Can discography cause long-term back symptoms in previously asymptomatic subjects?
A prospective controlled study of patients without low back pain observed after experimental lumbar discography. To determine whether discography may cause long-term low back symptoms in selected patients. Lumbar discography is generally considered safe, although controversial, with few complications. There is little information on long-term follow-up of asymptomatic patients after experimental discography. Twenty-six patients without pre-existing low back pain were observed for 1 year after lumbar discography to determine the effects of lumbar discography in three experimental groups: 10 patients who had remote cervical spine surgery with excellent results (pain-free group); 10 patients who had the same surgery with poor results (chronic pain group); and 6 patients who had primary somatization disorders. Two control groups were also observed: a group of patients with somatization disorder who were similarly evaluated but without discography, a group of patients with low back pain observed for 1 year after discography without surgery. In the three experimental groups (no back pain before discography) no subject with normal psychometric testing had persistent pain after discography (0/11), whereas 6 (40%) of 15 with abnormal psychometric test results reported significant new low back pain. None of the pain-free group (0/10), 20% of the chronic neck pain group (2/10), and 66% of the somatization group (4/6) continued to have significant back pain 1 year after injection. Psychological testing and occupational disability strongly predicted continued pain after discography. The control groups had no significant change in low back symptomatology during the year of observation. Discography in a subject group without low back pain but with significant emotional and chronic pain problems may result in reports of significant back pain for at least 1 year after injection. Subjects with normal psychometric test results had no reports of significant long-term back pain after discography.


Dental Bleaching Techniques; Hydrogen-carbamide Peroxides and Light Sources for Activation, an Update. Mini Review Article.
Hydrogen and carbamide peroxides have been successfully used for many years; in the past century the dental bleaching technique suffered several changes and almost 10 years before new millennium the technique was finally recognized by the international agencies of regulation. It is important that Dentists handle the peroxides with the essential knowledge, because it is demonstrated that satisfactory final results of this technique depend on the correct diagnosis of stains, management of the substrates (enamel and dentin) and as well sensitivity. Dentists are exposed to several dental bleaching techniques, products and brands, and in the last 2 decades the devices for light activation of the peroxides have become an extensive catalog. Today, the technique is also suffering changes based on the effectiveness of the different light sources for peroxide activation and its relation to satisfactory final results of the technique. The purpose of this literature review is to explain the determinant factors that influence satisfactory final results of the techniques and provide a general overview, in order to achieve a treatment decision based on evidence.


[Irrational anxiety: obsessive-compulsive disorder].
Obsessive-compulsive disorder is an exemplar of an anxiety disorder where irrational thoughts and compulsive behaviors succeed each other in a mental system where every negative outcome can occur. Affects like doubt and guilt reinforce the need to prevent catastrophic consequences from occurring. Magical thinking replaces logical thoughts. The risk of suicide becomes high when compulsive acts cannot control anxiety. Behavior and cognitive therapy is the most frequent type of psychological help: the principal target is the change of emotional reactions.


Twin anemia-polycythemia sequence in monochorionic twins: implications for diagnosis and treatment.
Twin anemia-polycythemia sequence (TAPS) is a recently described complication of monochorionic placentation characterized by discordance in hemoglobin (Hgb) levels in the absence of amniotic fluid abnormality characteristic of classical twin-twin transfusion syndrome (TTTS). The placental angioarchitecture that predisposes to TAPS consists of small diameter arteriovenous anastomoses and the absence of balancing arterioarterial anastomoses. This vascular pattern occurs sporadically in 3 to 5% of monochorionic twins or iatrogenically following 2 to 13% of selective fetoscopic laser surgeries for TTTS. The diagnosis is based on measurement of the middle cerebral artery peak systolic velocity (MCA-PSV) which is not part of the Quintero staging for TTTS. With mild disease increased MCA-PSV in the anemic donor twin and a decreased MCA-PSV in the recipient twin are characteristic while severe disease is associated with critical Doppler findings, hydrops or single twin demise as in TTTS. Treatment options include fetoscopic laser, fetal blood transfusion, conservative management, and often preterm delivery. The most promising approach to TAPS is its prevention since the iatrogenic form comprises the majority of cases. When the fetoscopic laser technique is modified by coagulating the chorionic plate along the vascular equator (equatorial dichorionization or "Solomon" technique) the incidence of postlaser TAPS and recurrent TTTS is significantly reduced, survival is improved, and there is no increase in complications.


Buspirone, a 5-hydroxytryptamine1A agonist, is active in cerebellar ataxia. Results of a double-blind drug placebo study in patients with cerebellar cortical atrophy.
To establish the antiataxic effect of buspirone hydrochloride, a serotonergic 5-hydroxytryptamine1A (5-HT1A) agonist, in a homogenous group of patients characterized by the same well-defined single condition, cerebellar cortical atrophy. University ataxia research center. Double-blind randomized study of buspirone vs placebo during a 4-month period. Nineteen patients met the inclusion criteria; all completed the study. Of these 19 patients, 9 were treated with placebo and 10 were treated with the drug. A semiquantitative scale for kinetic and static ("postural") cerebellar functions; quantitative clinical measurements measuring time in standard tests that evaluated stance, speech, writing, and drawing; and posturographic analysis of the sway path and sway area of the center-of-foot pressure. The primary end point was improvement of the posttherapeutic change of one of the semiquantitative ataxic scores. The secondary end points were modification of the changes of quantitative measures--clinical or posturographic. In intention-to-treat analysis, a significant improvement of the primary end point, ie, the posttherapeutic change of the ataxic kinetic score, was shown. Among secondary end points, the maximum time of standing with feet together also was significantly improved. Buspirone is active in cerebellar ataxia of patients with cerebellar atrophy. These results confirm the data suggested by open-label studies with buspirone. However, the effect is partial and not clinically major. These pharmacological results might be due to serotonergic mechanisms and confirm a possible link between cerebellar ataxia and the metabolism of serotonin.


Cone of direct gaze as a marker of social anxiety in males.
The fear of being scrutinised is a core feature of social anxiety disorder and socially anxious individuals overestimate being 'looked at'. A recent development in the vision sciences is a reliable psychophysical index of the range of eye gaze angles judged as being directed at oneself (Cone of Direct Gaze: CoDG). We tested the CoDG as a measure of "being looked at" in social anxiety. Participants were stratified into high/low social anxiety groups and asked to judge whether they were being 'looked at' by computerised male faces varying in eye gaze deviation and facial emotion. High socially anxious males had a wider CoDG than low socially anxious males; high and low socially anxious females did not differ. Fearful faces elicited narrower cones than neutral or angry faces; however, the effect size was small and not evident for the high socially anxious males. Measures of subjective reactions to the study, and to being looked at in general, indicated that the results may be in part due to males suffering more discomfort when being looked at. The results show that measures derived from psychophysics, in this case, the CoDG, have potential as clinical and research tools for measuring anxiety about being scrutinised.


Seasonal variation in the incidence of mania.
The seasonal variation of admissions to hospital with a diagnosis of mania (296.1) in England and Wales was examined. The results indicated that for females there was a significant seasonal trend, the peak being in August-September, while for males there was no significant seasonal pattern. The possible reasons for these findings are discussed.


