The Good, the Bad, and the Ugly of Faith Healers and Psychiatric Illnesses: A Systematic Review of the Literature in the Arab World.
Faith healing is a traditional healing method involving spiritual and faith-based practices performed by a religious medicine man referred to here as a faith healer. The practice of faith healing is widespread in the Arab World for treating a range of mental disorders. This research aims to review the literature concerned with faith healing practice in the Muslim Arab population. Based on the results of the review, there are seven distinct aspects of faith healing. These include the characteristics of persons who visit faith healers, the rate of visits, the symptoms for which visits are made, the treatment methods, the general stigma and prevalent attitudes toward mental disorders in the Arab world, and the perceived effectiveness of faith healing as applied to mental disorders. The results of the review show that many patients with mental disorders, as a first resort, prefer to seek the help of faith healers (or other non-professional trusted counselors) rather than approach mental health services. This is due to several factors: the misconceptions around causes of mental illness in Arab traditions and culture and the stigma associated with mental illness. As an overall determination derived from the literature, Arabs remain highly reliant on faith healers as helpful resources for dealing with mental health problems. In conclusion, the recommendation to public health authorities is to consider including faith healers in the support system for mental health and cease viewing them as barriers to optimal care.


Ablation of bone and polymethylmethacrylate by an XeCl (308 nm) excimer laser.
One of the main problems in orthopaedics is the surgical removal of hard substances, such as bone and polymethylmethacrylate (PMMA). Such materials are often very difficult to remove without mechanical trauma to the remaining tissue. This study investigated the feasibility of the ultraviolet 308 nm excimer laser in the ablation of these materials. The beam was delivered through a 1 mm-diameter fiber optic at 40 Hz with energy densities at the target surface of 20-80 J/cm2 per pulse. The goal of the study was to establish the ideal dosimetry for removing bone and PMMA with minimum trauma to the adjacent tissue. Histology revealed that the 308 nm laser effectively removed bone leaving a thermal damage zone of only 2-3 microns in the remaining tissue. Increasing the energy per pulse gave correspondingly larger and deeper cuts with increasing zones of thermal damage. The excimer laser was also effective in the ablation of PMMA, creating craters in the substrate with a thermal damage zone of 10-40 microns. The debris from both substrates was evaluated.


Molecularly targeted anti-cancer drugs inhibit the invasion and metastasis of hepatocellular carcinoma by regulating the expression of MMP and TIMP gene families.
To investigate the effect of multi-kinase kinase inhibitors (sorafenib; regorafenib; lenvatinib) on the invasion and metastasis of human hepatocellular carcinoma (HCC) cells, and the outcome of this effect on the expression of matrix metalloproteinases (MMPs) and tissue inhibitors of MMPs (TIMPs), yet unclarified. Cells were subjected to four different treatments: blank control group, sorafenib (10 μmol/L) treatment group, regorafenib (20 mmol/L) treatment group, and lenvatinib (4 μmol/L) treatment group. Anti-invasion and anti-metastasis effects were tested using the wound-healing assay and transwell invasion assay. Real-time PCR and Western blot analyses were used to determine the impact of sorafenib, regorafenib, and lenvatinib on the gene expression of MMPs and TIMPs in the two HCC lines (Hep3B and SMMC-7721). Results from the wound-healing and transwell invasion assays showed the three tested anti-cancer drugs to have a significant inhibitory effect on the metastasis and invasion of HCC cells. Real-time PCR and western blot analyses revealed that sorafenib down-regulated the expressions of MMP-7,10,16 and up-regulated those of TIMP-1,3,4, regorafenib down-regulated the expression of MMP-1 and up-regulated TIMP-3 gene expression, and lenvatinib down-regulated the expressions of MMP-1,2,7,9,10,16 and up-regulated those of TIMP-1,3,4. However, these three targeted anti-cancer drugs seem to have no significant regulatory effect on the expressions of other MMPs and TIMPs family genes. In conclusion, sorafenib, regorafenib, and lenvatinib inhibit the invasion and metastasis of HCC cells by regulating MMPs/TIMPs expression levels.


Identification of compounds that contribute to trigeminal burn in aqueous ethanol solutions.
The influence of carbonyl species on the trigeminal burn of distilled spirit model systems was investigated. Quantities of the intrinsic carbonyl compounds were significantly altered in 40% ethanol solutions using two methods; (1) increasing or decreasing the product pH, to induce hemiacetal formation and acetal stabilization or induce and stabilize carbonyl species such as aldehydes, respectively and (2) utilizing a sulfonyl hydrazine polymer treatment. Samples with reduced carbonyl concentrations had significantly lower perceived trigeminal burn intensity. Sensory recombination experiments revealed that addition of carbonyl compounds increased trigeminal burn perception in model systems; confirming the direct relationship between the concentration of carbonyl compounds and trigeminal burn. The strongest potentiators of the trigeminal response were carbonyl compounds octanal, nonanal, benzaldehyde and 2-heptanone suggesting the probability that carbonyl species such as saturated aldehydes and ketones act as agonists to activate nociceptors such as TRPV1 and TRPA1 and elicit trigeminal burn.


Life-prolonging measures for a dead theory?
In a recent review article, Selman and colleagues (Trends Ecol Evol 27:570-577, 2012) discuss the status quo of the oxidative stress theory of aging (OSTA) and how it links to life history evolution. They suggest that the OSTA should be tested in wild populations which might show effects masked in laboratory settings. We disagree with their propositions for several reasons. We argue that there is increasing evidence that reactive oxygen species (ROS) are not causally linked with aging and that ROS do not play a straightforward role in shaping life history evolution. We propose that laboratory animals and semi-wild populations rather than wild animals are suited best to test any hypothesized effect of reactive oxygen species. This is because data from controlled manipulative experiments rather than observational correlations are preferred to solve this issue. In addition, nonconventional model organisms will be useful in answering the question how relevant the OSTA could be for life history evolution.


Serum bactericidal activity from intravenous ciprofloxacin and azlocillin given alone and in combination to healthy subjects.
Ciprofloxacin plus azlocillin have been shown to exhibit in vitro synergy versus a variety of organisms, including Pseudomonas aeruginosa. This study examined this interaction in vivo, testing serum bactericidal activity (SBA) in six healthy male subjects after intravenous administration of ciprofloxacin 4 mg/kg (C), azlocillin 60 mg/kg (A), and the two simultaneously (C/A). Eight different organisms were tested: four isolates of P. aeruginosa with varying susceptibilities to C and A, and one isolate each of Escherichia coli (EC), Staphylococcus aureus (SA) Serratia marcescens (SM), and Klebsiella pneumoniae (KP), all of which were susceptible to both drugs. Blood samples were collected at the end of 30-min infusions and at 4 and 8 hr. Reciprocal titers were plotted versus time and area under the bactericidal titer curve (AUBC) calculated to assess antibacterial interactions. Results indicated that P. aeruginosa-1 (PA-1), EC, and KP were synergistically killed by C/A. AUBC for PA-1 were C = 36, A = 11, C/A = 144, p less than 0.05. AUBC for EC were C = 1059, A = 180, C/A = 1504, p = 0.05. AUBC for KP were C = 327, A = 97, C/A = 584, p = 005. Additive effects were demonstrated versus all of the other organisms except Serratia marcescens, where an indifferent effect was observed. Ciprofloxacin plus azlocillin may be a useful combination of the treatment of selected Gram-negative bacillary infections.


Body map proto-organization in newborn macaques.
Topographic sensory maps are a prominent feature of the adult primate brain. Here, we asked whether topographic representations of the body are present at birth. Using functional MRI (fMRI), we find that the newborn somatomotor system, spanning frontoparietal cortex and subcortex, comprises multiple topographic representations of the body. The organization of these large-scale body maps was indistinguishable from those in older monkeys. Finer-scale differentiation of individual fingers increased over the first 2 y, suggesting that topographic representations are refined during early development. Last, we found that somatomotor representations were unchanged in 2 visually impaired monkeys who relied on touch for interacting with their environment, demonstrating that massive shifts in early sensory experience in an otherwise anatomically intact brain are insufficient for driving cross-modal plasticity. We propose that a topographic scaffolding is present at birth that both directs and constrains experience-driven modifications throughout somatosensory and motor systems.


Diabetes and new-onset atrial fibrillation in a hypertensive population.
The association of diabetes with new-onset atrial fibrillation (AF) remains controversial. Hypertension may partly explain the risk association ascribed to diabetes. We studied the role and characteristics of diabetes in hypertensive patients with no ischemic vascular disease. Records of 262,892 persons from the Information System for the Development of Research in Primary Care in Catalonia (Spain) were examined from July 2006 to December 2011. Included participants were ≥55-years-old and hypertensive with no ischemic heart disease, stroke, or peripheral artery disease. We used Cox proportional hazards regression to model incidences in the diabetic and non-diabetic subgroups of our population, and among diabetic patients, diabetes duration and pharmacological treatment, hemoglobin A1C, and body mass index. New-onset AF incidence in diabetic patients was 13.3 per 1000 person-years (mean follow-up: 4.3 years). In non-diabetic patients, it was 10.4 per 1000 person-years (mean follow-up: 4.1 years). Diabetes hazard ratio (HR) for new-onset AF was 1.11 (95% confidence interval (CI): 1.06-1.16). Diabetic patients also diagnosed with obesity had an HR of 1.41 (95% CI: 1.22-1.64). Diabetes was modestly associated with new-onset AF in hypertensive patients with no ischemic vascular disease. Among diabetic patients, only obesity reached significance in its association with this arrhythmia.


Dual axonal terminations from the retrosplenial and visual association cortices in the laterodorsal thalamic nucleus of the rat.
Light and electron microscopic tracing studies were conducted to assess the synaptic organization in the laterodorsal thalamic nucleus (LD) of the rat and the laminar origins of corticothalamic terminals from the retrosplenial and visual association cortices to LD. A survey of the general ultrastructure of LD revealed at least three types of presynaptic terminals identified on the basis of size, synaptic vesicle morphology, and synaptic membrane specializations: (1) small axon terminals with round synaptic vesicles (SR), which accounted for the majority of terminal profiles and made asymmetric synaptic contacts predominantly with small dendritic shafts and spines; (2) large axon terminals with round synaptic vesicles (LR), which formed asymmetric synaptic contacts mainly with large dendritic shafts; and (3) small to medium-size axon terminals with pleomorphic synaptic vesicles (SMP), which symmetrically synapsed with a wide range of postsynaptic structures from cell bodies to small dendrites. Synaptic glomeruli were identified, whereas no presynaptic dendrites were found. To characterize and identify corticothalamic terminals arising from the retrosplenial and visual association cortices that project to LD, wheat germ agglutinin conjugated to horseradish peroxidase (WGA-HRP) was injected into these cortices. Axons anterogradely labeled with WGA-HRP ended in both SR and LR terminals. On the other hand, dextran-tetramethylrhodamine injected into LD as a retrograde fluorescent tracer labeled large pyramidal cells of layer V as well as small round or multiform cells of layer VI in the retrosplenial and visual association cortices. These findings provide the possibility that corticothalamic terminations from cortical neurons in layer V end as LR terminals, while those from neurons in layer VI end as SR boutons.


