Independent determinants of operative mortality for patients with aortic dissections.
A 20 year (1963 to 1982) surgical experience including 175 consecutive patients with aortic dissections was analyzed by logistic discriminant analyses to identify predictors of high operative risk. The patient population had characteristics similar to those in large autopsy series. Sixty-nine percent had type A and 58% had acute dissections. The intimal tear was located in the ascending aorta in 60% of the patients, the descending aorta in 27%, and the transverse arch in 13%. The overall operative mortality rate was 23 +/- 3%. The operative mortality rates were substantially lower between 1977 and 1982: mortality in patients with acute type A dissections, 7 +/- 5%; in those with chronic type A, 11 +/- 7%; in those with acute type B, 13 +/- 12%; and in those with chronic type B, 11 +/- 11%. After preliminary univariate screening, the following factors were determined to be significant independent predictors of operative mortality (in rank order of declining predictive power): type A patients (n = 121), renal dysfunction, tamponade, renal/visceral ischemia, and operative date; type B patients (n = 54), rupture, renal/visceral ischemia, and age; all patients (n = 175), renal dysfunction, renal/visceral ischemia, site of tear (ascending less than descending less than arch), tamponade, operative date, and pulmonary disease. Interestingly, several variables had no important bearing on operative mortality, including type (acute vs chronic) of dissection, age, previous operation, rupture, stroke, paraplegia, Marfan's syndrome, concomitant aortic valve replacement and/or coronary artery bypass grafting, site of tear, and whether or not the tear was resected in type A patients; emergency operation, hypertension, previous cardiac symptoms, paraplegia, site of tear, and resection of tear in type B patients; and, when all patients were considered together, age, sex, cardiac symptoms, prior operation, stroke, paraplegia, acute myocardial infarction, acute aortic regurgitation, Marfan's syndrome, and tear resection. These data allow calculation of any individual patient's operative risk and document that the operative mortality rate today is relatively low for all patients with aortic dissections, irrespective of type or acuity. Earlier surgical referral of patients with acute type A or acute type B dissection before irreversible major end-organ ischemia and/or infarction is probably in part responsible for the substantially improved results since 1977.


DNAlive: a tool for the physical analysis of DNA at the genomic scale.
DNAlive is a tool for the analysis and graphical display of structural and physical characteristics of genomic DNA. The web server implements a wide repertoire of metrics to derive physical information from DNA sequences with a powerful interface to derive 3D information on large sequences of both naked and protein-bound DNAs. Furthermore, it implements a mesoscopic Metropolis code which allows the inexpensive study of the dynamic properties of chromatin fibers. In addition, our server also surveys other protein and genomic databases allowing the user to combine and explore the physical properties of selected DNA in the context of functional features annotated on those regions. http://mmb.pcb.ub.es/DNAlive/ ; http://www.inab.org/


Frequency of fimbriation of nontypable Haemophilus influenzae and its ability to adhere to chinchilla and human respiratory epithelium.
To date, we have examined nearly 60 clinical isolates of nontypable Haemophilus influenzae (26 nasopharyngeal, 33 from middle ear effusions) and have found that 100% were fimbriated. The percentage of cells bearing fimbriae within each isolate varied from less than 10 to 100%, with fimbriae being either peritrichous or bipolar in distribution. Fimbriae were approximately 2.4 to 3.6 nm in width; however, there was a high degree of variability in both length and number of fimbriae per individual bacterial cell among these isolates. All isolates tested adhered to both human oropharyngeal cells and chinchilla tracheal epithelium regardless of the degree to which the particular isolate was fimbriate. The level or degree of fimbriation did not correlate with either site of isolation, biotype, strength of hemagglutination reaction, or type of effusion present in the ear. These appendages appear to be quite different from those described for type b H. influenzae in which the ability to adhere and strength of ability to hemagglutinate correlated strongly with degree of fimbriation.


Cardiopulmonary bypass management and neurologic outcomes: an evidence-based appraisal of current practices.
Neurologic complications after cardiac surgery are of growing importance for an aging surgical population. In this review, we provide a critical appraisal of the impact of current cardiopulmonary bypass (CPB) management strategies on neurologic complications. Other than the use of 20-40 microm arterial line filters and membrane oxygenators, newer modifications of the basic CPB apparatus or the use of specialized equipment or procedures (including hypothermia and "tight" glucose control) have unproven benefit on neurologic outcomes. Epiaortic ultrasound can be considered for ascending aorta manipulations to avoid atheroma, although available clinical trials assessing this maneuver are limited. Current approaches for managing flow, arterial blood pressure, and pH during CPB are supported by data from clinical investigations, but these studies included few elderly or high-risk patients and predated many other contemporary practices. Although there are promising data on the benefits of some drugs blocking excitatory amino acid signaling pathways and inflammation, there are currently no drugs that can be recommended for neuroprotection during CPB. Together, the reviewed data highlight the deficiencies of the current knowledge base that physicians are dependent on to guide patient care during CPB. Multicenter clinical trials assessing measures to reduce the frequency of neurologic complications are needed to develop evidence-based strategies to avoid increasing patient morbidity and mortality.


Alkali metal complexes based on bisheterocyclomethanide ligands.
A series of new alkali metal complexes containing deprotonated bisheterocyclomethanide were synthesised and structurally as well as spectroscopically characterised. Starting from the neutral bis-(benzoxazol-2-yl)methane ({NCOC6H4}2CH2), the complexes were obtained by facile deprotonation of the methylene bridge with nbutyllithium (nBuLi) or potassium hydride. Each of the resulting complexes [({NCOC6H4}2CH)Li(OEt2)2] (1), [({NCOC6H4}2CH)K(thf)]n (2) and [({NCOC6H4}2CH)K(18-crown-6)]n (3) (n → ∞) was analysed in the solid state by single crystal X-ray diffraction and in solution by various NMR techniques. All the compounds show a nearly planar ligand with the alkali metal ion chelated by the two ring nitrogen atoms of the conjugated C3N2 moiety. Furthermore, water NMR titration experiments revealed that both compounds 2 and 3 are examples of water-stable reactive organo potassium compounds. Due to their hydrolysis stability, these complexes are under further investigations in deep eutectic solvents.


Management of atypical cranial meningiomas, part 1: predictors of recurrence and the role of adjuvant radiation after gross total resection.
Indications for external beam radiation therapy (EBRT) for atypical meningiomas (AMs) remain unclear. To analyze features associated with recurrence in AM patients after gross total resection (GTR) and to assess the relative benefit of EBRT in a retrospective cohort study. One hundred fifty-one primary AMs after GTR (88 female patients; median follow-up, 45.0 months) were examined for possible predictors of recurrence (age, sex, location, volume, bone involvement, brain invasion). The Fisher exact and Wilcoxon rank-sum tests were used to analyze the association between these predictors and use of EBRT. The impact on recurrence for these predictors and EBRT was analyzed with Kaplan-Meier and Cox regression. Of 151 patients, 13 (8.6%) experienced recurrence after GTR (median, 47.0 months). Multivariate analysis identified elevated mitotic index (P = .007) and brain invasion (P = .002) as predictors of recurrence. Larger volume (P = .96) was not associated with recurrence but was more likely to prompt EBRT (P = .001). Recurrences occurred in 11 of 112 with GTR (9.8%; median, 44 months) and 2 of 39 with GTR/EBRT (5.1%; median, 133 months). The 2-, 5-, and 10-year progression-free survival rates after GTR vs GTR/EBRT were 97%, 86%, and 68% vs 100%, 100%, and 78%. Kaplan-Meier analysis demonstrated no difference in progression-free survival or overall survival after GTR vs GTR/EBRT (P = .8, P > .99). Brain invasion and high mitotic rates may predict recurrence. After GTR of AMs, EBRT appears not to affect progression-free survival and overall survival, suggesting that observation rather than EBRT may be indicated after GTR.


Widespread head-to-head hydrocarbon biosynthesis in bacteria and role of OleA.
Previous studies identified the oleABCD genes involved in head-to-head olefinic hydrocarbon biosynthesis. The present study more fully defined the OleABCD protein families within the thiolase, alpha/beta-hydrolase, AMP-dependent ligase/synthase, and short-chain dehydrogenase superfamilies, respectively. Only 0.1 to 1% of each superfamily represents likely Ole proteins. Sequence analysis based on structural alignments and gene context was used to identify highly likely ole genes. Selected microorganisms from the phyla Verucomicrobia, Planctomyces, Chloroflexi, Proteobacteria, and Actinobacteria were tested experimentally and shown to produce long-chain olefinic hydrocarbons. However, different species from the same genera sometimes lack the ole genes and fail to produce olefinic hydrocarbons. Overall, only 1.9% of 3,558 genomes analyzed showed clear evidence for containing ole genes. The type of olefins produced by different bacteria differed greatly with respect to the number of carbon-carbon double bonds. The greatest number of organisms surveyed biosynthesized a single long-chain olefin, 3,6,9,12,15,19,22,25,28-hentriacontanonaene, that contains nine double bonds. Xanthomonas campestris produced the greatest number of distinct olefin products, 15 compounds ranging in length from C(28) to C(31) and containing one to three double bonds. The type of long-chain product formed was shown to be dependent on the oleA gene in experiments with Shewanella oneidensis MR-1 ole gene deletion mutants containing native or heterologous oleA genes expressed in trans. A strain deleted in oleABCD and containing oleA in trans produced only ketones. Based on these observations, it was proposed that OleA catalyzes a nondecarboxylative thiolytic condensation of fatty acyl chains to generate a beta-ketoacyl intermediate that can decarboxylate spontaneously to generate ketones.


