The CSAW Study (Can Shoulder Arthroscopy Work?) - a placebo-controlled surgical intervention trial assessing the clinical and cost effectiveness of arthroscopic subacromial decompression for shoulder pain: study protocol for a randomised controlled trial.
Arthroscopic subacromial decompression (ASAD) is a commonly performed surgical intervention for shoulder pain. The rationale is that removal of a bony acromial spur relieves symptoms by decompressing rotator cuff tendons passing through the subacromial space. However, the efficacy of this procedure is uncertain. The objective of this trial was to compare the efficacy and cost-effectiveness of ASAD in patients with subacromial pain using appropriate control groups, including placebo intervention. The trial is a three-group, parallel design, pragmatic, randomised controlled study. The intervention content for each group (ASAD, active monitoring with specialist reassessment (AMSR) and investigational shoulder arthroscopy only (AO)) enables assessment of (1) the efficacy of the surgery against no surgery; (2) the need for a specific component of the surgery-namely, removal of the bony spur; and (3) quantification of the placebo effect. Concealed allocation was performed using a 1:1:1 randomisation ratio and using age, sex, baseline Oxford Shoulder Score (OSS) and centre as minimisation criteria. The primary outcome measure is the OSS at 6 months post randomisation. A total of 300 patients recruited over 24 months from a minimum of 14 UK shoulder units over 24 months were required to detect a difference of 4.5 points on the OSS (standard deviation, 9) with 90% power and to allow for 15% loss to follow-up. Secondary outcomes include cost-effectiveness, pain, complications and patient satisfaction. A substantial qualitative research component is included. The primary analysis will be conducted on the modified intention-to-treat analysis. Sensitivity analysis will be used to assess the robustness of the results with regard to the underlying assumptions about missing data using multiple imputation. This trial uses an innovative design to account for the known placebo effects of surgery, but it also will delineate the mechanism for any benefit from surgery. The investigational AO group is considered a placebo intervention (not sham surgery), as it includes all components of subacromial decompression except the critical surgical element. Some discussion is also dedicated to the challenges of conducting placebo surgery trials. UK Clinical Research Network UKCRN12104. Registered 22 May 2012. International Standard Randomised Controlled Trial ISRCTN33864128 . Registered 22 June 2012. ClinicalTrials.gov NCT01623011 . Registered 15 June 2012.


The efficacy and safety of probiotics for prevention of chemoradiotherapy-induced diarrhea in people with abdominal and pelvic cancer: a systematic review and meta-analysis.
A systematic review and meta-analysis were designed to evaluate the efficacy and safety of probiotics for prevention of chemoradiotherapy-induced diarrhea in people with abdominal and pelvic cancer. We searched the Cochrane Library, PubMed, EMBASE and Web of Science up to November 2015. We also hand searched the citation lists of included studies and previously identified systematic reviews to identify further relevant trials. Odds ratio (OR) was used to compare efficacy, and the pooled OR was estimated using a random effects model; heterogeneity was assessed with Cochran's Q and the Higgins' I2-test. Two reviewers assessed trial quality and extracted data independently. Analysis and bias for each included study were performed using Review Manager 5.2. Nine randomized and placebo-controlled studies (N=1265 participants) were included for assessing efficacy, of which seven were about radiotherapy and two about chemotherapy. Probiotic groups were compared with control groups with respect to the the incidence of diarrhea, OR=0.47 (95% confidence interval 0.28-0.76; P=0.002). Eleven studies, including 1612 people (873 consuming probiotics and 739 not consuming probiotics), were used for the analysis of safety of probiotics. Of the 11 studies, seven studies had no adverse events (AEs) caused by probiotics, whereas four studies reported varying degrees of AEs in their treatment. Probiotics may have a beneficial effect in prevention of chemoradiotherapy-induced diarrhea generally, especially for Grade⩾2 diarrhea. Probiotics may rarely cause AEs.


Enhanced tunneling conductivity induced by gelation of attractive colloids.
We show that the formation of a gel by conducting colloidal particles leads to a dramatic enhancement in bulk conductivity, due to interparticle electron tunneling, combining predictions from molecular-dynamics simulations with structural measurements in an experimental colloid system. Our results show how colloidal gelation can be used as a general route to huge enhancements of conductivity, and suggest a feasible way for developing cheap materials with novel properties and low metal content.


The implications of facility design and enabling policies on the economics of dry anaerobic digestion.
Diverting organic waste from landfills provides significant emissions benefits in addition to preserving landfill capacity and creating value-added energy and compost products. Dry anaerobic digestion (AD) is particularly attractive for managing the organic fraction of municipal solid waste because of its high-solids composition and minimal water requirements. This study utilizes empirical data from operational facilities in California in order to explore the key drivers of dry AD facility profitability, impacts of market forces, and the efficacy of policy incentives. The study finds that dry AD facilities can achieve meaningful economies of scale with organic waste intake amounts larger than 75,000 tonnes per year. Materials handling costs, including the disposal of inorganic residuals from contaminated waste streams and post-digester mass (digestate) management, are both the largest and the most uncertain facility costs. Facilities that utilize the biogas for vehicle fueling and earn associated fuel credits collect revenues that are 4-6x greater than those of facilities generating and selling electricity and 10-12x greater than facilities selling natural gas at market prices. The results suggest important facility design elements and enabling policies to support an increased scale of organic waste handling infrastructure.


Serial sectioning and three-dimensional reconstruction of mouse Peyer's patch.
Peyer's patches (PPs) are typical gut-associated lymphoid tissues that are located along the wall of the small intestine and that serve as the major sites for generation of immunity to intestinal antigens. Their unique micro-organization is crucial for the generation of the immune response. Although many studies have been reported on the functional anatomy of PP, most investigations have relied on the random sampling of these organs, a procedure that is insufficient for the systemic scanning of the whole tissue or organ. By combining a variety of methods, we have accomplished 3D reconstructions of Peyer's patch. The complex reconstruction procedure includes several steps. First, the PP are serially sectioned at a thickness of 10 microm with a cryostat; (b) the serial sections are stained with haematoxylin-eosin; (c) multiple images from the PP are acquired with an automatic microscope and stitched together with Image Pro Plus to generate a composite image for the whole organ; (d) the serial images are reconstructed with Image J, Reconstruct and 3D Studio Max. The combinational approaches that we present here should be of value when extrapolated to the reconstruction of other tissues or organs. Moreover, the 3D model that we have created and our stereological analysis should be extremely helpful for further in vivo microscopic studies of PP with respect to the immune response.


Accuracy of intrasheath injection techniques for de Quervain's disease: a cadaveric study.
The purpose of this study was to assess the accuracy of injections of dye into the first extensor compartment of the wrist using three different techniques in 150 wrists in 75 fresh cadavers. To compare injections, 50 wrists from 25 cadavers were used for each technique. After the injections, the first extensor compartment was dissected and the dispersion of dye around the abductor pollicis longus and extensor pollicis brevis tendons was investigated. In 72 % of all the wrists, acrylic dye was dispersed into one compartment containing both the abductor pollicis longus and extensor pollicis brevis tendons, but in 28% of the wrists there was a separate compartment for extensor pollicis brevis and dye entered only one of the compartments (14% for each compartment). For accurate injections, we think the injections should be made separately over the two tendons, to allow for the possibility of a septum within the compartment.


Damage to histaminergic tuberomammillary neurons and other hypothalamic neurons with traumatic brain injury.
The need for increased sleep after traumatic brain injury is a common and disabling complaint, yet its etiology is unknown. Previous studies have demonstrated diffuse damage to various hypothalamic systems, but the integrity of the histaminergic tuberomammillary nucleus, a major arousal-promoting system located in the posterior hypothalamus, has never been examined in head trauma patients. Here, we demonstrate that severe head trauma is associated with a marked loss (41%) of histaminergic neurons. Reduced histamine signaling may contribute to increased sleep need, and therapies that enhance histaminergic tone may improve arousal after head trauma or other conditions.


De novo crypt formation and juvenile polyposis on BMP inhibition in mouse intestine.
Little is known about the signaling mechanisms that determine the highly regular patterning of the intestinal epithelium into crypts and villi. With the use of mouse models, we show that bone morphogenetic protein (BMP)-4 expression occurs exclusively in the intravillus mesenchyme. Villus epithelial cells respond to the BMP signal. Inhibition of BMP signaling by transgenic expression of noggin results in the formation of numerous ectopic crypt units perpendicular to the crypt-villus axis. These changes phenocopy the intestinal histopathology of patients with the cancer predisposition syndrome juvenile polyposis (JP), including the frequent occurrence of intraepithelial neoplasia. Many JP cases are known to harbor mutations in BMP pathway genes. These data indicate that intestinal BMP signaling represses de novo crypt formation and polyp growth.


The dissociated form of kappa-casein is the precursor to its amyloid fibril formation.
Bovine milk kappa-casein forms a self-associating oligomeric micelle-like species, in equilibrium with dissociated forms. In its native form, intra- and inter-molecular disulfide bonds lead to the formation of multimeric species ranging from monomers to decamers. When incubated under conditions of physiological pH and temperature, both reduced and non-reduced kappa-casein form highly structured beta-sheet amyloid fibrils. We investigated whether the precursor to kappa-casein fibril formation is a dissociated state of the protein or its oligomeric micelle-like form. We show that reduced kappa-casein is capable of forming fibrils well below its critical micelle concentration, i.e. at concentrations where only dissociated forms of the protein are present. Moreover, by regulating the degree of disulfide linkages, we were able to investigate how oligomerization of kappa-casein influences its propensity for fibril formation under conditions of physiological pH and temperature. Thus, using fractions containing different proportions of multimeric species, we demonstrate that the propensity of the disulfide-linked multimers to form fibrils is inversely related to their size, with monomeric kappa-casein being the most aggregation prone. We conclude that dissociated forms of kappa-casein are the amyloidogenic precursors to fibril formation rather than oligomeric micelle-like species. The results highlight the role of oligomerization and natural binding partners in preventing amyloid fibril formation by disease-related proteins in vivo.


