Using two-dimensional impedance maps to study weak scattering in sparse random media.
Impedance maps (ZMs) have been proposed as a tool for modeling acoustic properties of tissue microstructure. Three-dimensional (3D) ZMs are constructed from a series of adjacent histological tissue slides that have been stained to emphasize acoustic impedance structures. The power spectrum of a 3DZM can be related to the ultrasound backscatter coefficient, which can be further reduced to a form factor. The goal of this study is to demonstrate the ability to estimate form factors using two-dimensional (2D) ZMs instead of 3DZMs, which have reduced computational and financial cost. The proposed method exploits the properties of isotropic media to estimate the correlation coefficient from slices before estimating the 3D volume power spectrum. Simulated sparse collections of objects were used to study the method by comparing the results obtained using 2DZMs to those predicted by theory. 2DZM analysis was conducted on normal rabbit liver histology and compared to 3DZM analysis of the same histology. The mean percent error between effective scatterer diameter estimates from 2DZMs and 3DZMs of rabbit liver histology was <10% when using three 2DZMs. The results suggest that 2DZMs are a feasible alternative to 3DZMs when estimating form factors for sparse collections of objects.


Nutrient Rescue of Early Maturing and Deteriorating Satellite Cell-Derived Engineered Muscle Tissue.
Engineered human muscle tissue is a promising tool for tissue models to better understand muscle physiology and diseases, since they can replicate many biomimetic structures and functions of skeletal muscle in vitro. We have developed a method to produce contractile muscle sheet tissues from human myoblasts, based on our cell sheet fabrication technique. This study reports that our tissue engineering technique allowed us to discover unique characteristics of human muscle satellite cells as a cell source for our muscle sheet tissue. The tissues engineered from satellite cells functionally matured within several days, which is earlier than those created from myoblasts. On the other hand, satellite cell-derived muscle sheet tissues were unable to maintain the contractile ability, whereas the myoblast-derived tissues showed muscle contractions for several weeks. The sarcomere structures and membrane-like structures of laminin and dystrophin were lost along with early functional deterioration. Based on a hypothesis that an insufficiency of nutrients caused a shortened lifetime, we supplemented the culture medium for the satellite cell-derived muscle sheet tissues with 10% serum, although a lower serum medium is commonly used to produce muscle tissues. Further combined with the transforming growth factor (TGF-β1) receptor inhibitor, SB431542, the contractile ability of the muscle tissues was increased remarkably and the tissue microstructures were maintained for a longer term, while retaining the early functionalization and the enriched culture conditions prevented early deterioration. These results strengthened our understanding of the biology of myoblasts and satellite cells in muscle tissue formation and provided new insights into the applications of muscle tissue engineering.


Transition from B to Z DNA: contribution of internal fluctuations to the configurational entropy difference.
The internal motions of the double-stranded DNA oligomer (dCdG)3 (dC, deoxycytidylate; dG, deoxyguanylate) in the B and Z forms have been calculated in the harmonic approximation. A complete vibrational analysis has been made, and the resulting normal mode frequencies have been used to evaluate the vibrational entropy of B and Z DNA. The greater flexibility of the B DNA hexamer leads to an entropic stabilization relative to the stiffer Z DNA hexamer of 22 calories per mole per kelvin at 300 K. The calculated value is of the same order as that (21 to 27 calories per mole per kelvin) obtained from nuclear magnetic resonance measurements on the methylated duplexes (m5dCdG)3 and (dCdGm5dCdGdCdG). This result demonstrates the importance of internal motions, which have been neglected in earlier studies of the transition from B to Z DNA, in the stability of different nucleic acid conformers.


Risk determinants of acute mountain sickness in trekkers in the Nepali Himalaya: a 24-year follow-up.
Exposure to altitude may lead to acute mountain sickness (AMS) in nonacclimatized individuals. We surveyed AMS prevalence and potential risk factors in trekkers crossing a 5400-m pass in Nepal and compared the results with those of 2 similar studies conducted 12 and 24 years earlier. In April 2010, 500 surveys were distributed to English-speaking trekkers at 3500 m on their way to 5400 m, of which 332 (66%) surveys were returned complete. Acute mountain sickness was quantified with the Lake Louise Scoring System (LLSS, cutoff ≥3 and ≥5) and the Environmental Statistical Questionnaire III AMS-C score (ESQ-III, cutoff ≥0.7). We surveyed demographics, body mass index (BMI), smoking habit, rate of ascent, awareness of AMS, and acetazolamide use. Prevalence of AMS was 22%, 23%, and 48% (ESQ-III ≥0.7, LLSS ≥5, and LLSS ≥3, respectively) lower when compared with earlier studies. Risk factors for AMS were younger age, female sex, higher BMI, and smoking habit. Forty-two percent had elementary knowledge about the risk and prevention of AMS. Forty-four percent used acetazolamide. Trekkers took longer to climb from 3500 to 5400 m than in earlier studies. Prevalence of AMS continued to decline over a period of 24 years, likely as a result of slower ascent and increased use of acetazolamide. The AMS risk factors of younger age, female sex, and high BMI are consistent with prior studies. Awareness of risk and prevention of AMS remains low, indicating an opportunity to better educate trekkers and potentially further reduce AMS prevalence.


Seed priming with growth regulators modulates production, physiology and antioxidant defense of Indian squash (Praecitrullus fistulosus) under semi-arid conditions.
Indian squash (Praecitrullus fistulosus) crop faces heat and drought during its growth that is considered the most important abiotic stress in semi-arid areas. Seed priming with growth regulators enhances stress tolerance; hence, mitigates the adverse effects of unpredictable stresses due to adverse weather conditions. This two-year (2019 and 2020) study was conducted to infer the role of seed priming in improving heat tolerance of Indian squash (cultivar Sahavi) through improvement in physiological and antioxidant defense systems. Six treatments that included no priming (control), hydropriming, priming with indole acetic acid (IAA) at 100 mg L-1, salicylic acid (SA) at 50 mg L-1, ascorbic acid (AA) at 100 mg L-1 and thiourea at 500 mg L-1 each for 06 hours) were included in the study. Results revealed that priming with AA and SA significantly (P ≤ 0.05) enhanced germination (39 and 47%), germination index (57 and 58%), plant height (23 and 22%), vine length (15 and 14%), number of fruits per plant (62%), fruit weight per plant (66 and 67%), economic yield (32%), photosynthesis rate (18 and 17%), protein content (10%), proline (23%), glycine betaine (3%), malondialdehyde content (11 and 10%) and catalase activity (24%) compared to control treatment. Furthermore, seed priming with AA and SA significantly (P ≤ 0.05) shortened the mean germination time (25 and 28%) compared to the control. The results indicated that AA and SA had significant potential to mitigate adverse effects of heat stress in Indian squash. Findings from this study showed that seed priming with AA and SA promoted heat-stress tolerance and enhanced growth and productivity of Indian squash.


Isolation and characterization of a new species of kobuvirus associated with cattle.
A cytopathic agent was isolated using Vero cells from the culture medium of HeLa cells that had been used for more than 30 years in our laboratory. This agent, termed U-1 strain, was serially passed in Vero cells with distinct CPE. Particles of U-1 strain negatively stained with phosphotungstic acid exhibited a distinct surface that resembled Aichi virus. The RNA genome of U-1 strain comprises 8374 nt, with a genome organization analogous to that of picornaviruses. Possible cleavage sites of the large ORF, which encoded a leader protein prior to the capsid protein region, were assigned following amino acid alignment with Aichi virus. The virus sequence had 33 and 75 % amino acid identity with the Aichi virus VP1 and 3D regions, respectively, but no more than 23 and 36 % with those of the prototype strains of other PICORNAVIRIDAE: The dendrogram based on the P1, P2 and P3 proteins indicated that U-1 strain is genetically included in the genus Kobuvirus but is distinct from Aichi virus. Of 72 cattle sera, 43 (59.7 %) were positive for neutralizing antibody against U-1 strain at a titre of 1 : 8 or more. However, sera from 190 humans, 242 monkeys, 139 pigs, 5 horses, 22 dogs and 9 cats did not neutralize U-1 strain at a 1 : 4 dilution. RNA corresponding to U-1 strain was detected in 12 (16.7 %) of 72 faecal samples from cattle by RT-PCR. These results indicated that U-1 strain, suspected to be a contaminant from calf sera, is a new species of the genus Kobuvirus, now termed bovine kobuvirus.


[Beta-endorphin and corticotropin in the blood of patients during the acute period of severe craniocerebral injury].
An increase in content of beta-endorphin simultaneously with either low or high concentrations of corticotropin were observed in blood of patients with critical craniocerebral injury at the first day of the trauma. The content of beta-endorphin was increased and the content of corticotropin was decreased in blood of the patients within one day after the surgical treatment of sub-, epi- and intracerebral hematomas. No correlation between contents of beta-endorphin and corticotropin was noted. The data obtained suggest existence of various pathways for regulation of beta-endorphin synthesis and secretion, which are independent from the corticotropin regulation processes.


The association between sedentary behavior, physical activity and hyperuricemia.
A significant discovery was recently made in which participation in physical activity and sedentary behavior, two contrasting lifestyles, was found to be related to the frequency of hyperuricemia diagnosis. The purpose of this study was to identify the association between sedentary behavior and physical activity levels in South Korean men and women diagnosed with hyperuricemia. This study included 161,064 healthy men and women participants who had obtained a complete health examination. Physical activity levels and sitting time were assessed by the validated International Physical Activity Questionnaire Short Form Korean version. The presence of hyperuricemia in the subjects was determined by measuring serum uric acid (SUA) concentration (SUA ≥6 mg/dL [male], SUA ≥7 mg/dL [female]). Logistic regression analysis, adjusting other confounding factors, was conducted to identify the association of sedentary behavior and physical activity levels with hyperuricemia (p<0.05). Subjects who spent ≥10 hr/day in sedentary behavior were more likely to have hyperuricemia than those who spent <5 hour/day in sedentary behavior (OR=1.08, 95% CI=1.03-1.12). The subject group that more frequently participated in health enhanced physical activity (HEPA) had a lower hyperuricemia odds ratio than the subject group with lower physical activity participation rate (OR=0.90, 95% Ci=0.86-0.93). From the analysis of sex (male, female), age (young, middle, older), methods of measuring obesity (body mass index, waist circumference, body fat percentage), the association of sedentary behavior and physical activity levels with hyperuricemia was shown differently in different multivariable models. Participation in regular physical activity and reduced sedentary time is highly recommended in order to reduce the prevalence of hyperuricemia.