Cervical Cord Neurodegeneration in Traumatic and Non-Traumatic Spinal Cord Injury.
This study aimed to compare macrostructural and microstructural neurodegenerative changes remote from a cervical spinal cord injury in traumatic spinal cord injury (tSCI) and degenerative cervical myelopathy (DCM) patients using quantitative magnetic resonance imaging (MRI). Twenty-nine tSCI patients, 20 mild/moderate DCM patients, and 22 healthy controls underwent a high-resolution MRI protocol at the cervical cord (C2/C3). High-resolution T2*-weighted and diffusion-weighted scans provided data to calculate tissue-specific cross-sectional areas of the spinal cord and tract-specific diffusion indices of cord white matter, respectively. Regression analysis determined associations between neurodegeneration and clinical impairment. tSCI patients showed more impairment in upper limb strength and manual dexterity when compared with DCM patients. While macrostructural MRI measures revealed a similar extent of remote cord atrophy at cervical level, microstructural measures (diffusion indices) were able to distinguish more pronounced tract-specific neurodegeneration in tSCI patients when compared with DCM patients. Tract-specific neurodegeneration was associated with upper limb impairment. Despite clinical differences between severely impaired tSCI compared with mildly affected DCM patient, extensive cord atrophy is present remotely from the focal spinal cord injury. Diffusion indices revealed greater tract-specific alterations in tSCI patients. Therefore, diffusion indices are more sensitive than macrostructural MRI measures as these are able to distinguish between traumatic and non-traumatic spinal cord injury. Neuroimaging biomarkers of cervical cord integrity hold potential as predictors of recovery and might be suitable biomarkers for interventional trials both in traumatic and non-traumatic SCI.


MiR-4638-5p inhibits castration resistance of prostate cancer through repressing Kidins220 expression and PI3K/AKT pathway activity.
MicroRNAs (miRNAs) are short, conserved segments of non-coding RNA which play a significant role in prostate cancer development and progression. To identify miRNAs associated with castration resistance, we performed miRNA microarray analysis comparing castration resistant prostate cancer (CRPC) with androgen dependent prostate cancer (ADPC). We identified common underexpression of miR-4638-5p in CRPC compared to ADPC samples, which were further confirmed by quantitative PCR analysis. The role of miR-4638-5p in prostate cancer androgen-independent growth has been demonstrated both in vitro and in vivo. We also identified Kidins220 as a target gene directly regulated by miR-4638-5p and shRNA-mediated knockdown of Kidins220 phenocopied miR-4638-5p restoration. Subsequently, we revealed that Kidins220 activates PI3K/AKT pathway, which plays a key role in CRPC. Loss of miR- 4638-5p may lead to CRPC through the activity of Kidins220 and PI3K/AKT pathway. Furthermore, we found that miR-4638-5p, through regulating Kidins220 and the downstream activity of VEGF and PI3K/AKT pathway, influences prostate cancer progression via angiogenesis. The identification of miR-4638-5p down-regulation in CRPC and the understanding of the functional role of miR-4638-5p and its downstream genes/pathways have the potential to develop biomarkers for CRPC onset and to identify novel targets for novel forms of treatments of this lethal form of PCa.


An in vivo microfluidic study of bacterial transit in C. elegans nematodes.
Caenorhabditis elegans (C. elegans) constitutes an important model organism for use in nutrition and aging studies. We report a novel method for studying the dynamics of Escherichia coli (E. coli) bacterial transit through the worms' intestine. A microfluidic chip was designed for alternating C. elegans on-chip culture and immobilization, thereby enabling periodic high-resolution time-lapse imaging at single-worm resolution over several days. Immobilization was achieved in a reversible way using arrays of tapered channels suitable for assay parallelization. Dedicated C. elegans feeding protocols were applied. Two E. coli bacterial strains, HT115 and OP50, respectively labeled with green fluorescent protein (GFP) and red fluorescent protein (RFP), were used as food source and imaged with fluorescence microscopy techniques to measure relevant parameters of the bacterial transit process. Feeding behavior and E. coli transit dynamics in the whole intestinal tract of the worms were characterized in an automated way over the first 3 days of adulthood, revealing both fast transit phenomena and variations in microbial accumulation. In particular, we studied the bacterial food transit periodicity in wild-type and eat-2 (ad465) mutant C. elegans strains in both trapped and free-swimming conditions. In order to further demonstrate the versatility of our microfluidic platform, we also studied drug-induced modifications of the bacterial transit by measuring the response of the worms' intestine to exposure to the neurotransmitter serotonin.


Assessing Trends in Tobacco Cessation in Diverse Patient Populations.
This study examined change in tobacco use over 4 years among the general population of patients in six diverse health care organizations using electronic medical record data. The study cohort (N = 34 393) included all patients age 18 years or older who were identified as smokers in 2007, and who then had at least one primary care visit in each of the following 4 years. In the 4 years following 2007, this patient cohort had a median of 13 primary care visits, and 38.6% of the patients quit smoking at least once. At the end of the fourth follow-up year, 15.4% had stopped smoking for 1 year or more. Smokers were more likely to become long-term quitters if they were 65 or older (OR = 1.32, 95% CI = [1.16, 1.49]), or had a diagnoses of cancer (1.26 [1.12, 1.41]), cardiovascular disease (1.22 [1.09, 1.37]), asthma (1.15 [1.06, 1.25]), or diabetes (1.17 [1.09, 1.27]). Characteristics associated with lower likelihood of becoming a long-term quitter were female gender (0.90 [0.84, 0.95]), black race (0.84 [0.75, 0.94]) and those identified as non-Hispanic (0.50 [0.43, 0.59]). Among smokers who regularly used these care systems, one in seven had achieved long-term cessation after 4 years. This study shows the practicality of using electronic medical records for monitoring patient smoking status over time. Similar methods could be used to assess tobacco use in any health care organization to evaluate the impact of environmental and organizational programs.


Identification of a class of human cancer germline genes with transcriptional silencing refractory to the hypomethylating drug 5-aza-2'-deoxycytidine.
Bona fide germline genes have expression restricted to the germ cells of the gonads. Testis-specific germline development-associated genes can become activated in cancer cells and can potentially drive the oncogenic process and serve as therapeutic/biomarker targets; such germline genes are referred to as cancer/testis genes. Many cancer/testis genes are silenced via hypermethylation of CpG islands in their associated transcriptional control regions and become activated upon treatment with DNA hypomethylating agents; such hypomethylation-induced activation of cancer/testis genes provides a potential combination approach to augment immunotherapeutics. Thus, understanding cancer/testis gene regulation is of increasing clinical importance. Previously studied cancer/testis gene activation has focused on X chromosome encoded cancer/testis genes. Here we find that a sub-set of non-X encoded cancer/testis genes are silenced in non-germline cells via a mechanism that is refractory to epigenetic dysregulation, including treatment with the hypomethylating agent 5-aza-2'-deoxycytidine and the histone deacetylase inhibitor tricostatin A. These findings formally indicate that there is a sub-group of the clinically important cancer/testis genes that are unlikely to be activated in clinical therapeutic approaches using hypomethylating agents and it indicates a unique transcriptional silencing mechanism for germline genes in non-germline cells that might provide a target mechanism for new clinical therapies.


Gametogenic responses of the testis in spotted munia (Lonchura punctulata; Aves) to oral administration of lithium chloride.
In the present study, the effects of orally-administered lithium on testicular morphology were examined in the spotted munia (Lonchura punctulata), a seasonally breeding sub-tropical finch. Adult males were procured from natural populations during the month of August, a time when these birds begin to show seasonal reproductive maturity in an annual cycle. Both during the period of acclimation, and throughout the subsequent experimental period, the birds were maintained in an open aviary simulating natural environmental conditions. Lithium was dissolved in distilled water and was administered via the oral route by means of a commercially available stomach-tube. A total of five experimental groups were utilized. The first group (Group A) served as control and received lithium-free distilled water in a similar manner. In the remaining four groups, lithium was administered daily as follows: Group B (2.5 mEq/Kg body weight for 5 days); Group C (2.5 mEq/Kg for 10 days); Group D (5.0 mEq/Kg for 5 days) and Group E (5.0 mEq/Kg for 10 days). All lithium administrations were carried out between 14:00 and 15:00h. Twenty-four hours after the last oral lithium, final body weights were recorded, blood samples were obtained (by brachial vein puncture for the measurement of serum lithium) and the animals were sacrificed, and testes were collected for histological studies. Our results indicated that lithium treatment led to a significant reduction in testicular weight and seminiferous tubular diameter, and a marked degenerative changes in germ cells in that most of the spermatids and mature spermatozoa showed necrotic changes and were sloughed off from the seminiferous tubular epithelium. Complete desquamation and loss of germ cells, and their clump formation were also noted within many seminiferous tubular lumen. Notably these adverse effects were observed when serum lithium levels were within the therapeutic range for human. These results confirm our earlier report on lithium's adverse effects on testicular function, and extend further to show that lithium indeed has a significant adverse effect on the histomorphology, and, thus, the function of the testis in birds.


Homeless Shelter Entry in the Year After an Emergency Department Visit: Results From a Linked Data Analysis.
Housing instability is prevalent among emergency department (ED) patients and is known to adversely affect health. We aim to determine the incidence and timing of homeless shelter entry after an ED visit among patients who are not currently homeless. We conducted a random-sample survey of ED patients at an urban public hospital from November 2016 to September 2017. Patients provided identifying information and gave informed consent for us to link their survey data with the New York City Department of Homeless Services shelter database. Shelter use was followed prospectively for 12 months after the baseline ED visit. We examined timing of shelter entry in the 12 months after the ED visit, excluding patients who were homeless at baseline. Of 1,929 unique study participants who were not currently homeless, 96 (5.0%) entered a shelter within 12 months of their baseline ED visit. Much of the shelter entry occurred in the first month after the ED visit, with continued yet slower rates of entry in subsequent months. Patients in our sample who entered a shelter were predominantly men and non-Hispanic black, and commonly had past shelter and frequent ED use. In this single-center study, 5.0% of urban ED patients who were not currently homeless entered a homeless shelter within the year after their ED visit. Particularly if replicated elsewhere, this finding suggests that ED patients may benefit from efforts to identify housing instability and direct them to homelessness prevention programs.


Dose-response association between multi-site musculoskeletal pain and work ability in physical therapists: a cross-sectional study.
Multi-site musculoskeletal pain (MP) is common among health care professionals and is considered a threat to work ability and thereby a long and healthy working life. However, literature is scarce regarding these associations among physical therapists (PTs). This study aims to quantify the prevalence of local and multi-site MP among PTs, to investigate the associations between pain intensity and number of pain sites, respectively, with the level of work ability. We conducted a survey among 1006 PTs about pain the previous month in different body areas and work ability. Work ability was measured using the Work Ability Index (WAI) including its seven categories. The odds of having lower level of work ability as a function of pain intensity (0-10) and multi-site pain were determined using binary logistic regression controlled for relevant confounders. The neck (36.3%) and the low back (32.3%) were the most commonly affected body areas. Furthermore, a dose-response relationship was observed between the number of pain sites and lower work ability (trend test, p < 0.001). With low pain intensity as reference, a moderate to strong association existed for lower levels of work ability in PTs who reported pain intensity of > 5 in one to two body regions (OR 2.14, 95% CI 1.27-3.60). This association was stronger when participants reported pain in three to four sites (OR 4.02, 95% CI 2.36-6.82) and even stronger when pain was experienced in five or more sites (OR 6.13, 95% CI 3.31-11.38). Multi-site MP is strongly associated-in a dose-response fashion-with lower levels of work ability among PTs.