Antibiotic properties of bovine lactoferrin on Helicobacter pylori.
To investigate a potential new treatment for gastric Helicobacter pylori infection, we have examined the use of the natural antibiotic lactoferrin, found in bovine milk, for activity against Helicobacter species both in vitro and in vivo. Lactoferrin was bacteriostatic to H. pylori when cultured at concentrations > or =0.5 mg/ml. Growth of H. pylori was not inhibited by another milk constituent, lysozyme, or by a metabolite of lactoferrin, lactoferricin B, but growth was inhibited by the iron chelator deferoxamine mesylate. Lactoferrin inhibition of growth could be reversed by addition of excess iron to the medium. Lactoferrin in retail dairy milk was found to be more stable intragastrically than unbuffered, purified lactoferrin. Treatment of H. felis-infected mice with lactoferrin partially reversed mucosal disease manifestations. It is concluded that bovine lactoferrin has significant antimicrobial activity against Helicobacter species in vitro and in vivo. Bovine lactoferrin should be further investigated for possible use in H. pylori infections in man.


Progressive subclinical left ventricular systolic dysfunction in severe aortic regurgitation patients with normal ejection fraction: a 24 months follow-up velocity vector imaging study.
We aimed to evaluate long-term changes in left ventricular (LV) longitudinal systolic functions in patients with asymptomatic, severe aortic regurgitation (AR) by using novel 2D strain imaging. Thirty severe AR patients with normal ejection fraction (EF) and 30 healthy controls were evaluated by both conventional echocardiography and velocity vector maging (VVI) based strain imaging at baseline and 24 months follow-up. To evaluate LV longitudinal systolic function, segmental peak systolic strain and strain rate (SRs) data were acquired from apical four-chamber, two-chamber and long-axis views. Longitudinal peak systolic strain and SRs of the LV were decreased in patients with severe AR compared to controls at baseline (P = 0.0001). The impairment was more significant in 24 months follow-up (P = 0.0001 for strain, P = 0.01 for SRs). Longitudinal peak systolic strain was significantly correlated with left ventricular end-diastolic (LVEDD; r =-0.42, P = 0.0001) and left ventricular end-systolic diameter (LVESD) (r =-0.41, P = 0.0001) There was also a strong negative correlation between LV SRs and LVEDD (r =-0.50, P = 0.0001), and LVESD (r =-0.39, P = 0.0001). VVI-derived strain and SRs may be used as adjunctive, noninvasive parameters in the assessment of subclinical LV dysfunction and its progress during clinical follow-up, in patients with severe AR.


Monitoring Plasmodium vivax resistance to antimalarials: Persisting challenges and future directions.
Emerging antimalarial drug resistance may undermine current efforts to control and eliminate Plasmodium vivax, the most geographically widespread yet neglected human malaria parasite. Endemic countries are expected to assess regularly the therapeutic efficacy of antimalarial drugs in use in order to adjust their malaria treatment policies, but proper funding and trained human resources are often lacking to execute relatively complex and expensive clinical studies, ideally complemented by ex vivo assays of drug resistance. Here we review the challenges for assessing in vivo P. vivax responses to commonly used antimalarials, especially chloroquine and primaquine, in the presence of confounding factors such as variable drug absorption, metabolism and interaction, and the risk of new infections following successful radical cure. We introduce a simple modeling approach to quantify the relative contribution of relapses and new infections to recurring parasitemias in clinical studies of hypnozoitocides. Finally, we examine recent methodological advances that may render ex vivo assays more practical and widely used to confirm P. vivax drug resistance phenotypes in endemic settings and review current approaches to the development of robust genetic markers for monitoring chloroquine resistance in P. vivax populations.


Novel approach to select genes from RMA normalized microarray data using functional hearing tests in aging mice.
Presbycusis - age-related hearing loss - is the number one communicative disorder and one of the top three chronic medical condition of our aged population. High-throughput technologies potentially can be used to identify differentially expressed genes that may be better diagnostic and therapeutic targets for sensory and neural disorders. Here we analyzed gene expression for a set of GABA receptors in the cochlea of aging CBA mice using the Affymetrix GeneChip MOE430A. Functional phenotypic hearing measures were made, including auditory brainstem response (ABR) thresholds and distortion-product otoacoustic emission (DPOAE) amplitudes (four age groups). Four specific criteria were used to assess gene expression changes from RMA normalized microarray data (40 replicates). Linear regression models were used to fit the neurophysiological hearing measurements to probe-set expression profiles. These data were first subjected to one-way ANOVA, and then linear regression was performed. In addition, the log signal ratio was converted to fold change, and selected gene expression changes were confirmed by relative real-time PCR. expression of GABA-A receptor subunit alpha6 was upregulated with age and hearing loss, whereas subunit alpha1 was repressed. In addition, GABA-A receptor associated protein like-1 and GABA-A receptor associated protein like-2 were strongly downregulated with age and hearing impairment. Lastly, gene expression measures were correlated with pathway/network relationships relevant to the inner ear using Pathway Architect, to identify key pathways consistent with the gene expression changes observed.


Electrodiffusion of Cl- and K+ in epithelial membranes reconstituted into planar lipid bilayers.
An electrodiffusive permeability for Cl-, its activation by low extracellular Cl--concentrations and the interaction between electrodiffusive fluxes of Cl- and K+ are demonstrated in the ventricular membranes from the epithelium of the bovine choroid plexus. Membranes were fused into artificial lipid bilayers formed at the tip of micropipettes. What is thought to be the cytoplasmic side of the membrane (the trans-side or the inside of pipette) was clamped at negative potentials (0 to -90 mV). Under these conditions the current was discrete, fluctuating less than 2 pA. With Cl- as the only conducting ion on the two sides we observed a small electrodiffusive permeability which was reduced by bumetanide or furosemide by 62%. When the outside solution was rendered Cl--free then the permeability to Cl- increased by a factor of 2-5; this activation was reduced by bumetanide or furosemide by about 80%. We observed an interaction between inwards movements of K+ and outwards movements of Cl- via the activated permeability: The total current was smaller than the sum of the expected inward K+-current and the expected outward activated Cl--current. Bumetanide or furosemide increased the total current; apparently the loss of current carried by Cl- was smaller than the gain in current carried by K+. The presence of K+ on both sides of the membrane was a condition for this interaction.


Methods of peripheral nerve tissue preparation for second harmonic generation imaging of collagen fibers.
Second harmonic generation (SHG) imaging of the peripheral nerve using multi-photon microscopy is a novel technique with little documentation. It affords the significant possibility of non-destructive imaging of internal nerve anatomy. The nature of nerve tissue, especially its size and viscoelastic properties, present special challenges for microscopy. While nerves are under an innate in situ strain, they retract once dissected, thus distorting microscopic structure. The challenge is to preserve the nerve in its natural strain range to obtain images that most truly reveal its structure. This study examined backscattered SHG images of rat median nerve prepared by several different methods to compare image quality and content. Nerve segments were fixed under strained (constant load or length) and unstrained conditions and imaged as whole nerve as well as plastic (methyl methacrylate) and paraffin embedded sections. These were tested for optimal excitation wavelength, quantitative image contrast, and overall quality. Root mean squared (RMS) contrast proved to be a reliable measure of the level of image contrast perceived by eye. We concluded that images obtained from tissue sections (plastic and paraffin) provided the most accurate and revealing SHG images of peripheral nerve structure. Removing the embedding material prior to imaging significantly improved image quality. Optimal excitation wavelengths were consistent regardless of the preparation method.


Appliance effects on the masseter and temporal muscle electromyography of patients with facial asymmetry.
The usual symmetrical EMG recordings were disturbed in all 5 cases of asymmetrical dentofacial deformity. A marked electrical activity of the masseter and temporal muscles opposite to the site of the lesion was observed.


Evaluation of photochemical tissue bonding for closure of skin incisions and excisions.
Photochemical tissue bonding (PTB) is a new non-thermal technique for tissue repair involving application of a photochemically active dye and irradiation with visible light. The objective was to compare PTB with standard sutures and the tissue adhesive, octyl cyanoacrylate, for closure of skin incisions and excisions. Incisions and excisions made on the flanks of a Hanford mini-pig were secured with subcutaneous sutures. Superficial closure methods were 3-0 monofilament sutures, PTB (Rose Bengal and green light), tissue adhesive and the combination of tissue adhesive then PTB. Wounds were evaluated 2, 4, and 6 weeks postoperatively for cosmetic outcomes and histology. Cosmetic outcomes and histological scar width of incisions and excisions did not differ among the treatment groups at 2, 4, and 6 weeks. PTB is as effective as standard sutures for wound closure in porcine skin in terms of cosmetic outcomes and safety.


Edaravone Attenuates Aβ 1-42-Induced Inflammatory Damage and Ferroptosis in HT22 Cells.
Ferroptosis and neuroinflammation play a crucial role in the pathogenesis of Alzheimer's disease (AD), and Edaravone (EDA) has been demonstrated to have anti-inflammatory, antioxidant and neuroprotective effects in neurodegenerative diseases. However, the relationship between EDA and ferroptosis in AD is unidentified. This research aimed to elucidate the mechanism of EDA in AD with Aβ 1-42-induced HT22 cells as in vitro cell model. The results showed that EDA could significantly reduce Aβ1-42-induced apoptosis of HT22 cells and formation of pro-inflammatory factors TNF-α, IL-1β and IL-6, prevent the activation of TLR4/NF-κB /NLRP3 signaling pathway, and inhibit ferroptosis and lipid peroxidation. Taken together, EDA contributes to inhibiting neuroinflammatory injury and ferroptosis in Aβ 1-42-induced HT22 cells, and thus may be a potential candidate for the treatment of AD.


