Clinical management of oxaliplatin-associated neurotoxicity.
In recent years, oxaliplatin-based chemotherapy protocols, particularly oxaliplatin in combination with infusional 5-fluorouracil/leucovorin (FOLFOX or FUFOX), have emerged as the standard of care in first- and second-line therapy of advanced-stage colorectal cancer. Although oxaliplatin by itself has only mild hematologic and gastrointestinal side effects, its clinically dominating toxicity affects the peripheral sensory nervous system in the form of 2 distinct types of neurotoxicity: (1) a unique, frequent, acute sensory neuropathy that is triggered or aggravated by exposure to cold but at the same time is rapidly reversible without persistent impairment of sensory functions; (2) the dose-limiting toxicity of oxaliplatin, a cumulative, chronic sensory neurotoxicity that resembles that of cisplatin with the important difference of its being more rapidly and completely reversible. This chronic sensory neurotoxicity is highly predictable, being closely associated with the cumulative dose of oxaliplatin that is administered. Various strategies have been proposed to prevent or treat oxaliplatin-induced neurotoxicity. The stop-and-go concept uses the predictability and reversibility of neurologic symptoms to allow patients to stay on an oxaliplatin-containing first-line therapy for a prolonged period. Several neuromodulatory agents such as calcium-magnesium infusions; antiepileptic drugs like carbamazepine, gabapentin, and venlafaxine; amifostine; a-lipoic acid; and glutathione have demonstrated some activity in the prophylaxis and treatment of oxaliplatin-induced acute neuropathy. However, randomized trials demonstrating a prophylactic or therapeutic effect on oxaliplatin's cumulative neurotoxicity are still lacking. The predictability of neurotoxicity associated with oxaliplatin-based therapy should allow patients and doctors to develop strategies to manage this side effect in view of the individual patient's clinical situation. This is of increasing importance, because the addition of bevacizumab to FOLFOX will conceivably further prolong the progression-free survival achieved with FOLFOX so that neurotoxicity and not tumor progression could become the dominating treatment-limiting issue in the first-line therapy of advanced colorectal cancer.


Considerations for the programming of an open-loop insulin infusion device from the biostator glucose controller.
To assess the feasibility of preprogramming an open-loop device with insulin flow rates generated by the Biostator Glucose Controller, comparisons were made in 10 juvenile-onset diabetic patients between meals of equal size and composition taken in the morning, at noon, and in the evening and a bedtime snack during a 24-h period of Biostator glucose control. Four additional diabetic patients had Biostator glucose control for 72 h. Similar amounts of insulin were infused for the meals taken at differing times of the day and, except for the morning meal, for the same meal on two successive days. The meal-related glycemic patterns expressed as mean indices of meal excursions (MIME) were similar for meals of identical size and composition during a single day and for the same meal taken on two consecutive days. Preliminary results using an open-loop device preprogrammed by the Biostator system, although encouraging, underscore the deficiency of the subcutaneous route viz. the delayed entry of insulin into the circulation in achieving normal glucose levels and patterns.


Integration of care for hypertension and diabetes: a scoping review assessing the evidence from systematic reviews and evaluating reporting.
With the rise in pre-mature mortality rate from non-communicable disease (NCD), there is a need for evidence-based interventions. We evaluated existing systematic reviews on effectiveness of integration of healthcare services, in particular with focus on delivery of care designed to improve health and process outcomes in people with multi-morbidity, where at least one of the conditions was diabetes or hypertension. We searched MEDLINE, EMBASE, Cochrane Library, and Health Evidence to November 8, 2016 and consulted experts. One review author screened titles, abstracts and two review authors independently screened short listed full-texts and selected reviews for inclusion. We considered systematic reviews evaluating integration of care, compared to usual care, for people with multi-morbidity. One review author extracted data and another author verified it. Two review authors independently evaluated risk of bias using ROBIS and AMSTAR. Inter-rater reliability was analysed for ROBIS and AMSTAR using Cohen's kappa and percent agreement. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist was used to assess reporting. We identified five systematic reviews on integration of care. Four reviews focused on comorbid diabetes and depression and two covered hypertension and comorbidities of cardiovascular disease, depression, or diabetes. Interventions were poorly described. The health outcomes evaluated included risk of all-cause mortality, measures of depression, cholesterol levels, HbA1c levels, effect of depression on HbA1c levels, symptom improvement, systolic blood pressure, and hypertension control. Process outcomes included access and utilisation of healthcare services, costs, and quality of care. Overall, three reviews had a low and medium risk of bias according to ROBIS and AMSTAR respectively, while two reviews had high risk of bias as judged by both ROBIS and AMSTAR. Findings have demonstrated that collaborative care in general resulted in better health and process outcomes when compared to usual care for both depression and diabetes and hypertension and diabetes. Several knowledge gaps were identified on integration of care for comorbidities with diabetes and/or hypertension: limited research on this topic for hypertension, limited reviews that included primary studies based in low-middle income countries, and limited reviews on collaborative care for communicable and NCDs.


Optical Trapping Nanometry of Hypermethylated CPG-Island DNA.
Cytosine methylation is a key mechanism of epigenetic regulation. CpG-dense loci, called "CpG islands", play a particularly important role in modulating gene expression. Methylation has long been suspected to alter the physical properties of DNA, but the full spectrum of the evoked changes is unknown. Here we measured the methylation-induced nanomechanical changes in a DNA molecule with the sequence of a CpG island. For the molecule under tension, contour length, bending rigidity and intrinsic stiffness decreased in hypermethylated dsDNA, pointing at structural compaction which may facilitate DNA packaging in vivo. Intriguingly, increased forces were required to convert hypermethylated dsDNA into an extended S-form configuration. The reduction of force hysteresis during mechanical relaxation indicated that methylation generates a barrier against strand unpeeling and melting-bubble formation. The high structural stability is likely to have significant consequences on the recognition, replication, transcription, and reparation of hypermethylated genetic regions.


Incorporating the Spine Instability Neoplastic Score into a Treatment Strategy for Spinal Metastasis: LMNOP.
Study Design Review. Objective To describe a decision framework that incorporates key factors to be considered for optimal treatment of spinal metastasis and highlight how this system incorporates the Spinal Instability Neoplastic Score (SINS). Methods We describe how treatment options for spinal metastasis have broadened in recent years with advancements in stereotactic radiosurgery, vertebral augmentation, and other minimally invasive techniques. We discuss classification-based approaches to the treatment of spinal metastasis versus principles-based approaches and argue that the latter may be more appropriate for optimal patient informed consent. Case examples are provided. Results Scoring systems at best produce an estimate of life expectancy but fall short in incorporating all of the relevant factors that determine which treatment(s) may be indicated. We advocate a principle-based decision framework called LMNOP that considers: (L) location of disease with respect to the anterior and/or posterior columns of the spine and number of spinal levels involved (contiguous or non-contiguous); (M) mechanical instability as graded by SINS; (N) neurology (symptomatic epidural spinal cord compression); (O) oncology (histopathologic diagnosis), particularly with respect to radiosensitivity; and (P) patient fitness, patient wishes, prognosis (which is mostly dependent on tumor type), and response to prior therapy. Conclusions LMNOP is the first systematic approach to spinal metastasis that incorporates SINS. It is easy to remember, it addresses clinical factors not directly addressed by other systems, and it is adaptable to changes in technology.


Forensic 3D documentation of skin injuries using photogrammetry: photographs vs video and manual vs automatic measurements.
Accurate and precise documentation of lesions is an important aspect of the forensic pathologists' work. Photogrammetry provides a useful tool to take precise measurements from photographs. These photographs are normally acquired with single camera photographs, but the procedure is quite time-consuming. Video recording has the potential to record a larger amount of image data faster. We documented 33 cadaveric skin lesions, using photographs and video recordings. The dimensions of the lesions ranged between 0.27 and 21.8 cm. The measurements of the lesions were extracted with both manual and automatic point measurements from photographs and from video frames, respectively. Very small differences (mean and median < 1 mm) were found between measurements taken in photographs versus video frames. Video frames were often blurred, preventing clear demarcation of the edges of the lesions and presenting a larger amount of noise in the 3D models. The differences between the manual point and automatic point measurements were very small (mean and median < 1 mm), but the manual procedure is to be preferred, since automatic points were not always located on the edges of the lesions. The only aspect in which video frames were superior to photographs was the recording time: video recording was almost five times faster than the photo sessions. In conclusion, this study shows that precise and comparable measurements can be extracted both from photographs and video frames. The video is the fastest method, but the use of photographs is still recommended. Manual measurements are more precise than automatic measurements and equally time-consuming.


Communicable diseases in the Eastern Mediterranean Region: prevention and control 2010-2011.
One-third of all morbidities and mortalities in the Eastern Mediterranean Region are attributed to communicable diseases. A continued situation of war and conflict, and growing political unrest in the Region, coupled with factors such as travel and migration, and insufficient infrastructure and inadequate technical and managerial capacity ofthe programmes are the major challenges. Despite these challenges, the Region continued making progress towards the elimination of specific diseases such as lymphatic filariasis, measles, malaria, schistosomiasis and dracunculiasis during 2010-11. Coverage for vaccine-preventable diseases was enhanced. Preparedness and response to emerging (e.g. dengue fever in Pakistan and Yemen) and re-emerging (e.g. cholera in Sudan) infections was improved. The Region has continued its efforts for controlling tuberculosis and curbing HIV/AIDS. Looking ahead, the Region aims to improve surveillance and response capacities, legislation issues, coordination, bio-risk and bio-security and quality management in the coming years.


