Outcomes of Fenestrated and Branched Endografts for Partial and Total Endovascular Repair of the Aortic Arch - A Systematic Review and Meta-Analysis.
Fenestrated and branched thoracic endovascular aortic repair (F/B-TEVAR) of the aortic arch is a viable approach in patients unsuitable for open repair. The aim was to summarise the published results of manufactured F/B-TEVAR devices for partial and total repair of the aortic arch, and to compare fenestrated with branched configurations. PubMed, Scopus and The Cochrane Library were searched for articles (2018 - 2021) about patients with elective, urgent, or emergency aortic requiring a proximal landing zone in the aortic arch (zone 0 - 1 - 2) and treated by F/B-TEVAR. The systematic review and meta-analysis were performed according to the PRISMA guidelines. Open repair, supra-aortic trunk (SAT) debranching + standard TEVAR, and in situ physician modified and parallel grafts were excluded. Primary outcomes were technical success and 30 day mortality rate. Secondary outcomes were 30 day major adverse events, and overall survival and procedure related endpoints during follow up. Of 458 articles screened, 18 articles involving 571 patients were selected. Indications for intervention were chronic dissections (50.1%), degenerative aneurysms (39.6%), penetrating aortic ulcers (7.4%), and pseudoaneurysms (2%). F-TEVAR, B-TEVAR, and F+B-TEVAR were used in 38.4%, 54.1%, and 7.5% of patients, respectively. Overall, technical success was 95.9% (95% confidence interval [CI] 0.93 - 0.97; I2 = 0%; p for heterogeneity (Het) = .77) and the 30 day mortality rate was 6.7% (95% CI 0.05 - 0.09; I2 = 0%; p Het = .66). No statistical differences were found comparing fenestrated with branched endografts, except for a higher rate of type I - III endoleaks in F-TEVAR (9.8% vs. 2.6%; p = .034). The overall survival rate and freedom from aortic related death at the one year follow up ranged between 82 - 96.4% and 94 - 94.7%, respectively. Thirteen and five studies were considered at moderate and high risk of bias, respectively. F/B-TEVAR for the treatment of the aortic arch, according to experience in dedicated centres, now enjoys a satisfactory level of technical success together with a progressively reduced early mortality rate. There are of several limitations, and further studies are needed to reach clearer conclusions.


Fixation of displaced subcapital femoral fractures. Compression screw fixation versus double divergent pins.
One hundred and twenty-seven consecutive patients with displaced subcapital fractures of the femoral neck (Garden Grade III or IV) all under 80 years of age and independently mobile, were randomly allocated to fixation with either double divergent pins or a single sliding screw-plate device. The incidence of non-union and infection in the sliding screw-plate group was significantly higher, and we believe that when internal fixation is considered appropriate multiple pinning should be used. Mobility after treatment was disappointing in about half of the patients, and we feel that internal fixation can only be justified in patients who are physiologically well preserved and who maintain a high level of activity.


Hereditary motor neuropathy, distal type: electrophysiological and pathological studies of a case.
A case of HMN, distal type transmitted as autosomal dominant is described. Clinical findings appear to be consistent with a peroneal muscular atrophy, indistinguishable from HMSN types I and II. The electrophysiological data reveal a pathological involvement of the anterior horns, whereas sensory and motor conduction are normal. A muscle biopsy showed neurogenic atrophy, while the morphology of the sural nerve was normal.


Ergastoplasmic paracrystalline inclusion bodies in the adipose gonadal envelope and fat body of the glow worm, Lampyris noctiluca (Insecta, Coleoptera).
The gonads of glow worm larvae are enveloped by adipose tissue which represents a specialized fat body. The adipose gonadal envelope, and also to a lesser extent the fat body cells, contain tubular paracrystalline inclusion bodies (PIBs). Cells of other tissues are devoid of such inclusions. The PIBs form in the cisternae of rough ER. In young larvae PIB formation is sparse, but at advanced larval stages PIBs often occur as bundles in stacks of ergastoplasm. Typically, a PIB within a cisterna consists of four to seven parallel tubules. The outer diameter of a tubule is ca 28.8 nm and the width of the tubule lumen ca 12.2 nm. The "wall" of a tubule contains globular protein subunits of ca 8.3 nm diameter; the subunits are arranged helically. Since the adipose gonadal envelope progresses through a cytological differentiation process during differentiation and maturation of the gonads, the increased number of PIBs may indicate enhanced metabolic activity of the tissue related to nutrition of the growing gonads.


Changes of central visual receptive fields in experimental glaucoma.
Retinal ganglion cell apoptotic death in experimental glaucoma is protracted over several months and it leads to the visual dysfunction. In the rat with increased intraocular pressure (IOP), the lack of visual scotoma was observed where visual field was determined electrophysiologically on the contralateral optic tectum in the early stages of the disease. Increases in the sizes of receptive fields on the periphery represented early stage of glaucomatous dysfunction. The relationship of duration and magnitude of IOP elevation had a significant correlation between percentages of receptive field sizes in the tectum. Large increases in receptive field sizes noted in the glaucomatous retinal terminal areas suggest the ability of the remaining retinal axons to compete and compensate for the loss of retinal axons. This compensatory adaptation leads to the degradation of the visual acuity and visual thresholds when measured psychophysically.


Ontogeny of gastric emptying patterns in the human fetus.
Fetal swallowing and gastric emptying contribute importantly to amniotic fluid (AF) homeostasis and fetal gastrointestinal development. We speculated that fetal gastric emptying must be functional early in gestation to prevent rapid increases in AF. We sought to determine the human fetal ontogenic pattern of gastric emptying. Gastric emptying of eighty normal fetuses at 12-39 weeks was studied. Real-time ultrasound of the fetal stomach was continuously recorded for 1 hour. The gastric area ratio (GAR) was defined as the gastric area divided by the abdominal transverse area. The delta GAR was defined as the change between the maximum and the minimum gastric area ratiox100 (expressed as percent). A change of the fetal gastric area more than the 10th percentile of the delta GAR at 36-39 weeks was used to define gastric emptying. The 10th, 50th and 90th percentile of delta GAR at 36-39 weeks' was 5.2, 6.5 and 8.7%, respectively. Fetal gastric emptying was detected as early as 12 5/7 weeks of gestation. The proportion of fetuses demonstrating gastric emptying (>10th percentile delta GAR) increased with gestational age: 4/33 (12.1%) 12-23 weeks, 3/9 (33.3%) at 24-27 weeks, 8/11 (72.7%) at 28-31 weeks, 12/14 (85.7%) at 32-35 weeks, and 11/13 (84.6%) at 36-39 weeks. Fetal gastric emptying occurs by the beginning of the second trimester, contributing to AF regulation. The increased frequency of gastric emptying in late gestation is likely secondary to increased swallowing, altered fetal behavioral state or endogenous production of gastrointestinal motility factors.


Health and Habitability in the Solar Decathlon University Competitions: Statistical Quantification and Real Influence on Comfort Conditions.
Medicine and architecture are disciplines with the main objectives of satisfying the fundamental needs of human beings: health, comfort, well-being, safety, and ensuring an acceptable quality of life in a sustainable habitat. In both areas of knowledge, the advances and the most innovative proposals in the fields of research and teaching are focused on transversal knowledge and the use of learning methods through problem solving (learning by doing). The student competitions called "Solar Decathlon" are focused on the development of these concepts, in which prototypes of sustainable and, as far as possible, healthy social housing are tested. In these university competitions, the design of energy-efficient and comfortable living environments that contribute to the health of the occupants are encouraged; however, the methodology for evaluating the "comfort conditions" stipulated in the competition rules considers only parameters that can be monitored by sensors. For this article, the prototypes presented by the "Solar Decathlon Team of the University of Seville" to the editions of said competition held in Latin America and Europe (in 2015 and 2019, respectively) are being studied. The present research starts from the fact that the unique consideration of measurable indices (such as temperature, humidity, etc.), is clearly insufficient when it comes to evaluating the real conditions of habitability and comfort that a domestic architectural space presents. For this reason, a theoretical-practical analysis is carried out by means of surveys, with the final objective of determining a methodology for evaluating comfort-complementary to that of the competition-which assesses other relevant issues and which, in short, takes into account the repercussion on people's health. From our analysis, we conclude that at least these two methodologies should be used to evaluate comfort because they are individually considered incomplete in terms of the data provided by each one of them. The survey-based methodology provides complementary information on comfort and health that could be taken into account in future editions of Solar Decathlon.


Beneficial effects of preoperative oral nutrition supplements on postoperative outcomes in geriatric hip fracture patients: A PRISMA-compliant systematic review and meta-analysis of randomized controlled studies.
Geriatric hip fracture patients often present malnutrition during admission, which leads to higher morbidity and mortality. Protein-based oral nutrition supplements may improve nutritional status. We conducted this systematic review and meta-analysis of randomized controlled trials (RCTs) according to the PRISMA guidelines to elucidate whether preoperative nutrition supplements can improve postoperative outcomes in geriatric hip fracture patients. Only RCTs conducted to compare postoperative outcomes between geriatric hip fracture patients (>60 years old) receiving preoperative oral protein-based nutrition supplement (ONS group) and those who receiving regular diet (Control group) were included. PubMed, Embase, and Cochrane Central Register of Controlled Trials were searched from inception until August, 2021. Postoperative outcomes, including complications, length of hospital stay, and in-hospital mortality, were assessed. A total of 5 RCTs with 654 geriatric hip fracture patients (ONS group: 320 subjects; Control group 334 subjects) were included. Our data revealed that postoperative complications risk in the ONS group was significantly lower than in the Control group (odd's ratio: 0.48, 95% confidence intervals [CI]: 0.26-0.89, P = .02, I2 = 64%). However, no significant differences in the length of hospital stay (standardized mean difference: -0.35 days, 95% CI: -1.68 to 0.98 days, P = .61, I2 = 0%) and the risk of having postoperative in-hospital mortality (odd's ratio: 1.07, 95% CI: 0.43-2.63, P = .89, I2 = 54%) between these 2 groups were observed. Quality assessment revealed high risk of bias and significant data heterogeneity (I2>50%) in most included RCTs. Preoperative protein-based oral nutrition supplements exert beneficial, but limited, effects on postoperative outcomes in geriatric patients with hip fracture undergoing surgery.


