The influence of probiotic bacteria and human gut microorganisms causing opportunistic infections on Blastocystis ST3.
Blastocystis subtype 3 is an intestinal protist present in humans throughout the world with a controversial pathogenic potential. It has been suggested that probiotic bacteria inhibit the multiplication of gut protozoans, while others are beneficial for their development. This study aimed to evaluate the efficacy of the lactic acid bacteria Lactobacillus rhamnosus, Lactococcus lactis and Enterococcus faecium in Blastocystis ST3 eradication and the relevance of the intestinal microorganisms Escherichia coli, Candida albicans and Candida glabrata in protozoan proliferation. Blastocystis xenic and axenic culture was co-incubated with the above-mentioned microorganisms and their cell free supernatants at different concentrations in vitro. The number of protozoan cells was counted every day. Both experiments, with xenic and axenic cultures, showed Blastocystis inhibition by L. rhamnosus and L. lactis and their supernatants from the 2nd day of co-incubation. Furthermore, co-incubation with both E. faecium and E. coli showed a beneficial influence on Blastocystis during the first 2 days. Only after 3 days did the above-mentioned bacteria start to inhibit Blastocystis growth in both cultures. The supernatant containing the metabolites of E. coli was effective to a lesser degree. Compared to the control samples, co-incubation with both C. albicans and C. glabrata showed a faster decrease in Blastocystis proliferation, but this was not statistically significant. This study has shown the potential of using L. rhamnosus and L. lactis, as well as E. faecium as a prophylactic treatment against Blastocystis colonization or as an additional treatment regimen in combination with standard drugs.


Postoperative blood pressure changes associated with cervical block versus general anesthesia following carotid endarterectomy.
The purpose of this report was to determine if cervical block anesthesia (CBA) was associated with fewer hypertensive and hypotensive episodes and decreased need for ICU monitoring following carotid endarterectomy, compared with general anesthesia (GA). A retrospective review of carotid endarterectomies performed using GA (n = 118) versus CBA (n = 116) was carried out and perioperative blood pressure changes and morbidity and mortality rates were analyzed. With increasing emphasis in today's health care market concerning cost containment without sacrificing safety, our results suggest that CBA should be considered preferable to GA for patients undergoing carotid endarterectomy. Fewer significant postoperative hemodynamic changes occurred and costly intensive care monitoring may be avoided.


Effect of light quality on the growth and main chemical composition of Bletilla striata.
This study aimed to investigate the effects of light quality on the morphological traits, photosynthetic pigment content, protective enzyme (superoxide dismutase, peroxidase, and catalase) activity, and bioactive compound (BSP, total phenol, and militarine) content in Bletilla striata. Plants of B. striata were grown under light filtered through three differently colored films. The treatments were red film (RF), yellow film (YF), and blue film (BF), and an uncovered treatment was included as a control (CK). Compared with the B. striata plants in the RF, YF, and CK treatment groups, those receiving BF treatment showed significantly promoted growth of the aerial parts. Meanwhile, the total phenol and militarine contents in B. striata tubers were increased without affecting the accumulation of B. striata polysaccharides. These results show that growing B. striata plants under blue film could be a useful technique to improve quality and production. This technique is conducive to achieving large-scale sustainable production of high-quality plant materials.


Mâmawihitowin (bringing the camps together): Perinatal healthcare provider and staff participation in an Indigenous-led experiential intervention for enhancing culturally informed care-a mixed methods study.
In partnership with a Nehiyawak (Plains Cree) community of Maskwacîs,central Alberta (Canada), we implemented an Indigenous-led intervention to provide experiential learning opportunities for perinatal health care providers (HCPs) and staff. Our objective was to capture the impact of participating in cultural safety learning opportunities on perceived self-awareness for HCPs and staff to provide enhanced culturally informed care. Perinatal HCPs and staff who work regularly with Indigenous women from our partnering community took part in a series of experiential learning activities designed by a Community Advisory Committee. We used an explanatory sequential mixed methods approach informed by community-based participatory research. We compared Cultural Intelligence Scale (CQS) and Maskwacîs-Specific Cultural Scale (MSCS) scores pre- and post-intervention using non-parametrical statistical analysis (Wilcoxon signed rank test). Post-intervention, we conducted a qualitative description study using semi-structured interviews. Qualitative data was analyzed using thematic analysis. A total of 17 participants completed pre- and post-intervention questionnaires. Responses indicated a shift in perceived cultural and community knowledge and comfort levels, with positive gains in overall mean scores for both the CQS (p = 0.01) and MSCS (p = 0.01). Nine participants completed qualitative interviews. Overall, participants felt better equipped to provide more culturally informed care to their patients post-intervention. An Indigenous-led experiential learning intervention was effective in enhancing overall perceived cultural awareness and preparedness to provide culturally informed care for perinatal HCPs and staff. This study provides evidence for fostering relationships between Indigenous communities and health systems toward enhanced perinatal care.


The novel red-fluorescent probe DAR-4M measures reactive nitrogen species rather than NO.
Several fluorescent probes were designed for the measurement of nitric oxide (NO), however, questions arose regarding their specificity and sensitivity in biological samples. In the present study we tested the reaction of a novel rhodamine-based chromophore diaminorhodamine-4M (DAR-4M) with NO and other reactive nitrogen and oxygen species. We performed fluorometry in 96-well plates in a cell-free buffer with similar ion concentrations as the cytoplasm. Dose-response curves were generated using various NO donors and reactive nitrogen and oxygen species. The effects were compared between the red-fluorescent DAR-4M and its green-fluorescent counterpart 4-amino-5-methylamino-2',7'-difluorofluorescein (DAF-FM). DAR-4M had a markedly higher fluorescence yield to NO donors than DAF-FM, while both probes had a comparable threshold of sensitivity (in the range of 0.1 mM nitroprusside). Both dyes reacted with various NO donors in a dose-dependent manner, while superoxide, hydrogen peroxide, peroxynitrite, or nitroxyl failed to change the fluorescence intensity of the probes. DAR-4M was potentiated in the presence of peroxynitrite to react with low levels of NO donors in a similar manner to DAF-FM. We conclude that DAR-4M is a suitable red-fluorescent probe for the qualitative assessment of reactive nitrogen species production, but not specific for NO. Quantitative comparisons among samples is inappropriate since the fluorescent yield is affected by the presence of other oxidants in the sample.


Mitochondrial involvement in RP-1 mediated apoptosis in U 87 cells.
The aqueous extract of RP-1, which rendered significant protection to whole body irradiated mice, was found to be tumoricidal. The mode of cytotoxic action of RP-1 attributing to its antitumor action was investigated in U 87 cells with special reference to mitochondrial contribution. RP-1 doses above 0.5 microg/ml reduced colonogenic survival (maximum reduction of 62% at 10 microg/ml) and increased the free radical generation, G2/M fraction and apoptotic frequency. Prolonged exposure to RP-1 rendered significant increase in mitochondrial mass. It also reduced mitochondrial membrane potential in a dose and time dependent manner that was restored by verapamil, a Ca+2 channel blocker. Mitochondrial anti-apoptotic proteins Bcl-2 and Hsp-70 levels were also reduced by RP-1 treatment in a dose and time dependent manner. The ability of RP-1 to disrupt mitochondrial structure and function could be responsible for its cytotoxic action.


Bismuth(III)-Catalyzed Oxidative Cross-Coupling of 3-Hydroxycarbazoles with Arenols under an Oxygen Atmosphere.
A Bi(OTf)3-catalyzed oxidative cross-coupling reaction of 3-hydroxycarbazoles with arenols was developed under mild conditions. Both substrates were used in a 1:1 molar ratio in the presence of a catalytic amount of Bi(OTf)3. The reaction was carried out under an oxygen atmosphere at 30 °C to afford C1-symmetric hydroxybiaryls in good yields (up to 94%) with high chemo- and regioselectivity.


Forebrain ischemia induced by temporary bilateral common carotid occlusion in normotensive rats.
Ischemic brain lesions were induced in adult Wistar and Fischer rats by temporary occlusion of the bilateral common carotid artery. The severity of ischemic lesions depended on the duration of carotid occlusion. While 2 h occlusion resulted in 15 deaths among 40 rats and the development of ischemic lesions in 16 of 25 asymptomatic survivors, none died after 0.5 h occlusion and yet 13 of 30 apparently asymptomatic rats had ischemic lesions when examined on day 7. Histological examination combined with immunohistochemistry of autologous albumin for assessing the integrity of the blood-brain barrier (BBB) revealed two distinct lesions: (1) ischemic neural damage with extensive tissue permeation of serum albumin, (2) death of individual neurons sparing other neural elements in the absence of the BBB breakdown. Ischemic neural damage with BBB breakdown was common in animals dying within 48 h after reflow. The lesions without BBB breakdown, on the other hand, were found solely in asymptomatic animals in which groups of severely degenerated neurons were preferentially located in the CA 1 region of the hippocampus, the caudoputamen and deeper layers of the neocortex. The sequential measurements of regional cerebral blood flow (rCBF) in the bilateral hippocampus by the hydrogen clearance method disclosed a steady decrease in rCBF after the occlusion, 51% of the pre-occlusion state at 10 min, 35% at 25 min and 32% at 40 min. The simplicity of procedure could make this model suitable for the study of the pathogenesis of ischemic neuronal damage in a critically low perfusion state.


Modeling a semi-optimal deceleration of a rigid body rotational motion in a resisting medium.
This paper studies the shortest time of slowing rotation of a free dynamically asymmetric rigid body (RB), analogous to Euler's case. This body is influenced by a rotatory moment of a tiny control torque with closer coefficients but not equal, a gyrostatic moment (GM) due to the presence of three rotors, and in the presence of a modest slowing viscous friction torque. Therefore, this problem can be regarded as a semi-optimal one. The controlling optimal decelerating law for the rotation of the body is constructed. The trajectories that are quasi-stationary are examined. The obtained new results are displayed to identify the positive impact of the GM. The dimensionless form of the regulating system of motion is obtained. The functions of kinetic energy and angular momentum besides the square module are drawn for various values of the GM's projections on the body's principal axes of inertia. The effect of control torques on the body's motion is investigated in a case of small perturbation, and the achieved results are compared with the unperturbed one. For the case of a lack of GM, the comparison between our results and those of the prior ones reveals a high degree of consistency, in which the deviations between them are examined. As a result, these outcomes generalized those that were acquired in previous studies. The significance of this research stems from its practical applications, particularly in the applications of gyroscopic theory to maintain the stability and determine the orientation of aircraft and undersea vehicles.