Characterization of sinoatrial parasympathetic innervation in humans.
The response to sinoatrial parasympathetic nerve stimulation (shortened atrial refractoriness) was used to determine the atrial distribution of these nerve fibers in humans. We hypothesized that, in humans, parasympathetic nerves that innervate the sinoatrial node also innervate the right atrium and that the greatest density of innervation is near the sinoatrial nodal fat pad. Temporary epicardial wire electrodes were sutured in pairs in the sinoatrial nodal fat pad, high right atrium, and right ventricle by direct visualization during coronary artery bypass surgery in nine patients. Appropriate electrode placement was confirmed by electrically stimulating the fat pad in the operating room to prolong sinus cycle length by 50%. Experiments were performed in the electrophysiology laboratory 1 to 5 days after surgery. Programmed atrial stimulation was performed via an endocardial electrode catheter advanced to the right atrium. The catheter tip electrode was moved in 1-cm concentric zones around the epicardial wires by fluoroscopic guidance. Atrial refractoriness was determined in the presence and absence of sinoatrial parasympathetic nerve stimulation at each catheter site. In 8 of 9 patients, parasympathetic nerve stimulation reproducibly prolonged sinus cycle length by 50%. There was no effect on AV nodal conduction (no prolongation of PR interval) and no change in AV nodal refractoriness. Atrial effective refractory periods reproducibly shortened in response to parasympathetic nerve stimulation in 1-cm zones up to 3 cm surrounding the fat pad, by a mean (+/- SEM) of 26.6+/-4.3 msec (zone 1), 11.4+/-1.8 msec (zone 2), and 10.0+/-2.5 msec (zone 3), respectively (P = 0.0001). At distances > 3 cm from the fat pad, the effective refractory period did not shorten. Stimulation of parasympathetic nerves that innervate the sinoatrial node shortened atrial refractoriness in humans.


Oncorna-like viruses in baboon prostate tissue.
Oncorna-like virus particles were observed in prostate tissue of 2 of 11 baboons inoculated 3 years previously with a chemical carcinogen. There were no indications, however, of any relationship between the carcinogen and the development of virus particles. Biopsy specimens from the animals showed no evidence of neoplasia, and electron microscopic examination suggested that this virus should be categorized as a B-type oncornavirus.


A freshwater cyanophage whose genome indicates close relationships to photosynthetic marine cyanomyophages.
Bacteriophage S-CRM01 has been isolated from a freshwater strain of Synechococcus and shown to be present in the upper Klamath River valley in northern California and Oregon. The genome of this lytic T4-like phage has a 178,563 bp circular genetic map with 297 predicted protein-coding genes and 33 tRNA genes that represent all 20-amino-acid specificities. Analyses based on gene sequence and gene content indicate a close phylogenetic relationship to the 'photosynthetic' marine cyanomyophages infecting Synechococcus and Prochlorococcus. Such relatedness suggests that freshwater and marine phages can draw on a common gene pool. The genome can be considered as being comprised of three regions. Region 1 is populated predominantly with structural genes, recognized as such by homology to other T4-like phages and by identification in a proteomic analysis of purified virions. Region 2 contains most of the genes with roles in replication, recombination, nucleotide metabolism and regulation of gene expression, as well as 5 of the 6 signature genes of the photosynthetic cyanomyophages (hli03, hsp20, mazG, phoH and psbA; cobS is present in Region 3). Much of Regions 1 and 2 are syntenic with marine cyanomyophage genomes, except that a segment encompassing Region 2 is inverted. Region 3 contains a high proportion (85%) of genes that are unique to S-CRM01, as well as most of the tRNA genes. Regions 1 and 2 contain many predicted late promoters, with a combination of CTAAATA and ATAAATA core sequences. Two predicted genes that are unusual in phage genomes are homologues of cellular spoT and nusG.


Modification of Ti implant surface for cell proliferation and cell alignment.
Surface properties of implants are the keys for ensuring their long-lasting anchorage to the tissue. This study aims to develop a novel implant surface microstructure with high biocompatibility and ability of guided tissue formation. By a photolithography method, gold (Au) grids (1 x 1 mm(2) square lattices, 10 mum in grid-line width) were deposited on titanium substrates. They were oxidized with H(2)O(2) solution to yield titania (anatase) layer, and the Au grid formed channels due to larger molar volume of anatase than Ti. L-Cysteine and type I collagen were then immobilized on them to yield the target substrates, CHT-Au-cys-col. Apatite deposited within 3 days when they were soaked in Kokubo's simulated body fluid, regardless of the protein coating, but not on the bottom of the Au channel. Osteoblast-like MC3T3-E1 cells were cultured on the CHT-Au-cys-col substrates, showing that (1) the cysteine-collagen coating promoted cell attachment and proliferation, and (2) the Au channels were filled with the cells which were aligned along the channel direction and were connected to the neighboring cells as well as attached to the channel wall with cytoplasmic extensions. The results thus ensured filopodial guidance for the substrates.


Inactivation-mimicking block of the epithelial calcium channel TRPV6.
Epithelial calcium channel TRPV6 plays vital roles in calcium homeostasis, and its dysregulation is implicated in multifactorial diseases, including cancers. Here, we study the molecular mechanism of selective nanomolar-affinity TRPV6 inhibition by (4-phenylcyclohexyl)piperazine derivatives (PCHPDs). We use x-ray crystallography and cryo-electron microscopy to solve the inhibitor-bound structures of TRPV6 and identify two types of inhibitor binding sites in the transmembrane region: (i) modulatory sites between the S1-S4 and pore domains normally occupied by lipids and (ii) the main site in the ion channel pore. Our structural data combined with mutagenesis, functional and computational approaches suggest that PCHPDs plug the open pore of TRPV6 and convert the channel into a nonconducting state, mimicking the action of calmodulin, which causes inactivation of TRPV6 channels under physiological conditions. This mechanism of inhibition explains the high selectivity and potency of PCHPDs and opens up unexplored avenues for the design of future-generation biomimetic drugs.


Pentagastrin-stimulated DNA synthesis in mouse gut is influenced by the circadian system.
Gastrin is trophic for rodent gut mucosa. Proglumide, a competitive inhibitor of gastrin, can exert an antitrophic effect and can block pentagastrin-stimulated DNA synthesis. We have examined the influence of the circadian system on pentagastrin-stimulated DNA synthesis in the murine stomach (glandular and nonglandular stomach) and colon. We studied 224 male CD2F1 mice divided into four groups. Group A was ad lib fed (controls). Groups B, C, and D received 6-9 intraperitoneal injections of either NaCl, pentagastrin or pentagastrin + proglumide, at 8-h intervals prior to sacrifice. Mice from each group (A-D) were killed (by cervical dislocation) at 3-h intervals for 24 h. Incorporation of tritiated thymidine (DNA synthesis) was measured, and significant (p less than 0.001) circadian rhythms were found, which were not eliminated after treatment with either pentagastrin or pentagastrin + proglumide. DNA synthesis in the glandular stomach increased significantly after treatment with pentagastrin , but only during the span of time when DNA synthesis was increasing also in control mice; it had no effect at other times. Proglumide blocked the effect of pentagastrin only during the time of increasing DNA synthesis; it had no effect at other times. The identical regimen given at different times in the circadian cycle yielded significantly different results. In the intact animal, studies on the effects of various stimulators or inhibitors of DNA synthesis should be time-qualified.


Major transmembrane movement associated with colicin Ia channel gating.
Colicin Ia, a bacterial protein toxin of 626 amino acid residues, forms voltage-dependent channels in planar lipid bilayer membranes. We have exploited the high affinity binding of streptavidin to biotin to map the topology of the channel-forming domain (roughly 175 residues of the COOH-terminal end) with respect to the membrane. That is, we have determined, for the channel's open and closed states, which parts of this domain are exposed to the aqueous solutions on either side of the membrane and which are inserted into the bilayer. This was done by biotinylating cysteine residues introduced by site-directed mutagenesis, and monitoring by electrophysiological methods the effect of streptavidin addition on channel behavior. We have identified a region of at least 68 residues that flips back and forth across the membrane in association with channel opening and closing. This identification was based on our observations that for mutants biotinylated in this region, streptavidin added to the cis (colicin-containing) compartment interfered with channel opening, and trans streptavidin interfered with channel closing. (If biotin was linked to the colicin by a disulfide bond, the effects of streptavidin on channel closing could be reversed by detaching the streptavidin-biotin complex from the colicin, using a water-soluble reducing agent. This showed that the cysteine sulfur, not just the biotin, is exposed to the trans solution). The upstream and downstream segments flanking the translocated region move into and out of the bilayer during channel opening and closing, forming two transmembrane segments. Surprisingly, if any of several residues near the upstream end of the translocated region is held on the cis side by streptavidin, the colicin still forms voltage-dependent channels, indicating that a part of the protein that normally is fully translocated across the membrane can become the upstream transmembrane segment. Evidently, the identity of the upstream transmembrane segment is not crucial to channel formation, and several open channel structures can exist.


The effect of selenium supplementation on coronary heart disease: A systematic review and meta-analysis of randomized controlled trials.
Selenium is a crucial mineral with antioxidant and immune functions, and selenium deficiency may increase the risk of coronary heart disease (CHD). However, the effect of selenium supplementation on CHD is still controversial according to numerous randomized controlled trials (RCTs). The aim of our meta-analysis study was to investigate the impact of selenium on CHD. PUBMED, EMBASE, MEDLINE, and the Cochrane Central Register of Controlled Trials databases were systematically searched to identify RCTs evaluating the effect of selenium supplementation on CHD mortality, blood lipid profile (high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and total cholesterol), serum C-reactive protein (CRP), and the level of glutathione peroxidase (GSH-PX) from inception until September 20, 2016. Odds ratio of CHD mortality and the associated 95% confidence intervals (CIs) were calculated using the fixed effect model. Weighted mean difference or standardized mean difference (SMD) and 95% confidence intervals (CIs) were calculated to determine the lipid profile, serum CRP, and GSH-PX using fixed effect or random effect models depending on the observed heterogeneity. A total of 16 eligible RCTs with 43998 participants were included. Significant effects were observed for serum CRP (SMD=-0.48; 95% CI, -0.96 to 0; p=0.049) and GSH-PX (SMD=0.5; 95% CI, 0.36-0.64; p<0.001) after selenium supplementation. However, selenium supplementation was not statistically associated with CHD mortality and an aberrant lipid profile. Selenium supplementation decreased serum CRP and increased the GSH-PX level, suggesting a positive effect on reducing oxidative stress and inflammation in CHD. However, selenium supplementation is not sufficient to reduce mortality and to improve the lipid status.