Biogenesis of embryonic chick liver delta-aminolevulinate synthase: regulation of the level of mRNA by hemin.
The effects of hemin on the concentration of the mRNA for delta-aminolevulinate synthase (ALA synthase) and on the association of the messenger with polysomes were investigated in primary cultures of embryonic chick hepatocytes incubated with allylisopropylacetamide (AIA). A synthetic 24-mer DNA complementary to ALA synthase mRNA was used to determine by solution hybridization the effects of AIA and of AIA plus hemin on the ALA synthase-specific RNA sequences in the cells. The results indicated that ALA synthase mRNA concentrations increased significantly in hepatocytes incubated for 5 h with AIA (0.075 mg/ml), and that hemin in the medium (2 or 10 microM) blocked the increase in the messenger. When delta-aminolevulinic acid (ALA) and FeCl3 were added into the culture medium (1 mM and 5 microM, respectively), the increase in ALA synthase mRNA brought on by AIA was also inhibited. Neither ALA nor FeCl3, when individually added to the cultures, was as effective as the combination of the two. The results with ALA + FeCl3 suggested that stimulation of intracellular production of heme was also effective in blocking the increase in ALA synthase mRNA caused by AIA. Finally, the distributions of ALA synthase mRNA were compared in polysomes isolated from hepatocytes which had been incubated with AIA for 5 h in the presence and absence of 10 microM hemin in the medium. Although a drop was detected in the concentration of ALA synthase mRNA in polysomes from hepatocytes incubated with hemin for 30 min, the decrease was explained by the effect of hemin on the mRNA concentration in the cells.


Microglia promote the death of developing Purkinje cells.
The loss of neuronal cells, a prominent event in the development of the nervous system, involves regulated triggering of programmed cell death, followed by efficient removal of cell corpses. Professional phagocytes, such as microglia, contribute to the elimination of dead cells. Here we provide evidence that, in addition to their phagocytic activity, microglia promote the death of developing neurons engaged in synaptogenesis. In the developing mouse cerebellum, Purkinje cells die, and 60% of these neurons that already expressed activated caspase-3 were engulfed or contacted by spreading processes emitted by microglial cells. Apoptosis of Purkinje cells in cerebellar slices was strongly reduced by selective elimination of microglia. Superoxide ions produced by microglial respiratory bursts played a major role in this Purkinje cell death. Our study illustrates a mammalian form of engulfment-promoted cell death that links the execution of neuron death to the scavenging of dead cells.


Immunocytochemical localization of hypothalamic luteinizing hormone-releasing hormone in male ferrets.
LHRH-containing neurons within the hypothalamus were immunocytochemically identified in adult male ferrets that were either gonadally intact, castrated, or castrated and treated with testosterone. The distribution of LHRH-immunopositive neuron cell bodies was similar in the three treatment groups. The majority of these cells was located mediobasally in the retrochiasmatic area, including some within the ventrolateral aspects of the arcuate nucleus. These soma were associated with a dense basal LHRH fiber plexus which extended to the median eminence. A smaller number of cell bodies was found slightly more dorsal and lateral to the major concentration at the base and midline. Isolated LHRH perikarya were occasionally observed in dorsal areas of the hypothalamus. There were no differences in the mean total number of hypothalamic LHRH cell bodies identified in the three treatment groups. These results indicate that the documented negative feedback effects of testosterone on LH secretion in male ferrets are not the result of an alteration in the absolute number of neurons capable of synthesizing LHRH.


Do you see what I see? Weight status misperception and exposure to obesity among children and adolescents.
Obesity prevention in childhood is important. However, changing children's lifestyle behaviors to reduce overweight is a substantial challenge. Accurately perceiving oneself as overweight/obese has been linked to greater motivation to change lifestyle behaviors. Children and adolescents may be less likely to perceive themselves as overweight/obese if they are exposed to overweight/obese people in their immediate environments. This study examined whether youth who are exposed to overweight parents and schoolmates were more likely to misperceive their own weight status. The Quebec Child and Adolescent Health and Social Survey was a provincially representative, school-based survey of children and adolescents conducted between January and May 1999. 3665 children and adolescents (age 9, n=1267; age 13, n=1186; age 16, n=1212) from 178 schools. Mean body mass index (BMI) was 17.5, 20.6 and 22.2 kg/m(2), respectively. The misperception score was calculated as the standardized difference between self-perception of weight status (Stunkard Body Rating Scale) and actual BMI (from measured height and weight). Exposure to obesity was based on parent and schoolmate BMI. Overweight and obese youth were significantly more likely to misperceive their weight compared with non-overweight youth (P<0.001). Multilevel modeling indicated that greater parent and schoolmate BMI were significantly associated with greater misperception (underestimation) of weight status among children and adolescents. Children and adolescents who live in environments in which people they see on a daily basis, such as parents and schoolmates, are overweight/obese may develop inaccurate perceptions of what constitutes appropriate weight status. Targeting misperception may facilitate the adoption of healthy lifestyle behaviors and improve the effectiveness of obesity prevention interventions.


Perinatal outcome of monochorionic diamniotic twin pregnancy complicated by selective intrauterine growth restriction according to umbilical artery Doppler flow pattern: single-center study using strict fetal surveillance protocol.
To determine the perinatal outcome of monochorionic diamniotic (MCDA) twin pregnancies complicated by selective intrauterine growth restriction (sIUGR), which were classified according to the umbilical artery (UA) Doppler flow pattern of the IUGR twin. This was a retrospective cohort study of all MCDA twin pregnancies diagnosed with sIUGR and managed at a single tertiary referral center between 2012 and 2018. Cases were classified according to the UA Doppler flow pattern of the IUGR twin as Type I (positive end-diastolic flow), Type II (persistently absent/reversed end-diastolic flow) or Type III (intermittently absent/reversed end-diastolic flow). Patients with Type-II or -III sIUGR were hospitalized at 26-28 weeks of gestation for increased fetal surveillance. Perinatal and immediate and long-term neurodevelopmental outcomes were stratified according to the UA Doppler flow pattern at the final examination. Intact survival rate was defined as the number of infants surviving without neurological impairment, divided by the total number of fetuses. Composite adverse outcome, defined as any mortality, presence of severe brain lesions on postnatal transcranial ultrasound or severe neurological morbidity, was also assessed. Of 88 MCDA twin pregnancies with sIUGR included in the study, 28 underwent selective termination by cord occlusion using radiofrequency ablation, resulting in a perinatal survival rate of 89.3% and a median gestational age (GA) at delivery of 33.8 (interquartile range (IQR), 28.8-38.2) weeks for the large cotwin. Expectant management was employed in 60 cases. In 26 (43.3%) cases in the expectant-management group, the classification according to the UA Doppler flow pattern changed during gestation, resulting in 26 (43.3%) cases of Type-I, 22 (36.7%) cases of Type-II and 12 (20.0%) cases of Type-III sIUGR at the final examination. The perinatal survival rate of both twins with sIUGR Types I, II and III at the final examination was 100%, 81.8% and 75.0%, respectively (P = 0.04). Two cases of double fetal death and one case of single fetal death occurred 1-4 weeks after the Doppler pattern had changed from Type I or Type II to Type III. The median GA at delivery was 34.8 (IQR, 33.1-35.7) weeks in Type I, 30.3 (IQR, 28.6-32.1) weeks in Type II and 32.0 (IQR, 31.3-32.6) weeks in Type III (P < 0.01). The total intact survival rate was 100% for Type I, 77.3% for Type II and 75.0% for Type III (P < 0.001). Multivariate analysis demonstrated that early GA at diagnosis (odds ratio (OR), 0.83 (95% CI, 0.69-0.99); P = 0.04) and the presence of Type II or III vs Type I at the last examination (OR, 13.16 (95% CI, 1.53-113.32); P = 0.02) were associated with preterm birth < 32 weeks' gestation. Early GA at diagnosis was also associated with the composite adverse outcome (OR, 0.60 (95% CI, 0.36-0.99); P = 0.04). The classification system of MCDA pregnancy complicated by sIUGR, according to the UA Doppler flow pattern of the IUGR twin at final examination, is associated with perinatal outcome. Importantly, the UA Doppler flow pattern can change during gestation, which has an impact on the risk of fetal death. Nevertheless, under strict fetal surveillance, the perinatal outcome of these pregnancies is favorable. © 2020 International Society of Ultrasound in Obstetrics and Gynecology.


Source-based morphometry reveals gray matter differences related to suicidal behavior in criminal offenders.
Relative to the general population, criminal offenders have a higher risk of suicide. Neurobiological deficits related to suicidal behavior have been identified in the general population, but unexamined in offenders to date. We examined the association between brain morphology and suicidal behavior in adult male criminal offenders. Brain morphology was examined using voxel-based morphometry (VBM) and source-based morphometry (SBM), a multivariate alternative to VBM which analyzes brain volume in between-subject spatially independent networks. Results showed that offenders with past suicide attempts (n = 19), relative to offenders without past suicide attempts (n = 19) and non-offenders (n = 26), had reduced gray matter in an SBM component that comprised the posterior cingulate, dorsal prefrontal cortex, and amygdala. The SBM source weights were significantly associated with suicide attempts independent of other suicide risk variables (e.g., depression). VBM results were similar to the SBM results but less robust. The results reveal a potential neurobiological marker of vulnerability to suicidal behavior among criminal offenders and illustrate the utility of multivariate methods of gray matter analyses.


Caffeine withdrawal symptoms and self-administration following caffeine deprivation.
This study examined the effects of complete or partial caffeine deprivation on withdrawal symptomatology and self-administration of coffee in caffeine-dependent coffee drinkers. Nine habitual coffee drinkers abstained from dietary sources of caffeine for 33.5 h. Caffeine deprivation was manipulated by administering capsules containing 0%, 50%, or 100% of each subject's daily caffeine intake (complete, partial, and no deprivation conditions). Caffeine withdrawal symptomatology was measured using self-report questionnaires. Caffeine self-administration was measured using: i) the amount of coffee subjects earned on a series of concurrent random-ratio schedules that yielded coffee and money reinforcers; ii) the amount of earned coffee they consumed. Saliva samples revealed that subjects complied with the caffeine abstinence instructions. Caffeine withdrawal symptoms occurred reliably following complete caffeine deprivation, though not in the partial deprivation condition. Caffeine self-administration was not related to deprivation condition. We conclude that caffeine withdrawal symptomatology is not necessarily associated with increased caffeine consumption.


Structural basis of the interaction between BCL9-Pygo and LDB-SSBP complexes in assembling the Wnt enhanceosome.
The Wnt enhanceosome is responsible for transactivation of Wnt-responsive genes and a promising therapeutic target for treatment of numerous cancers with Adenomatous Polyposis Coli (APC) or β-catenin mutations. How the Wnt enhanceosome is assembled remains poorly understood. Here we show that B-cell lymphoma 9 protein (BCL9), Pygopus (Pygo), LIM domain-binding protein 1 (LDB1) and single-stranded DNA-binding protein (SSBP) form a stable core complex within the Wnt enhanceosome. Their mutual interactions rely on a highly conserved N-terminal asparagine proline phenylalanine (NPF) motif of Pygo, through which the BCL9-Pygo complex binds to the LDB-SSBP core complex. Our crystal structure of a ternary complex comprising the N-terminus of human Pygo2, LDB1 and SSBP2 reveals a single LDB1-SSBP2 complex binding simultaneously to two Pygo2 molecules via their NPF motifs. These interactions critically depend on the NPF motifs which bind to a deep groove formed between LDB1 and SSBP2, potentially constituting a binding site for drugs blocking Wnt/β-catenin signaling. Analysis of human cell lines lacking LDB or Pygo supports the functional relevance of the Pygo-LDB1-SSBP2 interaction for Wnt/β-catenin-dependent transcription.