Pathogenic role of P-selectin in experimental cerebral malaria: importance of the endothelial compartment.
P-selectin is a leukocyte adhesion receptor expressed on the surface of activated platelets and endothelial cells. Its role in the pathogenesis of cerebral malaria was explored in a murine model of cerebral malaria. Infection of mice with Plasmodium berghei ANKA led to P-selectin up-regulation in brain vessels of cerebral malaria-susceptible mice but not of cerebral malaria-resistant mice. Treatment of susceptible mice with anti-mouse P-selectin mAb failed to prevent the development of the neurological syndrome. However, P-selectin-deficient mice infected with Plasmodium berghei ANKA had a cumulative incidence of cerebral malaria which was significantly reduced compared to wild-type animals (4.5% versus 80%, respectively), despite identical levels of parasitemia, platelet and leukocyte accumulation. To determine whether P-selectin on platelets and/or endothelium was responsible for the microvascular pathology, cerebral malaria was assessed in chimeric mice deficient in platelet or endothelial P-selectin, which were generated by bone marrow transplantation. Mice deficient only in endothelial P-selectin did not show any sign of cerebral malaria (vascular plugging, hemorrhages, or edema), while mice lacking only platelet P-selectin showed signs of cerebral malaria similar to that seen in wild-type mice. These results indicate that endothelial P-selectin plays an important role in the pathogenesis of cerebral malaria.


Arachidonic and docosahexanoic acid content of bovine brain myelin: implications for the pathogenesis of multiple sclerosis.
Lipids were extracted from bovine brain myelin using a mixture of hexane and isopropanol (3:2). Myelin lipids were resolved, using Sep Pak chromatography, into four fractions: Fraction 1 contained neutral lipids, fraction 2, free fatty acids, fraction 3, ethanolamine phospholipids and fraction 4, choline phospholipids. Doscosahexanoic (DHA) and arachidonic (AA) acids in these fractions were measured by RPHPLC. Fraction 2 was analyzed directly, the other three fractions were subjected to alkaline hydrolysis before analysis for DHA and AA. DHA and AA were not found in fraction 1. Both DHA and AA were found in fractions 2 and 3. Only AA was consistently found in fraction 4. These results were confirmed by GC.


Interactions of Listeria monocytogenes with the autophagy system of host cells.
Macrophages are immune cells that participate in the host defense against bacterial pathogens. These cells mediate bacterial clearance by internalizing bacteria into a phagosome, which ultimately fuses with lysosomes to kill bacteria. One bacterial strategy to evade killing in the phagosome is to escape from this compartment prior to lysosomal fusion. Listeria monocytogenes is a classic example of a "cytosol-adapted pathogen" in that it can rapidly escape from the phagosome in macrophages (and other cell types) and replicate rapidly in the cytosol. Phagosome escape also enables cell-to-cell spread by the bacteria through a bacterial driven actin-based motility mechanism. How the bacteria escape the phagosome and evade host cellular defenses, including autophagy, will be discussed in this review. We also discuss an underappreciated population of L. monocytogenes that can replicate in macrophage vacuoles and how these may be important for the establishment of chronic infections.


Prevalence of carbapenemase-producing Enterobacteriaceae from human clinical samples in Ethiopia: a systematic review and meta-analysis.
Carbapenemase-producing Enterobacteriaceae are by far the most public health and urgent clinical problems with antibiotic resistance. They cause longer hospital stays, more expensive medical care, and greater mortality rates. This systematic review and meta-analysis aimed to indicate the prevalence of carbapenemase-producing Enterobacteriaceae in Ethiopia. This systematic review and meta-analysis was conducted based on Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Electronic databases like PubMed, Google Scholar, CINAHL, Wiley Online Library, African Journal Online, Science Direct, Embase, ResearchGate, Scopus, and the Web of Sciences were used to find relevant articles. In addition, the Joanna Briggs Institute quality appraisal tool was used to assess the quality of the included studies. Stata 14.0 was used for statistical analysis. Heterogeneity was assessed by using Cochran's Q test and I2 statistics. In addition, publication bias was assessed using a funnel plot and Egger's test. A random effect model was used to estimate the pooled prevalence. Sub-group and sensitivity analysis were also done. The overall pooled prevalence of carbapenemase-producing Enterobacteriaceae in Ethiopia was 5.44% (95% CI 3.97, 6.92). The prevalence was highest [6.45% (95% CI 3.88, 9.02)] in Central Ethiopia, and lowest [(1.65% (95% CI 0.66, 2.65)] in the Southern Nations and Nationalities People Region. In terms of publication year, 2017-2018 had the highest pooled prevalence [17.44 (95% CI 8.56, 26.32)] and 2015-2016 had the lowest [2.24% (95% CI 0.87, 3.60)]. This systematic review and meta-analysis showed a high prevalence of carbapenemase-producing Enterobacteriaceae. So, to alter the routine use of antibiotics, regular drug susceptibility testing, strengthening the infection prevention approach, and additional national surveillance on the profile of carbapenem resistance and their determining genes among Enterobacteriaceae clinical isolates are required. PROSPERO (2022: CRD42022340181).


Severe overdose of quetiapine treated successfully with extracorporeal life support.
Quetiapine is a second-generation antipsychotic drug, used mainly in the treatment of psychotic disorders. Overdose is associated with sedation, tachycardia and a prolonged QT-interval on the ECG. Cardiovascular symptoms are uncommon but in severe cases profound cardiovascular depression may occur. To report a case where extracorporeal circulatory support (ECCS) was used successfully in severe quetiapine overdose. A 40-year-old woman was admitted to the emergency department (ED) with reduced consciousness apparently due to intoxication. She had a history of schizophrenia and was treated with 900 mg of quetiapine daily. In the ED, she presented with immeasurable low blood pressure, irregular bradycardia, hypothermia and a Glasgow Coma Scale (GCS) of 8. An immunoassay test for tricyclic antidepressive agents (TCA) was positive. Despite resuscitation with intravenous fluids, intensive vasopressor treatment and renal replacement therapy (CRRT) the patient's condition deteriorated. The patient was quickly moved to an intensive care unit where ECCS could be instituted. The patient subsequently recovered after 4 days in the ICU without any residual symptoms. Further laboratory analysis did not confirm the immunoassay finding. Severe poisoning with quetiapine may imitate tricyclic antidepressant poisoning, and drug screening methods may be falsely positive for TCA. In case of cardiovascular collapse due to quetiapine overdose, ECCS may be life saving.


Collagen score in the tumor microenvironment predicts the prognosis of rectal cancer patients after neoadjuvant chemoradiotherapy.
Little is known about the relationship between collagen and the prognosis of patients with locally advanced rectal cancer (LARC) after neoadjuvant chemoradiotherapy (nCRT). This study aimed to quantitatively analyze collagen alterations, establish a collagen score (CS) in the tumor microenvironment, and evaluate and validate the relationship of the CS with prognosis in these patients. A total of 365 primary patients diagnosed with LARC after nCRT between 2011 and 2018 were retrospectively reviewed (training cohort: 210; independent validation cohort: 155). Multiple collagen features of two fields in the tumor microenvironment, the core of the tumor (CT) and the invasive margin (IM), were derived from multiphoton imaging, and the CSIM-CT was generated using least absolute shrinkage and selection operator (LASSO) Cox regression analysis. The CSIM-CT was created based on 3 features: collagen area, number of collagen fibers and a Gabor textural feature. In the training cohort, the CSIM-CT predicted 3-year disease-free survival (DFS) with an area under the receiver operating characteristic curve (AUROC) of 0.765 (0.675-0.854) and an overall survival (OS) with AUROC of 0.822 (0.734-0.909). Additionally, the CSIM-CT was significantly associated with DFS and OS in the two cohorts. A nomogram with the CSIM-CT was developed and showed good prognostic value predicting a 3-year DFS with an AUROC of 0.826 (0.748-0.905) and an OS with AUROC of 0.882 (0.803-0.960). The CSIM-CT is an effective prognostic marker in patients with LARC after nCRT, and the nomogram with the CSIM-CT can be used to accurately predict the individual prognosis of these patients.


The business of good doctoring or doctoring as good business: reflections on Freidson's view of the medical game.
This paper reflects on selected aspects of the work of Eliot Freidson and is based mainly on his three latest books--Profession of Medicine, Professional Dominance, and Doctoring Together--in which he draws together his various contributions and elaborates a substantial argument concerning the dominant position of physicians within the institution of medicine in particular and, more generally, their unique position within the broader society. Freidson's work is considered from the perspective of political economy. The paper discusses, on a broad level, some of the assumptions underlying his analysis, the adequacy of his theoretical orientation and level of analysis for understanding the House of Medicine in the United States, and some implications that follow.


Effects of commercial chlorophenolate, 2,3,7,8-TCDD, and pure phenoxyacetic acids on hepatic peroxisome proliferation, xenobiotic metabolism and sister chromatid exchange in the rat.
The induction of hepatic peroxisome proliferation and drug metabolizing enzymes and of sister chromatid exchange (SCE) in lymphocytes was studied in male Han/Wistar rats after exposing them for 2 weeks to a commercial chlorophenolate formulation (Ky-5) (100 mg/kg/day), to 2,3,7,8-tetrachlorodibenzo-p-dioxin (2,3,7,8-TCDD; 0.05-5 micrograms/kg/wk) and to the pure phenoxyacetic acids, 2,4-dichlorophenoxyacetic acid (2,4-D; 100 mg/kg/day) and 2-chloro-4-methylphenoxyacetic acid (MCPA; 100 mg/kg/day). The chlorophenolate formulation and pure 2,4-D and MCPA caused significant increases in the number of peroxisomes in liver cells, although the average size of peroxisomes was not affected, whereas the effect of even the highest dose of 2,3,7,8-TCDD remained small. This finding indicates that dioxin impurities do not account for the peroxisome proliferation induced by chlorophenolate. The relative weight of the liver increased significantly in rats treated with the chlorophenolate formulation and with 2,3,7,8-TCDD (5.0 and 0.5 micrograms/kg). The pattern of induction of xenobiotic metabolizing enzymes showed some differences between chlorophenolate treatment and 2,3,7,8-TCDD treatment. Furthermore, the effects of pure phenoxyacetic acids were different from that seen with chlorophenolate and 2,3,7,8-TCDD. The highest dose of 2,3,7,8-TCDD increased the frequency of SCE in circulating lymphocytes slightly, but significantly.


Long-term intracranial pressure monitoring in comatose patients suffering from head injuries. A critical survey.
On the basis of a series of 75 patients, the practical use of Icp continuous long-term recording in severe head injuries without mass lesions or remaining deeply comatose after surgical procedures is critically analyzed. ICP monitoring alone seems to be not essential for prognosis. Conversely it is of much greater use as a guide to management (respirator treatment, osmotics, CSF drainage). If the pros and cons of the procedure are carefully weighed, it would appear that, for the time being, ICP long-term monitoring is justified only in comatose patients on intensive care.


[New mucogingival surgical technics. 1. The subepithelial connective tissue graft. Review of the literature and report of a case].
The Authors refer in this note about a new technic to recover root recessions particularly those wide and deep: the subepithelial connective tissue graft.