Temperature measurements using multicolor pyrometry in thermal radiation heating environments.
Temperature measurements are important for thermal-structural experiments in the thermal radiation heating environments such as used for thermal-structural stress analyses. This paper describes the use of multicolor pyrometry for the measurements of diffuse surfaces in thermal radiation environments that eliminates the effects of background radiation reflections and unknown emissivities based on a least-squares algorithm. The near-infrared multicolor pyrometer had a spectral range of 1100-2400 nm, spectrum resolution of 6 nm, maximum sampling frequency of 2 kHz, working distance of 0.6 m to infinity, temperature range of 700-1700 K. The pyrometer wavelength response, nonlinear intensity response, and spectral response were all calibrated. The temperature of a graphite sample irradiated by quartz lamps was then measured during heating and cooling using the least-squares algorithm based on the calibrated irradiation data. The experiments show that higher temperatures and longer wavelengths are more suitable for the thermal measurements in the quartz lamp radiation heating system. This analysis provides a valuable method for temperature measurements of diffuse surfaces in thermal radiation environments.


Reperfusion injury in free bone grafts after tourniquet-induced ischemia.
For successful revascularization, incorporation, and survival of fracture fragments or free nonpedicled bone grafts, the first days after surgery seem to be most critical. Using intravital fluorescence microscopy, the effects of 3 hours of tourniquet-induced ischemia were assessed on newly formed angiogenic microvessels 4, 8, and 12 days after isogeneic transplantation of metatarsal bones into dorsal skin fold chambers of adult inbred C57BL/6 mice. The microvascular perfusion index of newly formed microvessels was quantified 30 and 120 minutes after initiation of reperfusion. Four days after transplantation, a complete breakdown of the perfusion of all grafts was found accompanied by hemorrhage as a sign of microvascular damage. In contrast, at 8 and 12 days after transplantation a complete breakdown of graft perfusion rarely occurred. Therefore, the tourniquet-induced ischemia was most pronounced in early stages of development of angiogenic microvessels. These experimental data provide rationale for critical application of tourniquets in revision surgery shortly after initiation of fracture treatment or transplantation of free nonpedicled grafts so as not to compromise angiogenesis-induced tissue revascularization.


The role of marine reserves in achieving sustainable fisheries.
Many fishery management tools currently in use have conservation value. They are designed to maintain stocks of commercially important species above target levels. However, their limitations are evident from continuing declines in fish stocks throughout the world. We make the case that to reverse fishery declines, safeguard marine life and sustain ecosystem processes, extensive marine reserves that are off limits to fishing must become part of the management strategy. Marine reserves should be incorporated into modern fishery management because they can achieve many things that conventional tools cannot. Only complete and permanent protection from fishing can protect the most sensitive habitats and vulnerable species. Only reserves will allow the development of natural, extended age structures of target species, maintain their genetic variability and prevent deleterious evolutionary change from the effects of fishing. Species with natural age structures will sustain higher rates of reproduction and will be more resilient to environmental variability. Higher stock levels maintained by reserves will provide insurance against management failure, including risk-prone quota setting, provided the broader conservation role of reserves is firmly established and legislatively protected. Fishery management measures outside protected areas are necessary to complement the protection offered by marine reserves, but cannot substitute for it.


Analysis of reconstruction of an RNP particle which stores 5S RNA and tRNA in amphibian oocytes.
Previtellogenic oocytes of Triturus cristatus accumulate a free cytoplasmic RNP which sediments at 40S and contain 5S RNA and tRNA in association with two proteins of MW 45,000 and 39,000 daltons (P45 and P39). The 40S particle has a buoyant density of 1.53 g . cm-3 in CsCl and consists of four identical RNP subunits. Each monomeric subunit contains one molecule of 5S RNA, three molecules of tRNA, two molecules of P45 and one molecule of P39. The 40S particle can be completely dissociated by SDS treatment into its individual components, and the subunits, and even the complete 40S particle, can be reformed by removal of SDS in the presence of 0.2 M NaCl. RNA/protein binding experiments with isolated components, and analysis of reformed RNP complexes in CsCl gradients, demonstrate that the stable interactions are: 5S RNA/P45, 3(tRNA)/P45, 5S RNA/P39 and 5S RNA/P45/P39. Immunological studies show that P45 has also a nuclear location and may bind to the 5S RNA transcript in the chromatin, whereas P39 is predominantly cytoplasmic and is possibly related to proteins associated with 5S RNA in the ribosomal 60S subunit. It is suggested that the 40S RNP particle not only stores 5S RNA and tRNA but also provides a means for the exchange of the 5S RNA transcript binding protein (P45) for the 5S RNA ribosome associated protein (P39).


Nursing interventions in depressed children with low serum levels of BDNF.
The purpose of this study was to investigate the correlation between brain-derived neurotrophic factor (BDNF) in serum and depression in children, and explore the effects of different nursing protocols on patients with low levels of BDNF. We recruited 128 children with depression and 50 healthy subjects. Compared with healthy controls, the mRNA and protein levels of BDNF in serum were lower in children with depression (p<0.01). We selected 60 depressed children with low BDNF and randomly divided them in two groups: comprehensive nursing (n=30) and regular nursing (n=30). Compared to healthy children, there was a significant increase in Hamilton depression (HAMD) scores in patients with depression in childhood (p<0.01). After treatment, BDNF protein expression was higher in the comprehensive nursing group than that in the regular nursing group (p<0.05). Also, the HAMD score in the comprehensive nursing group was significantly lower than that in the regular nursing group (p<0.05). Compliance to treatment and quality of life after treatment improved in the comprehensive nursing group compared with the regular nursing group (p<0.05). Overall, a decrease in BDNF expression is closely correlated with depression, and comprehensive nursing care can significantly ameliorate the depression symptoms in pediatric patients, increase the BDNF expression, and improve compliance and quality of life. These results provide theoretical and practical significance for clinical nursing care of patients with depression in childhood.


[In Process Citation].
IgA nephropathy is the most common glomerulonephritis in Europe. The disease has been discovered in 1968 in Paris by Jean Berger at the Necker-Children's Hospital. Diagnosis is made by kidney biopsy and requires the presence of mesangial deposits of IgA. This form of glomerulonephritis can be seen in children and adults. In childhood, it most frequently presents within the context of Schoenlein-Henoch purpura. In adulthood, the most common form is limited to the kidney. Schoenlein-Henoch purpura can be seen in adults and manifests as a very aggressive vasculitis, usually in the context of a specific drug intake. The underlying pathophysiological concept today is an insufficient glycosylation of the IgA1 hinge region triggering the formation of autoantibodies against this site. Therapeutic options for the disease are limited. Important is optimal blood pressure control. Selected patients will profit from steroid therapy.


Response to sensory uncertainty in Parkinson's disease: a marker of cerebellar dysfunction?
Motor performance is profoundly influenced by sensory information, yet sensory input can be noisy and uncertain. The basal ganglia and the cerebellum are important in processing sensory uncertainty, as the basal ganglia incorporate the uncertainty of predictive reward cues to reinforce motor programs, and the cerebellum and its connections mitigate the effect of ambiguous sensory input on motor performance through the use of forward models. Although Parkinson's disease (PD) is classically considered a primary disease of the basal ganglia, alterations in cerebellar activation are also observed, which may have consequences for the processing of sensory uncertainty. The aim of this study was to investigate the effect of visual uncertainty on motor performance in 15 PD patients and ten age-matched control subjects. Subjects performed a visually guided tracking task, requiring large-amplitude arm movements, by tracking with their index finger a moving target along a smooth trajectory. To induce visual uncertainty, the target position randomly jittered about the desired trajectory with increasing amplitudes. Tracking error was related to target ambiguity to a significantly greater degree in PD subjects off medication compared with control subjects, indicative of susceptibility to visual uncertainty in PD. l-Dopa partially ameliorated this deficit. We interpret our findings as suggesting an inability of PD subjects to create adequate forward models and/or de-weight less informative visual input. As these computations are normally associated with the cerebellum and connections, we suggest that alterations in normal cerebellar functioning may be a significant contributor to altered motor performance in PD.


Therapeutic intervention in a rat model of adult respiratory distress syndrome: III. Cyclooxygenase pathway inhibition.
Current strategies for the treatment of ARDS have been unsuccessful in reducing mortality. In the present study, we have evaluated the role of cyclooxygenase (CO) products in a rat model of ARDS by testing naproxen, indomethacin, ibuprofen, and a thromboxane A2 (TXA2) receptor antagonist (SK&F 96148). Rats were treated 1 hr prior to endotoxin (LPS) exposure and 24 hr later, survival, body weight changes, wet/dry lung weight (W/D), total protein content (TP) of the bronchoalveolar lavage (BAL) fluid, and total erythrocyte and differential leukocyte counts of the BAL fluid were measured. In addition, the following hematologic measurements were taken: hemoglobin (Hb), hematocrit (Hct), circulating erythrocyte, differential leukocyte, and platelet counts. Treatment with the TXA2 receptor antagonist reduced mortality to zero after 24 hr after LPS administration. Other compounds had no significant effect on LPS-induced mortality. Pretreatment with CO inhibitors or the TXA2 receptor antagonist attenuated the LPS-induced increase in TP and W/D. Although all compounds tended to reduce the LPS-induced increase in BAL erythrocytes, only the TXA2 receptor antagonist did so significantly. The LPS-induced increase in BAL neutrophil counts was significantly reduced by 30 mg/kg ibuprofen, but not by the other compounds. In fact, the TXA2 receptor antagonist actually exacerbated BAL neutrophil counts, but diminished the peripheral neutrophilia and lymphopenia induced by LPS. None of the CO inhibitors tested significantly affected LPS-induced hematologic responses. We conclude that by virtue of its protection against LPS-induced mortality, the TXA2 receptor antagonist was the most effective compound in this model. However, it did cause certain negative side effects such as increased pulmonary inflammation.(ABSTRACT TRUNCATED AT 250 WORDS)


Complete elimination of reflux symptoms does not guarantee normalization of intraesophageal acid reflux in patients with Barrett's esophagus.
Normalization of intraesophageal acid exposure is increasingly recognized as a desired goal in the management of Barrett's esophagus. In this prospective trial, we studied patients with Barrett's esophagus by 24-h intraesophageal pH monitoring after having completely eliminated their reflux symptoms with lansoprazole, to determine whether they had achieved normalization of intraesophageal pH. Thirty patients with Barrett's esophagus, all of whom had presented with reflux symptoms, were treated with lansoprazole (15-30 mg/day) until they were asymptomatic. Twenty-four-hour ambulatory pH monitoring was performed while they were receiving lansoprazole and were asymptomatic. Twelve patients (40%) showed persistent bipositional, pathologic acid reflux while on therapy, with a mean DeMeester score of 52.8 (95% CI: 33.8-71.8); the remaining 18 (60%) exhibited normalization of intraesophageal acid exposure with a score of 4.4 (95% CI: 2.3-6.6,p < 0.001). This inadequate control of intraesophageal pH is most likely due to incomplete gastric acid suppression induced by the drug and is associated with a variable acid (distal > proximal) exposure within the esophagus. The two groups were not different in regard to their symptom frequency and severity before therapy, amount of lansoprazole dosage required to eliminate symptoms, length of Barrett's metaplasia, presence of hiatal hernia, lower esophageal sphincter resting tone and length, or esophageal peristaltic function. Complete symptom eradication with lansoprazole (15-30 mg daily) in patients with Barrett's esophagus does not guarantee normalization of intraesophageal pH profile. If the goal of therapy in such patients is to achieve complete intraesophageal acid suppression, 24-h ambulatory esophageal pH monitoring should be performed to titrate therapy.