The influence of action potentials on the development of the central visual pathway in mammals.
The development of the mammalian visual system begins prenatally at distributed sites, where cells generated at different embryonic ages are destined to interconnect and form the visual pathways, and ends postnatally with the functional tuning of neuronal receptive-field properties. It is reasonable to assume that the earliest stages in this developmental sequence are completed prior to the onset of neural activity, and also that activity may play only a minor role or even none at all in primary axon outgrowth and pathway finding (Harris, 1981; Harris and Holt, 1990). However, recent evidence indicates that subsequent events in development, such as the sorting of axons at their targets, the cellular differentiation of target cells and the formation of synaptic contacts by developing axons, are all influenced by action potentials. Action potentials in the developing retino-geniculo-cortical pathway can be eliminated by blocking the voltage-gated sodium channel with tetrodotoxin. Prenatal blockade prevents the laminar segregation of retinogeniculate axons. Postnatal blockade interrupts the formation of retinogeniculate synaptogenesis, slows the cytoarchitectonic differentiation of the lateral geniculate nucleus and produces abnormalities in the responses of lateral geniculate neurons. In the visual cortex, the development of cells and synapses is retarded and the eye-specific separation of geniculocortical axons is halted, thereby blocking the formation of ocular dominance columns. While the cellular mechanisms underlying these effects are not understood, a partial restoration of normal development can be produced by stimulating blocked axonal pathways electrically.


ActinoBase: tools and protocols for researchers working on Streptomyces and other filamentous actinobacteria.
Actinobacteria is an ancient phylum of Gram-positive bacteria with a characteristic high GC content to their DNA. The ActinoBase Wiki is focused on the filamentous actinobacteria, such as Streptomyces species, and the techniques and growth conditions used to study them. These organisms are studied because of their complex developmental life cycles and diverse specialised metabolism which produces many of the antibiotics currently used in the clinic. ActinoBase is a community effort that provides valuable and freely accessible resources, including protocols and practical information about filamentous actinobacteria. It is aimed at enabling knowledge exchange between members of the international research community working with these fascinating bacteria. ActinoBase is an anchor platform that underpins worldwide efforts to understand the ecology, biology and metabolic potential of these organisms. There are two key differences that set ActinoBase apart from other Wiki-based platforms: [1] ActinoBase is specifically aimed at researchers working on filamentous actinobacteria and is tailored to help users overcome challenges working with these bacteria and [2] it provides a freely accessible resource with global networking opportunities for researchers with a broad range of experience in this field.


A Dose Escalation Study of Trientine Plus Carboplatin and Pegylated Liposomal Doxorubicin in Women With a First Relapse of Epithelial Ovarian, Tubal, and Peritoneal Cancer Within 12 Months After Platinum-Based Chemotherapy.
Background: Epithelial ovarian cancer (EOC) is the leading cause of gynecological cancer-related deaths worldwide. Preclinical studies found that copper-lowering agents could re-sensitize platinum-resistant cancer cells by enhancing the human copper transporter 1 (hCtr1)-mediated uptake of platinum. In the clinic, re-sensitization of platinum-resistance in relapsed EOC has been discovered by the application of trientine plus platinum (NCT01178112). However, no pharmacokinetic data of trientine has been reported in cancer patients. Purpose: Our study aimed to explore the safety and activity of trientine combined with carboplatin and pegylated liposomal doxorubicin (PLD) in patients with EOC, tubal, and peritoneal cancer who experienced disease progression during platinum-based chemotherapy or showed relapse <12 months after completing first-line chemotherapy. Also, we aimed to demonstrate pharmacokinetic parameters and to discover potential biomarkers in our EOC patients. Methods: In this dose escalation study, 18 Asian patients in six dosing cohorts received fixed doses of carboplatin (AUC 4) and PLD (LipoDox®, TTY Biopharm Co. Ltd., Taipei, Taiwan) (40 mg/m2, day 1 per 4-week cycle), and escalated daily trientine doses (range: 300-1800 mg; initiated 7 days before the 1st combination cycle) according to a 3 + 3 design. Results: No dose-limiting toxicity or treatment-related death was observed. Four patients (22.2%) developed grade 3 drug-related adverse events (AEs), whereas no grade 4 AEs were encountered. Anemia and grade 2 dizziness were the most common hematological toxicity and neurotoxicity, respectively. In a pharmacokinetics comparison with healthy volunteers in the literature, our patients achieved greater absorption after oral trientinem, and more rapid elimination of triethylenetetramine dihydrochloride at high doses. The clinical benefit rate was 33.3 and 50.0% in the platinum-resistant and the partially platinum-sensitive group, respectively. A high baseline serum iron level and low serum copper level might help differentiate subgroups of patients with different clinical responses. Nevertheless, no associations of the clinical response with the levels of serum hCtr1, ceruloplasmin, or copper were observed. Conclusion: Combination therapy with carboplatin, trientine, and PLD was well-tolerated and safe. Our results encourage the development of a future phase II trial. Clinical trial registration: ClinicalTrials.gov # NCT03480750.


The respiratory responses of Carcinus maenas to declining oxygen tension.
The degree of respiratory independence shown by Carcinus under conditions of declining oxygen tension is dependent on the animal's level of activity. Inactive Carcinus are capable of maintaining respiratory independence down to a Po2 of 60-80 mmHg. This is achieved primarily by an increase in ventilation volume such that the amount of oxygen made available at the respiratory surfaces remains constant over a wide range of oxygen tension. The Po2 at which this can no longer be maintained corresponds closely to the Po2 at which respiratory independence is lost. Under normoxic conditions the Po2 of the post- and prebranchial blood was 97 and 18 mmHg respectively. At the high oxygen tensions prevailing in the postbranchial blood the respiratory pigment is fully saturated. Under conditions of declining oxygen tension the heart rate remains more or less constant until the Po2 reaches 60-80 mmHg, the onset of bradycardia coinciding with the loss of saturation of the haemocyanin. Although cardiac output falls during hypoxia, the capacity rate ratio remains approximately constant, which enables the effectiveness of oxygen uptake by the blood to remain at a high level.


Swedish Plectida (Nematoda). Part 6. Neocamacolaimus parasiticus gen. n., sp. n.
A new genus Neocamacolaimus gen. n., with one new species N. parasiticus gen. n., sp. n. is described from the benthic polychaete Sphaerosyllis cf. hystrix collected in the Skagerrak off the west coast of Sweden. Neocamacolaimus gen. n. is placed in the family Camacolaimidae and is particularly characterised by having annulated cuticle with lateral alae; setiform cephalic sensilla located at level with amphids; amphidial fovea ventrally spiral; buccal cavity without armament; pharynx muscular; nerve ring located at base of pharynx; male reproductive system diorchic with outstretched testes; spicules weakly arcuate with straight manubrium; gubernaculum absent; alveolar supplements located in the pharyngeal region; tubular supplements absent; tail conoid; caudal glands and spinneret present. Juveniles of this genus are particularly characterised by their parasitic lifestyle and the following unique morphological features: lips form a dorso-ventrally elongated perioral disc with internal sclerotizations: one midventral and two dorsosublateral (right and left); cephalic sensilla setiform, subventral sensilla are noticeably longer than the subdorsal ones; intestine extends posterior to rectum and anal opening, forming a post-anal pouch.


Accuracy of digital periapical radiography and cone-beam computed tomography in detecting external root resorption.
The purpose of this study was to evaluate and compare the efficacy of cone-beam computed tomography (CBCT) and digital intraoral radiography in diagnosing simulated small external root resorption cavities. Cavities were drilled in 159 roots using a small spherical bur at different root levels and on all surfaces. The teeth were imaged both with intraoral digital radiography using image plates and with CBCT. Two sets of intraoral images were acquired per tooth: orthogonal (PA) which was the conventional periapical radiograph and mesioangulated (SET). Four readers were asked to rate their confidence level in detecting and locating the lesions. Receiver operating characteristic (ROC) analysis was performed to assess the accuracy of each modality in detecting the presence of lesions, the affected surface, and the affected level. Analysis of variation was used to compare the results and kappa analysis was used to evaluate interobserver agreement. A significant difference in the area under the ROC curves was found among the three modalities (P=0.0002), with CBCT (0.81) having a significantly higher value than PA (0.71) or SET (0.71). PA was slightly more accurate than SET, but the difference was not statistically significant. CBCT was also superior in locating the affected surface and level. CBCT has already proven its superiority in detecting multiple dental conditions, and this study shows it to likewise be superior in detecting and locating incipient external root resorption.


β2-Agonist induced cAMP is decreased in asthmatic airway smooth muscle due to increased PDE4D.
Asthma is associated with airway narrowing in response to bronchoconstricting stimuli and increased airway smooth muscle (ASM) mass. In addition, some studies have suggested impaired β-agonist induced ASM relaxation in asthmatics, but the mechanism is not known. To characterize the potential defect in β-agonist induced cAMP in ASM derived from asthmatic in comparison to non-asthmatic subjects and to investigate its mechanism. We examined β(2)-adrenergic (β(2)AR) receptor expression and basal β-agonist and forskolin (direct activator of adenylyl cyclase) stimulated cAMP production in asthmatic cultured ASM (n = 15) and non-asthmatic ASM (n = 22). Based on these results, PDE activity, PDE4D expression and cell proliferation were determined. In the presence of IBMX, a pan PDE inhibitor, asthmatic ASM had ∼50% lower cAMP production in response to isoproterenol, albuterol, formoterol, and forskolin compared to non-asthmatic ASM. However when PDE4 was specifically inhibited, cAMP production by the agonists and forskolin was normalized in asthmatic ASM. We then measured the amount and activity of PDE4, and found ∼2-fold greater expression and activity in asthmatic ASM compared to non-asthmatic ASM. Furthermore, inhibition of PDE4 reduced asthmatic ASM proliferation but not that of non-asthmatic ASM. Decreased β-agonist induced cAMP in ASM from asthmatics results from enhanced degradation due to increased PDE4D expression. Clinical manifestations of this dysregulation would be suboptimal β-agonist-mediated bronchodilation and possibly reduced control over increasing ASM mass. These phenotypes appear to be "hard-wired" into ASM from asthmatics, as they do not require an inflammatory environment in culture to be observed.