Study on adsorption of low-concentration methyl mercaptan by starch-based activated carbon.
The development of a low-concentration methyl mercaptan adsorbing material for an efficient decontamination has become a hot research topic. In this study, carbonization activation was employed with starch and urea as carbon and nitrogen sources, respectively, to prepare a type of starch-based activated carbon. Subsequently, the product was used to adsorb low-concentration methyl mercaptan. Based on sorption experiments and molecular simulations, the underlying mechanism of the adsorption effect of the adsorbent's pore structure and surface oxygen- and nitrogen-containing functional groups on methyl mercaptan molecules were discussed. The results indicated that when the methyl mercaptan equilibrium concentration was 0.197 mg/L, the adsorption capacity of SUAC-16-2 for methyl mercaptan was 78.16 mg/g. Its adsorption performance was better than that of its previously reported counterparts. The well-developed microporous structure of SUAC-16-2 promoted the adsorption of methyl mercaptan. In addition, methyl mercaptan molecules could be broken down to produce CH3S- and H+ by the effect of the surface functional groups. Adjacent carbon atoms containing nitrogen and oxygen functional groups could better adsorb CH3S- and H+, and further strengthen the methyl mercaptan adsorption performance of activated carbon. The study could help to develop new technology for treatment of low concentration of methyl mercaptan in the air.


Age-related distribution of c-fos expression in the striatum of CD-1 mice after acute methylphenidate administration.
Ritalin (methylphenidate hydrochloride, MPH) is the drug of choice for the treatment of attention deficit hyperactivity disorder. Previous research has shown that MPH administration affects the adult brain in a manner different from the young brain. In the current study, we set out to determine the target brain regions of acutely administered MPH at different stages of development. On postnatal days 3, 7, 11, 24, and 45, mice were treated with a single injection (s.c.) of saline, 5 or 20 mg/kg of MPH, and sacrificed 1 h later. Localization of c-fos expression was determined by immunocytochemistry. Compared to saline treated controls, mice treated with the high dose of MPH (20 mg/kg) showed dense Fos-immunoreactivity (Fos-IR) in the striatum. In most cases the low dose of MPH (5 mg/kg) produced only weak c-fos expression that was nearly indistinguishable from saline-treated controls. At PND 3 and 7, Fos-IR was localized in patches in the striatum. This patchy distribution of c-fos positive cells began to decline by PND 11 and was absent in PND 45 mice, with Fos-IR showing a scattered distribution throughout the striatum. The results of this study indicate that MPH induces the expression of c-fos in the same brain regions as cocaine and amphetamine, and that this expression is distributed differentially according to the age of the mouse.


Evolving Strategies for the Treatment of Chronic Lymphocytic Leukemia in the Upfront Setting.
Chronic lymphocytic leukemia (CLL) is a disease of marked clinical heterogeneity, and while some patients have a normal life expectancy, others develop rapidly progressive disease shortly after diagnosis. The current standard for upfront treatment of CLL is chemoimmunotherapy for younger fit patients, FCR (fludarabine, cyclophosphamide, and rituximab) being the prototype. For older patients, BR (bendamustine and rituximab) exhibits excellent activity with decreased toxicity. For the frailest patients, CD20 monoclonal antibodies with or without chlorambucil have proven to be efficacious. The novel oral kinase inhibitors ibrutinib and idelalisib are FDA-approved in the relapsed/refractory setting, and ibrutinib is approved upfront for those with del(17p). These drugs have produced long-term durable responses in the relapsed/refractory setting, and studies are underway using these as single agent upfront or in combination with both chemotherapy and monoclonal antibodies. Here, we review standard upfront therapies and new agents and combinations that are on the horizon for CLL.


Environmental chemical carcinogens and liver cancer.
An appraisal is made of these chemical carcinogens available in the human environment that have been implicated in the etiology of liver cancer. The possible role of mycotoxins is discussed in detail, in particular the association between the aflatoxins and liver cancer in Africa and the Far East.


In Vivo Development of Transplant Arteriosclerosis in Humanized Mice Reflects Alloantigen Recognition and Peripheral Treg Phenotype of Lung Transplant Recipients.
Experimentally, regulatory T cells inhibit rejection. In clinical transplantations, however, it is not known whether T cell regulation is the cause for, or an epiphenomenon of, long-term allograft survival. Here, we study naïve and alloantigen-primed T cell responses of clinical lung transplant recipients in humanized mice. The pericardiophrenic artery procured from human lung grafts was implanted into the aorta of NODrag-/- /IL-2rγc-/- mice reconstituted with peripheral blood mononuclear cells (PBMCs) from the respective lung recipient. Naïve or primed allogeneic PBMCs procured 21 days post-lung transplantation with or without enriching for CD4+ CD25high T cells were used. Transplant arteriosclerosis was assessed 28 days later by histology. Mice reconstituted with alloantigen-primed PBMCs showed significantly more severe transplant arteriosclerosis than did mice with naïve PBMCs (p = 0.005). Transplant arteriosclerosis was equally suppressed by enriching for autologous naïve (p = 0.012) or alloantigen-primed regulatory T cells (Tregs) (p = 0.009). Alloantigen priming in clinical lung recipients can be adoptively transferred into a humanized mouse model. Transplant arteriosclerosis elicited by naïve or alloantigen-primed PBMCs can be similarly controlled by potent autologous Tregs. Cellular therapy with expanded autologous Tregs in lung transplantation might be a promising future strategy.


Intrastromal invasion by limbal epithelial cells is mediated by epithelial-mesenchymal transition activated by air exposure.
Corneal epithelial stem cells are located in the basal layer of the limbus between the cornea and the conjunctiva. Regulation of these limbal epithelial progenitor cells by the stromal niche dictates corneal surface health. To further characterize this process, limbal explants were cultured at the air-fluid interface, termed air-lifting, to stimulate the niche. As compared to submerged cultures, air-lifting significantly promoted epithelial stratification, migration, proliferation, and intrastromal invasion by limbal epithelial cells. Epithelial intrastromal invasion was noted when the limbal, but not corneal, epithelium was recombined with the limbal stroma containing live, but not dead, cells. Invading limbal basal cells displayed up-regulated nuclear expression of p63 and Ki67, down-regulated E-cadherin and cornea-specific keratin 3, and switched expression of beta-catenin from intercellular junctions to the nucleus and cytoplasm, indicating the activation of the Wnt/beta-catenin pathway. Invaded cells isolated by collagenase from the stroma of air-lifted, but not submerged, explants showed vivid clonal growth on 3T3 fibroblast feeder layers and complete epithelial-mesenchymal transition by expressing nuclear p63 and cytoplasmic S100A4. These findings collectively suggest that epithelial-mesenchymal transition via the Wnt/beta-catenin pathway influences the fate of limbal epithelial cells, likely to be progenitor cells, between regeneration and fibrosis when the stromal niche is activated.


Aberrant CpG island methylation in early-onset sporadic gastric carcinoma.
Gastric carcinoma more commonly affects older patients, and it is thought that cases of early-onset gastric carcinoma may develop with a different molecular profile different from that of carcinoma occurring at a later age. We assayed the methylation status and genetic changes in genes associated with the APC-beta-catenin axis and the mismatch repair system in relatively early-onset gastric carcinoma samples to determine their association with gastric carcinogenesis. Tumor and normal tissue DNA samples were obtained from 40 patients with early-onset (< 50 y) gastric carcinomas and assayed for APC and CTNNB1 mutations, microsatellite instability, and methylation of the promoters of the hMLH1, TIMP3, THBS1, DAP- K, GSTP1 , APC, and MINT2. Promoter methylation at these seven loci ranged from 12.5 to 62%, with 38/40 tumors (95%) showing promoter methylation at more than one locus. The CpG island methylation phenotype (CIMP) was classified as high in 16 tumors (40%), low in 22 tumors (55%), and negative in 2 tumors (5%). Two concurrent missense mutations (E1685G, R1763L) in the APC mutation cluster region were detected in two tumors, nine tumors showed loss of APC heterozygosity (LOH), and two showed both LOH and promoter methylation. Our results indicate that, unlike in colorectal carcinoma, APC and CTNNB1 mutations do not appear to be highly implicated in early-onset gastric carcinogenesis. In contrast, our data show that promoter methylation is a prevalent phenomenon in early-onset gastric carcinoma and may be related to gastric carcinogenesis.


Epitope-specific in vivo protection against cytomegalovirus disease by CD8 T cells in the murine model of preemptive immunotherapy.
Preclinical research in murine models as well as subsequent clinical trials have concordantly revealed a high protective potential of antiviral CD8 T cells, of donor-derived ex vivo memory CD8 T cells in particular, in the immunotherapy of cytomegalovirus (CMV) infection in immunocompromised recipients. Although it is generally held view that the observed beneficial effect of the transferred cells is viral epitope-specific, involving the recognition of MHC class-I presented peptides by cognate T cell receptors, this assumption awaits formal proof, at least with regard to the in vivo function of the CD8 T cells. This question is particularly evident for CMV, since the function of viral immune evasion proteins interferes with the MHC class-I pathway of peptide presentation. Alternatively, therefore, one has to consider the possibility that the requirement for epitope recognition may be bypassed by other ligand-receptor interactions between CD8 T cells and infected cells, which may trigger the signaling for effector functions. Clearly, such a mechanism might explain why CD8 T cells are so efficient in controlling CMV infection despite the expression of viral immune evasion proteins. Here we provide direct evidence for epitope-specificity of antiviral protection by employing a recombinant murine CMV (mCMV), namely the mutant virus mCMV-IE1-L176A, in which an immunodominant viral epitope of the regulatory immediate-early protein IE1 is functionally deleted by a point mutation replacing leucine with alanine at the C-terminal MHC anchor position of the antigenic peptide.


Efficacy of telehealth in integrated chronic disease management for older, multimorbid adults with heart failure: A systematic review.
We conducted a systematic review to assess the comparative efficacy of integrated telehealth versus other strategies of chronic disease management in older, multimorbid adults with heart failure (HF) in primary care and community settings. Specific efficacy outcomes included CVD-related hospitalizations, rehospitalizations, and mortality. We searched for randomized controlled trials (RCTs) in MEDLINE, Scopus, EMBASE, CINAHL, and CENTRAL from the date of each database's inception to January 2020. The literature search retrieved 9,181 articles, which were screened by two independent raters. Twenty-two of these articles were included in the systematic review. Data extraction, risk of bias assessment, and narrative synthesis followed article screening. This systematic review found that integrated telehealth is efficacious in reducing CVD-related hospitalizations, rehospitalizations, and mortality in older, multimorbid adults within primary care and community settings. However, numerous discrepancies existed between the studies, due largely to differences in telehealth modalities and risk of bias. Overall, the combinations of modalities were so diverse that the reviewed literature did not suggest an optimal integrated telehealth strategy. At most, no more than three studies featured the same combination of telehealth modalities and outcomes. Furthermore, only 3 of the 22 included RCTs scored low on the Cochrane risk of bias tool. Researchers should focus on the quality of future RCTs to better assess the efficacy of different telehealth modalities in multimorbid older adults with HF. Also, since all the included RCTs focused on HF, a knowledge gap exists with regard to the efficacy of using integrated telehealth to manage other cardiovascular diseases (CVD).


