A tomographic reconstruction algorithm for cross-sectional imaging of IMRT beams from six projections.
Objective. Patient-specific Quality Assurance (QA) measurements are of key importance in radiotherapy for safe and efficient treatment delivery and allow early detection of clinically relevant errors. Such QA processes remain challenging to implement for complex Intensity Modulated Radiation Therapy (IMRT) radiotherapy fields delivered using a multileaf collimator (MLC) which often feature small open segments and raise QA issues similar to those encountered in small field dosimetry. Recently, detectors based on long scintillating fibers have been proposed to measure a few parallel projections of the irradiation field with good performance for small field dosimetry. The purpose of this work is to develop and validate a novel approach to reconstruct MLC-shaped small irradiation fields from six projections.Approach. The proposed field reconstruction method uses a limited number of geometric parameters to model the irradiation field. These parameters are iteratively estimated with a steepest descent algorithm. The reconstruction method was first validated on simulated data. Real data were measured with a water-equivalent slab phantom equipped with a detector made of 6 scintillating-fiber ribbons placed at 1 m from the source. A radiochromic film was used to acquire a reference measurement of a first dose distribution in the slab phantom at the same source-to-detector distance and the treatment planning system (TPS) provided the reference for another dose distribution. In addition, simulated errors introduced on the delivered dose, field location and field shape were used to evaluate the ability of the proposed method to efficiently identify a deviation between the planned and delivered treatments.Main results. For a first small IMRT segment, 3%/3 mm, 2%/2 mm and 2%/1 mm gamma analysis conducted between the reconstructed dose distribution and the dose measured with radiochromic film exhibited pass rates of 100%, 99.9% and 95.7%, respectively. For a second and smaller IMRT segment, the same gamma analysis performed between the reconstructed dose distribution and the reference provided by the TPS showed pass rates of 100%, 99.4% and 92.6% for the 3%/3 mm, 2%/2 mm and 2%/1 mm gamma criteria, respectively. Gamma analysis of the simulated treatment delivery errors showed the ability of the reconstruction algorithm to detect a 3% deviation between the planned and delivered doses, as well as shifts lower than 7 mm and 3 mm when considering an individual leaf and a whole field shift, respectively.Significance. The proposed method allows accurate tomographic reconstruction of IMRT segments by processing projections measured with six scintillating-fiber ribbons and is suitable for water-equivalent real-time small IMRT segments QA.


Pregnancy does not influence colonic polyp multiplicity but may modulate upper gastrointestinal disease in patients with FAP.
Reproductive factors have been shown by epidemiology studies to alter colorectal cancer risk in women. Familial adenomatous polyposis (FAP) patients carry a germline adenomatous polyposis coli (APC) mutation predisposing to multiple adenoma formation in the intestine. The Min mouse provides a good model of FAP, and we recently reported a significant increase in intestinal tumour multiplicity in a recombinant line of mice following pregnancy. We considered whether reproduction modulates intestinal tract disease in a large cohort of female patients with FAP (n = 180). Multiple regression analysis showed that the number of colonic polyps observed was not related to the person's pregnancy status nor the position of their APC germline mutation. The proportion of women attaining a high Spigelman stage (3 or 4) was unrelated to having a pregnancy prior to attaining the maximum Spigelman stage (p = 0.6). On the other hand, having a pregnancy significantly increased the proportion of women that attained the highest Spigelman stage when their APC germline mutation occurred within the mutation cluster region or at or after codon 1020 (50%, 6/12, p = 0.005 and 42%, 13/31, p = 0.006, respectively; multivariable logistic regression). Our data suggest that reproduction may influence disease severity in the upper gastrointestinal tract in patients with FAP.


An Optokinetic Nystagmus Detection Method for Use With Young Children.
The detection of vision problems in early childhood can prevent neurodevelopmental disorders such as amblyopia. However, accurate clinical assessment of visual function in young children is challenging. optokinetic nystagmus (OKN) is a reflexive sawtooth motion of the eye that occurs in response to drifting stimuli, that may allow for objective measurement of visual function in young children if appropriate child-friendly eye tracking techniques are available. In this paper, we present offline tools to detect the presence and direction of the optokinetic reflex in children using consumer grade video equipment. Our methods are tested on video footage of children ([Formula: see text] children and 20 trials) taken as they freely observed visual stimuli that induced horizontal OKN. Using results from an experienced observer as a baseline, we found the sensitivity and specificity of our OKN detection method to be 89.13% and 98.54%, respectively, across all trials. Our OKN detection results also compared well (85%) with results obtained from a clinically trained assessor. In conclusion, our results suggest that OKN presence and direction can be measured objectively in children using consumer grade equipment, and readily implementable algorithms.


The Importance of Endogenously Secreted GLP-1 and GIP for Postprandial Glucose Tolerance and β-Cell Function After Roux-en-Y Gastric Bypass and Sleeve Gastrectomy Surgery.
Enhanced secretion of glucagon-like peptide 1 (GLP-1) seems to be essential for improved postprandial β-cell function after Roux-en-Y gastric bypass (RYGB) but is less studied after sleeve gastrectomy (SG). Moreover, the role of the other major incretin hormone, glucose-dependent insulinotropic polypeptide (GIP), is relatively unexplored after bariatric surgery. We studied the effects of separate and combined GLP-1 receptor (GLP-1R) and GIP receptor (GIPR) blockade during mixed-meal tests in unoperated (CON), SG-operated, and RYGB-operated people with no history of diabetes. Postprandial GLP-1 concentrations were highest after RYGB but also higher after SG compared with CON. In contrast, postprandial GIP concentrations were lowest after RYGB. The effect of GLP-1R versus GIPR blockade differed between groups. GLP-1R blockade reduced β-cell glucose sensitivity and increased or tended to increase postprandial glucose responses in the surgical groups but had no effect in CON. GIPR blockade reduced β-cell glucose sensitivity and increased or tended to increase postprandial glucose responses in the CON and SG groups but had no effect in the RYGB group. Our results support that GIP is the most important incretin hormone in unoperated people, whereas GLP-1 and GIP are equally important after SG, and GLP-1 is the most important incretin hormone after RYGB.


PPARα activation can help prevent and treat non-small cell lung cancer.
Non-small cell lung cancer (NSCLC) not amenable to surgical resection has a high mortality rate, due to the ineffectiveness and toxicity of chemotherapy. Thus, there remains an urgent need of efficacious drugs that can combat this disease. In this study, we show that targeting the formation of proangiogenic epoxyeicosatrienoic acids (EET) by the cytochrome P450 arachidonic acid epoxygenases (Cyp2c) represents a new and safe mechanism to treat NSCLC growth and progression. In the transgenic murine K-Ras model and human orthotopic models of NSCLC, we found that Cyp2c44 could be downregulated by activating the transcription factor PPARα with the ligands bezafibrate and Wyeth-14,643. Notably, both treatments reduced primary and metastatic NSCLC growth, tumor angiogenesis, endothelial Cyp2c44 expression, and circulating EET levels. These beneficial effects were independent of the time of administration, whether before or after the onset of primary NSCLC, and they persisted after drug withdrawal, suggesting the benefits were durable. Our findings suggest that strategies to downregulate Cyp2c expression and/or its enzymatic activity may provide a safer and effective strategy to treat NSCLC. Moreover, as bezafibrate is a well-tolerated clinically approved drug used for managing lipidemia, our findings provide an immediate cue for clinical studies to evaluate the utility of PPARα ligands as safe agents for the treatment of lung cancer in humans.


A Comparison of Adherence Timeframes Using Missed Dose Items and Their Associations with Viral Load in Routine Clinical Care: Is Longer Better?
Questions remain regarding optimal timeframes for asking about adherence in clinical care. We compared 4-, 7-, 14-, 30-, and 60-day timeframe missed dose items with viral load levels among 1099 patients on antiretroviral therapy in routine care. We conducted logistic and linear regression analyses examining associations between different timeframes and viral load using Bayesian model averaging (BMA). We conducted sensitivity analyses with subgroups at increased risk for suboptimal adherence (e.g. patients with depression, substance use). The 14-day timeframe had the largest mean difference in adherence levels among those with detectable and undetectable viral loads. BMA estimates suggested the 14-day timeframe was strongest overall and for most subgroups although findings differed somewhat for hazardous alcohol users and those with current depression. Adherence measured by all missed dose timeframes correlated with viral load. Adherence calculated from intermediate timeframes (e.g. 14-day) appeared best able to capture adherence behavior as measured by viral load.


Dietary Fiber, Whole Grains, and Head and Neck Cancer Prognosis: Findings from a Prospective Cohort Study.
No studies, to date, have examined the relationship between dietary fiber and recurrence or survival after head and neck cancer diagnosis. The aim of this study was to determine whether pretreatment intake of dietary fiber or whole grains predicted recurrence and survival outcomes in newly diagnosed head and neck cancer (HNC) patients. This was a prospective cohort study of 463 participants baring a new head and neck cancer diagnosis who were recruited into the study prior to the initiation of any cancer therapy. Baseline (pre-treatment) dietary and clinical data were measured upon entry into the study cohort. Clinical outcomes were ascertained at annual medical reviews. Cox proportional hazard models were fit to examine the relationships between dietary fiber and whole grain intakes with recurrence and survival. There were 112 recurrence events, 121 deaths, and 77 cancer-related deaths during the study period. Pretreatment dietary fiber intake was inversely associated with risk of all-cause mortality (hazard ratio (HR): 0.37, 95% confidence interval (CI): 0.14-0.95, ptrend = 0.04). No statistically significant associations between whole grains and prognostic outcomes were found. We conclude that higher dietary fiber intake, prior to the initiation of treatment, may prolong survival time, in those with a new HNC diagnosis.