Determination of dopamine in the presence of ascorbic acid using poly(3,5-dihydroxy benzoic acid) film modified electrode.
A polymerized film of 3,5-dihydroxy benzoic acid (DBA) was prepared on the surface of a glassy carbon electrode (GCE) in neutral solution by cyclic voltammetry (CV). The poly(DBA) film-coated GCE exhibited excellent electrocatalytic activity toward the oxidation of dopamine (DA). A linear range of 1.0 x 10(-7) to 1.0 x 10(-4)M and a detection limit of 6.0 x 10(-8)M were observed in pH 7.4 phosphate buffer solutions. Moreover, the interference of ascorbic acid (AA) was effectively eliminated. This work provides a simple and easy approach to selective detection of DA in the presence of AA.


Monoclonal antibodies and superantigens: a novel therapeutic approach.
We have developed a monoclonal antibody (mAb) based therapy intended for the treatment of solid tumors utilizing both main arms of the immune system by incorporating the colon carcinoma recognizing mAb C215 and the T cell activating bacterial staphylococcal enterotoxin A (SEA) in a single hybrid molecule. The recombinant tumor specific superantigen C215-SEA retained excellent antigen binding properties while the binding to MHC class II was markedly reduced and should allow targeting of a large fraction of T cells to tumors in vivo. C215-SEA mediated T cell killing of C215 expressing tumor cells irrespective of their expression of MHC class II antigens and induced levels of IFN-gamma and TNF in mononuclear cells sufficient to completely suppress the growth of colon carcinoma cells in vitro. In initial studies of anti-tumor effects, C215Fab-SEA was found to markedly inhibit the growth of colon carcinoma cells transplanted to Scid mice adoptively transferred with human mononuclear cells.


Ventilatory effects of hypercapnic end-tidal PCO2 clamps during aerobic exercise of varying intensity.
Nine subjects performed a sequence of sustained and randomised changes between 40 W and 100 W on a cycle ergometer while the end-tidal PO2 was kept close to 17.3 kPa (130 mm Hg) by means of a dynamic forcing technique (reference experiment). In a second series inspiratory CO2 was additionally manipulated so as to hold end-tidal PCO2 (PETCO2) near 6.5 kPa (49 mm Hg; 'CO2-clamp' experiment). By this forcing PETCO2 oscillations were attenuated and more evenly distributed over the frequency range. Ventilation (VT) responded to this manoeuvre with an upward trend that could not be ascribed to a slow CO2-response component, changes in metabolic rate or a dissociation of end-tidal and arterial PCO2. VT differences between reference and CO2-clamp experiments were abolished within a 3-min period following the termination of the external CO2 control. The present results suggest that the CO2-H+ stimulus plays a major role in adjusting ventilation when exercise intensity is decreased. The underlying CO2 effect appears to be neither additive nor bi-directionally symmetrical.


[Is it possible to cure a patient with mycosis fungoides? A case report].
Sezary syndrome (SS) and mycosis fungoides (MF) are a group of non Hodgkin lymphomas that originate from T-lymphocytes and involve mostly the skin. These entities are generally non treatable and patient prognosis remains poor even with the advent of current treatment schedules. Complete remissions are seldom observed. For this reason, bone marrow transplant has been used as a treatment option. The high mortality associated with this procedure has turned reduced intensity conditioning stem cell transplant into a treatment option. This case study illustrates how stem cell transplant offers complete remission of this type of lymphomas.


Cytoplasmic origin of the so-called nuclear neutral histone protease.
1. We have investigated the origin of proteolytic activity which causes degradation of histones in chromatin isolated from Xenopus liver and the rat liver at neutral pH. Polyacrylamide disc gel electrophoresis was used for detection of proteolytic products of histones. 2. No proteolytic degradation of histones occurs in chromatin isolated from Xenopus erythrocytes and rat liver according to our procedure even after prolonged incubation at pH 8.0 and pH 5.0. However with chromatin isolated from Xenopus liver a high level of histone degradation is observed under similar conditions. 3. Mixing isolated nuclei from Xenopus erythrocytes with a crude cytoplasmic fraction from Xenopus liver causes histone proteolysis in isolated chromatin at pH 8.0. In similar experiments with corresponding fractions from rat liver histone proteolysis can be introduced only after repeated freezing and thawing of the cytoplasmic fraction. 4. A purified lysosomal preparation from rat liver causes a similar type of histone degradation upon incubation with chromatin from Xenopus erythrocytes and rat liver. 5. The neutral proteolytic activity that can be introduced in isolated chromatin by a crude cytoplasmic fraction and by a purified lysosomal erythrocytes and rat liver. 5. The neutral proteolytic activity that can be introduced in isolated chromatin by a crude cytoplasmic fraction and by a purified lysosomal fraction from rat liver is inhibited by sodium bisulphite. 6. We conclude that the neutral proteolytic activity which causes degradation of histones in isolated chromatin is due to a contamination with neutral protease(s) originating from cytoplasmic organelles.


Reversal of acute polyhydramnios after fetal renal decompression.
Polyhydramnios and premature labor at twenty-seven weeks secondary to an intrafetal renal cyst are described. Antenatal fetal cyst decompression successfully reversed the polyhydramnios and prevented premature delivery, resulting in a full-term healthy infant delivered vaginally at thirty-nine weeks. Urologic investigation postpartum revealed a probable congenital ureteropelvic junction obstruction.


Biologic rationale and clinical activity of mTOR inhibitors in gynecological cancer.
Advanced recurrent gynecological malignancies have a poor prognosis despite systemic treatment, which is usually cytotoxic chemotherapy. Responses are generally short-lived and more effective treatments are needed. Rationally designed molecularly targeted therapy is an emerging and important option in this setting. The mammalian target of rapamycin (mTOR) is a serine/threonine protein kinase of the phosphatidylinositol-3-kinase (PI3K)/AKT signaling pathway with a critical role in controlling cancer cellular growth, metabolism and cell cycle progression. Aberrant PI3K-dependent signaling occurs frequently in a wide range of tumor types, including ovarian, endometrial and cervical cancer. Early clinical studies of first-generation mTOR inhibitors have shown promising clinical activity in endometrial cancer. However, the molecular basis of sensitivity and resistance to these agents remains largely unknown. In this review, we will update the clinical and biological data underlying the development of first generation mTOR inhibitors in the treatment of gynecological tumors. The role of potential new combination regimens with mTOR inhibitors in gynecological cancers will also be discussed.


Prevalence and risk factors of meibomian gland dysfunction: the Singapore Malay eye study.
To describe the prevalence and associations of meibomian gland dysfunction (MGD) in an urban Malay population in Singapore. Population-based cross-sectional study of 3280 (78.7% response rate) Malay persons aged 40 to 80 years, living in Singapore. MGD was defined by a slit-lamp clinical examination as either lid margin telangiectasia or meibomian gland orifice plugging in at least one eye. Participants underwent a standardized questionnaire and clinical examination, including laboratory investigations. Data were analyzed for 3271 persons. The age-standardized prevalence of MGD was 56.3% [95% confidence interval (CI), 53.3-59.4]. A higher MGD prevalence was found in male participants across all age groups [odds ratio (OR), 1.30; 95% CI, 1.35-1.79], postmenopausal women (OR, 1.64; 95% CI, 1.19-2.33), and all participants with pinguecula (OR, 2.43; 95% CI, 2.08-2.85), high diastolic blood pressure (OR, 1.32; 95% CI, 1.08-1.62), and use of angiotensin II receptor blockers (OR, 4.02; 95% CI, 1.74-9.27). MGD was highly prevalent in this Asian population and associated with various systemic and ocular conditions.


Activation of protein kinase C reverses capsaicin-induced calcium-dependent desensitization of TRPV1 ion channels.
Ca2+ selective ion channels of vanilloid receptor subtype-1 (TRPV1) in capsaicin-sensitive dorsal root ganglion (DRG) neurons and TRPV1 transfected Chinese hamster ovarian (CHO) cells are desensitized following calcium-dependent tachyphylaxis induced by successive applications of 100 nM capsaicin. Tachyphylaxis of TRPV1 to 100 nM capsaicin stimuli was not observed in the absence of extracellular calcium. Capsaicin sensitivity of desensitized TRPV1 ion channels recovered on application of phorbol-12-myristate-13-acetate (PMA). PMA-induced recovery of desensitized TRPV1 was primarily due to influx of extracellular calcium observed during re-application of capsaicin following desensitization. Capsazepine blocked the re-sensitization to capsaicin by PMA. Protein kinase C (PKC) inhibitory peptide PKC fragment 19-36 also inhibited re-sensitization to capsaicin by PMA. Reversal of capsaicin-induced desensitization by PMA was prevented by a mutation of TRPV1 where phosphorylation sites serine502 and serine800 were replaced with alanine. This study provides evidence for a role of PKC in reversing capsaicin-induced calcium-dependent desensitization of TRPV1 ion channels.


Six-year cost trends at PPG industries paralleling the introduction of health promotion programs directed at cardiovascular disease prevention.
Over the past several years, PPG Industries (PPG) implemented worksite health promotion programs aimed at improving employees' health and reducing overall medical costs as well as those specific to cardiovascular disease. Using medical claims data, we examined trends in these costs among PPG employees for a 6-year period, from 2005 to 2010. Overall medical costs remained relatively flat, increasing by 1.2% compounded annually, unadjusted for inflation, while inflation-adjusted costs declined by 2.9%. Comparing worksites rated "high-high" on both program implementation and leadership support with worksites scoring highly on one or none of those dimensions, the "high-high" group experienced a decreasing cost trend, whereas the "other" group showed an increase. The analysis suggests that PPG's efforts to reconfigure and intensify its wellness program offerings may have resulted lower health care cost trends.


GABAergic synaptic current in dissociated nucleus basalis of Meynert neurons of the rat.
gamma-Aminobutyric acid (GABA)-mediated spontaneous inhibitory postsynaptic currents (IPSCs) were recorded from dissociated rat nucleus basalis of Meynert neurons which still had their synaptic boutons attached. The membrane currents were recorded by the whole-cell patch-clamp technique. Elevated extracellular K+ concentration and the addition of the calcium ionophore, A23187, enhanced the amplitude and frequency of spontaneous IPSCs. Ryanodine and Ca(2+)-free external solution containing EGTA or BAPTA markedly decreased the spontaneous IPSC activities. Spontaneous IPSC activities were reversibly reduced by baclofen and increased by phaclofen, indicating that the GABAB receptor regulates the release of GABA from nerve terminals and acts as a negative autoreceptor.


Retracted: Deformation Analysis and Research of Building Envelope by Deep Learning Technology under the Reinforcement of the Diaphragm Wall.
[This retracts the article DOI: 10.1155/2022/9489445.].


