Maintained autonomic responses to moderate exercise in hypertensive patients treated with lacidipine.
Excessive adrenergic responses have been reported in hypertensive patients treated with short-acting dihydropiridine calcium channel antagonists that might worsen cardiovascular risk. In this study we addressed whether lacidipine, a long-acting dihydropiridine, increases the sympathetic excitation produced by moderate dynamic exercise. Because of the wide changes in autonomic drive during everyday life, the possible influence of antihypertensive regimens should be assessed not only at rest but also during spontaneous, behaviourally induced alterations of sympathovagal balance. This study was designed to test whether treatment with lacidipine might alter the autonomic response to supine moderate dynamic exercise. We studied 16 moderate hypertensive patients (arterial pressure 151/102 mmHg) at rest and during 30% of nominal maximum recumbent bicycle exercise. The low frequency spectral component of RR interval and of systolic variability (Finapres) furnished markers of sympathetic modulation of the sinoatrial node and of the vasculature, respectively. Studies were performed during placebo and active treatment (lacidipine 4 mg per day). Lacidipine treatment significantly reduces arterial pressure values at rest and during moderate dynamic exercise, without affecting RR interval and systolic arterial pressure variabilities, both at rest and during moderate exercise. In conclusion, spectral analysis of RR interval and systolic arterial pressure variabilities indicate that antihypertensive treatment with lacidipine is not associated to an excessive sympathetic drive during moderate exercise.


Effects of various modes of mechanical ventilation in normal rats.
Recent studies in healthy mice and rats have reported that positive pressure ventilation delivered with physiological tidal volumes at normal end-expiratory volume worsens lung mechanics and induces cytokine release, thus suggesting that detrimental effects are due to positive pressure ventilation per se. The aim of this study in healthy animals is to assess whether these adverse outcomes depend on the mode of mechanical ventilation. Rats were subjected to 4 h of spontaneous, positive pressure, and whole-body or thorax-only negative pressure ventilation (N = 8 per group). In all instances the ventilatory pattern was that of spontaneous breathing. Lung mechanics, cytokines concentration in serum and broncho-alveolar lavage fluid, lung wet-to-dry ratio, and histology were assessed. Values from eight animals euthanized shortly after anesthesia served as control. No evidence of mechanical ventilation-dependent lung injury was found in terms of lung mechanics, histology, or wet-to-dry ratio. Relative to control, cytokine levels and recruitment of polymorphonuclear leucocytes increased slightly, and to the same extent with spontaneous, positive pressure, and whole-body negative pressure ventilation. Thorax-only negative pressure ventilation caused marked chest and lung distortion, reversible increase of lung elastance, and higher polymorphonuclear leucocyte count and cytokine levels. Both positive and negative pressure ventilation performed with tidal volumes and timing of spontaneous, quiet breathing neither elicit an inflammatory response nor cause morpho-functional alterations in normal animals, thus supporting the notion of the presence of a critical volume threshold above which acute lung injury ensues. Distortion of lung parenchyma can induce an inflammatory response, even in the absence of volotrauma.


Delayed-onset systolic anterior motion of the mitral valve after aortic valve replacement for severe aortic stenosis.
Systolic anterior motion (SAM) of the mitral valve after aortic valve replacement (AVR) for severe aortic stenosis (AS) is one of the causes of perioperative left ventricular outflow tract (LVOT) obstruction in older patients. A 90-year-old woman underwent AVR with a 19-mm bioprosthesis for symptomatic aortic valve stenosis. Preoperative transthoracic echocardiography (TTE) showed left ventricular hypertrophy, with LVOT obstruction and mild mitral regurgitation (MR). Intraoperative transesophageal echocardiography and postoperative TTE showed that the degree of MR was unchanged after surgery. The patient's postoperative course was uneventful. However, she developed shortness of breath 6 months after discharge. A subsequent TTE showed significant LVOT obstruction and SAM, which resulted in moderate to severe MR. Because of the patient's advanced age, cibenzoline was administered to decrease the left ventricular pressure gradient (LVPG) and improve the left ventricular diastolic function. Two months after administration of cibenzoline, a TTE showed decreased LVPG, trivial MR, and the absence of SAM. This case clearly demonstrated that cibenzoline improved the SAM of the mitral valve that arose after AVR for AS in a remote postoperative period.


Post-Fire Recovery in Coastal Sage Scrub: Seed Rain and Community Trajectory.
Disturbance is a primary mechanism structuring ecological communities. However, human activity has the potential to alter the frequency and intensity of natural disturbance regimes, with subsequent effects on ecosystem processes. In Southern California, human development has led to increased fire frequency close to urban areas that can form a positive feedback with invasive plant spread. Understanding how abiotic and biotic factors structure post-fire plant communities is a critical component of post-fire management and restoration. In this study we considered a variety of mechanisms affecting post-fire vegetation recovery in Riversidean sage scrub. Comparing recently burned plots to unburned plots, we found that burning significantly reduced species richness and percent cover of exotic vegetation the first two years following a 100-hectare wildfire. Seed rain was higher in burned plots, with more native forb seeds, while unburned plots had more exotic grass seeds. Moreover, there were significant correlations between seed rain composition and plant cover composition the year prior and the year after. Collectively, this case study suggests that fire can alter community composition, but there was not compelling evidence of a vegetation-type conversion. Instead, the changes in the community composition were temporary and convergence in community composition was apparent within two years post-fire.


Effects of model traumatic injury on hepatic drug metabolism in the rat. IV. Glucuronidation.
A previously validated small mammal trauma model, hind-limb ischemia secondary to infrarenal aortic ligation in the rat, was utilized to investigate the effects of traumatic injury on hepatic glucuronidation activity. As was previously observed with hepatic oxidative drug metabolism, model trauma resulted in a significant decrease in the in vivo glucuronidation of chloramphenicol, with a 23% drop in clearance of this drug. The effect on in vivo pharmacokinetics appeared to result from a complex interaction between trauma's differential influences on conjugating enzyme(s), deconjugating enzyme(s), and hepatic UDP-glucuronic acid levels, as well as the relative physiological importance of these variables. Hepatic UDP-glucuronyltransferase activities towards both p-nitrophenol and chloramphenicol were elevated (44-54%) after model injury when measured in native hepatic microsomes. However, microsomes which had been "activated" by treatment with Triton X-100 showed no significant difference between control and traumatized animals. Serum beta-glucuronidase activities were elevated by 58%, while hepatic beta-glucuronidase rose by about 16%. Nevertheless, in vivo deconjugation showed no significant change. Model trauma also resulted in a 46% decrease in hepatic UDP-glucuronic acid content. Thus, the observed post-traumatic depression of in vivo chloramphenicol glucuronidation could be due either to a diminished availability of a necessary cofactor (UDP-glucuronic acid) or to an alteration in enzyme kinetics or function in vivo.


Immune Cell Production of Interleukin 17 Induces Stem Cell Features of Pancreatic Intraepithelial Neoplasia Cells.
Little is known about how the immune system affects stem cell features of pancreatic cancer cells. Immune cells that produce interleukin 17A (IL17A) in the chronically inflamed pancreas (chronic pancreatitis) contribute to pancreatic interepithelial neoplasia (PanIN) initiation and progression. We investigated the effects that IL17A signaling exerts on pancreatic cancer progenitor cells and the clinical relevance of this phenomena. We performed studies with Mist1Cre;LSLKras;Rosa26mTmG (KCiMist;G) and Kras(G12D);Trp53(R172H);Pdx1-Cre (KPC) mice (which upon tamoxifen induction spontaneously develop PanINs) and control littermates. Some mice were injected with neutralizing antibodies against IL17A or control antibody. Pancreata were collected, PanIN epithelial cells were isolated by flow cytometry based on lineage tracing, and gene expression profiles were compared. We collected cells from pancreatic tumors of KPC mice, incubated them with IL17 or control media, measured expression of genes regulated by IL17 signaling, injected the cancer cells into immune competent mice, and measured tumor growth. IL17A was overexpressed in pancreata of KCiMist mice from an adenoviral vector. Pancreata were collected from all mice and analyzed by histology and immunohistochemistry. Levels of DCLK1 and other proteins were knocked down in KPC pancreatic cancer cells using small interfering or short hairpin RNAs; cells were analyzed by immunoblotting. We obtained 65 pancreatic tumor specimens from patients, analyzed protein levels by immunohistochemistry, and compared results with patient survival times. We also analyzed gene expression levels and patient outcome using The Cancer Genome Atlas database. PanIN cells from KCiMist;G mice had a gene expression pattern associated with embryonic stem cells. Mice given injections of IL17-neutralizing antibodies, or with immune cells that did not secrete IL17, lost this expression pattern and had significantly decreased expression of DCLK1 and POU2F3, which regulate tuft cell development. KCiMist mice that overexpressed IL17 formed more PanINs, with more DCLK1-positive cells, than control mice. Pancreatic tumor cells from KPC mice and human Capan-2 cells exposed to IL17A had increased activation of NF-κB and mitogen-activated protein kinase signaling and increased expression of DCLK1 and ALDH1A1 (a marker of embryonic stem cells) compared with cells in control media. These cells also formed tumors faster that cells not exposed to IL17 when they were injected into immunocompetent mice. KPC cells with knockdown of DCLK1 expressed lower levels of ALDH1A1 after incubation with IL17 than cells without knockdown. Expression of the IL17 receptor C was higher in DCLK1-positive PanIN cells from mice compared with DCLK1-negative PanIN cells. In human pancreatic tumor tissues, high levels of DCLK1 associated with a shorter median survival time of patients (17.7 months, compared with 26.6 months of patients whose tumors had low levels of DCLK1). Tumor levels of POU2F3 and LAMC2 were also associated with patient survival time. In studies of mouse and human pancreatic tumors and precursors, we found that immune cell-derived IL17 regulated development of tuft cells and stem cell features of pancreatic cancer cells via increased expression of DCLK1, POU2F3, ALDH1A1, and IL17RC. Strategies to disrupt this pathway might be developed to prevent pancreatic tumor growth and progression.


