Long-term satisfaction after extraoperative invasive EEG recording.
This retrospective cohort study investigated 53 patients with drug-resistant focal epilepsy and identified factors predictive of long-term satisfaction of patients and families following extraoperative intracranial EEG (iEEG) recording. The mixed model analysis assessed the utility of intracranial EEG (iEEG) predictor variables, including the seizure-onset zone (SOZ), modulation index (MI), and naming-related high-gamma activity. Modulation index, quantifying the coupling between high-frequency activity at >80 Hz and local slow wave at 3-4 Hz, effectively functions as a surrogate marker of the burden of interictal spike-and-slow-wave discharges. The mixed model specifically incorporated 'subtraction-MI', defined as the subtraction of mean z-score normalized MI across all preserved sites from that across all resected sites. Auditory naming-related high-gamma activity at 70-110 Hz is a biomarker to characterize the underlying language and speech function. The model incorporated 'maximum resected high-gamma', defined as the high-gamma percent change largest among sites included in the resected language-dominant hemispheric region. The model also incorporated the clinical and imaging profiles of given patients. The analysis revealed that complete removal of SOZ (p = 0.003) and younger patient age (p = 0.040) were independently associated with greater satisfaction. Neither 'subtraction-MI' nor 'maximum naming-related high-gamma' showed a significant and independent association with long-term satisfaction in our patient cohort. The observed impact of complete resection of SOZ and early surgery can be considered when counseling candidates for epilepsy surgery.


In Vitro Propagation of Salt-Tolerant Wild Rice Relative, Porteresia coarctata Tateoka.
Micropropagation of Porteresia coarctata Tateoka, a wild relative of rice with useful genetic traits of salinity and submergence tolerance, was achieved through nodal segment culture. Woody Plant (WP) medium supplemented with benzyladenine (5.5 µm) and kinetin (2.3 µm) gave the greatest response to initiation and multiplication. The multiplication rate of 11 shoots/explant with an average shoot length of 3.5 cm was observed after 8 weeks of culture period. The rooting response was observed simultaneously in the multiplication media, but subsequent establishment was poor. When the in vitro raised shoots were transferred to optimal 1/2 WP and 1/2 MS media with 10.7 µm alpha-naphthaleneacetic acid, the rooting response was enhanced. Such rooted plants were hardened successfully under field conditions. Key Words. Conservation-Mangrove associates-Micropropagation-Nodal explants-Porteresia coarctata-Salt tolerance


Nasal high flow higher than 60 L/min in patients with acute hypoxemic respiratory failure: a physiological study.
Nasal high flow delivered at flow rates higher than 60 L/min in patients with acute hypoxemic respiratory failure might be associated with improved physiological effects. However, poor comfort might limit feasibility of its clinical use. We performed a prospective randomized cross-over physiological study on 12 ICU patients with acute hypoxemic respiratory failure. Patients underwent three steps at the following gas flow: 0.5 L/kg PBW/min, 1 L/kg PBW/min, and 1.5 L/kg PBW/min in random order for 20 min. Temperature and FiO2 remained unchanged. Toward the end of each phase, we collected arterial blood gases, lung volumes, and regional distribution of ventilation assessed by electrical impedance tomography (EIT), and comfort. In five patients, the etiology was pulmonary; infective disease characterized seven patients; median PaO2/FiO2 at enrollment was 213 [IQR 136-232]. The range of flow rate during NHF 1.5 was 75-120 L/min. PaO2/FiO2 increased with flow, albeit non significantly (p = 0.064), PaCO2 and arterial pH remained stable (p = 0.108 and p = 0.105). Respiratory rate decreased at higher flow rates (p = 0.014). Inhomogeneity of ventilation decreased significantly at higher flows (p = 0.004) and lung volume at end-expiration significantly increased (p = 0.007), but mostly in the non-dependent regions. Comfort was significantly poorer during the step performed at the highest flow (p < 0.001). NHF delivered at rates higher than 60 L/min in critically ill patients with acute hypoxemic respiratory failure is associated with reduced respiratory rate, increased lung homogeneity, and additional positive pressure effect, but also with worse comfort.


Engraftment of retrovirally transduced Bet v 1-GFP expressing bone marrow cells leads to allergen-specific tolerance.
Molecular chimerism is a promising strategy to induce tolerance to disease-causing antigens expressed on genetically modified haematopoietic stem cells. The approach was employed successfully in models of autoimmunity and organ transplantation. Recently, we demonstrated that molecular chimerism induces robust and lasting tolerance towards the major grass pollen allergen Phl p 5. Since allergens are a group of antigens differing widely in their function, origin and structure we further examined the effectiveness of molecular chimerism using the Phl p 5-unrelated major birch pollen allergen Bet v 1, co-expressed with the reporter GFP. Besides, inhibition of CD26 was used to promote engraftment of modified stem cells. Retrovirus VSV-Betv1-GFP was generated to transduce 5-FU-mobilized BALB/c hematopoietic cells to express membrane-bound Bet v 1 (VSV-GFP virus was used as control). Myeloablated BALB/c mice received Betv1-GFP or GFP expressing bone marrow cells, pre-treated with a CD26 inhibitor. Chimerism was followed by flow cytometry. Tolerance was assessed by measuring allergen-specific isotype levels in sera, RBL assays and T-cell proliferation assays. Mice transplanted with transduced BMC developed multi-lineage molecular chimerism which remained stable long-term (>8 months). After repeated immunizations with Bet v 1 and Phl p 5 serum levels of Bet v 1-specific antibodies (IgE, IgG1, IgG2a, IgG3 and IgA) remained undetectable in Betv1-GFP chimeras while high levels of Phl p 5-specific antibodies developed. Likewise, basophil degranulation was induced in response to Phl p 5 but not to Bet v 1 and specific non-responsiveness to Bet v 1 was observed in proliferation assays. These data demonstrate successful tolerization towards Bet v 1 by molecular chimerism. Stable long-term chimerism was achieved under inhibition of CD26. These results provide evidence for the broad applicability of molecular chimerism as tolerance strategy in allergy.


Lymphocyte and CD62E expression in lichen planus and lichenoid reaction.
It is difficult to distinguish the clinical and histopathological aspects of oral lichen planus lesions from those of oral lichenoid reaction. Some criteria were proposed to distinguish them, mainly because they have different biological behaviors. The aim of the present study was to compare the lymphocyte population and the expression of E-selectin between these lesions. Participants with a clinical diagnosis of oral lichen planus (GOLP) and oral lichenoid reaction (GOLR) who needed to perform a biopsy were selected. The tissue was frozen and immunostaining was performed for CD3/CD4, CD3/CD8, CD4/CLA, CD8/CLA, and CD62E. The analysis of each immunostaining was accomplished using the ImageJ program. In total, 25 participants with oral lichen planus and 11 with oral lichenoid reaction were seen. In the evaluation of CD3 + CD4+/CD3 + and CD3 + CD8+/CD3 + proportions, there was a higher percentage of these cells in the oral lichen planus group when compared with the oral lichenoid reaction group (p = 0.027 and p = 0.038 respectively). The average number of CLA + lymphocytes for CD4+/CLA + and CD8+/CLA + in both groups was not statistically significant (p = 0.840; d = 0.363). In GOLP, the number of CD4 + CLA+/E-selectin and CD8 + CLA+/E-selectin was not statistically significant (p = 0.951 and p = 0.454 respectively); neither in GOLR (p = 0.454 and p = 0.989 respectively). Our results indicate that CD3 + CD4+, CD3 + CD8+, CD4 + CLA+, CD8 + CLA + lymphocytes and E-selectin are present in both lesions. However, the proportion of CD3 + CD4+/CD3 + and CD3 + CD8/CD3 + cells is higher in the oral lichen planus group when compared with the oral lichenoid reaction group, suggesting that these cells may be important for the etiopathogenic mechanism of these lesions.


Ask and ye shall not receive: Interpreter-related access barriers reported by Deaf users of American sign language.
Healthcare providers are mandated to provide reasonable accommodations for Deaf users of American Sign Language (ASL) accessing healthcare services, including ASL interpreters. Provision of accommodations improves access and provider/patient communication. Describe the types, frequency, severity, and trends in healthcare access complications experienced by Deaf patients. A six-year retrospective review of complaints (n = 108) filed regarding interpreter provision in healthcare settings with the Idaho Council for the Deaf and Hard of Hearing by Deaf users of ASL was conducted and summarized. An analysis of demographic and language factors associated with interpreter-related barriers and whether the complaint was resolved was performed using multivariate logistic regression. Reasons for complaints of interpreter-related barriers to care included: 48.2% were "told an interpreter was not available"; 28.7% received an unqualified interpreter; interpreter was promised but not provided (18.5%). Factors independently associated with having been promised an interpreter were: medical clinics (vs. dental) (OR 3.92 95%CI 1.18-12.98), and complaints filed later in the study period (OR 1.55 per year 95%CI 1.19-2.01). For each additional year during the study period, complaints were 1.6 times (95%CI 1.15-2.22) more likely to have an interpreter promised but not provided. Patients from rural areas were less likely to have their complaints satisfactorily resolved (OR 0.18 95%CI 0.06-0.55). Deaf patients experience various interpreter-related barriers throughout the process of accessing healthcare and communicating with providers/staff, though further regional and nationwide documentation is warranted.


Cardiac xenotransplantation: recent preclinical progress with 3-month median survival.
Transplantation is limited by a lack of human organ donors. Organs derived from animals, most likely the pig, represent a potential solution to this problem. For the heart, 90-day median graft survival of life-supporting pig hearts transplanted to nonhuman primates has been considered a reasonable standard for entry into the clinical arena. Overcoming the immune barrier to successful cardiac xenotransplantation is most appropriately first explored with the non-life-supporting heterotopic model. We performed a series of 7 heterotopic heart transplantations from CD46 transgenic pigs to baboons using a combination of therapeutic agents largely targeted at controlling the synthesis of anti-pig antibodies. Rituximab (anti-CD20) and Thymoglobulin (rabbit antithymocyte globulin [ATG]; SangStat Medical Corp, Fremont, Calif) were used as induction therapy. Baseline immunosuppression consisted of splenectomy, tacrolimus, sirolimus, steroids, and TPC (an anti-Gal antibody therapeutic). Rejection events were not treated. By using Kaplan-Meier analysis, median graft survival was 96 days (range, 15-137 days; 95% confidence interval, 38-99 days). Only 2 grafts were lost as a result of rejection, as defined by cessation of graft palpation. There was no evidence of a consumptive coagulopathy, infectious complications were treatable, and no posttransplantation lymphoproliferative disorders occurred. No cellular infiltration was observed. This study reports the longest median survival to date (96 days) of pig hearts transplanted heterotopically into baboons. Duplication of these results in the orthotopic life-supporting position could bring cardiac xenotransplantation to the threshold of clinical application.