Predicting outcome of children with diffuse intrinsic pontine gliomas using multiparametric imaging.
Noninvasive evaluation using MRI is the primary means to routinely assess children with diffuse intrinsic pontine gliomas (DIPGs). However, no standard MR sequence has correlated with outcome in these patients. In this study, patients with DIPGs were assessed to determine the combined prognostic value via dynamic susceptibility contrast (DSC) MRI, single-voxel spectroscopy (SVS), multivoxel MR spectroscopy (MRS), and T1-weighted post-gadolinium imaging. Eligible patients had clinical and radiographic findings consistent with a DIPG. Imaging studies were acquired on a 1.5T MRI at various time points during each patient's course. Data were evaluated using a Cox proportional hazard model, a time-dependent covariant Cox model, a Wald test, and a Kaplan-Meier analysis. Ninety-eight studies were performed on 34 patients of median age 5.5 years. Median survival from diagnosis was 468 days. At baseline imaging only, increased ratio of choline to n-acetylaspartate (Cho:NAA) on SVS and increased perfusion on DSC-MRI each predicted shorter survival (relative risk [RR] = 1.48, P = .015 and RR = 4.91, P = .0012, respectively). When analyzing all subsequent time points, increased maximum Cho:NAA on MRS (RR = 1.45, P = .042), increased Cho:NAA on SVS (RR = 1.69, P = .003), increased perfusion (RR = 4.68, P = .0016), and the presence of enhancement (RR = 5.69, P = .022) each predicted shorter survival. Kaplan-Meier analysis showed shorter survival associated with increased perfusion at baseline (P = .0004). Increased perfusion at any time point predicts a significantly shorter survival in children with DIPG. In addition, enhancement, increased Cho:NAA on SVS, and increased maximum Cho:NAA on chemical shift imaging are predictive of shorter survival over time. Routine baseline and subsequent imaging for children with DIPG should, at minimum, incorporate DSC-MRI and SVS.


Comparison of ¹⁸F-fluoride PET/CT, ¹⁸F-FDG PET/CT and bone scintigraphy (planar and SPECT) in detection of bone metastases of differentiated thyroid cancer: a pilot study.
We compared the efficacies of ¹⁸F-fluoride positron emission tomography (¹⁸F-fluoride PET)/CT, ¹⁸F-fludeoxyglucose PET (¹⁸F-FDG PET)/CT, and ⁹⁹mTc bone scintigraphy [planar and single photon emission CT (SPECT)] for the detection of bone metastases in patients with differentiated thyroid carcinoma (DTC). We examined 11 patients (8 females and 3 males; mean age 6 standard deviation, 61.968.7 years) with DTC who had been suspected of having bone metastases after total thyroidectomy and were hospitalized to be given ¹³¹I therapy. Bone metastases were verified either when positive findings were obtained on both ¹³¹I scintigraphy and CT or when MRI findings were positive if MRI was performed. Metastases were confirmed in 24 (13.6%) of 176 bone segments in 9 (81.8%) of the 11 patients. The sensitivities of ¹⁸F-fluoride PET/CT and ⁹⁹mTc bone scintigraphy (SPECT) were significantly higher than those of ¹⁸F-FDG PET/CT and ⁹⁹mTc bone scintigraphy (planar) (p,0.05). The accuracies of ¹⁸F-fluoride PET/CT and mTc bone scintigraphy (SPECT) were significantly higher than that of ⁹⁹mTc bone scintigraphy (planar) (p,0.05). The sensitivity and accuracy of ¹⁸F-fluoride PET/CT for the detection of bone metastases of DTC are significantly higher than those of ⁹⁹mTc bone scintigraphy (planar). However, the sensitivity and accuracy of ⁹⁹mTc bone scintigraphy (planar) are improved near to those of ¹⁸F-fluoride PET/CT when SPECT is added to a planar scan. The sensitivity of ¹⁸F-FDG PET/CT is significantly lower than that of 18F-fluoride PET/CT or ⁹⁹mTc bone scintigraphy (SPECT).


Isomerism in benzyl-DOTA derived bifunctional chelators: implications for molecular imaging.
The bifunctional chelator IB-DOTA has found use in a range of biomedical applications given its ability to chelate many metal ions, but in particular the lanthanide(III) ions. Gd(3+) in particular is of interest in the development of new molecular imaging agents for MRI and is highly suitable for chelation by IB-DOTA. Given the long-term instability of the aryl isothiocyanate functional group we have used the more stable nitro derivative (NB-DOTA) to conduct a follow-up study of some of our previous work on the coordination chemistry of chelates of these BFCs. Using a combination of NMR and HPLC to study the Eu(3+) and Yb(3+) chelates of NB-DOTA, we have demonstrated that this ligand will produce two discrete regioisomeric chelates at the point at which the metal ion is introduced into the BFC. These regioisomers are defined by the position of the benzylic substituent on the macrocyclic ring: adopting an equatorial position either at the corner or the side of the [3333] ring conformation. These regioisomers are incapable of interconversion and are distinct, separate structures with different SAP/TSAP ratios. The side isomer exhibits an increased population of the TSAP isomer, pointing to more rapid water exchange kinetics in this regioisomer. This has potential ramifications for the use of these two regioisomers of Gd(3+)-BFC chelates in MRI applications. We have also found that, remarkably, there is little or no freedom of rotation about the first single bond extending from the macrocyclic ring to the benzylic substituent. Since this is the linkage through which the chelate is conjugated to the remainder of the molecular imaging probe, this result implies that there may be reduced local rotation of the Gd(3+) chelate within a molecular imaging probe. This implies that this type of BFC could exhibit higher relaxivities than other types of BFC.


Colorimetric and ratiometric fluorescent chemosensor based on diketopyrrolopyrrole for selective detection of thiols: an experimental and theoretical study.
A colorimetric and ratiometric fluorescent thiol probe was devised with diketopyrrolopyrrole (DPP) fluorophore. The probe gives absorption and emission at 523 and 666 nm, respectively. In the presence of thiols, such as cysteine, the absorption and emission band shifted to 479 and 540 nm, respectively. Correspondingly, the color of the probe solution changed from purple to yellow, and the fluorescence changed from red to yellow. The emission intensity at 540 nm was enhanced by 140-fold. The Stokes shift of probe 1 (107 nm) is much larger than the unsubstituted DPP fluorophore (56 nm). Mass spectral analysis demonstrated that besides the expected Michael addition of thiols to the C═C bonds, the CN groups of the malonitrile moieties also react with thiols to form 4,5-dihydrothiazole structure. Probe 1 was used for fluorescence imaging of intracellular thiols. In the presence of thiols, both the green and red channel of the microscopy are active. With removal of the intracellular thiols, signal can only be detected through the red channel; thus, ratiometric bioimaging of intracellular thiols was achieved. The ratiometric response of probe 1 was rationalized by DFT calculations. Our complementary experimental and theoretical studies will be useful for design of ratiometric/colorimetric molecular probes.


Solar photo-Fenton with simultaneous addition of ozone for the treatment of real industrial wastewaters.
Simultaneous application of solar photo-Fenton and ozonation (SPFO) for the efficient treatment of real wastewaters was studied. Four different industrial effluents were selected for the study: landfill leachate, pharmaceutical effluent and two textile wastewaters, in order to demonstrate the effectiveness and versatility of the proposed technology. SPFO performance was compared with individual processes (either solar photo-Fenton or ozonation), as well as the hybrid Fenton and ozonation treatment. In highly polluted wastewaters, combined strategies led to higher organic matter removal than O3 and photo-Fenton processes applied individually. Solar light favoured catalyst regeneration, allowing removal efficiencies up to 67% of chemical oxygen demand (COD) and 62% of total organic carbon (TOC) (in the case of textile wastewaters) using an initial concentration of only 10 mg Fe2+ L-1. The reduction of catalyst consumption, along with the absence of sludge production (since Fe2+ removal from the effluent is not required), led to a significant decrease in operational costs (up to 1.22 € kg-1 COD removed) when combined Fenton and ozonation was applied under solar light. SPFO results in a versatile, effective and economically efficient technology, thus postulating as a promising alternative for reducing the organic load of highly polluted industrial effluents prior to biological treatment.


The potential and challenges of alternative sources of β cells for the cure of type 1 diabetes.
The experience in the field of islet transplantation shows that it is possible to replace β cells in a patient with type 1 diabetes (T1D), but this cell therapy is limited by the scarcity of organ donors and by the danger associated to the immunosuppressive drugs. Stem cell therapy is becoming a concrete opportunity to treat various diseases. In particular, for a disease like T1D, caused by the loss of a single specific cell type that does not need to be transplanted back in its originating site to perform its function, a stem cell-based cell replacement therapy seems to be the ideal cure. New and infinite sources of β cells are strongly required. In this review, we make an overview of the most promising and advanced β cell production strategies. Particular hope is placed in pluripotent stem cells (PSC), both embryonic (ESC) and induced pluripotent stem cells (iPSC). The first phase 1/2 clinical trials with ESC-derived pancreatic progenitor cells are ongoing in the United States and Canada, but a successful strategy for the use of PSC in patients with diabetes has still to overcome several important hurdles. Another promising strategy of generation of new β cells is the transdifferentiation of adult cells, both intra-pancreatic, such as alpha, exocrine and ductal cells or extra-pancreatic, in particular liver cells. Finally, new advances in gene editing technologies have given impetus to research on the production of human organs in chimeric animals and on in situ reprogramming of adult cells through in vivo target gene activation.


Single molecular catalysis of a redox enzyme on nanoelectrodes.
Due to a high turnover coefficient, redox enzymes can serve as current amplifiers which make it possible to explore their catalytic mechanism by electrochemistry at the level of single molecules. On modified nanoelectrodes, the voltammetric behavior of a horseradish peroxidase (HRP) catalyzed hydroperoxide reduction no longer presents a continuous current response, but a staircase current response. Furthermore, single catalytic incidents were captured through a collision mode at a constant potential, from which the turnover number of HRP can be figured out statistically. In addition, the catalytic behavior is dynamic which may be caused by the orientation status of HRP on the surface of the electrode. This modified nanoelectrode methodology provides an electrochemical approach to investigate the single-molecule catalysis of redox enzymes.


[Actinomycetoma and Nocardia sp. Report of five cases treated with imipenem or imipenem plus amikacin].
Dapsone with trimethoprim-sulfamethoxazol is currently the standard treatment for actinomycetoma. In select cases, amikacin, streptomycin, kanamycin, amoxicillin/clavulanic acid or phosphomycin may be also added. Imipenem has shown to be effective both in vitro and in vivo against some actinomycetes. Amikacin with Imipenem has a synergistic effect. To report our preliminary findings using imipenem alone or with amikacin for severe or multi-resistant mycetomas due to Nocardia sp. We present 5 cases of chronic mycetoma infection previously treated with anti-bacterial multidrug regimens. All patients were hospitalized and treated with imipenem 500 mg IV, three times a day for three weeks. Three patients received in addition amikacin. We included 3 male and 2 female patients. The average length of disease duration was 7.4 years. In 3 cases mycetoma was located on the back; one of them involved the rib and the lung. One case was localized in the abdominal wall, and another one involved the posterior side of the cervical region. Two patients achieved clinical and bacteriological cure one year after treatment with Imipenem, and the remaining three displayed clinical improvement, even though grains were observed, cultures where negative. None of the 5 patients studied showed clinical evidence of adverse reactions to Imipenem. Imipenem is a strong antibiotic and constitutes an important treatment alternative for severe or multi-resistant mycetoma especially for cases with bone and visceral involvement.