Giovanni Filippo Ingrassia: A five-hundred year-long lesson.
Giovanni Filippo Ingrassia was born five centuries ago in Regalbuto, a small town in the center of Sicily. After his medical course in Padua, under the guidance of Vesalius and Fallopius, he gained international fame as a physician and was recruited as a Professor of human anatomy in Naples and later in Palermo. He is remembered as "the new Galen" or "the Sicilian Hippocrates." He contributed to the knowledge of human anatomy through the description of single bones rather than the whole skeleton. In particular, he was the first to describe the "stapes," the "lesser wings of the sphenoid" and various other structures in the head (probably the pharyngotympanic tube) as well as in the reproductive system (corpora cavernosa and seminal vesicles). He was also a pioneer in the study of forensic medicine, hygiene, surgical pathology, and teratology. As Protomedicus of Sicily, he developed the scientific culture in this country. During those years, he faced the spread of malaria and plague with competence and authoritativeness. Indeed, he was one of the first physicians to suppose that certain diseases could be transmitted between individuals, therefore, introducing revolutionary measures of prevention. He is remembered for his intellectual authority and honesty. Five-hundred years after his birth, his teaching is still alive. In this article, we survey the life and contribution of this pioneer of early anatomical study.


CD9 is expressed in extravillous trophoblasts in association with integrin alpha3 and integrin alpha5.
The CD9 molecule is a 24-27 kDa cell surface glycoprotein, which may be related to Schwann cell migration and adhesion. In this study, we examined the expression of CD9 in human extravillous trophoblasts, which invade into the endometrium during implantation and placentation. CD9 was detected immunohistochemically on the extravillous trophoblasts in the cell columns of first trimester placentae, but not on villous trophoblasts. In the second and third trimester, CD9 was highly expressed on the extravillous trophoblasts in the basal plate of placentae, and in the chorion laeve in the fetal membrane of term placentae. The molecular mass of CD9 in the chorion laeve was shown to be 27 kDa by Western blotting. The mRNA of CD9 was also detected in the chorion laeve by reverse transcription-polymerase chain reaction (RT-PCR). Proteins were purified from chorion laeve by affinity chromatography with anti-integrin alpha3 and alpha5 monoclonal antibodies and Western blotting, revealed that CD9 was associated with both integrins. These findings indicate that CD9 is a differentiation-related molecule present in the extravillous trophoblasts. Since it is associated with integrin alpha5 which has been proposed to regulate trophoblast invasion, CD9 may be implicated in trophoblast invasion at the feto-maternal interface.


The controversial telomeres of lily plants.
The molecular structure of the exceptional telomeres of six plant species belonging to the order Asparagales and two species of the order Liliales was analyzed using Southern blot and fluorescence in situ hybridization. Three different situations were found, namely: i) In the two Liliales species, Tulipa australis (Liliaceae) and Merendera montana (Colchicaceae), the chromosome ends display hybridization signals with oligonucleotides resembling telomere repeats of both plants (TTTAGGG)n and vertebrates (TTAGGG)n. ii) Asparagales species such as Phormium tenax (Hemerocallidaceae), Muscari comosum (Hyacinthaceae), Narcissus jonquilla (Amaryllidaceae) and Allium sativum (Alliaceae) lack both the plant telomere repeats and the vertebrate telomere repeats. iii) Two other Asparagales species, Aloe vera (Asphodelaceae) and an Iris hybrid (Iridaceae), display positive hybridization with the vertebrate telomere repeats but not with the plant telomere repeats. Southern blot hybridization revealed concurring results. On this basis, the composition of the telomere structure in this plant group is discussed.


The rare case of a large complex intraosseous cranial arteriovenous malformation with successful multidisciplinary management.
Intraosseous cranial arteriovenous malformations (AVMs) are very rare, challenging entities. The authors report the case of an extracranial parietooccipital vascular lesion. A 12-year-old boy presented with accelerated growth of a right scalp lesion over a few months. Digital subtraction angiography showed a large, right parietooccipital intraosseous AVM with multiple complex arterial feeders. Treatment of these lesions is difficult and can necessitate a multidisciplinary approach. In the featured case, 6 embolization procedures were performed over 1 year, including both transarterial and transvenous approaches, followed by total resection. The authors describe what is thought to be the second case of an AVM originating in the cranial bones and the first case with successful multidisciplinary management.


Incidence and determinants of acute diarrhoea in Malaysia: a population-based study.
Acute diarrhoea is a major health problem in many parts of the world, contributing to about 1.8 million deaths globally. The objectives of the study were to assess the incidence, determinants, and severity of acute diarrhoea in the population. A nation-wide cross-sectional survey involving about 57,000 respondents was conducted via face-to-face interview among eligible respondents of all ages. An acute diarrhoeal episode was defined as having three or more episodes of loose stools in any 24-hour period within the past four weeks before the interview. The severity was measured by duration of acute diarrhoea and associated symptoms. The variables tested as determinants were age, sex, ethnicity, the highest educational level, total monthly household income, and locality. Univariate, bivariate and multivariate procedures meant for complex study design were used in the analyses. The four-week incidence of acute diarrhoea was 5% [95% confidence interval (CI) 4.8-5.2]. The incidence of acute diarrhoea among the estimated population was the highest among young adults aged 20-29 years, Other Bumiputras (the pre-dominant ethnic group in East Malaysia), those with tertiary-level of education, those earning a monthly household income of less than RM 400, and rural dwellers. Only age, ethnicity, the highest level of education attained, and locality were significantly associated with acute diarrhoea in bivariate analysis. In multivariate analysis, these four variables were found to be the determinants of acute diarrhoea. Sex and monthly household income were excluded from the model. The mean duration of acute diarrhoea was 2.0 days (standard deviation 1.3). Forty-six percent of the respondents reported stomach cramps as an associated symptom. The findings revealed that acute diarrhoea is still a major public-health concern in Malaysia and grossly under-notified. There is a need for intensification of public-health intervention efforts to reduce the incidence of acute diarrhoea while improving surveillance and notification of the disease.


Bifurcations and chaos in a predator-prey system with the Allee effect.
It is known from many theoretical studies that ecological chaos may have numerous significant impacts on the population and community dynamics. Therefore, identification of the factors potentially enhancing or suppressing chaos is a challenging problem. In this paper, we show that chaos can be enhanced by the Allee effect. More specifically, we show by means of computer simulations that in a time-continuous predator-prey system with the Allee effect the temporal population oscillations can become chaotic even when the spatial distribution of the species remains regular. By contrast, in a similar system without the Allee effect, regular species distribution corresponds to periodic/quasi-periodic oscillations. We investigate the routes to chaos and show that in the spatially regular predator-prey system with the Allee effect, chaos appears as a result of series of period-doubling bifurcations. We also show that this system exhibits period-locking behaviour: a small variation of parameters can lead to alternating regular and chaotic dynamics.


Evolutionary Model of Plastidial RNA Editing in Angiosperms Presumed from Genome-Wide Analysis of Amborella trichopoda.
Amborella trichopoda is placed close to the base of the angiosperm lineage (basal angiosperm). By genome-wide RNA sequencing, we identified 184C-to-U RNA editing sites in the plastid genome of Amborella. This number is much higher than that observed in other angiosperms including maize (44 sites), rice (39 sites) and grape (115 sites). Despite the high frequency of RNA editing, the biased distribution of RNA editing sites in the genome, target codon preference and nucleotide preference adjacent to the edited cytidine are similar to that in other angiosperms, suggesting a common editing machinery. Consistent with this idea, the Amborella nuclear genome encodes 2-3 times more of the E- and DYW-subclass members of pentatricopeptide repeat proteins responsible for RNA editing site recognition in plant organelles. Among 165 editing sites in plastid protein coding sequences in Amborella, 100 sites were conserved at least in one out of 38 species selected to represent key branching points of the angiosperm phylogenetic tree. We assume these 100 sites represent at least a subset of the sites in the plastid editotype of ancestral angiosperms. We then mapped the loss and gain of editing sites on the phylogenetic tree of angiosperms. Our results support the idea that the evolution of angiosperms has led to the loss of RNA editing sites in plastids.


