Left ventricular aneurysm: comprehensive assessment of morphology, structure and thrombus using cardiovascular magnetic resonance.
To demonstrate that cardiac magnetic resonance (CMR) techniques provide unique and definitive information on the presence, location, size and nature of left ventricular aneurysm and pseudoaneurysm, the presence of thrombus and the viability of myocardium. A retrospective study of 27 patients with a final diagnosis of left ventricular aneurysm or pseudoaneurysm, who underwent CMR at a tertiary referral centre in the period between 2000 and 2003. In 7 cases the correct diagnosis of true aneurysm was confirmed; in 7 cases previously unsuspected thrombus was identified; in 7 cases an unsuspected pseudoaneurysm was identified; and in a further 6 cases a previously unsuspected aneurysm was identified. CMR refined the diagnosis in the majority of patients with left ventricular aneurysm, and should be considered in all cases of confirmed or suspected left ventricular aneurysm.


Distribution of catecholamine-containing cell bodies in the human diencephalon.
The distribution and morphological characteristics of catecholamine (CA)-containing cell bodies in the diencephalon of 7-9-month-old fetuses were studied by means of the Faglu histofluorescence method. Although the general distribution of CA cell bodies in human diencephalon observed in the present study is similar to that in other mammals, there are some significant differences. A great number of CA neurons lie within the lateroventral hypothalamic zone. There are more numerous larger CA neurons distributed outside the periventricular gray in the human diencephalon.


Magnetic resonance imaging of renal oncocytoma.
Two cases of renal oncocytoma studied by magnetic resonance imaging (MRI) suggest that this new imaging modality may prove useful in the preoperative diagnosis of oncocytoma and its differentiation from renal cell carcinoma.


Toxicity assessment of the herbicide acetochlor in the human liver carcinoma (HepG2) cell line.
Acetochlor is a high-volume herbicide used on a global scale and toxicity assessments are needed to define its potential for adverse effects in wildlife and humans. This study was conducted to determine the effects of acetochlor on human liver carcinoma cells (HepG2), a cell model widely used to assess the potential for chemical hepatotoxicity. Experiments were conducted at concentrations ranging 0-800 μM acetochlor over a 12 to 48h period to quantify underlying mechanisms of toxicity. Our data indicate that acetochlor suppressed HepG2 cell proliferation in both a concentration- and time-dependent manner. Acetochlor induced reactive oxygen species (ROS) generation more than 700% with exposure to 400 μM acetochlor, and acetochlor decreased the activities and levels of anti-oxidant responses (superoxide dismutase, glutathione) following exposure to 100 μM, 200 μM and 400 μM acetochlor. Acetochlor also (1) induced HepG2 cell damage through apoptotic-signaling pathways; (2) enhanced intracellular free Ca2+ concentration (>400%); (3) decreased mitochondrial transmembrane potential (∼77%), and reduced ATP levels (∼65%) following exposure to 400 μM acetochlor compared to untreated cells. Notably, cell cycle progression was blocked at G0/G1 phase in HepG2 cells when treated for 24 h with 400 μM acetochlor. Taken together, acetochlor induced significant cytotoxicity toward HepG2 cells, and the underlying toxicity mechanisms appear to be related to ROS generation, mitochondrial dysfunction and disruption in the cell cycle regulation. These data contribute to toxicity assessments for acetochlor, a high-use herbicide, to quantify risk to wildlife and human health.


Constitutive activity of transient receptor potential vanilloid type 1 triggers spontaneous firing in nerve growth factor-treated dorsal root ganglion neurons of rats.
Dorsal root ganglion (DRG) neurons cultured in the presence of nerve growth factor (NGF, 100 ng/ml) often show a spontaneous action potential. Underlying mechanisms of this spontaneous firing were examined using the patch clamp technique. The spontaneous firing in the on-cell configuration was abolished by a decrease in the Na+ concentration and by the TRPV1 antagonists capsazepine (10 μM) and BCTC (1 μM). These responses were accompanied by hyperpolarization of the resting potential. The holding current observed in neurons voltage clamped at -60 mV in the whole-cell configuration was significantly larger in the neurons that fired spontaneously, indicating that these neurons had an additional cation conductance that caused depolarization and triggered action potentials. The holding current in the firing neurons was decreased by extracellular Na+ reduction, capsazepine and BCTC. The amplitudes of the capsazepine- or BCTC-sensitive component of the holding current in the spontaneously firing neurons were ten times as large as those recorded in the other neurons showing no spontaneous firing. However, the amplitudes of the current responses to capsaicin (1 μM) were not different regardless of the presence of spontaneous firing or treatment with NGF. These results indicate that chronic NGF treatment of cultured DRG neurons in rats induces a constitutively active cation conductance through TRPV1, which depolarizes the neurons and triggers spontaneous action potentials in the absence of any stimuli. Since NGF in the DRG is reported to increase after nerve injury, this NGF-mediated regulation of TRPV1 may be a cause of the pathogenesis of neuropathic pain.


Diet composition and slaughter age up to 24weeks have minimal impact on pork eating quality of loin steaks and silverside roasts from female pigs.
Female crossbred pigs were randomly allocated at 16weeks of age to one of three dietary treatments (A: corn and soybean meal; B: wheat and canola meal; C: wheat and sorghum) matched for digestible energy (13.6MJ DE/kg) and total lysine (0.93-0.95%) and fed for 4, 5 or 8weeks, respectively, prior to slaughter. Loin (M. longissimus thoracis et lumborum) and silverside (M. biceps femoris) were obtained from 20 pigs per dietary treatment group and prepared into steaks and roasts, respectively, for consumer evaluation with ageing treatments of 7 and 28days post-slaughter allocated within muscle. Neither dietary treatment/age at slaughter nor ageing treatment influenced sensory traits of either cut. Intramuscular fat levels were also not influenced by dietary treatment. Higher (P<0.001) fail rates for silverside roasts compared with loin steaks indicate that different interventions are needed at a cut level to optimise pork eating quality consistency and consumer expectations.


Corporate political activity of baby food companies in Thailand.
Recent studies show corporate political activity (CPA) can have detrimental impacts on health policy processes. The Control of Marketing Promotion of Infant and Young Child Food Act B.E. 2560 (the Act) was implemented in Thailand in 2017, but there have been no studies documenting CPA during its policy processes. Furthermore, the effects of CPA on the Act and how non-industry stakeholders dealt with the CPA have not been explored. This study aimed to analyze the CPA of baby food companies in Thailand, its effects on the Act, and how policymakers have responded to CPA around the Act. This qualitative study applied an established framework developed by Mialon and colleagues to collect and systematically analyze publicly available information from seven baby food companies with the highest percentage market share in Thailand. In-depth interviews were also used to explore how people involved in the policy process of the Act experienced the CPA of baby food companies, the consequent effects on the Act, and how they responded to the CPA. During development of the Act, baby food companies used two main strategies, 'information and messaging' and 'constituency building'. We found the companies met policymakers, and they employed evidence or provided information that was favorable to companies. Also, they established relationships with policymakers, health organizations, communities and media. The effects of CPA were that the scope of products controlled by the Act was reduced, and CPA led relevant people to misunderstand and have concerns about the Act. Officials and others countered the influence of CPA by raising awareness and building understanding among involved people, as well as avoiding contact with companies informally. CPA consists of a variety of practices that resulted in a weakened Act in Thailand. Government officials and other non-industry stakeholders employed strategies to counteract this influence. This study suggests the Department of Health, and other relevant government agencies, would benefit from establishing safeguards and protections against CPA. Efforts to raise awareness about the harms of CPA within and outside of government and establish a systematic monitoring system, including avoid conflict of interest in policy process would improve policymaking and implementation of the Act.


Redesigning of the cap conformation and symmetry of the diphenylethyne core to yield highly potent pan-genotypic NS5A inhibitors with high potency and high resistance barrier.
Herein, we report the discovery of several NS5A inhibitors with potency against HCV genotype 1b in the picomolar range. Compounds (15, 33) were of extremely high potency against HCV genotype 1b (EC50 ≈ 1 pM), improved activity against genotype 3a (GT 3a) and good metabolic stability. We studied the impact of changing the cap conformation relative to the diphenylethyne core and/or compound symmetry on both potency and metabolic stability. The analogs obtained exhibited improved potency against HCV genotypes 1a, 1b, 3a and 4a compared to the clinically approved candidate daclatasvir with EC50 values in the low picomolar range and SI50s > 7 orders of magnitude. Compound 15, a symmetrically m-, m'-substituted diphenyl ethyne analog, was 150-fold more potent than daclatasvir against GT 3a, while compound 33, an asymmetrically m-, p-substituted diphenyl ethyne analog, was 35-fold more potent than daclatasvir against GT 3a. In addition, compound 15 exhibited a higher resistance barrier than daclatasvir against genotype 1b.


A prospective, multi-center randomized, controlled, blinded trial of vagus nerve stimulation for difficult to treat depression: A novel design for a novel treatment.
Few treatment options exist for patients with difficult-to-treat depression (DTD). One potentially efficacious treatment is vagus nerve stimulation (VNS): chronic stimulation of the vagus nerve using an implanted stimulator. Given a series of recent VNS clinical studies, including a large, five-year naturalistic investigation, the Center for Medicare and Medicaid Services (CMS) reconsidered the previous non coverage determination and announced coverage for patients participating in a "coverage with evidence" trial. This study, entitled, A PRospective, Multi-cEnter, Randomized Controlled Blinded Trial DemOnstrating the Safety and Effectiveness of VNS Therapy® System as AdjunctivE Therapy Versus a No Stimulation Control in Subjects With Treatment-Resistant Depression (RECOVER), includes DTD patients with at least four unsuccessful antidepressant treatments in the current episode and will randomize both unipolar and bipolar DTD participants, each up to 500 evaluable enrollees. Predetermined interim analyses will define the necessary sample size. All participants will be implanted with VNS devices: half receive active stimulation during year one, and half receive delayed stimulation after year one. Participants will be followed for 5 years. This RCT is unique for DTD studies: 1) large sample size and long study duration (one year of controlled comparison); 2) use of a percent time in response as the primary outcome measure, given the chronic illness and its fluctuating course (vis-à-vis meeting a response criteria at a single time point); 3) inclusion of diverse measures of VNS impact on function, including quality of life, degree of disability, health status, and suicidality.