Adverse pregnancy outcome following post-chorionic villus sampling amniocentesis compared to chorionic villus sampling.
To assess the adverse pregnancy outcome of post-chorionic villus sampling (CVS) amniocentesis and chorionic villus sampling. Adverse pregnancy outcomes of 32 post-CVS amniocentesis cases and 264 CVS only cases were compared. The base-line characteristics were comparable in the 2 groups. One (3.1%) chromosomal abnormality was detected in the post-CVS amniocentesis group, compared to 5 (1.8%) in the CVS only group (p > 0.05). The fetal loss rate (spontaneous abortions and stillbirths) among continuing pregnancies was 3.2% in the post-CVS amniocentesis group and 3.5% in the CVS only group (p > 0.05). No statistically significant difference was found in the incidence of neonatal death, preterm delivery, fetal growth restriction, or congenital anomalies between the 2 groups. Adverse pregnancy outcome occurred at a similar frequency in the post-CVS amniocentesis group as in the CVS only group. Therefore, a subsequent amniocentesis after CVS can be considered as a safe procedure that does not introduce any additional adverse pregnancy outcome compared to that of CVS only.


Cyclosporin A effective therapy for fifty-two cadaver kidney recipients.
Fifty-two consecutive patients receiving cadaveric renal transplants were prescribed cyclosporin A and steroid therapy. Three of the recipients underwent re-transplantation and two of the patients were grafted with kidneys shipped from the United States. One year actuarial patient and graft survival rate with no exclusions were 94.2 percent and 81.6 percent, respectively, this rate being significantly better than results in case of the conventional combination of azathioprine, steroid and antilymphocyte globulin. The role of HLA-DR matching on cyclosporin A treatment was studied. One year actuarial graft survival rates of two HLA-DR matched and one HLA-DR matched were 91.7 percent and 78.9 percent, respectively. To assess the effects of cyclosporin A in the management of patients with acute tubular necrosis, the patients were divided into two groups, in terms of whether or not hemodialysis treatment was required for acute tubular necrosis. Although in the present protocol, cyclosporin A administration was begun before the operation, no significant differences in the graft survivals were evident between the two groups. Nephrotoxicity, hepatotoxicity and other side-effects of cyclosporin A could usually be dealt with by dosage adjustments, making feasible the chronic ingestion of this agent. The exceptional effectiveness and safety of cyclosporin A were evident throughout these early trials.


Making Science Education More Accessible: A Case Study of TikTok's Utility as a Science Communication Tool.
Social media has revolutionized science communication, allowing for rapid dissemination of science-related content to the public. In recent years, video platforms like TikTok and Instagram have implemented recommendation algorithms that track users' interests andsuggest personalized videos. As a result, these apps have become powerful tools for public messaging, facilitating access to audiences that are naturally curious about science. In 2020 I began uploading educational science videos to TikTok which have collectively accumulated more than 48 million views and 8 million "likes." Here I present an analysis of video metrics collected from the TikTok app for a random sampling of 150 videos, searching for factors that predict the number of views a video receives and the level of viewer engagement. Videos with higher view counts were liked and shared at higher rates and sustained viewer attention for longer. Properties like hashtags, sounds, and effects did not significantly influence video views. Interestingly, videos summarizing research papers received the highest levels of engagement, potentially reflecting high demand from lay audiences who are traditionally unable to access scientific literature. Finally, I present survey data demonstrating that 84% of users report feeling more trustful of science & scientists after following this account. Although the generalizability of these findings is limited, the results offer insights into the factors that drive video performance on TikTok and how users engage with scientific content on social media. These findings may help science communicators more effectively reach wider audiences and promote science literacy in new and innovative ways.


Diagnosing renal failure due to diethylene glycol in children in a resource-constrained setting.
In 2008, several Nigerian children developed acute kidney injury (AKI) after ingesting teething syrup contaminated with diethylene glycol (DEG). Because there are limited diagnostic facilities in resource-constrained countries, this study investigated whether AKI associated with DEG could be identified by other means. This was a multicenter study. Information was obtained from hospital records. Clinicopathological features of all children with AKI over a 6-month period were reviewed. Sixty (50.4%) of 119 children ingested "My pikin" teething syrup. Compared to children who had not ingested it, they were significantly (p < 0.05) younger (11.95 vs. 31 months), more were anuric (98.3 vs. 74.6%), hypertensive (84 vs. 52%), had severe metabolic acidosis (46.7 vs. 20.5%), and died (96.6 vs. 71.2%). They developed increasing metabolic acidosis and multiorgan dysfunction despite peritoneal dialysis. Late presentation, financial difficulties, inadequate facilities for toxicology, and hemodialysis complicated management. Identifying AKI associated with DEG is difficult. Detailed drug history, increasing metabolic acidosis, and multiorgan deterioration despite peritoneal dialysis should arouse suspicion. Simple diagnostic tests need to be developed and facilities for hemodialysis of infants and financial support provided. Recurrences can be prevented by creating awareness, improving manufacturing practices, field-testing of drugs, and international monitoring of pharmaceuticals imported for manufacture.


Development and validation of self- and caregiver-report of a distress screening tool for pediatric cancer survivors.
To develop and validate the Distress Screening Tool (DST) for child and adolescent cancer survivors. In part 1, items of the DST were generated through literature search and group interviews. Initially, the DST was tested on pediatric cancer survivors and their caregivers. In part 2, the modified version of the DST was retested with a different set of participants. Lastly, the psychometric properties and cutoff scores of the DST were evaluated on a separate set of survivors and caregivers. In part 1, six items of the DST self- and caregiver-report versions were generated. The initial 6 DST items of both versions showed acceptable internal consistency, but low inter-item correlation. Following the item modification, both versions of the DST showed improved inter-item correlation. In part 2, the modified DST had acceptable internal consistency and convergent validity, with acceptable psychometric properties. Cutoff scores were also generated. The DST could be a useful tool for pediatric cancer survivors.


Properties of Binuclear Rhodium(II) Complexes and Their Antibacterial Activity.
Binuclear rhodium(II) complexes [Rh(2)Cl(2)(mu-OOCR)(2)(N-N)(2)], [Rh(2)(mu-OOCR)(2)(N-N)(2)(H(2)O)(2)](RCOO)(2) and [Rh(2)Cl(2)(mu-OOCCH(3))(terpy)(2)](H(3)O)Cl(2).9H(2)O (R = H, Me, Bu(n), ph, PhCHOH; N-N = 2,2'-bipyridine (bpy), 1,10-phenanthroline (phen), 2,9-dimethyl-1,10-phenanthroline (dmp) and 6,7-dimethyl-2,3- di(2-pyridyl)quinoxaline (dmpq); terpy 2,2':6',2''-terpyridine) have been synthesized and their structure and properties have been studied by electronic, IR and (1)H NMR spectroscopy. Antibacterial activity of these complexes against Staphylococcus aureus and Escherichia coli has been investigated. The most active antibacterial agents against S. aureus were [Rh(2)(OOCPh)(2)(phen)(2)(H(2)O)(2)](2+), [Rh(2)(OOCPh)(2)(dmpq)(2)(H(2)O)(2)](2+), [Rh(2)(OOCBu)(2)(phen)(2)(H(2)O)(2)](2+) and [Rh(2)-(OOCBu)(2)(bpy)(2)(H(2)O)(2)](2+) which were considerably more active than the appropriate nitrogen ligands. The complexes show rather low activity against E. coli.


Tree diversity, biomass and carbon storage in sacred groves of Central India.
Sacred groves are small or large patches of forest and are rich in biodiversity, store carbon (C) in biomass and soil, besides providing important ecosystem services. However, the information on tree species diversity, biomass, and C storage in sacred groves of Central India, Madhya Pradesh is elusive and fragmented. In the present study, 41 sacred groves were inventoried for tree species diversity, biomass, and C storage in vegetation and soil. A total of 103 tree species from 81 genera belonging to 37 families were recorded. Shannon's diversity, Dominance, Fisher's alpha, and species evenness indices for trees varied: 0.77-2.53, 0.07-0.64, 1.58-20.37, and 0.28-0.90 respectively. Tree density ranged 75-675 no. of stems ha-1 with a mean of 271 no. of stems ha-1, while basal area ranged 6.8-47 m2 ha-1 with a mean value of 27 m2 ha-1. Tree biomass ranged 34.9-409.8 Mg ha-1 with a mean value of 194.01 Mg ha-1, while, tree C ranged between 17.5 and 204.9 Mg C ha-1 with a mean value of 97.0 Mg C ha-1. The total soil organic carbon stock (0-30 cm) ranged from 22.4 to 112.5 Mg C ha-1 with the mean value of 62 Mg C ha-1. Biomass C and SOC contributed 61% and 39% of the total C stocks, respectively. Tree C stock showed a significant positive relationship with tree basal area (R2 = 0.968). A total of five tree species belonging to four families were found to be vulnerable in Central India. The present study reveals that the sacred groves of Central India are species rich, have higher C stocks and sequestration potential in both vegetation and soil, and calls for an immediate attention for conservation and planning for long-term C sequestration.


Mechanical evaluation of two loop tensioning methods for crimp clamp extracapsular stabilization of the cranial cruciate ligament-deficient canine stifle.
To describe a method of tightening nylon loops secured with a crimping system for extracapsular fabello-tibial stabilization of the cranial cruciate ligament-deficient stifle and to compare this with a method using a commercially available tensioning device. In vitro mechanical testing. Fourteen standardized nylon loops were tensioned using a tensioning device and secured with crimp clamps. Another 14 loops were tightened by partially securing the crimp clamp, followed by tightening of the loop by hand, before definitively securing the crimp clamp. Loops were loaded to failure in a materials testing machine. Mean ultimate loads for instrument-tightened and hand-tightened loops were 383.7 and 371.4 N, respectively. Mean stiffness values for instrument-tightened and hand-tightened loops were 59.7 and 59.3 N/mm, respectively. These differences were not significant. The hand tightening method does not affect the mechanical properties of the loop. The hand tightening method described is a valuable technique for unassisted surgeons without access to tensioning devices.