Estradiol accelerates the effects of fluoxetine on serotonin 1A receptor signaling.
A major problem with current anti-depressant therapy is that it takes on average 6-7 weeks for remission. Since desensitization of serotonin (5-HT)1A receptor signaling contributes to the anti-depressive response, acceleration of the desensitization may reduce this delay in response to antidepressants. The purpose of the present study was to test the hypothesis that estradiol accelerates fluoxetine-induced desensitization of 5-HT1A receptor signaling in the paraventricular nucleus of the hypothalamus (PVN) of rats, via alterations in components of the 5-HT1A receptor signaling pathway. Ovariectomized rats were injected with estradiol and/or fluoxetine, then adrenocorticotropic hormone (ACTH) and oxytocin responses to a 5-HT1A receptor agonist (+)-8-hydroxy-2-dipropylaminotetralin (8-OH-DPAT) were examined to assess the function of 5-HT1A receptors in the PVN. Treatment with estradiol for either 2 or 7 days or fluoxetine for 2 days produced at most a partial desensitization of 5-HT1A receptor signaling, whereas 7 days of fluoxetine produced full desensitization. Combined treatment with estradiol and fluoxetine for 2 days produced nearly a full desensitization, demonstrating an accelerated response compared to either treatment alone. With two days of combined treatments, estradiol prevented the fluoxetine-induced increase in 5-HT1A receptor protein, which could contribute to the more rapid desensitization. Furthermore, EB treatment for 2 days decreased the abundance of the 35 kD Gαz protein which could contribute to the desensitization response. We found two isoforms of Gαz proteins with molecular mass of 35 and 33 kD, which differentially distributed in the detergent resistant microdomain (DRM) and in Triton X-100 soluble membrane region, respectively. The 35 kD Gαz proteins in the DRM can be sumoylated by SUMO1. Stimulation of 5-HT1A receptors with 8-OH-DPAT increases the sumoylation of Gαz proteins and reduces the 33 kD Gαz proteins, suggesting that these responses may be related to the desensitization of 5-HT1A receptors. Treatment with estradiol for 2 days also reduced the levels of the G-protein coupled estrogen receptor GPR30, possibly limiting to the ability of estradiol to produce only a partial desensitization response. These data provide evidence that estradiol may be effective as a short-term adjuvant to SSRIs to accelerate the onset of therapeutic effects.


An early granulocyte colony-stimulating factor treatment attenuates neuropathic pain through activation of mu opioid receptors on the injured nerve.
Several studies have shown that the mu opioid receptor (MOR) located in the peripheral nerves can be activated after nerve injury and that it attenuates peripheral nociceptive signals to the spinal dorsal horn. Various cytokines and phosphorylated-p38 (p-p38) activation in the dorsal horn also play an important role in neuropathic pain development. Granulocyte-colony stimulating factor (GCSF) is a growth factor that can stimulate granulocyte formation and has been shown to exert an analgesic effect on neuropathic pain through recruiting opioid-containing leukocytes to the injured nerve. However, the underlying mechanisms are not well understood. Herein, the results of behavior tests in addition to MOR levels in the injured sciatic nerve and the levels of p-p38 and various cytokines in the spinal dorsal horn were studied in vehicle-treated or GCSF-treated chronic constriction injured (CCI) rats at different time points (i.e., 1, 3, and 7 days, respectively) after nerve injury. The results showed that a single early systemic GCSF treatment after nerve injury can up-regulate MORs in the injured nerve, which can decrease peripheral nociceptive signals. Thereafter, those changes suppress the pro-inflammatory cytokine IL-6 but enhance the anti-inflammatory cytokine IL-4, followed by decreases in p-p38 in the dorsal horn, and thus further attenuate neuropathic pain.


Formation of angiotensin III by angiotensin-converting enzyme.
Angiotensin III is formed from des-Asp1 -angiotensin I by angiotensin-converting enzyme. The Km (11 muM) of the reaction is one-third of that for the conversion of angiotensin I into angiotensin II. As suggested by the Km values, bradykinin, peptide BPP9a and angiotensins II and III are better inhibitors of the formation of angiotensin II than of the formation of angiotensin III.


Thrombus precursor protein and clinical outcomes in patients with acute coronary syndromes.
We sought to test the prognostic performance of thrombus precursor protein (TpP) in patients presenting with an acute coronary syndrome (ACS). Because thrombus formation is a critical step in the development of ACS, a measurement of activated coagulation could yield important information. Thrombus precursor protein is a biomarker that is used to measure soluble fibrin polymers, which are the penultimate products in fibrin formation. We measured the levels of TpP in 284 healthy volunteers and in 2,349 patients with ACS. Median TpP concentrations were 3.6 mug/ml (interquartile range 2.6 to 5.5) in the volunteers and 8.9 mug/ml (interquartile range 4.9 to 15.9) in the ACS patients (p < 0.001). Patients with ACS who had elevated TpP were older, more likely to be women, and more likely to have diabetes and pre-existing CAD (p < 0.02 for each). Thrombus precursor protein levels greater than the median were associated with a significantly increased risk for the composite of death, myocardial infarction (MI), or recurrent ischemia leading to rehospitalization or urgent revascularization through 10 months (hazard ratio [HR] 1.45, p < 0.001), as well as death or MI (HR 1.42, p = 0.02). We found that TpP correlated only weakly with cardiac troponin I, B-type natriuretic peptide, and high-sensitivity C-reactive protein (|r| <0.15 for each). After adjusting for clinical characteristics, cardiac troponin I, high-sensitivity C-reactive protein, and B-type natriuretic peptide, we found that patients with TpP levels greater than the median remained at significantly increased risk for the composite outcome (adjusted HR 1.51, p = 0.001) and death or MI (adjusted HR 1.58, p = 0.02). In patients with ACS, increased levels of TpP are associated with an increased risk of death or ischemic complications. The incorporation of a marker of activated coagulation, such as TpP, with established cardiovascular risk factors may offer valuable complementary insight into risk assessment in ACS.


Factors associated with male mating success of the dengue vector mosquito, Aedes aegypti.
We studied the effects of male Aedes aegypti age, body size, and density on mating success under laboratory and field conditions. Older males under field conditions transferred the greatest number of sperm to females (1,152 by 1-day-old males to 1,892 sperm by 10-day-old males). Larger males inseminated females with more sperm than smaller ones. Male age, female body size, and density also influenced male mating success. Larger females successfully mated with males more often than smaller females, especially with older males (> 25 days old). Female insemination rates in small high-density laboratory cages (0.009 m(3)) were artificially high (81.6-98.7%) compared with rates (65.4-84.6%) in large low-density field cages (9 m(3)). This is the first study to systematically evaluate the effect of Ae. aegypti male body size and age on sperm transfer to females and the first one to evaluate the mating performance of males in a field setting.


Renal hemodynamic, inflammatory, and apoptotic responses to lipopolysaccharide in HO-1-/- mice.
Lipopolysaccharide (LPS) induces the stress-responsive gene heme oxygenase-1 (HO-1). The present study examined the significance of HO-1 in response to LPS. In HO-1(-/-) mice, as compared with HO-1(+/+) mice, LPS provoked a greater reduction in glomerular filtration rate and renal blood flow, increased renal cytokine expression, and increased activation of nuclear factor (NF)-kappaB. Conversely, HO-1-overexpressing renal epithelial cells, exposed to LPS, exhibited a blunted activation of NF-kappaB and less phosphorylation of its inhibitor, IkappaB. In HO-1(-/-) mice, as compared with HO-1(+/+) mice, LPS provoked markedly greater elevations in serum levels of Th1 cytokines, Th2 cytokines, chemokines, and cytokines that stimulate bone marrow progenitors. The liver, a major source of serum cytokines, showed an increased activation of NF-kappaB in LPS-treated HO-1(-/-) mice. In addition, LPS provoked widespread apoptosis of immune cells in the spleen and thymus in HO-1(-/-) mice but not in HO-1(+/+) mice. We conclude that HO-1 deficiency exhibits a heightened and dysregulated inflammatory response to LPS accompanied by greater impairment in renal hemodynamic response and widespread apoptosis of immune cells. Because polymorphisms in the HO-1 gene with diminished HO activity predispose to human disease, we speculate that our findings may be relevant to the clinical outcome in patients with sepsis syndromes.


Amino acid fermentation at the origin of the genetic code.
There is evidence that the genetic code was established prior to the existence of proteins, when metabolism was powered by ribozymes. Also, early proto-organisms had to rely on simple anaerobic bioenergetic processes. In this work I propose that amino acid fermentation powered metabolism in the RNA world, and that this was facilitated by proto-adapters, the precursors of the tRNAs. Amino acids were used as carbon sources rather than as catalytic or structural elements. In modern bacteria, amino acid fermentation is known as the Stickland reaction. This pathway involves two amino acids: the first undergoes oxidative deamination, and the second acts as an electron acceptor through reductive deamination. This redox reaction results in two keto acids that are employed to synthesise ATP via substrate-level phosphorylation. The Stickland reaction is the basic bioenergetic pathway of some bacteria of the genus Clostridium. Two other facts support Stickland fermentation in the RNA world. First, several Stickland amino acid pairs are synthesised in abiotic amino acid synthesis. This suggests that amino acids that could be used as an energy substrate were freely available. Second, anticodons that have complementary sequences often correspond to amino acids that form Stickland pairs. The main hypothesis of this paper is that pairs of complementary proto-adapters were assigned to Stickland amino acids pairs. There are signatures of this hypothesis in the genetic code. Furthermore, it is argued that the proto-adapters formed double strands that brought amino acid pairs into proximity to facilitate their mutual redox reaction, structurally constraining the anticodon pairs that are assigned to these amino acid pairs. Significance tests which randomise the code are performed to study the extent of the variability of the energetic (ATP) yield. Random assignments can lead to a substantial yield of ATP and maintain enough variability, thus selection can act and refine the assignments into a proto-code that optimises the energetic yield. Monte Carlo simulations are performed to evaluate the establishment of these simple proto-codes, based on amino acid substitutions and codon swapping. In all cases, donor amino acids are assigned to anticodons composed of U+G, and have low redundancy (1-2 codons), whereas acceptor amino acids are assigned to the the remaining codons. These bioenergetic and structural constraints allow for a metabolic role for amino acids before their co-option as catalyst cofactors.


