Effect of Matricaria chamomilla L. flower essential oil on the growth and ultrastructure of Aspergillus niger van Tieghem.
The antifungal activity of Matricaria chamomilla L. flower essential oil was evaluated against Aspergillus niger with the emphasis on the plant's mode of action at the electron microscopy level. A total of 21 compounds were identified in the plant oil using gas chromatography/mass spectrometry (GC/MS) accounting for 92.86% of the oil composition. The main compounds identified were alpha-bisabolol (56.86%), trans-trans-farnesol (15.64%), cis-beta-farnesene (7.12%), guaiazulene (4.24%), alpha-cubebene (2.69%), alpha-bisabolol oxide A (2.19%) and chamazulene (2.18%). In the bioassay, A. niger was cultured on Potato Dextrose Broth medium in 6-well microplates in the presence of serial two fold concentrations of plant oil (15.62 to 1000 microg/mL) for 96 h at 28 degrees C. Based on the results obtained, A. niger growth was inhibited dose dependently with a maximum of approximately 92.50% at the highest oil concentration. A marked retardation in conidial production by the fungus was noticed in relation to the inhibition of hyphal growth. The main changes of hyphae observed by transmission electron microscopy were disruption of cytoplasmic membranes and intracellular organelles, detachment of plasma membrane from the cell wall, cytoplasm depletion, and complete disorganization of hyphal compartments. In scanning electron microscopy, swelling and deformation of hyphal tips, formation of short branches, and collapse of entire hyphae were the major changes observed. Morphological alterations might be due to the effect on cell permeability through direct interaction of M. chamomilla essential oil with the fungal plasma membrane. These findings indicate the potential of M. chamomilla L. essential oil in preventing fungal contamination and subsequent deterioration of stored food and other susceptible materials.


Functional neuroimaging using F-18 FDG PET/CT in amnestic mild cognitive impairment: A preliminary study.
People with amnestic mild cognitive impairment (aMCI) are at a higher risk of developing Alzheimers Dementia (AD) than their cognitively normal peers. Decreased glucose metabolism with F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) is a downstream marker of neuronal injury and neurodegeneration. The risk of developing AD is higher in patients with aMCI who have a pattern of AD related glucose metabolic changes on FDG-PET than those who do not have these changes. We evaluated the utility of visual and 'statistical parametric mapping (SPM)-supported reading' of the FDG-PET scans of patients clinically classified as aMCI for identification of predementia patterns and for prediction of their progression to AD (PTAD). A total of 35 patients diagnosed as aMCI (mini mental state examination (MMSE) score ≥ 25) at the cognitive disorders and memory (CDM) clinic of speciality neurology centers were referred for a resting FDG-PET study. All patients had a detailed neurological, neuropsychological, and magnetic resonance imaging (MRI) evaluation prior to referral. Mean age of patients was 67.9 ± 8.7 (standard deviation (SD)) years, male: female (M: F) =26:9. Twenty healthy age-matched controls were included in the study for SPM (http://www.fil.ion.ucl.ac.uk/spm/). Scans were interpreted visually and using SPM. Each scan was classified as high, intermediate, or low likelihood for PTAD. On visual analysis, four scans were classified as high likelihood of PTAD and reveled hypometabolism in AD related territories. Seven patients had hypometabolism in at least one AD related territory and were classified as intermediate likelihood for PTAD. Two patients had hypometabolism in other than AD territories, while 22 patients did not show any significant hypometabolism on their FDG-PET scans and were classified as low likelihood for PTAD. SPM analysis of these cases confirmed the areas hypometabolism in all 13 patients compared to a normal subgroup (P < 0.05). On follow-up of 24 months, all four cases with high likelihood scans had progression of cognitive deficits and were confirmed as AD in the CDM clinic while none of the others showed cognitive decline. A pattern of AD hypometabolism on the FDG-PET study is useful for predicting PTAD. A longer follow-up of patients with hypometabolism in single AD territories is needed to predict their clinical behavior.


Effect of arterial stretch on transmural albumin and Evan's blue dye transport.
The influence of arterial wall circumferential stretch (lambda) on the 32-min diffusive mural uptake of 125I-albumin and of Evan's blue dye (EBD) across the injured endothelial surface was studied in the intimal-medial preparation of the canine descending thoracic aorta (DTA). Albumin uptake (MA nmol/cm2) was measured by standard gamma counting techniques and the corresponding EBD uptake (ME) by the reflectance method. MA and ME were measured at a physiological stretch (lambda = 1.4) and at a hypertensive stretch (lambda = 1.8) at four equispaced locations (z) along the DTA. When lambda was changed from 1.4 to 1.8, the average percentage change of MA was -2% and of ME was -4%. These decreases were not significant (P greater than 0.10), and we conclude that arterial wall stretch exerts only minor influence on the parameters governing albumin and EBD-albumin accumulation in the intimal surface of the deendothelialized arterial intimal-medial tissue system.


Re-entrant bimodality in spheroidal chiral swimmers in shear flow.
We use a continuum model to report on the behavior of a dilute suspension of chiral swimmers subject to externally imposed shear in a planar channel. Swimmer orientation in response to the imposed shear can be characterized by two distinct phases of behavior, corresponding to unimodal or bimodal distribution functions for swimmer orientation along the channel. These phases indicate the occurrence (or not) of a population splitting phenomenon changing the swimming direction of a macroscopic fraction of active particles to the exact opposite of that dictated by the imposed flow. We present a detailed quantitative analysis elucidating the complexities added to the population splitting behavior of swimmers when they are chiral. In particular, the transition from unimodal to bimodal and vice versa are shown to display a re-entrant behavior across the parameter space spanned by varying the chiral angular speed. We also present the notable effects of particle aspect ratio and self-propulsion speed on system phase behavior and discuss potential implications of our results in applications such as swimmer separation/sorting.


Diarrhea incidence and intestinal infections among rotavirus vaccinated infants from a poor area in Brazil: a spatial analysis.
Acute diarrhea is the second leading cause of mortality among children under 5 years of age in developing countries. The pathogen most strongly associated with diarrhea is rotavirus followed by enteric pathogens such as bacteria, helminthes and protozoan. Adequate sanitation and water supply contribute to decrease acute diarrhea incidence of most etiologic agents, although vaccination remains the most important intervention to control rotavirus acute diarrhea. This study aimed to describe environmental conditions and analyze spatially the acute diarrhea and intestinal infection among rotavirus vaccinated infants from Laranjeiras-Sergipe, Brazil. Children were enrolled between 2 and 11 months of age and followed through 12 months. Demographic, socioeconomic and environmental data were obtained from a questionnaire, and immunization data were obtained from children vaccination card. Children stool samples were collected each month in order to run laboratory analyses. The household spatial localization was obtained by using a Global Positioning System (GPS). Spatial analysis was performed using the TerraView computer program and Kernel intensity estimation. A total of 1,113 stool samples were collected with 80 being diarrhea associated. Diarrhea incidence rate was 0.5 ± 1.0 episodes/child/year. The overall infection rates by Ascaris lumbricoides, Endolimax nana, Giardia lamblia and rotavirus were 5.1%, 3.0%, 0.9% and 2.6%, respectively. 3.8% of diarrhea-associated stool samples were positive for rotavirus and 11.3% were positive for helminths and protozoans. There were some changes on spatial distribution of intestinal infections and diarrhea episodes along the four trimesters evaluated. The studied infants live equally in precarious conditions of sanitation which probably explain the significant rates of parasitic infections appearing in early life. The low acute diarrhea incidence in the studied rotavirus vaccinated population and the low number of symptomatic rotavirus infection may indicate vaccination efficacy to prevent acute diarrhea among young children in a poor environmental sanitary setting.


Chronic protein undernutrition and an acute inflammatory stimulus elicit different protein kinetic responses in plasma but not in muscle of piglets.
The changes in protein metabolism of severe childhood malnutrition are generally perceived as a metabolic adaptation to chronic protein undernutrition. However, severe malnutrition is invariably accompanied by infections which also have profound effects on protein metabolism. This study aimed to distinguish the effect of protein undernutrition from that of an inflammatory stimulus on muscle and plasma protein synthesis rates. Two groups of five piglets consumed diets containing either 23% or 3% protein for 4 wk. They then were infused intravenously with 2H3-leucine before and 48 h after subcutaneous injections of turpentine to measure the fractional synthesis rates (FSR) of muscle protein and both the FSR and the absolute synthesis rates (ASR) of albumin and fibrinogen. Prior to turpentine injection, compared to control piglets, protein-deficient piglets had significantly lower muscle FSR and plasma concentrations of both albumin and fibrinogen, although only albumin had lower FSR and ASR. Turpentine injection decreased muscle FSR but increased the FSR, ASR and plasma concentrations of both albumin and fibrinogen in control piglets. In protein-deficient piglets, the inflammatory stress caused a further decrease in muscle protein FSR and in plasma albumin concentration despite marked increases in albumin FSR and ASR. Fibrinogen FSR, ASR and plasma concentration were increased. We conclude that protein undernutrition and inflammation elicit the same kinetic response in muscle protein but different kinetic responses in plasma proteins. Furthermore, whereas protein deficiency reduces the plasma albumin pool via a reduction in albumin synthesis, inflammation reduces it through a stimulation of catabolism and/or loss from the intravascular space.


Design, Challenges, and Implications of Quality Improvement Projects Using the Electronic Medical Record: Case Study: A Protocol to Reduce the Burden of Postoperative Atrial Fibrillation.
Postoperative atrial fibrillation (POAF) is a frequent complication of cardiac surgery, which results in increased morbidity, mortality, length of stay, and hospital costs. We developed and followed a process map to implement a protocol to decrease POAF: (1) identify stakeholders and form a working committee, (2) formal literature and guideline review, (3) retrospective analysis of current institutional data, (4) data modeling to determine expected effects of change, (4) protocol development and implementation into the electronic medical record, and (5) ongoing review of data and protocol adjustment. Retrospective analysis demonstrated that POAF occurred in 29.8% of all cardiovascular surgery cases. Median length of stay was 2 days longer (P<0.001), and median total variable costs $2495 higher (P<0.001) in POAF patients. Modeling predicted that up to 60 cases of POAF and >$200 000 annually could be saved. A clinically based electronic medical record tool was implemented into the electronic medical record to aid preoperative clinic providers in identifying patients eligible for prophylactic amiodarone. Initial results during the 9-month period after implementation demonstrated a reduction in POAF in patients using the protocol, compared with those who qualified but did not receive amiodarone and those not evaluated (11.1% versus 38.7% and 38.8%; P=0.022); however, only 17.3% of patients used the protocol. A standardized methodological approach to quality improvement and electronic medical record integration has potential to significantly decrease the incidence of POAF, length of stay, and total variable cost in patients undergoing elective coronary artery bypass graft and valve surgeries. This framework for quality improvement interventions may be adapted to similar clinical problems beyond POAF.


