Different impacts of various tocolytic agents on increased risk of postoperative hemorrhage in preterm labor women undergoing Cesarean delivery: A population-based cohort study.
Tocolytic agents, commonly used for inhibiting preterm labor, pose the risk of uterine atony, leading to postpartum hemorrhage. This study elucidated the effects of different tocolytic agents on postoperative hemorrhage among women in preterm labor undergoing Cesarean delivery (CD). Data from Taiwan National Health Insurance Research Database were analyzed. The risk (adjusted hazard ratio [aHR] and 95% confidence intervals [CI]) of postoperative hemorrhage in CD women with preterm labor diagnosis using tocolytic agents (Tocolysis group) comparing to CD women not using tocolytic agents (Control group) were determined. Impacts of different tocolytic agents in this regard were also investigated. Our data revealed that the incidence (11.7% vs 2.6%, P < .001) and risk (aHR: 1.21, 95% CI: 1.12-1.31, P < .001) of postoperative hemorrhage were significantly higher in the Tocolysis group (n = 15,317) than in the Control group (n = 244,096). Ritodrine was the most frequently used tocolytic agent (80.5%), followed by combination therapy (using more than one tocolytic agents) (8.5%), magnesium sulfate (MgSO4, 4.6%), calcium channel blockers (3.8%), betamimetics other than ritodrine (1.9%), prostaglandin synthase inhibitors (0.5%), and nitrates (0.1%). Barring those using calcium channel blockers and combination therapy, the use of MgSO4 (aHR: 1.43, P = .001), betamimetics other than ritodrine (aHR: 1.71, P < .001), prostaglandin synthase inhibitors (aHR: 2.67, P < .001) and nitrates (aHR: 3.30, P = .001) was associated with higher risks of postoperative hemorrhage compared with ritodrine. In conclusion, CD women with preterm labor diagnosis using tocolytic agents exhibit an increased risk of postoperative hemorrhage and that this risk varies with the use of different tocolytic agents.


Incidence rate of pathogen-specific clinical mastitis on conventional and organic Canadian dairy farms.
Mastitis is a common and costly production disease on dairy farms. In Canada, the incidence rate of clinical mastitis (IRCM) has been determined for conventionally managed dairy farms; however, no studies to date have assessed rates in organically managed systems. The objectives of this observational study were (1) to determine the producer-reported IRCM and predominant pathogen types on conventional and organic dairy farms in Southern Ontario, Canada, and (2) to evaluate the association of both mean overall IRCM and pathogen-specific IRCM with management system, housing type, and pasture access. Data from 59 dairy farms in Southern Ontario, Canada, distributed across conventional (n=41) and organic management (n=18) systems, were collected from April 2011 to May 2012. In addition to management system, farms were categorized by housing method (loose or tie-stall) and pasture access for lactating cows. Participating producers identified and collected samples from 936 cases of clinical mastitis. The most frequently isolated mastitis pathogens were coagulase-negative staphylococci, Bacillus spp., Streptococcus spp., Staphylococcus aureus, and Escherichia coli. The IRCM was higher on conventional farms than organic (23.7 vs. 13.2 cases per 100 cow-years) and was not associated with housing type (loose or tie-stall), pasture access, or herd-average milk yield. Bulk tank somatic cell count tended to be lower on conventional farms than organic (222,000 vs. 272,000 cells/mL). Pathogen-specific IRCM attributed to Staph. aureus, Bacillus spp., and E. coli was greater on conventional than organic farms, but was not associated with housing or any other factors. In conclusion, organic management was associated with reduced overall and pathogen-specific IRCM.


Effect of low-frequency deep brain stimulation on sensory thresholds in Parkinson's disease.
OBJECTIVE Chronic pain is a major distressing symptom of Parkinson's disease (PD) that is often undertreated. Subthalamic nucleus (STN) deep brain stimulation (DBS) delivers high-frequency stimulation (HFS) to patients with PD and has been effective in pain relief in a subset of these patients. However, up to 74% of patients develop new pain concerns while receiving STN DBS. Here the authors explore whether altering the frequency of STN DBS changes pain perception as measured through quantitative sensory testing (QST). METHODS Using QST, the authors measured thermal and mechanical detection and pain thresholds in 19 patients undergoing DBS via HFS, low-frequency stimulation (LFS), and off conditions in a randomized order. Testing was performed in the region of the body with the most pain and in the lower back in patients without chronic pain. RESULTS In the patients with chronic pain, LFS significantly reduced heat detection thresholds as compared with thresholds following HFS (p = 0.029) and in the off state (p = 0.010). Moreover, LFS resulted in increased detection thresholds for mechanical pressure (p = 0.020) and vibration (p = 0.040) compared with these thresholds following HFS. Neither LFS nor HFS led to changes in other mechanical thresholds. In patients without chronic pain, LFS significantly increased mechanical pain thresholds in response to the 40-g pinprick compared with thresholds following HFS (p = 0.032). CONCLUSIONS Recent literature has suggested that STN LFS can be useful in treating nonmotor symptoms of PD. Here the authors demonstrated that LFS modulates thermal and mechanical detection to a greater extent than HFS. Low-frequency stimulation is an innovative means of modulating chronic pain in PD patients receiving STN DBS. The authors suggest that STN LFS may be a future option to consider when treating Parkinson's patients in whom pain remains the predominant complaint.


The importance of emotional distress, cognitive behavioural factors and pain for life impact at baseline and for outcomes after rehabilitation - a SQRP study of more than 20,000 chronic pain patients.
Although literature concerning chronic pain patients indicates that cognitive behavioural variables, specifically acceptance and fear of movement/(re)injury, are related to life impact, the relative roles of these factors in relation to pain characteristics (e.g. intensity and spreading) and emotional distress are unclear. Moreover, how these variables affect rehabilitation outcomes in different subgroups is insufficiently understood. This study has two aims: (1) to investigate how pain, cognitive behavioural, and emotional distress variables intercorrelate and whether these variables can regress aspects of life impact and (2) to analyse whether these variables can be used to identify clinically meaningful subgroups at baseline and which subgroups benefit most from multimodal rehabilitation programs (MMRP) immediately after and at 12-month follow-up. Pain aspects, background variables, psychological distress, cognitive behavioural variables, and two life impact variables were obtained from the Swedish Quality Registry for Pain Rehabilitation (SQRP) for chronic pain patients. These data were analysed mainly using advanced multivariate methods. The study includes 22,406 chronic pain patients. Many variables, including acceptance variables, showed important contributions to the variation in clinical presentations and in life impacts. Based on the statistically important variables considering the clinical presentation, three clusters/subgroups of patients were identified at baseline; from the worst clinical situation to the relatively good situation. These clusters showed significant differences in outcomes after participating in MMRP; the subgroup with the worst situation at baseline showed the most significant improvements. Pain intensity/severity, emotional distress, acceptance, and life impacts were important for the clinical presentation and were used to identify three clusters with marked differences at baseline (i.e. before MMRP). Life impacts showed complex relationships with acceptance, pain intensity/severity, and emotional distress. The most significant improvements after MMRP were seen in the subgroup with the lowest level of functioning before treatment, indicating that patients with complex problems should be offered MMRP. This study emphasizes the need to adopt a biopsychosocial perspective when assessing patients with chronic pain. Patients with chronic pain referred to specialist clinics are not homogenous in their clinical presentation. Instead we identified three distinct subgroups of patients. The outcomes of MMRP appears to be related to the clinical presentation. Thus, patients with the most severe clinical presentation show the most prominent improvements. However, even though this group of patients improve they still after MMRP show a complex situation and there is thus a need for optimizing the content of MMRP for these patients. The subgroup of patients with a relatively good situation with respect to pain, psychological distress, coping and life impact only showed minor improvements after MMRP. Hence, there is a need to develop other complex interventions for them.


Sub-20-fs terawatt-class laser system with a mirrorless regenerative amplifier and an adaptive phase controller.
We have developed an ultrabroadband regenerative amplifier with a mirrorless cavity to eliminate the limitation of bandwidth of dielectric coats on cavity mirrors. The large amount of material dispersion in the Pellin-Broca prisms that are used instead of cavity mirrors is compensated for with a hybrid technique that uses Brewster prism pairs in the regenerative amplifier and an adaptive phase controller of a liquid-crystal spatial light modulator. We obtained a 16-fs pulse width with an energy of 13 mJ, which is to our knowledge the highest energy obtained in the sub-20-fs regime by use of an adaptive phase controller.


SU-E-T-505: BrainLab Plan Comparisons: Brain Scan Pencil Beam versus IPlan Monte Carlo.
Monte Carlo (MC) dose modeling techniques are available in the newest version of Brain Lab's IPlan treatment planning system (TPS). Prior to the upgrade, at our facility, BrainLab's BrainScan was the treatment planning system available; pencil beam (PB) modeling is employed by BrainScan. As published in the literature, MC calculations, as compared to the PB algorithm, can generate differences in coverage as much as 20%. With the introduction of the new treatment planning system, treatment parameter comparisons were made with quantitative assessments. Differences due to changes in the dose calculation that could impact patient treatments and outcomes were investigated. Beam data was collected for the new BrainLab TPS IPLAN under the conditions as outlined in the manufacturer's Version 1.3 data collection, commissioning and acceptance guidelines. Utilizing BrainLab's treatment planning systems, treatment plan comparisons were made. First, PB modeling treatment plans were assessed for each treatment plan with pencil beam modeling in the BrainScan and IPlan TPS. Treatment plans with MC modeling were then compared to PB models. Differences in the dose distribution, DVH values, and monitor units were evaluated between the older version software (BrainScan) and the newer treatment planning system (IPlan). As predicted by the literature, the differences in the MC modeling versus PB modeling were significant depending upon the anatomy (tumor site). Modeling comparison for the treatment plans will be presented for SRS (Stereotactic Radiosurgery) and Stereotactic Body Radiation Therapy (SBRT). Clinical implementation of a new treatment planning system must be approached with caution and with adherence to AAPM recommendations and guidelines. Whenever a new TPS calculation model is introduced, thorough comparison between former and new models should be obtained. An additional recommended test would be to perform an independent, end-to-end check of the overall system utilizing the RPC (Radiological Physics Center) phantom.