[A Rarely Differential Diagnosis of Exertional Dyspnea].
The determination of exercise-induced dyspnea is an important multifaceted task for a differential diagnosis of the pulmonologist. We are reporting the case of a 70-year old female patient at the time of the first presentation with a tumor filling almost the entire left hemithorax. Histologically a solitary pleural fibroma could be diagnosed.


Dependence-producing properties of alprazolam in the dog.
Alprazolam (48 mg/kg/day) administered orally to dogs 4 times a day in equally divided doses produced physical dependence. This dependence was revealed by a precipitated abstinence syndrome which occurred after either oral administration of flumazenil (6, 18 and 36 mg/kg) or intravenous administration of a liposomal suspension of flumazenil. Flumazenil alone (18, 36 and 72 mg/kg) produced no significant signs of precipitated abstinence in naive dogs. This precipitated abstinence syndrome in alprazolam-dependent dogs was characterized by both clonic and tonic-clonic seizures. Other signs of precipitated abstinence which comprise the NPAS score were less intense in the alprazolam-dependent than in diazepam-dependent dogs. Alprazolam is extensively metabolized in the dog and does not accumulate whereas its predominant metabolite, alpha hydroxyalprazolam, does accumulate. The data suggest that alpha hydroxyalprazolam plays a role in the dependence-producing properties of alprazolam in the dog as revealed by the precipitated abstinence syndrome.


Characterization of charge neutralization reaction in aqueous solution using the membrane separation method.
Colloid titration and streaming current detector are two popular techniques used to determine the charge density of dissolved and colloidally dispersed polyelectrolytes. However, both techniques are based on some assumptions that may not be valid under some circumstances. In this paper, a membrane separation technique developed to determine the charge density and characterize a charge neutralization reaction is described. The technique characterizes the reaction between cationic and anionic charge carriers by measuring the counterions released during reaction or the unreacted small molecule charge carriers. Membranes with selected cutoff pore size were used to separate the species of interest from the bulk of the reaction mixture. Three different charge determination techniques were also compared.


Conjugated steroids: analytical approaches and applications.
An introduction to conjugated steroids and the justification for their analysis is provided covering both environmental and biological samples. Determining conjugated steroids or indeed any organic chemical which is conjugated upon excretion from the body has relevance in diagnostic monitoring, forensic screening and environmental analysis (from the endocrine disrupter perspective). The various analytical approaches and the accompanying issues are application-dependent. There are numerous options at each stage of analysis, from extraction, hydrolysis, derivatisation, and detection, and advances can be confined to the specific application for which it was developed. Emphasis is placed on the choice of separation and how gas or liquid chromatography necessitates different preparative stages to enable conjugated steroid determination. Possible future directions and research for conjugated steroid analysis are discussed.


Pharmacological and clinical importance of narcotic antagonists and mixed antagonists--use in cardiology.
1 The treatment of pain of cardiac origin requires a knowledge of the haemodynamic action of the analgesic agents used. 2 The haemodynamic effects of morphine, diamorphine, pavaveretum, pethidine and pentazocine are reviewed. 3 Clinical experience with the new antagonist analgesic buprenorphine is reported. 4 These studies indicate that buprenorphine may be the agent of choice for the relief of severe pain in patients with unstable circulation.


The effect of topically administered latanoprost on the cochlear blood flow and hearing.
The application of intratympanic latanoprost (PGF2α analog) has been recently used to alleviate vertigo, disequilibrium and to improve hearing in Meniere's disease patients. However, there is no known report on the effect of topically applied latanoprost on hearing and cochlear hemodynamic parameters including cochlear blood flow (CBF) and vascular conductance. Our goal was to assess the influence of topically applied latanoprost on cochlear blood flow (CBF) and hearing. Twenty male Sprague-Dawley rats were randomly divided into the group A, 50 μl of latanoprost (1 ml containing 50 μg, n=10) and group B, 100 μl (1 ml containing 50 μg, n=10). Topical application of latanoprost was performed at the right side, and the left side was applied with phosphate buffered saline (PBS) as a negative control. Five rats at each group were used to measure cochlear blood flow (CBF). And the others at each group were used for hearing test by auditory brainstem response (ABR). After physiological examination, bullas were extracted. The changes of cochlear hair cells were observed by performing the field emission-scanning electron microscopy (FE-SEM). The CBF of both groups was found to be decreased compared to the PBS applied left side. Significant decrement of CBF was observed in group B compared to the group A. Significant elevation of hearing threshold at high frequencies was observed in both groups compared to the PBS applied group. However, inner and outer hair cells were intact. Topically administered latanoprost decreased the CBF and impaired hearing. Based on our findings, additional studies are required to evaluate the side effects of intratympanic latanoprost before its use in clinical practice.


In Vivo Evaluation of Effect of Preoperative Ibuprofen on Proinflammatory Mediators in Irreversible Pulpitis Cases.
Preoperative administration of nonsteroidal anti-inflammatory drugs has been suggested as a method for increasing the efficacy of local anesthetics and decreasing postoperative pain in symptomatic irreversible pulpitis cases. However, the effects of ibuprofen at the molecular level are still unknown. Hence, the purpose of this study was to compare the levels of proinflammatory mediators in the dental pulp of teeth with irreversible pulpitis in patients who medicated with preoperative ibuprofen versus those who did not. Thirty-four patients undergoing conventional endodontic therapy for teeth with irreversible pulpitis were selected and randomly assigned into either the ibuprofen or nonibuprofen group. Four patients undergoing endodontic therapy for prosthodontic reasons served as controls. Patients in the ibuprofen group were instructed to take 600 mg ibuprofen 1 hour before treatment, whereas patients in the nonibuprofen and control groups were asked to avoid analgesics before treatment. Blood samples obtained from the pulp upon access were tested for levels of prostaglandin E2, tumor necrosis efactor alpha, interleukin (IL)-6, IL-1β, and interferon gamma using high-sensitivity enzyme-linked immunosorbent assay. Postoperative pain levels were recorded for the groups. Data for the cytokine levels and postoperative pain were analyzed using statistical analysis. There was a significant decrease in the levels of prostaglandin E2, tumor necrosis factor alpha, IL-6, and interferon gamma in the ibuprofen group compared with the nonibuprofen group. No significant differences were noted in the postoperative pain levels between these groups. The data showed that preoperative ibuprofen significantly decreased the levels of most proinflammatory cytokines in the dental pulp, which could possibly help with anesthesia in irreversible cases.


Ag-PIE: a GIS-based screening model for assessing agricultural pressures and impacts on water quality on a European scale.
Diffuse pollution of water resources from agricultural sources is a major environmental issue in the European Union, and has been dealt with by specific legislation: the Nitrate Directive of 1991 and the Water Framework Directive of 2000. These attempts to provide a coordinated approach to solving environmental problems require methods and tools for spatial analysis and modelling on a continental scale, with river basins being used as spatial units. This paper presents a screening model (Ag-PIE), developed in a GIS environment, for the assessment of pressures from agricultural land use and the consequent impacts on surface and groundwater. Ag-PIE has been applied at the European scale (EU15), with focus on nitrogen pollution from chemical fertilisers and manure. The model adopts a multi-criteria evaluation procedure applied to spatial data layers which represent the variety of factors affecting the pollution process. The DPSIR (Driving forces, Pressures, State, Impact, Responses) approach is applied to provide the modelling approach with a conceptual framework and to further analyse and communicate results. Ag-PIE is ultimately aimed at providing a tool making use of state-of-the-art geographical databases to support policy-makers at the European level. The scale of reference adopted is the river basin, in particular those that extend across national boundaries. The quality of the results obtained has been assessed against existing related studies and monitoring reports and by means of sensitivity analysis. Conclusions are driven by considering the potential of Ag-PIE in devising policy support and its strengths and weaknesses in view of identifying future research needs.


Neck recontouring with suture suspension and liposuction: an alternative for the early rhytidectomy candidate.
The authors present a new technique that uses liposuction of the submental and submandibular areas to remove fat and initiate skin contracture. The technique also includes platysmal resection and the use of interlocking sutures running through a subcutaneous tunnel immediately below the submandibular border. The results of the procedure are a recontoured neck and highlighted mandibular border.


Early mortality among triplets in the United States: black-white disparity.
In this study, we sought to estimate the black-white gap in early mortality among triplets. This was a retrospective cohort study on triplets delivered in the United States from 1995 to 1997. We computed relative risks for early mortality among triplets born to black mothers using the generalized estimating equation framework. There were 1317 black and 14,364 white triplets analyzed. Black triplets were twice as likely to have neonatal and infant mortality compared with whites (Odds ratio [OR], 2.00, 95% CI, 1.38-2.77; and OR, 2.20, 95% CI, 1.59-3.00, respectively). The widest disparity was observed postneonatally, with black triplets sustaining a level of risk almost 4-fold that of whites (OR, 3.60, 95% CI, 2.10-6.10). Stillbirth and perinatal mortality were comparable for both races. Black-white disparity for early mortality among triplets was widest postneonatally. This finding bears important clinical and public health implications.


The absence of melanopsin alters retinal clock function and dopamine regulation by light.
The retinal circadian clock is crucial for optimal regulation of retinal physiology and function, yet its cellular location in mammals is still controversial. We used laser microdissection to investigate the circadian profiles and phase relations of clock gene expression and Period gene induction by light in the isolated outer (rods/cones) and inner (inner nuclear and ganglion cell layers) regions in wild-type and melanopsin-knockout (Opn 4 (-/-) ) mouse retinas. In the wild-type mouse, all clock genes are rhythmically expressed in the photoreceptor layer but not in the inner retina. For clock genes that are rhythmic in both retinal compartments, the circadian profiles are out of phase. These results are consistent with the view that photoreceptors are a potential site of circadian rhythm generation. In mice lacking melanopsin, we found an unexpected loss of clock gene rhythms and of the photic induction of Per1-Per2 mRNAs only in the outer retina. Since melanopsin ganglion cells are known to provide a feed-back signalling pathway for photic information to dopaminergic cells, we further examined dopamine (DA) synthesis in Opn 4 (-/-) mice. The lack of melanopsin prevented the light-dependent increase of tyrosine hydroxylase (TH) mRNA and of DA and, in constant darkness, led to comparatively high levels of both components. These results suggest that melanopsin is required for molecular clock function and DA regulation in the retina, and that Period gene induction by light is mediated by a melanopsin-dependent, DA-driven signal acting on retinal photoreceptors.