The nature of halogen substitution determines the mode of cytotoxicity of halopropanols.
The cytochrome P450-dependent generation of reactive metabolites from 1,3-dichloropropanol and 1,3-dibromopropanol was assessed in a microsomal thiol depletion assay, while the toxicity of these compounds was assessed in rat hepatocyte cultures and in the 3T3 cell line. Thiol-depleting metabolites of both compounds were generated in the microsomal assay; however, only dibromopropanol extensively depleted glutathione when glutathione S-transferase was used as the enzyme source. The cytotoxicity of dichloropropanol was both cytochrome P450- and glutathione-dependent, whereas that of dibromopropanol was glutathione-dependent but largely independent of cytochrome P450. These results indicate that the mechanisms underlying the cytotoxicity of halopropanols are dependent on the nature of the halogen substitution and that microsomal and cellular assays for reactive metabolite generation may yield conflicting results.


Evaluation of obstructive sleep apnea in pediatric patients with facio-craniostenosis: a brief communication.
This study aimed to evaluate our experience in treating cranio-maxillo-mandibular malformations with hypoplasia of the upper and middle third of the face. We wished to determine a new diagnostic path involving a new clinical questionnaire for obstructive sleep apnea (OSA) evaluation, which we have developed by merging existing tests, literature findings, and our clinical experience to obtain a high level of information with minimal cost. This questionnaire is an improvement of the other anamnestic tests in the literature. The study was carried out on 17 pediatric patients affected by syndromic craniofacial malformations and treated with surgical advancement of the middle third of the face, associated with or without upper third advancement, through osteodistraction. We used the obstructive airway child test (OACT) for clinical evaluation. The OACT is an OSA assessment test based on questions proposed to the patient's relatives. All patients underwent polysomnography for instrumental assessment of OSA. These patients were also required to have a computed tomography scan for surgical planning. At the start of the treatment, 11 patients had severe OSA, 4 patients had moderate OSA, and 2 patients had slight OSA. At the end of the treatment, 6 patients had slight OSA and 11 patients had no OSA; these data were confirmed with OACT and polysomnography. Based on our results, we suggest the following flowchart: OACT for OSA clinical evaluation; CT scan for evaluation of the volume of the rhinoropharyngeal air column, anatomical obstruction detection, and surgical planning; and polysomnography for diagnostic confirmation.


Common polymorphisms in ERCC2 (Xeroderma pigmentosum D) are not associated with breast cancer risk.
A substantial proportion of the familial risk of breast cancer may be due to genetic variants, each contributing a small effect. The protein encoded by ERCC2 is a key enzyme involved in nucleotide excision repair, in which gene defects could lead to cancer prone syndromes such as Xeroderma pigmentosum D. We have examined the association between single nucleotide polymorphisms in the ERCC2 gene and the incidence of invasive breast cancer in three case-control series, with a maximum of 3,634 patients and of 3,340 controls. None of the three single nucleotide polymorphisms were significantly associated with the incidence of breast cancer.


Photochromic control of a plasmon-quantum dots coupled system.
The control of quantum dot (QD) photoluminescence (PL) is a challenge for many applications. It is well known that plasmonic resonances can enhance this PL. In this work, we couple QDs with silver nanoparticles and immerse the system in a photochromic organic material. As these molecules are optical switches going from a transparent to a colored isomer by absorbing UV light, we observe on one hand a Förster Resonant Energy Transfer (FRET) between the QD emission and the absorbing isomer and on the other hand a plasmonic PL enhancement. The photochromic transition leads to the optical control of the FRET, allowing us to control the QD de-excitation preferences (radiative or non-radiative) and so the emitted light.


Prediction of heart failure mortality in emergent care: a cohort study.
Heart failure contributes to millions of emergency department (ED) visits, but hospitalization-versus-discharge decisions are often not accompanied by prognostic risk quantification. To derive and validate a model for acute heart failure mortality applicable in the ED. Clinical data abstraction with development of a broadly applicable multivariate risk index for 7-day death using initial vital signs, clinical and presentation features, and readily available laboratory tests. Multicenter study of 86 hospitals in Ontario, Canada. Population-based random sample of 12 591 patients presenting to the ED from 2004 to 2007. Death within 7 days of presentation. In the derivation cohort (n = 7433; mean age, 75.4 years [SD, 11.4]; 51.5% men), mortality risk increased with higher triage heart rate (adjusted odds ratio [OR], 1.15 [95% CI, 1.03 to 1.30] per 10 beats/min) and creatinine concentration (OR, 1.35 [CI, 1.14 to 1.60] per 1 mg/dL [88.4 µmol/L]), and lower triage systolic blood pressure (OR, 1.52 [CI, 1.31 to 1.77] per 20 mm Hg) and initial oxygen saturation (OR, 1.16 [CI, 1.01 to 1.33] per 5%). Nonnormal serum troponin levels (OR, 2.75 [CI, 1.86 to 4.07]) were associated with increased mortality risk. Areas under the receiver-operating characteristic curves of the multivariate model were 0.805 for the derivation data set (bootstrap-corrected, 0.811) and 0.826 for validation data set (n = 5158; mean age, 75.7 years [SD, 11.4]; 51.6% men). In the derivation cohort, a multivariate index score stratified 7-day mortality with rates of 0.3%, 0.3%, 0.7%, and 1.9% in quintiles 1 to 4, respectively. Mortality rates in the 2 highest risk groups were 3.5% and 8.2% in deciles 9 and 10, respectively. Left ventricular ejection fraction was not included in the model. A multivariate index comprising routinely collected variables stratified mortality risk with high discrimination in a broad group of patients with acute heart failure presenting to the ED. Canadian Institutes of Health Research.


[Coenzyme q10 in complex therapy of patients with ischemic heart disease].
The paper contains results of assessment of clinical efficacy and safety of coenzyme Q10 in patients with ischemic heart disease. Coenzyme Q10 (60 mg/day for 8 weeks) added to basic treatment of patients with stable class II-III angina significantly improved clinical status of these patients without clinically significant side effects.


The mechanisms of action of lithium. I. Effects on serotoninergic and noradrenergic systems in normal subjects.
The effects of 2 weeks of lithium carbonate administration at therapeutic plasma levels were examined in 11 normal volunteers. Serotoninergic function before and after lithium administration was assessed using low-dose intravenous clomipramine hydrochloride challenge, while urinary and plasma metabolites of norepinephrine (NE) were used to assess noradrenergic systems. Long-term lithium administration in normal subjects did not significantly or consistently enhance serotonin-mediated neuroendocrine responses but did increase measures related to neuronal release of NE. No statistically significant effects of lithium on prolactin, corticotropin, or cortisol responses to serotoninergic challenge could be detected. The probability of a type II error was assessed, and a doubling of prolactin level was unlikely to have been missed, although more modest increases (less than 75%) could have been overlooked. After 2 weeks of lithium administration, there were significant increases in 24-hour urinary excretion of NE, normetanephrine, and fractional NE release, compatible with increased neuronal release of NE and a lithium-induced subsensitivity in alpha 2-adrenergic receptor function. These changes were not statistically significant after 1 week of administration, suggesting that increased NE release is characteristic of long- rather than short-term lithium administration. Since previous reports have demonstrated enhanced prolactin responses after short- but not long-term lithium use, the present study points to temporal specificity in lithium's effects on both serotoninergic and noradrenergic function. Lithium's effects on NE release were consistent but small (a 16% increase), while its effects on serotoninergic responses were larger (a 50% increase in prolactin responses) but quite inconsistent, suggesting that neither of these systems is the primary site of action of lithium.


