Occurrence and tissue distribution of c-series gangliosides in the common squid Todarodes pacificus.
We have recently demonstrated that the common squid Todarodes pacificus express acidic lipids that were reactive with a monoclonal antibody A2B5. In the present study, two A2B5-reactive acidic lipids were isolated from squid hepatopancreatic tissue and characterized for their structures by methods including glycolipid overlay analysis, product analysis after sialidase treatment, and electrospray ionization-mass spectrometry (ESI-MS). Accordingly, the two acidic lipid were identified as GT3 and GQ1c, respectively. Another A2B5-reactive acidic lipid in the tissue was tentatively assigned to GT2 based upon its reactivity to A2B5 and chromatographic mobility on thin-layer chromatography. The composition and concentration of c-series gangliosides significantly differed among squid tissues (i.e. hepatopancreas, cerebral ganglion, eye lens, and mantle tissue). Interestingly, the percentages of c-series gangliosides within total gangliosides of hepatopancreas and cerebral ganglion were even higher than that of cod fish brain, which is known to be highly enriched with this ganglioside species. These findings strongly support the hypothesis that c-series gangliosides in squid tissues are not derived from ganglioside-containing food intake, but biosynthesized in a tissue-specific manner.


Chemopreventive Agents from Physalis minima Function as Michael Reaction Acceptors.
The fruits of some varieties of genus Physalis have been used as delicious fruits and functional food in the Northeast of China. To reveal the functional material basis, we performed bioactivity-guided phytochemical research and chemopreventive effect assay of the constituents from Physalis minima. It was demonstrated that the ethyl acetate extract of P. minima L. (EEPM) had potential quinone reductase (QR) inducing activity with induction ratio (IR, QR induction activity) value of 1.47 ± 0.24, and glutathione binding property as potential Michael reaction acceptors (with an α, β-unsaturated ketone moiety). Furthermore, bioactivity-guided phytochemical research led eight compounds (1-8), which were elucidated as 3-isopropyl-5-acetoxycyclohexene-2-one-1 (1), isophysalin B (2), physalin G (3), physalin D (4), physalin I (5), physordinose B (6), stigmasterol-3-O-β-D-glucopyranoside (7) and 5α-6β-dihydroxyphysalin R (8) on the basis of nuclear magnetic resonance spectroscopy analyses and HRESIMS. Then, isophysalin B (2) and physordinose B (6) showed significant QR inducing activity with IR value of 2.80 ± 0.19 and 2.38 ± 0.46, respectively. An ultra-performance liquid chromatographic method with glutathione as the substrate was used to detect the Michael reaction acceptors in extracts of Physalis minima (EPM)We investigated the chemical constituents of EPM guided by biological activity methodIsophysalin B (1) and physordinose B (6) showed strong quinone reductase inducing activity with induction ratio values of 2.80 ± 0.19 and 2.38 ± 0.46This study generated useful information for consumers and many encourage researchers to utilize edible fruits from Physalis as a source of phytochemicals Abbreviations used: EPM: Extracts of Physalis minima, EEPM: Ethyl acetate extract of Physalis minima L., GSH: Glutathione, MRAs: Michael reaction acceptors, QR: Quinone reductase.


Lack of agreement between measured and self-reported distance from public green parks in Glasgow, Scotland.
Reviews have reported mixed findings for associations between physical activity and proximity to a range of environmental resources. Initially most studies used self reported proximity, but more are now using GIS techniques to measure proximity objectively. We know little about the extent of agreement between self reported and directly measured proximity of the same resource. We used previously collected data in a community survey in Glasgow in which 658 respondents aged around 40 and 60 were asked whether they lived within half a mile of a public park. We compared their answers with GIS measures of whether there was a park within a half mile service area of their home (and whether their home was within a half mile crow fly buffer of a park). Agreement was poor; percentage agreement between measured network distance and reported residence within 0.5 miles of a park was 62.0%, and the kappa value was 0.095. Agreement was no higher than poor in any socio-demographic subgroup, or when using crow fly buffers instead of service areas. One should be cautious about assuming that respondents' self reports of proximity to a resource are a valid proxy for actual distance, or vice versa. Further research is needed to establish whether actual or self-reported proximity predict physical activity or other behaviours, and if so which is the strongest predictor. Further, qualitative study, also needs to examine the basis of people's judgements about the location of resources, and the possibility that these are shaped by their social and personal significance.


Peroneal motor nerve conduction velocity in diabetic children and adolescents. Relationships to metabolic control, HLA-DR antigens, retinopathy, and EEG.
To investigate incipient diabetic neuropathy, peroneal motor nerve conduction velocity (PMNCV) was measured in 61 diabetic children and adolescents whose type 1 diabetes became clinically apparent before the age of 14 years. PMNCV in diabetic patients (48.3 +/- 5.6 m/s) was significantly lower than in controls (56.5 +/- 5.5 m/s), 23 diabetics (36%) having a value more than 2 SD below the mean for normals. There was a highly significant negative correlation between PMNCV and HbA1 levels concomitant with PMNCV measurement or mean annual HbA1 concentrations preceding PMNCV. The relationship between PMNCV and the clinical score of diabetic control since the onset of the disease was also significant. Age, duration of diabetes and HLR-DR antigens were unrelated to PMNCV. EEG abnormalities and retinopathy, whose pathogenesis is different, were not necessarily associated with subclinical neuropathy. Being easy and sensitive, PMNCV determination provides the paediatric diabetologist and the patient himself with an important motivation to improve diabetic control.


Characterization of a novel 5-HT4 receptor antagonist of the azabicycloalkyl benzimidazolone class: DAU 6285.
Three chemical classes of serotonin 5-HT4 receptor agonists have been identified so far: 5-substituted indoles (e.g. 5-HT), benzamides (e.g. renzapride) and benzimidazolones (e.g. BIMU 8). In a search for 5-HT4 receptor antagonists, we have discovered that the benzimidazolone derivative DAU 6285 (for structure see text), is 3-5 times more potent than tropisetron in blocking 5-HT, renzapride and BIMU 8 induced stimulation of adenylate cyclase activity in mouse embryo colliculi neurons. Schild plot analysis yielded Ki values of 220, 181 and 255 nmol/l, respectively. In addition, DAU 6285 showed poor activity as a 5-HT3 receptor ligand with respect to tropisetron, as demonstrated by in vitro binding studies (Ki, 322 vs 2.8 nmol/l) and by its antagonistic activity in the Bezold-Jarisch reflex test (ID50, 231 vs 0.5 micrograms/kg, i.v.). No significant binding (Ki greater than 10 mumol/l) of DAU 6285 to serotonergic 5-HT1A, 5-HT1B, 5-HT1C, 5-HT1D, and 5-HT2 receptors as well as to adrenergic alpha 1, alpha 2, dopaminergic D1, D2 or muscarinic M1-M3 receptor subtypes was found. The data indicate that DAU 6285 has a somewhat higher affinity than tropisetron for 5-HT4 receptors, a property confirmed in functional tests, and much lower affinity than tropisetron for 5-HT3 receptors. The compound represents a new interesting tool for investigating the pharmacological and physiological properties of 5-HT4 receptors.


A statistical procedure for predicting medical school graduates' specialty choices.
A statistical procedure was devised for selecting, from a group of contenders, a relatively small set of variables which most efficiently predict medical specialty choice. While it is possible to predict medical specialty choice with fair accuracy using subsets of variables, predictions are not conclusive enough to be useful in actual decision-making concerning individuals.


Extinction of an immunoglobulin kappa promoter in cell hybrids is mediated by the octamer motif and correlates with suppression of Oct-2 expression.
When immunoglobulin-expressing B cells are fused with fibroblasts, immunoglobulin expression is rapidly and selectively suppressed. here we demonstrate that the conserved octamer motif of a kappa light chain gene promoter plays a crucial role in mediating this "extinction" phenomenon. Replacement of this octamer site by an Sp1 or NF1 binding site is sufficient to bypass extinction. Furthermore, in early cell hybrids, immunoglobulin suppression is correlated with absence of the cell-specific transcription factor Oct-2 and its transcripts. Such hybrids cannot support transcription of a transiently introduced reporter plasmid, driven by an octamer-containing promoter, unless an expression vector encoding Oct-2 is cotransfected. Transfection of the same Oct-2 expression vector into hybrid cells is also sufficient to "reactivate" an integrated kappa promoter construct. Thus, our data further establish the role of Oct-2 for immunoglobulin transcription and show that in B cell x fibroblast hybrids, the lack of a necessary cell-specific transcription factor is involved in the extinction of immunoglobulin expression.


Endoscopic tacking system as a novel tissue approximation measure for very large EMR defects.
Defect closure post-EMR and endoscopic submucosal dissection (ESD) is recommended to decrease the risk of delayed bleeding and perforation. Current methods of tissue approximation and closure of mucosal defects have their limitations, including restricted maneuverability, need for scope withdrawal, or difficulty in apposing larger defects. Through-the-scope HeliX tacking system (Apollo Endosurgery, Austin, Tex, USA) is a novel tissue apposition device designed to mimic suture closure without the need to withdraw the endoscope or insert bulky devices on the tip of the endoscope. Previous reports demonstrate its effectiveness for closure of standard postresection defects, fistulae, and peroral endoscopic myotomy mucosectomy sites. However, reports on its feasibility and technique for very large defects are scarce. In this case series, we demonstrate a tissue approximation technique using a novel through-the-scope HeliX tacking system for a 10-cm ascending colon and a 5-cm gastric antrum postresection defects. A zig-zag running pattern and figure 8 suturing pattern were used for the colonic and gastric defect approximation, respectively. Tissue approximation was easily and successfully achieved in both cases. Four and 2 sets of tacks were used in the colonic and gastric defect, respectively. Closure of these defects otherwise would have required a substantial number of clips, withdrawal/exchange of the endoscope to mount the suturing device, or difficulty in maneuvering the closure devices. There was no immediate or delayed adverse event postprocedure. Through-the-scope suturing using the HeliX tacking system is a unique tool that integrates the capabilities of current tissue apposition devices post EMR and ESD. Through-the-scope suturing is an ideal option especially for tissue approximation of large resection beds within the right side of the colon and areas with limited space for maneuverability.


