Delayed diagnosis of bronchobiliary fistula complicating a pediatric living donor liver transplantation: a case report.
Bronchobiliary fistula (BBF) is a very rare condition in children. Only a few pediatric BBF cases have been reported, in the context of a ruptured hydatid cyst or liver abscess. BBF after living donor liver transplantation (LDLT) has not been reported in the pediatric literature. We report a 7-year-old female child with Wilson disease, who developed BBF post-LDLT. She had a clinically uneventful course in the immediate post-transplant period. She was readmitted on postoperative day (POD) 75 with a productive cough and respiratory difficulty, which was diagnosed as bilioptysis secondary to BBF. Endoscopic retrograde cholangiopancreaticography was attempted but failed. Exploratory laparotomy showed a fistula from the strictured biliary anastomotic site to the right thoracic cavity; it was excised, and a Roux-en-Y hepaticojejunostomy was performed. She tolerated the procedure well and remained clinically well on follow-up through POD 185. BBF is extremely rare in children. This is the first case report of BBF in a child following LDLT. BBF requires a high index of suspicion for a timely intervention to prevent subsequent complications.


A gradient projection algorithm for relaxation methods.
We consider a particular problem which arises when apply-ing the method of gradient projection for solving constrained optimiza-tion and finite dimensional variational inequalities on the convex set formed by the convex hull of the standard basis unit vectors. The method is especially important for relaxation labeling techniques applied to problems in artificial intelligence. Zoutendijk's method for finding feasible directions, which is relatively complicated in general situations, yields a very simple finite algorithm for this problem. We present an extremely simple algorithm for performing the gradient projection and an independent verification of its correctness.


Identification of wortmannin-sensitive targets in 3T3-L1 adipocytes. DissociationoOf insulin-stimulated glucose uptake and glut4 translocation.
The current studies investigated the contribution of phosphatidylinositol 3-kinase (PI3-kinase) isoforms to insulin-stimulated glucose uptake and glucose transporter 4 (GLUT4) translocation. Experiments involving the microinjection of antibodies specific for the p110 catalytic subunit of class I PI3-kinases demonstrated an absolute requirement for this form of the enzyme in GLUT4 translocation. This finding was confirmed by the demonstration that the PI3-kinase antagonist wortmannin inhibits GLUT4 and insulin-responsive aminopeptidase translocation with a dose response identical to that required to inhibit another class I PI3-kinase-dependent event, activation of pp70 S6-kinase. Interestingly, wortmannin inhibited insulin-stimulated glucose uptake at much lower doses, suggesting the existence of a second, higher affinity target of the drug. Subsequent removal of wortmannin from the media shifted this dose-response curve to one resembling that for GLUT4 translocation and pp70 S6-kinase. This is consistent with the lower affinity target being p110, which is irreversibly inhibited by wortmannin. Wortmannin did not reduce glucose uptake in cells stably expressing Myr-Akt, which constitutively induced GLUT4 translocation to the plasma membrane; this demonstrates that wortmannin does not inhibit the transporters directly. In addition to elucidating a second wortmannin-sensitive pathway in 3T3-L1 adipocytes, these studies suggest that the presence of GLUT4 on the plasma membrane is not sufficient for activation of glucose uptake.


The unity assumption facilitates cross-modal binding of musical, non-speech stimuli: The role of spectral and amplitude envelope cues.
An observer's inference that multimodal signals originate from a common underlying source facilitates cross-modal binding. This 'unity assumption' causes asynchronous auditory and visual speech streams to seem simultaneous (Vatakis & Spence, Perception & Psychophysics, 69(5), 744-756, 2007). Subsequent tests of non-speech stimuli such as musical and impact events found no evidence for the unity assumption, suggesting the effect is speech-specific (Vatakis & Spence, Acta Psychologica, 127(1), 12-23, 2008). However, the role of amplitude envelope (the changes in energy of a sound over time) was not previously appreciated within this paradigm. Here, we explore whether previous findings suggesting speech-specificity of the unity assumption were confounded by similarities in the amplitude envelopes of the contrasted auditory stimuli. Experiment 1 used natural events with clearly differentiated envelopes: single notes played on either a cello (bowing motion) or marimba (striking motion). Participants performed an un-speeded temporal order judgments task; viewing audio-visually matched (e.g., marimba auditory with marimba video) and mismatched (e.g., cello auditory with marimba video) versions of stimuli at various stimulus onset asynchronies, and were required to indicate which modality was presented first. As predicted, participants were less sensitive to temporal order in matched conditions, demonstrating that the unity assumption can facilitate the perception of synchrony outside of speech stimuli. Results from Experiments 2 and 3 revealed that when spectral information was removed from the original auditory stimuli, amplitude envelope alone could not facilitate the influence of audiovisual unity. We propose that both amplitude envelope and spectral acoustic cues affect the percept of audiovisual unity, working in concert to help an observer determine when to integrate across modalities.


Chemical Composition and Biological Activities of Allium roseum L. var. grandiflorum Briq. Essential Oil.
Allium roseum L. (Alliaceae) endemic mediterranean specie was represented in the North Africa by 12 different taxa. In the present study, chemical composition, antiproliferative, antioxidant and antimicrobial activities of the essential oil extracted from A. roseum var. grandiflorum Briq. bulbs collected in the North of Tunisia were investigated. Chemical characterization has shown methyl methanethiosulfinate as major sulphurous compounds. A. roseum bulbs essential oil provides interesting antiproliferative activity against two human colonic adenocarcinoma HT29 and CACO2 cell lines in dose-dependent manner with a half-maximal inhibition (IC50) of 4.64 µg/mL and 8.22 µg/mL respectively. The antioxidant activity, as determined by FRAP assay, was 285 µmol equivalent Trolox/g of essential oil. The scavenging effect on DPPH radicals of essential oil was estimated as IC50 values at 156 µg/mL. The inhibition of superoxide anion production in a model of cancer cell lines was significant for both lines HT29 and CACO2 with IC50 of 20.25 µg/mL and 29.12 µg/mL respectively. Allium roseum essential oil exhibited antibacterial and antifungal activities with a high effectiveness against Candida albicans given by an MIC value of 0.019 mg/mL. This biological effect appears to be related mainly to the presence of organosulfur compounds.


A comparison of the requirements for primary care physicians in HMOs with projections made by the GMENAC.
We compared staffing patterns in primary care specialties in three large health maintenance organizations (HMOs) with the national requirements for physicians in 1990 projected by the Graduate Medical Education National Advisory Committee (GMENAC). The HMOs varied in their use of nonphysician providers, family practice specialists, and subspecialists in internal medicine. Nevertheless, projections based on the average experience of these HMOs suggest that 20 percent fewer primary care physicians for children and 50 percent fewer primary care physicians for adults will be needed to meet national primary care needs in 1990 than projected by the GMENAC. As enrollment in HMOs continues to grow, their impact on national requirements for medical personnel will increase. The variety of staffing patterns found among HMOs operating in highly competitive markets suggests the importance of considering alternative configurations for meeting national requirements for primary care.


Independent COL17A1 Variants in Cats with Junctional Epidermolysis Bullosa.
Epidermolysis bullosa (EB), characterized by defective adhesion of the epidermis to the dermis, is a heterogeneous disease with many subtypes in human patients and domestic animals. We investigated two unrelated cats with recurring erosions and ulcers on ear pinnae, oral mucosa, and paw pads that were suggestive of EB. Histopathology confirmed the diagnosis of EB in both cats. Case 1 was severe and had to be euthanized at 5 months of age. Case 2 had a milder course and was alive at 11 years of age at the time of writing. Whole genome sequencing of both affected cats revealed independent homozygous variants in COL17A1 encoding the collagen type XVII alpha 1 chain. Loss of function variants in COL17A1 lead to junctional epidermolysis bullosa (JEB) in human patients. The identified splice site variant in case 1, c.3019+1del, was predicted to lead to a complete deficiency in collagen type XVII. Case 2 had a splice region variant, c.769+5G>A. Assessment of the functional impact of this variant on the transcript level demonstrated partial aberrant splicing with residual expression of wildtype transcript. Thus, the molecular analyses provided a plausible explanation of the difference in clinical severity between the two cases and allowed the refinement of the diagnosis in the affected cats to JEB. This study highlights the complexity of EB in animals and contributes to a better understanding of the genotype-phenotype correlation in COL17A1-related JEB.


Bicyclic α-Iminophosphonates as High Affinity Imidazoline I2 Receptor Ligands for Alzheimer's Disease.
Imidazoline I2 receptors (I2-IR), widely distributed in the CNS and altered in patients that suffer from neurodegenerative disorders, are orphans from a structural point of view, and new I2-IR ligands are urgently required for improving their pharmacological characterization. We report the synthesis and three-dimensional quantitative structure-activity relationship (3D-QSAR) studies of a new family of bicyclic α-iminophosphonates endowed with relevant affinities for human brain I2-IR. Acute treatment in mice with a selected compound significantly decreased Fas-associated protein with death domain (FADD) in the hippocampus, a key signaling mediator of neuroprotective actions. Additionally, in vivo studies in the familial Alzheimer's disease 5xFAD murine model revealed beneficial effects in behavior and cognition. These results are supported by changes in molecular pathways related to cognitive decline and Alzheimer's disease. Therefore, bicyclic α-iminophosphonates are tools that may open new therapeutic avenues for I2-IR, particularly for unmet neurodegenerative conditions.


Increased cancer risk in a cohort of 230 patients with hereditary hemochromatosis in comparison to matched control patients with non-iron-related chronic liver disease.
It has been suggested that excess iron may facilitate the occurrence of cancer. Patients with hereditary hemochromatosis (HH) are at high risk of developing liver cancer, and studies of limited series reported a high frequency of nonhepatic cancers. To verify whether patients with HH are at higher risk of liver cancer and other malignancies as compared with patients with non-iron-related chronic liver disease (CLD), we analyzed the occurrence of neoplasms in 230 patients with HH and 230 with non-iron-related CLD. The patients were matched by sex, age, duration of follow-up (+/-5 years), and severity of liver disease. On enrollment, the following variables were considered: hepatitis B virus (HBV) and hepatitis C virus (HCV) infections, alcohol abuse, smoking, and a family history of cancer (first-degree relatives). The diagnosis of primary cancers was confirmed by histology. During the follow-up, hepatocellular carcinoma (HCC) developed in 49 and 29 patients (all cirrhotic patients) with HH and non-iron-related CLD, respectively, with a relative risk of 1.8 (95% confidence interval [CI] 1.1-2.9); nonhepatic cancers occurred in 20 and 11 patients, respectively, with a relative risk of 1.8 (95% CI 0.8-4). Four patients with HH and 1 with non-iron-related CLD developed 2 different primary cancers during follow-up. The risk of cancer after adjustment for alcohol abuse, smoking, and family history of cancer was 1.9 (95% CI 1.1-3.1) in the patients with HH. In conclusion, patients with HH are at high risk of both liver cancer and other malignancies, which should be carefully sought during follow-up.


