Sumatriptan (all routes of administration) for acute migraine attacks in adults - overview of Cochrane reviews.
Migraine is a highly disabling condition for the individual and also has wide-reaching implications for society, healthcare services, and the economy. Sumatriptan is an abortive medication for migraine attacks, belonging to the triptan family. It is available for administration by four different routes: oral, subcutaneous, intranasal, and rectal. To summarise evidence from four Cochrane intervention reviews on the efficacy and tolerability of sumatriptan in the treatment of acute migraine attacks in adults by four routes of administration (oral, subcutaneous, intranasal, and rectal) compared with both placebo and active comparators. The included reviews were written by the authors of this overview; no additional searching was carried out. All included reviews were conducted according to a standard protocol and reported a standard set of outcomes. From each individual review we extracted results for pain relief at different levels, and adverse events. No additional statistical comparison was undertaken as part of the overview. We focused on the most important findings for doses and routes licensed in North America or Europe (oral 25 mg, 50 mg, 100 mg; subcutaneous 4 mg, 6 mg; intranasal 5 mg, 10 mg, 20 mg; rectal 25 mg). Included reviews provided data for 18 different dose and route of administration combinations in 52,236 participants. Data for the primary outcomes sought were generally well reported, and involved adequate numbers of participants to give confidence in the results, except for the rectal route of administration, where numbers were low.Subcutaneous administration was the most effective, with pain reduced from moderate or severe to none by two hours in almost 6 in 10 people (59%) taking 6 mg sumatriptan, compared with approximately 1 in 7 (15%) taking placebo; the number needed to treat (NNT) was 2.3 (95% confidence interval 2.1 to 2.4) with 2522 participants in the analysis. The most commonly used doses of oral, rectal, and intranasal sumatriptan also provided clinically useful pain relief, with the oral 50 mg dose providing complete relief of pain in almost 3 in 10 people (28%) compared with about 1 in 10 (11%) after placebo (NNT 6.1 (5.5 to 6.9) in 6447 participants). Subcutaneous administration provided more rapid pain relief than the other routes. Taking medication early, when pain was mild, was more effective than waiting until the pain was moderate or severe.The most effective dose of sumatriptan for each route of administration for the outcome of headache relief (pain reduced from moderate or severe to none or mild) at two hours was oral 100 mg (NNT 3.5 (3.2 to 3.7) in 7811 participants), subcutaneous 6 mg (NNT 2.1 (2.0 to 2.2) in 2738 participants), intranasal 20 mg (NNT 3.5 (3.1 to 4.1) in 2020 participants), and rectal 25 mg (NNT 2.4 (1.9 to 3.4) in 240 participants).Adverse events were generally of mild or moderate severity, of short duration, and more common with subcutaneously administered sumatriptan and higher doses of oral and intranasal sumatriptan than with other dose and route combinations. Sumatriptan is an effective abortive treatment for acute migraine attacks, but is associated with increased adverse events relative to placebo. The route of administration influences efficacy, particularly within the first hour after administration. Subcutaneous sumatriptan shows the greatest efficacy in terms of pain relief, but at the expense of relatively high levels of adverse events, and with a high financial cost compared with other routes. Information about the relative efficacy of the different routes of administration for different outcomes should help to inform decisions about the suitability of sumatriptan as a migraine treatment, as well as about the most appropriate way to administer the treatment for individual patients.


Patient-focused perioperative documentation: an outcome management approach.
Perioperative nursing care and subsequent documentation is a key component in the continuum of care for the pediatric burn and reconstructive patient. A system was developed to streamline and improve the method of documentation, avoid inconsistencies, and provide an ongoing means of performance improvement monitoring. Narrative documentation is limited to charting by exception. The preoperative and intraoperative forms were developed in conjunction with the Perioperative Standards of Nursing Practice and integrated with policies and procedures already established. These guidelines are intended to incorporate the physician orders and recommended practices of professional organizations.


[Activity of neurons of the hypothalamic suprachiasmatic nuclei and circadian rhythms: the role of the suprachiasmatic nuclei in rhythmic activities of neurons in the lateral hypothalamic area and ventromedian nuclei and the control of the pineal gland].
Unit activity of lateral hypothalamic area (LHA) and ventromedian nuclei (VMN) was recorded in urethane anesthetized male rats. A 5 to 10 sec, a 3 to 5 min and a circadian rhythmicity were observed. In about 15% of all neurons, spontaneous activity of LHA and VMN showed reciprocal relationships. Subthreshold stimuli applied at a slow rate in the septum and the suprachiasmatic nuclei (SCN) suppressed the rhythms without changing firing rates. On the other hand stimulation of the optic nerve at a rate of 5 to 10/sec increased firing rates in one third of neurons of SCN. Iontophoretically applied acetycholine increased 80% of tested neurons of SCN, whereas norepinephrine, dopamine and 5HT inhibited 64%, 60% and 75% of SCN neurons, respectively. These inhibitions were much stronger in neurons, the activity of which was increased by optic nerve stimulation. Stimulation of the SCN inhibited the tonic activity in cervical sympathetic nerves. These data suggest that SCN plays a significant role in controlling the rhythmic activity of LHA, VMN and the pineal gland. Dopamine and 5HT may be involved in regulation of the firings of SCN neurons.


Phenytoin and gingival mucosa: A molecular investigation.
Several distinct classes of drugs, such as anticonvulsants, immunosuppressants, and calcium channel blockers, caused gingival overgrowth. One of the main drugs associated with the gingival overgrowth is the anti-epileptic such as phenytoin, which affects gingival tissues by altering extracellular matrix metabolism. In our study, we evaluate the effect of phenytoin, a drug whose active substance is phenytoin, on gingival fibroblasts of healthy volunteers. Gene expression of 29 genes was investigated in gingival fibroblasts' cell culture treated with phenytoin compared with untreated cells. Among the studied genes, only 13 genes (CXCL5, CXCL10, CCR1, CCR3, CCR5, CCR6, IL-1A, IL-1B, IL-5, IL-7, IL-6R, BMP-2, and TNFSF-10) were statistically significant. All but one gene resulted downregulated after 24 h of treatment with phenytoin. BPM2 was the only, although weakly, up-expressed gene. Probably, we have not highlighted overexpression of the other inflammatory molecules because the study was performed on healthy people. Many studies show that phenytoin induces the overexpression of these cytokines but, probably, in our study, the drug does not have the same effect because we used gingival fibroblasts of healthy people.


Fetal meconium does not have a detectable microbiota before birth.
Microbial colonization of the human intestine impacts host metabolism and immunity; however, exactly when colonization occurs is unclear. Although many studies have reported bacterial DNA in first-pass meconium samples, these samples are typically collected hours to days after birth. Here, we investigated whether bacteria could be detected in meconium before birth. Fetal meconium (n = 20) was collected by rectal swab during elective breech caesarean deliveries without labour and before antibiotics and compared to technical and procedural controls (n = 5), first-pass meconium (neonatal meconium; n = 14) and infant stool (n = 25). Unlike first-pass meconium, no microbial signal distinct from negative controls was detected in fetal meconium by 16S ribosomal RNA gene sequencing. Additionally, positive aerobic (n = 10 of 20) and anaerobic (n = 12 of 20) clinical cultures of fetal meconium (13 of 20 samples positive in at least one culture) were identified as likely skin contaminants, most frequently Staphylococcus epidermidis, and not detected by sequencing in most samples (same genera detected by culture and sequencing in 2 of 13 samples with positive culture). We conclude that fetal gut colonization of healthy term infants does not occur before birth and that microbial profiles of neonatal meconium reflect populations acquired during and after birth.


[Practical possibilities of omentoorgranopexy].
Anatomy of the greater omentum was studied in 129 human cadavers with a special regard to its size, shape and type of blood supply. The experiment on omentization of various parenchymal organs in 125 dogs has been run. On the grounds of the analysis of the findings some recommendations concerned with the use of various methods of the great omentum plasty, aimed at the omentization of organs situated both close to the omentum base and at some distance from it, are given.


Sympathetic ophthalmitis. Successful treatment of late cases.
Three severe cases of sympathetic ophthalmitis, which presented late for treatment, are described. The response to prolonged treatment with systemic prednisolone was unexpectedly good, occurring as long as 70 days after starting treatment and continuing up to 16 months.


Distributed treatment systems.
This section presents a review of the scientific literature published in 2018 on topics relating to distributed treatment systems. This review is divided into the following sections: constituent removal, treatment technologies, planning and treatment management, and other topics.


Elderly care recipients' perceptions of treatment helpfulness for depression and the relationship with help-seeking.
This study aims to examine perceptions of the helpfulness of treatments/interventions for depression held by elderly care recipients, to examine whether these beliefs are related to help-seeking and whether the experience of depression affects beliefs about treatment seeking, and to identify the characteristics of help-seekers. One hundred eighteen aged care recipients were surveyed on their beliefs about the helpfulness of a variety of treatments/interventions for depression, on their actual help-seeking behaviors, and on their experience of depression (current and past). From the sample, 32.4% of the participants screened positive for depression on the Geriatric Depression Scale, and of these, 24.2% reported receiving treatment. Respondents believed the most helpful treatments for depression were increasing physical activity, counseling, and antidepressant medication. Help-seeking from both professional and informal sources appeared to be related to belief in the helpfulness of counseling and antidepressants; in addition, help-seeking from informal sources was also related to belief in the helpfulness of sleeping tablets and reading self-help books. In univariate analyses, lower levels of cognitive impairment and being in the two lower age tertiles predicted a greater likelihood of help-seeking from professional sources, and female sex and being in the lower two age tertiles predicted greater likelihood of help-seeking from informal sources. In multivariate analyses, only lower levels of cognitive impairment remained a significant predictor of help-seeking from professional sources, whereas both lower age and female sex continued to predict a greater likelihood of help-seeking from informal sources. Beliefs in the helpfulness of certain treatments were related to the use of both professional and informal sources of help, indicating the possibility that campaigns or educational programs aimed at changing beliefs about treatments may be useful in older adults.


Papillary carcinoma of apocrine sweat glands in a capuchin monkey (Cebus albifrons).
A tumor removed from the skin of the right pectoral region of a 19-year-old male Capuchin monkey (Cebus albifrons) was morphologically classified as a papillary carcinoma of apocrine sweat gland origin. The designation of malignancy was based primarily on cellular pleomorphism and stromal invasion. This is believed to be the first report of this neoplasm in nonhuman primates. There has been no evidence of recurrence nor metastasis in the 12 months following excision.