Impact of the Mekong River flow alteration on the Tonle Sap flood pulse.
Rapid development in the upper reaches of the Mekong River, in the form of construction of large hydropower dams and reservoirs, large irrigation schemes, and rapid urban development, is putting water resources under stress. Recent studies have concluded that these developments will lead to flow alterations in the Mekong River. These flow alterations would threaten the sensitive ecosystems downstream, particularly Tonle Sap River, Tonle Sap Lake, its floodplain, and its gallery forest and protected areas, by changing the flood-pulse system of the lake. This article estimates the changes in parameters of the Tonle Sap flood pulse due to the aforementioned flow alterations. The impacts on the flooded area and loss of gallery forest and protected areas were analyzed using geographic information system-based methods. Relatively small rises in the dry-season lake water level would permanently inundate disproportionately large areas of floodplain, rendering it inaccessible to floodplain vegetation and eroding the productivity basis of the ecosystem. It is highly important to maintain the natural hydrological pattern of the Mekong River, particularly the dry-season water levels, to preserve Tonle Sap Lake's ecosystem productivity.


A method for making chronic fetal preparation in the lamb: results of 4 year's experiences.
During the period between 1980 and 1983, a versatile experimental model for fetal physiology (chronic fetal preparation) was made using 26 pregnant Corriedale and Suffolk sheep. The sheep fetuses were removed from the uterus at the gestational ages of from 96 to 133 days. After performing cannulation of the carotid arteries, the jugular veins , and the trachea of the fetuses, applying tripolar cardioelectrodes, and attaching an occluder of the umbilical cord, the fetuses were returned to the uterus to complete the gestational period. The time left until the termination of the postoperative pregnancy and available for various intrauterine monitoring procedures varied from 3 to 800 hr. Eleven sheep (42.3%) continued their postoperative intrauterine term for 5 days or more. The continuation of the postoperative gestation for longer than 5 days indicated a return to the physiological state on the evidence of the measured PO2, PCO2 and pH values and rapid irregular breathing movements.


Pharmacologic inhibition of bone resorption prevents cancer-induced osteolysis but enhances soft tissue metastasis in a mouse model of osteolytic breast cancer.
Osteoprotegerin (OPG) is a secreted member of the TNF receptor superfamily, which binds to the receptor activator of nuclear factor κB ligand (RANKL) and inhibits osteoclast activity and bone resorption. Systemic administration of recombinant OPG was previously shown to inhibit tumor growth in bone and to prevent cancer-induced osteolysis. In this study, we examined the effect of OPG, when produced locally by breast cancer cells located within bone, using a mouse model of osteolytic breast cancer. MDA-MB-231-TXSA breast cancer cells, tagged with a luciferase reporter gene construct and engineered to overexpress full-length human OPG, were transplanted directly into the tibial marrow cavity of nude mice. Overexpression of OPG by breast cancer cells protected the bone from breast cancer-induced osteolysis and diminished intra-osseous tumor growth but had no effect on extra-skeletal tumor growth. This effect was associated with a significant reduction in the number of osteoclasts that lined the bone surface, resulting in a net increase in bone volume. Despite limiting breast cancer-mediated bone loss, OPG overexpression resulted in a significant increase in the incidence of pulmonary metastasis. Our results demonstrate that inhibition of osteoclastic bone resorption by OPG when secreted locally by tumors in bone may affect the behaviour of cancer cells within the bone microenvironment and their likelihood of spreading and establishing metastasis elsewhere in the body.


Biology of adenovirus vectors with E1 and E4 deletions for liver-directed gene therapy.
Recombinant adenoviruses with E1 sequences deleted efficiently transfer genes into a wide variety of target cells. Antigen- and nonantigen-specific responses to the therapy lead to toxicity, loss of transgene expression, and difficulties with vector readministration. We have created new cell lines that allowed the isolation of more disabled adenovirus vectors that have both E1 and E4 deletions. Studies with murine models of liver-directed gene therapy indicated that the E1- and E4-deleted vector expresses fewer virus proteins and induces less apoptosis, leading to blunted host responses and an improved safety profile. The impact of the E4 deletion on the stability of vector expression was confounded by immune responses to the transgene product, which in this study was beta-galactosidase. When transgene responses were eliminated, the doubly deleted vector was substantially more stable in mouse liver than was the E1-deleted construct. These studies indicate that adenovirus vectors with both E1 and E4 deletions may have advantages in terms of safety and efficacy over first-generation constructs for liver-directed gene therapy.


Emotional intelligence: A unique group training in a hematology-oncology unit.
Emotional intelligence (EI) is increasingly viewed as one of the important skills required for a successful career and personal life. Consequently, efforts have been made to improve personal and group performance in EI, mostly in commercial organizations. However, these programs have not been widely applied in the health field. The aim of this study is to assess the impact of a unique special EI interventional process within the framework of an active hematology-oncology unit in a general hospital. This investigation employed a pre- and post-training design using the Bar-On Emotional Quotient Inventory (EQ-i) measure of EI, both before and after completion of training 10 months later. The training included personal and group EI assessments and 10 EI workshops, each 2 weeks apart and each lasting approximately 2 h. Results were compared to a control group of medical staff who did not undergo any EI training program during the same time period. Average total Bar-On EQ-i level at baseline for the group was 97.9, which increased significantly after the interventional process to a score of 105.6 (P = 0.001). There were also significant increases in all five main EQ-i scales, as well as for 12 of the 15 subscales. In contrast, the control group showed no significant differences in general EI level, in any of the five main scales or 15 EI subscale areas. This pilot study demonstrated the capability of a group intervention to improve EI of medical staff working in a hematology-oncological unit. The results are encouraging and suggest that the model program could be successfully applied in a large-scale interventional program.


Building confidence and trust in Ireland's National Maternity Services Workforce -What matters most and how?
National surveys on care experiences are increasingly adopted as regulatory mechanisms for improving care quality and increasing public trust in healthcare services. Based on data collected as part of Ireland's 2020 National Maternity Experience Survey, this study investigates care-related factors that contribute most to confidence and trust in the professional workforce (or carers) within Irish maternity services. The survey covered the full spectrum of maternity care and received 3,206 responses which were analysed using structural equation modelling. Results show that trust in carers may be enhanced through greater attention to the quality of interpersonal aspects of maternity care in a few core areas. We found that factors related to dignity and respect (β=0.270), involvement in decision-making (β=0.186), pain management (β=0.172), and communication (β=0.151) are core determinants of confidence and trust in the professional workforce of maternity services. Perceived quality of care in these four aspects increased on average, with the women's age. Women under 29 rated their experiences in these areas as significantly lower than the average. Women with a disability also rated their experiences significantly lower than average in three core areas. Our results suggest that trustworthy, equitable, and high-quality maternity care requires ongoing development of interpersonal skills within the maternity services professional workforce particularly in caring for younger women (under 29 years) and those with a disability.


A culturally-specific dance intervention to increase functional capacity in African American women.
This study examined a culturally-specific dance intervention on functional capacity in African American women at three time points. The intervention was two times per week for 8 weeks using two African American churches randomly assigned to either the experimental or comparison group, had 126 participants, ages 36-82 years. Analysis of covariance revealed that both groups improved over time and the only significant difference between groups was at 18 weeks. The increase at 18 weeks in the experimental group remained when controlling for baseline covariates. This study supported culturally-specific dance as an intervention to improve functional capacity in African American women.


Three-dimensional building detection and modeling using a statistical approach.
In this paper, we address the problem of building reconstruction in high-resolution stereoscopic aerial imagery. We present a hierarchical strategy to detect and model buildings in urban sites, based on a global focusing process, followed by a local modeling. During the first step, we extract the building regions by exploiting to the full extent the depth information obtained with a new adaptive correlation stereo matching. In the modeling step, we propose a statistical approach, which is competitive to the sequential methods using segmentation and modeling. This parametric method is based on a multiplane model of the data, interpreted as a mixture model. From a Bayesian point of view the so-called augmentation of the model with indicator variables allows using stochastic algorithms to achieve both model parameter estimation and plane segmentation. We then report a Monte Carlo study of the performance of the stochastic algorithm on synthetic data, before displaying results on real data.


Financial compensation of oocyte donors: an Ethics Committee opinion.
Financial compensation of women donating oocytes for infertility therapy or for research is justified on ethical grounds and should acknowledge the time, inconvenience, and discomfort associated with screening, ovarian stimulation, and oocyte retrieval, and not vary according to the planned use of the oocytes, the number or quality of oocytes retrieved, the number or outcome of prior donation cycles, or the donor's ethnic or other personal characteristics. This document replaces the document of the same name, last published in 2007 (Fertil Steril 2007;88:305-9).


What's the Point? How Point-of-Care STI Tests Can Impact Infected Patients.
Point-of-care (POC) tests are an important strategy to address the epidemic of sexually transmitted infections (STIs) among both adolescents and young adults. While access to care and confidentiality are major barriers to STI care, POC tests allow the clinician to provide immediate and confidential test results and treatment. In addition, POC test results constitute a "teachable moment"; that is, an opportunity to provide immediate feedback to the patient that may impact his/her risk behaviors. This paper reviews published data and manufacturer's product literature describing current point-of-care STI tests, including studies of test performance as well as impact on treatment intervals and disease spread. It presents theoretical and proposed pitfalls and solutions of implementing POC tests in clinical settings, non-traditional settings, and home care venues. We reviewed the available STI tests according to the World Health Organization (WHO) criteria for judging POC tests: the "ASSURRED" criteria (Affordable, Sensitive, Specific, User-friendly, Rapid and Robust, Equipment-free, Delivered).