Clinical Pharmacokinetics of Cannabinoids and Potential Drug-Drug Interactions.
Over the past few years, considerable attention has focused on cannabidiol (CBD) and Δ9-tetrahydrocannabinol (THC), the two major constituents of Cannabis sativa, mainly due to the promising potential medical uses they have shown. However, more information on the fate of these cannabinoids in human subjects is still needed and there is limited research on the pharmacokinetic drug-drug interactions that can occur in the clinical setting and their prevalence. As the use of cannabinoids is substantially increasing for many indications and they are not the first-line therapy in any treatment, health care professionals must be aware of drug-drug interactions during their use as serious adverse events can happen related with toxic or ineffective outcomes. The present chapter overview summarizes our current knowledge on the pharmacokinetics and metabolic fate of CBD and THC in humans and discusses relevant drug-drug interactions, giving a plausible explanation to facilitate further research in the area.


Addressing health system barriers to access to and use of skilled delivery services: perspectives from Ghana.
Poor access to and use of skilled delivery services have been identified as a major contributory factor to poor maternal and newborn health in sub-Saharan African countries, including Ghana. However, many previous studies that examine norms of childbirth and care-seeking behaviours have focused on identifying the norms of non-use of services, rather than factors, that can promote service use. Based on primary qualitative research with a total of 185 expectant and lactating mothers, and 20 healthcare providers in six communities in Ghana, this paper reports on strategies that can be used to overcome health system barriers to the use of skilled delivery services. The strategies identified include expansion and redistribution of existing maternal health resources and infrastructure, training of more skilled maternity caregivers, instituting special programmes to target women most in need, improving the quality of maternity care services provided, improving doctor-patient relationships in maternity wards, promotion of choice, protecting privacy and patient dignity in maternity wards and building partnerships with traditional birth attendants and other non-state actors. The findings suggest the need for structural changes to maternity clinics and routine nursing practices, including an emphasis on those doctor-patient relational practices that positively influence women's healthcare-seeking behaviours. Copyright © 2015 John Wiley & Sons, Ltd.


Evidence summaries: the evolution of a rapid review approach.
Rapid reviews have emerged as a streamlined approach to synthesizing evidence - typically for informing emergent decisions faced by decision makers in health care settings. Although there is growing use of rapid review 'methods', and proliferation of rapid review products, there is a dearth of published literature on rapid review methodology. This paper outlines our experience with rapidly producing, publishing and disseminating evidence summaries in the context of our Knowledge to Action (KTA) research program. The KTA research program is a two-year project designed to develop and assess the impact of a regional knowledge infrastructure that supports evidence-informed decision making by regional managers and stakeholders. As part of this program, we have developed evidence summaries - our form of rapid review - which have come to be a flagship component of this project. Our eight-step approach for producing evidence summaries has been developed iteratively, based on evidence (where available), experience and knowledge user feedback. The aim of our evidence summary approach is to deliver quality evidence that is both timely and user-friendly. From November 2009 to March 2011 we have produced 11 evidence summaries on a diverse range of questions identified by our knowledge users. Topic areas have included questions of clinical effectiveness to questions on health systems and/or health services. Knowledge users have reported evidence summaries to be of high value in informing their decisions and initiatives. We continue to experiment with incorporating more of the established methods of systematic reviews, while maintaining our capacity to deliver a final product in a timely manner. The evolution of the KTA rapid review evidence summaries has been a positive one. We have developed an approach that appears to be addressing a need by knowledge users for timely, user-friendly, and trustworthy evidence and have transparently reported these methods here for the wider rapid review and scientific community.


High viral loads despite absence of clinical and pathological findings in cats experimentally infected with feline coronavirus (FCoV) type I and in naturally FCoV-infected cats.
Specified pathogen-free cats were naturally infected with FCoV or experimentally infected with FCoV type I. Seroconversion was determined and the course of infection was monitored by measuring the FCoV loads in faeces, whole blood, plasma and/or monocytes. Tissue samples collected at necropsy were examined for viral load and histopathological changes. Experimentally infected animals started shedding virus as soon as 2 days after infection. They generally displayed the highest viral loads in colon, ileum and mesenteric lymph nodes. Seroconversion occurred 3-4 weeks post infection. Naturally infected cats were positive for FCoV antibodies and monocyte-associated FCoV viraemia prior to death. At necropsy, most animals tested positive for viral shedding and FCoV RNA was found in spleen, mesenteric lymph nodes and bone marrow. Both experimentally and naturally infected cats remained clinically healthy. Pathological findings were restricted to generalized lymphatic hyperplasia. These findings demonstrate the presence of systemic FCoV infection with high viral loads in the absence of clinical and pathological signs.


Laser Processing of Hard and Ultra-Hard Materials for Micro-Machining and Surface Engineering Applications.
Polycrystalline diamonds, polycrystalline cubic boron nitrides and tungsten carbides are considered difficult to process due to their superior mechanical (hardness, toughness) and wear properties. This paper aims to review the recent progress in the use of lasers to texture hard and ultra-hard materials to a high and reproducible quality. The effect of wavelength, beam type, pulse duration, fluence, and scanning speed is extensively reviewed, and the resulting laser mechanisms, induced damage, surface integrity, and existing challenges discussed. The cutting performance of different textures in real applications is examined, and the key influence of texture size, texture geometry, area ratio, area density, orientation, and solid lubricants is highlighted. Pulsed laser ablation (PLA) is an established method for surface texturing. Defects include melt debris, unwanted allotropic phase transitions, recast layer, porosity, and cracking, leading to non-uniform mechanical properties and surface roughness in fabricated textures. An evaluation of the main laser parameters indicates that shorter pulse durations (ns-fs), fluences greater than the ablation threshold, and optimised multi-pass scanning speeds can deliver sufficient energy to create textures to the required depth and profile with minimal defects. Surface texturing improves the tribological performance of cutting tools in dry conditions, reducing coefficient of friction (COF), cutting forces, wear, machining temperature, and adhesion. It is evident that cutting conditions (feed speed, workpiece material) have a primary role in the performance of textured tools. The identified gaps in laser surface texturing and texture performance are detailed to provide future trends and research directions in the field.


Structural analysis of CsoS1A and the protein shell of the Halothiobacillus neapolitanus carboxysome.
The carboxysome is a bacterial organelle that functions to enhance the efficiency of CO2 fixation by encapsulating the enzymes ribulose bisphosphate carboxylase/oxygenase (RuBisCO) and carbonic anhydrase. The outer shell of the carboxysome is reminiscent of a viral capsid, being constructed from many copies of a few small proteins. Here we describe the structure of the shell protein CsoS1A from the chemoautotrophic bacterium Halothiobacillus neapolitanus. The CsoS1A protein forms hexameric units that pack tightly together to form a molecular layer, which is perforated by narrow pores. Sulfate ions, soaked into crystals of CsoS1A, are observed in the pores of the molecular layer, supporting the idea that the pores could be the conduit for negatively charged metabolites such as bicarbonate, which must cross the shell. The problem of diffusion across a semiporous protein shell is discussed, with the conclusion that the shell is sufficiently porous to allow adequate transport of small molecules. The molecular layer formed by CsoS1A is similar to the recently observed layers formed by cyanobacterial carboxysome shell proteins. This similarity supports the argument that the layers observed represent the natural structure of the facets of the carboxysome shell. Insights into carboxysome function are provided by comparisons of the carboxysome shell to viral capsids, and a comparison of its pores to the pores of transmembrane protein channels.


Long-term development of human iPSC-derived pyramidal neurons quantified after transplantation into the neonatal mouse cortex.
One of the main obstacles for studying the molecular and cellular mechanisms underlying human neurodevelopment in vivo is the scarcity of experimental models. The discovery that neurons can be generated from human induced pluripotent stem cells (hiPSCs) paves the way for novel approaches that are stem cell-based. Here, we developed a technique to follow the development of transplanted hiPSC-derived neuronal precursors in the cortex of mice over time. Using post-mortem immunohistochemistry we quantified the differentiation and maturation of dendritic patterns of the human neurons over a total of six months. In addition, entirely hiPSC-derived neuronal parenchyma was followed over eight months using two-photon in vivo imaging through a cranial window. We found that transplanted hiPSC-derived neuronal precursors exhibit a "protracted" human developmental programme in different cortical areas. This offers novel possibilities for the sequential in vivo study of human cortical development and its alteration, followed in "real time".


Identification of antiviral compounds against equid herpesvirus-1 using real-time cell assay screening: Efficacy of decitabine and valganciclovir alone or in combination.
Equid herpesvirus-1 infections cause respiratory, neurological and reproductive syndromes. Despite preventive treatments with vaccines, resurgence of EHV-1 infection still constitutes a major threat to equine industry. However, no antiviral compound is available to treat infected horses. In this study, 2891 compounds were screened against EHV-1 using impedance measurement. 22 compounds have been found to be effective in vitro against EHV-1. Valganciclovir, ganciclovir, decitabine, aphidicolin, idoxuridine and pritelivir (BAY 57-1293) are the most effective compounds identified, and their antiviral potency was further assessed on E. Derm, RK13 and EEK cells and against 3 different field strains of EHV-1 (ORF30 2254 A/G/C). We also provide evidences of synergistic interactions between valganciclovir and decitabine in our in vitro antiviral assay as determined by MacSynergy II, isobologramm and Chou-Talalay methods. Finally, we showed that deoxycytidine reverts the antiviral effect of decitabine, thus supporting some competition at the level of nucleoside phosphorylation by deoxycytidine kinase and/or DNA synthesis. Deoxycitidine analogues, like decitabine, is a family of compounds identified for the first time with promising antiviral efficacy against herpesviruses.


Kedo-S Paediatric Rotary Files for Root Canal Preparation in Primary Teeth - Case Report.
Nickel-Titanium (Ni-Ti) instrument are widely used for root canal preparation in permanent tooth compared to primary teeth. Hand instrumentation technique remains the conventional method for root canal preparation in primary teeth. The time taken for root canal preparation with the conventional method is more resulting in patients and clinicians fatigue. Recently Ni-Ti rotary files designed for permanent tooth has been used for root canal preparation in primary teeth. Using rotary instruments for primary tooth pulpectomies resulted in better and predictable root canal filling. This article presents case reports of pulpectomy treatment performed using Kedo-S an exclusive paediatric Ni-Ti rotary files. The advantages and disadvantages in use of Ni-Ti rotary files in primary teeth are discussed in this article.