Increasing weaning age of piglets from 4 to 7 weeks reduces stress, increases post-weaning feed intake but does not improve intestinal functionality.
This study tested the hypothesis that late weaning and the availability of creep feed during the suckling period compared with early weaning, improves feed intake, decreases stress and improves the integrity of the intestinal tract. In this study with 160 piglets of 16 litters, late weaning at 7 weeks of age was compared with early weaning at 4 weeks, with or without creep feeding during the suckling period, on post-weaning feed intake, plasma cortisol (as an indicator of stress) and plasma intestinal fatty acid binding protein (I-FABP; a marker for mild intestinal injury) concentrations, intestinal morphology, intestinal (macro)molecular permeability and intestinal fluid absorption as indicators of small intestinal integrity. Post-weaning feed intake was similar in piglets weaned at 4 weeks and offered creep feed or not, but higher (P < 0.001) in piglets weaned at 7 weeks with a higher (P < 0.05) intake for piglets offered creep feed compared with piglets from whom creep feed was witheld. Plasma cortisol response at the day of weaning was lower in piglets weaned at 7 weeks compared with piglets weaned at 4 weeks, and creep feed did not affect cortisol concentration. Plasma I-FABP concentration was not affected by the age of weaning and creep feeding. Intestinal (macro)molecular permeability was not affected by the age of weaning and creep feeding. Both in uninfected and enterotoxigenic Escherichia coli-infected small intestinal segments net fluid absorption was not affected by the age of weaning or creep feeding. Creep feeding, but not the age of weaning, resulted in higher villi and increased crypt depth. In conclusion, weaning at 7 weeks of age in combination with creep feeding improves post-weaning feed intake and reduces weaning stress but does not improve functional characteristics of the small intestinal mucosa.


Collaborative normal tension glaucoma study.
Before this study was done, there was a difference of opinion concerning whether intraocular pressure (IOP) was involved in producing optic nerve damage when there was glaucomatous damage to the optic nerve and characteristic visual field loss, even though the IOP was in the statistically normal range. This article reviews the findings of a collaborative study aimed at finding the answer to this question. The level of pressure influences the course of normal tension glaucoma, as evidenced by a slower rate of incident visual field loss in cases with 30% or more lowering of intraocular pressure. The rate of progression without treatment is highly variable, but often slow enough that half of the patients have no progression in 5 years. A faster rate occurs in women, in patients with migraine headaches, and in the presence of disc hemorrhages. Some patients may experience greater benefit from lowering of IOP than others, but further research is needed to be able to identify those most likely to benefit. As a group, patients with normal tension glaucoma benefit from lowering of IOP. Variable rate of deterioration, as well as lack of progression in a substantial number in 5 years, suggest that treatment should be individualized according to the stage of disease and rate of progression. Traits that help predict risk and rate of progression and response to treatment are beginning to become known and, when fully known, will help guide management decisions.


Predicting the outcome of carpal tunnel release.
To test the hypothesis that the result of steroid injection in the carpal tunnel provides a better predictor of the outcome of later surgery. We also explored other possible factors that might predict the outcome directly or interact with the results of steroid injection to better predict the outcome. We performed a historical cohort study on 57 patients who had carpal tunnel release. Care was taken to avoid problems of statistical nonindependence caused by both hands being studied and confounding from previous surgeries. We found a large and significant difference in the success rate of surgery for patients who had obtained some relief from injection (87%) versus those who had not (54%). No other significant predictor was found. We discovered factors that may interact with the results of injection in predicting the outcome of surgery (eg, Katz and Stirrat hand diagram assessment of the probability of carpal tunnel syndrome) although not significant in our study. Some relief from steroid injection is the best predictor for success of surgery. Further study is warranted to identify factors that interact with this predictor.


Hospital resource utilization in childhood cancer.
To describe the patterns and predictors of hospital resource utilization in a cohort of children with newly diagnosed cancer, a retrospective cohort study of 195 consecutively diagnosed children with cancer at a single large Midwestern children's hospital was conducted. Patients were diagnosed between November 1995 and March 1997. All hospital encounters for these patients starting from the time of diagnosis to 3 years from diagnosis were identified using hospital administrative data. The patients were categorized into four diagnostic groups: lymphoid malignancies (acute lymphoblastic leukemia and lymphoma), myeloid leukemias (acute myeloid leukemia and chronic myeloid leukemia), central nervous system tumors, and solid tumors. Hospital charges and length of stay for patients in each diagnostic category were described. Predictive models for total resource consumption (total hospital charges) and intensive care use were derived. One hundred sixty-five of the 195 were admitted to Riley Hospital for Children at least once during the 3-year period following diagnosis. Among these 165, mean age at diagnosis was 6.9 years (minimum newborn, maximum 18.7 years). The ratio of boys to girls was 99:66 (1.5:1). The distribution of 165 diagnoses was as follows: 65 (39%) with lymphoid malignancy, 13 (8%) with myeloid leukemia, 36 (22%) with central nervous system tumors, and 51 (31%) with solid tumors. Sixty-two patients (38%) used the pediatric intensive care unit (PICU) at least once; 22 patients (13%) underwent stem cell transplantation. Sixty-five patients (39%) entered clinical trials. One hundred thirty-nine patients (84%) were alive at the end of 3 years. Three-year cumulative hospital charges were USD 16 million--almost USD 100,000/child hospitalized. Half of these charges were incurred in the first 4.5 months after diagnosis. Half of all hospital charges accrued to only 12.7% of patients; these patients were more likely to have a diagnosis of myeloid leukemia, to have undergone stem cell transplantation, and to have used the PICU. There were three independent predictors of hospital charges (log transformed): stem cell transplantation, PICU utilization, and death within 3 years of diagnosis. PICU utilization was predicted by tumor type (myeloid leukemia and central nervous system tumors were positive predictors of PICU utilization; lymphoid malignancy and solid tumors were negative predictors), stem cell transplantation, and death within 3 years of diagnosis. The authors conclude that hospitalization for childhood cancer is common, costly in the short term, and to some extent predictable. These data suggest that failures of current treatment not only lead to death but also add significantly to hospital resource utilization.


Seeing Jay-Z in Taipei.
How does the newly arrived immigrant respond to the news that an identity already awaits him? How does an African American hip-hop artist translate his struggles and triumphs across oceanic divides? What significance do American demographic shifts have in a global context? Hsu's essay examines what happens once individuals or identities migrate beyond the contexts that first produced them. He explores a variety of circuits: the satellite communities of Asian immigrant students who arrived on American university campuses in the late 1960s; enduring debates about a "post-city" identity, spurred by advances in cheap, efficient, world-shrinking communication technologies; and the new affinities and categories of self-identification made possible by a present-day culture that prizes interactivity and participation.


Metformin activates a duodenal Ampk-dependent pathway to lower hepatic glucose production in rats.
Metformin is a first-line therapeutic option for the treatment of type 2 diabetes, even though its underlying mechanisms of action are relatively unclear. Metformin lowers blood glucose levels by inhibiting hepatic glucose production (HGP), an effect originally postulated to be due to a hepatic AMP-activated protein kinase (AMPK)-dependent mechanism. However, studies have questioned the contribution of hepatic AMPK to the effects of metformin on lowering hyperglycemia, and a gut-brain-liver axis that mediates intestinal nutrient- and hormone-induced lowering of HGP has been identified. Thus, it is possible that metformin affects HGP through this inter-organ crosstalk. Here we show that intraduodenal infusion of metformin for 50 min activated duodenal mucosal Ampk and lowered HGP in a rat 3 d high fat diet (HFD)-induced model of insulin resistance. Inhibition of duodenal Ampk negated the HGP-lowering effect of intraduodenal metformin, and both duodenal glucagon-like peptide-1 receptor (Glp-1r)-protein kinase A (Pka) signaling and a neuronal-mediated gut-brain-liver pathway were required for metformin to lower HGP. Preabsorptive metformin also lowered HGP in rat models of 28 d HFD-induced obesity and insulin resistance and nicotinamide (NA)-streptozotocin (STZ)-HFD-induced type 2 diabetes. In an unclamped setting, inhibition of duodenal Ampk reduced the glucose-lowering effects of a bolus metformin treatment in rat models of diabetes. These findings show that, in rat models of both obesity and diabetes, metformin activates a previously unappreciated duodenal Ampk-dependent pathway to lower HGP and plasma glucose levels.


Auditory disturbance as a prodrome of anterior inferior cerebellar artery infarction.
To investigate the clinical and radiological features of patients presenting with an acute auditory syndrome as a prodromal symptom of anterior inferior cerebellar artery (AICA) infarction. 16 consecutive cases of AICA infarction diagnosed by brain magnetic resonance imaging completed a standardised audiovestibular questionnaire and underwent a neuro-otological evaluation by an experienced neuro-otologist. Five patients (31%) had an acute auditory syndrome as a prodrome of AICA infarction one to 10 days before onset of other brain stem or cerebellar symptoms. Two types of acute auditory syndrome were found: recurrent transient hearing loss with or without tinnitus (n = 3), and a single episode of prolonged hearing loss with or without tinnitus (n = 2). The episodic symptoms were brief, lasting only minutes. The tinnitus preceding the infarction was identical to the tinnitus experienced at the time of infarction. At the time of infarction, all patients developed hearing loss, tinnitus, vertigo, and ipsilateral hemiataxia. The most commonly affected site was the middle cerebellar peduncle (n = 5). Four of the five patients had incomplete hearing loss and all had absence of vestibular function to caloric stimulation on the affected side. Acute auditory syndrome may be a warning sign of impending pontocerebellar infarction in the distribution of the AICA. The acute auditory syndrome preceding an AICA infarct may result from ischaemia of the inner ear or the vestibulocochlear nerve.