Consideration of the influence of place on access to employment for persons with serious mental illness in northeastern Ontario.
Despite increasing attention to employment within the mental health sector, reports indicate that people with serious mental illness (SMI) continue to experience limited employment success in the province of Ontario, Canada. Research specifies that people with SMI who live in rural places are less likely than those living in urban centers to have access to satisfactory employment services or to become gainfully employed. The objective of this study was to examine access to employment from the perspectives of people with SMI, mental health and vocational service providers, and decision-makers, and to explore whether place influenced their access to work in northeastern Ontario. A qualitative case study using community-based participatory research methods was chosen to examine the experience of access to competitive employment in two northeastern Ontario communities. The cases selected for study were two geographic areas in northeastern Ontario which provided best-practice, mental health services to persons with SMI. Community-based site partners advertised and recruited participants, and a consumer advisory provided input on key stakeholders, questions, findings and the study action plan. The study findings were informed by individual and group interviews conducted with 46 individuals who resided in both rural and urban settings in the case communities, and feedback from 49 participants who attended town hall forums for presentation of study findings and development of an action plan. The qualitative data was supported by a secondary data source reporting on the employment outcomes of 4112 people with SMI who received disability income support and who resided in the case communities. Qualitative data were analyzed inductively, and categories and themes were developed. Findings were member checked with all informants and town hall participants in each case community. This article draws on the findings of a larger study and reports on the influence of place to the low employment success experienced by people with SMI who reside in the case communities; 91.3% of those receiving disability income support are unemployed, and rural residents experience higher levels of unemployment than those in urban places. Place was found to influence access to employment in five ways: by limited access to employment support services in rural places, and to recommended ratios in urban places; by the use of different models and practices that were inconsistent with best practices for people with SMI; by the lack of a plan for the implementation of employment services in the case communities; by limited use of the available, dedicated vocational resources for employment purposes; and by inadequate supports provided to persons with SMI who wish to enter the workforce. The results also underscore how people with SMI continue to be perceived negatively regarding their capacity for employment. Such stereotypical attitudes additionally contributed to employment marginalization of people with SMI from the workforce, especially in rural communities. The study highlights the influence of geography and human resources to the implementation of best practice employment services and supports for persons with SMI. Important policy implications include the need to consider place when implementing evidence-based practices in places where geography, distance and human health resources limit the communities' capacity to successfully do so. The study also underscores the need to build community capacity for supported employment, especially in rural places, in order to improve the participation of people with SMI in employment, and subsequently, to help shift the communities' thinking about their capacity for work.


[Several suggestion of operation for colorectal cancer under the outbreak of Corona Virus Disease 19 in China].
Pneumonia caused by SARS-Cov-2 infection has been reported in Wuhan since December 2019, and spread rapidly across the country. The radical operation of colorectal cancer is confine operation. Patients with colorectal cancer should receive operation as soon as possible after elective operation is resumed in each hospital. SARS-Cov-2 virus can be transmitted by asymptomatic infectors, and it has been confirmed to be transmitted by droplets and contact. However, fecal-oral transmission and aerosol transmission have not been excluded. Based onLaparoscopic colorectal operation experiences, the author suggests that the surgery strategy for colorectal cancer patients under the COVID-19 situation. Recommending laparoscopy-assisted radical surgery for colorectal cancer patients. The aerosols need to be strictly managed during operation. NOSES and TaTME should be carried out with cautious during the epidemic period. Protective stoma should be carried out scientifically and reasonably, and the protection of operating room personnel should be strengthened.


Genetic Contribution to the Heterogeneity of Major Depressive Disorder: Evidence From a Sibling-Based Design Using Swedish National Registers.
Major depressive disorder (MDD) is highly heterogeneous. Standard typology partly captures the disorder's symptomatic heterogeneity, although whether it adequately captures etiological heterogeneity remains elusive. The aim of this study was to investigate the genetic characterization of MDD heterogeneity. Using Swedish patient register data on 1.5 million individuals, the authors identified 46,255 individuals with specialist-diagnosed MDD. Eighteen subgroups were identified based on nine comparison groups defined by clinical and psychosocial features, including severity, recurrence, comorbidities, suicidality, impairment, disability, care unit, and age at diagnosis. A sibling-based design and classic quantitative genetic models were applied to estimate heritability of MDD subgroups and genetic correlations between subgroups. Estimates of heritability ranged from 30.5% to 58.3% across subgroups. The disabled and youth-onset subgroups showed significantly higher heritability (55.1%-58.3%) than the overall MDD sample (45.3%, 95% CI=43.0-47.5), and the subgroups with single-episode MDD and without psychiatric comorbidity showed significantly lower estimates (30.5%-34.4%). Estimates of genetic correlations between the subgroups within comparison groups ranged from 0.33 to 0.90. Seven of nine genetic correlations were significantly smaller than 1, suggesting differences in underlying genetic architecture. These results were largely consistent with previous work using genomic data. The findings of differential heritability and partially distinct genetic components in subgroups provide important insights into the genetic heterogeneity of MDD and a deeper etiological understanding of MDD clinical subgroups.


Treatment of cerebral arteriovenous malformations: combined neurosurgical and neuroradiologic approach.
Experience with 31 intraoperative embolizations performed on 23 patients is reported. The procedure involves the direct injection of embolic material into the main arterial feeders during craniotomy. The combined effort involves the exposure of the lesion at craniotomy, standard arteriotomy, and fluoroscopically monitored intravascular infusion of contrast material followed by the injection of bucrylate (IBCA, Ethicon, Somerville, NJ) mixed with tantalum or Pantopaque into the feeding vessels and into the interstices of the malformation. It was concluded that the procedure significantly diminishes operating time and blood loss for the lesions that were subsequently resected. Fluoroscopy coupled with high-quality stop-frame videotape recording allows a detailed study of the flow characteristics of the malformation so that polymerization time can be regulated appropriately. Follow-up varied from 3 months to 4 1/2 years. There were two deaths related to the procedure and one additional complication of cortical blindness that partially resolved. None of the survivors rebled. Most of the survivors improved.


Is measurement of bone density useful?
Bone density testing is safe, accurate, and useful. Specific clinical indications and the types of equipment available to assess them are reviewed. A positive effect on the practice of a clinical rheumatologist with resultant improved patient care appears likely in light of the information available.


Huge Parathyroid Adenoma with Dysphagia Presentation; A Case Report from Southern Iran.
Parathyroid adenoma is a benign tumor of the parathyroid glands. The cause of most parathyroid adenomas is unknown. Parathyroid adenoma increases the secretion of parathyroid hormone and results in primary hyperparathyroidism. High amounts of parathyroid hormone in the blood cause the imbalance of calcium, which leads to various complications such as kidney stones, depression, lethargy, nausea, vomiting, abdominal pain, myalgia, bone and joint pain, hoarseness, etc. Oropharyngeal dysphagia is defined as having problem in swallowing due to abnormalities in the structure and function of oropharynx and other related organs. The exact prevalence of dysphagia caused by parathyroid adenoma is unknown, but since this complication can lead to increased mortality and morbidity, its diagnosis is important. It is difficult to distinguish parathyroid malignancies from parathyroid adenoma even after surgery. Therefore, the final diagnosis is possible through surgery and histopathological evaluation. Here, a case of parathyroid adenoma with first presentation of generalized weakness and dysphagia has been reported.


The effect of fructose supplementation on feed intake, nutrient digestibility and digesta retention time in Reeves's muntjac (Muntiacus reevesi).
The aim of the study was to determine the effect of fructose supplementation in the diet on feed intake, nutrient digestibility and digesta retention time in Reeves's muntjac (Muntiacus reevesi), a browsing cervid. In Experiment 1, six adult males of Reeves's muntjac were used in a replicated 3 × 3 Latin square design and fed a diet consisting of dehydrated chopped lucerne (ad libitum), high-fibre pellet (120 g/day) and wheat bran (30 g/day) without (F0) or with addition of 12 and 24 g fructose/day (F12 and F24, respectively). In Experiment 2, the same six adult muntjacs were used in crossover design and fed F0 or F12. Doses of supplemental fructose were set to increase intake of water-soluble carbohydrates (WSC; ≈40 g/day; ≈8% of WSC in consumed dry matter [DM]) by 25 and 50% relative to F0. Feed intake was controlled daily (Experiment 1 and 2) and total tract digestibility and digesta retention time were determined (Experiment 2). In Experiment 1, DM intake of chopped dehydrated lucerne decreased with fructose supplementation (F0 vs. F12 and F24; p = .01) but was not different between F12 and F24 (p = .76). Total DM intake was also not different between treatments (p ≥ .13). In Experiment 2, DM intake of lucerne, total DM intake and nutrient digestibility was not affected by fructose supplementation (p ≥ .17), but mean retention time of long particles in the whole GIT tended to be longer for F12 compared to F0 (p = .09). Under conditions of the current study, additional fructose intake (resulting in a range of WSC content in consumed DM from 8.6% to 13%) had only minor impact on feed intake and investigated functions of the gastrointestinal tract of Reeves's muntjac.


Isolation and characterization of antioxidative peptides from gelatin hydrolysate of Alaska pollack skin.
Gelatin extracted from Alaska pollack skin was hydrolyzed with serial digestions in the order of Alcalase, Pronase E, and collagenase using a three-step recycling membrane reactor. The fraction from the second step, which was hydrolyzed with Pronase E, was composed of peptides ranging from 1.5 to 4.5 kDa and showed high antioxidative activity. Two different peptides showing strong antioxidative activity were isolated from the hydrolysate using consecutive chromatographic methods including gel filtration on a Sephadex G-25 column, ion-exchange chromatography on a SP-Sephadex C-25 column, and high-performance liquid chromatography on an ODS column. The isolated peptides, P1 and P2, were composed of 13 and 16 amino acid residues, respectively; and both peptides contained a Gly residue at the C-terminus and the repeating motif Gly-Pro-Hyp. The antioxidative activities of the purified peptides were measured using the thiobarbituric acid method, and the cell viability was measured with MTT assay. The results showed that P2 had potent antioxidative activity on peroxidation of linoleic acid. Moreover, the cell viability of cultured liver cells was significantly enhanced by addition of the peptide. These results indicate that the purified peptide, P2, from gelatin hydrolysate of Alaska pollack skin is a natural antioxidant which has potent antioxidative activity.


Hematology and blood chemistry parameters differ in free-ranging maned wolves (Chrysocyon brachyurus) living in the Serra da Canastra National Park versus adjacent farmlands, Brazil.
There has been growing interest in the specific impacts of anthropogenic factors on the health of wildlife. This study examined hematology and serum chemistry status of a prominent carnivore, the maned wolf (Chrysocyon brachyurus), living in, on the boundaries to, or on adjacent farmlands to the Serra da Canastra National Park, Brazil. Twenty-eighty wolves were captured, and values were compared 1) between subadults (n=8 animals) and adults (n=20 animals), 2) males (n=12 animals) and females (n=16 animals), and 3) among wolves living inside the park (n=11), near the park border (n=11 animals), and in neighboring farming areas (n=6 animals). Age, gender, and wolf locations influenced (P<0.05) hematology and serum biochemistry values. Specifically, adults had lower (P<0.05) circulating phosphorus than subadults. Males had lower (P<0.05) serum glucose, creatinine phosphokinase, and cholesterol and higher (P<0.05) potassium than females. Erythrocyte count and serum cholinesterase were lower (P<0.05) in wolves living within the park compared with near the park border or on farmlands. Mean corpuscular volume was lower (P<0.05) in wolves living near the park border than those ranging within the park and on farmlands. Aspartate transaminase and chloride were higher (P<0.05) in wolves living inside the park compared with those ranging near the park border. Creatinine phosphokinase was lower (P<0.05) in wolves living on farmland compared with the other two locations. These results clearly reveal a relationship between age and gender on hematology and serum biochemistry values in free-living maned wolves. More importantly, certain traits indicative of health are potentially compromised in wolves living in areas under anthropogenic pressure. These data lay a foundation for examining the influence of farming and local domestic species on disease susceptibility and fitness in the maned wolf.