Advances in preimplantation genetic diagnosis.
Strategies for preimplantation genetic diagnosis (PGD) have become increasingly complex. For single gene disorders it is now usual for several DNA fragments to be simultaneously amplified using multiplex-PCR. This allows redundant diagnostic loci to be analyzed, reducing the chance of misdiagnosis due to allele dropout (ADO). Additionally, hypervariable 'fingerprinting' loci can be amplified, revealing the presence of DNA contaminants. Chromosomal screening has also increased in complexity. Current FISH techniques investigate up to nine chromosomes per cell and are offered to an increasingly wide range of patients, including women of advanced reproductive age and those with a history of repeated spontaneous abortion. Technical limitations, which preclude a full assessment of all chromosomes using FISH, have encouraged the development alternative tests. These include nuclear conversion, comparative genomic hybridization (CGH) and the use of DNA microarray 'chip' technology. This paper discusses technical innovations that have improved the scope and accuracy of PGD, as well as the emergence of new indications for PGD that are sometimes considered controversial (e.g. HLA-typing).


Uncoiling collagen: a multidimensional mass spectrometry study.
Mass spectrometry can be used to determine structural information about ions by activating precursors and analysing the resulting series of fragments. Two-dimensional Fourier transform ion cyclotron resonance mass spectrometry (2D FT-ICR MS) is a technique that correlates the mass-to-charge (m/z) ratio of fragment and precursor ions in a single spectrum. 2D FT-ICR MS records the fragmentation of all ions in a sample without the need for isolation. To analyse specific precursors, horizontal cross-sections of the spectrum (fragment ion scans) are taken, providing an alternative to conventional tandem mass spectrometry (MS/MS) experiments. In this work, 2D FT-ICR MS has been used to study the tryptic digest of type I collagen, a large protein. Fragment ion scans have been extracted from the 2D FT-ICR MS spectrum for precursor m/z ratios: 951.81, 850.41, 634.34, and 659.34, and 2D FT-ICR MS spectra are compared with a set of 1D MS/MS spectra using different fragmentation methods. The results show that two-dimensional mass spectrometry excells at MS/MS of complex mixtures, simplifying spectra by eliminating contaminant peaks, and aiding the identification of species in the sample. Currently, with desktop computers, 2D FT-ICR MS is limited by data processing power, a limitation which should be alleviated using cluster parallel computing. In order to explore 2D FT-ICR MS for collagen, with reasonable computing time, the resolution in the fragment ion dimension is limited to 256k data points (compared to 4M data points in 1D MS/MS spectra), but the vertical precursor ion dimension has 4096 lines, so the total data set is 1G data points (4 Gbytes). The fragment ion coverage obtained with a blind, unoptimized 2D FT-ICR MS experiment was lower than conventional MS/MS, but MS/MS information is obtained for all ions in the sample regardless of selection and isolation. Finally, although all 2D FT-ICR MS peak assignments were made with the aid of 1D FT-ICR MS data, these results demonstrate the promise of 2D FT-ICR MS as a technique for studying complex protein digest mixtures.


The impact of an arts-based programme on the affective and cognitive components of empathic development.
Medical education research demonstrates that empathic behaviour is amenable to positive change when targeted through educational programmes. This study evaluates the impact of an arts-based intervention designed to nurture learner empathy through the provision of facilitated visual literacy activities. Health Sciences students (N=19) were assigned to two learning groups: a group that participated in a visual literacy programme at the McMaster Museum of Art and a control group that participated in the normal Health Sciences curriculum. All participants completed an inter-reactivity index, which measures empathy on affective and cognitive levels, prior to and following the programme. Those individuals assigned to the visual literacy programme also completed open-ended questions concerning the programme's impact on their empathic development. The index scores were subjected to independent within-group, between-test analyses. There was no significant impact of the programme on the participants' overall empathic response. However, sub-component analyses revealed that the programme had a significant positive effect on cognitive aspects of empathy. This finding was substantiated by the narrative reports. The study concludes that the affective focus of humanities-based education needs to be enhanced and recommends that learners are educated on the different components that comprise the overall empathic response.


Genomic prediction for latent variables related to milk fatty acid composition in Holstein, Simmental and Brown Swiss dairy cattle breeds.
Genomic selection (GS) reports on milk fatty acid (FA) profiles have been published quite recently and are still few despite this trait represents the most important aspect of milk nutritional and sensory quality. Reasons for this can be found in the high costs of phenotype recording but also in issues related to its nature of complex trait constituted by multiple genetically correlated variables with low heritabilities. One possible strategy to deal with such constraint is represented by the use of dimension reduction methods. We analysed 40 individual FAs from Italian Brown Swiss, Holstein and Simmental milk through multivariate factor analysis (MFA) to study the genetics of milk FA-related latent variables (factors) and assess their potential use in breeding. A total of nine factors were obtained, and their genetic parameters were inferred under a Bayesian framework using two statistical approaches: the classical pedigree best linear unbiased prediction (ABLUP) and the single-step genomic BLUP (ssGBLUP). The resulting factorial solutions were able to represent groups of FAs with common origin and function and can be considered concise pathway-level phenotypes. The heritability (h2 ) values showed relevant variations across different factors in each breed (0.03 ≤ h2 ≤ 0.38). The accuracies of breeding values predicted were low to high, ranging from 0.13 to 0.72 and from 0.18 to 0.74 considering the pedigree and the genomic model, respectively. The gain in accuracy in genetic prediction due to the addition of genomic information was ~30% and ~5% in validation and training groups respectively, confirming the contribution of genomic information in yielding more accurate predictions compared to the traditional ABLUP methodology. Our results suggest that MFA in combination with GS can be a valuable tool in dairy cattle breeding and deserves to be further investigated for use in future breeding programs to improve cow's milk FA-related traits.


Dapagliflozin Inhibits Cell Adhesion to Collagen I and IV and Increases Ectodomain Proteolytic Cleavage of DDR1 by Increasing ADAM10 Activity.
Dapagliflozin, empagliflozin, tofogliflozin, selective inhibitors of sodium-glucose cotransporter 2 (SGLT2), is used clinically to reduce circulation glucose levels in patients with type 2 diabetes mellitus by blocking the reabsorption of glucose by the kidneys. Dapagliflozin is metabolized and inactivated by UGT1A9. Empagliflozin is metabolized and inactivated by UGT1A9 and by other related isoforms UGT2B7, UGT1A3, and UGT1A8. Tofogliflozin is metabolized and inactivated by five different enzymes CYP2C18, CYP3A4, CYP3A5, CYP4A11, and CYP4F3. Dapagliflozin treatment of HCT116 cells, which express SGLT2 but not UGT1A9, results in the loss of cell adhesion, whereas HepG2 cells, which express both SGLT2 and UGT1A9, are resistant to the adhesion-related effects of dapagliflozin. PANC-1 and H1792 cells, which do not express either SGLT2 or UGT1A9, are also resistant to adhesion related effects of dapagliflozin. On the other hand, either empagliflozin or tofogliflozin treatment of HCT116, HepG2, PANC-1, and H1792 cells are resistant to the adhesion-related effects as observed in dapagliflozin treated HCT116 cells. Knockdown of UGT1A9 by shRNA in HepG2 cells increased dapagliflozin sensitivity, whereas the overexpression of UGT1A9 in HCT116 cells protected against dapagliflozin-dependent loos of cell adhesion. Dapagliflozin treatment had no effect on cellular interactions with fibronectin, vitronectin, or laminin, but it induced a loss of interaction with collagen I and IV. In parallel, dapagliflozin treatment reduced protein levels of the full-length discoidin domain receptor I (DDR1), concomitant with appearance of DDR1 cleavage products and ectodomain shedding of DDR1. In line with these observations, unmetabolized dapagliflozin increased ADAM10 activity. Dapagliflozin treatment also significantly reduced Y792 tyrosine phosphorylation of DDR1 leading to decrement of DDR1 function and detachment of cancer cells. Concomitant with these lines of results, we experienced that CEA in patients with colon cancer, which express SGLT2 but not UGT1A9, and type 2 diabetes mellitus treated by dapagliflozin in addition to chemotherapy was decreased (case 1). CEA in patients with colon cancer, which express SGLT2 but not UGT1A9, and type 2 diabetes mellitus was treated by dapagliflozin alone after radiation therapy was decreased but started to rise after cessation of dapagliflozin (case 2). CA19-9 in two of patients with pancreatic cancer and type 2 diabetes mellitus was resistant to the combination therapy of dapagliflozin and chemotherapy (case 3 and 4 respectively). PIVKAII in patients with liver cancer and type 2 diabetes mellitus, and CYFRA in patients with squamous lung cancer and type 2 diabetes mellitus was also resistant the combination therapy of dapagliflozin and chemotherapy (case 5 and 6 respectively). Taken together, these data suggest a potential role for dapagliflozin anticancer therapy against colon cancer cells that express SGLT2, but not UGT1A9.


Spatial competition dynamics between reef corals under ocean acidification.
Climate change, including ocean acidification (OA), represents a major threat to coral-reef ecosystems. Although previous experiments have shown that OA can negatively affect the fitness of reef corals, these have not included the long-term effects of competition for space on coral growth rates. Our multispecies year-long study subjected reef-building corals from the Gulf of Aqaba (Red Sea) to competitive interactions under present-day ocean pH (pH 8.1) and predicted end-of-century ocean pH (pH 7.6). Results showed coral growth is significantly impeded by OA under intraspecific competition for five out of six study species. Reduced growth from OA, however, is negligible when growth is already suppressed in the presence of interspecific competition. Using a spatial competition model, our analysis indicates shifts in the competitive hierarchy and a decrease in overall coral cover under lowered pH. Collectively, our case study demonstrates how modified competitive performance under increasing OA will in all likelihood change the composition, structure and functionality of reef coral communities.