[Radioprotective effect of hydroxy phenylethanolamine phenolic hydroxyl esters].
Experiments are carried out on 3000 mice, irradiated in dose 8 Gy (LD97/30). A number of phenolic hydroxyl esters of phenylephrine, norphenylephrine and epinephrine has the high RPE (70-100%) within 1 h before irradiation. 3-esters of 3-hydroxy phenylethanolamines are active in small doses (19-50 mumol/kg) and protect per os too. RPE of 3-benzoylphenylephrine realizes via alpha 1-adrenoreceptors.


[Predictive value of preoperative abdominopelvic CT for optimal cytoreduction surgery in ovarian carcinoma].
Some patients underwent laparoscopy without optimal debulking surgery as initial treatment for advanced ovarian carcinoma. The amount of residual tumor following primary surgery was an important prognosis factor. Neoadjuvant chemotherapy is a new therapeutic approach. Secondary, optimal surgery could be done in better conditions. The purpose was to access the ability of preoperative abdominopelvic CT to predict success of debulking surgery for ovarian carcinoma: less than 1 cm of residual tumor size after initial surgery. We reviewed 39 patients (2 stages Ic, 1 stage IIc, 22 stages III and 14 stages IV) operated on for ovarian carcinoma between January 1992 and December 1997. Surgical criteria of inability to perform optimal surgical cytoreduction were compared with abdominopelvic CT done the month before. CT scans were prospectively assessed by radiologist A and retrospectively (3 months to 6 years delay) rewiewed separately by radiologists A and B without surgical data. Nineteen patients underwent optimal debulking surgery: 13 no residual tumor and 6 with residual lesions under 1 cm. The interreader (0.73) and intrareader (0.9) agreement, worked out by Kappa coefficient, was juged good to very good. The sensitivity of CT was 91% with a specificity of 95%. These results allowed us to determine wich CT criteria were accurate and reproducible to be a helpfull for therapeutic choice and to avoid laparotomy without optimal surgery.


How Can Adolescents Benefit from the Use of Social Networks? The iGeneration on Instagram.
In the last few years, Instagram has been a topic of much contention, as it has been shown to be associated with both risks and benefits for young users. This study explores the influence of the use of Instagram on adolescents' constructions of self and interpersonal experience. Forty Italian adolescents aged between 11 and 16 years were interviewed and completed repertory grids. The results showed that the adolescents' self-construction and distance from others were mostly influenced by receiving, or not receiving, positive feedback, rather than by using Instagram itself. Specifically, there was an increase in self-acceptance and social desirability after receiving a "like" and an increase in social isolation after receiving no "likes". The regression model also showed a decrease in self-acceptance on Instagram in the case of female adolescents, and in participants who edited photos. These findings are useful for understanding the constant need for approval adolescents require today and could be used as a guiding tool for future studies and intervention policies. The present study offers an innovative methodology that refers to the relevant dimensions of adolescents' self-construction rather than investigating the more general relationship between personality traits and social networks' use.


Medium term water deficit elicits distinct transcriptome responses in Eucalyptus species of contrasting environmental origin.
Climatic and edaphic conditions over geological timescales have generated enormous diversity of adaptive traits and high speciation within the genus Eucalyptus (L. Hér.). Eucalypt species occur from high rainfall to semi-arid zones and from the tropics to latitudes as high as 43°S. Despite several morphological and metabolomic characterizations, little is known regarding gene expression differences that underpin differences in tolerance to environmental change. Using species of contrasting taxonomy, morphology and physiology (E. globulus and E. cladocalyx), this study combines physiological characterizations with 'second-generation' sequencing to identify key genes involved in eucalypt responses to medium-term water limitation. One hundred twenty Million high-quality HiSeq reads were created from 14 tissue samples in plants that had been successfully subjected to a water deficit treatment or a well-watered control. Alignment to the E. grandis genome saw 23,623 genes of which 468 exhibited differential expression (FDR < 0.01) in one or both ecotypes in response to the treatment. Further analysis identified 80 genes that demonstrated a significant species-specific response of which 74 were linked to the 'dry' species E. cladocalyx where 23 of these genes were uncharacterised. The majority (approximately 80%) of these differentially expressed genes, were expressed in stem tissue. Key genes that differentiated species responses were linked to photoprotection/redox balance, phytohormone/signalling, primary photosynthesis/cellular metabolism and secondary metabolism based on plant metabolic pathway network analysis. These results highlight a more definitive response to water deficit by a 'dry' climate eucalypt, particularly in stem tissue, identifying key pathways and associated genes that are responsible for the differences between 'wet' and 'dry' climate eucalypts. This knowledge provides the opportunity to further investigate and understand the mechanisms and genetic variation linked to this important environmental response that will assist with genomic efforts in managing native populations as well as in tree improvement programs under future climate scenarios.


Is colectomy for fulminant Clostridium difficile colitis life saving? A systematic review.
It is unclear whether colectomy for fulminant Clostridium difficile colitis (FCDC) leads to a improvement in survival compared with continued medical therapy for this moribund population. Selected studies from 1994-2010 were identified through a comprehensive search theme applied to MEDLINE (OvidSP and PubMed), EMBASE and by hand searching. Data regarding mortality rates between medically and surgically treated patients were extracted. Risk of bias was assessed using a Newcastle-Ottawa Scale score. A meta-analysis of the odds ratios for mortality between surgical and medical treatment for FCDC was conducted using the Mantel-Haenszel method and fixed-effects modelling. Five hundred and ten patients with FCDC were identified in six studies. The pooled adjusted odds ratio of mortality comparing surgery with medical therapy was 0.70 (0.49-0.99), suggesting that surgery provided a survival benefit. Emergent colectomy for patients with FCDC provides a survival advantage compared with continuing antibiotics. Though there is selection bias of patients having surgery, the results of this systematic review suggest that colectomy has a therapeutic role in treating severe forms of C. difficile colitis.


Management of atrial fibrillation: direct factor IIa and Xa inhibitors or "warfarin shotgun"?
Nonvalvular atrial fibrillation increases in prevalence with age and often requires long-term oral anticoagulation to prevent ischemic stroke. Vitamin K antagonists are highly effective for stroke prevention. However, suboptimal risk assessment, variability in response, drug and food interactions, and monitoring requirements result in underprescription of warfarin by physicians and poor adherence to therapy by patients. In addition, the vitamin K antagonists modulate coagulation by inhibiting multiple coagulation factors (factors II, VII, IX, and X). New oral direct factor IIa and Xa inhibitors offer improved risk-benefit profiles, simplifying thromboprophylaxis and overcoming some practical barriers to long-term therapy. Their potential benefit is a function of targeting specific activated factors produced at key junctions of the coagulation system. However, important questions about patient management with these new agents have not been fully answered by studies completed to date and clinical inertia must yet be overcome.


Intussusception presenting to a paediatric accident and emergency department.
In a retrospective study, 110 patients episodes with intussusception presenting to a paediatric accident and emergency (A&E) department were reviewed, with particular attention being paid to presenting symptoms, time to diagnosis, radiological investigation, management and outcome. Between 1983 and 1993 100 patients presented to this department with 110 episodes of intussusception. Delay in diagnosis of greater than 12 h from initial medical contact was associated with increased morbidity. Associated factors in delayed diagnosis were departure from the classical symptoms (pain, vomiting and blood per rectum) and the presence of diarrhoea. General practitioner (GP) referral was to the medical team (rather than the surgical team) in around 50% of cases. Irrespective of the specialty of the first hospital doctor to see the patient only 42% were diagnosed correctly within 3 h of admission. In this population diarrhoea is a common symptom of intussusception and should alert the clinician rather than reassure. Because of its many presentations and relative rarity, intussusception remains a difficult condition to diagnose.


Subepithelial fibroblast cell lines from different levels of gut axis display regional characteristics.
The intestine is characterized by morphofunctional differences along the proximodistal axis. The aim of this study was to derive mesenchymal cell lines representative of the gut axis. We isolated and cloned rat intestinal subepithelial myofibroblasts raised from 8-day proximal jejunum, distal ileum, and proximal colon lamina propria. Two clonal cell lines from each level of the gut were characterized. They 1) express the specific markers vimentin, smooth muscle alpha-actin, and smooth muscle myosin heavy chain, revealed by immunofluorescence microscopy and 2) distinctly support endodermal cell growth in a coculture model, depending on their regional origin, and 3) the clones raised from the various proximodistal regions maintain the same pattern of morphogenetic and growth and/or differentiation factor gene expression as in vivo: hepatocyte growth and/or scatter factor and transforming growth factor-beta 1 mRNAs analyzed by RT-PCR were more abundant, in the colon and ileal clones and mucosal connective tissue, respectively. In addition, epimorphin mRNA studied by Northern blot was also the highest in one ileal clone, in which it was selectively upregulated by all-trans retinoic acid (RA) treatment. Epimorphin expression in isolated 8-day intestinal lamina propria was higher in the distal small intestine and proximal colon than in the proximal small intestine. In conclusion, we isolated and characterized homogeneous cell subtypes that can now be used to approach the molecular regulation of the epithelium-mesenchyme-dependent regional specificity along the gut.