The influence of different sample preparation on mechanical properties of human iliotibial tract.
In the run-up to biomechanical testing, fresh human tissue samples are often frozen in order to inhibit initial decomposition processes and to achieve a temporal independence of tissue acquisition from biomechanical testing. The aim of this study was to compare the mechanical properties of fresh tissue samples of the human iliotibial tract (IT) to fresh-frozen samples taken from the same IT and those modified with different concentrations of Dimethylsulfoxide (DMSO) prior to freezing. All samples were partial plastinated and destructive tensile tests were conducted with a uniaxial tensile test setup. A plastination technique already established in the laboratory was modified to improve the clamping behaviour of the samples. Material failure was caused by a gradual rupture of the load-bearing collagen fibre bundles. Contrary to our expectations, no significant difference was found between the tensile strength of fresh and fresh frozen specimens. The addition of 1 wt% DMSO did not increase the tensile strength compared to fresh-frozen samples; an addition of 10 wt% DMSO even resulted in a decrease. Based on our findings, the use of simple fresh-frozen specimens to determine the tensile strength is viable; however fresh specimens should be used to generate a complete property profile.


Vascular intracranial malformations and dementia: An under-estimated cause and clinical correlation. Clinical note.
Cerebrovascular malformations (CVMs) such as arteriovenous malformations (AVMs) or dural arteriovenous fistulas (DAVFs) represent a possible source of intracranial hemorrhage, but these malformations can also manifest with neurologic disorders secondary to ischemic penumbra from vascular steal. In the latter case, the clinical manifestations are less obvious and characteristic, and may include a varied clinical spectrum ranging from focal deficits to generalized malfunction of the brain parenchyma resulting in dementia. Dementias secondary to CVMs constitute a probably underestimated subpopulation of patients of great interest because they present with devastating but potentially reversible cognitive impairment. We examined the pertinent literature regarding the clinical manifestations of CVMs characterized by cognitive impairment and describe the distinctive clinical features. Our results confirm that cognitive impairment is one of the clinical manifestations of CVMs and is a frequently misrecognized and often late-diagnosed cause of reversible dementia.


The surgical treatment of hypertrophic intertriginous Darier's disease.
Darier's disease is a rare autosomal-dominant genodermatosis characterised by persistent hyperkeratotic papules and plaques in seborrhoeic areas. The flexural areas of the body are especially difficult to treat, and they are often resistant to current topical and systemic treatment strategies. To our knowledge, this article provides the first description of a successful surgical treatment of a severely debilitating, hypertrophic Darier's disease of intergluteal area, resistant to oral retionids. A 25-year-old male patient was successfully treated with the use of tissue expanders and diseased skin excision. There are no signs of recurrence of the disease in the perianal region 6 months postoperatively, and there is a good result in functional as well as cosmetic terms. The formation of new skin on the excision site was observed, and there were no evident signs of infection. These encouraging results suggest that a patient who responds poorly to conventional treatment in a specific area should be presented to the plastic surgeon at an earlier point in time. Therefore, unnecessary hospitalisations, antibiotic treatments, dose-related adverse effects of oral retionids can be avoided, and eventually a long-term result can be achieved.


Molecular cloning, overexpression, purification, and characterization of an aerobic FMN-dependent azoreductase from Enterococcus faecalis.
Azo dyes represent a major class of synthetic colorants that are ubiquitous in foods and consumer products. Enterococcus faecalis is a predominant member of the human gastrointestinal microflora. Strain ATCC 19433 grew in the presence of azo dyes and metabolized them to colorless products. A gene encoding a putative FMN-dependent aerobic azoreductase that shares 34% identity with azoreductase (AcpD) of Escherichia coli has been identified in this strain. The gene in E. faecalis, designated as azoA, encoded a protein of 208 amino acids with a calculated isoelectric point of 4.8. AzoA was heterologously overexpressed in E. coli with a strong band of 23 kDa on SDS-PAGE. The purified recombinant enzyme was a homodimer with a molecular weight of 43 kDa, probably containing one molecule of FMN per dimer. AzoA required FMN and NADH, but not NADPH, as a preferred electron donor for its activity. The apparent Km values for both NADH and 2-[4-(dimethylamino)phenylazo]benzoic acid (Methyl red) substrates were 0.14 and 0.024 mM, respectively. The apparent Vmax was 86.2 microM/min/mg protein. The enzyme was not only able to decolorize Methyl red, but was also able to convert sulfonated azo dyes Orange II, Amaranth, Ponceau BS, and Ponceau S. AzoA is the first aerobic azoreductase to be identified and characterized from human intestinal gram-positive bacteria.


[An new filling material of hair for the application of plastic surgery].
To investigate the possibility of hair as a filling material for reconstructive or cosmetic surgery. Sterilized pellets of hairs and silicone were selected and implanted subcutaneously in white rabbits. The clinical trial was carried out in 3 cases. A thin fibrous capsule, with much few inflammatory cells, was formed around the implanted hair pellets in 3-4 months. The inflammatory cells disappeared in the 9th month. No implant rejection, granulomatous formation or hair degradation was showed. Hair may be a valuable filling material for augmentation of the soft tissue.


Triangulating stapling technique for anastomosis in laparoscopy-assisted pylorus-preserving gastrectomy.
The anastomosis performed during laparoscopy-assisted pylorus-preserving gastrectomy (PPG) is usually handsewn; however, the technique is sometimes difficult because it is done through a small incision and the level of skill of each operator may vary. The present study describes a triangulating stapling technique used during an anastomosis in laparoscopy-assisted pylorus-preserving gastrectomy. The 80-mm stapler was used 3 times for the triangulating stapling technique. The posterior walls, including the stay sutures, were joined by firing the stapler, and the anterior stomach ends were stapled in an everting fashion using two firings of the stapler. Both the anterior staple lines should overlap in the middle. Patient demographics and the operative data were examined. The triangulating stapling technique was performed during laparoscopy-assisted PPG in 9 patients. The median time for the anastomosis during laparoscopy-assisted PPG using the triangulating stapling technique was 19.0 min (16.0-31.0). Postoperative complications, including gastric stasis and anastomotic failure, were not found in any of the present patients. The triangulating stapling technique using a linear stapler is a safe and reliable technique to perform and can be easily conducted in a short time. We therefore consider it a useful anastomosis method for laparoscopy-assisted pylorus-preserving gastrectomy, even by unskilled surgeons.


A Giant Apocrine Hidrocystoma Presenting as Lacrimal Gland Mass.
Apocrine hidrocystomas are cysts resulting from obstruction of the apocrine sweat gland ducts. They are usually solitary and seen in the head and neck areas. Apocrine hidrocystomas are rarely seen in the orbit with very few adult cases published in literature until now.


The future of the IL-1 receptor antagonist anakinra: from rheumatoid arthritis to adult-onset Still's disease and systemic-onset juvenile idiopathic arthritis.
IL-1 receptor antagonist (IL-1Ra) is a naturally occurring IL-1RI-binding molecule that blocks the biologic effects of the proinflammatory cytokine IL-1. A recombinant form of human IL-1Ra, anakinra (Kineret), has been approved for use in rheumatology initially to manage rheumatoid arthritis (RA) patients that are refractory to more conventional forms of treatment. This review summarizes the experience with anakinra in the treatment of patients with rheumatic diseases emphasizing its beneficial effects in novel applications. English-language trials of anakinra were searched using MEDLINE and abstracts from rheumatology scientific meetings. In the treatment of patients with RA anakinra is effective but inferior to TNF-alpha blocking agents. Over the last few years it has become increasingly evident that anakinra is highly effective and safe in patients with systemic-onset juvenile idiopathic arthritis, adult-onset Still's disease, hereditary autoinflammatory syndromes, Schnitzler's syndrome and recently in gouty attacks.


FEF-Controlled Alpha Delay Activity Precedes Stimulus-Induced Gamma-Band Activity in Visual Cortex.
Recent findings in the visual system of nonhuman primates have demonstrated an important role of gamma-band activity (40-100 Hz) in the feedforward flow of sensory information, whereas feedback control appears to be established dynamically by oscillations in the alpha (8-13 Hz) and beta (13-18 Hz) bands (van Kerkoerle et al., 2014; Bastos et al., 2015). It is not clear, however, how alpha oscillations are controlled and how they interact with the flow of visual information mediated by gamma-band activity. Using noninvasive human MEG recordings in subjects performing a visuospatial attention task, we show that fluctuations in alpha power during a delay period in a spatial attention task preceded subsequent stimulus-driven gamma-band activity. Importantly, these interactions correlated with behavioral performance. Using Granger analysis, we further show that the right frontal-eye field (rFEF) exerted feedback control of the visual alpha oscillations. Our findings suggest that alpha oscillations controlled by the FEF route cortical information flow by modulating gamma-band activity.SIGNIFICANCE STATEMENT Visual perception relies on a feedforward flow of information from sensory regions, which is modulated by a feedback drive. We have identified the neuronal dynamics supporting integration of the feedforward and feedback information. Alpha oscillations in early visual regions reflect feedback control when spatial attention is allocated and this control is exercised by the right frontal eye field. Importantly, the alpha-band activity predicted both performance and activity in the gamma band. In particular, gamma activity was modulated by the phase of the alpha oscillations. These findings provide novel insight into how the brain operates as a network and suggest that the integration of feedforward and feedback information is implemented by cross-frequency interactions between slow and fast neuronal oscillations.


Clinical factors associated with the development of atrial fibrillation in the year following STEMI treated by primary PCI.
Advanced age, poor left ventricular function, and congestive heart failure are known predictors of atrial fibrillation (AF) in acute myocardial infarction (AMI) patients. Recent advances in AMI treatment may have changed the occurrence of new-onset AF. Thus, we investigated the factors associated with the development of new-onset AF in ST elevation myocardial infarction (STEMI) patients. This study included 527 STEMI patients [mean age, 60.6±12.8 years; 102 (19.4%) women] who underwent primary percutaneous coronary intervention (PCI) in the previous 7 years. New-onset AF was evaluated following STEMI treated by primary PCI. Patients who developed AF during this follow-up period were compared with those who did not develop AF to identify factors that were associated with the development of AF. New-onset AF was documented in 81 patients (15.4%) at 1 year after STEMI. Patients with new-onset AF (n=81) tended to be older (p<0.001); were more often female (p=0.009); had more congestive heart failure (p=0.015); had less use of beta-blockers (p=0.001); had more often used antiarrhythmic drugs (p<0.001); experienced cardiogenic shock more frequently (p=0.038); had lower left ventricular ejection fraction (p=0.024); and had higher E velocity (p<0.001), E/e' (p=0.011), and left atrial volume index (LAVI; p=0.029) than the 446 patients with no AF. Multivariate regression analysis revealed that cardiogenic shock, LAVI, and age were predictors of new-onset AF in STEMI patients (OR 2.823, 1.254, and 1.124; p=0.005, <0.001, and 0.028, respectively). Cardiogenic shock was a new predictor of new-onset AF in STEMI patients.