Adversarial reinforcement learning for dynamic treatment regimes.
Treatment recommendation, as a critical task of delivering effective interventions according to patient state and expected outcome, plays a vital role in precision medicine and healthcare management. As a well-suited tactic to learn optimal policies of recommender systems, reinforcement learning is promising to address the challenge of treatment recommendation. However, existing solutions mostly require frequent interactions between treatment recommender systems and clinical environment, which are expensive, time-consuming, and even infeasible in clinical practice. In this study, we present a novel model-based offline reinforcement learning approach to optimize a treatment policy by utilizing patient treatment trajectories in Electronic Health Records (EHRs). Specifically, a patient treatment trajectory simulator is firstly constructed based on the ground-truth trajectories in EHRs. Thereafter, the constructed simulator is utilized to model the online interactions between the treatment recommender system and clinical environment. In this way, the counterfactual trajectories can be generated. To alleviate the bias deriving from the ground-truth and the counterfactual trajectories, an adversarial network is incorporated into the proposed model, such that a large space of treatment actions can be explored with the scaled rewards. The proposed model is evaluated on a simulated dataset and a real-world dataset. The experimental results demonstrate that the proposed model is superior to other methods, giving rise to a new solution for dynamic treatment regimes and beyond.


Isolation and characterization of a rat amylase gene family.
Portions of at least nine distinct rat amylase genes or pseudogenes have been isolated. Cloned rat genomic DNA fragments containing complete or major portions of seven of these have been examined by heteroduplex analysis and fall within two separate groups based on their degree of homology. Four gene sequences comprising one of these groups are closely related to pancreatic amylase mRNA. The other group shows significant nonhomology to both pancreatic and parotid amylase cDNAs and may represent an additional gene type(s). All of the cloned amylase gene sequences are found in rat genomic DNA. Additional amylase sequences which have not yet been cloned are also detected. Comparison of DNA from individual Sprague-Dawley rats by Southern blotting techniques indicates allelic variation at multiple amylase loci.


Understanding the effects of chilling on color and quality characteristics of bovine longissimus thoracis.
Meat quality in the m. longissimus thoracis (LT) associated with decreased muscle temperature early post-mortem was investigated using ten Angus crossbred steer carcasses. LT chill rate of each carcass right side was increased by removing superficial subcutaneous fat and associated muscles. LT muscles were removed at 24 h post-mortem and divided into halves with the posterior portion analyzed immediately and the anterior portion analyzed after 14 days post-mortem ageing. Denuding the LT decreased its temperature by 2 °C at 3 h post-mortem and decreased intramuscular lactate concentration, sensory panel tenderness score, a*, b* and chroma values, and proportion of oxymyoglobin and increased proportions of metmyoglobin and deoxymyoglobin at day 2 post-mortem without affecting intramuscular pH, or cooked LT shear force. Small shifts in early post-mortem muscle temperature can alter the extent of anaerobic glycolysis, influencing early retail display color and sensory tenderness, emphasizing the importance of proper early post-mortem management of carcasses in controlling beef quality.


Moderators of the intervention effects for a dissonance-based eating disorder prevention program; results from an amalgam of three randomized trials.
To investigate factors hypothesized to moderate the effects of a dissonance-based eating disorder prevention program, including initial elevations in thin-ideal internalization, body dissatisfaction, eating disorders symptoms, and older participant age. Adolescent female high school and college students with body image concerns (N=977; M age=18.6) were randomized to a dissonance-based thin-ideal internalization reduction program or an assessment-only control condition in three prevention trials. The intervention produced (a) significantly stronger reductions in thin-ideal internalization for participants with initial elevations in thin-ideal internalization and a threshold/subthreshold DSM-5 eating disorder at baseline, (b) significantly greater reductions in eating disorder symptoms for participants with versus without a DSM-5 eating disorder at baseline, and (c) significantly stronger reductions in body dissatisfaction for late adolescence/young adulthood versus mid-adolescent participants. Baseline body dissatisfaction did not moderate the intervention effects. Overall, intervention effects tended to be amplified for individuals with initial elevations in risk factors and a DSM-5 eating disorder at baseline. Results suggest that this prevention program is effective for a broad range of individuals, but is somewhat more beneficial for the subgroups identified in the moderation analyses.


Superficial temporal artery graft for bypass of the maxillary to proximal middle cerebral artery using a transantral approach: an anatomical and technical study.
Using a transantral approach, we examined a new bypass of the maxillary artery (MA) to proximal middle cerebral artery (MCA). The caliber of the MA was suitable to provide sufficient blood flow. The length of the graft was shorter and it had a straighter course in the new technique than in previously described techniques. To examine a new bypass of the MA to proximal MCA using a transantral approach as an alternative to other forms of anterior circulation bypass surgery. The method was applied to five adult cadavers bilaterally. The MA and its branches were easily found after removal of the posterior sinus wall using a transantral approach. Then, a hole was created in the sphenoid bone 5-6 mm lateral to the posteroinferior edge of the superior orbital fissure extradurally. After the carotid and sylvian cisternae had been opened, the M2 segment of the MCA was exposed. The MA was transected just before the origin of the descending palatine artery branch. After opening the dura over the hole, the MA was passed through the hole to reach the intracranial cavity. The proximal side of the superficial temporal artery graft was anastomosed end-to-end with the MA and the distal side was anastomosed end-to-side with the M2 segment of the MCA. The mean caliber of the MA was 2.4+/-0.3 mm before the origin of the descending palatine artery branch. The mean caliber of the largest trunk of the M2 segment of the MCA was 2.3+/-0.3 mm. The average length of the graft was 24+/-3 mm.


Comparison of extensive brain calcification in postoperative hypoparathyroidism on CT and NMR scan.
A case of postoperative hypoparathyroidism is presented in which calcifications seen on CT scan were differently visualized on T2 weighted NMR images. High and low signal intensities may reflect different stages of the calcifying process thus confirming neuropathological findings.


[Clinical dilemma: an unusual case of ascites].
Cirrhotic portal hypertension is the major cause of ascites. Ascites is the most common expression of decompensated liver disease. However, other etiologies may occur and may pose a diagnostic and therapeutic challenge. A patient with chronic hepatitis C and an unusual cause of ascites is presented.


A new knee arthrometer demonstrated to be reliable and accurate to assess anterior tibial translation in comparison with stress radiographs.
For several years, many arthrometers have been developed to assess anterior knee laxity. The aim of our study was to evaluate the validity of a new practical and handy testing device with the hypothesis that the new arthrometer had good validity in terms of reliability and accuracy. Lachman test was performed on five fresh frozen cadaveric knees by five examiners. Anterior tibial translation (ATT) was measured with a new arthrometer (BLU-DAT) and on lateral stress radiographs. Data on ATT were obtained under 7 kg (69 N), 9 kg (88 N), and maximum manual traction (MMT). Tests were performed on the same specimens before and after arthroscopic ACL excision. Inter-rater reliability of the BLU-DAT measures was assessed with the intraclass correlation coefficient (ICC) for single and average measurements. The Bland-Altman method was used to estimate agreement between the BLU-DAT and stress radiographs. ICC values for single measurements were 0.62, 0.54 and 0.58 for 7-kg, 9-kg and MMT assessment, respectively. Overall reliability was good (ICC = 0.63). ICC values for average measurements were 0.89, 0.85 and 0.88 for 7-kg, 9-kg and MMT assessment, respectively. Overall reliability was very good (ICC = 0.90) SEM ranged from 1.4 mm to 1.6 mm for single measurements and was below 1 mm at each testing condition for average measurements. Analysis of agreement between BLU-DAT and radiographic measurements showed a mean difference equal to 0.83 mm ± 2.1 mm (95% CI: 0.55-1.11). Upper LOA was equal to 4.9 mm (95% CI: 5.39-4.41). Lower LOA was equal to - 3.2 mm (95% CI: - 2.71 to - 3.69). Measurement of anterior knee laxity with the BLU-DAT testing device has a good to very good inter-rater reliability and good agreement with a gold standard such as stress radiographs. Cadaveric Diagnostic Study, Level of Evidence IV.


Adult patients with uveitis associated with juvenile idiopathic arthritis: a retrospective review.
To describe clinical characteristics and outcomes of adults with uveitis associated with juvenile idiopathic arthritis (JIA). Retrospective chart review from 2001 to 2014 of adult patients with JIA and follow-up ≥2 months. Outcome measures included visual acuity, intraocular pressure (IOP), inflammation grade, ocular findings/complications, immunosuppressive therapies, and surgeries. Nineteen patients were included (95% female, 84% bilateral uveitis, 47% anterior uveitis). Mean (SD) ages at presentation and JIA diagnosis were 25.6 (7.8) years and 8.9 (5.6) years, respectively. Visual acuity and IOP did not significantly change throughout the study. Mean (SD) presenting inflammation grade was significantly decreased at 6 and 12 months. Fifteen (79%) patients were on topical medications, and 17 (89%) were on systemic immunosuppression. Two (12%) patients developed side effects requiring medication cessation. Uveitis associated with JIA may extend into adulthood despite the use of topical medications and/or systemic immunosuppression and result in significant ocular morbidity, including the need for surgical intervention.


Quantitation of Poly (A)-containing mRNA in rat cardiac biopsies.
Using a combination of conventional mRNA-extraction methods and newer hybridization techniques, a method was developed which allows the quantitation of cardiac Poly(A)-containing mRNA in cardiac biopsies. This provides a new tool to directly assess changes in cardiac gene expression in cardiac biopsies. It is proposed that the method described may be valuable in investigations dealing with various human or animal heart diseases where changes in cardiac gene expression are expected and where only biopsy material is available.


Raman spectroscopy of CaSnO3 at high temperature: a highly quasi-harmonic perovskite.
Calcium stannate perovskite (CaSnO(3)) has been studied by Raman spectroscopy at two excitation wavelengths (514.5 and 632.8 nm). No phase transition was observed. Rather, the thermal evolution of the Raman lines showed a high degree of harmonicity with small Grüneisen parameters and thermal line broadening following Γ=Acothθ/T, where the quantum temperature θ is determined by the phonon branch without further coupling with other degrees of freedom. The geometrical nature of phonon lines has been identified. High-temperature powder x-ray diffraction measurements provide thermal expansion coefficients of α(x)=13.9 × 10(-6) K(-1), α(y)=2.7 × 10(-6) K(-1), α(z)=14.3 × 10(-6) K(-1). The strongly quasi-harmonic behaviour observed and the lack of any indication of instability with respect to the post-perovskite structure points to the strongly first-order character of the reported perovskite to post-perovskite phase transition in this material, which appears to behave as a very good analogue to MgSiO(3) in the Earth's interior.