Morcellation in gynecology: short review and suggestions from Turkish Society of Minimally Invasive Gynecologic Oncology
Morcellation allows the removal of a large uterus and fibroids through small incisions with minimally invasive surgery. It helps to prevent the complications associated with large incisions in both hysterectomy and myomectomy operations. Currently, there is much debate regarding the use of power morcellation in laparoscopic hysterectomy and myomectomy, mainly due to the risk of peritoneal dissemination of undiagnosed uterine sarcomas. Unfortunately, there is no valid pre-operative diagnostic method that can differentiate sarcomas from myomas, and the currently available scientific literature regarding morcellation is insufficient. As the Turkish Society of Minimally Invasive Gynecological Oncology, we present our consensus opinion and suggestions for the preoperative evaluation and morcellation of fibroids, in line with the recent literature.


Assessing children's perceptions of academic interventions: The Kids Intervention Profile.
The psychometric properties of the Kids Intervention Profile (KIP), a rating scale designed to measure academic intervention acceptability from the perspective of students, were examined as well as the influence of background factors on students' acceptability ratings. Data were extracted from 4 randomized controlled trials investigating the effects of a performance feedback intervention on third-grade students' writing fluency (n = 228). Results indicated that the KIP contains 2 factors (General Intervention Acceptability, Skill Improvement) and has adequate internal consistency and stability across a 3-week period. There were gender differences in students' acceptability ratings, with female students rating the intervention as significantly more acceptable than males. In addition, results suggested a modest, positive relationship between students' intervention acceptability ratings and their intervention outcomes. Considerations regarding the use of the KIP, as well as limitations of the study, are discussed. (PsycINFO Database Record


Differential sympathetic-parasympathetic interactions in sinus node and AV junction.
This study examined the effects and interactions evoked by various combinations of parasympathetic (P) and sympathetic (S) stimulations on sinus node automaticity and atrioventricular (AV) conduction (both anterograde and retrograde) in 11 two-mo old anesthetized puppies. The respective effects of these autonomic maneuvers were assessed by covariant analysis using a linear regression model of the form Y = alpha 0 + alpha 1 X base line + alpha 2 X sequence + alpha 3 X S + alpha 4 X S2 + alpha 5 X P + alpha 6 X P2 + alpha 7 X (P X S).... The effects of parasympathetic and sympathetic stimulation, of the quadratic term S2, and of the interaction term (P X S) were highly significant (P less than 0.0001) on both sinus node automaticity and AV conduction (anterograde and retrograde). In contrast, the effect of the quadratic term P2 was significant on sinus node automaticity only. Sequence of stimulation whether (SP) or (PS) had no significant effect on either chronotropic or dromotropic properties. Furthermore, whereas augmented antagonism with parasympathetic predominance over sympathetic activity was readily demonstrable in the control of sinus rate, the reverse, i.e., augmented antagonism with sympathetic preponderance over parasympathetic activity, was found to apply to the control of AV conduction (both anterograde and retrograde). Hence, the nature and extent of parasympathetic-sympathetic interactions vary considerably, depending on which cardiac structure and/or function is under scrutiny. It appears that AV conduction is especially sensitive to modulation of sympathoadrenergic activity, whereas sinus node automaticity is particularly responsive to cholinomimetic influences.


Effect of the energy density of non-purified diets on reproduction, obesity, alopecia and aging in mice.
Four diets with graded levels of energy at 24% crude protein were fed to C57BL/6J mice for approximately 3 years to develop pelleted non-purified diets. The nitrogen-corrected metabolizable energy (MEn) of the diets ranged from 2.86 to 3.73 kcal per g of dry matter (DM). Fifteen males and 30 females were assigned to each diet. The mice were housed together for 1 week at 7 week intervals, experiencing 5 matings. After the reproduction stage, they were allowed to complete their life span. Moribund mice after 60 weeks of age were subjected to histopathological examination. The highest energy diet showed the following results in comparison with the lowest energy diet: (1) weaning weight of pups increased by 31.6%; (2) males showed slight obesity even during the reproduction stage, but females did not; (3) both sexes developed remarkable obesity after 50 weeks of age with 41.2% (males) and 49.6% (females) increasing in maximum body weight; (4) although daily feed intake decreased by approximately 18%, the MEn was slightly over consumed; (5) females showed higher incidence of alopecia with age; (6) the survival rate after 50 weeks of age decreased earlier and life span was shortened; (7) histopathological changes associated with aging developed earlier. On the other hand, the early death rate of dams at parturition increased with a decrease in dietary energy. It was concluded that at least 2 types of diets are needed throughout the life span of C57BL/6J mice; a high energy diet with an MEn value of 3.73 kcal/g DM for maximum reproduction and a low energy diet with an MEn value of 2.86 kcal/g DM for the long term stage after reproduction to retard obesity and aging most effectively.


Risk factors for overall recidivism and severity of recidivism in serious juvenile offenders.
This study was aimed at finding risk factors that predict both overall recidivism and severity of recidivism in serious juvenile offenders. Seventy static and dynamic risk factors associated with family characteristics, peers, psychopathology, substance abuse, psychological factors, and behavior during treatment were assessed with the Juvenile Forensic Profile in a sample of 728 juvenile offenders. Official reconviction data were used to register recidivism with a minimum time at risk of 2 years. Severity of offending was categorized according to the maximum sentence for the offense committed combined with expert opinion. Several risk factors for recidivism were found: past criminal behavior (number of past offenses, young age at first offense, unknown victim of past offenses), conduct disorder, family risk factors (poor parenting skills, criminal behavior in the family, a history of physical and emotional abuse), involvement with criminal peers, and lack of treatment adherence (aggression during treatment, lack of coping strategies). Having an unknown victim in past offenses, criminal behavior in the family, lack of treatment adherence, and lack of positive coping strategies were predictive of serious (violent) recidivism. The results are discussed in terms of their use for risk assessment and in improving treatment effect. Targeting poor parenting skills, involvement in criminal environment, lack of treatment adherence, and problematic coping strategies should reduce the severity of recidivism.


Response of an actin network in vesicles under electric pulses.
We study the role of a biomimetic actin network during the application of electric pulses that induce electroporation or electropermeabilization, using giant unilamellar vesicles (GUVs) as a model system. The actin cortex, a subjacently attached interconnected network of actin filaments, regulates the shape and mechanical properties of the plasma membrane of mammalian cells, and is a major factor influencing the mechanical response of the cell to external physical cues. We demonstrate that the presence of an actin shell inhibits the formation of macropores in the electroporated GUVs. Additionally, experiments on the uptake of dye molecules after electroporation show that the actin network slows down the resealing process of the permeabilized membrane. We further analyze the stability of the actin network inside the GUVs exposed to high electric pulses. We find disruption of the actin layer that is likely due to the electrophoretic forces acting on the actin filaments during the permeabilization of the GUVs. Our findings on the GUVs containing a biomimetic network provide a step towards understanding the discrepancies between the electroporation mechanism of a living cell and its simplified model of the empty GUV.


Effects of trap design and CO2 presentation on the measurement of adult mosquito abundance using Centers for Disease Control-style miniature light traps.
Centers for Disease Control miniature light traps augmented with CO2 provide an effective method of monitoring Culex abundance and may provide a useful supplement to New Jersey light traps used by the California Mosquito Surveillance Program. To assist in standardizing sampling protocols, the present research compared the catch of adult mosquitoes collected using 4 trap designs and 3 CO2 presentation methods. When augmented with dry ice, the Arbovirus Field Station (AFS) trap (consisting of a 3-in. fan mounted into a white polyvinyl chloride pipe and operated without a light source or rain shield) collected as many or more Culex females than similar traps purchased from John W. Hock and American Biophysics, or a trap with a 4.25-in. 2-bladed fan constructed by the Orange County Vector Control District (similar to the Encephalitis Virus Surveillance model distributed by Bioquip). Few blooded or gravid females and males were collected, indicating that CO2 released from the dry ice and not light probably was the primary attractant. Catch of Culex tarsalis females in traps baited with CO2 released at 0.5-1.5 liters/min from gas cylinders was significantly greater than in traps baited with dry ice, even though the CO2 release rates from the dry ice at dusk probably were comparable to that released from the cylinders and averaged 0.4-0).5 liters/min for the night. Traps baited with 0.5 liters/ min of CO2 gas released in 15 3- or 2-sec bursts per hour collected the fewest mosquitoes. In all experiments, trap location effects were significant and accounted for as much variability in catch size as trap design or CO2 presentation. Sampling efficiency of all trap designs or CO2 presentations were consistent over time, space, and different levels of mosquito abundance.


Elevated [18F]fluorodopamine turnover in brain of patients with schizophrenia: an [18F]fluorodopa/positron emission tomography study.
Previous positron emission tomography (PET) studies with levodopa analogs have revealed a modestly increased capacity for dopamine synthesis in the striatum of patients with schizophrenia compared with healthy age-matched control subjects. We hypothesized that not just the synthesis but also the turnover of radiolabeled dopamine is elevated in patients. To test the hypothesis, we reanalyzed 2-h-long [18F]fluorodopa (FDOPA)/PET recordings from eight unmedicated patients with schizophrenia and 15 healthy age-matched control subjects, using new methods for the quantification of [18F]fluorodopamine steady-state kinetics. The fractional rate constant for the catabolism and elimination of [18F]fluorodopamine was elevated nearly twofold in striatum, the largest biochemical difference in brain of schizophrenics yet reported. The magnitude of the intrinsic blood-brain FDOPA clearance with correction for this loss of [18F]fluorodopamine metabolites was increased by 20% in caudate and putamen and by 50% in amygdala and midbrain of the patients. However, the magnitude of the steady-state storage of FDOPA and its decarboxylated metabolites (V(d)) was reduced by one-third in the caudate nucleus and amygdala of the schizophrenic group. Thus, reduced steady-state storage of [18F]fluorodopamine occurs in the midst of accelerated synthesis in brain of untreated patients. Positive scores of the positive and negative syndrome scale correlated inversely with the magnitude of V(d) in amygdala, suggesting an association between positive symptoms and impaired steady-state storage of FDOPA metabolites in that structure.


