Algorithm for tissue ischemia estimation based on electrical impedance spectroscopy.
The purpose of this paper is to present an algorithm developed for real-time estimation of skeletal muscle ischemia, based on parameters extracted from in vivo obtained electrical impedance spectra. A custom impedance spectrometer was used to acquire data sets: complex impedance spectra measured at 27 frequencies in the range of 100 Hz-1 MHz, and tissue pH. Twenty-nine in vivo animal studies on rabbit anterior tibialis muscle were performed to gather data on the behavior of tissue impedance during ischemia. An artificial neural network (ANN) was used to quantitatively describe the relationship between the parameters of complex tissue impedance spectra and tissue ischemia via pH. The ANN was trained on 1249, and tested on 946 ischemic tissue impedance data sets. A correlation of 94.5% and a standard deviation of 0.15 pH units was achieved between the ANN estimated pH and measured tissue pH values.


Special article: an optimistic prognosis for the clinical utility of laboratory test data.
It is hoped that anesthesiologists and other clinicians will be able to increasingly rely upon laboratory test data to improve the perioperative care of patients. However, it has been suggested that in order for a laboratory test to have clinically useful diagnostic performance characteristics (sensitivity and specificity), its performance must be considerably better than those that have been evaluated in most etiologic or epidemiologic studies. This pessimism about the clinical utility of laboratory tests is based upon the untested assumption that laboratory data are normally distributed within case and control populations. We evaluated the data distribution for 700 commonly ordered laboratory tests, and found that the vast majority (99%) do not have a normal distribution. The deviation from normal was most pronounced at extreme values, which had a large quantitative effect on laboratory test performance. At the sensitivity and specificity values required for diagnostic utility, the minimum required odds ratios for laboratory tests with a nonnormal data distribution were significantly smaller (by orders of magnitude) than for tests with a normal distribution. By evaluating the effect that the data distribution has on laboratory test performance, we have arrived at the more optimistic outlook that it is feasible to produce laboratory tests with diagnostically useful performance characteristics. We also show that moderate errors in the classification of outcome variables (e.g., death vs. survival at a specified end point) have a small impact on test performance, which is of importance for outcomes research that uses anesthesia information management systems. Because these analyses typically seek to identify factors associated with an undesirable outcome, the data distributions of the independent variables need to be considered when interpreting the odds ratios obtained from such investigations.


Automatic audiovisual integration in speech perception.
Two experiments aimed to determine whether features of both the visual and acoustical inputs are always merged into the perceived representation of speech and whether this audiovisual integration is based on either cross-modal binding functions or on imitation. In a McGurk paradigm, observers were required to repeat aloud a string of phonemes uttered by an actor (acoustical presentation of phonemic string) whose mouth, in contrast, mimicked pronunciation of a different string (visual presentation). In a control experiment participants read the same printed strings of letters. This condition aimed to analyze the pattern of voice and the lip kinematics controlling for imitation. In the control experiment and in the congruent audiovisual presentation, i.e. when the articulation mouth gestures were congruent with the emission of the string of phones, the voice spectrum and the lip kinematics varied according to the pronounced strings of phonemes. In the McGurk paradigm the participants were unaware of the incongruence between visual and acoustical stimuli. The acoustical analysis of the participants' spoken responses showed three distinct patterns: the fusion of the two stimuli (the McGurk effect), repetition of the acoustically presented string of phonemes, and, less frequently, of the string of phonemes corresponding to the mouth gestures mimicked by the actor. However, the analysis of the latter two responses showed that the formant 2 of the participants' voice spectra always differed from the value recorded in the congruent audiovisual presentation. It approached the value of the formant 2 of the string of phonemes presented in the other modality, which was apparently ignored. The lip kinematics of the participants repeating the string of phonemes acoustically presented were influenced by the observation of the lip movements mimicked by the actor, but only when pronouncing a labial consonant. The data are discussed in favor of the hypothesis that features of both the visual and acoustical inputs always contribute to the representation of a string of phonemes and that cross-modal integration occurs by extracting mouth articulation features peculiar for the pronunciation of that string of phonemes.


Effects of an anxiogenic benzodiazepine receptor ligand on motor activity and dopamine release in nucleus accumbens and striatum in the rat.
The effects of the anxiogenic beta-carboline FG 7142 (N-methyl-beta-carboline-3-carboxylate) on motor activity and dopamine release in nucleus accumbens and striatum were measured in the rat. Changes in extracellular homovanillic acid (HVA) concentration, monitored by computer-controlled linear sweep voltammetry with carbon-paste electrodes, were used as an index of changes in dopamine release. An intraperitoneal injection of FG 7142 was followed by an inhibition of the nocturnal rise in motor activity and in dopamine release in nucleus accumbens, but not striatum. Two days after the drug injection, dopamine release in nucleus accumbens returned to control level and then increased on days 3-6 after the injection; there was no delayed change in motor activity or in striatal dopamine release. In parallel experiments using ex vivo changes in the ratio of 3,4-dihydroxyphenylacetic acid (DOPAC) to dopamine as an index of changes in dopamine turnover, a similar early depression and delayed increase of dopamine turnover in nucleus accumbens, with no change in striatum, was found after an intraperitoneal injection of FG 7142. Regression analysis of motor activity versus dopamine release showed a decrease in correlation between these 2 parameters for nucleus accumbens but not striatum after FG 7142 injection. These results suggest that the inverse benzodiazepine receptor agonist FG 7142 has a biphasic effect on dopamine release from mesolimbic neurons and support the hypothesis that dopamine release in nucleus accumbens and striatum has a modulatory effect on the control of motor activity but does not play a determining role in the regulation of movement.


Breast biopsy technique: a plea for cosmesis.
Breast cancer is the leading cause of cancer death among American women. Early detection and treatment greatly increase long-term survival rates, but many women delay seeking treatment of suspected lesions out of fear of mutilation. Unfortunately, this fear is compounded by the fact that although 60% to 80% of all biopsies prove benign, many women are left with unsightly scars from the biopsies themselves. The great majority of these avoidable scars result from the use of radial biopsy incisions, which are unnecessary in virtually all cases. Most lesions can be reached via periareolar incisions and even those few that require incisions away from the areola can be reached through incisions that follow Langer's lines circumferential to the breast. Even total subcutaneous mastectomy and reconstruction can often be done via periareolar incisions, with minimal scarring, less likelihood of keloid formation, no deformity, and less emotional trauma for the recovered patient.


Skull base metastasis from follicular thyroid carcinoma -two case reports-.
A 58-year-old woman and a 71-year-old woman presented with extremely rare skull base metastases from follicular thyroid carcinoma (FTC). Surgical removal and external radiotherapy were performed followed by iodine-131 ((131)I) brachytherapy and thyroid hormone administration. The metastatic tumors in the skull base were well controlled. Treatment for skull base metastasis from FTC includes surgical debulking of the metastatic lesion, as well as complete resection of the thyroid gland, followed by internal irradiation with (131)I, external irradiation, and administration of thyroid hormone to prevent tumor growth by suppression of endogenous thyroid-stimulating hormone. Skull base metastases may be the initial clinical presentation of FTC, with silent primary sites. The possibility of skull base metastasis from FTC should be considered in patients with clinical symptoms of cranial nerve dysfunction and radiological findings of bone destruction.


Isolation of the oncogene and epidermal growth factor-induced transin gene: complex control in rat fibroblasts.
Various oncogenes or epidermal growth factor (EGF) induce transcription of a 1.9-kilobase RNA (transin RNA) in rat fibroblasts. The induction by EGF can be blocked by cycloheximide. Thus the response of the transin gene to EGF appears to require de novo protein synthesis. Transin RNA induction is specific to EGF, as neither insulin, platelet-derived growth factor, fibroblast growth factor, nor transforming growth factor beta could elicit the same response. However, transforming growth factor beta could block the EGF induction of transin RNA. Whereas the calcium ionophore A23187 and the tumor promoter TPA, either alone or administered together, did not increase transin RNA levels, TPA could synergise with a serum factor to effect such an increase. Dibutyryl cyclic AMP also induced transin RNA. Treatment of cells with the microfilament-disrupting agent cytochalasin B, but not the microtubule-disrupting agent colcemid, resulted in an increase in transin RNA levels, suggesting a role for the cytoskeleton in control of transin gene expression. The transin RNA does not contain repeated sequences and appears to be encoded by a single-copy gene. The protein sequence encoded by the last four exons of the transin gene shows some homology to two regions of the heme-binding protein hemopexin.


CD44 and CD44v6 downregulation in clinical prostatic carcinoma: relation to Gleason grade and cytoarchitecture.
Altered expression of CD44 has been implicated in tumor progression and metastasis in multiple neoplasms. CD44 expression in archival tissues of prostate carcinoma was examined by immunohistochemistry with monoclonal antibodies against core CD44 and the RNA splice variant CD44v6 (v6). Core CD44 expression was reduced in the majority of primary neoplastic foci (n = 94) and loss of expression correlated with increasing Gleason grade. Staining for v6 was absent in most carcinomas and metastases. Expression of core CD44 in pelvic lymph node (n = 27) and bone metastases (n = 21) was significantly reduced. In addition, CD44 expression correlated with cytoarchitecture. Tall columnar tumor cells typically stained positively, yet more rounded cells forming cribiform structures or nests showed reduced expression. All cases of high-grade prostatic intraepithelial neoplasia were positive for core CD44 yet, there was decreased expression in cribiform and micropapillary variants. The majority of clinically relevant human prostatic carcinomas and metastases downregulate expression of CD44. Additional studies to determine whether CD44 cell surface expression relates to clinical outcome independent of other established clinicopathologic risk factors are warranted.


Fenretinide derivatives act as disrupters of interactions of serum retinol binding protein (sRBP) with transthyretin and the sRBP receptor.
Serum retinol binding protein (sRBP) is released from the liver as a complex with transthyretin (TTR), a process under the control of dietary retinol. Elevated levels of sRBP may be involved in inhibiting cellular responses to insulin and in generating first insulin resistance and then type 2 diabetes, offering a new target for therapeutic attack for these conditions. A series of retinoid analogues were synthesized and examined for their binding to sRBP and their ability to disrupt the sRBP-TTR and sRBP-sRBP receptor interactions. A number inhibit the sRBP-TTR and sRBP-sRBP receptor interactions as well as or better than Fenretinide (FEN), presenting a potential novel dual mechanism of action and perhaps offering a new therapeutic intervention against type 2 diabetes and its development. Shortening the chain length of the FEN derivative substantially abolished binding to sRBP, indicating that the strength of the interaction lies in the polyene chain region. Differences in potency against the sRBP-TTR and sRBP-sRBP receptor interactions suggest variant effects of the compounds on the two loops of sRBP guarding the entrance of the binding pocket that are responsible for these two protein-protein interactions.


