Sleep-disordered breathing in orthodontic practice: Prevalence of snoring in children and morphological findings.
The purpose of this work was to evaluate the prevalence of snoring and its correlation with cranial and upper airway morphology in young individuals with orthodontic treatment need. Parents of 379 children were consecutively interviewed, using eight questions from a more comprehensive questionnaire about sleep behavior. A total of 100 patients (54 girls, 46 boys, average age 11.3 years) met the inclusion criteria. Based on the parents' interviews, the sample was divided into snorers (n = 53) and nonsnorers (n = 47). Using cephalograms obtained for initial orthodontic diagnostics, airway morphology was measured based on hyoid position and on the posterior airway space (PAS) dimensions at the maxillary, occlusal, and mandibular plane levels (PAS_NL, PAS_OCCL, PAS_ML). Mann-Whitney U testing, ANOVA, and Spearman's rank correlation coefficient were used for statistical analysis. Snoring was reported by 53 % of parents for 63 % (n = 29) of the boys and 44 % (n = 24) of the girls. Significant morphological differences were noted between snorers and nonsnorers. PAS dimensions were significantly reduced in the snorers compared to the nonsnorers at all three anatomical levels tested, which remained statistically significant when adjusted for age and gender. No differences between the two groups emerged for hyoid position or any of the vertical cranial parameters. A significant correlation between sagittal maxillary position (SNA) and PAS_NL was noted, indicating that larger SNA values were mildly associated with larger sagittal PAS dimensions at the maxillary level. This random sample of young patients with orthodontic treatment need was found to involve a high prevalence of parent-reported snoring. Characteristic features in cranial and upper airway morphology and thus differences between the snorers and nonsnorers were found.


The chromatin remodelling factor Chd7 protects auditory neurons and sensory hair cells from stress-induced degeneration.
Neurons and sensory cells are particularly vulnerable to oxidative stress due to their high oxygen demand during stimulus perception and transmission. The mechanisms that protect them from stress-induced death and degeneration remain elusive. Here we show that embryonic deletion of the chromodomain helicase DNA-binding protein 7 (CHD7) in auditory neurons or hair cells leads to sensorineural hearing loss due to postnatal degeneration of both cell types. Mechanistically, we demonstrate that CHD7 controls the expression of major stress pathway components. In its absence, hair cells are hypersensitive, dying rapidly after brief exposure to stress inducers, suggesting that sound at the onset of hearing triggers their degeneration. In humans, CHD7 haploinsufficiency causes CHARGE syndrome, a disorder affecting multiple organs including the ear. Our findings suggest that CHD7 mutations cause developmentally silent phenotypes that predispose cells to postnatal degeneration due to a failure of protective mechanisms.


How do hospitals handle patients complaints? An overview from the Paris area.
The incidence of complaints about health care has been rising. Reviewing the reasons why patients complain and how hospital staff respond to them can participate in an evaluation of quality in health care. There is a dearth of published information on complaints handling. In order to analyse complaints handling, we surveyed complaints referred to hospital managers in two French hospitals over one year: characteristics of complaints and characteristics of responses made to complainants. We used a scale for 10 criteria evaluating the responses to complaints. A total of 115 complaints were analysed. Complaints mainly concerned the communication, the quality of medical care, waiting delays, and inadequate bills. Consequences of dissatisfaction included loss of confidence and refusal to pay the bill. Complainants wanted an explanation, their bill to be reduced, or something to change after the complaint. Most complainants wrote to the hospital manager. Hospital managers answered, using medical information as a basis for their responses. Median response time was 23 days. Interobserver agreement on evaluation criteria was almost perfect, substantial or moderate for 8 of 10 criteria. Major weaknesses of the responses were their lack of comprehensiveness (52%), the absence of intention to investigate (50%) and to act (77%), and of practical support (51%). The response of hospital managers misinterpreted the medical information given by the physician concerned in 5 (11%) of 45 cases. We suggest that quality of complaints handling should be improved, possibly through the systematic reception of complainants by a physician not involved in the patient's care.


Peptide and non-peptide G-protein coupled receptors (GPCRs) in skeletal muscle.
G-protein coupled receptors (GPCRs) represent a large class of cell surface receptors that mediate a multitude of functions. Over the years, a number of GPCRs and ancillary proteins have been shown to be expressed in skeletal muscle. Unlike the case with other muscle tissues like cardiac and vascular smooth muscle cells, there has been little attempt at systematically analyzing GPCRs in skeletal muscle. Here we have compiled all the GPCRs that are expressed in skeletal muscle. In addition, we review the known function of these receptors in both skeletal muscle tissue and in cultured skeletal muscle cells.


Isolation of Human Microglia from Neuropathologically Diagnosed Cases in the Single-Cell Era.
This chapter describes the core procedures that we have developed over the last two decades to isolate routinely the microglia from postmortem human brains. The method is suitable for brain slices consisting of both gray and white matter.The ability to concomitantly isolate vascular cells with glial cells provides the opportunity to investigate multiple cell types originating from the same donor. This represents a novel approach for -omics research, with the potential for discovering the shared or distinct molecular features among the glia and vascular cells from the same individual.


[Significance of endomyocardial biopsy for heart transplantation].
The development and retreat of acute rejection was studied by repeated right-side endomyocardial biopsy in a patient after orthotopic heart transplantation. Endomyocardial biopsy was a sensitive detector of acute rejection.


Coronary Artery Bypass Surgery: Comparing the Long-Term Impact of Total Arterial Grafting With Multiarterial Plus Saphenous Vein Grafting.
This study aimed to compare the long-term outcomes in a propensity matched population receiving total arterial grafting (TAG) and multiple arterial grafts (MAG) in addition to saphenous vein graft (SVG) following multivessel coronary artery bypass grafting requiring at least three distal anastomoses. In this retrospective study, 655 patients from two centers met the inclusion criteria and were divided into two groups: TAG group (n = 231) and MAG + SVG group (n = 424). Propensity score matching was performed resulting in 231 pairs. No significant differences were observed between both groups in terms of early outcomes. Survival probabilities at 5, 10, and 15 y were 89.1% versus 94.2%, 76.2% versus 76.1%, and 66.7% versus 69.8% in the TAG and MAG + SVG groups, respectively (hazard ratio stratified on matched pairs: 0.90; 95% confidence interval [0.45-1.77]; P = 0.754). Freedom from major adverse cardiac and cerebral events (MACCE) in the matched cohort did not show any significant difference between both groups. Probabilities at 5, 10, and 15 y were 82.7% versus 85.6%, 62.2% versus 75.3%, and 48.8% versus 59.5% in the TAG and MAG + SVG groups, respectively (hazard ratio stratified on matched pairs: 1.12; 95% confidence interval [0.65-1.92]; P = 0.679). Subgroup analyses of the matched cohort showed no significant difference between TAR with three arterial conduits compared to TAR with two arterial conduits with sequential grafting and MAG + SVG in terms of long-term survival and freedom from MACCE. Multiple arterial revascularizations in addition to SVG may yield comparable long-term outcomes in terms of survival and freedom from MACCE compared to total arterial revascularization.


STING deficiency protects against wasp venom-induced acute kidney injury.
Recent evidence suggests a key role of the inflammatory responses in wasp venom-induced acute kidney injury (AKI). However, the potential regulatory mechanisms underlying the inflammatory responses in wasp venom-induced AKI remain unclear. STING reportedly plays a critical role in other AKI types and is associated with inflammatory responses and diseases. We aimed to investigate the involvement of STING in inflammatory responses associated with wasp venom-induced AKI. The role of the STING signaling pathway in wasp venom-induced AKI was studied in vivo using a mouse model of wasp venom-induced AKI with STING knockout or pharmacological inhibition and in vitro using human HK2 cells with STING knockdown. STING deficiency or pharmacological inhibition markedly ameliorated renal dysfunction, inflammatory responses, necroptosis, and apoptosis in wasp venom-induced AKI in mice. Moreover, STING knockdown in cultured HK2 cells attenuated the inflammatory response, necroptosis, and apoptosis induced by myoglobin, the major pathogenic factor in wasp venom-induced AKI. Urinary mitochondrial DNA upregulation has also been observed in patients with wasp venom-induced AKI. STING activation mediates the inflammatory response in wasp venom-induced AKI. This may offer a potential therapeutic target for the management of wasp venom-induced AKI.


Complicated Growth Plate Fracture: Torn Metaphyseal Periosteum with Physeal Interposition.
Teaching point: Displacement of torn periosteum into the growth plate is an uncommon pediatric entity following trauma - which can be seen on an MRI as low signal intensity physeal interposition on all pulse sequences, and requires open surgical reduction, as it may lead to growth plate bridging and subsequent extremity length discrepancy.


A theory of virus-induced demyelination in the Landry-Guillain-Barré syndrome.
The Landry-Guillain-Barré syndrome (LGBS) is a demyelinating disorder of the peripheral nervous system frequently preceded by infection with common viruses. Most prevalent among these agents are herpesviruses, particularly Epstein-Barr virus (EBV) and cytomegalovirus (CMV). The specific role played by antecedent viral infection in the pathogenesis of the LGBS remains obscure. In this regard, recent studies of Marek's disease (MD) neuropathy, an avian herpesvirus-induced experimental model for the LGBS, may provide insight. The autoimmune pattern of demyelination seen in MD neuropathy is histopathologically indistinguishable from that seen in the LGBS. In this paper, a comprehensive theory is discussed regarding the pathogenetic mechanisms that may be operative in the LGBS.


[Living kidney donation - an overview].
The living kidney donation has become increasingly important in recent years. Because of the decreasing number of postmortem donors, there has been a dramatic increase in morbidity and mortality due to the long waiting times for patients on dialysis. By timely living donation after dialysis entry or even preemptively, this can be avoided. In addition, the living donor has better graft function and better graft survival which is due to the predictability of the donation, the optimal conditioning of donor and recipient, and the short ischemia time. To protect the donor, to provide legal protection, and to avoid abuse, the German legislature reacted with the Transplantation Act and its amendment. The recent recommendations for donor evaluation from the Amsterdam Forum have been used by the Federal Medical Council to revise current guidelines and guidelines for living donation will be drawn up. The focus of these efforts is standardization of the procedure and protection of the kidney donor. This is also reflected in the recommendations for organ removal technique and the selection of the organ to be used for kidney donation.