London force correction disparity in the modeling of crystalline asparagine and glutamine.
Solid-state density functional theory is a powerful computational method used to provide insight into the low-frequency vibrations of crystalline solids. A known limitation of this method is its general underestimation of weak intermolecular forces. Semiempirical London force corrections have been developed to augment density functional theory calculations with the ultimate goal being corrections that are applicable to a range of compounds. In this study, two structurally similar amino acids, asparagine and glutamine, were chosen to gauge the proximity of the widely used DFT-D2 approach to this goal. Despite their chemical similarities, it was determined that the two molecular solids required considerably different semiempirical correction magnitudes, with asparagine requiring a 42% greater London force correction factor when compared to glutamine. To validate these findings, terahertz spectroscopy was used to investigate the intermolecular vibrations of both amino acids in the low-frequency, sub-100 cm(-1) region. The excellent correlation between the experimental and the theoretical spectra demonstrates that the noncovalent interactions are well represented by the applied model despite the correction disparity. These results have highlighted a practical shortcoming of a common semiempirical method for the modeling of weak forces and emphasizes that care must be exercised for effective use of such corrections in crystalline solids.


Utility of single versus sequential measurements of risk factors for prediction of stroke in Chinese adults.
Absolute risks of stroke are typically estimated using measurements of cardiovascular disease risk factors recorded at a single visit. However, the comparative utility of single versus sequential risk factor measurements for stroke prediction is unclear. Risk factors were recorded on three separate visits on 13,753 individuals in the prospective China Kadoorie Biobank. All participants were stroke-free at baseline (2004-2008), first resurvey (2008), and second resurvey (2013-2014), and were followed-up for incident cases of first stroke in the 3 years following the second resurvey. To reflect the models currently used in clinical practice, sex-specific Cox models were developed to estimate 3-year risks of stroke using single measurements recorded at second resurvey and were retrospectively applied to risk factor data from previous visits. Temporal trends in the Cox-generated risk estimates from 2004 to 2014 were analyzed using linear mixed effects models. To assess the value of more flexible machine learning approaches and the incorporation of longitudinal data, we developed gradient boosted tree (GBT) models for 3-year prediction of stroke using both single measurements and sequential measurements of risk factor inputs. Overall, Cox-generated estimates for 3-year stroke risk increased by 0.3% per annum in men and 0.2% per annum in women, but varied substantially between individuals. The risk estimates at second resurvey were highly correlated with the annual increase of risk for each individual (men: r = 0.91, women: r = 0.89), and performance of the longitudinal GBT models was comparable with both Cox and GBT models that considered measurements from only a single visit (AUCs: 0.779-0.811 in men, 0.724-0.756 in women). These results provide support for current clinical guidelines, which recommend using risk factor measurements recorded at a single visit for stroke prediction.


Social networking site addiction and undergraduate students' irrational procrastination: The mediating role of social networking site fatigue and the moderating role of effortful control.
With the popularity of social networking sites (SNSs), the problems of SNS addiction have been increasing. Research has revealed the association between SNS addiction and irrational procrastination. However, the mechanism underlying this relation is still unclear. The present study aimed to examine the mediating role of social networking site fatigue and the moderating role of effortful control in this link among Chinese undergraduate students. The Social Networking Site Addiction Scale, Social Networking Service Fatigue Scale, Effortful Control Scale and Irrational Procrastination Scale were completed by 1,085 Chinese undergraduate students. Results indicated that SNS addiction, SNS fatigue and irrational procrastination were positively correlated with each other, and negatively correlated with effortful control. Further analyses revealed that, SNS addiction has a direct effect on irrational procrastination. SNS fatigue mediated the relationship between SNS addiction and irrational procrastination. Both direct and indirect effects of SNS addiction on irrational procrastination were moderated by effortful control. Specifically, this effect was stronger for people with lower effortful control. These findings help clarify the mechanism underlying the association between SNS addiction and irrational procrastination, which have potential implications for intervention.


Rectal carriage of enterohemorrhagic Escherichia coli O157 in slaughtered cattle.
Escherichia coli O157:H7 is an important cause of diarrhea, hemorrhagic colitis, and potentially fatal human illness. Cattle are considered a primary reservoir of infection, and recent experimental evidence has indicated that the terminal rectum is the principal site of bacterial carriage. To test this finding in naturally colonized animals, intact rectum samples from 267 cattle in 24 separate lots were obtained immediately after slaughter, and fecal material and mucosal surfaces were cultured for E. coli O157 by direct and enrichment methods. Two locations, 1 and 15 cm proximal to the recto-anal junction, were tested. In total, 35 animals were positive for E. coli O157 at at least one of the sites and 232 animals were negative as determined by all tests. The frequency of isolation and the numbers of E. coli O157 cells were higher at the site closer to the recto-anal junction, confirming our previous experimental findings. We defined low- and high-level carriers as animals with E. coli O157 levels of <1 x 10(3) CFU g(-1) or <1 x 10(3) CFU ml(-1) and animals with E. coli O157 levels of > or =1 x 10(3) CFU g(-1) or > or =1 x 10(3) CFU ml(-1) in feces or tissues, respectively. High-level carriage was detected in 3.7% of the animals (95% confidence interval, 1.8 to 6.8%), and carriage on the mucosal surface of the terminal rectum was associated with high-level fecal excretion. In summary, our results support previous work demonstrating that the mucosal epithelium in the bovine terminal rectum is an important site for E. coli O157 carriage in cattle. The data also support the hypothesis that high-level fecal shedding (> or =1 x 10(3) CFU g of feces(-1)) of enterohemorrhagic E. coli O157 results from colonization of this site.


Do individuals with autism process words in context? Evidence from language-mediated eye-movements.
It is widely argued that people with autism have difficulty processing ambiguous linguistic information in context. To investigate this claim, we recorded the eye-movements of 24 adolescents with autism spectrum disorder and 24 language-matched peers as they monitored spoken sentences for words corresponding to objects on a computer display. Following a target word, participants looked more at a competitor object sharing the same onset than at phonologically unrelated objects. This effect was, however, mediated by the sentence context such that participants looked less at the phonological competitor if it was semantically incongruous with the preceding verb. Contrary to predictions, the two groups evidenced similar effects of context on eye-movements. Instead, across both groups, the effect of sentence context was reduced in individuals with relatively poor language skills. Implications for the weak central coherence account of autism are discussed.


Are microbial indicators and pathogens correlated? A statistical analysis of 40 years of research.
Indicator organisms are used to assess public health risk in recreational waters, to highlight periods of challenge to drinking water treatment plants, and to determine the effectiveness of treatment and the quality of distributed water. However, many have questioned their efficacy for indicating pathogen risk. Five hundred and forty cases representing independent indicator-pathogen correlations were obtained from the literature for the period 1970-2009. The data were analyzed to assess factors affecting correlations using a logistic regression model considering indicator classes, pathogen classes, water types, pathogen sources, sample size, the number of samples with pathogens, the detection method, year of publication and statistical methods. Although no single indicator was identified as the most correlated with pathogens, coliphages, F-specific coliphages, Clostridium perfringens, fecal streptococci and total coliforms were more likely than other indicators to be correlated with pathogens. The most important factors in determining correlations between indicator-pathogen pairs were the sample size and the number of samples positive for pathogens. Pathogen sources, detection methods and other variables have little influence on correlations between indicators and pathogens. Results suggest that much of the controversy with regards to indicator and pathogen correlations is the result of studies with insufficient data for assessing correlations.


The somatotropic axis in short children born small for gestational age: relation to insulin resistance.
To determine whether hyperinsulinemia and reduced insulin sensitivity in individuals born small for gestational age (SGA) could be related to persisting abnormalities of the GH/IGF-I axis, we assessed overnight GH secretory profiles and measured fasting glucose, insulin, intact and 32,33 split proinsulin, and IGF-I levels in 16 short SGA children (age range 2.3-8.0 y) and in controls. Insulin sensitivity was calculated using the homeostasis model. Compared with short normal-birthweight controls (n = 7, age range 2.3-5.0 y), short SGA children had higher fasting insulin levels (means: 26.8 vs 20.6 pmol/L, p = 0.02), lower insulin sensitivity [means: 204 vs 284 %homeostasis model assessment (HOMA), p = 0.01], and higher beta cell function (112 vs 89 %HOMA, p = 0.04). SGA children also had lower levels of IGFBP-1 (87.0 vs 133.8, p = 0.04), but similar IGF-I levels (IGF-I SDS: -1.1 vs -1.7, p = 0.4). Compared with normal-height controls (n = 15, age range 5.6-12.1 y), SGA children had higher overnight GH secretion (GH maximum: 55.9 vs 39.6 mU/L, p = 0.01; mean: 13.1 vs 8.9, p = 0.004; minimum: 1.2 vs 0.6, p = 0.02). Interestingly, among SGA children, fasting insulin levels and insulin sensitivity were significantly related to overnight GH secretion (insulin sensitivity vs maximum GH: r = -0.68, p = 0.01; vs GH pulse amplitude r = -0.71, p = 0.007). The only hormone level significantly related to current height velocity was C-peptide (r = 0.75, p = 0.008). In conclusion, elevated fasting insulin levels and reduced insulin sensitivity in short SGA children was related to elevated levels of overnight GH secretion. We hypothesize that resistance to the somatotropic actions of GH and IGF-I in short SGA children may contribute directly to reduced insulin sensitivity.