Analysis of the feeding behavior of pigs using different models.
Short-term feeding behavior is conventionally analysed using random process models. The assumption underlying these models have recently been questioned and this article describes the application of both random, and more biologically based, models to the feeding behavior of pigs. Feeder visits of 16 growing pigs, housed individually from 17 to 52 kg live weight, were recorded electronically over a continuous period of 35 days. Daily food intake increased linearly with time, but there was considerable individuality in the degree of order. Pigs made between 18.8 and 80.3 (mean 47.9) daily visits to the feeder. Intervals between visits could be described by two log-normal distributions. Two Gaussian density functions were fitted to the distribution of the log-transformed intervals. For the combined data from all animals the within- and between-meal intervals were 11.2 s and 100.1 min, respectively. A model with three Gaussian functions gave an improved fit to the interval distribution. The within and between meal intervals were then estimated to be 4.2 s and 93.9 min, respectively. The middle distribution of intervals ranged from 0.5 to 38.1 min. The intervals were also described by random process models; again, a three-process model gave an improved fit compared to a two-process model. The mean estimated number of meals per day from the three Gaussian model was 14.3, and from the three process random model, 16.3. A biological interpretation of the three types of interval suggests that: (1) pigs eat in meals separated by long intervals; (2) meals consist of clusters of eating bouts separated by shorter intervals, sometimes associated with drinking; (3) within each eating bout short intervals occur as pigs constantly move in and out of the feeder. It remains unclear what underlies the observed patterns of eating.


Two-photon laser-assisted device alteration in silicon integrated-circuits.
Optoelectronic imaging of integrated-circuits has revolutionized device design debug, failure analysis and electrical fault isolation; however modern probing techniques like laser-assisted device alteration (LADA) have failed to keep pace with the semiconductor industry's aggressive device scaling, meaning that previously satisfactory techniques no longer exhibit a sufficient ability to localize electrical faults, instead casting suspicion upon dozens of potential root-cause transistors. Here, we introduce a new high-resolution probing technique, two-photon laser-assisted device alteration (2pLADA), which exploits two-photon absorption (TPA) to provide precise three-dimensional localization of the photo-carriers injected by the TPA process, enabling us to implicate individual transistors separated by 100 nm. Furthermore, we illustrate the technique's capability to reveal speed-limiting transistor switching evolution with an unprecedented timing resolution approaching <10 ps. Together, the exceptional spatial and temporal resolutions demonstrated here now make it possible to extend optical fault localization to sub-14 nm technology nodes.


The ethics of genomic medicine: redefining values and norms in the UK and France.
This paper presents a joint position of the UK-France Genomics and Ethics Network (UK-FR GENE), which has been set up to reflect on the ethical and social issues arising from the integration of genomics into routine clinical care in the UK and France. In 2018, the two countries announced enhanced cooperation between their national strategies, Genomics England and Plan France Médecine Génomique 2025, which offers a unique opportunity to study the impact of genomic medicine and relevant policies in different national contexts. The paper provides first insights into the two national strategies and the norms, values and principles at stake in each country. It discusses the impact of genomic medicine on established relationships and existing regulations, and examines its effects on solidarity and trust in public healthcare systems. Finally, it uses the social contract as an analytical lens to explore and redefine the balance between individual rights and collective duties in the context of genomic medicine. This paper leads to three key observations: (1) despite each country's strategy being at a different stage of implementation, the two countries face similar ethical issues; (2) each country tries to solve these issues by (re-)defining individual rights and collective duties in its own way; (3) the social contract presents a useful tool to analyse the ways the UK and France address the ethical challenges raised by genomics. This overview lays the groundwork for future in-depth comparison, and drive collaborative research, between the UK and France.


Malignant pleural neoplasm with both differentiation of epithelioid mesothelioma and squamous-cell carcinoma, a rare phenomena.
Malignant mesothelioma, a neoplasm arising within the serosal surfaces, has been linked closely to asbestos exposure. We present a case of 72-year-old male with a 27 year work-related history of asbestos exposure who presented with dyspnea. Chest computed tomography scan showed a large, right pleural effusion with compressive right lung atelectasis. Biopsies, subsequent pleurectomy and lung wedge resections revealed epithelioid malignant mesothelioma with associated focal non-keratinizing squamous-cell carcinoma, supported by extensive immunohistochemical stains and molecular studies. The patient was treated with 6 cycles of carboplatin/pemetrexed, showing no new metastases. Seven months post-treatment, the patient presented with progressive dyspnea and large pleural effusions. Bilateral pleural fluid was collected and showed malignant epithelioid cells, morphologically similar to the patient's pleural neoplastic cells. However, the tumor was positive for squamous cells markers and showed BAP1 loss, while negative for mesothelial markers. The findings support the diagnosis of squamous-cell carcinoma and were consistent with the patient's previously diagnosed pleural neoplastic origin. A malignant mesothelioma associated with squamous-cell carcinoma is a rare phenonmenon. To our knowledge, only two case reports are available in current literature. This unique case shows a single pleura tumor differentiating as both malignant mesothelioma and squamous-cell carcinoma. Squamous-cell carcinoma is the predominating malignancy seen within the bilateral pleural effusions, a potential pitfall for cytology specimen diagnosis.


Multiple sclerosis. Oligodendrocyte proliferation and differentiation in fresh lesions.
Fresh lesions in the brain and spinal cord of patients with multiple sclerosis who died shortly after the onset of symptoms were examined immunocytochemically for myelin and oligodendrocyte antigens that are known to be sequentially expressed during normal development. Cells with oligodendrocyte-like morphology that appear in large numbers throughout fresh lesions after acute myelin breakdown and before new myelin formation were found to express galactocerebroside, carbonic anhydrase, and 2',3'-cyclic nucleotide 3'-phosphohydrolase but not myelin-associated glycoprotein or myelin basic protein. They also exhibit intense surface reactivity for a carbohydrate epitope associated with the family of cell adhesion molecules recognized by the monoclonal antibody HNK-1. With the onset of remyelination and the appearance of myelin-associated glycoprotein, myelin basic proteins, CNP, and the HNK-1 epitope is newly formed myelin sheaths, perikaryon CNP and HNK-1 reactivity diminished. A possible oligodendrocyte precursor cell in the form of a large HNK-1 positive glial fibrillary acidic protein negative glial cell was observed among interfascicular oligodendrocytes in white matter bordering these hypercellular plaques. Because a similar progression in the expression of CNP and the HNK-1 epitope occurs during normal oligodendrocyte differentiation, these observations are additional evidence that extensive oligodendrocyte regeneration occurs in some plaques early in the course of the disease. The finding of large numbers of immature oligodendrocytes, presumably expressing many developmentally restricted antigens not normally present in the mature nervous system, in plaques at a particular stage in their evolution may be important in understanding why remyelination eventually fails in multiple sclerosis.


Exploring cannabis concentrates on the legal market: User profiles, product strength, and health-related outcomes.
Concentrated cannabis products are increasingly available and used, particularly in states with legal cannabis, but little is known about the profiles and characteristics of concentrate users. We aimed to characterize user profiles of cannabis users living in states with legal medical or recreational cannabis who reported using concentrates to those who do not use concentrates. An anonymous online survey was advertised in California, Colorado, Nevada, Oregon, and Washington. We compared respondents who endorsed frequent concentrate use (FC; N = 67) (i.e. 4 days/week) with cannabis users who never use concentrates (NC; N = 64), and with those who smoke/vaporize cannabis flower frequently but never or very rarely use concentrates (FF; N = 60), on measures related to cannabis use patterns and cannabinoid product strength, other substance use, and occupational functioning and health. FC endorsed more symptoms of cannabis use disorder as compared to non-concentrate users (p < 0.05), but were similar to FF and NC on other health and occupational outcomes. FC also differed from FF and NC in that they tended to use cannabis that was higher in THC (p < 0.0005), even when using non-concentrated forms of cannabis (p < 0.005). Over half of FC users reported typically using concentrates of at least 80% THC, and 21% endorsed use of (non-concentrated) dry cannabis flower containing at least 30% THC. Concentrate users endorsed higher symptoms of cannabis use disorder and use higher strength cannabis even when using non-concentrated forms. Frequent use of concentrates may be associated with additional risks over and above frequent use of flower forms.


Dissociations of spatial congruence effects across response measures: an examination of delta plots.
Spatial congruence ("Simon") effects on reaction time (RT) and response force (RF) were studied in two experiments requiring speeded choice responses to the color of a stimulus located irrelevantly to the left or right of fixation. In Experiment 1 with unimanual responses, both RT and incorrect-hand RF were sensitive to spatial congruence, and both showed larger Simon effects following a congruent trial than following an incongruent one. RT and incorrect-hand RF were dissociated in distributional (i.e., delta plot) analyses, however. As in previous studies, the Simon effect on RT was largest for the fastest responses and diminished as RT increased (i.e., decreasing delta plot). In contrast, Simon effects on RF did not decrease for slower responses; if anything, they increased slightly. In Experiment 2 participants made bimanual responses, allowing measurement of the spatial congruence effect for each trial. Responses were both faster and more forceful with the spatially congruent hand than with the spatially incongruent one, but neither of these effects decreased for slower responses. Overall, the results demonstrate that at least some motor-level effects of irrelevant spatial location persist for slower responses.


Ultrasound Molecular Imaging of VEGFR-2 in Clear-Cell Renal Cell Carcinoma Tracks Disease Response to Antiangiogenic and Notch-Inhibition Therapy.
Metastatic clear-cell renal cell carcinoma (ccRCC) affects thousands of patients worldwide each year. Antiangiogenic therapy has been shown to have beneficial effects initially, but resistance is eventually developed. Therefore, it is important to accurately track the response of cancer to different therapeutics in order to appropriately adjust the therapy to maximize efficacy. Change in tumor volume is the current gold standard for determining efficacy of treatment. However, functional variations can occur much earlier than measurable volume changes. Contrast-enhanced ultrasound (CEUS) is an important tool for assessing tumor progression and response to therapy, since it can monitor functional changes in the physiology. In this study, we demonstrate how ultrasound molecular imaging (USMI) can accurately track the evolution of the disease and molecular response to treatment. Methods A cohort of NSG (NOD/scid/gamma) mice was injected with ccRCC cells and treated with either the VEGF inhibitor SU (Sunitinib malate, Selleckchem, TX, USA) or the Notch pathway inhibitor GSI (Gamma secretase inhibitor, PF-03084014, Pfizer, New York, NY, USA), or started on SU and later switched to GSI (Switch group). The therapies used in the study focus on disrupting angiogenesis and proper vessel development. SU inhibits signaling of vascular endothelial growth factor (VEGF), which is responsible for the sprouting of new vasculature, and GSI inhibits the Notch pathway, which is a key factor in the correct maturation of newly formed vasculature. Microbubble contrast agents targeted to VEGFR-2 (VEGF Receptor) were delivered as a bolus, and the bound agents were imaged in 3D after the free-flowing contrast was cleared from the body. Additionally, the tumors were harvested at the end of the study and stained for CD31. Results The results show that MI can detect changes in VEGFR-2 expression in the group treated with SU within a week of the start of treatment, while differences in volume only become apparent after the mice have been treated for three weeks. Furthermore, USMI can detect response to therapy in 92% of cases after 1 week of treatment, while the detection rate is only 40% for volume measurements. The amount of targeting for the GSI and Control groups was high throughout the duration of the study, while that of the SU and Switch groups remained low. However, the amount of targeting in the Switch group increased to levels similar to those of the Control group after the treatment was switched to GSI. CD31 staining indicates significantly lower levels of patent vasculature for the SU group compared to the Control and GSI groups. Therefore, the results parallel the expected physiological changes in the tumor, since GSI promotes angiogenesis through the VEGF pathway, while SU inhibits it. Conclusion This study demonstrates that MI can track disease progression and assess functional changes in tumors before changes in volume are apparent, and thus, CEUS can be a valuable tool for assessing response to therapy in disease. Future work is required to determine whether levels of VEGFR-2 targeting correlate with eventual survival outcomes.


