 1960-ties leading up to the formulation of the Craig-Gordan Evaporation Model in 1965.


Laminin-1 and SIKVAV a laminin-1-derived peptide, regulate the morphology and protease activity of a human salivary gland adenoid cystic carcinoma cell line.
In a previous paper, we demonstrated that laminin-1 and its derived peptide SIKVAV modulates the morphology of an adenoid cystic carcinoma cell line (CAC2 cells). Light microscopy of CAC2 cells grown in three-dimensional preparations of SIKVAV-enriched laminin-1 showed the presence of pseudocystic spaces. Pseudocysts are hallmarks of adenoid cystic carcinoma in vivo. We hypothesized that these pseudocystic spaces could be due to the protease-inducing/activating role of SIKVAV. Thus, we studied the presence of matrix metalloproteinases (MMPs) in CAC2 cells treated either by laminin-1 or by SIKVAV-enriched laminin-1. Immunohistochemistry and zymography suggested that SIKVAV enhanced the secretion of MMP-2 and MMP-9 in CAC2 cells. We propose that SIKVAV induces pseudocystic formation probably through the secretion of MMPs 2 and 9.


Michael Bárány: a recollection.
In this special edition of the Journal of Muscle Research and Cell Motility, we recall the lives and scientific contributions of Michael and Kate Bárány, who died in 2011. Michael and Kate were Holocaust survivors who went on to become leading researchers in muscle contraction. Their research topics included myosin isoforms, phosphorylation as a regulator of muscle contraction and the application of NMR to study muscle metabolism. They were deeply committed to science and to fostering the careers of young investigators.


A double-blind clinical trial of kamalahar, an indigenous compound preparation, in acute viral hepatitis.
Kamalahar is an indigenous preparation reported to be beneficial in acute viral hepatitis. To evaluate the efficacy of Kamalahain acute viral hepatitis in a double-blind, placebo-controlled study. Fifty two patients with acute viral hepatitis were randomized to receive either Kamalahar 500 mg or a matched placebo three times a day for 15 days. Forty four patients (Kamalahar 20; placebo 24) completed the trial. Improvement in clinical signs was more marked with Kamalahar compared to placebo. The fall in serum bilirubin (p < 0.001), SGPT (p < 0.001) and serum alkaline phosphatase (p < 0.005) at day 15 was significantly greater with the drug. No significant side effects were observed. Kamalahar offers therapeutic promise in acute viral hepatitis.


Postoperative intussusception after surgery for malrotation and appendicectomy in a newborn.
Postoperative intussusception in the newborn is an infrequent condition. A 17-day-old female with duodenal stenosis and malrotation underwent excision of the membrane in the duodenum and incidental appendicectomy. Postoperatively, a ceco-colic type of intussusception occurred, necessitating a right hemicolectomy. We speculate that the causative factors are twofolds: the embedded appendiceal stump, a polyp-like protrusion that became a lead point, and the non-fixation of the ileocecal mesentery, which facilitated a ceco-colic type of invagination.


Early Graft Dysfunction in Living Donor Liver Transplantation and the Small for Size Syndrome.
LDLT has arisen as a viable means to reduce waitlist mortality. However, its widespread embrace by the liver transplant community has been met with frustration centered on donor morbidity and small-for-size-syndrome. Focusing on the later entity, we describe the initial recognition of this early graft dysfunction, the theorized pathophysiology and solutions to remedy its emergence.


Spinal cord involvement in two children with posterior reversible encephalopathy syndrome.
Spinal cord involvement (SCI) is a rare feature of posterior reversible encephalopathy syndrome (PRES), especially in children. SCI is generally symptomatic, and may have a different outcome compared with encephalic localization of PRES. We reported about two cases of SCI in pediatric patients with PRES, after multimodal anticancer therapies, including radiotherapy, chemotherapy and targeted agents.