Is Bone Loss or Devascularization Associated With Recurrence of Osteomyelitis in Wartime Open Tibia Fractures?
During recent wars, 26% of combat casualties experienced open fractures and these injuries frequently are complicated by infections, including osteomyelitis. Risk factors for the development of osteomyelitis with combat-related open tibia fractures have been examined, but less information is known about recurrence of this infection, which may result in additional hospitalizations and surgical procedures. (1) What is the risk of osteomyelitis recurrence after wartime open tibia fractures and how does the microbiology compare with initial infections? (2) What factors are associated with osteomyelitis recurrence among patients with open tibia fractures? (3) What clinical characteristics and management approaches are associated with definite/probable osteomyelitis as opposed to possible osteomyelitis and what was the microbiology of these infections? A survey of US military personnel injured during deployment between March 2003 and December 2009 identified 215 patients with open tibia fractures, of whom 130 patients developed osteomyelitis and were examined in a retrospective analysis. No patients with bilateral osteomyelitis were included. Twenty-five patients meeting osteomyelitis diagnostic criteria were classified as definite/probable (positive bone culture, direct evidence of infection, or symptoms with culture and/or radiographic evidence) and 105 were classified as possible (bone contamination, organism growth in deep wound tissue, and evidence of local/systemic inflammation). Patients diagnosed with osteomyelitis were treated with débridement and irrigation as well as intravenous antibiotics. Fixation hardware was retained until fracture union, when possible. Osteomyelitis recurrence was defined as a subsequent osteomyelitis diagnosis at the original site ≥ 30 days after completion of initial treatment. This followup period was chosen based on the definition of recurrence so as to include as many patients as possible for analysis. Factors associated with osteomyelitis recurrence were assessed using univariate analysis in a subset of the population with ≥ 30 days of followup. Patients who had an amputation at or proximal to the knee after the initial osteomyelitis were not included in the recurrence assessment. Of 112 patients meeting the criteria for assessment of recurrence, 31 (28%) developed an osteomyelitis recurrence, of whom seven of 25 (28%) had definite/probable and 24 of 87 (28%) had possible classifications for their initial osteomyelitis diagnosis. Risk of osteomyelitis recurrence was associated with missing or devascularized bone (recurrence, 14 of 31 [47%]; nonrecurrence, 22 of 81 [28%]; hazard ratio [HR], 3.94; 1.12-13.81; p = 0.032) and receipt of antibiotics for 22-56 days (recurrence, 20 of 31 [65%]; nonrecurrence: 37 of 81 [46%]; HR, 2.81; 1.05-7.49; p = 0.039). Compared with possible osteomyelitis, definite/probable osteomyelitis was associated with localized swelling at the bone site (13 of 25 [52%] versus 28 of 105 [27%]; risk ratio [RR], 1.95 [1.19-3.19]; p = 0.008) and less extensive skin and soft tissue injury at the time of trauma (9 of 22 [41%; three definite/probably patients missing data] versus 13 of 104 [13%; one possible patient missing data]; RR, 3.27 [1.60-6.69]; p = 0.001). Most osteomyelitis infections were polymicrobial (14 of 23 [61%; two patients with missing data] for definite/probable patients and 62 of 105 [59%] for possible patients; RR, 1.03 [0.72-1.48]; p = 0.870). More of the definite/probable patients received vancomycin (64%) compared with the possible patients (41%; p = 0.046), and the duration of polymyxin use was longer (median, 38 days versus 16 days, p = 0.018). Time to definitive fracture fixation was not different between the groups. Recurrent osteomyelitis after open tibia fractures is common. In a univariate model, patients with an intermediate amount of bone loss and those treated with antibiotics for 22 to 56 days were more likely to experience osteomyelitis recurrence. Because only univariate analysis was possible, these findings should be considered preliminary. Osteomyelitis recurrence rates were similar, regardless of initial osteomyelitis classification, indicating that diagnoses of possible osteomyelitis should be treated aggressively. Level III, therapeutic study.


Dramatic escalation in metabolic syndrome and cardiovascular risk in a Chinese population experiencing rapid economic development.
Metabolic syndrome (MetSyn) increases the incidence of cardiovascular disease. Information on changes in prevalence of MetSyn in developing countries is limited. This study aims to compare MetSyn prevalence and its associated vascular risk over the period between 2002 and 2010 in a population which has had the world's fastest economic development over the past three decades. Two health surveys were conducted by using the multistage cluster random sampling method in a Chinese population of 85 million in southern China. The participants received a full medical check-up, including measurement of blood pressure (BP), obesity indices, fasting lipids and glucose levels. Data describing socio-economic status and lifestyle factors were also collected through interview. Metabolic syndrome was defined in accordance with the International Diabetes Federation criteria. A total of 3,561 participants from Survey 2010 were included in the data analysis. Women had a significantly higher prevalence of MetSyn than men. Comparison between the two surveys shows that age-standardized prevalence of MetSyn increased fourfold (from 5.4% in 2002 to 21.3% in 2010) in those ≧ 20 years. Among the MetSyn components, prevalence of hyperglycaemia has increased most (from 9.1% to 53.1%). The age-standardized prevalence of central obesity, hypertension, hypertriglyceridaemia and low HDL-cholesterol increased from 13.5% to 25.4%, from 23.6% to 40.8%, from 12.1% to 17.4% and from 32.1% to 71.1%, respectively. Differences between rural and urban residents in the prevalence in MetSyn and its components narrowed in 2010. Cardiovascular risk escalated dramatically in this population between 2002 and 2010. The escalation may relate to the rapid economic development, which led to accelerating changes in nutrition, lifestyle, and socio-economic status. Our findings suggest that health transition in rapidly developing second- and third-world countries may be much faster than what has been observed in Western countries.


High-throughput determination of structural phase diagram and constituent phases using GRENDEL.
Advances in high-throughput materials fabrication and characterization techniques have resulted in faster rates of data collection and rapidly growing volumes of experimental data. To convert this mass of information into actionable knowledge of material process-structure-property relationships requires high-throughput data analysis techniques. This work explores the use of the Graph-based endmember extraction and labeling (GRENDEL) algorithm as a high-throughput method for analyzing structural data from combinatorial libraries, specifically, to determine phase diagrams and constituent phases from both x-ray diffraction and Raman spectral data. The GRENDEL algorithm utilizes a set of physical constraints to optimize results and provides a framework by which additional physics-based constraints can be easily incorporated. GRENDEL also permits the integration of database data as shown by the use of critically evaluated data from the Inorganic Crystal Structure Database in the x-ray diffraction data analysis. Also the Sunburst radial tree map is demonstrated as a tool to visualize material structure-property relationships found through graph based analysis.


The role of neuromuscular properties in determining the end-point of a movement.
How does the activation of several muscles combine to produce reliable multijoint movements? To study this question, we stimulated up to six sites in muscles, nerves, and the spinal cord. Flexion and extension of the hip, knee, and ankle were elicited in anesthetized and decerebrate cats. The movements occurred largely in the sagittal plane against a constant spring load and covered most of the passive range of motion of the cat's limb. The movements of the end-point (foot) were compared with predictions based on vectorial summation of end-point movements elicited by stimulating single electrodes. The lengths of the movements produced by stimulating more than one site exceeded what was expected from linear summation for small movements (<3 cm) and showed a less than linear summation for large movements (>11 cm). The data were compared with muscle and limb models. Since the deviations from linearity were predictable as a function of distance, adjustments might easily be learned by trial and error. The summation was less complete for spinal stimulation, compared to nerve and muscle stimulation, so spinal circuits do not appear to compensate for the nonlinearities. Movements were elicited from positions of the limb not only in a neutral position, but also in front and behind the neutral position. A degree of convergence was seen, even with stimulation of some individual muscles, but the convergence increased as more muscles were stimulated and more joints were actively involved. This suggests that convergence to an equilibrium-point arises at least partly from muscle properties. In conclusion, there are deviations from linear vectorial summation, and these deviations increase when more muscles are stimulated. The convergence to an equilibrium-point may simplify the computations needed to produce movements involving many muscles.


Linking the congenital heart surgery databases of the Society of Thoracic Surgeons and the Congenital Heart Surgeons' Society: part 1--rationale and methodology.
The Society of Thoracic Surgeons Congenital Heart Surgery Database (STS-CHSD) is the largest Registry in the world of patients who have undergone congenital and pediatric cardiac surgical operations. The Congenital Heart Surgeons' Society Database (CHSS-D) is an Academic Database designed for specialized detailed analyses of specific congenital cardiac malformations and related treatment strategies. The goal of this project was to create a link between the STS-CHSD and the CHSS-D in order to facilitate studies not possible using either individual database alone and to help identify patients who are potentially eligible for enrollment in CHSS studies. Centers were classified on the basis of participation in the STS-CHSD, the CHSS-D, or both. Five matrices, based on CHSS inclusionary criteria and STS-CHSD codes, were created to facilitate the automated identification of patients in the STS-CHSD who meet eligibility criteria for the five active CHSS studies. The matrices were evaluated with a manual adjudication process and were iteratively refined. The sensitivity and specificity of the original matrices and the refined matrices were assessed. In January 2012, a total of 100 centers participated in the STS-CHSD and 74 centers participated in the CHSS. A total of 70 centers participate in both and 40 of these 70 agreed to participate in this linkage project. The manual adjudication process and the refinement of the matrices resulted in an increase in the sensitivity of the matrices from 93% to 100% and an increase in the specificity of the matrices from 94% to 98%. Matrices were created to facilitate the automated identification of patients potentially eligible for the five active CHSS studies using the STS-CHSD. These matrices have a sensitivity of 100% and a specificity of 98%. In addition to facilitating identification of patients potentially eligible for enrollment in CHSS studies, these matrices will allow (1) estimation of the denominator of patients potentially eligible for CHSS studies and (2) comparison of eligible and enrolled patients to potentially eligible and not enrolled patients to assess the generalizability of CHSS studies.