Endoscopic identification of Peyer's patches of the terminal ileum in a patient with Crohn's disease.
We presented a 20-year-old patient with Crohn's disease (CD). Colonoscopy revealed longitudinal ulceration in the terminal ileum and rectal aphtoid ulcers. After treatment with mesalamine and total parenteral nutrition, repeat colonoscopy revealed a granular elevated area in the terminal ileum, which appeared as an irregular dome-like elevation with irregularly arranged villi on magnifying endoscopy. Biopsy specimens taken from the region showed microgranulomas and lymphoid hyperplasia. Scanning electron microscopy revealed the presence of M cells, confirming that the area corresponded to Peyer's patches. Peyer's patches by magnifying endoscopy and electron microscopy may provide insights into the pathogenesis of CD.


Acute appendicits in pregnancy.
Acute appendicitis in pregnancy and its treatment are reviewed. Six cases are described. Early surgery is recommended, and a conservative watchfulness for more than 4 to 6 hours is condemned.


Chronic insulin effects on insulin signalling and GLUT4 endocytosis are reversed by metformin.
Decreases in insulin-responsive glucose transport and associated levels of cell surface GLUT4 occur in rat adipocytes maintained in culture for 20 h under hyperinsulinaemic and hyperglycaemic conditions. We have investigated whether this defect is due to reduced signalling from the insulin receptor, GLUT4 expression or impaired GLUT4 trafficking. The effects of chronic insulin treatment on glucose transport and GLUT4 trafficking were ameliorated by inclusion of metformin in the culture medium. In comparison with the ic insulin treatment attenuated changes in signalling processes leading to glucose transport. These included insulin receptor tyrosine phosphorylation, phosphoinositide 3-kinase activity and Akt activity, which were all reduced by 60-70%. Inclusion of metformin in the culture medium prevented the effects of the chronic insulin treatment on these signalling processes. In comparison with cells maintained in culture without insulin, the total expression of GLUT4 protein was not significantly altered by chronic insulin treatment, although the level of GLUT1 expression was increased. Trafficking rate constants for wortmannin-induced cell-surface loss of GLUT4 and GLUT1 were assessed by 2-N-4-(1-azi-2, 2,2-trifluoroethyl)benzoyl-1,3-bis(D-mannose-4-yloxy)-2-propyla min e (ATB-BMPA) photolabelling. In comparison with cells acutely treated with insulin, chronic insulin treatment resulted in a doubling of the rate constants for GLUT4 endocytosis. These results suggest that the GLUT4 endocytosis process is very sensitive to the perturbations in signalling that occur under hyperinsulinaemic and hyperglycaemic conditions, and that the resulting elevation of endocytosis accounts for the reduced levels of net GLUT4 translocation observed.


Sequence-dependent conformational sampling using a database of phi(i)+1 and psi(i) angles for predicting polypeptide backbone conformations.
A method to sample the conformational space of polypeptides in a sequence-dependent manner was developed and applied to predict backbone conformations of polypeptides. The method uses a database of phi(i)+1 and psi(i) angles sorted into pools corresponding to 400 dimers of naturally occurring amino acids. The pools of phi(i)+1 and psi(i) angles for dimers were further dynamically divided into sub-pools based on the homology of two amino acids on either side of the dimer. Typically, 10000 backbone conformations for every overlapping hexamer of a polypeptide are generated by randomly assigning a set of phi(i)+1 and psi(i) angles for every dimer from the sorted sub-pool for that dimer. The conformational preference for each hexamer is evaluated by superimposing each simulated conformation on a set of pre-selected hexameric templates which are derived from high-resolution crystal structures representing helical, extended and turn conformations. A model is classified as compatible with a template if it has a backbone root mean square deviation of < or = 1 A to that template. The template that has the highest population of compatible models for a given hexamer is interpreted as the most probable conformation of that hexamer. The method was applied to predict backbone conformations that arise primarily from local interactions and the predictions were compared with experimental results. Results from simulations on structurally characterized polypeptides in helical, extended, turn and mixed alphabeta conformations are presented to demonstrate the predictive powers of the method. It is also demonstrated how models of overlapping hexamers can be assembled to obtain near-native models for the entire sequence.


Decreased bone mineral density and increased fracture risk in aging men with or at risk for HIV infection.
Osteopenia has been described in HIV-infected persons, but most studies have not focused on aging men, have not included an HIV-negative comparison group with similar risks to those of the HIV-infected men, or lacked data on fracture rates. We analyzed bone mineral density (BMD) and incident fractures in 559 men who were >or= 49 years old with or at-risk for HIV, including 328 with and 231 without HIV infection. Median age was 55 years, 56% were black and 89% had used illicit drugs. In unadjusted analysis, BMD was lower in HIV-infected compared with HIV-uninfected men at the femoral neck (0.97 +/- 0.14 versus 1.00 +/- 0.15 g/cm; P < 0.05) and lumbar spine (1.17 +/- 0.20 versus 1.20 +/- 0.21 g/cm; P = 0.06); both differences were significant (P < 0.05) after adjusting for age, weight, race, testosterone level, and prednisone and illicit drug use. Non-black race and body weight were independently associated with BMD at both measurement sites and methadone therapy was independently associated with spine BMD. Among HIV-infected men, 87% had taken antiretrovirals and 74% had taken protease inhibitors, but their use was not associated with BMD. Among men who had at least one subsequent study visit (94%), incident fracture rates per 100 person-years differed among men with normal BMD, osteopenia and osteoporosis (1.4 versus 3.6 versus 6.5; P < 0.01). A 38% increase in fracture rate among HIV-infected men was not statistically significant. HIV infection is independently associated with modestly reduced BMD in aging men, and decreased BMD is associated with increased fracture risk.


Sense of coherence (SOC) and styles of coping with stress in women after premature delivery.
The aim of the study was to assess the psychological condition of women after premature delivery, especially 1) the types of problems and negative emotional reactions associated with premature delivery, 2) ways of coping with difficult situation associated with premature delivery, and 3) the relationship between a sense of coherence and applied strategies for coping. The study was conducted on 33 women after premature delivery (study group) and 102 women after full-term delivery (control group) hospitalized at the Department of Obstetrics and Perinatology, Skubiszewski Medical University of Lublin. The study revealed that the mothers of premature infants experienced different problems and more negative emotions than mothers of full-term infants. There were substantial differences in strategies for coping with stress applied by both groups. Women who had had premature deliveries applied emotional strategies more often than task-oriented strategies and strategies aimed at avoidance. There was a relationship between sense of coherence and its components and the emotional strategies for coping in both groups. Psychological care given to women after a premature delivery should be concentrated much more on recognizing and reinforcing mechanisms stimulating adaptation to the difficult situation which poses a threat to infant's health. The important aspects of such care are actions which reinforce the parents' sense of competence in childcare, acquiescence to parents' participation in taking decisions, and full and communicative information about the infant's health.


Child compliance/noncompliance and maternal contributors to internalization in maltreating and nonmaltreating dyads.
Moral development in maltreated and nonmaltreated children was examined by coding child compliance and noncompliance behaviors in a mother-child interaction during a cleanup situation that followed a semistructured free play. Features of child compliance/noncompliance involve a shift from reliance on external controls to internal mechanisms, thereby reflecting child internalization of the maternal agenda. Differences in maltreating versus comparison mothers' use of control strategies (power-assertive and inductive techniques) and their relations to child internalization were examined. Eighty-nine mother-child dyads participated; approximately half of the children (n = 46) had documented histories of maltreatment and the remaining children (n = 43) were nonmaltreated, demographically similar comparison children. Maltreated children were divided into two subgroups: physically abused and neglected. Compared with nonmaltreated children, abused children were found to exhibit less internalization, whereas neglected children displayed significantly more negative affect. No differences were found between groups for the maternal control strategies. However, maltreated and nonmaltreated groups differed in the maternal variables that predicted child internalization. A lower level of maternal negative affect was linked to child internalization in maltreated children, whereas a lower level of maternal joy predicted internalization for the comparison children. The findings suggest that maltreated children exhibit both behavioral and affective differences in their moral development, with differential effects based on the type of maltreatment. The clinical implications for maltreated children's self and moral development are discussed.


Preventive health care for women in Croatia: ongoing trends from 1995 to 2012.
The privatization of gynecological services and the introduction of additional reimbursements to capitation fees are ongoing mini reforms in Croatia. In order to evaluate the outcomes of this, study was performed with the main aim of determining trends in preventive activities carried out in public and private gynecological practices from 1995 to 2012. The Croatian Health Service Yearbooks served as the basis for data collection. Data were collected on the number of general check-ups, the number of targeted check-ups, and the number of follow-up check-ups. The results indicate a trend of continuous decline in the number of general and follow-up check-ups, as well as breast examinations and Pap smears, in public gynecological practices even after the introduction of contractual obligations and additional reimbursements and fee-for-service payments. One important note is that many resources were invested in general checks-up interventions, which proved to be ineffective, while fewer resources were invested in the more effective Pap smear interventions.