Proteomics approach to study the functions of Drosophila myosin VI through identification of multiple cargo-binding proteins.
Myosin VI is a molecular motor implicated in many processes, and it likely associates with a variety of cargoes that specify its functions. Although it is critical to Drosophila development, little is known about its cellular roles. To reveal its involvement in specific pathways, we sought to identify the binding partners of Drosophila myosin VI. We used affinity chromatography and mass spectrometry to discover interacting proteins, which we tested for direct binding. Using this approach, we found that the microtubule-associated protein Cornetto bound myosin VI, and we demonstrated a role for both in secretion of the lipidated morphogen Hedgehog. We also identified a number of other binding proteins, and further characterization of their interactions with myosin VI will advance our understanding of the roles of these complexes in cellular and developmental processes. Thus, our method has provided us the means to gain valuable insight into the multifaceted roles of a motor protein in vivo.


Variation of initial serum bilirubin rise in newborn infants with type of illness.
Hyperbilirubinaemia in newborn infants is generally regarded as a problem, and bilirubin itself as toxic metabolic waste, but the high frequency in newborn infants suggests that the excess of neonatal bilirubin may have a positive function. To investigate the hypothesis that bilirubin has a role as a free-radical scavenger, the rate of rise in serum bilirubin in the first few days of life was measured in 44 infants with five illnesses thought to enhance free-radical production and in 58 control infants. The infants were selected from 2700 consecutive births by exclusion of those with factors known to affect bilirubin metabolism, including enteral feeding. The control infants were those who seemed to be ill and received treatment, including restriction of enteral feeds, but in whom no illness, or disorders not related to free-radical production, were found. The mean serum bilirubin rise was significantly lower in the combined illness group than in the control group (36.1 [95% Cl 26.9-45.3] vs 66.7 [55.9-77.5] mumol.l-1.day-1; p less than 0.0001). In subgroup analyses the mean rises in infants with circulatory failure, neonatal depression/asphyxia, aspiration syndromes, and proven sepsis were significantly lower than in controls matched for gestational age and birthweight, but rises in infants with respiratory distress and their matched controls did not differ. These findings are consistent with the hypothesis that bilirubin is consumed in vivo as an antioxidant. Such consumption may operate in vivo in addition to the standard pathways for bilirubin metabolism (production, isomerisation, and excretion).


Intussusception secondary to metastasis from a low-grade retroperitoneal liposarcoma.
Liposarcomas are the most prevalent soft tissue sarcomas in adults. Low-grade liposarcomas are the most frequent and least aggressive and are noted as having a low risk of metastasis. We present a case of low-grade myxoid liposarcoma that metastasized to the small bowel resulting in intussusception. This case involves a 44-year-old woman with a recurrent retroperitoneal liposarcoma. Approximately 30 months after initial diagnosis, the patient was found to have a solitary metastasis to the small bowel that presented as a jejunal intussusception. Interestingly, there was no indication of a round cell component in either the metastasis or recurrent tumor, although the original tumor did contain a small round cell component. This is the first report in the English literature of liposarcoma metastasizing to the small bowel. We suggest that atypical presentations of liposarcoma metastases should always be considered in the management of patients with a history of liposarcoma.


[Conformation states of thymopentin and its synthetic analogs].
Spatial structures of the biologically active fragment Arg-Lys-Asp-Val-Tyr of tymopoetin (tymopentin) and its synthetic analogs: [Lys1-Arg2]-, [Glu3]- and [Gly3] have been investigated by theoretical conformational analysis. These results indicate that the conformational properties of fragments are represented in aqueous solution by five different backbone forms.


CNS lymphoma masquerading as stroke: Cases report and literature review.
Central nervous system (CNS) involvement in Hodgkins lymphoma (HL) is extremely rare. There are only two reported case series of intracranial involvement of HL. CNS HL can be presented at any point in the course of HL, most mimicking with a prominent neurological symptom. This challenges the diagnosis of CNS involvement and stroke. Here, we report four cases of patients having refractory HL with CNS involvement to garner attention among neurologists for this rare disease presents with stroke symptoms and reviews its disease characteristics, prognosis, and treatment.


A north atlantic climate pacemaker for the centuries.
Although El Niño and La Niña are the largest single sources of global interannual climate variability, climate shifts on longer time scales than El Niño's 2 to 7 years are also drawing the attention of researchers. On multidecadal time scales of 40 to 80 years, a restless North Atlantic seems to be at work, alternately countering and enhancing humankind's alterations of climate. The evidence for this is turning up in such records as tree rings, ice cores, and corals.


Model-based estimates of chikungunya epidemiological parameters and outbreak risk from varied data types.
Assessing the factors responsible for differences in outbreak severity for the same pathogen is a challenging task, since outbreak data are often incomplete and may vary in type across outbreaks (e.g., daily case counts, serology, cases per household). We propose that outbreaks described with varied data types can be directly compared by using those data to estimate a common set of epidemiological parameters. To demonstrate this for chikungunya virus (CHIKV), we developed a realistic model of CHIKV transmission, along with a Bayesian inference method that accommodates any type of outbreak data that can be simulated. The inference method makes use of the fact that all data types arise from the same transmission process, which is simulated by the model. We applied these tools to data from three real-world outbreaks of CHIKV in Italy, Cambodia, and Bangladesh to estimate nine model parameters. We found that these populations differed in several parameters, including pre-existing immunity and house-to-house differences in mosquito activity. These differences resulted in posterior predictions of local CHIKV transmission risk that varied nearly fourfold: 16% in Italy, 28% in Cambodia, and 62% in Bangladesh. Our inference method and model can be applied to improve understanding of the epidemiology of CHIKV and other pathogens for which outbreaks are described with varied data types.


Chemotherapy Induces Senescence-Like Resilient Cells Capable of Initiating AML Recurrence.
Patients with acute myeloid leukemia (AML) frequently relapse after chemotherapy, yet the mechanism by which AML reemerges is not fully understood. Herein, we show that primary AML cells enter a senescence-like phenotype following chemotherapy in vitro and in vivo. This is accompanied by induction of senescence/inflammatory and embryonic diapause transcriptional programs, with downregulation of MYC and leukemia stem cell genes. Single-cell RNA sequencing suggested depletion of leukemia stem cells in vitro and in vivo, and enrichment for subpopulations with distinct senescence-like cells. This senescence effect was transient and conferred superior colony-forming and engraftment potential. Entry into this senescence-like phenotype was dependent on ATR, and persistence of AML cells was severely impaired by ATR inhibitors. Altogether, we propose that AML relapse is facilitated by a senescence-like resilience phenotype that occurs regardless of their stem cell status. Upon recovery, these post-senescence AML cells give rise to relapsed AMLs with increased stem cell potential. SIGNIFICANCE: Despite entering complete remission after chemotherapy, relapse occurs in many patients with AML. Thus, there is an urgent need to understand the relapse mechanism in AML and the development of targeted treatments to improve outcome. Here, we identified a senescence-like resilience phenotype through which AML cells can survive and repopulate leukemia.This article is highlighted in the In This Issue feature, p. 1307.


Patellar fracture after total knee arthroplasty.
Patellar fracture can occur as a complication following total knee arthroplasty. The purpose of this study was to evaluate a large series of patellar fractures to determine the results of different forms of treatment of specific fracture types. A retrospective review identified eighty-five fractures (in seventy-seven patients) following 12,464 consecutive total knee arthroplasties performed between 1985 and 1998. Seventy-eight fractures occurred after primary total knee arthroplasty and seven, after revision total knee arthroplasty. Five fractures were treated elsewhere, and two others were lost to follow-up. The results of treatment of the remaining seventy-eight fractures were reviewed. Fractures were classified according to three main criteria: integrity of the extensor mechanism, fixation status of the patellar implant, and quality of the remaining bone stock. The mean duration of follow-up was 3.6 years. The prevalence of patellar fracture after total knee arthroplasty was 0.68%; fractures were significantly more prevalent among men (1.01%) than among women (0.40%) (p = 0.0004). Thirty-eight fractured patellae had a stable implant and an intact extensor mechanism (Type I). All but one were treated nonoperatively, and there was only one late failure of nonoperative treatment, which required operative intervention. Twelve fractures were associated with disruption of the extensor mechanism (Type II). Eleven were treated operatively; six knees had complications and five had a reoperation. Twenty-eight fractures occurred in association with a loose patellar component (Type III). Twenty were treated operatively; nine knees had complications, and four had a reoperation. Patellar fractures after total knee arthroplasty are infrequent. Treatment can be guided by three main criteria: integrity of the extensor mechanism, fixation status of the patellar implant, and quality of the remaining bone. Fractures associated with a stable implant and an intact extensor mechanism were usually treated successfully with nonoperative means, with minimal complications. When operative treatment was required, it was associated with a high rate of complications and reoperations.


[Total dream loss secondary to left temporo-occipital brain injury].
Recently the case of a woman who reported cessation of dreaming after a bilateral PCA stroke but without REM sleep loss has been reported, suggesting that deep bilateral occipital lobe damage including the right inferior lingual gyrus may represent the "minimal lesion extension" necessary for dream loss. We report the case of a 24-year-old man who ceased dreaming after a unilateral left temporo- occipital hematoma. The polysomnographic characteristics in rapid eyes movements (REM) sleep were otherwise normal. Our patient demonstrates that a unilateral left temporo-occipital injury could be sufficient for losing dreams.


Fecal microbiota composition of breast-fed infants is correlated with human milk oligosaccharides consumed.
This study tested the hypothesis that the fecal bacterial genera of breast-fed (BF) and formula-fed (FF) infants differ and that human milk oligosaccharides (HMOs) modulate the microbiota of BF infants. Fecal samples were obtained from BF (n = 16) or FF (n = 6) infants at 3-month postpartum. Human milk samples were collected on the same day when feces were collected. The microbiota was assessed by pyrosequencing of bacterial 16S ribosomal RNA genes. HMOs were measured by high-performance liquid chromatography-chip time-of-flight mass spectrometry. The overall microbiota of BF differed from that of FF (P = 0.005). Compared with FF, BF had higher relative abundances of Bacteroides, lower proportions of Clostridium XVIII, Lachnospiraceae incertae sedis, Streptococcus, Enterococcus, and Veillonella (P < 0.05). Bifidobacterium predominated in both BF and FF infants, with no difference in abundance between the 2 groups. The most abundant HMOs were lacto-N-tetraose + lacto-N-neotetraose (LNT + LNnT, 22.6%), followed by 2'-fucosyllactose (2'FL, 14.5%) and lacto-N-fucopentaose I (LNFP I, 9.5%). Partial least squares regression of HMO and microbiota showed several infant fecal bacterial genera could be predicted by their mothers' HMO profiles, and the important HMOs for the prediction of bacterial genera were identified by variable importance in the projection scores. These results strengthen the established relation between HMO and the infant microbiota and identify statistical means whereby infant bacterial genera can be predicted by milk HMO. Future studies are needed to validate these findings and determine whether the supplementation of formula with defined HMO could selectively modify the gut microbiota.