Angiogenesis in pituitary adenomas and the normal pituitary gland.
Angiogenesis is essential for tumor growth beyond a few millimeters in diameter, and the intratumoral microvessel count that represents a measure of angiogenesis has been correlated with tumor behavior in a variety of different tumor types. To date no systematic study has assessed pituitary tumors of different secretory types, correlating vascular count with tumor size. The vascular densities of pituitary tumors and normal anterior pituitary were therefore assessed by counting vessels labeled using the vascular markers CD31 and ulex europaeus agglutinin I. One hundred and twelve surgically removed pituitary adenomas (30 GH-secreting, 25 prolactinomas, 15 ACTH-secreting, and 42 nonfunctioning tumors) were compared with 13 specimens of normal anterior pituitary gland. The vascular counts in the normal anterior pituitary gland were significantly higher (P < 0.05) than those in the tumors using both CD31 and ulex europaeus agglutinin I. In addition, microprolactinomas were significantly less vascular (P < 0.05) than macroprolactinomas, although there was no such difference between vascular densities of microadenomas and macroadenomas producing GH. ACTH-secreting tumors were, like microprolactinomas, of much lower vascular density than the normal pituitary and other secreting and nonsecreting tumor types. In marked contrast to other tumors, pituitary adenomas are less vascular than the normal pituitary gland, suggesting that there may be inhibitors of angiogenesis that play an important role in the behavior of these tumors.


Barriers to adherence to cystic fibrosis infection control guidelines.
In 2003, the American Cystic Fibrosis (CF) Foundation published revised, evidence-based guidelines for infection control. We sought to assess potential barriers to adherence to these guidelines experienced by health care professionals (HCPs) caring for CF patients. From April 2004 to December 2005, a knowledge, attitude, and practice survey was administered to HCPs at randomly selected CF centers in the United States to explore potential barriers to adherence to selected guidelines: (1) obtaining quarterly cultures from CF patients, (2) discouraging socialization among CF patients during hospitalization, (3) educating patients and families about hand hygiene, (4) educating patients and families to clean and disinfect home nebulizers, and (5) cleaning the clinic exam rooms between CF patients. The survey was completed by 528 HCPs from 25 sites (5-50 respondents per site). Only 60% of respondents were aware of the guidelines, but despite awareness, 31-47% were unfamiliar with the specific guidelines. Self-reported adherence was low; only 23-63% of respondents reported practicing the selected guidelines >75% of the time/opportunities. Lack of self-efficacy, that is, confidence in adequately performing the guidelines, was commonly experienced by respondents. Access to a copy of the guidelines was associated with increased agreement with the recommendations and increased self-efficacy. Strategies to reduce barriers to adherence to CF infection control guidelines are needed. Strategies could include quality improvement initiatives with enhanced education and skills workshops, sharing successful interventions among CF centers, and linking adherence to improved patient outcomes.


Effect of feeding whole, unprocessed sunflower seeds and flaxseed on milk production, milk composition, and prostaglandin secretion in dairy cows.
Four multiparous Holstein cows were used in a 4 x 4 Latin-square design experiment to study the effects of different fat sources on milk production and composition, N utilization, follicular development, and prostaglandin secretion. Cows were fed 4 total mixed rations (TMR) based either on calcium salts of palm oil (Megalac), whole flaxseed, whole sunflower seed, or no supplementary fat (control). Feed intake and digestibilities were generally similar among treatments, except that ether extract digestibility was the lowest for cows fed the control diet. Milk yields were greater for cows fed whole flaxseed and Megalac (32.1 and 31.5 kg/d, respectively) than for those fed sunflower seed and control (25.9 and 24.8 kg/d, respectively). Milk protein concentration was significantly lower for cows fed Megalac (3.68%) compared with those fed flaxseed (3.87%) or control (3.92%). Concentrations of n-3 fatty acids and the n-6 to n-3 fatty acids ratio in milk were the highest and lowest, respectively, for cows fed whole flaxseed. There was an interaction between treatment and time for levels of 13,14-dihydro-15-keto-PGF(2alpha) in plasma; they were greater 30 and 45 min after the oxytocin challenge for cows that were fed sunflower seed compared with those fed either Megalac, flaxseed, or control. Moreover, when concentrations of 13,14-dihydro-15-keto-PGF(2alpha) in plasma were expressed as the area under the overall response curve from 0 to 120 min after the oxytocin injection, it tended to be greater for cows that were fed the sunflower diet compared with those fed either Megalac or flaxseed. In general, follicle dynamics were similar among treatments. These results suggest that feeding diets with high proportions of n-6 fatty acids (61% of total fatty acids for the sunflower seed diet) tended to increase the secretion of series 2 prostaglandins in blood.


Dysregulated chaperones associated with cell proliferation and negative apoptosis regulation in the uterine leiomyoma.
Uterine leiomyomas are benign smooth muscle cell tumors that originate from the myometrium. In this study we focus on dysregulated chaperones associated with cell proliferation and apoptosis. Paired tissue samples of 15 leiomyomas and adjacent myometria were obtained and analyzed by two-dimensional gel electrophoresis (2-DE). Mass spectrometry was used for protein identification and western blotting for 2-DE data validation. The values of 6 chaperones were found to be significantly different in the leiomyoma when compared with the myometrium. A total of 4 proteins were upregulated in the leiomyoma and 2 proteins were downregulated. Calreticulin and 78 kDa glucose-regulated protein were further validated by western blotting because the first is considered a marker of cell proliferation, while the second protects against apoptotic cell death. In addition, we also validated the two downregulated proteins heat shock protein β-1 and heat shock 70 kDa protein 1A. Our study shows the existence of a dysregulation of chaperone proteins associated with leiomyoma development. Functional studies are needed to ascertain the role of these chaperones in the leiomyoma. This may be crucial for the further development of specific inhibitors against the activity of these proteins in order to block the growth of the leiomyoma.


Selected characteristics of a new polyvinyl siloxane impression material--a randomized clinical trial.
This study evaluated the ability of a new polyvinyl siloxane impression material (Affinis, Coltène/Whaledent, material A) to obtain final impressions free of bubbles and voids for indirect fixed cuspal-coverage restorations. The results were compared to a control polyvinyl siloxane impression material (material B). Both materials were handled by inexperienced clinicians (undergraduate dental students) in student clinics. One-hundred and thirty patients who were treated in the Louisiana State University School of Dentistry Junior Student Clinic for indirect fixed cuspal-coverage restorations and who met the inclusion criteria were randomly assigned to either one of two treatment groups, group A (n = 65) or group B (n = 65). Two calibrated examiners evaluated the first impression of prepared posterior teeth at a magnification of 10x for acceptability (no voids or bubbles). Position of tooth, type of preparation, preparation finish line (Class I-V), and gingival bleeding scores were recorded. All statistical tests were performed with the level of significance set at .05. The Fisher-Freeman-Halton test did not reveal significant associations between material and gingival bleeding score (P = .492). Significant differences in the location of the preparation finish line between materials were observed (P = .0096); material A was more frequently used in cases where the preparation finish line was located at least 2 mm subgingivally. Logistic regression was used to assess the effect of the material on the success of the impression (acceptable/ unacceptable). Material was highly significant in the logistic model (P < .001) with an odds in favor of an acceptable impression being eight times higher with material A than with material B (odds ratio = 8.00; 95% confidence index for odds ratio: 2.832, 22.601). The 60/65 (92.3%) impressions made with material A and 39/65 (60%) impressions made with material B were rated "acceptable." The new polyvinyl siloxane impression material provided a significantly higher proportion of impressions free of bubbles and voids than the control polyvinyl siloxane material.


Use of Silk Road, the online drug marketplace, in the United Kingdom, Australia and the United States.
To investigate the prevalence of awareness of the online illicit drug marketplace Silk Road (SR), consumption of drugs purchased from SR and reasons for use and non-use of SR. Global Drug Survey: purposive sample collected in late 2012. The base sample (n = 9470) reported recent drug purchase and resided in the United Kingdom (n = 4315, median age 24, 76% male), Australia (n = 2761, median age 32, 76% male) or the United States (n = 2394, median age 21, 80% male). Online questionnaire. A total of 65% of US, 53% of Australian and 40% of UK respondents had heard of SR; 18% of US, 10% of UK and 7% of Australian respondents had consumed drugs purchased through SR. Across the three countries, 3,4-methylenedioxy-N-methylamphetamine (MDMA) was the most commonly purchased drug (53-60%), followed by cannabis (34-51%), lysergic acid diethylamide (LSD) (29-45%) and the 2C family (16%-27%). The most common reasons for purchasing from SR were wider range (75-89%), better quality (72-77%), greater convenience (67-69%) and the use of vendor rating systems (60-65%). The most common reasons for avoiding SR purchase were adequate drug access (63-68%) and fear of being caught (41-53%). Logistic regressions found that, compared with people from the UK, Australians [odds ratio (OR) = 3.37; 95% confidence interval (CI) = 2.29, 4.97) and Americans (OR = 1.46; 95% CI = 1.10, 1.94) were more likely to use SR due to lower prices; and to avoid SR purchase due to fear of being caught (Australia: OR = 1.65; 95% CI = 1.39, 1.96; USA: OR = 1.62; 95% CI = 1.37, 1.92). While reasons for Silk Road use accord with broader online commerce trends (range, quality, convenience, ratings), its appeal to drug purchasers is moderated by country-specific deterrents and market characteristics.


Breastfeeding as a specific value in women's lives: the experiences and decisions of breastfeeding women.
Worldwide, breastfeeding is recommended for every woman who gives birth to a child. The propensity to breastfeed varies. There is considerable knowledge about the experiences and circumstances that affect the decision to breastfeed, but knowledge about what actually generates the decision's force still needs to be increased. The aim of this study was to gain knowledge of how the decision to breastfeed is initiated and upheld. Eighteen women from three generations were interviewed, and the data were analyzed by qualitative content analysis. Six categories were revealed: "Task," "Instinct," "Silent Impact," "Conflicts," "Job," and "Joy." The women took on the Task of breastfeeding during pregnancy. The will to breastfeed was also recognized as an Instinct. The older women remained more in the background, exerting a Silent Impact. Parents' agreement that mothers remain at home and breastfeed for the first 6 months could be considered disturbing from a gender equality perspective. Competition arose between spouses, which could lead to Conflicts at weaning. The mothers in the study chose to stay home to do the Job and experience the Joy of breastfeeding. A summarizing theme was the specific life value of breastfeeding, encompassing feelings of coherence, pleasure, and pride, regardless of generation affiliation. As the favorable interplay of biological, sensual, relational, and social elements this value upheld the decision to breastfeed. It compensated for the effort and negative experiences, and as a finding, it appears to be transferable among breastfeeding mothers in other developed countries.