Berberine hydrochloride protects against cytokine-induced inflammation through multiple pathways in undifferentiated C2C12 myoblast cells.
Obesity is associated with skeletal muscle insulin resistance and the development of metabolic syndrome. Undifferentiated skeletal muscle cells are sensitive to oxidative stress. Berberine hydrochloride (BBR) improves insulin resistance and exhibits anti-inflammatory properties. However, the underlying mechanism and the cell signaling pathways involved remain largely elusive. We therefore investigated the anti-inflammatory effects of BBR and the signaling pathways using skeletal C2C12 myoblast cells. Undifferentiated C2C12 myoblast cells were treated with interleukin-1β alone or in combination with tumor necrosis factor-α in the presence or absence of BBR. We found that BBR reduced the cytokine-induced expression of inducible nitric oxide synthase and stress-related kinases including p-38 mitogen-activated protein kinase, nuclear factor kappa B (NF-κB), and stress-activated protein kinases/Jun amino-terminal kinases (SAPK/JNK) in C2C12 myoblast cells. Furthermore, BBR reversed cytokine-mediated suppression of AMP-activated protein kinase (AMPKα), sirtuin-1 (SIRT-1), and PPAR-γ coactivator-1α (PGC-1α). In addition, cytokine-induced reduction of mitochondrial marker proteins and function were rescued after BBR treatment. Catalase, an antioxidant enzyme, was elevated after BBR treatment. Our results demonstrate that BBR ameliorates cytokine-induced inflammation. The anti-inflammatory effect of BBR in skeletal progenitor cells is mediated through pathways including activation of the AMPKα-SIRT-1-PGC-1α, inhibition of the mitogen-activated protein kinase 4 (MKK4)-SAPK/JNK-C-JUN, as well as protection of mitochondrial bioenergetics. BBR may be a potential medication for metabolic syndrome.


Androgenic maintenance of the rat erectile response via a non-nitric-oxide-dependent pathway.
Prior studies have demonstrated that the erectile response in the rat penis is androgen dependent and is mediated by nitric oxide (NO), the neurotransmitter synthesized by the enzyme nitric oxide synthase (NOS). The present studies used L-nitro-L-arginine methyl ester (L-NAME), an inhibitor of NOS, to determine if androgens also regulate alternative pathways leading to the erectile response but not mediated by NO. Castrated rats that were treated with L-NAME (L-NAME CASTRATE) exhibited little or no increase in intracavernosal pressure in response to stimulation of the major pelvic ganglion. This ganglion controls blood flow into the penis and, when stimulated, normally leads to erection. However, when castrated animals were treated with testosterone along with L-NAME (L-NAME TESTO), the animals responded to the ganglionic stimulation with increased intracavernosal pressure. This finding suggests that there are other androgen-dependent pathways that lead to penile erection but are not mediated by NO. Erection occurred in both L-NAME CASTRATE and L-NAME TESTO rats in response to intracavernosal injection of sodium nitroprusside (an NO donor drug), proving that the NO responsive mechanisms were unaffected by the inhibition of NOS activity. To investigate further the nature of this NO independent pathway, L-NAME CASTRATE and L-NAME TESTO rats were treated with either zaprinast (a specific phosphodiesterase 5 inhibitor), which would block the breakdown of cGMP to 5'GMP, or methylene blue (an inhibitor of guanylate cyclase) to prevent the synthesis of cGMP. Zaprinast treatment led to increased erectile response in L-NAME TESTO rats but not in L-NAME CASTRATE rats, demonstrating that androgen-sensitive alternative pathways increased guanylate cyclase activity. Methylene blue inhibited the erectile response in all treatment groups, showing that cyclic GMP is critical to the NO-independent pathway as well as the NO-dependent pathway. Taken together, these results support the hypothesis that androgens maintain the erectile response by alternate pathways, including one that is independent of NO but involves the synthesis of cyclic GMP.


The Medicare hospice benefit's influence on dying in nursing homes.
For dying nursing home residents, the prevalence of symptoms and care utilization prior to death has yet to be empirically described for a population-based sample. Yet, related work has suggested that the quality of care for dying nursing home residents is less optimal. The provision of Medicare hospice care in nursing homes offers a means for improving terminal care in nursing homes. However, other than controversial findings emanating from the U.S. Office of Inspector General's (OIG's) hospice studies, there is a dearth of evaluative research on the comparative costs and the benefits of Medicare hospice care in nursing homes. In this article, we discuss current knowledge concerning the dying experience of nursing home residents and of the influence of the Medicare hospice benefit in nursing homes. In doing so, we critique the OIG's study of hospice care in nursing homes and we raise concerns regarding access to the Medicare hospice benefit in nursing homes. We conclude by delineating the research needed to more fully understand the dying experience of nursing home residents and the influence of Medicare hospice care provision on this experience.


Characterization of rhodopsin mis-sorting and constitutive activation in a transgenic rat model of retinitis pigmentosa.
To determine the extent to which rhodopsin mis-sorting and constitutive activation of the phototransduction cascade contribute to retinal degeneration in a transgenic rat model of retinitis pigmentosa. Retinas from transgenic rats expressing truncated rhodopsin (Ser334ter) were examined by light and electron microscopic immunocytochemistry at several time points. Retinal degeneration in transgenic rats raised in darkness was evaluated by quantification of outer nuclear layer thickness and by electroretinography. Mutant rhodopsin was found at inappropriately high levels in the plasma membrane and cytoplasm of Ser334ter rat photoreceptors. When the cell death rate was high this mis-sorting was severe, but mis-sorting attenuated greatly at later stages of degeneration, as the cell death rate decreased. The distributions of two other outer segment proteins (the cGMP-gated channel and peripherin) were examined and found to be sorted normally within the photoreceptors of these rats. Raising Ser334ter transgenic rats in darkness resulted in minimal rescue from retinal degeneration. Because dark rearing Ser334ter rats results in little rescue, it is concluded that constitutive activation of the phototransduction cascade does not contribute significantly to photoreceptor cell death in this rat model. The nature of the rhodopsin sorting defect and the correlation between the severity of mis-sorting and rate of cell death indicate that truncated rhodopsin may cause apoptosis by interfering with normal cellular machinery in the post-Golgi transport pathway or in the plasma membrane.


Investigations on the UV photorefractivity of LiNbO(3):Hf.
The UV photorefractivity of LiNbO(3):Hf was investigated by beam distortion and two-wave coupling experiments. A sharp decrease of beam distortion was found between Hf concentrations of 2 and 2.5 mol.%, indicating a significant increase of photoconductivity there. The energy-transfer direction of the two-wave coupling and the effect of chemical reduction on the UV photorefractivity reveal that electrons are the carriers responsible for the UV photorefraction. Moreover, dissimilar with LiNbO(3) highly doped with Mg, Zn, and In, the grating recorded in LiNbO(3):Hf was found to be nearly stable in the dark but sensitive to red light, which can be attributed to the special location of Fe ions in the crystal lattice.


Six new triterpenoid saponins from the leaves of Ilex oblonga and their inhibitory activities against TMV replication.
Six new triterpenoid saponins of the ursane types were isolated from the MeOH extract of the leaves of Ilex oblonga. They were oblonganoside A (1), oblonganoside B (2), oblonganoside C (6), oblonganoside D (8), oblonganoside E (9), and oblonganoside F (10), together with three known triterpenoid saponins. The structures of these compounds were elucidated on the basis of spectroscopic analysis, and compound 1 showed appreciable inhibitory activity against TMV replication with EC50 value 0.074 mM.


Coronary microvascular reactivity to sympathetic stimulation in patients with idiopathic dilated cardiomyopathy.
The objective of this study was to assess noninvasively the microvascular reactivity to sympathetic stimulation in patients with idiopathic dilated cardiomyopathy (IDC) and in healthy volunteers, who underwent cardiac catheterization for exclusion of coronary artery disease. Myocardial flow was quantified with 13N-ammonia PET and tracer kinetic modeling at rest and in response to cold pressor testing (CPT). Ten healthy volunteers (8 men, 2 women; mean age +/- SD, 50.7 +/- 15 y) and 10 matched patients (8 men, 2 women; mean age, 52.5 +/- 14 y) with IDC (mean left ventricular ejection fraction, 0.30 +/- 0.12) were included in the study. Myocardial perfusion at rest was not significantly different between the groups. However, myocardial vascular resistance (MVR) was significantly lower in IDC patients at rest than in healthy volunteers. In response to CPT a significant decrease in MVR was found in healthy volunteers (1.9 +/- 0.4 to 1.5 +/- 0.4 mm Hg x 100 g/mL; 22% decrease) but not in IDC patients (1.5 +/- 0.4 to 1.4 +/- 0.3 mm Hg x 100 g/mL; 9% decrease). Consequently, the increase of the myocardial blood flow in response to CPT was significantly lower (P < 0.008) in IDC patients (56 +/- 17 to 66 +/- 18 mL/100g/min; 20% increase) compared with healthy volunteers (52 +/- 12 to 80 +/- 30 mL/100 g/min; 52% increase), whereas both showed comparable hemodynamic reactions. The data indicate that CPT in combination with 13N PET imaging is a valuable noninvasive tool for assessment of coronary microvascular reaction to sympathetic stimulation in IDC patients. Lower coronary vascular resistance was found in IDC patients at rest compared with healthy volunteers, suggesting possible exhaustion of sympathetically induced dilation of the coronary microvasculature in IDC patients at rest. This mechanism may explain the impaired flow response to cold in IDC patients in the present study.


Patisiran Treatment in Patients with Transthyretin Cardiac Amyloidosis.
Transthyretin amyloidosis, also called ATTR amyloidosis, is associated with accumulation of ATTR amyloid deposits in the heart and commonly manifests as progressive cardiomyopathy. Patisiran, an RNA interference therapeutic agent, inhibits the production of hepatic transthyretin. In this phase 3, double-blind, randomized trial, we assigned patients with hereditary, also known as variant, or wild-type ATTR cardiac amyloidosis, in a 1:1 ratio, to receive patisiran (0.3 mg per kilogram of body weight) or placebo once every 3 weeks for 12 months. A hierarchical procedure was used to test the primary and three secondary end points. The primary end point was the change from baseline in the distance covered on the 6-minute walk test at 12 months. The first secondary end point was the change from baseline to month 12 in the Kansas City Cardiomyopathy Questionnaire-Overall Summary (KCCQ-OS) score (with higher scores indicating better health status). The second secondary end point was a composite of death from any cause, cardiovascular events, and change from baseline in the 6-minute walk test distance over 12 months. The third secondary end point was a composite of death from any cause, hospitalizations for any cause, and urgent heart failure visits over 12 months. A total of 360 patients were randomly assigned to receive patisiran (181 patients) or placebo (179 patients). At month 12, the decline in the 6-minute walk distance was lower in the patisiran group than in the placebo group (Hodges-Lehmann estimate of median difference, 14.69 m; 95% confidence interval [CI], 0.69 to 28.69; P = 0.02); the KCCQ-OS score increased in the patisiran group and declined in the placebo group (least-squares mean difference, 3.7 points; 95% CI, 0.2 to 7.2; P = 0.04). Significant benefits were not observed for the second secondary end point. Infusion-related reactions, arthralgia, and muscle spasms occurred more often among patients in the patisiran group than among those in the placebo group. In this trial, administration of patisiran over a period of 12 months resulted in preserved functional capacity in patients with ATTR cardiac amyloidosis. (Funded by Alnylam Pharmaceuticals; APOLLO-B ClinicalTrials.gov number, NCT03997383.).