Unraveling the capture mechanism of gaseous As2O3 over H-ZSM-5 zeolite from coal-fired flue gas: Experimental and theoretical insights.
Gaseous As2O3 discharged from coal-fired power plants results in severe detriments to the ecological environment. It is of great urgency to develop highly efficient As2O3 capture technology for reducing atmospheric arsenic contamination. Utilizing solid sorbents for gaseous As2O3 capture is a promising treatment for As2O3 capture. The zeolite of H-ZSM-5 was applied for As2O3 capture at high temperatures of 500-900 °C. Special attention was paid to clarifying its capture mechanism and identifying the influence of flue gas components via density functional theory (DFT) calculations and ab initio molecular dynamics (AIMD) simulations. Results revealed that due to high thermal stability with large specific areas, H-ZSM-5 demonstrated excellent arsenic capture at 500-900 °C. The captured arsenic consisted of As3+ and As5+ speciations, ascribed to As2O3 adsorption and oxidation. Moreover, As3+ and As5+ compounds were both through physisorption or chemisorption at 500-600 °C while dominant chemisorption at 700-900 °C. In particular, As3+ compounds were much more steadily fixed in products at all operating temperatures. Combining the characterization analysis and DFT calculations, it further verified that both Si-OH-Al groups and external Al species of H-ZSM-5 could chemisorb As2O3, and the latter exhibited much stronger affinities via orbital hybridization and electron transfer. The introduced O2 could facilitate As2O3 oxidation and fixation in H-ZSM-5, especially at a lower concentration of 2%. Additionally, H-ZSM-5 possessed great acid gas resistance for As2O3 capture under the concentration of NO or SO2 less than 500 ppm. AIMD simulations further identified that compared to NO and SO2, As2O3 was far more competitive and occupied the active sites of the Si-OH-Al groups and external Al species of H-ZSM-5. Overall, it demonstrated that H-ZSM-5 is a promising sorbent for As2O3 capture from coal-fired flue gas.


Familial financial stress and child internalizing behaviors: The roles of caregivers' maltreating behaviors and social services.
Based on the family stress model and the stress-buffering model, the present study examines the relationship between caregivers' financial stress and child internalizing problem behaviors, the mediating role of caregiver maltreating behaviors, and whether social services for caregivers buffer this relationship. The current study is based on data from wave two of the National Survey of Child and Adolescent Well-Being dataset (N = 2670). Results indicated increased high familial financial stress was associated with child internalizing problems. Caregivers' psychological aggression, physical assault, child neglect, and sexual maltreatment emerged as mechanisms mediating this relationship. Tangible service and social network service were found to mitigate the deleterious effect of financial stress on child internalizing behaviors, but primarily for those whom financial stress was high. These findings highlight the role perceived financial stress has on potential maltreatment and child outcomes, rather than relying on objective measures of economic status. Implications for social services focused interventions for children and caregivers coping with high levels of perceived financial stress are discussed.


Universal light-guiding geometry for on-chip resonators having extremely high Q-factor.
By providing an effective way to leverage nonlinear phenomena in integrated devices, high-Q optical resonators have led to recent advances in on-chip photonics. However, developing fabrication processes to shape any new material into a resonator with extremely smooth surfaces on a chip has been an exceptionally challenging task. Here, we describe a universal method to implement ultra-high-Q resonators with any new material having desirable properties that can be deposited by physical vapor deposition. Using this method light-guiding cores with surface roughness on the molecular-scale are created automatically on pre-patterned substrates. Its efficacy has been verified using As2S3, a chalcogenide glass that has high-nonlinearity. The Q-factor of the As2S3 resonator so-developed approached the propagation loss record achieved in chalcogenide fibers which were limited by material losses. Owing to the boosted Q-factor, lasing by stimulated Brillouin scattering has been demonstrated with 100 times lower threshold power than the previous record.


Interaction of chromosomal stains with DNA. An electrofluorescence study.
A novel fluorescence procedure has been used to study the binding characteristics of DNA with three modern fluorochromes currently used in chromosome cytochemistry. The transient changes in the polarised components of fluorescence have been recorded for dye-tagged DNA solutions when subjected to short duration electric pulses. From these data, it has been inferred that, like ethidium bromide, berberine sulphate and quinacrine mustard both intercalate the DNA structure whilst the bi-benzimidazole derivative Hoechst 33258 binds with a distinctively different geometry, probably within the helical grooves.


Some observations concerning the demographic and geographic incidence of carcinoma of the lip and buccal cavity.
The geographic and demographic data obtained during the Third National Cancer Survey have provided a perspective on etiologic factors and incidence trends for cancers of low frequency. The incidence of cancer of the lip, oral cavity and skin from this survey was compared to similar studies in 1947 and intra-regional patterns in one area of the Third National Cancer Survey (Dallas-Fort Worth Metropolitan SMSA) were evaluated. The average age-adjusted annual incidence of cancer of the lip in white men in this latter area was 11.5 per 100,000 (based on 1950 population standard), 2-fold greater than that geographic area with the second highest incidence and approximately 3-fold greater than in all the other areas. The incidence in white women was only 8% that seen in white men. Intra-regional differences of similar populations were seen with the incidence in Fort Worth men being 50% greater than in a similar population in Dallas. Incidence trends over the past 2 decades reveal a significant decline in the incidence of oral cavity cancer and a slight decrease in lip cancer. Comparisons of the incidence of lip cancer did not correlate with the incidence of skin cancer nor with geographic latitude in the other survey areas. The studies fail to support the classical implication of actinic radiation as the primary etiologic factor in lip cancer incidence.


Randomized trial of intermittent intraputamenal glial cell line-derived neurotrophic factor in Parkinson's disease.
We investigated the effects of glial cell line-derived neurotrophic factor (GDNF) in Parkinson's disease, using intermittent intraputamenal convection-enhanced delivery via a skull-mounted transcutaneous port as a novel administration paradigm to potentially afford putamen-wide therapeutic delivery. This was a single-centre, randomized, double-blind, placebo-controlled trial. Patients were 35-75 years old, had motor symptoms for 5 or more years, and presented with moderate disease severity in the OFF state [Hoehn and Yahr stage 2-3 and Unified Parkinson's Disease Rating Scale motor score (part III) (UPDRS-III) between 25 and 45] and motor fluctuations. Drug delivery devices were implanted and putamenal volume coverage was required to exceed a predefined threshold at a test infusion prior to randomization. Six pilot stage patients (randomization 2:1) and 35 primary stage patients (randomization 1:1) received bilateral intraputamenal infusions of GDNF (120 µg per putamen) or placebo every 4 weeks for 40 weeks. Efficacy analyses were based on the intention-to-treat principle and included all patients randomized. The primary outcome was the percentage change from baseline to Week 40 in the OFF state (UPDRS-III). The primary analysis was limited to primary stage patients, while further analyses included all patients from both study stages. The mean OFF state UPDRS motor score decreased by 17.3 ± 17.6% in the active group and 11.8 ± 15.8% in the placebo group (least squares mean difference: -4.9%, 95% CI: -16.9, 7.1, P = 0.41). Secondary endpoints did not show significant differences between the groups either. A post hoc analysis found nine (43%) patients in the active group but no placebo patients with a large clinically important motor improvement (≥10 points) in the OFF state (P = 0.0008). 18F-DOPA PET imaging demonstrated a significantly increased uptake throughout the putamen only in the active group, ranging from 25% (left anterior putamen; P = 0.0009) to 100% (both posterior putamina; P < 0.0001). GDNF appeared to be well tolerated and safe, and no drug-related serious adverse events were reported. The study did not meet its primary endpoint. 18F-DOPA imaging, however, suggested that intermittent convection-enhanced delivery of GDNF produced a putamen-wide tissue engagement effect, overcoming prior delivery limitations. Potential reasons for not proving clinical benefit at 40 weeks are discussed.


Different outcomes among favourable and unfavourable intermediate-risk prostate cancer patients treated with hypofractionated radiotherapy and androgen deprivation therapy.
to evaluate the role of a risk stratification system in intermediate-risk prostate cancer (PCa) treated with hypofractionated radiotherapy (HyRT). 131 patients affected by intermediate-risk PCa were treated with HyRT at the total dose of 54,75 Gy in 15 fraction plus 9 months of androgen deprivation therapy (ADT). Patients were classified as favourable risk (FIR) if they had a single NCCN intermediate-risk factor (IRF), a Gleason score ≤3 + 4 = 7, and <50 % of biopsy cores containing cancer (PBCC). If these criteria were not met were classified as unfavourable risk (UIR). Univariate and multivariate analyses using Cox proportional hazards model were calculated for biochemical recurrence-free survival (bRFS), the risk of local recurrence and metastasis-free survival (MFS). After a median follow-up of 56.7 months (range 9.8 to 93.7 months), 11 patients (8.4 %) died, of whom 2 (1.5 %) for PCa. In the univariate analysis, Gleason score, PPBCs, IRFs and PSA at first follow-up were prognostic factors for bRFS and LF while Gleason score, PPBCs and PSA at first follow-up were significant predictor for MFS. In the multivariate analysis only the PSA at first follow-up resulted a prognostic factor for bRFS and MFS. Patients with a value of PSA at first follow-up <0.7 ng/mL respect to those with PSA ≥0,7 ng/mL had a 5y-bRFS of 93.3 % vs. 57.5 %, 5y-MFS of 99.0 % vs. 78.9 % and 5y-LF of 5.8 % vs. 38.3 %. Patients in the UIR PCa group with a PSA value <0.7 ng/mL at first follow-up had significant better bRFS, LF and MFS. Risk factors currently not included in the guidelines are useful to stratify patients with intermediate-risk PCa in two groups of different prognosis even when HyRT is delivered. PSA at first follow-up is useful in UIR PCa to guide the overall length of ADT.


[Oral misoprostol against vaginal dinoprostone for labor induction at term: a randomized comparison].
It was the objective of this study to compare the efficacy and safety of oral misoprostol with those of vaginal dinoprostone for the induction of labour at term. Between 2003 and 2006 224 pregnant women were included in our prospective randomised clinical trial. All of them were admitted for induction of labor at term. Half of the patients received oral misoprostol, initially at a test dose of 25 microg, followed by 50 microg and 100 microg every 4 hours. The control group received 3 mg vaginal dinoprostone every 6 hours. Primary endpoints were time interval until delivery and mode of delivery as well as maternal and neonatal outcome, secondary endpoints were side effects and costs. In the dinoprostone group, the median time interval until delivery was 17.6 hours compared to 24.1 hours in the misoprostol group. Without the test dose, the difference was no longer significant. After dinoprostone induction, more patients had a vaginal delivery within 24 hours (n=60, 53.6%, vs. n=46, 41.1%). The frequencies of spontaneous deliveries and emergency Caesarean sections did not differ between the groups. The rate of vacuum extractions was higher in the misoprostol group (23 vs. 11, i. e. 20.5 vs. 9.8%, p<0.05). With regard to side effects there was no significant difference. No case of hyperstimulation was documented. Oral misoprostol is effective and safe for induction of labour at term. In addition, it is much cheaper and independent of storage conditions. At the doses and with the administration intervals used in this study, dinoprostone was slightly more effective than misoprostol.