Competition between chiral solvents and chiral monomers in the helical bias of supramolecular polymers.
Solute-solvent interactions are key for the assembly and proper functioning of biomacromolecules and play important roles in many fields of organic and polymer chemistry. Despite numerous reports describing the effects of (chiral) solvents on helical conformations of (supramolecular) polymers, the combination of chiral solvents and chiral monomers is unexplored. Here we report diastereomeric differences in the supramolecular polymerization of enantiomers of chiral triphenylene-2,6,10-tricarboxamides in chiral chlorinated solvents. Competition between the preferences induced by the stereocentres of the assembled monomers and those present in the solvent molecules results in unforeseen temperature-dependent solvation effects. By combining experiments and mathematical modelling, we show that the observed differences between enantiomers originate from the combined additive entropic effects of stereocentres present in the monomer and in the solvent. Remarkably, copolymerizations show that the chiral solvent can bias the copolymer helicity and thereby overrule the helical preference of the monomers. Our results highlight the importance of cumulative solvation effects in supramolecular polymerizations.


Serum uric acid level and endothelial dysfunction in patients with nondiabetic chronic kidney disease.
An elevated serum uric acid level is strongly associated with endothelial dysfunction and inflammation, both of which are common in chronic kidney disease (CKD). We hypothesized that endothelial dysfunction in subjects with CKD would correlate with uric acid levels. We evaluated the association between serum uric acid level and ultrasonographic flow-mediated dilatation (FMD) in 263 of 486 patients with recently diagnosed CKD (stage 3-5) (48% male, age 52 ± 12 years). To minimize confounding, 233 patients were excluded because they were diabetic, had established cardiovascular complications or were taking drugs (renin-angiotensin system blockers, statins) interfering with vascular function. Serum uric acid level was significantly increased in all stages of CKD and strongly correlated with estimated glomerular filtration rate (eGFR-MDRD); FMD was inversely associated with serum uric acid (r = -0.49, p < 0.001). The association of serum uric acid with FMD remained after adjustment for age, gender, smoking, LDL cholesterol, eGFR, high-sensitivity C-reactive protein, systolic blood pressure, proteinuria, and homeostatic model assessment index (β = -0.27, p < 0.001). Increased serum uric acid is an independent predictor of endothelial dysfunction in subjects with CKD.


Omnidirectional whispering-gallery-mode lasing in GaN microdisk obtained by selective area growth on sapphire substrate.
The optical properties of hexagonal GaN microdisk arrays grown on sapphire substrates by selective area growth (SAG) technique were investigated both experimentally and theoretically. Whispering-gallery-mode (WGM) lasing is observed from various directions of the GaN pyramids collected at room temperature, with the dominant lasing mode being Transverse-Electric (TE) polarized. A relaxation of compressive strain in the lateral overgrown region of the GaN microdisk is illustrated by photoluminescence (PL) mapping and Raman spectroscopy. A strong correlation between the crystalline quality and lasing behavior of the GaN microdisks was also demonstrated.


Studies on the antigenic properties of complement. II. Analysis of specific agglutinins against certain components of guinea pig complement fixed on sensitized sheep erythrocytes.
Sheep erythrocytes sensitized with amboceptor and persensitized thereafter with guinea pig complement are agglutinated by rabbit anti-guinea pig globulin and by immune sera obtained by injection of rabbits with fixed complement. In this agglutination neither C'1 nor C'2 takes part. Fixed C'4 acts as an agglutinogen. An additional agglutinogen, distinct from C'4, was found on persensitized cells. This additional agglutinogen appears to be distinct from hemolytically active C'3.


Highly coplanar very long oligo(alkylfuran)s: a conjugated system with specific head-to-head defect.
Well-defined monodisperse conjugated oligomers, which have planar backbones and are free from the disturbance of substituents, attract broad interest. Herein, we report a series of symmetrical, isomerically pure oligofurans, namely, the 16-mer 16F-6C6 together with the related nF-2C6 (n = 4, 6, 8). Through computational studies and detailed spectroscopic and X-ray characterization, for the first time, we show that the planarity of the furan backbone is almost unaffected by the head-to-head defect which is known to cause considerable twists in its oligo- or polythiophene analogues. We present that the properties of these rigid oligo(alkylfuran)s are strongly influenced by the conjugation length. As the longest monodisperse α-oligofuran synthesized to date, 16F-6C6 was observed to be stable and highly fluorescent. Experimental and computational studies of the redox states of these oligo(alkylfuran)s reveal that 16F-6C6 has singlet biradical (polaron-pair) character in the doubly oxidized ground state: the open-shell singlet (⟨S2⟩ = 0.989) is 3.8 kcal/mol more stable than the closed-shell dication.


Aerobiology over the Southern Ocean - Implications for bacterial colonization of Antarctica.
Parts of the Antarctic are experiencing dramatic ecosystem change due to rapid and record warming, which may weaken biogeographic boundaries and modify dispersal barriers, increasing the risk of biological invasions. In this study, we collected air samples from 100 locations around the Southern Ocean to analyze bacterial biodiversity in the circumpolar air around the Antarctic continent, as understanding dispersal processes is paramount to assessing the risks of microbiological invasions. We also compared the Southern Ocean air bacterial biodiversity to non-polar ecosystems to identify the potential origin of these Southern Ocean air microorganisms. The bacterial diversity in the air had both local and global origins and presented low richness overall but high heterogeneity, compatible with a scenario whereby samples are composed of a suite of different species in very low relative abundances. Only 4% of Amplicon Sequence Variants (ASVs) were identified in both polar and non-polar air masses, suggesting that the polar air mass over the Southern Ocean can act as a selective dispersal filter. Furthermore, both microbial diversity and community structure both varied significantly with meteorological data, suggesting that regional bacterial biodiversity could be sensitive to changes in weather conditions, potentially altering the existing pattern of microbial deposition in the Antarctic.


Emergency treatment of athletic injuries.
Dental-related injuries continue to occur in high incidence in sporting events. Many of these injuries are preventable although the use of protective mouthguards remains sparce unless the rules of a particular sport explicitly dictate use during participation. Thus many athletes sustain dental-related injuries resulting in deformity and discomfort which may persist throughout their lives. Acute management of these injuries often determines the extent to which the dental disability is recoverable. It is essential that those health care professionals working directly with the athletes during competition reinforce the importance of protection and prevention as well as refine the skills necessary for immediate management of the injuries. Guidelines for management of dental injuries should be established by the team dental consultant and should be reviewed continually by team athletic trainers and team physicians. Often the primary care professional will determine the fate and ultimate recovery from the variety of dental injuries encountered regularly in sports.


100 or 30 years after Janeway or Bartter, Healthwatch helps avoid 'flying blind'.
Longitudinal records of blood pressure (BP) and heart rate (HR) around the clock for days, weeks, months, years, and even decades obtained by manual self-measurements (during waking) and/or automatically by ambulatory monitoring reveal, in addition to well-known large within-day variation, also considerable day-to-day variability in most people, whether normotensive or hypertensive. As a first step, the circadian rhythm is considered along with gender differences and changes as a function of age to derive time-specified reference values (chronodesms), while reference values accumulate to also account for the circaseptan variation. Chronodesms serve for the interpretation of single measurements and of circadian and other rhythm parameters. Refined diagnoses can thus be obtained, namely MESOR-hypertension when the chronome-adjusted mean value (MESOR) of BP is above the upper limit of acceptability, excessive pulse pressure (EPP) when the difference in MESOR between the systolic (S) and diastolic (D) BP is too large, CHAT (circadian hyper-amplitude tension) when the circadian BP amplitude is excessive, DHRV (decreased heart rate variability) when the standard deviation (SD) of HR is below the acceptable range, and/or ecphasia when the overall high values recurring each day occur at an odd time (a condition also contributing to the risk associated with 'non-dipping'). A non-parametric approach consisting of a computer comparison of the subject's profile with the time-varying limits of acceptability further serves as a guide to optimize the efficacy of any needed treatment by timing its administration (chronotherapy) and selecting a treatment schedule best suited to normalize abnormal patterns in BP and/or HR. The merit of the proposed chronobiological approach to BP screening, diagnosis and therapy (chronotheranostics) is assessed in the light of outcome studies. Elevated risk associated with abnormal patterns of BP and/or HR variability, even when most if not all measurements lie within the range of acceptable values, becomes amenable to treatment as a critical step toward prevention (prehabilitation) to reduce the need for rehabilitation (the latter often after costly surgical intervention).


Phenotypic integration and the evolution of signal repertoires: A case study of treefrog acoustic communication.
Animal signals are inherently complex phenotypes with many interacting parts combining to elicit responses from receivers. The pattern of interrelationships between signal components reflects the extent to which each component is expressed, and responds to selection, either in concert with or independently of others. Furthermore, many species have complex repertoires consisting of multiple signal types used in different contexts, and common morphological and physiological constraints may result in interrelationships extending across the multiple signals in species' repertoires. The evolutionary significance of interrelationships between signal traits can be explored within the framework of phenotypic integration, which offers a suite of quantitative techniques to characterize complex phenotypes. In particular, these techniques allow for the assessment of modularity and integration, which describe, respectively, the extent to which sets of traits covary either independently or jointly. Although signal and repertoire complexity are thought to be major drivers of diversification and social evolution, few studies have explicitly measured the phenotypic integration of signals to investigate the evolution of diverse communication systems. We applied methods from phenotypic integration studies to quantify integration in the two primary vocalization types (advertisement and aggressive calls) in the treefrogs Hyla versicolor, Hyla cinerea, and Dendropsophus ebraccatus. We recorded male calls and calculated standardized phenotypic variance-covariance (P) matrices for characteristics within and across call types. We found significant integration across call types, but the strength of integration varied by species and corresponded with the acoustic similarity of the call types within each species. H. versicolor had the most modular advertisement and aggressive calls and the least acoustically similar call types. Additionally, P was robust to changing social competition levels in H. versicolor. Our findings suggest new directions in animal communication research in which the complex relationships among the traits of multiple signals are a key consideration for understanding signal evolution.