Improved ethanol productivity and ethanol tolerance through genome shuffling of Saccharomyces cerevisiae and Pichia stipitis.
Genome shuffling by recursive protoplast fusion between Saccharomyces cerevisiae and Pichia stipitis also known as Scheffersomyces stipitis resulted in a promising yeast hybrid strain with superior qualities than those of the parental strains in enhancing biofuel production. Our study focused on the substrate utilization, ethanol fermentation, and ethanol tolerance of the hybrids and the parental strains. The parental strain S. cerevisiae is limited to utilize only hexose sugars, and this leads to decrease in the ethanol yield when they are subjected to ethanol production from lignocellulosic biomass which is rich in pentose sugars. To overcome this limitation, we constructed a hybrid yeast strain through genome shuffling which can assimilate all the sugars present in the fermentation medium. After two rounds of recursive protoplast fusion, there was a higher increase in substrate utilization by hybrid SP2-18 compared to parental strain S. cerevisiae. SP2-18 was able to consume 34% of xylose sugar present in the fermentation medium, whereas S. cerevisiae was not able to utilize xylose. Further, the hybrid strain SP2-18 was able to reach an ethanol productivity of 1.03 g L-1 h-1, ethanol yield 0.447 g/g, and ethanol concentration 74.65 g L-1 which was relatively higher than that of the parental strain S. cerevisiae. Furthermore, the hybrid SP2-18 was found to be stable in the production of ethanol. The random amplified polymorphic DNA profile of the yeast hybrid SP2-18 shows the polymorphism between the parental strains indicating the migration of specific sugar metabolizing genes from P. stipitis, while the maximum similarity was with the parent S. cerevisiae.


Impacts of human activities on nutrient transport in the Yellow River: The role of the Water-Sediment Regulation Scheme.
Anthropogenic activities alter the natural states of large rivers and their surrounding environment. The Yellow River is a well-studied case of a large river with heavy human control. An artificial managed water and sediment release system, known as the Water-Sediment Regulation Scheme (WSRS), has been carried out annually in the Yellow River since 2002. Nutrient concentrations and composition display significant time and space variations during the WSRS period. To figure out the anthropogenic impact of nutrient changes and transport in the Yellow River, biogeochemical observations were carried out in both middle reaches and lower reaches of the Yellow River during 2014 WSRS period. WSRS has a direct impact on water oxidation-reduction environment in the middle reaches; concentrations of nitrite (NO2-) and ammonium (NH4+) increased, while nitrate (NO3-) concentration decreased by enhanced denitrification. WSRS changed transport of water and sediment; dissolved silicate (DSi) in the middle reaches was directly controlled by sediments release during the WSRS while in the lower reaches, DSi changed with both sediments and water released from middle reaches. During the WSRS, the differences of nutrient fluxes and concentrations between lower reaches and middle reaches were significant; dissolved inorganic phosphorous (DIP) and dissolved inorganic nitrogen (DIN) were higher in low reaches because of anthropogenic inputs. Human intervention, especially WSRS, can apparently change the natural states of both the mainstream and estuarine environments of the Yellow River within a short time.


A novel, microvascular evaluation method and device for early diagnosis of peripheral artery disease and chronic limb-threatening ischemia in individuals with diabetes.
A novel transdermal arterial gasotransmitter sensor (TAGS) has been tested as a diagnostic tool for lower limb microvascular disease in individuals with and without diabetes mellitus (DM). The TAGS system noninvasively measures hydrogen sulfide (H2S) emitted from the skin. Measurements were made on the forearm and lower limbs of individuals from three cohorts, including subjects with DM and chronic limb-threatening ischemia, to evaluate skin microvascular integrity. These measurements were compared with diagnosis of peripheral artery disease (PAD) using the standard approach of the toe brachial index. Other measures of vascular health were made in some subjects including fasting blood glucose, hemoglobin A1c, plasma lipids, blood pressure, estimated glomerular filtration, and body mass index. The leg:arm ratio of H2S emissions correlated with risk factors for microvascular disease (ie, high-density lipoprotein levels, estimated glomerular filtration rate, systolic blood pressure, and hemoglobin A1c). The ratios were significantly lower in symptomatic DM subjects being treated for chronic limb-threatening ischemia (n = 8, 0.48 ± 0.21) compared with healthy controls (n = 5, 1.08 ± 0.30; P = .0001) and with asymptomatic DM subjects (n = 4, 0.79 ± 0.08; P = .0086). The asymptomatic DM group ratios were also significantly lower than the healthy controls (P = .0194). Using ratios of leg:arm transdermal H2S measurement (17 subjects, 34 ratios), the overall accuracy to identify limbs with severe PAD had an area under the curve of the receiver operating curve of 0.93. Ratios of transdermal H2S measurements are lower in legs with impaired microvascular function, and the decrease in ratio precedes clinically apparent severe microvascular disease and diabetic ulcers. The TAGS instrument is a novel, sensitive tool that may aid in the early detection and monitoring of PAD complications and efforts for limb salvage.


Identification and Structure Elucidation of Epoxyjanthitrems from Lolium perenne Infected with the Endophytic Fungus Epichloë festucae var. lolii and Determination of the Tremorgenic and Anti-Insect Activity of Epoxyjanthitrem I.
Epoxyjanthitrems I-IV (1-4) and epoxyjanthitriol (5) were isolated from seed of perennial ryegrass (Lolium perenne) infected with the endophytic fungus Epichloë festucae var. lolii. Although structures for epoxyjanthitrems I-IV have previously been proposed in the literature, this is the first report of a full structural elucidation yielding NMR (Nuclear magnetic resonance) assignments for all five epoxyjanthitrem compounds, and additionally, it is the first isolation of epoxyjanthitriol (5). Epoxyjanthitrem I induced tremors in mice and gave a dose dependent reduction in weight gain and feeding for porina (Wiseana cervinata), a common pasture pest in New Zealand. These data suggest that epoxyjanthitrems are involved in the observed effects of the AR37 endophyte on livestock and insect pests.


An hypothesis concerning control networks and aging in Drosophila melanogaster and Caenorhabditis elegans.
To explain trends emerging from the study of longevity mutants, a modification of the reactive oxygen species (ROS) model of aging is suggested. ROS do not appear to be produced in greater quantities during cellular activity unless specific factors are also present. These include raised cytosolic calcium and sodium ions, nitric oxide (NO) or dopamine. Metabolically active cells that are repeatedly exposed to these factors, especially in combination, show the most ROS damage and may contribute most to aging. This explains the importance of neurons, which is highlighted by genetic studies, and points to which cells are the most aging-sensitive. Control pathways disrupted in long-lived mutants are those which control one or more of these ROS promoting factors. The daf-2/daf-16 pathway may interact with these factors in several ways. Changes in control networks may be propagated from a relatively small number of cells/junctions by neural connectivity and hormonal means.


Miscibility of dl-α-tocopherol β-glucoside in DPPC monolayer at air/water and air/solid interfaces.
The role of newly synthesized tocopherol glycosidic derivative in modifying molecular organization and phase transitions of phospholipid monolayer at the air/water interface has been investigated. Two-component Langmuir films of dl-α-tocopheryl β-D-glucopyranoside (BG) mixed with dipalmitoyl phosphatidylcholine (DPPC) in the whole range of mole fractions were formed at the water surface. An analysis of surface pressure versus mean molecular area (π-A) isotherms and Brewster angle microscope images showed that the presence of BG molecules changes the structure and packing of the DPPC monolayer in a BG concentration dependent manner. BG molecules incorporated into DPPC monolayer inhibit its liquid expanded to liquid condensed phase transition proportionally to the BG concentration. The monolayers were also transferred onto solid substrates and visualized using an atomic force microscope. The results obtained indicate almost complete miscibility of BG and DPPC in the monolayers at surface pressures present in the biological cell membrane (30-35·10(-3) N·m(-1)) for a BG mole fraction as high as 0.3. This makes the monolayer less packed and more disordered, leading to an increased permeability. The results support our previous molecular dynamics simulation data.


Pollination success in a population of dioecious rain forest trees.
Pollination success in female trees was determined for a population of Neolitsea dealbata (R. Br.) Merr., a locally abundant dioecious tree pollinated by small, unspecialized insects in northern Queensland rain forest, Australia. The population consisted of a clustered group of trees with a mean male-to-female distance of 4.5 m and more isolated individuals, including females more than 90 m away from the nearest pollen source. A map of all reproductive trees was produced to determine accurate male-to-female distances. The size of the pollen source available to females was defined as a function of the distance to the nearest ten male trees and their sizes (male neighbourhood index). The rate of pollen movement to females was measured by counting pollen tubes (and the number of tubes per style) in female trees 6 days after the commencement of population flowering. The pollination rate decreased steeply to less than half when the nearest male was only 6.5 m away. Although pollen reached a female 330 m away from the nearest pollen source, only 10% of receptive flowers had been pollinated. The short flowering period (2-3 weeks) combined with the the slow rate of pollen movement means that a large proportion of flowers in isolated trees are unpollinated, confirming an earlier finding that isolated females set fewer fruits than gregarious females. The reliability of pollen transfer to females was determined by quantifying insects and their pollen loads trapped at female trees with a range of male neighbourhood indices. Quantities of insects and pollen were significantly correlated with the size of the male neighbourhood index, indicating a strong density-dependent response by vectors to flowering. Pollen was also collected from insect visitors to non-flowering trees. Females with large male neighbourhood indices received more pollen than non-flowering trees with equivalent male neighbourhood indices. However, when the male neighbourhood indices were small for both female and non-flowering trees, the changces of pollinators encountering female and non-flowering trees were similar, suggesting random movements of pollinators in sparse-flowering sub-populations. The dioecious breeding system, brief, synchronous flowering period, clustered population structure and random, opportunistic foraging behaviour of vectors interacted in a way that reduced reproduction in relatively isolated trees. These results demonstrate a mechanism for differential breeding success between trees in natural populations and emphasize the possible impact of logging regimes on pollen flow between trees. Large interconspecific distances in species-rich environments may have been a factor in the selection for synchronous flowering between trees in outcrossing tree species with generalist insect pollinators.


The role of disgust in body image disturbance: Incremental predictive power of self-disgust.
The relationship between disgust and symptoms of disorders characterized by body image disturbance (BID) is increasingly being examined. In cognitive-behavioral models of psychopathology, disgust may function as a negative emotional response to perceived body defects, leading to avoidance and compulsive behavior. Little research has examined the role of self-disgust - a form of disgust that may be particularly relevant to the body. The present study is a descriptive analysis of the association between BID and self-disgust, controlling for other related variables. Two non-clinical samples completed measures of BID, self-disgust, negative affect, anxiety sensitivity, disgust propensity, and disgust sensitivity. Although BID was associated with all three forms of disgust at the bivariate level, in multivariate analyses self-disgust emerged as a unique predictor of BID, above and beyond all included variables, although effect sizes were small. Potential implications for understanding, preventing, and treating body image-related disorders are discussed.