Late onset of subfoveal choroidal neovascularisation following cerebral radiotherapy.
A report of choroidal neovascularisation (CNV) associated with radiation retinopathy. A 43-year-old Caucasian man presented with a 4-week history of sudden loss of central vision in the left eye, 8.5 years following radical radiotherapy for left tempero-parietal anaplastic astrocytoma. His visual acuity was 6/6 in the right eye and 6/60 in the left eye. Ophthalmoscopy of the left eye showed central macular pigmented area surrounded by subretinal fluid, haemorrhage and exudates. Fundus fluorescein angiography revealed left subfoveal CNV with surrounding macular oedema and peripheral retinal ischaemia. Radiation retinopathy associated CNV is a late ocular complication of cerebral radiotherapy. It should be investigated as a possible aetiology of severe visual loss in long-term survivors of cerebral tumours who have previously received radiotherapy.


Intensive medical weight loss or laparoscopic adjustable gastric banding in the treatment of mild to moderate obesity: long-term follow-up of a prospective randomised trial.
Proven short-term effectiveness of obesity therapy should be re-evaluated in the long-term. The objective of this paper is to determine the long-term (10 years) outcome for patients from a randomised controlled trial (RCT). A RCT in 2002 compared laparoscopic adjustable gastric band (LAGB) for obesity with non-surgical therapy. Follow-up has been conducted at 10 years. Eighty patients (BMI 30-35) were randomised to a non-surgical or a surgical program. Outcome data are available on 37 (92.5 %) of the surgical patients and 27 (62.5 %) of the non-surgical patients at 10 years. Weight change, the metabolic syndrome, quality of life, adverse events and direct costs of the surgical cohort were the main results of the study. A durable weight loss is present in the surgical group with a mean (SD) 10-year weight loss of 14.1 (7.7) kg (63.4 % EWL), better than the non-surgical group (mean (SD) = 0.4 (10.5) kg; p < 0.001). The metabolic syndrome was reduced from 14 to 4 of the 37 patients who completed 10 years within the LAGB groups. Proximal gastric enlargements occurred in 17 (30 %) of the 57 who had LAGB and removal of the band occurred in 7 (12 %). The annual maintenance costs including additional surgery was AUD $765 per patient per year. Bariatric surgery with the LAGB can achieve long-term weight reduction which is better than a program of non-surgical therapy. There is also a sustained reduction of the metabolic syndrome. There is a significant maintenance requirement after LAGB.


Metabolic Changes in Synaptosomes in an Animal Model of Schizophrenia Revealed by 1H and 1H,13C NMR Spectroscopy.
Synaptosomes are isolated nerve terminals that contain synaptic components, including neurotransmitters, metabolites, adhesion/fusion proteins, and nerve terminal receptors. The essential role of synaptosomes in neurotransmission has stimulated keen interest in understanding both their proteomic and metabolic composition. Mass spectrometric (MS) quantification of synaptosomes has illuminated their proteomic composition, but the determination of the metabolic composition by MS has been met with limited success. In this study, we report a proof-of-concept application of one- and two-dimensional nuclear magnetic resonance (NMR) spectroscopy for analyzing the metabolic composition of synaptosomes. We utilize this approach to compare the metabolic composition synaptosomes from a wild-type rat with that from a newly generated genetic rat model (Disc1 svΔ2), which qualitatively recapitulates clinically observed early DISC1 truncations associated with schizophrenia. This study demonstrates the feasibility of using NMR spectroscopy to identify and quantify metabolites within synaptosomal fractions.


Lazy-Learning-Based Data-Driven Model-Free Adaptive Predictive Control for a Class of Discrete-Time Nonlinear Systems.
In this paper, a novel data-driven model-free adaptive predictive control method based on lazy learning technique is proposed for a class of discrete-time single-input and single-output nonlinear systems. The feature of the proposed approach is that the controller is designed only using the input-output (I/O) measurement data of the system by means of a novel dynamic linearization technique with a new concept termed pseudogradient (PG). Moreover, the predictive function is implemented in the controller using a lazy-learning (LL)-based PG predictive algorithm, such that the controller not only shows good robustness but also can realize the effect of model-free adaptive prediction for the sudden change of the desired signal. Further, since the LL technique has the characteristic of database queries, both the online and offline I/O measurement data are fully and simultaneously utilized to real-time adjust the controller parameters during the control process. Moreover, the stability of the proposed method is guaranteed by rigorous mathematical analysis. Meanwhile, the numerical simulations and the laboratory experiments implemented on a practical three-tank water level control system both verify the effectiveness of the proposed approach.


Early cranial vault distraction for a more balanced and enhanced expansion: a 3D craniometric analysis of anterior versus posterior distraction osteogenesis in patients with craniosynostosis.
Posterior distraction osteogenesis (DO) is widely accepted for the treatment of craniosynostosis. The aim of this study was to quantitatively compare the effect of DO on the cranial vault according to the age of the patient and direction of distraction. This was a retrospective study of patients with craniosynostosis who underwent DO in the anteroposterior direction. Postdistraction changes in intracranial volume (ICV), anteroposterior distance, biparietal distance, cranial height, and frontal bossing angle were measured using Mimics software on CT scans. Craniometric data were analyzed using a multivariate regression model. Thirty-two patients (16 anterior and 16 posterior DOs) were included in the study. The mean ICV increase in the anterior and posterior DO group was 211 cm3 (range 142-281 cm3) and 214 cm3 (range 150-279 cm3), respectively. Patients who were aged 1 year or younger showed a greater percentage increase in ICV than patients older than 1 year. In the anterior DO group, a more balanced increase in both anterior and posterior anteroposterior distance was observed in patients aged 1 year or younger when compared to patients older than 1 year. In the posterior DO group, a bigger expansion and smoother contour in the posterior cranial fossa was observed in patients aged 1 year or younger. Both anterior and posterior DO are effective surgical options for expanding the cranial vault in patients with craniosynostosis. Early distraction appeared to show greater morphological changes in the growing cranial vault than those predicted with the vector of distraction.


Long-term follow-up and residual sequelae after treatment for intracerebral germ-cell tumour in children and adolescents.
Information on long-term follow-up of children and adolescents treated for intracerebral germ-cell tumour is scant. We report on the results of a small series of patients treated at a single institution. Hospital records from 15 patients treated between 1980 and 1998 were reviewed. An attempt was made to correlate sequelae to tumour location and treatment modalities. This cohort constitutes 5.5% of all brain tumours diagnosed at our institution. 10 germinomas, 2 benign teratomas, 2 malignant teratomas, and one mixed germ-cell tumour. Overall survival was 87%, with a mean follow-up time of 7 years and 8 months. The majority of patients have long-term sequelae involving one or several organ systems. In 66% endocrine, in 47% ophthalmologic, in 60% neuropsychological defects were observed. Endocrine and ophthalmologic sequelae show a correlation to tumour location. Neuropsychological long-term abnormalities are frequent and are associated with cranial irradiation in particular at young age, but less with tumour location, irradiation dose or surgery. Our preliminary data suggest that today intracerebral germinomas and mature teratomas have a good prognosis even when a relapse occurs. The outcome for mixed germ-cell tumours and malignant teratomas is less favourable. Although long-term sequelae are present in the majority of patients, there is some evidence that patients treated after 1990 suffer fewer severe long-term defects, thereby indicating that recent treatment protocols may result in a reduction of sequelae.


Characteristics of inhibition of infectious pancreatic necrosis virus (IPNV) by normal rainbow trout Oncorhynchus mykiss serum.
We studied the characteristics of rainbow trout serum (RTS) inhibitory activity against infectious pancreatic necrosis virus (IPNV). Serum inhibition was related to the serum source and host cell in which the virus had been propagated. IPNV was more efficiently inhibited by RTS in salmonid cell lines than in non-salmonid cell lines, with inhibition highest in rainbow trout gonad (RTG)-2 cells. The RTS sensitivity of the virus was modified by the cell line through which the virus passed, with multiple passages through Chinook salmon embryo (CHSE)-214 cells producing a virus that was less sensitive to RTS. The RTS inhibition level was dependent on cell density: at a cell density of < or = 2 x 10(5) cells ml(-1), inhibition was insignificant (tissue culture infective dose 50% = 10(-1.1) TCID50 ml(-1) reduction); however, above a density of 3 x 10(5) cells ml(-1), the inhibition level was very high (> or = 10(-6.3) TCID50 ml(-1) reduction). The salmonid sera tested showed high inhibition, except for brook trout serum (BTS), while non-salmonid sera did not inhibit IPNV, replication on RTG-2 cells. Pretreatment of cultured cells with RTS prior to exposure did not affect inhibition of IPNV and thus did not mask a viral receptor. The RTS inhibition level was dependent on the time of serum addition, with inhibition being maintained for at least 16 h postinfection. Pretreatment of IPNV revealed that the virus is directly inhibited by RTS, and more strongly so when RTS is present during viral replication.


Magnetic circular dichroism studies of exogenous ligand and substrate binding to the non-heme ferrous active site in phthalate dioxygenase.
Mononuclear non-heme iron centers are found in the active sites of a variety of enzymes that require molecular oxygen for catalysis. The mononuclear non-heme iron is believed to be the active site for catalysis, and is presumed to bind and activate molecular oxygen. The mechanism of this reaction is not understood. Phthalate dioxygenase is one such enzyme. Because it also contains a second iron site, the Rieske site, it is difficult to obtain information on the structure of the active site. We therefore used magnetic circular dichroism (MCD) spectroscopy to probe the mononuclear, non-heme Fe2+ site in this biodegradative enzyme. The MCD spectrum of the resting enzyme shows features indicative of one six-coordinate Fe2+ site; substrate binding converts the site to two different five-coordinate species, opening up a coordination position for O2 binding. MCD spectra of the corresponding apoenzyme have been subtracted to account for temperature-independent contributions from the Rieske site. Azide binds both to the resting enzyme to produce a new six-coordinate species, showing that one of the ferrous ligands is exchangeable, and also to the enzyme-substrate complex to form a ternary species. The low azide binding constant for the substrate-enzyme species relative to the resting enzyme indicates steric interaction and close proximity between exogenous ligand and the substrate. We have been able to provide some detailed structural insight into exogenous ligand and substrate binding to the non-heme Fe2+ site, even in the presence of the enzyme's [2Fe-2S] Rieske center. Further mechanistic studies are now required to maximize the molecular-level detail available from these spectroscopic studies.