Rikkunshito, a traditional Japanese medicine, suppresses cisplatin-induced anorexia in humans.
The aim of this study was to investigate the effects of Rikkunshito on ghrelin secretion and on cisplatin-induced anorexia in humans. The study was performed as a crossover design, and ten unresectable or relapsed gastric cancer patients were randomly divided into two groups. Group A (n = 5) was started on Rikkunshito (2.5 g three times daily, orally) from the first course of chemotherapy and followed by a second course without Rikkunshito. A treatment with reversed order was performed for Group B (n = 5). All patients received combined chemotherapy with S-1 plus cisplatin. The primary endpoint was the amount of oral intake, and the categories of scales of anorexia, nausea, and vomiting; secondary endpoints included the plasma concentration of acylated ghrelin. In the Rikkunshito-on period, no decrease of the plasma concentration of acylated ghrelin induced by cisplatin was observed. The average oral intake in the Rikkunshito-on period was significantly larger than that in the Rikkunshito-off period, and the grade of anorexia was significantly lower in the Rikkunshito-on period than in the Rikkunshito-off period. Rikkunshito appeared to prevent anorexia induced by cisplatin, resulting in effective prophylactic administration of chemotherapy with cisplatin, and patients could continue their treatments on schedule.


Critical illness-associated cerebral microbleeds in severe COVID-19 infection.
Neurologic complications of COVID-19 infection have been recently described and include dizziness, headache, loss of taste and smell, stroke, and encephalopathy. Brain MRI in these patients have revealed various findings including ischemia, hemorrhage, inflammation, and demyelination. In this article, we report a case of critical illness-associated cerebral microbleeds identified on MRI in a patient with severe COVID-19 infection and discuss the potential etiologies of these neuroimaging findings.


Host genes affecting survival period of chemically induced bladder cancer in mice.
Treatment of C57BL/6 J (B6) and NON male mice with N-butyl-N-(4-hydroxybutyl)nitrosamine (BBN) resulted in a high incidence of bladder cancer. The mean survival period, however, differed significantly by strain: 481+/-219 days in B6 (n = 31) and 203+/-119 days in NON (n = 30) (P < 0.0001). Major causes of death were renal failure due to obstruction of the urinary tract, or local invasion of tumors. The fact that the BBN-treated NON x B6 reciprocal F1 mice had survival periods as short as those of the parental NON mice suggests a genetically dominant susceptibility in NON or recessive resistance in B6. A linkage analysis of 248 back-cross mice to B6 suggested at least two quantitative trait loci determining the length of the survival period: one was mapped close to D2Mit260 (logarithm of odds, LOD, score 2.21), a microsatellite marker locus 83 cM from the centromere on chromosome 2, and another was close to D6Mit159, 7 cM from the centromere on chromosome 6 (LOD score 2.51).


[Effect of the natriuretic factor on the transport of electrolytes and energy metabolism in kidney cortex sections].
The peptide material of the 2nd and 3rd fractions of the natriuretic factor did not affect the passive sodium transport while inhibiting the active transport in slices of the rat kidney cortex. This inhibition was accompanied by a decrease of both the succinic dehydrase system and Na+, K+-activated ATPase activities in the slices. The natriuresis caused by the natriuretic factor seems to be due to the inhibition of the active sodium transport.


Interlobar lymph node metastases according to primary tumor location in lung cancer.
Interlobar lymph node metastases were analyzed in consecutive 284 lung cancer patients with lobar-hilar and mediastinal lymph node dissection. Interlobar lymph node metastases were observed in 46 (16.2%) patients with no difference between right and left cases. On the right side, there was a significant difference in the frequency of inferior interlobar lymph node metastases between upper lobe and middle/lower lobe tumors (P=0.0004), but no difference in the frequencies of superior ones according to primary site. On the left, there was a significant difference in the frequency of interlobar lymph node metastases between upper lobe and lower lobe tumors (P=0.0021). In per-segment analyses, the frequency of inferior interlobar lymph node metastases in segments 1-3 and 6 was significantly lower than in the other total segments (P<0.0001) on the right, and that of interlobar lymph node metastases in the upper division segments (S1-3) was significantly lower than in the other total segments (P=0.0008) on the left. Even limited to one lobe, the patterns of interlobar lymph node metastases were different among the segments in the right lower lobe and the left upper lobe.


[TraumaregisterTraumaNetwork DGU® und TraumaRegister DGU®. Success by cooperation and documentation].
The TraumaNetwork DGU® (TNW) connects hospitals with different capacities for the treatment of severely injured patients who work together as superregional (STC), regional (RTC) and local trauma centres (LTC). The standards of treatment and equipment are defined on the basis of current guidelines as published in the"White book of the Treatment of Severely Injured Patients". An external audit process evaluates the organisation and structure of participating hospitals as well as the cooperation of the trauma centres within a regional TNW. In May 2013 a total of 618 hospitals were visited and assessed according to the White book and 39 fully certified regional TNWs covered around 85% of the area of Germany. Treatment quality in the certified TCs was analyzed on the basis of 25,249 severely injured patients in the TraumaRegister DGU® (2008-2011) and significant differences between the expected and observed mortality rates were found. These differences were most obvious in superregional and regional trauma centres. The TraumaNetwork represents an innovative, cooperative project for successfully improving the treatment of severely injured patients.


New development in carbon quantum dots technical applications.
As a newly emerged member in carbon nanomaterials family, carbon quantum dots (CQDs) attracted everincreasing attention owing to their ultracompact size, excellent photoluminescence, favorable biocompatibility, versatile surface and superior electron transfer ability. The past decade has witnessed continuous advancements in the production of CQDs with high photoluminescence quantum yields for various applications. Herein, we track the newest development of CQDs with advanced physicochemical properties and their applications in sensing, bioimaging, nanomedicine and catalysis, and propose the challenges and perspectives in this exciting and promising field.


Enhanced photocatalysis and anticancer activity of green hydrothermal synthesized Ag@TiO2 nanoparticles.
Titanium dioxide (TiO2) nanoparticles (NPs) have been doped with varying amounts (0.005, 0.010 and 0.015 M) of silver nanoparticles (Ag NPs) using hydrothermal method. Further, in this work, a green approach was followed for the formation of Ag@TiO2 NPs using Aloe vera gel as a capping and reducing agent. The structural property confirmed the presence of anatase phase TiO2. Increased peak intensity was observed while increasing the Ag concentration. Further, the morphological and optical properties have been studied, which confirmed the effective photocatalytic behavior of the prepared Ag@TiO2 NPs. The photocatalytic performance of Ag@TiO2 has been considered for the degradation of picric acid in the visible light region. The concentration at 0.010 M of the prepared Ag@TiO2 has achieved higher photocatalytic performance within 50 min, which could be attributed to its morphological behavior. Similarly, anticancer activity against lung cancer cell lines (A549) was also determined. The Ag@TiO2 NPs generated a large quantity of reactive oxygen species (ROS), resulting in complete cancer cell growth suppression after their systemic in vitro administration. Ag@TiO2 NPs was adsorbed visible light that leads to an enhanced anticancer sensitivity by killing and inhibiting cancer cell reproduction through cell viability assay test. It was clear that 0.015 M of Ag@TiO2 NPs were highly effective against human lung cancer cell lines and showed increased production of ROS in cancer cell lines due to the medicinal behavior of the Aloe vera gel.


Changes of the directional brain networks related with brain plasticity in patients with long-term unilateral sensorineural hearing loss.
Previous studies often report that early auditory deprivation or congenital deafness contributes to cross-modal reorganization in the auditory-deprived cortex, and this cross-modal reorganization limits clinical benefit from cochlear prosthetics. However, there are inconsistencies among study results on cortical reorganization in those subjects with long-term unilateral sensorineural hearing loss (USNHL). It is also unclear whether there exists a similar cross-modal plasticity of the auditory cortex for acquired monaural deafness and early or congenital deafness. To address this issue, we constructed the directional brain functional networks based on entropy connectivity of resting-state functional MRI and researched changes of the networks. Thirty-four long-term USNHL individuals and seventeen normally hearing individuals participated in the test, and all USNHL patients had acquired deafness. We found that certain brain regions of the sensorimotor and visual networks presented enhanced synchronous output entropy connectivity with the left primary auditory cortex in the left long-term USNHL individuals as compared with normally hearing individuals. Especially, the left USNHL showed more significant changes of entropy connectivity than the right USNHL. No significant plastic changes were observed in the right USNHL. Our results indicate that the left primary auditory cortex (non-auditory-deprived cortex) in patients with left USNHL has been reorganized by visual and sensorimotor modalities through cross-modal plasticity. Furthermore, the cross-modal reorganization also alters the directional brain functional networks. The auditory deprivation from the left or right side generates different influences on the human brain.


Stand-off Raman spectroscopic detection of minerals on planetary surfaces.
We have designed and developed two breadboard versions of stand-off Raman spectroscopic systems for landers based on a 5-in. Maksutov-Cassegrain telescope and a small (4-in. diameter) Newtonian telescope receiver. These systems are capable of measuring the Raman spectra of minerals located at a distance of 4.5-66 m from the telescope. Both continuous wave (CW) Ar-ion and frequency doubled Nd:YAG (532 nm) pulsed (20 Hz) lasers are used as excitation sources for measuring remote Raman spectra of rocks and minerals. We have also made complementary measurements on the same rock samples with a micro-Raman system in 180 and 135 degrees geometry for evaluating the system performance and for estimating effect of grain size and laser-induced heating on the spectra of minerals using alpha-quartz as a model mineral. A field portable remote pulsed Raman spectroscopic system based on the 5-in. telescope and an f/2.2 spectrograph has been developed and tested. We have also demonstrated a prototype of a combined Raman and laser-induced breakdown spectroscopy (LIBS) system, capable of providing major element composition and mineralogical information on both biogenic and inorganic minerals at a distance of 10 m from the receiver.