Large improvement of the electrical impedance of imaging and high-intensity focused ultrasound (HIFU) phased arrays using multilayer piezoelectric ceramics coupled in lateral mode.
With a change in phased-array configuration from one dimension to two, the electrical impedance of the array elements is substantially increased because of their decreased width (w)-to-thickness (t) ratio. The most common way to compensate for this impedance increase is to employ electrical matching circuits at a high cost of fabrication complexity and effort. In this paper, we introduce a multilayer lateral-mode coupling method for phased-array construction. The direct comparison showed that the electrical impedance of a single-layer transducer driven in thickness mode is 1/(n²(1/(w/t))²) times that of an n-layer lateral mode transducer. A large reduction of the electrical impedance showed the impact and benefit of the lateral-mode coupling method. A one-dimensional linear 32-element 770-kHz imaging array and a 42-element 1.45-MHz high-intensity focused ultrasound (HIFU) phased array were fabricated. The averaged electrical impedances of each element were measured to be 58 Ω at the maximum phase angle of -1.2° for the imaging array and 105 Ω at 0° for the HIFU array. The imaging array had a center frequency of 770 kHz with an averaged -6-dB bandwidth of approximately 52%. For the HIFU array, the averaged maximum surface acoustic intensity was measured to be 32.8 W/cm² before failure.


[An evaluation of new prevention programs for tuberculous infection. II. BCG vaccination].
Tuberculosis is an infectious disease produced by Mycobacterium tuberculosis in a 98-99% of the cases and by Mycobacterium bovis in a 1-2%. Its early diagnosis is of a great importance because permits to reduce the transmission of the infection. Until now, the diagnostic techniques used to discover the dissemination of the disease are indirect. We have the PPD skin test and, among them, Mantoux is the most common. Correctly used it has a great diagnostic and epidemiological value, because it permits to evaluate those patients who can obtain a benefit with the chemoprophylaxis when the skin test is positive. We analyse the actual via of chemoprophylaxis, when and how it must be used. We study not only the drugs for the prophylaxis, but also the good and bad utilisation of the BCG vaccine, that it starts to have its indications in other countries.


Oxytocin increases eye contact during a real-time, naturalistic social interaction in males with and without autism.
Autism spectrum conditions (autism) affect ~1% of the population and are characterized by deficits in social communication. Oxytocin has been widely reported to affect social-communicative function and its neural underpinnings. Here we report the first evidence that intranasal oxytocin administration improves a core problem that individuals with autism have in using eye contact appropriately in real-world social settings. A randomized double-blind, placebo-controlled, within-subjects design is used to examine how intranasal administration of 24 IU of oxytocin affects gaze behavior for 32 adult males with autism and 34 controls in a real-time interaction with a researcher. This interactive paradigm bypasses many of the limitations encountered with conventional static or computer-based stimuli. Eye movements are recorded using eye tracking, providing an objective measurement of looking patterns. The measure is shown to be sensitive to the reduced eye contact commonly reported in autism, with the autism group spending less time looking to the eye region of the face than controls. Oxytocin administration selectively enhanced gaze to the eyes in both the autism and control groups (transformed mean eye-fixation difference per second=0.082; 95% CI:0.025-0.14, P=0.006). Within the autism group, oxytocin has the most effect on fixation duration in individuals with impaired levels of eye contact at baseline (Cohen's d=0.86). These findings demonstrate that the potential benefits of oxytocin in autism extend to a real-time interaction, providing evidence of a therapeutic effect in a key aspect of social communication.


IL-8 gene expression and bronchial asthma phenotypes in children.
Asthma is a common chronic illness among school children, where different cytokines, including IL-8 play a role in its pathogenesis. IL-8 induces chemotaxis and migration of immune cells, especially neutrophils to the site of inflammation. IL-8 level was significantly increased in sputum of severely asthmatic patients, but can it be linked to some asthma phenotypes. Our aim of the study was to detect the IL 8 gene expression in different asthma phenotypes and to determine its relation to asthma severity. This case control study included 320 subjects (160 asthmatic and 160 matched controls) aged from 5 to 16 years old in Beni-Suef governorate. IL-8 gene expression was assessed by a real-time quantitative reverse transcription-polymerase chain reaction (qRT-PCR) and studied regarding its level in cases versus controls and its relations to severity, phenotype and other laboratory parameters. IL-8 gene expression was statistically higher in asthmatic cases (P<0.001) and was significantly correlated to the phenotype (presence of other allergy as urticaria and drug eruption) and degree of asthma symptoms (r=0.869, P<0.001), FEV1(r=0.757, P<0.001) and serum IgE level (r=0.789, P<0.001). IL-8 gene expression level is increased with the degree of severity in asthmatic children and can be looked for in certain asthma phenotypes especially in presence of other atopic manifestation.


[The treatment of patients with arthrosis deformans of the large joints using interstitial electrostimulation].
The authors propose a new kind of conservative treatment-the intratissue electrostimulation when electric current is brought directly to the pathology focus. An analysis of results of clinical and biomechanical examination of 72 patients of the main and control groups allowed a conclusion to be made concerning high effectiveness of the new kind of therapy which makes the terms of treatment 2 times shorter. Mechanisms of curative effects reestablishing blood circulation and metabolism in the joints are studied.


Conceptualization of anatomical spatial entities in the Digital Anatomist Foundational Model.
Anatomical spatial concepts are indispensable in educational and clinical discourse, yet a system for representing these concepts has not been proposed. Guided by explicit principles and definitions of the Digital Anatomist Foundational Model, we developed an ontology of spaces, surfaces, lines and points that are associated with anatomical structures. Ontologies for Anatomical Structure and Anatomical Spatial Entity were instantiated for the thorax, abdomen, pelvis and perineum. Representing the concepts in--part of--hierarchies as well, provided formative evaluation of the classification. We invite empirical evaluation of the Foundational Model through its use for educational and clinical applications.


Exploring the use of tablet PCs in veterinary medical education: opportunity or obstacle?
A tablet PC is a laptop computer with a touch screen and a digital pen or stylus that can be used for handwritten notes and drawings. The use of tablet PCs has been investigated in many disciplines such as engineering, mathematics, science, and education. The purpose of this article is to explore student and faculty attitudes toward and experiences with tablet PCs 6 years after the implementation of a tablet PC program in the College of Veterinary Medicine (CVM) at Kansas State University (K-State). This study reports that the use of tablet PCs has enhanced students' learning experiences through learner-interface interaction, learner-content interaction, learner-instructor interaction, and learner-learner interaction. This study also identifies digital distraction as the major negative experience with tablet PCs during class time. The tablet PC program provides CVM faculty the potential to pursue technology integration strategies that support expected learning outcomes and provides students the potential to develop self-monitoring and self-discipline skills that support learning with digital technologies.


Sequential operation droplet array: an automated microfluidic platform for picoliter-scale liquid handling, analysis, and screening.
This contribution describes a sequential operation droplet array (SODA) system, a fully automated droplet-based microfluidic system capable of performing picoliter-scale liquid manipulation, analysis, and screening. The SODA system was built using a tapered capillary-syringe pump module and a two-dimensional (2D) oil-covered droplet array installed on an x-y-z translation stage. With the system, we developed a novel picoliter-scale droplet depositing technique for forming a 2D picoliter-droplet array. On this basis, an automated droplet manipulation method with picoliter precision was established using the programmable combination of the capillary-based liquid aspirating-depositing and the moving of the oil-covered droplet array, the so-called "aspirating-depositing-moving" (ADM) method. Differing from the previously reported droplet systems based on microchips, microcapillaries, or digital microfluidics, this method can achieve complete and flexible droplet manipulations, including droplet assembling, generation, indexing, transferring, splitting, and fusion in the picoliter range, endowing the present system with ultralow sample/reagent consumptions and substantial versatility in analysis and screening for multiple different samples. To demonstrate its feasibility and versatility, we applied the SODA system in multiple experiments required in drug screening, including the screening of inhibitors for capases-1 from a chemical library, the measurement of IC50 values for the identified inhibitors, and the screening of the synergistic effect of multiple inhibitors. In the experiments, the consumptions of samples and reagents are only 60-180 pL for each droplet microreactor, which are commonly 3-5 orders of magnitude lower than those of conventional multiwell plate systems, and 1-2 orders of magnitude lower than other droplet-based microfluidic systems for multiple sample screening. The ability of the SODA system in performing complicated and multistep droplet manipulations was further demonstrated in the serial dilution of nanoliter-scale inhibitor droplets with concentrations spanning 6 orders of magnitude for IC50 profiling, which includes droplet generation, indexing, splitting, transferring, and fusion with picoliter precision.


The Effect of Monophosphoryl Lipid A on Maturation of DCs from Patients with Acute Myeloid Leukaemia.
Generation of monocyte-derived dendritic cells (MDDC) is induced in the presence of GM-CSF and IL-4, and a maturation stimulus is added to the monocyte culture to obtain mature Dendritic Cells (DCs) suitable for therapy. TNF-α is the most common cytokine used for activating DCs and generating mature MDDC either alone or in combination with other cytokines. To compare effects of traditional cytokine cocktail (TNF-α + IL-1β) versus TLR4-agonist monophosphoryl lipid A on the viability, phenotype, cytokine profile and functionality of MDDC. The study included 32 individuals; twenty Acute Myeloid Leukaemia (AML) cases in complete remission and 12 healthy volunteers. They were divided into 3 groups: Group 1: control group: 12 subjects to measure the baseline levels of all markers in the monocytic preparation. Group 2: cytokine cocktail (TNF-α) group, which included 10 AML subjects. Group 3: MPLA group which included 10 AML subjects. TNF-α group showed higher expression of CD83 than MPLA group indicating higher capacity to induce DC maturation but both were similar in CD86, CCR7 and IL-10 expression. Preparation of dendritic cells from AML cases in remission and loading them with tumor peptides was successful. MPLA effect in DC maturation is comparable with traditional DC maturation cocktail.