Clinical, laboratory, and neuroimaging characteristics of fatigue in HIV-infected individuals.
Fatigue is among the most common symptoms reported by HIV-infected individuals. Previous reports suggest that the prevalence of fatigue varies by disease status with rates close to 80% in patients with AIDS. However, most studies have not been conducted in the setting of a controlled trial and have not assessed the association of fatigue with cellular markers of brain activity. Data for this study were derived from baseline and longitudinal evaluations in ACTG A5090, a randomized, double-blind, placebo-controlled trial of the Selegiline Transdermal System for the treatment of HIV-associated cognitive impairment. Fatigue was assessed using the Fatigue Severity Scale with scores of >4 considered "fatigued". Participants in a substudy underwent brain magnetic resonance spectroscopy (MRS) imaging, an in vivo method for assessing brain metabolites associated with neuronal and glia activity. Differences between fatigued and non-fatigued participants were evaluated with respect to demographics and clinical characteristics, plasma and CSF HIV-1 RNA concentration, CD4 counts, and brain metabolites. One hundred and twenty-eight participants were enrolled (88% male, median age = 45 years) and 82 participants (64%, 95% confidence interval 55%, 72%) were fatigued at baseline. MRS was conducted in 62 of the 128 participants. Fatigued participants were significantly younger (p = 0.011), had lower Karnofsky scores (p = 0.032), and had higher levels of depressive symptoms on the Center for Epidemiologic Studies Depression (CES-D) scale (p < 0.001) than non-fatigued participants. Statistically significant differences between fatigued and non-fatigued groups were not detected for plasma and CSF HIV-1RNA concentration, CD4 counts, or on neuropsychological tests. MRS revealed significantly lower levels of the cellular energy marker total creatine (p = 0.002) in the basal ganglia of fatigued participants. Statistically significant differences in other brain metabolites were not detected. Longitudinal data showed that fatigue persisted and worse fatigue at baseline was predictor of future fatigue. Among the cognitive tests, baseline Stroop score was associated with future fatigue. Fatigue was present in 64% of A5090 study participants and persisted during the 24 weeks of follow-up. Fatigue was associated with worse functional performance and depressive mood. Lower cellular energy levels in the basal ganglia, as measured by MRS total creatine concentration, suggest energy dysmetabolism in this brain region. This observation, taken together with the association between fatigue and neuropsychological tests of frontal lobe performance is consistent with the hypothesis of a striatal-cortical circuitry involvement in the symptoms of fatigue.


Dynamic interaction networks in a hierarchically organized tissue.
Intercellular (between cell) communication networks maintain homeostasis and coordinate regenerative and developmental cues in multicellular organisms. Despite the importance of intercellular networks in stem cell biology, their rules, structure and molecular components are poorly understood. Herein, we describe the structure and dynamics of intercellular and intracellular networks in a stem cell derived, hierarchically organized tissue using experimental and theoretical analyses of cultured human umbilical cord blood progenitors. By integrating high-throughput molecular profiling, database and literature mining, mechanistic modeling, and cell culture experiments, we show that secreted factor-mediated intercellular communication networks regulate blood stem cell fate decisions. In particular, self-renewal is modulated by a coupled positive-negative intercellular feedback circuit composed of megakaryocyte-derived stimulatory growth factors (VEGF, PDGF, EGF, and serotonin) versus monocyte-derived inhibitory factors (CCL3, CCL4, CXCL10, TGFB2, and TNFSF9). We reconstruct a stem cell intracellular network, and identify PI3K, Raf, Akt, and PLC as functionally distinct signal integration nodes, linking extracellular, and intracellular signaling. This represents the first systematic characterization of how stem cell fate decisions are regulated non-autonomously through lineage-specific interactions with differentiated progeny.


Capture of endogenously biotinylated proteins from Pseudomonas aeruginosa displays unexpected downregulation of LiuD upon iron nutrition.
The uptake and storage but also removal of excess iron are of utmost importance to microorganisms since surplus levels of iron may lead to the formation of reactive oxygen species. Therefore, iron homeostasis is generally tightly regulated by the ferric uptake regulator (Fur), a global iron regulator acting as a transcriptional repressor. While detecting biotinylated proteins in labelling experiments, we discovered that the endogenously biotinylated protein LiuD differentially accumulated upon iron treatment. LiuD represents the α-subunit of the methylcrotonyl-CoA-carboxylase (MCCase), an enzyme from the leucine/isovalerate utilization pathway. Real-time PCR transcription analysis revealed that the observed lower levels of LiuD biotinylation could be traced back to lower LiuD protein levels via a transcriptional repression of liuABCDE expression that however does not seem to be mediated by Fur. In accordance with LiuD's role for the leucine/isovalerate utilization pathway and its protein level regulation by nutritional iron levels, we found that wild-type Pseudomonas aeruginosa did not grow in the presence of iron if the medium contained only leucine as a carbon source. Conversely, iron stimulated the growth when glucose was used as a carbon source. Our study thus demonstrates the complexities of iron-regulated bacterial growth in Pseudomonas aeruginosa.


Design of the Coronary ARtery DIsease Genome-Wide Replication And Meta-Analysis (CARDIoGRAM) Study: A Genome-wide association meta-analysis involving more than 22 000 cases and 60 000 controls.
Recent genome-wide association studies (GWAS) of myocardial infarction (MI) and other forms of coronary artery disease (CAD) have led to the discovery of at least 13 genetic loci. In addition to the effect size, power to detect associations is largely driven by sample size. Therefore, to maximize the chance of finding novel susceptibility loci for CAD and MI, the Coronary ARtery DIsease Genome-wide Replication And Meta-analysis (CARDIoGRAM) consortium was formed. CARDIoGRAM combines data from all published and several unpublished GWAS in individuals with European ancestry; includes >22 000 cases with CAD, MI, or both and >60 000 controls; and unifies samples from the Atherosclerotic Disease VAscular functioN and genetiC Epidemiology study, CADomics, Cohorts for Heart and Aging Research in Genomic Epidemiology, deCODE, the German Myocardial Infarction Family Studies I, II, and III, Ludwigshafen Risk and Cardiovascular Heath Study/AtheroRemo, MedStar, Myocardial Infarction Genetics Consortium, Ottawa Heart Genomics Study, PennCath, and the Wellcome Trust Case Control Consortium. Genotyping was carried out on Affymetrix or Illumina platforms followed by imputation of genotypes in most studies. On average, 2.2 million single nucleotide polymorphisms were generated per study. The results from each study are combined using meta-analysis. As proof of principle, we meta-analyzed risk variants at 9p21 and found that rs1333049 confers a 29% increase in risk for MI per copy (P=2×10⁻²⁰). CARDIoGRAM is poised to contribute to our understanding of the role of common genetic variation on risk for CAD and MI.


Prepubertal social subjugation and anabolic androgenic steroid-induced aggression in male rats.
Abused children are more prone to abuse drugs, such as anabolic androgenic steroids (AAS), as teenagers and display violence as adults. AAS use has been linked with elevated aggression. Thus, exposure to child abuse and AAS may potentiate aggression. A social subjugation paradigm was used as an animal model of childhood abuse to determine whether prior subjugation increases AAS-induced aggression in male rats. Prepubertal gonadally intact male rats were exposed to social subjugation, a novel cage experience, or remained undisturbed in their home cages. Experimental males were socially subjugated by being placed in the home cage of an adult male. At puberty, both subjugated and nonsubjugated rats were injected with either the AAS testosterone or vehicle. AAS treatment continued for 5 weeks. Aggression was measured during the last week of AAS exposure. AAS was then discontinued. Aggression was again tested 12 weeks after AAS withdrawal. Aggression was tested under three conditions: (i) physical provocation of the experimental male; (ii) provocation of the intruder male; and (iii) without provocation. Both AAS-treated males and socially subjugated males displayed significantly more aggression than did controls. Elevated aggression by subjugated males was still present 17 weeks after social subjugation. AAS males also showed increased aggression 12 weeks after AAS withdrawal. However, exposure to both social subjugation and AAS had no long-term effects on aggression. The results of the present study indicate that social subjugation may have lasting consequences on the expression of adaptive social behaviours.


Alterations in filarial antigen-specific immunologic reactivity following treatment with ivermectin and diethylcarbamazine.
The presence of circulating microfilariae has been associated with alterations in B and T cell functions. In this study, we compared the influence of diethylcarbamazine (DEC) and ivermectin on filarial antigen-specific immune responses in a Haitian population. Both drugs were effective at reducing microfilaremia levels to less than 10% of pretreatment levels for up to one year. This reduction in microfilaremia was associated with two phases of altered cellular responsiveness monitored with in vitro assays. Five days post-treatment, cellular proliferation in response to both filarial and nonfilarial antigens was significantly increased, as was the background response in the absence of any antigen. At both nine months and one year post-treatment, the filarial antigen-specific reactivity of both DEC- and ivermectin-treated patients was significantly increased over baseline levels. No differences were observed between the two treatment groups in terms of humoral or cellular reactivity to filarial antigens, despite evidence suggesting a role for DEC in adult worm killing. These results provide additional evidence that microfilariae modulate antifilarial immune reactivity.


Prenatal Diagnosis of Antley-Bixler Syndrome and POR Deficiency.
Prenatal diagnosis of severe bone diseases is challenging and requires complete and precise analysis of fetal anomalies to guide genetic investigation and parental counselling. We report a rare case of Antley-Bixler syndrome prenatally diagnosed at 26 weeks' gestation by ultrasound and computed tomography in a 28-year-old woman with a history of early termination of pregnancy for "malposition of the inferior limbs". The prenatal ultrasound scan showed severe femoral bowing and frontal bossing. Taking into account the high probability of a recurrent severe skeletal disorder, a computed tomography (CT) scan was proposed. CT findings revealed bilateral femora deformation, craniosynostosis, severe midface hypoplasia, and radiohumeral synostosis. These anomalies strongly suggested Antley-Bixler syndrome. Sequencing of the POR gene in the fetus and the parents revealed compound heterozygous mutations in exon 9 and intron 7, both inherited from each parent, and this finding allowed genetic counseling. The first step in the proper prenatal diagnosis of fetal bone disorders is the precise analysis of ultrasonographic images. However, when a severe fetal inherited disorder is strongly suspected in late mid-trimester, CT may be discussed and usefully contribute to diagnosis and prognosis assessment.