The gene encoding rat insulinlike growth factor-binding protein 1 is rapidly and highly induced in regenerating liver.
The liver is an epithelioid organ that can regenerate following partial hepatectomy. Although it is composed mainly of hepatocytes, it has a complex, multicellular architecture, implying that intercellular communications must exist during regeneration. As in other mitogen-stimulated cells, immediate-early growth response genes induced in the absence of prior protein synthesis are likely to play an important regulatory role in the regenerative process. Through differential screening of regenerating liver cDNA libraries, we found that one of the most highly expressed immediate-early genes in liver regeneration encodes the rat homolog of the low-molecular-weight insulinlike growth factor (IGF)-binding protein (IGFBP-1). This protein has been implicated in enhancing the mitogenic effect of IGF on tissues. IGFBP-1 gene induction is transcriptionally mediated and specific to regenerating liver, as the gene is not expressed in mitogen-stimulated fibroblasts. IGFBP-1 expression has been shown to increase under low-insulin conditions such as diabetes, and the complex regulation of expression is indicated by our finding that insulin treatment of H35 rat hepatoma cells, which induces proliferation, also causes a rapid decrease in transcription and expression of the IGFBP-1 gene. Of note, IGFBP-1 mRNA is abundant in fetal rat liver, implying that it participates in normal liver growth and development. Although regenerating liver cells continue to produce IGF-I, we did not detect IGF-I receptor mRNA during the first 24 h after hepatectomy. However, some IGFBPs may act to enhance the activity of IGF-I independently of IGF-I receptors. Thus, IGF-1 and IGFBPs may interact with hepatocytes or nonparenchymal liver cells, through either IGF-I or novel receptors. In this way, IGFBP-I and IGF-I could act in a paracrine and/or autocrine fashion in maintaining normal liver architecture during regeneration.


The association between age of onset of opioid use and comorbidity among opioid dependent patients receiving methadone maintenance therapy.
Opioid use disorder (OUD) affects approximately 21.9 million people worldwide. This study aims to determine the association between age of onset of opioid use and comorbid disorders, both physical and psychiatric, in patients receiving methadone maintenance treatment (MMT) for OUD. Understanding this association may inform clinical practice about important prognostic factors of patients on MMT, enabling clinicians to identify high-risk patients. This study includes data collected between June 2011 and August 2016 for the Genetics of Opioid Addiction research collaborative between McMaster University and the Canadian Addiction Treatment Centers. All patients were interviewed by trained health professionals using the Mini-International Neuropsychiatric Interview and case report forms. Physical comorbidities were verified using patients' electronic medical records. A multi-variable logistic regression model was constructed to determine the strength of the association between age of onset of opioid use and the presence of physical or psychiatric comorbidity while adjusting for current age, sex, body mass index, methadone dose and smoking status. Data from 627 MMT patients with a mean age of 38.8 years (SD = 11.07) were analyzed. Individuals with an age of onset of opioid use younger than 18 years were found to be at higher odds for having a physical or psychiatric comorbid disorder compared to individuals with an age of onset of opioid use of 31 years or older (odds ratio 2.94, 95% confidence interval 1.20, 7.19, p = 0.02). A significant association was not found between the risk of having a comorbidity and an age of onset of opioid use between 18 and 25 years or 26 and 30 years, compared to an age of onset of opioid use of 31 years or older. Our study demonstrates that the younger one begins to use opioids, the greater their chance of having a physical or psychiatric co-morbidity. Understanding the risk posed by an earlier onset of opioid use for the later development of comorbid disorders informs clinical practice about important prognostic predictors and aids in the identification of high-risk patients.


The rationale for fractionation in radiotherapy.
The use of radiotherapy as a cancer treatment is common, so an appreciation of the biologic effects of radiation at a cellular level is essential to help nurses prepare their patients for the challenging journey ahead using appropriate lay language. The four Rs of radiotherapy (repair, redistribution, reoxygenation, and repopulation) are well established with regard to the principles of radiotherapy; however, these concepts appear undeveloped in nursing literature. The current article aims to succinctly explain how radiation impacts cancer and provides rationale as to why radiation treatment is delivered during a number of sessions. Through receipt of this knowledge, oncology nurses will be better equipped to communicate more efficiently and effectively with their patients.


Mechanism and biomarkers in aortitis--a review.
Aortitis can be the manifestation of an underlying infectious or noninfectious disease process. An autoimmune cause is suggested in a large proportion of noninfectious causes. Similar to other autoimmune diseases, the pathophysiology of aortitis has been investigated in detail, but the etiology remains unknown. Most cases of aortitis often go undetected for a long time and are often identified at late stages of the disease. Recent advances in imaging techniques have significantly improved the diagnosis of aortitis. However, significant challenges associated with the imaging techniques limit their use. Several routine inflammation-based markers, such as erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and inflammatory cytokines, are nonspecific and, therefore, have limited use in the diagnosis of aortitis. The search for more specific serum biomarkers, which can facilitate detection and progression is under progress. Several autoantibodies have been identified, but assigning their role in the pathogenesis as well as their specificity remains a challenge. The current review addresses some of these issues in detail. KEY MESSAGES: • Noninfectious aortitis is an autoimmune disease. • Several biomarkers, including cytokines and autoantibodies, are increased in aortitis. • Imaging techniques, commonly used to detect aortitis, are associated with the high cost and technical challenges. • There is a need to develop low-cost biomarker-based detection tools. • The knowledge of biomarkers in aortitis detection is discussed.


Evaluation of thrombolysis in a porcine model of chronic deep venous thrombosis: an endovascular model.
The advancement of catheter-based interventions for vascular recanalization has underscored the need for an experimental animal model of vascular thrombosis that can be used for the evaluation of interventional therapies. In this model, a porcine model of deep venous thrombosis with a novel endovascular technique was described, and the efficacy of thrombolytic therapy with urokinase was evaluated. An endovascular device that consisted of a tapered polytetrafluoroethylene graft attached within a self-expanding nitinol stent was delivered to bilateral common iliac veins in 20 pigs. Venous thrombosis occurred as a result of flow stasis created by the intrastent stenosis. Catheter-directed pulse-spray thrombolysis with urokinase (250,000 units) and heparin (5000 IU) was performed on one limb while the contralateral limb received control saline solution. Thrombolysis was performed in 1 hour (n = 4), 8 hours (n = 4), 3 days (n = 4), 7 days (n = 4), and 14 days (n = 4) after the stent-graft deployment. Venography and intravascular ultrasound were used to evaluate the efficacy of thrombolysis. Light microscopy was used for histologic analysis of the thrombus. Complete thrombolysis was achieved in groups with deep vein thrombosis that were younger than 1 day. Angioplasty of the tapered stent-grafts in the completely thrombolysed iliac vein was successful in restoring venous flow. The efficacy of thrombolysis in 3-day, 7-day, and 14-day groups was 86% +/- 7%, 73% +/- 13%, and 42% +/- 23%, respectively. The thrombolytic efficacy was enhanced to 92% +/- 16% and 86% +/- 18% (P <.05) in 3-day and 7-day groups, respectively, when doses of the pulse-spray thrombolysis were doubled. Increased dosages of the thrombolytic agent, however, did not significantly enhance the thrombus dissolution in the 14-day group. The thrombolytic efficacy of urokinase correlated with the chronicity of deep venous thrombosis in our model. An increased dose of urokinase may be used to enhance the efficacy of thrombolysis in a 1-week-old thrombus.


Techniques and indications for surgery of the superior and inferior oblique muscles.
The oblique muscles pose diagnostic as well as therapeutic challenges which place demands on the surgeon who attempts to treat the more complicated cyclovertical strabismus. A thorough knowledge of the anatomy, physiology, and pathology of these muscles is necessary. This should be combined with a thorough knowledge of the diagnostic techniques, the appropriate surgical therapeutic measures, and the results which can reasonably be expected.


New insights into the roles of fungi and bacteria in the development of medicinal plant.
The interaction between microorganisms and medicinal plants is a popular topic. Previous studies consistently reported that microorganisms were mainly considered pathogens or contaminants. However, with the development of microbial detection technology, it has been demonstrated that fungi and bacteria affect beneficially the medicinal plant production chain. of review: Microorganisms greatly affect medicinal plants, with microbial biosynthesis a high regarded topic in medicinal plant-microbial interactions. However, it lacks a systematic review discussing this relationship. Current microbial detection technologies also have certain advantages and disadvantages, it is essential to compare the characteristics of various technologies. Key scientific concepts of review: This review first illustrates the role of fungi and bacteria in various medicinal plant production procedures, discusses the development of microbial detection and identification technologies in recent years, and concludes with microbial biosynthesis of natural products. The relationship between fungi, bacteria, and medicinal plants is discussed comprehensively. We also propose a future research model and direction for further studies.


Ultrasonografic changes in the axillary vein of patients with lymphedema after mastectomy.
To determine the prevalence of sonographic abnormalities (SA) in the axillary vein of patients with and without post-mastectomy lymphedema. We studied a sample of 80 women, divided into two equal groups, with and without lymphedema, with B mode ultrasound, color and pulsed Doppler. The primary variable, SA, is defined as change in the venous diameter, parietal thickening, intraluminal images, compressibility, parietal collapse at inspiration and feature of the axillary venous flow on the operated side. Secondary variables were: stage of lymphedema, surgical technique, number of radio and chemotherapy sessions, limb volume, weight and age. The differences between the proportions in the groups were determined using the Chi-square test and / or Fisher's test. For continuous variables, we used the Mann-Whitney Test. To estimate the magnitude of the associations, we used the prevalence rate of SA in both groups as a measure of frequency, and as a measure of association, the prevalence ratio (PR) obtained as a function of relative risk (RR) and estimated by the test Mantel-Haenszel homogeneity test. We adopted the statistical significance level of 5% (p < 0.05). only the criterion "parietal thickening" was strongly associated with the lymphedema group (p = 0.001). The prevalence of SA was 55% in patients with lymphedema and 17.5% in the group without it, with difference in prevalence of 37.5%. the prevalence of SA was higher in patients undergoing mastectomy with lymphedema than in those without lymphedema.