Perfusion CT assessment of the colon and rectum: feasibility of quantification of bowel wall perfusion and vascularization.
The aim was to determine the feasibility of vascular quantification of the bowel wall for different anatomical segments of the colorectum. Following institutional ethical approval and informed consent, 39 patients with colorectal cancer underwent perfusion CT. Blood flow (BF), blood volume (BV), mean transit time (MTT), and permeability surface area product (PS) were assessed for different segments of the colorectum: ascending, transverse, descending colon, sigmoid, or rectum, that were distant from the tumor, and which were proven normal on contemporary colonoscopy, and subsequent imaging and clinical follow up. Mean (SD) for BF, BV, MTT and PS for the different anatomical colorectal segments were obtained and compared using a pooled t-test. Significance was at 5%. Assessment was not possible in 9 of 39 (23%) patients as the bowel wall was ≤ 5 mm precluding quantitative analysis. Forty-four segments were evaluated in the remaining 30 patients. Mean BF was higher in the proximal than distal colon: 24.0 versus 17.8 mL/min/100g tissue; p=0.009; BV, MTT and PS were not significantly different; BV: 3.46 versus 3.15 mL/100g tissue, p=0.45; MTT: 15.1 versus 18.3s; p=0.10; PS: 6.84 versus 8.97 mL/min/100 tissue, p=0.13, respectively. In conclusion, assessment of bowel wall perfusion may fail in 23% of patients. The colorectum demonstrates segmental differences in perfusion.


FedLGAN: a method for anomaly detection and repair of hydrological telemetry data based on federated learning.
The existing data repair methods primarily focus on addressing missing data issues by utilizing variational autoencoders to learn the underlying distribution and generate content that represents the missing parts, thus achieving data repair. However, this method is only applicable to data missing problems and cannot identify abnormal data. Additionally, as data privacy concerns continue to gain public attention, it poses a challenge to traditional methods. This article proposes a generative adversarial network (GAN) model based on the federated learning framework and a long short-term memory network, namely the FedLGAN model, to achieve anomaly detection and repair of hydrological telemetry data. In this model, the discriminator in the GAN structure is employed for anomaly detection, while the generator is utilized for abnormal data repair. Furthermore, to capture the temporal features of the original data, a bidirectional long short-term memory network with an attention mechanism is embedded into the GAN. The federated learning framework avoids privacy leakage of hydrological telemetry data during the training process. Experimental results based on four real hydrological telemetry devices demonstrate that the FedLGAN model can achieve anomaly detection and repair while preserving privacy.


Pathological hepatic accumulation of long-chain n-alkanes ("paraffin liver") in cows (Harbitz and Fölling, 1940). An overlooked discovery. Description of lesions and identification of alkanes.
About 50 years ago crystalline deposits of a substance representing approximately 7 per cent wet tissue weight and believed to be hentriacontane or a mixture of similar long-chain n-alkanes (30-34 carbon atoms) were detected in two discoloured and swollen cow livers. Stored purified extracts from these livers were recently reanalysed using gas chromatography and mass spectrometry. They were found to contain about equal amounts of nonacosane and hentriacontane with a small admixture of tritriacontane and other long carbon-chain alkanes. On the basis of histological findings, five additional cases of "paraffin liver" in cows have been recorded. In the discussion comparison is made with the only known case of a similar disorder in a human, visceral accumulation of the same three alkanes as in the cows, which was recently described in the literature. Concerning the origin of the deposits, importance is given to the fact that the long-chain alkanes with odd carbon numbers identified both in cattle and man predominate in the cuticular waxes of many dietary plants. The very large quantities of the abnormal substance in the cow livers indicate low toxicity, and evidently accumulation over long periods of time.


The Three Mile Island Population Registry.
Shortly after the March 28, 1979, accident at the Three Mile Island (TMI) nuclear plant outside Harrisburg, Pa., the Pennsylvania Department of Health, in conjunction with the Centers for Disease Control and the U.S. Bureau of the Census, conducted a census of the 35,930 persons residing within 5 miles of the plant. With the help of 150 enumerators, demographic and health-related information was collected on each person to provide baseline data for future short- and long-term epidemiologic studies of the effects of the accident. Individual radiation doses were estimated on the basis of residential location and the amount of time each person spent in the 5-mile area during the 10 days after the accident. Health and behavioral resurveys of the population will be conducted approximately every 5 years. Population-mobility, morbidity, and mortality will be studied yearly by matching the TMI Population Registry with postal records, cancer registry records, and death certificate data. Because the radiation dose from TMI was extremely small, any increase in morbidity or mortality attributable to the accident would be so small as not to be measurable by present methods; however, adverse health effects as a result of psychological stress may occur. Also, a temporary increase in reporting of disease could occur because of increased surveillance and attention to health.


A Pilot Observational Exploratory Study of Well-Being in Hospice Interdisciplinary Team Members.
Well-being and turnover intent represent key aspects to the promotion of a healthy workforce. Alarming levels of burnout and low levels of well-being have been documented in health professionals across care settings. Not only do high levels of burnout, low well-being and high turnover affect health professionals, but they are associated with poor patient care. However, limited research has investigated this topic specifically in hospice interdisciplinary team (IDT) members, nurses, chaplains, social workers. Thus, the purpose of this study was to explore hospice IDT members' well-being, and turnover intent. This observational, pilot study used quantitative surveys to examine the well-being, and turnover intention at baseline and at 3 months. Twenty-five hospice IDT members at one site participated. Paired t-tests and percent change demonstrated significant decreases in compassion satisfaction (44.5 vs. 42.1, p = 0.04) and secondary traumatic stress score (18.5 vs. 13.3, p = 0.0001) and a significant increase in burnout score (17.6 vs. 20.5, p = 0.03) from baseline to follow up. Employee turnover slightly decreased from baseline to follow-up. In this pilot study, hospice IDT members had low levels of well-being at baseline that worsened over 3-months indicating a higher potential risk for burnout. Moreover, given the COVID-19 pandemic, this may be an ominous sign of what lies ahead for hospice providers regarding turnover, leading to significant long-term staffing problems in the field. If these results hold true in a larger sample, it could necessitate developing and testing further strategies to ensure a healthy and stable workforce.


Simple Preoperative Ink Test as a Novel Adjunct to Intrastromal Keratopigmentation for Post-laser Peripheral Iridotomy Dysphotopsias.
To describe a simple preoperative ink test as a novel adjunct to intrastromal keratopigmentation for post-laser peripheral iridotomy (LPI) dysphotopsias. A surgical marking pen is applied to the area over a peripheral iridotomy before intrastromal keratopigmentation. The patient can then assess whether there is any improvement in their symptoms of dysphotopsias. Manual intrastromal keratopigmentation can then be performed using a crescent blade into the clear cornea at 50% depth and tunneled centrally to create a pocket ensuring that the peripheral iridotomy is fully occluded. The crescent blade is coated with an alcohol-based commercially available black tattoo pigment, and the pocket is filled. We have used the preoperative ink marker test on 5 eyes in patients with post-LPI (4 temporal and 1 superior) dysphotopsias before performing intrastromal keratopigmentation, with good patient satisfaction. Patients report immediate symptomatic relief after the procedure. This ink marking technique can also be extended to help identify which iris defect is symptomatic in patients with multiple iris defects. The preoperative ink test before intrastromal keratopigmentation is a novel adjunct to the treatment of post-LPI dysphotopsias.


Biomechanical Stress in Obturator Prostheses: A Systematic Review of Finite Element Studies.
This systematic review is aimed at investigating the biomechanical stress that develops in the maxillofacial prostheses (MFP) and supporting structures and methods to optimize it. Design and Methods. A literature survey was conducted for full-text English articles which used FEA to examine the stress developed in conventional and implant-assisted MFPs from January 2010 to December 2020. 87 articles were screened to get an update on the desired information. 74 were excluded based on a complete screening, and finally, 13 articles were recruited for complete reviewing. Discussion. The MFP is subjected to stress, which is reflected in the form of compressive and tensile strengths. The stress is mainly concentrated the resection line and around the apices of roots of teeth next to the defect. Diversity of designs and techniques were introduced to optimize the stress distribution, such as modification of the clasp design, using materials with different mechanical properties for dentures base and retainer, use of dental (DI) and/or zygomatic implants (ZI), and free flap reconstruction before prosthetic rehabilitation. Using ZI in the defective side of the dentulous maxillary defect and defective and nondefective side of the edentulous maxillary defect was found more advantageous, in terms of compression and tensile stress and retention, when compared with DI and free flap reconstruction.


Narcissism in Political Participation.
Much attention has focused on the social, institutional, and mobilization factors that influence political participation, with a renewed interest in psychological motivations. One trait that has a deep theoretical connection to participation, but remains underexplored, is narcissism. Relying on three studies in the United States and Denmark, two nationally representative, we find that those scoring higher in narcissism, as measured by the Narcissistic Personality Inventory-40 (NPI-40), participate more in politics, including contacting politicians, signing petitions, joining demonstrations, donating money, and voting in midterm elections. Both agentic and antagonistic components of narcissism were positively and negatively related to different types of political participation when exploring the subfactors independently. Superiority and Authority/Leadership were positively related to participation, while Self Sufficiency was negatively related to participation. In addition, the combined Entitlement/Exploitativeness factor was negatively related to turnout, but only in midterm elections. Overall, the findings support a view of participation that arises in part from instrumental motivations.


miR-200c-3p spreads invasive capacity in human oral squamous cell carcinoma microenvironment.
Oral squamous cell carcinoma (OSCC) constitutes over 90% of all cancers in the oral cavity. The prognosis for patients with invasive OSCC is poor; therefore, it is important to understand the molecular mechanisms of invasion and subsequent metastasis not only to prevent cancer progression but also to detect new therapeutic targets against OSCC. Recently, extracellular vesicles-particularly exosomes-have been recognized as intercellular communicators in the tumor microenvironment. As exosomic cargo, deregulated microRNAs (miRNAs) can shape the surrounding microenvironment in a cancer-dependent manner. Previous studies have shown inconsistent results regarding miR-200c-3p expression levels in OSCC cell lines, tissues, or serum-likely because of the heterogeneous characters of the specimen materials. For this reason, single-cell clone analyses are necessary to effectively assess the role of exosome-derived miRNAs on cells within the tumor microenvironment. The present study utilized integrated microarray profiling to compare exosome-derived miRNA and exosome-treated cell-derived mRNA expression. Data were acquired from noninvasive SQUU-A and highly invasive SQUU-B tongue cancer cell clones derived from a single patient to determine candidate miRNAs that promote OSCC invasion. Matrigel invasion assays confirmed that hsa-miR-200c-3p was a key pro-invasion factor among six miRNA candidates. Consistently, silencing of the miR-200c-3p targets, CHD9 and WRN, significantly accelerated the invasive potential of SQUU-A cells. Thus, our data indicate that miR-200c-3p in exosomes derived from a highly invasive OSCC line can induce a similar phenotype in non-invasive counterparts.