[About a case of laryngeal location of SAPHO].
Synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO) is a syndrome that combines dermatological, articular and osseous inflammatory manifestations. Bilateral laryngeal immobility relative to cricoarytenoid joint origin is very uncommon. This article presents a case of bilateral cricoarytenoid joint ankylosis in a SAPHO syndrome context. A 53-year-old patient presenting with a two year history of intermittent bouts of dyspnea. A SAPHO syndrome was discussed on repeated thoracic CT-scan. The link between dyspnea and SAPHO syndrome had not been made immediately given the absence of any known anteriority. However, having ruled out other etiologies and after having had to perform a tracheotomy due a worsening of the respiratory condition, this diagnosis was considered. Treatment by corticosteroids and infliximab permitted a clinical improvement of the patient. This clinical case report should increase awareness of possible cricoarytenoid joint involvement in SAPHO.


Dependence of cell yield and specific growth rate of Candida boidinii on temperature during continuous cultivation.
Investigation of the dependence of cell yield of Candida boidinii in a chemostat and specific growth rate in a turbidostat on temperature was carried out using methanol as substrate. Each of the curves obtained had only one maximum, the optimum temperature for yield (Ys) and for specific growth rate (micron) being somewhat different. With deviation of temperature from the corresponding optimum the micron value decreases more sharply than that of Ys. The shape of two-factor dependences Ys(micron, T) and micron(S, T) is analyzed on the basis of these data and the known dependences of Ys on micron and micron on the limiting substrate concentration S. It is shown that the decelerating action of methanol on the growth rate increases at elevated and lower temperatures.


Radiotherapy plus anti-PD1 versus radiotherapy for hepatic toxicity in patients with hepatocellular carcinoma.
In this study, we aimed to compare the radiation-induced hepatic toxicity (RIHT) outcomes of radiotherapy (RT) plus antibodies against programmed cell death protein 1 (anti-PD1) versus RT alone in patients with hepatocellular carcinoma (HCC), evaluate prognostic factors of non-classic radiation-induced liver disease (ncRILD), and establish a nomogram for predicting the probability of ncRILD. Patients with unresectable HCC treated with RT and anti-PD1 (RT + PD1, n = 30) or RT alone (n = 66) were enrolled retrospectively. Patients (n = 30) in each group were placed in a matched cohort using propensity score matching (PSM). Treatment-related hepatotoxicity was evaluated and analyzed before and after PSM. The prognostic factors affecting ncRILD were identified by univariable logistic analysis and Spearman's rank test in the matched cohort to generate a nomogram. There were no differences in RIHT except for increased aspartate aminotransferase (AST) ≥ grade 1 and increased total bilirubin ≥ grade 1 between the two groups before PSM. After PSM, AST ≥ grade 1 occurred more frequently in the RT + PD1 group (p = 0.020), and there were no significant differences in other hepatotoxicity metrics between the two groups. In the matched cohort, V25, tumor number, age, and prothrombin time (PT) were the optimal prognostic factors for ncRILD modeling. A nomogram revealed a good predictive performance (area under the curve = 0.82). The incidence of RIHT in patients with HCC treated with RT + PD1 was acceptable and similar to that of RT treatment. The nomogram based on V25, tumor number, age, and PT robustly predicted the probability of ncRILD.


Design and application of a Staphylococcus-specific single strand conformation polymorphism-PCR analysis to monitor Staphylococcus populations diversity and dynamics during production of raw milk cheese.
Development of a nested-PCR single strand conformation polymorphism (SSCP) assay targeting the 16S rRNA genes of the Staphylococcus genus, to monitor staphylococci in cheese. New primer sets to specifically amplify 16S rDNA of staphylococci were designed to be used in a nested-PCR SSCP assay. The method was efficient in discriminating the staphylococcal species most frequently found in cheese. It was validated by monitoring Staphylococcus populations in three productions of raw milk cheese. Analysis of milk samples revealed dominant SSCP peaks corresponding to Staphylococcus aureus, Staphylococcus equorum and Staphylococcus saprophyticus. After 12 h, the S. aureus peak became dominant. The combination of specific Staphylococcus nested-PCR and SSCP allows rapid and direct monitoring of staphylococci diversity and dynamics in milk and cheese. In the core of the cheeses studied, S. aureus may have ecological advantages against other Staphylococcus populations. This approach is a promising tool to study the ecology of staphylococci in cheeses and in other food samples.


Metabolic abnormalities, but not obesity per se, associated with chronic kidney disease in a Taiwanese population.
It is inconclusive whether obesity itself or metabolic abnormalities are linked to chronic kidney disease (CKD). The aim of this study was to examine the association between different subtypes of obesity and metabolic abnormalities with CKD in adults. This study enrolled 14,983 eligible subjects stratified into metabolically healthy normal weight (MHNW), metabolically healthy overweight (MHOW), metabolically healthy obesity (MHO), metabolically unhealthy normal weight (MUNW), metabolically unhealthy overweight (MUOW), and metabolically unhealthy obesity (MUO) according to body mass index and metabolic syndrome status (ATP-III criteria). The metabolic healthy phenotype was defined as the absence of both metabolic syndrome and any known diabetes, coronary artery disease, stroke, hypertension or dyslipidemia. Early and advanced CKD were defined as eGFR<60, proteinuria, or structural abnormalities as detected by renal sonography. The prevalence of CKD was 2.5, 3.0, 4.0, 10.6, 9.5, and 10.5% in subjects with MHNW, MHOW, MHO, MUNW, MUOW, and MUO, respectively. In the multivariate analysis, the MUNW (OR:2.22, P < 0.001), MUOW (OR:2.22, P < 0.001), and MUO (OR:2.45, P < 0.001) groups were associated with early CKD. For advanced CKD, the OR was 2.56 (P < 0.001), 2.31 (P < 0.001), and 3.49 (P < 0.001) in the MUNW, MUOW, and MUO groups, respectively. The associated risks of early and advanced CKD were not significant in the MHOW and MHO group. MUOW and MUO were associated with higher risk of CKD compared with MHOW and MHO after adjusting other variables. Metabolic abnormalities, but neither overweight nor obesity, were associated with a higher risk of CKD in adults.


On beam quality and flatness of radiotherapy megavoltage photon beams.
Ratio of percentage depth dose (PDD) at two depths, PDD at a depth of 10 cm (PDD10), and beam flatness are monitored regularly for radiotherapy beams for quality assurance. The purpose of this study is to understand the effects of changes in one of these parameters on the other. Is it possible to monitor only the beam flatness and not PDD? The investigation has two components. Naturally occurring i.e., unintended changes in PDD ratio and in-plane flatness for 6 and 10 MV photon beams for one particular Siemens Artiste Linac are monitored for a period of about 4 years. Secondly, deliberate changes in the beam parameters are induced by changing the bending magnet current (BMI). Relationships between various beam parameters for unintended changes as well as deliberate changes are characterized. Long term unintentional changes of PDD ratio are found to have no systematic trend. The flatness in the inplane direction for 6 and 10 MV beams show slow increase of 0.43 and 0.75% respectively in about 4 years while the changes in the PDD ratio show no such trend. Over 10% changes in BMI are required to induce changes in the beam quality indices at 2% level. PDD ratio for the 10 MV beam is found to be less sensitive, while the depth of maximum dose, d(max), is more sensitive to the changes in BMI compared to the 6 MV beam. Tolerances are more stringent for PDD10 than PDD ratio for the 10 MV beam. PDD ratio, PDD10, and flatness must be monitored independently. Furthermore, off axis ratio alone cannot be used to monitor flatness. The effect of beam quality change in the absolute dose is clinically insignificant.


Coronary artery bypass grafting and perioperative stroke: imaging of atherosclerotic plaques in the ascending aorta with ungated high-pitch CT-angiography.
Perioperative stroke is a devastating complication after coronary artery bypass graft (CABG) surgery, with atherosclerosis of the ascending aorta as important risk factor. During surgical manipulation, detachment of plaques can lead to consecutive embolization into brain-supplying arteries. High-pitch computed tomography angiography (HP-CTA) represents a non-invasive imaging modality, which provides the opportunity for comprehensive imaging of the ascending aorta, including plaque detection and advanced characterization. In our present retrospective study on 719 individuals, who had undergone HP-CTA within 6 months prior to CABG, atherosclerotic disease of the ascending aorta was evaluated with respect to perioperative stroke rates. For image analysis, the ascending aorta was divided into a proximal and distal part, consisting of four segments, and evaluated for presence and distribution of calcified and mixed plaques. All patients with perioperative stroke presented with atherosclerotic disease of the ascending aorta. The stroke rate was significantly associated with the presence and extent of atherosclerotic disease. Patients burdened with mixed plaques presented with significantly higher perioperative stroke rates. This study demonstrates that HP-CTA allows accurate evaluation of plaque extent and composition in the ascending aorta, and therefore may improve risk stratification of stroke prior to CABG.


A detailed study of the effects of in vitro interferon treatment on the growth of two variants of the B16 mouse melanoma in the lungs: evidence for non-specific effects.
Interferon treatment increases the ability of tumour cells to colonize the lungs. Although it has been suggested that this effect can be explained by increases in the expression of MHC molecules the precise mechanism is still uncertain. The growth in the lungs of a low (F1) and a high colonizing variant (BL6) of the B16 mouse melanoma have been studied after in vitro treatment with interferon. Interferon-gamma, but not interferon-alpha/beta, increased the number of lung colonies formed after intravenous injection, but not after subcutaneous administration. Treatment also increased the sizes of the lung colonies formed and the number of radiolabelled cells retained by the lungs. However, no clear relationship was observed between the number of colonies formed and the concentration of interferon used. The effect of interferon on F1 was greater than on BL6, but the overall number of colonies formed was very similar. These results suggest that interferon increases the adhesiveness of these cell lines in a fairly non-specific manner, that seems unlikely to involve MHC molecules. As a results of this and other studies the importance of interferon in the process of tumour spread seems very questionable.


Buprenorphine and methadone maintenance in jail and post-release: a randomized clinical trial.
Buprenorphine has rarely been administered as an opioid agonist maintenance therapy in a correctional setting. This study introduced buprenorphine maintenance in a large urban jail, Rikers Island in New York City. Heroin-dependent men not enrolled in community methadone treatment and sentenced to 10-90 days in jail (N=116) were voluntarily randomly assigned either to buprenorphine or methadone maintenance, the latter being the standard of care for eligible inmates at Rikers. Buprenorphine and methadone maintenance completion rates in jail were equally high, but the buprenorphine group reported for their designated post-release treatment in the community significantly more often than did the methadone group (48% vs. 14%, p<.001). Consistent with this result, prior to release from Rikers, buprenorphine patients stated an intention to continue treatment after release more often than did methadone patients (93% vs. 44%, p<.001). Buprenorphine patients were also less likely than methadone patients to withdraw voluntarily from medication while in jail (3% vs. 16%, p<.05). There were no post-release differences between the buprenorphine and methadone groups in self-reported relapse to illicit opioid use, self-reported re-arrests, self-reported severity of crime or re-incarceration in jail. After initiating opioid agonist treatment in jail, continuing buprenorphine maintenance in the community appears to be more acceptable to offenders than continuing methadone maintenance.