The effect of depression on motor function and disease severity of Parkinson's disease.
Approximately 40% of patients with Parkinson's disease (PD) experience symptoms of depression. Our aim was to evaluate the effect of depression on disease severity, motor function and other phenotypic characteristics of PD. We studied 32 PD patients with major depression (PD-D) according to the DSM-IV criteria and 32 PD patients with no depression (PD-C) matched for gender, age of onset and duration. Major depression in PD patients was associated with increased disease severity, poorer motor function and worse performance in the activities of daily living as measured by UPDRS scores. Furthermore, there was an association of depression with the severity of bradykinesia and axial rigidity. Depression in PD can have a profound negative impact on a patient's sense of wellbeing and motor functioning. Therefore, PD patients should be routinely and carefully screened for the presence of depression and appropriate management should be considered. Larger studies on the subject are warranted.


Risk of respiratory distress in the patients who were applied nasal packing at the end of nasal surgery.
This prospective study investigated the risk of respiratory distress in the patients who were applied nasal packing at the end of nasal surgery; and effects of nasal packing on consciousness level while the patients were awake or asleep, measured by Bispectral Index (BIS). The study group consisted of 15 adult patients (10 male, 5 female), who were applied nasal packing at the end of nasal surgery. The control group consisted of 15 adult patients (10 male, 5 female), who received general anesthesia for various reasons. In the study and control groups, BIS index, respiratory rate, peripheral oxygen saturation, pulse per minute and blood pressure were measured at seven different times. There was no statistically significant difference between BIS indexes of the study and control groups. In the fourth hour after sleep (AS-4h), respiratory rate of the study group was significantly lower than that of the control group. In the fourth hour after the anesthesia (AA-4h), oxygen saturation value of the study group was lower than that of the control group. We conclude that in patients who are applied nasal packing at the end of nasal surgery; at AA-4h and AS-4h times, there may be risk of decrease in the oxygen saturation and respiratory rate parameters, respectively. Therefore, it is necessary to monitor non-invasive respiratory parameters and to give enriched oxygen by an oral catheter.


Study of agreement of aortic, radial and femoral blood pressures during aortic endografting.
To estimate the agreement between radial or femoral, and ascending aortic invasive blood pressure values. Prospective study on 32 patients who underwent an aortic endografting under general anesthesia. After deploying the prosthesis under controlled hypotension, a catheter was introduced in the aorta to measure the staged systolic (SAP), diastolic (DAP) and mean (MAP) arterial pressures, in particular at the level of ascending aorta and femoral artery. No differences were observed between SAP, DAP or MAP measured in the aorta versus femoral or radial arteries. A better agreement was observed between the aortic and femoral MAP (bias of 1mmHg, limits of agreement between: -8.8mmHg and +10.8mmHg) than between the aortic and the radial MAP (bias of 1.7mmHg, limits of agreement between: -14.1mmHg and +17.5mmHg). The comparison between radial and femoral MAP was not satisfying (bias of -4.7mmHg and limits of agreement between -19.1mmHg and +9.7mmHg). The femoral MAP is more accurate to predict value of the aortic MAP than the radial MAP in a hypotensive setting. The clinician should be aware of these discrepancies in conditions of hemodynamic impairment to optimize the treatment.


The prevalence of syphilis in HIV-seropositive patients: a retrospective study at the regional hospital in Agadir, Morocco.
HIV and syphilis are major public health problems in Morocco. The region of Souss-Massa, south-west of the country, hold more than 24% of HIV seropositive cases registered in Morocco during 2009. The aim of this study is to evaluate the seroprevalence of syphilis among HIV seropositive patients in the region of Souss-Massa, south-west of Morocco. To evaluate the seroprevalence of syphilis and neurosyphilis among HIV seropositive patients, we retrospectively investigated the medical records of HIV-infected patients attending the regional hospital located in the city of Agadir, during the period comprised between 2011 and 2016. The population studied involved 1381 males (49.18%) and 1427 females (50.82%) HIV seropositive patients. Among them, 481 patients were seropositive for syphilis and three cases were diagnosed with neurosyphilis. The sex ratio distribution was 243 male (52.71%) and 218 female (47.29%). The prevalence of syphilis among the studied population was estimated to 16.42% with a slight dominance in male (17.63%) compared to female (15.28%). By contrast, neurosyphilis was only detected in male patients, with a prevalence estimated to 0.11%. Even if the prevalence of HIV and syphilis is stable in the region of Souss-Massa, the prevalence of syphilis among HIV seropositive patients remained high and correlated positively with that of HIV infection. We did not find a significant difference between the genders, in relation to the prevalence of HIV and syphilis. We concluded that it was essential to continue monitoring the population, in order to improve the prevention and the access to the medical care in the south-west of Morocco.


NIR techniques create added values for the pellet and biofuel industry.
A 2(3)-factorial experiment was carried out in an industrial plant producing biofuel pellets with sawdust as feedstock. The aim was to use on-line near infrared (NIR) spectra from sawdust for real time predictions of moisture content, blends of sawdust and energy consumption of the pellet press. The factors varied were: drying temperature and wood powder dryness in binary blends of sawdust from Norway spruce and Scots pine. The main results were excellent NIR calibration models for on-line prediction of moisture content and binary blends of sawdust from the two species, but also for the novel finding that the consumption of electrical energy per unit pelletized biomass can be predicted by NIR reflectance spectra from sawdust entering the pellet press. This power consumption model, explaining 91.0% of the variation, indicated that NIR data contained information of the compression and friction properties of the biomass feedstock. The moisture content model was validated using a running NIR calibration model in the pellet plant. It is shown that the adjusted prediction error was 0.41% moisture content for grinded sawdust dried to ca. 6-12% moisture content. Further, although used drying temperatures influenced NIR spectra the models for drying temperature resulted in low prediction accuracy. The results show that on-line NIR can be used as an important tool in the monitoring and control of the pelletizing process and that the use of NIR technique in fuel pellet production has possibilities to better meet customer specifications, and therefore create added production values.


Divergent evolution of metachronous follicular lymphoma and extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue from a common precursor.
The translocation t(14;18)(q32:q21)/IGH::BCL2 occurs at the pre-B stage of B-cell development in the bone marrow and is insufficient for malignant transformation, although it leads to the formation of in situ follicular B-cell neoplasia (ISFN). Despite that, the translocation is the genetic hallmark of follicular lymphoma (FL), it occurs infrequently in metachronous/synchronous lymphomas, including extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (EMZL), mantle cell lymphoma, and Hodgkin's lymphoma. In each of these scenarios, the two lymphomas often appear to be clonally related by analyses of IGH::BCL2 and/or rearranged IG genes. However, it remains largely unknown whether one lymphoma originates from the other or they develop independently. We studied five cases of metachronous EMZL and FL. In four cases, the two lymphomas were clonally related, as shown by identical IGH::BCL2 and/or rearranged IG genes or shared mutations. There were common and unique mutations between the paired EMZL and FL, indicating that they developed independently from a common premalignant cell population, harbouring IGH::BCL2 in three cases. Furthermore, case 1 presented with three metachronous FLs, and all of them originated from a common precursor cell population via divergent evolution. Our findings highlight the multi-malignant potential of IGH::BCL2-positive B-cells. © 2023 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.


Efficacy of five-step shoulder manipulation for rotator cuff-related shoulder pain: protocol for a multicenter randomized controlled trial.
Rotator cuff-related shoulder pain (RCRSP) is the most common cause of shoulder disorders. In China, manipulation has been used extensively for the treatment of patients with RCRSP. However, high-quality clinical evidence to support the therapeutic effect of manipulation is still limited. A multicenter, participant-, outcome assessor-, and data analyst-blinded, randomized, placebo-controlled trial will be conducted. A total of 280 participants with RCRSP will be recruited from three hospitals and randomly assigned to a five-step shoulder manipulation (FSM) group or a sham manipulation (SM) group. Each group will receive four weekly treatment sessions, with all participants performing exercises at home for 12 weeks. Assessments, namely the Constant-Murley score, visual analog scale, range of motion, and 36-Item Short Form Survey, will be made at baseline, 4, 12, 18, and 24 weeks. Adverse events during the study will also be recorded. This is a pragmatic clinical trial to evaluate the efficacy and safety of FSM in patients with RCRSP. The findings of this study will provide worthy clinical evidence for manual therapy for RCRSP. China Registered Clinical Trial Registration Center ChiCTR2000037577. Registered on 29 August 2020.


Bronchial responsiveness to inhaled metabisulfite in asthmatic children increases with age.
Inhaled bisulfite (HSO3) aerosol produces bronchoconstriction in asthmatics but not in normals. This effect is probably due to local formation of SO2 which stimulates vagal afferents in the airway mucosa, and gives rise to bronchoconstriction that is partly due to a cholinergic reflex. Metabisulfite (MBS) produces bronchoconstriction in most adult asthmatics, but its effect in children has received little attention. The present study was done to assess MBS-induced bronchoconstriction as a function of age in asthmatic children, and to compare MBS responsiveness with the response to inhaled metacholine (MCH), which is commonly used for bronchoprovocation testing. In 36 children with moderate asthma, selected to cover the age range between 3 and 20 years, we compared airway responsiveness to MBS and MCH, expressed as the provocative dose that causes a 20% fall in baseline forced expiratory volume in 1 sec (FEV1, PD20). We also measured the PD20 to MBS after pretreatment with the anticholinergic ipratropiumbromide, to estimate the noncholinergic component of the response. After bronchial provocation with MCH, a PD20 was reached in 32 children, and no significant relation of PD20 to age was found. A PD20[MBS] was seen in only 17 patients, and more frequently in older children. There was a significant negative correlation between age and PD20[MBS]. Ipratropium pretreatment reduced the response to MBS in 14 of the 17 children who had a PD20[MBS]. The PD20[MBS] after ipratropium pretreatment was also significantly negatively related with age. This suggested that the increased prevalence of MBS responsiveness was due to an increase of the noncholinergic component of the response.(ABSTRACT TRUNCATED AT 250 WORDS)


External Validation of the FSAC Model Using On-Therapy Changes in Noninvasive Fibrosis Markers in Patients with Chronic Hepatitis B: A Multicenter Study.
Antiviral therapy (AVT) induces the regression of non-invasive fibrosis markers (NFMs) and reduces hepatocellular carcinoma (HCC) risk among chronic hepatitis B (CHB) patients. We externally validated the predictive performance of the FSAC prediction model for HCC using on-therapy NFM responses. Our multicenter study consecutively recruited treatment-naïve CHB patients (n = 3026; median age, 50.0 years; male predominant (61.3%); cirrhosis in 1391 (46.0%) patients) receiving potent AVTs for >18 months between 2007 and 2018. During follow-up (median 64.0 months), HCC developed in 303 (10.0%) patients. Patients with low FIB-4 or APRI levels at 12 months showed significantly lower HCC risk than those with high NFM levels at 12 months (all p < 0.05). Cumulative 3-, 5-, and 8-year HCC probabilities were 0.0%, 0.3% and 1.2% in the low-risk group (FSAC ≤ 2); 2.1%, 5.2%, and 11.1% in the intermediate-risk group (FSAC 3-8); and 5.2%, 15.5%, and 29.8% in the high-risk group (FSAC ≥ 9) (both p < 0.001 between each adjacent pair). Harrell's c-index value for FSAC score (0.770) was higher than those for PAGE-B (0.725), modified PAGE-B (0.738), modified REACH-B (0.737), LSM-HCC (0.734), and CAMD (0.742). Our study showed that the FSAC model, which incorporates on-therapy changes in NFMs, had better predictive performance than other models using only baseline parameters.