Education attainment as a predictor of HIV risk in rural Uganda: results from a population-based study.
We examined the association between education and prevalent HIV-1 infection in the Rakai district, rural Uganda based on a cross-sectional analysis of a population-based cohort. In 1990, 1397 men and 1705 women aged 13 years and older, were enrolled in 31 randomly selected communities. Strata were comprised of main road trading centres, secondary road trading villages and rural villages. Sociodemographic and behavioural data were obtained by interview and serum for HIV serostatus were obtained in the home. The analysis examines the association between sex-specific prevalent HIV infection and educational attainment, categorized as secondary, primary or none. The odds ratios (ORs) and 95% confidence intervals (95% CIs) of HIV infection were estimated, using no education as the referent group. Higher levels of education were associated with a higher HIV seroprevalence in bivariate analyses (OR 2.7 for primary and 4.1 for secondary education, relative to no education). The strength of the association was diminished but remained statistically significant after multivariate adjustment for sociodemographic and behavioural variables (adjusted OR of HIV infection 1.6 (95% CI: 1.2-2.1)) for primary education and 1.5 (95% CI: 1.0-2.2) for secondary education. Stratified multivariate analyses by place of residence indicated that the association between education and HIV prevalence was statistically significant in the rural villages, but not in the main road trading centres and intermediate trading villages. Educational attainment is a significant predictor of HIV risk in rural Uganda, in part because of risk behaviours and other characteristics among better educated individuals. Preventive interventions need to focus on better educated adults and on school-aged populations.


Control of multiple impulse-initiation sites in a leech interneuron.
1. Several heart interneurons (HN cells) of the leech nerve cord have impulse-initiation sites in every segmental ganglion through which their single axons pass. All these initiation sites are capable of producing rhythmic impulse bursts. However, under normal conditions a dominant primary initiation site in the ganglion where the cell body is located suppresses the activity of the other secondary sites. 2. Hyperpolarization of the primary initiation site by injected current permits immediate expression of rhythmic activity by a secondary site, usually the one located in the next posterior ganglion. 3. The free-running impulse burst rhythm of the primary site is stronger than that of the secondary site, having a greater burst duration and a tendency toward a higher burst frequency. 4. Bursts of primary-site impulses intercalated into the secondary-site impulse burst rhythm have a twofold effect. First, early to midway through the secondary-site's burst cycle, they phase delay its impulse burst rhythm. Second, early in the secondary-site's burst cycle, they tend to suppress ongoing impulse bursts, and late in the secondary-site's burst cycle, they tend to suppress the next expected impulse burst. The amount of burst suppression seen early and late in the secondary-site burst cycle depends on the burst duration and intraburst impulse frequency of the intercalated burst. 5. The ability of a train of primary-site impulse bursts to completely suppress secondary-site activity depends on burst duration, intraburst impulse frequency, and burst period. 6. Primary-site impulse trains with burst parameters close to those of naturally occurring primary-site bursts completely suppress secondary-site activity. 7. These results are consistent with the notion that the primary-site impulse burst rhythm of an HN cell suppresses the activity of its secondary site because, cycle by cycle, it delays and/or suppresses the next secondary-site burst so that no secondary-site bursts are produced. Dominance of the primary site over the secondary site is ensured by virtue of the primary-site's stronger impulse burst rhythm.


The foot-surface interaction and its impact on musculoskeletal adaptation and injury risk in the horse.
The equine limb has evolved for efficient locomotion and high-speed performance, with adaptations of bone, tendon and muscle. However, the system lacks the ability seen in some species to dynamically adapt to different circumstances. The mechanical interaction of the limb and the ground is influenced by internal and external factors including fore-hind mass distribution, lead limb, moving on a curve, shoeing and surface properties. It is unclear which of the components of limb loading have the largest effect on injury and performance but peak load, impact and vibration all play a role. Factors related to the foot-ground interface that limit performance are poorly understood. Peak performance varies vastly between disciplines but at high speeds such as racing and polo, force and grip are key limits to performance.


[Test with 0.1g L-DOPA in clinical neuroses and neurosis-like states].
Effect of a test with administration of 0.1 g L-DOPA, reflecting the synthetic processes in sympathoadrenal system and its reactivity, on dynamics of catecholamine and DOPA excretion with urine was studied in patients with neuroses and neurosis-like states, namely, in women with climacteric syndrome, in men with sexual deteriorations, in patients with general neuroses and in patients with initial manifestations of brain circulation insufficiency. Evaluation of various specific types of sympathoadrenal system responses to the L-DOPA administration as compared with healthy persons as well as evaluation of the response types characteristic for individual syndromes, improved the diagnostics of neuroses. The test with 0.1 g DOPA permitted also to estimate the efficiency of treatment as well as to design the most specialized treatment of the patients.


Effects of changes in osmolality on the stability and function of cultured chromaffin cells and the possible role of osmotic forces in exocytosis.
Recent evidence indicates that osmotic forces may play a role in exocytosis. To examine this possibility and to investigate the osmotic properties of storage granules within cells, we investigated the effects of changes of osmolality on stability and function of cultured bovine chromaffin cells. Cell volume measurements indicated that the cells behaved as osmometers and that the intracellular osmolality rapidly equilibrated with the osmolality of the extracellular medium. Hyperosmotic solutions strongly inhibited nicotinic agonist-stimulated secretion but did not alter nicotinic agonist-stimulated Ca(2+) uptake. Hyperosmotic solutions also strongly inhibited elevated potassium- stimulated secretion but only weakly inhibited elevated K(+)-stimulated Ca(2+) uptake. Thus, hyperosmotic solutions inhibited secretion at a step after calcium entry. Cells exposed to 165 mOs(1) solutions did not lyse and retained their capacity to store and secrete catecholamine upon stimulation. Significant intracellular lysis of chromaffin granules occurred within cells exposed to lower osmolalities. In contrast, 75 percent of the catecholamine was released from granules from cultured cells or from fresh adrenal medulla incubated in vitro at 210 mOs. The data provide evidence for a role for osmotic forces in exocytosis and suggest that if osmotic stress of the granule occurs during exocytosis, then water influx into chromaffin granules increases granule volume by at least 70 percent. The results also indicate that the osmotic properties of the granules are altered upon homogenization and subcellular fractionation of the cells.


[Clinical characteristics associated with unfavorable outcomes in peripartum myocardiopathy].
To assess the clinical characteristics of women with a previous diagnosis of peripartum myocardiopathy and to study the characteristics associated with unfavorable outcomes. Clinical, obstetric, and echocardiographic variables were studied in 12 patients with peripartum myocardiopathy, assessed at diagnosis and at a current appointment, when they were divided into 2 groups: FG (n = 6, without cardiac alterations) and UG (n = 6, with cardiomegaly and persistent ventricular dysfunction). The comparisons were made using the Student t test and Fisher's exact test (P < 0.05). At diagnosis, mean age of the patients (8 Caucasian and 4 black/non-Caucasian) was 24+/-7.4 years, all in Functional Class IV (NYHA) and 8 reporting gestational hypertension or preeclampsia. Mean follow-up time was 25 months. Ten patients developed Functional Class I/II. Comparison between the groups demonstrated that UG had lower left ventricular ejection fractions (0.30+/-0.05 vs. 0.58+/-0.09; P < 0.001) and greater LV systolic diameter (58+/-5 mm vs. 46+/-3 mm; P < 0.001) at diagnosis. An unfavorable outcome was more frequent among non-Caucasian women (P = 0.01). In the current evaluation, UG had lower relative wall thickness (0.13+/-0.02 vs. 0.17+/-0.02; P < 0.05) and greater LV mass (283+/-90 g vs. 186+/-41 g; P < 0.05). Patients with previous peripartum myocardiopathy had unfavorable outcomes associated with black race, and stronger initial cardiac alterations; a favorable outcome was associated with a reduction in myocardial mass and an increase in relative ventricular wall thickness.


Large-scale model of mammalian thalamocortical systems.
The understanding of the structural and dynamic complexity of mammalian brains is greatly facilitated by computer simulations. We present here a detailed large-scale thalamocortical model based on experimental measures in several mammalian species. The model spans three anatomical scales. (i) It is based on global (white-matter) thalamocortical anatomy obtained by means of diffusion tensor imaging (DTI) of a human brain. (ii) It includes multiple thalamic nuclei and six-layered cortical microcircuitry based on in vitro labeling and three-dimensional reconstruction of single neurons of cat visual cortex. (iii) It has 22 basic types of neurons with appropriate laminar distribution of their branching dendritic trees. The model simulates one million multicompartmental spiking neurons calibrated to reproduce known types of responses recorded in vitro in rats. It has almost half a billion synapses with appropriate receptor kinetics, short-term plasticity, and long-term dendritic spike-timing-dependent synaptic plasticity (dendritic STDP). The model exhibits behavioral regimes of normal brain activity that were not explicitly built-in but emerged spontaneously as the result of interactions among anatomical and dynamic processes. We describe spontaneous activity, sensitivity to changes in individual neurons, emergence of waves and rhythms, and functional connectivity on different scales.


[Survival after motor vehicle crash: impact of clinical and prehospital variables].
To assess clinical and prehospital variables associated with survival of motor vehicle crash victims. Study carried out in the city of São Paulo (Southeastern Brazil), from 1999 to 2003. Data from 175 patients, who were aged between 12 and 65 years and had been motor vehicle crash victims, were analyzed. Kaplan-Meier Survival Analysis was used to approach the results at the accident scene with victims scoring <11, according to the Revised Trauma Score. Variables analyzed were: sex, age, injury mechanisms, basic and advanced support procedures, Revised Trauma Score parameters and fluctuations, time elapsed in the prehospital phase and trauma severity according to the Injury Severity Score and Maximum Abbreviated Injury Scale. Analysis revealed that victims who were less likely to survive during the hospitalization period showed serious lesions in the abdomen, thorax, or lower limbs, with negative fluctuation of respiratory frequency and Revised Trauma Score in the prehospital phase. In addition, they needed specialized interventions or thoracic compressions. Brain lesions were associated with late death. Recognition of variables involved in the survival of motor vehicle crash victims may help to determine protocols and to make decisions in order to perform pre- and in-hospital interventions and, consequently, maximize survival.