The Use of Mechanical Cardiopulmonary Resuscitation May Be Associated With Improved Outcomes Over Manual Cardiopulmonary Resuscitation During Inhospital Cardiac Arrests.
We aimed to investigate the impact of mechanical cardiopulmonary resuscitation devices over manual cardiopulmonary resuscitation on outcomes from inhospital cardiac arrests. Restrospective review. Single academic medical center. Data were collected on all patients who suffered cardiac arrest from December 2015 to November 2019. Primary end point was return of spontaneous circulation. Secondary end points included survival to discharge and survival to discharge with favorable neurologic outcomes. About 104 patients were included in the study: 59 patients received mechanical cardiopulmonary resuscitation and 45 patients received manual cardiopulmonary resuscitation during the enrollment period. Return of spontaneous circulation rate was 83% in the mechanical cardiopulmonary resuscitation group versus 48.8% in the manual group (p = 0.009). Survival-to-discharge rate was 32.2% in the mechanical cardiopulmonary resuscitation group versus 11.1% in those who received manual cardiopulmonary resuscitation (p = 0.02). Of the patients who survived to discharge and received mechanical cardiopulmonary resuscitation, 100% (n = 19) had a favorable neurologic outcome versus 40% (two out of five) of patients who survived and received manual cardiopulmonary resuscitation (p = 0.005). Our findings demonstrate a significant association of improved outcomes with mechanical cardiopulmonary resuscitation over manual cardiopulmonary resuscitation during inhospital cardiac arrests. Mechanical cardiopulmonary resuscitation may improve rates of return of spontaneous circulation, survival to discharge, and favorable neurologic outcomes.


Coronary MR angiography using image-based respiratory motion compensation with inline correction and fixed gating efficiency.
The purpose of this study was to evaluate a new inline motion compensation approach called image-based navigation with Constant Respiratory efficiency UsIng Single End-expiratory threshold (iNAV-CRUISE) for coronary MR angiography (CMRA). The CRUISE gating technique was combined with iNAV motion correction and implemented inline for motion-compensated CMRA on a 1.5 Tesla scanner. The approach was compared to conventional diaphragmatic navigator gating (dNAVG) in 10 healthy subjects. The CMRA images were compared for vessel sharpness and visual score of the right coronary artery (RCA), left anterior descending artery (LAD), left circumflex, and scan time. The scan time was similar between the methods (dNAVG : 6:32 ± 1:09 vs. iNAV-CRUISE: 6:58 ± 0:17, P = not significant). However, the vessel sharpness of the RCA (dNAVG : 60.2 ± 10.1 vs. iNAV-CRUISE: 71.8 ± 8.9, P = 0.001) and LAD (dNAVG : 58.0 ± 8.0 vs. iNAV-CRUISE: 67.4 ± 7.1, P = 0.008) were significantly improved using iNAV-CRUISE. The visual score of the RCA was higher using iNAV-CRUISE compared to dNAVG (dNAVG : 3,4,3 vs. iNAV-CRUISE: 4,4,3, P < 0.01). The iNAV-CRUISE approach out-performs the conventional respiratory motion compensation technique in healthy subjects. Although scan time was comparable, the image quality was improved using iNAV-CRUISE. Magn Reson Med 79:416-422, 2018. © 2017 The Authors Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.


Delay in emergency hernia surgery is associated with worse outcomes.
Patients requiring emergent surgery for hernia vary widely in presentation and management. The purpose of this study was to determine if the variation in timing of urgent surgery impacts surgical outcomes. The national NSQIP database for years 2011-2016 was queried for emergent surgeries for abdominal hernia resulting in obstruction or gangrene by primary post-op diagnosis. Diaphragmatic hernias were excluded. Patients were grouped by surgical timing from admission to day of surgery: same day, next day, and longer delay. Multinomial propensity score weighting was used to address potential differences in underlying covariates' clustering across the timing groups followed by multivariable logistic regression of morbidity and mortality. Weighted analysis yielded an effective sample size of 76,364. Hernia types included inguinal (20.9%); femoral (6.7%); umbilical (20.2%); ventral (41.0%); and other (10.4%). Delayed surgery was associated with increased rates of major complications (26.4% vs. 20.9%, p < 0.001), longer operative times (+ 12.5 min, p < 0.001), longer postoperative lengths of stay (+ 1.6 days, p < 0.001), increased re-operations (5.9% vs. 4.7%, p = 0.019), increased readmissions (7.0% vs. 5.7%, p = 0.004), and increased 30-day mortality (2.4% vs. 1.7%, p = 0.002). When controlling for other factors, next-day surgery (OR 1.23, 95% CI 1.05-1.45, p = 0.009) and surgery delayed more than one day (OR 1.40, 95% CI 1.13-1.73, p < 0.002) were associated with an increased odds of a major complication. Mortality and readmission by timing of surgery were not independently significant. Delay in surgery for emergent hernias increased the odds of major morbidity but not mortality. Patients presenting with hernia and an indication for urgent surgical intervention may benefit from an operation as soon as feasible rather than warrant waiting for further physiologic optimization, medical clearance, or specialized surgical personnel.


Microbial colonization and antibacterial resistance patterns after Boston type 1 keratoprosthesis.
To characterize the bacterial and fungal flora colonizing the ocular surface of eyes with Boston type 1 keratoprosthesis (KPro) and to determine the prevalence of resistance to antibiotics. Culture positivity and antibiotic resistance rates in eyes with KPro are compared with those of eyes after penetrating keratoplasty (PKP) as well as control eyes. Cross-sectional, case-control study. A total of 75 eyes of 75 patients (25 KPro eyes, 25 PKP eyes, and 25 control eyes) were recruited from the Centre Hospitalier de l'Université de Montréal (Université de Montréal, Montréal, Canada) Ophthalmology Department. The inferior bulbar conjunctiva was sampled using calcium alginate swabs. Standard culture media and protocols were used to identify colonizing bacteria and fungi. Extensive antibiotic susceptibility testing was performed on every isolate. Patients completed a validated questionnaire evaluating adherence to antibiotic prophylaxis. Hospital charts were reviewed to identify risk factors for bacterial resistance. Culture positivity rates and prevalence of resistance to fourth-generation fluoroquinolones (FQ). Bacterial cultures were positive in 64% of KPro eyes, 76% of PKP eyes, and 80% of control eyes (chi-square test; P = 0.41). Fungal cultures were negative in all but 1 eye with PKP. The most common isolates were Staphylococcus epidermidis, other coagulase-negative Staphylococci, and Corynebacterium species. At least 1 bacterial isolate resistant to fourth-generation FQ was found in 44% of eyes with KPro, 24% of eyes with PKP, and 8% of control eyes (chi-square test; P = 0.01). Patient adherence to antibiotic prophylaxis did not alter microbial susceptibility to fourth-generation FQ (odds ratio, 0.83; 95% confidence interval, 0.2-4.1). Culture positivity rates and bacterial species composition were similar in KPro, PKP, and control eyes. Eyes with KPro were more likely to be colonized with FQ-resistant bacteria. Chronic prophylaxis with low-dose FQ is likely responsible for this increased antibiotic resistance. Modifications to the current prophylaxis regimen may be helpful in preventing further emergence of resistant pathogens. The authors have no proprietary or commercial interest in any of the materials discussed in this article.


Induction of ovulation in women with hyperprolactinemic amenorrhea using clomiphene and human chorionic gonadotropin of bromocriptine.
Clomiphene citrate (Clomid), when given alone, is generally considered ineffective in inducing ovulation in women with hyperprolactinemia. This study reports the treatment of 29 infertile women with hyperprolactinemic amenorrhea. Twenty-one patients (eighteen of whom had previously had no ovulation response to Clomid alone) were treated with a combined regimen of Clomid (100 to 200 mg/day for 5 days) and two injections of 5000 IU of human chorionic gonadotropin (HCG), the first 8 to 10 days after Clomid withdrawal and a second injection 1 week later. Basal body temperature charts, conception, and/or plasma progesterone measurements showed that 19 patients ovulated (90%). There were 17 pregnancies in 12 of 21 patients (57% pregnancy rate) with 15 single live births and two abortions. When bromocriptine (Parlodel) became available, a total of 22 patients (including 14 patients previously treated with Clomid/HCG, six of them successfully) with amenorrhea associated with hyperprolactinemia were treated with this drug with dosages varying from 2.5 mg to 15 mg/day. Ovulation was confirmed in 20 patients (90%). There were 17 pregnancies in 15 patients (68% pregnancy rate) with 15 single live births and two first-trimester abortions. In all, 21 of 29 patients (73%) achieved one or more pregnancies resulting in live births with one or both of the above treatments. It is concluded that a combined Clomid/HCG regimen can often be used as an effective alternative to bromocriptine therapy in the treatment of infertility associated with hyperprolactinemic amenorrhea.


Liaison psychiatry professionals' views of general hospital care for patients with mental illness: The care of patients with mental illness in the general hospital setting.
Explore the experiences of liaison psychiatry professionals, to gain a greater understanding of the quality of care patients with mental illness receive in the general hospital setting; the factors that affect the quality of care; and their insights on interventions that could improve care. A survey questionnaire and qualitative in depth interviews were used to collect data. Data collection took place at the Royal College of Psychiatrists Faculty of Liaison Psychiatry Annual conference. Qualitative analysis was done using thematic analysis. Areas of concern in the quality of care of patients with co-morbid mental illness included 'diagnostic overshadowing', 'poor communication with patient', 'patient dignity not respected' and 'delay in investigation or treatment'. Eleven contributing factors were identified, the two most frequently mentioned were 'stigmatising attitudes of staff towards patients with co-morbid mental illness' and 'complex diagnosis'. The general overview of care was positive with areas for improvement highlighted. Interventions suggested included 'formal education' and 'changing the liaison psychiatry team'. The cases discussed highlighted several areas where the quality of care received by patients with co-morbid mental illness is lacking, the consequences of which could be contributing to physical health disparities. It was acknowledged that it is the dual responsibility of both the general hospital staff and liaison staff in improving care.