Chronic hepatitis B surface antigen-negative hepatitis after treatment of malignancy.
We reviewed the records of all patients with a diagnosis of malignancy who were treated at our center and who had not had chemotherapy for at least 18 months, to assess the prevalence of chronic hepatitis B surface antigen (HBsAg)-negative hepatitis, to assess the prevalence of a marker of hepatitis C virus infection, and to determine the severity of chronic liver disease. Of 557 eligible patients, 38 (6.8%) had chronic HBsAg-negative hepatitis. Of these 38 patients, 20 (52.6%) had a marker of hepatitis C virus infection. The prevalence of chronic HBsAg-negative hepatitis was higher in patients previously treated for leukemia than in patients treated for another malignancy (11.8% vs 4.6%; p = 0.004). The liver biopsy revealed chronic active hepatitis or cirrhosis or both in 8 (28%) of 28 patients with clinical chronic HBsAg-negative hepatitis. Four patients without hepatitis C virus infection who underwent liver biopsy had hepatitis B virus antigen in the liver, confirmed by immunohistochemistry studies. One patient uninfected with hepatitis C virus had hemochromatosis. We conclude that infection with hepatitis C virus was the major cause of chronic HBsAg-negative hepatitis in pediatric patients previously treated for malignancy; the cause remained unidentified in 30% of the patients.


Direct transduction of allele-specific primer extension into electrical signal using genetic field effect transistor.
We have developed a genetic field effect transistor (FET) for single nucleotide polymorphism (SNP) genotyping, which is based on potentiometric detection of molecular recognition on the gate insulator. Here, we report direct transduction of allele-specific primer extension on the gate surface into electrical signal using the genetic FETs. This method is based on detection of intrinsic negative charges of polynucleotide synthesized by DNA polymerase. The charge density change at the gate surface could be monitored during primer extension reaction. Moreover, three different genotypes could be successfully distinguished without any labeling for target DNA by the use of the genetic FET in combination with allele-specific primer extension. The platform based on the genetic FETs is suitable for a simple, accurate and inexpensive system for SNP genotyping in clinical diagnostics.


Engineering D-glucose utilization in Azospirillum brasilense Sp7 promotes rice root colonization.
Bacteria of the genus Azospirillum include several plant associated bacteria which often promote the growth of their host plants. Although the host range of Azospirillum brasilense Sp7 is much wider than its close relative Azospirillum lipoferum 4B, it lacks the ability to efficiently utilize D-glucose for its growth. By comparing the genomes of both the species, the genes of A. lipoferum 4B responsible for conferring D-glucose utilization ability in A. brasilese Sp7 were identified by cloning individual or a combination of genes in a broad host range expression vector, mobilizing them in A. brasilense Sp7 and examining the ability of exconjugants to use D-glucose as sole carbon source for growth. These genes also included the homologs of genes involved in N-acetyl glucosamine utilization in Pseudomonas aeruginosa PAO1. A transcriptional fusion of the 5 genes encoding glucose-6-phosphate dehydrogenase and 4 components of glucose phosphotransferase system were able to improve D-glucose utilization ability in A. brasilense Sp7. The A. brasilense Sp7 strain engineered with D-glucose utilization ability showed significantly improved root colonization of rice seedling. The improvement in the ability of A. brasilense Sp7 to colonize rice roots is expected to bring benefits to rice by promoting its growth. KEY POINTS: • Genes required for glucose utilization in Azospirillum lipoferum were identified. • A gene cassette encoding glucose utilization was constructed. • Transfer of gene cassette in A. brasilense improves glucose utilization and rice root colonization..


A novel synthetic adjuvant effectively enhances the immunogenicity of the influenza vaccine.
Influenza vaccination is a key intervention to reduce morbidity and mortality provoked by this disease. To date, the challenge of improving its efficacy remains unmet. The immunogenic synthetic peptide GK1 from Taenia crassiceps cysticerci was tested herein in its capacity as adjuvant, co-administered with the inactivated anti-influenza vaccine before and after challenge with influenza virus in both young and aged mice. Co-administration of GK1 with the influenza vaccine increased levels of anti-influenza antibodies in aged mice before and after infection, reduced the local inflammation that accompanied influenza vaccination itself and favored virus clearance after infection in both young and aged mice.


Apremilast mechanism of action and application to psoriasis and psoriatic arthritis.
Psoriasis and psoriatic arthritis are common clinical conditions that negatively impact health-related quality of life and are linked to serious medical comorbidities. Disease mechanisms involve local and systemic chronic inflammatory processes. Available biologic therapies specifically target single inflammatory mediators, such as tumor necrosis factor-α (TNF-α), in the context of a larger inflammatory signaling cascade. To interrupt this pathological cascade earlier in the response or further upstream, and return pro-inflammatory and anti-inflammatory signaling to a homeostatic balance, the use of a phosphodiesterase4 (PDE4) inhibitor has been explored. PDE4 is the major enzyme class responsible for the hydrolysis of cyclic adenosine monophosphate (cAMP), an intracellular second messenger that controls a network of pro-inflammatory and anti-inflammatory mediators. With PDE4 inhibition, and the resulting increases in cAMP levels in immune and non-immune cell types, expression of a network of pro-inflammatory and anti-inflammatory mediators can be modulated. Apremilast is an orally available targeted PDE4 inhibitor that modulates a wide array of inflammatory mediators involved in psoriasis and psoriatic arthritis, including decreases in the expression of inducible nitric oxide synthase, TNF-α, and interleukin (IL)-23 and increases IL-10. In phase II studies of subjects with psoriasis and psoriatic arthritis, apremilast reversed features of the inflammatory pathophysiology in skin and joints and significantly reduces clinical symptoms. The use of an oral targeted PDE4 inhibitor for chronic inflammatory diseases, like psoriasis and psoriatic arthritis, represents a novel treatment approach that does not target any single mediator, but rather focuses on restoring a balance of pro-inflammatory and anti-inflammatory signals.


Gastric cancer in rats after chronic intraperitoneal application of sap of green parts of potatoes (Solanum tuberosum L.).
Chronic i.p. application of the sap of green potato plants (potato-tops) induced carcinomas of the stomach in 4 out of 12 treated rats.


Susceptibility testing for aztreonam plus ceftazidime/avibactam combination: A general guidance for clinical microbiology laboratories in India.
Metallo beta-lactamases-producing Gram-negative infection is often challenging and there is no defined treatment option. In recent years, the combination of aztreonam with ceftazidime-avibactam has gained much clinical attention mainly for MBL-producing Enterobacterales, while MBL-producing P. aeruginosa and A. baumannii are likely to be resistant. A consensus susceptibility testing method for this triple combination has yet to be recommended. Various methods such as broth disk elution, disk stacking, gradient strip stacking, and strip crossing have been proposed for testing this combination. Among them, broth disk elution and strip based testing methods showed good correlation with the broth micro-dilution method.


[Rare electrophoretic variants of the proteins adenylate kinase 1, phosphoglucomutase 1 and 2, and transferrin (AK1, PGM1, PGM2, Tf) in two populations of French Guiana].
Two small populations of inner French Guiana were investigated for red cell enzymes and serum proteins. Rare variants were found in four systems (AK1, PGM1, PGM2, Tf). Similarities between some of these variants and those found in other Amerindian populations indicate that these genetic markers may be valuable in studies of Amerindians. A mutation rate has been estimated from the results.


Unusual pitfall of use of retrograde cardioplegia.
The use of retrograde cardioplegia can lead to several complications, mainly related to injuries during the cannulation of the coronary sinus. We herein present a case report of injury to the right coronary artery related to kinking due to the pursestring on the right atrium.


Enantioselective α-Alkylation of Aldehydes by Photoredox Organocatalysis: Rapid Access to Pharmacophore Fragments from β-Cyanoaldehydes.
The combination of photoredox catalysis and enamine catalysis has enabled the development of an enantioselective α-cyanoalkylation of aldehydes. This synergistic catalysis protocol allows for the coupling of two highly versatile yet orthogonal functionalities, allowing rapid diversification of the oxonitrile products to a wide array of medicinally relevant derivatives and heterocycles. This methodology has also been applied to the total synthesis of the lignan natural product (-)-bursehernin.


Hypoxia promotes steroidogenic competence of buffalo (Bubalus bubalis) theca cells.
Theca cells (TCs) play an important role in follicular development and atresia. TCs synthesize androgens that act as substrate for granulosa cells aromatization to estrogens needed for follicular growth. However, the effects of hypoxia on steroidogenesis in buffalo TCs remain unclear. In the present study, the impacts of hypoxic conditions (5% oxygen) on androgen synthesis in buffalo TCs were examined. The results showed that hypoxia improved both the expression levels of androgen synthesis-related genes (CYP11A1, CYP17A1, and 3β-HSD) and the secretion levels of testosterone in buffalo TCs. Hypoxic conditions promoted the sensitivity of buffalo TCs to LH. Furthermore, inhibition of PI3K/AKT signaling pathway reduced both the expression levels of androgen synthesis-related genes (CYP11A1, CYP17A1, and 3β-HSD) and the secretion levels of testosterone in hypoxia-cultured buffalo TCs. Besides, inhibition of PI3K/AKT signaling pathway lowered the sensitivity of buffalo TCs to LH under hypoxic conditions. This study indicated that hypoxia enhanced the steroidogenic competence of buffalo TCs main through activating PI3K/AKT signaling pathway and subsequently facilitating the responsiveness of TCs to LH. This study provides a basis for further exploration of ovarian endocrine mechanism for steroidogenesis.


Bladder perforation by orthopedic implants 26 years after limb-sparing surgery for left proximal femoral chondrosarcoma: A case report.
The need for implant use during orthopedic surgeries has been increasing. Accordingly, increased implant failures have been reported. However, bladder perforation remains a rare complication after orthopedic surgery. Although a few reports have described bladder perforation after total hip arthroplasty, no previous studies have reported the migration of staples into the bladder after limb-sparing surgery. A 65-year-old patient underwent limb-sparing surgery to remove a chondrosarcoma in the left proximal thigh. Twenty-six years after surgery, a staple that had been used to fix artificial ligaments to the pubis migrated to perforate the bladder, resulting in painful urination. The staple was removed, and her symptoms improved. In this case, bladder perforation by the staple resulted in painful urination. The bladder perforation was not detected until 26 years after the initial surgery. Our observations emphasize that implant complications may occur even after a long postoperative period, and the possibility of delayed bladder perforation from previous pelvic surgeries should be considered in patients presenting with urinary tract symptoms.