Randomised trial of effects of vitamin supplements on pregnancy outcomes and T cell counts in HIV-1-infected women in Tanzania.
In HIV-1-infected women, poor micronutrient status has been associated with faster progression of HIV-1 disease and adverse birth outcomes. We assessed the effects of vitamin A and multivitamins on birth outcomes in such women. In Tanzania, 1075 HIV-1-infected pregnant women at between 12 and 27 weeks' gestation received placebo (n=267), vitamin A (n=269), multivitamins excluding vitamin A (n=269), or multivitamins including vitamin A (n=270) in a randomised, double-blind, placebo-controlled trial with a 2x2 factorial design. We measured the effects of multivitamins and vitamin A on birth outcomes and counts of T lymphocyte subsets. We did analyses by intention to treat. 30 fetal deaths occurred among women assigned multivitamins compared with 49 among those not on multivitamins (relative risk 0.61 [95% CI 0.39-0.94] p=0.02). Multivitamin supplementation decreased the risk of low birthweight (<2500 g) by 44% (0.56 [0.38-0.82] p=0.003), severe preterm birth (<34 weeks of gestation) by 39% (0.61 [0.38-0.96] p=0.03), and small size for gestational age at birth by 43% (0.57 [0.39-0.82] p=0.002). Vitamin A supplementation had no significant effect on these variables. Multivitamins, but not vitamin A, resulted in a significant increase in CD4, CD8, and CD3 counts. Multivitamin supplementation is a low-cost way of substantially decreasing adverse pregnancy outcomes and increasing T-cell counts in HIV-1-infected women. The clinical relevance of our findings for vertical transmission and clinical progression of HIV-1 disease is yet to be ascertained.


Risk assessment of lung cancer and asbestosis in workers exposed to asbestos fibers in brake shoe factory in Iran.
Chrysotile asbestos fiber, imported from Russia, is used mainly for manufacturing purposes in Iran and related risks in the form of asbestosis and cancer were studied. Occupational exposure of all male workers (61 persons) to asbestos in a brake shoe factory was monitored. Cumulative exposures were determined through multiplication of typical exposure and work history. Risk assessment of exposed workers was estimated by risk criteria recommended by the American Environmental Protection Agency. Measurement of lung function parameters such as forced expiratory volume in one second (FEV(1)), forced volume capacity (FVC) and FEV(1)/FVC of exposed workers were obtained. Unadjusted correlation and adjusted correlation analysis for support of the association between cumulative exposure (fiber/ml-yr) and lung function parameters were used. Exposure of majority of exposed group was far greater than the occupational exposure limits (0.1 fiber/ml) in the range of 0.06-8.06 fiber/ml. Cumulative exposures in the range of 0.02 to 110.77 fiber/ml-yr were obtained. According to the risk criteria stated by ATSDR, risk assessment of workers in term of fibrotic changes was predicted for at least 24.6 percent of the exposed subjects. Again, according to the lung cancer risk criteria stated by EPA, 59 percent of workers will have excess risk. Negative correlation between lung function parameters (FEV(1), FEV(1)/FVC) and cumulative exposures adjusted for age and BMI were significant (p<0.05).


Trans-activation of the Tetrahymena group I intron ribozyme via a non-native RNA-RNA interaction.
The peripheral P2.1 domain of the Tetrahymena group I intron ribozyme has been shown to be non-essential for splicing. We found, however, that separately prepared P2.1 RNA efficiently accelerates the 3' splice-site-specific hydrolysis reaction of a mutant ribozyme lacking both P2.1 and its upstream region in trans. We report here the unusual properties of this trans-activation. Compensatory mutational analysis revealed that non-native long-range base-pairings between the loop region of P2.1 RNA and L5c region of the mutant ribozyme are needed for the activation in spite of the fact that P2.1 forms base-pairings with P9.1 in the Tetrahymena ribozyme. The trans -activation depends on the non-native RNA-RNA interaction together with the higher order structure of P2.1 RNA. This activation is unique among the known trans-activations that utilize native tertiary interactions or RNA chaperons.


Unaccepted applicants to medical school as a health resource.
The career decisions of national samples of male and female unaccepted applicants to the 1971-72 entering U.S. medical school class are studied in order to determine whether the increasing number of unaccepted applicants is a potential manpower pool for alternative health occupations. The dominant response to rejection among respondents is reapplication to medical school in subsequent years, and the principal determinant of reapplication is receiving postrejection support (usually from family or friends) of the original career intentions. Most of the respondents who do not gain admittance to medical school on reapplications still aspire to doctoral-level degrees, but only half remain in the health area. Those respondents who had formulated contingency career plans in the professions and who had high science aptitude but low math aptitude tended to remain in the health area. A service orientation toward occupations is not associated with remaining in the health area.


[Regional circulation in gunshot wounds of the ankle joint and foot].
Problems of treatment of battle injuries of the ankle joint and foot are discussed. These injuries are characterized with severe disturbances of regional circulation and microcirculation causing hypoxia and metabolic disorders both in soft tissues and in bones. Digital substraction angiography (DSA) was used in 7 wounded (7.53%) of all patients with battle injuries of the foot and ankle joint. Combined treatment including surgery, drugs, physical and exercise therapy, hyperbaric oxygenation was used in all the patients. Prolonged intraarterial infusion of drugs was carried out in 4 of 7 patients. It is concluded that early evaluation of regional circulation permits to clarify expediency of applied combined treatment. Injury of three arteries is the indication for amputation, but even one functioning artery enables use of combined therapy with intraarterial infusion for extremity salvage.


The alpha subunit of initiation factor 2 is phosphorylated in vivo in the yeast Saccharomyces cerevisiae.
The phosphorylation state of the alpha subunit of initiation factor 2 (eIF-2 alpha) in Saccharomyces cerevisiae has been determined by two-dimensional gel electrophoresis and autoradiography of lysates from cultures grown under a variety of conditions. The alpha subunit was maintained in a phosphorylated state during logarithmic growth on fermentable and nonfermentable carbon sources, during starvation for an essential amino acid, during heat shock, during stationary phase, and during sporulation. Only when cells were starved for a carbon source for 2 h in 1 M sorbitol was eIF-2 alpha isolated in the nonphosphorylated state. This is in contrast with the studies in rabbit reticulocyte lysates, in which arrested protein synthesis was correlated with a relative increase in the extent of phosphorylation of eIF-2 alpha.


Processing ChIP-chip data: from the scanner to the browser.
High-density tiling microarrays are increasingly used in combination with chromatin immunoprecipitation (ChIP) assays to delineate the regulation of gene expression. Besides the technical challenges inherent to such complex biological assays, a critical, often daunting issue is the correct interpretation of the sheer amount of raw data generated by utilizing computational methods. Here, we go through the main steps of this intricate process, including optimized chromatin immunoprecipitation on chip (ChIP-chip) data normalization, peak detection, as well as quality control reports. We also describe convenient standalone software suites, including our own, CoCAS, which works on the latest generation of Agilent high-density arrays, allows dye-swap, replicate correlation, and easy connection with genome browsers for results interpretation, or with, e.g., other peak detection algorithms. Overall, the guidelines described herein provide an effective introduction to ChIP-chip technology and analysis.


Short-term and long-term adverse cardiovascular events across the glycaemic spectrum in patients with acute coronary syndrome: the Gulf Registry of Acute Coronary Events-2.
Limited data exist on the prognostic impacts of diabetes mellitus (DM) and new-onset hyperglycaemia (NOH) on cardiovascular outcomes in Middle Eastern patients with acute coronary syndrome (ACS). Here, we explored this relationship in a large contemporary Middle Eastern ACS registry: the second Gulf Registry of Acute Coronary Events (Gulf RACE-2). Our analysis included 6362 consecutive ACS patients enrolled from October 2008 to June 2009, with or without a known DM diagnosis, and with an available fasting blood sugar measurement from the index hospitalization. Baseline demographics, risk factors for atherosclerosis, medical history, investigations and therapies were registered. Adverse hospital outcomes, as well as short-term and long-term mortalities were compared. Comparisons for categorical data were performed using χ or Fisher's exact tests, whereas analysis of variance or the Kruskal-Wallis test was used for continuous variables. Multiple logistic regression models were used to estimate the odds ratio. Almost half of the ACS cohort had been diagnosed previously with DM, and 8.8% had NOH. DM patients were more frequently older, female and Arab Gulf nationals. Compared with nondiabetic patients, DM patients had higher rates of adverse in-hospital clinical events, and 30-day and 1-year mortality. NOH was an independent predictor of in-hospital mortality, major bleeding and cardiogenic shock. Patients with NOH had higher in-hospital mortality (8.29 vs. 5.37%, P=0.035), ventricular arrhythmia (4.97 vs. 1.91%, P<0.001) and cardiogenic shock rates (6.45 vs. 4.12%, P=0.019) compared with DM patients not requiring insulin. DM was very common among ACS patients in the Arab Gulf area, and ACS patients with NOH were at a higher risk compared with euglycaemic patients and diabetic patients not requiring insulin. Further studies are needed to examine the clinical impact of in-hospital intensive glycaemic control in these patients and to explore the long-term glycaemic status of ACS patients with NOH.


Near-null interferometry using an aspheric null lens generating a broad range of variable spherical aberration for flexible test of aspheres.
A null lens moving back and forth relative to a point source can generate variable spherical aberration for flexible test of aspheres. Different from the previous methods, variable spherical aberration null theory was developed by us to optimize the null lens. The optimized null was a plano-convex singlet containing a high order even asphere. Its attractive advantages are the simple structure and the broad range of testable surfaces. Most concave prolate conic and near conic surfaces with k∙R value varying between 0 and about 70000mm and with smaller relative aperture than that determined by each k∙R value can be tested. The testable asphericity range is between 0 and about 230λ. Relations among these testable surfaces were revealed as different groups of equidistant surfaces. To explicitly show the ability of the null, the measurable surfaces range map that contains all parameters defining a conic surface was offered. A practical near-null test system using this null was established. Alignment, near-null data processing, and error sources are analyzed in detail. To verify the broad testable surfaces range, three surfaces with widely varying amounts of asphericity were tested. Cross tests were provided to verify the test system accuracy.