Multiple repetitions reveal functionally and anatomically distinct patterns of hippocampal activity during continuous recognition memory.
We used a continuous recognition procedure that included multiple presentations of test items, along with high-resolution functional magnetic resonance imaging (fMRI), to investigate the relationship between item novelty and recognition-related activity in the medial temporal lobe (MTL). In several regions of hippocampus and parahippocampal cortex, activity elicited by new items exceeded that for old items, whereas no MTL regions exhibited greater activity for old items. Critically, anatomically distinct regions of MTL were engaged by item novelty in two different ways, as evidenced by statistically dissociable profiles of activity. In bilateral medial hippocampus and left posterior parahippocampal cortex, activity followed a categorical profile in which it was greater for new than old items but did not differ further with additional presentations of old items. By contrast, effects in adjacent regions of right lateral hippocampus and left parahippocampal cortex were graded, whereby activity declined linearly with respect to each successive item presentation. These findings suggest that the relationship between hippocampal (and parahippocampal) activity and continuous psychological dimensions, such as item novelty, cannot be captured by a unitary function.


Genetic polymorphisms in Toll-like receptors among pediatric patients with renal parenchymal infections of different clinical severities.
Although several studies have suggested single gene defects or variations in the genes associated with host immune response could confer differences in susceptibility to urinary pathogen invasion, no studies have examined the genetic polymorphisms in various toll-like receptors (TLRs) that activate innate immune responses in pediatric renal parenchymal infections of different clinical severities, namely acute pyelonephritis and the clinically more severe disease, acute lobar nephronia. Patients who fulfilled the diagnostic criteria for acute pyelonephritis (APN) and acute lobar nephronia (ALN) without underlying diseases or structural anomalies, except for vesicoureteral reflux (VUR), were enrolled. Genotyping of the single nucleotide polymorphisms (SNPs) in the genes encoding TLR-1, TLR-2, TLR-4, TLR-5, and TLR-6 was performed by matrix-assisted laser desorption/ionization time-of-flight-based mini-sequencing analysis. A total of 16 SNPs were selected for genotyping. Analysis of 96 normal and 48 patients' samples revealed that only four SNPs had heterozygosity rates >0.01. These SNPs were selected for further investigation. Hardy-Weinberg equilibrium was satisfied for the observed genotype frequencies. Statistically significant differences in the genotype frequency of TLR-2 (rs3804100, T1350C) between controls and ALN or (APN+ALN) combined group were identified using the recessive model with the correction for multiple-SNP testing. Further genotype pattern frequency analysis in TLR-2 SNPs (rs3804099 and rs3804100) showed significantly reduced occurrence of the rare allele homozygote (CC+CC) in the no-VUR subgroup of APN and ALN cases. As the inflammatory responses in ALN patients are more severe than those in APN patients (higher CRP levels, longer duration of fever after antibiotic treatment), these findings suggest that the genetic variant in TLR-2 (rs3804100, T1350C) may protect the host from severe urinary tract infections as ALN.


RareVar: A Framework for Detecting Low-Frequency Single-Nucleotide Variants.
Accurate identification of low-frequency somatic point mutations in tumor samples has important clinical utilities. Although high-throughput sequencing technology enables capturing such variants while sequencing primary tumor samples, our ability for accurate detection is compromised when the variant frequency is close to the sequencer error rate. Most current experimental and bioinformatic strategies target mutations with ≥5% allele frequency, which limits our ability to understand the cancer etiology and tumor evolution. We present an experimental and computational modeling framework, RareVar, to reliably identify low-frequency single-nucleotide variants from high-throughput sequencing data under standard experimental protocols. RareVar protocol includes a benchmark design by pooling DNAs from already sequenced individuals at various concentrations to target variants at desired frequencies, 0.5%-3% in our case. By applying a generalized, linear model-based, position-specific error model, followed by machine-learning-based variant calibration, our approach outperforms existing methods. Our method can be applied on most capture and sequencing platforms without modifying the experimental protocol.


A NIR-II fluorescent probe for articular cartilage degeneration imaging and osteoarthritis detection.
Articular cartilage (AC) is a complex water-bearing tissue consisting of chondrocytes, proteoglycans, and collagen. AC degeneration, which occurs in the early stage and throughout the entire course of osteoarthritis (OA), is one of the main pathological changes of OA. However, current clinical approaches are unable to detect AC degradation during the early stage of OA. Herein, a novel NIR-II probe, CH1055-WL, was developed with an organic fluorophore (CH1055) and type II collagen-binding peptide (WYRGRL) for AC targeting and degeneration imaging. In vitro and in vivo imaging studies demonstrated that CH1055-WL specifically bound to AC and permitted sensitive detection of age-related or surgically induced AC degeneration in living mice. In vitro imaging of cartilage samples from pig knee joint and in vivo imaging of live mice with the probe administered via local injection in joint cavities demonstrated that CH1055-WL specifically and efficiently bound to AC. Further evaluation of CH1055-WL revealed sensitive detection of age-related AC degeneration and surgically induced AC degeneration in living mice. Our results indicated that the cartilage-targeting probe CH1055-WL allowed visual monitoring of AC degeneration in living subjects, thus displaying promise for early OA detection.


Phorbol diester-induced H2O2 production by peritoneal macrophages. Different H2O2 production by macrophages from normal and BCG-infected mice despite comparable phorbol diester receptors.
Mouse peritoneal macrophages respond to environmental stimuli in different ways depending on their state of differentiation. Macrophages from mice with bacillus Calmette--Guerin (BCG) infection produced large amounts of H2O2 in response to phorbol diesters (PDEs), while those from noninfected mice produced little or no H2O2. The effects of PDEs on cells are mediated by specific cellular receptors for these ligands. The purpose of this study was to determine if the varying responses of macrophages from different groups of mice were caused by differences in their receptors for the PDE ligands. By all parameters studied, the binding of [20-3H]phorbol 12,13-dibutyrate ( [3H]PDBu) was similar in all macrophages irrespective of their ability to produce H2O2 in response to PDEs. Binding of [3H]PDBu was rapid at 23 degrees C reaching a maximum at 10-20 min with a subsequent decline to 50-60% of maximum by 30-60 min. Binding was slower at 0 degrees C reaching a maximum at 90-120 min. The binding was reversible, with dissociation kinetics paralleling association kinetics. The binding was saturable; the Kd's (45 to 91 nM) and number of binding sites (about 7-14 X 10(5)/cell or 11-12 pmol/mg protein) were essentially the same for the different classes of macrophages. The binding was specific, and analogs of PDBu inhibited [3H]PDBu binding to macrophages with potencies comparable to their potencies in causing in vivo tumor promotion and elicitation of other cellular responses in vitro. The ligands [3H]PDBu and [3H]PMA were degraded to comparable degrees by macrophages from normal or BCG-infected mice. Macrophages from C3H/HeJ and C3H/HeN mice, although known to differ in their abilities to respond to stimuli such as lymphokines and LPS, did not differ in their ability to produce H2O2 in response to PDEs or in their receptors for PDEs. Results of this study suggest that in vivo "activation" of macrophages in mice infected with BCG is not associated with a change in the cells' receptors for PDEs, but may be associated with "postreceptor" changes such as linkage of the PDE receptor with NAD(P)H oxidase, a change in NAD(P)H oxidase, or induction of synthesis of NAD(P)H oxidase.


Comparative in vitro activity of tobramycin, gentamicin, kanamycin, colistin, carbenicillin, and ticarcillin and clinical isolates of Pseudomonas aeruginosa: epidemiological and therapeutic implications.
The susceptibility of clinical isolates of Pseudomonas aeruginosa to six antibiotics was related to the epidemiologic knowledge yielded by serotyping. The agar dilution method for determination of minimal inhibitory concentrations (MICs) and the Habs serotyping system were used. Effectiveness of each agent ranked highest to lowest as follows: tobramycin, colistin, ticarcillin, carbenicillin, gentamicin, and kanamycin. For many isolates, the MICs of gentamicin were close to the peak level in serum. Susceptibility to carbenicillin and to ticarcillin were highly correlated, with MICs of ticarcillin half those of carbenicillin. Similary, susceptibility to gentamicin and to tobramycin were correlated. For susceptible strains, MICs of gentamicin were two to four times greater than those of tobramycin. However, strains resistant to gentamicin were clearly in one of two groups: susceptible to tobramycin or resistant to the drug. Most strains resistant to both gentamicin and tobramycin were serotype 11, whereas those resistant gentamicin and kanamycin only were nonagglutinable.


Threshold gradient descent method for censored data regression with applications in pharmacogenomics.
An important area of research in pharmacogenomics is to relate high-dimensional genetic or genomic data to various clinical phenotypes of patients. Due to large variability in time to certain clinical event among patients, studying possibly censored survival phenotypes can be more informative than treating the phenotypes as categorical variables. In this paper, we develop a threshold gradient descent (TGD) method for the Cox model to select genes that are relevant to patients' survival and to build a predictive model for the risk of a future patient. The computational difficulty associated with the estimation in the high-dimensional and low-sample size settings can be efficiently solved by the gradient descent iterations. Results from application to real data set on predicting survival after chemotherapy for patients with diffuse large B-cell lymphoma demonstrate that the proposed method can be used for identifying important genes that are related to time to death due to cancer and for building a parsimonious model for predicting the survival of future patients. The TGD based Cox regression gives better predictive performance than the L2 penalized regression and can select more relevant genes than the L1 penalized regression.


[Clinical trials--viewpoints from participants].
In relation to the large number of clinical trials performed, little is written about how the study subjects have experienced their participation. The article presents the results from a questionnaire survey among participants in 18 clinical trials undertaken at the Lipid Clinic, Rikshospitalet, Norway in 2005 and 2006. A study-specific questionnaire was developed and comprised 17 questions about study participation. Response was anonymous. Results are given as percentage distribution of answers. 56 % (287 persons) completed the questionnaire. Motivation for study participation was twofold, both personal health gains and the desire to contribute to research and development are important motives. 28 % [corrected] thought the new drug could be beneficial for them. Study participants responded the following: 90 % meant that the risk of adverse events and harmful effects of the study drug was small, 73 % that follow-up was good, 85 % that they had received sufficient information about the study and 77 % that study participation had no disadvantages. 73 % thought it had a positive health impact for them to be involved in the study. Participants in our clinical trials are concerned about their own health, but they also want to contribute to research for the well-being of others. Study participants seem to overestimate the health benefits associated with use of the study drug. Frequent medical follow-up and guidance in diet and lifestyle are benefits associated with participation in clinical studies, but the effects are difficult to measure.