Caregiving expectations and challenges among elders and their adult children in Southern Sri Lanka.
The elderly population in Sri Lanka is growing rapidly. Elders are traditionally cared for in the homes of their adult children, but the shifting socio-economic environment in Sri Lanka challenges this arrangement. This paper describes the dynamics of elder-caregiver relationships in Southern Sri Lanka. Data included 4 focus group discussions and 5 in-depth interviews with elderly, and 10 in-depth interviews with adult children of the elderly. Discussion guide topics included caregiving arrangements, and roles/responsibilities of elders and caregivers. Using a grounded theory approach, a comprehensive analytic memo was developed and discussed to explore emerging themes on the caregiver dynamic. Both elders and caregivers felt that elders should be taken care of in the home by their children. They pointed to a sense of duty and role modeling of parental caregiving that is passed down through generations. Even as elders desired support from their children, they feared losing their independence, and saw financial autonomy as important for maintaining relationship balance. Caregiving challenges included: households where both the adult child and his/her spouse worked outside the home; households where elders had a disproportionate amount of household work; economically stressed households; and lack of direct communication between elders and caregivers regarding conflicts. Results point to strong values around caring for elderly in the home, but identify challenges to this arrangement in the future.


Cooperative elastic switching vs. laser heating in [Fe(phen)2(NCS)2] spin-crossover crystals excited by a laser pulse.
Spin-crossover crystals show multi-step responses to femtosecond light excitation. The local molecular photo-switching from low to high spin states occurs on sub-picosecond timescale. It is followed by additional conversion due to elastic (ns) and thermal (μs) effects. In [Fe(phen)2(NCS)2] crystals discussed herein, the thermal switching can be made unobtrusive for the investigation of cooperative elastic switching. We evidence a cooperative transformation induced by lattice expansion through elastic coupling between molecules in the crystal, where up to 3 molecules are transformed per photon.


Differential brain mechanisms during reading human vs. machine translated fiction and news texts.
Few neuroimaigng studies on reading comprehension have been conducted under natural reading settings. In this study, we showed texts presented in a natural way during functional MRI (fMRI) measurements to reveal brain areas sensitive to reading comprehension. Specifically, this paradigm independently manipulated two holistic features of article style: text genre and translation style, a qualitative index of how typical word choices and arrangements are made in daily use of the language. Specifically, articles from The New York Times (news) and Reader's Digest (fiction) translated from English to Mandarin Chinese either by human experts or machine (Google Translate) were used to investigate the correlation of brain activity across participants during article reading. We found that bi-hemispheric visual cortex, precuneus, and occipito-parietal junction show significantly correlated hemodynamics across participants regardless of translation style and article genre. Compared to machine translation, reading human expert translation elicited more reliable fMRI signals across participants at precuneus, potentially because narrative representations and contents can be coherently presented over tens of seconds. We also found significantly stronger inter-subject correlated fMRI signals at temporal poles and fusiform gyri in fiction reading than in news reading. This may be attributed to more stable empathy processing across participants in fiction reading. The degree of stability of brain responses across subjects at extra-linguistic areas was found correlated with subjective rating on the text fluency. The functional connectivity between these areas was modulated by text genre and translation style. Taken together, our imaging results suggested stable and selective neural substrates associated with comprehending holistic features of written narratives.


Histamine release in vivo by pentagastrin from the canine stomach.
The effect of intragastric arterial infusion of pentagastrin on gastric histamine release was evaluated in mongrel dogs in vivo. Histamine secretory rates were evaluated by measuring the arterial and gastric venous plasma histamine concentrations at 0, 5, 10, 15 and 20 min into pentagastrin infusions, and gastric blood flow was continuously monitored. Histamine secretory rates were calculated by subtracting the arterial from the venous histamine concentrations and multiplying the difference by gastric plasma flow. Two separate 20-min infusions of pentagastrin, separated by 60 min, resulted in a peak of histamine release in 5 to 10 min that returned to base line within 20 min. During the first infusion, histamine release peaked at 179 ng/min, whereas, during the second infusion, histamine peaked at 125 ng/ml. The increase in gastric blood flow to pentagastrin correlated with the increases in histamine release. Somatostatin infused into the gastric artery to attain a concentration of 10 nM, a concentration that results in the inhibition of gastric acid secretion, abolished the gastric histamine release to pentagastrin. In addition, somatostatin also attenuated the gastric vasodilation to pentagastrin. Our data indicate that, in the in vivo dog model, pentagastrin can cause a pulsed release of gastric histamine, and somatostatin inhibits this release of histamine.


Reliability of electrophysiologic anal tests in predicting the outcome of sacral nerve modulation for fecal incontinence.
Sacral nerve modulation has been demonstrated to be a new efficacious treatment for fecal incontinence. The effectiveness of the procedure is preliminarily tested by means of a peripheral nerve evaluation. Integrity of the sacral neural pathway is generally believed to be a necessary condition for a good response, but no data are available to confirm whether electrophysiologic anal tests are predictive of the clinical outcome of the peripheral nerve evaluation. Eighty-two incontinent patients underwent the peripheral nerve evaluation after full evaluation of the anorectal physiology. Univariate analysis was performed, and the positive predictive value, sensitivity, and specificity were calculated for each of the tests. Forty-six patients had successful results to the peripheral nerve evaluation and were subjected to permanent implant of a sacral electrostimulator. Anal sphincter electromyography had been performed in 60 patients, whereas pudendal nerve terminal motor latency had been assessed in 68 and evoked sacral potentials in 29 patients. Anal electromyography was statistically related to the outcome of the peripheral nerve evaluation ( P = 0.0004) with a positive predictive value of 81 percent, a sensitivity of 44 percent, and a specificity of 81 percent. Pudendal nerve terminal motor latency on the right side did not correlate with the outcome, but left pudendal nerve terminal motor latency was weakly correlated ( P = 0.02), although both tests had a low positive predicting value and sensitivity vs. good specificity. Evoked sacral potentials did not correlate with the outcome and had a low positive predictive value, sensitivity, and specificity. Simple anal sphincter electromyography can predict the outcome of the peripheral nerve evaluation with good positive predictive value and specificity in patients with fecal incontinence. Other, more expensive, electrophysiologic anal tests do not add further prognostic information.


Comparative diagnostic utility of 1H MRS and DWI in evaluation of temporal lobe epilepsy.
To compare the ability of diffusion-weighted MRI (DWI) and (1)H MRS to lateralize to the temporal lobe of seizure onset and to predict postoperative seizure control in patients with temporal lobe epilepsy (TLE). Forty TLE patients who subsequently underwent epilepsy surgery and 20 normal subjects were studied with (1)H MRS and DWI. Medial parietal and temporal lobe N-acetylaspartate (NAA)/creatine (Cr) ratios and hippocampal and temporal stem apparent diffusion coefficients (ADC) were obtained. Lateralization to either temporal lobe with each MR measurement was based on the threshold values derived from +/-1-SD right/left ratios of normal subjects. Temporal lobe NAA/Cr lateralized to the operated temporal lobe in 18 of 40 (45%), hippocampal ADC in 32 of 40 (80%), and temporal stem ADC in 26 of 40 (65%) patients. Almost all of the cases that lateralized to the surgical side with NAA/Cr ratios (94%) had an excellent postoperative seizure control (p = 0.01). Lateralization to the side of surgery was not associated with surgical outcome with hippocampal and temporal stem ADC (p > 0.05). (1)H MRS and DWI complement each other in the clinical setting. DWI more frequently lateralized to the operated side, and (1)HMRS was a better predictor of postoperative seizure control.


Physiologic effects and plasma kinetics of phenylethanolamine and its N-methyl homolog in the dog.
Single i.v. doses of the endogenous trace amine phenylethanolamine (PEOH) and its N-methyl homolog (NMPEOH) were administered to separate groups of five dogs. The dose- and time-related effects of these compounds were measured on pupillary diameter, heart rate and body temperature. Blood samples were obtained concurrently with the physiologic measures and plasma levels of PEOH and NMPEOH were determined by gas chromatography. Both compounds dilated pupils, decreased heart rate and tended to lower body temperature. NMPEOH was approximately 1.25 times more potent than PEOH in dilating pupils. The plasma pharmacokinetics of both PEOH and NMPEOH could be described by a biexponential function with half-lives for the elimination phase of approximately 30 to 60 min. Plasma levels correlated significantly with increases in pupil diameter for both drugs, but only plasma levels of NMPEOH correlated significantly with changes in heart rate or body temperature. The present findings demonstrate that the endogenous trace amine PEOH and its N-methyl homolog NMPEOH, which may be produced endogenously by the enzymatic action of phenylethanolamine-N-methyl-transferase, produce prominent physiologic effects when administered i.v. in the dog, thus suggesting they may have physiologic roles in mammalian nervous system function.


Dance therapy for schizophrenia.
Dance therapy or dance movement therapy (DMT) is defined as 'the psychotherapeutic use of movement as a process which furthers the emotional, social, cognitive, and physical integration of the individual'. It may be of value for people with developmental, medical, social, physical or psychological impairments. Dance therapy can be practiced in mental health rehabilitation units, nursing homes, day care centres and incorporated into disease prevention and health promotion programmes. To evaluate the effects of dance therapy for people with schizophrenia or schizophrenia-like illnesses compared with standard care and other interventions. We updated the original July 2007 search of the Cochrane Schizophrenia Group' register in July 2012. We also searched Chinese main medical databases. We included one randomised controlled trial (RCT) comparing dance therapy and related approaches with standard care or other psychosocial interventions for people with schizophrenia. We reliably selected, quality assessed and extracted data. For continuous outcomes, we calculated a mean difference (MD); for binary outcomes we calculated a fixed-effect risk ratio (RR) and their 95% confidence intervals (CI). We created a 'Summary of findings' table using the GRADE approach. We included one single blind study (total n = 45) of reasonable quality. It compared dance therapy plus routine care with routine care alone. Most people tolerated the treatment package but nearly 40% were lost in both groups by four months (1 RCT n = 45, RR 0.68 95% CI 0.31 to 1.51, low quality evidence). The Positive and Negative Syndrome Scale (PANSS) average endpoint total scores were similar in both groups (1 RCT n = 43, MD -0.50 95% CI -11.80 to 10.80, moderate quality evidence) as were the positive sub-scores (1 RCT n = 43, MD 2.50 CI -0.67 to 5.67, moderate quality evidence). At the end of treatment, significantly more people in the dance therapy group had a greater than 20% reduction in PANSS negative symptom score (1 RCT n = 45, RR 0.62 CI 0.39 to 0.97, moderate quality evidence), and overall, average negative endpoint scores were lower (1 RCT n = 43, MD -4.40 CI -8.15 to -0.65, moderate quality evidence). There was no difference in satisfaction score (average Client's Assessment of Treatment Scale (CAT) score, 1 RCT n = 42, MD 0.40 CI -0.78 to 1.58, moderate quality evidence) and quality of life data were also equivocal (average Manchester Short Assessment of Quality of life (MANSA) score, 1 RCT n = 39, MD 0.00 CI -0.48 to 0.48, moderate quality evidence). Based on predominantly moderate quality data, there is no evidence to support - or refute - the use of dance therapy in this group of people. This therapy remains unproven and those with schizophrenia, their carers, trialists and funders of research may wish to encourage future work to increase high quality evidence in this area.