Dietary antioxidant supplementation reverses age-related neuronal changes.
Evidence suggests that reactive oxygen species in brain may play a role in the development of age-related neuronal impairments, and that the increase in the concentration of the proinflammatory cytokine, interleukin-1beta (IL-1beta), in aged brain tissue, may also be a contributory factor. In this study, we have analyzed changes in enzymatic and nonenzymatic antioxidant levels, in parallel with interleukin-1beta concentration, in cortical tissue prepared from young and aged rats. We report that there was an age-related increase in the activity of superoxide dismutase without concomitant changes in the activity of catalase or glutathione peroxidase and an age-related decrease in the concentrations of alpha-tocopherol and ascorbate. These observations, coupled with age-related increases in lipid peroxidation and interleukin-1beta concentration, are consistent with a compromised antioxidant defense in cortex of aged rats, a proposal supported by the finding that these changes were not observed in cortical tissue prepared from rats fed on a diet supplemented with alpha-tocopherol and ascorbate for 12 weeks.


Measurement of beta-methyldigoxin level in serum from patients by enzyme immunoassay using novel specific antiserum with a phenyl boric acid column.
The authors compared serum beta-methyldigoxin (MDx) levels in digitalized patients by enzyme immunoassay (EIA) using anti-MDx 3'-hemisuccinate BSA antiserum (antiserum-I) with commercial antidigoxin antiserum (antiserum-II). The usefulness of a phenyl boric acid (PBA) column for pretreatment of the serum samples was also investigated. The assay using antiserum-I demonstrated good accuracy and precision in the concentration range of 0.5 to 5 ng/mL. When the specificities of antiserum-I and antiserum-II were assessed by cross-reactivity studies with various related compounds, antiserum-I was much more specific for MDx antiserum-II. Using a phenyl boric acid (PBA) column, MDx, and digoxigenin, which exhibits a negligible cross-reactivity, were separated from serum, including MDx and its metabolites. The recovery tests of MDx using antiserum-I with a PBA column in human serum were satisfactory and no interference of metabolites of MDx was observed. Mean MDx concentrations in serum samples (n = 30) from digitalized patients by EIA using antiserum-I with PBA column, antiserum-I, and antiserum-II were 1.06, 1.30, and 1.74 ng/mL, respectively. These results indicate that our EIA system using antiserum-I with a PBA column for pretreatment of serum samples is useful to more precisely measure the unchanged type of MDx in patients.


Percutaneous feeding gastrostomy in patients with head and neck tumors: a 5-year review.
Since the beginning of this decade major advances have taken place in the alimentation of patients with tumors of the head and neck. Gauderer and Ponsky described a percutaneous method of gastrostomy and, in 1983, a number of radiologists, including the senior author, described a percutaneous radiologic method using the Seldinger technique to create a feeding gastrostomy. This method is ideally suited for patients with advanced tumors of the head and neck because it requires neither endoscopy nor general anesthesia. Over the past 5 years, 55 patients with tumors of the head and neck have undergone this procedure. Eighty-one percent of the patients had advanced disease at initial presentation. One patient (1.8%) had a procedure-related death and another patient (1.8%) had a complication that required a laparotomy. Three patients (5.4%) had minor complications that required minimal medical attention. None of the patients required general anesthesia and an endoscopy was not required. Patient discomfort during the procedure was minimal.


Biosynthesis of polyphenol-stabilised nanoparticles and assessment of anti-diabetic activity.
Green synthesis of nanoparticles (NPs) is a major developing field. In this study, we utilised Whitania somnifera leaves as a green source to synthesise platinum (Pt) NPs. Synthesised Pt NPs resulted from controlled synthesis of 12nm spherical particles. The synthesised Pt NPs were subjected to anti-diabetic applications resulting in a significant decrease in plasma glucose levels after injecting the Pt NPs into streptozotocin-induced diabetic rats.


Phytosterols do not change susceptibility to obesity, insulin resistance, and diabetes induced by a high-fat diet in mice.
Most studies have focused on the cholesterol-lowering activity of phytosterols; however, other biological actions have also been attributed to these plant compounds. In this study, we investigated whether phytosterols could delay (progression phase) and/or reverse (regression phase) insulin resistance or type 2 diabetes mellitus in an experimental mouse model of diet-induced obesity, insulin resistance, and diabetes. Body mass, plasma lipid levels, insulin resistance, and hyperglycemia were determined. Phytosterol intake did not improve these metabolic parameters. Therefore, we were unable to substantiate any protective effect of phytosterol intake on diabetes development or regression in the mouse model used.


Universal cell labelling with anionic magnetic nanoparticles.
Magnetic labelling of living cells creates opportunities for numerous biomedical applications, from individual cell manipulation to MRI tracking. Here we describe a non-specific labelling method based on anionic magnetic nanoparticles (AMNPs). These particles first adsorb electrostatically to the outer membrane before being internalized within endosomes. We compared the labelling mechanism, uptake efficiency and biocompatibility with 14 different cell types, including adult cells, progenitor cells, immune cells and tumour cells. A single model was found to describe cell/nanoparticle interactions and to predict uptake efficiency by all the cell types. The potential impact of the AMNP label on cell functions, in vitro and in vivo, is discussed according to cellular specificities. We also show that the same label provides sufficient magnetization for MRI detection and distal manipulation.


Stimulation of dopamine D-1 receptors by SKF 38393 induces EEG desynchronization and behavioral arousal.
The dopamine D-1 receptor agonist SKF 38393 dose-dependently (2.5-10 mg/kg) induced desynchronization of the electroencephalographic (EEG) activity and behavioral arousal in both rabbits and rats. Unlike apomorphine, SKF 38393 elicited no signs of stereotyped behavior in rabbits and minimal effects, such as episodes of grooming, in rats. The effects of SKF 38393 10 mg/kg on the EEG were prevented by the selective D-1 receptor antagonist SCH 23390 at a dose as low as 0.003 mg/kg, but not by the D-2 antagonist (-)-sulpiride (25-50 mg/kg). These data provide evidence of a role of D-1 receptors in the generation of EEG activity related to behavioral arousal. In addition, this model is a valuable tool to functionally evaluate the D-1 antagonistic properties of neuroleptics.


Effect of rhTACI-Ig fusion protein on antigen-specific T cell responses from keyhole limpet haemocyanin challenged mice.
In addition to modulate B cells function, B cell activating factor belonged to TNF family (BAFF) also regulates T cells response via BAFFR and transmembrane activator and calcium modulator and cyclophilin-ligand interactor (TACI) expressing on activated T cells. This study explored the effect of a recombinant fusion protein containing the extracellular ligand-binding portion of TACI and the Fc portion of human immunoglobulin G (TACI-Ig) on activated T cells that were obtained from antigen-specific T-cell responses mice model induced by keyhole limpet haemocyanin (KLH), the characteristics of KLH-challenged mice were observed simultaneously. KLH immunization leaded to a significant positive relationship between BAFF level in serum and the extent of spleen histopathology. Serum concentration of BAFF, APRIL, IgM and IgG antibodies to KLH, and IL-4 were increased under KLH immunization, but IL-2 synthesis was decreased, resulting in a downregulation of IL-2/IL-4 ratio. Antigen-specific T cells proliferation, IL-5 production, the percentage of Th and activation T cells were significantly upregulated, however, IL-2 secretion and the percentage of naïve T cells were downregulated in vitro. RhBAFF co-stimulation further evoked T cells hyperplasy, IL-4 and IFN-γ expression, the subgroups of Th, early antigen activation and activation T cells were also further increased. On the contrary, naïve T cells were further reduced under rhBAFF stimuli. Administration of rhTACI-Ig significantly inhibited T cells proliferation, cytokines production and T cells differentiation, and the inhibitory effects might be associated with its ability to neutralize both the exogenous and endogenetic BAFF and APRIL.


Gene expression enhancement mediated by the 5' UTR intron of the rice rubi3 gene varied remarkably among tissues in transgenic rice plants.
Introns are important sequence elements that modulate the expression of genes. Using the GUS reporter gene driven by the promoter of the rice (Oryza sativa L.) polyubiquitin rubi3 gene, we investigated the effects of the 5' UTR intron of the rubi3 gene and the 5' terminal 27 bp of the rubi3 coding sequence on gene expression in stably transformed rice plants. While the intron enhanced GUS gene expression, the 27-bp fused to the GUS coding sequence further augmented GUS expression level, with both varying among different tissues. The intron elevated GUS gene expression mainly at mRNA accumulation level, but also stimulated enhancement at translational level. The enhancement on mRNA accumulation, as determined by realtime quantitative RT-PCR, varied remarkably with tissue type. The augmentation by the intron at translational level also differed by tissue type, but to a lesser extent. On the other hand, the 27-bp fusion further boosted GUS protein yield without affecting mRNA accumulation level, indicating stimulation at translation level, which was also affected by tissue type. The research revealed substantial variation in the magnitudes of intron-mediated enhancement of gene expression (IME) among tissues in rice plants and the importance of using transgenic plants for IME studies.


The development of pronoun usage in the psychotic child.
Twenty-three psychotic children ranging in age from 5 to 16 were interviewed in half-hour play sessions. The play session comprised three activities designed to elicit statements using the pronouns I, you, and he to express the concepts of possession, action, and description. It was hypothesized that psychotic children would use the third-person pronoun he more readily than the first-person pronoun I (Hypothesis I), and that possession, action, and description statements would develop in an orderly sequence as predicted by Bosch (1962/1970) (Hypothesis II). Hypothesis I was not confirmed: Some of the least advanced psychotic children used the pronoun I, and only the most advanced children used you and he. Hypothesis II was confirmed: the least advanced children used pronouns correctly in statements expressing the concept of possession, whereas the most advanced children had mastered all three contexts of pronoun use. These results have implications for language therapy, and they are concordant with the language theories of Piaget and Werner and Kaplan.