Efficacy of Nutritional Therapy for Patients With Cirrhosis and Minimal Hepatic Encephalopathy in a Randomized Trial.
Minimal hepatic encephalopathy (MHE) impairs health-related quality of life (HRQOL), leads to the development of overt HE, and is associated with poor outcome. We performed a randomized controlled trial to assess the effects of nutritional therapy on cognitive functions and HRQOL in patients with cirrhosis with MHE. In a tertiary care setting in New Delhi, India, patients with cirrhosis with MHE were assigned randomly to groups given nutritional therapy (30-35 kcal/kg/d, 1.0-1.5 g vegetable protein/kg/d; n = 60; age, 42.1 ± 10.3 y; 48 men) or no nutritional therapy (patients continued on their same diet; n = 60; age, 42.4 ± 9.6 y; 47 men) for 6 months in 2014. MHE was diagnosed based on their psychometry hepatic encephalopathy score (PHES). HRQOL was assessed by a sickness impact profile (SIP) questionnaire. Primary end points were improvement or worsening in MHE and improvement in HRQOL. There was no significant difference in baseline PHES (-8.12 ± 1.32 vs -8.53 ± 1.38; P = .08) or SIP (14.25 ± 5.8 vs 15.44 ± 5.03; P = .85) scores. After the 6-month study period, a higher proportion of patients in the nutritional therapy group had reversal of MHE (71.1% vs 22.8%; P = .001). Patients in the nutritional therapy group also had larger increases in PHES (3.86 ± 3.58 vs 0.52 ± 4.09; P = .001) and HRQOL (improvement in SIP score of 3.24 ± 3.63 vs 0.54 ± 3.58; P = .001). Overt HE developed in 10% of patients in the nutritional therapy group vs 21.7% of the control group (P = .04). Based on a randomized controlled trial performed in India, nutritional therapy is effective in the treatment of MHE and is associated with improvement in HRQOL. Clinical Trial Registry-India registration no: CTRI/2013/07/003851.


An evolutionary deep learning soft sensor model based on random forest feature selection technique for penicillin fermentation process.
Accurate and reliable measurement of key biological parameters during penicillin fermentation is of great significance for improving penicillin production. In this research context, a new hybrid soft sensor model method based on RF-IHHO-LSTM (random forest-improved Harris hawks optimization-long short-term memory) is proposed for penicillin fermentation processes. Firstly, random forest (RF) is used for feature selection of the auxiliary variables for penicillin. Next, improvements are made for the Harris hawks optimization (HHO) algorithm, including using elite opposition-based learning strategy (EOBL) in initialization to enhance the population diversity, and using golden sine algorithm (Gold-SA) in the search strategy to make the algorithm accelerate convergence. Then the long short-term memory (LSTM) network is constructed to build a soft sensor model of penicillin fermentation processes. Finally, the hybrid soft sensor model is used to the Pensim platform in simulation experimental research. The simulation test results show that the established soft sensor model, with high accuracy of measurement and good effect, can meet the actual requirements of engineering.


Proteomic analysis identifies differentially expressed proteins in AML1/ETO acute myeloid leukemia cells treated with DNMT inhibitors azacitidine and decitabine.
Azacitidine and decitabine are DNA methyltransferase inhibitors used to treat myelodysplastic syndromes and acute myeloid leukemias. To further characterize different mechanisms between these two agents, cellular extracts from leukemic cells untreated or treated with either drug were analyzed using 2D electrophoresis. Numerous differentially expressed proteins were identified with MALDI-TOF/TOF-MS. Cyclophilin A, Catalase, Nucleophosmin and PCNA were decreased exclusively by azacitidine, TCP1 and hnRNP A2/B1 by both drugs; alpha-Enolase and Peroxiredoxin-1 by decitabine. Interestingly, the expression of the proinflammatory protein Cyclophilin A, also suggested as marker of cell necrosis, was stimulated by decitabine. Finally, a comprehensive pathway analysis of data highlighted a relationship between the identified proteins and potential effectors.


Piloting a Basic Life Support instructor course: A short report.
The aim was to describe a new shortened pilot of the European Resuscitation Council's standard Basic Instructor Course. The four-hour pilot followed a blended learning strategy (pre-course preparation, on-site small-group sessions). Each participant taught a short Basic Life Support competency to the group (micro-teaching) and received the group's feedback. A feedback "drill" session followed. Primary quantitative outcome was the proportion of Basic Instructor Course participants subsequently teaching Basic Life Support. Post-course teachings were recorded and compared to standard eight-hour Basic Instructor Courses. Participants' open feedback question answers were qualitatively analyzed and presented descriptively. This pilot Basic Instructor Course taught 31 healthcare providers in 4 courses in 2019-2021 (aged 31.5 ± 12.9 years; 61 % women; 29 % physicians; 71 % medical students; 21 % no teaching experience). Participants reported that they gained most from micro-teaching (64 %), and advice on their teaching (50 %). Some judged the course as being too long (29 %). Twenty-seven pilot course participants (87 %) (including three instructor candidates) started teaching, whereas only nine of 37 participants of the 3 courses (24 %, including three instructor candidates) from the standard eight-hour course did. Participants of the pilot shortened Basic Instructor Course in a healthcare setting were successfully trained to teach European Resuscitation Council's Basic Life Support provider courses in a short four-hour format. The pilot course seems to enable future instructors to teach Basic Life Support provider courses. Higher motivation to teach resulted in four times as many instructors who taught courses after the pilot course compared to the standard course.


WITHDRAWN: Co-exposure effects of arsenic and fluoride on intelligence and oxidative stress in school-aged children: A cohort study.
This article has been withdrawn at the request of the editor. The Publisher apologizes for any inconvenience this may cause.


Cerebrospinal fluid analysis for Whipple's disease in patients with progressive supranuclear palsy.
The clinical picture of neurological involvement in Whipple's disease (WD) may resemble progressive supranuclear palsy (PSP). We looked for WD pathogen DNA in the cerebrospinal fluid of 9 patients with a clinical diagnosis of PSP. The analysis was negative for all samples, showing that WD is not commonly involved in the aetiopathogenesis of PSP.


Ureteral mullerian carcinosarcoma (mixed mullerian tumor) associated with endometriosis occurring in a patient with a concentrated soy isoflavones supplementation.
Malignant transformation and particularly malignant mixed mullerian tumor arising in extragenital endometriosis is extremely rare and occurs in the majority of cases after estrogen replacement therapy. We present a case of a 75-year-old woman who developed a ureteral malignant mullerian carcinosarcoma in a context of florid endometriosis. The patient had a history of total hysterectomy with bilateral salpingo-oophorectomy 30 years earlier for extensive endometriosis. Since 5 years, the patient has been on phytoestrogen supplementation consisting of 72 mg/day of superconcentrated soy isoflavones. This is the first case of ureteral mullerian carcinosarcoma arising in endometriosis foci after extensive phytoestrogen supplementation. Our data suggest that phytoestrogens at least in concentrated form may play a role not only in maintenance of endometriosis but also in its malignant transformation. Given the extraordinary popularity and availability of these dietary supplements, several studies are indispensable regarding their safety particularly in women with extensive endometriosis.


Bucking the tide in family violence research.
This autobiographical article recounts a 60-year career on research and teaching, 40 of which focused on interpersonal violence against other family members. Much of that research was carried despite prevailing beliefs which characterized either the methodology or the theory to be wrong. The article illustrates four underlining themes: iconoclasm; capitalizing on chance occurrences to select research topics; the conflict between ideology, evidence, and steps taken by critics to deny or discredit the results of my research; and the role of the personal history and the personality of the researcher in molding a scientific career.


Libraries of Uniform Magnetic Multicore Nanoparticles with Tunable Dimensions for Biomedical and Photonic Applications.
Multicore iron oxide nanoparticles, also known as colloidal nanocrystal clusters, are magnetic materials with diverse applications in biomedicine and photonics. Here, we examine how both of their characteristic dimensional features, the primary particle and sub-micron colloid diameters, influence their magnetic properties and performance in two different applications. The characterization of these basic size-dependent properties is enabled by a synthetic strategy that provides independent control over both the primary nanocrystal and cluster dimensions. Over a wide range of conditions, electron microscopy and X-ray diffraction reveal that the oriented attachment of smaller nanocrystals results in their crystallographic alignment throughout the entire superstructure. We apply a sulfonated polymer with high charge density to prevent cluster aggregation and conjugate molecular dyes to particle surfaces so as to visualize their collection using handheld magnets. These libraries of colloidal clusters, indexed both by primary nanocrystal dimension (dp) and overall cluster diameter (Dc), form magnetic photonic crystals with relatively weak size-dependent properties. In contrast, their performance as MRI T2 contrast agents is highly sensitive to cluster diameter, not primary particle size, and is optimized for materials of 50 nm diameter (r2 = 364 mM-1 s-1). These results exemplify the relevance of dimensional control in developing applications for these versatile materials.


Experimental evaluation of the usefulness of osteochondral allograft for articular cartilage defect.
This study was conducted to evaluate the usefulness of osteochondral allografts for articular cartilage defects. Cartilaginous defects measuring 4.5 mm in diameter were experimentally prepared in both the weight-bearing and non-weight-bearing regions of the femur in six male miniature pigs (9 months old). Osteochondral grafting was performed using fresh autografts (group AU), fresh allografts (group AL), or frozen allografts (group FA). Untreated cartilaginous defects were used as the control (group D). All the pigs were killed 4 weeks later, and the respective osteochondral grafts were macro- and microscopically evaluated. Hematoxylin and eosin staining, safranin O staining, and immunostaining [matrix metalloprotease-1 (MMP-1) and tissue inhibitor of metalloprotease-2 (TIMP-2)] were used for the histological evaluations of transplanted cartilage. Macroscopic and microscopic findings were assessed according to the criteria proposed by Wakitani et al. Although groups AU and AL showed similar median scores (ranges) for the evaluation of cartilaginous defect restoration, groups FA and D showed unfavorable scores: 3.9 (0-9) in group AU; 4.5 (0-12) in group AL; 10.2 (4-12) in group FA; and 7.0 (5-11) in group D. Immunostaining revealed almost identical results in groups AU and AL. As there were no histologically significant differences in the status of the osteochondral grafts between fresh autografts and fresh allografts, fresh allografts might be useful donor osteochondral grafts.


Grafting with epidermal Langerhans cell depressed cadaver split skin.
Viable cadaver split skin is very useful as a temporary coverage of excised burns. However, the functional time on the patients is short (2-3 weeks) due to rejection of the tissue. By depression of the epidermal Langerhans cell by ultraviolet light B and glucocorticosteroid, a prolongation of the allograft survival can be obtained.