How four U.S. states are regulating recreational marijuana edibles.
Sales of edible marijuana products have been strong in Colorado and Washington State since the legalization of recreational marijuana. Initially, these states did not have comprehensive labelling or packaging requirements in place. In response to increases in marijuana-related emergency room visits and poison control centre calls, additional regulations were implemented. Currently, Alaska, Colorado, Oregon, and Washington each have passed into law various labelling and packaging requirements for edibles. This article presents the primary legal research findings of relevant statutes and regulations for edibles in Alaska, Colorado, Oregon, and Washington. These laws were identified by using Boolean terms and connectors searches in these states' legal databases in LexisNexis. Alaska, Colorado, Oregon, and Washington vary greatly in how they regulate labelling and packaging. Colorado, Oregon and Washington require a Universal Symbol to be affixed to edibles, but only Oregon and Washington require that the use of pesticides be disclosed on the label. Only Colorado and Oregon require that the packaging for edibles bear a Nutrition Facts Panel on the label. Δ9-Tetrahydracannabinol (THC) in a single serving or single edible product as Alaska and Oregon. All four states prohibit the manufacture or packaging of edibles that appeal to youth. State laws governing recreational marijuana edibles have evolved since the first recreational edible products were available for sale. Alaska, Colorado, Oregon, and Washington now require edible product labels to disclose a variety of product information, including risk factors associated with consumption. However, there still remain concerns about the regulatory gaps that exist in each of these states, inherent difficulties in enforcing laws around the labelling, packaging, and manufacturing of edibles, and the outstanding question of whether these edible laws are actually informing consumers and keeping the public safe.


Agonist-selective NOP receptor phosphorylation correlates in vitro and in vivo and reveals differential post-activation signaling by chemically diverse agonists.
Agonists of the nociceptin/orphanin FQ opioid peptide (NOP) receptor, a member of the opioid receptor family, are under active investigation as novel analgesics, but their modes of signaling are less well characterized than those of other members of the opioid receptor family. Therefore, we investigated whether different NOP receptor ligands showed differential signaling or functional selectivity at the NOP receptor. Using newly developed phosphosite-specific antibodies to the NOP receptor, we found that agonist-induced NOP receptor phosphorylation occurred primarily at four carboxyl-terminal serine (Ser) and threonine (Thr) residues, namely, Ser346, Ser351, Thr362, and Ser363, and proceeded with a temporal hierarchy, with Ser346 as the first site of phosphorylation. G protein-coupled receptor kinases 2 and 3 (GRK2/3) cooperated during agonist-induced phosphorylation, which, in turn, facilitated NOP receptor desensitization and internalization. A comparison of structurally distinct NOP receptor agonists revealed dissociation in functional efficacies between G protein-dependent signaling and receptor phosphorylation. Furthermore, in NOP-eGFP and NOP-eYFP mice, NOP receptor agonists induced multisite phosphorylation and internalization in a dose-dependent and agonist-selective manner that could be blocked by specific antagonists. Our study provides new tools to study ligand-activated NOP receptor signaling in vitro and in vivo. Differential agonist-selective NOP receptor phosphorylation by chemically diverse NOP receptor agonists suggests that differential signaling by NOP receptor agonists may play a role in NOP receptor ligand pharmacology.


A smart-card-enabled privacy preserving E-prescription system.
Within the overall context of protection of health care information, privacy of prescription data needs special treatment. First, the involvement of diverse parties, especially nonmedical parties in the process of drug prescription complicates the protection of prescription data. Second, both patients and doctors have privacy stakes in prescription, and their privacy should be equally protected. Third, the following facts determine that prescription should not be processed in a truly anonymous manner: certain involved parties conduct useful research on the basis of aggregation of prescription data that are linkable with respect to either the patients or the doctors; prescription data has to be identifiable in some extreme circumstances, e.g., under the court order for inspection and assign liability. In this paper, we propose an e-prescription system to address issues pertaining to the privacy protection in the process of drug prescription. In our system, patients' smart cards play an important role. For one thing, the smart cards are implemented to be portable repositories carrying up-to-date personal medical records and insurance information, providing doctors instant data access crucial to the process of diagnosis and prescription. For the other, with the secret signing key being stored inside, the smart card enables the patient to sign electronically the prescription pad, declaring his acceptance of the prescription. To make the system more realistic, we identify the needs for a patient to delegate his signing capability to other people so as to protect the privacy of information housed on his card. A strong proxy signature scheme achieving technologically mutual agreements on the delegation is proposed to implement the delegation functionality.


Identifying peach and plum polyphenols with chemopreventive potential against estrogen-independent breast cancer cells.
Our objective was to evaluate the cancer suppression activity of extracts from a commercial variety of yellow-fleshed peach 'Rich Lady' (RL) and a red-fleshed plum 'Black Splendor' (BS) and identify the phenolic fractions that may possess potential as chemopreventive and/or chemotherapeutic natural compounds. The peach RL extract effectively inhibited the proliferation of the estrogen-independent MDA-MB-435 breast cancer cell line. The concentration to inhibit 50% of cell proliferation (IC(50)) was approximately 42 mg/L for this cell line compared to an IC(50) of approximately 130 and approximately 515 mg/L for the noncancerous breast cell line MCF-10A and the estrogen-dependent breast cancer cell line MCF-7, respectively. Similarly, BS extracts showed greater effects on MDA-MB-435 cells as compared to the other breast cancer or the normal breast cell lines. In general, BS extracts were less effective than RL extracts. Within all RL and BS fractions, fraction 3 (F3, flavonoids) and fraction 4 (F4, procyanidins) were more potent than fraction 1 (F1, phenolic acids) and fraction 2 (F2, anthocyanins) against the three cell lines. The order of potency of RL fractions against MDA-MB-435 was F(3) approximately F(4) > F(1) > F(2). The antiproliferative activity of pure compounds identified in F(3) and F(1) confirmed that quercetin 3beta-glucoside is the bioactive compound in F(3), with the same level of toxicity on the estrogen-independent MDA-MB-435 breast cancer and breast epithelial MCF-10A cells (IC(50) = 1.9 +/- 0.2 and 1.8 +/- 0.3, respectively). However, we confirmed that phenolic acids present in F(1): chlorogenic and neo-chlorogenic acids have potential as chemopreventive dietary compounds because of the relatively high growth inhibition exerted on the estrogen-independent MDA-MB-435 breast cancer cell line and low toxicity exerted in the normal MCF-10A cells.


Chemical contrast in X-ray microscopy and spatially resolved XANES spectroscopy of organic specimens.
The scanning transmission x-ray microscope at the National Synchrotron Light Source has been used to record x-ray absorption near-edge structure (XANES) spectra from 0.01-square-micrometer regions of organic specimens. The spectral features observed reflect the molecular structure of the dominant absorbing atoms and provide the contrast mechanism for high-resolution imaging with chemical sensitivity. This technique was used with x-ray energies near the carbon K absorption edge to identify and map separate phases in various polymer blends and to map the DNA distribution in chromosomes with a spatial resolution of 55 nanometers.


Alternative splicing in osteoclasts and Paget's disease of bone.
Mutations in the SQSTM1/p62 gene have been reported in Paget's disease of bone (PDB), but they are not sufficient to induce the pagetic osteoclast (OC) phenotype. We hypothesized that specific RNA isoforms of OC-related genes may contribute to the overactivity of pagetic OCs, along with other genetic predisposing factors. Alternative splicing (AS) events were studied using a PCR-based screening strategy in OC cultures from 29 patients with PDB and 26 healthy donors (HD), all genotyped for the p62P392L mutation. Primer pairs targeting 5223 characterized AS events were used to analyze relative isoform ratios on pooled cDNA from samples of the four groups (PDB, PDBP392L, HD, HDP392L). Of the 1056 active AS events detected in the screening analysis, 192 were re-analyzed on non-amplified cDNA from each subject of the whole cohort. This analysis led to the identification of six AS events significantly associated with PDB, but none with p62P392L. The corresponding genes included LGALS8, RHOT1, CASC4, USP4, TBC1D25, and PIDD. In addition, RHOT1 and LGALS8 genes were upregulated in pagetic OCs, as were CASC4 and RHOT1 genes in the presence of p62P392L. Finally, we showed that the proteins encoded by LGALS8, RHOT1, USP4, TBC1D25, and PIDD were expressed in human OCs. This study allowed the identification of hitherto unknown players in OC biology, and our findings of a differential AS in pagetic OCs may generate new concepts in the pathogenesis of PDB.


Noise Exposure and Cardiovascular Health.
Noise is considered an environmental stressor adversely affecting well-being and quality of life, inter-individual communications, and attention and cognitive function and inducing emotional responses, corresponding to noise annoyance. In addition, noise exposure is associated with nonauditory effects including worsening mental health, cognitive impairments, and adverse birth outcomes, sleep disorders, and increased annoyance. An accumulating body of evidence has indicated that traffic noise is also associated with CVD, through multiple pathways. It has been shown that psychological stress and mental health disorders such as depression and anxiety have a negative impact on the development of cardiovascular diseases and outcomes. Likewise, reduced sleep quality and/or duration has been reported to increase sympathetic nervous system activity, which can predispose to conditions like hypertension and diabetes mellitus, known risk factors for CVD. Finally, there seems to be a disruption in the hypothalamic-pituitary-axis secondary to noise pollution that also results in an increased risk of CVD. The World Health Organization has estimated that the number of DALYs (disability-adjusted life-years) lost resulting from environmental noise in Western Europe ranges from 1 to 1.6 million, making noise the second major contributor to the burden of disease in Europe, only after air pollution. Thus, we sought to explore the relationship between noise pollution and risk of CVD.