The use of intraoperative graft assessment in guiding graft revision.
Quality assurance (QA) in medicine is the practice of the prevention of errors and avoiding problems when delivering care in the form of medical therapy, both in terms of non-invasive and invasive procedures. It is rightly expected by patients. Up until the last 10 years, verification of intraoperative bypass graft patency was limited to a stable hemodynamic status, lack of electrocardiographic evidence of myocardial infarction and, if available, no new regional wall motion abnormalities on transesophageal echo. This perspective outlines two technologies for QA during coronary artery bypass graft (CABG) surgery: transit-time flow measurement (TTFM) for functional assessment of coronary grafts and anatomical evaluation with epicardial ultrasound (ECUS). TTFM is a seasoned technology, used since the late 1990s. ECUS is relatively new, used since 2012. TTFM alone, although useful for intraoperative bypass graft assessment, is not enough; 10-15% of graft values are ambiguous as to the efficacy of graft function. Therefore, although newer, ECUS is already being established as an indispensable tool for quality assessment in coronary surgery. The two modalities combined are vital for 'state of the art' intraoperative bypass graft assessment.


Melatonin and its metabolites vs oxidative stress: From individual actions to collective protection.
Oxidative stress (OS) represents a threat to the chemical integrity of biomolecules including lipids, proteins, and DNA. The associated molecular damage frequently results in serious health issues, which justifies our concern about this phenomenon. In addition to enzymatic defense mechanisms, there are compounds (usually referred to as antioxidants) that offer chemical protection against oxidative events. Among them, melatonin and its metabolites constitute a particularly efficient chemical family. They offer protection against OS as individual chemical entities through a wide variety of mechanisms including electron transfer, hydrogen transfer, radical adduct formation, and metal chelation, and by repairing biological targets. In fact, many of them including melatonin can be classified as multipurpose antioxidants. However, what seems to be unique to the melatonin's family is their collective effects. Because the members of this family are metabolically related, most of them are expected to be present in living organisms wherever melatonin is produced. Therefore, the protection exerted by melatonin against OS may be viewed as a result of the combined antioxidant effects of the parent molecule and its metabolites. Melatonin's family is rather exceptional in this regard, offering versatile and collective antioxidant protection against OS. It certainly seems that melatonin is one of the best nature's defenses against oxidative damage.


Uncommon gastrointestinal complications of enteric fever in a non-endemic country.
Enteric fever is a systemic illness with varying presentation. It is an important infectious disease in developing countries and also in industrialized countries where many migrants reside. Enteric fever can result in complications in different organ systems and delay in identification and prompt treatment can be fatal. The important gastrointestinal complications of enteric fever include hepatitis, intestinal ulcers, bleeding and bowel perforation. We report three relatively uncommon complications of enteric fever in Qatar, a non-endemic country, ileal ulcer presenting with hematochezia; duodenal ulcer with polyserositis, cholestatic hepatitis and bone marrow suppression; enteric fever related peritonitis.


Organizing care for persons with psychotic disorders and risk of or existing diabetes mellitus type 2.
This literature review aimed to explore previous knowledge about specific care requirements for persons with psychotic disorders and risk of or existing type 2 diabetes. Sixteen qualitative and quantitative studies in the area were identified and summarized. The studies together indicate that mental health nurses play an important role in motivating people to perform diabetes care as they are often known to and trusted by the patients. A holistic approach to the person's health, with close follow-ups by psychiatric care and cooperation with diabetes care, may have benefits for the person with diabetes. Screening for and treating psychotic symptoms is an important task for the mental health nurse, as these symptoms drain energy from the person and prevent diabetes self-care. Lifestyle and diabetes education needs to be practical, adapted to the individual and focused on maintaining a healthy diet, regular exercise, changing smoking habits and preventing diabetes complications. Treatment with antipsychotic drugs increases the need for follow-ups of glycaemic control.


A quantitative proteomic analysis of lung epithelial (A549) cells infected with 2009 pandemic influenza A virus using stable isotope labelling with amino acids in cell culture.
Influenza A virus is one of the world's major uncontrolled pathogens, causing seasonal epidemics as well as global pandemics. This was evidenced by the recent emergence and now prevalence of the 2009 swine origin pandemic H1N1 influenza A virus. In this study, quantitative proteomics using stable isotope labelling with amino acids in cell culture was used to investigate the changes in the host cell proteome in cells infected with pandemic H1N1 influenza A virus. The study was conducted in A549 cells that retain properties similar to alveolar cells. Several global pathways were affected, including cell cycle regulation and lipid metabolism, and these could be correlated with recent microarray analyses of cells infected with influenza A virus. Taken together, both quantitative proteomics and transcriptomic approaches can be used to identify potential cellular proteins whose functions in the virus life cycle could be targeted for chemotherapeutic intervention.


Major histocompatibility complex-restricted self-recognition in responses to trinitrophenyl-Ficoll. A novel cell interaction pathway requiring self-recognition of accessory cell H-2 determinants by both T cells and B cells.
In vitro primary antibody responses to limiting concentrations of trinitrophenyl (TNP)-Ficoll were shown to be T cell dependent, requiring the cooperation of T helper (TH) cells, B cells, and accessory cells. Under these conditions, TH cells derived from long-term radiation bone marrow chimeras were major histocompatibility complex (MHC) restricted in their ability to cooperate with accessory cells expressing host-type MHC determinants. The requirement for MHC-restricted self-recognition by TNP-Ficoll-reactive B cells was assessed under these T-dependent conditions. In the presence of competent TH cells, chimeric B cells were found to be MHC restricted, cooperating only with accessory cells that expressed host-type MHC products. In contrast, the soluble products of certain monoclonal T cell lines were able to directly activate B cells in response to TNP-Ficoll, bypassing any requirement for MHC-restricted self-recognition. These findings demonstrate the existence of a novel cell interaction pathway in which B cells as well as TH cells are each required to recognize self-MHC determinants on accessory cells, but are not required to recognize each other. They further demonstrate that the requirement for self-recognition by B cells may be bypassed in certain T-dependent activation pathways.


Tardive dyskinesia and tardive dystonia with second-generation antipsychotics in non-elderly schizophrenic patients unexposed to first-generation antipsychotics: a cross-sectional and retrospective study.
This study investigates the clinical nature, prevalence rates, and associated factors of second-generation antipsychotic (SGA)-related tardive dyskinesia and tardive dystonia. To date, these subjects have not been thoroughly investigated.The subjects were 80 non-elderly schizophrenic patients who received SGAs for more than 1 year without any previous exposure to first-generation antipsychotics. Multiple (≥2) direct assessments of movement symptoms were performed. Hospital records longer than 1 recent year describing any observed tardive movement symptoms were reviewed.A current or history of tardive dyskinesia and/or tardive dystonia associated with SGA was identified in 28 (35%) subjects. These patients were being treated with risperidone (n = 15), amisulpride, olanzapine, aripiprazole, ziprasidone, or clozapine at the time of the onset of the movement symptoms. Tardive dyskinesia was mostly in the orolingual area, and the most frequently observed tardive dystonia was torticollis. The median interval between the first exposure to the SGA and the movement syndrome onset was 15 months for tardive dyskinesia and 43 months for tardive dystonia. A history of acute dystonia was significantly associated with tardive dystonia, and comorbid obsessive-compulsive syndrome was related to both tardive movement syndromes.This study indicates that more clinical attention and research efforts are needed regarding SGA-associated tardive movement syndromes, including a larger-scale prevalence assessment. This study is the first to indicate that a comorbid obsessive-compulsive syndrome might be an associated factor of tardive movement syndrome. The association warrants further investigation.


An investigation into the effect of gabapentin capsules on the reduction of nausea and vomiting after chemotherapy in cancerous patients under platinum-based treatment.
Chemotherapy-induced nausea and vomiting (CINV) is a condition that occur in most patients. This study aimed to investigate the effect of gabapentin capsules on the reduction of chemotherapy-induced nausea and vomiting in patients admitted in the hematological ward for adult patients with platinum-based treatment. The present study was a randomized clinical trial, which consisted of a control group and an experimental one. The study population consisted of 126 women and men with colonic and gastric cancer who were admitted to Ahwaz Shafa Hospital of adult hematology ward. Of these, 120 subjects were eligible to enter the study. Immediately after chemotherapy, gabapentin capsules were taken. Up to 72 hours later, nausea and vomiting were compared. Descriptive statistics was used to investigate the demographic characteristics. Paired t-test, independent t-test and ANOVA were used to compare the results. The results showed that most of the patients had gastric cancer in the experimental (70%) and control group (66.66%). The results also showed that chemotherapy-induced nausea and vomiting in gabapentin recipient group was different from the placebo group. Accordingly, chemotherapy induced nausea and vomiting in gabapentin group was lower than the placebo group. Post-operative nausea and vomiting is an unpleasant experience. Today, the patients find it worse than pain, and they believe it is hard to afford the cost of treatment. Gabapentin seems to be a good drug for reducing nausea and vomiting.


Effect of a High-Intensity, Intermittent-Exercise Protocol on Neurocognitive Function in Healthy Adults: Implications for Return-to-Play Management After Sport-Related Concussion.
Determination of return to play (RTP) after sport-related concussion (SRC) is critical given the potential consequences of premature RTP. Current RTP guidelines may not identify persistent exercise-induced neurocognitive deficits in asymptomatic athletes after SRC. Therefore, postexercise neurocognitive testing has been recommended to further inform RTP determination. To implement this recommendation, the effect of exercise on neurocognitive function in healthy athletes should be understood. To examine the acute effects of a high-intensity intermittent-exercise protocol (HIIP) on neurocognitive function assessed by the Symbol Digits Modality Test (SDMT) and Stroop Interference Test. Cohort study. University laboratory. 40 healthy male athletes (age 21.25 ± 1.29 y, education 16.95 ± 1.37 y). Each participant completed the SDMT and Stroop Interference Test at baseline and after random allocation to a condition (HIIP vs control). A mixed between-within-subjects ANOVA assessed time- (pre- vs postcondition) -by-condition interaction effects. SDMT and Stroop Interference Test scores. There was a significant time-by-condition interaction effect (P < .001, η2 = .364) for the Stroop Interference Test scores, indicating that the HIIP group scored significantly lower (56.05 ± 9.34) postcondition than the control group (66.39 ± 19.6). There was no significant time-by-condition effect (P = .997, η2 < .001) for the SDMT, indicating that there was no difference between SDMT scores for the HIIP and control groups (59.95 ± 10.7 vs 58.56 ± 14.02). In healthy athletes, the HIIP results in a reduction in neurocognitive function as assessed by the Stroop Interference Test, with no effect on function as assessed by the SDMT. Testing should also be considered after high-intensity exercise in determining RTP decisions for athletes after SRC in conjunction with the existing recommended RTP protocol. These results may provide an initial reference point for future research investigating the effects of an HIIP on the neurocognitive function of athletes recovering from SRC.