Impact of peritoneal absorption of glucose on appetite, protein catabolism and survival in CAPD patients.
Dietary protein and calorie intake, protein catabolism and peritoneal kinetics were measured in 97 CAPD patients to establish the effect of peritoneal glucose absorption on appetite and survival. There was a large variability in the number of calories obtained from the dialysate, mean 5.89 cal/kg (median 5.43 cal/kg), with a skewed distribution, due to the increased requirement for hypertonic solutions by patients with more rapid glucose absorption and poor ultrafiltration. On average calories derived from peritoneal absorption accounted for 19% of the total energy intake which in itself was well below that recommended. Patients with > 6 cal/kg, obtained from the dialysate (top 20th percentile, n = 19) were compared with those with < 6 cal/kg, but no significant differences in oral protein or calorie intake, protein catabolism or total calorie intake were found. Age, body mass index (BMI) and KT/V were also similar in both groups. Patients were followed-up prospectively for a minimum of 24 months and a comparison made of actuarial survival. Patients with high peritoneal calorie intake tended to survive longer but this was not significantly different (p = 0.25). This study suggests that calories derived from the peritoneum in CAPD patients do not suppress appetite, provide a useful and significant proportion of the total energy intake, that does not cause excessive obesity or have a negative effect on patient survival.


Carbon pools and flux of global forest ecosystems.
Forest systems cover more than 4.1 x 10(9) hectares of the Earth's land area. Globally, forest vegetation and soils contain about 1146 petagrams of carbon, with approximately 37 percent of this carbon in low-latitude forests, 14 percent in mid-latitudes, and 49 percent at high latitudes. Over two-thirds of the carbon in forest ecosystems is contained in soils and associated peat deposits. In 1990, deforestation in the low latitudes emitted 1.6 +/- 0.4 petagrams of carbon per year, whereas forest area expansion and growth in mid- and high-latitude forest sequestered 0.7 +/- 0.2 petagrams of carbon per year, for a net flux to the atmosphere of 0.9 +/- 0.4 petagrams of carbon per year. Slowing deforestation, combined with an increase in forestation and other management measures to improve forest ecosystem productivity, could conserve or sequester significant quantities of carbon. Future forest carbon cycling trends attributable to losses and regrowth associated with global climate and land-use change are uncertain. Model projections and some results suggest that forests could be carbon sinks or sources in the future.


Intermittent versus continuous operation of biosand filters.
The biosand filter is a household-scale point-of-use water filtration system based on slow sand filtration, but modified for intermittent operation. Studies on slow sand filters show that intermittent operation reduces filter effectiveness. However, continuous versus intermittent operation of biosand filters has never been compared. Eight 10-cm diameter columns were constructed to represent field biosand filters. Five were operated intermittently with a 24-h residence period, while the remaining three were operated continuously. Continuous operation of the filters resulted in significantly better reduction of Escherichia coli (3.71 log10 versus 1.67 log10), bacteriophage MS2 (2.25 log10 versus 0.85 log10), and turbidity (96% versus 87%). Dissolved oxygen levels at 5 and 10 cm of media depth in intermittent filters reached an average of 0 mg/L by 24 h of residence time on day 60 of the experiment. A simple numerical model was developed to describe E. coli removal during ripening from days 0-58 for continuously operated versus intermittent filters. This research confirms that although biosand filters were developed for intermittent operation, the filters perform significantly better when operated continuously. However, both operational modes resulted in a significant reduction of microbial indicators.


The validity and reliability of a novel indoor player tracking system for use within wheelchair court sports.
The aim of the current study was to investigate the validity and reliability of a radio frequency-based system for accurately tracking athlete movement within wheelchair court sports. Four wheelchair-specific tests were devised to assess the system during (i) static measurements; (ii) incremental fixed speeds; (iii) peak speeds; and (iv) multidirectional movements. During each test, three sampling frequencies (4, 8 and 16 Hz) were compared to a criterion method for distance, mean and peak speeds. Absolute static error remained between 0.19 and 0.32 m across the session. Distance values (test (ii)) showed greatest relative error in 4 Hz tags (1.3%), with significantly lower errors seen in higher frequency tags (<1.0%). Relative peak speed errors of <2.0% (test (iii)) were revealed across all sampling frequencies in relation to the criterion (4.00 ± 0.09 m · s-(1)). Results showed 8 and 16 Hz sampling frequencies displayed the closest-to-criterion values, whilst intra-tag reliability never exceeded 2.0% coefficient of variation (% CV) during peak speed detection. Minimal relative distance errors (<0.2%) were also seen across sampling frequencies (test (iv)). To conclude, the indoor tracking system is deemed an acceptable tool for tracking wheelchair court match play using a tag frequency of 8 or 16 Hz.


The effects of molecular structure on sol-to-gel transition of biodegradable poly(depsipeptide-co-lactide)-g-PEG copolymers.
We report on the effects of number and length of PEG chains in poly(depsipeptide-co-dl-lactide)-g-poly(ethylene glycol) (P(DG-dl-LA)-g-PEG) copolymers on their sol-to-gel transition behavior. The graft-type copolymer is suitable for the systematic study of the effects of molecular structure and hydrophilic/hydrophobic balance on its sol-to-gel transition. We prepared various P(DG-dl-LA)-g-PEG copolymers through coupling reactions between the pendant carboxylic acid groups of P(GD-dl-LA) and the end hydroxyl group of MeO-PEG having various molecular weights. Temperature-responsive sol-to-gel transition of the obtained copolymer solution in phosphate-buffered solution (pH 7.4, ionic strength = 0.14) was investigated by the test tube inverting method and rheological measurements. P(GD-dl-LA)-g-PEG copolymer prepared from higher molecular weight PEG showed higher sol-to-gel transition temperatures compared with the copolymers prepared from lower molecular weight PEG, although these copolymers have similar weight content of PEG (23-24 wt.%). Similar trends were observed for groups of copolymers whose PEG contents were 27 or 30 wt.%. These results are informative for providing strategies on rational design of thermo-gelling polymers.


Dialysis modality choices among chronic kidney disease patients: identifying the gaps to support patients on home-based therapies.
Home dialysis is a cost-effective renal replacement strategy, which provides improved quality of life compared to conventional in-center hemodialysis (CHD). To date, most studies support the use of multidisciplinary chronic kidney disease (CKD) clinics to facilitate timely initiation of dialysis. This is an observational cohort study examining 486 patients with CKD over the period of 2001-2007 to ascertain potential demographic differences among patients transitioned to in-center versus home dialysis. From January 2001 to December 2007, 486 patients with CKD attended the multidisciplinary renal management clinic at the University Health Network in Toronto. One hundred and fifty-three of the 486 patients were initiated on renal replacement therapy [59 to center hemodialysis (CHD), 15 to home hemodialysis (HHD) and 79 to home peritoneal dialysis (PD)]. HHD patients were younger (48 ± 15 years) than those who selected CHD (62 ± 16 years) or PD (64 ± 16 years). Although the gender distribution was similar overall, the percentage of single males was higher in CHD versus home dialysis patients (29 vs. 15%, P < 0.05). There were no significant differences in other demographic, clinical and biochemical parameters at the time of dialysis initiation. Disinterest in home dialysis by patients and their families (25.4%) and lack of social support (12.1%) constituted the main barriers to home dialysis. Medical contraindications for home dialysis were present among 11% of the patients. Other less frequent barriers were inadequate space, communication barrier and inability to perform their own dialysis. Sixty-one percent of patients requiring dialysis chose a home dialysis modality. Patients' and their families' disinterest in home dialysis and lack of support (either perceived or actual) represented the major overall barriers to adoption of home dialysis.


Evaporable Fullerene Indanones with Controlled Amorphous Morphology as Electron Transport Layers for Inverted Perovskite Solar Cells.
Fullerenes are among the most commonly used electron-transporting materials (ETMs) in inverted perovskite solar cells (IPSCs). Although versatile functionalized fullerene derivatives have shown excellent performance in IPSCs, pristine [60]fullerene (C60) is still the most widely used in devices mainly because of its uniform morphology by thermal deposition. However, thermally evaporable fullerene derivatives have not yet been achieved. Herein, we developed a series of evaporable fullerene derivatives, referred to as fullerene indanones (FIDOs), affording IPSCs with high power conversion efficiency (PCE) and long-term storage stability. The FIDOs were designed with a unique architecture in which the fullerene moiety and a benzene ring moiety are linked via a five-membered carbon ring in benzene ring plane. This molecular arrangement affords exceptional thermal stability, allowing the FIDOs to withstand harsh thermal deposition conditions. Moreover, by manipulating the steric bulk of the functional groups, we could control the state of the organic film from crystalline to amorphous. Subsequently, we used FIDOs as an electron transport layer (ETL) in IPSCs. Thanks to the suitable energy level and dual-passivation effect of FIDOs compared with a reference ETL using C60, the device using FIDOs achieved an open-circuit voltage of 1.16 V and a fill factor of 0.77. As a result, the PCE reached 22.11%, which is superior to 20.45% of the best-performing reference device. Most importantly, the FIDO-based IPSC devices exhibited exceptional stability in comparison to the reference device due to the stability of the amorphous ETL films.


Imaging of oncologic emergencies: what every radiologist should know.
Acute life-threatening conditions in oncology patients may develop either because of underlying malignancy or as a complication from treatment. Oncologic emergencies can be categorized as metabolic, hematologic, and structural conditions. Metabolic and hematologic emergencies are mainly diagnosed on the basis of clinical and laboratory findings. Structural pathologic conditions that result in bleeding, mechanical compression, or obstruction to the hollow organs, such as the trachea and bowel loops, may first be suspected because of clinical findings, including decreasing hematocrit levels, difficulty in breathing, and abdominal pain; however, performance of imaging studies is critical for timely diagnosis and management. Life-threatening conditions of the central nervous system (such as cerebral herniation, carcinomatous meningitis, and spinal cord compression), thoracic emergent conditions (such as central airway obstruction, esophagorespiratory fistula, massive hemoptysis, pulmonary embolism, superior vena cava syndrome, and pericardial tamponade), and abdominopelvic emergencies (such as uncontrolled intraabdominal hemorrhage, bowel obstruction, intestinal perforation, bowel ischemia, intussusception, and urinary tract obstruction) can be definitively diagnosed on the basis of projectional or cross-sectional imaging findings in appropriate clinical scenarios. Select emergent conditions in cancer patients related to chemotherapy and radiation treatment, as well as iatrogenic emergencies secondary to either surgery or placement of central venous catheters, may also demonstrate characteristic findings at imaging studies. In addition, interventional procedures are of great help in the treatment of acute superior vena cava syndrome, massive hemoptysis, and uncontrolled intraabdominal hemorrhage. Radiologists should be aware of these select, "not to be missed" imaging findings of oncologic emergencies to make an accurate, timely diagnosis and provide appropriate patient care.