Clinical relevance of voltage-gated potassium channel–complex antibodies in children.
To assess the clinical and immunologic findings in children with voltage-gated potassium channel (VGKC)-complex antibodies (Abs). Thirty-nine of 363 sera, referred from 2 pediatric centers from 2007 to 2013, had been reported positive (.100 pM) for VGKC-complex Abs. Medical records were reviewed retrospectively and the patients' condition was independently classified as inflammatory (n 5 159) or noninflammatory (n 5 204). Positive sera (.100 pM) were tested/retested for the VGKC complex Ab–positive complex proteins LGI1 and CASPR2, screened for binding to live hippocampal neurons, and 12 high-titer sera (.400 pM) tested by radioimmunoassay for binding to VGKC Kv1 subunits with or without intracellular postsynaptic density proteins. VGKC-complex Abs were found in 39 children, including 20% of encephalopathies and 7.6% of other conditions (p 5 0.001). Thirty children had inflammatory conditions and 9 had noninflammatory etiologies but titers.400 pM (n512) were found only in inflammatory diseases (p , 0.0001). Four sera, including from 2 children with coexisting NMDA receptor Abs and one with Guillain-Barré syndrome and Abs to both LGI1 and CASPR2, bound to hippocampal neurons. None of the sera bound detectably to VGKC Kv1 subunits on live HEK cells, but 4 of 12 .400 pM sera immunoprecipitated VGKC Kv1 subunits, with or without postsynaptic densities, extracted from transfected cells. Positive VGKC-complex Abs cannot be taken to indicate a specific clinical syndrome in children, but appear to be a nonspecific biomarker of inflammatory neurologic diseases, particularly of encephalopathy. Some of the Abs may bind to intracellular epitopes on the VGKC subunits, or to the intracellular interacting proteins, but in many the targets remain undefined.


Copper-mediated regioselective hydrodifluoroalkylation of alkynes.
A highly regioselective copper-mediated hydrodifluoroalkylation of alkynes with ethyl bromodifluoroacetate or bromodifluoroacetamides has been developed. This strategy provides straightforward access to a variety of difluoroalkylated alkenes under mild reaction conditions with low-cost cuprous bromide and metabisulfite as reduction agents. A wide range of alkynes are applicable under these reaction conditions. The excellent functional-group compatibility and good regio- and stereoselectivities are the notable features of this transformation.


The pathogenesis and treatment of pediatric Henoch-Schönlein purpura nephritis.
Henoch-Schönlein purpura (HSP) is a systemic disorder characterized by leukocytoclastic vasculitis involving the capillaries and the deposition of IgA immune complexes. Renal involvement is the principal cause of morbidity and mortality in children with HSP. Thus, it is important to clarify the onset mechanism of Henoch-Schönlein purpura nephritis (HSPN) and to identify the most appropriate treatment. We herein review the pathogenesis and treatment of HSPN. As to the pathogenesis, several studies suggest that galactose-deficient IgA1 is recognized by anti-glycan antibodies, leading to the formation of circulating immune complexes and their mesangial deposition, thereby inducing renal injury. Aggressive therapies for the treatment of severe HSPN, including multiple drug combination therapy and plasmapheresis, have been shown to be effective in ameliorating proteinuria and histological severity. Nevertheless, detailed investigations of the pathogenesis of HSPN and double-blind randomized control studies on children with HSPN are still necessary.


Daily aspirin use and prostate cancer-specific mortality in a large cohort of men with nonmetastatic prostate cancer.
In a recent analysis of a large clinical database, postdiagnosis aspirin use was associated with 57% lower prostate cancer-specific mortality (PCSM) among men diagnosed with nonmetastatic prostate cancer. However, information on this association remains limited. We assessed the association between daily aspirin use and PCSM in a large prospective cohort. This analysis included men diagnosed with nonmetastatic prostate cancer between enrollment in the Cancer Prevention Study-II Nutrition Cohort in 1992 or 1993 and June 2009. Aspirin use was reported at enrollment, in 1997, and every 2 years thereafter. During follow-up through 2010, there were 441 prostate cancer deaths among 8,427 prostate cancer cases with information on prediagnosis aspirin use and 301 prostate cancer deaths among 7,118 prostate cancer cases with information on postdiagnosis aspirin use. Compared with no aspirin use, neither prediagnosis nor postdiagnosis daily aspirin use were statistically significantly associated with PCSM (prediagnosis use, multivariable-adjusted hazard ratio (HR) = 0.92, 95% CI 0.72 to 1.17, postdiagnosis use, HR = 0.98; 95% CI, 0.74 to 1.29). However, among men diagnosed with high-risk cancers (≥ T3 and/or Gleason score ≥ 8), postdiagnosis daily aspirin use was associated with lower PCSM (HR = 0.60; 95% CI, 0.37 to 0.97), with no clear difference by dose (low-dose, typically 81 mg per day, HR = 0.50; 95% CI, 0.27 to 0.92, higher dose, HR = 0.73; 95% CI, 0.40 to 1.34). A randomized trial of aspirin among men diagnosed with nonmetastatic prostate cancer was recently funded. Our results suggest any additional randomized trials addressing this question should prioritize enrolling men with high-risk cancers and need not use high doses.


Molecular epidemiology of rabies in Botswana: a comparison between antibody typing and nucleotide sequence phylogeny.
A panel of rabies virus isolates (RABV) endemic within Botswana between 1988 and 1992 have been typed by anti-nucleocapsid monoclonal antibodies (MAb) into two dominant groups. The first associated with the domestic dog (Canis familiaris) and the second associated with a range of wildlife species. Using nucleoprotein coding sequence data, we have applied molecular phylogenetic techniques to the same panel of 35 well-characterised rabies virus isolates from throughout Botswana in an attempt to compare both techniques and to further investigate the virus/host species relationships within this African country. The results confirm that there are indeed two major groups and that these are related primarily to biotype. The wildlife-associated biotype appeared more phylogenetically diverse and was more commonly isolated in the southeast of the country, with the canine-associated group dominating the north of the country. In addition, molecular phylogeny identified further groupings within both biotypes and a small number of isolates, which were not classified by MAb typing, could be assigned to a group. During the study period (4 years) there appeared to be little sequence variation within groups suggesting that distinct lineages persisted throughout the study and that there appears to be little evolutionary pressure on the nucleoprotein coding region of the viral genome.


Detection of normal and chimeric nucleophosmin in human cells.
In anaplastic large-cell lymphoma (ALCL), the (2;5) chromosomal translocation creates a fusion gene encoding the 80-kD NPM-ALK hybrid protein. This report describes three new monoclonal antibodies, two of which recognize, by Western blotting, the N-terminal portion of NPM present in the NPM-ALK fusion protein and also in two other NPM fusion proteins (NPM-RARalpha and NPM-MLF1). The third antibody recognizes the C-terminal portion (deleted in NPM-ALK) and reacts only with wild-type NPM. The three antibodies immunostain wild-type NPM (in paraffin-embedded normal tissue samples) in cell nuclei and in the cytoplasm of mitotic cells. Cerebral neurones, exceptionally, show diffuse cytoplasmic labeling. In contrast to normal tissues, the two antibodies against the N-terminal portion of NPM labeled the cytoplasm of neoplastic cells, in four ALK-positive ALCL, reflecting their reactivity with NPM-ALK fusion protein, whereas the antibody to the C-terminal NPM epitope labeled only cell nuclei. Immunocytochemical labeling with these antibodies can therefore confirm that an ALK-positive lymphoma expresses NPM-ALK (rather than a variant ALK-fusion protein) and may also provide evidence for chromosomal anomalies involving the NPM gene other than the classical (2;5) translocation.


Carbohydrates and exercise performance in non-fasted athletes: a systematic review of studies mimicking real-life.
There is a consensus claiming an ergogenic effect of carbohydrates ingested in the proximity of or during a performance bout. However, in performance studies, the protocols that are used are often highly standardized (e.g. fasted subjects, constant exercise intensity with time-to-exhaustion tests), and do not necessarily reflect competitive real-life situations. Therefore, we aimed at systematically summarizing all studies with a setting mimicking the situation of a real-life competition (e.g., subjects exercising in the postprandial state and with time-trial-like performance tests such as fixed distance or fixed time tests). We performed a PubMed search by using a selection of search terms covering inclusion criteria for sport, athletes, carbohydrates, and fluids, and exclusion criteria for diseases and animals. This search yielded 16,658 articles and the abstract of 16,508 articles contained sufficient information to identify the study as non-eligible for this review. The screening of the full text of the remaining 150 articles yielded 17 articles that were included in this review. These articles described 22 carbohydrate interventions covering test durations from 26 to 241 min (mostly cycling). We observed no performance improvement with half of the carbohydrate interventions, while the other half of the interventions had significant improvement between 1% and 13% (improvement with one of five interventions lasting up to 68 min and with 10 of 17 interventions lasting between 70 and 241 min). Thus, when considering only studies with a setting mimicking real-life competition, there is a mixed general picture about the ergogenic effect of carbohydrates ingested in the proximity of or during a performance bout with an unlikely effect with bouts up to perhaps 70 min and a possible but not compelling ergogenic effect with performance durations longer than about 70 min.


Instability, unfolding and aggregation of human lysozyme variants underlying amyloid fibrillogenesis.
Tissue deposition of soluble proteins as amyloid fibrils underlies a range of fatal diseases. The two naturally occurring human lysozyme variants are both amyloidogenic, and are shown here to be unstable. They aggregate to form amyloid fibrils with transformation of the mainly helical native fold, observed in crystal structures, to the amyloid fibril cross-beta fold. Biophysical studies suggest that partly folded intermediates are involved in fibrillogenesis, and this may be relevant to amyloidosis generally.


Evaluating the predictive accuracy and the clinical benefit of a nomogram aimed to predict survival in node-positive prostate cancer patients: External validation on a multi-institutional database.
To assess the predictive accuracy and the clinical value of a recent nomogram predicting cancer-specific mortality-free survival after surgery in pN1 prostate cancer patients through an external validation. We evaluated 518 prostate cancer patients treated with radical prostatectomy and pelvic lymph node dissection with evidence of nodal metastases at final pathology, at 10 tertiary centers. External validation was carried out using regression coefficients of the previously published nomogram. The performance characteristics of the model were assessed by quantifying predictive accuracy, according to the area under the curve in the receiver operating characteristic curve and model calibration. Furthermore, we systematically analyzed the specificity, sensitivity, positive predictive value and negative predictive value for each nomogram-derived probability cut-off. Finally, we implemented decision curve analysis, in order to quantify the nomogram's clinical value in routine practice. External validation showed inferior predictive accuracy as referred to in the internal validation (65.8% vs 83.3%, respectively). The discrimination (area under the curve) of the multivariable model was 66.7% (95% CI 60.1-73.0%) by testing with receiver operating characteristic curve analysis. The calibration plot showed an overestimation throughout the range of predicted cancer-specific mortality-free survival rates probabilities. However, in decision curve analysis, the nomogram's use showed a net benefit when compared with the scenarios of treating all patients or none. In an external setting, the nomogram showed inferior predictive accuracy and suboptimal calibration characteristics as compared to that reported in the original population. However, decision curve analysis showed a clinical net benefit, suggesting a clinical implication to correctly manage pN1 prostate cancer patients after surgery.