Molecular and Pathological Events Involved in the Pathogenesis of Diabetes-Associated Nonalcoholic Fatty Liver Disease.
Diabetes mellitus is a rising epidemic in most part of the world and is often associated with multiple organ disorders such as kidney, liver, and cardiovascular diseases. Liver is a major metabolic hub, and the metabolic disorders associated with diabetes result in liver dysfunctions culminating in spectrum of liver diseases such as fatty liver disorders, cirrhosis, and hepatocellular carcinoma. The intervention strategies to prevent diabetes-associated liver injury require an overall understanding of the key factors and molecular pathways which can be strategically targeted. The present review focuses on some of the key aspects of fatty acid metabolism, fetuin-A regulation, inflammatory pathways, and genetic factors associated with insulin resistance, dyslipidemia, hyperglycemia, oxidative stress, and so on involved in the nexus between diabetes and liver injury. Further recent interventions, pharmacological target, and newer therapeutic agents are discussed briefly for the better clinical management of diabetes-associated hepatic disorders.


Reduced expression of Krüppel-like factor 17 is related to tumor growth and poor prognosis in lung adenocarcinoma.
Krüppel-like factor 17 (KLF17), a new member of the Krüppel-like factors (KLFs), has been reported to be a negative regulator of epithelial-mesenchymal transition (EMT) and metastasis in breast cancer. However, the biological role and clinical significance of KLF17 in lung adenocarcinoma has been less clear. In the present study, we showed that KLF17 expression was decreased in lung adenocarcinoma. Reduced expression of KLF17 was correlated significantly with a short survival time in patients with lung adenocarcinoma (P<0.0001). Moreover, KLF17 expression was an independent prognostic indicator for patients with lung adenocarcinoma. KLF17 expression level was correlated with the tumor stage (P=0.016) and tumor size (P=0.001) in lung adenocarcinoma. Overexpression of KLF17 inhibited cell growth in A549 and PC-9 cell lines. In conclusion, it is possible that KLF17 inhibits tumor growth in lung adenocarcinoma. The reduced expression of KLF17 is a valuable prognostic indicator for patients with lung adenocarcinoma, and KLF17 could be a novel target for treatment of lung adenocarcinoma.


Inter- and intrahemispheric relationships of the EEG activity during sleep in man.
Using both linear and non-linear multivariate analysis associated with classical statistical tests, inter- and intrahemispheric relations of the cerebral electrical activity (EEG) during sleep were analysed by spectral power, coherence (CH) and correlation functions. Whilst a steady diffuse decrease in linear phase relations (CH) appeared during the evolution from waking to slow wave sleep, paradoxical sleep was associated with low interhemispheric CHs (mostly frontal) and high intrahemispheric CHs. Simultaneously, at a much lower degree of temporal resolution (25.6 sec periods), the correlations between EEG activities of identical frequencies but of different topographies were highly positive during sleep, whilst the correlations between activities of different frequencies at the same site on the scalp varied according to sleep states and frequencies. These findings suggest the interpretation of deep sleep in man as a state of transient partial disconnection between hemispheres.


Effect of hip flexion angle on stiffness of the adductor longus muscle during isometric hip flexion.
This study examined the effect of hip flexion angle on the stiffness of the adductor longus (AL) muscle during isometric hip flexion. Seventeen men were recruited. Ten participants performed submaximal voluntary contraction at 0%, 25%, 50%, and 75% of maximal voluntary contraction (MVC) during isometric hip flexion after performing MVC at 0°, 40°, and 80° of hip flexion. Seven participants performed submaximal voluntary tasks during isometric hip extension in addition to hip flexion task. The shear modulus of the AL muscle was used as the index of muscle stiffness, and was measured using ultrasound shear-wave elastography during the tasks at each contraction intensity for each hip flexion angle. During hip flexion, the shear modulus of the AL muscle was higher at 0° than at 40° and 80° of hip flexion at each contraction intensity (p < 0.016). Conversely, a significant effect was not found among hip flexion angle during hip extension at 75% of MVC (p = 0.867). These results suggest that mechanical stress of the AL muscle may be higher at 0° of hip flexion during isometric hip flexion.