Pulmonary cryptococcosis in late pregnancy and review of published literature.
Naturally occurring maternal immunosuppression increases the risk of infection by a variety of pathogens during pregnancy and the postpartum period. Pulmonary cryptococcosis during pregnancy is relatively rare. Here, we report on two cases of pulmonary cryptococcosis during pregnancy and puerperium. Both cases were successfully treated using oral fluconazole after parturition to avoid fetal toxicity. For the two patients, the placentas were checked and found to be pathologically normal, and the cryptococcal serum antigen in both infants was negative. Pulmonary cryptococcosis should be considered during differential diagnosis as a possible cause of abnormal chest shadow in pregnant patients.


Calibration and field performance of triolein embedded acetate membranes for passive sampling persistent organic pollutants in water.
Triolein embedded cellulose acetate membrane (TECAM) passive samplers provide potentially powerful tool for monitoring time weighted average concentrations (C(TWA)) of trace hydrophobic organic contaminants in water. To study the field performance of TECAM, exchange kinetics of chemicals between water and TECAM were studied at different temperature and water flow rates. Results showed that the uptake rate constant (k(u)) in TECAM was less sensitive to temperature variation than the SPMD and Chemcatcher. The k(u) in TECAM was sensitive to even a slight change of the flow rate, which required the field calibration using performance reference compounds (PRCs). To estimate C(TWA) by TECAM, both empirical model and WBL model were compared in laboratory conditions, and only small differences were observed between the predicted and measured k(u). Field validation was conducted to test the sampler performance alongside spot sampling. A good agreement of water concentration was obtained by the two sampling techniques.


Sources of Experimental Variation in 2-D Maps: The Importance of Experimental Design in Gel-Based Proteomics.
The success of proteomic studies employing 2-D maps largely depends on the way surveys and experiments have been organized and performed. Planning gel-based proteomic experiments involves the selection of equipment, methodology, treatments, types and number of samples, experimental layout, and methods for data analysis. A good experimental design will maximize the output of the experiment while taking into account the biological and technical resources available. In this chapter we provide guidelines to assist proteomics researchers in all these choices and help them to design quantitative 2-DE experiments.


Physician Coaching.
The practice of anesthesiology requires both clinical skills and the ability to navigate complex social situations. Leadership skills such as emotional intelligence, adaptability, conflict management, and negotiation are crucial for success but infrequently taught. Coaching is a thought-provoking process that enhances self-awareness and inspires the maximization of personal and professional potential. It has been used in the business world for personal and professional development for decades, and evidence now exists that coaching also provides benefits for physicians in both professional development and well-being.


The role of speaker eye gaze and mutual exclusivity in novel word learning by monolingual and bilingual children.
The current study examined the combined effect of a speaker's eye gaze and mutual exclusivity (ME) on novel word retention in monolingual and bilingual children. A novel object was presented with a familiar object, and children were taught new labels for objects under two conditions. In the Align condition, the speaker's gaze and the ME cue provided the same information (the speaker looked at the novel object while labeling it with a novel name). In the Conflict condition, the speaker's gaze and the ME cue provided competing information (the speaker looked at the familiar object while labeling it with a novel name). Using a visual world eye-tracking paradigm, children's retention was assessed by testing novel objects with novel labels and by testing the familiar objects with novel labels. We found that all children successfully retained the novel labels for novel objects when both eye gaze and ME provided the same information. However, when the cues conflicted, bilingual children did not perform above chance for either novel objects or familiar objects. In contrast, monolingual children demonstrated retention of novel labels for familiar objects but not for novel objects. Together, the findings suggest that redundant cues benefit word retention in all children regardless of linguistic background. Furthermore, when speaker gaze and ME conflict, bilingual children appear to disregard both cues during retention, whereas monolingual children may be more willing to retain novel labels for familiar words, suggesting that they prioritize a speaker's eye gaze over ME.


Detection of impaired cerebrovascular reactivity in patients with chronic cerebral ischemia using whole-brain 7T MRA.
Cerebrovascular reactivity (CVR) to acetazolamide (ACZ) on single-photon emission computed tomography (SPECT) can be used to assess the severity of chronic cerebral ischemia; however, this is an invasive method. We examined whether whole-brain magnetic resonance angiography (MRA) at 7T could non-invasively detect impaired CVR in patients with chronic cerebral ischemia by demonstrating the leptomeningeal collaterals (LMCs). Fifty-seven patients with symptomatic unilateral cervical stenosis underwent whole-brain time-of-flight MRA at 7T and cerebral perfusion SPECT before/after the ACZ challenge. MRA images were visually assessed based on 6-point grading systems to evaluate the development of LMCs toward the middle cerebral artery (MCA) and antegrade flow of MCA. CVR of the affected side was calculated from the SPECT data. Subsequently, we compared the LMC grades on MRA with CVR on SPECT. CVR was significantly lower in grades ≥ 2 of LMCs than in grades 0-1 (P < 0.05) when applying LMCs from the anterior cerebral artery (ACA) and/or posterior cerebral artery (PCA). These differences were more evident than those in the grading of the antegrade MCA flow. The LMC grades from ACA/PCA readily detected reduced CVR (< 18.4%) with a sensitivity/specificity of 0.79/0.82. The development of LMCs on whole-brain MRA at 7T can non-invasively detect reduced CVR with a high sensitivity/specificity in patients with unilateral cervical stenosis.


Complete assignments of 1H and 13C NMR spectral data for three polyhydroxylated 12-ursen-type triterpenoids from Dischidia esquirolii.
The complete assignments of all the (1)H and (13)C NMR signals of three polyhydroxylated 12-ursen-type triterpenes, 6beta,19alpha,22alpha-trihydroxyurs-12-en-3-oxo-28-oic acid (1), 3beta,6alpha,19alpha,23-tetrahydroxyurs-12-en-28- oic acid (2) and 3beta,6beta,19alpha,23-tetrahydroxyurs-12-en-28-oic acid (3), were carried out by means of homo- and hetero-nuclear two-dimensional NMR experiments. Compounds 1-3 were isolated from the aerial parts of Dischidia esquirolii. Of them, 1 and 2 were identified as new polyhydroxylated ursolic acid derivatives. Compound 2 is the C-6 hydroxyl epimer of 3, which was isolated first from Adina rubella, and its structure is revised in this paper.


Reversing multidrug resistance by tyrosine kinase inhibitors.
Recently, a large number of tyrosine kinase inhibitors(TKIs) have been developed as anticancer agents. These TKIs can specifically and selectively inhibit tumor cell growth and metastasis by targeting various tyrosine kinases and thereby interfering with cellular signaling pathways. The therapeutic potential of TKIs has been hindered by multidrug resistance(MDR), which is commonly caused by overexpression of ATP-binding cassette(ABC) membrane transporters. Interestingly, some TKIs have also been found to reverse MDR by directly inhibiting the function of ABC transporters and enhancing the efficacy of conventional chemotherapeutic drugs. In this review, we discuss ABC transporter-mediated MDR to TKIs and MDR reversal by TKIs.


Does increased body mass index lead to elevated prostate cancer risk? It depends on waist circumference.
We examined the association between obesity and prostate cancer based on both body mass index (BMI) and waist circumference (WC) using the National Health Insurance System (NHIS) database for the entire male population of Korea. A total of 1,917,430 men who underwent at least one health examination in 2009 without a previous diagnosis of any other cancer were tracked through December 2015. The hazard ratio (HR) and 95% confidence interval (CI) value for the association between prostate cancer and obesity were analyzed using multiple Cox regression model. Since there was a statistically significant interaction between WC and BMI, a multiple HR for prostate cancer was estimated with stratifying both WC and BMI to control the interaction between WC and BMI. Without considering WC as an adjustment factor, very weak association between BMI and prostate cancer development risk was observed. When WC was considered as an adjustment factor, no significant change in the HRs for prostate cancer development beyond the reference BMI was observed in the group with WC < 85 cm in the multivariable-adjusted models. However, in the group with WC ≥ 85 cm, the HRs for prostate cancer increased as the BMI increased beyond the reference BMI. In addition, there was a discrepancy in the trend of prostate cancer development according to BMI among the groups with different categories for WC. In groups with abdominal obesity, a significant linear relationship was observed between increasing BMI and prostate cancer risk. Higher the WC category, the stronger was the association with BMI, signifying that the association of BMI with risk of prostate cancer development depends on abdominal obesity.


Data Augmentation Based on Substituting Regional MRIs Volume Scores.
Due to difficulties in collecting sufficient training data, recent advances in neural-network-based methods have not been fully explored in the analysis of brain Magnetic Resonance Imaging (MRI). A possible solution to the limited-data issue is to augment the training set with synthetically generated data. In this paper, we propose a data augmentation strategy based on regional feature substitution. We demonstrate the advantages of this strategy with respect to training a simple neural-network-based classifier in predicting when individual youth transition from no-to-low to medium-to-heavy alcohol drinkers solely based on their volumetric MRI measurements. Based on 20-fold cross-validation, we generate more than one million synthetic samples from less than 500 subjects for each training run. The classifier achieves an accuracy of 74.1% in correctly distinguishing non-drinkers from drinkers at baseline and a 43.2% weighted accuracy in predicting the transition over a three year period (5-group classification task). Both accuracy scores are significantly better than training the classifier on the original dataset.


Clinical characteristics and physical functioning in persons hospitalized following the Norwegian terror attacks in July 2011: A follow up study.
To describe the clinical characteristics and physical functioning in persons hospitalized after 2 terror attacks in Norway in 2011. Cross-sectional study with retrospective acute medical data. Surviving persons hospitalized with physical injuries. Medical and psychological assessments 3-4 years after injury, with data on injury type and severity collected from medical records. A total of 30 out of 43 potential subjects participated (19 women, 11 men; age range 17-71 years (median 23 years)). Eighteen participants had suffered a severe injury, with New Injury Severity Scale (NISS) scores > 15. All body parts were affected. The number of surgical procedures ranged from 0 to 22 (median 3), and days in intensive care ranged from 0 to 59 (median 2.5), of which 16 had more than 24 h intensive care. Three to 4 years later, a majority of the participants had a broad spectrum of somatic and psychological problems and reduced physical functioning. Two-thirds of the participants reported their physical health to be unsatisfactory, and continuous need for healthcare and unmet needs were identified for all except 4 of the participants. Persons hospitalized following a terror attack experience a broad spectrum of somatic and psychological problems and need long-term physical and psychological follow-up. This study indicates specific needs for rehabilitation after injuries acquired under psychological traumatic circumstances.


The successful treatment of tropical fish tank granuloma (Mycobacterium marinum) with co-trimoxazole.
Three cases of tropical fish tank granuloma caused by Mycobacterium marinum (balnei) are described. Abundant acid fact bacilli were demonstrated in homogenates prepared from the fish thus providing early confirmation of the suspected clinical diagnosis: acid fast bacilli could not be demonstrated in biopsy material from the patients' lesions through M. marinum grew on culture. The infection responded to oral co-trimoxazole.