Neuregulin-induced ErbB3 downregulation is mediated by a protein stability cascade involving the E3 ubiquitin ligase Nrdp1.
The molecular mechanisms underlying epidermal growth factor (EGF) receptor tyrosine kinase down-regulation in response to growth factor binding are coming into focus and involve cbl-mediated receptor ubiquitination followed by lysosomal degradation. However, mechanisms underlying the ligand-stimulated degradation of the related receptor tyrosine kinases of the ErbB family do not involve cbl and remain unexplored. Previous studies have demonstrated that the E3 ubiquitin ligase Nrdp1 contributes to the maintenance of steady-state ErbB3 levels by mediating its growth factor-independent degradation. Here we demonstrate that treatment of cells with the ErbB3 ligand neuregulin-1 (NRG1) stabilizes the deubiquitinating enzyme USP8, which in turn stabilizes Nrdp1. The catalytic activity of USP8 is required for NRG1-induced Nrdp1 stabilization. We provide evidence that Akt-mediated phosphorylation of USP8 threonine residue T907 contributes to USP8 stability. Finally, we demonstrate that Nrdp1 or USP8 knockdown suppresses NRG1-induced ErbB3 ubiquitination and degradation in MCF7 breast cancer cells. We conclude that an NRG1-induced protein stability cascade involving USP8 and Nrdp1 mediates the down-regulation of ErbB3. Our observations raise the possibility that the ligand-induced augmentation of pathways involved in the maintenance of basal levels of receptor tyrosine kinases can contribute to ligand-stimulated down-regulation.


BrainIAK tutorials: User-friendly learning materials for advanced fMRI analysis.
Advanced brain imaging analysis methods, including multivariate pattern analysis (MVPA), functional connectivity, and functional alignment, have become powerful tools in cognitive neuroscience over the past decade. These tools are implemented in custom code and separate packages, often requiring different software and language proficiencies. Although usable by expert researchers, novice users face a steep learning curve. These difficulties stem from the use of new programming languages (e.g., Python), learning how to apply machine-learning methods to high-dimensional fMRI data, and minimal documentation and training materials. Furthermore, most standard fMRI analysis packages (e.g., AFNI, FSL, SPM) focus on preprocessing and univariate analyses, leaving a gap in how to integrate with advanced tools. To address these needs, we developed BrainIAK (brainiak.org), an open-source Python software package that seamlessly integrates several cutting-edge, computationally efficient techniques with other Python packages (e.g., Nilearn, Scikit-learn) for file handling, visualization, and machine learning. To disseminate these powerful tools, we developed user-friendly tutorials (in Jupyter format; https://brainiak.org/tutorials/) for learning BrainIAK and advanced fMRI analysis in Python more generally. These materials cover techniques including: MVPA (pattern classification and representational similarity analysis); parallelized searchlight analysis; background connectivity; full correlation matrix analysis; inter-subject correlation; inter-subject functional connectivity; shared response modeling; event segmentation using hidden Markov models; and real-time fMRI. For long-running jobs or large memory needs we provide detailed guidance on high-performance computing clusters. These notebooks were successfully tested at multiple sites, including as problem sets for courses at Yale and Princeton universities and at various workshops and hackathons. These materials are freely shared, with the hope that they become part of a pool of open-source software and educational materials for large-scale, reproducible fMRI analysis and accelerated discovery.


Phase transitions and chromium(iii) luminescence in perovskite-type [C2H5NH3][Na0.5CrxAl0.5-x(HCOO)3] (x = 0, 0.025, 0.5), correlated with structural, dielectric and phonon properties.
We report the synthesis, crystal structure, dielectric, vibrational and emission spectra of heterometallic MOFs, [C2H5NH3][Na0.5Cr0.5(HCOO)3] (EtANaCr), [C2H5NH3][Na0.5Al0.5(HCOO)3] (EtANaAl) and [C2H5NH3][Na0.5Al0.475Cr0.025(HCOO)3] (EtANaAlCr). These compounds crystallize in non-centrosymmetric monoclinic polar structures (space group Pn) and undergo order-disorder phase transitions upon heating to the monoclinic centrosymmetric structure (space group P21/n) at 369 (EtANaAl) and 373 K (EtANaCr). In principle, they are ferroelectric below these temperatures. In the high-temperature phase, ethylammonium (EtA+) cations are dynamically disordered over two symmetrically independent positions while upon cooling they begin to order. The ordering is accompanied by distortion of the metal formate framework. The hydrogen bonds (HBs) between the NH3+ group and NaO6 octahedral units are more robust than between the NH3+ group and CrO6 (AlO6) octahedral units and this feature explains a much stronger distortion of the former units and a weak effect of a trivalent cation type on the phase transition temperature. The dielectric studies have confirmed the occurrence of phase transitions of dipolar character and dipole relaxation processes. The optical studies show that EtANaCr and EtANaAlCr exhibit efficient Cr(iii)-based emission characteristics for intermediate-ligand field strength.


Education and racial-ethnic differences in types of exercise in the United States.
Epidemiological research typically focuses on the intensity, frequency, or duration of physical activity, without consideration of the socially meaningful dimensions of exercise. The authors use data from the 1998 National Health Interview Survey (N = 17,455) and information on participation in 15 exercise behaviors to examine educational differences in exercise among non-Hispanic whites, non-Hispanic blacks, and Mexican Americans. Factor analysis identifies three types of exercise: team sports (e.g., basketball, football), fitness activities (e.g., running, weight lifting), and activities that require the use of specialized facilities (e.g., golf, tennis). Cultural capital and human capital perspectives offer insight into different dimensions of the relationship between education and exercise. Whites disproportionately undertake facility-based exercise, blacks tend toward team and fitness activities, and Mexican Americans gravitate toward team sports. Our findings offer insight into the social stratification of health and can aid the design of public health interventions.


Effects of gamma-oryzanol on serum lipids and apolipoproteins in dyslipidemic schizophrenics receiving major tranquilizers.
The subjects were 20 chronic schizophrenic patients with dyslipidemia (total cholesterol levels greater than or equal to 220 mg/dl, triglycerides greater than or equal to 150 mg/dl, or high-density lipoprotein cholesterol less than or equal to 40 mg/dl) who had been receiving neuroleptics for a mean of ten years. Each patient was given 100 mg of gamma-oryzanol three times daily for 16 weeks. Total cholesterol and low-density lipoprotein cholesterol levels, respectively, decreased significantly, from 204 and 124 mg/dl at baseline to 176 and 101 mg/dl at week 12. High-density lipoprotein cholesterol levels were 36.1 mg/dl at baseline and 35.9 mg/dl at week 12. Apolipoprotein (apo) B levels decreased significantly from 116 mg/dl to 101 mg/dl at week 16; apo A-II levels increased significantly from 31.7 mg/dl to 34.7 mg/dl; and the apo B/apo A-I ratio declined significantly from 0.99 to 0.84. No treatment side effects were recorded. It is concluded that gamma-oryzanol is safe and effective in the treatment of dyslipidemia.


[The long-term effect of day care rehabilitation on individuals with dementia].
In the treatment of senile dementia, rehabilitation rather than drugs, could result in more positive long-term effects. A Day Care program designed for individuals with Senile Dementia of the Alzheimer type (SDAT) and Vascular Dementia (VD:MID and BD), activates the brain through memory training, creative arts therapy, physical activity, and social interaction. The objective of this study is to determine if Day Care can modify the patients intellectual decline or even alter the natural course of the dementing illness. 135 SDAT and 213 VD patients were studied over three years. ADL (Activities of Daily Living) measurements were evaluated by the Barthel Index and cognitive measurements by the NM-scale. The Wilcoxon test and the Sign test were carried out using the BI and NM-scale scores. These results indicated a decline or arrest in the progression of SDAT and VD as determined by the multiple logistical models. The 8 variables (risk factors, medication, age at onset, self-rehabilitation, family support, sex, grade of dementia and Day Care) influence on the survival curves was calculated using the Kaplan-Meire Life table method. The Cox proportional hazard analysis was then used to examine the relationship between the 8 variables and dementia. The significantly positive results from these four analyses of the ADL and cognitive measurements indicate that Day Care programs clearly retards the progression of intellectual decline in dementia patients and improves the quality of life (QOL) in all cases. In VD patients the mortality rate was notably decreased through Day Care. These results make one consider the benefits of introducing such programs into society as a strong treatment against the onset of dementia developing into severe, dehabilitating dementia. However a healthy diet, a physically and mentally active life, as well as early diagnosis, are the best preventions against dementia.


Crystallization, microPIXE and preliminary crystallographic analysis of the complex between the third KH domain of hnRNP K and single-stranded DNA.
hnRNP K is one of the major proteins found in hnRNP particles which are ribonucleoprotein complexes containing proteins and pre-mRNA. hnRNP K contains hnRNP K homology (KH) domains which bind both CT-rich single-stranded DNA (ssDNA) and CU-rich ssRNA. Co-crystallization of the third KH domain of human hnRNP K with a 15-mer ssDNA gave rod-shaped crystals belonging to the trigonal space group P3(1)21 (unit-cell parameters a = 54.0, c = 149.7 A) and diffracting to 2.4 A resolution. MicroPIXE (proton-induced X-ray emission) experiments showed that the crystals contained the complex and that the phosphorus to sulfur atomic ratio was consistent with the asymmetric unit containing three KH3 domains per 15-mer ssDNA. This was confirmed by structure solution by molecular replacement.


Action of insulin in rat adipocytes and membrane properties.
Several small peptides inhibit insulin-promoted glucose uptake in rat adipocytes. At 10 microM peptide concentration, the extent of their inhibition of the insulin effect is related to the ability of these peptides to raise the bilayer- to hexagonal-phase transition temperature in model membranes. Hexane and DL-threo-dihydrosphingosine lower this phase transition temperature in model membranes, and they promote glucose uptake in adipocytes. There is thus an empirical relationship between the action of membrane additives on glucose uptake in adipocytes and their effect on the hexagonal-phase-forming tendency in model membranes. The most potent of the bilayer-stabilizing peptides tested in this work is carbobenzoxy-D-Phe-L-Phe-Gly. This peptide also inhibits insulin-stimulated protein synthesis in adipocytes. In contrast, DL-threo-dihydrosphingosine stimulates protein synthesis. The uptake of [125I]iodoinsulin by adipocytes is inhibited by carbobenzoxy-D-Phe-L-Phe-Gly. The mechanism of action of the bilayer-stabilizing peptides includes inhibition of insulin-dependent protein phosphorylation in adipocytes. The peptides are not specific inhibitors of a single function but are suggested to cause their effects by altering the physical properties of the membrane in a nonspecific manner. These results demonstrate that insulin-dependent functions of rat adipocytes can be modified by membrane additives in a manner predictable from the properties of these additives in model membranes.