Conformational studies of cyclic tetrapeptides. Evidence for a bis gamma-turn conformation for chlamydocin and Ala4-chlamydocin in nonpolar solvents.
The conformations of chlamydocin and cyclo (Ala-Aib-Phe-D-Pro) (Ala4-chlamydocin) in chloroform have been investigated by nuclear magnetic resonance, infrared and circular dichroism spectroscopy. The data obtained from these experiments establish an all transoid, bis gamma-turn conformation for both compounds in chloroform with the following torsional angles (+/- 20 degrees): Ala4-chlamydocin: Aib, phi + 60 degrees, psi - 50 degrees; omega + 160 degrees; Phe phi - 120 degrees, psi + 120 degrees, omega - 160 degrees; D-Pro phi + 60 degrees, psi - 55 degrees, omega + 160 degrees; Ala phi - 110 degrees, psi + 110 degrees, omega - 160 degrees. Chlamydocin adopts a closely related conformation in neat chloroform. Nuclear Overhauser Effect (NOE) data are utilized to assign amide bond geometries in the cyclic tetrapeptide ring system.


Cost-effectiveness of decompression according to Gill versus instrumented spondylodesis in the treatment of sciatica due to low grade spondylolytic spondylolisthesis: a prospective randomised controlled trial [NTR1300].
Nerve root decompression with instrumented spondylodesis is the most frequently performed surgical procedure in the treatment of patients with symptomatic low-grade spondylolytic spondylolisthesis. Nerve root decompression without instrumented fusion, i.e. Gill's procedure, is an alternative and less invasive approach. A comparative cost-effectiveness study has not been performed yet. We present the design of a randomised controlled trial on cost-effectiveness of decompression according to Gill versus instrumented spondylodesis. All patients (age between 18 and 70 years) with sciatica or neurogenic claudication lasting more than 3 months due to spondylolytic spondylolisthesis grade I or II, are eligible for inclusion. Patients will be randomly allocated to nerve root decompression according to Gill, either unilateral or bilateral, or pedicle screw fixation with interbody fusion. The main primary outcome measure is the functional assessment of the patient measured with the Roland Disability Questionnaire for Sciatica at 12 weeks and 2 years. Other primary outcome measures are perceived recovery and intensity of leg pain and low back pain. The secondary outcome measures include, incidence of re-operations, complications, serum creatine phosphokinase, quality of life, medical consumption, costs, absenteeism, work perception, depression and anxiety, and treatment preference. The study is a randomised prospective multicenter trial in which two surgical techniques are compared in a parallel group design. Patients and research nurse will not be blinded during the follow-up period of 2 years. Currently, nerve root decompression with instrumented fusion is the golden standard in the surgical treatment of low-grade spondylolytic spondylolisthesis, although scientific proof justifying instrumented spondylodesis over simple decompression is lacking. This trial is designed to elucidate the controversy in best surgical treatment of symptomatic patients with low-grade spondylolytic spondylolisthesis.


Regrowth of axons within Schwann cell-filled polycarbonate tubes implanted into the damaged optic tract and cerebral cortex of rats.
The efficacy of Schwann cell-filled polycarbonate tubes as a bridging substrate for regrowing axons following lesions of the rat optic tract or cerebral cortex has been assessed after short (11-31 days) or long (82-119 days) survival times. Tubes were impregnated with Iaminin and poly-L-lysine, soaked in basic FGF and filled with Schwann cells. They were implanted into optic tract lesions in 34 rats aged 15-21 days and into cortical lesion cavities in 3 adult rats. Gelfoam soaked in basic FGF and Schwann cell conditioned medium was placed over the tubes. In one group of rats, axon regrowth into implants was assessed using neurofilament antibody RT97; antibodies to proteolipid protein, Po, Iaminin, the low-affinity nerve growth factor receptor (NGFr), S-100 and EDI were also used to study myelination and the cellular content of the tubes. In a second group of rats, anterograde tracing techniques were used to specifically identify host retinal axons within the implanted polymers. After long survival times, the relationships between regrown axons and cells inside the tubes were also examined ultrastructurally. In all implants examined immunohistochemically at short survival times, large numbers of RT97+ axons were found throughout the tubes, usually in association with Iaminin+, NGFr+ Schwann cells. At longer survival times, viable Schwann cells were still present, but tubes contained fewer axons and less cellular material. This material often formed a cord (200-250 μm thick) which extended the length of the implant. In the second group of rats, labelled retinal axons were found in 11 of the 16 implants that were attached to the dLGN. Axons regrew up to 1 mm but did not reach the distal (tectal) end of the implants. Interestingly, there was no evidence of myelinogenesis by either implanted Schwann cells or by host-derived oligodendroglia which had migrated into the tubes. Oligodendroglia were usually encircled by processes, many of which originated from Schwann cells, suggesting that the grafted cells may have been involved in isolating the central glia. The data show that Schwann cell-filled polycarbonate tubes provided a favourable milieu for axonal regeneration in the short term; however over time there was a decrease in the cellular and fibre content of the tubes. After intracranial implantation, an additional supporting matrix inside the polycarbonate tubes may aid in providing an environment conducive to the long term maintenance of regenerated retinal and other axons.


A theoretical definition of minimal acceptable dialysis therapy.
A theoretical definition of "minimal acceptable dialysis therapy" is that which: provides optimal sodium, potassium, hydrogen, and water homeostasis, optimal calcium and phosphorus homeostasis, and nontoxic concentration profiles for all other solutes which exhibit concentration-dependent toxicity normally controlled by renal excretion; results in maximal patient well-being and rehabilitation with minimal dialysis related morbidity; is sufficiently well-defined with respect to dose to be reliably prescribed for any individual patient which requires that, for all solutes of clinical importance, the kinetic behavior and closure of mass balance be verified for individual patients. Empirically, the minimum dose of dialysis (dialyzer urea clearance, treatment time and frequency) sufficient to result in mean predialysis BUN values of 80 mg/dl with documented dietary protein intake (DPI) greater than or equal to 1.0 g/kg/day and measured protein catabolic rate (PCR) equal to DPI has been shown to be acceptable with respect to currently achieved clinical outcome parameters.


Energy balance and body composition after switch between integrase strand transfer inhibitors and doravirine among people with HIV.
Integrase strand transfer inhibitors (INSTIs) are associated with excessive weight gain among a subset of persons with HIV (PWH), due to unclear mechanisms. We assessed energy intake (EI) and expenditure (EE) following switch off and onto INSTIs. PWH with >10% weight gain on an INSTI-based regimen switched INSTI to doravirine for 12 weeks, then back to INSTI for 12 weeks while keeping their remaining regimen stable. Twenty-four-hour EE, EI and weight were measured on INSTI, following switch to doravirine, and upon INSTI restart. Mixed models analysed changes over time. Among 18 participants, unadjusted 24 h EE decreased by 83 (95% CI -181 to 14) kcal following switch to doravirine, and by 2 (-105 to 100) kcal after INSTI restart; energy balance (EE-EI) increased by 266 (-126 to 658) kcal from Week 0 to Week 12, and decreased by 3 (-429 to 423) kcal from Week 12 to Week 24. Trends toward weight loss occurred following switch to doravirine [mean -1.25 (-3.18 to 0.69) kg] and when back on INSTI [-0.47 (-2.45 to 1.52) kg]. Trunk fat decreased on doravirine [-474 (-1398 to 449) g], with some regain following INSTI restart [199 (-747 to 1145) g]. Fat-free mass decreased on doravirine [-491 (-1399 to 417) g] and increased slightly after INSTI restart [178 (-753 to 1108) g]. Among PWH with >10% weight gain on an INSTI, switch to doravirine was associated with a trend towards decreases in 24 h EE, weight, trunk fat mass and fat-free mass. Observed changes were not significant, but suggest a mild weight-suppressive effect of doravirine among PWH.


Cervical Strip Biopsy for High-Grade Cervical Intraepithelial Lesions: a Valid Alternative to Conventional Punch Technique.
Introduction: To evaluate, if targeted strip biopsies decrease trauma/pain perception while maintaining diagnostic accuracy in patients with the diagnosis of high-grade squamous intraepithelial lesions of the uterine cervix. Patients and Methods: Between July 1st and December 31st 2014 we performed colposcopically directed strip biopsies in 102 patients with colposcopic suspicion of high-grade squamous intraepithelial lesions of the uterine cervix. We used a 3 mm curette for harvesting tissue samples under VITOM® videocolposcopy. So far, 60 patients underwent additional loop excision. Histologic examination of strip biopsies and loop specimens included routine hematoxylin and eosin staining as well as immunohistochemical staining for p16, Ki 67 and stathmin-1. Results: 55 patients (53 %), were histologically diagnosed with cervical intraepithelial neoplasia grade 3 on strip biopsies. Adenocarcinoma in situ was diagnosed in 2 patients (2 %), cervical intraepithelial neoplasia grade 2 in 35 patients (34 %), and cervical intraepithelial neoplasia grade 1 in 10 patients (10 %). The agreement between histologic results of strip biopsy and loop specimen was highly significant: In all 60 strip biopsies diagnosed with high-grade squamous intraepithelial lesions this diagnosis was confirmed histologically during follow-up loop specimen excision (high-grade squamous intraepithelial lesions in 58 patients, invasive disease in 2 patients). The pain level experienced during strip biopsy was rated on average 0.25 on a scale from 0 to 10. No clinically significant bleeding was reported. Conclusion: Targeted strip biopsies with a 3 mm curette are a reliable procedure to diagnose high-grade squamous intraepithelial lesions of the uterine cervix and yield high patient satisfaction (Video 1).