Effect of essential oil from fresh leaves of Ocimum gratissimum L. on mycoflora during storage of peanuts in Benin.
The aim of this study was to evaluate the effect of essential oil from fresh leaves of Sweet Fennel (Ocimum gratissimum) on mycoflora and Aspergillus section Flavi populations in stored peanuts. Aspergillus, Fusarium and Mucor spp. were the most common genera identified from peanuts at post-harvest in Benin by using a taxonomic schemes primarily based on morphological characters of mycelium and conidia. The isolated fungi include Aspergillus niger, A. parasiticus, A. flavus, A. ochraceus, Fusarium graminearum, F. solani, F. oxysporum and Mucor spp. The most prevalent fungi recorded were A. niger (94.18 %), A. flavus (83.72 %), A. parasiticus (77.90 %), A. ochraceus (72.09 %), F. graminearum (59.30 %) and F. oxysporum (51.16 %). Antifungal assay, performed by the agar medium assay, indicated that essential oil exhibited high antifungal activity against the growth of A. flavus, A. parasiticus, A. ochraceus and F. oxysporium. The minimal inhibitory concentration (MIC) of the essential oil was found to be 7.5 μl/ml for A. flavus and A. parasiticus and 5.5 μl/ml for A. ochraceus and F. oxysporium. The minimal fungicidal concentration (MFC) was recorded to be 8.0 μl/ml for A. flavus and A. parasiticus, 6,5 μl/ml for A. ochraceus and 6.0 μl/ml for F. oxysporium. The essential oil was found to be strongly fungicidal and inhibitory to aflatoxin production. Chemical analysis by GC/MS of the components of the oil led to the identification of 31 components characterized by myrcene (6.4 %), α-thujene (8.2 %), p-cymene (17.6 %), γ-terpinene (20.0 %), and thymol (26.9 %) as major components. The essential oil of Sweet Fennel, with fungal growth and mycotoxin inhibitory properties, offers a novel approach to the management of storage, thus opening up the possibility to prevent mold contamination in stored peanuts.


Probing the intermolecular interactions into serum albumin and anthraquinone systems: a spectroscopic and docking approach.
Intermolecular interaction study of human serum albumin (HSA) with two anthraquinones i.e. danthron and quinizarin has been performed through fluorescence, UV-vis and CD spectroscopy along with docking analysis. The titration of drugs into HSA solution brought about the quenching of fluorescence emission by way of complex formation. The binding constants were found to be 1.51 × 104 L mol-1 and 1.70 × 104 L mol-1 at λexc = 280 nm while at λexc = 295 nm, the values of binding constants were 1.81 × 104 L mol-1 and 1.90 × 104 L mol-1 which hinted toward binding of both the drugs in the vicinity of subdomain IIA. Different temperature study revealed the presence of static quenching mechanism. Moreover, more effective quenching of the fluorescence emission was observed at λexc = 295 nm which also suggested that both the drug molecule bind nearer to Trp-214. Thermodynamic parameters showed that hydrophobic interaction was the major force behind the binding of drugs. The UV-vis spectroscopy testified the formation of complex in both the systems and primary quenching mechanism as static one. The changes in secondary structure and α-helicity in both the systems were observed by circular dichroism spectroscopy. Furthermore, molecular docking analysis predicted the probable binding site of drugs in subdomain IIA of HSA molecule. The types of amino acid residues surrounding the drug molecule advocated that van der Waals forces, hydrophobic forces and electrostatic forces played a vital role in the stabilization of drug-protein complex formed.


Comparative study on the antithrombotic efficacy of hirudin, heparin and a low-molecular weight heparin in preventing experimentally induced venous thrombosis.
In a random, blind study, we compared the antithrombotic potential of unfractioned heparin, a low-molecular weight heparin (LMWH) and a recombinant hirudin (r-hirudin) given subcutaneously in a jugular vein thrombosis model in rabbits. All drugs and placebo were injected subcutaneously 2 h before inducing experimental thrombosis. A good thromboprophylactic effect was obtained with either LMWH and r-hirudin as compared with placebo. By contrast, no significant differences were found between groups in bleeding time. We also found a small (non-significant) prolongation of the activated partial thromboplastin time in the r-hirudin-treated animals. As for thrombin time, r-hirudin-treated rabbits exhibited too much sensitivity, with noncoagulable end-points. In our study, r-hirudin at the dose used seemed to be as effective as LMWH is in the prophylaxis of venous thrombosis.


[Chemosensitivity test on brain tumors].
During last 50 years chemotherapy has played a very important part in the cancer treatment. However, success or failures of news drugs in one particular cancer its difficult to predict. In vitro chemosensitivity is an attractive method for knowing about responses of a tumor to ChT treatment and assess the best dose in the patient with cancer. To know brain tumors sensitivity against antineoplastic drugs. Five different drugs (carmustin, camptotecin, taxol, hydroxyurea and tamoxifen) were tested on short-term cultures from 7 patients with Glioblastoma multiforme, 15 patients with meningiomas and one patient with meduloblastoma. For testing chemosensitivity we used MTT assay, and we measured optic density by spectophotometry to 450 nm. RESULTS. A total of 49 measurement were done, getting 44 valid dose-result curves. For each drug we used from 10-2 M to 10-12 M gap, and IC50 result was representative of tumor sensitivity to the drug. our data support MTT assays like valid method for measuring in vitro chemosensitivity in brain tumors to news drugs.


Autologous urothelial cells transplantation onto a prefabricated capsular stent for tissue engineered ureteral reconstruction.
In this study, we have fabricated an artificial ureter by transplantation of in vitro-expanded urothelial cells onto an in vivo-prefabricated capsular stent using tissue engineering methods. Spiral poly (L-lactic acid) (PLLA) stents were transplanted into the subcutaneous of Wistar rats for a period of 1, 2 or 3 weeks to induce the formation of connective tissue capsules on their surfaces. The capsular PLLA stents were then decellularized and further recellularized with bladder epithelial cells to fabricate artificial ureters. The results showed that the entrapped cells in all capsules remained continuously proliferation and lined up in continuous layers. In addition, the urothelial cells on the capsular stents with an embedding period of 2 or 3 weeks showed higher proliferative viability compared with the cells on the stents with an embedding time of 1 week (P < 0.05). The results of the study indicated that the prefabricated capsular stents could serve as alternative cell carriers for tissue engineered ureters, especially with embedding time from 2 to 3 weeks.


Stereospecific synthesis of chiral 2,3-dihydro-1,4-benzodithiine and methyl-2,3-dihydro-1,4-benzodithiine derivatives and their toxic effects on Trypanosoma brucei.
Preparation of chiral 2,3-dihydro-1,4-benzodithiine and methyl-2,3-dihydro-1,4-benzodithiine derivatives with known absolute configurations from the easily accessible chiral synthons benzyl 4-O-trifloxy-2,3-anhydro-beta-L-ribopyranoside and benzyl 4-O-trifloxy-2,3-anhydro-alpha-D-ribopyranoside is described. These compounds showed significant in vitro toxicity of the bloodstream form of Trypanosoma brucei with an IC50 of 11 microM. The parasites' energy metabolism and consumption of oxygen were found to be affected during incubation.


[Evaluation of globular osmotic resistance (GOR) and of the lysis test with glycerol (GLT/50) in the screening of heterozygous thalassemia].
A rapid and simple procedure measuring the rate of hemolysis of 50% of erytrocytes suspended in a standardized glycerol mixture (GLT/50) has been compared with the erytrocyte osmotic fragility to NaCl 0.375% concentration, carried out according to Parpat's method modified, in order to estimate the respective behaviour in the screening of beta-thalassemia trait. The GLT/50 is provided with more selectivity especially between beta-thalassemia trait carriers and other subjects with iron deficiency anemia.


Extended criteria for vitrectomy and fluid/silicone oil exchange.
The results of vitrectomy combined with fluid/silicone oil exchange at six months after surgery in 39 eyes with complex retinal detachments without (initially) severe proliferative vitreoretinopathy, proliferative diabetic retinopathy or giant retinal tears, are reported. Eyes with detachments as a result of macular holes, large multiple or posterior breaks, and eyes which had undergone previous, unsuccessful vitreoretinal surgery are included. In 90% the retina remained reattached, with functional improvement in 72%. These findings, together with the relatively low incidence of complications observed, lead us to recommend this technique in the management of selected detachments falling outside the parameters within which its use is generally accepted.


Assessment of clinical risk factors to validate the probability of osteoporosis and subsequent fractures in Korean women.
This cross-sectional, observational study was designed to identify clinical risk factors of osteoporosis and fractures in Korean women to validate the probability of osteoporosis and subsequent fractures. A total of 1541 Korean women were recruited nationally. Fracture history of any site, risk factors of osteoporosis, and fall-related risk factors were surveyed and physical performance tests were conducted. Peripheral dual-energy X-ray absorptiometry was used to measure calcaneus bone mineral density (BMD). The number of positive responses on the modified 1-min osteoporosis risk test was related to the risk of osteoporosis. The frequency of osteoporosis was higher in those with a height reduction of >4 cm and a reduced body mass index (BMI). Multivariate analysis showed that older age and lower BMI were related to higher relative risk of osteoporosis. Time required to stand up from a chair and questions related to fall injury were significantly related to clinical fracture history of any site. Multivariate analysis showed that the relative risk of fractures at any site was higher in older subjects with a lower T-score and parental hip fracture history. This study shows that age and BMI are the most significant clinical risk factors for osteoporosis and that age, BMD, and parental history of hip fracture are highly applicable risk factors for validating the probability of osteoporotic fractures in Korean women.


Reaction products of alpha-tocopherol with a free radical initiator, 2,2'-Azobis(2,4-dimethylvaleronitrile).
alpha-Tocopherol was reacted with an alkylperoxyl radical at 37 degrees C in ethanol. 2,2'-Azobis(2,4-dimethylvaleronitrile) was used to generate the alkylperoxyl radicals. The reaction products of alpha-tocopherol were isolated by reverse-phase and normal-phase high performance liquid chromatography, and their structures were characterized by infrared, ultraviolet, 1H and 13C nuclear magnetic resonances and mass spectrometry. They were 8aS-hydroperoxy-alpha-tocopherone, 8aR-hydroperoxy-alpha-tocopherone, a mixture of 7,8-epoxy-8aS-ethoxy-alpha-tocopherone and 7,8-epoxy-8aR-ethoxy-alpha-tocopherone, 8aS-(1R-cyano-1,3-dimethyl)butylperoxy-alpha-tocopherone+ ++, 8aS-(1S-cyano-1,3-dimethyl)butylperoxy-alpha-tocopherone+ ++, a mixture of 8aR-(1R-cyano-1,3-dimethyl)butylperoxy-alpha-tocopherone+ ++ and 8aR-(1S-cyano-1,3-dimethyl)butyl-peroxy-alpha-tocopherone, 4aS,5R-epoxy-8aR-ethoxy-alpha-tocopherone, 4aR,5S-epoxy-8aS-ethoxy-alpha-tocopherone, 4aS,5R-epoxy-8aS-ethoxy-alpha-tocopherone and 4aR,5S-epoxy-8aR-ethoxy-alpha-tocopherone.