Determinants of general practitioners' wages in England.
We analyse the determinants of annual net income and wages (net income/hours) of general practitioners (GPs) using data for 2271 GPs in England recorded during Autumn 2008. The average GP had an annual net income of £97,500 and worked 43 h per week. The mean wage was £51 per h. Net income and wages depended on gender, experience, list size, partnership size, whether or not the GP worked in a dispensing practice, whether they were salaried of self-employed, whether they worked in a practice with a nationally or locally negotiated contract, and the characteristics of the local population (proportion from ethnic minorities, rurality, and income deprivation). The findings have implications for pay discrimination by GP gender and ethnicity, GP preferences for partnership size, incentives for competition for patients, and compensating differentials for local population characteristics. They also shed light on the attractiveness to GPs in England of locally negotiated (personal medical services) versus nationally negotiated (general medical services) contracts.


Effect of perphenazine enanthate in Pyrenean chamois (Rupicapra pyrenaica).
Perphenazine enanthate was used to allow adaptation to captivity in 11 Pyrenean chamois (Rupicapra pyrenaica). At the time of capture, all animals received 0.10 mg/kg of acepromazine maleate and 2.5 mg/kg of perphenazine enanthate intramuscularly. The effect was evaluated by means of three behaviors: alertness, defecation, and flight distance. The tranquilization and lack of fear of humans of all animals were determined and the usefulness of this long-acting tranquilizer for chamois adaptation to captivity was confirmed.


Fine mapping of replication origins (ori A and ori B) in Nicotiana tabacum chloroplast DNA.
Using a partially purified replication complex from tobacco chloroplasts, replication origins have been localized to minimal sequences of 82 (pKN8, positions 137 683-137 764) and 243 bp (pKN3, positions 130 513-130 755) for ori A and ori B respectively. Analysis of in vitro replication products by two-dimensional agarose gel electrophoresis showed simple Y patterns for single ori sequence-containing clones, indicative of rolling circle replication. Double Y patterns were observed when a chloroplast DNA template containing both ori s (pKN9) was tested. Dpn I analysis and control assays with Escherichia coli DNA polymerase provide a clear method to distinguish between true replication and DNA repair synthesis. These controls also support the reliability of this in vitro chloroplast DNA replication system. EM analysis of in vitro replicated products showed rolling circle replication intermediates for single ori clones (ori A or ori B), whereas D loops were observed for a clone (pKN9) containing both ori s. The minimal ori regions contain sequences which are capable of forming stem-loop structures with relatively high free energy and other sequences which interact with specific protein(s) from the chloroplast replication fraction. Apparently the minimal ori sequences reported here contain all the necessary elements for support of chloroplast DNA replication in vitro.


[Specific mortality rates at the Algeciras hospital during 1995-1996].
In-hospital mortality has been proposed as an indicator of health care quality. It is also a fact that should be used for epidemiological monitoring and health planning. The aim of this work is to analyse the mortality in Algeciras Hospital, belonging to the Andalusia Health Authority. A descriptive study was carried out of the patients discharged from hospital between January 1995 and December 1996, using discharge data and/or their medical record. The structure of the joint basic minimum data report on hospital discharge was used. The periods of hospitalisation were grouped into the diagnosis-related groups (DRGs). Following an initial analysis of all the periods of hospitalisation, the discharges of patients under 80 years of age were analysed and the risk of death in hospital in line with the reason for admission was set. In Algeciras Hospital between January 1995 and December 1996 a total of 24,194 episodes of hospitalisation and a 4.1% death rate were recorded. A higher death rate was observed for males (5.3%), as opposed to females (3.2%). (P < 0.01). There were 750 in-hospital deaths in patients under 80 years of age, with a continued higher mortality rate for males. The most frequent causes of deaths in this age group are: 66 deaths caused by cerebro-vascular disease (the probability of dying in this age group if the patients were admitted to hospital because of cerebro-vascular disease IC95% 0.12-0.19), 58 deaths due to AIDS (IC95% 0.09-0.15), 51% due to bronchial and lung neoplasias (IC95% 0.18-0.30), 49 deaths from acute myocardial infarction (IC95% 0.12-0.21), 39% as a result of chronic obstructive pulmonary disease (IC95% 0.07-0.14). The abundant information supplied by hospital mortality statistics is confirmed, especially if the age and illness of the patients involved is taken into account. There is an evident need for health policies to prevent HIV/AIDS, cerebro-vascular disease, lung cancer and ischaemic heart disease to be adopted in the Algeciras catchment area. Thus, there is a need to monitor and draw up new indicators of hospital mortality and to expand the list of unnecessarily premature and avoidable deaths with strictly hospital causes.


Impacts of changing ocean circulation on the distribution of marine microplastic litter.
Marine plastic pollution is currently a major scientific focus, with attention paid to its distribution and impacts within ecosystems. With recent estimates indicating that the mass of plastic released to the marine environment may reach 250 million metric tons by 2025, the effects of plastic on our oceans are set to increase. Distribution of microplastics, those plastics measuring less than 5 mm, are of increasing concern because they represent an increasing proportion of marine litter and are known to interact with species in a range of marine habitats. The local abundance of microplastic is dependent on a complex interaction between the scale of local plastic sources and prevailing environmental conditions; as a result, microplastic distribution is highly heterogeneous. Circulation models have been used to predict plastic distribution; however, current models do not consider future variation in circulation patterns and weather systems caused by a changing climate. In this study, we discuss the potential impacts of global climate change on the abundance and distribution of marine plastic pollution. Integr Environ Assess Manag 2017;13:483-487. © 2017 SETAC.


A critical comparison of technologies for a plant genome sequencing project.
A high-quality genome sequence of any model organism is an essential starting point for genetic and other studies. Older clone-based methods are slow and expensive, whereas faster, cheaper short-read-only assemblies can be incomplete and highly fragmented, which minimizes their usefulness. The last few years have seen the introduction of many new technologies for genome assembly. These new technologies and associated new algorithms are typically benchmarked on microbial genomes or, if they scale appropriately, on larger (e.g., human) genomes. However, plant genomes can be much more repetitive and larger than the human genome, and plant biochemistry often makes obtaining high-quality DNA that is free from contaminants difficult. Reflecting their challenging nature, we observe that plant genome assembly statistics are typically poorer than for vertebrates. Here, we compare Illumina short read, Pacific Biosciences long read, 10x Genomics linked reads, Dovetail Hi-C, and BioNano Genomics optical maps, singly and combined, in producing high-quality long-range genome assemblies of the potato species Solanum verrucosum. We benchmark the assemblies for completeness and accuracy, as well as DNA compute requirements and sequencing costs. The field of genome sequencing and assembly is reaching maturity, and the differences we observe between assemblies are surprisingly small. We expect that our results will be helpful to other genome projects, and that these datasets will be used in benchmarking by assembly algorithm developers.


Measuring melasma patients' quality of life using willingness to pay and time trade-off methods in Thai population.
Melasma is a common hyperpigmentation disorder that has a significant effect on an individual's quality of life. However, there is no preference-based measurement that reflects quality of life in patients with melasma. The objective of this study was to assess the impact of melasma on quality of life by using a health status measurement - the Dermatology Life Quality Index (DLQI) - and a preference-based measurement - Willingness to Pay (WTP) and Time Trade-Off (TTO). A cross-sectional descriptive study was conducted. Seventy-eight patients with melasma who attended the melasma clinic at Siriraj Hospital from February to March 2009 were recruited in this study. The Thai version of the DLQI, questionnaires about WTP, standard TTO, and daily TTO were used to assess patients' quality of life. Seventy-seven (98.7%) patients were female with a mean age of 47.8 ± 7.9 years. The mean health utility based on standard TTO was 0.96. The utility obtained by the daily TTO method was 0.92 and was significantly correlated with an economically inactive occupation (p < 0.05). The mean monthly WTP for the most effective treatment was 1,157 baht (7.2% of monthly income), ranging from 100 to 5,000 baht (1 USD ~ 35.1 baht). The WTP was significantly correlated with monthly personal income and the total DLQI score. The WTP method could be a useful tool with which to measure the quality of life of patients with melasma.


Close-Packed Langmuir Monolayers of Saccharide-Based Carbon Dots at the Air-Subphase Interface.
Carbon dots (CDs) are zero-dimensional carbon-based spherical nanoparticles with diameters less than 10 nm. Here, we report for the first time CDs forming stable Langmuir monolayers at the air-subphase interface. Langmuir monolayers are of great interest both fundamentally to study the interactions at the interfaces and for many applications such as the development of sensors. However, CDs usually do not form Langmuir monolayers because of their highly hydrophilic nature. In this study, amphiphilic CDs were prepared through hydrothermal carbonization using saccharides as the precursors. The surface chemistry behavior and optical properties of CDs at the air-subphase interface were studied. CDs derived from saccharides consistently formed stable Langmuir monolayers which show all essential phases, namely, gas, liquid-expanded, liquid-condensed, and solid phases. The compression-decompression cycle method showed minimum hysteresis (4.3%), confirming the retaining capacity of the CDs as a monolayer. Limiting CD areas from surface pressure-area isotherm at the air-subphase interface were used to calculate the average diameter of the CDs at the air-subphase interface. UV/vis absorption spectra of CDs dispersed in water and in Langmuir monolayers had the same bands in the UV region. The intensity of the UV/vis absorption increases with increasing surface pressure at the air-subphase interface. Interestingly, photoluminescence (PL) of the Langmuir monolayer of CDs was excitation-independent, whereas the same CDs had excitation-dependent PL when dispersed in water.


Antagonistic role of tea against sodium arsenite-induced oxidative DNA damage and inhibition of DNA repair in Swiss albino mice.
Arsenic (As) contamination in groundwater is of increasing health concern in West Bengal, India. Arsenic has been associated with various human cancers, but the precise mechanism of its co-carcinogenic action is not clearly elucidated. Oxidative stress and defective repair mechanisms may promote accumulation of mutations and may be a stepping stone for carcinogenesis. Prevention of arsenic-induced oxidative stress and repair inhibition may reduce the chances of initiation of cancer. Tea polyphenols are reported to have excellent chemopreventive properties against cancer. This study aimed to elucidate the role of tea against arsenic-induced formation of 8-hydroxy-2'-deoxyguanosine (8OHdG) and arsenic-suppressed DNA repair in Swiss albino mice. Both green and black tea gave fruitful results in the reduction of 8OHdG and 8-oxoguanine DNA glycosylase (OGG1) in Swiss albino mice administered sodium arsenite (As III). DNA repair enzymes--such as PARP1, DNA β-polymerase, XRCC1, DNA ligase III, DNA protein kinase (catalytic subunit), XRCC 4, DNA ligase IV, and DNA topoisomerase IIβ--were induced by the phytochemicals at both the protein and genetic levels. Thus, tea polyphenols may prove effective in treating arsenic-induced carcinogenesis.