[Years of potential life lost: their usefulness in the analysis of mortality in Mexico].
The evolution of the epidemiology of mortality in developing countries requires the use of indicators additional to cause specific mortality rates. This paper presents the leading causes of potential years of life lost in Mexico in 1983, by sex. Methodologic discussion focused on age limits and relative numbers. The indicator proved useful to assess the impact of infectious diseases, accidents and homicides as causes of premature death. It was also useful to identify years of potential life lost attributable to specific age and sex groups. The use of years of potential life lost provides valuable information to epidemiologic mortality analysis.


Vitamin D in cancer chemoprevention.
There is increasing evidence that Vitamin D (Vit D) and its metabolites, besides their well-known calcium-related functions, may also exert antiproliferative, pro-differentiating, and immune modulatory effects on tumor cells in vitro and may also delay tumor growth in vivo. The aim of this review is to provide fresh insight into the most recent advances on the role of Vit D and its analogues as chemopreventive drugs in cancer therapy. A systematic review of experimental and clinical studies on Vit D and cancer was undertaken by using the major electronic health database including ISI Web of Science, Medline, PubMed, Scopus and Google Scholar. Experimental and clinical observations suggest that Vit D and its analogues may be effective in preventing the malignant transformation and/or the progression of various types of human tumors including breast cancer, prostate cancer, colorectal cancer, and some hematological malignances. These findings suggest the possibility of the clinical use of these molecules as novel potential chemopreventive and anticancer agents.


In vitro and in silico interactions of antiulcer, glucocorticoids and urological drugs on human carbonic anhydrase I and II isozymes.
Carbonic anhydrases (CAs, Enzyme Commission 184.108.40.206) convert carbon dioxide to bicarbonate in metabolism and use Zn2+ ions as a cofactor for their catalytic activity. The activators or inhibitors of CA-I and CA-II, which are the most abundant CA isozymes in erythrocytes, have pharmacological applications in medicine. So, investigation of drug-protein interaction of these isozymes is significant. On this basis, the objective of this study was to clarify the primer effects of widely used drugs on the activity of human CA-I and CA-II enzymes and elucidate the inhibition mechanism through molecular docking studies. For this aim isozymes were purified from human erythrocytes by affinity chromatography technique. Then inhibition profiles of antiulcer, glucocorticoids, and urological drugs were investigated. As a result, while budesonide had the highest inhibitory potency on hydratase activity of hCA-I with the IC50 of 0.08 mM, levofloxacin showed the highest inhibition effect on hCA-II with the IC50 of 0.886 mM. The most effective inhibitor on the esterase activity of isozymes was found as fluticasone propionate with the Ki values of 0.0365 ± 0.016 mM and 0.054 ± 0.018 mM respectively. However, by molecular docking study, it was estimated that budesonide showed maximum inhibition potency for both isozymes with the free binding energy of -7.58 and -6.97 kcal/mol, respectively. Consequently, it was observed that some of the drugs studied did not show any inhibitory effect. Drug-enzyme interactions were also estimated by molecular docking. This study could contribute to the discovery of new drug candidates and as well as target proteins.


The influence of Argonaute proteins on alternative RNA splicing.
Alternative splicing of precursor RNAs is an important process in multicellular species because it impacts several aspects of gene expression: from the increase of protein repertoire to the level of expression. A large body of evidences demonstrates that factors regulating chromatin and transcription impact the outcomes of alternative splicing. Argonaute (AGO) proteins were known to play key roles in the regulation of gene expression at the post-transcriptional level. More recently, their role in the nucleus of human somatic cells has emerged. Here, we will discuss some of the nuclear functions of AGO, with special emphasis on alternative splicing. The AGO-mediated modulation of alternative splicing is based on several properties of these proteins: their binding to transcripts on chromatin and their interactions with many proteins, especially histone tail-modifying enzymes, HP1γ and splicing factors. AGO proteins may favor a decrease in the RNA-polymerase II kinetics at actively transcribed genes leading to the modulation of alternative splicing decisions. They could also influence alternative splicing through their interaction with core components of the splicing machinery and several splicing factors. We will discuss the modes of AGO recruitment on chromatin at active genes. We suggest that long intragenic antisense transcripts (lincRNA) might be an important feature of genes containing splicing events regulated by AGO.


Field matching of electron beams using plastic wedge penumbra generators.
We describe the use of polystyrene wedges to match adjacent electron beams with improved dose uniformity. These wedges were designed to increase the penumbra width at the field junction from about 1.5 to about 3.5 cm, to achieve dose uniformity. Measurements using thermoluminescent dosimeters (TLD) and therapy localization film showed that the use of polystyrene wedges (penumbra generators) produced only a small increase (less than 3%) in the surface dose and a small increase (less than 1%) in the x-ray contamination. Without wedges at the field junction, lateral mismatching of beam edges by 2 or 3 mm may introduce high dose variations (120% or more or 50% or less). Similar 2-3 mm set-up errors did not cause more than +/- 5% dose variations when plastic wedges were used to match the fields. These wedges are particularly useful when matching fields of different beam energies or matching fields on curved surfaces, such as the chest wall.


Red wine extract decreases pro-inflammatory markers, nuclear factor-κB and inducible NOS, in experimental metabolic syndrome.
We aimed to analyse the effects of alcohol-free Alibernet red wine extract (AWE) on nitric oxide synthase (NOS) activity and pro-inflammatory markers such as nuclear factor-κB (NFκB) and inducible NOS (iNOS) protein expression in experimental metabolic syndrome. Young 6 week-old male Wistar Kyoto (WKY) and obese, spontaneously hypertensive rats (SHR/N-cp) were divided into control groups and groups treated with AWE (24.2 mg per kg per day) for 3 weeks (n = 6 in each group). Total NOS activity and endothelial NOS (eNOS), iNOS and NFκB (p65) protein expressions were determined in the heart left ventricle and aorta by Western blot and immunohistochemical analysis. All parameters investigated significantly increased in the aorta of SHR/N-cp rats. Pro-inflammatory markers such as NFκB and iNOS were increased in the left ventricle as well. AWE treatment did not affect total NOS activity and eNOS expression in the aorta; however, it was able to decrease NFκB and iNOS protein expression in both the left ventricle and aorta. In conclusion, in the cardiovascular system, Alibernet red wine extract decreased NFκB and iNOS protein expressions elevated as a consequence of developed metabolic syndrome. This effect may represent one of the protective, anti-inflammatory properties of Alibernet red wine polyphenols on cardiovascular risk factors related to metabolic syndrome.


Anterior trans-frontal endoscopic resection of third-ventricle colloid cyst: how I do it.
The endoscopic technique has been recognised as a viable and safe alternative to microsurgery for the treatment of third-ventricle colloid cyst. However, the standard precoronal endoscopic approach does not always provide an adequate visualisation of the attachment of the cyst to the velum interpositum. Using a more anterior approach, it is easier to reach the roof of the cyst and its possible adherences with the tela choroidea. The authors describe step by step the anterior trans-frontal endoscopic approach for management of third ventricle colloid cyst. The described approach has shown to be safe, quick and effective for the treatment of third-ventricle colloid cyst.


ATTENDING: Critiquing a Physician's Management Plan.
The ATTENDING system is designed to critique a physician's preoperative plan for anesthetic management. In undertaking to critique a physician's plan, ATTENDING differs from other medical decision making systems, which in effect attempt to tell a physician what to do. ATTENDING's approach may prove more acceptable clinically, and may avoid certain social, medical, and medicolegal drawbacks. To cri-tique a physician's plan, ATTENDING must confront three basic problems. 1) It must be able to explore flexibly all possible approaches for a patient's management. The formalism of an ``augmented decision network'' allows this. 2) It must be able to assess the relative risks and benefits of alternative approaches intelligently. A heuristic approach to risk analysis is outlined, based on three basic principles which are de-scribed in detail. 3) It must produce a potentially complex analysis which critiques the plan in focused, readable prose. This is facilitated by PROSENET, an approach which allows clean separation between the organization of the content of an analysis and its expression in English prose.


Can intense endurance exercise cause myocardial damage and fibrosis?
There has been long-standing debate as to whether intense endurance exercise provokes acute myocardial damage and whether cardiac remodeling associated with long-standing endurance training is entirely physiological. Despite the lack of concrete evidence on either side, the potential for serious clinical consequences, including life-threatening arrhythmias, elevates the importance of the debate. Studies have taught us that elite athletes enjoy excellent health, and athletic animal models consistently show up-regulation of molecular pathways, which are free of fibrosis and entirely different from those induced through pathological cardiac loading. On the other hand, extreme exercise has been associated with biochemical and functional evidence of acute damage, and some recent imaging techniques raise the possibility of small areas of myocardial scar. Moreover, some arrhythmias appear to be more prevalent amongst endurance athletes. Only large prospective trials will enable us to really assess the health benefits and risks of regular intense endurance sports.


Relevance of eosinophilia and hyper-IgE in immigrant children.
Immigrants from undeveloped countries are a growing problem in Europe. Spain has become a frequent destination for immigrants (20% of whom are children) because of its geographic location and its historic and cultural links with Africa and Latin America. Eosinophilia is frequent in adult immigrants, travelers and expatriates coming from tropical areas. However, there are few studies that focus on the incidence and causes of tropical eosinophilia and hyper-IgE in immigrant children.We evaluated, prospectively, the prevalence and causes of eosinophilia and hyper-immunoglobulin E (IgE) in 362 immigrant children coming from Sub-Saharan Africa, Northern Africa and Latin America to Salamanca, Spain, between January 2007 and December 2011.Absolute eosinophilia and hyper-IgE were present in 22.9% and 56.8% of the analyzed children, respectively. The most frequent causes of absolute eosinophilia were filariasis (52.6%), strongyloidiasis (46.8%) and schistosomiasis (28.9%). Filariasis (41.9%), strongyloidiasis (29.6%) and schistosomiasis (22.2%) were the most frequent causes of increased levels of IgE. The area under the ROC curve showed similar values between eosinophil count and IgE levels in the diagnosis of helminthiasis (69% [95% confidence interval (CI) 63%-74%] vs 67% [95% CI 60%-72%], P = 0.24). Eosinophilia and hyper-IgE have a high value as biomarkers of helminthiasis in children coming from tropical and subtropical areas.