Loss of E-cadherin-dependent cell-cell adhesion due to mutation of the beta-catenin gene in a human cancer cell line, HSC-39.
Detachment of cell-cell adhesion is indispensable for the first step of invasion and metastasis of cancer. This mechanism is frequently associated with the impairment of either E-cadherin expression or function. However, mechanisms of such abnormalities have not been fully elucidated. In this study, we demonstrated that the function of E-cadherin was completely abolished in the human gastric cancer cell line HSC-39, despite the high expression of E-cadherin, because of mutations in one of the E-cadherin-associated cytoplasmic proteins, beta-catenin. Although immunofluorescence staining of HSC-39 cells by using an anti-E-cadherin antibody (HECD-1) revealed the strong and uniform expression of E-cadherin on the cell surface, cell compaction and cell aggregation were not observed in this cell. Western blotting (immunoblotting) using HECD-1 exhibited a 120-kDa band which is equivalent to normal E-cadherin. Northern (RNA) blotting demonstrated a 4.7-kb band, the same as mature E-cadherin mRNA. Immunoprecipitation of metabolically labeled proteins with HECD-1 revealed three bands corresponding to E-cadherin, alpha-catenin, and gamma-catenin and a 79-kDa band which was apparently smaller than that of normal beta-catenin, indicating truncated beta-catenin. The 79-kDa band was immunologically identified as beta-catenin by using immunoblotting with anti-beta-catenin antibodies. Examination of beta-catenin mRNA by the reverse transcriptase-PCR method revealed a transcript which was shorter than that of normal beta-catenin. The sequencing of PCR product for beta-catenin confirmed deletion in 321 bases from nucleotides +82 to +402. Southern blotting of beta-catenin DNA disclosed mutation at the genomic level. Expression vectors of Beta-catenin were introduced into HSC-39 cells by transfection. In the obtained transfectants, E-cadherin-dependent cell-cell adhesiveness was recovered, as revealed by cell compaction, cell aggregation, and immunoflourescence staining. From these results, it was concluded that in HSC-39 cells, impaired cell-cell adhesion is due to mutations in beta-catenin which results in the dysfunction of E-cadherin.


Acute effects of nicotine on prolactin release in the rat: agonist and antagonist effects of a single injection of nicotine.
The effects of nicotine on prolactin release were studied in conscious, unrestrained rats in which an indwelling jugular cannula allowed multiple samplings of blood after i.v. administration of nicotine. Intravenous administration of nicotine bitartrate dihydrate increases plasma prolactin concentrations in a dose-dependent manner with an ED50 of approximately 100 micrograms/kg (200 nmol/kg) and this effect is blocked completely by pretreatment with mecamylamine, indicating that it is mediated by a nicotinic cholinergic receptor. Intracerebral ventricular injection of 1 microgram of nicotine also increases plasma prolactin levels, but i.v. injection of this same amount of nicotine has no effect, indicating that nicotine acts within the brain to release prolactin. A single i.v. injection of nicotine resulted in desensitization of the prolactin response to a subsequent injection of nicotine given 1 to 2 hr later, thus confirming a previous report by Sharp and Beyer (J. Pharmacol. Exp. Ther. 238: 486-491, 1986). The prolactin response to nicotine was restored within 24 hr after a single injection. The acute desensitization after a single injection of nicotine appears to be specific to release of prolactin by nicotine because the prolactin response to morphine was unaffected 1 hr after injection of nicotine. A single injection of nicotine appears to desensitize the prolactin response to a subsequent injection of nicotine with an ED50 of approximately 20 micrograms/kg (40 nmol/kg), indicating that nicotine is even more potent in stimulating desensitization of nicotinic cholinergic receptors than in stimulating prolactin release. These results support the concept that nicotine acts as a time-averaged antagonist.(ABSTRACT TRUNCATED AT 250 WORDS)


CD4+CTLs in Fibrosing Mediastinitis Linked to Histoplasma capsulatum.
Although fibrotic disorders are frequently assumed to be linked to TH2 cells, quantitative tissue interrogation studies have rarely been performed to establish this link and certainly many fibrotic diseases do not fall within the type 2/allergic disease spectrum. We have previously linked two human autoimmune fibrotic diseases, IgG4-related disease and systemic sclerosis, to the clonal expansion and lesional accumulation of CD4+CTLs. In both these diseases TH2 cell accumulation was found to be sparse. Fibrosing mediastinitis linked to Histoplasma capsulatum infection histologically resembles IgG4-related disease in terms of the inflammatory infiltrate and fibrosis, and it provides an example of a fibrotic disease of infectious origin in which the potentially profibrotic T cells may be induced and reactivated by fungal Ags. We show in this study that, in this human disease, CD4+CTLs accumulate in the blood, are clonally expanded, infiltrate into disease lesions, and can be reactivated in vitro by H. capsulatum Ags. TH2 cells are relatively sparse at lesional sites. These studies support a general role for CD4+CTLs in inflammatory fibrosis and suggest that fibrosing mediastinitis is an Ag-driven disease that may provide important mechanistic insights into the pathogenesis of idiopathic fibrotic diseases.


Genetic variations in the human cannabinoid receptor gene are associated with happiness.
Happiness has been viewed as a temporary emotional state (e.g., pleasure) and a relatively stable state of being happy (subjective happiness level). As previous studies demonstrated that individuals with high subjective happiness level rated their current affective states more positively when they experience positive events, these two aspects of happiness are interrelated. According to a recent neuroimaging study, the cytosine to thymine single-nucleotide polymorphism of the human cannabinoid receptor 1 gene is associated with sensitivity to positive emotional stimuli. Thus, we hypothesized that our genetic traits, such as the human cannabinoid receptor 1 genotypes, are closely related to the two aspects of happiness. In Experiment 1, 198 healthy volunteers were used to compare the subjective happiness level between cytosine allele carriers and thymine-thymine carriers of the human cannabinoid receptor 1 gene. In Experiment 2, we used positron emission tomography with 20 healthy participants to compare the brain responses to positive emotional stimuli of cytosine allele carriers to that of thymine-thymine carriers. Compared to thymine-thymine carriers, cytosine allele carriers have a higher subjective happiness level. Regression analysis indicated that the cytosine allele is significantly associated with subjective happiness level. The positive mood after watching a positive film was significantly higher for the cytosine allele carriers compared to the thymine-thymine carriers. Positive emotion-related brain region such as the medial prefrontal cortex was significantly activated when the cytosine allele carriers watched the positive film compared to the thymine-thymine carriers. Thus, the human cannabinoid receptor 1 genotypes are closely related to two aspects of happiness. Compared to thymine-thymine carriers, the cytosine allele carriers of the human cannabinoid receptor 1 gene, who are sensitive to positive emotional stimuli, exhibited greater magnitude positive emotions when they experienced positive events and had a higher subjective happiness level.


Extended spectrum cephalosporins and Clostridium difficile.
There is little information about how commonly the newer cephalosporins cause diarrhoea due to Clostridium difficile. In this study of 111 patients with C. difficile-associated diarrhoea, 106 had received antimicrobial agents in the four weeks before detection of C. difficile. The relative risk for each antimicrobial agent was greatest with clindamycin, followed by cefotaxime, cephamandole and ceftriaxone. There was no statistically significant difference in risk between the cephalosporins evaluated. Narrower spectrum penicillins, anti-pseudomonal penicillins and aminoglycosides were not potent inciting agents.


Multispecies and Clonal Dissemination of OXA-48 Carbapenemase in Enterobacteriaceae From Companion Animals in Germany, 2009-2016.
The increasing spread of carbapenemase-producing Enterobacteriaceae (CPE) poses a serious threat to public health. Recent studies suggested animals as a putative source of such bacteria. We investigated 19,025 Escherichia coli, 1607 Klebsiella spp. and 570 Enterobacter spp. isolated from livestock, companion animal, horse, and pet samples between 2009 and 2016 in our routine diagnostic laboratory for reduced susceptibility to carbapenems (CP) by using meropenem-containing media. Actively screened CP non-susceptible strains as well as 367 archived ESBL/AmpC-β-lactamase-producing Enterobacteriaceae were then tested for the presence of CP genes by PCRs. Among 21,569 isolates, OXA-48 could be identified as the sole carbapenemase type in 137 (0.64%) strains. The blaOXA-48 gene was located on an ∼60-kb IncL plasmid and sequence analysis revealed high similarity to reference plasmid pOXA-48a, which has been involved in the global spread of the blaOXA-48 gene in humans for many years. Klebsiella pneumoniae was the predominant OXA-48 producer (n = 86; 6.6% of all K. pneumoniae isolates), followed by E. cloacae (n = 28; 5.0%), Klebsiella oxytoca (n = 1; 0.3%), and E. coli (n = 22, 0.1%). OXA-48 was not found in livestock, but in dogs (120/3182; 3.8%), cats (13/792; 1.6%), guinea pig (1/43; 2.3%), rat (1/23; 4.3%), mouse (1/180; 0.6%), and one rabbit (1/144; 0.7%). Genotyping identified few major clones among the different enterobacteria species, including sequence types ST11 and ST15 for K. pneumoniae, ST1196 for E. coli, and ST506 and ST78 for E. cloacae, most of which were previously involved in the dissemination of multidrug-resistant strains in humans. The majority of OXA-48 isolates (n = 112) originated from a university veterinary clinic (UVC), while animals from further 16 veterinary institutions were positive. Clonal analyses suggested nosocomial events related to different species and STs in two veterinary clinics and horizontal transfer of the pOXA-48-like plasmid between bacterial species and animals. A systematic monitoring is urgently needed to assess the dissemination of CPE not only in livestock but also in companion animals and veterinary clinics.