Mucopolysaccharidosis type III (Sanfilippo syndrome) and misdiagnosis of idiopathic developmental delay, attention deficit/hyperactivity disorder or autism spectrum disorder.
Mucopolysaccharidosis III is a rare genetic disease characterized by progressive cognitive decline and severe hyperactivity that does not respond to stimulants. Somatic features are relatively mild. Patients are often initially misdiagnosed as having idiopathic developmental delay, attention deficit/hyperactivity disorder and/or autism spectrum disorders, putting them at risk for unnecessary testing and treatments. Children with developmental or speech delay, especially those with a characteristic somatic feature or behavioural abnormalities, should be screened for MPS III.


N-Acetylaspartate synthase is bimodally expressed in microsomes and mitochondria of brain.
N-Acetylaspartate (NAA) is an abundant amino acid derivative of the central nervous system that is localized primarily in neurons and has found widespread use in clinical NMR spectroscopy (MRS) as a non-invasive indicator of neuronal survival and/or viability. Its function, although still obscure, is thought to reflect its unusual metabolic compartmentalization wherein NAA synthase occurs in the neuron and aspartoacylase, the hydrolytic enzyme that removes the acetyl moiety, occurs in myelin and glia. The NAA synthase enzyme, acetyl-CoA/l-aspartate N-acetyltransferase (ANAT), was previously shown to function in mitochondria (MIT), although other subcellular fractions were apparently not examined. In this study we confirmed its presence in MIT but also found significant activity in rat brain microsomes (MIC). The reaction mixture, consisting of [(14)C]aspartate plus acetyl-CoA in Na-phosphate buffer (pH 7), gave rise to [(14)C]NAA that was separated and quantified by TLC. Reaction rates were 29.0+/-0.46 and 6.27+/-0.27 nmol/h/mg for MIC and MIT, respectively. K(m) values and pH optima were similar, and both fractions showed modest enhancement of ANAT activity with the detergents Triton CF-54 and CHAPS. Our tentative conclusion is that ANAT is bimodally targeted to MIT and a component of MIC-likely endoplasmic reticulum. ANAT activity increased in both MIC and MIT between 29 and 60 days of age but differed thereafter in that only MIT ANAT showed a decrease after 1 year.


Novel Gene Expression Signature Predictive of Clinical Recurrence After Radical Prostatectomy in Early Stage Prostate Cancer Patients.
Current clinical tools have limited accuracy in differentiating patients with localized prostate cancer who are at risk of recurrence from patients with indolent disease. We aimed to identify a gene expression signature that jointly with clinical variables could improve upon the prediction of clinical recurrence after RP for patients with stage T2 PCa. The study population includes consented patients who underwent a radical retropubic prostatectomy (RP) and bilateral pelvic lymph node dissection at the University of Southern California in the PSA-era (1988-2008). We used a nested case-control study of 187 organ-confined patients (pT2N0M0): 154 with no recurrence ("controls") and 33 with clinical recurrence ("cases"). RNA was obtained from laser capture microdissected malignant glands representative of the overall Gleason score of each patient. Whole genome gene expression profiles (29,000 transcripts) were obtained using the Whole Genome DASL HT platform (Illumina, Inc). A gene expression signature of PCa clinical recurrence was identified using stability selection with elastic net regularized logistic regression. Three existing datasets generated with the Affymetrix Human Exon 1.0ST array were used for validation: Mayo Clinic (MC, n = 545), Memorial Sloan Kettering Cancer Center (SKCC, n = 150), and Erasmus Medical Center (EMC, n = 48). The areas under the ROC curve (AUCs) were obtained using repeated fivefold cross-validation. A 28-gene expression signature was identified that jointly with key clinical variables (age, Gleason score, pre-operative PSA level, and operation year) was predictive of clinical recurrence (AUC of clinical variables only was 0.67, AUC of clinical variables, and 28-gene signature was 0.99). The AUC of this gene signature fitted in each of the external datasets jointly with clinical variables was 0.75 (0.72-0.77) (MC), 0.90 (0.86-0.94) (MSKCC), and 0.82 (0.74-0.91) (EMC), whereas the AUC for clinical variables only in each dataset was 0.72 (0.70-0.74), 0.86 (0.82-0.91), and 0.76 (0.67-0.85), respectively. We report a novel gene-expression based classifier identified using agnostic approaches from whole genome expression profiles that can improve upon the accuracy of clinical indicators to stratify early stage localized patients at risk of clinical recurrence after RP. Prostate 76:1239-1256, 2016. © 2016 Wiley Periodicals, Inc.


Reduced thiol content in L1210 cells treated with BSO increases DNA crosslinking by melphalan.
Endogenous thiols such as glutathione (GSH) are known to mediate the activity of bifunctional alkylating agents such as melphalan (L-PAM). GSH levels can be reduced by cell growth in the presence of an analog of gamma glutamyl, alpha-aminobutyrate, L-buthionine (S/R) sulfoximine (L-BSO). L-1210 murine lymphocytic leukemia cells grown in vitro in the presence of 10 microM less than 15% L-BSO possessed 1% of the normal GSH levels. This pretreatment regimen did not significantly alter cell viability but did enhance the cytotoxicity produced by a 15 microM-1hr L-PAM treatment. The increased cell killing correlated with enhanced DNA-DNA crosslinking immediately following L-PAM exposure. No effect of BSO pretreatments on the incomplete removal of crosslinks over 36 hr of observation was seen. These results suggest that GSH levels modulate the initial degree of L-PAM-induced DNA crosslinking, but not the long term repair of these lesions.


A cross-sectional study to understand the pervasiveness of psychiatric features among tinnitus and vertigo patients.
To identify the mental health problems among patients having symptoms of tinnitus and vertigo due to vestibulocochlear disturbances. The cross-sectional study was conducted from May to September 2019 at the Hearts International Hospital and the Hearing and Balance Clinic, Rawalpindi, in collaboration with the Foundation University, Islamabad, and comprised vestibulocochlear disorder patients of either gender aged >18 years having chief symptoms of vertigo and tinnitus for at least the preceding 3 months. Psychiatric evaluation was conducted using the Tinnitus Handicap Inventory, the Dizziness Handicap Inventory and the Depression, Anxiety, Stress Scale. Audiological evaluations were carried out to gauge the severity of symptoms. Data was analysed using SPSS 20. Of the 202 subjects, 60(30%) were females and 142(70%) were males. Patients experiencing vertigo and tinnitus symptoms had a strong tendency to develop psychiatric problems (p<0.05). Significant differences were noted among male and female patients regarding the representation of psychiatric symptoms (p<0.05). Patients experiencing tinnitus and vertigo symptoms tended to have a deviant psychological profile analogous with other chronic diseases.


Rapid spectrofluorimetric determination of lisinopril in pharmaceutical tablets using sequential injection analysis.
The present work reports for the first time a simple and rapid method for the spectrofluorimetric determination of lisinopril (LSP) in pharmaceutical formulations using sequential injection analysis (SIA). The method is based on reaction of LSP with o-phthalaldehyde (OPA) in the presence of 2-mercaptoethanol (borate buffer medium, pH=10.6). The emission of the derivative is monitored at 455 nm upon excitation at 346 nm. The various chemical and physical conditions that affected the reaction were studied. The calibration curve was linear in the range 0.3-10.0 mg L(-1) LSP, at a sampling rate of 60 injections h(-1). Consumption of OPA reagent was significantly reduced compared with conventional flow injection (FI) systems, because only 50 microL of OPA was consumed per run. The method was found to be adequately precise ( s(r)=2% at 5 mg L(-1) LSP, n=10) and the 3 sigma detection limit was 0.1 mg L(-1). The method was successfully applied to the analysis of two pharmaceutical formulations containing LSP. The results obtained were in good agreement with those obtained by use of high-performance liquid chromatography (HPLC), because the mean relative error, e(r), was <1.8%.


Interrater reliability of the modified scapular assistance test with and without handheld weights.
Prospective, blinded interrater reliability study. To determine the interrater reliability of the modified Scapular Assistance Test (mSAT) with and without the use of additional handheld weights. 110 Shoulder patients with various shoulder pathologies were consecutively recruited. Tests were performed independently and randomly on each participant by 2 different examiners, which were blinded to further clinical information (e.g. patient history, former diagnostic results). Percent agreement, Cohen's kappa (Κ), proportion of positive/negative agreement, maximum Κ, prevalence and bias indexes and prevalence-adjusted-bias-adjusted kappa (PABAK) were calculated as estimates of interrater reliability of the mSAT with and without additional handheld weights. Weights were chosen according to body weight. The reliability measures for the mSAT (Cohen's Κ: 0.68, confidence interval (CI): 0.51-0.85; PABAK: 0.78, CI: 0.67-0.90) as well as for the mSAT with handheld weights (Cohen's Κ: 0.63, CI: 0.44-0.81; PABAK: 0.76, CI: 0.64-0.88) showed substantial agreement according to the classification system proposed by Landis and Koch. Based on the results of this study, the mSAT with and without additional weights can be considered as reliable for clinical use. Since both tests showed substantial agreement, the use of additional handheld weights might not be necessary in case of obvious scapula dyskinesis. However, to perform the mSAT with/without additional weights should depend not only on its reliability values. Name of the public trials registry and the registration number: German Clinical Trials Register, protocol number DRKS00005377.