Operating room to intensive care unit handoffs and the risks of patient harm.
The goal of this study was to assess systems and processes involved in the operating room (OR) to intensive care unit (ICU) handoff in an attempt to understand the criticality of specific steps of the handoff. We performed a failure modes, effects, and criticality analysis (FMECA) of the OR to ICU handoff of deceased donor liver transplant recipients using in-person observations and descriptions of the handoff process from a multidisciplinary group of clinicians. For each step in the process, failures were identified along with frequency of occurrence, causes, potential effects and safeguards. A Risk Priority Number (RPN) was calculated for each failure (frequency × potential effect × safeguard; range 1-least risk to 1,000-most risk). Using FMECA, we identified 37 individual steps in the OR to ICU handoff process. In total, 81 process failures were identified, 22 of which were determined to be critical and 36 of which relied on weak safeguards such as informal human verification. Process failures with the greatest risk of harm were lack of preliminary OR to ICU communication (RPN 504), team member absence during handoff communication (RPN 480), and transport equipment malfunction (Risk Priority Number 448). Based on the analysis, recommendations were made to reduce potential for patient harm during OR to ICU handoffs. These included automated transfer of OR data to ICU clinicians, enhanced ICU team member notification processes and revision of the postoperative order sets. The FMECA revealed steps in the OR to ICU handoff that are high risk for patient harm and are currently being targeted for process improvement.


Measurement of pH-dependent surface-enhanced hyper-Raman scattering at desired positions on yeast cells via optical trapping.
Surface-enhanced hyper-Raman scattering (SEHRS) spectra were obtained at desired positions on yeast by focusing a continuous wave near-infrared laser beam while silver nanoparticles (AgNPs) were simultaneously optically trapped. However, the optically trapped colloidal AgNP suspension bubbled up at the focusing point, preventing spectral measurement. In the case of optically trapped AgNPs functionalized with 4-mercaptobenzoic acid (p-MBA), surface-enhanced hyper-Rayleigh scattering was considerably strong, indicating the suppression of the photothermal conversion to form the bubble. Interestingly, the SEHRS peaks that are attributed not only to p-MBA, but also to other species, were very occasionally observed. They may be partly assigned to the β1,3 glucan and protein amide II band. The SEHRS peak at 1366 cm-1 was barely visible in the measurements of conventional baker's yeast even in the suspension (pH 9) despite the effects of high pH on p-MBA. In contrast, the SEHRS peak in the measurements of yeast for biological applications was occasionally observed at 1366 cm-1. This suggests that acidity is correlated with fermentation efficiency. At different positions on single yeast cells, the intensity of the SEHRS peak at 1366 cm-1 varied. This result represents the pH distribution on yeast.


Prothrombotic disorders and ischemic stroke in children.
Childhood ischemic stroke, including arterial ischemic stroke (AIS) and sinovenous thrombosis (SVT), is relatively rare in children but can result in devastating morbidity and mortality. An understanding of the etiology of childhood stroke is important because strategies for primary and secondary prevention can be devised. Prothrombotic disorders may contribute to the etiology of childhood stroke, and include deficiencies of antithrombin, protein C, protein S, plasminogen, and presence of Factor V Leiden, Prothrombin gene G20210A, dysfibrinogenemia, antiphospholipid antibodies, hyperhomocysteinemia, and elevated lipoprotein (a). The overall incidence of prothrombotic disorders in childhood AIS is estimated to be 20% to 50% in most studies and, in childhood SVT, to be 33% to 99%. In addition, hyperlipidemia, polycythemia, iron deficiency anemia, and platelet disorders may result in a prothrombotic state associated with ischemic stroke. The etiologic contribution of these prothrombotic disorders to initial and recurrent stroke has not been clearly defined; however, additional risk factors are usually present in affected children. Given the prevalence of prothrombotic disorders in childhood stroke, and their likely causative role, children with stroke should be screened for prothrombotic disorders. Future prospective and multicenter studies will elucidate the contribution of specific prothrombotic disorders to initial and recurrent stroke, and optimal therapy.


Perianal extramammary Paget's disease associated with primary linitis plastica of the rectum: report of a case.
We report herein a case of perianal extramammary Paget's disease associated with primary linitis plastica of the rectum. An 82-year-old woman was admitted to our hospital for investigation and treatment of a perianal eczematous lesion. A skin biopsy of the lesion revealed perianal extramammary Paget's disease and a barium enema demonstrated diffuse narrowing with an irregular contour at the ampulla recti. Under a suspected diagnosis of linitis plastica of the rectum, an abdominoperineal resection was performed to resect both the rectal and perianal lesions with regional lymphadenectomy. Grossly, marked narrowing and wall thickness were observed at the lower rectum, and a histological diagnosis of signet ring cell carcinoma was confirmed. The perianal eczematous lesion revealed many atypical cells with clear cytoplasm, being Paget cells, throughout the entire epidermis. Sparse distributions of signet ring cells were also observed in the subcutaneous tissue beneath the perianal eczematous lesion. The pathogenesis of perianal extramammary Paget's disease in this patient was therefore considered to be an intraepidermal extension of primary linitis plastica of the rectum.


Survey of gross anatomy, microscopic anatomy, neuroscience, and embryology courses in medical school curricula in the United States.
Directors of courses in the basic anatomical sciences in allopathic and osteopathic medical schools in the United States were surveyed regarding the present composition of their courses. Results indicate the majority of gross anatomy courses are in the range of 126 to 200 total course hours, and that laboratory dissection is a key component of these courses. The majority of microscopic anatomy courses are in the range of 61 to 100 total course hours, generally divided equally between lecture and laboratory components. Additionally, despite the availability of computer technology, microscopes are still used in the vast majority of microscopic anatomy courses. The majority of neuroscience courses are in the range of 71 to 90 total course hours, with most of these hours devoted to lectures. Embryology is usually taught in conjunction with gross anatomy, although some schools present it with the microscopic anatomy course or as a separate course. Most embryology courses are in the range of 6 to 20 total course hours, with only a few having a laboratory component.


Migraine in the Emergency Department: A Prospective Multinational Study of Patient Characteristics, Management, and Outcomes.
Migraine headache is commonly diagnosed in emergency departments (ED). There is relatively little real-world information about the epidemiology, investigation, management, adherence to therapeutic guidelines and disposition of patients treated in ED with a final diagnosis of migraine. The primary aim of the current study is to get a snapshot of assessment and management patterns of acute migraine presentations to the different settings of EDs with a view to raise awareness. This is a planned sub-study of a prospective study conducted in 67 health services in 10 countries including Australia, New Zealand, Southeast Asia, Europe, and the UK investigating the epidemiology and outcome of adult patients presenting to ED with nontraumatic headache. Outcomes of interest for this study are demographics, clinical features (including severity), patterns of investigation, treatment, disposition, and outcome of patients diagnosed as having migraine as their final ED diagnosis. The cohort comprises 1,101 patients with a mean age of 39 years (SD ± 13.5; 73.7% [811]) were female. Most patients had had migraine diagnosed previously (77.7%). Neuroimaging was performed in 25.9% with a very low diagnostic yield or significant findings (0.07%). Treatment of mild migraine was in accordance with current guidelines, but few patients with moderate or severe symptoms received recommended treatment. Paracetamol (46.3%) and nonsteroidal anti-inflammatory drugs (42.7%) were the most commonly prescribed agents. Metoclopramide (22.8%), ondansetron (19.2%), chlorpromazine (12.8%), and prochlorperazine (12.8%) were also used. This study suggests that therapeutic practices are not congruent with current guidelines, especially for patients with severe symptoms. Efforts to improve and sustain compliance with existing management best practices are required.