Role of MRI bone marrow imaging in recurrent lymphoma.
Infiltration by Hodgkin disease of the bone marrow of a thoracic vertebral body in a symptomatic patient was identified by magnetic resonance imaging, but not by radiography, radionuclide bone scanning, or computed tomography. The discovery of disease at this site substantially altered subsequent therapy.


Increased expression of hypoxia-inducible factor-1 alpha in venous stenosis of arteriovenous polytetrafluoroethylene grafts in a chronic renal insufficiency porcine model.
To create a more clinically relevant model of hemodialysis graft failure in pigs by creating chronic renal insufficiency before polytetrafluoroethylene (PTFE) hemodialysis graft placement and to determine the expression of hypoxia-inducible factor-1 alpha (HIF-1 alpha) at the vein-to-graft anastomosis (VGA). Chronic renal insufficiency was created in 14 castrated juvenile male pigs with complete embolization of the left renal artery and the partial embolization of the right renal artery by infusing 150-250-mum polyvinyl acrylide spherical particles. The efficacy of the embolization was assessed by determining the amount of polyvinyl acrylide particles used per kidney, the weight of the kidneys at sacrifice, and kidney function (blood urea nitrogen [BUN] and creatinine levels). Twenty-eight days after embolization, PTFE grafts were placed from the carotid artery to the ipsilateral jugular vein and removed 3, 7, and 14 days after graft placement. Western blot for HIF-1 alpha was performed in the VGA and control vessel. The left kidney required two times the polyvinyl acrylide particles than did the right kidney (P < .05). The right kidney weighed nearly three times more than the left (P < .05). The BUN and creatinine levels at graft placement were significantly higher than those at baseline (P < .05). Four grafts were patent at day 3, four at day 7, and four at day 14. By day 7, the mean HIF-1 alpha at the VGA had increased significantly when compared with that of control vessels (P < .05). A more clinically relevant porcine model of hemodialysis graft failure was created, and there was significantly increased expression of HIF-1 alpha by day 7 at the VGA.


ModelTest Server: a web-based tool for the statistical selection of models of nucleotide substitution online.
ModelTest server is a web-based application for the selection of models of nucleotide substitution using the program ModelTest. The server takes as input a text file with likelihood scores for the set of candidate models. Models can be selected with hierarchical likelihood ratio tests, or with the Akaike or Bayesian information criteria. The output includes several statistics for the assessment of model selection uncertainty, for model averaging or to estimate the relative importance of model parameters. The server can be accessed at http://darwin.uvigo.es/software/modeltest_server.html.


Coexistence of Crohn's disease in a patient with systemic lupus erythematosus.
The concurrence of inflammatory bowel disease with systemic lupus erythematosus (SLE) is rare. The concomitant diagnosis of Crohn's disease and SLE is even more rare. The patient, a 40-year-old woman, was admitted to our hospital because of relapsing episodes of abdominal pain, diarrheas upper and lower extremities arthralgias, Raynaud's phenomenon with positive antinuclear antibodies, and fever for the last 2 years. The patient was diagnosed elsewhere with SLE and treated with hydroxychloroquine. Her medical history also included tonsillectomy and total hip replacement after a car accident. Family history was unremarkable. Physical examination was unremarkable except of very mild pain at lower left abdominal quadrant. Laboratory tests showed erythrocyte sedimentation rate at 32 mm/h, C-reactive protein at 36 mg/dl, positive rheumatoid factor, and increased C3, C4, positive antinuclear antibodies with the presence of anti-Sm and anti-RNP antibodies. Ileocolonoscopy revealed colonic inflammation with ulcers and pseudopolyps. Subsequent biopsies were diagnostic of Crohn's disease. Patient was diagnosed with Crohn's colitis concomitant to systemic lupus erythematosus and was started on therapy with azathioprine 2 mg/Kg, methylprednisolone 16 mg/d with slow tapering, mesalazine 1.5 g/day, and hydroxychloroquine. Patient is in excellent health status on the six-month follow-up.


Selected papers from the 14th Annual Bio-Ontologies Special Interest Group Meeting.
Over the 14 years, the Bio-Ontologies SIG at ISMB has provided a forum for discussion of the latest and most innovative research in the bio-ontologies development, its applications to biomedicine and more generally the organisation, presentation and dissemination of knowledge in biomedicine and the life sciences. The seven papers selected for this supplement span a wide range of topics including: web-based querying over multiple ontologies, integration of data from wikis, innovative methods of annotating and mining electronic health records, advances in annotating web documents and biomedical literature, quality control of ontology alignments, and the ontology support for predictive models about toxicity and open access to the toxicity data.


The HER2-miR125a5p/miR125b loop in gastric and esophageal carcinogenesis.
A subset of gastric (intestinal-type) and esophageal (Barrett) adenocarcinoma features HER2 protein overexpression. Consistent evidence demonstrates that microRNAs have a major role in HER2 (dys)regulation. MiR-125a-5p and miR125b expressions were tested in the spectrum of lesions in the gastroesophageal carcinogenic cascade, also correlating miR-125a-5p/125b levels with HER2 status. MiR-125a-5p and miR-125b expression (quantitative reverse transcriptase polymerase chain reaction [qRT-PCR]) and HER2 status (immunohistochemistry [IHC] and chromogenic in situ hybridization [CISH]) were assessed in a series of 90 biopsy samples spanning the whole histologic spectrum of gastric and esophageal carcinogenesis. To support the obtained results, the qRT-PCR levels of microRNAs and their expression (in situ hybridization) were tested in an adjunctive series of gastric and esophageal adenocarcinoma, including (IHC/CISH validated) HER2-negative and HER2-positive cases. Both miR-125a-5p and miR-125b levels were significantly down-regulated throughout the gastric and esophageal carcinogenic cascade. HER2 status (IHC and CISH) correlated inversely with miR-125 expression (qRT-PCR and in situ hybridization). Dysregulation of miR-125a-5p/125b and HER2 is an early event in the gastric (intestinal-type) and esophageal (Barrett) oncogenesis. In both oncogenetic cascades, miR-125 expression correlates inversely with HER2 status. MiR-125a-5p/125b can be considered among the therapeutic targets in HER2-positive esophageal and gastric adenocarcinoma.


Molecular phylogenetics of 'river dolphins' and the baiji mitochondrial genome.
It is well known that the classical river dolphins are not a natural group, but up to now the phylogenetic relationships among them are not very clear because different views have been referred from different studies. In the present study, we determined the complete nucleotide sequence of the mitochondrial (mt) genome of the baiji (Lipotes vexillifer), the most endangered cetacean species, and conducted phylogenetic analyses for the classical river dolphins based on data from cetacean mitochondrial genomes available. In our analyses, the classical river dolphins split into two separate lineages, Platanista and Lipotes+(Inia+Pontoporia), having no sister relationship with each other, and the Platanista lineage is always within the odontocete clade instead of having a closer affinity to Mysticeti. The position of the Platanista is more basal, suggesting separate divergence of this lineage well before the other one. The Lipotes has a sister relationship with Inia+pontoporia, and they together formed the sister group to the Delphinoidea. This result strongly supports paraphyly of the classical river dolphins, and the nonplatanistoid river dolphins do represent a monophyletic grouping, with the Lipotidae as the sister taxa to (Iniidae+Pontoporiidae), and is well congruent with the studies based on short interspersed repetitive elements (SINEs).


Characteristics of paediatric frequent presenters at emergency departments: A whole-of-population study.
To quantify the frequency of emergency department (ED) presentations and profile the socio-demographic, health and presentation characteristics of paediatric ED frequent presenters. A population-based data linkage study of 55 921 children in the South Australian Early Childhood Data Project aged 0-12 years with 100 976 presentations to public hospital EDs in South Australia. For each child, the total number of recurrent ED presentations during a 364-day period post-index presentation was calculated. Frequent presenters were children who experienced ≥4 recurrent ED presentations. We determined the socio-demographic, health and presentation characteristics by number of recurrent presentations. Children with ≥4 recurrent presentations (4.4%) accounted for 15.4% of all paediatric ED presentations and 22.5% of subsequent admissions to hospital during the 12-month study period. Compared to children with no recurrent ED presentation, frequent presenters had higher proportions of socio-economic and health disadvantage at birth. One in two (49.3%) frequent presenters had at least one injury presentation and one (21.3%) in five had at least one presentation related to a chronic condition. Children with ≥4 presentations do not represent the majority of ED users. Nevertheless, they represent a disproportionate burden accounting for 15% of all paediatric ED presentations in a 12-month period. Frequent presenters were characterised by early socio-economic and health disadvantage, and childhood injury. Strategies targeting social disadvantage and childhood injury may reduce the burden of ED presentations.


Human microbiome: a genetic bazaar for microbes?
A recent study suggests that lateral gene transfer has been particularly intense among human-associated microbes. What can this tell us about our relationship with our internal microbial world?


Truncation of NH2-terminal amino acid residues increases agonistic potency of leukotactin-1 on CC chemokine receptors 1 and 3.
Leukotactin-1 (Lkn-1) is a human CC chemokine that binds to both CC chemokine receptor 1 (CCR1) and CCR3. Structurally, Lkn-1 is distinct from other human CC chemokines in that it has long amino acid residues preceding the first cysteine at the NH(2) terminus, and contains two extra cysteines. NH(2)-terminal amino acids of Lkn-1 were deleted serially, and the effects of each deletion were investigated. In CCR1-expressing cells, serial deletion up to 20 amino acids (Delta20) did not change the calcium flux-inducing activity significantly. Deletion of 24 amino acids (Delta24), however, increased the agonistic potency approximately 100-fold. Deletion of 27 or 28 amino acids also increased the agonistic potency to the same level shown by Delta24. Deletion of 29 amino acids, however, abolished the agonistic activity almost completely showing that at least 3 amino acid residues preceding the first cysteine at the NH(2) terminus are essential for the biological activity of Lkn-1. Loss of agonistic activity was due to impaired binding to CCR1. In CCR3-expressing cells, Delta24 was the only form of Lkn-1 mutants that revealed increased agonistic potency. Our results indicate that posttranslational modification is a potential mechanism for the regulation of biological activity of Lkn-1.