Cross-linked α-Ni(OH)2 nanosheets with a Ni3+-rich structure for accelerating electrochemical oxidation of 5-hydroxymethylfurfural.
Electrochemical oxidation of biomass-based 5-hydroxymethylfurfural (HMF) is an effective approach for achieving the high-value products of 2,5-furandicarboxylic acid (FDCA). However, the restricted formation of high-valence metal active species for electrocatalysts results in a sluggish kinetic process of HMF oxidation reaction (HMFOR). Herein, we fabricated the Ni3+-rich cross-linked α-Ni(OH)2 nanosheets for accelerating the HMFOR through an anion-mediated strategy. It is identified that the Cl- ions with strong penetrability replace a portion of lattice oxygen atoms in α-Ni(OH)2 to form Ni-Cl bonds, contributing to breaking the inherent lattice order and generating a special Ni3+-rich structure. Owing to the promoted adsorption and accelerated oxidation of hydroxyl and aldehyde groups by the affluent Ni3+ active species, the large oxidation current density of 116.5 mA cm-2 and HMFOR kinetic constant of 0.067 min-1 has been achieved at 1.45 V (vs. RHE). By analyzing the oxidation products, the FDCA yield and Faradic efficiency are both higher than 99.25 % and 99.36 % for five successive determinations. Therefore, this work provides an insightful anion-mediated strategy for designing high-performance electrocatalysts for biomass conversion application.


Evaluation of Clinical Competence and Job Satisfaction and Their Related Factors Among Emergency Nurses in Palestinian Hospitals.
Nurses are responsible for providing primary care to millions of patients, and emergency nurses serve on the frontline in providing care for mildly to severely critically ill patients. This study aims to assess and evaluate the clinical competence and its related factors among emergency nurses in Palestinian hospitals. A cross-sectional study was conducted among 170 nurses working in the emergency units of hospitals in the West Bank, Palestine. Data collection utilized the Nurse Competence Scale, and the Job Satisfaction Scale. The results showed that only 33(19.4%) of the participants exhibited a good level of clinical competence, with none reaching the very good level. Among them, the highest proportion of good level 60 (35.3%) was in the helping role, while the lowest 38 (22.4%) was in ensuring quality. About 35% of nurses reported very low or low job satisfaction, while 58% had high or very high job satisfaction. Additionally, the results revealed a statistically significant relationship between clinical competence and job satisfaction (P < 0.05). Both clinical competence and job satisfaction were positively correlated with age and experience. The study found a significant relationship between demographic characteristics (e.g., education, experience, and marital status) and clinical competency among emergency nurses. Notably, less than half of the participants demonstrated good clinical competency, with none reaching a very good level. The highest scores were observed in the helping role domain, while the lowest were in the ensuring quality domain. Furthermore, clinical competence was found to be significantly associated with job satisfaction. Consequently, enhancing nurses' clinical competency will lead to an improvement in the quality of patient care.


Necessary symmetry conditions for the rotation of light.
Two conditions on symmetries are identified as necessary for a linear scattering system to be able to rotate the linear polarization of light: Lack of at least one mirror plane of symmetry and electromagnetic duality symmetry. Duality symmetry is equivalent to the conservation of the helicity of light in the same way that rotational symmetry is equivalent to the conservation of angular momentum. When the system is a solution of a single species of particles, the lack of at least one mirror plane of symmetry leads to the familiar requirement of chirality of the individual particle. With respect to helicity preservation, according to the analytical and numerical evidence presented in this paper, the solution preserves helicity if and only if the individual particle itself preserves helicity. However, only in the particular case of forward scattering the helicity preservation condition on the particle is relaxed: We show that the random orientation of the molecules endows the solution with an effective rotational symmetry; at its turn, this leads to helicity preservation in the forward scattering direction independently of any property of the particle. This is not the case for a general scattering direction. These results advance the current understanding of the phenomena of molecular optical activity and provide insight for the design of polarization control devices at the nanoscale.


Use of a simplified clinical scoring system and D-dimer testing can reduce the requirement for radiology in the exclusion of deep vein thrombosis by over 20%.
A simplified, robust, clinical assessment, used in conjunction with a D-dimer assay, has been developed to identify patients with a low risk of deep vein thrombosis. These patients did not undergo radiological examination. The protocol has been used by junior doctors in a district general hospital with a predominantly elderly population. Four hundred and thirty-one patients with potential deep vein thrombosis of the lower limb were assessed using this method and 98 (22.7%) did not require further investigation. Of these, one was admitted 5 months later with a pulmonary embolus. None of the other patients subsequently required admission for a thromboembolic event or died during a minimum of 3 months follow-up.


Modeling reaction pathways of low energy particle deposition on polymer surfaces via first principle calculations.
The chemical processes that lead to polystyrene surface modification via low energy deposition of C(2)H(+), C(2)F(+), CH(2), CH(2)(+), and H(+) radicals and ions are examined using first principles calculations. Specifically, the reaction mechanisms responsible for products identified in classical molecular dynamics with reactive empirical bond-order potentials are examined using density functional theory. In addition, these calculations consider how the presence of charges on the incident particles changes the result for the CH(2) system through the comparison of barriers, transition states, and final products for CH(2) and CH(2)(+). The structures of the reaction species and energy barriers are determined using the B3LYP hybrid functional. Finally, CCSD/6-31G(d,p) single point energy calculations are carried out to obtain optimized energy barriers. The results indicate that the large variety of reactions occurring on the polystyrene surface are a consequence of complex interactions between the substrate and the deposited particles, which can easily be identified and characterized using advanced computational methodologies, such as first principle calculations.


In situ fixation of pelvic nonunions following pathologic and insufficiency fractures.
A nonunion of the pelvic ring after a pathologic or insufficiency fracture of osteopenic bone is rare. The purpose of the present study was to evaluate the radiographic and clinical results of in situ fixation of these nonunions. The records of forty-four patients who had been managed with in situ fixation of pelvic fracture nonunions were reviewed retrospectively. Twenty-seven patients had sustained pathologic fractures after a simple fall, and seventeen had sustained insufficiency fractures. Forty-two of the forty-four nonunions were unstable and were located unilaterally or bilaterally in the posterior pelvic arch, and thirty-six involved the lateral aspect of the sacrum. Two of the forty-four non-unions involved only the pubic rami. The average age of the patients was sixty-six years (range, thirty-five to eighty-seven years), and the average duration of postoperative follow-up was four years (range, two to eleven years). All patients were assessed with regard to fracture union, residual pelvic pain, pelvic instability, and functional status. In addition, all patients were asked to rate the surgical result as highly satisfactory, satisfactory, or unsatisfactory. Thirty-six (82%) of the forty-four nonunions healed after in situ fixation, and seven of the eight persistent nonunions healed after additional surgery. Thirteen patients (30%), including five patients who had radiographic evidence of union, had persistent pain at the one-year follow-up assessment. None of the forty-three patients in whom the fractures eventually healed complained of persistent pelvic instability. At the time of the final follow-up examination, twenty-four patients (55%) were highly satisfied, twelve (27%) were satisfied, and eight (18%) were unsatisfied with the surgical result. In situ fixation of a nonunion of the pelvic ring following a pathologic or insufficiency fracture can result in a decrease in pelvic pain and instability along with an improvement in walking ability. A high percentage of patients complain of persistent pain, even if there is radiographic evidence of union of the pelvic ring.


Belief in sexism shift: Defining a new form of contemporary sexism and introducing the belief in sexism shift scale (BSS scale).
The belief that the target of sexism has shifted from women to men is gaining popularity. Yet despite its potential theoretical and practical importance, the belief that men are now the primary target of sexism has not been systematically defined nor has it been reliably measured. In this paper, we define the belief in sexism shift (BSS) and introduce a scale to measure it. We contend that BSS constitutes a new form of contemporary sexism characterized by the perception that anti-male discrimination is pervasive, that it now exceeds anti-female discrimination, and that it is caused by women's societal advancement. In four studies (N = 666), we develop and test a concise, one-dimensional, 15-item measure of BSS: the BSS scale. Our findings demonstrate that BSS is related to, yet distinct from other forms of sexism (traditional, modern, and ambivalent sexism). Moreover, our results show that the BSS scale is a stable and reliable measure of BSS across different samples, time, and participant gender. The BSS scale is also less susceptible to social desirability concerns than other sexism measures. In sum, the BSS scale can be a valuable tool to help understand a new and potentially growing type of sexism that may hinder women in unprecedented ways.