Cardiac telerehabilitation: current status and future perspectives.
Multidisciplinary cardiac rehabilitation (CR) improves the prognosis and quality of life of patients with cardiovascular disease and has therefore received strong recommendations in international guidelines for the treatment of patients with chronic coronary syndromes and chronic heart failure. Aiming to both resolve several barriers that impede participation in CR and to improve the effectiveness of CR, cardiac telerehabilitation (CTR) has emerged as a cost-effective alternative to traditional, centre-based CR. Although the body of evidence for the feasibility and effectiveness of CTR is large and still growing, real-life implementations are scarce, which may be due to insufficient knowledge about CTR interventions and due to the challenges its implementation comes with. Up to now, mainly exercise-related core components of CR and e‑coaching have been investigated in the setting of CTR. Translation of research findings to clinical practice may be hampered by methodological limitations present in most CTR studies, being selection bias of participants, lack of long-term follow-up, heterogeneity of studied interventions and the lack of robust outcome measures. Besides conducting highly needed implementation studies for CTR interventions, their implementation could be facilitated by the development of guideline-based, multidisciplinary and personalised CTR programmes and widespread reimbursement for CTR.


Relapsing polychondritis: Best Practice & Clinical Rheumatology.
Relapsing polychondritis (RP) is an uncommon inflammatory disorder that predominantly targets cartilaginous structures. The disease frequently affects the nose, ears, airways, and joints, but it can also impact organs that aren't primarily cartilage-based, such as blood vessels, skin, inner ear, and eyes. Given its infrequent occurrence and recurrent symptoms, patients often experience delays in proper diagnosis. Lately, based on the organs involved, the disease's diverse manifestations have been categorized into specific clinical groups, based on the most likely organ involvement including auricular, nasal, pulmonary, and musculoskeletal. More recently the discovery of a new disease, called (Vacuoles, E1 enzyme, X-linked, Autoinflammatory, Somatic) VEXAS syndrome, due to mutations in UBA1 gene, identified the cause of 8 % of the patients with a clinical diagnosis of RP. VEXAS is likely the cause of a previously described "hematologic subgroup" in RP. This discovery is proof of concept that RP is likely more than one disease (Beck et al., Dec 31 2020; Ferrada et al., 2021). People diagnosed with RP face numerous hurdles, with the quality of their lives and overall prognosis being affected. Diagnosing the condition is particularly challenging due to its fluctuating symptoms, the absence of specific markers, and the lack of universally recognized classification criteria. For a correct diagnosis, it's imperative for healthcare professionals to identify its unique clinical patterns. Moreover, there are no approved metrics to gauge the disease's severity, complicating patient management. This review seeks to equip clinicians with pertinent insights to better diagnose and attend to these complex patients.


Hydrogen-bonded PTCDA-melamine networks and mixed phases.
A stable hydrogen-bonding junction is formed between 3,4,9,10-perylene-3,4,9,10-tetracarboxylic-dianhydride (PTCDA) and 1,3,5-triazine-2,4,6-triamine (melamine). This bimolecular system was studied on the Ag-Si(111) square root 3 x square root R 30 degrees surface at sub-monolayer coverage, and two distinct phases are observed. A hexagonal lattice is formed that is stabilized by hydrogen bonding between PTCDA and melamine. This phase, in which melamine acts as a 3-fold vertex, is a close analogue to the 3,4,9,10-perylene-3,4,9,10-tetracarboxylic-diimide-melamine network reported recently. To our knowledge this hydrogen-bonding junction has not been previously observed and might not be expected due to lone pair repulsion. However we confirm that this combination is stable using ab initio methods. In the second intermixed phase parallel rows of PTCDA molecules coexist with an array of melamine molecules, and we propose a model for this structure.


Overexpression of exchange protein directly activated by cAMP-1 (EPAC1) attenuates bladder cancer cell migration.
Exchange protein directly activated by cAMP (EPAC) is a mediator of a cAMP signaling pathway that is independent of protein kinase A. EPAC has two isoforms (EPAC1 and EPAC2) and is a cAMP-dependent guanine nucleotide exchange factor for the small GTPases, Rap1 and Rap2. Recent studies suggest that EPAC1 has both positive and negative influences on cancer and is involved in cell proliferation, apoptosis, migration and metastasis. We report that EPAC1 and EPAC2 expression levels were significantly lower in bladder cancer tissue than in normal bladder tissue. In addition, bladder cancer cell lines showed reduced EPAC1 mRNA expression. Furthermore, EPAC1 overexpression in bladder cancer cell lines induced morphologic changes and markedly suppressed cell migration without affecting cell viability. The overexpressed EPAC1 preferentially localized at cell-cell interfaces. In conclusion, reduced EPAC1 expression in bladder tumors and poor migration of EPAC1-overexpressing cells implicate EPAC1 as an inhibitor of bladder cancer cell migration.


Novel expression-linked copies of the genes for variant surface antigens in trypanosomes.
Pathogenic African trypanosomes evade the immune system of their mammalian hosts by the sequential expression of alternative cell-surface glycoproteins (reviewed in refs 1,2). Variant surface glycoproteins (VSGs) purified from cloned variants of Trypanosoma brucei have similar molecular weights (about 60,000), but differ in amino acid composition, N-terminal amino acid sequence and C-terminal structure. We have cloned DNA complementary to the messenger RNA's for four immunologically distinct VSGs and hybridised these complementary DNAs (cDNAs) with restriction digests of T. brucei nuclear DNA, fractionated by gel electrophoresis and transferred to nitrocellulose strips. Each cDNA recognises a unique set of fragments and this basic set is present unaltered in the nuclear DNAs from the four variants. In addition, each probe recognises an extra fragment only in nuclear DNA isolated from cells expressing the VSG corresponding to the cDNA probe. We infer that activation of a VSG gene involves the production of an expression-linked copy of that gene.


Frailty's influence on 30-day mortality in old critically ill ICU patients: a bayesian analysis evaluating the clinical frailty scale.
Frailty is widely acknowledged as influencing health outcomes among critically ill old patients. Yet, the traditional understanding of its impact has predominantly been through frequentist statistics. We endeavored to explore this association using Bayesian statistics aiming to provide a more nuanced understanding of this multifaceted relationship. Our analysis incorporated a cohort of 10,363 older (median age 82 years) patients from three international prospective studies, with 30-day all-cause mortality as the primary outcome. We defined frailty as Clinical Frailty Scale ≥ 5. A hierarchical Bayesian logistic regression model was employed, adjusting for covariables, using a range of priors. An international steering committee of registry members reached a consensus on a minimal clinically important difference (MCID). In our study, the 30-day mortality was 43%, with rates of 38% in non-frail and 51% in frail groups. Post-adjustment, the median odds ratio (OR) for frailty was 1.60 (95% CI 1.45-1.76). Frailty was invariably linked to adverse outcomes (OR > 1) with 100% probability and had a 90% chance of exceeding the minimal clinically important difference (MCID) (OR > 1.5). For the Clinical Frailty Scale (CFS) as a continuous variable, the median OR was 1.19 (1.16-1.22), with over 99% probability of the effect being more significant than 1.5 times the MCID. Frailty remained outside the region of practical equivalence (ROPE) in all analyses, underscoring its clinical importance regardless of how it is measured. This research demonstrates the significant impact of frailty on short-term mortality in critically ill elderly patients, particularly when the Clinical Frailty Scale (CFS) is used as a continuous measure. This approach, which views frailty as a spectrum, enables more effective, personalized care for this vulnerable group. Significantly, frailty was consistently outside the region of practical equivalence (ROPE) in our analysis, highlighting its clinical importance.