[Side effects of anticonvulsants in the treatment of idiopathic generalized epilepsy].
This investigation was ainced on detection of frequency and main features of side effects of anticonvulsants in therapy of idiopathic generalized epilepsy. There were observed 190 patients aged 5-29 years suffering from different forms of idiopathic generalized epilepsy. Side effects were revealed in 48.4% of patients as a result of the investigation. Almost half of patients (49.0%) who were administered valproic acid developed side effects. Neuroendocrine dysfunctions and digestive disturbances were the most frequent. Side effects were revealed within the first two months after administration of valproats. Only in 13.2% of cases the treatment and to be stopped at the expense of severeness of side effects. Barbiturates caused side effects in 39.6% of cases. Toxic damage of CNS was the most significant. Hyperkinetic syndrome with lack of attention was observed 37.9% of cases. Succinimides caused side effects in 37.9% of cases. Toxic damage of CNS was the most frequent--in 22.4% of cases, digestive disturbances was in 15.5% of cases. There are no really effective means for correction of above mentioned side effects.


Predicting body composition in college students using the womersley and durnin body mass index equation.
When assessing fitness levels, body composition is usually measured. The purpose of this study was to determine the overall efficacy of a body mass index (BMI) equation for predicting body composition with respect to college aged participants. Body composition was measured using dual-energy x-ray absorptiometry (DXA) and was estimated using the Womersley and Durnin BMI prediction equation. There was no significant (P=0.8) percent body fat (%BF) difference between the BMI prediction equation and DXA (BMI Predicted=25 (10) [min=6; max=52] %BF vs DXA=25 (6) [min=10; max=45] %BF). In addition, a significant correlation was found between the two approaches (r=0.791, P=0.001). However, both the standard error of estimate (6.32 %BF) and total error (6.63 %BF) were outside acceptable ranges for prediction equations. The Womersley and Durnin equation for estimating %BF was not found to be a good estimate. Therefore, although the BMI predicted %BF has been previously found to predict skinfold estimated %BF, it does not appear valid in estimating %BF from DXA.


Massive Dirac fermion on the surface of a magnetically doped topological insulator.
In addition to a bulk energy gap, topological insulators accommodate a conducting, linearly dispersed Dirac surface state. This state is predicted to become massive if time reversal symmetry is broken, and to become insulating if the Fermi energy is positioned inside both the surface and bulk gaps. We introduced magnetic dopants into the three-dimensional topological insulator dibismuth triselenide (Bi2Se3) to break the time reversal symmetry and further position the Fermi energy inside the gaps by simultaneous magnetic and charge doping. The resulting insulating massive Dirac fermion state, which we observed by angle-resolved photoemission, paves the way for studying a range of topological phenomena relevant to both condensed matter and particle physics.


Treating primary insomnia - the efficacy of valerian and hops.
To evaluate the efficacy of valerian and hops in the treatment of primary insomnia. The AMED and MEDLINE databases were searched for primary sources of literature published between 1950 and 2009, using keywords: herbal medicine, medicinal plants, herbal, Valeriana officinalis, valerian, Humulus lupulus, hops, sleep, insomnia. Studies were included if they evaluated the efficacy of valerian or hops in improving primary insomnia in adults: sixteen studies met the inclusion criteria. Twelve of these found that the use of valerian, on its own, or in combination with hops, is associated with improvements in some sleep parameters (eg. sleep latency and quality of sleep). However, these results need to be interpreted cautiously as there were significant differences in design between the studies. Further randomised, double blind, placebo controlled trials are needed before such herbal treatments can be confidently recommended for the treatment of primary insomnia.


Exploring the Value of BRD9 as a Biomarker, Therapeutic Target and Co-Target in Prostate Cancer.
Despite recent advances in advanced prostate cancer treatments, clinical biomarkers or treatments for men with such cancers are imperfect. Targeted therapies have shown promise, but there remain fewer actionable targets in prostate cancer than in other cancers. This work aims to characterise BRD9, currently understudied in prostate cancer, and investigate its co-expression with other genes to assess its potential as a biomarker and therapeutic target in human prostate cancer. Omics data from a total of 2053 prostate cancer patients across 11 independent datasets were accessed via Cancertool and cBioPortal. mRNA M.expression and co-expression, mutations, amplifications, and deletions were assessed with respect to key clinical parameters including survival, Gleason grade, stage, progression, and treatment. Network and pathway analysis was carried out using Genemania, and heatmaps were constructed using Morpheus. BRD9 is overexpressed in prostate cancer patients, especially those with metastatic disease. BRD9 expression did not differ in patients treated with second generation antiandrogens versus those who were not. BRD9 is co-expressed with many genes in the SWI/SNF and BET complexes, as well as those in common signalling pathways in prostate cancer. BRD9 has potential as a diagnostic and prognostic biomarker in prostate cancer. BRD9 also shows promise as a therapeutic target, particularly in advanced prostate cancer, and as a co-target alongside other genes in the SWI/SNF and BET complexes, and those in common prostate cancer signalling pathways. These promising results highlight the need for wider experimental inhibition and co-targeted inhibition of BRD9 in vitro and in vivo, to build on the limited inhibition data available.


Economic evaluation of an implementation strategy for the management of low back pain in general practice.
In connection with the publication of a clinical practice guideline on the management of low back pain (LBP) in general practice in Denmark, a cluster randomised controlled trial was conducted. In this trial, a multifaceted guideline implementation strategy to improve general practitioners' treatment of patients with LBP was compared with a usual implementation strategy. The aim was to determine whether the multifaceted strategy was cost effective, as compared with the usual implementation strategy. The economic evaluation was conducted as a cost-utility analysis where cost collected from a societal perspective and quality-adjusted life years were used as outcome measures. The analysis was conducted as a within-trial analysis with a 12-month time horizon consistent with the follow-up period of the clinical trial. To adjust for a priori selected covariates, generalised linear models with a gamma family were used to estimate incremental costs and quality-adjusted life years. Furthermore, both deterministic and probabilistic sensitivity analyses were conducted. Results showed that costs associated with primary health care were higher, whereas secondary health care costs were lower for the intervention group when compared with the control group. When adjusting for covariates, the intervention was less costly, and there was no significant difference in effect between the 2 groups. Sensitivity analyses showed that results were sensitive to uncertainty. In conclusion, the multifaceted implementation strategy was cost saving when compared with the usual strategy for implementing LBP clinical practice guidelines in general practice. Furthermore, there was no significant difference in effect, and the estimate was sensitive to uncertainty.


Ferroptosis-associated lncRNA prognostic signature predicts prognosis and immune response in laryngeal squamous carcinoma.
In order to construct a prognostic model of ferroptosis-related lncRNA associated with laryngeal carcinoma and to investigate its prognostic value, RNA sequencing, genomic mutation, and clinical data of laryngeal squamous carcinoma patients were collected from the TCGA database. Patients were randomly divided into train and test groups. Cox regression analysis and lasso regression analysis were performed on the data of patients in the training group, and their independent prognostic effect was validated in the test group and the whole cohort. Data from 123 laryngeal squamous carcinoma patients in the TCGA database were collected. According to previous literature, 484 ferroptosis-related genes were collected, and 912 ferroptosis-related lncRNAs were obtained by co-expression. Cox models suggested six lncRNAs involved in ferroptosis (AC083862.2, CYTOR, AC114296.1, LINC02768, GATA2-AS1, CTB-178M22.2). Patients were divided into high-risk and low-risk groups based on median risk scores. Kapkan-Meier survival curve results showed a statistical difference in survival between the high- and low-risk groups. Receiver operating characteristic curves and principal component analysis demonstrated the high accuracy of the model. Univariate and multifactorial Cox regression analyses and column plots demonstrated risk scores as independent prognostic factors. The distribution of prognostic marker risk scores was correlated with clinical staging. Immune infiltration studies suggested the model was associated with immune checkpoints and multiple immune functions. GATA2-AS1 was able to promote cell proliferation, cell migration, and cell invasion. This study identified six lncRNAs associated with ferroptosis in laryngeal squamous carcinoma as prognostic predictors, which may be promising biomarkers involved in the treatment of laryngeal squamous carcinoma.


Proteogenomic Analysis Provides Novel Insight into Genome Annotation and Nitrogen Metabolism in Nostoc sp. PCC 7120.
Cyanobacteria, capable of oxygenic photosynthesis, play a vital role in nitrogen and carbon cycles. Nostoc sp. PCC 7120 (Nostoc 7120) is a model cyanobacterium commonly used to study cell differentiation and nitrogen metabolism. Although its genome was released in 2002, a high-quality genome annotation remains unavailable for this model cyanobacterium. Therefore, in this study, we performed an in-depth proteogenomic analysis based on high-resolution mass spectrometry (MS) data to refine the genome annotation of Nostoc 7120. We unambiguously identified 5,519 predicted protein-coding genes and revealed 26 novel genes, 75 revised genes, and 27 different kinds of posttranslational modifications in Nostoc 7120. A subset of these novel proteins were further validated at both the mRNA and peptide levels. Functional analysis suggested that many newly annotated proteins may participate in nitrogen or cadmium/mercury metabolism in Nostoc 7120. Moreover, we constructed an updated Nostoc 7120 database based on our proteogenomic results and presented examples of how the updated database could be used to improve the annotation of proteomic data. Our study provides the most comprehensive annotation of the Nostoc 7120 genome thus far and will serve as a valuable resource for the study of nitrogen metabolism in Nostoc 7120. IMPORTANCE Cyanobacteria are a large group of prokaryotes capable of oxygenic photosynthesis and play a vital role in nitrogen and carbon cycles on Earth. Nostoc 7120 is a commonly used model cyanobacterium for studying cell differentiation and nitrogen metabolism. In this study, we presented the first comprehensive draft map of the Nostoc 7120 proteome and a wide range of posttranslational modifications. In addition, we constructed an updated database of Nostoc 7120 based on our proteogenomic results and presented examples of how the updated database could be used for system-level studies of Nostoc 7120. Our study provides the most comprehensive annotation of Nostoc 7120 genome and a valuable resource for the study of nitrogen metabolism in this model cyanobacterium.