Beyond Infection: Integrating Competence into Reservoir Host Prediction.
Most efforts to predict novel reservoirs of zoonotic pathogens use information about host exposure and infection rather than competence, defined as the ability to transmit pathogens. Better obtaining and integrating competence data into statistical models as covariates, as the response variable, and through postmodel validation should improve predictive research.


Clinicopathologic Characteristics of Oestrogen Receptor-Positive/Progesterone Receptor-Negative/Her2-Negative Breast Cancer According to a Novel Definition of Negative Progesterone Receptor Status: A Large Population-Based Study from China.
A lack of progesterone receptor (PgR) expression in oestrogen receptor-positive (ER+) tumours is associated with worse survival. PgR status is usually defined as positive or negative using 1% positive nuclei as a cut-off point. In this study, we aimed to assess the clinicopathologic characteristics of ER+/PgR-/HER2- tumours by comparing them with ER+/PgR+/HER2- tumours using a PgR cut-off point of 20% as a divisive criterion. We analysed 1,522 patients with primary breast cancer who had undergone surgery at the Cancer Center of Fudan University between 2012 and 2014. Age, grade, tumour size, lymph node status and lymphovascular invasion were assessed. Multinomial logistic regression, linear regression and chi-square test models were applied to assess associations between ER, PR and clinical features. ER+/PgR-/HER2- tumours showed poorer clinicopathologic characteristics relative to ER+/PgR+/HER2- tumours using a PgR threshold of 20% instead of 1%. The clinicopathologic characteristics did not differ between tumours with purely negative PgR expression and tumours with a PgR percentage ranging from 1% to 19%. The prognostic significance of PR expression appeared more pronounced in patients under a high Ki-67 status than those under a low Ki-67 status. Based on these findings, we propose the use of a novel threshold of 20% to define PgR status. Nevertheless, the impact of this new criterion on patient management and clinical treatment requires additional study.


Multiple Lipid Nanoparticles (MLN), a New Generation of Lipid Nanoparticles for Drug Delivery Systems: Lamivudine-MLN Experimental Design.
An optimized methodology for the development of a new generation of lipid nanoparticles, the multiple lipid nanoparticles (MLN) is described. MLN have characteristics between nanostructured lipid carriers (NLC) and multiple emulsions (W/O/W), but without the outer aqueous phase. The production is based on a hot homogenization method combined with high shear and ultrasonication. The antiretroviral agent lamivudine (3TC), was loaded in the MLN. For comparison purposes, NLC-3TC formulation was also developed and physico-chemically characterized by the same parameters as MLN-3TC. The development and optimization of MLN and NLC formulations were supported by a Quality by Design (QbD) approach. The MLN-3TC formulation exhibited a size of about 450 nm, polydispersity <0.3 and negative zeta potential > -20 mV. Furthermore, the morphology assessed by TEM showed a structure with multiples aqueous vacuoles. MLN-3TC was physically stable for at least 45 days, had low cytotoxicity and drug release studies showed a sustained and controlled release of 3TC under gastric and plasma-simulated conditions (at pH 7.4 for about 45 h). The optimized formulations present suitable profiles for oral administration. Overall, the results reveal that MLN present higher loading capacity and storage stability than NLC.


[Cardiovascular risk factors. An audit of their detection in primary care].
After having found that the prevalences of hypertension, hypercholesterolemia, obesity and smoking were low in our adult population on care, we developed a study to investigate the causes of the problem and to introduce measures for its solution following the methodology of the medical audit. The indexes showed that the performance of preventive cardiovascular activities (PCVA) was low: blood pressure measurement 45%, blood cholesterol determination 23%, height and weight measurement 8% and questioning on smoking habits 40%. After the implementation of corrective measures, indexes of 79%, 76%, 71% and 56%, respectively, have been achieved. In addition, a defective recording of the detected risk factors was found: 87% in the clinical history record, 72% in the age and sex card; after the corrective measures, the rates were 98% and 91% respectively. The present study demonstrates the effectiveness of quality control measures carried out by the professionals responsible for care to improve its quality.


Evaluation of gingival fiber retention technique on the treatment of patients with chronic periodontitis: A comparative study.
The destructive action of the chronic periodontitis on the periodontal tissues has provided a continuous challenge to the dental profession to develop better methods to achieve repair of the recession regions and even regeneration of post periodontal tissues. To assess the effect of periodontal muco-periostal flap surgery with gingival fiber retention technique on minimizing the post surgical recession. The sample for the study comprised of 20 patients. The criteria for selection included patients with moderate periodontitis, with minimum recession in the anterior teeth, with adequate width of the attached gingiva, and with no traumatic occlusion. Periodontal muco-periosteal flap surgery with gingival fiber retention technique was done in the experimental site with internal bevel incision, and in control site, muco periosteal flap surgery with crevicular incision was done. Thereafter, observation period was of one week, four weeks, and eight weeks were done for both the sites. The results were subjected to statistical analysis using student's t'-test. The result of this study suggests that the periodontal flap surgery with gingival fiber retention technique has a beneficial effect on the anterior teeth, as it maintains the esthetics, recontours the gingiva with minimal recession. The area of recession was more on the control site as compared to experimental site at 4 weeks, 8 weeks and 12 weeks. Gingival fiber retention technique showed less post-surgical recession and also there was fall in values of plaque index, gingival index, and periodontal index scores, throughout the study.


Characterization of gut microbiota in children with pulmonary tuberculosis.
Gut microbiota plays a critical role in many important physiological processes and is linked with various pulmonary infectious diseases. The relationship between pulmonary tuberculosis (PTB) and gut microbiota has been poorly studied. The present study aimed to characterize gut microbiota in pediatric patients with PTB. A case-controlled study was executed for the characterization of gut microbiota in pediatric PTB patients. Fecal samples were collected from the PTB patients and healthy controls upon admission. In addition, a one-month follow-up assessment was performed to investigate alterations in the gut microbiota post anti-tuberculosis treatment. 16SrDNA sequencing analysis of fecal DNA was completed on the Illumina MiSeq platform. Compared with healthy controls, the gut microbiota of pediatric patients with PTB was characterized by decreased microbial diversity. PTB patients further presented an up-regulation of the pro-inflammatory bacteria Prevotella, the opportunistic pathogen Enterococcus, as well as a reduction of beneficial bacteria including Ruminococcaceae, Bifidobacteriaceae and prausnitzii. One-month after anti-tuberculosis therapy, the richness of gut microbiota in PTB patients was distinctly depleted. The gut microbiota of pediatric patients with PTB was significantly distinct from healthy controls. Additionally, the richness of gut microbiota in PTB patients decreased after one-month anti-tuberculosis treatment. It is hypothesized that the homeostasis of gut microbiota in PTB patients may affect the pathogenies of PTB by de-regulation of the hosts' immune status through the gut-lung axis.


Determination of the risk of self-ignition of coals and biomass materials.
The safe storage, processing and handling of coals and biomass resources requires their tendency to self-ignite be understood; fires caused by self-ignition have occurred on many occasions in ports and at industrial plants. This work provides information on the tendency of several types of coal and four types of biomass to self-ignite. Data were obtained using the isothermal oven procedure and analyzed using the Frank-Kamenetskii method and a scaling procedure, both contemplated in standard EN15188. The results obtained throw light on the optimum volumes and storage times of the studied materials. The results also validate the methodology followed for determining the risk of self-ignition.


Evidence linking life-form to a major shift in diversification rate in Crassula.
Plants have evolved different ecological strategies in response to environmental challenges, and a higher lability of such strategies is more common in plant groups that adapt to various niches. Crassula (Crassulaceae), occurring in varied mesic to xeric habitats, exhibits a remarkable diversity of life-forms. However, whether any particular life-form trait has shaped species diversification in Crassula has remained unexplored. This study aims to investigate diversification patterns within Crassula and identify potential links to its life-form evolution. A phylogenetic tree of 140 Crassula taxa was reconstructed using plastid and nuclear loci and dated based on the nuclear DNA information only. We reconstructed ancestral life-form characters to estimate the evolutionary trends of ecophysiological change, and subsequently estimated net diversification rates. Multiple diversification models were applied to examine the association between certain life-forms and net diversification rates. Our findings confirm a radiation within Crassula in the last 10 million years. A configuration of net diversification rate shifts was detected, which coincides with the emergence of a speciose lineage during the late Miocene. The results of ancestral state reconstruction demonstrate a high lability of life-forms in Crassula, and the trait-dependent diversification analyses revealed that the increased diversification is strongly associated with a compact growth form. Transitions between life-forms in Crassula seem to have driven adaptation and shaped diversification of this genus across various habitats. The diversification patterns we inferred are similar to those observed in other major succulent lineages, with the most-speciose clades originating in the late Miocene.


Impact of positive end-expiratory pressure during heterogeneous lung injury: insights from computed tomographic image functional modeling.
Image Functional Modeling (IFM) synthesizes three dimensional airway networks with imaging and mechanics data to relate structure to function. The goal of this study was to advance IFM to establish a method of exploring how heterogeneous alveolar flooding and collapse during lung injury would impact regional respiratory mechanics and flow distributions within the lung at distinct positive end-expiratory pressure (PEEP) levels. We estimated regional respiratory system elastance from computed tomography (CT) scans taken in 5 saline-lavaged sheep at PEEP levels from 7.5 to 20 cmH(2)O. These data were anatomically mapped into a computational sheep lung model, which was used to predict the corresponding impact of PEEP on dynamic flow distribution. Under pre-injury conditions and during lung injury, respiratory system elastance was determined to be spatially heterogeneous and the values were distributed with a hyperbolic distribution in the range of measured values. Increases in PEEP appear to modulate the heterogeneity of the flow distribution throughout the injured lung. Moderate increases in PEEP decreased the heterogeneity of elastance and predicted flow distribution, although heterogeneity began to increase for PEEP levels above 12.5-15 cmH(2)O. By combining regional respiratory system elastance estimated from CT with our computational lung model, we can potentially predict the dynamic distribution of the tidal volume during mechanical ventilation and thus identify specific areas of the lung at risk of being overdistended.