Association between rs20456 and rs6930913 of Kinesin-Like Family 6 and Hypertension in a Chinese Cohort.
This study aimed to investigate the relationship between kinesin-like family 6 (KIF6) polymorphisms and hypertension in a northeast Chinese cohort. In this study, two single nucleotide polymorphisms of KIF6 (rs20456 and rs6930913) and their haplotype were analyzed in 382 hypertension patients and 378 controls with SHEsis analysis platform, and the gene-environmental interactions were evaluated with logistic regression analysis. After adjusting for confounding factors, significantly lower risk of hypertension was observed in participants with genotype TC (0.416 (CI 0.299-0.578), p < 0.001) and CC (0.577 (0.389-0.857), p=0.007) of rs20456 compared with TT. For rs6930913, allele T (0.522 (0.386-0.704), p < 0.001), genotype TT (0.325 (0.205-0.515), p < 0.001), and genotype CT (0.513 (0.379-0.693), p < 0.001) were significantly associated with lower risk of hypertension than allele C and CC genotype, respectively. Gene-environment analyses confirmed the significant influence on hypertension by the interactions between genotypes distribution in rs20456 (CT: p=0.036, TT: p=0.022) and smoking status. No interactions were found between smoking and rs6930913, except those with dominant or recessive genetic models (both P s =0.006). There were no interactions between KIF6 and overweight (all P s > 0.05). Haplotype analyses showed that CC (p=0.005) and TC (p=0.001) of rs20456 and rs6930913 were significantly associated with a statistically increased risk of hypertension. The false-positive report probability (FPRP) analysis was used to verify significant findings. In conclusions, KIF6 might affect the susceptibility of hypertension. The allele C (rs20456) and allele T (rs690913) were inclined to protect individuals from hypertension both in genotype and haplotype analyses.


An aeronautic suicide attempt (2). The psychiatrist's comments.
A man without previous flying experience stole an aircraft and took off in order to commit suicide. An air traffic controller managed to convince him to land the plane. This article reports the psychiatrist's investigation into the case.


The Arg/N-degron pathway targets transcription factors and regulates specific genes.
The Arg/N-degron pathway targets proteins for degradation by recognizing their N-terminal or internal degrons. Our previous work produced double-knockout (2-KO) HEK293T human cell lines that lacked the functionally overlapping UBR1 and UBR2 E3 ubiquitin ligases of the Arg/N-degron pathway. Here, we studied these cells in conjunction with RNA-sequencing, mass spectrometry (MS), and split-ubiquitin binding assays. 1) Some mRNAs, such as those encoding lactate transporter MCT2 and β-adrenergic receptor ADRB2, are strongly (∼20-fold) up-regulated in 2-KO cells, whereas other mRNAs, including those encoding MAGEA6 (a regulator of ubiquitin ligases) and LCP1 (an actin-binding protein), are completely repressed in 2-KO cells, in contrast to wild-type cells. 2) Glucocorticoid receptor (GR), an immunity-modulating transcription factor (TF), is up-regulated in 2-KO cells and also physically binds to UBR1, strongly suggesting that GR is a physiological substrate of the Arg/N-degron pathway. 3) PREP1, another TF, was also found to bind to UBR1. 4) MS-based analyses identified ∼160 proteins whose levels were increased or decreased by more than 2-fold in 2-KO cells. For example, the homeodomain TF DACH1 and the neurofilament subunits NF-L (NFEL) and NF-M (NFEM) were expressed in wild-type cells but were virtually absent in 2-KO cells. 5) The disappearance of some proteins in 2-KO cells took place despite up-regulation of their mRNAs, strongly suggesting that the Arg/N-degron pathway can also modulate translation of specific mRNAs. In sum, this multifunctional proteolytic system has emerged as a regulator of mammalian gene expression, in part through conditional targeting of TFs that include ATF3, GR, and PREP1.


Hand-assisted laparoscopic nephrectomy versus transperitoneal anterior approach in living donors for renal transplantation.
The objective of this study was to compare two surgical approaches for living donor nephrectomy: transperitoneal anterior approach and the hand-assisted laparoscopic nephrectomy. Between January 2001 and October 2003 we performed 63 kidney transplantations from living donors. The transperitoneal anterior approach was used in 36 cases and the hand-assisted laparoscopic nephrectomy in 27. Outcomes were compared in terms of hospital stay, postoperative analgesia, and graft quality. Mean hospital stay was 4.7 days in the transperitoneal anterior approach group and 3.7 days in the hand-assisted laparoscopic group (P < .005). Postoperative analgesia dosage was significantly lower in the hand-assisted laparoscopic group (P < .001). Surgical complications and graft quality were similar. We concluded that hand-assisted laparoscopic nephrectomy patients had shorter hospital stays and less pain in the postoperative period, with better cosmetic results and equivalent graft quality compared to transperitoneal anterior approach patients.


[Mechanism of potentiation of contractions after muslce loading with glycerin. II. Relationship between incubation conditions and obstructing the inflow of glycerin].
A study was made of the influence of glycerol loading on contraction responses of the m. sartorius upon stimulation in normal and calcium-free Reinger solutions by caffeine, tetanic electrostimulation and single electric impulses. It was determined that in the glycerol medium each type of stimulation caused contractility potentiation. Ca2+-ions proved to block the responses of potentiation. The data suggest that there should be a potentiation mechanism common to each type of stimulation.


Transcatheter embolisation to control severe bleeding in fungating breast cancer.
Severe and recurrent haemorrhage from ulcerating breast or skin lesions was controlled in seven of nine women with breast cancer. Arterial catheterisation and embolisation with a variety of materials (gelfoam, polyvinyl alcohol, steel coils, 50% dextrose) was used. Local anaesthesia only was needed, allowing very ill patients to be treated. This approach is the treatment of choice for severe haemorrhage in breast cancer.


Ambulatory Electrocardiographic Monitoring Following Minimalist Transcatheter Aortic Valve Replacement.
The aim of this study was to determine the impact of delayed high-degree atrioventricular block (HAVB) or complete heart block (CHB) after transcatheter aortic valve replacement (TAVR) using a minimalist approach followed by ambulatory electrocardiographic (AECG) monitoring. Little is known regarding the clinical impact of HAVB or CHB in the early period after discharge following TAVR. A prospective, multicenter study was conducted, including 459 consecutive TAVR patients without permanent pacemaker who underwent continuous AECG monitoring for 14 days (median length of hospital stay 2 days; IQR: 1-3 days), using 2 devices (CardioSTAT and Zio AT). The primary endpoint was the occurrence of HAVB or CHB. Patients were divided into 3 groups: 1) no right bundle branch block (RBBB) and no electrocardiographic (ECG) changes; 2) baseline RBBB with no further changes; and 3) new-onset ECG conduction disturbances. Delayed HAVB or CHB episodes occurred in 21 patients (4.6%) (median 5 days postprocedure; IQR: 4-6 days), leading to PPM in 17 (81.0%). HAVB or CHB events were rare in group 1 (7 of 315 [2.2%]), and the incidence increased in group 2 (5 of 38 [13.2%]; P < 0.001 vs group 1) and group 3 (9 of 106 [8.5%]; P = 0.007 vs group 1; P = 0.523 vs group 2). No episodes of sudden or all-cause death occurred at 30-day follow-up. Systematic 2-week AECG monitoring following minimalist TAVR detected HAVB and CHB episodes in about 5% of cases, with no mortality at 1 month. Whereas HAVB or CHB was rare in patients without ECG changes post-TAVR, baseline RBBB and new-onset conduction disturbances determined an increased risk. These results would support tailored management using AECG monitoring and the possibility of longer hospitalization periods in patients at higher risk for delayed HAVB or CHB.


Inhibition of dentine demineralization by zinc oxide: in vitro and in situ studies.
The objective of this study was to evaluate the inhibitory effect of zinc oxide on dentine demineralization in vitro and in situ. In the in vitro study, dentine specimens treated with a zinc oxide suspension were demineralized in a pH 5 solution. In the in situ study, subjects wore dentine specimens on their teeth and instructed to rinse with zinc-containing toothpaste slurry three times a day for 14 days. The design of study was a crossover one. Microradiography employed in the in vitro study revealed the dentine surfaces treated with distilled water had a lower mineral content than those treated by zinc. Toothpaste with zinc had a statistically significant, 49% greater inhibitory efficacy on dentine demineralization over the control. In the in situ study, zinc-containing toothpaste was also confirmed to have an inhibitory effect on dentine demineralization when compared to the zinc-free toothpaste. These in vitro and in situ studies revealed that zinc oxide can have a significant effect on the inhibition of dentine demineralization, even when the zinc oxide is blended into toothpaste. This suggests that zinc oxide may be effective in the prevention of root caries.


Toxicokinetics of selenium in the slider turtle, Trachemys scripta.
Selenium (Se) is an essential element that can be harmful for wildlife. However, its toxicity in poikilothermic amniotes, including turtles, remains poorly investigated. The present study aims at identifying selenium toxicokinetics and toxicity in juvenile slider turtles (age: 7 months), Trachemys scripta, dietary exposed to selenium, as selenomethionine SeMet, for eight weeks. Non-destructive tissues (i.e. carapace, scutes, skin and blood) were further tested for their suitability to predict selenium levels in target tissues (i.e. kidney, liver and muscle) for conservation perspective. 130 juvenile yellow-bellied slider turtles were assigned in three groups of 42 individuals each (i.e. control, SeMet1 and SeMet2). These groups were subjected to a feeding trial including an eight-week supplementation period SP 8 and a following 4-week elimination period EP 4 . During the SP8, turtles fed on diet containing 1.1 ± 0.04, 22.1 ± 1.0 and 45.0 ± 2.0 µg g(-1) of selenium (control, SeMet1 and SeMet2, respectively). During the EP4, turtles fed on non-supplemented diet. At different time during the trial, six individuals per group were sacrificed and tissues collected (i.e. carapace, scutes, skin, blood, liver, kidney, muscle) for analyses. During the SP8 (Fig. 1), both SeMet1 and SeMet2 turtles efficiently accumulated selenium from a SeMet dietary source. The more selenium was concentrated in the food, the more it was in the turtle body but the less it was removed from their tissues. Moreover, SeMet was found to be the more abundant selenium species in turtles' tissues. Body condition (i.e. growth in mass and size, feeding behaviour and activity) and survival of the SeMet1 and SeMet2 turtles seemed to be unaffected by the selenium exposure. There were clear evidences that reptilian species are differently affected by and sensitive to selenium exposure but the lack of any adverse effects was quite unexpected. Fig. 1 Design of the feeding trial. T, Time of tissues collection in weeks. The feeding trial included a supplementation period of 8 weeks (i.e. SP8) followed by an elimination period of 4 weeks (i.e. EP4). Six turtles from each turtle group (i.e. control, SeMet1 and SeMet2) were sacrifice at each collection time, from T1 to T12. At T0, four turtles were sacrificed.