Zearalenone promotes porcine ESCs apoptosis by enhancing Drp1-mediated mitochondrial fragmentation and activating the JNK pathway.
Zearalenone (ZEA) is widely present in food and feed, and pigs are susceptible to its effects. This study explored the underlying function of ZEA-induced apoptosis in porcine endometrial stromal cells (ESCs) through activation of the JNK signaling pathway and mitochondrial division. This study utilized ESCs to explore the impact of exposure to ZEA. A mitochondrial division inhibitor (Mdivi) was also included as a reference. The results indicated a gradual decrease in cell viability with increasing ZEA concentration. In addition, ZEA can modify the growth status of porcine ESCs, disrupt their ultrastructure, and lead to apoptosis of porcine ESCs via the mitochondrial division pathway and JNK signaling pathway. In summary, our study found the critical targets of ZEA infected with pig ESCs, which provided a conceptual foundation to prevent and control ZEA.


Ex vivo biofilm-forming ability of dermatophytes using dog and cat hair: an ethically viable approach for an infection model.
The aim of this study was to establish an ex vivo model for dermatophyte biofilm growth, using hair from dogs and cats. Strains of Microsporum canis, M. gypseum, Trichophyton mentagrophytes and T. tonsurans were assessed for in vitro and ex vivo biofilm production. All T. mentagrophytes and T. tonsurans isolates and 8/12 M. canis and 1/7 M. gypseum isolates formed biofilms in vitro, while all tested isolates presented biofilm growth on ex vivo models. T. mentagrophytes and M. canis formed more homogeneous and better-structured biofilms with greater biomass production on cat hair but T. tonsurans formed more biofilm on dog hair. Confocal and scanning electron microscopy demonstrated fungal hyphae colonizing and perforating the hair shaft, abundant fungal conidia, biofilm extracellular matrix and biofilm water channels. The present study demonstrated an ex vivo model for the performance of studies on biofilm formation by dermatophytes, using dog and cat hair.


Importance of methodological details in the measurement of cortisol in human hair.
The measurement of cortisol in hair became a popular and frequently used methodology in human stress research. This methodological approach, depending on the length of hair analyzed, allows to reflect cortisol secretion over prolong time periods in a retrospective fashion. There is a big variability in the experimental approaches to cortisol extraction used in individual laboratories. Moreover, there are many methodological details which are not described in most of the published papers, although they may be influential. The aim of the present study was to identify and optimize selected methodological steps of hair cortisol extraction. As the starting point served the methodology of Xiang et al. (2016). A hair pool was used to test the procedures. The main steps modified were pulverization, methanol extraction and centrifugation. In the presented procedure, we decreased the speed and duration of the pulverization, we increased the volume of methanol and increased the time and speed of centrifugation. The results showed obtaining lower variability and higher cortisol concentrations than those we obtained by the methodology of Xiang et al. (2016), which was optimized. The presented methodology is relatively simple and is likely to provide reliable results with low variability of cortisol concentrations measured in the same sample.


Goal attainment scaling in the evaluation of treatment of upper limb spasticity with botulinum toxin: a secondary analysis from a double-blind placebo-controlled randomized clinical trial.
To examine goal attainment scaling for evaluation of treatment for upper limb post-stroke spasticity with botulinum toxin-A. Secondary analysis of a multi-centre double-blind, placebo-controlled randomized clinical trial. Six outpatient clinics in Australia. Patients (n=90) completing per protocol 2 cycles of treatment/placebo. Mean age 54.5 (standard deviation 13.2) years. Mean time since stroke 5.9 (standard deviation 10.5) years. Intramuscular botulinum toxin-A (Dysport 500-1000U) or placebo given at 0 and 12 weeks. Measurement points were baseline, 8 and 20 weeks. Individualized goal attainment and its relationship with spasticity and other person-centred measures - pain, mood, quality of life and global benefit. A significant treatment effect was observed with respect to goal attainment (Mann-Whitney z=-2.33, p< or = 0.02). Goal-attainment scaling outcome T-scores were highly correlated with reduction in spasticity (rho=0.36, p=0.001) and global benefit (rho=0.45, p<0.001), but not with other outcome measures. Goal-attainment scaling T-scores were lower than expected (median 32.4, interquartile range 29.6-40.6). Goals related to passive tasks were more often achieved than those reflecting active function. Qualitative analysis of goals nevertheless demonstrated change over a wide area of patient experience. Goal-attainment scaling provided a responsive measure for evaluating focal intervention for upper limb spasticity, identifying outcomes of importance to the individual/carers, not otherwise identifiable using standardized measures.


Pitfalls in the analysis of phytocannabinoids in cannabis inflorescence.
The chemical analysis of cannabis potency involves the qualitative and quantitative determination of the main phytocannabinoids: Δ9-tetrahydrocannabinol (Δ9-THC), cannabidiol (CBD), cannabigerol (CBG), cannabichromene (CBC), etc. Although it might appear as a trivial analysis, it is rather a tricky task. Phytocannabinoids are present mostly as carboxylated species at the aromatic ring of the resorcinyl moiety. Their decarboxylation caused by heat leads to a greater analytical variability due to both reaction kinetics and possible decomposition. Moreover, the instability of cannabinoids and the variability in the sample preparation, extraction, and analysis, as well as the presence of isomeric forms of cannabinoids, complicates the scenario. A critical evaluation of the different analytical methods proposed in the literature points out that each of them has inherent limitations. The present review outlines all the possible pitfalls that can be encountered during the analysis of these compounds and aims to be a valuable help for the analytical chemist. Graphical abstract.


Investigation of genetic diversity and polyandry of Leptinotarsa decemlineata using X-linked microsatellite markers.
A panel of X-linked microsatellite markers was newly designed using the data from a previous sequencing project available in NCBI and used for a study of the Colorado potato beetle (CPB, Leptinotarsa decemlineata) X-haplotype variability. The analysis of scaffolds 49 and 61 (newly identified as fragments of CPB chromosome X) found ten high-quality markers, which were arranged in two PCR multiplexes and evaluated in both 420 CPB adults, collected from 14 localities of Czechia and Slovakia, and 866 larvae from five single-female families from two more Czech localities. Length polymorphisms found in 6 loci have predicted 192 potential X-haplotypes, however, only 36 combinations were detected in the adult males (N = 189), and seven additional ones in the larvae. The X-haplotypes were also generally unevenly distributed; five of the most frequent haplotypes were detected in 55% of males, 19 repeating up to ten-times in 38.7% of males and the remained 12 occurred uniquely in 6.3% of males. Bulk analysis of X-haplotypes dissimilarity indicated seven haplotype groups diversified by mutations and recombinations. Two haplotypes showed a distinctive regional distribution, which indicates an east-west disruption of CPB migration probably caused by different environments of localities in the South Bohemia region and Vysocina region. On the contrary, the results indicate a south-north migration corridor alongside the Vltava River. In the single-female families, from 6 to 13 distinct paternal haplotypes were detected, which proved and quantified a frequented polyandry in CPB.


The association between circulating endostatin levels and incident myocardial infarction.
Increased levels of circulating endostatin have been observed in patients with prevalent ischemic heart disease. However, the association between circulating endostatin, and incident myocardial infarction (MI) is less studied. Our main aim was to study the association between circulating endostatin and incident MI in the community adjusted for established cardiovascular risk factors in men and women. Circulating endostatin was measured in a nested case control study based on three large community-based Swedish cohorts, including 533 MI cases, and 1003 age-, sex- and cohort-matched controls. Odds ratios (OR) with 95% confidence intervals (CI) were calculated with adjustments for established cardiovascular risk factors. Higher endostatin was associated with a higher incidence of MI independently of established cardiovascular risk factors (OR 1.19, 95% CI 1.03-1.37, p = .02), but this association was abolished after additional adjustment for C-reactive protein. Sex-stratified analyses suggest that the association was substantially stronger in women as compared to men. In our community based sample, higher endostatin predicted incident myocardial infarction predominantly in women but not independently of CRP. Thus, our findings do not support a broad utility of endostatin measurements for the prediction of incident myocardial infarction in clinical practice.


Templating of multiple ligand metal ion complexation sites in 8-hydroxyquinoline-modified silica sol-gel materials investigated by in situ Raman spectroscopy.
Metal ion templating in a sol-gel synthesis is used to develop multiligand 8-hydroxyquinoline binding sites in porous silica structures. The acid-base equilibria and the metal ion binding equilibria and stoichiometry of these materials are investigated by in situ Raman spectroscopy. This technique is capable of resolving spectral responses of the free ligand and its acid-base forms along the monomeric and dimeric ligand complexes with Cu2+. The proton-transfer equilibrium constants and first ligand binding equilibrium constant to Cu2+ for the metal ion-templated silica are equivalent to surface-immobilized 8HQ on silica gel. The second ligand binding constant to Cu2+, however, is comparable to the first ligand binding constant, which differs from free-solution behavior, where an order of magnitude smaller value is expected. The free energy available for binding the second ligand within the templated material is comparable to the first ligand, probably due to the nearly optimal location of the second ligand for binding, based on the templating that is done during this synthesis. The metal ion concentration responses of sol-gels prepared with varying amounts of metal ion during the syntheses were also tested, and the results indicate control over the fraction of templated binding sites.


Evaluation of liver function tests to predict operative risk in liver surgery.
Despite numerous studies in the past it is not possible yet to predict postoperative liver failure and safe limits for hepatectomy. In this study the following liver function tests ICG-ER (indocyaninegreen elimination rate), GEC (galactose elimination capacity) and MEGX-F (monoethylglycinexylidid formation) are examined with regard to loss of liver tissue and prediction of operative risk. Liver function tests were assessed in 20 patients prior to liver resection and on the 10th. postoperative day. Liver and tumor volume were measured by ultrasound and pathologic specimen and the parenchymal resection rate was calculated. In patients without cirrhosis (n = 10) ICG-ER and MEGX-F remained unchanged after resection, GEC was reduced but did not correspond to the resection rate. Patients with cirrhosis (n = 10) had a significantly lower ICG-ER and GEC before resection than patients without cirrhosis. After resection these tests were unchanged. Patients with liver related complications and cirrhosis (n = 5) had lower ICG-ER and GEC than patients with cirrhosis and no complications. In the postoperative course all liver function tests in these patients were significantly lower compared to preoperative results. Comparing liver function tests ICG serves best to indicate postoperative liver failure. Liver function tests do not correspond with loss of liver tissue.