Whey protein delays gastric emptying and suppresses plasma fatty acids and their metabolites compared to casein, gluten, and fish protein.
Whey protein has been demonstrated to improve fasting lipid and insulin response in overweight and obese individuals. To establish new hypotheses for this effect and to investigate the impact of stomach emptying, we compared plasma profiles after intake of whey isolate (WI), casein, gluten (GLU), and cod (COD). Obese, nondiabetic subjects were included in the randomized, blinded, crossover meal study. Subjects ingested a high fat meal containing one of the four protein sources. Plasma samples were collected at five time points and metabolites analyzed using LC-Q-TOF-MS. In contrast to previous studies, the WI meal caused a decreased rate of gastric emptying compared to the other test meals. The WI meal also caused elevated levels of a number of amino acids, possibly stimulating insulin release leading to reduced plasma glucose. The WI meal also caused decreased levels of a number of fatty acids, while the GLU meal caused elevated levels of a number of unidentified hydroxy fatty acids and dicarboxylic fatty acids. Also reported are a number of markers of fish intake unique to the COD meal.


Consensus on the competencies required for public health nutrition workforce development in Europe - the JobNut project.
To assess and develop consensus among a European panel of public health nutrition stakeholders regarding the competencies required for effective public health nutrition practice and the level of proficiency required in different practice contexts. A modified Delphi study involving three rounds of questionnaires. European Union. Public health nutrition workforce development stakeholders, including academics, practitioners and employers, from twenty European countries. A total of fifty-two expert panellists (84 % of an initial panel of sixty-two Delphi participants) completed all three rounds of the Delphi study. The panellists rated the importance of fifty-seven competency units possibly required of a public health nutritionist to effectively practice (Essential competencies). Twenty-nine of the fifty-seven competency units (51 %) met the consensus criteria (≥66·7 % agreement) at the second round of the Delphi survey, with the highest agreement for competencies clustered within the Nutrition science, Professional, Analytical and Public health services competency domains. Ratings of the level of competencies required for different levels in the workforce indicated that for a public health nutrition specialist, advanced-level competency was required across almost all the twenty-nine competencies rated as essential. There were limited differences in rating responses between academics and employer panellists throughout the Delphi study. Competencies identified as essential can be used to review current public health nutrition practices and provide the basis for curriculum design and re-development, continuing education and workforce quality assurance systems in Europe. These are all important tools for systematic and strategic workforce development.


Prevalence of Helicobacter pylori infection in a group of morbidly obese Saudi patients undergoing bariatric surgery: a preliminary report.
Earlier reports from Saudi Arabia have shown high prevalence of Helicobacter pylori infection. However, recent studies have documented a reduction in the infection prevalence. No prior study has assessed the prevalence in morbidly obese Saudi patients. We aimed to study the prevalence of H. pylori infection in a group morbidly obese Saudi patients referred for endoscopy prior to bariatric surgery. We retrospectively reviewed the medical records of all patients who were referred for upper endoscopy prior to bariatric surgery from June 2006 to September 2008. All data were recorded including patient's demographics, comorbid conditions, endoscopic and histological findings. There were 62 patients included, 20 males and 42 females. The mean age was 34 years (range 18-51) with a mean BMI of 55 Kg/m 2 (range 35-92). H. pylori were present in 53 patients (85.5%) with chronic active gastritis. All patients with positive H. pylori had chronic gastritis of variable severity. Intestinal metaplasia was present in 5%. The prevalence of H. pylori infection was similar in patients with and without co-morbid conditions. Main endoscopic findings were gastritis in 67.7%, hiatus hernia in 13%, and gastric erosions in 13%. No patient had duodenal or gastric ulcer. There is a high prevalence of H. pylori infection in morbidly obese Saudi patients undergoing bariatric surgery being referred for upper GI endoscopy. Further prospective studies are needed to evaluate the clinical implication and benefit of eradication treatment of infection in these patients.


Melanogenesis in dermatophyte species in vitro and during infection.
Dermatophytes are keratinophilic fungi that are the most common cause of fungal skin infections worldwide. Melanin has been isolated from several important human fungal pathogens, and the polymeric pigment is now recognized as an important virulence determinant. This study investigated whether dermatophytes, including Trichophyton rubrum, Trichophyton mentagrophytes, Epidermophyton floccosum and Microsporum gypseum, produce melanin or melanin-like compounds in vitro and during infection. Digestion of the pigmented microconidia and macroconidia of dermatophytes with proteolytic enzymes, denaturant and hot concentrated acid yielded dark particles that retained the size and shape of the original fungal cells. Electron spin resonance spectroscopy revealed that particles derived from pigmented conidia contained a stable free radical signal, consistent with the pigments being a melanin. Immunofluorescence analysis demonstrated reactivity of a melanin-binding mAb with the pigmented conidia and hyphae, as well as the isolate particles. Laccase, an enzyme involved in melanization, was detected in the dermatophytes by an agar plate assay using 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) as the substrate. Skin scrapings from patients with dermatophytoses contained septate hyphae and arthrospores that were reactive with the melanin-binding mAb. These findings indicate that dermatophytes can produce melanin or melanin-like compounds in vitro and during infection. Based on what is known about the function of melanin as a virulence factor of other pathogenic fungi, this pigment may have a similar role in the pathogenesis of dermatophytic diseases.


Large Scale Screening of Southern African Plant Extracts for the Green Synthesis of Gold Nanoparticles Using Microtitre-Plate Method.
The preparation of gold nanoparticles (AuNPs) involves a variety of chemical and physical methods. These methods use toxic and environmentally harmful chemicals. Consequently, the synthesis of AuNPs using green chemistry has been under investigation to develop eco-friendly nanoparticles. One approach to achieve this is the use of plant-derived phytochemicals that are capable of reducing gold ions to produce AuNPs. The aim of this study was to implement a facile microtitre-plate method to screen a large number of aqueous plant extracts to determine the optimum concentration (OC) for the bio-synthesis of the AuNPs. Several AuNPs of different sizes and shapes were successfully synthesized and characterized from 17 South African plants. The characterization was done using Ultra Violet-Visible Spectroscopy, Dynamic Light Scattering, High Resolution Transmission Electron Microscopy and Energy-Dispersive X-ray Spectroscopy. We also studied the effects of temperature on the synthesis of the AuNPs and showed that changes in temperatures affect the size and dispersity of the generated AuNPs. We also evaluated the stability of the synthesized AuNPs and showed that some of them are stable in biological buffer solutions.


Laser-Doppler flowmetry in the investigation of irritant compounds on human skin.
The value of laser-Doppler flowmetry was assessed in the evaluation of increased microvascular blood flow caused by the application of low concentrations of irritant compounds on the skin. Laser-Doppler flow values were compared with a visual scoring system for erythema and with skin vapour loss measurements. To this end patch tests were performed on the volar side of the forearm of 24 healthy Caucasian volunteers. The test substances were sodium lauryl sulphate 0.5 g/v%, 1 g/v%, 2 g/v% and phenol 5.0 g/v% in aqua dest. Distilled water served as a control. Laser-Doppler flow and skin vapour loss measurements were performed before and after an application time of 24 h. Data obtained with skin vapour loss measurements and with the visual scoring system demonstrated a statistically significant contribution of substance- as well as subject-related factors to the obtained scoring patterns. The results of laser-Doppler flow measurements were less consistent and could only partly be explained in this way, indicating that other factors also influence the microvascular blood flow in the skin. In this investigation laser-Doppler flowmetry and the visual scoring system were equally sensitive. The results of all three methods make it clear that (analogous to experience in daily life) barrier function impairment and inflammatory response caused by irritant compounds vary in different subjects. For the elucidation of the pathogenesis of irritant contact dermatitis further (longitudinal) investigations on the possible predictive value of skin blood flow measurements will be necessary.


Genomic instability and telomere fusion of canine osteosarcoma cells.
Canine osteosarcoma (OSA) is known to present with highly variable and chaotic karyotypes, including hypodiploidy, hyperdiploidy, and increased numbers of metacentric chromosomes. The spectrum of genomic instabilities in canine OSA has significantly augmented the difficulty in clearly defining the biological and clinical significance of the observed cytogenetic abnormalities. In this study, eight canine OSA cell lines were used to investigate telomere fusions by fluorescence in situ hybridization (FISH) using a peptide nucleotide acid probe. We characterized each cell line by classical cytogenetic studies and cellular phenotypes including telomere associated factors and then evaluated correlations from this data. All eight canine OSA cell lines displayed increased abnormal metacentric chromosomes and exhibited numerous telomere fusions and interstitial telomeric signals. Also, as evidence of unstable telomeres, colocalization of γ-H2AX and telomere signals in interphase cells was observed. Each cell line was characterized by a combination of data representing cellular doubling time, DNA content, chromosome number, metacentric chromosome frequency, telomere signal level, cellular radiosensitivity, and DNA-PKcs protein expression level. We have also studied primary cultures from 10 spontaneous canine OSAs. Based on the observation of telomere aberrations in those primary cell cultures, we are reasonably certain that our observations in cell lines are not an artifact of prolonged culture. A correlation between telomere fusions and the other characteristics analyzed in our study could not be identified. However, it is important to note that all of the canine OSA samples exhibiting telomere fusion utilized in our study were telomerase positive. Pending further research regarding telomerase negative canine OSA cell lines, our findings may suggest telomere fusions can potentially serve as a novel marker for canine OSA.


Changes in regulation of a transcription factor lead to autogamy in cultivated tomatoes.
We report the cloning of Style2.1, the major quantitative trait locus responsible for a key floral attribute (style length) associated with the evolution of self-pollination in cultivated tomatoes. The gene encodes a putative transcription factor that regulates cell elongation in developing styles. The transition from cross-pollination to self-pollination was accompanied, not by a change in the STYLE2.1 protein, but rather by a mutation in the Style2.1 promoter that results in a down-regulation of Style2.1 expression during flower development.