The antithrombogenic in vivo effects of calcium channel blockers in experimental thrombosis in mice.
A new model of thrombotic challenge, well suited for screening agents and which acts primarily against platelet thromboembolism, has been used to test the in vivo anti-platelet effects of four calcium channel blockers (CCB). An i.v. injection of a mixture of collagen plus epinephrine (15 micrograms and 1.8 micrograms/mouse, respectively) was given to male mice. 94% control mice died or remained paralyzed for more than 15 minutes. The dihydropyridine agents, CRE-223 and Nifedipine, were highly protective against experimental thrombosis, whereas Verapamil had a weaker and much shorter effect and, on the other hand, Diltiazem had no protective effect over a range of doses. The activity on both dihydropyridines lasted for seven hours or even longer.


Surgery for aortic dissection associated with congenital bicuspid aortic valve.
Congenital bicuspid aortic valve is a relatively rare malformation. It is reported that the presence of this anomaly predisposes the patient to the development of dissecting aortic aneurysms. Between 1981 and October 1997, 7 patients with aortic dissection associated with congenital bicuspid aortic valve underwent surgical treatment at our institution. The patients consisted of six males and one female. The age of the patients ranged from 54 to 74 years (mean 61 years). The classification of dissecting aortic aneurysms was DeBakey type I dissection in 4 patients, type II dissection in 2 patients and type IIIb dissection in 1 patient. These 7 patients constituted 2.0% (7/356) of all cases of surgical operation for dissecting thoracic aneurysm. Aortic valve dysfunction was noted in 5 patients, 4 of whom had previously undergone aortic valve replacement. We performed graft replacement of the ascending aorta in 4 patients, graft replacement of the ascending aorta and aortic arch in 2 patients, and graft replacement of the descending aorta in 1 patient. There were no hospital deaths in any of the 7 patients. Pathological examination of surgical specimens of the aortic wall showed cystic medial necrosis in 2 patients and mucoid degeneration in 4 patients. In addition to complication by valve dysfunction, patients with congenital bicuspid aortic valve are at risk for the development of aortic dissection.


Adult diffuse midline gliomas H3 K27-altered: review of a redefined entity.
Diffuse midline glioma (DMG) H3 K27-altered is a type of high-grade gliomas first recognized as a new entity in the 2016 World Health Organization Classification of Central Nervous System (CNS) Tumors as DMG H3 K27M-mutant, recently renamed in the new 2021 WHO classification. The aim of this review is to describe the characteristics of diffuse midline gliomas H3 K27-altered in the adult population. We performed a review of the current literature regarding the genetic, clinical, imaging characteristics and management of diffuse midline gliomas H3 K27-altered in adult patients. The 2021 WHO classification now designates the previously recognized DMG H3K27M-mutant as DMG H3 K27-altered, recognizing the alternative mechanisms by which the pathogenic pathway can be altered. Thus, the diagnostic criteria for this entity consist of diffuse growth pattern, midline anatomic location, and H3 K27-specific neuroglial mutations. DMGs' characteristic midline location makes them difficult to surgically resect and biopsy, carrying high mortality and morbidity rates, with median survival ranging from 9 to 12 months in adult patients. The diagnosis of DMGs H3 K27-altered in adult patients should be considered upon neurological symptoms associated with an infiltrative midline brain tumor detected on imaging. Future studies are necessary to continue refining their characteristics in this age group.


Contact allergy to corticosteroids and Malassezia furfur in seborrhoeic dermatitis patients.
Seborrhoeic dermatitis (SD) is a chronic skin disease, requiring long-term treatment, which might promote sensitization. Malassezia furfur (Mf) plays an important role in seborrhoeic dermatitis. Objectives The aim of this study was to determine the frequency of contact sensitivity in SD patients. A total of 100 patients and 20 healthy controls (HC) were investigated: 50 suffering from SD with no previous local corticosteroid treatment (SDN), 50 SD patients treated with local corticosteroids (SDC). Mycological examination for Mf was performed. All patients were patch tested with the baseline standard, corticosteroid series, with 12 commercial corticosteroid preparations frequently used in Croatia; and also with Mf. Malassezia furfur was found in 44 (88%) SDN, 37 (74%) SDC, and in 4 (20%) HC; patch test reaction to Mf was positive in one SDN and in three SDC. Positive patch tests to standard allergens were observed in 17 (34%) SDN, 33 (66%) SDC and 2 (10%) HC. Patch tests to the corticosteroid series revealed positive reactions in 4 SDC and to commercial corticosteroids in seven patients, i.e. 2 SD and 5 SDC. Patch tests to the baseline series and to both individual corticosteroid and commercial corticosteroid preparations should be performed in SD patients with persistent dermatitis, as contact-allergic reactions may complicate their dermatitis. Sensitization to Mf was found to be infrequent.


Volumetric T2 -weighted spin echo imaging with improved SNR using localized quadratic encoding and a spiral readout trajectory.
To demonstrate T2 -weighted (single-echo) spin-echo (SE) imaging with near-optimal acquisition efficiency by applying SNR-efficient RF slice encoding and spiral readout. A quadratic-phase (frequency swept) excitation RF pulse replaced the conventional excitation in T2 -weighted SE sequence to excite a thick slab that is internally spatially encoded by a variable phase along the slice direction. Highly overlapping slabs centered at every desired slice location were acquired in multiple passes, such that the entire imaging volume was excited by contiguous slabs in any given pass. Following 90° excitation, each slab was refocused with a conventional 180° RF to produce a SE signal, followed by a spiral in-out readout. A noise-insensitive reconstruction removed the quadratic phase in the spatial frequency domain, yielding desired slice resolution and improved SNR. Increasing the RF frequency sweep (hence, excitation width) allowed more frequent encoding of each slice over the multiple passes, improving final image SNR, until crosstalk ensued at excessive slab widths compared to their center-to-center spacing. With an optimized slab width, the proposed technique used all passes to acquire every prescribed slice, with substantially improved SNR over conventional SE or 2D-turbo-spin-echo (TSE) scans. Quantitative SNR measurements indicated similar SNR as 3D-TSE, but radiologist scoring favored 3D-TSE, mainly because of spiral-related artifacts and possibly because of regularized reconstructions in 3D-TSE. Using SNR-efficient slice excitation scheme and spiral readout helped eliminate SNR and temporal inefficiencies in conventional T2 -weighted imaging, yielding SNR independent of TR or number of passes.


Effect of intraperitoneal application of an endotoxin inhibitor on survival time in a laparoscopic model of peritonitis in rats.
Gram-negative sepsis due to fecal peritonitis is a hazardous disease with a high percentage having a lethal course. The inflammatory effects are induced by endotoxin release. We performed this study to evaluate the potential of direct intraperitoneal application of an endotoxin inhibitor in a laparoscopic peritonitis model in rats. The human feces specimen was prepared, and a standard fecal specimen (0.5 ml/kg b.w.) was applied via minilaparotomy. The rats were randomized to two studies. First, rats were randomized to three groups to define the survival time: (1) rats without further manipulation; (2) rats with laparoscopic lavage using NaCl; (3) rats with laparoscopic lavage using endotoxin inhibitor. Second, rats underwent the same procedure used in the first part of the study and an additional group with only NaCl lavage without peritonitis was randomized. To evaluate the immunologic or biochemical effects, animals were killed at a standard time of 20 hours until the postmortem examination was established. Interleukins 6 and 10 (IL-6, IL-10), malondialdehyde, and protein carbonyl group levels in plasma and particularly in peritoneal fluid were assayed. The first part of the experiment showed significantly increased survival after endotoxin inhibitor lavage. In the second part, administration of endotoxin inhibitor intraperitoneally caused a significant reduction of IL-6 in the peritoneal fluid, in contrast to that in the other groups. Laparoscopic application of endotoxin inhibitor intraperitoneally thus produced a beneficial effect on survival and reduction of IL-6 in peritoneal fluid. Hence, it is possible to influence the inflammation cascade by causing intraperitoneal endotoxin inhibition.


Outcomes of laparoscopic modified Cellan-Jones repair versus open repair for perforated peptic ulcer at a community hospital.
Minimally invasive or open Graham Patch repair remains the gold standard approach for management of perforated peptic ulcers (PPU). Herein, we report outcomes of laparoscopic technique and compare it with open approach at a community hospital. Retrospective observational study conducted comparing laparoscopic modified Cellan-Jones repair (mCJR) versus the standard open repair of PPU. Patients aged 18-90 years during 2016-2021 were offered either a minimally invasive or open approach depending on surgeon laparoscopic capability, and were compared in terms of demographics, co-morbidities, intra-operative details, and short-term outcomes. A total of 49 patients were included (46.9% males, mean age 52.9 years, mean BMI 25.0, ASA ≥ III 75.5%, 75.5% smokers, 26.5% current NSAIDs use, and 71.4% alcohol drinkers). Duodenum was the most common perforation site (57.1%), and majority of ulcers were 1-2 cm (72.9%). Laparoscopic approach was performed in 16 consecutive patients (32.7%) by a single surgeon, with no conversions. Preoperative characteristics were similar for both groups. Compared to open approach, laparoscopic group were taken to operation immediately (< 4 h) (87.5% vs. 15.2%, p < 0.001), had lower estimated blood loss (11.8 ml vs. 73.8 ml, p = 0.063), and longer operative time (117.1 min vs. 85.6 min, p = 0.010). Postoperatively, nasogastric tube was removed earlier in laparoscopic group (POD1-2, 87.5% vs. 24.2%, p = 0.001), with earlier resumption of diet (POD1-2, 62.6% vs. 9.1%, p = 0.002), less narcotic usage (< 3 days, 58.3% vs. 6.1%, p < 0.001), earlier return of bowel function (POD1-2, 43.8% vs. 9.1%, p = 0.003) and shorter length of stay (LOS) (3.7 days vs. 16.1 days, p < 0.001). Both in-house mortality and morbidity rates were lower in the laparoscopic group, but not statistically significant [(0% vs. 6.1%, p = 0.347) and (12.5% vs. 39.4%, p = 0.500), respectively]. Laparoscopic mCJR is a feasible method for repair of PPU, and it is associated with shorter LOS, and less narcotics usage in comparison to the open repair approach.


cAMP signaling cascades and CFTR: is there more to learn?
CFTR is an apically resident ion channel whose activity is regulated by the activation of the cAMP mediated second messenger cascade. As depicted in textbooks, the cAMP mediated signaling cascade appears deceptively simple, yet, our growing understanding of this pathway shows it to be much more complicated and finely tuned than originally thought. The intent of this review is to evaluate our current understanding of the cAMP mediated signaling as it relates to the secretion of mucin and chloride, two compounds whose regulated secretion is altered in cystic fibrosis.


Oesophageal varices in schistosomiasis: treatment with a modified Warren's distal splenorenal shunt.
Thirty-five patients of bleeding oesophageal varices were treated by modified Warren's distal splenorenal procedure. In this procedure the spleen was removed. The value of the technique in maintaining liver perfusion, and relieving hypersplenism is discussed.