Segmentation of bright targets using wavelets and adaptive thresholding.
A general systematic method for the detection and segmentation of bright targets is developed. We use the term "bright target" to mean a connected, cohesive object which has an average intensity distribution above that of the rest of the image. We develop an analytic model for the segmentation of targets, which uses a novel multiresolution analysis in concert with a Bayes classifier to identify the possible target areas. A method is developed which adaptively chooses thresholds to segment targets from background, by using a multiscale analysis of the image probability density function (PDF). A performance analysis based on a Gaussian distribution model is used to show that the obtained adaptive threshold is often close to the Bayes threshold. The method has proven robust even when the image distribution is unknown. Examples are presented to demonstrate the efficiency of the technique on a variety of targets.


Biological pacemakers: Concepts and techniques.
The sinoatrial (SA) node is the dominant pacemaker of the heart which initiates the process of impulse generation in the cardiac tissue, thereby defining the rate and rhythm of cardiac contraction. The automaticity of the conduction cells in the SA node is due to ion channels which are inter-linked by molecular, histological and electrophysiological mechanisms causing spontaneous diastolic depolarization and generation of an impulse. The SA nodal action potentials are then transmitted to the ventricles by electrical coupling of the myocytes in different areas of the heart. Regulatory pathways overseeing cardiac impulse generation and conduction provide effective and safe pacing, and help maintain the rate according to the physiological demands of the individual's body. Failure of physiological pacing due to any pathology in the SA or atrioventricular node necessitates implantation of a permanent pacemaker. Implantable pacemakers, despite technological advances, are not without practical limitations including a defined battery life leading to lead and/or generator replacement at periodic intervals, vascular complications, occasional component failure, electronic interference from external/ internal sources, e.g. myopotentials, electromechanical interference, etc., inadequate or incomplete physiological rate response to autonomic influences (devices have certain algorithms to address these issues) and most importantly the risk of infection. A biological pacemaker is therefore emerging as a promising technique to counter these challenges.


Cardiac subluxation in traumatic rupture of diaphragm and pericardium.
A patient is described with a traumatic rupture of diaphragm and pericardium which caused intermittent cardiac subluxation. Aspects of diagnosis and surgical treatment are discussed. A survey of the literature is given.


On 1/f noise and other distributions with long tails.
It is shown, following Shockley [Shockley, W. (1957) Proc. IRE 45, 279-290], that, when a population is engaged in tasks whose completion requires the successful conclusion of many independent subtasks, the distribution function for successes in the primary task is log normal. It is also shown that, when the dispersion of the log-normal distribution is large, the distribution is mimicked by a 1/x distribution over a wide range of x. This argument provides a generic set of processes that yields the much observed 1/x distribution, and will also lead to a 1/f noise spectrum. It is commonly found that distributions that seem to be log normal over a broad range (say to the 95th percentile of a population) change to an inverse fractional power (Pareto) distribution for the last few percentile. Annual income distributions are examples with this structure. The very wealthy generally achieve their superwealth through amplification processes that are not available to most. We have introduced a simple amplification model to characterize the transition from a log-normal distribution to an inverse-power Pareto tail.


Interaction of Co, Mn, Mg and Al with d(GCGTACGC): a spectroscopic study.
Spectroscopic study on the interactions of trace elements Co., Mn, Mg and Al with d(GCGTACGC) indicated the following: Al and Mg did not alter Tm values. Mn enhanced Tm at lower concentration and decreased it at higher concentrations. Interestingly Co at higher concentration elevated the Tm. These studies also showed lower concentrations of Mn displaced EtBr, whereas Al could displace it at higher ionic strength. Mg and Co displaced EtBr fluorescence at moderate concentrations. The binding constant values and CD spectra clearly indicated strong binding of these elements to DNA.


Study of Arcobacter spp. contamination in fresh lettuces detected by different cultural and molecular methods.
Arcobacters are considered potential emerging food and waterborne pathogens. However, there is no data on the presence of Arcobacter spp. in fresh vegetables. Therefore the objective of this research was to study the presence of Arcobacter spp. in fresh lettuces. Fifty fresh lettuces purchased from different local shops in Valencia (Spain) were analyzed. The assay was performed simultaneously by cultural and molecular methods. Isolates were identified by real-time, multiplex PCR and restriction fragment length polymorphism analysis of PCR-amplified DNA fragment (PCR-RFLP). Finally, all the isolates were genotyped using the randomly amplified polymorphic DNA (RAPD-PCR) method. Arcobacter sp. was detected in 10 of the 50 samples (20%) by real-time PCR, being A. butzleri the unique detected species by mPCR. The detection levels obtained by conventional PCR (7 samples/50, 14%) were slightly lower. These seven samples were found to be positive also by culture isolation. All 19 obtained isolates were identified as A. butzleri by multiplex PCR and PCR-RFLP. Great genetic heterogeneity among the isolates was observed by RAPD-PCR profiling. To our knowledge, this is the first study in which Arcobacter spp. is detected in fresh vegetables such as lettuces. Although these foods are generally considered safe, given the large quantities consumed and the fact that further cooking is absent, lettuce could be a source of Arcobacters of public health concern.


Microbiomes of the Enteropneust, Saccoglossus bromophenolosus, and Associated Marine Intertidal Sediments of Cod Cove, Maine.
Enteropneusts are widely distributed marine invertebrates that accumulate high concentrations of halogenated aromatics. Some of these compounds affect benthic biogeochemistery (e.g., denitrification and ammonia oxidation), but little is known about interactions between enteropneusts and their associated microbial communities. Even less is known about enteropneust host-microbe relationships in the digestive tract. More generally, microbial community composition and diversity in intertidal sediments have received little attention. In this study, high throughput sequence analyses of 16S rRNA genes extracted from microbial communities associated with sediment-free whole individuals of Saccoglossus bromophenolosus and freshly excreted S. bromophenolosus gut sediments revealed a potential Spirochaete symbiont that was abundant, present in gut sediment, but absent in other sediments. Relative to surface sediments, gut communities also revealed evidence for selective losses of some groups and blooms of others, especially Colwellia, Photobacterium, Pseudoalteromonas, and Vibrio. After deposition, gut sediment communities rapidly resembled those of surface sediments. Although hierarchical cluster analysis and Linear Discriminant Analysis Effect Size (LEfSe) differentiated among burrow walls of S. bromophenolosus and a polychaete, Alitta virens, as well as between surface and sub-surface sediments, most operational taxonomic units (OTUs) were shared, with differences largely occurring in relative abundances. This suggests that sediment mixing through bioturbation might act to homogenize community composition, while species-specific impacts by infauna might alter local population abundances. Although Cod Cove is a relatively isolated intertidal system, microbial community members included groups with cosmopolitan distributions and roles in sulfur cycling, e.g., Gammaproteobacteria BD7 and Sva0071, as well as novel OTUs representing a large number of phyla.


Five-step neck lift: integrating anatomy with clinical practice to optimize results.
A harmonious and youthful appearing neckline is arguably the most vital aspect of a successful facial rejuveation. Without sound principles, the neck appears skeletonized, tethered, and hollow. The anatomical studies that the authors have performed regarding the neck, jowl, and subplatysmal elements have influenced the techniques that they now use. The authors' approach modifies the classic techniques of the past, and seeks a nuanced approach to each patient by resuspension and reshaping of deeper neck elements. In this article, the authors apply their anatomical research and cadaveric studies to demonstrate and support their neck-lift techniques. The authors integrate their knowledge to describe how the technique of one of the senior authors (R.J.R.) has evolved over time. The main tenets of the authors' approach have evolved into a sequence that involves skin undermining over the neck and cheek, submental access to the neck, with possible excision of fat and midline plication of the platysma with release of the muscle inferiorly, platysmal window suspension laterally, precise release of the mandibular septum and ligament if needed, and finally redraping of the superficial musculoaponeurotic system (SMAS) by plication or SMASecomy. These five steps ensure correction of jowling, a smooth jawline, and a well-shaped neck. The five-step neck lift helps to optimize results in creating the ideal neck contour. The authors provide four points that should be considered in any neck-lift procedure. The end result is a well-defined, well-contoured neck, with an approach grounded in sound anatomical principles.


Evaluation of anxiety levels and their characteristics in dental care: Cross-sectional study.
Anxiety is defined as an emotion produced by a set of feelings and physical changes. Many patients are afraid of some procedures involved in dental therapy. The objective of this study was to verify the anxiety of patients regarding the visits to dental clinics of a higher education institution, as well as to observe the moment of greatest anxiety. It is a cross-sectional observational study including 94 patients from the dental clinics of an educational institution in a city of southern Brazil. The Corah Dental Anxiety Scale, composed of four questions, was used to evaluate the dental anxiety levels of all patients. The sample universe included registered patients under treatment in the clinics of the studied institution, from August to November of 2016. We included only healthy patients over 18-year old who were subjected to surgical and nonsurgical procedures. The data were analyzed through descriptive statistic to verify the frequency distribution of all variables. Pearson's Chi-square test, at 5% significance level and 95% confidence interval, was used to evaluate the association between the dependent variable (dental treatment anxiety) and the independent variables (demographics), aided by the SPSS software 20.0. Results: It was found that most of the participants were not anxious (69.1%) and the moment of greatest anxiety reported was before local anesthesia. In addition, statistics showed no correlation among gender, age group, and type of procedure performed. It was possible to conclude that the level of anxiety of the patients regarding the dental care performed in the clinics of the studied institution was low for both surgical and nonsurgical procedures. This survey revealed that the moment of greatest anxiety for the patients was before the anesthetic procedure, and gender, age, and type of procedure did not influence the level of anxiety felt by the patient.


Synthesis, structure and magnetic phase transitions of the manganese succinate hybrid framework, MN(C4H4O4).
An anhydrous manganese succinate, Mn(C(4)H(4)O(4)), has been synthesised hydrothermally and studied by single-crystal X-ray diffraction. It adopts a succinate pillared structure in which layers of corner-sharing MnO(6) octahedra alternate with sheets that contain chains of edge-sharing octahedra. This unique 3D framework structure contains highly distorted MnO(6) octahedra, which are made possible by the lack of ligand field stabilisation energy for the high-spin Mn(2+) ion. Attempts to dope the structure with other divalent transition-metal ions were accordingly unsuccessful. Magnetic susceptibility and heat capacity measurements indicate that Mn(C(4)H(4)O(4)) undergoes antiferromagnetic ordering below 12 K, with a second antiferromagnetic transition at approximately 6 K. These two antiferromagnetic phases undergo further transitions in applied fields, underlining the subtle magnetic behaviour that is possible in inorganic-organic frameworks of this structural complexity.