KIOM-79 protects AGE-induced retinal pericyte apoptosis via inhibition of NF-kappaB activation in vitro and in vivo.
KIOM-79 is an herbal mixture of parched Puerariae radix, gingered Magnoliae cortex, Glycyrrhizae radix and Euphorbiae radix. In the present study, we determined the efficacy and possible mechanism of KIOM-79 on the advanced glycation end product (AGE)-modified bovine serum albumin (BSA)-induced apoptosis of cultured bovine retinal pericytes and rat retinal pericytes in Zucker diabetic fatty (ZDF) rats. Seven-week-old male ZDF rats were treated with KIOM-79 (50 mg/kg body weight) once a day orally for 13 weeks. KIOM-79 significantly inhibited pericyte apoptosis which were induced by the AGE-BSA treatment. The KIOM-79 treatment markedly suppressed the activation of nuclear factor-kappaB (NF-κB) through the inhibition of inhibitory κB kinase complex. In addition, the oral administration of KIOM-79 inhibited the changes in retinal vasculature (vascular hyperpermeability, acellular capillary). KIOM-79 strongly inhibited pericyte apoptosis, NF-κB activation and the expression of pro-apoptotic Bax and tumor necrosis factor-α. Our results suggest that KIOM-79 may exert inhibitory effects on AGE-induced pericyte apoptosis by blocking NF-κB activation, thereby ameliorating retinal microvascular dysfunction.


Impact of forestry on total and methyl-mercury in surface waters: distinguishing effects of logging and site preparation.
Forestry operations can increase the export of mercury (both total and methyl) to surface waters. However, little is known about the relative contribution of different forestry practices. We address this question using a paired-catchment study that distinguishes the effects of site preparation from the antecedent logging. Runoff water from three catchments, two harvested and one untreated control, was sampled biweekly during one year prior to logging, two years after logging, and three years after site preparation. The logging alone did not significantly increase the concentrations of either total or methyl-mercury in runoff, but export increased by 50-70% in one of the harvested catchments as a consequence of increased runoff volume. The combined effects of logging and site preparation increased total and methyl-mercury concentrations by 30-50% relative to preharvest conditions in both treated catchments. The more pronounced concentration effect after site preparation compared to logging could be related to site preparation being conducted during summer. This caused more soil disturbance than logging, which was done during winter with snow covering the ground. The results suggest that the cumulative impact of forest harvest on catchment mercury outputs depends on when and how forestry operations are implemented.


Quantum Interference, Graphs, Walks, and Polynomials.
In this paper, we explore quantum interference (QI) in molecular conductance from the point of view of graph theory and walks on lattices. By virtue of the Cayley-Hamilton theorem for characteristic polynomials and the Coulson-Rushbrooke pairing theorem for alternant hydrocarbons, it is possible to derive a finite series expansion of the Green's function for electron transmission in terms of the odd powers of the vertex adjacency matrix or Hückel matrix. This means that only odd-length walks on a molecular graph contribute to the conductivity through a molecule. Thus, if there are only even-length walks between two atoms, quantum interference is expected to occur in the electron transport between them. However, even if there are only odd-length walks between two atoms, a situation may come about where the contributions to the QI of some odd-length walks are canceled by others, leading to another class of quantum interference. For nonalternant hydrocarbons, the finite Green's function expansion may include both even and odd powers. Nevertheless, QI can in some circumstances come about for nonalternants from cancellation of odd- and even-length walk terms. We report some progress, but not a complete resolution, of the problem of understanding the coefficients in the expansion of the Green's function in a power series of the adjacency matrix, these coefficients being behind the cancellations that we have mentioned. Furthermore, we introduce a perturbation theory for transmission as well as some potentially useful infinite power series expansions of the Green's function.


International mixed methods study protocol to develop a patient-reported outcome measure for all types of chronic wounds (the WOUND-Q).
Most patient-reported outcome measures (PROM) for chronic wounds are specific to a single wound type (eg, pressure ulcer) or part of the body. A barrier to outcome assessment in wound care and research is the lack of a rigorously designed PROM that can be used across wound types and locations. This mixed method study describes the protocol for an international collaboration to develop and validate a new PROM called the WOUND-Q for adults with chronic wounds. In phase I, the qualitative approach of interpretive description is used to elicit concepts important to people with wounds regarding outcome. Participants from Canada, Denmark, the Netherlands, and the USA are aged 18 years and older and have a wound that has lasted 3 months or longer. Interviews are digitally recorded, transcribed and coded. A conceptual framework and preliminary item pool are developed from the qualitative dataset. Draft scales are formed to cover important themes in the conceptual framework. These scales are refined using feedback from people with chronic wounds and wound care experts. After refinement, the scales are translated into Danish and Dutch, following rigorous methods, to prepare for an international field-test study. In phase II, data are collected in Canada, Denmark, the Netherlands, and the USA. An international sample of people with a large variety of chronic wounds complete the WOUND-Q. Rasch Measurement Theory analysis is used to identify the best subset of items to retain for each scale and to examine reliability and validity. This study is coordinated at Brigham and Women's Hospital (Boston, USA). Ethics board approval was received at each participating site for both study phases. Findings will be published in peer-reviewed journals and presented at national and international conferences and meetings.


Uncovering residual effects of chronic sleep loss on human performance.
Sleep loss leads to profound performance decrements. Yet many individuals believe they adapt to chronic sleep loss or that recovery requires only a single extended sleep episode. To evaluate this, we designed a protocol whereby the durations of sleep and wake episodes were increased to 10 and 32.85 hours, respectively, to yield a reduced sleep-to-wake ratio of 1:3.3. These sleep and wake episodes were distributed across all circadian phases, enabling measurement of the effects of acute and chronic sleep loss at different times of the circadian day and night. Despite recurrent acute and substantial chronic sleep loss, 10-hour sleep opportunities consistently restored vigilance task performance during the first several hours of wakefulness. However, chronic sleep loss markedly increased the rate of deterioration in performance across wakefulness, particularly during the circadian "night." Thus, extended wake during the circadian night reveals the cumulative detrimental effects of chronic sleep loss on performance, with potential adverse health and safety consequences.


Relationships between fat and bone.
Body weight impacts both bone turnover and bone density, making it, therefore, an important risk factor for vertebral and hip fractures and ranking it alongside age in importance. The effect of body weight is probably contributed to by both fat mass and lean mass, though in postmenopausal women, fat mass has been more consistently demonstrated to be important. A number of mechanisms for the fat-bone relationship exist and include the effect of soft tissue mass on skeletal loading, the association of fat mass with the secretion of bone active hormones from the pancreatic beta cell (including insulin, amylin, and preptin), and the secretion of bone active hormones (e.g., estrogens and leptin) from the adipocyte. These factors alone probably do not fully explain the observed clinical associations, and study of the actions on bone of novel hormones related to nutrition is an important area of further research. An understanding of this aspect of bone biology may open the way for new treatments of osteoporosis. More immediately, the role of weight maintenance in the prevention of osteoporosis is an important public health message that needs to be more widely appreciated.


Striatal graft projections are influenced by donor cell type and not the immunogenic background.
Reconstruction of CNS circuitry is a major aim of neural transplantation, and is currently being assessed clinically using foetal striatal tissue in Huntington's disease. Recent work suggests that neuronal precursors derived from foetal striatum may have a greater capacity than primary foetal striatum to project to the usual striatal target areas such as the globus pallidus and substantia nigra, raising the possibility that they have a greater potential for circuit reconstruction. However, comparing the reconstructive capacity of the two donor cells types is confounded by the fact that many precursor experiments have been carried out in a xenogeneic background in order to utilize species-specific markers for tracking the donor cells, whereas most primary foetal transplant studies have utilized an allograft paradigm. Thus, differences in immunogenic background could influence the findings; for example, xenogeneic grafts may not recognize host inhibitory signals, thereby encouraging more profuse and extensive projections. We have addressed this issue directly by comparing foetal neural precursor and primary foetal grafts in both allo- and xenograft environments using several labelling techniques, including GFP-transgenic mice and LacZ-labelled cells as donor tissue and iontophoretic injection of the anterograde tracers BDA, neurobiotin and PHA-L in the host. We present clear evidence that foetal neural precursors produce grafts with richer axonal outgrowth than primary foetal grafts, and that this is independent of the immunogenic background. Furthermore, both neural precursor and primary grafts derived from human foetal tissue produced a significantly richer outgrowth than do grafts of mouse donor tissue, which may relate to their large final graft volume and the greater intrinsic potential of human CNS neurons for greater axon elongation.


Accelerated platelet inhibition by switching from atorvastatin to a non-CYP3A4-metabolized statin in patients with high platelet reactivity (ACCEL-STATIN) study.
CYP3A4-metabolized statins can influence the pharmacodynamic effect of clopidogrel. We sought to assess the impact of switching to a non-CYP3A4-metabolized statin on platelet function among patients receiving clopidogrel and atorvastatin with high on-treatment platelet reactivity (HPR). Percutaneous coronary intervention (PCI)-treated patients (n= 50) with HPR [20 μM adenosine diphosphate (ADP)-induced maximal platelet aggregation (MPA) >50%] were enrolled during chronic administration of atorvastatin (10 mg/day) and clopidogrel (75 mg/day) (≥6 months). They were randomly assigned to a 15-day therapy with either rosuvastatin 10 mg/day (n= 25) or pravastatin 20 mg/day (n= 25). Platelet function was assessed before and after switching by conventional aggregometry and the VerifyNow P2Y12 assay. Genotyping was performed for CYP2C19*2/*3, CYP3A5*3, and ABCB1 C3435T alleles. The primary endpoint was the absolute change in 20 μM ADP-induced MPA. After switching, MPAs after stimuli with 20 and 5 μM ADP were decreased by 6.6% (95% confidence interval: 3.2-10.1%; P < 0.001), and 6.3% (95% confidence interval: 2.5-10.2%; P = 0.002), respectively. Fifty-two P2Y12 reaction units fell (95% confidence interval: 35-70; P < 0.001) and the prevalence of HPR decreased (24%; P < 0.001). Pharmacodynamic effects were similar after rosuvastatin and pravastatin therapy. In addition to smoking status, the combination of calcium channel blocker usage and ABCB1 C3435T genotype significantly affected the change of 20 μM ADP-induced MPA. Among PCI-treated patients with HPR during co-administration of clopidogrel and atorvastatin, switching to a non-CYP3A4-metabolized statin can significantly decrease platelet reactivity and the prevalence of HPR. This switching effect appears similar irrespective of the type of non-CYP3A4-metabolized statin.