Temporal dynamics of attitude decisions: A test of the iterative reprocessing model using event-related potentials.
Although evaluative judgments are a central component of everyday decision making little is known about the temporal dynamics of the processes used to make them. The present study used the high temporal resolution of event-related brain potentials (ERPs) to test Cunningham and Zelazo's (2007) posited differences in the timing of attitude tag retrieval relative to stimulus categorization for 'attitudes' and 'evaluations,' as well as tenets of their Iterative Reprocessing (IR) loop model. Participants made agree/disagree decisions about their attitudes and You/Not You decisions about their autobiographical memories in separate reaction time (RT) tasks while brain activity was recorded from 32 scalp sites. A median-split analysis on RT was used to separate fast and slow decisions. Decisions about autobiographical stimuli produced the typical results in which retrieval and stimulus categorization occurred together just before the response regardless of decision difficulty. By contrast, the relative timing of tag retrieval and categorization differed with difficulty for attitude decisions as predicted by the model. Fast attitude decisions were processed similarly to fast You decisions with retrieval and categorization timing coupled to the response. Slow attitude decisions, however, differed because, while tag retrieval timing was the same as for fast attitude decisions, post-retrieval processing delayed stimulus categorization and a response by 450 msec. ERP activity over dorsolateral prefrontal cortex (DLPFC) in the pre-response interval was asymmetrical, with greater activity for attitude and autobiographical decisions over left and right hemispheres, respectively, while amplitude and duration increased with decision difficulty for both. Slow attitude decisions alone elicited a reduced pre-response positivity, a correlate of goal-directed response selection. The results provide empirical support for key aspects of Cunningham and Zelazo's (2007) attitude-evaluation dichotomy and the timing of the posited component processes in their IR model as well as novel information about the roles of stored tags and reflective processes in different attitude decisions.


Nestin expression in vascular malformations: a novel marker for proliferative endothelium.
Cavernous angiomas (CAs) and arteriovenous malformations (AVMs) sometimes show growth or de novo appearance. Proliferative capacity of the endothelium is evident in such malformations. Intermediate filament nestin is a newly identified marker for proliferative endothelium, which was originally detected in the neuroepithelial stem cells of the embryonal central nervous system. Immunohistochemical analysis of nestin was evaluated as a marker for proliferative capacity of endothelial cells by comparison with proliferating cell nuclear antigen (PCNA). Sixteen of 27 CAs and 13 of 20 AVMs were positive for nestin. Likewise, 12 of 27 CAs and 10 of 20 AVMs were positive for PCNA. Nestin staining was stronger in the typical malformative vessels of CAs than in AVMs, in both the endothelial cells and the interstitial cells. Newly formed endothelial cells expressed nestin strongly in the reactive tissues including organizing or encapsulated hematomas. These results suggest that neovascularization occurs in the process of repeated bleeding and remodeling of hematomas.


Impact of an Interactive On-line Tool on Therapeutic Decision-Making for Patients with Advanced Non-Small-Cell Lung Cancer.
Treatment guidelines provide recommendations but cannot account for the wide variability in patient-tumor characteristics in individual patients. We developed an on-line interactive decision tool to provide expert recommendations for specific patient scenarios in the first-line and maintenance settings for advanced non-small-cell lung cancer. We sought to determine how providing expert feedback would influence clinical decision-making. Five lung cancer experts selected treatment for 96 different patient cases based on patient and/or tumor-specific features. These data were used to develop an on-line decision tool. Participant physicians entered variables for their patient scenario with treatment choices, and then received expert treatment recommendations for that scenario. To determine the impact on decision-making, users were asked whether the expert feedback impacted their original plan. A total of 442 individual physicians, of which 88% were from outside the United States, entered 653 cases, with report on impact in 389 cases. Expert feedback affected treatment choice in 73% of cases (23% changed and 50% confirmed decisions). For cases with epidermal growth factor receptor (EGFR) mutation or anaplastic lymphoma kinase (ALK) fusion, all experts selected targeted therapy whereas 51% and 58% of participants did not. Greater variability was seen between experts and participants for cases involving EGFR or ALK wild-type tumors. Participants were 2.5-fold more likely to change to expert recommended therapy for ALK fusions than for EGFR mutations (p = 0.017). This online tool for treatment decision-making resulted in a positive influence on clinician's decisions. This approach offers opportunities for improving quality of care and meets an educational need in application of new therapeutic paradigms.


Interventions for actinic keratoses.
Actinic keratoses are a skin disease caused by long-term sun exposure, and their lesions have the potential to develop into squamous cell carcinoma. Treatments for actinic keratoses are sought for cosmetic reasons, for the relief of associated symptoms, or for the prevention of skin cancer development. Detectable lesions are often associated with alteration of the surrounding skin (field) where subclinical lesions might be present. The interventions available for the treatment of actinic keratoses include individual lesion-based (e.g. cryotherapy) or field-directed (e.g. topical) treatments. These might vary in terms of efficacy, safety, and cosmetic outcomes. To assess the effects of topical, oral, mechanical, and chemical interventions for actinic keratosis. We searched the following databases up to March 2011: the Cochrane Skin Group Specialised Register, CENTRAL in The Cochrane Library, MEDLINE (from 2005), EMBASE (from 2010), and LILACS (from 1982). We also searched trials registers, conference proceedings, and grey literature sources. Randomised controlled trials (RCTs) comparing the treatment of actinic keratoses with either placebo, vehicle, or another active therapy. At least two authors independently abstracted data, which included adverse events, and assessed the quality of evidence. We performed meta-analysis to calculate a weighted treatment effect across trials, and we expressed the results as risk ratios (RR) and 95% confidence intervals (CI) for dichotomous outcomes (e.g. participant complete clearance rates), and mean difference (MD) and 95% CI for continuous outcomes (e.g. mean reduction in lesion counts). We included 83 RCTs in this review, with a total of 10,036 participants. The RCTs covered 18 topical treatments, 1 oral treatment, 2 mechanical interventions, and 3 chemical interventions, including photodynamic therapy (PDT). Most of the studies lacked descriptions of some methodological details, such as the generation of the randomisation sequence or allocation concealment, and half of the studies had a high risk of reporting bias. Study comparison was difficult because of the multiple parameters used to report efficacy and safety outcomes, as well as statistical limitations. We found no data on the possible reduction of squamous cell carcinoma.The primary outcome 'participant complete clearance' significantly favoured four field-directed treatments compared to vehicle or placebo: 3% diclofenac in 2.5% hyaluronic acid (RR 2.46, 95% CI 1.66 to 3.66; 3 studies with 420 participants), 0.5% 5-fluorouracil (RR 8.86, 95% CI: 3.67 to 21.44; 3 studies with 522 participants), 5% imiquimod (RR 7.70, 95% CI 4.63 to 12.79; 9 studies with1871 participants), and 0.025% to 0.05% ingenol mebutate (RR 4.50, 95% CI 2.61 to 7.74; 2 studies with 456 participants).It also significantly favoured the treatment of individual lesions with photodynamic therapy (PDT) compared to placebo-PDT with the following photosensitisers: aminolevulinic acid (ALA) (blue light: RR 6.22, 95% CI 2.88 to 13.43; 1 study with 243 participants, aminolevulinic acid (ALA) (red light: RR 5.94, 95% CI 3.35 to 10.54; 3 studies with 422 participants), and methyl aminolevulinate (MAL) (red light: RR 4.46, 95% CI 3.17 to 6.28; 5 studies with 482 participants). ALA-PDT was also significantly favoured compared to cryotherapy (RR 1.31, 95% CI 1.05 to 1.64).The corresponding comparative risks in terms of number of participants completely cleared per 1000 were as follows: 313 with 3% diclofenac compared to 127 with 2.5% hyaluronic acid; 136 with 0.5% 5-fluorouracil compared to 15 with placebo; 371 with 5% imiquimod compared to 48 with placebo; 331 with ingenol mebutate compared to 73 with vehicle; 527 to 656 with ALA/MAL-PDT treatment compared to 89 to 147 for placebo-PDT; and 580 with ALA-PDT compared to 443 with cryotherapy.5% 5-fluorouracil efficacy was not compared to placebo, but it was comparable to 5% imiquimod (RR 1.85, 95% Cl 0.41 to 8.33).A significant number of participants withdrew because of adverse events with 144 participants affected out of 1000 taking 3% diclofenac in 2.5% hyaluronic acid, compared to 40 participants affected out of 1000 taking 2.5% hyaluronic acid alone, and 56 participants affected out of 1000 taking 5% imiquimod compared to 21 participants affected out of 1000 taking placebo.Based on investigator and participant evaluation, imiquimod treatment and photodynamic therapy resulted in better cosmetic outcomes than cryotherapy and 5-fluorouracil. For individual lesions, photodynamic therapy appears more effective and has a better cosmetic outcome than cryotherapy. For field-directed treatments, diclofenac, 5-fluorouracil, imiquimod, and ingenol mebutate had similar efficacy, but their associated adverse events and cosmetic outcomes are different. More direct comparisons between these treatments are needed to determine the best therapeutic approach.


A systematic review of the relationship between breastfeeding and early childhood caries.
This systematic review investigated the relationship between early childhood caries (ECC) and breastfeeding. The systematic review methodology used by the Cochrane Collaboration was modified and adopted for this review. 28 of 151 articles (18.5%) were relevant for the study and were rated as strong (0), moderate (3), weak (9) or very weak (16). Validity scores indicated whether a study met the reviewer's criteria for research rigour. The percentage of studies that received a passing score for each criterion examined were: study design (3.6%), confounders (21%), data collection method (54%), definition of ECC (57%), dental health practices (28%) and infant feeding practices (4%). A lack of methodological consistency related to the study of the association of breastfeeding and ECC, and inconsistent definitions of ECC and breastfeeding, make it difficult to draw conclusions. Moderate articles indicate that breastfeeding for over one year and at night beyond eruption of teeth may be associated with ECC. Due to conflicting findings in less rigorous research studies, no definitive time at which an infant should be weaned was determined, and parents should begin an early and consistent mouth care regime.


Isotypes of alpha-tubulin are differentially regulated during neuronal maturation.
The mRNAs for two isotypes of alpha-tubulin, termed T alpha 1 and T26, are known to be expressed in the rat nervous system. We have compared the expression of these two alpha-tubulin mRNAs during neural development, using RNA blotting and in situ hybridization techniques with probes directed against unique sequences of each mRNA. T alpha 1 mRNA is highly enriched in the embryonic nervous system but is markedly less abundant in the adult brain; T26 mRNA is expressed in many embryonic tissues with little change in abundance during development. Within the nervous system, T alpha 1 mRNA is enriched in regions with neurons actively undergoing neurite extension, such as the cortical plate, whereas T26 mRNA is relatively homogeneous in distribution, with some enrichment in proliferative zones. Expression of T alpha 1 mRNA is also increased in PC12 cells induced to differentiate and extend neurite processes by nerve growth factor. Taken together, the data indicate that T alpha 1-tubulin mRNA is expressed at high levels during the extension of neuronal processes. The abundant expression of T alpha 1-tubulin mRNA may therefore reflect either a means to increase the available pool of alpha-tubulin or a specific requirement for the T alpha 1 isotype for neurite extension.