Development of an experimental model of neurocysticercosis-induced hydrocephalus. Pilot study.
To develop an experimental model of neurocysticercosis-induced hydrocephalus There were used 17 rats. Ten animals were inoculated with Taenia crassiceps cysts into the subarachnoid. Five animals were injected with 0. ml of 25% kaolin (a standard solution for the development of experimental hydrocephalus) and two animals were injected with saline. Magnetic resonance imaging (MRI) was used to evaluate enlargement of the ventricles after one or three months of inoculation. Volumetric study was used to quantify the ventricle enlargement. Seven of the 10 animals in the cyst group developed hydrocephalus, two of them within one month and five within three months after inoculation. Three of the five animals in the kaolin group had hydrocephalus and none in the saline group. Ventricle volumes were significantly higher in the 3-months MRI cyst subgroup than in the 1-month cyst subgroup. Differences between cyst subgroups and kaolin group did not reach statistical significance. The developed model may reproduce the human condition of neurocysticercosis-related hydrocephalus, which exhibits a slowly progressive chronic course.


Trends in cardiogenic shock complicating acute myocardial infarction.
Few studies describe recent changes in the prevalence, management, and outcomes of cardiogenic shock (CS) patients complicating acute myocardial infarction (AMI) in the era of widespread use of invasive strategies. The aim of the present study was to analyse trends observed in CS complicating AMI over the past 10 years, focusing on the timing of CS occurrence (i.e. primary CS, CS on admission vs. secondary CS, CS developed subsequently during hospitalization). Three nationwide French registries conducted and designed to evaluate AMI management and outcomes in 'real-life' practice included consecutive AMI patients (n = 9951) admitted to intensive cardiovascular care units (ICCUs) over a 1-month period, 5 years apart. The prevalence of CS complicating AMI decreased from 2005 to 2015: 5.9%, mean age 74.1 ± 12.7 in 2005; 4.0%, mean age 73.9 ± 12.7 in 2010, 2.8%, mean age 71.1 ± 15.0 in 2015 (P < 0.001). It decreased for both primary (1.8% to 1.0%) and secondary CS (4.1% to 1.8%). The profile of CS patients also changed over time with more patients presenting out-of-hospital cardiac arrest. In both primary and secondary CS, the use of percutaneous coronary intervention increased markedly over time, as did the use of mechanical ventilation and cardiac assist devices. Over the 10-year period, in-hospital mortality remained unchanged for both primary CS (41.8% to 37.8%) or secondary CS (57.3% to 58.8%). However, 1-year mortality decreased in patients with primary CS (from 60% to 37.8%, P = 0.038), and remained unchanged in patients developing secondary CS (from 64.5% to 69.1%, P = 0.731). Cardiogenic shock complicating AMI has become less frequent but, if present, CS, and particularly secondary CS, carries a very high mortality, which has not substantially improved over the past 10 years, in spite of the more frequent use of invasive strategies.


Early detection of speech and voice disorders in Parkinson's disease patients treated with subthalamic nucleus deep brain stimulation: a 1-year follow-up study.
We previously reported that Parkinson's disease (PD) patients treated with subthalamic nucleus deep brain stimulation (STN-DBS) had distinct phenotypes of speech and voice disorders: hypokinetic dysarthria, stuttering, breathy voice, strained voice, and spastic dysarthria. However, changes over time remain unclear. In the present study, 32 consecutive PD patients were assessed before and up to 1 year after surgery (PD-DBS). Eleven medically treated PD patients were also assessed (PD-Med). Speech, voice, motor, and cognitive functions were evaluated. At baseline, the incidence of hypokinetic dysarthria (63% of PD-DBS vs. 82% of PD-Med), stuttering (50% vs. 45%), breathy voice (66% vs. 73%), and strained voice (3% vs. 9%) was similar between groups. At 1 year, a slight but significant deterioration in speech intelligibility (p < 0.001) and grade of dysphonia (p = 0.001) were observed only in PD-DBS group compared with baseline. During the follow-up, stuttering (9% vs. 18%) and breathy voice (13% vs. 9%) emerged in PD-DBS and PD-Med, but strained voice (28%) and spastic dysarthria (44%) emerged only in PD-DBS. After the stimulation was stopped, strained voice and spastic dysarthria improved in most patients, while stuttering and breathy voice improved in a minority of patients. These findings indicate that the most common DBS-induced speech and voice disorders are strained voice and spastic dysarthria and that STN-DBS potentially aggravates stuttering and breathy voice. An improved understanding of these types of disorders may help detect speech and voice deteriorations during the early phase and lead to appropriate treatments.


A cell wall damage response mediated by a sensor kinase/response regulator pair enables beta-lactam tolerance.
The bacterial cell wall is critical for maintenance of cell shape and survival. Following exposure to antibiotics that target enzymes required for cell wall synthesis, bacteria typically lyse. Although several cell envelope stress response systems have been well described, there is little knowledge of systems that modulate cell wall synthesis in response to cell wall damage, particularly in Gram-negative bacteria. Here we describe WigK/WigR, a histidine kinase/response regulator pair that enables Vibrio cholerae, the cholera pathogen, to survive exposure to antibiotics targeting cell wall synthesis in vitro and during infection. Unlike wild-type V. cholerae, mutants lacking wigR fail to recover following exposure to cell-wall-acting antibiotics, and they exhibit a drastically increased cell diameter in the absence of such antibiotics. Conversely, overexpression of wigR leads to cell slimming. Overexpression of activated WigR also results in increased expression of the full set of cell wall synthesis genes and to elevated cell wall content. WigKR-dependent expression of cell wall synthesis genes is induced by various cell-wall-acting antibiotics as well as by overexpression of an endogenous cell wall hydrolase. Thus, WigKR appears to monitor cell wall integrity and to enhance the capacity for increased cell wall production in response to damage. Taken together, these findings implicate WigKR as a regulator of cell wall synthesis that controls cell wall homeostasis in response to antibiotics and likely during normal growth as well.


The involvement of p38MAPK in the rat model of lower-extremity arterial ischemia-reperfusion injury.
This study aims to investigate the regulatory role of p38 mitogen-activated protein kinase (p38MAPK) in rats with lower-extremity arterial ischemia-reperfusion injury. A total of 60 Sprague-Dawley (SD) rats were randomly divided into four groups: control group (Group A), lower-extremity arterial ischemia-reperfusion group (Group B), lower-extremity arterial ischemic postconditioning group (Group C), and lower-extremity arterial ischemic postconditioning + SB203580 group (Group D, 5 μmol/L SB203580, the inhibitor of MAPK pathway, was injected after lower-extremity arterial ischemic postconditioning). The lower-extremity arterial vessels were collected after 24 h. The apoptosis in the lower-extremity arterial vessel in each group was detected via terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) method. The expression of phosphorylated (p)-p38MAPK was measured via Western blotting, and the level of p-activating transcription factor-2 (ATF-2) was detected via immunohistochemical method. The positive rate of apoptotic cells (%) in Group B was significantly increased compared to that in Group A (p<0.05). However, the positive rate was statistically decreased by postcondition in Group C, the rate was further reduced after injection of SB203580 in Group D compared to Group B (p<0.05). Compared with that in Group C, the expressions of p-p38MAPK and p-ATF-2 in Group D were significantly downregulated after injection of SB203580 (p<0.05). Lower-extremity arterial ischemia-reperfusion postconditioning can significantly reduce the apoptosis level in vascular tissues, decrease the expressions of p-p38MAPK and downstream factor ATF-2, and alleviate the damage in lower-extremity arterial vessels. The inhibition of MAPK pathway further restricted the apoptosis and contributed to a promoting role in the recovery of lower-extremity arterial ischemia-reperfusion injury.


Towards a framework for assessment and management of cumulative human impacts on marine food webs.
Effective ecosystem-based management requires understanding ecosystem responses to multiple human threats, rather than focusing on single threats. To understand ecosystem responses to anthropogenic threats holistically, it is necessary to know how threats affect different components within ecosystems and ultimately alter ecosystem functioning. We used a case study of a Mediterranean seagrass (Posidonia oceanica) food web and expert knowledge elicitation in an application of the initial steps of a framework for assessment of cumulative human impacts on food webs. We produced a conceptual seagrass food web model, determined the main trophic relationships, identified the main threats to the food web components, and assessed the components' vulnerability to those threats. Some threats had high (e.g., coastal infrastructure) or low impacts (e.g., agricultural runoff) on all food web components, whereas others (e.g., introduced carnivores) had very different impacts on each component. Partitioning the ecosystem into its components enabled us to identify threats previously overlooked and to reevaluate the importance of threats commonly perceived as major. By incorporating this understanding of system vulnerability with data on changes in the state of each threat (e.g., decreasing domestic pollution and increasing fishing) into a food web model, managers may be better able to estimate and predict cumulative human impacts on ecosystems and to prioritize conservation actions.


Characteristics of gastrointestinal absorption of DX-9065a, a new synthetic anticoagulant.
DX-9065a, a newly synthesized anticoagulant that selectively inhibits factor Xa, is a zwitterion and has characteristics of high water solubility and low lipophilicity. We predicted the fraction absorbed (Fa) of DX-9065a to be approximately 15-35% in humans, based on the boundary layer theory using the intestinal perfusion method in rats. However, human oral bioavailability was 2-3% in clinical trials, and the result of actual human bioavailability was lower than that of the predicted Fa. Thus, in this report, the reason for low oral bioavailability of DX-9065a was examined by in vitro and in vivo experiments. The factors affecting oral bioavailability of DX-9065a were not the hepatic first-pass effect, degradation of the drug in intestinal fluid, nor the interaction of the drug with the intestinal mucin. Furthermore, no effect of P-gp efflux was observed. Oral absorption of the drug in rats with bile duct ligation was significantly higher than that in normal rats with bioavailability of 17 and 3%, respectively. It was confirmed that bile acids inhibited DX-9065a absorption because DX-9065a interacted with bile acids to form insoluble complexes. The results suggest that the complex formation of DX-9065a with bile acids in the intestinal tract is an important factor affecting absorption of DX-9065a.