Cervical cancer as a public health issue--what next?
Cervical cancer is the second most common cancer in women worldwide. There are about 60,000 newly detected cases and 30,000 deaths annually in Europe, with the highest incidence reported from Eastern Europe countries. According to data from the National Institute of Public Health, in Croatia the incidence of cervical cancer was 14.9/100,000 in 2006, ranking eighth most common malignancy in women. Croatia has a lower incidence of the disease compared to many countries of Central and Southeast Europe. A large study carried out in 1995 by the International Agency for Research on Cancer, which included cervical cancer material collected from 22 countries all over the world revealed HPV genome in 99.7% of cases. Efficient methods of cervical cancer detection and screening methods for identification of precancerous lesions (conventional Pap smear) are available. Cervical cancer prevention programs should include education (of health care providers and women), stressing the benefits of screening, the age of the peak cervical cancer incidence, and the signs and symptoms of precancerous lesions and invasive disease. The aim of screening actions is to detect precancerous lesions that may lead to cancer if left untreated. Screening can only be effective if there is a well-organized system of follow up, diagnosis and treatment. Cervical cytology, or Papanicolaou (Pap) testing, has for decades been a cornerstone of cervical cancer screening. According to recent guidelines issued by the World Health Organization Regional Office for Europe, the primary task of the public health system is the introduction of secondary prevention through properly organized screening programs. Launching the national immunization program is only possible in the countries with well-organized secondary prevention programs and in those that can afford it.


A comparative study of four serological tumor markers for the detection of breast cancer.
Breast cancer is currently the third most common cause of cancer in the world. Circulating tumor antigens are often used as a minimally invasive tool for noting breast cancer progression. The objective of this study was to compare four tumor antigens (CA 15-3, CA 27.29, alpha-fetoprotein [AFP], and carcinoembryonic antigen [CEA]) for their diagnostic efficacy in breast cancer patients. It was hypothesized that CA 15-3 would proved to be superior to CA 27.29, CEA, and AFP in assay performance. Tumor marker assays were performed according to the manufacturers' directions. Assays used in this study were CA 15-3 and CA 27.29 (Fujirebio Diagnostics/Centocor Inc.), AFP (Abbott Inc.), and CEA (Hybritech Inc.). A total of 554 patient samples were obtained from an area hospital, plus 200 healthy adult samples which were used for the determination of normal reference intervals. The patients included patients with no disease (184), with non-malignant disease (11), with breast cancer (87), and with other types of cancer (272). Diagnostic percent sensitivities for each marker were: CA 15-3 (63%), CA 27.29 (39%), CEA (22%), and AFP (22%). Diagnostic specificities for each marker were comparable, ranging from 80-88%. Analytical parameters were evaluated for the assays and compared favorably. We concluded that CA 15-3 was the best tumor antigen for use as a diagnostic aid and monitoring agent.


Integrated single-cell analysis of multicellular immune dynamics during hyperacute HIV-1 infection.
Cellular immunity is critical for controlling intracellular pathogens, but individual cellular dynamics and cell-cell cooperativity in evolving human immune responses remain poorly understood. Single-cell RNA-sequencing (scRNA-seq) represents a powerful tool for dissecting complex multicellular behaviors in health and disease1,2 and nominating testable therapeutic targets3. Its application to longitudinal samples could afford an opportunity to uncover cellular factors associated with the evolution of disease progression without potentially confounding inter-individual variability4. Here, we present an experimental and computational methodology that uses scRNA-seq to characterize dynamic cellular programs and their molecular drivers, and apply it to HIV infection. By performing scRNA-seq on peripheral blood mononuclear cells from four untreated individuals before and longitudinally during acute infection5, we were powered within each to discover gene response modules that vary by time and cell subset. Beyond previously unappreciated individual- and cell-type-specific interferon-stimulated gene upregulation, we describe temporally aligned gene expression responses obscured in bulk analyses, including those involved in proinflammatory T cell differentiation, prolonged monocyte major histocompatibility complex II upregulation and persistent natural killer (NK) cell cytolytic killing. We further identify response features arising in the first weeks of infection, for example proliferating natural killer cells, which potentially may associate with future viral control. Overall, our approach provides a unified framework for characterizing multiple dynamic cellular responses and their coordination.


Photoinduced band gap shift and deep levels in luminescent carbon nanotubes.
Individual air-suspended single-walled carbon nanotubes are imaged both spatially and spectrally in photoluminescence. At low excitation power, photoluminescence is bright and stable with high quantum efficiency; however, higher power initially causes a gradual red shift and then more severe changes. Blinking, the loss of quantum efficiency, and the appearance of new deep levels are all seen and can be explained by the introduction of defects. We propose that optical excitation induces molecular deposition onto the nanotube by optically induced van der Waals interactions, leading to physisorption and ultimately chemisorption which severely degrades the luminescence.


An IgM-mediated immune response directed against nitro-bovine serum albumin (nitro-BSA) in chronic fatigue syndrome (CFS) and major depression: evidence that nitrosative stress is another factor underpinning the comorbidity between major depression and CFS.
It has been shown that chronic fatigue syndrome (CFS) and major depression (MDD) are accompanied by signs of oxidative stress and by a decreased antioxidant status. The aim of the present study was to examine whether CFS and MDD are accompanied by an IgM-mediated immune response directed against nitro-serum bovine albumin (BSA), which is a neoepitope of BSA formed by damage caused by nitrosative stress. Toward this end, we examined serum IgM antibodies to nitro-BSA in 13 patients with CFS, 14 subjects with partial CFS, 16 patients with MDD and 11 normal controls. We found that the prevalence and mean values for the serum IgM levels directed against nitro-BSA were significantly greater in patients with partial CFS, CFS and MDD than in normal controls, and significantly greater in CFS than in those with partial CFS and MDD. We found significant and positive correlations between serum IgM levels directed against nitro-BSA and symptoms of the FibroFatigue scale, i.e. aches and pain and muscular tension. There was also a strong positive correlation between serum IgM titers directed against nitro-BSA and an index of increased gut permeability ("leaky gut"), i.e. serum IgM and IgA directed against LPS of different gram-negative enterobacteria. The abovementioned results indicate that both CFS and MDD are accompanied by a) an increased gut permeability which has allowed an exaggerated passage of BSA through a compromised epithelial barrier; b) increased nitrosative stress which has induced damage to BSA; and c) an IgM-mediated immune response which is directed against the nitro-BSA neoepitopes. Nitrosative stress is one of the factors underpinning the comorbidity and clinical overlap between CFS and MDD.


The role of self-regulation in the context of driver distraction: A simulator study.
There is considerable evidence for the negative effects of driver distraction on road safety. In many experimental studies, drivers have been primarily viewed as passive receivers of distraction. Thus, there is a lack of research on the mediating role of their self-regulatory behavior. The aim of the current study was to compare drivers' performance when engaged in a system-paced secondary task with a self-paced version of this task and how both differed from baseline driving performance without distraction. Thirty-nine participants drove in a simulator while performing a secondary visual-manual task. One group of drivers had to work on this task in predefined situations under time pressure, whereas the other group was free to decide when to work on the secondary task (self-regulation group). Drivers' performance (e.g., lateral and longitudinal control, brake reaction times) was also compared with a baseline condition without any secondary task. For the system-paced secondary task, distraction was associated with high decrements in driving performance (especially in keeping the lateral position). No effects were found for the number of collisions, probably because of the lower driving speeds while distracted (compensatory behavior). For the self-regulation group, only small impairments in driving performance were found. Drivers engaged less in the secondary task during foreseeable demanding or critical driving situations. Overall, drivers in the self-regulation group were able to anticipate the demands of different traffic situations and to adapt their engagement in the secondary task, so that only small impairments in driving performance occurred. Because in real traffic drivers are mostly free to decide when to engage in secondary tasks, it can be concluded that self-regulation should be considered in driver distraction research to ensure ecological validity.


High-density lipoprotein from patients with coronary heart disease loses anti-thrombotic effects on endothelial cells: impact on arterial thrombus formation.
Thrombus formation is determined by the balance between pro- thrombotic mediators and anti-thrombotic factors.High-density lipoprotein (HDL) from healthy subjects exerts anti-thrombotic properties. Whether this is also the case for HDL from patients with stable coronary heart disease (CHD) or acute coronary syndrome (ACS) is unknown.In human aortic endothelial cells in culture,HDL (50 µg/ml) from healthy subjects (HS) inhibited thrombin-induced tissue factor (TF) expression and activity, while HDL (50 µg/ml) from CHD and ACS patients did not. Similarly, only healthy HDL increased endothelial tissue factor pathway inhibitor (TFPI) expression and tissue plasminogen activator (tPA) release, while HDL from CHD and ACS patients had no effect. Healthy HDL inhibited thrombin-induced plasminogen activator inhibitor type 1 (PAI-1) expression, while HDL from ACS patients enhanced endothelial PAI-1 expression. Inhibition of nitric oxide (NO) formation with L-NAME (100 µmol/l) abolished the anti-thrombotic effects of healthy HDL on TF, TFPI, and tPA expression. The exogenous nitric oxide donor, DETANO, mimicked the effects of healthy HDL and counterbalanced the loss of anti-thrombotic effects of HDL from CHD and ACS patients in endothelial cells. In line with this observation, healthy HDL, in contrast to HDL from CHD and ACS patients, increased endothelial NO production. In the laser-injured carotid artery of the mouse, thrombus formation was delayed in animals treated with healthy HDL compared with mice treated with vehicle or HDL from patients with CHD or ACS. In conclusion, HDL from CHD and ACS patients loses the ability of healthy HDL to suppress TF and to increase TFPI and t-PA and instead enhances PAI-1 and arterial thrombus formation.