Benefit of Filgotinib, a JAK1 Preferential Inhibitor, in Rheumatoid Arthritis Patients with Previous Rapid Radiographic Progression: Post Hoc Analysis of Two Trials.
We conducted a post hoc analysis of efficacy and safety of filgotinib stratified by estimated radiographic progression rate before baseline (BL) in patients with rheumatoid arthritis (RA) who had inadequate response to methotrexate (MTX; FINCH 1; NCT02889796) or were naïve to it (FINCH 3; NCT02886728). Radiographic progression rate was BL-Modified Total Sharp Score (mTSS) divided by RA duration (BL mTSS/year); estimated rapid radiographic progression (e-RRP) was BL change in mTSS/year ≥ 5; and estimated nonrapid radiographic progression (e-NRRP) was BL mTSS/year < 5. Efficacy and safety were compared between subgroups. All p-values are nominal. In FINCH 1 and FINCH 3, 558/1755 (31.8%) and 787/1249 (63.0%) patients, respectively, had BL e-RRP. BL characteristics were generally similar between subgroups within each trial. At week (W) 24, in FINCH 1, proportions achieving a Disease Activity Score 28 for rheumatoid arthritis with C-reactive protein < 2.6 were significantly greater with filgotinib 200 (FIL200) and 100 mg (FIL100) versus placebo among e-RRP and e-NRRP subgroups. In each study, proportions of FIL-treated patients achieving Clinical Disease Activity Index ≤ 2.8 and Simple Disease Activity Index ≤ 3.3 were similar between subgroups. In FINCH 3, disease activity measures were at least numerically improved among patients receiving FIL versus MTX monotherapy. At W24, mTSS changes from BL (CFB) were greater among patients with e-RRP in FINCH 1 and FINCH 3 versus e-NRRP (0.81 versus 0.19, p = 0.001; 0.67 versus 0.25, p = 0.31, respectively). At W52, in FINCH 1, mTSS CFBs were smaller among e-RRP patients treated with FIL200 (0.40; p < 0.001) and FIL100 (0.77; p = 0.024) versus adalimumab (ADA; 1.46). In FINCH 3 at W52, mTSS CFBs were significantly smaller with FIL200 versus MTX among e-RRP patients. Rates of treatment-emergent adverse events (AEs) were comparable between subgroups and across treatment arms. Patients with previous e-RRP who received standard care tended to progress radiographically. FIL200 demonstrated persistent, consistent benefit for disease activity control among e-RRP and e-NRRP subgroups, and AE profiles were similar between subgroups. Although filgotinib efficacy was somewhat reduced among patients with e-RRP, filgotinib treatment slowed radiographic progression in both subgroups. Clinicaltrials.gov NCT02889796, NCT02886728.


An evaluation of 18S rDNA approaches for the study of fungal diversity in grassland soils.
Fungal community structure and diversity in two types of agricultural grassland soil were investigated by amplified 18S ribosomal DNA restriction analysis (ARDRA) and 18S ribosomal DNA sequence analysis. These two grassland sites represent a species-rich old hay meadow and an agriculturally improved site with low floristic diversity. Two primer sets were used in combination to amplify approximately 550 bp of rDNA from three major fungal groups, the zygomycetes, basidiomycetes, and ascomycetes, and clone libraries were created for each site. 18S ARDRA was used to analyze 170 rDNA clones, and three diversity indices were calculated. A small-scale culturing analysis was also carried out and the most common isolates analyzed using ARDRA and sequence analysis. The soil fungal community revealed by the rDNA approaches was significantly different from that produced by this limited culture-based analysis. Twenty-eight soil-derived clones were sequenced, and many represented fungal taxa rarely reported in culture-based studies. The PCR-based techniques detected differences in diversity between the two fungal communities and changes in patterns of dominance that paralleled higher plant diversity. The results suggest that 18S rDNA-based approaches are a useful tool for initial screening of fungal communities, and that they represent a more comprehensive picture of the community than plate culturing.


Feeding preferences of range-shifting and native herbivorous fishes in temperate ecosystems.
Temperate reefs are being tropicalized worldwide. In temperate Western Australia, a marine heatwave led to a regime shift from kelp (Ecklonia radiata) dominated to canopy-free reefs, together with an increase in tropical herbivorous fishes that contribute to keeping low kelp abundances and even prevent kelp reestablishment in northern regions. However, whether tropical herbivorous fishes prefer kelps over other seaweeds and/or whether this preference changes with latitude remains untested. Multiple-choice experiments (young kelp vs. other seaweeds) with tropical, subtropical and temperate herbivorous fishes show shifting species-specific preferences and fish-to-fish interference shifting with latitude (assays replicated in two regions four degrees of latitude apart). Against expectations, only the temperate Kyphosus sydneyanus preferred kelp over other seaweeds, but only in the lower latitude region. Siganus fuscescens, the most abundant tropical herbivore in both regions, preferred grazing on turf, suggesting that tropical fish might reduce kelp recruitment by consuming microscopic sporophytes in turf matrix.


Tolerance and reliability of wireless pH monitoring in children.
The purpose of this study was to determine whether the placement of a wireless capsule pH monitoring system improved the reproducibility and patient comfort of pH probe studies in children. The records of 50 children who underwent wireless pH monitoring were retrospectively reviewed. Among this group, 44 children (27 males and 17 females) met inclusion criteria. The average age was 11.8 years, with a range from 6 years to 19 years. Each of these patients had a capsule placed 6 cm above the squamocolumnar junction and underwent pH telemetry for 2 days. In addition, 38 of the 44 families were contacted for follow-up to determine the tolerability of the catheter-free monitoring. Data analysis revealed that the overall reproducibility of a single 24 hour period was 77%. Studies were considered reproducible if the reflux index was normal (pH <4 for less than 5% of study period) or abnormal on both study days. Using McNemar's exact test, we found no significant difference between the two days (P = 0.11). Ten of 44 patients had conflicting results on day 1 compared with results on day 2. The majority (68%) of patients reported some degree of discomfort during the study; however, this pain was generally mild. Ninety-five percent of parents would be willing to have their child undergo pH monitoring in the future with the wireless pH monitoring. Catheter-free prolonged esophageal pH monitoring is feasible in children older than 6 years of age. A lack of consistent reproducibility in sequential 24 hour recordings with this technique concurs with findings using the conventional catheter methodologies. The catheter-free system is often associated with discomfort during the study, but these symptoms were generally well tolerated.


Computerized tomography and pathological correlation in cystic meningiomas. Report of two cases.
Meningiomas have been reported to have associated areas of surrounding low density on computerized tomography (CT). These low-density areas may represent edema, widened subarachnoid spaces, loculated cerebrospinal fluid, demyelination, or adjacent tumor. Two cases are presented in which this adjacent area of low density represented a tumor cyst. Recognition is important as the CT appearance of these lesions may simulate a metastatic tumor.


A new genus and new species of Hymenosomatidae (Crustacea: Brachyura) from Indonesian Papua.
A new hymenosomatid crab, Chartocinus rarus n. gen. n. sp., is described from coastal waters in western Papua (formerly Irian Jaya) in Indonesia. The new genus superficially resembles Amarinus Lucas, 1980, but can easily be distinguished by its subquadrate third maxillipeds with the merus produced along the anteroexternal edge, elongate ambulatory legs, elongate male thoracic sternum, short male pleon without distinct intercalated plates on somite 5, and a short male first gonopod in which the inner margin is distinctly bilobed.


Structural transitions during prothrombin activation: On the importance of fragment 2.
Prothrombin is activated to thrombin by the prothrombinase complex through sequential cleavage at two distinct sites. This occurs at sites of vascular injury in a highly regulated cascade of serine protease and cofactor activation, where activated platelets provide a suitable surface for protease/cofactor/substrate assembly. The precise structural and conformational changes undergone during the transition from prothrombin to thrombin have been studied for decades, and several structures of prothrombin fragments along the activation pathway have been solved. Here we present a new structure analyzed in context of other recent structures and biochemical studies. What emerges is an unexpected mechanism that involves a change in the mode of binding of the F2 domain (fragment 2) on the catalytic domain after cleavage at Arg320, and a subsequent reorientation of the linker between the F2 and catalytic domain to present the Arg271 site for cleavage.


Cytogenetic analysis of the sensitivity to anti-viral and anti-cell growth activities of human fibroblast interferon in aneuploid human tumor cell lines. Brief report.
The ability of human fibroblast interferon to suppress colony formation and papovavirus T-antigen expression in six human tumor cell lines did not appear to correlate with their content of chromosomes 16 and 21. Additional factors or chromosomes may be involved in the manifestation of interferon action in aneuploid cells.


Relationships between composite roughness and Streptococcus mutans biofilm depth under shear in vitro.
To investigate the effect of substrate, surface roughness, and hydraulic residence time (HRT) on Streptococcus mutans biofilms growing on dental composites under conditions relevant to the oral cavity. Dental composites were prepared with varying amounts of polishing and incubated in a CDC bioreactor with an approximate shear of 0.4 Pa. S. mutans biofilms developed in the bioreactors fed sucrose or glucose and at 10-h or 40-h HRT for one week. Biofilms were characterized by confocal laser microscopy (CLM). Composite surface roughness was characterized by optical profilometry, and pre- and post-incubation composite surface fine structure and elemental composition were determined using scanning electron microscopy-energy dispersive spectroscopy (SEM-EDS). Polishing had a significant impact on surface roughness, varying by a factor of 15 between the polished samples and the unpolished control. S. mutans biofilms grew statistically significantly thicker on the unpolished composites. Biofilm thickness was greater at shorter 10-h HRT compared to 40-h HRT. In most cases, biofilm thickness was not statistically significantly greater in sucrose-fed bioreactors than in glucose-fed bioreactors. SEM-EDS analysis did not identify any significant change in elemental composition after aging. Accurate characterization of oral cavity biofilms must consider shear forces and the use of techniques that minimize alteration of the biofilm structure. Under shear, surface smoothness is the most important factor determining S. mutans biofilm thickness followed by HRT, while sucrose presence did not result in significantly greater biofilm thickness. The obvious patterns of S. mutans growth along sub-micron scale grooving created by the polishing process suggested that initial biofilm attachment occurred in the shear-protected grooves. These results suggest that fine polishing may help prevent the initial formation of S. mutans biofilms compared to unpolished/coarse polished composites.


Spending the Best but Banking the Rest.
All vaccines rely on the ability of B cells to remember pathogen infections and respond more vigorously upon reinfection. In this issue of Cell, Viant et al. address the real-world issue of protection against rapidly emerging pathogen variants and describe how memory B cells may anticipate infections by such variants.


Binding properties of broad-specific monoclonal antibodies against three organophosphorus pesticides by a direct surface plasmon resonance immunosensor.
In this study, heterologous indirect competitive enzyme-linked immunosorbent assay (icELISA) was introduced into the screening of hybridomas for the development of broad-specific monoclonal antibodies (mAbs) against organophosphorus (OP) pesticides. After immunization, two formats of icELISA based on the homologous hapten antigen and four heterologous hapten antigens were conducted for hybridoma screening. Two mAbs 2G6 and 7B2 with good recognition toward three OP pesticides (parathion, methyl-parathion, and fenitrothion) were produced. Results of the icELISA showed that the two mAbs exhibited high sensitivity against three OP pesticides, with IC50 ranging from 2.93 to 19.71 ng mL-1. Moreover, a non-competitive surface plasmon resonance (SPR) immunosensor was used for characterizing the binding properties of the mAbs to OP pesticides. After kinetic analysis, equilibrium dissociation constant (KD) values of mAbs 2G6 and 7B2 were calculated as 1.45 × 10-9 M and 4.26 × 10-9 M for parathion, 6.75 × 10-9 M and 4.17 × 10-9 M for methyl-parathion, and 2.44 × 10-8 M and 1.19 × 10-8 M for fenitrothion, respectively. Whereas, both icELISA and SPR-based immunoassay indicated that the two mAbs could not recognize other five OP analogs. Since SPR-based immunoassay provides comprehensive information of two molecules directly interacting with each other, it is a valuable tool during the development and characterization of broad-specific mAbs. Graphical abstract .