Chronic apraxia of speech and Broca's area.
Apraxia of speech (AOS) is an impairment of motor planning and programming of speech articulation and is often considered an important stroke syndrome, localizable to Broca's area. However, an influential study raised doubts on this localization and reported that AOS is attributable to lesions of the anterior insula, based on an association between chronic AOS and anterior insula lesions. We hypothesized that chronic AOS is associated with large lesions (which include the insula) or lesions to Broca's area. Method- We tested 34 participants with chronic left supratentorial stroke on an AOS battery and obtained concurrent magnetic resonance imaging. We evaluated associations between AOS and locations and volume of infarct. The presence of chronic AOS (n=17) was associated with volume of infarct, but was also associated with infarct in Broca's area (and several other regions, but not anterior insula) in both volume- and age-adjusted linear regression and the dichotomous analysis. Carotid dissection was more common, and cardioembolism less common, as a cause of stroke in patients with AOS compared with those without. Severity of AOS was also strongly associated with lesion volume. Persistence of AOS after 12 months is associated with large left hemispheric stroke and strokes that involve Broca's area or other relatively anterior areas to which it is structurally or functionally connected. Patients with such lesions may benefit from early training in the use of technologies to support speech production and communication.


Proteomics of cancer cell lines resistant to microtubule-stabilizing agents.
Despite the clinical success of microtubule-interacting agents (MIA), a significant challenge for oncologists is the inability to predict the response of individual patients with cancer to these drugs. In the present study, six cell lines were compared by 2D DIGE proteomics to investigate cellular resistance to the class of MIAs known as microtubule-stabilizing agents (MSA). The human lung cancer cell line A549 was compared with two drug-resistant daughter cell lines, a taxol-resistant cell line (AT12) and an epothilone B (EpoB)-resistant cell line (EpoB40). The ovarian cancer cell line Hey was compared with two drug-resistant daughter cell lines, an EpoB-resistant cell line (EpoB8) and an ixabepilone-resistant cell line (Ixab80). All 2D DIGE results were validated by Western blot analyses. A variety of cytoskeletal and cytoskeleton-associated proteins were differentially expressed in drug-resistant cells. Differential abundance of 14-3-3σ, galectin-1 and phosphorylation of stathmin are worthy of further studies as candidate predictive biomarkers for MSAs. This is especially true for galectin-1, a β-galactose-binding lectin that mediates tumor invasion and metastasis. Galectin-1 was greatly increased in EpoB- and ixabepilone-resistant cells and its suppression caused an increase in drug sensitivity in both drug-sensitive and -resistant Hey cells. Furthermore, the growth medium from resistant Hey cells contained higher levels of galectin-1, suggesting that galectin-1 could play a role in resistance to MSAs.


Treatment of traumatic carotid-cavernous fistula using detachable balloon catheters.
The goal of therapy in patients with traumatic carotid-cavernous fistulas is to occlude the fistula, preferably while maintaining the carotid blood flow. Surgical techniques that treat the fistula remote from the cavernous sinus often cannot maintain carotid patency. Various interventional techniques using detachable balloons have been developed. The most common technique uses the endarterial route, introducing the balloon catheter in the neck or the groin. If the balloon is detached in the cavernous sinus, the carotid blood flow will be preserved. A second approach uses the venous retrograde route through the jugular vein, inferior petrosal sinus, and cavernous sinus. Elegant and safe, this method is appropriate when the fistula drains posteriorly. A third approach involves surgical exposure of the cavernous sinus and direct introduction of the balloon. This is sometimes the only recourse when the fistula has been previously treated with internal carotid ligation.


Glomerular lesions in HIV-infected patients: a Yale University Department of Medicine Residency Peer-Teaching Conference.
HIV-associated nephropathy (HIVAN) is a clinicopathologic entity characterized by heavy proteinuria, absence of edema and an irreversible decline in renal function. Findings on renal biopsy include: collapsed glomerular capillaries; visceral glomerular epitheliosis; microcystic tubules; mesangial prominence; and endothelial tubuloreticular inclusions. Early in the AIDS epidemic, HIVAN was the predominant glomerular lesion observed in HIV-infected patients. It is being increasingly recognized, especially in Caucasian populations, that a variety of immune complex-mediated lesions such as membranoproliferative glomerulonephritis, proliferative glomerulonephritis and IgA nephropathy are associated with HIV infection. In this review we present two cases: one patient whose first presentation of AIDS was end-stage renal disease, who on biopsy was found to have HIVAN, and the second, who was infected with HIV, and on biopsy was found to have hepatitis C-related hepatitis C related membranoproliferative glomerulonephritis. We also review the current literature on HIVAN and HIV-associated immune complex diseases (HIVICDs). Each case illustrates an important clinical point. The first that renal disease can be the first manifestation of HIV infection and the second that HIV-infected patients may develop immune complex related renal diseases, some of which may be potentially treatable.


The effect of fructose 2,6-bisphosphate and AMP on the activity of phosphorylated and unphosphorylated fructose-1,6-bisphosphatase from rat liver.
Rat liver fructose-1,6-bisphosphatase was partially phosphorylated in vitro and separated into unphosphorylated and fully phosphorylated enzyme. The effects of fructose 2,6-bisphosphate and AMP on these two enzyme forms were examined. Unphosphorylated fructose-1,6-bisphosphatase was more easily inhibited by both effectors. Fructose 2,6-bisphosphate affected both K0.5 and Vmax, while the main effect of AMP was to lower Vmax. Fructose 2,6-bisphosphate and AMP together acted synergistically to decrease the activity of fructose-1,6-bisphosphatase, and since unphosphorylated and phosphorylated enzyme forms are affected differently, this might be a way to amplify the effect of phosphorylation.


Change in concentrations of myogenic components of serum during 93 h of strenuous physical exercise.
Effects of 93 h of long, strenuous ranger training on activities of creatine kinase (CK) and lactate dehydrogenase (LD), along with their isoenzymes, and on concentration of myosin light chain were examined in sera of young soldiers. Total CK activity in serum was measured before, during, and after the training. Throughout, total CK activity in serum increased steadily. At the end of the training, activity of CK-MB was increased but its activity ratio to total CK remained unchanged; the activity ratio of LD1/LD2 also was not increased, although total LD activity was increased. Myosin light chain was increased by about fourfold at the end of the training and remained high for three days thereafter. However, its concentration was much lower than in myopathies such as polymyositis and Duchenne muscle dystrophy. The increased activities in serum of total CK and CK-MB isoenzyme on strenuous physical exercise evidently were of noncardiac origin. Although CK activity was comparable with that seen in myopathies accompanied by disintegration of skeletal muscle, the relatively low concentration of myosin light chain in serum suggests minimal skeletal muscle damage.


Enhancing visual perceptual learning using transcranial electrical stimulation: Transcranial alternating current stimulation outperforms both transcranial direct current and random noise stimulation.
Diverse strategies can be employed to enhance visual skills, including visual perceptual learning (VPL) and transcranial electrical stimulation (tES). Combining VPL and tES is a popular method that holds promise for producing significant improvements in visual acuity within a short time frame. However, there is still a lack of comprehensive evaluation regarding the effects of combining different types of tES and VPL on enhancing visual function, especially with a larger sample size. In the present study, we recruited four groups of subjects (26 subjects each) to learn an orientation discrimination task with five daily training sessions. During training, the occipital region of each subject was stimulated by one type of tES-anodal transcranial direct current stimulation (tDCS), alternating current stimulation (tACS) at 10 Hz, high-frequency random noise stimulation (tRNS), and sham tACS-while the subject performed the training task. We found that, compared with the sham stimulation, both the high-frequency tRNS and the 10-Hz tACS facilitated VPL efficiently in terms of learning rate and performance improvement, but there was little modulatory effect in the anodal tDCS condition. Remarkably, the 10-Hz tACS condition exhibited superior modulatory effects compared with the tRNS condition, demonstrating the strongest modulation among the most commonly used tES types for further enhancing vision when combined with VPL. Our results suggest that alpha oscillations play a vital role in VPL. Our study provides a practical guide for vision rehabilitation.


Understanding the Relationship Between Subjective Wellbeing and Gambling Behavior.
This paper examines the relationship between gambling behavior and subjective wellbeing. It is often asserted that populations consist of different types of gamblers: those for whom gambling is a harmless leisure activity and those (pathological/problem gamblers) for whom the activity has harmful effects. One might, therefore, assume that subjective wellbeing will be negativity associated with an individual's level of gambling addiction. Alternatively, gamblers may choose to gamble because they derive utility from participating in this activity and so the relationship between happiness and gambling might be positively correlated. In this paper we test this association, empirically, using data from the 2010 British Gambling Prevalence Survey. The statistically significant findings from this analysis support the hypothesis that individual wellbeing falls as gambling disorder increases.