Probing the influence of stereoelectronic effects on the biophysical properties of oligonucleotides: comprehensive analysis of the RNA affinity, nuclease resistance, and crystal structure of ten 2'-O-ribonucleic acid modifications.
The syntheses of 10 new RNA 2'-O-modifications, their incorporation into oligonucleotides, and an evaluation of their properties such as RNA affinity and nuclease resistance relevant to antisense activity are presented. All modifications combined with the natural phosphate backbone lead to significant gains in terms of the stability of hybridization to RNA relative to the first-generation DNA phosphorothioates (PS-DNA). The nuclease resistance afforded in particular by the 2'-O-modifications carrying a positive charge surpasses that of PS-DNA. However, small electronegative 2'-O-substituents, while enhancing the RNA affinity, do not sufficiently protect against degradation by nucleases. Similarly, oligonucleotides containing 3'-terminal residues modified with the relatively large 2'-O-[2-(benzyloxy)ethyl] substituent are rapidly degraded by exonucleases, proving wrong the assumption that steric bulk will generally improve protection against nuclease digestion. To analyze the factors that contribute to the enhanced RNA affinity and nuclease resistance we determined crystal structures of self-complementary A-form DNA decamer duplexes containing single 2'-O-modified thymidines per strand. Conformational preorganization of substituents, favorable electrostatic interactions between substituent and sugar-phosphate backbone, and a stable water structure in the vicinity of the 2'-O-modification all appear to contribute to the improved RNA affinity. Close association of positively charged substituents and phosphate groups was observed in the structures with modifications that protect most effectively against nucleases. The promising properties exhibited by some of the analyzed 2'-O-modifications may warrant a more detailed evaluation of their potential for in vivo antisense applications. Chemical modification of RNA can also be expected to significantly improve the efficacy of small interfering RNAs (siRNA). Therefore, the 2'-O-modifications introduced here may benefit the development of RNAi therapeutics.


Spinel-to-CaFe2O4-type structural transformation in LiMn2O4 under high pressure.
A new form of LiMn2O4 is reported. The structure is the CaFe2O4-type and 6% denser than the spinel. The structure transformation was achieved by heating at 6 GPa. Analysis of the neutron diffraction pattern confirmed an average of the structure; the unit cell was orthorhombic at a = 8.8336(5) angstroms, b = 2.83387(18) angstroms, and c = 10.6535(7) angstroms (Pnma). Electron diffraction patterns indicated an order of superstructure 3a x b x c, which might be initiated by Li vacancies. The exact composition is estimated at Li(0.92)Mn2O4 from the structure analysis and quantity of intercalated Li. The polycrystalline CaFe2O4-type compound showed semiconducting-like characters over the studied range above 5 K. The activation energy was reduced to approximately 0.27 eV from approximately 0.40 eV at the spinel form, suggesting a possible enhancement of hopping mobility. Magnetic and specific-heat data indicated a magnetically glassy transition at approximately 10 K. As the CaFe2O4-type transition was observed for the mineral MgAl2O4, hence the new form of the lithium manganese oxide would provide valuable opportunities to study not only the magnetism of strongly correlated electrons but also the thermodynamics of the phase transition in the mantle.


Streptozotocin nephrotoxicity: studies on the defect in renal tubular acidification.
A 64-year-old man developed hyperchloremic acidosis while being treated with streptozotocin for an unresectable hepatoma. Studies done during acid and alkali loading suggested that the defect in urinary acidification resided in the proximal tubule and thus represented a Type II or proximal renal tubular acidosis (RTA).


Application of Low-Dose CT and MRI in the Evaluation of Soft Tissue Injury in Tibial Plateau Fractures.
To explore the application value of low-dose CT and MRI in the evaluation of soft tissue injury in tibial plateau fractures. This study included 89 patients with high suspicion of TPF and KI admitted to our hospital from July 2015 to May 2021. After arthroscopy, 81 patients were diagnosed with FTP combined with KI. The Schatzker classification based on X-ray and CT plain scan combined with three-dimensional reconstruction was recorded, and the soft tissue injury was recorded according to the MRI examination of the affected knee joint. With the results of pathological examination and arthroscopic surgery as the gold standard, the results of MRI and pathological examination and arthroscopic examination were in good agreement (Kappa = 0.857, 0.844), and CT was moderately in agreement (Kappa = 0.697, 0.694). In KI examination, CT and MRI had no difference in the evaluation of ligament injury and bone injury (P > 0.05), but MRI had better diagnostic effect on meniscus injury (P < 0.05). Finally, the satisfaction survey showed that patients in the CT group were more satisfied with clinical services (P < 0.05). Both CT and MRI have certain diagnostic value for occult tibial plateau fractures, among which CT examination is more advantageous for trabecular bone fractures, MRI examination is more advantageous for cortical bone fractures, and MRI examination can improve occult tibial plateau fracture inspection accuracy.


A Completely Portable and Concealable, Lightweight Assistive Exosuit for Upper Limbs.
Exosuits are a relatively new trend in wearable robotics to answer the flaws of their exoskeleton counterparts, but they remain impractical as the lack of rigidity in their frames makes the integration of crucial components into a single unit a challenge. While some simple solutions exist, almost all current research focuses on the output performance of exosuits rather than the needs of potential beneficiaries of this technology. To address this, a novel mechanism of complete portability for exosuits was developed and tested to improve exosuit practicality and adoption. Designed for elbow flexion, the device produced 12.21-13.66Nm of assistive torque and could be mostly concealed by the wearer's clothing without impacting performance. The proof-of-concept design proved successful and demonstrated many advantages over current portability methods, particularly in size and convenience, weighing only 1.7kg. This device provides the sense of normalcy crucial for a technology to seamlessly integrate into the daily lives of its end users. It is extendable and upgradeable with access to advanced materials and manufacturing methods.Clinical Relevance- Exoskeletons are currently the only marketed wearable robotic device for full limb support. This research is the foundation for a new series of exosuits that could drastically enhance the adoptability, accessibility, and versatility of exosuits in physical rehabilitation and general physical enhancement, becoming a superior alternative or addition.


Effect of P-selectin on phosphatidylserine exposure and surface-dependent thrombin generation on monocytes.
Stimulation of monocytes with P-selectin induces the synthesis of an array of mediators of inflammation, as well as the expression of tissue factor (TF), the main initiator of coagulation. Because the membrane-bound reactions of coagulation are profoundly influenced by the presence of phosphatidylserine on the membranes of cells, factors that increase its expression may have an impact on coagulation. Using flow cytometry, we studied the effect of P-selectin on phosphatidylserine expression in blood monocytes and in the monocytic cells, THP-1. Soluble P-selectin at biologically relevant concentrations (0.31 to 2.5 microg/mL) induced a time-dependent increase in phosphatidylserine expression, an effect that could be inhibited with an anti-PSGL-1 blocking antibody, and by genistein, a tyrosine kinase inhibitor. Binding of activated platelets to THP-1 cells also resulted in a significant increase in phosphatidylserine expression that was dependent on PSGL-1. Consistent with the role of phosphatidylserine on surface-dependent reactions of coagulation, treatment of monocytic cells with soluble P-selectin led to increased thrombin generation. We excluded P-selectin induced apoptosis of monocyte as a mechanism for the increased phosphatidylserine exposure. In summary, we show that P-selectin, either soluble or in its membrane-bound form, induces phosphatidylserine exposure in monocytes through a mechanism dependent on PSGL-1.


Measuring Aptamer Folding Energy Using a Molecular Clamp.
Folding energy (ΔGfold) offers a useful metric for characterizing the stability and function of aptamers. However, experimentally measuring the folding energy is challenging, and there is currently no general technique to measure this parameter directly. In this work, we present a simple approach for measuring aptamer folding energy. First, the aptamer is stretched under equilibrium conditions with a double-stranded DNA "molecular clamp" that is coupled to the aptamer ends. We then measure the total internal energy of stressed DNA molecules using time-lapse gel electrophoresis and compare the folding and unfolding behavior of molecular clamp-stressed molecules that incorporate either the aptamer or unstructured random single-stranded DNA in order to derive the aptamer folding energy. Using this approach, we measured a folding energy of 10.40 kJ/mol for the HD22 thrombin aptamer, which is consistent with other predictions and estimates. We also analyzed a simple hairpin structure, generating a folding energy result of 9.05 kJ/mol, consistent with the value predicted by computational models (9.24 kJ/mol). We believe our strategy offers an accessible and generalizable approach for obtaining such measurements with virtually any aptamer.


Mortality of intravenous drug users in Rome: a cohort study.
A historical cohort study was carried out in Rome to examine overall and cause-specific mortality among intravenous drug users (IVDUs). A total of 4200 IVDUs (3411 men and 789 women) enrolled in methadone treatment centers between 1980 and 1988 were studied. There were 239 deaths during the follow-up period. The overall SMR was 10.10 in the entire cohort (95% confidence interval, 8.86-11.47), 9.30 in males and 18.07 in females. A large excess of mortality in both sexes was found for infectious, circulatory, respiratory, and digestive diseases as well as for violence, overdose, AIDS, and unknown or ill-defined causes. Tumors and suicide were excessive only in males. Deaths due to drug overdose, violence or trauma, and cirrhosis accounted for 63.6%, AIDS for 7.1%, endocarditis and other bacterial infections for 7.1%, and neoplasms for 3.8% of total mortality. These findings document serious health consequences of drug abuse in Italy.


Current paradigms and evolving concepts in metastatic castration-resistant prostate cancer.
Until recently, docetaxel-based therapy represented the only therapy shown to prolong survival in patients with metastatic castration-resistant prostate cancer (mCRPC). The past year and a half has been marked by unprecedented progress in treatments for this disease. Three positive phase III clinical trials have emerged, each evaluating agents (sipuleucel-T, cabazitaxel and abiraterone) with distinct mechanisms of action. Herein, the three pivotal trials are described alongside both past and current large phase III studies conducted in this mCRPC. The overall survival for patients with mCRPC treated in current clinical trials is considerably longer than noted in the past. We note that more recent trials with older agents have also shown improved survival and discuss potential non-therapeutic biases that influence this critical measure of outcome. The necessity for utilizing randomized trials when evaluating new therapeutics is emphasized given the changing prognosis in this mCRPC.