Exchange of phospholipids between unilamellar vesicles of 1,2-dipalmitoyl-sn-glycero-3-phosphatidylcholine and plasma very low density lipoproteins.
Purified phosphatidylcholine exchange protein from bovine liver was used to exchange [14C]dipalmitoyl phosphatidylcholine from sonicated vesicles to human plasma very low density lipoproteins (VLDL). The exchange of [14C]-dipalmitoyl phosphatidylcholine for VLDL phospholipids was temperature dependent and linear with respect to time and amount of exchange protein. In the absence of the exchange protein, less than 10% of the [14C]dipalmitoyl phosphatidylcholine was transferred. At an initial weight ratio of [14C]-dipalmitoyl phosphatidylcholine vesicles to VLDL phospholipid (1.2 mg) of 2.2, the exchange protein (14 microgram) replaced 55% of the VLDL phospholipids with [14C]dipalmitoyl phosphatidylcholine in 15 min; VLDL protein and cholesterol content were unaltered. From these studies we conclude that the exchange protein is a useful method to alter the phospholipid composition of VLDL under conditions such that there is minimal perturbation of the lipoprotein.


Macropinocytosis: Blowing bubbles.
Macropinocytosis is a form of endocytosis in which cells engulf relatively large quantities of extracellular fluid through cup-shaped invaginations of the plasma membrane. New work shows that macropinosome closure occurs without a localized constriction of actin filaments, indicating that membrane tension drives cup closure.


Skeletal muscle disorders associated with inflammatory bowel diseases: occurrence of myositis in a patient with ulcerative colitis and Hashimoto's thyroiditis--case report and review of the literature.
Ulcerative colitis (UC) and Crohn's disease are inflammatory bowel diseases often associated with extra-intestinal manifestations. Of these, neutrophilic dermatoses and arthropathies are the more frequently observed, while the occurrence of striated muscle disorders, namely, myositis, has been very rarely diagnosed in these kinds of patients. The coexistence of immuno-mediated diseases in patients with inflammatory bowel diseases and myositis suggests a common aetiopathogenetic mechanism underlying these conditions. The present report refers to a rare case of a 51-year-old female with UC and Hashimoto's thyroiditis who developed myositis.


Traditional Chinese Medicine formula FTZ protects against polycystic ovary syndrome through modulating adiponectin-mediated fat-ovary crosstalk in mice.
FuFang ZhenZhu TiaoZhi (FTZ) is a hospitalized traditional Chinese medicine herbal formula with documented metabolic benefits. Polycystic ovary syndrome (PCOS) characterized by ovarian dysfunction and insulin resistance represents one of the most common endocrine disorders in close association with metabolic dysfunction in premenopausal women. The present study aimed to investigate the preventive effect of FTZ on letrozole-induced experimental PCOS and its associated insulin resistance in mice. Prepubertal female mice in the experimental groups (letrozole and FTZ) received continuous infusion of letrozole (50 μg/day) for 35 days. FTZ was administrated to mice by oral gavage daily at dosage of 2.892 g/kg body weight for 5 weeks. All groups of mice were fed a high-fat diet (HFD). Ovary and adipose tissue were collected from all mice after 5 weeks and adiponectin, testosterone, estradiol, and luteinizing hormone level determined. Letrozole-induced morphological changes in the ovary, including a decreased number of corpora lutea and antral follicles, and increased cystic follicles, were significantly attenuated in FTZ-treated mice. Additionally, FTZ treatment notably reversed PCOS-related disruption of estrous status. PCOS-related insulin resistance was markedly alleviated. Mechanistically, FTZ treatment notably enhanced circulating level and transcriptional abundance of adiponectin in adipose tissue, thereby orchestrating fat-ovary crosstalk. Our data collectively demonstrate that FTZ exerted preventive benefits in an experimental model of PCOS, at least partially by potentiating the production of adiponectin from adipose tissues. This suggests that FTZ is a promising treatment for PCOS.


Chromosome 2 abnormalities (+Der 2) in two cases of childhood rhabdomyosarcoma.
Chromosome analysis was performed in two cases of rhabdomyosarcoma (RMS): one embryonal RMS and one alveolar RMS. Analysis showed number and structural abnormalities of chromosome 2. The relationship between these findings and published reports of karyotypes from RMS is discussed.


Clinical assessment of obesity in persons with spinal cord injury: validity of waist circumference, body mass index, and anthropometric index.
To study the relationship of waist circumference (WC) and bioelectrical impedance analysis (BIA) and degree of agreement between anthropometric index (AI) and BIA, using BIA as a reference or 'gold standard'. The second objective is to study the relationship between body mass index (BMI) and BIA in subjects with spinal cord injury (SCI). Comparative cross-sectional study. Convenience sample at outpatient clinic of spinal cord center. Estimation of obesity was made in 23 men with motor complete paraplegia (>1 year post-injury). Bland and Altman statistics were used to define level of agreement between AI and BIA, Pearson's r to describe correlation between WC and BIA and BMI and BIA. Good agreement between BIA and AI with a small systematic difference in fat mass (FM) (mean difference: -0.28%, Pearson's r: 0.91) was found. The correlation between WC and the BIA (% FM) was very high (Pearson's r: 0.83). The correlation between WC and BMI (% FM) was just over moderate (Pearson's r: 0.51). AI seems to be a valid proxy measure to estimate obesity in males living with SCI. Measurement of obesity in persons with SCI based on WC is promising. BMI showed not to be valid to estimate obesity in persons with SCI.


Disease Activity in Chronic Inflammatory Demyelinating Polyneuropathy: Association Between Circulating B Cell Subsets, Cytokine Levels and Clinical Outcomes.
To evaluate the relationship between immunological markers and clinical outcome measures in a mixed cohort of patients with typical CIDP and CIDP variants at different disease stages. Twenty-three typical, 16 multifocal and 5 distal CIDP patients were included. Twenty-five sex and age-matched healthy controls and 12 patients with Charcot-Marie-Tooth type 1A (CMT1A) disease served as controls. Peripheral B-cell populations were analyzed by flow cytometry. IL6, IL10, TNFA mRNA and mir-21, mir-146a and mir-155-5p expression levels were evaluated by real-time polymerase chain reaction in Peripheral blood mononuclear cells (PBMC) and/or skin biopsy specimens. Results were then assessed for a possible association with clinical disability scores and intraepidermal nerve fiber densities (IENFD) in distal leg. We detected significant reduction in naive B-cells (p≤0.001), plasma cells (p≤0.001) and regulatory B-cells (p<0.05), and an elevation in switched memory B-cells (p≤0.001) in CIDP compared to healthy controls. CMT1A and CIDP patients had comparable B-cell subset distribution. CIDP cases had significantly higher TNFA and IL10 gene expression levels in PBMC compared to healthy controls (p<0.05 and p≤0.01, respectively). IENFDs in distal leg showed a moderate negative correlation with switched memory B-cell ratios (r=-0.51, p<0.05) and a moderate positive correlation with plasma cell ratios (r=0.46, p<0.05). INCAT sum scores showed a moderate positive correlation with IL6 gene expression levels in PBMC (r=0.54, p<0.05). Altered B-cell homeostasis and IL10 and TNFA gene expression levels imply chronic antigen exposure and overactivity in humoral immune system, and seem to be a common pathological pathway in both typical CIDP and CIDP variants.


Pull-down analysis of interactions among jasmonic acid core signaling proteins.
Pull-down assays are key tools to test specific protein-protein interactions and have been particularly fruitful in jasmonate signaling research. Here, we describe a standard protocol in which a matrix-bound "bait" protein, expressed in Escherichia coli, pulls down a "prey" protein that is soluble in a protein extract obtained from Arabidopsis thaliana plant tissues. The pulled-down protein can be detected by immunoblot with protein-specific or epitope-specific antibodies. Such a pull-down method was used to reveal interactions among components of the jasmonic acid signaling, including hormone-dependent coreceptor interaction, homodimerization and heterodimerization of JASMONATE ZIM DOMAIN repressors, and interactions among other corepressor components and with transcription factors. Pull-down assays contributed not only to shape this signaling pathway but also to identify the active jasmonate hormone.


Origin of the algae.
Eukaryotic algae are traditionally separated into three broad divisions: the rhodophytes, the chromophytes and the chlorophytes. The evolutionary relationships between these groups, their links with other eukaryotes and with other photosynthetic groups, such as euglenophytes and cryptophytes, have been the subject of much debate and speculation. Here we analyse partial sequences of the large (28S) cytoplasmic ribosomal RNA from ten new species of protists belonging to various groups of unicellular algae. By combining them with the homologous sequences from 14 other unicellular and multicellular eukaryotes, we show that rhodophytes, chromophytes and chlorophytes emerge as three distinct groups late among eukaryotes, that is, close to the metazoa-metaphytes radiation. This implies a relatively late occurrence of eukaryotic photosynthetic symbiosis. We also provide details of intra- and inter-phyla relationships.


Agency and incentives in the NHS internal market.
This paper presents and assesses the structure of incentives created by the 1991 reforms to the U.K. National Health System. It argues that these reforms created a set of overlapping principal-agent relationships, in which the ownership of assets and the division of rewards from use of these assets is unclear. This lack of clarity and the form of performance monitoring used by the government as principal in these agency relationships seem likely to give limited incentives for improvements in efficiency in the medium term. The paper discusses possible means to improve incentives.


Human Telomerase RNA Processing and Quality Control.
The non-coding RNA subunit of telomerase provides the template for telomerase activity. In diverse fungi, 3' end processing of telomerase RNA involves a single cleavage by the spliceosome. Here, we examine how human telomerase RNA (hTR) primary transcripts are processed into the mature form of precisely 451 nt. We find that the splicing inhibitor isoginkgetin mimics the effects of RNA exosome inhibition and causes accumulation of long hTR transcripts. Depletion of exosome components and accessory factors reveals functions for the cap binding complex (CBC) and the nuclear exosome targeting (NEXT) complex in hTR turnover. Whereas longer transcripts are predominantly degraded, shorter precursor RNAs are oligo-adenylated by TRF4-2 and either processed by poly(A)-specific ribonuclease (PARN) or degraded by the exosome. Our results reveal that hTR biogenesis involves a kinetic competition between RNA processing and degradation and suggest treatment options for telomerase insufficiency disorders.