Are Physicians Healthy When They Are Aged and Retired? A Survey of the Ankara Chamber of Medicine and the Turkish Geriatrics Society.
In literature, there is a lack of knowledge about clinical and lifestyle characteristics of retired physicians. Aim of the study is to describe the health profile of older physicians registered to the Ankara Chamber of Medicine (Ankara, Turkey). Two hundred and seventy four registered physicians agreed to participate to a survery. Most of them (76.6%) were men. Mean age was 74.9 (standard deviation 6.3) years. More than 85% of the participants presented at least one chronic disease. High scores were reported for the role-physical component of the SF-36, differently from the general health section of it scoring low. The results of the present survey pose the basis for collaborative efforts from the Ankara Chamber of Medicine and the Turkish Geriatrics Society collaboratively to improve the design and development of services for local older physicians.


Diagnostic yield of 96-h wireless pH monitoring and usefulness in patients' management.
To get insight into usefulness of 96-h wireless monitoring in diagnosis of gastro-esophageal reflux disease (GERD) and in patients' management. 51 patients who underwent 96-h wireless and 51 matched patients who underwent 24-h traditional pH monitoring were enrolled and retrospectively contacted with a structured telephone interview. In the wireless group, the 96-h recording improved (p < 0.05) the diagnostic yield compared with the first 48-h recording by allowing Symptom Association Probability to be measured in eight more patients and by decreasing indeterminate tests from 11 to 5. After pH monitoring, concordance between results of the test and treatment for GERD was higher in the wireless compared with the traditional group, 78% versus 58% of the patients (p < 0.05). Both improvement/disappearance of the clinically relevant symptom and satisfaction (score of 1-10) at time of the telephone interview were however similar in the two groups, 73% versus 65% and 7.0 versus 6.5. Wireless pH monitoring prolonged to 96 h increased the likelihood to exclude/confirm GERD as the cause of the clinically relevant symptoms in those patients with an indeterminate result for GERD after the first 48 h. Outcome was however similar to the one of traditional pH monitoring.


The key role of newborn thyroid scintigraphy with isotopic iodide (123I) in defining and managing congenital hypothyroidism.
Thyroid imaging with isotopic iodide (123I) or technetium Tc 99m pertechnetate has been available for decades but is not routinely used in newborn infants diagnosed with congenital hypothyroidism (CH). Among clinicians who believe that presence, absence, or abnormal location of a thyroid does not alter management of CH, imaging is not advocated for anatomic diagnosis of CH. To define the role of thyroid scintigraphy in diagnosing and managing newborn CH. Retrospective review of 249 confirmed cases of CH seen at a large, group-model managed care organization during the 24-year period extending from September 1978 through December 2002. Neonatal thyroid scintigraphy was performed in 210 cases (86%): 123I was used in 143 cases (68%), and technetium Tc 99m pertechnetate was used in 67 cases (32%). To perform scintigraphy with 123I, 30 to 50 microCi ([1.11-1.85] x 10(6) Bq) of 123I was administered orally; an uptake image was taken in 3 to 6 hours; and, if necessary, another image was taken in 24 hours. For technetium, 0.5 to 1 mCi ([1.85-3.7] x 10(7) Bq) of technetium Tc 99m pertechnetate was administered intravenously with imaging 20 minutes later. Thyroid dysplasia was defined as an absent or ectopic gland requiring lifetime therapy and eutopic thyroid as a normal-appearing thyroid gland in the proper location but possibly malfunctioning and requiring therapy. Of the 210 infants with CH receiving scintigraphy, 90 (43%) had eutopic (normal-appearing) thyroid diagnosed, and 120 (57%) had ectopic or absent gland (25% ectopic, 32% absent) diagnosed. Of these 210 infants, ethnicity was known in 198; of these, 76 (38%) were Latino/Hispanic, and 122 (62%) of the infants were non-Latino/non-Hispanic. Prevalence of CH differed between ethnic groups in our population of >700,000 newborn infants; total prevalence of CH was 1 per 3139. Prevalence of CH in Latino/Hispanic infants was highest at 1 per 1750 infants (1:1357 females, 1:2463 males). Prevalence of CH in non-Latino/non-Hispanic infants was 1 per 4648 infants (1:3500 females, 1:6914 males). Given that the total Kaiser Permanente infant population was approximately 19% Latino/Hispanic, the percentage of Latino/Hispanic infants with CH was significantly higher than expected. Dysplastic thyroid was more common in Latino/Hispanic females (69%) than in non-Latino/non-Hispanic females (52%). The female-to-male ratio of patients with CH was 1.9:1. Among the 210 infants with CH, normal thyroid was diagnosed more by 123I scintigraphy (49% of cases) than by scintigraphy using technetium Tc 99m pertechnetate (31% of cases). Use of technetium Tc 99m pertechnetate could have diagnosed dysplastic thyroid in some cases that would be considered eutopic had 123I been used. Eight familial cases of CH were identified. CH, a heterogeneous disorder with prevalence influenced by familial, ethnic, and gender factors, is more common in Latino/Hispanic females. When present, a eutopic thyroid is more likely to be detected by 123I scintigraphy; this method is therefore preferred over scintigraphy using technetium Tc 99m pertechnetate for optimal management of CH. Parents can then be counseled on either the certainty of lifetime therapy (for dysplastic thyroid) or the possibility of later discontinuing therapy (for eutopic thyroid, because CH may be transient in these children). If the dysplastic thyroid gland is absent or ectopic (usually a small sublingual gland), parents can be told that the infant will need lifetime thyroid therapy. If the thyroid gland is present in the normal position (eutopic) and the condition is transient (as shown by controlled withdrawal of thyroid in older children), lifelong treatment may not be needed. Parents rightly expect this maximal clinical and laboratory information in the immediate newborn period. Some clinicians hesitate to recommend neonatal scintigraphy for children with CH because of concern about delaying L-thyroxine therapy, concern about radiation exposure, or both. We believe that neither concern is warranted. 123I thyroid imaging has been used for many decades without evidence of risk for thyroid cancer. Treatment need not be delayed until scintigraphy is done. We did not use ultrasonography for thyroid imaging because this technique was not available in the early years of our study and may still not have sufficient sensitivity. Sources of discrepancy in our study could include scintigraphy interpreter bias due to lack of objective standards. We cannot estimate the true prevalence of transient CH because not all physicians give children with CH a trial off therapy at 2 to 3 years old, even if a eutopic thyroid is shown by 123I scintigraphy. Because therapy with L-thyroxine is simple and inexpensive and the outcome of untreated CH can be devastating, some parents and physicians are reluctant to discontinue treatment in children with CH, even when scans show a eutopic thyroid. Additionally, the clinical information contained in our database was not detailed enough to enable us to discover all cases of CH in which thyroxine therapy was discontinued. Because the study began in 1978 (>25 years ago), some patients were unavailable for long-term follow-up. In addition to allowing a more rational clinical approach to CH, 123I thyroid scintigraphy may help define underlying genetic factors and mechanisms of thyroid development and differentiation. This study's findings, that prevalence of CH and of thyroid dysplasia differed between genders and among racial/ethnic groups, seem to support a genetic basis for CH. Our results confirm previously published reports from the State of California Department of Health Services, Genetic Disease Branch and other studies describing multiple genetic abnormalities associated with CH. Despite data limitations, we believe that neonatal diagnosis of CH represents perhaps the greatest success of newborn screening programs. Initial laboratory diagnosis is simple and sufficiently accurate; treatment is simple, inexpensive, and effective. Severe mental retardation and growth failure can be prevented. Considering today's rapid advances in understanding the basic mechanisms of thyroid embryogenesis and gene abnormalities, thyroid scintigraphy may provide insight into clinical and genetic correlates in CH.


Potential role of natural compounds against skin aging.
Skin aging is an inevitable biological phenomenon of human life. Advancing age brings changes to all components of the integumentary system with consequent signs on the skin. Skin aging is mainly due to intrinsic (chronologic) and extrinsic aging (photo-aging). Photo-aging is a consequence of exposure to ultraviolet radiations. Despite variable economic conditions, the skin care market based on natural products continues to see strong growth. In this context, the research of naturally occurring anti-aging agents is greatly expanding and in recent years numerous plant-derived products have been investigated. This review article focuses on highlighting recent advances in current knowledge on anti-aging natural products grouped and presented according to their family origin. Plants from 35 families were reviewed. A variety of phytomolecules, derived in particular from polyphenols, triterpenes and sterols classes, demonstrated a promising activity. Among them carnosic acid, curculigoside, curcumin, glycyrrhizic acid, mangiferin, mirkoin, asiaticoside, rosmarinic acid, tectorigenin, tyrosol etc., able to inhibit tyrosinase, hyaluronidase, elastase, and collagenase, to scavenge free radicals from skin cells, to prevent trans-epidermal water loss, and to contribute to protect skin from wrinkles, were largely investigated and herein discussed. Extracts and pure compounds from Fabaceae, Asperaceae and Zingiberaceae families have shown particular interest and appear most promising in the development of anti-aging products.


Smoke exposure associated with higher urinary benzene biomarker muconic acid (MUCA) in Golestan Cohort Study participants.
Background. Benzene is a known human carcinogen. Human exposure to benzene can be assessed by measuring trans, trans-muconic acid (MUCA) in urine. Golestan Province in northeastern Iran has been reported to have high incidence of esophageal cancer linked to the use of tobacco products. This manuscript evaluates the urinary MUCA concentrations among the participants of the Golestan Cohort Study (GCS).Methods. We analyzed MUCA concentration in 177 GCS participants' urine samples and performed nonparametric pairwise multiple comparisons to determine statistically significant difference among six different product use groups. Mixed effects model was fitted on 22 participants who exclusively smoked cigarette and 51 participants who were classified as nonusers. The urinary MUCA data were collected at the baseline and approximately five years later, and intraclass correlation coefficient (ICC) was calculated from the model.Results. Compared with nonusers, tobacco smoking was associated with higher urinary MUCA concentrations. Based on the nonparametric test of pairwise multiple comparisons, MUCA concentrations among participants who smoked combusted tobacco products were statistically significantly higher compared to nonusers. Urinary MUCA collected five years apart from the same individuals showed moderate reliability (ICC = 0.41), which was expected given the relatively short half-life (∼6 h) of MUCA.Conclusion. Our study revealed that tobacco smoke was positively associated with increased levels of urinary MUCA concentration, indicating that it is a significant source of benzene exposure among GCS participants.