Polymorphic residues in rice NLRs expand binding and response to effectors of the blast pathogen.
Accelerated adaptive evolution is a hallmark of plant-pathogen interactions. Plant intracellular immune receptors (NLRs) often occur as allelic series with differential pathogen specificities. The determinants of this specificity remain largely unknown. Here, we unravelled the biophysical and structural basis of expanded specificity in the allelic rice NLR Pik, which responds to the effector AVR-Pik from the rice blast pathogen Magnaporthe oryzae. Rice plants expressing the Pikm allele resist infection by blast strains expressing any of three AVR-Pik effector variants, whereas those expressing Pikp only respond to one. Unlike Pikp, the integrated heavy metal-associated (HMA) domain of Pikm binds with high affinity to each of the three recognized effector variants, and variation at binding interfaces between effectors and Pikp-HMA or Pikm-HMA domains encodes specificity. By understanding how co-evolution has shaped the response profile of an allelic NLR, we highlight how natural selection drove the emergence of new receptor specificities. This work has implications for the engineering of NLRs with improved utility in agriculture.


Traditional and new composite endpoints in heart failure clinical trials: facilitating comprehensive efficacy assessments and improving trial efficiency.
Composite endpoints are commonly used as the primary measure of efficacy in heart failure clinical trials to assess the overall treatment effect and to increase the efficiency of trials. Clinical trials still must enrol large numbers of patients to accrue a sufficient number of outcome events and have adequate power to draw conclusions about the efficacy and safety of new treatments for heart failure. Additionally, the societal and health system perspectives on heart failure have raised interest in ascertaining the effects of therapy on outcomes such as repeat hospitalization and the patient's burden of disease. Thus, novel methods for using composite endpoints in clinical trials (e.g. clinical status composite endpoints, recurrent event analyses) are being applied in current and planned trials. Endpoints that measure functional status or reflect the patient experience are important but used cautiously because heart failure treatments may improve function yet have adverse effects on mortality. This paper discusses the use of traditional and new composite endpoints, identifies qualities of robust composites, and outlines opportunities for future research.


Aminoacyl esterase activity of the Tetrahymena ribozyme.
Several classes of ribozymes (catalytic RNA's) catalyze reactions at phosphorus centers, but apparently no reaction at a carbon center has been demonstrated. The active site of the Tetrahymena ribozyme was engineered to bind an oligonucleotide derived from the 3' end of N-formyl-methionyl-tRNA(fMet). This ribozyme catalyzes the hydrolysis of the aminoacyl ester bond to a modest extent, 5 to 15 times greater than the uncatalyzed rate. Catalysis involves binding of the oligonucleotide to the internal guide sequence of the ribozyme and requires Mg2+ and sequence elements of the catalytic core. The ability of RNA to catalyze reactions with aminoacyl esters expands the catalytic versatility of RNA and suggests that the first aminoacyl tRNA synthetase could have been an RNA molecule.


Social calls used by a leaf-roosting bat to signal location.
Social calls in bats have many functions, including mate attraction and maintaining contact during flight. Research suggests that social calls may also be used to transfer information about roosts, but no studies have yet demonstrated that calls are used to actively attract conspecifics to roosting locations. We document the social calls used by Spix's disc-winged bat (Thyroptera tricolor) to actively recruit group members to roosts. In acoustic trials, we recorded two sets of calls; one from flying individuals termed 'inquiry calls', and another from roosting bats termed 'response calls'. Inquiry calls were emitted by flying bats immediately upon release, and quickly (i.e. 178 ms) elicited production of response calls from roosting individuals. Most flying bats entered the roost when roosting individuals responded, while few bats entered the roost in the absence of a response. We argue that information transfer concerning roost location may facilitate sociality in T. tricolor, given the ephemeral nature of roosting structures used by this species.


Kinetic Approach to the Influence of Chia Flour on Glucose Bioaccessibility from Hydrothermally Treated Maize and Quinoa Starch.
Starch structure and bioactive ingredients play an implicit role in the control of glucose release at intestinal level reducing the risk of inadequate metabolic response(s). This study performs a comparative kinetic approach to glucose release from hydrothermally treated (HT) maize (MS) and quinoa (QS) starch. Besides, chia flour (CF) (20%, w/w) was added to evaluate its influence of on the apparent diffusion coefficients (Dapp) when subjected to simulated gastrointestinal digestion. Hepatocyte cultures were used to monitor mitochondrial enzymes activity (test MTT) to bioaccessible glucose concentrations. With an increasing temperature, Dapp for both QS and its mixtures with CF were kept unaltered, while those for MS were disrupted progressively affecting glucose bioaccessibility. Principal component analysis revealed differences between maize and quinoa starches, but common features in the corresponding mixtures with CF. Data indicated that quinoa starch helps controlling glucose release and that addition of CF decreased mitochondrial activity in presence of insulin.


Recognizing silhouettes and shaded images across depth rotation.
Outline-shape information may be particularly important in the recognition of depth-rotated objects because it provides a coarse shape description which gives first-pass information about the structure of an object. In four experiments, we compared recognition of silhouettes (showing only outline shape) with recognition of fully shaded images of objects, by means of a sequential-matching task. In experiments 1 and 2, the first stimulus was always a shaded image, and the second stimulus was either a shaded image or a silhouette. Recognition costs associated with a change in viewpoint were no greater for silhouettes than they were for shaded images. Experiments 3 and 4 replicated the design of the earlier experiments, but showed a silhouette as the initial stimulus, rather than a shaded image. In these cases, recognition costs associated with a change in viewpoint were greater for silhouettes than for shaded images. Combined, these results indicate that, while visual representations clearly include additional information, outline shape plays an important role in object recognition across depth rotation.


Categorizing patients in a forced-choice triad task: the integration of context in patient management.
Studies of experts' problem-solving abilities have shown that experts can attend to the deep structure of a problem whereas novices attend to the surface structure. Although this effect has been replicated in many domains, there has been little investigation into such effects in medicine in general or patient management in particular. We designed a 10-item forced-choice triad task in which subjects chose which one of two hypothetical patients best matched a target patient. The target and its potential matches were related in terms of surface features (e.g., two patients of a similar age and gender) and deep features (e.g., two diabetic patients with similar management strategies: a patient with arthritis and a blind patient would both have difficulty with self-injected insulin). We hypothesized that experts would have greater knowledge of management categories and would be more likely to choose deep matches. We contacted 130 novices (medical students), 11 intermediates (medical residents), and 159 experts (practicing endocrinologists) and 15, 11, and 8 subjects (respectively) completed the task. A linear mixed effects model indicated that novices were less likely to make deep matches than experts (t(68) = -3.63, p = .0006), while intermediates did not differ from experts (t(68) = -0.24, p = .81). We also found that the number of years in practice correlated with performance on diagnostic (r = .39, p = .02), but not management triads (r = .17, p = .34). We found that experts were more likely than novices to match patients based on deep features, and that this pattern held for both diagnostic and management triads. Further, management and diagnostic triads were equally salient for expert physicians suggesting that physicians recognize and may create management-oriented categories of patients.


Cochlear Homocysteine Metabolism at the Crossroad of Nutrition and Sensorineural Hearing Loss.
Hearing loss (HL) is one of the most common causes of disability, affecting 360 million people according to the World Health Organization (WHO). HL is most frequently of sensorineural origin, being caused by the irreversible loss of hair cells and/or spiral ganglion neurons. The etiology of sensorineural HL (SNHL) is multifactorial, with genetic and environmental factors such as noise, ototoxic substances and aging playing a role. The nutritional status is central in aging disability, but the interplay between nutrition and SNHL has only recently gained attention. Dietary supplementation could therefore constitute the first step for the prevention and potential repair of hearing damage before it reaches irreversibility. In this context, different epidemiological studies have shown correlations among the nutritional condition, increased total plasma homocysteine (tHcy) and SNHL. Several human genetic rare diseases are also associated with homocysteine (Hcy) metabolism and SNHL confirming this potential link. Accordingly, rodent experimental models have provided the molecular basis to understand the observed effects. Thus, increased tHcy levels and vitamin deficiencies, such as folic acid (FA), have been linked with SNHL, whereas long-term dietary supplementation with omega-3 fatty acids improved Hcy metabolism, cell survival and hearing acuity. Furthermore, pharmacological supplementations with the anti-oxidant fumaric acid that targets Hcy metabolism also improved SNHL. Overall these results strongly suggest that cochlear Hcy metabolism is a key player in the onset and progression of SNHL, opening the way for the design of prospective nutritional therapies.


Efficacy of repeat isolated limb perfusions with tumor necrosis factor alpha and melphalan for multiple in-transit metastases in patients with prior isolated limb perfusion failure.
Isolated limb perfusion (ILP) is an effective treatment modality for multiple in-transit melanoma metastases confined to the limb. Recurrences after ILP, however, occur in approximately 50% of patients and are a challenge for further treatment. The efficacy of repeat ILPs to prolong local control in this patient category is evaluated in this article. We used a prospective database in a tertiary referral center. Out of 100 tumor necrosis factor (TNF)-based ILPs with TNF and melphalan (TM-ILPs) in melanoma patients between March 1991 and July 2003, 25 repeat ILP procedures were performed in 21 patients in whom prior ILP treatment failed. All patients had bulky and/or numerous lesions and were treated with mild hyperthermic TM-ILP by using 2 to 4 mg of TNF and 10 to 13 mg/L of limb volume for the leg and arm, respectively. The complete response rate was 76%, a partial response occurred in 20%, and no change was recorded in 4%. There was no difference in the complete response rate or local toxicity between first and repeat perfusions. Local recurrence occurred in 72%; the median time to local progression was 14 months. The 5-year survival rate was 47%, which compares favorably with known survival rates of stage IIIA/AB patients. The median follow-up of the patients was 26 months. Patients who experience treatment failure after previous ILP treatment respond very well to repeat perfusion, and prolonged local control can thus be obtained. The subgroup of patients qualifying for repeat ILP represents a relatively favorable biological behavior of the melanoma.


Diabetic Retinopathy: Vascular and Inflammatory Disease.
Diabetic retinopathy (DR) is the leading cause of visual impairment in the working-age population of the Western world. The pathogenesis of DR is complex and several vascular, inflammatory, and neuronal mechanisms are involved. Inflammation mediates structural and molecular alterations associated with DR. However, the molecular mechanisms underlying the inflammatory pathways associated with DR are not completely characterized. Previous studies indicate that tissue hypoxia and dysregulation of immune responses associated with diabetes mellitus can induce increased expression of numerous vitreous mediators responsible for DR development. Thus, analysis of vitreous humor obtained from diabetic patients has made it possible to identify some of the mediators (cytokines, chemokines, and other factors) responsible for DR pathogenesis. Further studies are needed to better understand the relationship between inflammation and DR. Herein the main vitreous-related factors triggering the occurrence of retinal complication in diabetes are highlighted.