Prediction for Cycloplegic Refractive Error in Chinese School Students: Model Development and Validation.
To predict cycloplegic refractive error using measurements obtained under noncycloplegic conditions. Refractive error was measured in 5- to 18-year-old Chinese students using a NIDEK autorefractor before and after administration of 0.5% tropicamide. Spherical equivalent (SER) in diopters (D) was calculated as sphere plus half cylinder. A multivariable prediction model for cycloplegic SER was developed using data from students in Jinyun (n = 1938) and was validated using data from students in Hangzhou (n = 1498). The performance of the prediction model was evaluated using R2, mean difference between predicted and measured cycloplegic SER, and sensitivity and specificity for predicting myopia (cycloplegic SER ≤ -0.5 D). Among 3436 students (mean age, 9.7 years; 51% female), the mean (SD) noncycloplegic and cycloplegic SER values were -1.12 (1.97) D and -0.20 (2.19) D, respectively. The prediction model that included demographics, noncycloplegic SER, axial length/corneal curvature radius ratio, uncorrected visual acuity (UCVA), and intraocular pressure predicted cycloplegic SER with R2 of 0.93 in the development dataset and 0.92 in the validation dataset. The mean (SD) differences between predicted and measured cycloplegic SER were 0.0 (0.55) D in the development dataset and 0.06 (0.64) D in the validation dataset. In both the development and validation datasets, the combination of predicted SER and UCVA yielded high sensitivity (91.4% and 91.9%, respectively) and specificity (95.0% and 90.1%, respectively) for detecting myopia. Cycloplegic refractive error can be predicted using measurements obtained under noncycloplegic conditions. The prediction model could potentially be used to correct the myopia prevalence in epidemiological studies in which administering cycloplegic agent on all participants is not feasible. The prediction model may provide a tool for correcting the overestimation of myopia from noncycloplegic refractive error in future epidemiological studies in which administering cycloplegic agent on all participants is not feasible.


Relationship between the IQ of people with Prader-Willi syndrome and that of their siblings: evidence for imprinted gene effects.
Genetic disorders occasionally provide the means to uncover potential mechanisms linking gene expression and physical or cognitive characteristics or behaviour. Prader-Willi syndrome (PWS) is one such genetic disorder in which differences between the two main genetic subtypes have been documented (e.g. higher verbal IQ in one vs. higher performance IQ in the other; slower than normal reaction time in one vs. normal in the other). In a population study of PWS, the IQ distribution of people with PWS was approximately normal. This raises the question of whether this distribution arose from a systematic effect of PWS on IQ (hypothesis 1) or whether it was the fortuitous result of random effects (hypothesis 2). The correlation between PWS and sibling IQ was determined in order to discriminate between the two hypotheses. In the first case we would expect the correlation to be similar to that found in the general population (0.5); in the second case it would be zero. It was found that the overall PWS-sibling IQ correlation was 0.3 but that the two main genetic subtypes of PWS differed in their familial IQ relationships. As expected, the IQs of normal siblings correlated 0.5, and this was also the case with one genetic subtype of PWS (uniparental disomy) and their siblings, while the other subtype IQ correlated -0.07 with sibling IQ. This is a potentially powerful result that gives another clue to the role of genes on chromosome 15 in the determination of IQ. It is another systematic difference between the genetic subtypes of PWS, which needs an explanation in terms of the very small genetic differences between them.


On the epidemiology of violent juvenile crime in America: a total arrest-referenced approach.
The catalyst for this study was a widely publicized U.S. government-sponsored report forecasting alarming increases in violent juvenile crime. Working from data for the entire United States given in annual FBI Uniform Crime Reports, the study presented a descriptive statistical, historical profile of violent juvenile crime in America based on the percentage of all arrests for criminal homicide, forcible rape, robbery, and aggravated assault attributable to juveniles, 1941-1995. Markedly different patterns resulted from focusing on rates and rates of change calculated for 1-, 5-, and 10-yr. periods. Thus, for example, the most recent 5-yr. trend for criminal homicide indicated an average annual increase of 7.81% in the incidence of arrests attributable to juveniles, with a corresponding projected increase of 117% from 1995 to 2010. An average annual rate increase of 5.13% was indicated over the most recent 10-yr. period, leading to a predicted increase of 77% in 2010 as compared to 1995. By sharp contrast, focusing on the 15.3% rate increase which occurred in the most recent single year led to the expectation that juvenile arrests will account for 229% more of this nation's criminal homicide arrests in 2015 than was the case in 1995. In every case, widely discrepant, 15-yr. projection differences such as those noted above, are magnified considerably if we assume validity of U.S. census estimates concerning increases in the size of America's juvenile population over the time period considered. Results of the study are taken to underscore the importance of qualifying archival data-based inferences about violent juvenile crime, in terms of the specific measure(s) used and time-frame context(s) of the unit(s) of analysis.


Real-time Estimation of Epidemiologic Parameters from Contact Tracing Data During an Emerging Infectious Disease Outbreak.
Contact tracing can provide accurate information on relevant parameters of an ongoing emerging infectious disease outbreak. This is crucial to investigators seeking to control such an outbreak. However, crude contact tracing data are difficult to interpret and methods for analyzing these data are scarce. We present a method to estimate and visualize key outbreak parameters from contact tracing information in real time by taking into account data censoring. Exposure type-specific attack rates and the reproduction number R(t) are estimated from contact tracing data by using maximum likelihood estimation to account for censored data. The attack rates reflect, in the context of contact tracing, the specificity of the contact definition; a higher value indicates relatively efficient contact tracing. The evolution of R(t) over time provides information regarding the effectiveness of interventions. To allow a real-time overview of the outbreak, the attack rates and the evolution of R(t) over time are visualized together with the case-contact network and epicurve. We applied the method to a well-documented smallpox outbreak in The Netherlands to demonstrate the added value. Our method facilitates the analysis of contact tracing information by quickly turning it into accessible information, helping outbreak investigators to make real-time decisions to more effectively and efficiently control infectious disease outbreaks.


TetR-based gene regulation systems for Francisella tularensis.
There are a number of genetic tools available for studying Francisella tularensis, the etiological agent of tularemia; however, there is no effective inducible or repressible gene expression system. Here, we describe inducible and repressible gene expression systems for F. tularensis based on the Tet repressor, TetR. For the inducible system, a tet operator sequence was cloned into a modified F. tularensis groESL promoter sequence and carried in a plasmid that constitutively expressed TetR. To monitor regulation the luminescence operon, luxCDABE, was cloned under the hybrid Francisella tetracycline-regulated promoter (FTRp), and transcription was initiated with addition of anhydrotetracycline (ATc), which binds TetR and alleviates TetR association with tetO. Expression levels measured by luminescence correlated with ATc inducer concentrations ranging from 20 to 250 ng ml(-1). In the absence of ATc, luminescence was below the level of detection. The inducible system was also functional during the infection of J774A.1 macrophages, as determined by both luminescence and rescue of a mutant strain with an intracellular growth defect. The repressible system consists of FTRp regulated by a reverse TetR mutant (revTetR), TetR r1.7. Using this system with the lux reporter, the addition of ATc resulted in decreased luminescence, while in the absence of ATc the level of luminescence was not significantly different from that of a construct lacking TetR r1.7. Utilizing both systems, the essentiality of SecA, the protein translocase ATPase, was confirmed, establishing that they can effectively regulate gene expression. These two systems will be invaluable in exploring F. tularensis protein function.