Sustainable landfill sites selection using geospatial information and AHP-GDM approach: A case study of Abha-Khamis in Saudi Arabia.
Social, environmental, and technical factors must be combined to solve the complex problem of ever-growing municipal solid waste (MSW) and minimize its negative impact on the environment. Saudi Arabia has launched a US$13 billion tourism strategy to transform the Asir region into a year-round tourist destination and has pledged to welcome 10 million local and foreign visitors by 2030. The estimated share of Abha-Khamis will increase to 7.18 million tons of household waste per year. With a gross domestic product (GDP) of USD 820.00 billion by the end of 2022, Saudi Arabia can no longer afford to neglect the issue of waste production and its safe disposal. In this study, to account for all factors and evaluation criteria, a combination of remote sensing, geographic information systems and an analytical hierarchy process (AHP) was used to determine the best locations for municipal solid waste (MSW) disposal in Abha-Khamis. The analysis revealed that 60% of the study area consists of faults (14.28%), drainage networks (12.80%), urban (11.43%), land use (11.41%) and roads (8.35%), while 40% of the suitable area for landfill. Of these, a total of 20 sites ranging in size from 100 to 595 ha are distributed at reasonable distances from the cities of Abha-Khamis, which meet all the critical criteria for suitable landfill sites mentioned in the literature. Current research shows that the use of integrated remote sensing, GIS and the AHP-GDM approach significantly improves the identification of land suitability for MSW management.


CEA promoter-regulated oncolytic adenovirus-mediated Hsp70 expression in immune gene therapy for pancreatic cancer.
Gene therapy is an important means for the comprehensive treatment of pancreatic cancer. Challenges associated with gene therapy include control of vector security and effective genetic screening. In this paper, a CEA promoter-regulated oncolytic adenovirus vector was constructed. The reporter gene assay demonstrated that the viral vector was confirmed to have tumor-specific replication features. In vitro cytology studies showed that the CEA promoter regulated the proliferation of the adenovirus vector carrying the Hsp70 gene (AdCEAp-Hsp70), which significantly increased the expression levels of Hsp70 in the CEA-positive pancreatic cancer cells, resulting in an overall reduction in the survival of cancer cells. In the human pancreatic cancer Panc-1 xenograft model in immune deficient nude mice, the CEA promoter-regulated adenovirus AdCEAp-Hsp70 significantly inhibited tumor growth. In the rat pancreatic cancer DSL-6A/C1 xenograft model in rats, the viral proliferation and high expression levels of Hsp70 promoted the interstitial infiltration of CD4+, CD8+ and gamma/delta T cells into tumors, induced host secretion of the cytokines TGF-β, INF-γ, and IL-6 and had a dual anti-tumor effects that completely inhibited the growth of pancreatic cancer. The results demonstrated that the oncolytic adenovirus under the control of CEA promoter provides additional assurances regarding the safety and efficiency of cancer gene therapy. This gene therapy model improves anti-cancer efficiency and has broad applications and developmental prospects.


Neonatal erythrocyte glutathione peroxidase deficiency as a consequence of selenium imbalance during pregnancy.
The red blood cell (RBC) glutathione peroxidase (GSH-Px) activity and routine haematological parameters were measured in 38 healthy north Italian full-term pregnant women and in their newborn infants. In 31 pairs the serum selenium concentration was also measured. Data were compared with those of 20 normal adult controls (10 males and 10 females). Newborn infants exhibited significantly lower RBC GSH-Px activity and serum selenium concentrations than adult controls. Pregnant women had serum selenium values intermediate between those of adult female controls and their newborn infants. In both the pregnant women and newborns the RBC GSH-Px activity correlated with the level of selenium in serum which suggests that the neonatal RBC GSH-Px deficiency may be partially due to insufficient availability of selenium during pregancy. Factors other than selenium concentration, e.g. hormonal and genetic, might also affect the RBC GSH-Px activity as suggested by sex differences and mother/child concordances in enzyme activity found in our cases.


A dimethoxytriazine type glycosyl donor enables a facile chemo-enzymatic route toward α-linked N-acetylglucosaminyl-galactose disaccharide unit from gastric mucin.
An efficient chemo-enzymatic process for construction of the α-linked disaccharide unit (GlcNAcα1-4Gal) found in gastric mucin has been developed. The process consists of a one-step preparation of a novel triazine type glycosyl donor in water and the subsequent transglycosylation to a galactose derivative catalysed by α-N-acetylglucosaminidase.


Epidemiology of central sleep apnoea in heart failure.
Central sleep apnoea occurs in about a third of patients with reduced systolic heart failure and is a marker of increased mortality. Such patients usually are older males with advanced heart failure (i.e., high pulmonary wedge pressure), often in atrial fibrillation, with evidence of hyperventilation (i.e., low PaCO2) in the absence of hypoxemia. Characteristically, ventilation waxes and wanes in a sinusoidal pattern, with mild hypoxemia, occurring in the lighter levels of sleep usually when supine. Snoring may also occur in central sleep apnoea, often at the peak of hyperventilation, sometimes contributing to the confusion or overlap with obstructive sleep apnoea. Central sleep apnoea is associated with orthopnoea, paroxysmal nocturnal dyspnoea and an oscillatory respiratory pattern with an incremental cardiopulmonary exercise study. Importantly, heart failure therapies (e.g., afterload reduction, diuresis, pacemakers, transplantation) attenuate central sleep apnoea. Night to night variability in severity of central sleep apnoea may occur with changes in patients' posture during sleep (less severe when sleeping on-side or upright).


[Fragments of linear unintegrated Rous sarcoma virus DNA, resulting from digestion with SmaI restriction endonuclease].
Linear unintegrated DNA of Schmidt-Ruppin Rous sarcoma virus, subgroup D (SR-RSV-D), was digested with SmaI restriction endonuclease, analyzed by agarose gel electrophoresis, "blotted" by Southern's method and hybridized with a viral 32P cDNA. SmaI cleaves this DNA at five sites, two of which are localized at the ends of the provirus. Src and env genes seem not to be restrictied by SmaI cleavage.


Motivating Action and Maintaining Change: The Time-Varying Role of Homework Following a Brief Couples' Intervention.
Studies regarding the effectiveness of homework assignments in cognitive-behavioral treatments have demonstrated mixed results. This study investigated predictors of compliance with homework recommendations and the time-varying relationship of recommendation completion with treatment response in a brief couples' intervention (N = 108). More satisfied couples and couples with more motivation to change completed more recommendations, whereas couples with children completed fewer. The association between recommendation completion and treatment response varied with the passage of time, with the strongest effect observed 6 months after the intervention, but no discernible differences at 1 year postintervention. Couples that completed more recommendations experienced more rapid treatment gains, but even those couples doing substantially fewer recommendations ultimately realized equivalent treatment effects, although they progressed more slowly. Implications are discussed.


Severely malnourished children with a low weight-for-height have similar mortality to those with a low mid-upper-arm-circumference: II. Systematic literature review and meta-analysis.
The WHO recommended criteria for diagnosis of sever acute malnutrition (SAM) are weight-for-height/length Z-score (WHZ) of <- 3Z of the WHO2006 standards, a mid-upper-arm circumference (MUAC) of < 115 mm, nutritional oedema or any combination of these parameters. A move to eliminate WHZ as a diagnostic criterion has been made on the assertion that children with a low WHZ are healthy, that MUAC is a "superior" prognostic indicator of mortality and that adding WHZ to the assessment does not improve the prediction of death. Our objective was to examine the literature comparing the risk of death of SAM children admitted by WHZ or MUAC criteria. We conducted a systematic search for reports which examined the relationship of WHZ and MUAC to mortality for children less than 60 months. The WHZ, MUAC, outcome and programmatic variables were abstracted from the reports and examined. Individual study's case fatality rates were compared by chi-squared analysis and random effects meta-analyses for combined data. Twenty-one datasets were reviewed. All the patient studies had an ascertainment bias. Most were inadequate because they had insufficient deaths, used obsolete standards, combined oedematous and non-oedematous subjects, did not report the proportion of children with both deficits or the deaths occurred remotely after anthropometry. The meta-analyses showed that the mortality risks for children who have SAM by MUAC < 115 mm only and those with SAM by WHZ < -3Z only are not different. As the diagnostic criteria identify different children, this analysis does not support the abandonment of WHZ as an important independent diagnostic criterion for the diagnosis of SAM. Failure to identify such children will result in their being denied treatment and unnecessary deaths from SAM.


Transporter-mediated drug--drug interactions involving OATP substrates: predictions based on in vitro inhibition studies.
Transporter-mediated drug–drug interactions (DDIs) are among the most important of the clinically relevant pharmacokinetic DDIs. We investigated the validity of a static prediction of area under the plasma concentration-time curve (AUC) ratios (AUCRs; AUC(with inhibitor)/AUC(control) using in vitro inhibition profiles, and selected the types of assumptions that improved the prediction accuracy with minimizing false-negative predictions. We used data from 58 DDI studies involving 12 substrates of hepatic organic anion–transporting polypeptides (OATPs). With original assumptions regarding the maximal increase in intestinal availability, maximum unbound concentration at the inlet to the liver, and inhibition of only the hepatic uptake process, the predicted AUCRs were comparable to those reported within a two/threefold error margin in 44/52 studies, whereas in 16 studies, the predictions were judged to be falsenegatives. When the inhibitory effects on both hepatic uptake and efflux/metabolisms were considered, the overall prediction accuracy became worse, although the false-negative prediction decreased to 11 studies. This illustrates that if appropriate assumptions are selected, unnecessary clinical DDI studies can be reasonably avoided.


Concordance among diagnostic criteria for metabolic syndrome is inconsistent in Spanish adolescents.
The metabolic syndrome (MetS), although more frequent in adults, is a growing health problem in adolescent population. There are different criteria for the diagnosis, however without a consensus of which is the best to be used in this population. The heterogeneity of the different diagnostic criteria makes it necessary to carry out more studies that analyse the degree of agreement among these criteria. The present study was aimed to evaluate the agreement between different criteria for diagnosis of MetS in adolescents. A cross-sectional study was performed on 981 adolescents (13.2 ± 1.2 years) randomly recruited from 18 schools in south-east Spain. MetS was diagnosed by eight different criteria. The criteria proposed by the IDF showed the highest mean values for WC and systolic blood pressure in boys and girls with MetS, and the lowest for glucose and triglycerides in boys. Depending on the diagnostic criteria used, the prevalence of MetS cases in boys ranged from 5.5% to 14.9%, while in girls varied from 3.4% to 32.6%. Both in boys and girls, the criteria proposed by the IDF was the less concordant with the other suggested criteria, while those proposed by Duncan et al, Rodriguez-Moran et al and Cruz and Goran, were very concordant among each other. However, in girls, concordance values were not as high as those found for boys. The variability observed in the agreement among the existing criteria suggests the need to validate uniform criteria for the diagnosis of MetS in adolescents.


[Collision carcinoma of the thyroid gland in Hashimoto's thyroiditis. Spinocellular carcinoma, arising from a cyst of the thyroglossal duct and a follicular carcinoma with an anaplastic turn].
A collision carcinoma of the thyroid was revealed in a surgically removed thyroid affected with Hashimoto's thyroiditis. A follicular carcinoma composed of rather uniform and spherical cells. The anaplastic carcinoma appeared to collide with structures of a noncornifying squamous cell carcinoma supposed to originate in the isthmic area from a ductus thyreoglossus cyst.