Mutation analysis of 20 SARS virus genome sequences: evidence for negative selection in replicase ORF1b and spike gene.
Recently, more SARS-CoV virus genome sequences are released to the GenBank database. The aim of this study is to reveal the evolution forces of SARS-CoV virus by analyzing the nucleotide mutations in these sequences. We obtained 20 SARS-CoV virus genome sequences from NCBI database, and calculated the ratio of non-synonymous nucleotide substitution per non-synonymous site (Ka) and synonymous nucleotide substitution per synonymous site (Ks) for SARS-CoV virus genes. The Ka/Ks ratios for replicase polyprotein ORF1a, ORF1b, and spike protein gene are 1.09 (P=0.6501), 0.38 (P=0.0074), 0.65 (P=0.0685) respectively. SARS-CoV virus replicase polyprotein ORF1b is undergoing negative selection; negative selection force is also probably operating on spike protein gene. These results provide basis for future developing a new drug and vaccine against SARS.


Long-term results from a series of patients managed with breast conservation surgery and hypofractionated radiotherapy in Christchurch: What is the recurrence rate and how do we detect recurrences.
Hypofractionated radiation treatment (HFRT) following breast conservation surgery (BCS) has similar efficacy to conventionally fractionated radiation treatment (CFRT). This study updates outcomes for patients treated with HFRT in Christchurch, New Zealand, and reports on the pattern, timing and method of detection of recurrences to inform follow-up practice. Between 2004 and 2006, 273 women with early breast cancer were treated with HFRT (42.5 Gray (Gy) in 16 fractions). Details of demographics, tumour characteristics, treatments, any recurrence (local, nodal or distant), follow-ups and date of death were collected. The primary endpoint was local recurrence rate (LRR); secondary endpoints were local recurrence-free survival (LRFS) and overall survival (OS). With a median follow-up of 12.9 years, 17 women developed a local recurrence. LRR at 5 and 10 years were 3.1% and 5.3%, respectively. Five-year LRFS was 91.7% and ten-year LRFS was 83.5%. The OS at five years was 93.7% and at ten years was 87.7%. For the 41 patients with a first recurrence at any site, 75.6% were symptomatic, 22% were screen detected with radiology and 2.4% were incidental findings. None of the first recurrences were detected when asymptomatic on clinical examination in follow-up clinics. The rate of local recurrence following HFRT for BCS is low. No asymptomatic recurrence was detected by routine clinic follow-up. The utility of regular clinical examination for the detection of recurrence is low and this should inform follow-up strategies.


Proposal of a framework for evaluating military surveillance systems for early detection of outbreaks on duty areas.
In recent years a wide variety of epidemiological surveillance systems have been developed to provide early identification of outbreaks of infectious disease. Each system has had its own strengths and weaknesses. In 2002 a Working Group of the Centers for Disease Control and Prevention (CDC) produced a framework for evaluation, which proved suitable for many public health surveillance systems. However this did not easily adapt to the military setting, where by necessity a variety of different parameters are assessed, different constraints placed on the systems, and different objectives required. This paper describes a proposed framework for evaluation of military syndromic surveillance systems designed to detect outbreaks of disease on operational deployments. The new framework described in this paper was developed from the cumulative experience of British and French military syndromic surveillance systems. The methods included a general assessment framework (CDC), followed by more specific methods of conducting evaluation. These included Knowledge/Attitude/Practice surveys (KAP surveys), technical audits, ergonomic studies, simulations and multi-national exercises. A variety of military constraints required integration into the evaluation. Examples of these include the variability of geographical conditions in the field, deployment to areas without prior knowledge of naturally-occurring disease patterns, the differences in field sanitation between locations and over the length of deployment, the mobility of military forces, turnover of personnel, continuity of surveillance across different locations, integration with surveillance systems from other nations working alongside each other, compatibility with non-medical information systems, and security. A framework for evaluation has been developed that can be used for military surveillance systems in a staged manner consisting of initial, intermediate and final evaluations. For each stage of the process parameters for assessment have been defined and methods identified. The combined experiences of French and British syndromic surveillance systems developed for use in deployed military forces has allowed the development of a specific evaluation framework. The tool is suitable for use by all nations who wish to evaluate syndromic surveillance in their own military forces. It could also be useful for civilian mobile systems or for national security surveillance systems.


Altered morpho-functional features of bones in autoimmune disease-prone BXSB/MpJ- Yaa mice.
Bone disease, such as osteoporosis and rheumatoid arthritis, increases because of the progression of an aging society. Autoimmune disease are important and predisposing factors for the pathogenesis of the bone disease; however, the pathological mechanism is unclear. We have demonstrated that systemic autoimmune disease in BXSB/MpJ- Yaa is closely associated with the morpho-functional abnormalities of bones including bone marrow and has complicated pathology. The abnormalities are characterized by altered regulations of serum calcium, anemia tendency, and hematopoiesis with increased WBCs and decreased PLs, short length and low mass of long bones, imbalance in the populations of osteoclasts and osteoblasts, and increased expression of candidate genes for causing and/or exacerbating their phenotypes. Therefore, BXSB/MpJ- Yaa serves as a model to elucidate bone phenotypes in systemic autoimmune disease that would be affected by the factors in the bone as well as the other immune and/or mineral metabolism organs both in human and experimental medicine.


Plasmon-enabled degradation of organic micropollutants in water by visible-light illumination of Janus gold nanorods.
The development of sustainable methods for the degradation of pollutants in water is an ongoing critical challenge. Anthropogenic organic micropollutants such as pharmaceuticals, present in our water supplies in trace quantities, are currently not remediated by conventional treatment processes. Here, we report an initial demonstration of the oxidative degradation of organic micropollutants using specially designed nanoparticles and visible-wavelength sunlight. Gold "Janus" nanorods (Au JNRs), partially coated with silica to enhance their colloidal stability in aqueous solutions while also maintaining a partially uncoated Au surface to facilitate photocatalysis, were synthesized. Au JNRs were dispersed in an aqueous solution containing peroxydisulfate (PDS), where oxidative degradation of both simulant and actual organic micropollutants was observed. Photothermal heating, light-induced hot electron-driven charge transfer, and direct electron shuttling under dark conditions all contribute to the observed oxidation chemistry. This work not only provides an ideal platform for studying plasmonic photochemistry in aqueous medium but also opens the door for nanoengineered, solar-based methods to remediate recalcitrant micropollutants in water supplies.


Data-driven algorithm for myelin water imaging: Probing subvoxel compartmentation based on identification of spatially global tissue features.
Multicomponent analysis of MRI T2 relaxation time (mcT2 ) is commonly used for estimating myelin content by separating the signal at each voxel into its underlying distribution of T2 values. This voxel-based approach is challenging due to the large ambiguity in the multi-T2 space and the low SNR of MRI signals. Herein, we present a data-driven mcT2 analysis, which utilizes the statistical strength of identifying spatially global mcT2 motifs in white matter segments before deconvolving the local signal at each voxel. Deconvolution is done using a tailored optimization scheme, which incorporates the global mcT2 motifs without additional prior assumptions regarding the number of microscopic components. The end results of this process are voxel-wise myelin water fraction maps. Validations are shown for computer-generated signals, uniquely designed subvoxel mcT2 phantoms, and in vivo human brain. Results demonstrated excellent fitting accuracy, both for the numerical and the physical mcT2 phantoms, exhibiting excellent agreement between calculated myelin water fraction and ground truth. Proof-of-concept in vivo validation is done by calculating myelin water fraction maps for white matter segments of the human brain. Interscan stability of myelin water fraction values was also estimated, showing good correlation between scans. We conclude that studying global tissue motifs prior to performing voxel-wise mcT2 analysis stabilizes the optimization scheme and efficiently overcomes the ambiguity in the T2 space. This new approach can improve myelin water imaging and the investigation of microstructural compartmentation in general.


We Need to Do Better: A Scoping Review of Wellness Programs In Surgery Residency.
Burnout, depression, and fatigue are common among surgical residents. Most published wellness studies in surgery only focus on a cross-sectional view of attitudes and perceptions around wellness in training. While much of this literature calls for interventions and presents strategies for improving resident well-being, there is a paucity of published wellness initiatives, and even fewer with programmatic evaluation. A scoping review was designed to address: (1) What wellness initiatives are used in surgery residency programs? (2) Which wellness domains do these programs address? and (3) How are program outcomes evaluated? A formal literature search was conducted using PubMed, Embase, and Scopus databases to identify English-language studies conducted in the United States that described wellness-focused initiatives for surgery residents. Two authors independently screened all abstracts and full texts for inclusion. Data were extracted including wellness domain(s) and outcomes evaluation methods with associated Kirkpatrick level(s) (1-reaction, 2-learning, 3-behavior, 4-results). Study quality was examined using the medical education research study quality index (MERSQI) score. A total of 2237 abstracts were screened with 115 full texts reviewed for eligibility. Fifty-one studies were included in the final analysis, representing 39 distinct wellness programs. The most common domains of wellness addressed were emotional (19/39, 48.7%), occupational (17/39, 43.6%), and physical (16/39, 41.0%). Of the 51 studies reviewed, 8 (15.7%) did not conduct any program evaluation, 27 (52.9%) evaluated level 1, 30 (58.8%) evaluated level 2, 3 (5.9%) evaluated level 3, and none evaluated level 4 outcomes. The mean MERSQI score was 9.16 (SD 1.8). Wellness is an established problem in surgical training. This review reveals a small number of published wellness interventions and even fewer that incorporate programmatic evaluation at the level of behavior and results change. Effective change will require rigorous and deliberate programming that addresses multiple domains and evaluation levels.


Totally laparoscopic total gastrectomy using the overlap method; early outcomes of 50 consecutive cases.
Construction of an esophagojejunostomy is still a challenging procedure in totally laparoscopic total gastrectomy (TLTG), and there is no standard anastomosing method. The aims of this study were to describe our TLTG with the overlap method using a linear stapler and report surgical outcomes. From January 2015 to April 2016, 50 patients underwent TLTG using the overlap method for gastric cancer. The procedures were performed by a single surgeon, and the patients' medical records were reviewed. Their clinicopathologic characteristics, operation time, date of flatus, hospital stay, morbidity, and mortality were analyzed. The median age and body mass index were 56 years and 23.5, respectively. Stage 1A tumors were the most common. Mean operating time was 144.6 min, and no cases required changing to open laparotomy during surgery. On average, flatus occurred 3.5 days after surgery, and patients were discharged 6.8 days after surgery. No patient experienced anastomosis leakage, stricture, duodenal stump leakage, luminal bleeding, pancreatic fistula, or wound problems. There were two cases of intra-abdominal bleeding that required additional surgery. Intra-abdominal fluid collection and mechanical ileus occurred in two patients, respectively, and were successfully managed with conservative treatment. We reported favorable surgical outcomes of TLTG using the overlap method. It is a feasible and safe option for treatment of gastric cancer.