Gas-Sensing Devices Based on Zn-Doped NiO Two-Dimensional Grainy Films with Fast Response and Recovery for Ammonia Molecule Detection.
Zn-doped NiO two-dimensional grainy films on glass substrates are shown to be an ammonia-sensing material with excellent comprehensive performance, which could real-time detect and monitor ammonia (NH3) in the surrounding environment. The morphology and structure analysis indicated that the as-fabricated semiconductor films were composed of particles with diameters ranging from 80 to 160 nm, and each particle was composed of small crystalline grain with a narrow size about 20 nm, which was the face-centered cubic single crystal structure. X-ray diffraction peaks shifted toward lower angle, and the size of the lattice increased compared with undoped NiO, which demonstrated that zinc ions have been successfully doped into the NiO host structure. Simultaneously, we systematically investigated the gas-sensing properties of the Zn-doped NiO sensors for NH3 detection at room temperature. The sensor based on doped NiO sensing films gave four to nine times faster response and four to six times faster recovery speeds than those of sensor with undoped NiO films, which is important for the NiO sensor practical applications. Moreover, we found that the doped NiO sensors owned outstanding selectivity toward ammonia.


Neuropsychological and MMPI correlates of patients' future employment characteristics.
Previous research has suggested that patients' neuropsychological test scores correlate not only with neurologic status but also with their success in coping with some of the demands of daily living. This study investigated the utility of such laboratory test scores in predicting several vocational variables. Patients who had recieved neuropsychological evaluations were recontacted and questioned about their employment over the previous 6 mo. Of the 78 individuals who participated, 25 had been chronically unemployed. The remaining 53 were asked about job stability, hours worked, and wages earned, and were administered the Minnsota Job Requirements Questionnaire. Patients' scores on the Halstead-Reitan Battery, the WAIS and the MMPI were highly correlated with employment status (employed or chronically unemployed), income, and skills required on the jobs held. The results suggest that these tests may have clinical utility in assessing patients' employability, as well as the types of jobs for which they are suited.


Assessing the awareness of performance decrements in distracted drivers.
Many studies have documented the performance decrements associated with driver distractions; however, few have examined drivers' awareness of these distraction effects. The current study measured how well-calibrated drivers are with respect to performance decrements from distracting tasks. In this test track study, 40 younger and older drivers completed a series of tasks on a hand-held or hands-free cell phone while driving around a course in an instrumented vehicle. Subjective estimates of performance decrements were compared to actual performance decrements. Although their driving performance suffered in dual-task conditions, drivers were generally not well-calibrated to the magnitude of the distraction effects (r=-.38 to .16). In some cases, estimates of distraction were opposite of the observed effects (i.e., smaller estimates of distraction corresponded to larger performance deficits). Errors in calibration were unassociated with several measures of overconfidence in safety and skill, among other variables. We discuss the implications of these findings for potential mitigation strategies for distracted driving.


The mechanism investigation of mutation genes in liver and lung metastasis of colorectal cancer by using NGS technique.
We analyzed the somatic mutation distributions as well as pathways associated with liver/lung metastasis of CRC using next-generation sequencing panel. We detected the somatic SNV/indel mutations of 1126 tumor-related genes in CRC, liver/lung metastasis of CRC and liver /lung cancer. We combined the MSK and GEO datasets to identified the genes and pathways related to the metastasis of CRC. We identified 174 genes related to liver metastasis of CRC, 78 genes related to lung metastasis of CRC, and 57 genes related to both liver and lung metastasis in two datasets. The genes related to liver and lung metastasis were collectively enriched in various pathways. Finally we found that IRS1, BRCA2, EphA5, PTPRD, BRAF, and PTEN could be prognosis-related genes in CRC metastasis. Our finding may help clarify the pathogenesis of CRC metastasis more clearly and provide new perspectives for the diagnosis and treatment of CRC metastasis.


Does abnormal expression of acetylcholine receptors in Hirschsprung's disease induce acetylcholine esterase positive nerve fibres?
Alpha bungarotoxin (alpha-BTX) is a neurotoxin isolated from the venom of Bungarus multicinctus that binds specifically to the beta-subunits of nicotinic acetylcholine receptors (nAChR) on myotube membranes. The purpose of the present study was to investigate the distribution of alpha-BTX-sensitive nAChR in Hirschsprung's disease (HD) to understand the histopathological features of HD, especially the increase in acetylcholine esterase (AChE) positive nerve fibres. Confocal microscopy was used to study the expression of FITC (fluorescein isothiocyanate)-alpha-BTX, anti-synaptophysin (A-SY) antibody, and anti-neurofilament (A-NF) antibody to determine the distribution of nAChR and ganglion cell and nerve fibres in colon specimens from five cases of HD and three normal controls. Quantitative assessment of the immunoreactivity of colonic muscle and colonic mucosal epithelium from an aganglionic segment of HD bowel demonstrated markedly increased nAChR compared with colonic muscle and colonic mucosal epithelium from a ganglionic segment of HD bowel and normal bowel (p < 0.0001, respectively), both of which have only a few positive nAChR. In colonic muscle from aganglionic and transitional segments of HD, there were many nAChR around hypertrophic nerve trunks identified by A-NF and A-SY staining. We suggest that abnormal expression of nAChR in HD might be implicated in causing gastrointestinal dysmotility because of their localization around hypertrophic nerve trunks.


Occurrence of fumonisin B1 in Bulgarian maize samples determined by ELISA and TLC methods using different clean up steps.
An enzyme linked immunosorbent assay (ELISA) method and a thin-layer chromatography (TLC) method with two different clean-up procedures have been used to analyse maize samples (food and feeding stuff) obtained from Bulgaria. The occurrence of Fumonisin B1 in Bulgarian maize was found to be in the range of what was reported for other European regions with a mean value of 1.5 mg/kg, 2.1 mg/kg and 1.8 mg/kg when analysed by ELISA and thin-layer chromatography with solid phase extraction clean up and immunoaffinity clean up, respectively. It was shown that results of the different methods are comparable, indicating that the methods applied are sufficiently reliable tools for the simple and rapid screening of maize samples.


Fibroblast-collagen-matrix contraction: growth-factor signalling and mechanical loading.
Fibroblast-collagen-matrix contraction provides a unique way to study reciprocal geometric and mechanical interactions between fibroblasts and extracellular matrix. Such interactions are difficult to appreciate or examine in routine cell culture because the culture surface is usually fixed in place. Forces exerted on collagen fibrils by cells cause isometric tension to develop in the cells if the collagen resists deformation; by contrast, the cells remain mechanically unloaded in the absence of matrix resistance. Recent evidence suggests that the state of cellular mechanical loading determines the mechanism that cells use to regulate contraction.


Characterization of a new alpha-glycoprotein as the major serum component in later fetal and newborn pigs.
1. Using crossed immunoelectrophoresis, fetuin, alpha-fetoprotein, albumin, transferrin, alpha1-antitrypsin and a fetospecific-like alpha-glycoprotein, were identified as the main serum components in fetal pig (Sus scrofa domesticus). 2. Fetuin was found to be a trypsin inhibitor, but not a chymotrypsin inhibitor. 3. The fetospecific-like alpha-glycoprotein, not previously reported, accounted for 50% of the total serum proteins in newborn pigs. This protein, however, was a minor component of the adult serum.


Sleep assessment by means of a wrist actigraphy-based algorithm: agreement with polysomnography in an ambulatory study on older adults.
The purpose of the present work is to examine, on a clinically diverse population of older adults (N = 46) sleeping at home, the performance of two actigraphy-based sleep tracking algorithms (i.e., Actigraphy-based Sleep algorithm, ACT-S1 and Sadeh's algorithm) compared to manually scored electroencephalography-based PSG (PSG-EEG). ACT-S1 allows for a fully automatic identification of sleep period time (SPT) and within the identified sleep period, the sleep-wake classification. SPT detected by ACT-S1 did not differ statistically from using PSG-EEG (bias = -9.98 min; correlation 0.89). In sleep-wake classification on 30-s epochs within the identified sleep period, the new ACT-S1 presented similar or slightly higher accuracy (83-87%), precision (86-89%) and F1 score (90-92%), significantly higher specificity (39-40%), and significantly lower, but still high, sensitivity (96-97%) compared to Sadeh's algorithm, which achieved 99% sensitivity as the only measure better than ACT-S1's. Total sleep times (TST) estimated with ACT-S1 and Sadeh's algorithm were higher, but still highly correlated to PSG-EEG's TST. Sleep quality metrics of sleep period efficiency and wake-after-sleep-onset computed by ACT-S1 were not significantly different from PSG-EEG, while the same sleep quality metrics derived by Sadeh's algorithm differed significantly from PSG-EEG. Agreement between ACT-S1 and PSG-EEG reached was highest when analyzing the subset of subjects with least disrupted sleep (N = 28). These results provide evidence of promising performance of a full-automation of the sleep tracking procedure with ACT-S1 on older adults. Future longitudinal validations across specific medical conditions are needed. The algorithm's performance may further improve with integrating multi-sensor information.


Zimography is an effective method for detection of matrix metalloproteinase 2 (MMP-2) activity in cultured human fibroblasts.
To describe a method to characterize the gelatinase activity of cultured human periodontal fibroblasts stimulated with Pam3Cys and E. coli LPS, ligands of TLR2 and TLR4 respectively, and by centrifugation of the cultures, simulating an orthodontic force. To study MMP-2 activity, primary cultures of human periodontal fibroblasts were stimulated with the addition of TLRs 2 and 4 ligands and the application of mechanical force by centrifugation at 141 x g for 30 min. Supernatant media was collected 24 hours later to perform protein quantification and zymography. MMP-2 activity suffered an increase in cultures co-stimulated with TLRs 2 and 4 ligands alone or with the presence of mechanical force application compared to basal levels. Zymography, one of the several methods to study MMPs activities, is a simple, qualitative and efficient method based on electrophoresis of bis-acrylamide gels copolymerized with a protein substrate.


McCune-Albright syndrome with gigantism and hyperprolactinemia.
We describe the case of a 38-year-old man with typical Mc Cune-Albright syndrome and the unusual combination of both growth-hormone and prolactin hypersecretion. The patient was extremely tall, which is unusual in Mc Cune-Albright syndrome, suggesting that he did not have precocious fusion of the epiphysis, a common finding in this syndrome. Unfortunately the patient refused any treatment for his disease. A similar case has been previously described only in a 14-year-old boy.