Efficacy of desmopressin (Minirin) in the treatment of nocturia: a double-blind placebo-controlled study in women.
The purpose of this study was to investigate the efficacy and safety of oral desmopressin in the treatment of nocturia in women. Women aged 18 years or older with nocturia (>or=2 voids per night with a nocturia index score >1) received desmopressin (0.1 mg, 0.2 mg, or 0.4 mg) during a 3-week dose-titration period. After a 1-week washout period, patients who responded in this period received desmopressin or placebo in a double-blind fashion for 3 weeks. In double-blind phase, 144 patients were randomly assigned to groups (desmopressin, n=72; placebo, n=72). For desmopressin, 33 (46%) patients had a 50% or greater reduction in nocturnal voids against baseline levels compared with 5 (7%) patients receiving placebo (P<.0001). The mean number of nocturnal voids, duration of sleep until the first nocturnal void, nocturnal diuresis, and ratios of nocturnal per 24 hours and nocturnal per daytime urine volumes changed significantly in favor of desmopressin versus placebo (P<.0001). In the dose-titration phase headache (22%), nausea (8%), and hyponatremia (6%) were reported. Two deaths occurred, although neither could be directly associated with the study drug. Oral desmopressin is an effective and well-tolerated treatment for nocturia in women.


Renal transplantation across HLA and ABO antibody barriers: integrating paired donation into desensitization protocols.
The field of desensitization and incompatible transplantation has made great gains over the past decade. There are now several options and effective therapies for many patients who face antibody barriers. Kidney paired donation (KPD) and desensitization have traditionally been considered competing strategies and patients have been offered one or the other without regard for the probability of a successful outcome. It is now possible to predict which donor/recipient phenotypes will benefit from each of these modalities. KPD should be favored among patients with immunologic phenotypes that are likely to match without prolonged waiting times. However, as many as 50% of patients with incompatible donors will fail to find a match in a KPD pool and many of these patients could be desensitized to their donor. Positive crossmatch and ABO incompatible transplantation has been accomplished in selective cases without the need for heavy immunosuppression or B-cell ablative therapy. Patients who are both difficult-to-match due to broad sensitization and hard-to-desensitize because of strong donor reactivity can often be successfully transplanted through a combination of desensitization and KPD. Using these various modalities it is estimated that most patients with incompatible live donors can undergo successful renal transplantation.


Persuading republicans and democrats to comply with mask wearing: An intervention tournament.
Many people practiced COVID-19-related safety measures in the first year of the pandemic, but Republicans were less likely to engage in behaviors such as wearing masks or face coverings than Democrats, suggesting radical disparities in health practices split along political fault lines. We developed an "intervention tournament" which aimed to identify the framings that would promote mask wearing among a representative sample of Republicans and Democrats in the U.S. from Oct 14, 2020, to Jan 14, 2021 (N = 4931). Seven different conditions reflecting different moral values and factors specific to COVID-19-including protection from harm (self), protection from harm (community), patriotic duty, purity, reviving the economy, threat, and scientific evidence-were implemented to identify which framings would "win" in terms of promoting mask wearing compared to a baseline condition. We found that Republicans had significantly more negative attitudes toward masks, lower intentions to wear them, and were less likely to sign or share pledges on social media than Democrats, which was partially mediated by Republicans, compared to Democrats, perceiving that the threat of COVID-19 was lower. None of our framing conditions significantly affected Republicans' or Democrats' attitudes, intentions, or behaviors compared to the baseline condition, illustrating the difficulty in overcoming the strength of political polarization during COVID-19.


Reversible magnetic resonance imaging changes associated with hypoglycemia. Case report.
A 63-year-old man was found with confusion and right limb monoparesis. He was taken to the emergency center under suspicion of stroke. Head computed tomography and magnetic resonance (MR) imaging and MR angiography were immediately conducted, which revealed no abnormality, but diffusion-weighted imaging showed increased intensity areas in the splenium of the corpus callosum and the left posterior limb of the internal capsule with decreased apparent diffusion coefficient (ADC) in the same areas. Immediately after the head scan, blood sugar level was measured, which revealed hypoglycemia (23 mg/dl). He quickly became lucid after intravenous administration of 20 ml of 50% glucose solution, and the paresis disappeared. Follow-up brain MR imaging was conducted 3 days later, but no clearly abnormal findings were seen on T(2)-weighted, fluid-attenuated inversion recovery, diffusion-weighted, or ADC images. Reports of reversible high intensity area in the splenium of the corpus callosum on diffusion-weighted imaging due to transient hypoglycemia are rare. Hemiparesis is one of the manifestations of hypoglycemia, so verifying the blood sugar level is important. Since MR imaging can be conducted easily now, we may need to consider the imaging findings in the differential diagnosis of hypoglycemia.


The prevalence of metabolic syndrome among university students in Wasit, Iraq.
To determine the prevalence of the metabolic syndrome (MetS) and its related risk factors in a group of healthy subjects. This cross-sectional analytic investigation used a convenient sample of 300 apparently healthy university students from Wasit, Iraq, between October 2021 and February 2022. The data was collected using a structured direct interview with a self-administered questionnaire. Anthropometric measurements (waist circumference [WC], body mass index [BMI], height, weight, and the blood pressure), total cholesterol level, triglyceride level, high-density lipoprotein (HDL-C), and fasting blood glucose (FBG) were all measured. IDF/AHA/NHLBI criteria were used to diagnose metabolic syndrome. Overall, 41.3% of students had MetS, with female (66.9%) students having the highest frequency. The most common component of MetS was elevated FBG (98.3%), followed by increased WC (87.9%), and finally a low HDL-C level (85.4%). The following factors were found to be predisposing to MetS: being female (OR=2.32), over the age of 20 (OR=1.96), obese (OR=9.46), high consumption of fast food (OR=2.35), and physically inactive. Metabolic syndrome prevalence and defining criteria are significantly high among Iraqi university students. Fasting blood glucose was the most common component followed by increased WC. The significant risk factors for MetS were older age, females, high BMI (≥25), low physical-activity, and eating of fast foods, and can remedy the risk if the components of the disease are reported at a younger age.


Noradrenergic modulation of behavioral odor detection and discrimination thresholds in the olfactory bulb.
The mammalian main olfactory bulb (MOB) receives a significant noradrenergic input from the locus coeruleus. Norepinephrine (NE) is involved in the acquisition of conditioned odor preferences in neonatal animals and in some species-specific odor-dependent behaviors. Thus far, the role of NE in odor processing in adult rats remains less studied. We investigated the role of noradrenergic modulation in the MOB on odor detection and discrimination thresholds using behavioral and computational modeling approaches. Adult rats received bilateral MOB injections of vehicle, NE (0.1-1000 microM), noradrenergic receptor antagonists and NE + receptor antagonists combined. NE infusion improved odor detection and discrimination as a function of NE and odor concentration. The effect of NE on detection and discrimination magnitude at any given odor concentration varied in a non-linear function with respect to NE concentration. Receptor antagonist infusion demonstrated that alpha1 receptor activation is necessary for the modulatory effect of NE. Computational modeling showed that increases in the strength of alpha1 receptor activation leads to improved odor signal-to-noise ratio and spike synchronization in mitral cells that may underlie the behaviorally observed decrease of detection and discrimination thresholds. Our results are the first to show that direct infusion of NE or noradrenergic receptor antagonists into a primary sensory network modulates sensory detection and discrimination thresholds at very low stimulus concentrations.


Treatment-Resistant Schizophrenia: Genetic and Neuroimaging Correlates.
Schizophrenia is a severe neuropsychiatric disorder that affects approximately 0.5-1% of the population. Response to antipsychotic therapy is highly variable, and it is not currently possible to predict those patients who will or will not respond to antipsychotic medication. Furthermore, a high percentage of patients, approximately 30%, are classified as treatment-resistant (treatment-resistant schizophrenia; TRS). TRS is defined as a non-response to at least two trials of antipsychotic medication of adequate dose and duration. These patients are usually treated with clozapine, the only evidence-based pharmacotherapy for TRS. However, clozapine is associated with severe adverse events. For these reasons, there is an increasing interest to identify better targets for drug development of new compounds and to establish better biomarkers for existing medications. The ability of antipsychotics to improve psychotic symptoms is dependent on their antagonist and reverse agonist activities at different neuroreceptors, and some genetic association studies of TRS have focused on different pharmacodynamic factors. Some genetic studies have shown an association between antipsychotic response or TRS and neurodevelopment candidate genes, antipsychotic mechanisms of action (such as dopaminergic, serotonergic, GABAergic, and glutamatergic) or pharmacokinetic factors (i.e., differences in the cytochrome families). Moreover, there is a growing body of literature on the structural and functional neuroimaging research into TRS. Neuroimaging studies can help to uncover the underlying neurobiological reasons for such resistance and identify resistant patients earlier. Studies examining the neuropharmacological mechanisms of antipsychotics, including clozapine, can help to improve our knowledge of their action on the central nervous system, with further implications for the discovery of biomarkers and the development of new treatments. The identification of the underlying mechanisms of TRS is a major challenge for developing personalized medicine in the psychiatric field for schizophrenia treatment. The main goal of precision medicine is to use genetic and brain-imaging information to improve the safety, effectiveness, and health outcomes of patients via more efficiently targeted risk stratification, prevention, and tailored medication and treatment management approaches. The aim of this review is to summarize the state of art of pharmacogenetic, pharmacogenomic and neuroimaging studies in TRS.


Diamond electrodes for controlling stem cells.
Electrical stimulation is one of several methods for controlling differentiation and proliferation of stem cells. This work demonstrated the use of nitrogen-doped ultra-nanocrystalline diamond (N-UNCD) electrodes as a substrate for the growth of human mesenchymal stem cells (hMSCs). As well as exhibiting a high charge injection capacity, N-UNCD displays high cytocompatibility making it suitable electrode material for stem cell stimulation.Clinical Relevance-This work establishes that N-UNCD electrodes can support the growth of hMSCs.