Football in inter-war Northern Ireland: Ballymena Football and Athletic Club Limited - religious and political exclusivity or civic inclusivity?
Historians have almost universally seen association football in the north of Ireland as a divisive influence. The impacts of sectarian and political tensions on the game have been stressed, alongside the extent to which this sport supposedly feeds into existing divisions. Much of the work carried out has concentrated on the last four decades, though even studies outside this period of widespread civil disorder have highlighted these problems. This paper uses the surviving records of the Ballymena Football and Athletic Club, the local press, census returns and other records to consider aspects of one particular Northern Irish club in the 1920s and 1930s. This short consideration of the players, supporters and shareholders suggests that at least in this case football was successful in bringing together and developing cooperation between men of widely differing political and religious views. While the club was a not a financial success, it was a social and sporting one. The evidence available suggests there was little exhibition of sectarian tension at any level.


Common genetic and environmental vulnerability for alcohol and tobacco use in a volunteer sample of older female twins.
A growing body of literature supports a shared genetic vulnerability underlying the use of alcohol and tobacco. We report patterns of genetic and environmental correlations for alcohol and tobacco use in a volunteer sample of older, white, female twins using three different levels of severity for alcohol use and smoking. A community-based sample of 1,926 female twins aged 50 to 96 was recruited through advertisements in a newsletter of the American Association of Retired Persons. Subjects were asked to rate alcohol and tobacco use over their lifetimes. Three levels of severity for alcohol use and smoking were coded: ever drank, weekly drinking, problem drinking; ever smoked, daily smoking of one-half pack or more, daily smoking of at least one pack or more. Twin correlations for alcohol and tobacco use measures were fit using a structural equation-modeling package (Mx). There were significant genetic correlations between problem drinking and ever smoking and using at least one-half pack per day. For problem drinking/ever smoking, R = 1.0 (95% CI: 0.32-1.0); for problem drinking/smoking at least one-half pack/day, R = 1.0 (95% CI: 0.43-1.0). The shared genetic influence on alcohol use and smoking in women is clearest for those subjects with the highest severity of alcohol use and problem drinking.


[Practical management of hidradenitis suppurativa].
Hidradenitis suppurativa is a chronic inflammatory disease that usually affects areas of the skin with a high density of apocrine glands (axillae, groin, perianal and perineal regions, submammary area, etc). It usually appears in women during puberty. The etiology of the disease is unknown, although it is thought to be a primary defect of the hair follicle. When diagnosing hidradenitis suppurativa, a number of genetic and hormonal predisposing factors should be considered alongside other putative triggers, such as obesity, smoking, and tight clothing. Diagnosis is essentially clinical and it is important to bear in mind the possible complications associated with the disease, such as the development of tumors. Management of the disease includes general measures (antiseptic soaps, warm baths, etc), pharmacological therapy (topical, intralesional, and systemic), surgery (direct closure, second-intention healing, grafts, flaps, etc), and other measures (carbon dioxide laser, radiation therapy, etc). It is important that the disease be diagnosed and treated as soon as possible given the potential physical and psychological problems that it can generate.


The association of selected pathological features with prostate cancer in a single-needle biopsy accession.
Isolated high-grade prostatic intraepithelial neoplasia (PIN) has been shown to be a positive predictor of prostate cancer (PCa) on follow-up biopsy. However, the incidence of isolated high-grade PIN in needle biopsy specimens has been reported with a highly variable frequency of 1% to 15%. The current study examined the relationship of various pathological features with PCa on a single biopsy accession. A study population of 388 community-based consecutive needle biopsy accessions was prospectively recorded by a single pathologist (T.M.W.). All of the individual biopsy specimens were coded for the presence of PCa, high-grade PIN, low-grade PIN, chronic inflammation (CI), intraluminal prostatic crystalloids (IPC) in benign glands, and mucinous metaplasia (MM). One hundred twenty-nine (33%) of the patients were diagnosed with PCa. The 8% incidence of isolated high-grade PIN was consistent with previous studies. The incidence of other pathological features were as follows: high-grade PIN, 14%; low-grade PIN, 13%; CI, 30%; IPC, 4%; and MM, 8%. Of the patients with high-grade PIN, 47% had PCa on a separate core biopsy, whereas 31% of patients without high-grade PIN were observed to have PCa (P=.021). Of the patients with CI, 21% were found to have PCa on a separate core, whereas 38% of patients without CI were found to have PCa (P=.0009). None of the other pathological features surveyed showed any significant association with PCa. High-grade PIN was a relatively common finding (14%) in this study and was positively associated with PCa on a separate core from the same accession biopsy. The negative association of CP with PCa within the same accession has not been reported previously and may be an artifact related to the clinical indications for a prostatic biopsy.


The computed tomographic appearances of angiosarcoma of the liver.
The computed tomographic (CT) appearances are described in five vinyl chloride workers with hepatic angiosarcoma subsequently confirmed at post-mortem. The tumour was multifocal in four patients. Non-enhanced scans were available in four cases showing hypodense masses relative to background liver. Dynamic scanning during intravenous contrast injection was performed in all five patients showing peripheral or central foci of enhancement within the tumour. On delayed post-contrast scans performed in three patients the angiosarcoma became wholly or partly isodense compared to normal liver. The CT appearances of angiosarcoma of the liver are non-specific but are consistent with a vascular tumour, and the differential diagnosis is discussed. Due to the vascularity of angiosarcoma, liver biopsy may be hazardous and can be avoided when there is a history of exposure to vinyl chloride monomer and the CT findings are consistent with the diagnosis.


Hyperornithinemia and gyrate atrophy of the choroid and retina.
The diagnosis of hyperornithinemia and gyrate atrophy (HOGA) depends upon the presence of five characteristic features: (1) typical chorioretinal lesions, (2) high myopia, (3) cataracts, (4) hyperornithinemia, and (5) autosomal recessive inheritance. We have seen three patients and described four new findings: (1) decreased whole blood glutamic acid, (2) low normal intelligence, (3) hepatic mitochondrial changes, and (4) urinary excretion of ornithine methyl ester. Investigations of amino acid metabolism in vivo are consistent with the presence of a defect in ornithine keto-acid transaminase.


You're the Flight Surgeon.
Tontz RC. You're the flight surgeon: complex regional pain syndrome. Aerosp Med Hum Perform. 2015; 86(6):574-577.


Effects of low- and high-density lipoproteins on the proliferation of human breast cancer cells in vitro: differences between hormone-dependent and hormone-independent cell lines.
The influence of low- and high-density lipoproteins on the proliferation of human breast cancer cells in culture was studied. We compared total cell number after incubation for 48 hr in culture medium containing or lacking plasma lipoproteins. Marked differences were found between hormone-dependent (MCF-7, T-47-D, ZR-75) and hormone-independent (MDA-MB-231, HBL-100) mammary tumor cell lines. The cells also reacted differently on the different lipoproteins offered in the medium. Human low-density lipoproteins (LDL) exhibited a marked stimulation of the growth of hormone-independent cell lines but no or only toxic effects upon the hormone-sensitive lines. Human high-density lipoproteins (HDL) stimulated the proliferation of all cell lines in a dose-dependent manner but hormone-independent cells showed a higher response. These findings point towards different utilizations of nutrients in hormone-dependent and hormone-independent cells.


Anatomical evidence for ileal Peyer's patches innervation by enteric nervous system: a potential route for prion neuroinvasion?
We have examined the innervation of the gut-associated lymphoid system of the sheep ileum, with a view to identifying potential sites for neuroinvasion by pathogens, such as prions (PrP(Sc)). Special attention has been paid to the follicles of Peyer's patches (PPs), which are major sites of PrP(Sc) accumulation during infection. Evidence exists that the enteric nervous system, together with the parasympathetic and sympathetic pathways projecting to the intestine, are important for PrP(Sc) entry into the central nervous system. Thus, PrP(Sc) might move from PPs to the neurons and nerve fibres that innervate them. We investigated, by immunohistochemistry and retrograde tracing (DiI) from the follicles, the distribution and phenotype of enteric neurons innervating the follicles. Antibodies against protein gene product 9.5, tyrosine hydroxylase, dopamine beta hydroxylase, choline acetyltransferase, calbindin (CALB), calcitonin gene-related peptide (CGRP), and nitric oxide synthase were used to characterise the neurons. Immunoreactivity for each of these was observed in fibres around and inside PP follicles. CGRP-immunoreactive fibres were mainly seen at the follicular dome. Retrograde tracing revealed submucosal neurons that contributed to the innervation of PPs, including Dogiel type II neurons and neurons immunoreactive for CALB and CGRP. The major source of the adrenergic fibres are the sympathetic ganglia. Our results thus suggest that enteric and sympathetic neurons are involved during the first stage of neuroinvasion, with neurons connecting to them acting as potential carriers of PrP(Sc) to the central nervous system.


Discrimination of white automotive paint samples using ATR-FTIR and PLS-DA for forensic purposes.
The consequences of a hit-and-run car crash are significant and may include serious injuries to the victims, health system overload and even victim's death. The vehicle and driver identification are often challenging for local law enforcement. The aim of this study was to develop a methodology to discriminate between automotive paint samples according to the make of the vehicle and its color shade. 143 white samples (collected at traffic accident scenes) were analyzed in situ by Fourier transform infrared spectroscopy with attenuated total reflectance (ATR-FTIR) and coupled microscopy. Principal component analysis (PCA) and partial least squares discriminant analysis (PLS-DA) were performed for data analysis. The samples were split into three groups: calibration set, validation set and external test set. The figures of merit were calculated to assess the quality of the model. Sensitivity, specificity, and efficiency rates were, respectively, 98,9%, 98.4% and 98.6%, for the calibration set. For the validation group, the classification accuracy was 100%. Correct classification rates for the internal validation set and external test set were 100% and 79.1% respectively. The technique is clean, fast, relatively low-cost, and non-destructive. Damaged regions of the samples were avoided by using the attached microscope. Limiting the age of the samples to a maximum of 10 years was enough to avoid misclassifications due to the natural degradation and weathering of the sample. Since the external test group is formed by underrepresented classes, its correct classification rate (79.1%) can be potentially improved at any time, by including and analyzing more samples.