Anti-inflammatory activity and structural identification of a sulfated polysaccharide CLGP4 from Caulerpa lentillifera.
In the present study, the in vitro anti-inflammatory activity of four purified polysaccharides (CLGP1, CLGP2, CLGP3 and CLGP4) extracted from edible green algae Caulerpa lentillifera was evaluated. As a result, CLGP4 exhibited more effectively inhibitory effect on LPS-induced HT29 cells, including reducing the production of IL-1β, TNF-α, SIgA and mucin2, and decreasing the expression of IL-1β and TNF-α. According to the results, CLGP4 showed a better anti-inflammatory effect, might highly related to the presence of sulfate groups. Furthermore, the structure of CLGP4 was analyzed by methylation analysis, GC-MS and NMR spectroscopy. It was found that CLGP4 was a novel xylogalactomanan consisting of β-(1 → 4)-Manp, →2,4)Manp(1→, β-(1 → 2)-Manp, β-(1 → 3)-Galp, β-(1 → 4)-Xylp, terminal β-Galp and terminal β-Xylp residues. Additionally, the sulfate groups were located on C-3 of →4)Xylp(1→, C-6 of →3)Galp(1→ and C-3 of →2)Manp(1→. These results could enlarge the potential application of CLGP4 as functional ingredient to attenuate inflammation.


Impact of portal hemodynamics on Doppler ultrasonography for predicting decompensation and long-term outcomes in patients with cirrhosis.
Significance of portal hemodynamics for non-invasive marker of cirrhosis remains unclear. The aim was to determine the value of portal hemodynamics on Doppler ultrasound for predicting decompensation and prognosis in cirrhosis. This retrospective study comprised 236 cirrhotic patients (132 males, 104 females; age 63.7 ± 11.3 years; 110 compensated, 126 decompensated). Clinical data, including Doppler findings, were analyzed with respect to decompensation and prognosis. The median follow-up period was 33.2 months (0.1-95.4). Fifty-three patients developed clinical decompensation, 13 patients received liver transplantation, and 71 died. Higher model for end-stage liver disease score (p < 0.001) at baseline was the significant factor for the presence of decompensation. Higher alanine transaminase (p = 0.020), lower albumin (p = 0.002) and lower mean velocity in the portal trunk (p = 0.038) were significant factors for developing decompensation (best cut-off value: Alanine transaminase > 31 IU/L, albumin < 3.6 g/dL, and portal trunk < 12.8 cm/s). The cumulative incidence of decompensation was higher in patients with portal trunk < 12.8 cm/s (22.5% at 1 year, 71.2% at 5 years) than those without (6.9% at 1 year, 35.4% at 5 years; p < 0.001). The significant prognostic factors were hepatocellular carcinoma (p = 0.036) and lower albumin (p = 0.008) for compensated patients, and reversed portal flow (p = 0.028), overt ascites (p < 0.001), and higher bilirubin (p < 0.001) for decompensated patients. Portal hemodynamics offer a non-invasive marker for decompensation and prognosis of cirrhosis, suggesting a future direction for practical management.


PyMieLab_V1.0: A software for calculating the light scattering and absorption of spherical particles.
Light scattering and absorption by small particles are widely used in fields such as biomedicine, information technology, and energy technology. However, their theoretical study requires not only a high level of knowledge in electromagnetism but also a high level of computer programming skills. To solve this problem, a software called PyMieLab (https://gitlab.com/Climb12/pymielab.git) for calculating the light scattering and absorption of spherical particles has been developed based on Mie theory. This software is interactive, versatile, visual, flexible, and scalable. It has a friendly graphical user interface and can be used as a numerical simulation platform for scientific research, as well as provides a rich database of particle refractive indices. Moreover, it offers a reliable research platform for discovering new optical properties of specific materials and exploring materials with better optical properties in related fields. This paper describes in detail the theoretical basis, the graphical user interface, the calculation functions, the operational and procedural processes, the features, and the numerical verification of the software. It illustrates the application value of the software with two simulation examples.


Aflatoxin M1 in raw cow milk and associated hepatocellular carcinoma risk among dairy farming households in Malawi.
In the present study, a total of 112 raw milk samples were collected between October and December of 2018 from dairy farming households in Malawi and analyzed for aflatoxin M1 (AFM1) using VICAM aflatest fluorometry procedure. These data together with the consumption data obtained through a milk consumption frequency questionnaire were used for the calculation of AFM1 exposure and its association with hepatocarcinoma (HCC) risk in dairy farming population. Average daily milk intake by children and adults were approximately 300 ± 0.07 and 541.7 ± 0.14 mL, respectively. All raw milk samples tested positive to AFM1 averaging 0.551 μg/L. Probable mean daily exposure to AFM1 for adults was 4.98 ± 7.25 ng/kg BW/day almost half that of children (8.28 ± 11.82 ng/kg BW/day). Estimated risk of AFM1-induced HCC associated with consumption of milk among children and adults were 0.038 and 0.023 cases per 100,000 individuals per year, respectively. Although the results of this investigation suggest a low risk of HCC, other negative health effects of AFM1 justify its continuous monitoring and update of the risk assessment. This work presents the first insight in the occurrence of AFM1 in cow milk in Malawi as well as associated AFM1 exposure in dairy farming population.


Influence of the CSF bicarbonate concentration on the ventilatory response to CO2 in relation to the location of the central chemoreceptors.
In anaesthetized cats, in which the cerebrospinal fluid bicarbonate concentration was varied by a ventriculocisternal perfusion technique, the ventilatory response to CO2 during hyperoxia could be satisfactorily described by VE = S(PCSFCO2 -B). Both the slope S and the intercept B were positively and linearly related to the CSF bicarbonate concentration. Assuming that the PCSFCO2 is equal to the PCO2 in extracellular fluid, it can be shown that VE is a linear, but not a unique function of the [H+] at the site of the chemoreceptors; the slope of this relation varies with the bicarbonate concentration at that site, possibly due to chemical complex formation between HCO-3 and Ca2+ or Mg2+. Changes in the B-value were related to the location of the central chemoreceptors with the models of Pappenheimer and Berndt aand their coworkers. It was found that changes in the CSF bicarbonate concentration are reflected for 60 per cent at the site of the central chemoreceptors, and that this was independent of the cerebral perfusion. Using Berndt's model a distance between CSF and central chemoreceptors of approximately 100 micron was found; this calculated distance is relatively insensitive to relationship (logarithmic or not) between ventilation and H+ concentration and to changes in cerebral perfusion, owing to the approximate nature of the diffusion model.


Cold resistance and overwintering survival of the cabbage root fly, Delia radicum (Anthomyiidae), and its parasitoid, Trybliographa rapae (Cynipidae), in England.
Overwintering Delia radicum (L.) in a field of swedes (Brassica napus L.) near Ascot, Berks., England, were exposed to soil temperatures below 10°C on 176 days from 21 October 1983 to 22 April 1984, but no temperatures below 0°C were recorded. Collections of D. radicum taken at monthly intervals from 1 November 1983 to 30 April 1984 showed that parasitism by the cynipid Trybliographa rapae (Westw.) and by the staphylinid Aleochara bilineata Gyll. was the main source of mortality. A substantial increase in parasitism by A. bilineata occurred during November, but much of the increase was by superparasitism of pupae previously parasitized by T. rapae. Mortality from causes other than parasitism was greater in the November and December collections (c. 22%) and in the spring (c. 12%) than during the winter (c. 3%) and could not be attributed to low temperatures.In all collections, most of the adult D. radicum (c. 90%) emerged within 230°D5.6. The mean number of °D5.6 to eclosion did not change from 1 November to 5 March but decreased significantly by 2 April. Late-emerging adults remired 259 to 992°D5.6 to eclosion and no changes in the nean number of °D occurred among collections.Among unparasitized D. radicum, individual supercooling points showed a strong peak at c.-23°C. A significant proportion of pupae with supercooling points above-20°C were found only in the 1 November 1983 and the 30 April 1984 collections. The 'high' supercooling points in the November collection may have comprised apparently healthy but moribund individuals, whereas in the April collection they may have included individuals that had initiated postdiapause development. The mean supercooling point of individuals in the 'low' category (supercooling points ≤20°C) did not vary among monthly samples. Parasitism by T. rapae increased the variability in supercooling points, resulting in a few individuals with lower, and many more with higher supercooling points than among unparasitized individuals. The mean supercooling point increasing from the collections of November and December to those of January to April.Puparia containing unparasitized D. radicum pupae were heavier and contained more water than those with parasitized pupae, but neither group showed significant ranges over winter. Supercooling points were positively correlated with puparial live weight among unparasitized but not among parasitized pupae. Supercooling points were not correlated with water content for either group.Parasitism did not affect the occurrence or concentration of sugars and polyhydric alcohols (all<1% of fresh weight), and trehalose, glucose and mannitol were the most abundant. D. radicum can be considered to be over-protected from lethal freezing in the pupal stage and its high supercooling capacity in England may persist because it is conferred by the structural properties of the dipteran puparium and pupa within it and therefore is not subject to selection pressures.


Distal sequences, but not ori-beta/OBR-1, are essential for initiation of DNA replication in the Chinese hamster DHFR origin.
In the Chinese hamster dihydrofolate reductase replication initiation zone, the ori-beta locus is preferred over other start sites. To test the hypothesis that ori-beta contains a genetic replicator, we restored a deletion in the 3' end of the DHFR gene with a cosmid that provides the missing sequence and simultaneously knocks out the downstream ori-beta locus. Replication initiates normally in ori-beta knockout cell lines, and the DHFR domain is still synthesized in early S phase. However, initiation is completely suppressed in the starting deletion variant lacking the 3' end of the gene. We conclude that ori-beta does not contain an essential replicator, but that distant sequence elements have profound effects on origin activity in this locus.


Hydralazine-enhanced selective heating of transmissible venereal tumor implants in dogs.
This study was designed to test the hypothesis that vasodilator drugs can enhance selective heating of solid tumors by producing a favorable redistribution of blood flow between tumor and normal tissues. Subcutaneous transmissible venereal tumor implants were heated by inductive diathermy using Helmholtz coils in 8 dogs. The temperature rise in tumor and adjacent muscle was measured before and after giving hydralazine (0.5 mg/kg i.v.). Blood flow to the tumors and underlying muscle was measured with radioactive tracer microspheres. Before hydralazine treatment mean muscle blood flow was about one-third tumor blood flow (0.11 +/- 0.02 vs 0.28 +/- 0.09 ml/min/g), and tumor and normal muscle temperatures were not significantly different (40.0 +/- 0.6 vs 39.7 +/- 0.1 degrees C). After hydralazine tumor blood flow decreased and muscle blood flow increased in every dog, and selective heating of the tumors became possible. Muscle blood flow averaged 0.67 +/- 0.13 ml/min/g, 17 times greater than tumor blood flow, which decreased to 0.04 +/- 0.02 ml/min/g. Core tumor temperature was 48.0 +/- 0.9 vs 38.5 +/- 0.5 degrees C for underlying muscle. Blood pressure was maintained at 80 +/- 5.7 mmHg. These results demonstrate that adjuvant treatment with vasodilators is a promising technique to increase the temperature difference between tumors and surrounding normal tissues during local heat therapy.