Small-molecule antagonists of p53-MDM2 binding: research tools and potential therapeutics.
p53 regulates a key pathway which protects normal tissues from tumor development that may result from diverse forms of stress. In the absence of stress, growth suppressive and proapoptotic activity of p53 is inhibited by MDM2 which binds p53 and negatively regulates its activity and stability. MDM2 antagonists could activate p53 and may offer a novel therapeutic approach to cancer. Recently, we identified the first potent and selective low molecular weight inhibitors of MDM2-p53 binding, the Nutlins. These molecules activate the p53 pathway and suppress tumor growth in vitro and in vivo. They represent valuable new tools for studying the p53 pathway and its defects in cancer. Nutlins induce p53-dependent apoptosis in human cancer cells but appear cytostatic to proliferating normal cells. Their potent activity against osteosarcoma xenografts suggests that MDM2 antagonists may have clinical utility in the treatment of tumors with wild-type p53.


Human duodenal spheroids for noninvasive intracellular pH measurement and quantification of regulation mechanisms under physiological conditions.
Three-dimensional cell cultures (spheroids) of biopsies of human duodenum were used to develop a new noninvasive method for studying intercellular and intracellular mechanisms. Through examinations of intracellular pH regulation, high functional similarity to native tissue could be shown, as already evidenced morphologically. A special microperfusion chamber was developed to fix individual spheroids physically to a nylon net, via laminar perfusion flow through the chamber. A significant improvement over current fixation methods was shown by the increase of cell viability almost up to 100%. Viability of the spheroids was confirmed by trypan blue exclusion, by a LIVE/DEAD viability/cytotoxicity kit, and by BCECF distribution. Intracellular pH was measured by use of the pH-sensitive fluorescence dye BCECF. To investigate the intracellular pH regulation, spheroid-like vesicles were acidified by NH4Cl prepulse technique. The subsequent active intracellular pH recovery was blocked with Na+-free Krebs Henseleit (KH) solution, with amiloride KH (inhibitor of the Na+-H+-exchanger), or with H2DIDS KH (inhibitor of the HCO3(-)-Cl(-)-exchanger and Na+-HCO3(-)-cotransporter). The intracellular pH of the spheroids was 7.31 +/- 0.05. pH-backregulation after acidification was prevented by sodium-free buffer, amiloride, and H2DIDS. These experiments indicated the presence of a Na+-H+-exchanger and a Na+-HCO3(-)-cotransporter. In conclusion, the human duodenal spheroid is an excellent physiological system for in vitro studies of the human duodenum.


Effect of hydrothermal pretreatment on properties of bio-oil produced from fast pyrolysis of eucalyptus wood in a fluidized bed reactor.
Eucalyptus wood powder was first subjected to hydrothermal pretreatment in a high-pressure reactor at 160-190°C, and subsequently fast pyrolyzed in a fluidized bed reactor at 500°C to obtain high quality bio-oil. This study focused on investigating effect of hydrothermal pretreatment on bio-oil properties. Hemicellulose and some metals were effectively removed from eucalyptus wood, while cellulose content was enhanced. No significant charring and carbonization of constituents was observed during hydrothermal pretreatment. Thus pretreated eucalyptus wood gave higher bio-oil yield than original eucalyptus wood. Chemical composition of bio-oil was examined by GC/MS and (13)C NMR analyses. Bio-oil produced from pretreated eucalyptus wood exhibited lower contents of ketones and acids, while much higher levoglucosan content than bio-oil produced from original eucalyptus wood, which would help to improve thermal stability of bio-oil and extract levoglucosan from bio-oil. Hydrothermal pretreatment also improved bio-oil fuel quality through lowering water content and enhancing heating value.


1-Methyl-4-(2'-methylphenyl)-1,2,3,6-tetrahydropyridine (2'-methyl-MPTP) is less neurotoxic than MPTP in the common marmoset.
Four adult marmosets were treated with increasing doses of 1-methyl-4-(2'-methylphenyl)-1,2,3,6-tetrahydropyridine (2'-methyl-MPTP) in the range 0.23-4.3 mg/kg i.p. to give a cumulative dose of 11.0-11.6 mg/kg over a 6-10 day period. After 4 days of treatment, and as the dosage was gradually increased, the animals exhibited mild motor deficits. These abnormalities slowly declined over the following 1-6 week period. In contrast, similar treatment of common marmosets with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) (1-4 mg/kg i.p.) for 3-5 days in a cumulative dose of 6.9-9.2 mg/kg produced gross impairment of motor function which persisted throughout the 5 weeks period of observation. Administration of 2'-methyl-MPTP for 6-10 days caused some decrease in dopamine and 3,4-dihydroxyphenylacetic acid (DOPAC), but not homovanillic acid (HVA) content in the caudate nucleus in animals 5-6 weeks after the start of treatment. There was a small decrease in [3H]dopamine uptake into putamen synaptosomes. This contrasted with the marked decreases in all these parameters observed after MPTP treatment of common marmosets. Histological examination of the substantia nigra from the four animals treated with 2'-methyl-MPTP did not show degeneration or loss of dopamine-containing cell bodies in the zona compacta. In contrast, MPTP caused severe destruction of these pigmented nigral neurones. In the common marmoset 2'-methyl-MPTP does not appear to show the same neurotoxic action as MPTP itself. This contrasts with findings in the mouse where 2'-methyl-MPTP is more toxic to dopamine-containing cells of substantia nigra than MPTP.


Prolactin and luteal insufficiency.
The relationship between mid-luteal plasma levels of progesterone and prolactin was studied in 75 women with regular menstrual cycles. Eighteen women had normal prolactin (mean 260 +/- 51.7 mU/l) and normal progesterone levels (mean 67 +/- 21.3 nmol/l). Thirty-nine women had elevated prolactin levels (mean 850 +/- 503 mU/l): progesterone levels were normal in all cases (mean 61 +/- 22.3 nmol/l). Eighteen women had evidence of luteal deficiency (mean progesterone 15.3 +/- 7.7 nmol/l); prolactin levels were normal in all cases (mean 243 +/- 106 mU/l). There was no correlation between plasma prolactin and progesterone levels.


Synaptic plasticity in neurological deficit as a form of indemnification: The utility of analogical reasoning.
Analogical reasoning is a useful analytical tool for formulating a hypothesis from which to springboard rigorous methodological analysis. Paradoxically, the tool's utility lies in its capacity to conceptualize a viable avenue for further inquiry as much as in its capacity to expose flaws in the analogical concept hypothesized. While it should not be the exclusive means upon which to rely absent evidence-based data or other valid corroboration, analogies provide an important means of stimulating creative thought. An illustration is offered: analogizing synaptic plasticity in neurological deficits to the invocation of a contractual indemnification.


High sensitive airborne radioiodine monitor.
Airborne radioiodine monitoring includes a problem in that commercial radioactive gas monitors have inadequate sensitivity. To solve this problem, we designed a highly sensitive monitoring system. The higher counting efficiency and lower background made it possible to perform the low-level monitoring. The characteristics of the system were investigated using gaseous (125)I. The minimum detectable activity concentration was 1 × 10(-4)Bq cm(-3) for 1 min counting, which is one tenth of the legal limit for the radiation controlled areas in Japan.


Immediate loading of a single hydroxyapatite-coated threaded root form implant: a clinical report.
The successful results of endosseous root form implants in the treatment of partially and completely edentulous patients has been made possible by the application of standardized surgical and prosthetic protocols. Different techniques have been published in the literature with the purpose of reducing implant prosthetic rehabilitation times. This clinical case report describes a new surgical concept and a technique to fabricate screw-retained provisional crowns for immediate loading of free-standing single tooth implants. Further clinical and histologic studies are necessary in order to promote routine clinical application of this technique.


Retracted: Value and Application of Traditional Culture of Embedded Network Teaching Platform in Moral Education in Colleges and Universities.
[This retracts the article DOI: 10.1155/2022/2096583.].


Effect of pH on the production of irritation in a chamber irritation test.
This study was designed to investigate the relationship between alteration of skin surface pH and the development of skin irritation. Application of a phosphate/borate/acetate buffer adjusted to pH 4.0-10.5 in a standard chamber irritation test did not result in significant clinical irritation. This was true in spite of maintaining a markedly altered skin surface pH over an extended period of time. There was also no correlation between irritation and the pH of applied surfactant solutions. These results demonstrate that a prolonged disturbance of the "acid mantle" is not sufficient to produce clinical irritation.


Adolescent-Mother Agreements and Discrepancies in Reports of Helicopter Parenting: Associations with Perceived Conflict and Support.
Adolescents' and parents' similar and/or divergent perceptions of parental behaviors may be associated with youth-parent relationship quality. This study examined adolescents' and mothers' perceptions of helicopter parenting, and whether (dis)agreements between these views were associated with perceived conflict and support. Participants were 349 late adolescents (MT1age = 18.20; 39.8% male) and their mothers (MT1age = 49.10) in Hong Kong who completed four assessments over one year. Results suggested that youth-mother agreements regarding helicopter parenting were positively associated with both conflict and support. Additionally, discrepancies between their reports were positively related to adolescent-reported conflict. These findings highlight the importance of examining multiple perspectives when studying helicopter parenting dynamics, and suggest both positive and negative aspects of these practices in Chinese families.


Uterine Gpr83 mRNA is highly expressed during early pregnancy and GPR83 mediates the actions of PEN in endometrial and non-endometrial cells.
To characterize the expression and signaling of uterine GPR83 in vivo in the nonpregnant and pregnant mouse and in vitro in human endometrial and nonendometrial cells. Controlled laboratory study. Not applicable. Not applicable. None. Expression of uterine Gpr83 was determined by quantitative polymerase chain reaction throughout the estrous cycle and during early pregnancy in ovarian-stimulated and non-ovarian-stimulated mice and pregnant and pseudopregnant mice. Expression was also determined in ovariectomized mice after the administration of oil, E2, P4, or E2 + P4 and in stromal cells following 6 days of in vitro decidualization. GPR83 signaling was studied in human endometrial and embryonic kidney cell lines. Cells were treated by PEN, a GPR83 ligand, and PEN-induced extracellular signal-regulated kinase (ERK) phosphorylation was assayed under conditions that blocked Gαq/11 and/or β-arrestin signaling. Uterine Gpr83 is expressed throughout the estrous cycle and during early pregnancy; expression increases dramatically at the time of uterine receptivity, embryo implantation, and stromal cell decidualization. In the ovariectomized mouse, hormone add-back reveals that Gpr83 expression is highly responsive to the combined treatment of E2 and P4, and studies in the ovarian-stimulated mouse show that expression is also very sensitive to changes in E2 and P4 and is therefore tightly regulated by E2 and P4. At the implantation site, expression is elevated up to D6 of pregnancy and then declines rapidly on D7 and D8, suggesting that if there is any involvement in decidualization, it is likely associated with primary but not secondary stromal cell decidualization. This premise was supported by the observation that stromal cell decidualization in vitro progresses with a decline in Gpr83 expression. In ERα/PR-expressing endometrial Ishikawa cells, GPR83 mediates PEN signals in a Gαq/11-dependent manner, and studies conducted in HEK 293 cells lacking β-arrestin revealed that GPR83 also signals via a β-arrestin-dependent manner. When signaling by either one or both pathways is downregulated, cells exhibit a major reduction in responsiveness to PEN treatment, demonstrating that signaling by both pathways is significant. We hypothesize that PEN/GPR83 signaling regulates uterine receptivity, embryo implantation, and primary stromal cell decidualization by coupling to Gαq/11- and β-arrestin-dependent pathways.