Lipid peroxide formation in microsomes. General considerations.
1. Liver microsomes form lipid peroxide when incubated with ascorbate or NADPH, but not with NADH. Increasing the concentration of ascorbate beyond the optimum (0.5mm) decreases the rate of lipid peroxide formation, but this effect does not occur with NADPH. Other reducing agents such as p-phenylenediamine or ferricyanide were not able to replace ascorbate and induce lipid peroxide formation. 2. The rate of ascorbate-induced peroxidation is optimum at pH6.0 whereas the rate of the NADPH system is optimum at pH7.0. Both systems require phosphate for maximum activity. 3. Lipid peroxide formation occurs at the maximum specific rate in very dilute microsome suspensions (0.15mg. of protein/ml.). 4. Treatment of microsomes with deoxycholate and other detergents causes membrane disintegration and inhibits lipid peroxide formation. 5. Lipid peroxide formation is accompanied by a rapid uptake of oxygen and there is a large excess of oxygen utilized for each molecule of malonaldehyde measured in the peroxide method. 6. Boiled microsomes form lipid peroxide in the presence of ascorbate, but not if NADPH is added. 7. Lipid peroxide formation induced by NADPH is strongly inhibited by p-chloromercuribenzoate, weakly inhibited by N-ethylmaleimide and unaffected by iodoacetamide. Ascorbate-induced peroxidation in untreated microsomes is unaffected by p-chloromercuribenzoate, but inhibited if boiled microsomes are used. These experiments may be interpreted on the basis that a ferredoxin-type protein forms part of the system in which NADPH induces lipid peroxide formation. 8. Most heavy-metal ions, with the exception of inorganic iron (Fe(2+) or Fe(3+)), which activates, inhibit both ascorbate-induced and NADPH-induced peroxidation. Mg(2+) increases the rate of peroxidation whereas Ca(2+) inhibits it. 9. Lipid peroxide formation is inhibited strongly by GSH and weakly by cysteine. Ascorbate-induced peroxidation is much more sensitive than NADPH-induced peroxidation. 10. Peroxidation is strongly inhibited by addition of low concentrations (0.01-0.1mm) of cytochrome c or of haemoglobin. 11. It is considered that lipid peroxide formation occurs as a result of the operation of the microsomal electron-transport chain switching from hydroxylation to oxidize unsaturated lipids of the endoplasmic reticulum.


Low endoglin vascular density and Ki67 index in Gleason score 6 tumours may identify prostate cancer patients suitable for surveillance.
The aim of this study was to explore whether vascular density and tumour cell proliferation are related to the risk of prostate cancer death in patients managed by watchful waiting. From a consecutive series of men diagnosed with prostate cancer at transurethral resection in 1975-1990, tissue microarrays (TMAs) were constructed. A majority of men had no metastases at diagnosis and were followed by watchful waiting (n = 295). The TMAs were stained for Ki67, endoglin and factor VIII-related antigen (vWf). In univariate Cox analyses, increased Ki67 index, endoglin vascular density and vWf vascular density were associated with shorter cancer-specific survival. Ki67 index and endoglin vascular density added independent prognostic information to clinical stage, estimated tumour size and Gleason score (GS) in multivariate Cox analysis. In GS 6 tumours, high Ki67 index and high endoglin vascular density identified patients with poor outcome. After 15 years of follow-up not a single man out of 34 men with low staining for both markers (35% of all GS 6 tumours) had died of prostate cancer, in contrast to 15 prostate cancer deaths among the remaining 63 men with GS 6 tumours (65% cumulative risk of prostate cancer death). vWf vascular density in benign areas was a prognostic marker in GS 6 and 7 tumours. Men with GS 6 tumours with both low Ki67 index and endoglin vascular density staining scores have a low risk of progression. Additional studies are needed to test whether these two markers can be applied to core biopsies to select patients suitable for surveillance.


SU-E-T-111: Single Line Multi-Detector Scintillation Dosimetry: Demonstration of Feasibility.
Obtain feasibility data on the use of multiple scintillators on a single optical line for dose measurements. A CsI (Tl doped) crystal and a plastic (Rexon Inc, Rp-408) scintillator detectors, both transparent, were attached to the end of a fiberoptic line and connected to an Ocean Optics USB-2000 spectrometer. After baseline spectra, spectra with the two scintillators adjacent to each other and then separated by a 7.6 cm plexiglass spacer were obtained. Irradiations were performed using 6 MV X-ray beam from a Varian EX linear accelerator. Utilizing the baseline spectra the dose received by each scintillator were calculated from the measured spectral peaks of the linear scintillator assemblies. Linearity tests were performed by varying dose and the dose rate in a homogeneous radiation field covering both scintillators. Unequal doses were delivered to the scintillator by gradually closing the collimator from one direction, blocking one detector at a time. Doses to the scintillators were modulated by different amount of solid water placed over the two detectors, as well. Measured scintillation spectra agreed with the published spectra. The spectra did not change with depth in the phantom. The multi-scintillator system response was strictly linear between 1.67 and 40 MUs, (approx. 1.3 to 31 cGy) and dose rate independent between 100 to 600 MU/min. The profile curves obtained by closing the collimator agreed with qualitatively expected curves. Doses measured under different phantom thicknesses were in good agreement with ion chamber measurements on the same locations (+/- 3%). The linearity and dose rate independence allow absolute dose calibration for given beam energies and scintillator arrangement. Multi-probe scintillation dosimetry along a single optical fiber is possible in therapeutic irradiation conditions. This is feasible by using signals from multiple select scintillators with distinct spectroscopic responses arranged along an optical fiber.


The Role of Chromosomal Instability in Cancer and Therapeutic Responses.
Cancer is one of the leading causes of death, and despite increased research in recent years, control of advanced-stage disease and optimal therapeutic responses remain elusive. Recent technological improvements have increased our understanding of human cancer as a heterogeneous disease. For instance, four hallmarks of cancer have recently been included, which in addition to being involved in cancer development, could be involved in therapeutic responses and resistance. One of these hallmarks is chromosome instability (CIN), a source of genetic variation in either altered chromosome number or structure. CIN has become a hot topic in recent years, not only for its implications in cancer diagnostics and prognostics, but also for its role in therapeutic responses. Chromosomal alterations are mainly used to determine genetic heterogeneity in tumors, but CIN could also reveal treatment efficacy, as many therapies are based on increasing CIN, which causes aberrant cells to undergo apoptosis. However, it should be noted that contradictory findings on the implications of CIN for the therapeutic response have been reported, with some studies associating high CIN with a better therapeutic response and others associating it with therapeutic resistance. Considering these observations, it is necessary to increase our understanding of the role CIN plays not only in tumor development, but also in therapeutic responses. This review focuses on recent studies that suggest possible mechanisms and consequences of CIN in different disease types, with a primary focus on cancer outcomes and therapeutic responses.


Laminins affect T cell trafficking and allograft fate.
Lymph nodes (LNs) are integral sites for the generation of immune tolerance, migration of CD4⁺ T cells, and induction of Tregs. Despite the importance of LNs in regulation of inflammatory responses, the LN-specific factors that regulate T cell migration and the precise LN structural domains in which differentiation occurs remain undefined. Using intravital and fluorescent microscopy, we found that alloreactive T cells traffic distinctly into the tolerant LN and colocalize in exclusive regions with alloantigen-presenting cells, a process required for Treg induction. Extracellular matrix proteins, including those of the laminin family, formed regions within the LN that were permissive for colocalization of alloantigen-presenting cells, alloreactive T cells, and Tregs. We identified unique expression patterns of laminin proteins in high endothelial venule basement membranes and the cortical ridge that correlated with alloantigen-specific immunity or immune tolerance. The ratio of laminin α4 to laminin α5 was greater in domains within tolerant LNs, compared with immune LNs, and blocking laminin α4 function or inducing laminin α5 overexpression disrupted T cell and DC localization and transmigration through tolerant LNs. Furthermore, reducing α4 laminin circumvented tolerance induction and induced cardiac allograft inflammation and rejection in murine models. This work identifies laminins as potential targets for immune modulation.


Treatment of anaphylactic sensitivity to peanuts by immunotherapy with injections of aqueous peanut extract.
Immediate hypersensitivity to peanuts is a frequent cause of anaphylactic reactions and deaths in children and adults. Currently, preventive treatment consists of avoidance, which is difficult because of the widespread and often disguised use of peanuts in the food industry. Twelve patients with immediate hypersensitivity to ingestion of peanuts were recruited. Half were treated with injections of peanut extract: a maintenance level of tolerance was first achieved by a rush protocol, then maintained with weekly injections for at least 1 year. The other six were untreated control subjects. All patients underwent double-blind, placebo-controlled, oral peanut challenges initially, after approximately 6 weeks, and after 1 year. All treated patients achieved the maintenance dose of 0.5 ml of 1:100 wt/vol peanut extract by the rush injection protocol. All experienced increased tolerance to double-blind, placebo-controlled peanut challenge and decreased sensitivity on titrated skin prick testing with peanut extract, whereas the threshold to oral peanut challenge and cutaneous reactivity to peanut extract were unchanged in the untreated control subjects. Systemic reactions were common in the treated group both during rush immunotherapy and with maintenance injections. Only three patients remained tolerant of the full maintenance dose. The increased tolerance to oral peanut challenge was maintained in the three subjects who received full maintenance doses, but there was partial (n = 2) or complete (n = 1) loss of protection in the patients who required dose reduction because of systemic reactions. Injections of peanut extract increase the tolerance of patients with peanut allergy to oral ingestion of peanuts. Injections result in repeated systemic reactions in most patients, even during maintenance injections. For clinical application of this method of treatment, a modified peanut extract is needed.


The dynamic landscape of fission yeast meiosis alternative-splice isoforms.
Alternative splicing increases the diversity of transcriptomes and proteomes in metazoans. The extent to which alternative splicing is active and functional in unicellular organisms is less understood. Here, we exploit a single-molecule long-read sequencing technique and develop an open-source software program called SpliceHunter to characterize the transcriptome in the meiosis of fission yeast. We reveal 14,353 alternative splicing events in 17,669 novel isoforms at different stages of meiosis, including antisense and read-through transcripts. Intron retention is the major type of alternative splicing, followed by alternate "intron in exon." Seven hundred seventy novel transcription units are detected; 53 of the predicted proteins show homology in other species and form theoretical stable structures. We report the complexity of alternative splicing along isoforms, including 683 intra-molecularly co-associated intron pairs. We compare the dynamics of novel isoforms based on the number of supporting full-length reads with those of annotated isoforms and explore the translational capacity and quality of novel isoforms. The evaluation of these factors indicates that the majority of novel isoforms are unlikely to be both condition-specific and translatable but consistent with the possibility of biologically functional novel isoforms. Moreover, the co-option of these unusual transcripts into newly born genes seems likely. Together, the results of this study highlight the diversity and dynamics at the isoform level in the sexual development of fission yeast.