Does patient education modify behaviour in the management of COPD?
With respect to the beneficial health effects of patient education in the treatment of asthma it might be expected that the active participation of COPD-patients in the management of their disease may reduce the burden of the disease. Self-management of chronic obstructive pulmonary disease (COPD) includes sufficient coping behaviour, compliance with inhaled medication, attention to changes in the severity of the disease, adequate inhalation technique, and self-adjustment of the medication in case of exacerbations. In contrast to the conflicting results of the current literature, the evaluation of our structured education programme for patients with mild to moderate COPD revealed a significant improvement of inhalation technique and self-control of the disease as well as a significant reduction of exacerbations. Therefore, it may be concluded that education may modify the behaviour of patients in the management of COPD by improving self-control and self-management of the disease and thus reducing morbidity.


Cell K activity in frog skin in the presence and absence of cell current.
Cell K activity, acK, was measured in the short-circuited frog skin by simultaneous cell punctures from the apical surface with open-tip and K-selective microelectrodes. Strict criteria for acceptance of impalements included constancy of the open-tip microelectrode resistance, agreement within 3% of the fractional apical voltage measured with open-tip and K-selective microelectrodes, and constancy of the differential voltage recorded between the open-tip and the K microelectrodes 30-60 sec after application of amiloride or substitution of apical Na. Skins were bathed on the serosal surface with NaCl Ringer and, to reduce paracellular Cl conductance and effects of amiloride on paracellular conductance, with NaNO3 Ringer on the apical surface. Under control conditions acK was nearly constant among skins (mean +/- SD = 92 +/- 8 mM, 14 skins) in spite of a wide range of cellular currents (5 to 70 microA/cm2). Cell current (and transcellular Na transport) was inhibited by either apical addition of amiloride or substitution of Na by other cations. Although in some experiments the expected small increase in acK after inhibition of cell current was observed, on the average the change was not significant (98 +/- 11 mM after amiloride, 101 +/- 12 mM after Na substitution), even 30 min after the inhibition of cell current. The membrane potential, which in the control state ranged from -42 to -77 mV, hyperpolarized after inhibition of cell current, initially to -109 +/- 5 mV, then depolarizing to a stable value (-88 +/- 5 mV) after 15-25 min. At this time K was above equilibrium (EK = 98 +/- 2 mV), indicating that the active pump mechanism is still operating after inhibition of transcellular Na transport. The measurement of acK permitted the calculation of the passive K current and pump current under control conditions, assuming a "constant current source" with almost all of the basolateral conductance attributable to K. We found a significant correlation between pump current and cell current with a slope of 0.31, indicating that about one-third of the cell current is carried by the pump, i.e., a pump stoichiometry of 3Na/2K.


Wideband acoustic transfer functions predict middle-ear effusion.
Compare the accuracy of wideband acoustic transfer functions (WATFs) measured in the ear canal at ambient pressure to methods currently recommended by clinical guidelines for predicting middle-ear effusion (MEE). Cross-sectional validating diagnostic study among young children with and without MEE to investigate the ability of WATFs to predict MEE. WATF measures were obtained in an MEE group of 44 children (53 ears; median age, 1.3 years) scheduled for middle-ear ventilation tube placement and a normal age-matched control group of 44 children (59 ears; median age, 1.2 years) with normal pneumatic otoscopic findings and no history of ear disease or middle-ear surgery. An otolaryngologist judged whether MEE was present or absent and rated tympanic-membrane (TM) mobility via pneumatic otoscopy. A likelihood-ratio classifier reduced WATF data (absorbance, admittance magnitude and phase) from 0.25 to 8 kHz to a single predictor of MEE status. Absorbance was compared to pneumatic otoscopy classifications of TM mobility. Absorbance was reduced in ears with MEE compared to ears from the control group. Absorbance and admittance magnitude were the best single WATF predictors of MEE, but a predictor combining absorbance, admittance magnitude, and phase was the most accurate. Absorbance varied systematically with TM mobility based on data from pneumatic otoscopy. Results showed that absorbance is sensitive to middle-ear stiffness and MEE, and WATF predictions of MEE in young children are as accurate as those reported for methods recommended by the clinical guidelines.


Evaluation of safety and efficacy of a new device for muscle toning and body shaping.
The spread of non-invasive procedures for fat deposits removal has increased rapidly in recent years. In the field of esthetic medicine, high-intensity focused electromagnetic field (HIFEM) technology has recently been introduced, as a tool for toning and strengthening muscles, which goes far beyond normal physical exercise. The purpose of this study is to evaluate the efficacy and safety of a new device for body remodeling. A set of 15 patients (7 males and 8 females, BMI 24.05 ± 2.01 kg m-2 , age 32-57) participated in this study. Patients were enrolled at Dermatos center, Montesilvano, Abruzzo, Italy. The technology used is FMS (Flat Magnetic Stimulation): 6-8 treatment sessions were performed. The sessions must be repeated twice a week, with a minimum of 2 days between each session. Treatment duration varies from 20 to 45 min, depending on patients. During 1-month follow-up after the last treatment evaluations, the results showed tonification, the strengthening of muscles, and the reduction of localized adiposity. There is a significant reduction in waist circumference (80.7 ± 4.3 cm vs 77.3 ± 5.6 cm, p < 0.001). All patients showed relatively high satisfaction immediately after the last treatment. Our data show that intense muscle activity is generated by FMS treatments, suggesting that this technology could be used as a convenient and effective muscle toning tool.


Microsite utilization by Bromus tectorum L. and Poa pratensis L. in a meadow steppe community.
Emergence of Bromus tectorum L. and Poa pratensis L., two dominant alien grasses in eastern Washington, from 24 microsites was monitored in spring and autumn 1979. Spring emergence of B. tectorum reached a maximum on north-facing slopes of artificially constructed pocket gopher mounds and burrows while spring emergence of P. pratensis was maximized on both north-and southfacing slopes of mounds. Earliest autumn emergence of B. tectorum seedlings was in fissures of 0.5 cm, 1 cm, and 2 cm depth while earliest emergence of P. pratensis was 24 days later in fissures of 0.5 cm, 1 cm, 2 cm, and 5 cm depth. All B. tectorum seedlings had emerged within 44 days after first emergence on north-facing slopes of artificially constructed mounds. Maximum emergence of P. pratensis (37%) seedlings occurred on the same north-facing positions of mound slopes and also on the north-facing slope of the burrow, 24 days after first emergence. Both species exhibit broad microsite tolerance and are found on similar but temporally separated microsites.


Author Correction: The transcriptional regulator NtrC controls glucose-6-phosphate dehydrogenase expression and polyhydroxybutyrate synthesis through NADPH availability in Herbaspirillum seropedicae.
An amendment to this paper has been published and can be accessed via a link at the top of the paper.


Observation of scalable sub-Poissonian-field lasing in a microlaser.
Sub-Poisson field with much reduced fluctuations in a cavity can boost quantum precision measurements via cavity-enhanced light-matter interactions. Strong coupling between an atom and a cavity mode has been utilized to generate highly sub-Poisson fields. However, a macroscopic number of optical intracavity photons with more than 3 dB variance reduction has not been possible. Here, we report sub-Poisson field lasing in a microlaser operating with hundreds of atoms with well-regulated atom-cavity coupling and interaction time. Its photon-number variance was 4 dB below the standard quantum limit while the intracavity mean photon number scalable up to 600. The highly sub-Poisson photon statistics were not deteriorated by simultaneous interaction of a large number of atoms. Our finding suggests an effective pathway to widely scalable near-Fock-state lasing at the macroscopic scale.


Investigation of the potential of aerosolized Salmonella Enteritidis on colonization and persistence in broilers from day 3 to 21.
The presence of Salmonella in air of poultry houses has been previously confirmed. Therefore, it is important to investigate the entry of Salmonella into broilers through air. The present study aimed to evaluate different levels of Salmonella Enteritidis aerosol inoculations in broiler chicks for colonization of ceca, trachea, and liver/spleen and persistence over time. In 3 independent trials, 112 one-day-old birds were randomly divided into 4 groups (n = 28/group). On d 1 of age, one group was exposed to an aerosol of sterile saline and the remaining three groups were exposed to an aerosol generated from one of 3 doses (103, 106, or 109 CFU/mL) of S. Enteritidis inoculum. Aerosol exposure time was 30 min/group and was performed using a nebulizer. On d 3, 7, 14, and 21 of age, ceca, trachea, and liver/spleen were aseptically removed. Ceca were cultured for Salmonella counts (log10 CFU/g) and all tissues were cultured for Salmonella prevalence. All tissues from the control group were Salmonella negative for all sampling days. On sampling d 3 and 7, ceca Salmonella counts were highest (5.14 and 5.11, respectively) when challenged with 109Salmonella (P ≤ 0.0281). Ceca Salmonella counts increased from d 3 (2.43) to d 7 (4.43), then remained constant when challenged at 103Salmonella, and counts decreased over time for all other groups. Tissue Salmonella prevalence increased with increasing challenge levels at all sampling timepoints (P ≤ 0.0213). Salmonella prevalence was low (0/18 to 4/18) and did not change over time following 103Salmonella challenge (P ≥ 0.2394). Prevalence decreased over time in ceca and trachea following 106 and 109Salmonella challenge (P ≤ 0.0483). Liver/spleen Salmonella prevalence increased from d 3 (13/18) to d 14 (18/18) and then decreased at d 21 (10/18) in birds exposed to an aerosol of 109Salmonella but remained constant over time for rest of the Salmonella inoculated groups. Overall, this study demonstrated the Salmonella colonization and persistence in different tissues in broilers following exposure to aerosolized Salmonella.


[Transurethral electroresection of the bladder neck in local anesthesia].
In 15 patients declared inoperable for internal reasons, spontaneous miction was achieved after resection of up to 20 g of tissue under suprapubic local anaesthesia using a resectoscope.