Developmental genoarchitectonics as a key tool to interpret the mature anatomy of the chondrichthyan hypothalamus according to the prosomeric model.
The hypothalamus is a key vertebrate brain region involved in survival and physiological functions. Understanding hypothalamic organization and evolution is important to deciphering many aspects of vertebrate biology. Recent comparative studies based on gene expression patterns have proposed the existence of hypothalamic histogenetic domains (paraventricular, TPa/PPa; subparaventricular, TSPa/PSPa; tuberal, Tu/RTu; perimamillary, PM/PRM; and mamillary, MM/RM), revealing conserved evolutionary trends. To shed light on the functional relevance of these histogenetic domains, this work aims to interpret the location of developed cell groups according to the prosomeric model in the hypothalamus of the catshark Scyliorhinus canicula, a representative of Chondrichthyans (the sister group of Osteichthyes, at the base of the gnathostome lineage). To this end, we review in detail the expression patterns of ScOtp, ScDlx2, and ScPitx2, as well as Pax6-immunoreactivity in embryos at stage 32, when the morphology of the adult catshark hypothalamus is already organized. We also propose homologies with mammals when possible. This study provides a comprehensive tool to better understand previous and novel data on hypothalamic development and evolution.


Trajectories and nuclear arrangement of PML bodies are influenced by A-type lamin deficiency.
Promyelocytic leukaemia (PML) bodies are specific nuclear structures with functional significance for acute promyelocytic leukaemia. In this study, we analysed the trajectories of PML bodies using single-particle tracking. We observed that the recovery of PML protein after photobleaching was ATP dependent in both wild-type (wt) and A-type lamin-deficient cells. The movement of PML bodies was faster and the nuclear area occupied by particular PML bodies was larger in A-type lamin-deficient fibroblasts compared with their wt counterparts. Moreover, dysfunction of the LMNA gene increased the frequency of mutual interactions between individual PML bodies and influenced the morphology of these domains at the ultrastructural level. As a consequence of A-type lamin deficiency, PML protein accumulated in nuclear blebs and frequently appeared at the nuclear periphery. We suggest that the physiological function of lamin A proteins is important for events that occur in the compartment of PML bodies. This observation was confirmed in other experimental models characterised by lamin changes, including apoptosis or the differentiation of mouse embryonic stem cells.


Job strain and the prevalence of uncontrolled hypertension among white-collar workers.
To determine whether white-collar workers treated for hypertension who are exposed to psychosocial stressors at work have a higher prevalence of uncontrolled hypertension than unexposed workers, this study conducted three waves of data collection over a 5-year period (repeated cross-sectional design). The study sample was composed of 464 white-collar workers treated for hypertension. At each collection time, ambulatory blood pressure (ABP) was measured every 15 min during the workday. Uncontrolled hypertension was defined as a mean daytime systolic ABP ≥135 mmHg and/or diastolic ABP ≥85 mmHg for non-diabetic participants and systolic ABP ≥125 mmHg and/or diastolic ABP ≥75 mmHg for diabetic participants. Job strain was evaluated with Karasek's demand-latitude model using validated scales for psychological demands and decision latitude. Prevalence ratios (PR) and 95% confidence intervals (CI) were estimated using generalized estimating equations, adjusting for sociodemographic and lifestyle-related risk factors. Men with job strain (high demands and low latitude) and active jobs (high demands and high latitude) had a higher prevalence of uncontrolled hypertension (PR job strain = 1.46, 95% CI: 1.07-1.98 and PR active = 1.47, 95% CI: 1.12-1.94). When considered separately, high demands were associated with a higher prevalence of uncontrolled hypertension in both men (PR highest tertile = 1.60, 95% CI: 1.25-2.06) and women (PR highest tertile = 1.60, 95% CI: 1.03-2.47). Workers exposed to psychosocial stressors at work according to the demand-latitude model had a higher prevalence of uncontrolled hypertension. Reducing these frequent exposures could help to reduce the burden of uncontrolled hypertension.


Determination of the Influence of the Antiphlogistic Ingredients Panthenol and Bisabolol on the SPF Value in vivo.
Today, the sun protection factor (SPF) value of sunscreen products is determined in vivo with a standardized protocol (EN ISO 24444:2010), and the measured SPF biological end point is the visible skin erythema. However, many of the sunscreen products currently available on the market have antiphlogistic ingredients, which may potentially result in an overestimated SPF of the sunscreen. To investigate the potential influence of the antiphlogistic ingredients panthenol and bisabolol in sunscreens on the determined SPF value in vivo. Formulations with different concentrations of the antiphlogistic ingredients bisabolol or panthenol were tested. As a reference, a base formulation (vehicle) without antiphlogistic ingredients was used. First, the SPF of the sunscreen formulas with and without antiphlogistic ingredients was analyzed in vitro. To investigate whether the antiphlogistic ingredient may suppress the inflammatory response to ultraviolet (UV) irradiation, the SPF was determined in vivo. Finally, selected formulations were also analyzed in an erythema model for testing formulations on UV-induced inflammation. It could be confirmed that no differences between the formula with and that without the active antiphlogistic ingredients bisabolol or panthenol exist when measured in vitro. However, there was also no statistically significant difference in the erythemal response between the vehicle (without an antiphlogistic active ingredient) and the test formulations with different concentrations of the antiphlogistic active ingredients in the in vivo determination of the SPF. Evidence of anti-inflammatory activity of the sunscreen antiphlogistics bisabolol and panthenol was also not apparent in the UV model over a time course of 48 h. Conlusion: The antiphlogistic ingredients panthenol and bisabolol incorporated in the tested sunscreen formula do not interfere with erythema reddening and thus do not affect the SPF value in vivo.


Gamma globulin therapy for chronic mononucleosis syndrome.
Antibodies against Epstein-Barr virus, associated with antibody dependent cytotoxic cell activity, were found to be present in diminished titer in 20 of 22 patients tested with chronic mononucleosis syndrome (CMS). Gamma globulin was shown to improve symptoms in 53% of the patients treated, compared with 32% of placebo injections. 89.5% of 57 patients treated with a gamma globulin treatment program remained in the treatment program because of relief of symptoms, and only four patients dropped out because there was no relief of symptoms or side effects. Four patients experienced complete relief of symptoms following a variable length treatment program. It would appear that intramuscular gamma globulin treatment is efficacious in the treatment of CMS and that the average interval between treatments is three weeks.


Rapid method for determination of kanamycin and dibekacin in serum by use of high-pressure liquid chromatography.
A rapid, simple, and accurate method for the determination of kanamycin and dibekacin in serum by use of high-pressure liquid chromatography is described. The serum proteins were precipitated with 3.5% perchloric acid containing sodium octanesulfonate. After centrifugation, a sample of the supernatant was directly injected into the chromatograph. The determination of kanamycin and dibekacin was performed by a combination of reverse-phase, ion-pair chromatography, postcolumn derivatization with o-phthalaldehyde, and fluorescence detection. The correlation coefficients with fluorescence polarization immunoassay were 0.996 for kanamycin and 0.957 for dibekacin.


Identification, structural modeling, gene expression analysis and RNAi effect of putative phospholipase A2 in the lone star tick Amblyomma americanum.
Amblyomma americanum, also known as the lone star tick, is a small arachnid that feeds on blood and can spread disease to humans and other animals. Despite the overlapped ecological niche, geographic distribution, and host selection, there is no proof that A. americanum transmits the pathogen Borrelia burgdorferi that causes Lyme disease. Studies have shown that phospholipase A2 (PLA2) may act as a tool to eliminate B. burgdorferi, but particular PLA2 genes in A. americanum have not been identified and functionally characterized. Using the de novo sequencing method, we identified 42 putative A. americanum PLA2 (pAaPLA2) homologs in the present study, of which three pAaPLA2 had calcium binding sites and canonical histidine catalytic sites. Then, we determined phylogenetic relationships, sequence alignments, and conserved protein motifs of these pAaPLA2s. Protein structural analysis demonstrated that pAaPLA2s primarily consisted of α-helices, β-sheets, and random coils. These genes were predicted to be engaged in the phospholipid metabolic process, arachidonic acid secretion, and PLA2 activity by functional annotation analysis. A transcriptional factor (Bgb) was discovered that interacted with pAaPLA2 proteins that may have unrecognized roles in regulating neuronal development. Based on the RNA-seq data, we surveyed expression profiles of key pAaPLA2-related genes to reveal putative modulatory networks of these genes. RNAi knockdown of pAaPLA2_1, a dominant isoform in A. americanum, led to decreased bacterial inhibition ability, suggesting pAaPLA2 may play an important role in mediating immune responses. Collectively, this study provides essential evidence of the identification, gene structure, phylogeny, and expression analysis of pAaPLA2 genes in A. americanum, and offers a deeper understanding of the putative borreliacidal roles in the lone star tick.


Assistive technology applications for students with reading difficulties: special education teachers' experiences and perceptions.
Purpose: Reading and writing applications (with text-to-speech, TTS and speech-to-text, STT functions), used as assistive technology (AT) for students with reading difficulties are increasingly used in education, however, research has not sufficiently enough evaluated its potential. The purpose of this study was to explore how assistive reading and writing applications were perceived to function with regard to students' possibilities to assimilate (i.e., "read") and communicate (i.e., "write") text.Methods: Following a six-week app intervention, this follow-up survey contained 54 special education teachers' perceptions of how the use of apps impacted student motivation, learning, and its usability in special education. A total of 59 students with reading difficulties from Grade 4, Grade 8 and from high school, were assessed. Analyses included quantitative and qualitative analyses of teachers' responses and written material.Results: The results showed individual differences in how teachers perceived app usage for text-interaction purposes, including how app usage affected student motivation and autonomy for text-based learning. Eighty-two per cent of the younger and forty-seven per cent of older students continued to use the technology after the intervention, but in various degrees.Conclusions: Based on these findings, students with reading difficulties seem to be able to use AT in order to assimilate text (i.e., to read) and to communicate text (i.e., to write), and, thus, AT has the potential to promote participation in regular education. Future research should focus on how to customize assistive technology support in order to better utilize the potential.Implication for rehabilitationThis study found that students with reading difficulties could use reading and writing apps (with text-to-speech, TTS and speech-to-text, STT) in portable tables to be able to gain access to, and to produce text in an applied school setting.To use TTS and STT as assistive technology efficiently may require relative extensive support and training, but even with this support, not all students in this study benefited from the potential use of the technology, as the processes of being able to gain access to and to produce text with assistive technology seem to be a difficult process for some of the students.It is proposed that in order to enable all students with reading difficulties possibilities to use assistive technology efficiently, its uses need to be customized even further than was done in this extensive intervention.