Multiplex PCR assay discriminates rabbit, rat and squirrel meat in food chain.
Rabbit meat is receiving increasing attention because it contains a high level of proteins with relatively little fat. On the other hand, squirrel meat is served in upper-class meals in certain countries, so is sold at higher prices. The other side of the coin is rat meat, which has family ties with rabbit and squirrel but poses substantial threats to public health because it is a potential carrier of several zoonotic organisms. Recently, rat meat was mislabelled and sold as lamb after chemical modification. Thus, the chances of rabbit and squirrel meat substitution by rat meat cannot be ruled out. For the first time, a multiplex PCR assay was developed in Malaysia for the discriminatory identification of rat, rabbit and squirrel in the food chain. Rabbit (123 bp), rat (108 bp) and squirrel (243 bp) targets were amplified from ATP6 and cytb genes, along with a eukaryotic internal control (141bp). The products were sequenced and cross-tested against 22 species. A total of 81 reference samples and 72 meatball specimens were screened to validate the assay. Analyte stability was evaluated through boiling, autoclaving and micro-oven cooking. The tested lower limits of detection were 0.01 ng DNA for pure meat and 0.1% for meatballs.


Development and validation of a follow-up methodology for a randomised controlled trial, utilising routine clinical data as an alternative to traditional designs: a pilot study to assess the feasibility of use for the BladderPath trial.
Bladder cancer outcomes have not changed significantly in 30 years; the BladderPath trial (Image Directed Redesign of Bladder Cancer Treatment Pathway, ISRCTN35296862) proposes to evaluate a modified pathway for diagnosis and treatment ensuring appropriate pathways are undertaken earlier to improve outcomes. We are piloting a novel data collection technique based on routine National Health Service (NHS) data, with no traditional patient-Health Care Professional contact after recruitment, where trial data are traditionally collected on case report forms. Data will be collected from routine administrative sources and validated via data queries to sites. We report here the feasibility and pre-trial methodological development and validation of the schema proposed for BladderPath. Locally treated patient cohorts were utilised for routine data validation (hospital interactions data (HID) and administrative radiotherapy department data (RTD)). Single site events of interest were algorithmically extracted from the 2008-2018 HID and validated against reference datasets to determine detection sensitivity. Survival analysis was performed using RTD and HID data. Hazard ratios and survival statistics were calculated estimating treatment effects and further validating and assessing the scope of routine data. Overall, 829/1042 (sensitivity 0.80) events of interest were identified in the HID, with varying levels of sensitivity; identifying, 202/206 (sensitivity 0.98; PPV 0.96) surgical events but only 391/568 (sensitivity 0.69; PPV 0.95) radiotherapy regimens. An overall temporal quality improvement trend was present: detecting 41/117 events (35%) in 2011 to 104/109 (95%) in 2017 (all event types). Using the RTD, 5-year survival rates were 43% (95% CI 25-59%) in the chemoradiotherapy group and 30% (95% CI 23-36%) in the radiotherapy group; using the HID, the 5-year radical cystectomy survival rate was 57% (95% CI 50-63%). Routine data are a feasible method for trial data collection. As long as events of interest are pre-validated, very high sensitivities for trial conduct can be achieved and further improved with targeted data queries. Outcomes can also be produced comparable to clinical trial and national dataset results. Given the real-time, obligatory nature of the HID, which forms the Hospital Episode Statistics (HES) data, alongside other datasets, we believe routine data extraction and validation is a robust way of rapidly collecting datasets for trials.


[Right ventricular dysfunction after left ventricular assist device implantation].
The frequency of long-term left ventricular assist device (LVAD) implantation is increasing. Acute right ventricular dysfunction or right ventricular failure after LVAD implantation has important influence on morbidity and mortality. The aim of our study was to assess the management of right ventricular dysfunction after LVAD implantation. The study group comprised 21 patients with implanted HeartMate II LVAD since December, 2006 to April, 2009. We evaluated in retrospective fashion baseline parameters of cardiovascular and other organ systems before LVAD implantation, applied pharmacological and mechanical support for the right ventricle, and important clinical outcomes to the end ofJune, 2009. LVAD was implanted in 18 men and 3 women with mean age of 48.7 +/- 11.2 years. The most frequent diagnosis was dilatational cardiomyopathy (9 patients; 42.9%), and the most frequent indication for implantation was bridge-to-transplantation (19 patients; 90.4%). Pharmacological support of the right ventricle after LVAD implantation comprised dobutamine (21 patients; 100%), milrinone (21 patients; 100%), isoproterenol (1 patient; 4.8%), and levosimendan (5 patients; 23.8%). In 2 (9.5%) cases there was a need for repeated application of levosimendan during postoperative course. Inhalational nitric oxide was used in 14 (66.7%) patients. Despite extensive pharmacological support, 3 (14.3%) patients needed right ventricular assist device (RVAD) implantation. Most patients (9; 42.8%) survived to heart transplantation; in one (4.8%) case LVAD was successfuly explanted; 6 (28.6%) patients is living with LVAD; 5 (23.8%) patients died during LVAD support. After LVAD implantation there is a need for aggressive pharmacological, and in some cases mechanical, support of the right ventricular function to provide adequate blood flow to LVAD in order to minimize morbidity and mortality.


Basic concepts of radiation emergency medicine.
Nuclear and radiological accidents are not frequent but may lead to major consequences in the population. For the health systems, the need to handle a large number of victims will probably remain as an exception. However, a high number of affected victims can be expected in some terrorist scenarios. In addition, medical accidents in radiotherapy, fluoroscopy and diagnostic radiology have increased the number of patients with severe radiation injuries considerably, especially in developed countries. Given the increased use of ionising radiation for industrial and medical purposes and new technological applications emerging, the number of accidents may increase in the future. Consequently, the early identification and adequate management of these emergencies is a priority, as well as the need for medical preparedness, requiring knowledge about various emergency scenarios and planning appropriate responses to them before they occur. Unfortunately, medical professionals have a substantial knowledge gap in identifying and treating injured persons affected by ionising radiation. As managing radiation accidents is a very challenging process, exercises must be carried out to organise a well-trained multidisciplinary group of professionals to manage any radiation accident properly. Efforts on a continuously updated guidance system should be developed. In addition, new approaches to foster sustainable interdisciplinary and international cooperative networks on radiation injuries are necessary. Lessons learned from past nuclear and radiological emergencies have significantly contributed to strengthening scientific knowledge and increasing the available medical information on the effects of ionising radiation in the human body. In this context, radiation emergency medicine has emerged as a discipline that contributes to the diagnosis, treatment, medical follow-up and prognosis of persons affected by radiation injuries in a nuclear or a radiological emergency. In this paper, we review some relevant concepts related to the medical preparedness and multidisciplinary response required to attend to persons affected by these emergencies.


Class II correction in patients treated with class II elastics and with fixed functional appliances: a comparative study.
The aim of the present study was to evaluate quantitatively the skeletal and dental changes contributing to Class II corrections in subjects treated with Class II elastics (Begg technique) compared with subjects treated with fixed functional appliances (Herbst appliance). Thirty-six male patients with Class II, Division 1 malocclusions whose treatment had not included extraction were investigated. Eighteen were treated with the Begg technique, and eighteen were treated with Herbst appliance for an average period of 1.3 and 0.5 years, respectively. Lateral radiographs in habitual occlusion were taken at the start of treatment and 12 months afterwards. In the Begg group, the maxilla moved forward 1 mm more than in the Herbst group, and the mandible moved 1 mm more in the Herbst group than in the Begg group. The skeletal improvement in the Herbst group exceeded the changes in the Begg group by, on average, 2.0 mm (P <.01). The overjet reduction in the Begg group was larger (2.1 mm; P <.01) than in the Herbst group, mostly because of dental movements. The skeletal part of the overjet reduction was 4% in the Begg group compared with 51% in the Herbst group. The molar correction was similar in both groups, but in the Begg group, the skeletal improvement was 10%, compared with 66% in the Herbst group. The overbite correction and the increase in the anterior lower facial height and in the NSL/ML angle were larger in the Begg group (P <.05). The conclusions of this study were that the changes contributing to the Class II corrections in Begg and Herbst therapy were skeletal and dental. The skeletal changes were, however, larger in the Herbst-treated group. On the other hand, favorable and unfavorable vertical changes were more pronounced in the group treated with Class II elastics.


Helminths of guineafowls in Limpopo Province, South Africa.
Between July 2005 and November 2006 the gastro-intestinal helminths of 15 Helmeted guineafowls and a single Crested guineafowl from Musina, Limpopo Province were examined, and in July and August 2005 helminths were collected from five Helmeted guineafowls from Mokopane in the same province. The acanthocephalan Mediorhynchus gallinarum, the cestodes Abuladzugnia gutterae, Davainea nana, Hymenolepis cantaniana, Numidella numida, Octopetalum numida, Ortleppolepis multiuncinata, Porogynia paronai, Raillietina angusta, Raillietina pintneri, Raillietina steinhardti and Raillietina sp. and the nematodes Ascaridia numidae, Cyrnea parroti, Gongylonema congolense, Hadjelia truncata, Sicarius caudatus, Subulura dentigera, Subulura suctoria, Subulura sp., Tetrameres numida and an unidentified subulurid were recovered. A single trematode species, Dicrocoelium macrostomum, was present in the liver. Mediorhynchus gallinarum, A. gutterae, O. multiuncinata, H. truncata and S. caudatus are recorded for the first time from Helmeted guineafowls, as well as from South Africa. South Africa is a new geographic record for D. macrostomum, G. congolense and D. nana. Subulura suctoria, G. congolense and H. truncata from the Crested guineafowl constitute new host-parasite associations.


Deceased donor organ transplantation potential: A peep into an untapped gold mine.
Organ transplantation is the gold standard for treating end-stage organ diseases, many of whom are on waiting lists. The reasons for this include the nonavailability of suitable organs to be transplanted. In many nations, most of these challenges have been surmounted by the adoption of deceased donor program, which is not so in sub-Saharan countries such as Nigeria. This study is to audit the potentially transplantable organs available from potential deceased donors from a Nigerian tertiary hospital. This is a study of deaths in the intensive care unit (ICU) and the accident and emergency units of the University of Ilorin Teaching Hospital, Nigeria. Data included the biodata, social history, diagnosis or indications for admission, time of arrival and death, causes of death, associated comorbidities, potential organs available, social history, and availability of relations at the time of death. There were 104 deaths in the ICU and 10 patients in the accident and emergency unit. There were 66 males (57.9%) and 48 females (42.1%). Eighty patients were Muslims (70.2%) and 34 were Christians (19.8%). A total of 33 participants were unmarried (28.9%),whereas 81 (71.1%) were married. The tribes of the patients were Yoruba (105, 92.1%), Igbo (7, 6.1%), Hausa (1, 0.9%), and Nupe (1, 0.9%). The age range was 0.08-85 years. Twenty-two (19.3%) had primary and the remaining had at least secondary education. The causes of death were myriad, and there were relatives available at the times of all deaths. The Maastricht classification of the deaths were Class I - 1 (0.9%), Class II - 37 (32.2%), Class III - 9 (7.8%), Class IV - 20 (17.4%), and Class V - 47(40.9%). There were no transplantable organs in 42 (36.5%), one organ in eight (7%), two organs in two (7%), three organs in one (0.9%), four organs in 13 (11.3%), five organs in six (5.2%), six organs in 11 (9.6%), seven organs in 11 (9.6%), eight organs in five (13%), and nine organs in five (4.3%). Deceased donor sources of organs are worthy of being exploited to improve organ transplantation in Nigeria.