HLA typing in birdshot chorioretinopathy.
We examined 49 patients with birdshot chorioretinopathy in whom HLA typing had been performed. Of these 49 patients, 47 (95.9%) had the HLA-A29 antigen. The HLA-B12 (B44) antigen was also significantly associated with the disease, but this antigen is known to be in linkage disequilibrium with the antigen HLA-A29. The HLA-A2 antigen was less frequent in patients with birdshot chorioretinopathy than in the control group of normal European individuals (20% as compared to 44.6%).


Plant uptake of 238U, 235U, 232Th, 226Ra, 210Pb and 40K from a coal ash and slag disposal site and control soil under field conditions: A preliminary study.
The aim of this study was to investigate the uptake of 238U, 235U, 232Th, 226Ra, 210Pb and 40K by plants that grow on a coal ash and slag disposal site known for its higher content of naturally occurring radionuclides. Plant species that were sampled are common for the Mediterranean flora and can be divided as follows: grasses & herbs, shrubs and trees. To compare the activity concentrations and the resultant concentration ratios of the disposal site with those in natural conditions, we used control data specific for the research area, obtained for plants growing on untreated natural soil. Radionuclide activity concentrations were determined by high resolution gamma-ray spectrometry. Media parameters (pH, electrical conductivity and organic matter content) were also analysed. We confirmed significantly higher activity concentrations of 238U, 235U, 226Ra and 210Pb in ash and slag compared to control soil. However, a significant increase in the radionuclide activity concentration in the disposal site's vegetation was observed only for 226Ra. On the contrary, a significantly smaller activity concentration of 40K in ash and slag had no impact on its activity concentration in plant samples. The calculated plant uptake of 238U, 235U, 226Ra and 210Pb is significantly smaller in comparison with the uptake at the control site, while it is vice versa for 40K. No significant difference was observed between the disposal site and the control site's plant uptake of 232Th. These results can be the foundation for further radioecological assessment of this disposal site but also, globally, they can contribute to a better understanding of nature and long-term management of such disposal sites.


Benzyne-functionalized graphene and graphite characterized by Raman spectroscopy and energy dispersive X-ray analysis.
The benzyne functionalization of chemical vapor deposition grown large area graphene and graphite was performed using a mixture of o-trimethylsilylphenyl triflate and cesium fluoride that react with the carbon surface. The reaction requires at least 2 days of treatment before the appearance of Raman and energy-dispersive X-ray spectral signatures that verify modification. Raman spectra of modified graphene and graphite show a rich structure of lines corresponding to C=C-C, C-H, and low frequency modes of surface-attached benzyne rings.


Natural variation in the HAN1 gene confers chilling tolerance in rice and allowed adaptation to a temperate climate.
Rice (Oryza sativa L.) is a chilling-sensitive staple crop that originated in subtropical regions of Asia. Introduction of the chilling tolerance trait enables the expansion of rice cultivation to temperate regions. Here we report the cloning and characterization of HAN1, a quantitative trait locus (QTL) that confers chilling tolerance on temperate japonica rice. HAN1 encodes an oxidase that catalyzes the conversion of biologically active jasmonoyl-L-isoleucine (JA-Ile) to the inactive form 12-hydroxy-JA-Ile (12OH-JA-Ile) and fine-tunes the JA-mediated chilling response. Natural variants in HAN1 diverged between indica and japonica rice during domestication. A specific allele from temperate japonica rice, which gained a putative MYB cis-element in the promoter of HAN1 during the divergence of the two japonica ecotypes, enhances the chilling tolerance of temperate japonica rice and allows it to adapt to a temperate climate. The results of this study extend our understanding of the northward expansion of rice cultivation and provide a target gene for the improvement of chilling tolerance in rice.