IL-27 inhibits the TGF-β1-induced epithelial-mesenchymal transition in alveolar epithelial cells.
IL-27 is a multifunctional cytokine that has both pro-inflammatory and anti-inflammatory functions. Although IL-27 has been shown to potently inhibit lung fibrosis, the detailed mechanism of IL-27 in this process is poorly understood. Epithelial-mesenchymal transition (EMT) is one of the key mechanisms involved in pulmonary fibrosis. We assessed the effects of IL-27 on TGF-β1-induced EMT in alveolar epithelial cells. A549 cells (a human AEC cell line) were incubated with TGF-β1, IL-27, or both TGF-β1 and IL-27, and changes in E-cadherin, β-catenin, vimentin and a-SMA levels were measured using real-time PCR, western blotting and fluorescence microscopy. The related proteins in the JAK/STAT and TGF-β/Smad signalling pathways were examined by western blot. IL-27 increased the expression of epithelial phenotypic markers, including E-cadherin and β-catenin, and inhibited mesenchymal phenotypic markers, including vimentin and a-SMA in A549 cells. Moreover, TGF-β1-induced EMT was attenuated by IL-27. Furthermore, we found that TGF-β1 activated the phosphorylation of JAK1, STAT1, STAT3, STAT5, Smad1, Smad3 and Smad5, and IL-27 partially inhibited these changes in this process. When cells were treated with the STAT3 specific inhibitor wp1006 and the Smad3 specific inhibitor SIS3, the inhibition of EMT by IL-27 was significantly strengthened. Our results suggest that IL-27 attenuates epithelial-mesenchymal transition in alveolar epithelial cells in the absence or presence of TGF-β1 through the JAK/STAT and TGF-β/Smad signalling pathways.


Characterization of a novel bacteriophage φCJ22 and its prophylactic and inhibitory effects on necrotic enteritis and Clostridium perfringens in broilers.
High necrotic enteritis (NE) incidence and mortality rates in poultry can be caused by Clostridium perfringens (CP) coinfected with Eimeria spp., a causative agent of coccidiosis. Banning of prophylactic use of antibiotics in feed has been accompanied by increased NE outbreaks, resulting in economically devastating losses to the broiler industry. To determine alternatives for controlling NE, we isolated CP-specific bacteriophages (BP), characterized their properties, evaluated their inhibitory effects on pathogenic CP, selected a highly effective phage (φCJ22), and used φCJ22 as a dietary supplement in experimental NE-afflicted broiler chickens. Male broilers (n = 780) were randomly assigned to 60 pens (n = 13 broilers/pen) and into 5 groups [CP-uninfected negative control (NC), basal diet (BD) without CP and BP; CP-infected positive control (PC), BD + CP; and 3 BP groups receiving low- (LP; BD + CP+105 BP), medium- (MP; BD + CP+106 BP), and high-phage (HP; BD + CP+107 BP plaque-forming units/kg) concentrations]. The results showed that MP and HP groups presented an antimicrobial activity toward clinical CP isolate strains, and the groups decreased NE lesions and mortality rates without changes in chicken performance at the end of the experimental period. After CP-challenge body weight gain and feed efficiency were significantly lower in phage-fed groups than that in the PC group (P < 0.05), and NE-associated mortality was the lowest in the HP group (P < 0.001). Moreover, histopathology revealed lesser gastrointestinal mucosal damage in the NC and BP-treated (LP, MP, and HP) groups than that in the PC group, and MP and HP significantly lowered viable CP number in the cecum content by up to 1.24log10 relative to only CP-infected PC group (P < 0.05). These findings suggest that addition of φCJ22 to chicken feed might effectively ameliorate NE, which is accompanied by reduced CP strains in the gut and compensate the performance of NE-afflicted broilers.


Comparison of 2 surgical techniques of posterolateral corner reconstruction of the knee.
Various surgical techniques to treat posterolateral knee instability have been described. To date, the recommended treatment is an anatomical form of reconstruction, in which the 3 key structures of the posterolateral corner are addressed: the lateral collateral ligament, the popliteofibular ligament, and the popliteus tendon. Two methods of surgical reconstruction will restore posterolateral knee instability, in terms of static laxity as well as dynamic 6 degrees of freedom kinematics, to statistically significant levels compared with the intact state. Controlled laboratory study. Two surgical techniques (A and B) were used to reconstruct the posterolateral structures in 10 cadaveric knees. Static tests were performed on the intact, sectioned, and reconstructed knees at 30 degrees and 90 degrees of flexion for anterior-posterior laxity and external rotational laxity, as well as at 0 degrees and 30 degrees of flexion for varus laxity; dynamic 6 degrees of freedom kinematic testing, through a path of motion from 90 degrees of flexion to full extension, was also performed. For the static varus tests, external rotation and varus laxity were significantly increased after the posterolateral structures were cut. Both reconstruction techniques restored external rotation and varus laxity to levels not significantly different from the intact state. For technique B, dynamic testing did not show any significant difference for all degrees of freedom kinematics compared with the intact state. However, for technique A, a significant internal tibial rotation was observed throughout the entire path of motion from 0 degrees to 90 degrees of knee flexion. Both surgical techniques for anatomical posterolateral corner reconstruction showed good results in the static laxity tests. The anatomical reconstruction of all structures, including the popliteus tendon, resulted in an abnormal internal tibial rotation during dynamic testing.


A mechanistic model for electrochemical nutrient recovery systems.
Electrochemical membrane technologies such as electrodialysis have been identified as key technologies to enable nutrient recovery from wastewater. However, current electrochemical models are focused on simpler solutions than wastewater and omit key outputs such as pH, or total cell potential. A combined physico-chemical and electrochemical model was developed which includes the mechanisms of competitive transport of ions, implicit inclusion of H(+) and OH(-), pH (including ionic activity and ion pairing), different factors contributing to total cell potential and a novel method for ion exchange membrane transport. The model outputs compare well with measurements from experiments and simulate secondary effects such as electrode reactions and current leakage. Results found that membrane, rather than boundary layer or bulk resistance was the major contributor to potential drop, and that apparent boundary layers were relatively thick (3 ± 1 mm). Non-ideal solution effects such as ion-pairing and ionic activity had a major impact, particularly on multi-valent Ca(2+) ions, which enhances the capability of electrodialysis to recover monovalent nutrient ions such as K(+) and NH4(+). Decreased resistivity of ion exchange membranes to specific ions (for example, in this case nitrate) could also be detected. The methods here are validated using a comparatively simple synthetic solution of five ionic components, but are able to be easily scaled for a more complex solution, and are also compatible with additional mechanisms such as precipitation, fouling, and scaling.


[Peri-uvulopalatopharyngoplasty erythrocyte immune function analysis in patients with obstructive sleep apnea hypopnea syndrome].
To investigate the effect of ECR I, RBC-C3bRR, RBC-ICR on obstructive sleep apnea-hypopnea syndrome (OSAHS). Fifty-four inpatients with OSAHS and 20 healthy controls at the same age were enrolled. 1 ml fresh whole blood with stomach empty in early morning were collected before and after the surgery to detect ECR I , RBC-C3bRR and RBC-ICR. The erythrocyte immune function of the OSAHS group was lower than that of the control group. Erythrocyte immune functional disorder plays an important role in OSAHS and surgical procedures is effective in correcting the changes.


Complications after proximal gastrectomy with jejunal pouch interposition: report of a case.
We report a rare case of proximal gastrectomy complication as a result of a severe dilatation of a jejunal pouch interposed for reconstruction. A 44-year-old man who had early gastric cancer underwent proximal gastrectomy with a jejunal pouch interposition at our department. Fourteen months after the procedure, he began to complain of left hypochondrial fullness and reflux symptoms. He had difficulty eating and his quality of life (QOL) was markedly impaired. Barium meal revealed severe dilatation of the jejunal pouch. Decompression using a stomach tube and other measures only achieved temporary improvement. 4.5 years later, the dilated jejunal pouch was resected together with apyloroplasty and double tract reconstruction. Six months after this secondary surgery, the patient recorded no further complications. Food intake increased and QOL improved.


Effects of tRNA(1Leu) overproduction in Escherichia coli.
Strains of Escherichia coli have been produced which express very high levels of the tRNA(1Leu) isoacceptor. This was accomplished by transforming cells with plasmids containing the leuV operon which encodes three copies of the tRNA(1Leu) gene. Most transformants grew very slowly and exhibited a 15-fold increase in cellular concentrations of tRNA(1Leu). As a result, total cellular tRNA concentration was approximately doubled and 56% of the total was tRNA(1Leu). We examined a number of parameters which might be expected to be affected by imbalances in tRNA concentration: in vivo tRNA charging levels, misreading, ribosome step time, and tRNA modification. Surprisingly, no increase in intracellular ppGpp levels was detected even though only about 40% of total leucyl tRNA was found to be charged in vivo. Gross ribosomal misreading was not detected, and it was shown that ribosomal step times were reduced between two- and threefold. Analyses of leucyl tRNA isolated from these slow-growing strains showed that at least 90% of the detectable tRNA(1Leu) was hypomodified as judged by altered mobility on RPC-5 reverse-phase columns, and by specific modification assays using tRNA(m1G)-methyltransferase and pseudo-uridylate synthetase. Analysis of fast-growing revertants demonstrated that tRNA concentration per se may not explain growth inhibition because selected revertants which grew at wild-type growth rates displayed levels of tRNA comparable to that of control strains bearing the leuV operon. A synthetic tRNA(1Leu) operon under the control of the T7 promoter was prepared which, when induced, produced six- to sevenfold increases in tRNA(1Leu) levels. This level of tRNA(1Leu) titrated the modification system as judged by RPC-5 column chromatography. Overall, our results suggest that hypomodified tRNA may explain, in part, the observed effects on growth, and that the protein-synthesizing system can tolerate an enormous increase in the concentration of a single tRNA.