Comparative study of the reaction mechanism of family 18 chitinases from plants and microbes.
Hydrolytic mechanisms of family 18 chitinases from rice (Oryza sativa L.) and Bacillus circulans WL-12 were comparatively studied by a combination of HPLC analysis of the reaction products and theoretical calculation of reaction time-courses. All of the enzymes tested produced beta-anomers from chitin hexasaccharide [(GlcNAc)(6)], indicating that they catalyze the hydrolysis through a retaining mechanism. The rice chitinases hydrolyzed predominantly the fourth and fifth glycosidic linkages from the nonreducing end of (GlcNAc)(6), whereas B. circulans chitinase A1 hydrolyzed the second linkage from the nonreducing end. In addition, the Bacillus enzyme efficiently catalyzed transglycosylation, producing significant amounts of chitin oligomers larger than the initial substrate, but the rice chitinases did not. The time-courses of (GlcNAc)(6) degradation obtained by HPLC were analyzed by theoretical calculation, and the subsite structures of the rice chitinases were identified to be (-4)(-3)(-2)(-1)(+1)(+2). From the HPLC profile of the reaction products previously reported [Terwisscha van Scheltinga et al. (1995) Biochemistry 34, 15619-15623], family 18 chitinase from rubber tree (Hevea brasiliensis) was estimated to have the same type of subsite structure. Theoretical analysis of the reaction time-course for the Bacillus enzyme revealed that the enzyme has (-2)(-1) (+1)(+2)(+3)(+4)-type subsite structure, which is identical to that of fungal chitinase from Coccidioides immitis [Fukamizo et al. (2001) Biochemistry 40, 2448-2454]. The Bacillus enzyme also resembled the fungal chitinase in its transglycosylation activity. Minor structural differences between plant and microbial enzymes appear to result in such functional variations, even though all of these chitinases are classified into the identical family of glycosyl hydrolases.


Imaging prodromal Parkinson disease: the Parkinson Associated Risk Syndrome Study.
The purpose of this study is to evaluate the relative risk of abnormal dopamine transporter (DAT) imaging for subjects with and without hyposmia and the feasibility of acquiring a large, community-based, 2-tiered biomarker assessment strategy to detect prodromal Parkinson disease (PD). In this observational study, individuals without a diagnosis of PD, recruited through 16 movement disorder clinics, underwent tier 1 assessments (olfactory testing, questionnaires). Tier 2 assessments (neurologic examination, DAT imaging, and other biomarker assessments) were completed by 303 subjects. The main outcome of the study is to compare age-expected [(123)I]β-CIT striatal binding ratio in hyposmic and normosmic subjects. Tier 1 assessments were mailed to 9,398 eligible subjects and returned by 4,999; 669 were hyposmic. Three hundred three subjects (203 hyposmic, 100 normosmic) completed baseline evaluations. DAT deficit was present in 11% of hyposmic subjects compared with 1% of normosmic subjects. Multiple logistic regression demonstrates hyposmia (odds ratio [OR] 12.4; 95% confidence interval [CI] 1.6, 96.1), male sex (OR 5.5; 95% CI 1.7, 17.2), and constipation (OR 4.3; 95% CI 1.6, 11.6) as factors predictive of DAT deficit. Combining multiple factors (hyposmia, male sex, and constipation) increased the percentage of subjects with a DAT deficit to >40%. Subjects with DAT deficit who do not meet criteria for a diagnosis of PD can be identified by olfactory testing. Sequential biomarker assessment may identify those at risk of PD. Selecting hyposmic individuals enriches the population for DAT deficit, and combining hyposmia with other potential risk factors (male sex, constipation) increases the percentage of subjects with a DAT deficit compatible with prodromal PD.


Application of ICD guidelines and indications in a community-based academic hospital: a case series-based discussion.
Implantable cardioverter defibrillators (ICDs) are indeed beneficial in selected patients as evidenced by multiple large randomized controlled trials (RCTs) since 1980. A systematic method for stratification of patients and hospital-wide criteria/guidelines to ascertain appropriate device implantation became necessary. Major ICD/CRT (cardiac resynchronization therapy) clinical studies and relevant guidelines were reviewed, and an institution-wide inclusion and exclusion criteria for ICD/CRT was formulated. A retrospective analysis of selected cases was performed to discuss the criteria and special clinical situations. We have translated the evolving ICD/CRT studies into a standard of care at our hospital by formulating a standard, practical, and update-to-date ICD inclusion and exclusion criteria. Thirteen cases were selected to represent major indications and contraindications of ICDs in our practice. These cases cover indications of ICD for secondary prevention of sudden cardiac death (SCD), primary prevention of SCD in patients with CHF resulted from either ischemic or non-ischemic cardiomyopathy, as well as for infiltrative cardiomyopathy and inherited conditions. We discussed the application of CRT in patients with CHF associated with prolonged QRS duration. We then covered the potential benefits of ICD with/without CRT in certain special populations of patients that have not been adequately evaluated by currently available RCTs; these include alcoholic, elderly, female, and ESRD/HD patients. Finally, we addressed risks, complications and contraindications of ICD, as well as application of an external wearable defibrillator in AMI, or status post-CABG patient during the mandatory waiting period for an ICD. Establishment of the ICD/CRT criteria represents a practical translation of emerging CRTs and helps to standardize patient care in our hospital. It also improves cost-effectiveness as well as appropriate utilization of institute and device resources.


Microneedle Arrays of Polyhydroxyalkanoate by Laser-Based Micromolding Technique.
Although many delivery systems have been proposed to improve drug permeation through the skin, all of them suffer from several limitations. This drives a continuous search for innovative systems that can provide safe and effective transdermal drug delivery solutions. In line with this, microneedle (MN) arrays, a hybrid combination of hypodermic injections and transdermal patches, have been proposed. MNs consist of microscale needles that can pierce the skin by a simple, minimally invasive, and painless route, enabling the transport of drugs and macromolecules into the human body. This study reports, for the first time, the use of a biobased, biodegradable, and biocompatible polymer, poly(3-hydroxybutyrate-co-3-hydroxyvalerate), P(3HB-co-3HV), for the fabrication of a biopolymer-based MN patch. Molds of poly(dimethylsiloxane) were prepared by direct laser writing technology, a low-cost and mask-less technology, and used to produce biodegradable P(3HB-co-3HV) MNs by a thermosetting process. The best results were obtained with a laser power of 30 W at 0.15 m/s with a spiral model as the pattern. The obtained MNs had a length of 0.69 mm and a diameter of 0.33 mm, ideal for painless penetration of the skin. Additionally, the produced MNs had good mechanical properties and the ability to be successfully impregnated with the fluorescent dye Rhodamine 6G. These features render P(3HB-co-3HV) a promising material for the development of MNs with improved functionality.


FBH1 protects melanocytes from transformation and is deregulated in melanomas.
FBH1 is a member of the UvrD family of DNA helicases and plays a crucial role in the response to DNA replication stress. In particular, upon DNA replication stress, FBH1 promotes double-strand breakage and activation of the DNA-PK and ATM signaling cascades in a helicase-dependent manner. In the present manuscript, we show that FBH1 is often deleted or mutated in melanoma cells, which results in their increased survival in response to replicative stress. Accordingly, FBH1 depletion promotes UV-mediated transformation of human melanocytes. Thus, FBH1 inactivation appears to contribute to oncogenic transformation by allowing survival of cells undergoing replicative stress due to external factors such as UV irradiation.


Cost analysis of a remote patient monitoring programme for post-discharge patients with type 2 diabetes.
Assessing costs of an evidence-based health promotion programme is crucial to understand the economic feasibility of adopting or sustaining the programme. This study conducted a cost analysis of a remote patient monitoring (RPM) programme to enhance the post-discharge management of type 2 diabetes. Using retrospective data collected during RPM implementation from September 2014 to February 2018, we estimated the costs of implementing an RPM in the primary care setting. Measures included total and average annual costs, costs per participant who was enrolled or completed the programme, and costs per person-day. We further conducted sensitivity and scenario analyses to examine variations in estimated programme costs associated with varying programme efficiencies and alternative personnel compositions of the RPM team. The total RPM implementation costs were estimated at US$4,374,544 with an average annual programme costs of US$1,249,870, which translated to US$3207 per participant (n = 1364) completing the three-month programme. The per person-day cost was averaged at US$24 (182,932 person-days). Sensitivity and scenario analyses results indicate that the sustainment costs were approximately US$1.6 million annually and the per-person-day costs were between US$21 and US$29 with each nurse coach on average serving a panel of 62-93 patients. The implementation and sustainment costs of an RPM programme, estimated under various assumptions of programme efficiency and care team compositions, as exemplified in this study, will help healthcare organizations make informed decisions in budgeting for and sustaining telehealth programmes to enhance diabetes management.


A report card on provider report cards: current status of the health care transparency movement.
Public reporting of provider performance can assist consumers in their choice of providers and stimulate providers to improve quality. Reporting of quality measures is supported by advocates of health care reform across the political spectrum. To assess the availability, credibility and applicability of existing public reports of hospital and physician quality, with comparisons across geographic areas. Information pertaining to 263 public reports in 21 geographic areas was collected through reviews of websites and telephone and in-person interviews, and used to construct indicators of public reporting status. Interview data collected in 14 of these areas were used to assess recent changes in reporting and their implications. Interviewees included staff of state and local associations, health plan representatives and leaders of local health care alliances. There were more reports of hospital performance (161) than of physician performance (103) in the study areas. More reports included measures derived from claims data (mean, 7.2 hospital reports and 3.3 physician reports per area) than from medical records data. Typically, reports on physician performance contained measures of chronic illness treatment constructed at the medical group level, with diabetes measures the most common (mean number per non-health plan report, 2.3). Patient experience measures were available in more hospital reports (mean number of reports, 1.2) than physician reports (mean, 0.7). Despite the availability of national hospital reports and reports sponsored by national health plans, from a consumer standpoint the status of public reporting depended greatly on where one lived and health plan membership. Current public reports, and especially reports of physician quality of care, have significant limitations from both consumer and provider perspectives. The present approach to reporting is being challenged by the development of new information sources for consumers, and consumer and provider demands for more current information.