Blockade of NaV1.8 Increases the Susceptibility to Ventricular Arrhythmias During Acute Myocardial Infarction.
SCN10A/NaV1.8 may be associated with a lower risk of ventricular fibrillation in the setting of acute myocardial infarction (AMI), but if and by which mechanism NaV1.8 impacts on ventricular electrophysiology is still a matter of debate. The purpose of this study was to elucidate the contribution of NaV1.8 in ganglionated plexi (GP) to ventricular arrhythmias in the AMI model. Twenty beagles were randomized to either the A-803467 group (n = 10) or the control group (n = 10). NaV1.8 blocker (A-803467, 1 μmol/0.5 mL per GP) or DMSO (0.5 mL per GP) was injected into four major GPs. Ventricular effective refractory period, APD90, ventricular fibrillation threshold, and the incidence of ventricular arrhythmias were measured 1 h after left anterior descending coronary artery occlusion. A-803467 significantly shortened ventricular effective refractory period, APD90, and ventricular fibrillation threshold compared to control. In the A-803467 group, the incidence of ventricular arrhythmias was significantly higher compared to control. A-803467 suppressed the slowing of heart rate response to high-frequency electrical stimulation of the anterior right GP, suggesting that A-803467 could inhibit GP activity. SCN10A/NaV1.8 was readily detected in GPs, but was not validated in ventricles by quantitative RT-PCR, western blot and immunohistochemistry. While SCN10A/NaV1.8 is detectible in canine GPs but not in ventricles, blockade of NaV1.8 in GP increases the incidence of ventricular arrhythmias in AMI hearts. Our study shows for the first time an influence of SCN10A/NaV1.8 on the regulation of ventricular arrhythmogenesis via modulating GP activity in the AMI model.


Early specialized palliative care for patients with metastatic lung cancer receiving chemotherapy: a feasibility study of a nurse-led screening-triggered programme.
Strategies to implement early specialized palliative care have not yet been established. The present study investigated the feasibility of a nurse-led, screening-triggered early specialized palliative care intervention programme and obtained data to design a randomized controlled trial. Patients with metastatic lung cancer undergoing first-line platinum-based chemotherapy were eligible. The intervention consisted of (1) a questionnaire-based screening programme and (2) advanced-level nurse counselling and care coordination with interdisciplinary team approach. The primary endpoint was the completion rate of the assessment questionnaire after the second course of first-line chemotherapy (T2). Secondary endpoints included changes in Functional Assessment of Cancer Therapy-Lung scores, depression and anxiety rates based on the Patient Health Questionnaire 9 and the Hospital Anxiety and Depression Scale, and the contents of specialized palliative care. A total of 50 patients were enrolled between August 2012 and March 2014. Median age was 66 years (range, 40-78 year) and 84% were male. A total of 38 patients had stage IV non-small cell lung carcinoma and 12 had extensive disease small-cell lung carcinoma. The completion rate was 70% (95% confidence interval 56.0-81.0). The median duration between baseline and T2 was 53 days. Improvement from baseline were observed at T2 in Functional Assessment of Cancer Therapy-Lung scores (86.0 ± 18.1 vs 94.9 ± 18.2, P = 0.057), depression (16.0 vs 5.7%; P = 0.26) and anxiety (32.0 vs 22.9%; P = 0.65); however, these results were not statistically significant. This early specialized palliative care intervention is feasible and could be useful in improving patients' quality of life. The present results justify the initiation of a randomized control trial.


Anti-malarial effect of gum arabic.
Gum Arabic (GA), a nonabsorbable nutrient from the exudate of Acacia senegal, exerts a powerful immunomodulatory effect on dendritic cells, antigen-presenting cells involved in the initiation of both innate and adaptive immunity. On the other hand GA degradation delivers short chain fatty acids, which in turn have been shown to foster the expression of foetal haemoglobin in erythrocytes. Increased levels of erythrocyte foetal haemoglobin are known to impede the intraerythrocytic growth of Plasmodium and thus confer some protection against malaria. The present study tested whether gum arabic may influence the clinical course of malaria. Human erythrocytes were in vitro infected with Plasmodium falciparum in the absence and presence of butyrate and mice were in vivo infected with Plasmodium berghei ANKA by injecting parasitized murine erythrocytes (1 × 10⁶) intraperitoneally. Half of the mice received gum arabic (10% in drinking water starting 10 days before the day of infection). According to the in vitro experiments butyrate significantly blunted parasitaemia only at concentrations much higher (3 mM) than those encountered in vivo following GA ingestion (<1 μM). According to the in vivo experiments the administration of gum arabic slightly but significantly decreased the parasitaemia and significantly extended the life span of infected mice. GA moderately influences the parasitaemia and survival of Plasmodium-infected mice. The underlying mechanism remained, however, elusive. Gum arabic favourably influences the course of murine malaria.


[Concepts of placental hormonology].
During pregnancy, different protein (hCG and hPL) and steroid (progesterone, oestradiol, oestrone, oestriol) hormones are secreted. hCG, measured by RIA in maternal serum, is a first-trimester trophoblastic function test. The serum levels of hPL reveal the placental function during the two last trimesters of gestation. The main steroid hormones, produced by the foeto-placental unit, are progesterone, oestradiol and oestrone, which control placental function, and oestriol, a good index of foetal vitality.


Comparison of multiple vaccine vectors in a single heterologous prime-boost trial.
The prevention of infectious disease via prophylactic immunization is a mainstay of global public health efforts. Vaccine design would be facilitated by a better understanding of the type and durability of immune responses generated by different vaccine vectors. We report here the results of a comparative immunogenicity trial of six different vaccine vectors expressing the same insert antigen, cowpox virus B5 (CPXV-B5). Of those vectors tested, recombinant adenovirus (rAd5) was the most immunogenic, inducing the highest titer anti-B5 antibodies and conferring protection from sublethal vaccinia virus challenge in mice after a single immunization. We tested select heterologous prime-boost combinations and identified recombinant vesicular stomatitis virus (rVSV) and recombinant Venezuelan equine encephalitis virus replicons (VRP) as the most synergistic regimen. Comparative data such as those presented here are critical to efforts to generate protective vaccines for emerging infectious diseases as well as for biothreat agents.


[Detection and management of the neurologic dysphagia].
Neurologic dysphagia is frequent and has consequences which can be severe, such as, denutrition andpneumonia. In most cases, it can be detected with a clinical exam. The management includes some general measures, an adaptation of textures, specific rehabilitation, and nutritional assessment to judge whether complementary enteral nutrition is needed.


Using open-source data to explore distribution of built environment characteristics across Kerala, India.
Built environment characteristics in the neighborhood are of utmost priority for a healthy lifestyle in the fast-urbanizing countries. These characteristics are closely linked to the disease burden and challenges in low- and middle-income countries (LMICs), which have been unexplored using open-source data. The present technology offers online resources and open source software that enable researchers to explore built environment characteristics with health and allied phenomena. This article intends to delineate methods to capture available and accessible objective built environment variables for a state in India and determine their distribution across the state. Built environment variables such as population density and residential density were collated from the Census of India. Safety from crime and traffic were captured as crime rates and pedestrian accident rates, respectively, acquired from State Crime Records Bureau. Greenness, built-up density, and land slope were gathered from open-source satellite imagery repository. Road intersection density was derived from OpenStreetMap. Processing and analysis differed for each dataset depending on its source and nature. Each variable showed a distinct pattern across the state. Population and residential density were found to be closely related to each other across both districts and subdistricts. They were both positively related to crime rates, pedestrian accident rates, built-up density, and intersection density, whereas negatively related to land slope and greenness across the subdistricts. Delineating the distribution of built environment variables using available and open-source data in resource-poor settings is a first in public health research among LMICs. Cost-effectiveness and reproducible nature of open-source solutions could equip researchers in resource-poor settings to identify built environment characteristics and patterns across regions.


Comparing short-term complex and compound training programs on vertical jump height and power output.
The purpose of this study was to determine whether there were differences in vertical jump height and lower body power production gains between complex and compound training programs. A secondary purpose was to determine whether differences in gains were observed at a faster rate between complex and compound training programs. Thirty-one college-aged club volleyball players (11 men and 20 women) were assigned into either a complex training group or a compound training group based on gender and pre-training performance measures. Both groups trained twice per week for 4 weeks. Work was equated between the 2 groups. Complex training alternated between resistance and plyometric exercises on each training day; whereas, compound training consisted of resistance training on one day and plyometric training on the other. Our analyses showed significant improvements in vertical jump height in both training groups after only 3 weeks of training (P < 0.0001); vertical jump height increased by approximately 5% and 9% in the complex and compound training groups, respectively. However, neither group improved significantly better than the other, nor did either group experience faster gains in vertical leap or power output. The results of this study suggest that performing a minimum of 3 weeks of either complex or compound training is effective for improving vertical jump height and power output; thus, coaches should choose the program which best suits their training schedules.