Social Support and Life Satisfaction in Women With Cervical Cancer: A Serial Multiple Mediation Model.
Although the number of studies focusing on life satisfaction in women with cervical cancer is increasing, there are limited studies on the pathway between social support and life satisfaction in this population. This study explored the pathway between social support and life satisfaction in women with cervical cancer by examining the serial mediating effects of self-care self-efficacy, coping strategies, and depressive symptoms. In this cross-sectional study, a total of 292 women with cervical cancer completed a questionnaire for assessing social support, self-efficacy, coping strategies, depressive symptoms, and life satisfaction. Structural equation modeling was used to test the direct and/or indirect effects of the variables on life satisfaction. Structural equation modeling analysis indicated that self-efficacy, coping strategies, and depressive symptoms mediates the effect of social support on life satisfaction. Direct paths from social support to life satisfaction, social support to self-efficacy, self-efficacy to coping strategies, coping strategies to depressive symptoms, and depressive symptoms to life satisfaction were significant ( P < .05). Moreover, indirect paths from social support to life satisfaction, self-efficacy to life satisfaction, and coping strategies to life satisfaction were also significant ( P < .05). Self-care self-efficacy, coping strategies, and depressive symptoms are potential pathways through which social support may affect life satisfaction in women with cervical cancer. Healthcare providers, family, and friends should offer more social support to the patients and make efforts to strengthen their self-care self-efficacy, facilitate active coping, and alleviate depressive symptoms to improve women's life satisfaction.


Insulin-like growth factor 1 and insulin reduce epidermal growth factor binding to Swiss 3T3 cells by an indirect mechanism that is apparently independent of protein kinase C.
Insulin-like growth factor 1 and insulin reduced the binding of 125I-labelled epidermal growth factor (125I-EGF) to Swiss 3T3 cells by 15-20% at 37 degrees C, but not at 4 degrees C. Scatchard analysis indicated that IGF-1 and insulin affected the higher-affinity component of EGF binding, an effect previously associated with the activation of protein kinase C. However, the inhibition of 125I-EGF binding by IGF-1 and insulin was increased, not reduced, when the cells were treated with high concentrations of phorbol esters to down-modulate protein kinase C. We suggest that IGF-1 and insulin activate a protein kinase with similar or overlapping specificity to that of protein kinase C.


Consulting dietitians in nursing homes: time in role functions and perceived problems.
A mail survey was conducted to describe Illinois consultant dietitians' perceptions of time adequacy for fulfilling role responsibilities and to identify dietary problems in nursing homes. Approximately three-fourths (74%) of the 43 respondents reported insufficient time at nursing homes, although all met or exceeded state consulting time requirements. Role functions receiving the greatest time investments were in the categories of foodservice management and nutrition care. Resident nutrition care issues were often rated as major problems. Dietitians' perceptions of nutrition care problems and inadequacy of time to perform role functions indicate a need to re-evaluate priorities for role performance and to obtain increased service hours. Methods to increase consulting time should include effective marketing of services and involvement in legislative and regulatory processes.


Feedback control of two supplemental feeds during fed-batch culture on a platform process using inline Raman models for glucose and phenylalanine concentration.
The use of Raman models for glucose and phenylalanine concentrations to provide the signal for a control algorithm to continuously adjust the feed rate of two separate supplemental feeds during the fed-batch culture of a CHOK1SV GS-KO® cell line in a platform process was evaluated. Automated feed rate adjustment of the glucose feed using a Raman model for glucose concentration, maintained the glucose concentration within the desired target (average deviation ± 0.49 g/L). Automated feed rate adjustment of the nutrient feed using a Raman model for phenylalanine concentration, maintained phenylalanine concentrations within the target (average deviation ± 29.97 mg/L). The novel use of a Raman model for phenylalanine concentration, combined with a Raman model for glucose concentration, to maintain target glucose and phenylalanine concentrations through feed-rate adjustments, reduced the average cumulative glucose and nutrient feed additions (19% and 27% respectively) compared to manually adjusted cultures. Additionally, the proposed automation strategy led to lower osmolality during culture, maintained the nutrient environment more consistently, and achieved higher harvest product concentration (≈ 20% higher) compared to typical fed-batch process control for the cell line and platform process evaluated. Furthermore, the proposed feeding strategy yielded similar glycosylation and charge variant profiles compared to manually adjusted fed-batch process control. The ability to continuously adjust the feed rate addition of two separate feeds in this manner helps enable a shift away from the current daily offline sampling needed to control fed-batch mammalian cell culture during clinical and commercial manufacturing on platform processes.


Atypical fibroxanthoma. A study with antibody to S-100 protein.
Fourteen biopsy specimens from ten patients with atypical fibroxanthoma were studied with the peroxidase-antiperoxidase method for binding of S-100 antibody. Six specimens from four patients were minimally positive. The S-100-positive cells were observed in greatest concentrations at the periphery of the lesions and were associated with perivascular inflammatory cells. By this method, it appears that there is not a Langerhans' cell type of atypical fibroxanthoma. The S-100 antibody can help differentiate desmoplastic juvenile melanoma and malignant melanoma from atypical fibroxanthoma.


Aortogastric fistula from hiatal hernia ulcer. A cause of massive upper gastrointestinal bleeding.
An 83-year-old woman with no history of vascular surgery presented with a fatal upper gastrointestinal bleed from an aortogastric fistula secondary to a penetrating gastric ulcer. The fistula was between the thoracic aorta and the gastric ulcer in a hiatus hernia. On autopsy, a discrete 1-cm ulcer had perforated into the otherwise normal thoracic aorta. Aortogastric fistula involving the thoracic aorta and a gastric ulcer is rare in the absence of vascular graft surgery or aneurysm. We review the pertinent literature.


In vitro anti-inflammatory activity of Phlebodium decumanum. Modulation of tumor necrosis factor and soluble TNF receptors.
The immunomodulatory activity of a standardized water soluble fraction of the fern Phlebodium decumanum (EXPLY-37) previously shown to have "in vivo" anti-inflammatory activity was analyzed "in vitro". This extract inhibited tumor necrosis factor (TNF) production by macrophages activated with lipopolysaccharide (LPS) or LPS plus interferon (IFN)-gamma. In contrast, nitric oxide (NO) and interleukin (IL)-1beta production were not affected in the same cultures, whereas IL-6 production was partially inhibited. More interestingly, EXPLY-37 increased the release of soluble TNF-receptor 2 (sTNFR2) and of IL-1R antagonist (IL-1Ra) but not of sTNFR1, by activated macrophages. EXPLY-37 had no effect on T lymphocyte activation, measured as proliferation as well as expression of early and late cell surface antigens CD69, CD25 (IL-2R-alpha) and CD71 (transferrin receptor) at the cell membrane. At the molecular level, EXPLY-37 did not inhibit the activation of the nuclear factor kappa B (NF-kappaB) transcription factor by TNF. In summary, EXPLY-37 has two anti-inflammatory activities "in vitro": it decreases TNF production and increases IL-1Ra and sTNFR2, which may be able to neutralize IL-1 and TNF activity, respectively.


Colonization of new habitats by earthworms.
In this paper a simple model is used to study the dispersal of earthworm populations into new habitats. Simple models do not describe processes accurately, but can help gain insight into the functioning of ecosystems or processes in ecosystems. Using information on reproduction, survival and dispersal at the level of the individual, the velocity of earthworm population expansion was calculated. Dispersal of earthworms can be active or passive. The parameters of active and passive dispersal were calculated from field experiments in one of the Dutch polders. Parameters of reproduction and survival were estimated from published data. The effects of processes at the individual level on the velocity of population expansion were studied for two species (Aporrectodea caliginosa and Lumbricus rubellus). The model shows that passive transport has a major influence on the velocity of population expansion, which is strongly increased even if this transport involves only a very small part of the population. At a high level of passive transport, however, death induced by this mode of dispersal can have a negative influence on population expansion. In the discussion it is indicated that optimising growth conditions of the earthworms might be the easiest way to promote population expansion. However, promoting dispersal by passive mechanisms can also be very important.


Meat quality, proximate composition and muscle fatty acid profile of young llamas (Lama glama) supplemented with hay or concentrate during the dry season.
Thirty llamas were used to study the effect of a 90 day feed supplementation on meat quality, chemical composition and muscle fatty acid profile. Treatments were: GR=llama on native pasture until slaughter; GR+SH=like GR, but with overnight free access to barley/alfalfa hay; and GR+SC=like GR, but with overnight free access to a wheat bran/sorghum grain concentrate. The supplementation had no effect on postmortem pH and temperature decline in the Longissimus lumborum muscle (LLM), cooking losses nor Warner-Bratzler shear force values (P>0.05). Meat from GR+SC llama had higher fat content in LLM (P<0.05) compared to GR and GR+SH llama. Intramuscular fat from GR+SH llama showed higher (P<0.01) proportions of polyunsaturated fatty acids, higher (P<0.05) polyunsaturated fatty acids/saturated fatty acids and desirable fatty acids ratio, lower (P<0.05) omega-6/omega-3 (n-6/n-3) ratio, and higher (P<0.01) conjugated linoleic acid.


Evaluation of Wide Complex Tachycardia.
When a patient develops wide complex tachycardia, it is important to determine the cause quickly and accurately. This article will help the bedside nurse understand different causes, determine the most probable cause, and provide appropriate first-line treatment.


Metal fractionation of cadmium, lead and arsenic of geogenic origin in topsoils from the Marrancos gold mineralisation, northern Portugal.
The Marrancos gold mineralisation has a chemical assemblage of Fe-As-Se-Bi-Au-Ag-Te-(Cu-Pb-Zn-Sn-W). The -200 mesh of 144 topsoil samples was analysed by ICP-MS to determine total contents of 53 elements that include potentially harmful elements like Cd, As and Pb. The soil geochemistry shows that some trace elements occur in considerably high concentrations. On the basis of data for total metal concentrations, 10 topsoil samples were selected to carry out a metal fractionation study using a selective extraction method. A set of four leaches of increasing strength was used sequentially in the soil samples. Across the study area, there is some evidence of past mining and exploration activity, indicating that these soils may be locally disturbed. The shallow mineralised quartz veins were exploited for gold by the Romans. Several galleries were constructed during the 2nd World War, probably for the exploration of quartz-cassiterite-wolframite veins. However, the main mineralised body in depth was never explored. The results of metal fractionation show different partitions for the three elements. Total Cd concentrations in these soils are low, with a median value of 0.1 mg/kg. In average, 12% of total Cd is adsorbed by clays and/or co-precipitated with carbonates, and 19% is bounded to Fe-Mn oxyhydroxides. However, the low concentrations indicate that the metal does not represent an immediate risk to human health. For Pb, metal fractionation shows that, on average, 22% of Pb is adsorbed by amorphous Fe and Mn oxides, but the samples from the northern part of the area have the major fractions of Pb in soluble forms. The low probability of exposure in this part of the study area decreases the risk posed by this heavy metal. Total As concentrations in the Marrancos soils are extremely high. A large area has As concentrations above 1,000 mg/kg. For As, metal fractions in the sulphide phase vary between 84 and 98% in the studied samples. But one sample has 20% of total As in easily reducible forms, corresponding to a partial concentration of 1,800 mg/kg that has a high probability of being bioavailable. The most labile As forms occur at the southern part of the area, where the probability of exposure is higher and the risk of human health increases in the same order. From the three studied potentially harmful elements, As is certainly the element of concern.