Endochondral ossification in hindlimbs during bufo gargarizans metamorphosis: A model of studying skeletal development in vertebrates.
Background Endochondral ossification, the process by which most of the skeleton is formed, is accurately regulated by many specific groups of molecules and extracellular matrix components. The molecular mechanisms of endochondral ossification have been extensively investigated in mammals. However, there are few studies about it in amphibians. Results Ossification of femur and tibiofibula was observed at Gs 40, and tarsals and metatarsals were ossified at Gs 42. Most of the skeletons in hindlimbs were completely ossified except for articular cartilages at Gs 46. Thirty-two genes related to endochondral ossification were found in the differentially expressed genes (DEGs) library of hindlimbs, and nine of these genes were validated by qRT-PCR during metamorphosis. Sox9 was expressed in the columnar, prehypertrophic, and upper hypertrophic zones, and the expression of Ihh was observed in prehypertrophic chondrocyte zone in hindlimbs of B. gargarizans. Conclusions The ossification of hindlimbs increased gradually, and the ossification sequence was from proximal to distal in B. gargarizans during metamorphosis. Thirty-two genes found in the DEGs library were related to the regulation of endochondral ossification of hindlimbs in amphibians. The present study will provide a valuable genomic resource for the future study of endochondral ossification in amphibian. Developmental Dynamics 247:1121-1134, 2018. © 2018 Wiley Periodicals, Inc.


Beyond the pre-shock pause: the effect of prehospital defibrillation mode on CPR interruptions and return of spontaneous circulation.
The pattern of interruptions to chest compressions in pre-hospital cardiac arrests in Wellington, New Zealand, was examined prospectively to determine whether the mode of defibrillation chosen by paramedics influenced interruptions, shock success and the return of spontaneous circulation (ROSC). A prospective observational cohort study of 44 adult cardiac arrests in which 203 shocks were administered by Wellington Free Ambulance (WFA) paramedics was undertaken to compare Code-stat electronic records from Medtronic Lifepak 12 and Lifepak 15 defibrillators used in semi-automated (AED) or manual mode. Interruptions during the 30s prior to shock delivery as well as pre-shock and post-shock pauses were calculated. Shock success and ROSC were the outcome measures. Pre-shock pauses were shorter in manual mode (median 3s, IQR 2-5) versus AED mode (median 4s, IQR 3-6; p=0.003). Interruptions of CPR in the 30s prior to shock delivery were also shorter in manual mode (median 7s, IQR 4-11) versus AED mode (median 14s, IQR 12-16; p=<0.001). Shock success rates and post-shock pauses were not statistically different between modes. ROSC was significantly higher in manual mode (18.49%) versus AED mode (8.33%, p=0.042). When paramedics used the defibrillator in manual mode as compared to AED mode, interruptions to CPR during the 30s prior to shock delivery were significantly reduced and pre-shock pauses were also shorter. This was associated with increased ROSC. Manual defibrillation should be the preferred option for appropriately trained paramedics. Training in this locality has been changed accordingly.


Oxic urban rivers as a potential source of atmospheric methane.
Urban rivers play a vital role in global methane (CH4) emissions. Previous studies have mainly focused on CH4 concentrations in urban rivers with a large amount of organic sediment. However, to date, the CH4 concentration in gravel-bed urban rivers with very little organic sediment has not been well documented. Here, we collected water samples from an oxic urban river (Xin'an River, China; annual mean dissolved oxygen concentration was 9.91 ± 1.99 mg L-1) with a stony riverbed containing very little organic sediment. Dissolved CH4 concentrations were measured using a membrane inlet mass spectrometer to investigate whether such rivers potentially act as an important source of atmospheric CH4 and the corresponding potential drivers. The results showed that CH4 was supersaturated at all sampling sites in the five sampling months. The mean CH4 saturation ratio (ratio of river dissolved CH4 concentration to the corresponding CH4 concentration that is in equilibrium with the atmosphere) across all sampling sites in the five sampling months was 204 ± 257, suggesting that the Xin'an River had a large CH4 emission potential. The CH4 concentration was significantly higher in the downstream river than in the upstream river (p < 0.05), which suggested that human activities along the river greatly impacted the CH4 level. Statistical analyses and incubation experiments indicated that algae can produce CH4 under oxic conditions, which may contribute to the significantly higher CH4 concentration in August 2020 (p < 0.001) when a severe algal bloom occurred. Furthermore, other factors, such as heavy rainfall events, dissolved organic carbon concentration, and water temperature, may also be vital factors affecting CH4 concentration. Our study enhances the understanding of dissolved CH4 dynamics in oxic urban rivers with very little organic sediment and further proposes feasible measures to control the CH4 concentration in urban rivers.


[Disclosure of a fatal pheochromocytoma during general anesthesia].
A case is reported of a phaeochromocytoma revealed during a general anaesthesia by a sudden hypertensive crisis associated with acute pulmonary oedema and signs of extreme sympathetic stimulation (bilateral mydriasis, piloerection, peripheral vasoconstriction). Aortic angiography revealed the tumour lying in an ectopic retroperitoneal situation and spasm in the superior mesenteric arterial territory. The patient died at the thirtieth hour from septic shock due to necrotizing colitis.


The effect of motor learning-based telerehabilitation on quality of life of children with cerebral palsy during the COVID-19 pandemic.
During the pandemic, the access of children with cerebral palsy (CP) to rehabilitation services was adversely affected due to the significant risk of infection. We assessed whether the effect of a motor learning-based treatment provided via a telerehabilitation method on the quality of life of children with cerebral palsy during the COVID-19 period was equivalent to face-to-face treatment. Distance exercises were explained by a physiotherapist to the patients in the telerehabilitation group, and motor learning-based treatment was applied by their families; the physiotherapist followed the sessions with video conferencing. Motor learning-based treatment was offered to the face-to-face group by a physiotherapist in the clinic. In the comparison between the groups, there was a significant difference in the parameters of play activities, pain-hurt, fatigue, eating activities, and speech communication activities after treatment (p<0.05). However, in the test performed by considering the nonhomogeneous parameters before the treatment, no time-dependent difference was found in the repeated measurements before and after the treatment in all parameters (p>0.05). Motor learning-based treatment provided using the telerehabilitation method has a positive effect on the quality of life of children with CP, but the results are similar to face-to-face treatment.


A brief overview of the clinical pharmacology of "club drugs".
Four different "club drugs" are reviewed: MDMA (methylenedioxymethamphetamine, "Ecstasy"), GHB (gamma-hydroxybutyrate), ketamine, and Rohypnol (flunitrazepam). The neurobiology, clinical pharmacology, and treatment issues for each are discussed.


Predictive value of ABCB1 polymorphisms G2677T/A, C3435T, and their haplotype in small cell lung cancer patients treated with chemotherapy.
Multiple drug resistance limits the efficacy of numerous cytotoxic drugs used in the treatment of small cell lung cancer (SCLC). The drug efflux protein ATP-binding cassette transporter B1 (ABCB1) has an important role in this process, and its gene variability may affect chemotherapy outcomes. This study aimed to evaluate the associations between ABCB1 polymorphisms G2677T/A, C3435T, and their haplotype with progression-free survival (PFS) and overall survival (OS) in 177 SCLC patients treated with cisplatin-etoposide or cyclophosphamide-epirubicin-vincristine chemotherapy. To determine the ABCB1 genotype, allelic specific TaqMan(®) probes were used in a RT-PCR . Patients carrying the G2677T/A TT + TA + AA genotypes (24 %) or the C3435T CT + TT genotypes (72 %) or the 2677T/A-3435T haplotype (40 %) had a longer PFS (Cox regression, P = 0.052, 0.037 and 0.037, respectively); these associations persisted also in multivariate analyses (Cox regression, P = 0.028, 0.037 and 0.030, respectively). Moreover, patients with the C3435T CT + TT genotypes had a longer OS both in univariate and multivariate analysis (Cox regression, P = 0.022 and 0.028, respectively). A trend toward longer OS was noted for the 2677T/A-3435T haplotype (Cox regression, P = 0.051), but its independent value was not confirmed (Cox regression, P = 0.071). Our study reported a possible predictive value of ABCB1 polymorphisms G2677T/A, C3435T, and their haplotype for longer PFS and OS in Caucasian SCLC patients treated with chemotherapy. However, to be implemented into routine clinical practice, ABCB1 polymorphisms require further validation.


Psychometric properties of the acceptance and action questionnaire (AAQ II) Malay version in cancer patients.
Acceptance and action questionnaire (AAQ II) is a scale used to assess psychological inflexibility. The aim of this study is to translate AAQ II into Malay language and evaluate the psychometric properties of AAQ II Malay version. The AAQ II which has been translated into Malay language via back translation procedure was distributed to 101 cancer patients and 100 non-cancer patients. The evaluation of psychometric properties in this study included content validity index, internal consistency, parallel reliability, exploratory factor analysis, concurrent validity, sensitivity and specificity of AAQ II Malay version. AAQ II Malay version has established good content validity index, acceptable internal consistency with Cronbach's alpha value of 0.91, excellent parallel reliability and adequate concurrent validity. Exploratory factor analysis (EFA) results demonstrated AAQ II Malay version is a unidimensional factor instrument. The result of sensitivity and specificity of AAQ II Malay version indicated cancer patients who scored more than 17.5 were having significant psychological inflexibility. AAQ II Malay version is a reliable and valid instrument to measure psychological inflexibility among cancer patient in Malaysia.


Role of P-glycoprotein in the brain disposition of seletalisib: Evaluation of the potential for drug-drug interactions.
Seletalisib is an orally bioavailable selective inhibitor of phosphoinositide 3-kinase delta (PI3Kδ) in clinical development for the treatment of immune-mediated inflammatory diseases. The present study investigated the role of P-gp in seletalisib disposition, especially brain distribution, and the associated risks of interactions. Seletalisib was found to be actively transported by rodent and human P-gp in vitro (transfected LLC-PK1 cells; Km of ca. 20 µM), with minimal or no affinity for the other tested transporters. A distribution study in knockout rats (single oral dosing at 750 mg kg-1) showed that P-gp restricts the brain disposition of seletalisib while having minimal effect on its intestinal absorption. Restricted brain penetration was also observed in cynomolgus monkeys (single oral dosing at 30 mg kg-1) using brain microdialysis and cerebrospinal fluid sampling (Kp,uu of 0.09 and 0.24, respectively). These findings opened the question of potential pharmacokinetic interaction between seletalisib and P-gp inhibitors. In vitro, CsA inhibited the active transport of seletalisib with an IC50 of 0.13 µM. In rats, co-administration of high doses of CsA (bolus iv followed by continuous infusion) increased the brain distribution of seletalisib (single oral dosing at 5 mg kg-1). The observed data were found aligned with those predicted by in vitro-in vivo extrapolation. Based on the same extrapolation method combined with literature data, only very few P-gp inhibitors (i.e. CsA, quinine, quinidine) were predicted to increase the brain disposition of seletalisib in the clinical setting (maximal 3-fold changes).