Kinematic Analysis of 2-Point and 3-Point Jump Shot of Elite Young Male and Female Basketball Players.
Basketball shooting is one of the most important offensive skills in basketball. Winning or losing a game mostly depends on the shooting effectiveness. The study aims to compare the selected kinematic variables of 2-point (2-pt) and 3-point (3-pt) jump shots (after making a cut and receiving the ball) and ascertain the differences between elite male under 16 and 18 (U16M, U18M) and female under 16 and 18 (U16F, U18F) basketball players. Overall, forty-eight young male and female basketball players participated in the study. 3D motion analysis using an inertial suit with the addition of utilizing a smart ball was performed for assessing the 2-pt and 3-pt shooting techniques. Players in male categories shot for 2-pt with a higher center of mass difference in the vertical direction (U16M 5.7 cm, U18M 3.9 cm vs. U16F 1.4 cm, U18F 0.6 cm), with higher release shoulder angle (U16M 110.9, U18M 113.8 vs. U16F 103, U18F 105), and with a higher entry angle of the ball (U16M 34, U18M 32 vs. U16F 30, U18F 30) when compared to female categories (p < 0.001). In the 3-pt shooting, there were differences between male and female categories in the shoulder angle when releasing the ball (p < 0.001). In the players shooting speed, there were differences between U16M vs. U18F (0.95 ± 0.1 vs. 0.88 ± 0.1; p = 0.03) and U16F vs. U18F (0.96 ± 0.06 vs. 0.88 ± 0.1; p = 0.02) players. Male categories shot 3-pt shots with a smaller center of mass difference in the horizontal direction when compared to 2-pt shots (p < 0.001). The entry angle was higher in successful shooting attempts compared to unsuccessful shooting attempts when shooting for 3-pt (p = 0.02). Player shooting speed was higher in all categories (except U18F) when shooting for 3-pt (p < 0.001). It appears that performers show difference in kinematic variables based on distance from the basket. Basketball coaches and players should work to minimize the kinematic differences between 2-pt and 3-pt shooting and to optimize the shooting technique.


Commensurate solid-solid phase transitions in self-assembled monolayers of alkylthiolates lying on metal surfaces.
A temperature-induced commensurate solid-solid phase transition in self-assembled monolayers (SAMs) of alkylthiolates lying on Pt(111) is predicted from molecular dynamics simulations based on ab initio potential energy surfaces. As the system cools down from room temperature to low enough temperature, SAMs of alkylthiolates with more than ~12 carbon atoms undergo an abrupt change of orientation from a nearly upright to a tilted configuration. As the initial hexagonal arrangement of the sulfur headgroups is kept fixed during the simulations, the phase transition is entirely governed by chain-chain interactions. Similar commensurate phase transitions are predicted for hexagonally arranged SAMs with lattice spacings of the order of 4.7-4.9 Å, which, among others, excludes the well-known cases of densely packed SAMs of alkylthiolates on Au(111) and Ag(111). These findings could be relevant for the design of novel electronic or optical devices controllable by temperature.


Investigation of diffuse correlation spectroscopy in multi-layered media including the human head.
In this work, diffuse correlation spectroscopy (DCS) is explored in multi-layered geometries. A quantitative comparison of an homogeneous versus a two-layered model efficiencies to recover flow changes is presented. By simulating a realistic human head with MRI anatomical data, we show that the two-layered model allows distinction between changes in superficial layers and brain. We also show that the two-layered model provides a better estimate of the flow change than the homogeneous one. Experimental measurements with a two-layered dynamical phantom confirm the ability of the two-layered analytical model to distinguish flow increase in each layer.


Implementation of a practical model for light and heat distribution using laser-induced thermotherapy near to a large vessel.
This paper introduces a simulation model for light and heat transport in tissues including perfusion effects. The model enables an efficient simulation of the damaged zone induced with an optical fibre for laser interstitial thermotherapy (LITT). It is designed specially for, but not limited to, tissue ablation in the neck region near to vessels. We describe in detail the effects of the rise in temperature caused by the absorption of light in tissue, using the heat equation and including the cooling effects of flow in vessels and of microperfusion in tissue in order to determine the extent of thermal damage. The extent of the necrosis zone is calculated with a damage function at each point of a finite element method (FEM) mesh. The FEM mesh is implemented with FEMLAB 2.3 as an add-on for finite element modelling for Matlab 6.5. LITT for tumour ablation in liver and some other anatomical regions is a well-known and established method (Bundesärztekammer und Kassenärztliche Bundesvereinigung 2002 Assessment der Bundesärztekammer und der Kassenärztlichen Bundesvereinigung, Köln). Investigations of treatments using LITT in the neck region are still in progress. We propose a refined model to validate the LITT method in the future in another anatomic region, e.g., in the highly sensitive region of the neck. Our calculations show that in order to induce a lesion with a maximum diameter of about 1 cm near to a large vessel, an application time between 3 and 4 min is needed using a laser power of about 10 W with a Nd:YAG 1064 nm radiation wavelength.


Dose-related safety and immunogenicity of a trivalent baculovirus-expressed influenza-virus hemagglutinin vaccine in elderly adults.
Influenza-virus hemagglutinin (HA) protein expressed in insect cells by recombinant baculovirus is a candidate influenza vaccine. In a randomized, double-blind trial conducted in 399 adults > or = 65 years of age, the efficacy of trivalent inactivated influenza vaccine (TIV) licensed for intramuscular injection was compared with that of trivalent baculovirus-expressed HA vaccine administered at doses of 15 microg, 45 microg, or 135 microg of each HA. Compared with TIV, baculovirus-expressed HA vaccine was safe and induced better serum antibody responses to the H3 component when administered at doses of 45 microg or 135 microg of each HA. Baculovirus-expressed HA is a safe and immunogenic influenza vaccine in elderly adults.


Nck recruitment to Eph receptor, EphB1/ELK, couples ligand activation to c-Jun kinase.
Eph family receptor tyrosine kinases signal axonal guidance, neuronal bundling, and angiogenesis; yet the signaling systems that couple these receptors to targeting and cell-cell assembly responses are incompletely defined. Functional links to regulators of cytoskeletal structure are anticipated based on receptor mediated cell-cell aggregation and migratory responses. We used two-hybrid interaction cloning to identify EphB1-interactive proteins. Six independent cDNAs encoding the SH2 domain of the adapter protein, Nck, were recovered in a screen of a murine embryonic library. We mapped the EphB1 subdomain that binds Nck and its Drosophila homologue, DOCK, to the juxtamembrane region. Within this subdomain, Tyr594 was required for Nck binding. In P19 embryonal carcinoma cells, activation of EphB1 (ELK) by its ligand, ephrin-B1/Fc, recruited Nck to native receptor complexes and activated c-Jun kinase (JNK/SAPK). Transient overexpression of mutant EphB1 receptors (Y594F) blocked Nck recruitment to EphB1, attenuated downstream JNK activation, and blocked cell attachment responses. These findings identify Nck as an important intermediary linking EphB1 signaling to JNK.


Postprandial response of plasma insulin, amylin and acylated ghrelin to various test meals in lean and obese cats.
The propensity of diets of different composition to promote obesity is a current topic in feline medicine. The effects of three meals with different protein:fat ratios on hormones (insulin, acylated ghrelin and amylin) involved in the control of food intake and glucose metabolism were compared. Five lean (two females and three males, 28.6 (sd 3.4) % body fat mass (BFM), mean body weight (BW) 4590 g) and five obese (two females and three males, 37.1 (sd 4.1) % BFM, mean BW 4670 g) adult cats were studied. Only BFM differed significantly between obese and lean cats. The cats were fed a high-protein (HP), a high-fat and a high-carbohydrate diet in a randomised cross-over design. Food intake did not differ between cats fed on the different diets, but obese cats consumed significantly more energy, expressed as per kg fat-free mass, than lean cats. After a 6-week adaptation period, a test meal was given and blood samples were collected before and 0, 30, 60 and 100 min after the meal. Baseline concentrations of glucose, amylin and acylated ghrelin were higher in obese cats than in lean cats, and obese cats showed the highest postprandial responses of glucose and amylin. The HP diet led to higher postprandial amylin concentrations than the other diets, indicating a possible effect of amino acids on beta-cell secretion. Postprandial ghrelin concentrations were unaffected by diet composition. The relationship between insulin, amylin and ghrelin secretion and their relevant roles in food intake and glucose metabolism in cats require further study.


Kinetic separation and characterization of three sugar transport modes in Caco-2 cells.
The question of sugar transport heterogeneity in the human intestinal Caco-2 cell line was addressed using alpha-methyl-D-glucose (AMG) and 2-deoxy-D-glucose (DG) as substrate analogues for D-glucose, the transport inhibitors phlorizin (PZ) and phloretin (PT), and NaCl or choline chloride uptake media. The data are compatible with the existence of three distinct pathways that can be isolated kinetically according to specific characteristics: 1) an "AMG-strict" system, strictly Na+ dependent and specific for AMG [Michaelis-Menten constant value (K(m)) = 2.0 +/- 0.3 mM] but sensitive to both PZ and PT, with PZ being more potent than PT, 2) a "DG-strict" system, strictly Na+ independent and specific for both DG (K(m) = 5.2 +/- 0.5 mM) and PT; and 3) a "DG/AMG-mixed" system, strictly Na+ dependent, with loose specificities for the glucose analogues DG (K(m) = 0.81 +/- 0.07 mM) and AMG (K(m) = 8.1 +/- 0.8 mM), and the inhibitors PZ and PT, but with PT being more potent than PZ. Since SGLT-1 obtained by polymerase chain reaction from either Caco-2 cells or normal human jejunum demonstrated identical transport properties when expressed in Xenopus laevis oocytes, we conclude that the "AMG-strict" system represents the expression of human SGLT-1 activity in this cell line. Moreover, Western blot analysis revealed that SGLT-1 is located exclusively in the apical membrane. In contrast, neither the nature nor the membrane location of both the DG-strict and DG/AMG-mixed pathways could be resolved unambiguously. Still it has been demonstrated that expression of the latter system is constitutive to all Caco-2 cells and that its Na+ dependence is not the consequence of H(+)-dependent transport activity. Aside from the presence of the DG/AMG-mixed system, a salient feature of Caco-2 cells is that the GLUT-3 protein is located exclusively in the brush-border membrane. Due to these limitations, it is concluded that the Caco-2 cell line cannot be considered as equivalent to either fetal colonic cells or normal enterocytes.


Relationship between Aerobic Capacity and Yo-Yo IR1 Performance in Brazilian Professional Futsal Players.
To evaluate the relationship between aerobic and intermittent capacities in a team of professional futsal players. FIFTEEN FUTSAL PLAYERS FROM BRAZILIAN FIRST DIVISION (AGE: 25.9±5.1 yrs; height: 1.77±0.04 m, body mass: 74.37±6.02 kg) performed in random order a ramp test and the Yo-Yo intermittent recovery test level 1 (Yo-Yo IR1) at the start of the season for determination of maximum oxygen consumption (VO2max), peak running speed (Speak), and intermittent running ability. Mean VO2max was of 57.25±6.35 ml·kg(-1)min(-1) with a Speak of 17.69±1.88 km·h(-1). Yo-Yo IR1 performance was of 1,226±282 m. There was no correlation between VO2max and Yo-Yo performance while Speak and Yo-Yo IR1 performance were correlated (r=0.641; P=0.007). From the current results, it may be suggested that both continuous and intermittent physical evaluations are necessary for obtaining a complete fitness profile of futsal players. The low Yo-Yo IR1 performance of Brazilian futsal players when compared to other elite team sport athletes warrants further investigation.