The influence of anticodon-codon interactions and modified bases on codon usage bias in bacteria.
Most transfer RNAs (tRNAs) can translate more than one synonymous codon, and most codons can be translated by more than one isoacceptor tRNA. The rates of translation of synonymous codons are dependent on the concentrations of the tRNAs and on the rates of pairing of each anticodon-codon combination. Translational selection causes a significant bias in codon frequencies in highly expressed genes in most bacteria. By comparing codon frequencies in high and low-expression genes, we determine which codons are preferred for each amino acid in a large sample of bacterial genomes. We relate this to the number of copies of each tRNA gene in each genome. In two-codon families, preferred codons have Watson-Crick pairs (GC and AU) between the third codon base and the wobble base of the anticodon rather than GU pairs. This suggests that these combinations are more rapidly recognized by the ribosome. In contrast, in four-codon families, preferred codons do not correspond to Watson-Crick rules. In some cases, a wobble-U tRNA can pair with all four codons. In these cases, A and U codons are preferred over G and C. This indicates that the nonstandard UU combination appears to be translated surprisingly well. Differences in modified bases at the wobble position of the anticodon appear to be responsible for the differences in behavior of tRNAs in two- and four-codon families. We discuss the way changes in the bases in the anticodon influence both the speed and the accuracy of translation. The number of tRNA gene copies and the strength of translational selection correlate with the growth rate of the organism, as we would expect if the primary cause of translational selection in bacteria is the requirement to optimize the speed of protein production.


Social risk management--reducing disparities in risk, vulnerability and poverty equitably.
Hurricane Katrina, which struck the Gulf Coast on August 29, 2005 and took 1,000 lives or more, was the third deadliest storm to hit the United States, falling behind only the Galveston Hurricane of 1900 and the 1928 Okeechobee Hurricane. It is New Orleans' worst natural disaster in its nearly 300-year history. The storm left hundreds of thousands without access to shelter, food, water, clothing and basic sanitation. The human suffering and health consequences are immeasurable. Dissatisfaction with the federal, national and local governments' planning and response is widespread. Many believe that the system discriminated cruelly by race and class against those in greatest need. The storm revealed serious flaws in disaster relief and preparedness structures, which require major reform. As an alternative, this article proposes a social risk management system to provide both universal risk protection and an efficient, more equitable approach to managing and reducing disparities in vulnerability. While one must realize that incremental rather than comprehensive reform of the system is most likely and most politically feasible, Katrina's horrific consequences and revealed inequities necessitate an alternative model.


Investigation of the Regulation of Roundabout4 by Hypoxia-Inducible Factor-1α in Microvascular Endothelial Cells.
We determined if hypoxia-inducible factor-1α (HIF-1α) and Roundabout4 (Robo4) colocalized in fibrovascular membranes (FVM) from patients with proliferative diabetic retinopathy (PDR), and investigated the regulation of HIF-1α on Robo4 in microvascular endothelial cells under normoxic and hypoxic conditions in vitro. Immunofluorescence and confocal laser scanning microscopy were done to analyze the colocalization of HIF-1α and Robo4 in the FVM. Expression of HIF-1α was knocked down by small interfering RNA (siRNA) technology to study its effects on Robo4 expression of human retinal endothelial cells (HREC) and human dermal microvascular endothelial cells (HDMEC) under normoxic and/or hypoxic conditions. Full-length human HIF-1α gene was transfected into HREC and HDMEC using GFP lentivirus vectors to overexpress HIF-1α under normoxic conditions. The HIF-1α and Robo4 mRNA and protein expressions were quantified by real-time PCR and Western blot. A cell proliferation, migration assay, and flow cytometry were used to analyze the effect of HIF-1α regulation on Robo4 in HREC under hypoxic conditions. Colocalization of HIF-1α and Robo4 in vessels of FVM was confirmed by immunofluorescence staining. Knockdown of HIF-1α expression by siRNA in the HREC and HDMEC inhibited Robo4 expression in mRNA and protein level, while overexpressed HIF-1α increased Robo4 mRNA and protein expression. Silencing HIF-1α in endothelial cells under hypoxic conditions inhibited cell invasion and proliferation, which showed that HIF-1α and Robo4 overexpression due to hypoxic conditions correlated with HREC migration and proliferation. Both HIF-1α and Robo4 may have a vital role during the formation of FVM. The increased or decreased expression of Robo4 by stimulation or knockdown of HIF-1α suggesting that Robo4 is positively regulated by HIF-1α under normoxic and hypoxic conditions in microvascular endothelial cells in vitro. The HIF-1α gene promotes HREC invasion and proliferation by transcriptionally upregulating Robo4 under hypoxic conditions.


Association of Polygenic Liability for Alcohol Dependence and EEG Connectivity in Adolescence and Young Adulthood.
Differences in the connectivity of large-scale functional brain networks among individuals with alcohol use disorders (AUD), as well as those at risk for AUD, point to dysfunctional neural communication and related cognitive impairments. In this study, we examined how polygenic risk scores (PRS), derived from a recent GWAS of DSM-IV Alcohol Dependence (AD) conducted by the Psychiatric Genomics Consortium, relate to longitudinal measures of interhemispheric and intrahemispheric EEG connectivity (alpha, theta, and beta frequencies) in adolescent and young adult offspring from the Collaborative Study on the Genetics of Alcoholism (COGA) assessed between ages 12 and 31. Our findings indicate that AD PRS (p-threshold < 0.001) was associated with increased fronto-central, tempo-parietal, centro-parietal, and parietal-occipital interhemispheric theta and alpha connectivity in males only from ages 18-31 (beta coefficients ranged from 0.02-0.06, p-values ranged from 10-6-10-12), but not in females. Individuals with higher AD PRS also demonstrated more performance deficits on neuropsychological tasks (Tower of London task, visual span test) as well as increased risk for lifetime DSM-5 alcohol and opioid use disorders. We conclude that measures of neural connectivity, together with neurocognitive performance and substance use behavior, can be used to further understanding of how genetic risk variants from large GWAS of AUD may influence brain function. In addition, these data indicate the importance of examining sex and developmental effects, which otherwise may be masked. Understanding of neural mechanisms linking genetic variants emerging from GWAS to risk for AUD throughout development may help to identify specific points when neurocognitive prevention and intervention efforts may be most effective.


Reliability and validity of the Geriatric Oral Health Assessment Index in Turkey.
The purpose of this study was to test the reliability and validity of the Turkish version of the Geriatric Oral Health Assessment Index (GOHAI). Data were obtained from a cross-sectional survey of 101 older adults living at a residential home in the Izmir municipality of Turkey. The Turkish version of the GOHAI showed acceptable reliability and validity. The Cronbach's alpha coefficient was 0.75, and item-scale (Pearson's) correlations varied between 0.30 and 0.67. Low GOHAI scores were associated with perceived poor oral health (p < 0.01) and dissatisfaction with oral health status (p < 0.05). Factor analyses of the index indicated a two-factor solution. It was concluded that the Turkish version of the GOHAI is a reliable and valid measure for use with Turkish adults age 65 and older.


Mucinous cystadenoma in a female patient with 45,X/46,XY karyotype.
The mosaic karyotype of 45,X/46,XY has a wide phenotypic spectrum and there are substantial differences between prenatally and postnatally diagnosed cases. The phenotype varies between normal male to classical Turner syndrome. There is a high risk of gonadal tumor development in the dysgenetic gonads of patients with sex chromosome mosaicism. We report a case of a 24-year-old patient with a pelvic mass and amenorrhea referred to our laboratory for karyotyping. Peripheral blood chromosome analysis showed a mosaic karyotype of 45,X[17]/46,XY[83]. The tumor originated from the left ovary and the right ovary was found to be a streak gonad. The uterus was intact. Pathologic examination of the tumor revealed mucinous cystadenoma. Physical examination of the patient showed signs of Turner syndrome, as short stature (145 cm), short neck and asymmetric shoulders. Her mental state was normal. Y chromosome microdeletion screening involving SRY and ZFY genes was performed and no deletion was found. The patient was informed about the condition during the genetic counseling session.


Hairy polyp of the oropharynx: case report and literature review.
Hairy polyp of the oronasopharynx is an uncommon developmental malformation that is most frequently seen as a pedunculated tumor in the neonate. Derived from the ectoderm and mesoderm, this benign tumor generally has been classified as dermoid. The clinical presentation is dependent on the polyp's size and location. A full-term girl was evaluated for an oral mass that was first noted at the time of birth. Evaluation showed a 5- x 2.5-cm soft, nontender, skin-covered mass that protruded from the oral cavity. During surgery, it was noted that the stalk was attached to the superior pole of the left tonsil. The histology of the mass was consistent with a hairy polyp. Knowledge of this type of malformation facilitates early intervention and avoids significant morbidity.


Optical mercury sensing using a benzothiazolium hemicyanine dye.
[structure: see text] The selectivity and sensitivity of a benzothiazolium hemicyanine dye toward mercury(II) in aqueous solutions are described. Mercury ions coordinate to the dye forming a 1:1 complex. This interaction induces a color change in the dye at micromolar concentrations of mercury. Furthermore, the color change and quenching of the dye emission are selective for mercury when compared with other ions such as lead(II), cadmium(II), zinc(II), or iron(II).