Analysis of 5-Hydroxymethyluracil Levels Using Flow Cytometry.
5-hydroxymethyluracil was originally identified as an oxidatively modified DNA base derivative. Recent evidence suggests that its formation may result from the oxidation of thymine in a reaction that is catalyzed by TET proteins. Alternatively, it could be generated through the deamination of 5-hydroxymethylcytosine by activation-induced cytidine deaminase. The standard method for evaluating 5-hydroxymethyluracil content is the highly sensitive and highly specific isotope-dilution automated online two-dimensional ultraperformance liquid chromatography with tandem mass spectrometry (2D-UPLC-MS/MS). Despite many advantages, this method has one great limitation. It is not able to measure compounds at a single-cell level. Our goal was to develop and optimize a method based on flow cytometry that allows the evaluation of 5-hydroxymethyluracil levels at a single cell level in peripheral leukocytes.


Sequelae of Cryptococcal-Immune Reconstitution Inflammatory Syndrome in a Kidney Transplant Recipient: A Case Report.
Cryptococcal-immune reconstitution inflammatory syndrome (C-IRIS) is a rare but recognized clinical entity in solid organ transplant recipients, though its clinical course and sequelae remain largely poorly described. We present the case of a kidney transplant recipient who presented with headache and fever. A cerebrospinal fluid analysis was performed and found to be compatible with cryptococcal meningitis. After down titration of immunosuppression and antifungal initiation, the patient initially improved. Weeks later, they experienced a sudden deterioration in mental status, prompting admission to the intensive care unit (ICU). This deterioration was attributed to C-IRIS, which developed following rapid de-escalation of immunosuppression in response to the diagnosis of cryptococcal meningitis. The initial episode of C-IRIS responded well to high-dose steroids; however, maintenance immunosuppression was not increased. Within 2 months, the patient presented again to the hospital with a pulmonary infiltrate and multifocal ischemic strokes. We argue this to be a case of relapsing multisystem C-IRIS, thus expanding the known spectrum of manifestations of C-IRIS in renal transplant recipients. We propose that following the diagnosis of C-IRIS, maintenance immunosuppression be escalated to avoid the risk of relapse and inflammatory-mediated organ dysfunction.


Properties of teratocarcinoma-thymus somatic cell hybrids.
A series of teratocarcinoma-thymus hybrid cells (PCT hybrids), which had been shown previously to give rise to multidifferentiated tumors and hence to be pluripotent, was tested to see whether these cells resembled their embryonal carcinoma parent in other ways as well. PCT hybrid cells looked like embryonal carcinoma parent in other ways as well. PCT hybrid cells looked like embryonal carcinoma cells by phase contrast and electron microscopy, have high levels of alkaline phosphatase, and fail to express Thy 1 alloantigen (which is present on thymocyte parental cells, but not on embryonal carcinoma cells). PCT hybrids do, however, exhibit H2 antigens, which are present only at very low levels, if at all, on embryonal carcinoma cells.


Feasibility of contrast-enhanced MRI derived textural features to predict overall survival in locally advanced breast cancer.
The prognosis for women with locally advanced breast cancer (LABC) is poor and there is a need for better treatment stratification. Gray-level co-occurrence matrix (GLCM) texture analysis of magnetic resonance (MR) images has been shown to predict pathological response and could become useful in stratifying patients to more targeted treatments. To evaluate the ability of GLCM textural features obtained before neoadjuvant chemotherapy to predict overall survival (OS) seven years after diagnosis of patients with LABC. This retrospective study includes data from 55 patients with LABC. GLCM textural features were extracted from segmented tumors in pre-treatment dynamic contrast-enhanced 3-T MR images. Prediction of OS by GLCM textural features was assessed and compared to predictions using traditional clinical variables. Linear mixed-effect models showed significant differences in five GLCM features (f1, f2, f5, f10, f11) between survivors and non-survivors. Using discriminant analysis for prediction of survival, GLCM features from 2 min post-contrast images achieved a classification accuracy of 73% (P < 0.001), whereas traditional prognostic factors resulted in a classification accuracy of 67% (P = 0.005). Using a combination of both yielded the highest classification accuracy (78%, P < 0.001). Median values for features f1, f2, f10, and f11 provided significantly different survival curves in Kaplan-Meier analysis. This study shows a clear association between textural features from post-contrast images obtained before neoadjuvant chemotherapy and OS seven years after diagnosis. Further studies in larger cohorts should be undertaken to investigate how this prognostic information can be used to benefit treatment stratification.


Genotyping based on complete coding sequences of porcine circovirus type 3 is stable and reliable.
Porcine circovirus type 3 (PCV3) is a newly identified virus, which is associated with PDNS-like clinical signs, reproductive failure, cardiac and multiorgan inflammation. However, the genotype of PCV3 is still controversial. Here, we reconstructed the phylogenies of 194 complete coding sequences of PCV3 using five different phylogenetic methods. The results showed five trees reconstructed using different methods displayed similar phylogenies, indicating genotyping based on complete coding sequences of PCV3 is stable and accurate.


Suppressor of cytokine signalling gene expression is elevated in breast carcinoma.
Cytokines are important for breast cell function, both as trophic hormones and as mediators of host defense mechanisms against breast cancer. Recently, inducible feedback suppressors of cytokine signalling (SOCS/JAB/SSI) have been identified, which decrease cell sensitivity to cytokines. We examined the expression of SOCS genes in 17 breast carcinomas and 10 breast cancer lines, in comparison with normal tissue and breast lines. We report elevated expression of SOCS-1-3 and CIS immunoreactive proteins within in situ ductal carcinomas and infiltrating ductal carcinomas relative to normal breast tissue. Significantly increased expression of SOCS-1-3 and CIS transcripts was also shown by quantitative in situ hybridisation within both tumour tissue and reactive stroma. CIS transcript expression was elevated in all 10 cancer lines, but not in control lines. However, there was no consistent elevation of other SOCS transcripts. CIS protein was shown by immunoblot to be present in all cancer lines at increased levels, mainly as the 47 kDa ubiquitinylated form. A potential proliferative role for CIS overexpression is supported by reports that CIS activates ERK kinases, and by strong induction in transient reporter assays with an ERK-responsive promoter. The in vivo elevation of SOCS gene expression may be part of the host/tumour response or a response to autocrine/paracrine GH and prolactin. However, increased CIS expression in breast cancer lines appears to be a specific lesion, and could simultaneously shut down STAT 5 signalling by trophic hormones, confer resistance to host cytokines and increase proliferation through ERK kinases.


Incidental splenectomy: early and late postoperative complications.
Of 542 splenectomies performed from 1964 to 1977, 242 were incidental to gastrointestinal surgery. The highest rate of complications was observed in these patients as opposed to those who underwent splenectomy for trauma or Hodgkin's disease. Eighteen laboratory studies did not show significant changes 1.5 to 10 years postoperatively in 96 patients. Ninety-three patients questioned because of late symptoms had the highest rate of complaints after incidental splenectomy.


Thermal stability and conformational changes of transglutaminase from a newly isolated Streptomyces hygroscopicus.
Thermal stability and conformational changes of transglutaminase (TGase) from a newly isolated Streptomyces hygroscopicus were investigated in this study. The inactivation kinetics of the microbial transglutaminase (MTGase) was fitted using one-step inactivation model. It was much more stable under 40 degrees C. The half-lives for the MTGase at 50 degrees C and 60 degrees C were only 20 min and 8 min, respectively. Spectroscopic studies of the enzyme suggested conformational transition from ordered secondary structural elements (alpha/beta-protein) to unordered structure during thermal denaturation. Some polyols could improve the thermal stability of the enzyme. Among the polyols examined, the prolonged half-lives of 40 min at 50 degrees C and 20 min at 60 degrees C were gained by adding 10% glycerol. The results of differential scanning calorimetric (DSC) analysis showed a distinct transition peak with a significant greater Tm and DeltaH for the MTGase mixed with polyols in comparison with the control, which indicated that the polyols could maintain the natural structure of the enzyme to some extent. The SDS-PAGE electrophoresis of cross-linked casein confirmed that the stabilizers could protect the MTGase from thermal denaturation.


Topical Cannabidiol (CBD) After Total Knee Arthroplasty Does Not Decrease Pain or Opioid Use: A Prospective Randomized Double-Blinded Placebo-Controlled Trial.
Multimodal analgesia has become the standard of care for pain management following total knee arthroplasty (TKA). Cannabidiol (CBD) is increasingly utilized in the postoperative period. The purpose of this study was to analyze the analgesic benefits of topical CBD following primary TKA. In this randomized double-blinded placebo-controlled trial, 80 patients undergoing primary unilateral TKA applied topical CBD (CBD; n = 19), essential oil (EO; n = 21), CBD and essential oil (CBD + EO; n = 21), or placebo (PLA; n = 19) thrice daily around the knee for two weeks postoperatively. This supplemented a standardized multimodal analgesic protocol. Outcomes included visual analog scale (VAS) pain and numeric rating scale (NRS) sleep scores (collected on postoperative day [POD] 0, 1, 2, 7, 14, 42), and cumulative postoperative opioid use (42 days). Demographic characteristics were similar among the four cohorts. Preoperative VAS and NRS scores were similar among groups. The CBD cohort had a higher mean VAS pain score on POD 2 compared to the EO cohort (CBD: 69.9 ± 19.3 versus. EO: 51.0 ± 18.2; P = .013). No statistically significant differences existed for VAS scores at other times, and no statistically significant differences were observed for postoperative NRS sleep scores or postoperative opioid use at any time point. Utilization of topical CBD in supplement to multimodal analgesia did not reduce pain or opioid consumption, or improve sleep scores following TKA. These results suggest that the local effects of topical CBD are not beneficial for providing additional pain relief after TKA.


Organ equivalent doses of patients undergoing chest computed tomography: measurements with TL dosimeters in an anthropomorphic phantom.
Dose reduction in patients undergoing computed tomography (CT) examinations has become a concern in many countries. CT dosimetric quantities were defined aiming optimization of CT procedures, organ absorbed doses and effective doses have been calculated for radiation risk assessments in patients. In this work, an experimental methodology was established for measuring organ doses with thermoluminescent (TL) dosimeters in an anthropomorphic phantom for routine CT chest examinations. Results may be useful for validating computational software used for CT dose calculations.