PRINS-labeled knobs are not associated with increased chromosomal stickiness in the maize st1 mutant.
In maize, the st1 mutant has been observed to result in chromosomes that stick together during both mitotic and meiotic anaphase. These sticky chromosomes result in abnormal chromosome separation at anaphase. Although the mechanism producing the st1 mutant phenotype is unknown, delayed replication of knob heterochromatin has been implicated in similar phenomena that result in sticky chromosomes. Primed in situ labeling (PRINS) was used to locate the 180-bp knob DNA sequences on mitotic metaphase chromosomes of several maize lines. The chromosomal regions labeled by PRINS corresponded to the reported C bands found in these lines. Additionally, PRINS was used to identify knob-bearing regions in anaphase spreads of a line carrying the st1 mutant and a nonmutant line having a similar number of chromosome knobs. The increase in abnormal anaphase figures in the st1 mutant was not accompanied by an increase in association of knob DNA with abnormal anaphases. Thus, the increase in chromosomal stickiness appears to be due to an increase in stickiness of knob and nonknob chromosomal regions. The mechanism responsible for the st1 mutant, therefore, is hypothesized to be different from that implicated in the other previously described sticky chromosomes situations.


Discussing parenthood with gay men diagnosed with HIV: a qualitative study of patient and healthcare practitioner perspectives.
Research on HIV and reproduction has focused largely on women and heterosexual men. This article examines whether it is relevant to address parenthood in HIV care with gay men and what ways of doing so are most appropriate. Qualitative interviews were conducted at four London clinics with 25 men living with HIV, aged 20-45, who did not have children, and 16 HIV clinicians. A thematic analysis identified potential reasons why parenthood was rarely discussed with gay men in HIV care. Two sets of ideas contributed to a lack of conversations about parenthood: clinicians' ideas about what matters to gay men and men's ideas about what it means to be HIV-positive. Both sets of ideas largely excluded having children, with patients and practitioners similarly unlikely to raise the topic of parenthood in the clinic. Contrary to what clinician commonly assumed, many men expressed interest in receiving more information, highlighting the importance of reassuring people upon diagnosis that it is possible to become parents while living with HIV. Parenting desires and intentions were rarely discussed with men in HIV care. Our findings illuminate the potentially beneficial effects of emphasising that having children is a possibility at diagnosis, regardless of patients' gender or sexuality. Conveying this information seems meaningful, not only to men who want to become parents in the future but also to others, as it appears to alleviate fears about mortality and ill health.


Heterogeneous surface-modified nanoplatforms for the targeted therapy of haematological malignancies.
Here, we focus on nanoparticle (NP)-based platforms for the targeted therapy of haematological malignancies (HMs), providing an overview of surface-modified nanoplatforms, such as aptamer-, metal-, nucleic acid-, toxin, and peptide-modified NPs, for the efficient targeting of tumor cells. We discuss NPs targeting subcellular compartments, including mitochondria, nucleus and Golgi apparatus, for enhanced therapy of HMs. We also review stimuli-responsive nanoplatforms for modulating site-specific release of drugs. We provide insight into alternative modes of therapy, such as phototherapy, gene therapy, dendritic cell (DC) therapy, and radiotherapy, highlighting recent advances in the treatment of HMs.


[DARS mutations responsible for hypomyelination with brain stem and spinal cord involvement and leg spasticity: report of two cases and review of literature].
Objective: To analyze the clinical and imaging features of hypomyelination with brain stem and spinal cord involvement and leg spasticity (HBSL) due to mutations in DARS, and to identify DARS mutations responsible for HBSL. Methods: Data on 2 HBSL patients who were admitted to the pediatric department of Peking University First Hospital from January 2009 through December 2016 were reviewed and the 2 patients were followed up. Targeted next generation sequencing, whole exome sequencing and Sanger sequencing were employed to identify potential genetic variations of the children and their parents. The clinical manifestations, MRI features and genotypic characteristics of two patients were reviewed, and the literature was reviewed. HBSL reported cases were searched with"leukoencephalopathies, DARS"on databases of PubMed, Wanfang, China National Knowledge Infrastructure and VIP from 1975 to 2017. The clinical manifestations and molecular features were analyzed. Results: Both patients showed delayed motor development, but had normal cognitive development. At the age of 8 years, case 1 reached the most significant motor development milestone of only standing with help during the last follow-up. At the age of 9, case 2 could walk independently during the last follow-up. On physical examination, both showed leg spastcity, active tendon reflex, positive Babinski sign. Both patients had brain MRI findings of high T2WI signal in bilateral deep cerebral white matter, slightly lower T1WI, and no abnormal DWI signal. Lesions of case 1 were relatively extensive and involved subcortical white matter, corpus callosum and internal capsule. Spinal MRI scans for both patients showed no abnormal signals. Novel mutations in DARS gene-namely, c.1498_1499insTCA (p.500_501insIle) and c.1210A>G (p.Met404Val) , c.1432A>G (p.Met478Val) and c.1210A>G (p.Met404Val) were identified in case 1 and case 2 respectively. On the database, 2 reports involving 13 foreign patients were retrieved. The age of disease onset was from 4 months to 18 years, and their initial symptoms were development delay or regression. Most of them presented with progressive lower extremity spasm, and the brain magnetic resonance imaging was characterized by hypomyelination in white matter. Clinical phenotypes of different age groups were significantly different. Conclusion: We have reported two patients with HBSL in China, and 3 novel mutations in DARS, which is helpful for the diagnosis and genetic counseling of HBSL.


Persistence of atopic dermatitis (AD): A systematic review and meta-analysis.
Previous studies found conflicting results about whether childhood atopic dermatitis (AD) persists into adulthood. We sought to determine persistence rates and clinical factors associated with prolonged AD. A systematic review was performed in MEDLINE, EMBASE, Scopus, GREAT, LILACS, Web of Science, Academic Search Complete, and Cochrane Library. Meta-analysis was performed using Kaplan-Meier plots and random-effects proportional hazards regression. In total, 45 studies including 110,651 subjects spanning 434,992 patient-years from 15 countries were included. In pooled analysis, 80% of childhood AD did not persist by 8 years and less than 5% persisted by 20 years after diagnosis (mean ± SE: 6.1 ± 0.02 years). Children with AD that persisted already for more than 10 years (8.3 ± 0.08 years) had longer persistence than those with 3 (3.2 ± 0.02 years) or 5 (6.8 ± 0.06 years) years of persistence. Children who developed AD by age 2 years had less persistent disease (P < .0001). Persistence was greater in studies using patient-/caregiver-assessed versus physician-assessed outcomes, female versus male patients (P ≤ .0006), but not in those with sensitivity to allergens (P = .90). Three studies found prolonged persistence with more severe AD. Some studies did not capture recurrences later in life. Most childhood AD remitted by adulthood. However, children with already persistent disease, later onset, and/or more severe disease have increased persistence.


Similarity analyses of chromatographic herbal fingerprints: a review.
Herbal medicines are becoming again more popular in the developed countries because being "natural" and people thus often assume that they are inherently safe. Herbs have also been used worldwide for many centuries in the traditional medicines. The concern of their safety and efficacy has grown since increasing western interest. Herbal materials and their extracts are very complex, often including hundreds of compounds. A thorough understanding of their chemical composition is essential for conducting a safety risk assessment. However, herbal material can show considerable variability. The chemical constituents and their amounts in a herb can be different, due to growing conditions, such as climate and soil, the drying process, the harvest season, etc. Among the analytical methods, chromatographic fingerprinting has been recommended as a potential and reliable methodology for the identification and quality control of herbal medicines. Identification is needed to avoid fraud and adulteration. Currently, analyzing chromatographic herbal fingerprint data sets has become one of the most applied tools in quality assessment of herbal materials. Mostly, the entire chromatographic profiles are used to identify or to evaluate the quality of the herbs investigated. Occasionally only a limited number of compounds are considered. One approach to the safety risk assessment is to determine whether the herbal material is substantially equivalent to that which is either readily consumed in the diet, has a history of application or has earlier been commercialized i.e. to what is considered as reference material. In order to help determining substantial equivalence using fingerprint approaches, a quantitative measurement of similarity is required. In this paper, different (dis)similarity approaches, such as (dis)similarity metrics or exploratory analysis approaches applied on herbal medicinal fingerprints, are discussed and illustrated with several case studies.


Treatment of gastrointestinal stromal tumours in paediatric and young adult patients with sunitinib: a multicentre case series.
Gastrointestinal stromal tumours (GIST) are rarely encountered mesenchymal tumours of the gastrointestinal tract (1.5 people per 100,000/year) that are even more rarely seen in paediatric patients (1-2% of all cases). The standard treatment for advanced adult GIST is imatinib with sunitinib as a second-line option. Although the efficacy and tolerability of sunitinib in adults with GIST has been established, little is known of the profile of sunitinib in paediatric/young adult patients with GIST given the rarity of this disease. Paediatric/young adult patients aged up to 21 years with diagnosis of GIST who were treated with sunitinib were identified from retrospective records from three centres in Europe and the US. Most patients commenced sunitinib in a 6-week cycle, however, dosing could be reduced, delayed, changed to (or initiated with) a continuous schedule. Objective response (Response Evaluation Criteria In Solid Tumours [RECIST]) and adverse events were recorded. We identified 9 paediatric/young adult patients (aged 11-21 years) with GIST who were treated with sunitinib de novo (n = 1) or following failure of imatinib (n = 8). Progressive disease was previously documented for all patients including 7 patients during imatinib therapy. Baseline patient and tumour profile characteristics showed a distinct profile (notably all were wild-type KIT/PDGFR) compared to that established for adults. Sunitinib treatment was associated with a best response of stable disease for 7 patients, with disease stabilisation lasting from 1 month to >73 months and a median progression free survival time of 15 months. There was some evidence of better disease control for sunitinib when compared to prior imatinib. Most adverse events with sunitinib were manageable and all were consistent with the known profile of the agent. The ability to draw firm conclusions from this case series is limited by the small number of patients and the use of retrospective data which is largely reflective of the rarity of this condition. However, our findings provide initial evidence of clinical benefit and a generally manageable toxicity profile for sunitinib when administered to paediatric/young adult patients with GIST, most of whom had documented progressive disease during prior imatinib treatment.