Noninvasive diagnosis of renal allograft rejections--application of an information-theoretical model.
This paper describes an information-theoretical model developed for detection of renal allograft rejection on the basis of various laboratory data. In this report the mathematical background of the model is described in detail and the rationale of its use is discussed. An example is given for the practical application of the model in kidney grafted patients. In the 30 patients of the test collective, seven rejection episodes were diagnosed by the clinicians and verified histologically. All seven rejection episodes were detected by the model, in the mean 2.4 days (median; 3 days) before the clinical diagnosis.


Validating a predictive model for caesarean section in low-risk nulliparous pregnancies.
Caesarean birth (CS) rates are steadily increasing. In 2017 Janssen et al. developed a model which could predict CB in nulliparous healthy woman with 71 % accuracy based on factors measurable on admission to the hospital. To validate the predictive model for risk of caesarean birth among low-risk, nulliparous women in a new setting. A retrospective chart study in Abbotsford Regional Hospital (British Columbia, Canada) of healthy nulliparous women in spontaneous labour, at term, with a singleton fetus in cephalic position. Sociodemographic, pregnancy and labour-related characteristics were collected and independent predictors of CS were determined using multivariate logistic regression. The Janssen model was tested in the Abbotsford sample and additionally novel predictors were tested in an effort to improve the model. The area under the ROC curve (C-statistic) was computed and model calibration, sensitivity and specificity evaluated for the final model. Of 348 women, 106 (30.5 %) had a CB. Applying the Janssen predictive model to the Abbotsford data resulted in a C-statistic of 0.77. No new predictors were added to the model. The mean predicted risk score for CS in the cohort was 0.30 ± 0.20. A risk score cut-off of 0.32 was determined resulting in a sensitivity and specificity of 69 %. The model had acceptable calibration. A model with variables easily accessible at admission can predict caesarean birth in nulliparous women. The results from this study can guide provision of more intensive care during labour to women at higher risk, with the overall goal of reducing CB rates.


Effect of parabranchial position on ventilatory pressures in the Pacific spiny dogfish (Squalus suckleyi).
The mechanics of ventilation in elasmobranchs have been described as a two-pump system which is dependent on the generation of differential pressures between the orobranchial and parabranchial cavities. However, this general model does not take into account sources of variation in parabranchial form and function. For example, the relative pressures that drive flow in each parabranchial chamber during ventilation remain largely unexplored. To address this gap, parabranchial pressures were collected from the Pacific spiny dogfish (Squalus suckleyi, n = 12) during routine ventilation using transducers inserted into parabranchial chambers 2, 3, and 5, numbered anteriorly to posteriorly. Pressure amplitudes collected from the three chambers displayed an attenuation of pressure amplitudes posteriorly, as well as differential, modular use of parabranchial chamber five These observations have implications for the functioning of the ventilatory pump and indicate distinct ventilatory modes, leading us to propose a new model to describe ventilation in Squalus suckleyi.


State of the vein grafts, native coronary arteries, and myocardium and principal cause of death in patients dying after aortocoronary bypass grafting.
Fifty five patients with 108 coronary bypass saphenous vein grafts were studied at necropsy. The mean duration of the grafts was 153 days (SD 516). The luminal narrowing of the native coronary arteries proximal to, at, and distal to the vein graft anastomoses and the narrowing of the non-grafted arteries were evaluated planimetrically. Twenty nine per cent of coronary arteries distal to graft anastomoses showed at least 76% narrowing and 50-75% occlusion was seen in 39% of such arteries. Fifty three per cent of non-grafted arteries showed at least 76% luminal narrowing and 26% had 50-75% narrowing. Six patients (11%) had surgically induced dissection of coronary arteries. Seventy seven vein grafts (71%) showed no appreciable luminal narrowing. Problems related to operative technique caused 30% of the deaths.


Treatment strategies for central low-grade chondrosarcoma of long bones: a systematic review of the literature and meta-analysis.
The need for wide local excision (WLE) versus intralesional (IL) treatment of low-grade chondrosarcomas (CS) of the appendicular skeleton remains controversial. We sought to perform a systematic review and meta-analysis to compare different conventional types of surgical treatments for grade I CS in terms of: (1) rate of local recurrence (LR) and metastases, (2) functional outcome as measured by the Musculoskeletal Tumor Society (MSTS) score, (3) complication rate. Eighteen studies enrolling 695 patients met our criteria. Studies reported on WLE versus IL treatment (n = 7), and IL treatment with or without different adjuvants (N = 11). The LR rate was not significantly different between WLE and IL treatment (OR 2.31; 95% CI, 0.85-6.2; P = 0.1). On the contrary, complication rates were significantly lower in favor of IL treatment (OR 2.27; 95% CI, 0.07-0.72; P = 0.012). The mean reported MSTS score ranged from 21.8 to 28.2 for WLE and from 26.5 to 29.7 for IL treatment, with a significant difference in favor of IL treatment. IL treatment as an alternative to WLE does not greatly increase the risk of LR or metastasis and has lower complication rates with better functional scores. In light of the retrospective nature of the studies available, our findings should be interpreted with caution.


Perceived risk of nuclear power and other risks during the last 25 years in Japan.
The present study described the results of three "fixed-point" surveys on perceived risk related to a list of social and individual risk events during 25 years in Japan. Female clerical staff and researchers were asked to rank 30 items related to various types of technologies and human activities according to their subjective judgments on the order of perceived magnitude of risk in 1983, 1992, and 2007. A similar survey was undertaken for Japanese citizens using web-based questionnaires in 2007. In general, the risk perceptions of the Japanese people, irrespective of gender, age, and occupation, have been uniform during the last 25 years. The female clerical staffs have consistently judged nuclear power as most risky during the last 25 years, whereas researchers' judgment fluctuated with events such as the Chernobyl accident. The ranking of the risk of motor vehicles fell during the 25-y period, whereas those of health risks with food preservatives, x-rays, and antibiotics rose transiently in the 1992 survey. During the 15 years from 1992 to 2007, people tended to learn how to accommodate themselves to these technologies with low risks in exchange for high benefits, except in the case of nuclear power. Nuclear power was regarded as a high-risk item by the Japanese even before the Fukushima nuclear power plant accident in March 2011. This partly explains that the crisis inevitably provokes further high risk perception in Japan, although the overall health threat to the human population in Japan is estimated to be relatively limited so far.


Invasive Right Ventricular Pressure-Volume Analysis: Basic Principles, Clinical Applications, and Practical Recommendations.
Right ventricular pressure-volume (PV) analysis characterizes ventricular systolic and diastolic properties independent of loading conditions like volume status and afterload. While long-considered the gold-standard method for quantifying myocardial chamber performance, it was traditionally only performed in highly specialized research settings. With recent advances in catheter technology and more sophisticated approaches to analyze PV data, it is now more commonly used in a variety of clinical and research settings. Herein, we review the basic techniques for PV loop measurement, analysis, and interpretation with the aim of providing readers with a deeper understanding of the strengths and limitations of PV analysis. In the second half of the review, we detail key scenarios in which right ventricular PV analysis has influenced our understanding of clinically relevant topics and where the technique can be applied to resolve additional areas of uncertainty. All told, PV analysis has an important role in advancing our understanding of right ventricular physiology and its contribution to cardiovascular function in health and disease.


Rate of Convergence of the FOCUSS Algorithm.
Focal underdetermined system solver (FOCUSS) is a powerful method for basis selection and sparse representation, where it employs the [Formula: see text]-norm with p ∈ (0,2) to measure the sparsity of solutions. In this paper, we give a systematical analysis on the rate of convergence of the FOCUSS algorithm with respect to p ∈ (0,2) . We prove that the FOCUSS algorithm converges superlinearly for and linearly for usually, but may superlinearly in some very special scenarios. In addition, we verify its rates of convergence with respect to p by numerical experiments.


[The effect of truncular subdiaphragmatic vagotomy and pyloroplasty on the nitrogen balance in bionomal rat gastric surgery using the isotope labeled amino acid 15N-glycine].
By use of stable isotope labeled amin acid 15N-glycine the effects of truncular subdiaphragmatic vagotomy and of pyloroplasty, which are comprised in the method of bionomic gastric operations, were studied separately. The assessment of nitrogen equilibrium in rats after only truncular vagotomy, only pyloroplasty, truncular vagotomy combined with pyloroplasty, and without surgery serving as controls yielded results as following: After truncular vagotomy the 15N equilibrium was worse than in the control animals or after pyloroplasty only. The cause of that is an enhanced nitrogen loss in urine. After truncular vagotomy with pyloroplasty, though, 15N excretion in feces was significantly higher than after only pyloroplasty. It may be concluded from these results that truncular vagotomy is primarily responsible for the disturbances in protein metabolism. Pyloroplasty in combination with truncular subdiaphragmatic vagotomy also causes a higher nitrogen excretion in the feces indeed.


[Continuous irrigation of the bladder with acetic acid solution and its therapeutic effect on candida-infection].
Our clinical experience with acetic acid solution in the treatment of candida infection of the bladder was confirmed by in vitro experiments. We apply continuous bladder irrigation with increasing concentrations of acetic acid solution up to pH 5.0. The majority of patients had received antibiotics or cytostatic drugs and suffered from chronic and malignant diseases. A case report is given with endoscopic documentation of the influence of acetic acid solution on the bladder.


Maturation of arteriovenous fistulas in patients with and without preexisting hemodialysis catheters.
Central venous catheter (CVC) placement has been linked to systemic inflammation. This study was conducted to compare the successful maturation of arteriovenous fistulas (AVFs) and the preoperative white blood cell (WBC) profiles between patients with and without preexisting CVCs. A retrospective cohort study was conducted with 550 patients who underwent first-time AVF creation. Patients were divided into three groups according to preexisting CVCs and CVC types as follows: tunneled CVC (n = 23), nontunneled CVC (n = 223), and no CVC (n = 304). These three groups were compared in terms of AVF maturation and preoperative WBC profiles. The mean age of the patients was 61.1 ± 14.3 years. The AVF maturation rates of the tunneled CVC, nontunneled CVC and no CVC groups were 65.2%, 54.7% and 74.7%, respectively (p < 0.001). According to the uni- and multivariate analyses, only the nontunneled CVC group had a lower odds of AVF maturation compared to the no CVC group (adjusted odds ratio 0.43; 95% confidence interval 0.29-0.62). Patients with preexisting nontunneled CVC but not tunneled CVC also had significantly higher mean WBC and neutrophil counts but a lower percentage of lymphocytes than patients with no preexisting CVC. Preexisting nontunneled CVC had a negative impact on the successful maturation of the newly created AVF. Patients in the nontunneled CVC group had the highest preoperative WBC and neutrophil counts but the lowest lymphocyte percentage compared to patients in the other two groups.