Use of Cognitive and Behavioral Strategies During a Weight Loss Program: A Secondary Analysis of the Doctor Referral of Overweight People to Low-Energy Total Diet Replacement Treatment (DROPLET) Trial.
Achieving a sustained energy deficit is essential for weight loss, but the cognitive and behavioral strategies that support this goal are unclear. The goal of this study was to investigate the number and type of cognitive and behavioral strategies used by participants who were enrolled in a 1-year weight loss trial and to explore associations between strategies and magnitude of weight loss at 3 months and 1 year. The study is a secondary post-hoc exploratory analysis of data collected as part of the Doctor Referral of Overweight People to Low-Energy total diet replacement Treatment (DROPLET), a randomized controlled trial conducted in general practices in England, United Kingdom, between January 2016 and August 2017. This study involved 164 participants from both intervention and control groups of the DROPLET trial who completed the Oxford Food and Behaviours (OxFAB) questionnaire to assess the use of 115 strategies grouped into 21 domains used to manage their weight. Participants were randomized to either a behavioral weight loss program involving 8 weeks total diet replacement (TDR) and 4 weeks of food reintroduction or a program delivered by a medical practice nurse over a 3-month period (usual care [UC]). Weight was objectively measured at baseline, 3 months, and 1 year. Cognitive and behavioral strategies used to support weight loss were assessed using the OxFAB questionnaire at 3 months. Exploratory factor analysis was used to generate data-driven patterns of strategy use, and a linear mixed-effects model was used to examine associations between use of these patterns and weight change. No evidence was found of a difference in the number of strategies (mean difference, 2.41; 95% confidence interval [CI], -0.83, 5.65) or the number of domains used (mean difference, -0.23; 95% CI, -0.69, 0.23) between the TDR group and the UC group. The number of strategies was not associated with weight loss at either 3 months (-0.02 kg; 95% CI, -0.11, 0.06) or 1 year (-0.05 kg; 95% CI, -0.14, 0.02). Similarly, the number of domains used was not associated with weight loss at 3 months (-0.02 kg; 95% CI, -0.53, 0.49) or 1 year (-0.07 kg; 95% CI, -0.60, 0.46). Factor analysis identified four coherent patterns of strategy use, identified as Physical Activity, Motivation, Planned Eating, and Food Purchasing patterns. Greater use of strategies in the Food Purchasing (-2.6 kg; 95% CI, -4.42, -0.71) and Planned Eating patterns (-3.20 kg; 95% CI, -4.94, -1.46) was associated with greater weight loss at 1 year. The number of cognitive and behavioral strategies or domains used does not appear to influence weight loss, but the types of strategy appear of greater importance. Supporting people to adopt strategies linked to planned eating and food purchasing may aid long-term weight loss.


Gender differences in practice patterns of Ontario family physicians (McMaster medical graduates).
This study examined the extent to which physician gender influences practice patterns. Data came from the Ontario Hospital Insurance Plan billing profiles of general practitioner and family medicine graduates of McMaster University School of Medicine. The women physicians studied were more likely to be certified in family medicine than the men and a higher proportion of their patients were female. Women were more likely to be working part time, billed during fewer months of the year, earned less, and saw fewer patients. They provided greater numbers of services in psychotherapy and counselling and ordered more laboratory tests; associated with this were higher costs per service and per patient. Women offered a less diverse mix of services than men. They provided fewer hospital, emergency room, and intrapartum services and a lower proportion of women included house calls, after-hours work, hospital, emergency room, surgical or intrapartum services in their service mix. Thus these women appeared more likely to restrict their practices to the office setting and to provide a higher proportion of psychosocial care. The overall impact of these sex differences in practice patterns on the health care system requires further exploration.


Reduced-Intensity Conditioning with Fludarabine, Cyclophosphamide, and High-Dose Rituximab for Allogeneic Hematopoietic Cell Transplantation for Follicular Lymphoma: A Phase Two Multicenter Trial from the Blood and Marrow Transplant Clinical Trials Network.
Allogeneic (allo) hematopoietic cell transplantation (HCT) can induce long-term remissions in chemosensitive relapsed follicular lymphoma (FL). The Blood and Marrow Transplant Clinical Trials Network conducted a multicenter phase 2 trial to examine the efficacy of alloHCT using reduced-intensity conditioning with rituximab (RTX) in multiply relapsed, chemosensitive FL. The primary endpoint was 2-year progression-free survival (PFS). The conditioning regimen consisted of fludarabine, cyclophosphamide, and high-dose RTX (FCR), in which 3 of the 4 doses of RTX were administered at a dose of 1 gm/m(2). Graft-versus-host disease (GVHD) prophylaxis was with tacrolimus and methotrexate. Sixty-five patients were enrolled and 62 were evaluable. Median age was 55 years (range, 29 to 74). This group was heavily pretreated: 77% had received ≥ 3 prior regimens, 32% had received ≥ 5 prior regimens, and 11% had received prior autologous HCT. Donors were HLA-matched siblings (n = 33) or HLA-matched unrelated adults (n = 29). No graft failures occurred. The overall response rate after HCT was 94% with 90% in complete remission (CR), including 24 patients not in CR before alloHCT. With a median follow-up of 47 months (range, 30 to 73), 3-year PFS and overall survival rates were 71% (95% confidence interval, 58% to 81%) and 82% (95% confidence interval, 70% to 90%), respectively. Three-year cumulative incidences of relapse/progression and nonrelapse mortality were 13% and 16%, respectively. Two-year cumulative incidences of grades 2 to 4 and grades 3 or 4 acute GVHD were 27% and 10%, respectively, and extensive chronic GVHD incidence was 55%. Serum RTX concentrations peaked at day +28 and remained detectable as late as 1 year in 59% of patients with available data. In conclusion, alloHCT with FCR conditioning confers high CR rates, a low incidence of relapse/progression, and excellent survival probabilities in heavily pretreated FL patients.


The role of cytochromes P-450 and flavin-containing monooxygenase in the metabolism of (S)-nicotine by rabbit lung.
Rabbit lung microsomes metabolize (S)-nicotine primarily to (S)-nicotine delta 1',5'-iminium ion, which is the precursor of (S)-cotinine, the major urinary metabolite of (S)-nicotine in mammals. (S)-Nicotine-N'-oxide and normicotine are also produced as minor metabolites. alpha-Methylbenzylaminobenzotriazole, a mechanism-based suicide inhibitor of rabbit lung cytochromes P-450 2 and 6, inhibited (S)-nicotine oxidation in parallel with inhibition of benzphetamine N-demethylation and ethoxyresorufin O-deethylation. Pretreatment of rabbits with TCDD or Aroclor 1260 had no effect and markedly inhibited (S)-nicotine oxidation, respectively, strongly suggesting that alpha-methylbenzylaminobenzotriazole inhibition was due to inactivation of rabbit lung P-450 2. Reconstitution with cytochromes P-450 2 and 5 demonstrated that only P-450 2 was active toward (S)-nicotine, yielding predominantly the iminium ion, with smaller amounts of nornicotine, (S)-nicotine N'-oxide, and an unknown metabolite also detected. The purified rabbit lung P-450 2-catalyzed oxidation of (S)-nicotine to (S)-nicotine delta 1',5'-iminium ion exhibited a Km of 70 microM and a Vmax of 1.5 min. Covalent binding of (S)-5-3H-nicotine to rabbit lung macromolecules was dependent upon rabbit lung P-450 2-catalyzed formation of the iminium ion. Antibodies raised against P-450 2 inhibited the rabbit lung microsomal metabolism of (S)-nicotine to (S)-nicotine delta 1',5'-iminium ion by almost 95%. Titration of reconstituted P-450 2 with cytochrome b5 produced a concentration-dependent inhibition of nicotine oxidase activity. Increasing the ratio of NADH to NADPH in incubations containing lung microsomes and (S)-nicotine decreased the yield of the iminium ion, confirming the inhibitory effect of cytochrome b5 on the P-450 2-catalyzed alpha-carbon oxidation reaction. NADH alone did not support the lung microsomal metabolism of (S)-nicotine. N'-oxidation of (S]-nicotine is catalyzed by purified pig liver flavin-containing monooxygenase. A number of experiments involving the use of P-450 inhibitors, titration with NADPH-cytochrome P-450 reductase antibodies, and determination of the pH-enzyme activity profile suggested that rabbit lung flavin-containing monooxygenase contributes to a small amount of the N'-oxide produced by rabbit lung microsomes. Further examination with purified flavin-containing monooxygenase isolated from rabbit lung microsomes demonstrated that (S)-nicotine is a poor substrate for this enzyme. The low yield of N'-oxide, relative to other metabolites, in rabbit lung is uncharacteristic for most mammalian tissues and presumably reflects the unusual substrate specificity of rabbit lung flavin-containing monooxygenase.


Androgen receptor characteristics in skin fibroblasts from men with pubertal macromastia.
Endocrine studies in men with pubertal macromastia (PM) have failed to reveal a hormonal abnormality to account for the disorder. As a result, it has been hypothesized that this form of gynecomastia may be a manifestation of a target organ abnormality. Because the syndromes of apparent androgen resistance, such as testicular feminization and Reifenstein's Syndrome, are associated with gynaecomastia, we examined skin fibroblasts cultured from men with pubertal macromastia for androgen receptor defects. We studied 12 men with PM and confirmed that plasma concentrations of testosterone, oestradiol, gonadotrophins, and prolactin, were all within the normal range; findings identical to those of a similar series of patients previously reported. Androgen receptor content (R0) and binding affinity (Kd) in cultured areolar and pubic skin fibroblasts were measured using a dispersed, whole cell assay. Nineteen areolar cell lines from the 12 patients with PM were compared with 4 areolar cell lines from three normal men and 9 areolar cell lines from nine normal women. There was no difference in the mean androgen receptor content (approximately 10 000 sites/cell) or binding affinity (approximately 1 nM) between the patients' fibroblasts and those of the normal subjects. Similarly, there were no differences in these parameters when pubic skin fibroblast androgen receptors were used for the comparison. We conclude that, although PM may yet be due to a defect in breast tissue sensitivity to androgen, the disorder cannot be explained by abnormalities in fibroblast androgen receptor number or affinity.