Dinaciclib (SCH 727965), a novel and potent cyclin-dependent kinase inhibitor.
Cyclin-dependent kinases (CDK) are key positive regulators of cell cycle progression and attractive targets in oncology. SCH 727965 inhibits CDK2, CDK5, CDK1, and CDK9 activity in vitro with IC(50) values of 1, 1, 3, and 4 nmol/L, respectively. SCH 727965 was selected as a clinical candidate using a functional screen in vivo that integrated both efficacy and safety parameters. Compared with flavopiridol, SCH 727965 exhibits superior activity with an improved therapeutic index. In cell-based assays, SCH 727965 completely suppressed retinoblastoma phosphorylation, which correlated with apoptosis onset and total inhibition of bromodeoxyuridine incorporation in >100 tumor cell lines of diverse origin and background. Moreover, short exposures to SCH 727965 were sufficient for long-lasting cellular effects. SCH 727965 induced regression of established solid tumors in a range of mouse models following intermittent scheduling of doses below the maximally tolerated level. This was associated with modulation of pharmacodynamic biomarkers in skin punch biopsies and rapidly reversible, mechanism-based effects on hematologic parameters. These results suggest that SCH 727965 is a potent and selective CDK inhibitor and a novel cytotoxic agent.


Decreased bone remodeling and porosity are associated with improved bone strength in ovariectomized cynomolgus monkeys treated with denosumab, a fully human RANKL antibody.
This study examined the effects of denosumab, an anti-RANKL antibody that inhibits bone resorption, on bone histomorphometry in adult ovariectomized cynomolgus monkeys (OVX cynos). A month after surgery, OVX cynos were treated with subcutaneous vehicle (OVX-Veh) or denosumab (25 or 50mg/kg/month) for 16months (n=14-20/group). Sham controls were treated with vehicle (Sham-Veh; n=17). Areal and volumetric BMD, urine NTx, and serum osteocalcin were measured at baseline and months 3, 6, 12, and 16. Double fluorochrome labels were injected prior to iliac and rib biopsies at month 6 and month 12, and prior to sacrifice at month 16. Histomorphometry was performed on these biopsies, the tibial diaphysis, the L2 vertebra, and the proximal femur. Strength of humeral cortical beams, femur diaphysis, femur neck, and trabecular cores of L5-L6 vertebrae was determined by destructive biomechanical testing. There was no evidence of woven bone, osteomalacia, or other bone histopathologic changes with OVX or with denosumab. OVX-Veh animals exhibited significantly greater bone remodeling at all skeletal sites relative to Sham-Veh controls. Both doses of denosumab markedly inhibited bone remodeling at all sites, including significant reductions in trabecular eroded surfaces (48-86% lower than OVX-Veh controls), cortical porosity (28-72% lower), and dynamic parameters of bone formation (81-100% lower). Decreased fluorochrome labeling with denosumab was related to reductions in cortical porosity and trabecular eroded surfaces, and regression analyses suggested that these reductions contributed to denosumab-related increments in BMD and bone strength. Denosumab-treated animals with the lowest levels of fluorescent labeling exhibited the greatest structural bone strength values at each site. Intracortical remodeling had no relationship with material properties including ultimate strength, elastic modulus or toughness (r(2)=0.00-0.01). These data suggest that remodeling inhibition with denosumab improved structural strength without altering material properties under these experimental conditions. Greater structural strength in the denosumab-treated animals can be primarily explained by the combined effects of increased trabecular and cortical bone mass, and reductions in trabecular eroded surfaces and cortical porosity.


Effect of structural analogues of PAF-acether on platelet desensitization.
The 1-O-alkyl-2-O-acetyl-sn-glyceryl-3-phosphorylcholine (PAF-acether) aggregates rabbit platelets and desensitizes them to a second challenge with the same agonist but not to arachidonic acid. The desensitizing activities of 14 analogues of PAF-acether were explored with particular attention to the dose-response dependency of the desensitization process. PAF-acether was 500-fold more active than its 1-O-acyl analogues. The 2-lyso PAF-acether was inactive and the PAF-acether enantiomer 2000 times less effective than the natural isomer, thus confirming the importance of the presence and steric position of the 2-acetate group. The desensitizing activities of the 2-propionyl and the 2-butyryl analogues were close to that of PAF-acether. Substituting an ether to an ester bond at the 2-position indicated that the number of carbon of the 2-substituant seems more determinant than the nature of the linkage for the desensitizing process. Indeed, the 2-ethoxy and the 2-methoxy analogues were 87 and 5000 times less active than PAF-acether respectively. The presence of methyl groups on the nitrogen base is also critical to desensitize platelets. The desensitizing potency of the tested phospholipids was always identical to their aggregating efficiency. It is suggested that these compounds activate cells through a common mechanism.


Description of the female of Navicordulia aemulatrix Pinto & Lamas and additional notes on the male (Odonata: Corduliidae).
The female of Navicordulia aemulatrix Pinto & Lamas is described and illustrated for the first time based on a single specimen from the same locality of the type series (state of Santa Catarina, [municipality of São Bento do Sul, 26°14'58"S, 49°22'59"W, railroad station] Rio Vermelho, 29.I.1952, in MZSP). In addition, further morphological notes for the male are provided based on three specimens collected at the type locality and at a new locality in the state of Santa Catarina (Timbó municipality). The pronotal process present in N. aemulatrix is re-evaluated and considered non-homologous to that found in Neocordulia setifera (Hagen in Selys) as previously suggested.


Genome of a middle Holocene hunter-gatherer from Wallacea.
Much remains unknown about the population history of early modern humans in southeast Asia, where the archaeological record is sparse and the tropical climate is inimical to the preservation of ancient human DNA1. So far, only two low-coverage pre-Neolithic human genomes have been sequenced from this region. Both are from mainland Hòabìnhian hunter-gatherer sites: Pha Faen in Laos, dated to 7939-7751 calibrated years before present (yr cal BP; present taken as AD 1950), and Gua Cha in Malaysia (4.4-4.2 kyr cal BP)1. Here we report, to our knowledge, the first ancient human genome from Wallacea, the oceanic island zone between the Sunda Shelf (comprising mainland southeast Asia and the continental islands of western Indonesia) and Pleistocene Sahul (Australia-New Guinea). We extracted DNA from the petrous bone of a young female hunter-gatherer buried 7.3-7.2 kyr cal BP at the limestone cave of Leang Panninge2 in South Sulawesi, Indonesia. Genetic analyses show that this pre-Neolithic forager, who is associated with the 'Toalean' technocomplex3,4, shares most genetic drift and morphological similarities with present-day Papuan and Indigenous Australian groups, yet represents a previously unknown divergent human lineage that branched off around the time of the split between these populations approximately 37,000 years ago5. We also describe Denisovan and deep Asian-related ancestries in the Leang Panninge genome, and infer their large-scale displacement from the region today.


Chronic PFOS exposures induce life stage-specific behavioral deficits in adult zebrafish and produce malformation and behavioral deficits in F1 offspring.
Perfluorooctane sulfonic acid (PFOS) is an organic contaminant that is ubiquitous in the environment. Few studies have assessed the behavioral effects of chronic PFOS exposure in aquatic organisms. The present study defined the behavioral effects of varying life span chronic exposures to PFOS in zebrafish. Specifically, zebrafish were exposed to control or 0.5 µM PFOS during 1 to 20, 21 to 120, or 1 to 120 d postfertilization (dpf). Exposure to PFOS impaired the adult zebrafish behavior mode under the tapping stimulus. The movement speed of male and female fish exposed for 1 to 120 dpf was significantly increased compared with control before and after tapping, whereas in the groups exposed for 1 to 20 and 21 to 120 dpf, only the males exhibited elevated swim speed before tapping. Residues of PFOS in F1 embryos derived from parental exposure for 1 to 120 and 21 to 120 dpf were significantly higher than control, and F1 embryos in these two groups also showed high malformation and mortality. The F1 larvae of parental fish exposed to PFOS for 1 to 20 or 21 to 120 dpf exhibited a higher swimming speed than control larvae in a light-to-dark behavior assessment test. The F1 larvae derived from parental fish exposed to PFOS for 1 to 120 dpf showed a significantly lower speed in the light period and a higher speed in the dark period compared with controls. Although there was little PFOS residue in embryos derived from the 1- to 20-dpf parental PFOS-exposed group, the adverse behavioral effects on both adult and F1 larvae indicate that exposure during the first 21 dpf induces long-term neurobehaviorial toxicity. The authors' findings demonstrate that chronic PFOS exposure during different life stages adversely affects adult behavior and F1 offspring morphology, behavior, and survival.


The ordinary work environment increases symptoms from eyes and airways in mild steel welders.
We aimed to follow diary-registered symptoms from eyes and airways in mild steel welders and relate them to different exposure measures. Furthermore, we would clarify the influence of possible effect modifiers. Non-smoking welders with (N = 74) and without (N = 32) work-related symptoms the last month were enroled. Symptoms and work tasks each day for three two-week periods during 1 year were obtained. Respirable dust (RD) was measured 1 day each period for each worker. The personal daily exposure was assessed as: (1) days at work, (2) welding time and (3) estimates of RD from welding and grinding, calculated from diary entries and measurements. Only 9.2 % of the particle measurements exceed the Swedish occupational exposure limit (OEL; 5 mg/m(3)). Days at work increased the risk of symptoms studied: eyes: 1.79 (1.46-2.19), nasal: 2.16 (1.81-2.58), dry cough: 1.50 (1.23-1.82) and wheezing and/or dyspnoea: 1.27 (1.03-1.56; odds ratio, 95 % confidence interval). No clear dose-response relationships were found for the other exposure estimates. Eye symptoms increased by number of years welding. Nasal symptoms and dry cough increased having forced expiratory volume in first second below median at baseline. Wheezing and/or dyspnoea increased in winter, by number of years welding, having a negative standard skin-prick test and having a vital capacity above median at baseline. The current Swedish OEL may not protect welders against eye and airway symptoms. The results add to the evidence that welders should be offered regular medical surveillance from early in the career.