The function of the floral corona in the pollination of a Mediterranean style dimorphic daffodil.
Narcissus papyraceus is a style dimorphic species with two floral forms, with anthers at similar height and stigmas above (long-styled L) and below (short-styled S) the anther level. The species is self-incompatible, but intra- and inter-morph compatible. Populations are either dimorphic (including both morphs) in the region of the Strait of Gibraltar, or L-monomorphic (with only L plants) in the inland of the Iberian Peninsula. This variation correlates with the most common floral visitors, being primarily long-tongued and short-tongued pollinators, respectively, a rare condition in Mediterranean plants. The maintenance of S-flowers relies on long-tongued insects, as only those deliver pollen to short-styled stigmas. Narcissus flowers present a long and narrow tube, at the bottom of which nectar accumulates, and a floral corona, which has been proposed as an important trait for the attraction of pollinators. Here we tested the importance of the corona on pollination of L and S flowers. We described UV reflectance patterns of the corona and tepals, and characterised VOCs in intact flowers and flowers with trimmed coronas. We also conducted a field experiment in the dimorphic and monomorphic region to estimate the importance of corona removal on seed production in stands with solitary plants and in groups to control for compatible pollen limitation. Reflectance was higher in the tepals than the corona, although both traits presented a reflectance peak around 450 nm wavelength. L- and S-flowers produced similar volatiles, regardless of the manipulation of the corona. Across dimorphic and monomorphic regions, S-flowers with the corona removed suffered a reduction in seed production of ca. 50%, while seed production remained similar in L flowers both with the corona intact and removed. Plants in solitary stands suffered a strong reduction in seed production, which was more pronounced in the monomorphic region. Our results suggest that the corona in Narcissus is more important for the pollination of S-flowers, which generally have lower seed production compared to L-flowers. Taken together, these results suggest that the floral corona indirectly plays an important role for maintenance of the polymorphism.


The Macaque Cerebellar Flocculus Outputs a Forward Model of Eye Movement.
The central nervous system (CNS) achieves fine motor control by generating predictions of the consequences of the motor command, often called forward models of the movement. These predictions are used centrally to detect not-self generated sensations, to modify ongoing movements, and to induce motor learning. However, finding a neuronal correlate of forward models has proven difficult. In the oculomotor system, we can identify neuronal correlates of forward models vs. neuronal correlates of motor commands by examining neuronal responses during smooth pursuit at eccentric eye positions. During pursuit, torsional eye movement information is not present in the motor command, but it is generated by the mechanic of the orbit. Importantly, the directionality and approximate magnitude of torsional eye movement follow the half angle rule. We use this rule to investigate the role of the cerebellar flocculus complex (FL, flocculus and ventral paraflocculus) in the generation of forward models of the eye. We found that mossy fibers (input elements to the FL) did not change their response to pursuit with eccentricity. Thus, they do not carry torsional eye movement information. However, vertical Purkinje cells (PCs; output elements of the FL) showed a preference for counter-clockwise (CCW) eye velocity [corresponding to extorsion (outward rotation) of the ipsilateral eye]. We hypothesize that FL computes an estimate of torsional eye movement since torsion is present in PCs but not in mossy fibers. Overall, our results add to those of other laboratories in supporting the existence in the CNS of a predictive signal constructed from motor command information.


Ultrasound power and irrigation volume in different lens opacity grades: comparison of femtosecond laser-assisted cataract surgery and conventional phacoemulsification.
To compare the amount of ultrasound energy and irrigation volume in conventional phacoemulsification cataract surgery versus femtosecond laser-assisted phacoemulsification at different nuclear-cortical cataract grades. This was a prospective, consecutive, investigator-masked nonrandomized parallel cohort study. Patients were divided into 4 groups (Phaco1, Phaco2, Femto1 and Femto2) according to the surgical technique (conventional phacoemulsification [Group Phaco] or femtosecond laser-assisted cataract surgery [Group Femto]) and the Lens Opacity Classification System III (LOCS) grade (LOCS<11 [group 1] or LOCS≥11 [group 2]). The measured outcomes were effective phacoemulsification time (EPT), indicating the ultrasound energy, and balanced salt solution (BSS) use, indicating the irrigation volume, to indirectly estimate the damage to the corneal endothelium caused by the cataract surgery. A total of 160 eyes from 109 patients were included: 87 eyes in Group Phaco, 73 eyes in Group Femto, 76 eyes in group 1 and 84 eyes in group 2. The EPT mean in Femto1 was 53% less (2.73±1.88, 0.1 to 8.65) than that in Phaco1 (5.80±2.86) (p=0.00) and in Femto2 (8.38±9.32) was 33% less than that in Phaco2 (12.55±8.38) (p=0.00). No significant differences in mean LOCS grades between the Phaco1 (8.21±1.44) and Femto1 (7.90±1.90) groups (p=0.73) or between the Phaco2 (13.15±2.55) and Femto2 (12.72±2.18) groups (p=0.95) were found. There were no significant differences in the mean BSS use between the Phaco1 (55.73±12.45) and Femto1 (59.37±10.93) groups (p=0.48) or between the Phaco2 (64.34±21.00) and Femto2 (65.71±17.60) groups (p=0.47). Compared to conventional phacoemulsification at different nuclear-cortical cataract grades, femtosecond laser-assisted cataract surgery provides an EPT reduction but does not influence the BSS use.


Anti-inflammatory and anti-allergic properties of donkey's and goat's milk.
Nowadays, donkey's and goat's milk consumption has been reevaluated for its potential benefits to human health. For example, in infants with intolerance to cow's milk, donkey's milk represents a good alternative due to its chemical characteristics similar to those of human milk. On the other hand, goat's milk in virtue of its higher content in short chain, medium chain, mono and polyunsaturated fatty acids than that of cow's milk, is more digestible than the bovine counterpart. From an immunological point of view, donkey's milk is able to induce release of inflammatory and anti-inflammatory cytokines from normal human peripheral blood lymphomononuclear cells, thus maintaining a condition of immune homeostasis. Similarly, goat's milk has been shown to trigger innate and adaptive immune responses in an in vitro human system, also inhibiting the endotoxin-induced activation of monocytes. Finally, in these milks the presence of their own microbiota may normalize the human intestinal microbiota with a cascade of protective effects at intestinal mucosal sites, even including triggering of intestinal T regulatory cells. In the light of the above considerations, donkey's and goat's milk should be recommended as a dietary supplement in individuals with inflammatory and allergic conditions, even including elderly people.


Bone mineral density and the risk of incident nonspinal fractures in black and white women.
Black women have a lower rate of fracture than white women, but whether bone mineral density (BMD) predicts fracture risk as well in black women as it does in white women is not established. To examine the association between BMD and incident nonspinal fractures in older black and white women. Prospective cohort study of baseline data collected from 1986 through 1990 (7334 white women aged 67-99 years) and from 1996 through 1998 (636 black women aged 65-94 years) at 4 US clinical centers in the Study of Osteoporotic Fractures; mean (SD) follow-up of 6.1 (1.5) years until October 1, 2004. Incident nonspinal fractures were confirmed by radiograpic report. Total hip and femoral neck BMD and bone mineral content were measured by dual energy x-ray absorptiometry. A total of 58 black women had a combined total of 61 fractures and 1606 white women had a combined total of 1712 fractures. In age-adjusted proportional hazard models, a 1-SD decrease in femoral neck BMD was associated with a 37% increased risk of fracture in black women (relative risk [RR], 1.37; 95% confidence interval [CI], 1.08-1.74) and a 49% increase in fracture in white women (RR, 1.49; 95% CI, 1.40-1.58). Adjustment for body weight and other risk factors for fracture weakened the association between BMD and fracture, especially among black women (multivariable adjusted RR per 1-SD decrease in femoral neck BMD for black vs white women: RR, 1.20 [95% CI, 0.93-1.55] vs RR, 1.42 [95% CI, 1.32-1.52]). The absolute incidence of fracture across the pooled BMD distribution was 30% to 40% lower among black women at every BMD tertile. The lower risk of fracture among black compared with white women was independent of BMD and other risk factors (RR, 0.48; 95% CI, 0.36-0.64). Decreased total hip and femoral neck BMD is associated with an increased risk of fracture in both older black and white women, but this relationship was largely explained by other risk factors in black women. Black women have a lower fracture risk than white women at every level of BMD. Race-specific normative databases may be appropriate for the densitometric definition of osteoporosis.


Effect of feeding tuna oil or soyabean oil as supplements to sows in late pregnancy on piglet tissue composition and viability.
To investigate whether long-chain n-3 polyunsaturated fatty acids could cross the porcine placenta in late pregnancy and alter neonatal piglet tissue composition, multiparous sows (seven per diet) were fed on diets containing a supplement (30 g/kg) of either soyabean oil or tuna oil for the last 21 d of pregnancy and the first 7 d of lactation. The proportions of all fatty acids, except 18:1n-7, differed between diets: in particular, the tuna-oil-containing diet supplied more 22:6n-3 and less 18:2n-6 fatty acids than the soyabean-oil-containing diet. The proportions of n-3 fatty acids, particularly 22:6n-3 (g/100 g total fatty acids) in sow plasma, colostrum and milk were increased and the proportion of 18:2n-6 was decreased by feeding tuna oil. Piglet tissue n-3 fatty acid proportions (particularly 22:6n-3), obtained shortly after birth, were increased in piglets born to tuna-oil-fed sows compared with progeny of soyabean-oil-fed sows. The increase in the proportion of n-3 fatty acids (g/100 g total fatty acids) in piglet tissues as a result of tuna-oil feeding, compared with soyabean-oil-feeding, was in the order plasma > liver > erythrocytes > spleen > brain > retina. Piglets born to tuna-oil-fed sows had a lower viability score at birth than the progeny of soyabean-oil-fed sows. The proportions of long-chain n-3 fatty acid in tissues of new-born piglets were increased by feeding tuna oil to the sow in late pregnancy; however no improvements in piglet viability were observed.


What can be inferred from bacterium-nanoparticle interactions about the potential consequences of environmental exposure to nanoparticles?
This article collates published information regarding the in vitro antibacterial activity of both metal and carbon nanoparticles. The aims are to establish a consensus regarding modes of antibacterial activity, and to evaluate the applicability of current knowledge to prediction of likely effects of nanoparticles upon important microbial processes in environmental exposures. The majority of studies suggest that nanoparticles cause disruption to bacterial membranes, probably by production of reactive oxygen species. Contact between the nanoparticle and bacterial membrane appears necessary for this activity to be manifested. Interfacial forces such as electrostatic interactions are probably important in this respect. However, the toxicity of free metal ions originating from the nanoparticles cannot be discounted. Passage of nanoparticles across intact membranes appears to be unlikely, although accumulation within the cytoplasm, probably after membrane disruption, is often observed. To date, published studies have not been designed to mimic natural systems and therefore provide poor understanding of the likely consequences of intentional or unintentional environmental release. The limited studies currently available fail to identify any significant effects at the microbial level of nanoparticles in more complex systems.