Somatic evolution of cancer cells.
Cancers develop through a process called genomic instability, which generates diversity, from which clonal evolution may occur. In colorectal cancers, this process has been extensively studied, and there are three identifiable processes involved in generating diversity at the genetic or epigenetic level. Colorectal cancers may have chromosomal instability (CIN), microsatellite instability (MSI), or the CpG island methylator phenotype (CIMP). Each of these processes is associated with a unique mutational or epigenetic "signature" identifiable in the tumor cells, and there are important conceptual and clinical implications of each.


A double-blind, randomised, placebo-controlled trial comparing intrathecal bupivacaine with bupivacaine plus morphine to reduce delirium in patients with hip fractures-Salmon-Mind trial study protocol.
Surgical treatment of proximal femur fractures is complicated by postoperative delirium in about one-third of patients. Pain and opioid consumption are modifiable factors that may influence the incidence of delirium.1 An intrathecal injection of morphine may lead to a reduction in postoperative pain and reduced systemic opioid consumption. In current practice, the addition of morphine to intrathecal anaesthesia is commonly used but depends on the anaesthesiologist's preference. Recently, a retrospective study found that intrathecal morphine was independently associated with a lower incidence of delirium. However, this has to be confirmed in a prospective, randomised study. We hypothesise that using intrathecal morphine reduces postoperative pain and opioid consumption during the first 48 h after surgery and reduces the incidence of delirium during hospital admission. We also seek additional evidence of the association between neuronal injury (delirium) and neurofilament light in serum of patients with proximal femur fractures. The primary objective is to compare the incidence of delirium. The secondary objectives are to compare pain scores, systemic opioid consumption, and (opioid-related) side-effects. The tertiary objective is to test the association between intrathecal morphine and neurofilament light as a marker of neuronal injury. A double-blind, randomised, placebo-controlled intervention study is proposed. All patients with a proximal femur fracture who are scheduled for surgery under spinal anaesthesia. The intervention is the addition of morphine 100 μg to the intrathecal injection for spinal anaesthesia. The intervention group will receive a mixture of bupivacaine 10 mg and morphine 100 μg. The control group will receive bupivacaine 10 mg. EU Clinical Trials Register: EudraCT number 2020-002143-27.


Mucosal permeability in the immature rat intestine: effects of ischemia-reperfusion, cold stress, hypoxia, and drugs.
Increased mucosal permeability may represent an important factor in the etiology of necrotizing enterocolitis (NEC). In the present study we used an immature rat model to assess the permeability effects of a number of stresses commonly seen in infants with NEC. In 10-day-old rats, mucosal permeability to 51Cr EDTA was measured after subjecting the animals to 10-minute ischemia-reperfusion injury, 30 minutes of hypoxia (14% oxygen), cold stress (4 degree C for 4 minutes), and intraperitoneal indomethacin (0.2 or 2.0 mg/kg) or theophylline (40 or 200 mg/kg). When compared with appropriate controls, mucosal permeability was found to be significantly increased by ischemia-reperfusion injury, hypoxia, and high-dose indomethacin, but not by cold, theophylline, or low-dose indomethacin. Renal clearance studies confirmed that elevated blood levels of 51Cr EDTA were due to increased permeability rather than decreased renal excretion of the probe. These studies confirm that mucosal permeability in the immature rat is increased by a variety of insults, and may represent a "common pathway" in the etiology of NEC.


Accelerated hypofractionated magnetic resonance-guided adaptive radiotherapy for oligoprogressive non-small cell lung cancer.
Given the positive results from recent randomized controlled trials in patients with oligometastatic, oligoprogressive, or oligoresidual disease, the role of radiotherapy has expanded in patients with metastatic non-small cell lung cancer (NSCLC). While small metastatic lesions are commonly treated with stereotactic body radiotherapy (SBRT), treatment of the primary tumor and involved regional lymph nodes may require prolonged fractionation schedules to ensure safety especially when treating larger volumes in proximity to critical organs-at-risk (OARs). We have developed an institutional MR-guided adaptive radiotherapy (MRgRT) workflow for these patients. We present a 71-year-old patient with stage IV NSCLC with oligoprogression of the primary tumor and associated regional lymph nodes in which MR-guided, online adaptive radiotherapy was performed, prescribing 60 Gy in 15 fractions. We describe our workflow, dosimetric constraints, and daily dosimetric comparisons for the critical OARs (esophagus, trachea, and proximal bronchial tree [PBT] maximum doses [D0.03cc]), in comparison to the original treatment plan recalculated on the anatomy of the day (i.e., predicted doses). During MRgRT, few fractions met the original dosimetric objectives: 6.6% for esophagus, 6.6% for PBT, and 6.6% for trachea. Online adaptive radiotherapy reduced the cumulative doses to the structures by 11.34%, 4.2%, and 5.62% when comparing predicted plan summations to the final delivered summation. Therefore, this case study presets a workflow and treatment paradigm for accelerated hypofractionated MRgRT due to the significant variations in daily dose to the central thoracic OARs to reduce treatment-related toxicity associated with radiotherapy.


Effects of glycerol on the in vitro percutaneous absorption of all-trans retinoic acid.
The nature of the receptor solution plays an important role in in vitro percutaneous absorption of highly lipophilic compounds having limited solubility. In vitro permeation studies of a lipophilic compound, all-trans retinoic acid (RA), through the rat dorsal skin were performed with the presence of glycerol (0-20% v/v) in the receptor solution, and the results were compared with those with the presence of albumin (4%). The results showed that an addition of glycerol (20%) into the receptor solution significantly increased the permeation rate of RA through the rat dorsal skin (0.0068 +/- 0.0041 vs. 0.0014 +/- 0.0010 microg/cm2/hr). It was also found that RA tends to accumulate in the lipophilic layer, and its log P value between the epidermis and the receptor solution significantly decreased with the presence of glycerol (20%) (1.48 +/- 0.14 vs. 2.45 +/- 0.21). An addition of glycerol, an osmotherapeutic agent, in the physiological receptor solution seemed to enhance the percutaneous absorption of RA by affecting the partition coefficient of RA.


Clostridium difficile toxin A induces intestinal epithelial cell apoptosis and damage: role of Gln and Ala-Gln in toxin A effects.
The aim of this study was to investigate the effect of Clostridium difficile toxin A (TxA) on intestinal epithelial cell migration, apoptosis, and transepithelial resistance and to evaluate the effect of glutamine (Gln) and its stable derivative, alanyl-glutamine (Ala-Gln), on TxA-induced damage. Migration was measured in rat intestinal epithelial cells (IEC-6) 6 and 24 hr after a razor scrape of the cell monolayer. Cell proliferation was indirectly measured utilizing the tetrazolium salt WST-1. The cells were incubated with TxA (1-100 ng/ml) in medium without Gln or medium containing Gln or Ala-Gln (1-30 mM). Apoptosis was quantified in IEC-6 cells using annexin V assay. Transepithelial resistance was measured using an epithelial voltohmmeter across T84 cells seeded on a transwell filter. TxA-induced a dose-dependent reduction of migration and also caused dose and time-dependent apoptosis in IEC-6 cells. Gln and Aln-Gln significantly enhanced IEC-6 cell migration and proliferation. Gln and Ala-Gln also prevented the inhibition of migration, apoptosis, and the initial drop in transepithelial resistance induced by TxA. In conclusion, both peptides reduced toxin-induced epithelial damage and thus might play an adjunctive role in C. difficile-induced colitis therapy.


Activity-evoked extracellular pH shifts in slices of rat dorsal lateral geniculate nucleus.
Activity-dependent extracellular pH shifts were studied in slices of the rat dorsal lateral geniculate nucleus (dLGN) using double-barreled pH-sensitive microelectrodes. In 26 mM HCO3--buffered media, afferent activation (10 Hz, 5 s) elicited an early alkaline shift of 0.04+/-0.02 pH units associated with a later, slow acid shift of 0.05+/-0.03 pH units. Extracellular pH shifts in the ventral lateral geniculate nucleus were rare, and limited to acidifications of approximately 0.02 pH units. The alkaline shift in the dLGN increased in the presence of benzolamide (1-2 microM), an extracellular carbonic anhydrase inhibitor. The mean alkaline shift in benzolamide was 0.10+/-0.05 pH units. In 26 mM HEPES-buffered saline, the alkaline response averaged 0.09+/-0.03 pH units. The alkaline shifts persisted in 100 microM picrotoxin (PiTX) but were blocked by 25 microM CNQX/50 microM APV. If stimulation intensity was raised in the presence of CNQX/APV, a second alkalinization arose, presumably due to direct activation of dLGN neurons. The direct responses were amplified by benzolamide, and blocked by either 0 Ca2+/EGTA, Cd2+ or TTX. In 0 Ca2+, addition of 500 microM-5 mM Ba2+ restored the alkalosis. Alkaline shifts evoked with extracellular Ba2+ were larger and faster than those elicited by equimolar Ca2+. In summary, synchronous activation in the dLGN results in an extracellular H+ sink, via a Ca2+-dependent mechanism, similar to activity-dependent alkaline shifts in hippocampus.


[Thyroid activity in common frogs and the heat resistance of their bodies and muscle tissue].
Thyroid activity of single individuals of the grass frog has been studied during winter hybernation (2-5 degrees) and heat acclimation (15 degrees) in relation to the heat resistance of the organism and muscle tissue at 2-5 degrees. A positive correlation has been observed between thyroid activity and the organismal heat resistance. At 15 degrees thyroid activity increases. It is the highest in females with a low initial heat resistance of the organism. It is assumed that changes in the heat resistance of the organism and muscle tissue are controlled by the thyroid gland. However, no correlation has been found between the initial (winter) level of the heat resistance of muscle tissue and the activity of thyroid.


Chemoprevention of Skin Carcinomas in High-Risk Transplant Recipients.
Long-term immunosuppressive therapy, as provided to solid organ transplant recipients, inevitably results in a significant inhibition of immune defenses; this leads to frequent skin infections and malignancies, which represent an important cause of morbidity and mortality for transplanted patients. The incidence and risk of skin carcinomas are elevated in solid organ transplant recipients in comparison with the general population, with a 10-fold increased risk for basal cell carcinoma and a 50-100-fold for squamous cell carcinoma. The schedule of immunosuppressive drugs influences the type and timing of skin malignancies, but a crucial role is also played by endogenous and exogenous risk factors. Here, we will review the state-of-the-art in chemoprevention of epidermal carcinomas in order to provide useful information for clinicians involved in the management of transplant recipients. One-hundred and forteen paper, published on peerreviewed journals, has been included. Chemoprevention would be key in controlling skin carcinogenesis in high-risk patients.