5-aminoimidazole-4-carboxamide ribonucleoside (AICAR) inhibits insulin-stimulated glucose transport in 3T3-L1 adipocytes.
Incubation of skeletal muscle with 5-aminoimidazole-4carboxamide ribonucleoside (AICAR), a compound that activates 5'-AMP-activated protein kinase (AMPK), has been demonstrated to stimulate glucose transport and GLUT4 translocation to the plasma membrane. In this study, we characterized the AMPK cascade in 3T3-L1 adipocytes and the response of glucose transport to incubation with AICAR. Both isoforms of the catalytic alpha-subunit of AMPK are expressed in 3T3-L1 adipocytes, in which AICAR stimulated AMPK activity in a time- and dose-dependent fashion. AICAR stimulated 2-deoxy-D-glucose transport twofold and reduced insulin-stimulated uptake to 62% of the control transport rate dose-dependently, closely correlating with the activation of AMPK. AICAR also inhibited insulin-stimulated GLUT4 translocation, assessed using the plasma membrane lawn assay. The effects of AICAR on insulin-stimulated glucose transport are not mediated by either adenosine receptors or nitric oxide synthase and are mediated downstream of phosphatidylinositol 3'-kinase stimulation. We propose that in contrast to skeletal muscle, in which AMPK stimulation promotes glucose transport to provide ATP as a fuel, AMPK stimulation inhibits insulin-stimulated glucose transport in adipocytes, inhibiting triacylglycerol synthesis, to conserve ATP under conditions of cellular stress. Investigation of the mode of action of AICAR and AMPK may, therefore, give insight into the mechanism of insulin action.


Midline central nervous lipomas in children.
We review the clinical, radiologic, surgical, and pathologic features of 15 children with central nervous system lipomas. Three were situated in the corpus callosum and 12 at the conus medullaris. The intracranial and the intraspinal disorders share several features suggesting that they are related. Both are midline developmental abnormalities associated with dysraphism and both may have extrinsic as well as intrinsic components. Both can occur as occult asymptomatic lesions, particularly early in life, or can be part of extensive dysraphic malformations. Computed tomography is the best way to demonstrate the nature and extent of these lesions prior to treatment.


Bombyx mori Silk Fibroin and Model Peptides Incorporating Arg-Gly-Asp Motifs and Their Application in Wound Dressings.
Skin plays an important role in protecting the human body from the environment, dehydration, and infection. Burns, wounds, and disease cause the skin to lose its role, but tissue-engineered skin substitutes offer the opportunity to restore skin loss. Silk fibroin from Bombyx mori (SF) has proven to be an excellent wound dressing material. In this study, we aim to develop an excellent wound dressing material by introducing three-residue sequence Arg-Gly-Asp (RGD), which is the most well-known adhesion site of fibronectin, in the films of SF and the model peptide. Its usefulness as a wound dressing material was evaluated both in vitro and in vivo. First, we showed that the flexible structures of the RGD sequence are still maintained in SF with a rigid antiparallel β-sheet structure using NMR in association with excellent wound dressings of SF containing RGD. Then, in in vitro experiments, two types of normal cells derived from human skin, normal human neonatal epidermal keratinocytes and normal human neonatal dermal fibroblasts, were used to evaluate the cell adhesion. On the other hand, in in vivo experiments, the study was conducted using a rat model of a whole skin layer defect wound. The results showed that the high-functionalized SF developed here has the potential to play a significant role in the field of wound dressings.


Dynamic spectroscopic measurements of the temperature and pressure cycles in a MOPITT pressure modulator cell.
The temperature and pressure cycles inside a pressure modulator cell (PMC) of the type used for gas-correlation radiometry aboard the Measurements of Pollution in the Troposphere (MOPITT) satellite instrument have been determined from dynamic measurements of the spectral line shapes of the R(0) and R(18) transitions in the fundamental vibrational-rotational band of carbon monoxide. The line strengths and linewidths were used to calculate the temperature and pressure, respectively, with a temporal resolution of approximately 200 micros, or 1/100 of a PMC cycle. The results are compared with a thermodynamic box model.


Stress Management Training Improves Overall Performance during Critical Simulated Situations: A Prospective Randomized Controlled Trial.
High-fidelity simulation improves participant learning through immersive participation in a stressful situation. Stress management training might help participants to improve performance. The hypothesis of this work was that Tactics to Optimize the Potential, a stress management program, could improve resident performance during simulation. Residents participating in high-fidelity simulation were randomized into two parallel arms (Tactics to Optimize the Potential or control) and actively participated in one scenario. Only residents from the Tactics to Optimize the Potential group received specific training a few weeks before simulation and a 5-min reactivation just before beginning the scenario. The primary endpoint was the overall performance during simulation measured as a composite score (from 0 to 100) combining a specific clinical score with two nontechnical scores (the Ottawa Global Rating Scale and the Team Emergency Assessment Measure scores) rated for each resident by four blinded independent investigators. Secondary endpoints included stress level, as assessed by the Visual Analogue Scale during simulation. Of the 134 residents randomized, 128 were included in the analysis. The overall performance (mean ± SD) was higher in the Tactics to Optimize the Potential group (59 ± 10) as compared with controls ([54 ± 10], difference, 5 [95% CI, 1 to 9]; P = 0.010; effect size, 0.50 [95% CI, 0.16 to 0.91]). After specific preparation, the median Visual Analogue Scale was 17% lower in the Tactics to Optimize the Potential group (52 [42 to 64]) than in the control group (63 [50 to 73]; difference, -10 [95% CI, -16 to -3]; P = 0.005; effect size, 0.44 [95% CI, 0.26 to 0.59]. Residents coping with simulated critical situations who have been trained with Tactics to Optimize the Potential showed better overall performance and a decrease in stress level during high-fidelity simulation. The benefits of this stress management training may be explored in actual clinical settings, where a 5-min Tactics to Optimize the Potential reactivation is feasible prior to delivering a specific intervention.


Painful Total Hip Arthroplasty: A Systematic Review and Proposal for an Algorithmic Management Approach.
The etiological diagnosis of painful primary total hip arthroplasty and its management is a complex clinical challenge for pain physicians. Extrinsic sources of pain in the hip joint might be efficiently treated by clinical pain units, although the topic remains controversial. To conduct a literature review and suggest an evidence-based algorithmic approach to managing painful hip arthroplasty. Systematic literature review with qualitative data synthesis. We conducted an online search of Medline/Pubmed, Embase, Clinical Trials, and Cochrane database using the Medical Subject Heading (MeSH) and free terms on all biomedical literature published up to August 2019. Articles that described either the etiologies and management of painful primary total hip arthroplasty or the imaging techniques to specifically assess any of its causes were included. We collected the demographic data (gender, age, body mass index), main etiologies, diagnostic tests, and specific treatments applied in each study. Based on the reviewed evidence, we propose an algorithmic approach, with a special emphasis on etiologies that should be referred to pain clinics. Twenty-four studies were included for the synthesis, 16 of which were observational studies and 8 of which were non-systematic literature reviews that described a wide range of etiologies of painful primary total hip arthroplasty. The results showed that 2/3 of the causes of pain were intrinsic and need to be managed by orthopedic surgeons. One third of the etiologies were extrinsic and should be referred to pain clinics once intrinsic causes have been ruled out. Among extrinsic sources of pain, the most frequent was myofascial etiology. A publication bias might have been present due to the inclusion of studies published only in English, Spanish, and German. The included studies also had heterogeneous methodologies. The current review suggests that painful hip arthroplasty is not a rare condition in clinical practice. We systematically reviewed etiologies and various treatments published in the literature and we suggest an algorithmic approach to management based on the available evidence. This approach incorporates the evidence regarding our knowledge of the etiologies, diagnosis, and management of chronic pain after total hip arthroplasty. Systematic review registration: The protocol was registered in PROSPERO the international prospective register of systematic reviews, ID CRD42020185663.


A systematic review of treatment of intermittent claudication in the lower extremities.
Peripheral arterial disease is common and is associated with significant morbidity and mortality. We conducted a systematic review to identify randomized trials and systematic reviews of patients with intermittent claudication to evaluate surgery, endovascular therapy, and exercise therapy. Outcomes of interest were death, amputation, walking distance, quality of life, measures of blood flow, and cost. We included eight systematic reviews and 12 trials enrolling 1548 patients. Data on mortality and amputation and on cost-effectiveness were sparse. Compared with medical management, each of the three treatments (surgery, endovascular therapy, and exercise therapy) was associated with improved walking distance, claudication symptoms, and quality of life (high-quality evidence). Evidence supporting superiority of one of the three approaches was limited. However, blood flow parameters improved faster and better with both forms of revascularization compared with exercise or medical management (low- to moderate-quality evidence). Compared with endovascular therapy, open surgery may be associated with longer length of hospital stay and higher complication rate but resulted in more durable patency (moderate-quality evidence). In patients with claudication, open surgery, endovascular therapy, and exercise therapy were superior to medical management in terms of walking distance and claudication. Choice of therapy should rely on patients' values and preferences, clinical context, and availability of operative expertise.


Mechanisms of tau self-aggregation and neurotoxicity.
Pathological tau protein aggregates can be found in brain of patients with some of the neurodegenerative diseases collectively known as tauopathies, which include Alzheimer's disease (AD). Since tau post-translational modifications including phosphorylations, glycosylations, truncation and the subsequent aggregation in oligomers, paired helical filaments (PHFs) and neurofibrillary tangles (NFTs), correlate with cognitive impairment and neurodegeneration in AD, a pathogenic role for tau and its modifications has been raised. Here we summarize the current status of knowledge about tau modifications under pathologic conditions and the evidence supporting neurotoxic - or neuroprotective - roles of the diverse forms of modified and aggregated tau. Finally, we analyze the structural and functional tau alterations found in different tauopathies and how these modifications are related to the pathophysiologic mechanisms of neurodegeneration.