Uncovering G protein-coupled receptor kinase-5 as a histone deacetylase kinase in the nucleus of cardiomyocytes.
G protein-coupled receptor (GPCR) kinases (GRKs) are critical regulators of cellular signaling and function. In cardiomyocytes, GRK2 and GRK5 are two GRKs important for myocardial regulation, and both have been shown to be up-regulated in the dysfunctional heart. We report that increased levels and activity of GRK5 in failing myocardium may have unique significance due to its nuclear localization, a property not shared by GRK2. We find that transgenic mice with elevated cardiac GRK5 levels have exaggerated hypertrophy and early heart failure compared with control mice after pressure overload. This pathology is not present in cardiac GRK2-overexpressing mice or in mice with overexpression of a mutant GRK5 that is excluded from the nucleus. Nuclear accumulation of GRK5 is enhanced in myocytes after aortic banding in vivo and in vitro in myocytes after increased G alpha q activity, the trigger for pressure-overload hypertrophy. GRK5 enhances activation of MEF2 in concert with Gq signals, demonstrating that nuclear localized GRK5 regulates gene transcription via a pathway critically linked to myocardial hypertrophy. Mechanistically, we show that this is due to GRK5 acting, in a non-GPCR manner, as a class II histone deacetylase (HDAC) kinase because it can associate with and phosphorylate the myocyte enhancer factor-2 repressor, HDAC5. Moreover, significant HDAC activity can be found with GRK5 in the heart. Our data show that GRK5 is a nuclear HDAC kinase that plays a key role in maladaptive cardiac hypertrophy apparently independent of any action directly on GPCRs.


Impact of Acute Dietary Manipulations on DXA and BIA Body Composition Estimates.
To examine the effects of acute preassessment diets on body composition estimates obtained by dual-energy x-ray absorptiometry (DXA) and bioelectrical impedance analysis (BIA). In a counterbalanced design, 48 males and females were provided with two 1-d diets: high-carbohydrate diet (9 g CHO·kg) and very low-carbohydrate diet (1 to 1.5 g CHO·kg). For each condition, body composition was assessed in the morning after an overnight fast, in the afternoon after feeding, and the following morning after a second overnight fast. Acute food ingestion, regardless of macronutrient content, altered DXA and BIA body composition estimates, and both sexes responded similarly. DXA total and regional lean soft tissue estimates increased up to 1.7% and 3% on average in response to feeding, with individual increases of over 4.5% and 9%. DXA total and trunk fat mass estimates decreased by up to 3% on average. All DXA-derived measures of body composition returned to baseline values after the second overnight fast. Impedance measured by BIA decreased by 4.4% in response to feeding, leading to a 2% increase in total body water and fat-free mass, with individual increases up to 4.5%. BIA fat mass estimates decreased 1.4% to 2.4%, with individual decreases of up to 10%. Unlike DXA, most BIA-derived estimates did not return to baseline values after a second overnight fast. Acute food and fluid intake can artificially influence body composition estimates, regardless of macronutrient content. An overnight fast is likely sufficient preassessment dietary control for DXA and possibly sufficient for BIA.


A questionnaire study on the knowledge, attitude, and the practice of pharmacovigilance among the healthcare professionals in a teaching hospital in South India.
The primary objective of this study was to evaluate the knowledge, attitude, and practices (KAP) of the healthcare professionals about pharmacovigilance in Dhanalakshmi Srinivasan Medical College and Hospital (DSMCH), Perambalur (Tamil Nadu), a tertiary care teaching hospital. The second primary objective was to assess the causation of underreporting of adverse drug reactions (ADRs) as it needs to be well-assessed in India. The secondary objective was to compare the findings of this study with the results of the published studies from India on evaluation of the KAP of pharmacovigilance among healthcare professional. A cross-sectional study was carried out using a pretested questionnaire. The questionnaire was designed to assess the KAP regarding pharmacovigilance. The healthcare professionals (doctors, nurses, and pharmacists) working in the DSMCH, Perambalur (Tamil Nadu) during the study period were included. Only those who gave their consent to participate were included in the study. The data was analyzed by using the Statistical Package for Social Sciences (SPSS) statistical software, version 16. One hundred and fifty pretested questionnaires were distributed among the healthcare professionals and 101 responded. 62.4% healthcare workers gave correct response regarding the definition of pharmacovigilance. 75.2% of healthcare workers were aware regarding the existence of a National Pharmacovigilance Program of India. 69.3% healthcare professional agreed that ADR reporting is a professional obligation for them. Among the participants, 64.4% have experienced ADRs in patients, but only 22.8% have ever reported ADR to pharmacovigilance center. Unfortunately only 53.5% healthcare workers have been trained for reporting adverse reactions. But, 97% healthcare professionals agreed that reporting of ADR is necessary and 92.1% were of the view that pharmacovigilance should be taught in detail to healthcare professional. This study demonstrated that knowledge and attitude towards pharmacovigilance is gradually improving among healthcare professionals, but unfortunately the actual practice of ADR reporting is still deficient among them.


Primary cicatricial alopecia: recent advances in understanding and management.
Primary cicatricial alopecias (PCA) are a rare group of disorders, in which the hair follicle is the main target of destructive inflammation resulting in irreversible hair loss with scarring of affected lesions. The most typical clinical manifestation of PCA is the loss of visible follicular ostia. The histopathological hallmark of a fully developed lesion is the replacement of the hair follicle structure by fibrous tissue. PCA could share similar clinical manifestations and eventually lead to "burn-out" alopecia. Some subsets are hardly distinguishable histopathologically and the mechanisms that elicit such a destructive reaction have not been fully elucidated. Thus, the management of PCA represents one of the most challenging clinical problems for dermatologists. The aim of this review is to provide a concise and comprehensive summary of recent advances in PCA management, especially focusing on novel methodologies to aid diagnosis, and updates on our understanding of the etiopathogenesis. Dermoscopy, a new pathological preparation technique and direct immunofluorescence analysis enable more accurate clinicopathological diagnosis of PCA. Microarray analysis may be beneficial to distinguish PCA subtypes. Currently suggested mechanisms underlying PCA include loss of immune protection of stem cells, impaired stem cell self-maintenance, enhanced autoimmunity by pro-inflammatory cytokines and environmental/genetic predispositions. Interestingly, recent data indicates the association between lipid metabolism dysregulation and PCA development, implying an important role of the sebaceous gland dysfunction in the etiopathogenesis. Based on that hypothesis and observations, novel therapeutic approaches have been proposed, including the use of peroxisome proliferator-activated receptor-γ agonist for lichen planopilaris.


Metabolic interactions of putative cytochrome P4503A substrates with alternative pathways of dapsone metabolism in human liver microsomes.
The cytochrome P4503A (CYP3A) subfamily of enzymes are responsible for the metabolism of a large number of endogenous and exogenous compounds, and activation of some procarcinogens; but the activity is not well understood. N-Hydroxylation of dapsone in human liver microsomes has been shown to be mediated largely by CYP3A4. We have also observed the formation of an as yet unidentified metabolite of dapsone, whose formation is inhibited by antibody to CYP3A4, by these microsomes. This study investigated the influence of various (22) CYP3A putative substrates on the formation of both metabolites of dapsone in human liver microsomes. The compounds fall into four different categories on the basis of the pattern of their inhibitory interaction with the formation of both metabolites: those that inhibited both metabolites; those that inhibited N-hydroxylamine alone; those that inhibited the unidentified metabolite alone; and those with no significant effect on either metabolite. Some others were stimulatory. These results are consistent with two alternative but not mutually exclusive hypotheses: 1) different isoforms of CYP3A are involved in the formation of the alternative metabolites and the pattern of interaction observed was caused by the particular isoform(s) that each compound interacted with; or 2) formation of the alternative metabolites is a result of dapsone's interaction with and orientation at the enzyme's active site and the pattern of interaction observed is a consequence of changes in orientation caused by these compounds. This study provides relevant observations that must be considered in understanding mechanisms of CYP3A-mediated metabolism.


Antibacterial potential of Manuka honey against three oral bacteria in vitro.
Honey is an ancient natural remedy for the treatment of infected wounds. It has regained attention in the medical profession, as it has recently been reported to have a broad-spectrum inhibitory effect against bacteria. Data concerning Manuka honey of New Zealand origin, which is claimed to provide additional non-peroxide antimicrobial activity (so-called standard NPA) against oral pathogens, is still scarce. Therefore, this study aimed to screen for the antibacterial efficacy of different Manuka honey products against S. mutans (OMZ 918), P. gingivalis (OMZ 925) and A. actinomycetemcomitans (OMZ 299). Chlorhexidine and saline served as positive and negative controls, respectively, whereas a Swiss multifloral honey served as control honey without intrinsic non-peroxide activity. Chlorhexidine showed the highest inhibiting potential against all specimens tested. Manuka honey below an NPA value of 15 showed the least bacterial growth-inhibiting potential, even less – although not significantly so – than multifloral Swiss honey. Manuka honey above an NPA value of 15 showed a significantly higher antibacterial effect compared to the other honeys tested. All Manuka honey preparations were more effective in inhibiting the growth of P. gingivalis and A. actinomycetemcomitans, rather than S. mutans. In conclusion, the study showed an NPA dose-dependent antibacterial efficacy of Manuka honey. Further investigations of this natural product are now open for scrutiny.


Refinement of the HIVAN1 Susceptibility Locus on Chr. 3A1-A3 via Generation of Sub-Congenic Strains.
HIV-1 transgenic mice on the FVB/NJ background (TgFVB) represent a validated model of HIV-associated nephropathy (HIVAN). A major susceptibility locus, HIVAN1, was previously mapped to chromosome 3A1-A3 in a cross between TgFVB and CAST/EiJ (CAST) strains, and introgression of a 51.9 Mb segment encompassing HIVAN1 from CAST into TgFVB resulted in accelerated development of nephropathy. We generated three sub-congenic strains carrying CAST alleles in the proximal or distal regions of the HIVAN1 locus (Sub-II, 3.02-38.93 Mb; Sub-III, 38.45-55.1 Mb and Sub-IV, 47.7-55.1 Mb, build 38). At 5-10 weeks of age, histologic injury and proteinuria did not differ between HIV-1 transgenic Sub-II and TgFVB mice. In contrast, HIV-1 transgenic Sub-III and Sub-IV mice displayed up to 4.4 fold more histopathologic injury and 6-fold more albuminuria compared to TgFVB mice, similar in severity to the full-length congenic mice. The Sub-IV segment defines a maximal 7.4 Mb interval for HIVAN1, and encodes 31 protein coding genes: 15 genes have missense variants differentiating CAST from FVB, and 14 genes show differential renal expression. Of these, Frem1, Foxo1, and Setd7 have been implicated in the pathogenesis of nephropathy. HIVAN1 congenic kidneys are histologically normal without the HIV-1 transgene, yet their global transcriptome is enriched for molecular signatures of apoptosis, adenoviral infection, as well as genes repressed by histone H3 lysine 27 trimethylation, a histone modification associated with HIV-1 life cycle. These data refine HIVAN1to 7.4 Mb and identify latent molecular derangements that may predispose to nephropathy upon exposure to HIV-1.