GTP causes calcium release from a plant microsomal fraction.
Studies on a variety of animal cell types have revealed a GTP-specific calcium-releasing mechanism in a non-mitochondrial, microsomal fraction. Here we report that GTP also induces rapid release of calcium from a zucchini (Cucurbita pepo L.) hypocotyl microsomal fraction. Maximal release occurs at 50 microM, and half-maximal release at 8 microM GTP. GTP is highly specific in its effect, and may not be replaced by UTP, ATP, CTP, TTP, GMP, or by non-hydrolysable analogues of GTP. Reuptake of calcium after release does not normally occur; however, this may be induced by non-hydrolysable GTP analogues. Calcium release is also blocked by prior treatment with these analogues.


Adipose insulin resistance is associated with cardiovascular risk factors in polycystic ovary syndrome.
The effects of adipose insulin resistance on cardiovascular risk factors in polycystic ovary syndrome (PCOS) remain largely unknown. We aimed to investigate associations between adipose insulin resistance and cardiovascular risk factors in PCOS. A total of 207 PCOS and 47 non-PCOS women were recruited from a large reproductive medicine center in this cross-sectional study. The PCOS diagnosis was based on the Rotterdam Criteria. The subjects received a standard oral glucose tolerance test. Adipose insulin resistance was evaluated using a validated index (adipose-IR = fasting insulin × free fatty acid concentrations). The women with PCOS showed a higher adipose-IR index, and the adipose-IR index was tightly associated with the blood pressure, glucose and lipid parameters. A total of 98.0% of the women with PCOS in the highest adipose-IR quartile showed cardiovascular risk factors (obesity, hypertension, glucose intolerance or dyslipidemia), and this percentage was significantly higher than the percentage of those in the lowest quartile (32.7%). In addition, the percentages of women with three (31.4%) and four (13.7%) cardiovascular risk factors were significantly elevated in the highest adipose-IR quartile. The multivariable logistic regression analysis indicated that each 1-SD increment in the adipose-IR index resulted in higher risks of obesity (OR = 3.18, 95% CI = 2.12-4.76), hypertension (OR = 1.89, 95% CI = 1.31-2.73), glucose intolerance (OR = 2.45, 95% CI = 1.73-3.48), and dyslipidemia (OR = 2.18, 95% CI = 1.57-3.01). The C-reactive protein (CRP) level was positively associated with the adipose-IR index in women with PCOS (r = 0.45, P < 0.001). The adipose-IR index was associated with cardiovascular risk factors in women with PCOS. Chronic inflammation may induce insulin resistance in the adipose tissue of women with PCOS.


The Alzheimer's disease Aβ peptide binds to the anionic DMPS lipid bilayer.
We have applied isobaric-isothermal replica exchange molecular dynamics (REMD) and the all-atom explicit water model to study binding of Aβ10-40 peptide to the anionic DMPS bilayer. To provide comparison with a zwitterionic bilayer, we used our previous REMD simulations probing binding of the same peptide to the DMPC bilayer. Using two sets of simulations, we comparatively analyzed the equilibrium Aβ conformational ensemble, peptide-bilayer interactions, and changes in the bilayer structure induced by Aβ binding. Our results are six-fold. (1) Binding to the DMPS bilayer triggers the formation of stable helix in the Aβ C-terminal, although the helix-inducing effect caused by DMPS lipids is weaker than that of DMPC. (2) Compared to the DMPC-bound Aβ monomer, the anionic bilayer weakens intrapeptide interactions, particularly, formed by charged amino acids. (3) Binding of Aβ peptide to the DMPS bilayer is primarily governed by electrostatic interactions between charged amino acids and charged lipid groups. In contrast, these interactions play minor role in Aβ binding to the DMPC bilayer. (4) Aβ peptide generally resides on the DMPS bilayer surface causing relatively minor bilayer thinning. The opposite scenario applies to Aβ binding to the DMPC bilayer. (5) In contrast to DMPC simulations, Aβ largely expels anionic lipids from its binding "footprint" forming a ring of charged amino acids mixed with charged lipid groups around the peptide. (6) Aβ binding disorders proximal DMPS lipids more strongly than their DMPC counterparts. Our simulations show that Aβ monomers fail to perturb anionic or zwitterionic bilayers across both leaflets.


Effect of Different Monochromatic LEDs on the Environmental Adaptability of Spathiphyllum floribundum and Chrysanthemum morifolium.
Light-emitting diodes (LEDs) can be programmed to provide specialized light sources and spectra for plant growth. UV-A (397.6 nm), blue (460.6 nm), green (520.7 nm), and red (661.9 nm) LED light sources were used to study the effects of different monochromatic lights on the growth, antioxidant system, and photosynthetic characteristics of Spathiphyllum floribundum 'Tian Jiao' (a shade-loving species) and Chrysanthemum morifolium 'Huang Xiu Qiu' (a sun-loving species). This research revealed that green and blue light could enhance the morphological indicators, Chl a/b, photosynthetic electron transfer chain performance, and photosystem activity of S. floribundum, blue and red light could enhance the solution protein, Chl a, and photosynthetic electron transfer chain performance of C. morifolium, red and UV-A light viewed the highest SOD and CAT activities of S. floribundum (275.56 U·min·g-1; 148.33 U·min·g-1) and C. morifolium (587.03 U·min·g-1; 98.33 U·min·g-1), respectively. Blue and green light were more suitable for the growth and development of the shade-loving plant S. floribundum, while red and blue light were more suitable for the sun-loving plant C. morifolium. UV-A light could be used for their stress research. The research revealed the different adaptation mechanism of different plants to light environmental conditions.


Enbloc resection of the largest thymic liposarcoma: A case report with literature review.
Liposarcoma is the most common soft tissue tumor which is commonly found in the retroperitoneal region. This kind of tumor is usually well-differentiated with low to no potential to metastasize. Thymoliposarcomas are extremely rare tumors that are difficult to diagnose and differentiate from thymomas and other benign conditions. Presentation of a case:This report presents a case of a 46-year-old male patient with dyspnea, generalized fatigue and non-specific chest pain caused by a giant anterior mediastinal mass. Computed tomography scan revealed a large mass in the anterior mediastinum. CT guided biopsy was consistent with thymolipoma. The tumor was surgically resected. The histological analysis of the tumor revealed thymoliposarcoma. Discussion:Thymoliposarcoma usually presents with non-specific symptoms. The mean age of the diagnosis is 55.8 years old with a slight predominance in males. The corner stone of the treatment remains surgical excision of the tumor while the role of adjuvant therapy is not well documented.


Longitudinal amyloid cognitive composite in preclinical Alzheimer's disease.
Previous studies have developed several cognitive composites in preclinical Alzheimer disease (AD). However, more sensitive measures to track cognitive changes and therapeutic efficacy in preclinical AD are needed considering the diverse sociocultural and linguistic backgrounds. This study developed a composite score that can sensitively detect the amyloid-β (Aβ)-related cognitive trajectory of preclinical AD using Korean data. A total of 196 cognitively normal participants who underwent amyloid positron emission tomography were followed-up with neuropsychological assessments. We developed the Longitudinal Amyloid Cognitive Composite in Preclinical AD (LACPA) using the linear mixed-effects model (LMM) and z scores. The LMM was also used to investigate the longitudinal sensitivity of the LACPA and the association between time-varying brain atrophy and the LACPA. Considering the group-time interaction effects of each subtest, the Seoul Verbal Learning Test-Elderly version immediate recall/delayed recall/recognition, the Korean Trail Making Test B Time, and the Korean Mini-Mental State Examination were selected as components of the LACPA. The LACPA exhibited a significant group-time interaction effect between the Aβ+ and Aβ- groups (t = -3.288, p = 0.001). Associations between time-varying LACPA and brain atrophy were found in the bilateral medial temporal, right lateral parietal, and right lateral frontal regions, and hippocampal volume. The LACPA may contribute to reduction in time and financial burden when monitoring Aβ-related cognitive decline and therapeutic efficacy of the disease-modifying agents specifically targeting Aβ in secondary prevention trials.


Application of non-Saccharomyces yeasts with high β-glucosidase activity to enhance terpene-related floral flavor in craft beer.
The rising interest in craft beer urging for novel yeasts that provide diverse attributes. This research aimed to explore the potential of four non-Saccharomyces yeasts with high β-glucosidase activity in beer fermentation. Fermentation ability, adverse environment resistance and carbohydrate affinity were measured via growth and physiochemical parameters and, based on these results, a Candida glabrata (D18) yeast was selected for subsequent sequential fermentations. Aroma analysis of the fermented beer was then performed using gas chromatography-mass spectrometry, demonstrated that some glucoside-binding terpenes had been significantly increased. In two D18 involved groups, geraniol content increased 51.5/11-fold in the single and mixed fermentations, respectively, while linalool increased 1.36-fold in the mixed fermentation, providing the final beer product with unique floral and fruity characteristics. Principal component analysis and sensory evaluation were also applied to further demonstrate these distinctions. Overall, D18 was found to be a potential yeast for beer fermentation with unique properties.


Circadian motor asymmetries in humans.
Previous research studies indicate that motor activity during sleep is lateralized to the non-dominant hand. We put forward the hypothesis that the relative superiority of the non-dominant hand movements during night could arise from a different circadian phase relationship between the two hemispheres, independently of the sleep condition. The present study evaluated whether actigraphic data are consistent with such hypothesis. A total of 58 right-handed university students wore actigraphs (AMI 32K) on both left and right wrist for 3 consecutive days. Mesor and acrophase were computed using cosinor analysis. Moreover, factorial analysis of variances were carried out on side (left versus right) and time of day. The results indicated that the left hand circadian rhythm had a significant phase delay in comparison to the right hand one. The mean activity of the left hand was significantly higher than that of the right hand from 20:00 until 04:00 h. The results are suggestive of a different circadian activation between the two hemispheres and are discussed in relation to models of circadian regulation of sleep/wake cycle.