Potential improvement in combustion and pollutant emissions of a hydrogen-enriched rotary engine by using novel recess configuration.
The rotary engine constitutes promising propulsion for unmanned aerial vehicles, and creating turbulence within the rotor chamber is an effective means to strengthen the combustion of this engine concept since it is characterized by a unidirectional flow from the trailing side to the leading side of the rotor chamber. Based on CFD modeling, this work proposed a novel turbulence-induced blade (TIB) configuration and carried out a feasibility assessment focused on this innovation for improving engine performance under different operation/design parameter conditions (spark timing, hydrogen enrichment, and compression ratio). The results of this work confirmed the benefit of this proposed configuration as a useful tool to enhance combustion characteristics and control emissions formation. When the TIB was arranged at the leading part of the rotor chamber, better turbulent flow could be formed in the desired location and actually enhanced the combustion. Compared with the no-blade rotor chamber, the indicated thermal efficiency of the leading-blade, middle-blade, and trailing-blade rotor chambers increased by 7.3%, 5.1%, and 0.8%, respectively. Further assessment of TIB benefits demonstrated that the introduction of the TIB could postpone the optimal spark timing, and effectively increase the pressure within the rotor chamber, and the later the spark timing is, the more significant the increment in the peak pressure. Compared with hydrogen-enriched rotary engines, the TIB is more sensitive to the combustion improvement of pure gasoline rotary engines, and the difference between the no-blade and leading-blade rotor chambers reduced notably in terms of emissions formation as hydrogen enrichment increased. It is recommended that a higher compression ratio could be realized by decreasing the chamber volume, thus producing better engine performance. The turbulence intensity in the leading-blade rotor chamber is higher than that in the non-blade rotor chamber, and the discrepancy shows an increasing trend with the increase of the compression ratio. The effect of the TIB on efficiency improvement and emissions reduction is negligible at a relatively higher compression ratio (9.6).


Age and gender effects on the proximal propagation of an impulsive force along the adult human upper extremity.
We tested the null hypotheses that neither age, gender nor muscle pre-cocontraction state affect the latencies of changes in upper extremity kinematics or elbow muscle activity following an impulsive force to the hand. Thirty-eight healthy young and older adult volunteers lay prone on an apparatus with shoulders flexed 75° and arms slightly flexed. The non-dominant hand was subjected to three trials of impulsive loading with arm muscles precontracted to 25, 50, or 75% of maximum pre-cocontraction levels. Limb kinematic data and upper extremity electromyographic (EMG) activity were acquired. The results showed that pre-cocontraction muscle level (p < 0.001) and gender (p < 0.05 for wrist and shoulder) affected joint displacement onset times and age affected EMG onset times (p < 0.05). The peak applied force (F1) occurred a mean (± SD) 27 (± 2) ms after impact. The latencies for the wrist, elbow, and shoulder displacements were 21 ± 3, 29 ± 5, and 34 ± 7 ms, respectively. Because the latencies for elbow flexion and lateral triceps EMG were 23 ± 5 and 84 ± 8 ms, respectively, muscle pre-activation rather than stretch reflexes prevent arm buckling under impulsive end loads.


Spermatogonial cells: mouse, monkey and man comparison.
In all mammals, spermatogonia are defined as constituting the mitotic compartment of spermatogenesis including stem, undifferentiated and differentiating cell types, possessing distinct morphological and molecular characteristics. Even though the real nature of the spermatogonial stem cell and its regulation is still debated the general consensus holds that in steady-state spermatogenesis the stem cell compartment needs to balance differentiation versus self-renewal. This review highlights current understanding of spermatogonial biology, the kinetics of amplification and the signals directing spermatogonial differentiation in mammals. The focus will be on relevant similarities and differences between rodents and non human and human primates.


Tetrabromobisphenol A induces THR β-mediated inflammation and uterine injury in mice at environmentally relevant exposure concentrations.
Tetrabromobisphenol A (TBBPA) is a widely used flame retardant, but the adverse outcomes induced by TBBPA has not been fully elucidated. In this study, TBBPA was detected in 54.9% of 102 female Chinese volunteers with an average serum concentration of 0.34 ng/mL. To investigate whether TBBPA induces adverse outcomes at environmentally relevant exposure doses, the mice were exposed to TBBPA for 14 and 28 days. The internal doses of TBBPA in mice serum were nearly the internal doses in volunteers. TBBPA significantly increased the secretion of some pro-inflammatory cytokines and suppressed immune responses in mice under such serum concentrations after 14- and 28-days exposure. Interestingly, uterine edema was observed in TBBPA-treated mice. In primary uterine cells model, the results showed TBBPA exposure suppressed THRβ expression, leading to the activation of the inflammatory PI3K/NF-κB signaling pathway. Our findings indicated that the uterus is the susceptible target organ of TBBPA and TBBPA exposure might increase risk of uterine cancer through deregulating inflammation pathways.


"Two-dimensional Terraced Compression method" and its application in contour detection of transmission image.
Multispectral transmission imaging provides a possibility for early breast cancer screening. Due to the strong scattering effect of the light source and the absorption characteristics of the material itself, the image signal is weak. The frame accumulation and demodulation technique can improve the accuracy of the image, but it brings a lot of redundant data. This paper proposes the "Two-dimensional Terraced Compression Method" and applies it to detecting heterogeneity contour in transmission images. The experiment is designed to prove its effectiveness. Four kinds of LEDs with different central wavelengths are respectively modulated as the light source to obtain the image sequences, and the Fast Fourier Transform (FFT) and frame accumulation are used to obtain single-wavelength images respectively. The image is first low-pass filtered, then find the gray minimum value in the image, and then find the connected area in the influence domain of the gradient threshold. If the connected area meets the area threshold, it is used as an effective growth point, and the gray value in the connected area is reassigned. Otherwise, mark it as an isolated point, return to find the minimum, and finally implement terraced compression on the image. This method not only reduces the redundancy of gray numbers but also greatly improves the gradient information of the image, and be used as a preprocessing image algorithm-nonlinear filtering also can be used to detect the contour of heterogeneity.


Epidural spinal meningioma. Role of magnetic resonance in differential diagnosis.
A rare case of an extradurally growing spinal meningioma in an elderly woman is reported. Neuro-imaging, particularly magnetic resonance (MR), allowed to recognize the lesion, which, otherwise, could raise problems of differential diagnosis with a spinal metastasis. An emergency operation, required by a sudden neurological deterioration, was decisive in recovery of neurological deficits. In a review of the literature, extradurally growing spinal meningiomas appear to occur with a higher frequency than it is thought. Therefore, they are to be suspected when dealing with extradural spinal lesions.


Outdoor air pollution and children's respiratory symptoms in the steel cities of New South Wales.
To investigate the relationship between outdoor air pollution and the respiratory health of children aged 8 to 10 years. A cross-sectional survey (between October 1993 and December 1993) of children's health and home environment. Summary measures of particulate pollution (levels of particles with an aerodynamic diameter less than 10 microns [PM10] each 6th day) and SO2 (daily mean and maximum hourly values) were estimated for each area (using air quality monitoring station data from July 1993 to June 1994). SETTING AND SURVEY PARTICIPANTS: Parents of 3023 primary school children (Years 3, 4 and 5) from industrial and non-industrial areas with air quality monitoring stations in the Hunter and Illawarra regions of New South Wales. Reported occurrence of four or more chest colds, four or more attacks of wheezing, and night-time cough without a cold for more than two weeks, all within the previous 12 months. 77% response rate, ranging by area from 66% to 88%. The average annual outdoor air pollution for the nine areas was 18.6-43.7 micrograms/m3 for PM10 and 0.16-0.90 parts per hundred million for SO2. The proportion of children reported to have the main outcome symptoms were: chest colds, 3.0%-9.7%; night cough, 12.3%-30.5%; and wheeze, 3.4%-11.3%. There was no significant association with SO2, but a significant increase in the odds of symptoms per 10 micrograms/m3 increase in PM10 on chest colds (odds ratio [OR], 1.43; 95% confidence interval [CI], 1.12-1.82) and night-time cough (OR, 1.34; 95% CI, 1.19-1.53), but not wheeze. Passive smoking was significantly associated with chest colds but not with the other symptoms. Maternal allergy was associated with all three respiratory symptoms, most strongly with wheeze. These results provide evidence of health effects at lower than expected levels of outdoor air pollution in the Australian setting. They also suggest differences in contributions of environmental and hereditary factors to cough and chest colds compared with wheeze.


Tweeting links to Cochrane Schizophrenia Group reviews: a randomised controlled trial.
To assess the effects of using health social media on web activity. Individually randomised controlled parallel group superiority trial. Twitter and Weibo. 170 Cochrane Schizophrenia Group full reviews with an abstract and plain language summary web page. Three randomly ordered slightly different 140 character or less messages, each containing a short URL to the freely accessible summary page sent on specific times on one single day. This was compared with no messaging. The primary outcome was web page visits at 1 week. Secondary outcomes were other metrics of web activity at 1 week. 85 reviews were randomised to each of the intervention and control arms. Google Analytics allowed 100% follow-up within 1 week of completion. Intervention and control reviews received a total of 1162 and 449 visits, respectively (IRR 2.7, 95% CI 2.2 to 3.3). Fewer intervention reviews had single page only visits (16% vs 31%, OR 0.41, 0.19 to 0.88) and users spent more time viewing intervention reviews (geometric mean 76 vs 31 s, ratio 2.5, 1.3 to 4.6). Other secondary metrics of web activity all showed strong evidence in favour of the intervention. Tweeting in this limited area of healthcare increases 'product placement' of evidence with the potential for that to influence care. ISRCTN84658943.