Surveillance of Safety of 3 Doses of COVID-19 mRNA Vaccination Using Electronic Health Records.
Recent reports on waning of COVID-19 vaccine-induced immunity have led to the approval and rollout of additional doses and booster vaccinations. Individuals at increased risk of SARS-CoV-2 infection are receiving additional vaccine doses in addition to the regimen that was tested in clinical trials. Risks and adverse event profiles associated with additional vaccine doses are currently not well understood. To evaluate the safety of third-dose vaccination with US Food and Drug Administration (FDA)-approved COVID-19 mRNA vaccines. This cohort study was conducted using electronic health record (EHR) data from December 2020 to October 2021 from the multistate Mayo Clinic Enterprise. Participants included all 47 999 individuals receiving 3-dose COVID-19 mRNA vaccines within the study setting who met study inclusion criteria. Participants were divided into 2 cohorts by vaccine brand administered and served as their own control groups, with no comparison made between cohorts. Data were analyzed from September through November 2021. Three doses of an FDA-authorized COVID-19 mRNA vaccine, BNT162b2 or mRNA-1273. Vaccine-associated adverse events were assessed via EHR report. Adverse event risk was quantified using the percentage of study participants who reported the adverse event within 14 days after each vaccine dose and during a 14-day control period, immediately preceding the first vaccine dose. Among 47 999 individuals who received 3-dose COVID-19 mRNA vaccines, 38 094 individuals (21 835 [57.3%] women; median [IQR] age, 67.4 [52.5-76.5] years) received BNT162b2 (79.4%) and 9905 individuals (5099 [51.5%] women; median [IQR] age, 67.7 [59.5-73.9] years) received mRNA-1273 (20.6%). Reporting of severe adverse events remained low after the third vaccine dose, with rates of pericarditis (0.01%; 95% CI, 0%-0.02%), anaphylaxis (0%; 95% CI, 0%-0.01%), myocarditis (0%; 95% CI, 0%-0.01%), and cerebral venous sinus thrombosis (no individuals) consistent with results from earlier studies. Significantly more individuals reported low-severity adverse events after the third dose compared with after the second dose, including fatigue (2360 individuals [4.92%] vs 1665 individuals [3.47%]; P < .001), lymphadenopathy (1387 individuals [2.89%] vs 995 individuals [2.07%]; P < .001), nausea (1259 individuals [2.62%] vs 979 individuals [2.04%]; P < .001), headache (1185 individuals [2.47%] vs 992 individuals [2.07%]; P < .001), arthralgia (1019 individuals [2.12%] vs 816 individuals [1.70%]; P < .001), myalgia (956 individuals [1.99%] vs 784 individuals [1.63%]; P < .001), diarrhea (817 individuals [1.70%] vs 595 individuals [1.24%]; P < .001), fever (533 individuals [1.11%] vs 391 individuals [0.81%]; P < .001), vomiting (528 individuals [1.10%] vs 385 individuals [0.80%]; P < .001), and chills (224 individuals [0.47%] vs 175 individuals [0.36%]; P = .01). This study found that although third-dose vaccination against SARS-CoV-2 infection was associated with increased reporting of low-severity adverse events, risk of severe adverse events remained comparable with risk associated with the standard 2-dose regime. These findings suggest the safety of third vaccination doses in individuals who were eligible for booster vaccination at the time of this study.


Observation of light localization in modulated Bessel optical lattices.
We generate higher-order azimuthally modulated Bessel optical lattices in photorefractive crystals by employing a phase-imprinting technique. We report on the experimental observation of self-trapping and nonlinear localization of light in such segmented lattices in the form of ring-shaped and single-site states. The experimental results agree well with numerical simulations accounting for an anisotropic and spatially nonlocal nonlinear response of photorefractive crystals.


Seawater Hydration Modulates IL-6 and Apelin Production during Triathlon Events: A Crossover Randomized Study.
A triathlon is an endurance event in which athletes need an efficient hydration strategy since hydration is restricted at different stages. However, it seems that seawater intake can be a suitable hydration alternative for this type of endurance event. Therefore, the aim of this study was to evaluate the efficacy of seawater hydration during a triathlon on cytokine production. Fifteen trained male triathletes (age = 38.8 ± 5.62 years old; BMI = 22.58 ± 2.51 kg/m2) randomly performed three triathlons, one of them consuming seawater (Totum SPORT, Laboratories Quinton International, S.L., Valencia, Spain), the other one consuming tap water ad libitum, and the last a physiologic saline solution as placebo. The triathlon consisted of an 800 m swim, a 90 km bike ride, and a 10 km run. Blood samples were taken at rest and after training, where markers of inflammation, hemoglobin, and hematocrit concentration were assessed. While the seawater was not ergogenic, it significantly increased the release of IL-6 and apelin post-exercise. However, no differences were found between the fractalkine, IL-15, EPO, osteonectin, myostatin, oncostatin, irisin, FSTL1, osteocrin, BDNF, and FGF-21 values over those of the placebo group. The present study demonstrates that hydration with seawater stimulates myokine production, which could lead to improved performance recovery after exercise.


Dietary genistein intake and cognitive performance in a multiethnic cohort of midlife women.
To examine the relationship between food frequency questionnaire estimated isoflavone intakes and cognitive performance. The Study of Women's Health Across the Nation (SWAN), is a multiethnic, community based, longitudinal study of women aged 42 to 52 years at entry. Dietary isoflavone intakes were estimated from an interviewer-administered food frequency questionnaire at baseline. Intakes of genistein and daidzein were highly correlated (r = 0.98); therefore, analyses were conducted using genistein only. The SWAN includes white, African American, Hispanic, Chinese, and Japanese women; this analysis was performed only in the latter two ethnic groups because the others had minimal genistein intake (median, <4 microg/day). Cognitive function tests were measured at the fourth annual follow-up visit using the East Boston Memory Test (Immediate and Delayed), Symbol Digit Modalities Test, and Digit Span Backward Test. Ethnicity-specific general linear models were used to examine the relationship between each of these cognitive tests and energy-adjusted genistein intake controlling for age, menopause stage, ever-use of any hormones, and current use of any hormones. Among 195 Japanese and women and 185 Chinese women, median intakes of genistein (mug/day) were 6,788 and 3,534, respectively. No associations between genistein intake and measures of cognitive performance were found in either ethnic group. Our results did not support the hypothesis that genistein intake, at the levels consumed by the study sample, benefits cognitive performance. It also possible that the bioavailability of genistein in food sources is insufficient to exert a neurophysiological effect or that the potential effect of genistein is only manifest in low-estrogen states; the current study is not able to address these possibilities.


Personality Traits, Motivations, and Emotional Consequences of Social Media Usage.
This study explores social media users' personality traits and motivations for the usage of two different social media platforms, Facebook and Pinterest, as well as how the varied uses impact users' negative emotional experiences. The findings suggest that the intensity of social media usage is positively related to negative emotions. For Facebook users, socialization, entertainment, and information seeking motivations significantly influence their platform use intensity and, subsequently, lead to negative emotions. Self-status seeking also has a direct effect on Facebook users' negative emotions. For Pinterest users, socialization is not a significant motivation for usage of that platform. However, entertainment, information seeking, and self-status seeking significantly predict their platform use intensity, which subsequently lead to negative emotions. Similarly, all four motivations for Facebook and Pinterest uses are influenced by users' personality traits: extraversion and openness. Yet, openness has a greater impact on using Pinterest than Facebook in terms of fulfilling socialization needs. Neuroticism has a positive impact on socialization and information seeking motives for use of both platforms, while conscientiousness and agreeableness have a negative influence on fulfilling self-status seeking needs. In addition, agreeable social networking site users are less likely to use Facebook than Pinterest for fulfilling self-status related gratifications, while they are likely to use Pinterest instead of Facebook for entertainment and information needs. Implications of the findings and suggestions for future research are discussed.


Occupational health nurse practitioners' roles in workers' compensation.
The occupational health nurse practitioner is an integral part of coordinating care for the injured or ill worker. Decisions regarding whether an injury or illness is related to work are based on the practitioner's diagnosis and reports of the worker's progress. Understanding workers' compensation laws will enable the practitioner to provide efficient care for the worker.


Disease management improves ESRD outcomes.
Renal disease management organizations have reported achieving significant decreases in mortality and hospitalization in conjunction with cost savings, improved patient satisfaction and quality of life. Disease management organizations strive to fill existing gaps in care delivery through the standardized use of risk assessment, predictive modeling, evidence based guidelines and process and outcomes measurement. Patient self-management education and the provision of individual nurse care managers are also key program components. As we more fully measure clinical outcomes and total health-care costs including payments from all insurance and government entities, pharmacy costs and out-of-pocket expenditures, the full implications of disease management can be better defined. The results of this analysis will have a profound influence on United States healthcare policy. At present, current data suggests that the promise of disease management, improved care at reduced cost, can and is being realized in ESRD.


Maximum likelihood difference scales represent perceptual magnitudes and predict appearance matches.
One central problem in perception research is to understand how internal experiences are linked to physical variables. Most commonly, this relationship is measured using the method of adjustment, but this has two shortcomings: The perceptual scales that relate physical and perceptual variables are not measured directly, and the method often requires perceptual comparisons between viewing conditions. To overcome these problems, we measured perceptual scales of surface lightness using maximum likelihood difference scaling, asking observers only to compare the lightness of surfaces presented in the same context. Observers were lightness constant, and the perceptual scales qualitatively and quantitatively predicted perceptual matches obtained in a conventional adjustment experiment. Additionally, we show that a contrast-based model of lightness perception predicted 98% of the variance in the scaling and 88% in the matching data. We suggest that the predictive power was higher for scales because they are closer to the true variables of interest.


Bioactivation of Phytoestrogens: Intestinal Bacteria and Health.
Phytoestrogens are polyphenols similar to human estrogens found in plants or derived from plant precursors. Phytoestrogens are found in high concentration in soya, flaxseed and other seeds, fruits, vegetables, cereals, tea, chocolate, etc. They comprise several classes of chemical compounds (stilbenes, coumestans, isoflavones, ellagitannins, and lignans) which are structurally similar to endogenous estrogens but which can have both estrogenic and antiestrogenic effects. Although epidemiological and experimental evidence indicates that intake of phytoestrogens in foods may be protective against certain chronic diseases, discrepancies have been observed between in vivo and in vitro experiments. The microbial transformations have not been reported so far in stilbenes and coumestans. However, isoflavones, ellagitanins, and lignans are metabolized by intestinal bacteria to produce equol, urolithins, and enterolignans, respectively. Equol, urolithin, and enterolignans are more bioavailable, and have more estrogenic/antiestrogenic and antioxidant activity than their precursors. Moreover, equol, urolithins and enterolignans have anti-inflammatory effects and induce antiproliferative and apoptosis-inducing activities. The transformation of isoflavones, ellagitanins, and lignans by intestinal microbiota is essential to be protective against certain chronic diseases, as cancer, cardiovascular disease, osteoporosis, and menopausal symptoms. Bioavailability, bioactivity, and health effects of dietary phytoestrogens are strongly determined by the intestinal bacteria of each individual.


[Selected nutritional behaviours of professionally active men in Cracovian population depending on the age].
The aim of the research was to analyse selected rates of feeding manners among professionally active men in Cracovian population depending on their age. The research was carried out by means of an author's questionnaire and comprised 1453 men aged 18-70, Tadeusz Sendzimir's Steelworks Plant employees. The presented results prove that the most common feeding errors among working men are: lack of variety in food rations (about 2/3 of the respondents), irregularity of consuming meals (about 50%), low distribution of consuming supper before 7 pm (about 2/3), frequent eating in between main meals (about 1/3), low consumption of fruit and vegetables (about 2/3), fish (about 40%) and a high consumption of confectinery (about 40%). The research has shown that the percentage of faulty feeding choices among men diminish with their age.