Decreased monoamine metabolites in frontotemporal dementia and Alzheimer's disease.
The concentrations of the monoamine metabolites homovanillic acid (HVA), 5-hydroxyindoleacetic acid (5-HIAA) and 3-methoxy-4-hydroxyphenylglycol (HMPG) in the cerebrospinal fluid (CSF) of patients with clinical frontotemporal dementia (FTD; n = 30), early onset Alzheimer's disease (EAD; n = 33), late onset Alzheimer's disease (LAD, n = 27) and normal controls (n = 31) were determined using HPLC. ANCOVA showed no significant effect of neuroleptic medication, extrapyramidal signs, myoclonia or gender on the CSF levels of the monoamine metabolites. Homovanillic acid was significantly reduced in all diagnostic groups (FTD, p = 0.0002; EAD, p = 0.016; LAD, p = 0.013). 5-Hydroxyindoleacetic acid was significantly reduced in EAD (p = 0.013) and in LAD (p = 0.0014), and HMPG was reduced in LAD only (p = 0.020). HMPG was significantly higher in FTD compared to EAD (p = 0.0005) and LAD (p = 0.0003). CSF-5-HIAA was significantly reduced in patients with antidepressant medication (p = 0.006). ANCOVA within the FTD group showed no significant effect of neuroleptic or antidepressant medication, extrapyramidal signs, myoclonia, gender or FTD subtype on the CSF levels of the monoamine metabolites. The results suggest that CSF-HMPG might differentiate FTD from EAD and LAD, but not from normals.


IgA rheumatoid factor in primary Sjogren's syndrome.
To assess the serum level of immunoglobulin A rheumatoid factor (IgA-RF) in patients with primary Sjogren's syndrome (pSS) and study the association with immunological and clinical factors. Sera from 97 pSS patients diagnosed according to the preliminary European criteria and 100 controls were analysed for IgA-RF in a cross-sectional study design. IgA-RF was detected in serum of 25.8% of the pSS patients and in 1% of the controls. In patients with positive vs. negative IgA-RF, the focus scores in biopsy of the minor salivary glands were 4.41 and 1.43 (p<0.0001), respectively. There was a correlation between positive IgA-RF and positive antinuclear antibodies (ANA) (r = 0.263, p<0.009), IgM-RF (r = 0.70, p<0.0001), anti-SSA/SSB (r = 0.73, p<0.0001), and a high serum level of IgG (r = 0.59, p<0.0001). The presence of renal disease was higher in IgA-RF-positive vs. negative pSS patients (20.0% vs. 5.6%, p = 0.047). The serum level of the hormone prolactin (PRL) correlated to the serum level of IgA-RF (r = 0.31, p = 0.026). The presence of IgA-RF in patients with pSS is closely associated with the presence of autoantibodies, and with focus scoring in biopsies of the salivary glands. IgA-RF is associated with renal disease in pSS but we found no correlation to other extraglandular manifestations.


Kinetics of Endogenous CaMKII Required for Synaptic Plasticity Revealed by Optogenetic Kinase Inhibitor.
Elucidating temporal windows of signaling activity required for synaptic and behavioral plasticity is crucial for understanding molecular mechanisms underlying these phenomena. Here, we developed photoactivatable autocamtide inhibitory peptide 2 (paAIP2), a genetically encoded, light-inducible inhibitor of CaMKII activity. The photoactivation of paAIP2 in neurons for 1-2 min during the induction of LTP and structural LTP (sLTP) of dendritic spines inhibited these forms of plasticity in hippocampal slices of rodents. However, photoactivation ∼1 min after the induction did not affect them, suggesting that the initial 1 min of CaMKII activation is sufficient for inducing LTP and sLTP. Furthermore, the photoactivation of paAIP2 expressed in amygdalar neurons of mice during an inhibitory avoidance task revealed that CaMKII activity during, but not after, training is required for the memory formation. Thus, we demonstrated that paAIP2 is useful to elucidate the temporal window of CaMKII activation required for synaptic plasticity and learning.


Search for a reliable model for bisphosphonate-related osteonecrosis of the jaw: establishment of a model in pigs and description of its histomorphometric characteristics.
The pathogenesis of bisphosphonate-related osteonecrosis of the jaw (BRONJ) remains unknown, and the development of a reliable experimental model would help to improve our understanding of it. We used 12 domestic pigs of which 6 made up the experimental group and were treated with zoledronate 4mg intravenously weekly for 5 weeks, while the control group (n=6) were given no drugs. On day 60 the right second maxillary and mandibular third molars were extracted. Thirty days later 3 animals in each group were killed; the rest were killed 90 days later. Histopathological specimens from the extraction sites were analysed for bone density, collagen architecture, density of osteons, and the amount of non-mineralised bone. Bone density, amount of non-mineralised bone, and density of osteons differed significantly between the 2 groups (p<0.001 in each case), but the chromatic pattern dictated by the collagen architecture did not. Our results correspond to the observations that have been made in patients with BRONJ, which means that the histomorphometric conditions seen in patients can be reproduced in this experimental setting.


Will reputational incentives stimulate a reversal of the physician brain drain?
An increased supply of physicians in high income countries both from domestic production and from immigration from low and middle income countries has made medical employment increasingly competitive. This has been heightened by the introduction of reputational incentives, such as public reporting of physicians' outcomes, and the use of other health care professionals, such as nurses. An unanticipated consequence might be a reversal of the 'brain drain', with physicians migrating to low and middle income countries.


Micronucleated erythrocytes frequency and radiocesium bioconcentration in pikes (Esox lucius) caught in the Tom River near the nuclear facilities of the Siberian Chemical Complex (Tomsk-7).
Between 1957 and 1993, the Siberian Chemical Complex (Tomsk-7) located in the Tomsk region (Russia) regularly discharged radioactive liquid wastes into the Tom River which resulted in an extensive contamination of large territories with long lived radionuclides such as cesium-137 and strontium-90. In the summers of 1996 and 1997, Research Team of Siberian Medical University conducted biodosimetry and cytogenetic monitoring of pikes (Esox lucius) caught in the Tom River at various distances downstream from the Siberian Chemical Complex (SCC) using the micronucleus test and the gamma spectroscopy. Our findings demonstrated that the difference in frequency of micronucleated erythrocytes between the radiation-exposed fish caught downstream from the SCC and the controls was statistically significant (P < 0.01). Moreover, we found a good correlation between radiocesium concentration and micronucleated erythrocyte frequency in pikes. It was found that both the micronucleated erythrocyte frequency in pike blood and the level of the pike radiocesium concentration depended on the age of pikes. The micronucleated erythrocyte frequency gradually increased from the 1-year-old pikes to the over 20-year-old pikes. On the other hand, the average level of radiocesium concentration gradually increased from the 1-year-old pikes only up to the 10-year-old pikes. There is no correlation between radiocesium concentration and micronucleated erythrocyte frequency in the over 10-year-old pikes.


Climatic conditions and the onset of primary spontaneous pneumothorax: an investigation of the influence of solar terms.
To study the correlation between climatic changes and the development of primary spontaneous pneumothorax (PSP). We retrospectively studied the relationship between 337 patients with conservatively treated PSP and meteorological conditions during a 3-year period in the urban area of Xi'an, China. The comparison was made depending on solar terms and on different aspects of atmospheric pressure, outdoor temperature, relative humidity, and wind speed. Significant differences were found between PSP and non-PSP days depending on daily mean values of outdoor temperature and atmospheric pressure (p = 0.001 and p < 0.001, respectively). However, no obvious differences of meteorological factor variations between the 'PSP day' and the 'pre-PSP day' on days with and without PSP were found. The occurrence of PSP was associated with the solar terms Spring Equinox (p < 0.05) and End of Heat (p < 0.01). Among the factors examined in our study, daily mean outdoor temperature and atmospheric pressure showed a strong correlation with the occurrence of PSP. The solar terms Spring Equinox and End of Heat were found to be closely related with PSP development, which shed light on a new way for PSP incidence evaluation.


CD103(+) Dendritic Cells Control Th17 Cell Function in the Lung.
Th17 cells express diverse functional programs while retaining their Th17 identity, in some cases exhibiting a stem-cell-like phenotype. Whereas the importance of Th17 cell regulation in autoimmune and infectious diseases is firmly established, the signaling pathways controlling their plasticity are undefined. Using a mouse model of invasive pulmonary aspergillosis, we found that lung CD103(+) dendritic cells (DCs) would produce IL-2, dependent on NFAT signaling, leading to an optimally protective Th17 response. The absence of IL-2 in DCs caused unrestrained production of IL-23 and fatal hyperinflammation, which was characterized by strong Th17 polarization and the emergence of a Th17 stem-cell-like population. Although several cell types may be affected by deficient IL-2 production in DCs, our findings identify the balance between IL-2 and IL-23 productions by lung DCs as an important regulator of the local inflammatory response to infection.


Cubic and tetragonal liquid crystal phases composed of non-chiral molecules: Chirality and macroscopic properties.
We discuss the symmetry properties as well as the macroscopic behavior of the cubic liquid crystal phases showing large chiral domains of either hand in some non-chiral compounds reported recently in the group of Tschierske. These phases are tricontinuous. While they have O or I432 symmetry in each chiral domain, the overall symmetry is [Formula: see text] as there is no net chirality for compounds composed of non-chiral molecules. It turns out that a rather similar type of phase has also been reported for triblock copolymers. Here we analyze in detail the macroscopic static and dynamic behavior of such phases and we predict, among other results, that they show the analog of static and dissipative Lehmann-type effects in their chiral domains. A description of a cubic liquid crystalline phase of Th symmetry, which has not yet been found experimentally, is also included. Suggestions for experiments are outlined to identify such a phase. In addition, we discuss tetragonal liquid crystalline phases of D4h and D4 (I422) symmetry as they have been reported last year experimentally in connection to the Q phase.


Common foods and farming methods thought to promote health: what the data show.
What are the best dietary practices and farming methods to promote health? The answer may depend on whether one looks at the health of individuals or the health of the planet (planetary health or PH). PH will equate to a healthy ecosphere fostered by dietary/farming practices that are less resource-intense, potentially decreasing starvation and carbon emissions. Best practices also may depend on whether by health one means lack of observable disease (such as obesity, nutritional deficiency, diabetes, or cancer), optimal health (also known as wellness), or longevity. This article attempts to give an overview of the evidence as regards all of these aspects and definitions of health.


Machine Learnable Fold Space Representation based on Residue Cluster Classes.
Protein fold space is a conceptual framework where all possible protein folds exist and ideas about protein structure, function and evolution may be analyzed. Classification of protein folds in this space is commonly achieved by using similarity indexes and/or machine learning approaches, each with different limitations. We propose a method for constructing a compact vector space model of protein fold space by representing each protein structure by its residues local contacts. We developed an efficient method to statistically test for the separability of points in a space and showed that our protein fold space representation is learnable by any machine-learning algorithm. An API is freely available at https://code.google.com/p/pyrcc/.


Scintigraphic demonstration of acute gastrointestinal bleeding caused by gallbladder carcinoma eroding the colon.
Massive lower gastrointestinal (GI) bleeding caused by gallbladder carcinoma eroding into the colonic wall was demonstrated accurately by Tc-99m RBCs. In addition, retrograde bleeding into the gallbladder was also identified while arteriography did not show contrast extravasation. This case supports the use of Tc-99m RBCs over Tc-99m sulfur colloid for more accurate localization of lower GI bleeding.