Plasmodium falciparum artemisinin resistance monitoring in Sabah, Malaysia: in vivo therapeutic efficacy and kelch13 molecular marker surveillance.
Spreading Plasmodium falciparum artemisinin drug resistance threatens global malaria public health gains. Limited data exist to define the extent of P. falciparum artemisinin resistance southeast of the Greater Mekong region in Malaysia. A clinical efficacy study of oral artesunate (total target dose 12 mg/kg) daily for 3 days was conducted in patients with uncomplicated falciparum malaria and a parasite count < 100,000/µL admitted to 3 adjacent district hospitals in Sabah, East Malaysia. On day 3 and 4 all patients were administered split dose mefloquine (total dose 25 mg/kg) and followed for 28 days. Twenty-one kelch13 polymorphisms associated with P. falciparum artemisinin resistance were also evaluated in P. falciparum isolates collected from patients presenting to health facilities predominantly within the tertiary referral area of western Sabah between 2012 and 2016. In total, 49 patients were enrolled and treated with oral artesunate. 90% (44/49) of patients had cleared their parasitaemia by 48 h and 100% (49/49) within 72 h. The geometric mean parasite count at presentation was 9463/µL (95% CI 6757-13,254), with a median time to 50% parasite clearance of 4.3 h (IQR 2.0-8.4). There were 3/45 (7%) patients with a parasite clearance slope half-life of ≥ 5 h. All 278 P. falciparum isolates evaluated were wild-type for kelch13 markers. There is no suspected or confirmed evidence of endemic artemisinin-resistant P. falciparum in this pre-elimination setting in Sabah, Malaysia. Current guidelines recommending first-line treatment with ACT remain appropriate for uncomplicated malaria in Sabah, Malaysia. Ongoing surveillance is needed southeast of the Greater Mekong sub-region.


Phonemic restoration in a sentence context: evidence from early and late ERP effects.
When a particular speech sound is obliterated and replaced by a non-speech sound in continuous speech the listener may not notice any disturbance in speech or have difficulties in understanding the word. The present study examined for the first time neurophysiological correlates of the perception of words with an obliterated initial phoneme. Behavioral responses and event-related potentials (ERPs) were measured while participants listened to naturally spoken sentences which had a highly or less expected final word. Half of the sentences were manipulated to have a cough replacing the beginning of the final word, thus, reducing the initial phonetic information available for the word recognition. An N1-P2 complex indicated an automatic registration of the cough's onset. An early negativity to less expected relative to highly expected words was observed for phonetically intact words but not for manipulated words. Although the N400 effect to manipulated words was elicited later than to intact words, after the fragment onset, its amplitude was not enhanced. Further, no significant enhancement of the N400 was found for the manipulated highly expected words. This finding, together with behavioral results, indicated an easier integration of the manipulated highly expected words with the sentence context than of intact but less expected words. Taken together, the study demonstrates an efficient usage of both a context-driven expectancy of the suitable word as well as a stimulus-driven processing of the phonetic information during online perception of speech. The present ERP results support the earlier behavioral research in showing that phonemic restoration is not a bottom-up phenomenon but rather reflects a top-down repair process.


Time and rate measures in choice transitions.
Three experiments with pigeons studied the relation between time and rate measures of behavior under conditions of changing preference. Experiment 1 studied a concurrent chain schedule with random-interval initial links and fixed-interval terminal links; Experiment 2 studied a multiple chained random-interval fixed-interval schedule; and Experiment 3 studied simple concurrent random-interval random-interval schedules. In Experiment 1, and to a lesser extent in the other two experiments, session-average initial-link wait-time differences were linearly related to session-average response-rate differences. In Experiment 1, and to a lesser extent in Experiment 3, ratios of session-average initial-link wait times and response rates were related by a power function. The weaker relations between wait and response measures in Experiment 2 appear to be due to the absence of competition between responses. In Experiments 1 and 2, initial-link changes lagged behind terminal-link changes. These findings may have implications for the relations between fixed- and variable-interval procedures and suggest that more attention should be paid to temporal measures in studies of free-operant choice.


Nonlinear kinetics of alendronate. Plasma protein binding and bone uptake.
Alendronate (4-amino-1-hydroxybutylidene-1,1-bisphosphonate), an antiosteolytic agent, is currently under investigation in the treatment of osteoporosis. The purpose of this study was to examine the plasma protein binding and the ability of bone to bind alendronate, and their effects on the distribution of the drug to bone tissues. In addition, the species differences in plasma protein binding and bone uptake between rats and dogs were studied. Following intravenous administration (0.8 or 1 mg/kg), the apparent uptake clearance (CL,up) by tibia in dogs and rats was approximately 0.075 and 0.18 ml/min/g bone tissue, respectively. The binding of alendronate to plasma protein was species-dependent; the drug was highly bound to rat plasma, but not to dog plasma. The unbound fraction of alendronate was approximately 0.03 for the rat and 0.53 for the dog. Binding studies with purified serum albumin revealed the presence of displacer(s) in dog plasma. This may explain the low binding of alendronate in dog plasma. Like other organs, uptake of drugs by bone tissue is controlled by the plasma flow (Q), the fraction of unbound drug in plasma (fp), and the intrinsic ability of bone to bind the drug (CLin) as described by the equation: CL,up = Q(1-e-tp.CLin/Q). Plasma flow to the tibia of dogs and rats is reported to be approximately 0.09 and 0.25 ml/min/g, respectively. By applying the equation, the CLin was estimated to be approximately 10 ml/min/g for the rat and 0.3 ml/min/g for the dog. These results indicate that both plasma protein binding and bone uptake were species-dependent.(ABSTRACT TRUNCATED AT 250 WORDS)


Identifying DNA methylation biomarkers for non-endoscopic detection of Barrett's esophagus.
We report a biomarker-based non-endoscopic method for detecting Barrett's esophagus (BE) based on detecting methylated DNAs retrieved via a swallowable balloon-based esophageal sampling device. BE is the precursor of, and a major recognized risk factor for, developing esophageal adenocarcinoma. Endoscopy, the current standard for BE detection, is not cost-effective for population screening. We performed genome-wide screening to ascertain regions targeted for recurrent aberrant cytosine methylation in BE, identifying high-frequency methylation within the CCNA1 locus. We tested CCNA1 DNA methylation as a BE biomarker in cytology brushings of the distal esophagus from 173 individuals with or without BE. CCNA1 DNA methylation demonstrated an area under the curve of 0.95 for discriminating BE-related metaplasia and neoplasia cases versus normal individuals, performing identically to methylation of VIM DNA, an established BE biomarker. When combined, the resulting two biomarker panel was 95% sensitive and 91% specific. These results were replicated in an independent validation cohort of 149 individuals who were assayed using the same cutoff values for test positivity established in the training population. To progress toward non-endoscopic esophageal screening, we engineered a well-tolerated, swallowable, encapsulated balloon device able to selectively sample the distal esophagus within 5 min. In balloon samples from 86 individuals, tests of CCNA1 plus VIM DNA methylation detected BE metaplasia with 90.3% sensitivity and 91.7% specificity. Combining the balloon sampling device with molecular assays of CCNA1 plus VIM DNA methylation enables an efficient, well-tolerated, sensitive, and specific method of screening at-risk populations for BE.


Oxidation of copper nanowire based transparent electrodes in ambient conditions and their stabilization by encapsulation: application to transparent film heaters.
Whereas the integration of silver nanowires in functional devices has reached a fair level of maturity, the integration of copper nanowires still remains difficult, mainly due to the intrinsic instability of copper nanowires in ambient conditions. In this paper, copper nanowire based transparent electrodes with good performances (33 Ω sq-1 associated with 88% transparency) were obtained, and their degradation in different conditions was monitored, in particular by electrical measurements, transmission electron microscopy, x-ray photoelectron spectrometry and Auger electron spectroscopy. Several routes to stabilize the random networks of copper nanowires were evaluated. Encapsulation through laminated barrier film with optical clear adhesive and atmospheric pressure spatial atomic layer deposition were found to be efficient and were used for the fabrication of transparent film heaters.


Fasting and weight-loss restrictive diet practices among 2,700 cancer survivors: results from the NutriNet-Santé cohort.
Nutrition is often used by cancer survivors as a lever to take charge of their own health. However, some dietary behaviors are not currently recommended for patients without medical supervision. Our study aimed at evaluating weight-loss restrictive diets and fasting practices among cancer survivors of the NutriNet-Santé cohort, as well as related socio-demographic and lifestyle factors. In October 2016, 2,741 cancer survivors had completed a specific questionnaire about their practices. Fasting and non-fasting patients (respectively dieting and non-dieting) were compared using logistic regression models. Analyses were weighted according to the age, gender, and cancer location distribution of French cancer cases. 13.8% had already practiced weight-loss restrictive diet as their diagnosis. They were more likely to be women, professionally active, overweight/obese, to use dietary supplements and to have breast cancer (all p < 0.05). 6.0% had already fasted, 3.5% as their diagnosis. They were more likely to be younger, with higher educational level, higher incomes, professionally active, to have a healthy weight, and to use dietary supplements (all p < 0.05). Fasting was associated with the opinion that such practice could improve cancer prognosis (p < 0.0001). Patients who received nutritional information from health care professionals were less likely to practice fasting or weight-loss restrictive diet (0.42[0.27-0.66], p < 0.0001 and 0.49[0.38-0.64], p < 0.0001 respectively). Our study provided original results suggesting that weight-loss restrictive diets are widely practiced by cancer survivors. Fasting was less common in our study though non negligible. Sources of nutritional information received as cancer diagnosis seemed to be a key determinant of these practices.