Contrasting effects of two alternative splicing forms of coactivator-associated arginine methyltransferase 1 on thyroid hormone receptor-mediated transcription in Xenopus laevis.
Thyroid hormone receptors (TRs) can repress or activate target genes depending on the absence or presence of thyroid hormone (T3), respectively. This hormone-dependent gene regulation is mediated by the recruitment of corepressors in the absence of T3 and coactivators in its presence. Many TR-interacting coactivators have been characterized in vitro. Among them is coactivator-associated arginine methyltransferase 1 (CARM1), which methylates histone H3. We are interested in investigating the role of CARM1 in TR-mediated gene expression in vivo during postembryonic development by using T3-dependent frog metamorphosis as a model. We first cloned the Xenopus laevis CARM1 and obtained two alternative splicing forms, CARM1a and CARM1b. Both isoforms are expressed throughout metamorphosis, supporting a role for these isoforms during the process. To investigate whether Xenopus CARM1s participate in gene regulation by TRs, transcriptional analysis was conducted in Xenopus oocyte, where the effects of cofactors can be studied in the context of chromatin in vivo. Surprisingly, overexpression of CARM1b had little effect on TR-mediated transcription, whereas CARM1a enhanced gene activation by liganded TR. Chromatin immunoprecipitation assays showed that both endogenous CARM1a and overexpressed CARM1a and b were recruited to the promoter by liganded TR. However, the binding of liganded TR to the target promoter was reduced when CARM1b was overexpressed, accompanied by a slight reduction in histone methylation at the promoter. These results suggest that CARM1 may play a role in TR-mediated transcriptional regulation during frog development and that its function is regulated by alternative splicing.


Is anaphoric reference cooperative?
Two experiments investigated whether the choice of anaphoric expression is affected by the presence of an addressee. Following a context sentence and visual scene, participants described a target scene that required anaphoric reference. They described the scene either to an addressee (Experiment 1) or without an addressee (Experiment 2). When an addressee was present in the task, participants used more pronouns and fewer repeated noun phrases when the referent was the grammatical subject in the context sentence than when it was the grammatical object and they used more pronouns when there was no competitor than when there was. They used fewer pronouns and more repeated noun phrases when a visual competitor was present in the scene than when there was no visual competitor. In the absence of an addressee, linguistic context effects were the same as those when an addressee was present, but the visual effect of the competitor disappeared. We conclude that visual salience effects are due to adjustments that speakers make when they produce reference for an addressee, whereas linguistic salience effects appear whether or not speakers have addressees.


Leachability of metals from waste incineration residues by iron- and sulfur-oxidizing bacteria.
Hazardous waste disposal via incineration generates a substantial amount of ashes and slags which pose an environmental risk due to their toxicity. Currently, these residues are deposited in landfills with loss of potentially recyclable raw material. In this study, the use of acidophilic bioleaching bacteria (Acidithiobacillus ferrooxidans, Acidithiobacillus thiooxidans, and Leptospirillum ferrooxidans) as an environmentally friendly, efficient strategy for the recovery of valuable metals from incineration residues was investigated. Zinc, Cobalt, Copper, and Manganese from three different incineration residues were bio-extracted up to 100% using A. ferrooxidans under ferrous iron oxidation. The other metals showed lower leaching efficiencies based on the type of culture used. Sulfur-oxidizing cultures A. ferrooxidans and A. thiooxidans, containing sulfur as the sole substrate, expressed a significantly lower leaching efficiency (up to 50%). According to ICP-MS, ashes and slags contained Fe, Zn, Cu, Mn, Cr, Cd, and Ni in economically attractive concentrations between 0.2 and 75 mg g-1. Compared to conventional hydrometallurgical and pyrometallurgical processes, our biological approach provides many advantages such as: the use of a limited amount of used strong acids (H2SO4 or HCl), recycling operations at lower temperatures (~30 °C) and no emission of toxic gases during combustion (i.e., dioxins and furans).


[Energy requirements of miners engaged in open-pit coal mining].
It has been found that according to the value of daily energy consumption the coal miners engaged in open-cast mining should be referred to group III-IV of work intensity. The determining component of daily energy consumption is energy consumption during the working period the value of which depends on the character of working activity and duration of the working shift. The method of strict evaluation of the calorific value of the food taken and the control of body mass is acceptable for the assessment of daily energy consumption.


On kineopsis and computation of structure and motion.
This correspondence deals with the computation of structure and motion of rigid objects in space from image positions and optical flow. A test for rigid motion of objects in space is introduced which yields a new formulation of the problem. Assuming a central projection model for the viewing system, it is shown that image positions and optical flow at four points can achieve this perception.


Effect of hydroxyl radical (OH.) on sphincter of Oddi motility.
Antioxidant enzymes are present in sphincter of Oddi nerves and regulate sphincter of Oddi motor function mediated by NO-releasing nerves. Oxygen free radicals (O2-.) produce hydrogen peroxide (H2O2) by the action of superoxide dismutase (SOD). Hydroxyl radical (OH.) has been shown to play an important role as a mediator of H2O2 toxicity. The aims of our study were to determine the effects of H2O2 on sphincter of Oddi motility and if these effects are mediated by OH.. Adult opossums were sacrificed and the sphincter of Oddi removed and placed in a tissue bath containing oxygenated Krebs solution. Force transducers recorded tension in a transverse orientation at two sites along the sphincter of Oddi specimen. H2O2 was added into the tissue bath at concentrations from 0.01 to 0.5%. O2-. radicals were inhibited by the addition of SOD, while OH. was scavenged by the addition of alcohol (ETOH) or dimethyl sulfoxide (DMSO). H2O2 produced a dose-dependent increase in baseline amplitude, frequency, and peak amplitude of contractions. The effect of 0.01% H2O2 on sphincter of Oddi contractile frequency was inhibited by 0.2% ETOH and DMSO, but not by SOD. We conclude that H2O2 has profound effects on sphincter of Oddi motility and that the actions of H2O2 are probably mediated through OH..


Distinct excitability of thalamocortical neurons correlates with the presence of cerebellar afferents.
Thalamocortical (TC) neurons within the ventrolateral thalamus (VL) receive projections from the cerebellum and the basal ganglia (BG) to facilitate motor and non-motor functions. Tonic and rebound firing patterns in response to excitatory cerebellar and inhibitory BG inputs, respectively, are a canonical feature of TC neurons and plays a key role in signal processing. The intrinsic excitability of TC neurons has a strong influence on how they respond to synaptic inputs, however, it is unknown whether their afferents influence their firing properties. Understanding the input-specific firing patterns could shed light into movement disorders with cerebellar or BG involvement. Here, we used whole-cell electrophysiology in brain slices from C57BL/6 mice to investigate the firing of TC neurons with optogenetic confirmation of cerebellar or BG afferents. TC neurons with cerebellar afferents exhibited higher tonic and rebound firing rates than those with BG afferents. This increased firing was associated with faster action potential depolarization kinetics and a smaller afterhyperpolarization potential. We also found differences in the passive membrane properties and sag currents during hyperpolarization. Despite higher rebound firing in TC neurons with cerebellar afferents, there were no differences in T-type calcium channel function compared to those with BG inputs. These data suggest input-specific differences in sodium and SK, but not T-type calcium channels, impact firing properties in TC populations. Altogether, we showed that the pronounced divergence observed in TC neuron firing properties correlate with its heterogeneous anatomical connectivity, which could signify a distinct signal integration and processing by these neurons. Thalamocortical neurons in the VL with cerebellar afferents have higher intrinsic tonic and rebound firing properties than those with basal ganglia afferents.Membrane resistance and action potential depolarization slope were different based on the presence of cerebellar afferents.Despite elevated rebound burst firing, T-type mediated currents did not correlate with increased firing in neurons with cerebellar afferents.


Emergence timing and fitness consequences of variation in seed oil composition in Arabidopsis thaliana.
Early seedling emergence can increase plant fitness under competition. Seed oil composition (the types and relative amounts of fatty acids in the oils) may play an important role in determining emergence timing and early growth rate in oilseeds. Saturated fatty acids provide more energy per carbon atom than unsaturated fatty acids but have substantially higher melting points (when chain length is held constant). This characteristic forms the basis of an adaptive hypothesis that lower melting point seeds (lower proportion of saturated fatty acids) should be favored under colder germination temperatures due to earlier germination and faster growth before photosynthesis, while at warmer germination temperatures, seeds with a higher amount of energy (higher proportion of saturated fatty acids) should be favored. To assess the effects of seed oil melting point on timing of seedling emergence and fitness, high- and low-melting point lines from a recombinant inbred cross of Arabidopsis thaliana were competed in a fully factorial experiment at warm and cold temperatures with two different density treatments. Emergence timing between these lines was not significantly different at either temperature, which aligned with warm temperature predictions, but not cold temperature predictions. Under all conditions, plants competing against high-melting point lines had lower fitness relative to those against low-melting point lines, which matched expectations for undifferentiated emergence times.


Beyond acculturation: an investigation of the relationship of familism and parenting to behavior problems in Hispanic youth.
In the adolescent research literature, acculturation processes have been linked to the development of serious behavior problems in Hispanic adolescents, but not enough is known about how that process takes place. This article reports an investigation that sought to shed light on empirically plausible mechanisms by which family processes (i.e., familism and parenting practices) may operate as mediators of acculturation-related factors on adolescent problem behaviors among 167 Hispanic sixth- or seventh-grade early adolescents. SEM analyses identified an empirically plausible mediated pathway through which parenting practices may operate as a mediator of the effects of acculturation-related variables on adolescent problem behaviors. Second, although the role of familism as a mediator was not supported, the results did provide support for familism having indirect effects on behavior problems also through parenting practices. The findings are discussed in the context of existing research and clinical developments in the treatment of Hispanic adolescents and families.