Yeast mother cell-specific ageing, genetic (in)stability, and the somatic mutation theory of ageing.
Yeast mother cell-specific ageing is characterized by a limited capacity to produce daughter cells. The replicative lifespan is determined by the number of cell cycles a mother cell has undergone, not by calendar time, and in a population of cells its distribution follows the Gompertz law. Daughter cells reset their clock to zero and enjoy the full lifespan characteristic for the strain. This kind of replicative ageing of a cell population based on asymmetric cell divisions is investigated as a model for the ageing of a stem cell population in higher organisms. The simple fact that the daughter cells can reset their clock to zero precludes the accumulation of chromosomal mutations as the cause of ageing, because semiconservative replication would lead to the same mutations in the daughters. However, nature is more complicated than that because, (i) the very last daughters of old mothers do not reset the clock; and (ii) mutations in mitochondrial DNA could play a role in ageing due to the large copy number in the cell and a possible asymmetric distribution of damaged mitochondrial DNA between mother and daughter cell. Investigation of the loss of heterozygosity in diploid cells at the end of their mother cell-specific lifespan has shown that genomic rearrangements do occur in old mother cells. However, it is not clear if this kind of genomic instability is causative for the ageing process. Damaged material other than DNA, for instance misfolded, oxidized or otherwise damaged proteins, seem to play a major role in ageing, depending on the balance between production and removal through various repair processes, for instance several kinds of proteolysis and autophagy. We are reviewing here the evidence for genetic change and its causality in the mother cell-specific ageing process of yeast.


Alternatives to Federal regulatory realignment of health care.
In this article, author Christopher J. Kalkhof puts forth the view that the U.S. healthcare system could be made more cost effective and cost efficient without the implementation of government-directed managed competition strategies. Noting that current private sector initiatives already are forming more cost-sensitive integrated delivery and financing mechanisms, Kalkhof asserts that corresponding realignment initiatives for publicly financed healthcare benefit programs would provide additional incentive and momentum for these private sector efforts without requiring reconfiguration of the healthcare system by the government.


Associations between persistent organic pollutants, type 2 diabetes, diabetic nephropathy and mortality.
Relationships were examined between persistent organic pollutants (POPs) and incident type 2 diabetes, end-stage renal disease (ESRD) and mortality. In a nested case-control study, 300 persons without diabetes had baseline examinations between 1969 and 1974; 149 developed diabetes (cases) and 151 remained non-diabetic (controls) during 8.0 and 23.1 years of follow-up, respectively. POPs were measured at baseline. ORs for diabetes were computed by logistic regression analysis. The cases were followed from diabetes onset to ESRD, death or 2013. HRs for ESRD and mortality were computed by cause-specific hazard models. Patterns of association were explored using principal components analysis. PCB151 increased the odds for incident diabetes, whereas hexachlorobenzene (HCB) was protective after adjusting for age, sex, body mass index, sample storage characteristics, glucose and lipid levels. Associations between incident diabetes and polychlorinatedbiphenyl (PCB) or persistent pesticide (PST) components were mostly positive but non-significant. Among the cases, 29 developed ESRD and 48 died without ESRD. PCB28, PCB49 and PCB44 increased the risk of ESRD after adjusting for baseline demographic and clinical characteristics. Several PCBs and PSTs increased the risk of death without ESRD. The principal components analysis identified PCBs with low-chlorine load positively associated with ESRD and death without ESRD, and several PSTs associated with death without ESRD. Most POPs were positively but not significantly associated with incident diabetes. PCB151 was significantly predictive and HCB was significantly protective for diabetes. Among participants with diabetes, low-chlorine PCBs increase the risk of ESRD and death without ESRD, whereas several PSTs predict death without ESRD.


Prognostic index for patients with relapsed or refractory acute myeloid leukemia who underwent hematopoietic cell transplantation: a KSGCT multicenter analysis.
A multicenter retrospective study was performed to explore a prognostic scoring index in order to identify a population who are least likely to benefit from allogeneic hematopoietic cell transplantation (HCT) in patients with relapsed or refractory acute myeloid leukemia (AML). The cohort included 519 patients with AML, who received HCT between 2005 and 2015 at a status of relapse or primary induction failure. Multivariate analysis demonstrated five independent predictors for OS, including C-reactive protein ≥ 1 mg/dL, peripheral blood blast fraction ≥ 20%, poor-risk karyotype, performance status ≥ 2, and bone marrow unrelated donor as a stem cell source. A prognostic scoring index was explored based on these predictors, and successfully separated the cohort into four groups. At 2 years, OS was 47%, 24%, 8%, and 0% for Good (Score 0, 1: n = 118), Intermediate-1 (Score 2: n = 75), Intermediate-2 (Score 3: n = 39), and Poor (Score 4: n = 24), respectively (P < 0.001). The predicting value of the index was confirmed in a validation cohort. Although a further validation study is warranted, the scoring index may be useful to predict survival and to identify the population with the lowest survival prior to HCT in patients with relapsed or refractory AML.


Interpopulation Similarity of Sex and Age-Related Body Composition Variations Among Older Adults.
The aim of the study was to analyze sex and age-related body composition variations among older adults from the Brazilian, Italian, and Mexican population. A cross-sectional analysis was conducted in 1103 community-dwelling older adults (634 women and 469 men), aged 60 to 89 years, living in Brazil (n = 176), Italy (n = 554), and Mexico (n = 373). Anthropometric measurements were taken, BMI was calculated, and impedance measurements were obtained (resistance, R, reactance, Xc). Specific bioelectrical impedance vector analysis (specific BIVA) was applied, with the specific vector defined by impedance, or vector length (Z = (Rsp2 + Xcsp)0.5), and phase angle (PA = arctan Xc/R 180/π). Population, sex, and age differences in anthropometric and bioelectrical variables were evaluated by means of a two way ANOVA. The mean bioelectrical vectors were graphed by confidence ellipses and statistically compared by the Hotelling's T2 test. The three population groups showed differences in body mass and composition (p < 0.001): the Brazilian sample was characterized by greater body dimensions, longer vectors (higher relative content of fat mass), and lower phase angles (lower skeletal muscle mass). Men were taller and heavier than women (p < 0.001) but had a similar BMI (p = 0.102). They also had higher phase angle (higher skeletal muscle mass) (p < 0.001) and lower vector length (lower %FM) (p < 0.001). In the three population groups, the oldest individuals showed lower anthropometric and phase angle values with respect to the youngest ones (p < 0.001), whereas the vector length did not change significantly with age (p = 0.665). Despite the differences between sexes and among populations, the trend of age-related variations was similar in the Brazilian, Italian, and Mexican older adults.


Narcolepsy and orexins: an example of progress in sleep research.
Narcolepsy is a chronic neurodegenerative disease caused by a deficiency of orexin-producing neurons in the lateral hypothalamus. It is clinically characterized by excessive daytime sleepiness and by intrusions into wakefulness of physiological aspects of rapid eye movement sleep such as cataplexy, sleep paralysis, and hypnagogic hallucinations. The major pathophysiology of narcolepsy has been recently described on the bases of the discovery of the neuropeptides named orexins (hypocretins) in 1998; considerable evidence, summarized below, demonstrates that narcolepsy is the result of alterations in the genes involved in the pathology of the orexin ligand or its receptor. Deficient orexin transmission is sufficient to produce narcolepsy, as we describe here, animal models with dysregulated orexin signaling exhibit a narcolepsy-like phenotype. Remarkably, these narcoleptic models have different alterations of the orexinergic circuit, this diversity provide us with the means for making comparison, and have a better understanding of orexin-cell physiology. It is of particular interest that the most remarkable findings regarding this sleep disorder were fortuitous and due to keen observations. Sleep is a highly intricate and regulated state, and narcolepsy is a disorder that still remains as one of the unsolved mysteries in science. Nevertheless, advances and development of technology in neuroscience will provide us with the necessary tools to unravel the narcolepsy puzzle in the near future. Through an evaluation of the scientific literature we traced an updated picture of narcolepsy and orexins in order to provide insight into the means by which neurobiological knowledge is constructed.