Increased expression of TBX2 is a novel independent prognostic biomarker of a worse outcome in colorectal cancer patients after curative surgery and a potential therapeutic target.
T-box2 (TBX2) plays a critical role in embryonic development. Recently, deregulated expression of TBX2 has been implicated in several malignancies. However, the expression and the role of TBX2 in colorectal cancer (CRC) remain unclear. In this study, we found that TBX2 was obviously up-regulated in CRC in comparison with the corresponding normal mucosa at transcriptional and protein level. Up-expression of TBX2 was significantly associated with depth of tumor invasion (P = 0.006), distant metastasis (P = 0.038), advanced AJCC stage (P = 0.008), and relapse (P = 0.003). TBX2 was a significantly prognostic factor for decreased survival and increased disease recurrence independent of tumor stage(II, III stage) and functioned as a biomarker to identify prognosis of patients with CRC (OS: HR 2.154; 95% CI 1.019-4.551; P = 0.044, DFS: HR 2.253; 95% CI 1.109-4.575; P = 0.025). Furthermore, TBX2 could serve as a potential target of cancer drug therapy.


Structural basis for cell type specific DNA binding of C/EBPβ: The case of cell cycle inhibitor p15INK4b promoter.
C/EBPβ is a key regulator of numerous cellular processes, but it can also contribute to tumorigenesis and viral diseases. It binds to specific DNA sequences (C/EBP sites) and interacts with other transcription factors to control expression of multiple eukaryotic genes in a tissue and cell-type dependent manner. A body of evidence has established that cell-type-specific regulatory information is contained in the local DNA sequence of the binding motif. In human epithelial cells, C/EBPβ is an essential cofactor for TGFβ signaling in the case of Smad2/3/4 and FoxO-dependent induction of the cell cycle inhibitor, p15INK4b. In the TGFβ-responsive region 2 of the p15INK4b promoter, the Smad binding site is flanked by a C/EBP site, CTTAA•GAAAG, which differs from the canonical, palindromic ATTGC•GCAAT motif. The X-ray crystal structure of C/EBPβ bound to the p15INK4b promoter fragment shows how GCGC-to-AAGA substitution generates changes in the intermolecular interactions in the protein-DNA interface that enhances C/EBPβ binding specificity, limits possible epigenetic regulation of the promoter, and generates a DNA element with a unique pattern of methyl groups in the major groove. Significantly, CT/GA dinucleotides located at the 5'ends of the double stranded element maintain local narrowing of the DNA minor groove width that is necessary for DNA recognition. Our results suggest that C/EBPβ would accept all forms of modified cytosine in the context of the CpT site. This contrasts with the effect on the consensus motif, where C/EBPβ binding is modestly increased by cytosine methylation, but substantially decreased by hydroxymethylation.


[The secret, let's talk about it!].
Medical secret, as other professional secrets, is highly suspected in a society witch emphasis communication about all. This article tempts to understand why this appears.


Return visits to the emergency department.
A persistent problem for emergency physicians is the patient who returns unscheduled to the emergency department with a problem that either has not improved or has worsened. The purpose of this study was to evaluate the frequency of revisits and the nature of the problems. All patients returning within 72 hours of their initial visit were entered into the study. The charts were evaluated for classification of problem, unavoidable v avoidable returns, and errors in medical care or patient education. Of the 64,336 patients seen during the study, 255 returned within 72 hours. Eighty-three (32.5%) of the returns were found to be avoidable with better patient education or medical care on the initial visit. The revisit population is a high-risk group of patients who should be approached carefully by emergency physicians.


Metabolic and cardiovascular benefits and risks of 4-hydroxy guanabenz hydrochloride: α2-adrenoceptor and trace amine-associated receptor 1 ligand.
α2-adrenoceptor ligands have been investigated as potential therapeutic agents for the treatment of obesity. Our previous studies have shown that guanabenz reduces the body weight of obese rats, presumably through its anorectic action. This demonstrates an additional beneficial effect on selected metabolic parameters, including glucose levels. The purpose of this present research was to determine the activity of guanabenz's metabolite-4-hydroxy guanabenz hydrochloride (4-OH-Guanabenz). We performed in silico analyses, involving molecular docking to targets of specific interest as well as other potential biological targets. In vitro investigations were conducted to assess the selectivity profile of 4-OH-Guanabenz binding to α-adrenoceptors, along with intrinsic activity studies involving α2-adrenoceptors and trace amine-associated receptor 1 (TAAR1). Additionally, the effects of 4-OH-Guanabenz on the body weight of rats and selected metabolic parameters were evaluated using the diet-induced obesity model. Basic safety and pharmacokinetic parameters were also examined. 4-OH-guanabenz is a partial agonist of α2A-adrenoceptor. The calculated EC50 value for it is 316.3 nM. It shows weak agonistic activity at TAAR1 too. The EC50 value for 4-OH-Guanabenz calculated after computer simulation is 330.6 µM. Its primary mode of action is peripheral. The penetration of 4-OH-Guanabenz into the brain is fast (tmax = 15 min), however, with a low maximum concentration of 64.5 ng/g. 4-OH-Guanabenz administered ip at a dose of 5 mg/kg b.w. to rats fed a high-fat diet causes a significant decrease in body weight (approximately 14.8% compared to the baseline weight before treatment), reduces the number of calories consumed by rats, and decreases plasma glucose and triglyceride levels. The precise sequence of molecular events within the organism, linking the impact of 4-OH-Guanabenz on α2A-adrenoceptor and TAAR1 with weight reduction and the amelioration of metabolic disturbances, remains an unresolved matter necessitating further investigation. Undoubtedly, the fact that 4-OH-Guanabenz is a metabolite of a well-known drug has considerable importance, which is beneficial from an economic point of view and towards its further development as a drug candidate.


Antiviral efficacy of combination therapy with entecavir and adefovir for entecavir/lamivudine-resistant hepatitis B virus with or without adefovir resistance.
There is little clinical information on the management of hepatitis B virus (HBV) that is resistant to multiple drugs including entecavir (ETV). The present retrospective cohort study assessed the antiviral efficacy of ETV/adefovir dipivoxil (ADV) combination therapy for ETV-resistant HBV with prior lamivudine (LAM) resistance, and either with or without previous ADV resistance. The cumulative probability of achieving a virological response (undetectable serum HBV DNA) was compared by Kaplan-Meier analysis and the Breslow method. Seventeen patients with ETV-resistant HBV who were treated with ETV/ADV combination therapy for at least 6 months at a tertiary care center, were included; seven had dual resistance to ETV and LAM [ADV-r(-) group] and 10 had triple resistance to ETV, LAM, and ADV [ADV-r(+) group]. The median follow-up period was 9 months (range, 6-23). A virological response was noted in seven patients after a median of 3 months (range, 3-12) of treatment; five in the ADV-r(-) group and two in the ADV-r(+) group. The cumulative probability of a virological response was significantly higher in the ADV-r(-) group than in the ADV-r(+) group (6 months cumulative probability, 57.1% vs. 11.1%). In conclusion, ETV/ADV combination therapy led to virological responses in five of seven patients with resistance to ETV and LAM, but a significantly poorer response in patients with prior ADV resistance than in those without prior ADV resistance. Therefore, ETV/ADV combination therapy could be a useful therapeutic option for ETV- and LAM-resistant HBV without prior ADV resistance.


The complex build algorithm to set up starting structures of lanthanoid complexes with stereochemical control for molecular modeling.
When handling metallic centers of higher coordination numbers, one is commonly deluded with the presumption that any assembled metal complex geometry (including a crystallographic one) is good enough as a starting structure for computational chemistry calculations; all oblivious to the fact that such a structure is nothing short of just one out of several, sometimes dozens, or even thousands of other stereoisomers. Moreover, coordination chirality, so frequently present in complexes of higher coordination numbers, is another often overlooked property, rarely recognized as such. The Complex Build algorithm advanced in this article has been designed with the purpose of generating starting structures for molecular modeling calculations with full stereochemical control, including stereoisomer complete identification and coordination chirality recognition. Besides being in the chosen correct stereochemistry, the ligands are positioned by the Complex Build algorithm in a very unobstructed and unclogged manner, so that their degrees of freedom do not hinder or even choke one another, something that would otherwise tend to lead to negative force constants after further geometry optimizations by more advanced computational model chemistries. The Complex Build algorithm has been conceived for any metallic center, but at present is targeting primarily lanthanoids whose coordination numbers range mostly from 5 to 12 and often lead to a combinatorial explosion of stereoisomers.


Oesophageal acid exposure and altered neurocardiac function in patients with GERD and idiopathic cardiac dysrhythmias.
Oesophageal sensory stimuli alter neurocardiac function through autonomic reflexes. To evaluate in patients with idiopathic supraventricular cardiac dysrhythmias and gastro-oesophageal reflux disease (GERD) whether GE reflux alters neurocardiac function and the effect of acid suppression on cardiac symptoms. Thirty-two patients (13 females and 19 males; age: 20-69 years) with dysrhythmias plus GERD, and nine patients (five females and four males; age: 43-58 years) with GERD only, underwent simultaneous 24-h pH-metry and ECG monitoring. Power spectrum analysis of heart rate variability (PSHRV) was obtained with both its low frequency (LF, sympathetic modulation) and high frequency (HF, vagal modulation) components. Hourly mean oesophageal pH and LF/HF ratio were correlated. A 3 months full-dosage PPI therapy (esomeprazole 40 mg/day) was prescribed. In 18 (56%) of the 32 patients with dysrhythmia and in none with GERD only, a significant (P < 0.05) correlation between oesophageal pH and LF/HF ratio (oesophagus-heart correlation) was observed. A significant reduction of cardiac symptoms after PPI therapy was observed only in these patients (13/16 vs. 4/11, P < 0.01). This study has identified a subgroup of dysrhythmic patients in whom the oesophageal acid stimulus elicited cardiac autonomic reflexes. In these patients acid suppression seems to improve GERD and cardiac symptoms.


Sequential dependencies in categorical judgments of radiographic images.
Sequential context effects, the psychological interactions occurring between the events of successive trials when a sequence of similar stimuli are judged, have interested psychologists for decades. It has been well established that individuals exhibit sequential context effects in psychophysical experiments involving unidimensional stimuli. Recent evidence shows that these effects generalize to quantitative judgments of more complex multidimensional stimuli such as images of faces, chairs, and shoes. In this article, we test for the presence of sequential context effects by re-examining previously published data on categorical judgments of 234 complex radiographic images made by 20 experienced physicians and 20 medical students engaged in an online training task. We found that medical students, but not experienced physicians, displayed evidence of sequential context effects. We also found evidence suggesting that as the students learned over blocks of trials, they tended to shift from relative comparisons between consecutive images toward more independent comparisons of each image against (strengthening) internalized standards.