Opioid Prescription, Morbidity, and Mortality in United States Dialysis Patients.
Aggressive pain treatment was advocated for ESRD patients, but new Centers for Disease Control and Prevention guidelines recommend cautious opioid prescription. Little is known regarding outcomes associated with ESRD opioid prescription. We assessed opioid prescriptions and associations between opioid prescription and dose and patient outcomes using 2006-2010 US Renal Data System information in patients on maintenance dialysis with Medicare Part A, B, and D coverage in each study year (n=671,281, of whom 271,285 were unique patients). Opioid prescription was confirmed from Part D prescription claims. In the 2010 prevalent cohort (n=153,758), we examined associations of opioid prescription with subsequent all-cause death, dialysis discontinuation, and hospitalization controlled for demographics, comorbidity, modality, and residence. Overall, >60% of dialysis patients had at least one opioid prescription every year. Approximately 20% of patients had a chronic (≥90-day supply) opioid prescription each year, in 2010 usually for hydrocodone, oxycodone, or tramadol. In the 2010 cohort, compared with patients without an opioid prescription, patients with short-term (1-89 days) and chronic opioid prescriptions had increased mortality, dialysis discontinuation, and hospitalization. All opioid drugs associated with mortality; most associated with worsened morbidity. Higher opioid doses correlated with death in a monotonically increasing fashion. We conclude that opioid drug prescription is associated with increased risk of death, dialysis discontinuation, and hospitalization in dialysis patients. Causal relationships cannot be inferred, and opioid prescription may be an illness marker. Efforts to treat pain effectively in patients on dialysis yet decrease opioid prescriptions and dose deserve consideration.


Alterations in fatty acid composition of murine keratinocytes with in vitro cultivation.
The availability of methods for the in vitro cultivation of keratinocytes has spawned numerous studies utilizing these systems to analyze epidermal biochemical pathways, e.g., eicosanoid production. To determine whether these culture systems are indeed valid models for studies of eicosanoid products, we analyzed the fatty acid (FA) composition, especially of eicosanoid precursors linoleic acid (LA) and arachidonic acid (AA), of cultured and noncultured mouse keratinocytes. Neonatal mouse epidermal keratinocytes were cultivated in Dulbecco's modification of Eagle's medium + 10% fetal calf serum (FCS). Lipids of the cultivated cells, as well as noncultivated keratinocytes and whole epidermis were extracted in CHCl3:MeOH (2:1) and lipid classes separated by thin-layer chromatography. The FA composition of the total lipid extract as well as of the phospholipid class was determined by gas-liquid chromatography of FA methyl esters. There was a gradual decrease in the LA levels in the cultured cells; by day 5 of culture the cells demonstrated a 4-fold (p less than 0.001) decrease in LA as compared to either noncultured cells or whole epidermis. Levels of AA, on the other hand, remained unchanged during culture. Analysis of the FCS used in the culture medium revealed that the level of LA was 4-fold lower than that of normal mouse serum. Since LA is an essential FA which is not synthesized by the cell, the decreased LA in cultured cells probably results from the paucity of this FA in the FCS-containing culture medium. These studies indicate that keratinocytes cultivated in FCS-containing medium demonstrate profound alterations in levels of LA. Hence, in vitro keratinocyte studies dependent on cellular polyunsaturated FA substrates should be interpreted with caution. The relationship of altered cellular levels of LA on keratinocyte differentiation remains to be determined.


Antisense inhibition of mitochondrial pyruvate dehydrogenase E1alpha subunit in anther tapetum causes male sterility.
We hypothesized that cytoplasmic male sterility (CMS) in sugar beet may be the consequence of mitochondrial dysfunctions affecting normal anther development. To test the hypothesis, we attempted to mimic the sugar beet CMS phenotype by inhibiting the expression of mitochondrial pyruvate dehydrogenase (PDH), which is essential for the operation of the tricarboxylic acid (TCA) cycle. Screening with a cDNA library of sugar beet flower buds allowed the identification of two PDH E1alpha subunit genes (bvPDH_E1alpha-1 and bvPDH_E1alpha-2). bvPDH_E1alpha-1 was found to be highly expressed in tap roots, whereas bvPDH_E1alpha-2 was expressed most abundantly in flower buds. Green fluorescent protein (GFP) fusion of bvPDH_E1alpha revealed mitochondrial targeting properties. A 300-bp bvPDH_E1alpha-1 cDNA sequence (from +620 to +926) was connected to a tapetum-specific promoter in the antisense orientation and then introduced into tobacco. Antisense expression of bvPDH_E1alpha-1 resulted in conspicuously decreased endogenous bvPDH_E1alpha-1 transcripts and male sterility. The tapetum in the male-sterile anthers showed swelling or abnormal vacuolation. It is also worth noting that in the sterile anthers, cell organelles, such as elaioplasts, tapetosomes and orbicules were poorly formed and microspores exhibited aberrant exine development. These features are shared by sugar beet CMS. The results thus clearly indicate that inhibition of PDH activity in anther tapetum is sufficient to cause male sterility, a phenocopy of the sugar beet CMS.


Bacteremic Staphylococcus aureus spondylitis.
The incidence of hematogenous Staphylococcus aureus osteomyelitis of the vertebral column is rapidly increasing and few studies dealing with the diagnosis, treatment, and outcome of this severe disease are available. Based on a nationwide registration, the clinical and bacteriological data were reviewed from 133 cases with a positive blood culture for S aureus and symptoms of vertebral osteomyelitis in Denmark for the period 1980 to 1990. The 133 cases of vertebral S aureus osteomyelitis reviewed were mainly community-acquired infections (82%) in older patients (median age, 65 years) and often occurred with underlying diseases. Both symptoms and laboratory values were relatively unspecific. Bone scan methods proved to be more optimal for diagnosis of vertebral S aureus osteomyelitis in the early stages compared with conventional radiography that proved a lack of consistency in the formative stages. The infection was mostly (70%) localized in the lower part of the column. The recurrence rate and rate of therapeutic failure depended on the duration and dosage of penicillinase-stable penicillins, respectively. Patients treated with fusidic acid in addition to penicillinase-stable penicillins had a significantly lower recurrence rate. Based on these findings, we recommend treatment with penicillinase-stable penicillins and fusidic acid for a total of 8 weeks, with a daily dosage of penicillinase-stable penicillins higher than 4 g. The diagnosis of vertebral S aureus osteomyelitis based on clinical findings is difficult to ascertain. Bone scans are necessary because radiographic methods do not detect disease as early. Treatment with penicillinase-stable penicillins, at least 4 g/d for at least 8 weeks, is recommended.


Pulmonary function and cardiac stress test after multimodality treatment of esophageal cancer.
Curative treatment of esophageal cancer is accompanied by frequent and sometimes severe side effects. However, prospectively collected data on side effects are scarce. The aim of this study was to evaluate if pulmonary function and exercise capacity were affected in the acute setting after neoadjuvant treatment and if there were long-lasting effects after neoadjuvant treatment and surgery. We also aimed to investigate whether the addition of radiation therapy to chemotherapy would aggravate side effects. A cohort of 97 patients enrolled in the randomized NeoRes trial was used for the present analysis. The patients had been randomized to receive 3 cycles of cisplatin and fluorouracil with or without concurrent radiation therapy to 40 Gy. A cardiac stress test on a stationary bicycle and a spirometry were performed before and after neoadjuvant treatment and 1 to 2 years later after surgery provided that the cancer had not recurred. We found impairment in pulmonary function measured as vital capacity and forced expiratory volume in 1 second and a decrease in exercise capacity after neoadjuvant treatment and 1 to 2 years later after surgery. We did not detect any differences between patients treated with chemoradiation therapy and those treated with chemotherapy alone. Multimodality treatment of esophageal cancer caused short-term and lasting impairments in pulmonary function and exercise capacity. The reductions were not aggravated by the addition of radiation therapy to neoadjuvant chemotherapy.


Utilization of preoperative cerebrospinal fluid drain in skull base surgery.
Retrospectively assess the efficacy of lumbar cerebrospinal fluid (CSF) drainage placed preoperatively in skull base operations in decreasing the incidence of postoperative CSF fistula. A retrospective review of 150 patients undergoing a posterior fossa craniotomy from 1989 to 2000 was conducted. Patients were divided into those receiving preoperative lumbar drains and those that did not. The rates of postoperative CSF leakage were compared between the two groups. Patient data were analyzed to determine if there were other comorbidities affecting the postoperative incidence of CSF leakage such as smoking, diabetes, or hypertension. Between 1989 and 1994, 25/72 (35%) patients with no preoperative lumbar drain had a postoperative CSF leak. From 1995 to 2000, 9/78 (12%) patients with a preoperative lumbar drain had a CSF leak. This was a 23% decreased incidence of postoperative CSF leakage and a significant decrease in the probability (p < 0.001) of CSF leakage in patients treated with a preoperative lumbar drain. The comorbidities of diabetes, smoking, or hypertension did not increase the probability of a CSF leak (p = 0.43). A preoperatively placed lumbar drain can significantly lower the rate of postoperative CSF leakage after skull base surgery. The drain is a well-tolerated adjunct to dural closure and helps increase surgical exposure of the posterior fossa. The comorbidities of diabetes, smoking, or hypertension do not contribute to an increased rate of CSF leakage.dagger Lyal Leibrock M.D., F.A.C.S. is Deceased.


[Role of bacteriocinogeny in regulating the population dynamics of oral cavity lactobacilli].
Bacteriocinogenicity and bacteriocine sensitivity of Lactobacilli isolated from human saliva were studied. It was shown that bacteriocinogenic cultures of Lactobacilli resistant to bacteriocines produced by them probably may play some ecological role in regulation of the population dynamics because of growth inhibition of Lactobacillus sensitive cultures in the saliva, thus providing favourable selective conditions for the development of both the strains producing them and the strains resistant to bacteriocines. Bacteriocinogenic strains sensitive to bacteriocines produced by them probably played no significant role in regulation of the dynamics of Lactobacillus population in the oral cavity, since they did not inhibit the growth of half of the Lactobacillus cultures present in human saliva.