The SLC6A15-SLC6A20 neutral amino acid transporter subfamily: functions, diseases, and their therapeutic relevance.
The neutral amino acid transporter subfamily that consists of six members; consecutively SLC6A15-SLC620, also called orphan transporters, represents membrane, sodium-dependent symporter proteins that belong to the family of solute carrier 6 (SLC6). Primarily, they mediate the transport of neutral amino acids from the extracellular milieu toward cell or storage vesicles utilizing an electric membrane potential as the driving force. Orphan transporters are widely distributed throughout the body, covering many systems; for instance, the central nervous, renal, or intestinal system, supplying cells into molecules utilized in biochemical, signaling, and building pathways afterward. They are responsible for intestinal absorption and renal reabsorption of amino acids. In the CNS, orphan transporters constitute a significant medium for the provision of neurotransmitter precursors. Diseases related with aforementioned transporters highlight their significance; SLC6A19 mutations are associated with metabolic Hartnup disorder, whereas altered expression of SLC6A15 has been associated with a depression/stress-related disorders. Mutations of SLC6A18-SLCA20 cause iminoglycinuria and/or hyperglycinuria. SLC6A18-SLC6A20 to reach the cellular membrane require an ancillary unit ACE2 that is a molecular target for the spike protein of the SARS-CoV-2 virus. SLC6A19 has been proposed as a molecular target for the treatment of metabolic disorders resembling gastric surgery bypass. Inhibition of SLC6A15 appears to have a promising outcome in the treatment of psychiatric disorders. SLC6A19 and SLC6A20 have been suggested as potential targets in the treatment of COVID-19. In this review, we gathered recent advances on orphan transporters, their structure, functions, related disorders, and diseases, and in particular their relevance as therapeutic targets. Significance Statement The following review systematizes current knowledge about the SLC6A15-SLCA20 neutral amino acid transporter subfamily and their therapeutic relevance in the treatment of different diseases.


Incorporation of [3H] uridine into the ribonucleic acid of rat uterus during pseudopregnancy and in the presence of I.C.I. 46474 [trans-1-(p-beta-dimethylaminoethoxyphenyl)-1,2-diphenylbut-1-ene].
1. The incorporation of [(3)H]uridine into RNA of rat uterine tissue has been measured during pseudopregnancy and in rats receiving different doses of an anti-implantation compound [trans-1-(p-beta-dimethylaminoethoxyphenyl)-1,2-diphenylbut- 1-ene, I.C.I. 46474]. 2. In the uterus of the pseudopregnant rat uridine incorporation into RNA increased markedly on day 3 of pseudopregnancy, remained high until day 5 and decreased sharply by day 6, rising again by day 9. 3. This pattern of change was similar to, but not identical with, that previously found in the pregnant rat. 4. Rats receiving I.C.I. 46474 at a dose concentration below that preventing implantation showed a pattern of RNA synthesis similar to that found in untreated control rats. 5. Rats treated with doses of I.C.I. 46474 sufficient to inhibit implantation revealed a totally different pattern of incorporation of [(3)H]uridine into uterine RNA. 6. The results are discussed in terms of previous findings with the normally pregnant rat. It is concluded that the increasing uterine RNA synthesis found on day 3 in the pregnant rat is an important requirement for the occurrence of the subsequent implantation.


Detection improvement in spatially filtered x-ray fluoroscopy image sequences.
The effect of spatial noise-reduction filtering on human observer detection of stationary cylinders mimicking arteries, catheters, and guide wires in x-ray fluoroscopy was investigated in both single image frames and image sequences. Ideal edge-preserving spatial filtering was simulated by filtering of the noise before addition of the target cylinder. This allowed us to separate the effect of edge blurring from those of noise reduction and spatial noise correlation. We used three different center-weighted averagers that reduced pixel noise variance by factors of 0.75, 0.50, and 0.25. As compared with no filtering, the effect of filtering on detection in single images was statistically insignificant. This indicated an adverse effect of spatial noise correlation on detection that countered the effect of noise reduction. By comparison, spatial filtering significantly improved detection in image sequences and yielded potential x-ray dose savings of 26-34%. Comparison of results with two observer models suggested that human observers have an improved detection efficiency in spatially filtered image sequences as compared with white-noise sequences. Pixel noise reduction, a measure commonly used to assess filter performance, overestimated the effect of filtering on detection and was not a good indicator of image quality. We conclude that edge-preserving spatial filtering is more effective in sequences than in single images and that such filtering can be used to improve image quality in noisy image sequences such as x-ray fluoroscopy.


Association of inflammatory markers with the morphology and extent of coronary plaque as evaluated by 64-slice multidetector computed tomography in patients with stable coronary artery disease.
We evaluated the association between inflammatory markers and coronary artery plaque assessed by 64-slice multidetector computed tomography. Coronary computed tomography angiography was performed in patients with chest discomfort suggestive of coronary artery disease (CAD). Individuals with an acute coronary syndrome were excluded from the study. Coronary plaque morphology, the number of artery segments exhibiting plaque, and the number of vessels with >50% stenosis were evaluated. Plasma levels of high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), plasminogen activator inhibitor-1, and vascular endothelial growth factor were measured. Among the 178 patients studied (age 65 ± 10 years; 70% men), 125 were diagnosed with CAD. Hs-CRP and IL-6 concentrations were significantly higher in patients with CAD than in patients without (2.73 ± 4.7 vs. 1.32 ± 2.6 mg/L, P = 0.018, and 3.06 ± 3.3 vs. 2.19 ± 2.4 pg/mL, P = 0.036). The IL-6 level was high in patients with predominantly calcified plaque, and was significantly higher in patients with 4-9 plaque segments than in those with no or 1-3 plaque segments (4.07 ± 5.3 vs. 2.19 ± 2.4 pg/mL and 2.43 ± 2.0 pg/mL, respectively, P = 0.025). The number of stenotic vessels was not significantly related to inflammatory markers. Multivariate logistic analysis revealed that plasma levels of hs-CRP but not IL-6 were associated with the presence of coronary plaque with calcification (OR 3.37, P = 0.026). This study supports the usefulness of inflammatory markers for the evaluation of coronary plaque in patients with stable CAD.


Gravitational Waves from Accretion-Induced Descalarization in Massive Scalar-Tensor Theory.
Many classes of extended scalar-tensor theories predict that dynamical instabilities can take place at high energies, leading to the formation of scalarized neutron stars. Depending on the theory parameters, stars in a scalarized state can form a solution-space branch that shares a lot of similarities with the so-called mass twins in general relativity appearing for equations of state containing first-order phase transitions. Members of this scalarized branch have a lower maximum mass and central energy density compared to Einstein ones. In such cases, a scalarized star could potentially overaccrete beyond the critical mass limit, thus triggering a gravitational phase transition where the star sheds its scalar hair and migrates over to its nonscalarized counterpart. Such an event resembles, but is distinct from, a nuclear or thermodynamic phase transition. We dynamically track a gravitational transition by first constructing hydrostatic, scalarized equilibria for realistic equations of state, and then allowing additional material to fall onto the stellar surface. The resulting bursts of monopolar radiation are dispersively stretched to form a quasicontinuous signal that persists for decades, carrying strains of order ≳10^{-22} (kpc/L)^{3/2} Hz^{-1/2} at frequencies of ≲300 Hz, detectable with the existing interferometer network out to distances of L≲10 kpc, and out to a few hundred kpc with the inclusion of the Einstein Telescope. Electromagnetic signatures of such events, involving gamma-ray and neutrino bursts, are also considered.


Abdominal obesity and its metabolic complications: implications for the risk of ischaemic heart disease.
Although the health hazards of obesity are well established, obese individuals are not all at equal risk of developing a disease, which reflects the heterogeneity of this condition. The regional distribution of body fat is now recognized as a very important component of the obesity-related health hazards. Epidemiological studies have shown that abdominal obesity, that is, a preponderance of fat in the abdominal area, is a better predictor of both cardiovascular disease and type 2 diabetes than obesity per se. It is now generally accepted that the fat located within the abdominal cavity, the visceral fat, is the best correlate of most of the highly atherogenic metabolic complications seen in individuals with abdominal obesity. These include, among others, insulin resistance and hyperinsulinaemia, hypertriglyceridaemia, reduced plasma high-density lipoprotein (HDL) cholesterol concentrations and an increased number of small, dense low-density lipoprotein (LDL) particles. This review summarizes the evidence that these metabolic complications may account to a large extent for the increased risk of cardiovascular disease associated with abdominal/visceral obesity. Abdominal obesity may be the most prevalent denominator of highly atherogenic dyslipidaemic and hyperinsulinaemic/insulin-resistant states in affluent, sedentary societies. Targeting individuals with this high-risk trait in primary prevention is therefore crucial if we are truly to have an impact on the incidence of cardiovascular disease.


Mechanism independence for texture-modulation detection is consistent with a filter-rectify-filter mechanism.
The ability of the visual system to detect stimuli that vary along dimensions other than luminance or color--"second-order" stimuli--has been of considerable interest in recent years. An important unresolved issue is whether different types of second-order stimuli are detected by a single, all purpose, mechanism, or by mechanisms that are specific to stimulus type. Using a conventional psychophysical paradigm, we show that for a class of second-order stimuli--textures sinusoidally modulated in orientation (OM), spatial frequency (FM), and contrast (CM)--the human visual system employs mechanisms that are selective to stimulus type. Whereas the addition of a subthreshold mask to a test pattern of the same stimulus type was found to facilitate the detection of the test, no facilitation was observed when mask and test were of different types, suggesting mechanism independence for the different types of stimulus. This finding raises the important question of whether mechanism independence is compatible with the well-known filter-rectify-filter (FRF) model of second-order stimulus detection, since FRF mechanisms, in principle, do not discriminate between stimulus types. We show that for all mask/test combinations except those with CM masks, the FRF mechanism giving the largest response to the test modulation is largely unaffected by subthreshold levels of a different stimulus-type mask. For this reason, we cannot rule out the possibility that FRF mechanisms mediate the detection of our stimuli. For combinations involving CM masks, however, we propose that a process of contrast normalization renders the test stimulus insensitive to the mask stimulus.


[Renal hematoma as a result of internal ureteral catheterization].
Urinary catheterization by means of an internal ureteral catheter in an usual procedure that may present complications. In this article we presented a case of perforation and later renal subcapsular hematoma after the placement of a "double-J" catheter. This complication, although rare, should be kept in mind. The manner of avoiding it is to maintain the tightness of the guidewire while inserting the ureteral catheter. Usually, the consequences are not life-threatening and are solved with conservative treatment. The administration of LFRE should be delayed until the resolution of the hematoma.