Economic burden of dengue in urban Bangladesh: A societal perspective.
Dengue, a vector-borne disease, is a major public health problem in many tropical and subtropical countries including Bangladesh. The objective of this study is to estimate the societal cost of illness of dengue infections among the urban population in Dhaka, Bangladesh. A cost-of-illness study was conducted using a prevalence-based approach from a societal perspective. Costs attributable to dengue were estimated from a bottom-up strategy using the guideline proposed by the World Health Organization for estimating the economic burden of infectious diseases. A total of 302 hospitalized confirmed dengue patients were enrolled in this study. The average cost to society for a person with a dengue episode was US$ 479.02. This amount was ranged between US$ 341.67 and US$ 567.12 for those patients who were treated at public and private hospitals, respectively. The households out-of-pocket cost contributed to a larger portion of the total costs of illness (66%) while the cost burden was significantly higher for the poorest households than the richest quintile. Dengue disease imposes a substantial financial burden on households and society. Therefore, decision-makers should consider the treatment cost of dengue infections, particularly among the poor in the population while balancing the benefits of introducing potentially effective dengue preventive programs in Bangladesh.


BCoR, a novel corepressor involved in BCL-6 repression.
BCL-6 encodes a POZ/zinc finger transcriptional repressor that is required for germinal center formation and may influence apoptosis. Aberrant expression of BCL-6 due to chromosomal translocations is implicated in certain subtypes of non-Hodgkin's lymphoma. The POZ domains of BCL-6 and several other POZ proteins interact with corepressors N-CoR and SMRT. Here we identify and characterize a novel corepressor BCoR (BCL-6 interacting corepressor), which is expressed ubiquitously in human tissues. BCoR can function as a corepressor when tethered to DNA and, when overexpressed, can potentiate BCL-6 repression. Specific class I and II histone deacetylases (HDACs) interact in vivo with BCoR, suggesting that BCoR may functionally link these two classes of HDACs. Strikingly, BCoR interacts selectively with the POZ domain of BCL-6 but not with eight other POZ proteins tested, including PLZF. Additionally, interactions between the BCL-6 POZ domain and SMRT, N-CoR, and BCoR are mutually exclusive. The specificity of the BCL-6/BCoR interaction suggests that BCoR may have a role in BCL-6-associated lymphomas.


Biomechanical investigation of the association between suspensory ligament injury and lateral condylar fracture in thoroughbred racehorses.
Objective-To determine whether partial transection of the medial branch of the suspensory ligament (MBSL) alters equine third metacarpal bone (MC3) condylar surface strains and forelimb, distal joint angles in a manner consistent with promotion of lateral condylar fracture. Study Design-In vitro biomechanical experiment. Sample Population-Right forelimbs from 7 Thoroughbred horse cadavers. Methods-Lateral and medial MC3 condylar, dorsal and abaxial, bone surface strains and distal joint angles were measured both before and after partial transection of the MBSL during in vitro axial limb compression. Dorsal, principal bone strains and abaxial, uniaxial, and proximodistal strains were compared before and after MBSL partial transection at 1,400-, 3,000-, and 5,600-N loads. Results-Bone strains increased in all locations with increasing axial load. All lateral condylar bone strains were significantly higher, and abaxial surface medial condylar bone strain was significantly lower, after partial transection of the MBSL. Respective distal joints became more flexed or extended as axial load increased but were not significantly different after partial transection of the MBSL. Conclusions-Partial transection of the MBSL increases in vitro MC3 lateral condylar bone surface strains. Clinical Relevance-Loss of integrity of the medial branch of the suspensory ligament could increase the risk for lateral condylar fracture in Thoroughbred horses by amplifying bone strain in the lateral condyle.


Mechanism of cis- and trans-substrate interactions at the tetraethylammonium/H+ exchanger of rabbit renal brush-border membrane vesicles.
The kinetic basis for trans-effects of intravesicular substrates on the uptake of the organic cation, tetraethylammonium (TEA), into rabbit renal brush-border membrane vesicles (BBMV) was studied. Preloading BBMV with 1, 2, or 4 mM TEA stimulated the initial rate of uptake and the total net accumulation of 0.1 mM [3H]TEA. The stimulatory effect of intravesicular TEA on the initial rate of uptake was a saturable function of the trans-TEA concentration, with a half-maximal effect noted at an intravesicular concentration of 0.28 mM. A 1 mM trans-concentration of TEA increased the Jmax of [3H]TEA uptake (from 4.3 to 6.8 nmol.mg-1.min-1) without affecting the apparent Kt. An outwardly directed H+ gradient also increased Jmax (to 10.7 nmol.mg-1.min-1), although the addition of an outwardly directed TEA gradient did not produce further increases in the rate of TEA uptake. External H+ acted as a competitive inhibitor of TEA uptake, and an increase in external [H+] (from 32 nM to 100 nM) produced an increase in the apparent Kt for TEA transport (from 0.12 to 0.26 mM) without affecting the Jmax. The results suggested that TEA and H+ compete for a common site or set of mutually exclusive sites on the cytoplasmic and luminal aspects of TEA/H+ exchanger in the renal brush border, and that these sites have a similar affinity for TEA.


Intakes of fruit, vegetables, and specific botanical groups in relation to lung cancer risk in the NIH-AARP Diet and Health Study.
Increased fruit and vegetable consumption may protect against lung cancer, although epidemiologic findings are inconclusive. The authors prospectively examined associations between lung cancer risk and intakes of fruit, vegetables, and botanical subgroups in 472,081 participants aged 50-71 years in the National Institutes of Health (NIH)-AARP Diet and Health Study. Diet was assessed at baseline (1995-1996) with a 124-item dietary questionnaire. A total of 6,035 incident lung cancer cases were identified between 1995 and 2003. Total fruit and vegetable intake was unrelated to lung cancer risk in both men and women. Higher consumption of several botanical subgroups, however, was significantly inversely associated with risk, but only in men. For example, the relative risks of lung cancer among men in the highest versus lowest quintiles of intake of rosaceae, convolvulaceae, and umbelliferae were 0.82 (95% confidence interval (CI): 0.73, 0.91), 0.86 (95% CI: 0.75, 0.96), and 0.86 (95% CI: 0.78, 0.96), respectively; corresponding relative risks in women were 0.97 (95% CI: 0.85, 1.12), 0.95 (95% CI: 0.83, 1.09), and 0.92 (95% CI: 0.80, 1.06). These results provide support for a protective role of specific botanical subgroups of fruits and vegetables in lung cancer prevention in men, although the findings could also be due to residual confounding by smoking or chance.


The collagenous architecture of articular cartilage--a synthesis of ultrastructure and mechanical function.
The fibrillar ultrastructure within the general matrix of articular cartilage has been examined in the stressed root region of predetermined notches propagating under tension in directions both perpendicular and parallel to the articular surface. From the different ultrastructural responses induced by the 2 notch geometries, it has been possible to further clarify the relationship between structure and load bearing function in normal articular cartilage, and identify features of the collagenous architecture that seem directly related to a loss of load bearing function associated with both osteoarthritis and nonprogressive degeneration.


[Renal-cell carcinoma and polycystic disease in an adult].
Polycystic disease of the adult is the most common presentation of renal cystic disease and is transmitted by dominant autosomic heredity. Development of renal cell carcinoma has been reported within this cystic disease, but the frequency of such coincidence is not higher than in the remaining population. Most of these tumours are found incidentally and may involve a diagnostic problem due to the marked distortion of the kidney's architecture produced by the polycystic disease of the adult.


Blue Nevus-Like Metastasis of a Cutaneous Melanoma Identified by Fluorescence In Situ Hybridization.
A blue nevus-like melanoma is a rare melanoma variant arising from or histologically similar to a blue nevus. It can be challenging to distinguish a cellular blue nevus from a blue nevus-like melanoma, particularly in cases of blue nevus-like melanoma lacking a transition from a clearly benign component. We present a case of a 78-year-old man who refused treatment for a previously existing melanoma and subsequently developed a gray nodule near the site of the previous melanoma. After fluorescence in situ hybridization revealed copy number gains in RREB1, this was diagnosed as a blue nevus-like metastatic melanoma. Blue nevus-like metastatic melanoma is most commonly seen near the site of the primary cutaneous melanoma. This entity should be considered in a patient with a history of melanoma and a new blue nevus-like lesion.


Prevalence and correlates of physical activity among adolescents from Southern Brazil.
To estimate the prevalence and identify correlates of physical activity among adolescents. Cross-sectional study nested within a cohort of 4,325 subjects from the city of Pelotas, Southern Brazil, aged 14-15 years in 2008. Physical activity was analyzed using three different approaches: (1) prevalence of any leisure-time physical activity; (2) prevalence of any active commuting to school; and (3) prevalence of engaging in at least 300 minutes per week of both (1) and (2) combined. Independent variables included sociodemographic, behavioral, social, and biological characteristics, and number of different leisure-time physical activities practiced. Statistical analyses were carried out using Poisson regression. The proportion of adolescents involved in any type of leisure-time physical activity was 75.6%, while 73.4% displayed some form of active commuting to school. Prevalence of total physical activity score (>300 min/week) was 48.2%, being greater among boys (62.6%) than among girls (34.5%). Furthermore, prevalence increased along with the number of physical activity modalities practiced (p<0.001). Factors associated with greater physical activity (leisure+commuting) at the recommended levels were: nonwhite skin color, having failed at school, and playing videogames. Lower socioeconomic status, more time spent on the computer, and parental physical activity were associated with the outcome only among girls. Less than half the adolescents reached recommended levels of physical activity, and this proportion tended to decrease among subjects with higher socioeconomic level. Associated factors were different for leisure-time and commuting. Engaging in a wide variety of physical activities should be encouraged already during childhood.


Epidemiology of breast cancer in a Mexican-American population.
This is a historical cohort study of breast cancer mortality in the Mexican-American community of Laredo, Texas. Included in this study were virtually all breast cancer deaths recorded in Laredo since 1875; controls matched to cases by age and birth year were drawn from the total population. Fertility history and family history of disease for cases and controls were retrieved from the genealogical data base reconstructed by our group from church and civil records for the whole city of Laredo. The findings of this study show an association between breast cancer risk and age at first birth. This study confirms familial risk to be a factor in breast cancer risk. Unlike postmenopausal breast cancer mortality in the total U.S. population, which has increased only slightly in the last 30-40 years, postmenopausal breast cancer death rates in Laredo have almost tripled since the 1940's.