Maladaptive cognitive appraisals in children with high-functioning autism: associations with fear, anxiety and theory of mind.
Despite the well-documented success of cognitive restructuring techniques in the treatment of anxiety disorders, there is still little clarity on which cognitions underpin fear and anxiety in children with high-functioning autism spectrum disorder. This study examined whether certain cognitive appraisals, known to be associated with fear and anxiety in typically developing groups, may help explain these emotions in children with high-functioning autism spectrum disorder. It also investigated relations between these cognitive appraisals and theory of mind. Appraisals, fear and anxiety were assessed using a vignette approach in 22 children with high-functioning autism spectrum disorders and 22 typically developing children. The two groups differed significantly on all four appraisal types. Anxiety was negatively correlated with future expectancy and positively with problem-focused coping potential in the high-functioning autism spectrum disorder group but was not correlated with appraisals in the typically developing group. The two appraisals associated with fear were emotion-focused coping potential (in the high-functioning autism spectrum disorder group only) and self-accountability (in the typically developing group only). Linear regression analysis found that appraisals of emotion-focused coping potential, problem-focused coping potential and future expectancy were significant predictors of theory-of-mind ability in the high-functioning autism spectrum disorders group. These findings indicate that specific, problematic patterns of appraisal may characterise children with high-functioning autism spectrum disorders.


The economic impact of the transition from branded to generic oncology drugs.
Economic evaluations are an integral component of many clinical trials. Costs used in those analyses are based on the prices of branded drugs when they first enter the market. The effect of genericization on the cost-effectiveness (ce) or cost-utility (cu) of an intervention is unknown because economic analyses are rarely updated using the costs of generic drugs. We re-examined the ce or cu of regimens previously evaluated in Canadian Cancer Trials Group (cctg) studies that included prospective economic evaluations and where genericization has occurred or is anticipated in Canada. We incorporated the new costs of generic drugs to characterize changes in ce or cu. We also determined acceptable cost levels of generic drugs that would make regimens reimbursable in a publicly funded health care system. The four randomized controlled trials included (representing 1979 patients) were cctg br.10 (early lung cancer, adjuvant vinorelbine-cisplatin vs. observation, n = 172), cctg br.21 (metastatic lung cancer, erlotinib vs. placebo, n = 731), cctg co.17 (metastatic colon cancer, cetuximab vs. best supportive care, n = 557), and cctg ly.12 (relapsed or refractory lymphoma, gemcitabine-dexamethasone-cisplatin vs. cytarabine-dexamethasone-cisplatin, n = 619). Since the initial publication of those trials, the genericization of vinorelbine, erlotinib, cetuximab, and cisplatin has taken place or is expected in Canada. Costs of generics improved the ces and cus of treatment significantly. For example, genericization of erlotinib ($1460.25 per 30 days) resulted in an incremental cost-effectiveness ratio (icer) of $45,746 per life-year gained compared with $94,638 for branded erlotinib. Likewise, genericization of cetuximab ($275.80 per 100 mg) produced an icer of $261,126 per quality-adjusted life-year (qaly) gained compared with $299,613 for branded cetuximab. Decreases in the cost of generic cetuximab to $129.39 and $63.51 would further improve the icer to $150,000 and $100,000 per QALY respectively. Genericization of a costly oncology drug can modify the ce and cu of a regimen significantly. Failure to revisit economic analyses with the costs of generics could be a missed opportunity for funding bodies to optimize value-based allocation of health care resources. At current levels, the costs of generics might not be sufficiently low to sustain publicly funded health care systems.


Efficacy of Whole-Lung Lavage in Pulmonary Alveolar Proteinosis: A Multicenter International Study of GELF.
New therapies have emerged in the treatment of pulmonary alveolar proteinosis (PAP) and, therefore, there is a real need to evaluate the efficacy of whole-lung lavage (WLL) in this rare disease. The aim of this study was to assess the efficacy of WLL in patients with PAP. We included 33 patients from 12 centers, which are members of the French-Speaking Thoracic Endoscopy Group, for analysis. Data collection concerned patients and disease characteristics, pulmonary function tests (PFTs) and technical information on the procedure. The median age of the patients was 44 years (range 13-77). There were 23 (71.9%) patients with respiratory insufficiency at presentation. All patients underwent WLL by general anesthesia and selective lung ventilation, except 1 who underwent awake flexible bronchoscopy. We noted differences in the technique, as 12 (36.36%) patients had percussion during the procedure and only 4 (12.1%) patients underwent 2-lung lavage during 1 anesthesia. A median of 12 L was used to perform WLL (1.0-40 L). Complications occurred in 11 (33.3%) patients, and 18 (56.25%) of them relapsed in a median period of 16.9 months. No significant changes were found in any PFT parameters studied, except for PaO2, which was significantly improved by 6.375 mm Hg (p = 0.0213) after the procedure compared to before. Although the application of the WLL technique was variable, overall, it significantly improved patients' short-term respiratory condition by improving PaO2. However, a long-term effect needs to be confirmed, as many of our patients relapsed.


Evidence for Soybean Aphid (Hemiptera: Aphididae) Resistance to Pyrethroid Insecticides in the Upper Midwestern United States.
Soybean aphid, Aphis glycines Matsumura (Hemiptera: Aphididae), is a damaging invasive pest of soybean in the upper Midwest. Threshold-based insecticide applications are the primary control method for soybean aphid, but few insecticide groups are available (i.e., pyrethroids, organophosphates, and neonicotinoids). To quantify current levels of soybean aphid susceptibility to pyrethroids in the upper Midwest and monitor for insecticide resistance, leaf-dip bioassays were performed with λ-cyhalothrin in 2013-2015, and glass-vial bioassays were performed with λ-cyhalothrin and bifenthrin in 2015 and 2016. Soybean aphids were collected from 27 population-years in Minnesota and northern Iowa, and were compared with a susceptible laboratory colony with no known insecticide exposure since discovery of soybean aphid in North America in 2000. Field-collected aphids from some locations in leaf-dip and glass-vial bioassays had significantly lower rates of insecticide-induced mortality compared with the laboratory population, although field population susceptibility varied by year. In response to sublethal concentrations of λ-cyhalothrin, adult aphids from some locations required higher concentrations of insecticide to reduce nymph production compared with the laboratory population. The most resistant field population demonstrated 39-fold decreased mortality compared with the laboratory population. The resistance documented in this study, although relatively low for most field populations, indicates that there has been repeated selection pressure for pyrethroid resistance in some soybean aphid populations. Integrated pest management and insecticide resistance management should be practiced to slow further development of soybean aphid resistance to pyrethroids.


Exocyclic DNA lesions stimulate DNA cleavage mediated by human topoisomerase II alpha in vitro and in cultured cells.
DNA adducts are mutagenic and clastogenic. Because of their harmful nature, lesions are recognized by many proteins involved in DNA repair. However, mounting evidence suggests that lesions also are recognized by proteins with no obvious role in repair processes. One such protein is topoisomerase II, an essential enzyme that removes knots and tangles from the DNA. Because topoisomerase II generates a protein-linked double-stranded DNA break during its catalytic cycle, it has the potential to fragment the genome. Previous studies indicate that abasic sites and other lesions that distort the double helix stimulate topoisomerase II-mediated DNA cleavage. Therefore, to further explore interactions between DNA lesions and the enzyme, the effects of exocyclic adducts on DNA cleavage mediated by human topoisomerase IIalpha were determined. When located within the four-base overhang of a topoisomerase II cleavage site (at the +2 or +3 position 3' relative to the scissile bond), 3,N(4)-ethenodeoxycytidine, 3,N(4)-etheno-2'-ribocytidine, 1,N(2)-ethenodeoxyguanosine, pyrimido[1,2-a]purin-10(3H)-one deoxyribose (M(1)dG), and 1,N(2)-propanodeoxyguanosine increased DNA scission approximately 5-17-fold. Enhanced cleavage did not result from an increased affinity of topoisomerase IIalpha for adducted DNA or a decreased rate of religation. Therefore, it is concluded that these exocyclic lesions act by accelerating the forward rate of enzyme-mediated DNA scission. Finally, treatment of cultured human cells with 2-chloroacetaldehyde, a reactive metabolite of vinyl chloride that generates etheno adducts, increased cellular levels of DNA cleavage by topoisomerase IIalpha. This finding suggests that type II topoisomerases interact with exocyclic DNA lesions in physiological systems.


Evidence-centered design for simulation-based assessment.
Simulations provide opportunities for people to learn and to develop skills for situations that are expensive, time-consuming, or dangerous. Careful design can support their learning by tailoring the features of situations to their levels of skill, allowing repeated attempts, and providing timely feedback. The same environments provide opportunities for assessing people's capabilities to act in these situations. This article describes an assessment design framework that can help projects develop effective simulation-based assessments. It reviews the rationale and terminology of the "evidence-centered" assessment design framework, discusses how it aligns with the principles of simulation design, and illustrates ideas with examples from engineering and medicine. Advice is offered for designing a new simulation-based assessment and for adapting an existing simulation system for assessment purposes.


[Anaplastic large cell lymphoma based on our clinicopathological cases].
CD30(Ki-1) positive anaplastic large cell lymphoma (ALCL) is a distinct entity, in which the monoclonal antibody-positivity against the CD30(Ki-1) antigen of tumour cells has a diagnostic value. The histological subtypes of ALCL show also certain clinical differences. Except for some pediatric cases and cutaneous forms clinical outcome is very unfavourable despite of the various treatment methods. In this prospective study (follow-up of 11-60, median 16 months) clinicopathological data and treatment results of fifteen adult patients with ALCL were analysed, Mean age was 46 (16-69) ys with a bimodal tendency and a distinct female: male ratio (3:2) was observed. Early clinical stages (I-II/A-B, eight patients) dominated, and two main groups could be distinguished histologically (Hodgkin-related, ALCL-HR and common type, -CT in eight and seven patients), respectively. In all histological specimens CD30 antigen expression was detected. Additional immunophenotyping was performed in five cases (two 0-variant, two of B-cell and one of T-cell origin), respectively. A bulky disease, mainly in the mediastinum was observed in six cases, and a primary gastrointestinal localization in two other patients. In the treatment of these high grade malignant lymphomas a combination of cobalt irradiation and aggressive chemotherapy was applied (in elder the CHOP-regimen, in younger patients mainly the Pro-MACE-Cyta-BOM-protocol). In one relapsed younger patient autologous bone marrow transplantation was also performed. A complete or partial remission was achieved in thirteen patients (86.6%) but six patients expired after only a short response period to therapy. Overall survival was 19, whilst disease-free survival revealed to be 15 months. Eight of their living nine patients have a durable complete remission. Due to residual mediastinal mass after radiotherapy in three cases a permanent radiological follow-up is needed. Advanced age and clinical stages are considered to be unfavourable, whilst histological subtypes were indifferent prognostic factors, as well. Favourable results in therapy and durable complete remission in younger patients are probably caused by the their better tolerance of third-line aggressive chemotherapy.