Chlorinated coumarins from the polypore mushroom Fomitopsis officinalis and their activity against Mycobacterium tuberculosis.
An EtOH extract of the polypore mushroom Fomitopsis officinalis afforded two new naturally occurring chlorinated coumarins, which were identified as the previously synthesized compounds 6-chloro-4-phenyl-2H-chromen-2-one (1) and ethyl 6-chloro-2-oxo-4-phenyl-2H-chromen-3-carboxylate (2). The structures of the two isolates were deduced by ab initio spectroscopic methods and confirmed by chemical synthesis. In addition, an analogue of each was synthesized as 7-chloro-4-phenyl-2H-chromen-2-one (3) and ethyl 7-chloro-2-oxo-4-phenyl-2H-chromen-3-carboxylate (4). All four compounds were characterized physicochemically, and their antimicrobial activity profiles revealed a narrow spectrum of activity with lowest MICs against the Mycobacterium tuberculosis complex.


The BH3 mimetic ABT-737 induces cancer cell senescence.
ABT-737, a small molecule cell-permeable Bcl-2 antagonist that acts by mimicking BH3 proteins, induces apoptotic cell death in multiple cancer types. However, when incubated with this agent many solid tumor cell lines do not undergo apoptosis. The current study reveals a novel mechanism whereby ABT-737 when added to apoptosis-resistant cancer cells has profound biologic effects. In PV-10 cells, a renal cell carcinoma that does not die after ABT-737 treatment, this agent induces a two-fold change in the transcription of nearly 430 genes. Many of these induced mRNA changes are in secreted proteins, IL-6, IL-8, and IL-11 and chemokines CXCL2 and CXCL5, or genes associated with an "inflammatory" phenotype. Strikingly, these gene changes are highly similar to those changes previously identified in cellular senescence. Brief exposure of apoptosis-resistant renal, lung and prostate cancer cell lines to ABT-737, although not capable of inducing cell death, causes the induction of senescence-associated β-galactosidase and inhibition of cell growth consistent with the induction of cellular senescence. Evidence indicates that the induction of senescence occurs as a result of reactive oxygen species elevation followed by low-level activation of the caspase cascade, insufficient to induce apoptosis, but sufficient to lead to minor DNA damage and increases in p53, p21, IL-6 and 8 proteins. By overexpression of a dominant-negative p53 protein, we show that ABT-737-induced cellular senescence is p53-dependent. Thus, in multiple cancer types in which ABT-737 is incapable of causing cell death, ABT-737 may have additional cellular activities that make its use as an anticancer agent highly attractive.


Paclitaxel-induced neuropathic hypersensitivity in mice: responses in 10 inbred mouse strains.
Mechanical allodynia, or hypersensitivity to tactile stimuli, is a frequent clinical symptom of neuropathy. Large interindividual differences have been observed in neuropathic pain, both in susceptibility to its development and in its severity. Identification of genetic factors relevant to this variability would be of obvious utility. Although many animal models of neuropathic pain following peripheral nerve injury have been developed, most involve intricate surgeries and are thus poorly suited for large-scale linkage mapping investigations in the mouse. Recently, a schedule of intraperitoneal injections of the chemotherapeutic agent, paclitaxel (Taxol(R)), has been shown to produce a long-lasting, bilateral neuropathy in the rat, featuring hypersensitivity to mechanical, thermal and cold stimuli. We present here a survey of the responses of 10 inbred mouse strains to paclitaxel injections. Virtually all strains developed statistically significant mechanical allodynia, with one strain, DBA/2J, exhibiting especially robust changes. Strain sensitivities to paclitaxel-induced mechanical allodynia were similar to those obtained previously using a surgical model of neuropathic pain, supporting our contention that genetic sensitivity to mechanical allodynia is independent of the precise mode of induction. Using sensitive DBA/2 mice and a resistant strain, C57BL/6J, for comparison, we further characterized the paclitaxel model in mice by examining cold allodynia and thermal hyperalgesia. Both strains displayed equivalent cold allodynia but neither strain developed thermal hyperalgesia. The present data confirm a genetic component in mechanical allodynia using this model, while dissociating mechanical hypersensitivity from other pain modalities.


Serum C-peptide, Total and High Molecular Weight Adiponectin, and Pancreatic Cancer: Do Associations Differ by Smoking?
Background: Studies examining associations between circulating concentrations of C-peptide and total adiponectin, two biomarkers related to obesity and insulin secretion and sensitivity and pancreatic ductal adenocarcinoma (PDA) risk have shown inconsistent results and included limited numbers of smokers.Methods: We examined associations of these biomarkers and high molecular weight (HMW) adiponectin with PDA, overall, and by smoking status. We conducted a pooled nested case-control analysis in 3 cohorts (Prostate, Lung, Colorectal, and Ovarian Cancer Trial, Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study, and Cancer Prevention Study-II), with 758 cases (435 current smokers) and 1,052 controls (531 smokers) matched by cohort, age, sex, race, blood draw date and follow-up time. We used conditional logistic regression adjusted for age, smoking, diabetes, and body mass index to calculate ORs and 95% confidence intervals (CI).Results: Circulating C-peptide concentration was not associated with PDA in never or former smokers, but was inversely associated with PDA in current smokers (per SD OR = 0.67; 95% CI, 0.54-0.84; Pinteraction = 0.005). HMW adiponectin was inversely associated with PDA in never smokers (OR = 0.43; 95% CI, 0.23-0.81), not associated in former smokers, and positively associated in smokers (OR = 1.23; 95% CI, 1.04-1.45; Pinteraction = 0.009). Total adiponectin was not associated with PDA in nonsmokers or current smokers.Conclusions: Associations of biomarkers of insulin secretion and sensitivity with PDA differ by smoking status. Smoking-induced pancreatic damage may explain the associations in smokers while mechanisms related to insulin resistance associations in nonsmokers.Impact: Future studies of these biomarkers and PDA should examine results by smoking status. Cancer Epidemiol Biomarkers Prev; 26(6); 914-22. ©2017 AACR.


Reversible severe hepatitis in anorexia nervosa: a case report and overview.
Mildly elevated transaminases are often observed in anorexia nervosa patients, but severe hepatitis is less common. We suggest that hypoperfusion is the pathogenetic factor that causes severe hepatitis in a patient with a very poor nutritional status and present an overview of previous case reports. In our patient, early initiation of intravenous fluids resulted in rapid recovery of the liver test abnormalities, despite minimal oral caloric intake, the refusal of enteral feeding and the development of a hypoglycemic coma. Two months after admission, transaminases had normalized. Reversible severe hepatitis has been described in most of the cases, with only one anorexia nervosa-related fatal hepatitis. In general, both adequate hydration and gradual enteral feeding with monitoring of electrolytes are essential in the management of anorexia patients with severe hepatitis.


Tripodal mandibular subperiosteal implant: basic sciences, operational procedures, and clinical data.
A tripodal mandibular subperiosteal dental implant is a three piece cast metal framework that fits on the residual ridge beneath the periosteum and provides support for a dental prosthesis by means of posts or other mechanisms protruding through the oral mucosa. This implant is indicated in patients with advanced atrophy of the mandible where the unstable alveolar bone has completely disappeared, leaving in place the more stable basal bone with specific anatomical contours. The authors present their experience of 317 cases carried out in three different centers related to this implant modality and underline the importance of the basic anatomic, physiologic, and medical knowledge required to optimize the results.


Assessment of Heart Failure Patients' Interest in Mobile Health Apps for Self-Care: Survey Study.
Heart failure is a serious public health concern that afflicts millions of individuals in the United States. Development of behaviors that promote heart failure self-care may be imperative to reduce complications and avoid hospital re-admissions. Mobile health solutions, such as activity trackers and smartphone apps, could potentially help to promote self-care through remote tracking and issuing reminders. The objective of this study was to ascertain heart failure patients' interest in a smartphone app to assist them in managing their treatment and symptoms and to determine factors that influence their interest in such an app. In the clinic waiting room on the day of their outpatient clinic appointments, 50 heart failure patients participated in a self-administered survey. The survey comprised 139 questions from previously published, institutional review board-approved questionnaires. The survey measured patients' interest in and experience using technology as well as their function, heart failure symptoms, and heart failure self-care behaviors. The Minnesota Living with Heart Failure Questionnaire (MLHFQ) was among the 11 questionnaires and was used to measure the heart failure patients' health-related quality of life through patient-reported outcomes. Participants were aged 64.5 years on average, 32% (16/50) of the participants were women, and 91% (41/45) of the participants were determined to be New York Heart Association Class II or higher. More than 60% (30/50) of the survey participants expressed interest in several potential features of a smartphone app designed for heart failure patients. Participant age correlated negatively with interest in tracking, tips, and reminders in multivariate regression analysis (P<.05). In contrast, MLHFQ scores (worse health status) produced positive correlations with these interests (P<.05). The majority of heart failure patients showed interest in activity tracking, heart failure symptom management tips, and reminder features of a smartphone app. Desirable features and an understanding of factors that influence patient interest in a smartphone app for heart failure self-care may allow researchers to address common concerns and to develop apps that demonstrate the potential benefits of mobile technology.


A Cryptic Marine Ciliate Feeds on Progametes of Noctiluca scintillans.
The dinoflagellate Noctiluca scintillans (Noctiluca) has the ability to reproduce sexually, which may help to increase or restore its population size during periods of blooms or environmental stress. Here, we documented for the first time a marine ciliate Strombidium sp. that feeds on Noctiluca's progametes undergoing stages 5 to 9 of nuclear division. This ciliate frequently swam on or around gametogenic and some vegetative Noctiluca cells. The ciliates associated with gametogenic cells had significantly lower swimming speed and changed direction more frequently than those associated with vegetative cells, which overall increased their time spent around the food patches (progametes). This trophic interaction constitutes an upside-down predator-prey link, in which ciliates within the typical size range of Noctiluca prey, become the predators. Based on the phylogenetic tree (maximum-likelihood), there are 14 environmental clones similar to Strombidium sp. found in other coastal waters, where Noctiluca presence or blooms have been reported. This novel predator-prey relationship could therefore be common in other Noctiluca habitats. Additional studies are needed to assess the magnitude of its impacts on Noctiluca population dynamics and plankton bloom succession.