A Roundup herbicide causes high mortality and impairs development of Chrysoperla carnea (Stephens) (Neuroptera: Chrysopidae).
Glyphosate has and is being used extensively in herbicide formulations worldwide. Thus, glyphosate-based herbicides (GBH) substantially add to the environmental load of pesticides and warrant a strict risk assessment. Ecotoxicological testing of herbicides focuses on non-target plants and higher animals while direct effects on arthropods are only cursory tested on the premise of contact exposure. However, oral exposure, as we show in our case, can be highly relevant for systemic pesticides, such as GBH. Specifically, in crop systems including genetically modified crops that are tolerant to GBH, these herbicides and their breakdown products are present both internally and externally of the crop plants and, therefore, are ingested by the crop-associated arthropod fauna. We tested the effects of oral uptake of the Roundup formulation WeatherMax on larvae of the lacewing Chrysoperla carnea, a model organism in ecotoxicity testing programs. Long-term oral exposure of C. carnea larvae throughout its juvenile life stages was tested with concentrations ranging from 0.001 to 1 % dilution, thus, lower than the 1.67 % recommended for field applications. Inhibition of metamorphosis was observable at 0.1 % but at a concentration of 0.5 %, GBH significantly impaired cocoon formation and led to massive lethal malformations. At GBH concentration of 1 % half of the individuals remained permanent larvae and no adult hatched alive. The effects observed followed a clear dose-response relationship. The hazard caused by direct insecticidal action of GHB after oral uptake is highly relevant for the environmental safety and reveals a gap in regulatory risk assessments that should urgently be addressed, specifically in light of the on-going insect decline.


Effects of coinfection with HIV and hepatitis C virus on the nervous system.
We evaluated a cohort of persons with late-stage HIV infection currently enrolled in a longitudinal tracking study to determine whether coinfection with hepatitis C virus (HCV) is associated with a greater prevalence and/or severity of HIV-associated cognitive-motor complex and distal predominantly sensory peripheral polyneuropathy compared with persons with HIV infection alone. Of 159 subjects, 31 tested positive for HCV, and this group was compared with 31 randomly selected subjects with HIV infection alone. All subjects underwent a structured neurological examination and a formal neuropsychological testing battery. Blood and cerebrospinal fluid samples were analyzed for cryoglobulins and glutamine levels, respectively. HIV/HCV-coinfected subjects showed a greater, statistically significant cognitive-motor impairment compared with those not coinfected. Despite the well-recognized neurological manifestations of both HIV infections and more recently hepatitis C, it is still uncertain whether the effects of HIV and HCV augment one another or are partially additive in their deleterious effects on the nervous system.


Creating mosquito-free outdoor spaces using transfluthrin-treated chairs and ribbons.
Residents of malaria-endemic communities spend several hours outdoors performing different activities, e.g. cooking, story-telling or eating, thereby exposing themselves to potentially-infectious mosquitoes. This compromises effectiveness of indoor interventions, notably long-lasting insecticide-treated nets (LLINs) and indoor residual spraying (IRS). This study characterized common peri-domestic spaces in rural south-eastern Tanzania, and assessed protective efficacy against mosquitoes of hessian fabric mats and ribbons treated with the spatial repellent, transfluthrin, and fitted to chairs and outdoor kitchens, respectively. Two hundred households were surveyed, and their most-used peri-domestic spaces physically characterized. Protective efficacies of locally-made transfluthrin-emanating chairs and hessian ribbons were tested in outdoor environments of 28 households in dry and wet seasons, using volunteer-occupied exposure-free double net traps. CDC light traps were used to estimate host-seeking mosquito densities within open-structure outdoor kitchens. Field-collected Anopheles arabiensis and Anopheles funestus mosquitoes were exposed underneath the chairs to estimate 24 h-mortality. Finally, The World Health Organization insecticide susceptibility tests were conducted on wild-caught Anopheles from the villages. Approximately half (52%) of houses had verandas. Aside from these verandas, most houses also had peri-domestic spaces where residents stayed most times (67% of houses with verandas and 94% of non-veranda houses). Two-thirds of these spaces were sited under trees, and only one third (34.4%) were built-up. The outdoor structures were usually makeshift kitchens having roofs and partial walls. Transfluthrin-treated chairs reduced outdoor-biting An. arabiensis densities by 70-85%, while transfluthrin-treated hessian ribbons fitted to the outdoor kitchens caused 77-81% reduction in the general peri-domestic area. Almost all the field-collected An. arabiensis (99.4%) and An. funestus (100%) exposed under transfluthrin-treated chairs died. The An. arabiensis were susceptible to non-pyrethroids (pirimiphos methyl and bendiocarb), but resistant to pyrethroids commonly used on LLINs (deltamethrin and permethrin). Most houses had actively-used peri-domestic outdoor spaces where exposure to mosquitoes occurred. The transfluthrin-treated chairs and ribbons reduced outdoor-biting malaria vectors in these peri-domestic spaces, and also elicited significant mortality among pyrethroid-resistant field-caught malaria vectors. These two new prototype formats for transfluthrin emanators, if developed further, may constitute new options for complementing LLINs and IRS with outdoor protection against malaria and other mosquito-borne pathogens in areas where peri-domestic human activities are common.


Involvement of putative chemical wound signals in the induction of phenolic metabolism in wounded lettuce.
Cutting leaves of Romaine lettuce (Lactuca sativa L. cv. Longifolia) produces a wound signal that induces the synthesis of phenylalanine ammonia lyase (PAL, EC 184.108.40.206) and the accumulation of phenolic compounds in cells up to 2 cm from the site of injury, and tissue browning near the site of injury. The response of leaves within a head of Romaine lettuce to putative chemical wound signals [abscisic acid (ABA), jasmonate (JA) and methyl jasmonate (MeJA)] differed significantly with leaf age. Exposure of harvested heads of lettuce to ABA, JA, MeJA, or salicylic acid (SA) did not induce changes in PAL activity, the concentration of phenolic compounds or browning in mature leaf tissue that was similar to the level induced by wounding. Methyl jasmonate applied as vapour (10, 100 or 1000 &mgr;l kg-1 FW), or as an aqueous spray or dip (0.01-100 &mgr;M) at 5 or 10 degrees C did not produce an effect on PAL activity or browning that differed significantly from the untreated controls. In contrast, JA, MeJA and SA did induce elevated levels of PAL activity in younger leaves. However, the levels induced were far lower than those induced by wounding. Wound induced phenolic metabolism in mature leaves appears to be induced by different signals than those functioning in young leaves.


Comparative analysis of the VP3 gene of divergent strains of the rotaviruses simian SA11 and bovine Nebraska calf diarrhea virus.
The gene encoding outer capsid protein VP3 of subpopulations of two animal rotaviruses, simian SA11 and Nebraska calf diarrhea virus (NCDV), was analyzed. Two laboratory strains of simian SA11 rotavirus (SA11-SEM and SA11-FEM) differed with respect to VP3. This dimorphism was indicated by a difference in electrophoretic mobility and a difference in reactivity with anti-VP3 monoclonal antibodies. The overall VP3 amino acid homology between the two SA11 VP3 proteins was 82.7%, whereas the VP3 protein of SA11-FEM was 98.5% homologous in amino acid sequence to NCDV VP3, suggesting that SA11-FEM VP3 was derived by gene reassortment in the laboratory during contamination with a bovine rotavirus. A comparison of the deduced amino acid sequence of the VP3 of two virulent NCDV strains and an attenuated NCDV strain (RIT 4237), revealed only five amino acid differences which were scattered throughout the protein but did not involve the trypsin cleavage sites. Of interest, the VP3 of the standard strain of NCDV which is virulent for cows differed in only one amino acid (position 23, Gln to Lys) from the VP3 of an NCDV mutant which was attenuated both for cows and for children.


Reproductive toxicity of Echinodorus grandiflorus in pregnant rats.
To evaluate the possible toxicity of the aqueous extract of Echinodorus grandiflorus in pregnant rats, animals were distributed in groups treated with 250, 500 and 1,000 mg/kg/day, by gavage, and a control group received saline solution. The treatment was carried out for 15 consecutive days, remaining during mating and until the 14(th) day of gestation. On the 15(th )day, pregnant animals were euthanized by exsanguination under anesthesia. A blood sample was destined to the hematological and biochemical analysis. The ovaries, liver, kidneys, spleen, and adrenal glands were removed and weighed. Liver, kidneys and spleen were processed for histopathological analysis. The number mated, cohabitated and pregnant rats were counted as well as the corpora lutea, implants, resorptions, and live and dead fetuses. Fetus body weight and placenta were measured. Treatment with 1,000 mg of extract caused anemia, leukocytosis, and an increase in AST and in cholesterol. The liver of animals treated with the two higher doses exhibited discrete inflammatory reaction, located mainly at the stroma which supports the portal space; in the kidneys of animals of T-500 and T-1000 groups there was an expressive decrease in the capsular space, and focal areas of vasodilatation and congestion, as well as a discrete hyalinization, and in the spleen of T-1000 group the red pulp presented excessive pigmentation suggestive of hemosiderin. There were no alterations in reproductive parameters, in fetus external morphology or in placenta weight. In conclusion, the extract causes maternal toxicity, though it does not alter the reproductive performance.


X-linked Charcot-Marie-Tooth disease: molecular analysis of interfamilial variability.
This report describes two families with type 1 Charcot-Marie-Tooth disease (CMTX), or hereditary motor sensory neuropathy type 1. Pedigree analysis is consistent with X-linked recessive inheritance in one family and X-linked dominant inheritance in the second. In the first family, a mutation in the connexin32 gene has been demonstrated and analyzed in family members. In the second family, linkage analysis is consistent with a mutation at the same locus. This report demonstrates the interfamilial variability in X-linked CMT and underscores the observation that regardless of the pattern of inheritance, X-linked CMT constitutes a single, variable disorder.