Effects of pravastatin on thoracic aortic atherosclerosis in patients with heterozygous familial hypercholesterolemia.
Data regarding the effects of plasma lipid lowering on the evolution of thoracic aortic atherosclerosis (TAA) are scarce. In this study, we performed transesophageal echocardiography to characterize TAA in 16 newly diagnosed patients with heterozygous familial hypercholesterolemia and to follow its evolution after 2 years of statin treatment. TAA was graded as follows: grade I = normal intima; grade II = increased intimal echo density without thickening; grade IIIA = increased intimal echo density with single atheromatous plaque < or = 3 mm; grade IIIB = multiple plaques < or = 3mm; grade IV = > or = 1 plaque >3 mm; and grade V = mobile or ulcerated plaques. Baseline aortic intimal morphology was grade I in one patient, grade II in 4, grade IIIA in 6, grade IIIB in 3, and grade IV in 2 patients. Hypolipidemic treatment resulted in significant reductions in plasma total cholesterol and low-density lipoprotein (LDL) cholesterol. Follow-up aortic morphology was grade I in 5 patients, grade II in 2, grade IIIA in 3, grade IIIB in 3, and grade IV in 3 patients. TAA remained stable in 7 patients, progressed in 3, and regressed in 6 patients. TAA evolved in a uniform manner in the ascending aorta, aortic arch, and descending aorta. Patients with TAA regression were younger (39+/-14 vs 52+/-8 years, p=0.038) and had a greater decrease in plasma LDL cholesterol as a result of treatment (138+/-56 vs 73+/-55 mg/dl, p=0.036) than patients with TAA stability or progression. These observations support the hypothesis that hypolipidemic treatment may favorably affect the course of TAA in patients with heterozygous familial hypercholesterolemia.


Hand-assisted laparoscopic radical nephrectomy: comparison with transabdominal radical nephrectomy.
The purpose of this study was to investigate whether hand-assisted laparoscopic radical nephrectomy (HALN) has benefits over the traditional transabdominal radical nephrectomy. More specifically we focused on the use of the hand-assisted technique as a definitive oncologic procedure for renal cancers. This study is a retrospective nonrandomized study comparing 12 hand-assisted laparoscopic radical nephrectomies with 12 transabdominal radical nephrectomies. All patients included in the study had the preoperative diagnosis of renal mass. HALN population averaged 1.83 +/- 1.64 (mean +/- standard deviation) major comorbidities versus 1.08 +/- 0.8 open (P = 0.032). The HALN OR time averaged 103 +/- 32.8 versus 57 +/- 18.3 minutes open (P = 0.001). The estimated blood loss mean for HALN was 83 versus 318 cm3 open (P = 0.001). Length of stay for HALN was 4.9 +/- 2.2 versus 5.9 +/- 2.9 days (P = 0.35). Days to regular diet was 2.9 +/- 2.3 in HALN versus 3.5 +/- 2.11 open (P = 0.52). Days of intravenous pain medications were 1.8 +/- 0.72 HALN versus 3.0 +/- 1.28 open (P = 0.016). Postoperative complication rates for the two groups were identical: two of 12 (ileus and post-operative bleeding). Tumor size mean was 6.8 +/- 2.99 cm for HALN versus 4.2 +/- 1.29 cm open (P = 0.012). Tumor margins were negative for 12 of 12 in HALN versus 11 of 12 open. Selection bias (selecting ailing patients to the HALN cohort) diminished the statistical significance of our postoperative recovery data. It is likely that a prospectively randomized study with a larger population may prove the hand-assisted approach equal if not superior to the open technique. The use of HALN in patients with renal tumors is an effective alternative to traditional transabdominal radical nephrectomy.


[What is the value of the corrective osteotomies in the therapy of the coxarthrosis (author's transl)].
Followup examinations of 29 corrective osteotomies carried out near the hip show that surgical removal of a contracture can yield quite favorable results in osteoarthritis of the hip. Surgery is indicated in cases where rotation and extension of the thigh is no longer possible, resulting in immobilization, whereas, on the other hand, flexion is still possible to a satisfactory extent and the patient is still too young for plastic surgery.


Conditional knockout of pik3c3 causes a murine muscular dystrophy.
Abnormalities in phosphoinositide metabolism are an emerging theme in human neurodegenerative disease. Myotubular myopathy is a prototypical disorder of phosphoinositide dysregulation that is characterized by profound muscle pathology and weakness and that is caused by mutations in MTM1, which encodes a phosphatase that targets 3-position phosphoinositides, including phosphatidylinositol 3-phosphate. Although the association between MTM1 and muscle disease has become increasingly clarified, the normal role(s) of phosphatidylinositol 3-phosphate metabolism in muscle development and homeostasis remain poorly understood. To begin to address the function of phosphatidylinositol 3-phosphate in skeletal muscle, we focused on the primary kinase responsible for its production, and created a muscle-specific conditional knockout of the class III phosphatidylinositol 3-kinase, Pik3c3. Muscle-specific deletion of Pik3c3 did not disturb embryogenesis or early postnatal development, but resulted in progressive disease characterized by reduced activity and death by 2 months of age. Histopathological analysis demonstrated changes consistent with a murine muscular dystrophy. Examination for cellular mechanism(s) responsible for the dystrophic phenotype revealed significant alterations in the autophagolysosomal pathway with mislocation of known dystrophy proteins to the lysosomal compartment. In all, we present the first analysis of Pik3c3 in skeletal muscle, and report a novel association between deletion of Pik3c3 and muscular dystrophy.


[The cytotoxic effect and the effect of permeability with OmpA like protein Loa22 from Leptospira interrogans serovar].
To study the toxic effect and the change of permeability on human umbilical vein endothelia (HUVE) of the Loa22 protein from virulent serovar Lai. Leptaspira interrogans by expressing its protein. In this study, the pGEX-Loa22 peptide prokaryotic recombinant plasmid of Leptospira interrogans serovar Lai preserved in our laboratory was used to express Loa22 fusion protein with GST lable. Then the target fusion protein was obtained by using affinity chromatography with the GST-Trap FF Column. The purified Loa22 fusion protein was detected by SDS-PAGE and confirmed by Western blot assay using the mouse anti-GST tag monoclonal anti-body. pGEX-Loa22 protein was administered to culture with human umbilical vein endothelial cells (HUVEC) to elucidate the cytotoxic role and the change of permeability of leptospiral outer membrane proteins. The recombiant plasmid with Loa22 mature peptide was expressed successfully and the protein was purfied. Significant higher level of apoptosis ratio, lower CCK-8 aborntion, and increasing permeability on HUVEC were observed after treated the HUVEC with the expressed fusion protein. The purified Loa22 fusion protein have obvious toxic effects on vascular endothelial cells, and also it can increase permeability of HUVEC.


[Lacrimal canalicular transposition for lower canaliculus repair: About four cases].
The main function of the eyelids is to support and protect the globe. The lower eyelid and medial canthus are often the location of malignant tumors that can be locally aggressive and require disfiguring surgeries. Chronic epiphora often appears in cases of inadequate reconstruction in this location and can require secondary procedures. We report four cases of medial canthus repair after tumor removal with loss of the inferior canaliculus. The ipsilateral superior canaliculus was removed before being transposed into the lower eyelid. This simple method allows for complete canalicular reconstruction. It obviates the need for artificial material and its potential associated complications. It has the advantage of a one-step eyelid and canalicular reconstruction and prevents epiphora after tumor resection.


Comparison of three FDA-approved diagnostic immunohistochemistry assays of PD-L1 in triple-negative breast carcinoma.
The Dako 28-8, Dako 22C3, and Ventana SP142 assays are among the approved programmed death ligand 1 (PD-L1) immunohistochemical companion/complementary diagnostics associated with cancer treatment. To address the concordance of these assays in triple-negative breast cancer (TNBC), we examined PD-L1 expression in 98 TNBC tumors and compared the positive rates using the three assays and three scoring methods: immune cell (IC), tumor cell (TC), and combined tumor cell and immune cell (TCIC) (an equivalent to combined positive score, or CPS). The positive rate for PD-L1 expression with a 1% cutoff was highest with 28-8, followed by the 22C3. These two assays demonstrated almost perfect or substantial agreement in all three scores. There was less agreement between SP142 and the other assays. Using the IC score or the TCIC score at a 1% cutoff (CPS 1), 4% of tumors were positive for PD-L1 with SP142 but negative with the other assays. Using SP142 with a 1% cutoff as a reference, the optimal cutoff for best agreement was at 1% for IC, 30% for TC, and 2% for TCIC (CPS 2) with the other two assays. A 2% cutoff for the 22C3 TCIC (CPS 2) yielded the best agreement with SP142 1% IC cutoff (kappa 0.65). Our study showed the lowest positive rate with SP142 among the three assays. However, the other two assays were not able to identify all tumors that would test positive with SP142 using IC or TCIC/CPS. It is unlikely to achieve high agreement between SP142 and the other two assays by changing the analytical cutoffs.


Selective lymphoid irradiation. V. Synergism with pretransplant thymectomy or thymic irradiation in cardiac transplantation in rats.
Selective lymphoid irradiation (SLI) using palladium-109-hematoporphyrin (Pd-H), given four days prior to transplantation, combined with two doses of antilymphocyte globulin (ALG) (10 mg, days -2 and -1), was evaluated as a method of induction of permanent heterotopic cardiac allograft survival in the highly histoincompatible rat strain combination of ACI (RT1(1))-to-Lewis (RT1a). Both Pd-H and ALG localize poorly in the thymus, so this study evaluated whether thymic irradiation (TI) or thymectomy (TX) of the adult recipient results in indefinite allograft survival. Immunosuppression with Pd-H or ALG alone gave a mean survival time (MST) of 6.7 +/- 0.6 days, but the combination of the two agents led to an MST of 17.6 +/- 3.4 days. When TI was combined with Pd-H and ALG, cardiac allograft survival was prolonged to 50.2 +/- 13.9 days, but TI alone showed an MST of 10.3 +/- 1.8 days. Permanent cardiac allograft survival (greater than 250 days) was achieved in all thymectomized recipients treated with the combination of Pd-H and a brief course of ALG. These animals also accepted second-set skin grafts and rejected third-party skin grafts following more than 150 days of ACI cardiac allograft survival. Thymic irradiation, although effective in acting synergistically with SLI and ALG, led to prolonged, but limited allograft survival, although thymectomy with SLI and ALG is synergistic in prolonging allograft survival permanently without chronic immunosuppression.