The overrepresentation of the fovea and adjacent retina in the striate cortex and dorsal lateral geniculate nucleus of the macaque monkey.
The central part of the retina, which includes the fovea, is substantially overrepresented in the topographic map of the retina in the striate cortex. We tested whether this simply reflects the uneven distribution of ganglion cells in the retina in accordance with the "principle" of peripheral scaling, or whether there is additional expansion of the fovea and adjacent retina in the retinocortical projection. Wheatgerm agglutinated horseradish peroxidase was injected into the striate cortex of three rhesus macaque monkeys so as to surround the representation of the fovea at a mean eccentricity of 8.6 degrees, and the retinae were processed histochemically to stain the retrogradely and transneuronally labelled ganglion cells which projected topographically to the injection sites. This enabled regions of the striate cortex to be related precisely to corresponding regions of the dorsal lateral geniculate nucleus and retina. Mathematical models of the distribution of ganglion cells in the retina, clipped, three-dimensional computer reconstructions of the striate cortex and lateral geniculate nucleus, and counts of neurons in the latter, were used to calculate the proportion of neurons allocated to the marked perifoveal region at each stage of projection. This was used to calculate the relative allocation of neurons to the representation of the fovea and surrounding retina among the different stages of the visual pathway. The values obtained showed that the cortical representation of the perifovea was expanded two to three times more than could be accounted for on the basis of ganglion cell topography in the retina, and that the expansion occurred both between the retina and the thalamus, and between the thalamus and the cortex. These results are inconsistent with the idea that peripheral scaling is a general principle of sensory representation in the cortex. They could also explain why many visual thresholds, including hyperacuities, cannot be accounted for by peripheral factors such as ganglion cell density.


Caregiver Reports of Interactions between Children up to 6 Years and Their Family Dog-Implications for Dog Bite Prevention.
In children up to 6 years, interactions such as interfering with the dog's resources and also benign behaviors (e.g., petting) commonly precede a bite incident with the family dog. Therefore, the aim of the present study was to explore the development of everyday interactions between children up to 6 years and their family dogs and whether parents' attitudes to supervision are related to those interactions. Additionally, we investigated whether behavior of dogs that had lived in the family for longer than the child differed from those that grew up with children. A self-selected sample of caregivers living with a child up to 6 years and a family dog was surveyed via an online questionnaire (N = 402). Frequency of observed child behaviors directed toward the dog and dog behaviors directed toward the child were scored on a six-point scale (1-never and 6-very often). Data on characteristics of the caregiver, the child, and the dog were collected, and a section surveying attitudes to supervision of child-dog interactions was included. Additionally, we asked whether the dog already injured the child. Benign child behaviors toward dogs were most frequently reported (mean ± SD: 4.1 ± 1.2), increased with child age (rs = 0.38, p < 0.001), and reached high levels from 6 months on. Overall, resource-related interactions were relatively infrequent (2.1 ± 1.1). Most common was the dog allowing the child to take objects from its mouth (4.1 ± 1.7). This behavior was more common with older children (rs = 0.37, p < 0.001). Reported injuries during resource-related interactions occurred while feeding treats or taking objects from the dog during fetch play. Dogs that had lived in the family for longer than the child showed less affiliative behaviors toward the child (e.g., energetic affiliative: U = -7.171, p < 0.001) and more fear-related behaviors (U = -3.581, p < 0.001). Finally, the caregivers' attitudes to supervision were related to all child behaviors (e.g., allow unsafe behaviors-benign child behavior: rs = 0.47, p < 0.001). The results of this study underline the need for a dog bite prevention approach directed toward the caregivers very early in the child-dog relationship, taking into account the child's age and individual needs of the dog.


Relations among religiousness, spirituality, and sexual practices.
Although religiousness is commonly associated with limited sexual activity, little is known about spirituality's unique effect. Study aims involved measuring spirituality's unique affect on young adults' sexual practices (frequency of sex, number of sexual partners, and condom use) and determining whether spirituality adds significant increment over well-established predictors. Three hundred fifty-three (61% female) heterosexual young adults aged 17 to 29 completed this cross-sectional, self-report questionnaire study. Hierarchical regression analyses demonstrated spirituality is positively associated with participants' number of sexual partners and frequency of sex without a condom. Spirituality contributed to the prediction of participants' number of partners and condom use above and beyond the variance accounted for by religiousness, alcohol use, and impulsivity. A moderating effect for gender was found. Spirituality appears to have a unique and strong association with the sexual practices of young adults, particularly women, and should be assessed in future studies of young adults' sexual practices.


Evolution of myrmecophytism in western Malesian Macaranga (Euphorbiaceae).
Plants inhabited by ants (myrmecophytes) have evolved in a diversity of tropical plant lineages. Macaranga includes approximately 300 paleotropical tree species; in western Malesia there are 26 myrmecophytic species that vary in morphological specializations for ant association. The origin and diversification of myrmecophytism in Macaranga was investigated using phylogenetic analyses of morphological and nuclear ITS DNA characters and studies of character evolution. Despite low ITS variation, the combined analysis resulted in a well-supported hypothesis of relationships. Mapping myrmecophytism on all most parsimonious trees resulting from the combined analysis indicated that the trait evolved independently between two and four times and was lost between one and three times (five changes). This hypothesis was robust when tested against trees constrained to have three or fewer evolutionary transformations, although increased taxon sampling for the ITS analysis is required to confirm this. Mapping morphological traits on the phylogeny indicated that myrmecophytism was not homologous among lineages; each independent origin involved a suite of different specializations for ant-plant association. There was no evidence that myrmecophytic traits underwent sequential change through evolution; self-hollowing domatia evolved independently from ant-excavated domatia, and different food-body production types evolved in different lineages. The multiple origins of myrmecophytism in Macaranga were restricted to one small, exclusively western Malesian lineage of an otherwise large and nonmyrmecophytic genus. Although the evolution of aggregated food-body production and the formation of domatia coincided with the evolution of myrmecophytism in all cases, several morphological, ecological, and biogeographic factors appear to have facilitated and constrained this radiation of ant-plants.


Association between latent toxoplasmosis and clinical course of schizophrenia - continuous course of the disease is characteristic for Toxoplasma gondii-infected patients.
The aim of the present study was to investigate the association between various clinical aspects of schizophrenia and seropositivity against Toxoplasma gondii (Nicolle et Manceaux, 1908). We selected 94 patients with schizophrenia and investigated the seropositivity rate for anti-T. gondii IgG antibodies by ELISA. Clinical parameters of schizophrenic patients such as illness type and status, clinical course, awareness of the illness and need for electroconvulsive therapy (ECT) were compared with their serological status. Anti-T. gondii IgG antibodies were detected in 43 (46%) of schizophrenic patients. Chronic patients had a rate of 34 (72%) seropositivity, whereas 9 (22%) of the patients with partial remission showed evidence of latent toxoplasmosis. Of continuous patients, 35 (81%) were found to be seropositive and this rate was significantly more than in the other groups. The rate of latent toxoplasmosis was detected significantly higher in patients who lack awareness of schizophrenia (36, i.e. 72%) than the patients who were aware of their illnesses (7, i.e. 16%). Anti-T. gondii IgG antibodies were detected in 38 (70%) of ECT performed patients while this percentage was 13% in the ones who had never been treated with ECT. This difference was also statistically significant. We showed that Toxoplasma-infected subjects had 15× higher probability of having continuous course of disease than Toxoplasma-free subjects. Our results put forth the possibility of latent toxoplasmosis to have a negative impact on the course of schizophrenia and treatment response of schizophrenic patients.


Complementary alternative medicine for children with autism: a physician survey.
Previous studies suggest over half of children with autism are using complementary alternative medicine (CAM). In this study, physicians responded (n = 539, 19% response rate) to a survey regarding CAM use in children with autism. Physicians encouraged multi-vitamins (49%), essential fatty acids (25%), melatonin (25%) and probiotics (19%) and discouraged withholding immunizations (76%), chelation (61%), anti-infectives (57%), delaying immunizations (55%) and secretin (43%). Physicians encouraging CAM were more likely to desire CAM training, inquire about CAM use, be female, be younger, and report greater autism visits, autism education and CAM knowledge. Physicians were more likely to desire CAM training, inquire about CAM and view CAM as a challenge for children with autism compared to children with other neurodevelopmental and chronic/complex conditions.


Surgical training technology for cerebrovascular anastomosis.
Cerebrovascular anastomosis (for example in the management of Moyamoya disease or complex aneurysms) is a rarely performed but essential procedure in neurosurgery. Because of the complexity of this technique and the infrequent clinical opportunities to maintain skills relevant to this surgery, laboratory training is important to develop a consistent and competent performance of cerebrovascular anastomosis. We reviewed the literature pertaining to the training practices surrounding cerebrovascular anastomosis in order to understand the ways in which trainees should best develop these skills. A wide variety of training methods have been described. These may be classified into five general categories, according to training materials used, being synthetic material, living animal, animal carcass, human cadaver, and computer simulation. Ideally, a novice begins training with non-biological material. After gaining sufficient dexterity, the trainee will be able to practice using biological materials followed by high fidelity models prior to actual surgery. Unfortunately, the effectiveness of each model has generally, to our knowledge, only been judged subjectively. Objective quantification methods are necessary to accelerate the acquisition of competence.


Bread Wheat Quality: Some Physical, Chemical and Rheological Characteristics of Syrian and English Bread Wheat Samples.
The relationships between breadmaking quality, kernel properties (physical and chemical), and dough rheology were investigated using flours from six genotypes of Syrian wheat lines, comprising both commercially grown cultivars and advanced breeding lines. Genotypes were grown in 2008/2009 season in irrigated plots in the Eastern part of Syria. Grain samples were evaluated for vitreousness, test weight, 1000-kernel weight and then milled and tested for protein content, ash, and water content. Dough rheology of the samples was studied by the determination of the mixing time, stability, weakness, resistance and the extensibility of the dough. Loaf baking quality was evaluated by the measurement of the specific weight, resilience and firmness in addition to the sensory analysis. A comparative study between the six Syrian wheat genotypes and two English flour samples was conducted. Significant differences were observed among Syrian genotypes in vitreousness (69.3%-95.0%), 1000-kernel weight (35.2-46.9 g) and the test weight (82.2-88.0 kg/hL). All samples exhibited high falling numbers (346 to 417 s for the Syrian samples and 285 and 305 s for the English flours). A significant positive correlation was exhibited between the protein content of the flour and its absorption of water (r = 0.84 **), as well as with the vitreousness of the kernel (r = 0.54 *). Protein content was also correlated with dough stability (r = 0.86 **), extensibility (r = 0.8 **), and negatively correlated with dough weakness (r = -0.69 **). Bread firmness and dough weakness were positively correlated (r = 0.66 **). Sensory analysis indicated Doumah-2 was the best appreciated whilst Doumah 40765 and 46055 were the least appreciated which may suggest their suitability for biscuit preparation rather than bread making.