Competitive foods available in Pennsylvania public high schools.
This study examined the types and extent of competitive foods available in public high schools in Pennsylvania. We developed, pilot tested, and distributed surveys to school foodservice directors in a random sample of 271 high schools in Pennsylvania. Two hundred twenty-eight surveys were returned, for a response rate of 84%. Statistical analyses were performed: Descriptive statistics were used to examine the extent of competitive food sales in Pennsylvania public high schools. The survey data were analyzed using SPSS software version 11.5.1 (2002, SPSS base 11.0 for Windows, SPSS Inc, Chicago, IL). A la carte sales provide almost dollar 700/day to school foodservice programs, almost 85% of which receive no financial support from their school districts. The top-selling a la carte items are "hamburgers, pizza, and sandwiches." Ninety-four percent of respondents indicated that vending machines are accessible to students. The item most commonly offered in vending machines is bottled water (71.5%). While food items are less often available through school stores and club fund-raisers, candy is the item most commonly offered through these sources. Competitive foods are widely available in high schools. Although many of the items available are low in nutritional value, we found several of the top-selling a la carte options to be nutritious and bottled water the item most often identified as available through vending machines.


The action of lipoxin-A on glomerular microcirculatory dynamics in the rat.
Intrarenal administration of 750 ng/kg/min of LX-A in euvolemic rats resulted in significant increases in single nephron GFR (38.4 +/- 1.7 to 45.5 +/- 3.0 nl/min) and plasma flow rate (95 +/- 6 to 127 +/- 9 nl/min). The latter was due to a dramatic fall in afferent arteriolar resistance. Mean transcapillary hydraulic pressure difference increased from 33 +/- 1 to 43 +/- 3 mmHg (p less than 0.05) and the glomerular capillary ultrafiltration coefficient fell from 0.060 +/- 0.013 to 0.033 +/- 0.005 nl/(s X mmHg) (p less than 0.05). These responses to LXA in the renal microcirculation are in sharp contrast to those previously observed for the leukotrienes, and thus may represent the first example of counterregulatory (constrictor/dilator) vascular interactions within the lipoxygenase pathways.


Multiple event times in the presence of informative censoring: modeling and analysis by copulas.
Motivated by a breast cancer research program, this paper is concerned with the joint survivor function of multiple event times when their observations are subject to informative censoring caused by a terminating event. We formulate the correlation of the multiple event times together with the time to the terminating event by an Archimedean copula to account for the informative censoring. Adapting the widely used two-stage procedure under a copula model, we propose an easy-to-implement pseudo-likelihood based procedure for estimating the model parameters. The approach yields a new estimator for the marginal distribution of a single event time with semicompeting-risks data. We conduct both asymptotics and simulation studies to examine the proposed approach in consistency, efficiency, and robustness. Data from the breast cancer program are employed to illustrate this research.


Correlates of children's dietary intake in childcare settings: A systematic review.
Children consume up to two-thirds of their daily dietary requirements in full-time childcare, making the setting a critical vector for preventing childhood obesity. To summarize the ecological correlates of children's dietary intake in childcare settings that were identified and categorized using the Six-Cs developmental ecological model of contributors to overweight and obesity in childhood. A literature search was conducted in 4 electronic databases. English-language, peer-reviewed publications that investigated at least 1 correlate of children's (ages 2-6 years) dietary intake in childcare settings and measured children's actual consumption of foods and beverages from food groups were included. Correlates were categorized into child, clan, community, and country groups. A total of 55 studies, which examined 29 correlates, were reviewed. Correlates identified included child's age, sex, characteristics of food provision (namely, food composition, foods and beverages served, portion sizes), repeated exposure, nutrition education, book reading, peer influence, meal service type, and childcare teachers' responsive feeding practices. Policies and participation in Head Start and the Child and Adult Care Food Program could not be determined as correlates of children's dietary intake, owing to a lack of evidence. This review produced a list of correlates to consider in designing interventions to improve children's dietary intake in childcare settings. The correlates could contribute to development of lifelong healthy eating habits, thereby preventing childhood obesity.


Correlation between quantitative measurements of tear film lipid layer thickness and meibomian gland loss in patients with obstructive meibomian gland dysfunction and normal controls.
To evaluate the correlation between tear film lipid layer thickness and other objective measurements such as tear film break-up time (TBUT), upper and lower meibomian gland losses, and Schirmer 1 test in patients with obstructive meibomian gland dysfunction (MGD) and normal controls. Cross-sectional study. Thirty eyes of 30 patients with obstructive MGD and 25 eyes of 25 normal controls were enrolled. Lipid layer thickness was measured using an interferometer. Tear film stability and tear production were evaluated by TBUT and Schirmer 1 test. Upper and lower meibomian gland losses were evaluated using noncontact meibography. The correlations among variables were evaluated in the obstructive MGD group and the control group. TBUT was significantly shorter in the obstructive MGD group than in the control group (P < .001). Upper and lower meibomian gland losses were higher in the obstructive MGD group than in the control group (P < .001 and P < .001, respectively), and lipid layer thickness was significantly thicker in the control group than in the obstructive MGD group (P = .028). Lipid layer thickness was significantly negatively correlated with upper and lower meibomian gland losses in both groups. Lipid layer thickness objectively measured with the interferometer was significantly thicker in the control group than in the obstructive MGD group. Lipid layer thickness was negatively correlated with upper and lower meibomian gland losses in the control group as well as in the obstructive MGD group.


Preparation of Amyloid Fibrils Seeded from Brain and Meninges.
Seeding of amyloid fibrils into fresh solutions of the same peptide or protein in disaggregated form leads to the formation of replicate fibrils, with close structural similarity or identity to the original fibrillar seeds. Here we describe procedures for isolating fibrils composed mainly of β-amyloid (Aβ) from human brain and from leptomeninges, a source of cerebral blood vessels, for investigating Alzheimer's disease and cerebral amyloid angiopathy. We also describe methods for seeding isotopically labeled, disaggregated Aβ peptide solutions for study using solid-state NMR and other techniques. These methods should be applicable to other types of amyloid fibrils, to Aβ fibrils from mice or other species, tissues other than brain, and to some non-fibrillar aggregates. These procedures allow for the examination of authentic amyloid fibrils and other protein aggregates from biological tissues without the need for labeling the tissue.


High Self-Efficacy Is Associated with Prescription Contraceptive Use.
In the United States, 45% of pregnancies continue to be unintended. Although many previous studies have focused on external barriers to contraceptive use such as cost or access, fewer studies have evaluated internal barriers such as individual characteristics. We hypothesize that high self-efficacy for contraception will be associated with use of more effective contraceptive methods. The analytic sample is 861 privately insured Pennsylvania women aged 18 to 40 years not intending pregnancy for 12 months at enrollment. Contraceptive self-efficacy (high vs. low) was measured using an eight-item scale. The association of self-efficacy with prescription contraceptive use was determined using multivariable logistic regression adjusting for future pregnancy intention, history of unintended pregnancy, number of live births, non-White race, frequency of sexual intercourse, marital status, and age group. Prescription contraceptive use was higher among those with high self-efficacy (adjusted odds ratio, 1.75; 95% confidence interval, 1.29-2.37). Women with high self-efficacy for contraception had an increased use of prescription contraceptive methods compared with nonprescription methods. Strategies for encouraging effective contraceptive choices in women with low contraceptive self-efficacy should be further studied.


Effect of an Endoprosthetic Reconstruction Tube and Medial Gastrocnemius Flap on Extensor Mechanism Function After Oncologic Prosthesis Reconstruction of the Proximal Tibia.
Extensor mechanism reconstruction after the proximal tibial resection and implantation of a megaprosthesis is challenging. In this study, we evaluated the effectiveness of the Trevira tube and medial gastrocnemius flap in restoring extensor mechanism following the resection of proximal tibial tumor and implantation of megaprosthesis. Forty patients who underwent endoprosthetic implantation following the resection of proximal tibial tumor and patellar tendon reconstruction with the Trevira tube and medial gastrocnemius flap were included. The outcome measures were knee range of motion, extensor mechanism function, patellar position, and limb function subjectively evaluated through Toronto Extremity Salvage Score and objectively through Musculoskeletal Tumor Society score. The mean follow-up of the patients was 6.1 years. The patellar position was normal in 28 (70%) patients, patella baja in 3 (7.5%) patients, and patella alta in 9 (22.5%) patients. The mean active knee range of motion was 98.9 ± 17° (range: 85°-125°). Extension lag was present in 7 (17.5%) patients (range: 5°-20°). The mean Toronto Extremity Salvage Score of patients was 92.1 ± 6.9% (range: 85-100). The mean Musculoskeletal Tumor Society score of the patients was 87.7 ± 13 (range: 73.3-100). Postoperative complications included aseptic wound dehiscence (2 patients), aseptic loosening of the tibial component (1 patient), periprosthetic fracture in the femur (2 patients), and wound infection (1 patient). Trevira tube combined with gastrocnemius flap augmentation is a suitable procedure for restoring extensor mechanism after proximal tibial resection and megaprosthesis implantation.


The pleasure of multiple images.
How many pleasures can you track? In a previous study, we showed that people can simultaneously track the pleasure they experience from two images. Here, we push further, probing the individual and combined pleasures felt from seeing four images in one glimpse. Participants (N = 25) viewed 36 images spanning the entire range of pleasure. Each trial presented an array of four images, one in each quadrant of the screen, for 200 ms. On 80% of the trials, a central line cue pointed, randomly, at some screen corner either before (precue) or after (postcue) the images were shown. The cue indicated which image (the target) to rate while ignoring the others (distractors). On the other 20% of trials, an X cue requested a rating of the combined pleasure of all four images. Later, for baseline reference, we obtained a single-pleasure rating for each image shown alone. When precued, participants faithfully reported the pleasure of the target. When postcued, however, the mean ratings of images that are intensely pleasurable when seen alone (pleasure >4.5 on a 1-9 scale) dropped below baseline. Regardless of cue timing, the rating of the combined pleasure of four images was a linear transform of the average baseline pleasures of all four images. Thus, while people can faithfully track two pleasures, they cannot track four. Instead, the pleasure of otherwise above-medium-pleasure images is diminished, mimicking the effect of a distracting task.