Mitochondrial calpain-5 truncates caspase-4 during endoplasmic reticulum stress.
Calpains are cysteine proteases activated in response to intracellular calcium signaling. Activated calpains regulate various cellular functions by degrading substrate molecules in a site-specific manner. Although most calpains are localized in the cytosol, we previously reported that calpain-5 exists in the mitochondria. The mitochondrial calpain-5 is activated during endoplasmic reticulum (ER) stress. However, the substrate of calpain-5, as well as the physiological significance of calpain-5 activation, has not yet been elucidated. In the present study, we treated HeLa cells with A23187, tunicamycin, or hydrogen peroxide to induce intracellular calcium increase, resulting in cell death. The cells treated with A23187 or tunicamycin exhibited the activation of calpain-5 and truncation of caspase-4. The truncation of caspase-4 was inhibited by the repression of calpain-5 expression with the appropriate siRNA. Additionally, both calpain-5 and caspase-4 were observed in the mitochondria. Our study is the first to demonstrate that the activation of mitochondrial calpain-5 triggers the truncation of caspase-4, suggesting that mitochondrial calpain-5 regulates the downstream pathway of caspase-4, including cell death and the inflammatory cascade. The results of the present study provide new insights into ER-stress-related diseases such as Alzheimer's disease and cancer. These perspectives allow us to propose new therapeutic strategies such as the development of inhibitors or activators of calpain-5, which may be useful in the development of treatment for ER-stress-related diseases.


Biological response of endothelial cells and its modulation by cytokines: prospects for therapy and bioprocesses.
Endothelial cells are involved in important pathological situations. They could be the target for infectious processes as for example in Cowdriosis, an important disease in cattle due to the rickettsia Cowdria ruminantium prevalent in the south of the Sahara. They are also connected to angiogenic processes related to tumor invasion.Our results indicate that AIDS related Kaposi sarcoma cells may be of endothelial origin. We conclude from our data the mobility of those cells, related to the expression of the metalloproteinases (especially the 92 kD form of the enzyme), is an important factor in Kaposi saroma dissemination and is the main factor limiting the scale up of Cowdriosis vaccine production in Bovine Umbilical Endothelial Cell line. We showed that PMA and TNF increased the 92 kD Metallaproteinase and that TGFβ, produced in an inactive form in cultures of Human Umbilical Vein Endothelial Cells, is a potential inhibitor of Kaposi sarcoma spreading, and could also be useful in improving our process for Cowdria ruminantium vaccine production, since it reduces the sensitivity of the cells to mechanical stress without affecting significantly the overall infectious process.


A systematic review to investigate outcome tools currently in use for those with hand burns, and mapping psychometric properties of outcome measures.
Severe burn injuries to the hand impact multiple domains of function and participation. Measurement of outcomes after hand burn injuries is multifaceted and is influenced by several variables. The aim of this systematic review was to review outcome measures reported in studies used to measure outcomes after severe hand burn injuries; and to critically evaluate the reliability, validity and clinical utility of each hand assessment tool identified from the literature to determine suitability for use with the burn's population. A search of the published literature using electronic data bases MEDLINE, CINAHL, PEDro, OT seeker and PubMed was undertaken. Studies were included if they reported assessment tools and outcome measures used to determine hand function after severe burn injuries; were published in English and available in their full-length. Studies were excluded if they were related to a group under 18 years of age. Thirty-four papers were included in this systematic review. A total of 25 outcome measures were confirmed for inclusion in this paper and each underwent further evaluation to identify their psychometric properties. A factor which could cause bias in this systematic review was the search was restricted to English language journals therefore excluding any primary papers in other languages. Mapping of the outcome measures to the ICF was conducted by the primary author which may give rise to bias however a member checking was conducted in order to remove this bias. This review established that no one outcome measure meets all the psychometric properties of validity, reliability and responsiveness SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO: CRD42018085059.


Normal pregnancy and delivery following conservative surgery and chemotherapy for ovarian endodermal sinus tumor.
Management of younger patients with early stage ovarian endodermal sinus tumor who desire to have children can be a challenging problem. However, after an adequate and thorough staging procedure for the patient's tumor status, a Stage Iai endodermal sinus tumor may be treated with conservative surgery only, followed by chemotherapy. Successful pregnancy and delivery following unilateral adnexectomy and chemotherapy for ovarian endodermal sinus tumor have been reported only once [J. P. Forney, Obstet. Gynecol. 52, 360 (1977)]; the second reported case is presented here. It should be pointed out that strict follow-up and reliability of the patient are mandatory for such conservative therapy.


Surgery: indications and options.
The challenge is to better define the present role of spine surgery and more completely understand its realistic benefits and consequences. In spite of modern sophistication, spine surgery can still accomplish only the same two broad objectives, decompression and fusion, that have been possible for more than a century. Never vague or tentative, surgery has its place in the narrow spectrum of cases with clearly established, well circumscribed, structural pathology unresponsive to nonsurgical treatment and producing significant persistent disability. Identifying valid indications and options within the plethora of choices requires knowledge of what is available, what can actually be accomplished, and what limitations apply.


Results of vascular resections during pancreatectomy from two European centres: an analysis of survival and disease-free survival explicative factors.
The object of our study was to report on the experience with vascular resections at pancreatectomy in two European specialist hepatopancreatobiliary centres and evaluate outcome and prognostic factors. From 1989 to 2002, 45 patients (21 men, 24 women) underwent pancreatectomy for a pancreatic mass: Whipple's procedure (n=33), total pancreatectomy (n=10) or left splenopancreatectomy (n=2), along with a vascular resection, i.e. venous (n=39), arterial (n=1) or venous + arterial (n=5). Operative mortality was nil, postoperative mortality was 2.2% (n=1); 34 patients had an uneventful postoperative course. Reoperations were performed for portal vein thrombosis (n=1), pancreatic leak (n=1), gastric outlet syndrome (n=1) and gastrointestinal bleeding (n=1). In all, 43 patients had cancer on pathology examination, with retropancreatic invasion in 72% and lymph node extension in 62.8%. Resection was R0 in 21 cases. Vessel wall invasion was present in 13 cases and 19 had perivascular invasion. Disease-free survival (DFS) at 1, 2 and 3 years was 36.0%, 15.0% and 12.0%, respectively. Median DFS length was 8.7 months (95% CI: 7.2; 10.2). Overall survival rates were 56.6%, 28.9% and 19.2%, respectively. Median survival length was 14.2 months (95% CI: 9.8; 18.6). A multivariate analysis of prognostic variables identified tumour location (other than head of pancreas), neoadjuvant chemotherapy and advanced disease stage as adverse factors for DFS. Survival and DFS rates of these patients are comparable to those without vascular resection. Tumour localization, tumour stage, neoadjuvant treatment and tumour recurrence are explanatory variables of survival. Tumour localization, tumour stage and neoadjuvant treatment were explanatory variables for DFS. However, the type and extent of vascular resections as well as vessel wall invasion does not affect survival and DFS.


Conformation and proteolysis of glucagon and insulin in surfactant and lipid solutions.
The effects of micelles of nonionic, zwitterionic, anionic and cationic surfactants and lipids on the conformation of glucagon and insulin have been investigated by circular dichroism and intrinsic protein fluorescence. The influence of these amphipathic compounds on the hydrolysis, monitored by HPLC, of glucagon and insulin by trypsin and chymotrypsin has also been studied. The alpha-helix content of glucagon was increased to a similar extent by all the micelles, irrespective of their charge and of whether they were synthetic surfactants or phospholipids. The amphipathic compounds always induced a blue-shift in the wavelength of maximum emission of fluorescence of glucagon of about 9 nm, whereas the fluorescence intensity was increased in some cases and decreased in others. The circular dichroism of insulin was also modified in some cases. Some amphipathic compounds protected glucagon against proteolysis by trypsin and chymotrypsin very markedly, whereas others did not protect at all or only slightly protected the hormone. Two hypotheses have been formulated to explain the different results. Hydrolysis of insulin was generally not influenced by surfactants and lipids.


Impact of the hospitalist system on inpatient mortality and length of hospital stay in a teaching hospital in Japan: a retrospective observational study.
To examine the differences in the quality of care among inpatients before and after the introduction of the hospitalist system. A retrospective observational study. A community teaching hospital in Japan. The inpatients admitted between the preintervention (January-December 2018) and 1-year intervention (January-December 2019) periods. There were 8508 and 8788 inpatients in 2018 and 2019, respectively. The study compared the lengths of hospital stay and mortality among inpatients between the pre-and post-intervention (2018 and 2019) periods concerning the introduction of a hospital medicine department. The primary objective was to evaluate and compare the in-hospital mortality and the length of stay (LOS) between 2018 and 2019. The secondary objective was to identify the characteristics of hospitalists and non-hospitalists in the system. The LOS was significantly reduced after the introduction of the hospital medicine department (adjusted difference, -0.659 days; 95% CI -1.118 to -0.136, p=0.01). There were no differences in the adjusted mortalities between the two periods. To the best of our knowledge, our study is the first involving a teaching hospital in Japan to reveal that the hospitalist system had a positive effect on the efficiency of inpatient care by shortening the LOS. Further studies are needed to clarify other benefits related to the introduction of the hospital medicine department in Japan.


Antituberculous agents.
Antituberculous agents have radically improved the prognosis of patients with active tuberculosis. Generally, 6-month and 9-month regimens have been successful, and surgical therapy is rarely necessary. Extrapulmonary tuberculosis should be managed with the drug regimens outlined for pulmonary tuberculosis. The major cause of therapeutic failure is poor compliance of the patient in taking the medication regularly. The second major cause of treatment failure is resistance of tubercle bacilli to the antimicrobial agents used. When treatment failure is apparent, careful reassessment by physicians experienced in the treatment of tuberculosis is indicated. A single drug should never be added to a failing regimen. For prophylaxis, isoniazid, given for 6 to 12 months, is effective in most cases.


Use of response surface methods and path of steepest ascent to optimize ligand-binding assay sensitivity.
Response surface methods (RSM) combined with a steepest ascent approach is a powerful technique to optimize assay performance. In this case, a ligand-binding assay (LBA) to quantitate a peptide biotherapeutic was optimized for improved sensitivity using this technique. Conditions were elucidated to enable pg/mL quantitation of the peptide in human plasma using steepest ascent to efficiently optimize assay factors. Instead of relying solely on assay development experience and intuition to improve assay sensitivity, this systematic approach takes advantage of a predictive mathematical model generated through response surface methods that defines a specific path towards greater predicted assay sensitivity. The actual response observed along the steepest ascent path was in good agreement with the model for several steps, until reagent concentrations moved beyond the physical limits of the system, and model breakdown occurred. RSM combined with steepest ascent method proved a useful tool for sensitivity optimization in three ways: (1) The required LBA sensitivity performance (approximately 200 pg/mL), measured as a signal-to-noise ratio (SNR) at the targeted lower limit of quantitation (LLOQ), was efficiently achieved in only two optimization experiments; (2) Steepest ascent confirmed that the desired sensitivity was found within the initial RSM design space, and no further gain in sensitivity was found venturing beyond this design space along the steepest ascent path; (3) The desired assay sensitivity was maintained over a reasonable range of reagent concentrations along the steepest ascent path, indicating assay robustness for this parameter.