Generation of finite power Airy beams via initial field modulation.
We investigate the finite power Airy beams generated by finite extent input beams such as a Gaussian beam, a uniform beam of finite extent, and an inverse Gaussian beam. Each has different propagation behavior: A finite Airy beam generated by a uniform input beam keeps its Airy profile much longer than the conventional finite Airy beam. Also, an inverse Gaussian beam generates a finite Airy beam with a good bent focusing in free space. In this paper, the analysis and experimental results of finite Airy beams are presented.


Sex differences of the association between marital status and coronary artery disease in patients experiencing chest pain: The Korean Women's Chest Pain Registry.
Marriage is an important social practice that predicts various health outcomes, including those of cardiovascular disease. This study investigated the sex-specific association between marital status and coronary artery disease (CAD) in patients experiencing chest pain. Study data were obtained from a nationwide registry of patients with suspected CAD who underwent coronary angiography. We dichotomized all participants according to marital status as follows: without a spouse (single, divorced, or widowed), and with a spouse. Significant CAD was defined as greater than 50% narrowing of the lumen diameter in any of the coronary arteries. The presence of significant CAD was significantly higher in female participants without a spouse than in female participants with a spouse. However, there was no significant difference in the presence of CAD in men between the two groups. Interestingly, there was also no significant difference in the presence of CAD between women without a spouse and men without a spouse. After adjustment for all possible confounding factors, women without a spouse had a 1.62-fold increased hazard for significant CAD in multivariate regression analysis. In contrast to men, a without spouse status is independently associated with significant CAD in women experiencing chest pain. Women with a spouse had the lowest presence of CAD among all groups. In the management of female patients experiencing chest pain, clinicians should consider their social characteristics, including marital status, to predict subsequent cardiovascular disease and determine the appropriate treatment. : Video Summary:http://links.lww.com/MENO/A567.


On the functional order of binocular rivalry and blind spot filling-in.
Binocular rivalry is an important phenomenon for understanding the mechanisms of visual awareness. Here we assessed the functional locus of binocular rivalry relative to blind spot filling-in, which is thought to transpire in V1, thus providing a reference point for assessing the locus of rivalry. We conducted two experiments to explore the functional order of binocular rivalry and blind spot filling-in. Experiment 1 examined if the information filled-in at the blind spot can engage in rivalry with a physical stimulus at the corresponding location in the fellow eye. Participants' perceptual reports showed no difference between this condition and a condition where filling-in was precluded by presenting the same stimuli away from the blind spot, suggesting that the rivalry process is not influenced by any filling-in that might occur. In Experiment 2, we presented the fellow eye's stimulus directly in rivalry with the 'inducer' stimulus that surrounds the blind spot, and compared it with two control conditions away from the blind spot: one involving a ring physically identical to the inducer, and one involving a disc that resembled the filled-in percept. Perceptual reports in the blind spot condition resembled those in the 'ring' condition, more than those in the latter, 'disc' condition, indicating that a perceptually suppressed inducer does not engender filling-in. Thus, our behavioral data suggest binocular rivalry functionally precedes blind spot filling-in. We conjecture that the neural substrate of binocular rivalry suppression includes processing stages at or before V1.


Allergen-induced release of GM-CSF and IL-8 in vitro by nasal polyp tissue from atopic subjects prolongs eosinophil survival.
Eosinophilia is a feature of nasal polyposis. The aim of this study was to determine the role of cytokines and allergen in maintaining the eosinophilic infiltrate in this condition. Polyp fragments from house dust mite (HDM)-sensitive atopic individuals and nonatopic individuals were cultured in the presence of HDM, or phytohaemagglutinin (PHA) or culture medium alone. Culture supernatants were assayed for interleukins (IL) 3, 5, and 8 and granulocyte macrophage colony stimulating factor (GM-CSF), and eosinophil survival enhancing activity (ESEA) in vitro. Significant ESEA was produced spontaneously. When polyp tissue from atopics, but not from nonatopics, was stimulated with allergen for 2 days there was a further increase in ESEA associated with a median 12 and fourfold increase in IL-8 and GM-CSF, respectively. This increased ESEA was markedly reduced with anti-GM-CSF and, to a lesser extent, anti-IL-8 blocking antibodies. When stimulated with PHA, polyp tissue from atopic subjects also produced increased ESEA, implicating possible T-cell involvement. This was associated with a small (twofold), but significant, increase in IL-8 and a less consistent increase in GM-CSF. However, anti-IL-8 or anti-GM-CSF blocking antibodies failed to reduce the ESEA in these supernatants, suggesting involvement of other mechanisms. This study suggests that in sensitized individuals, allergen may contribute to polyp eosinophilia by stimulating the production of granulocyte/macrophage colony stimulating factor and interleukin 8.


Stretch-dependent extinction ratio in a birefringent single-mode optical fiber.
The stretch-dependent extinction ratio for a birefringent single-mode fiber is examined. This ratio exhibits a quasi-periodic change as the fiber is axially stretched. This effect can be explained as the power transfer from alinearly polarized guided HE(11) mode to an orthogonally polarized HE(11) that is due to mode coupling.


Evaluation of Carotid Flow Time to Assess Fluid Responsiveness in the Emergency Department.
Assessing fluid responsiveness in critically ill patients is challenging. Objective, noninvasive tests that are easy to perform are needed. Doppler measurements of dynamic carotid artery parameters such as carotid blood flow (CBF) and carotid flow time (CFT) are being studied as the potential indicators of volume responsiveness, but the data supporting its use are sparse. This prospective, observational study was conducted in the adult emergency department from June to September 2018. Patients who were prescribed a bolus of 500 ml of crystalloid for any indication were enrolled. Carotid Doppler was performed before and after a fluid bolus to measure the change in CBF and CFT. The aim of our study was to determine if CFT can be used as a marker of fluid responsiveness. During the 4-month study period, 209 patients were recruited through convenient sampling after obtaining informed written consent. 29.6% of patients presented with a mean arterial pressure (MAP) <65, among whom 58.1% had septic shock. The baseline CBF was 643.0 ± 212.7 ml/min, and it was 583.9 ± 207.1 ml/min and 668 ± 210.8 ml/min in hypotensive and normotensive patients, respectively. Considering a >10% increase in CBF as fluid response, there were 59% responders and 41% nonresponders. The MAP increased by 9.5% in the responders, while there was no significant change in CFT after the fluid bolus. There was no difference in CFT among the responders as compared to the nonresponders. There was no correlation between the change of CBF and CFT (r [207] = 0.013, P = 0.061) after the fluid bolus. Though easy to perform, CFT is probably not a good indicator of fluid responsiveness.


Analysis of G-block distributions and their impact on gel properties of in vitro epimerized mannuronan.
This paper reports a study of the distribution and function of homopolymeric guluronic acid blocks (G-blocks) in enzymatically modified alginate. High molecular weight mannuronan was incubated with one native (AlgE6) and two engineered G-block generating mannuronan C-5 epimerases (AlgE64 and EM1). These samples were found to contain G-blocks with a DP ranging from 20 to approximately 50, lacking the extremely long G-blocks (DP > 100) found in algal alginates. Calcium gels from epimerized materials were highly compressible and exhibited higher syneresis and rupture strength but lower Youngs modulus than gels made from algal polymers of similar G-content. Addition of extremely long G-blocks to the epimerized alginate resulted in decreased syneresis and rupture strength and an increased Young's modulus that can be explained by reinforcement of the cross-linking zones at the cost of length and/or numbers of elastic segments. The presence and impact of these extremely long G-blocks found in natural alginates suggest that alginate gels can be viewed as a nanocomposite material.


Larger dentate gyrus volume as predisposing resilience factor for the development of trauma-related symptoms.
Early interventions to improve resilience require the identification of objective risk biomarkers for PTSD symptom development. Although altered hippocampal and amygdala volumes are consistently observed in PTSD, it remains currently unknown whether they represent a predisposing vulnerability factor for PTSD symptom development or an acquired consequence of trauma exposure and/or the disorder. We conducted a longitudinal, prospective study in 210 police recruits at high risk for trauma exposure (56 females(26.7%); mean[SD] age = 24.02[5.19]). Structural MRI scans and trauma-related symptom severity were assessed at pre-trauma baseline and at 16-month follow-up. Between assessments, police recruits were exposed to various potentially traumatic events during their police training. Police recruits reported a significant increase in police-related trauma exposure and stress-related symptoms between assessments. Smaller hippocampal left dentate gyrus (DG) volumes at baseline predicted increase in self-reported PTSD symptoms (B[SE] = -0.21[0.08], p = 0.011), stress symptoms (B[SE] = -0.16[0.07], p = 0.024) and negative affect (B[SE] = -0.21[0.07], p = 0.005) upon trauma exposure. Amount of police-related trauma exposure between assessments was positively associated with an increase in left basal amygdala nucleus volume (B[SE] = 0.11[0.05], p = 0.026). Taken together, smaller DG-volumes pre-trauma may represent a predisposing neurobiological vulnerability factor for development of trauma-related symptoms. On the other hand, amount of trauma exposure between assessments was positively associated with increased amygdala basal nucleus volume, suggesting acquired neural effects. These findings suggest that preventive interventions for PTSD aimed at improving resilience could be targeted at increasing DG-volume and potentially its functioning.


Robust prediction of t-year survival with data from multiple studies.
Recently meta-analysis has been widely utilized to combine information across multiple studies to evaluate a common effect. Integrating data from similar studies is particularly useful in genomic studies where the individual study sample sizes are not large relative to the number of parameters of interest. In this article, we are interested in developing robust prognostic rules for the prediction of t-year survival based on multiple studies. We propose to construct a composite score for prediction by fitting a stratified semiparametric transformation model that allows the studies to have related but not identical outcomes. To evaluate the accuracy of the resulting score, we provide point and interval estimators for the commonly used accuracy measures including the time-specific receiver operating characteristic curves, and positive and negative predictive values. We apply the proposed procedures to develop prognostic rules for the 5-year survival of breast cancer patients based on five breast cancer genomic studies.