Increased risk of nonrelapse mortality post T-cell-replete haploidentical stem cell transplantation in patients with recurrence of acute graft-versus-host disease.
Acute graft-versus-host disease (aGVHD) causes significant morbidity and mortality. While most studies focus on classic or late aGVHD, some patients with previous aGVHD achieve complete remission and later develop another episode of aGVHD. Data on recurrence of aGVHD (RaGVHD) are lacking. This study aimed to identify the incidence, risk factors, and impacts of RaGVHD after T-cell-replete haploidentical hematopoietic cell transplantation (haplo-HCT) without posttransplantation cyclophosphamide. We evaluated patients with RaGVHD after haplo-HCT between 2017 and 2019 and compared their outcomes to those of patients with no aGVHD and those of patients with one episode of de novo aGVHD. Of 199 patients included in the analysis, 45 experienced 50 cases of RaGVHD with a 1-year cumulative incidence of 19.0% (95% CI: 14.5-24.6). Grade III-IV aGVHD was more common in RaGVHD than in previous aGVHD (22.2% vs. 4.4%, p = 0.01). Female donor to male recipient was strongly associated with RaGVHD (HR: 2.5, p = 0.009). The most common death in patients with RaGVHD was GVHD-related, which was different from controls who mostly died from relapse (p = 0.008). RaGVHD was an independent risk factor for chronic GVHD (HR: 2.6, p = 0.006) and nonrelapse mortality (HR: 2.4, p = 0.019) and a significant predictor of lower GVHD relapse-free survival (HR: 1.9, p = 0.020) and cGVHD relapse-free survival (HR: 2.1, p = 0.007). In conclusion, clinical manifestations and negative impacts of RaGVHD needs to be recognized independently.


The effect of intensive rehabilitation treatment on sleep disorder in children with motor delays.
Although the importance of sleep problems has been increasingly emphasized due to the effects on children's development and children's and families' daytime behaviors, physical health, and quality of life, they have been overlooked in clinical practice. However, there have been few studies on the effects of rehabilitation on sleep problems. Therefore, in this study, we investigated the effects of an intensive rehabilitation program on sleep problems in children with developmental delays (DD). We included 36 children with DD (30 outpatients, 6 inpatients) and their caregivers who completed all items on the Sleep Disturbance Scale for Children. Of the children with DD, 19 (59.3%) had cerebral palsy (CP) and 13 (40.7%) had DD of non-CP origins, of which 6 (18.8%) had prematurity, 4 (12.5%) had genetic causes, and 3 (9.4%) had an unknown origin. Changes in sleep problems after the intensive rehabilitation program were evaluated using a paired or unpaired t-test, depending on the distribution of the continuous variables. After the intensive rehabilitation program, in 36 children with DD, there was a significant improvement in the difficulty in initiating and maintaining sleep (DIMS) sub-score (p < 0.05). However, there was no significant improvement in the total score or other sub-scores, such as those for sleep breathing disorders (SBD), disorders of arousal (DA), sleep-wake transition disorders (SWTD), disorders of excessive somnolence (DOES), and sleep hyperhidrosis (SH). In the subgroup analysis according to the cause of DD, children with CP had a significant improvement in DIMS and DOES sub-scores (p < 0.05). The intensive rehabilitation program, consisting of more than two sessions per day, effectively alleviated sleep problems in children with DD, especially in those with CP. Among the sleep problems, the intensive rehabilitative program was most effective at improving the DIMS. However, further prospective studies with a larger number of patients with DD and a more standardized protocol are necessary to generalize this effect.


Psychiatric conditions and the social sciences.
Psychiatric disorders have a distinct shape, come in types and are inherent in Homo sapiens. To a social scientist, disorders exist by stipulation: contingent on a psychiatric frame of reference. Their materiality has meaning only in that framework. What is important is what that material might correspond to in a society's systems of representation and associated institutions. If one assigns disorders some sort of 'objective' reality (a scientific ontology), then one needs to explain what that corresponds to in cultural terms. Moreover, if disorders exist and have an evolutionary history, one has to formulate how they might have been perceived and understood during phases of biological and cultural evolution. The article provides a way to conceptualize meanings psychiatric disorders have had in these two systems of representation and their change during evolution.


Improving Quality of Carotid Interventions: Identifying Hospital-Level Structural Factors that can Improve Outcomes.
"Structural factors" relating to organization of hospitals may affect procedural outcomes. This study's aim was to clarify associations between structural factors and outcomes after carotid endarterectomy (CEA) and carotid endarterectomy stenting (CAS). A systematic review of studies published in English since 2005 was conducted. Structural factors assessed were as follows: population size served by the vascular department; number of hospital beds; availability of dedicated vascular beds; established clinical pathways; surgical intensive care unit (SICU) size; and specialty of surgeon/interventionalist. Primary outcomes were as follows: mortality; stroke; cardiac complications; length of hospital stay (LOS); and cost. There were 11 studies (n = 95,100 patients) included in this systematic review. For CEA, reduced mortality (P < 0.0001) and stroke rates (P = 0.001) were associated with vascular departments serving >75,000 people. Larger hospitals were associated with lower mortality, stroke rate, and cardiac events, compared with smaller hospitals (less than 130 beds). Provision of vascular beds after CEA was associated with lower mortality (P = 0.0008) and fewer cardiac events (P = 0.03). Adherence to established clinical pathways was associated with reduced stroke and cardiac event rates while reducing CEA costs. Large SICUs (≥7 beds) and dedicated intensivists were associated with decreased mortality after CEA while a large SICU was associated with reduced stroke rate (P = 0.001). Vascular surgeons performing CEA were associated with lower stroke rates and shorter LOS (P = 0.0001) than other specialists. CAS outcomes were not influenced by specialty but costless when performed by vascular surgeons (P < 0.0001). Structural factors affect CEA outcomes, but data on CAS were limited. These findings may inform reconfiguration of vascular services, reducing risks and costs associated with carotid interventions.


Prader-Willi syndrome: how does growth hormone affect body composition and physical function?
Children with Prader-Willi syndrome (PWS) display diminished growth, reduced muscle mass (lean body mass), and increased adipose tissue-body composition abnormalities resembling those seen in growth hormone (GH) deficiency. Diminished GH responses to various provocative agents, low insulin-like growth factor-I levels, and the presence of other hypothalamic dysfunction support the presence of true GH deficiency (GHD) in many children with PWS. GH treatment in these children decreases body fat, and increases linear growth, muscle mass, fat utilization and energy expenditure. Strength and agility are also improved. These improvements are most dramatic during the first year of GH therapy, and prolonged treatment still does not 'normalize' these parameters. The metabolic effects, including changes in physical strength and agility, may be the most important features for this particular pediatric population. These observations support a contribution of GHD to disabilities of children with PWS, and a clinically significant benefit of GH treatment.


Continuous in-vivo monitoring of arterial oxygen tension in a patient treated with bleomycin.
Patients receiving bleomycin therapy may develop pulmonary fibrosis. The risk of fibrosis is increased by the administration of general anaesthesia and fatal cases with pulmonary lesions resembling those of "oxygen toxicity" have been reported. The causes are not entirely clear but the enriched inspired oxygen given intraoperatively or postoperatively has been identified as an etiological factor. Optimal intraoperative management thus requires the administration of the lowest inspired oxygen fraction (FIO2) compatible with adequate oxygenation. To achieve this aim safely, continuous in vivo monitoring of arterial oxygen tension would be preferable to intermittent sampling of blood gases. We report the successful management of a patient undergoing thoracotomy following bleomycin therapy using an intravascular PO2 sensor to monitor arterial oxygen tension continuously. The uses and limitations of the PO2 sensor are discussed.


Workers' Compensation and return-to-work in low back pain.
The relationship of Workers' Compensation and litigation to low back pain (LBP) outcome is not established in the literature. Our study investigated the characteristics of disabled persons applying for Worker's Compensation or employing a lawyer, the factors predicting receipt of compensation, and the effects of compensation and litigation on employment outcome. One hundred sixty-nine unemployed persons with LBP were assessed by medical history, physical exam, biomechanical testing, psychiatric interview, and MMPI. Subjects were asked whether they had applied for compensation, received it, or had employed a lawyer. Six months later, subjects were asked about their employment and compensation status. Neither compensation status nor involvement of a lawyer significantly improved prediction of employment status 6 months later. Receipt of compensation predicted better outcome in those at risk for poor outcome due to external locus of control. Factors predicting failure to obtain compensation over 6 months, having applied, include education, spinal flexion, ability to do daily activities and affective inhibition. Neurological dysfunction did not predict receipt of compensation in univariate or multivariate analyses; emotional distress reduced the probability of receiving compensation, after controlling for severity of spinal dysfunction. Receipt of compensation and use of a lawyer did not reduce the probability of RTW in disabled persons in the present sample, but increased the likelihood of return to work for groups of individuals at higher risk such as those with external locus of control. Although compensation is awarded on the basis of physical evaluation under the present system, the present findings suggest that the likelihood of receiving compensation is also significantly determined by level of emotional distress.


Sulfated glycosaminoglycans of cells grown in culture: dermatan sulfate disappearance in successive fibroblast subcultures.
Sulfated glycosaminoglycan content of primary cultures of guinea pig embryo fibroblast in reported. It is shown that changes of sulfated glycosaminoglycans occur in successive subcultures: 1) disappearance of dermatan sulfate and 2) a slight increase in the proportion of heparitin sulfate. The sulfated glycosaminoglycan composition of the mammalian cell established lines: VERO, SIRK, Hep-2, MK-2, BGM, IB-RS-11 (S6) and 3T6 is also reported. It is shown that chondroitin sulfate AC and/or heparitin sulfate are the main glycosaminoglycans of the established cell lines (except 3T6). A possible role of these glycosaminoglycans in cell biology is discussed.


Tuning Nickel with Lewis Acidic Group 13 Metalloligands for Catalytic Olefin Hydrogenation.
A series of bimetallic complexes pairing zero-valent nickel with group 13 M(III) ions is reported. Stronger Ni→M(III) dative bonds that render Ni more electron-deficient are seen for larger ions (In > Ga > Al). The larger Ga and In ions stabilize rare, nonclassical Ni-H2 adducts that catalyze olefin hydrogenation. In contrast, neither the Ni-Al complex nor a single nickel center enables H2 binding or olefin hydrogenation. By comparison of the structures, redox properties, and catalytic activities of the Ni-M series, the electronic and steric effects of the supporting metal ion are elucidated.