Comparison of five methods for the detection of measles specific immunoglobulin G antibody.
In this work we compare the sensitivity, specificity and predictive values of hemagglutination inhibition (HI), immunofluorescent assay (IFA), biotin-streptavidin immunofluorescent assay (B/SA-IFA), enzyme-linked immunosorbent assay (EIA) and plaque neutralization test (PN). This study includes serum samples from children taken before and after vaccination, children with clinically diagnosed measles and household contacts. EIA were the most specific and better serological diagnostic test. HI and IFA had high sensitivity but low specificity. An alternative to EIA is B/SAIFA, which is cheaper than EIA and can be used in the study of small outbreaks or in isolated cases.


Mapping the transition state for DNA bending by IHF.
How DNA-bending proteins recognize their specific sites on DNA remains elusive, particularly for proteins that use indirect readout, which relies on sequence-dependent variations in DNA flexibility/bendability. The question remains as to whether the protein bends the DNA (protein-induced bending) or, alternatively, "prebent" DNA conformations are thermally accessible, which the protein captures to form the specific complex (conformational capture). To distinguish between these mechanisms requires characterization of reaction intermediates and, in particular, snapshots of the transition state along the recognition pathway. We present such a snapshot, from measurements of DNA bending dynamics in complex with Escherichia coli integration host factor (IHF), an architectural protein that bends specific sites on λ-DNA in a U-turn by creating two sharp kinks in DNA. Fluorescence resonance energy transfer measurements in response to laser temperature-jump perturbation monitor DNA bending. We find that nicks or mismatches that enhance DNA flexibility at the site of the kinks show 3- to 4-fold increase in DNA bending rates that reflect a 4- to 11-fold increase in binding affinities, while sequence modifications away from the kink sites, as well as mutations in IHF designed to destabilize the complex, have negligible effect on DNA bending rates despite >250-fold decrease in binding affinities. These results support the scenario that the bottleneck in the recognition step for IHF is spontaneous kinking of cognate DNA to adopt a partially prebent conformation and point to conformational capture as the underlying mechanism of initial recognition, with additional protein-induced bending occurring after the transition state.


How bilateral iliolumbar fusion increases the stability of horizontal osteosynthesis in unstable pelvic ring injuries?
In type C pelvic ring injuries, the operative stabilization of the posterior ring is absolutely indicated. There exist four different types of operative methods: iliosacral screw fixation, transsacral plate synthesis, ventral plate fixation (primarily for sacroiliac luxations), and local plate synthesis performed on the dorsal cortex of the sacrum. In our current article, we analyzed the stability of fixation methods used together with bilateral iliolumbar techniques. We analyzed a finite element pelvic model attached to lumbar 4-5 vertebrae. By imitating a standing position on two feet, we measured the differences in tension and displacement in T1 and T2 thoracic vertebrae fractures with and without iliolumbar fusion in cases of iliosacral screw fixation, transsacral plate synthesis and KFI-H (small fragment-H) plate synthesis. The osteosynthesises reinforced via Galveston technique were rather stable; the amount of displacement measured in the fracture gap was significantly less than in the cases without iliolumbar fusion. The tension in the implants were below the allowed values, therefore they were capable of withstanding the imposed loads without permanent deformation. In unilateral pelvis injuries, if a non-weight bearing status cannot be achieved on the injured side, unilateral iliolumbar fusion reinforcement is justified, since the contralateral lower limb must also be non-weight bearing due to the pelvis injury itself. In the case of the most unstable sacrum fracture--"jumper's fracture", bilateral iliolumbar fusion is necessary, in which case the patient will be able to bear weight during the early postoperative period.


Intra-operative pneumothorax complicating laparoscopic Roux-en-Y gastric bypass.
Intra-operative pneumothorax (PTX) is an infrequent complication of laparoscopic surgery. Most cases are attributed to CO(2) diffusion across congenital diaphragmatic defects and resolve spontaneously. We report a case of PTX during a laparoscopic Roux-en-Y gastric bypass (LRYGBP). When applied to this specific patient population, the current literature recommendations for the management of intra-operative PTX are questioned. A retrospective chart review of 400 consecutive LRYGBP procedures performed over a 30-month period revealed 1 case of PTX (0.025%). A bulging left diaphragm, hypotension, bradycardia, decreased pO(2), and elevated EtCO(2) and airway pressures, were noted early in the case. She initially responded to conservative management but required multiple subsequent hospital admissions for pulmonary complications. Pneumoperitoneum-induced PTX during laparoscopic bariatric surgery is a rare complication. Its treatment must be based on the potential underlying cause, with consideration of these patients' often delicate pulmonary status. In stable patients, where the PTX is attributed to diaphragmatic or hiatal dissection, expectant treatment is appropriate. In all other situations, however, we believe that tube thoracostomy is indicated. An algorithm for treatment of PTX in laparoscopic bariatric surgery is proposed. It follows the dictum of maintaining extreme vigilance and a low threshold for aggressive intervention in this group of patients.


Human PIEZO1: removing inactivation.
PIEZO1 is an inactivating eukaryotic cation-selective mechanosensitive ion channel. Two sites have been located in the channel that when individually mutated lead to xerocytotic anemia by slowing inactivation. By introducing mutations at two sites, one associated with xerocytosis and the other artificial, we were able to remove inactivation. The double mutant (DhPIEZO1) has a substitution of arginine for methionine (M2225R) and lysine for arginine (R2456K). The loss of inactivation was accompanied by ∼30-mmHg shift of the activation curve to lower pressures and slower rates of deactivation. The slope sensitivity of gating was the same for wild-type and mutants, indicating that the dimensional changes between the closed and open state are unaffected by the mutations. The unitary channel conductance was unchanged by mutations, so these sites are not associated with pore. DhPIEZO1 was reversibly inhibited by the peptide GsMTx4 that acted as a gating modifier. The channel kinetics were solved using complex stimulus waveforms and the data fit to a three-state loop in detailed balance. The reaction had two pressure-dependent rates, closed to open and inactivated to closed. Pressure sensitivity of the opening rate with no sensitivity of the closing rate means that the energy barrier between them is located near the open state. Mutant cycle analysis of inactivation showed that the two sites interacted strongly, even though they are postulated to be on opposite sides of the membrane.


Assessment of the safety of regular DDAVP therapy in primary nocturnal enuresis.
A group of 7 patients with refractory primary nocturnal enuresis on long-term DDAVP therapy (mean 13 months) were submitted to a standard water deprivation test in conjunction with a hormone profile and routine haematological and biochemical investigations. No abnormalities were demonstrated, which suggests that the drug is safe in this clinical situation.


[Structured conservative therapy].
In the case of typical whiplash after low-energy rear-end collision we recommend a clear and structured therapeutic regimen to overcome and prevent neuromuscular deficits. Patients with bony and discoligamentous lesions have to be excluded, as well as patients with distinct neurologic deficits. A therapeutic rationale is the basis of full neuromuscular recovery ad integrum.


Plasma infusion for hemolytic-uremic syndrome in children: results of a multicenter controlled trial.
The results of a controlled trial to ascertain the usefulness of plasma infusion for the treatment of hemolytic-uremic syndrome (HUS) are reported. Criteria for admission were (1) observation within 8 days from first symptoms, (2) dialysis treatment required, and (3) no special treatments and no more than 25 ml blood/kg previously received. Children were subdivided according to age (less than or more than 3 years) and then randomly assigned to treatment with plasma or symptomatic therapy. Thirty-two children ranging in age from 4 months to 6 years entered this study; 17 received plasma (P+ group) and 15 only symptomatic therapy (P- group). The mean follow-up period was 16 months in both groups. Surgical renal biopsy was performed 29 to 49 days after onset in 11 P+ and 11 P- children, and 33 histologic findings were semiquantitatively evaluated. No death occurred in either group. No differences were found in blood pressure, proteinuria, or hematuria at the end of the follow-up period; in no case were severe arteriolar lesions found. There were no significant differences for the scores of the individual histologic measurements; on electron microscopy, no vascular changes were observed in seven children of the P+ group, whereas in five of seven of the P- group, thickening of the lamina rara interna and arteriolar damage were present. The ability of plasma to stimulate prostacyclin (PGI2) production, measured as its stable derivative 6-keto-PGF1 alpha, was within the normal range for all patients. In our patients with predominant glomerular involvement who were treated in a very early phase of HUS, infusions of plasma did not significantly influence the short- and medium-term clinical outcome and were not effective in severe HUS when given later in the course of the disease. A longer follow-up is needed to ascertain whether the presence of endothelial damage, demonstrated by electron microscopy in children who were not given plasma, is of clinical relevance.


Roman aqueduct maintenance in the water supply system of Divona, France.
Carbonate deposits formed in Roman aqueducts provide a window onto the environment and water management in antiquity. These laminated archives precipitated over a period of decades to centuries and are a potential high-resolution source of unwritten history. However, their use as environmental archives is hampered by local and partial removal during maintenance work in some aqueducts. This apparent problem, however, creates a unique opportunity to study Roman water management. We present the discovery of traces of regular maintenance in carbonate deposits of the Roman aqueduct of Divona (Cahors, France). The main objective of this study is to determine the periodicity of local carbonate removal and repairs in this aqueduct. Traces such as tool marks, calcite deformation twins, debris from cleaning and repairs are attested in the deposits as proof of periodic manual carbonate removal by Roman maintenance teams. The δ18O profile, recording at least 88 years of deposition, shows that maintenance work was done at intervals of 1-5 years. The undisturbed periodicity of the δ18O profile indicates that work was carried out rapidly and never in summer, consonant with the advice of the Roman author Frontinus about maintenance of the aqueducts of the city of Rome. Maintenance intervals lengthened and cleaning became less frequent close to the final years of the aqueduct. This change in maintenance policy gives insight into changing local population and socio-economic dynamics in late antiquity.


Removal of hydrogen sulfide generated during anaerobic treatment of sulfate-laden wastewater using biochar: Evaluation of efficiency and mechanisms.
Removal of hydrogen sulfide (H2S) from biogas was investigated in a biochar column integrated with a bench-scale continuous-stirred tank reactor (CSTR) treating sulfate-laden wastewater. Synthetic wastewater containing sulfate concentrations of 200-2000mg SO42-/L was used as substrate, and the CSTR was operated at an organic loading rate of 1.5g chemical oxygen demand (COD)/L·day and a hydraulic retention time (HRT) of 20days. The biochar was able to remove about 98.0 (±1.2)% of H2S for the ranges of concentrations from 105-1020ppmv, especially at high moisture content (80-85%). Very high H2S adsorption capacity (up to 273.2±1.9mg H2S/g) of biochar is expected to enhance the H2S oxidation into S0 and sulfate. These findings bring a potentially novel application of sulfur-rich biochar as a source of sulfur, an essential but often deficient micro-nutrient in soils.