Anesthetic propofol attenuates the isoflurane-induced caspase-3 activation and Aβ oligomerization.
Accumulation and deposition of β-amyloid protein (Aβ) are the hallmark features of Alzheimer's disease. The inhalation anesthetic isoflurane has been shown to induce caspase activation and increase Aβ accumulation. In addition, recent studies suggest that isoflurane may directly promote the formation of cytotoxic soluble Aβ oligomers, which are thought to be the key pathological species in AD. In contrast, propofol, the most commonly used intravenous anesthetic, has been reported to have neuroprotective effects. We therefore set out to compare the effects of isoflurane and propofol alone and in combination on caspase-3 activation and Aβ oligomerization in vitro and in vivo. Naïve and stably-transfected H4 human neuroglioma cells that express human amyloid precursor protein, the precursor for Aβ; neonatal mice; and conditioned cell culture media containing secreted human Aβ40 or Aβ42 were treated with isoflurane and/or propofol. Here we show for the first time that propofol can attenuate isoflurane-induced caspase-3 activation in cultured cells and in the brain tissues of neonatal mice. Furthermore, propofol-mediated caspase inhibition occurred when there were elevated levels of Aβ. Finally, isoflurane alone induces Aβ42, but not Aβ40, oligomerization, and propofol can inhibit the isoflurane-mediated oligomerization of Aβ42. These data suggest that propofol may mitigate the caspase-3 activation by attenuating the isoflurane-induced Aβ42 oligomerization. Our findings provide novel insights into the possible mechanisms of isoflurane-induced neurotoxicity that may aid in the development of strategies to minimize potential adverse effects associated with the administration of anesthetics to patients.


Multisensory impairment reported by veterans with and without mild traumatic brain injury history.
With the use of Veterans Health Administration and Department of Defense databases of veterans who completed a Department of Veterans Affairs comprehensive traumatic brain injury (TBI) evaluation, the objectives of this study were to (1) identify the co-occurrence of self-reported auditory, visual, and vestibular impairment, referred to as multisensory impairment (MSI), and (2) examine demographic, deployment-related, and mental health characteristics that were potentially predictive of MSI. Our sample included 13,746 veterans with either a history of deployment-related mild TBI (mTBI) (n = 9,998) or no history of TBI (n = 3,748). The percentage of MSI across the sample was 13.9%, but was 17.4% in a subsample with mTBI history that experienced both nonblast and blast injuries. The factors that were significantly predictive of reporting MSI were older age, being female, lower rank, and etiology of injury. Deployment-related mTBI history, posttraumatic stress disorder, and depression were also significantly predictive of reporting MSI, with mTBI history the most robust after adjusting for these conditions. A better comprehension of impairments incurred by deployed servicemembers is needed to fully understand the spectrum of blast and nonblast dysfunction and may allow for more targeted interventions to be developed to address these issues.


Hypertension in peripheral arterial disease.
Peripheral arterial disease (PAD) of the lower limbs is associated with a high cardiovascular morbidity and mortality. Intermittent claudication is the most common symptomatic manifestation of PAD, but is in its own value an important predictor of cardiovascular death, increasing it by three-fold, and increasing all-cause mortality by two-to-five fold. Hypertension is a risk factor for vascular disorders, including PAD. Of hypertensives at presentation, about 2-5% have intermittent claudication, with increasing prevalence with age. Otherwise, 35-55% of patients with PAD at presentation also show hypertension. Patients who suffer from hypertension with PAD have a greatly increased risk of myocardial infarction and stroke. There is no consensus on the specific treatment of hypertension in PAD because of the limited controlled studies on antihypertensive therapy in such specific PAD population. There is an obvious need of such outcome studies, especially since the two conditions are frequently encountered together. However, as risk is high in all PAD patients, the most important goal remains to decrease the global cardiovascular risk in such patients rather than to focus on the control of blood pressure only and on the reduction of symptoms of PAD. Therefore, treatment with antiplatelet drugs, ACE-inhibitors and statins should be considered.


Rapid sensitization of physiological, neuronal, and locomotor effects of nicotine: critical role of peripheral drug actions.
Repeated exposure to nicotine and other psychostimulant drugs produces persistent increases in their psychomotor and physiological effects (sensitization), a phenomenon related to the drugs' reinforcing properties and abuse potential. Here we examined the role of peripheral actions of nicotine in nicotine-induced sensitization of centrally mediated physiological parameters (brain, muscle, and skin temperatures), cortical and VTA EEG, neck EMG activity, and locomotion in freely moving rats. Repeated injections of intravenous nicotine (30 μg/kg) induced sensitization of the drug's effects on all these measures. In contrast, repeated injections of the peripherally acting analog of nicotine, nicotine pyrrolidine methiodide (nicotine(PM), 30 μg/kg, i.v.) resulted in habituation (tolerance) of the same physiological, neuronal, and behavioral measures. However, after repeated nicotine exposure, acute nicotine(PM) injections induced nicotine-like physiological responses: powerful cortical and VTA EEG desynchronization, EMG activation, a large brain temperature increase, but weaker hyperlocomotion. Additionally, both the acute locomotor response to nicotine and nicotine-induced locomotor sensitization were attenuated by blockade of peripheral nicotinic receptors by hexamethonium (3 mg/kg, i.v.). These data suggest that the peripheral actions of nicotine, which precede its direct central actions, serve as a conditioned interoceptive cue capable of eliciting nicotine-like physiological and neural responses after repeated nicotine exposure. Thus, by providing a neural signal to the CNS that is repeatedly paired with the direct central effects of nicotine, the drug's peripheral actions play a critical role in the development of nicotine-induced physiological, neural, and behavioral sensitization.


Multibranch activity in basal and tuft dendrites during firing of layer 5 cortical neurons in vivo.
Layer 5 pyramidal neurons process information from multiple cortical layers to provide a major output of cortex. Because of technical limitations it has remained unclear how these cells integrate widespread synaptic inputs located in distantly separated basal and tuft dendrites. Here, we obtained in vivo two-photon calcium imaging recordings from the entire dendritic field of layer 5 motor cortex neurons. We demonstrate that during subthreshold activity, basal and tuft dendrites exhibit spatially localized, small-amplitude calcium transients reflecting afferent synaptic inputs. During action potential firing, calcium signals in basal dendrites are linearly related to spike activity, whereas calcium signals in the tuft occur unreliably. However, in both dendritic compartments, spike-associated calcium signals were uniformly distributed throughout all branches. Thus, our data support a model of widespread, multibranch integration with a direct impact by basal dendrites and only a partial contribution on output signaling by the tuft.


Ultrastructure of a magnetotactic spirillum.
The ultrastructure of a magnetotactic bacterium (strain MS-1) was examined by transmission, scanning, and scanning-transmission electron microscopy. The organism resembled other spirilla in general cell morphology, although some differences were detected at the ultrastructural level. Electron-dense particles within magnetotactic cells were shown by energy-dispersive X-ray analysis to be localizations containing iron. A non-magnetotactic variant of strain MS-1 lacked these novel bacterial inclusion bodies. A chain of these particles traversed each magnetotactic cell in a specific arrangement that was consistent from cell to cell, seemingly associated with the inner surface of the cytoplasmic membrane. Each particle was surrounded by an electron-dense layer separated from the particle surface by an electron-transparent region. The term "magnetosome" is proposed for the electron-dense particles with their enveloping layer(s) as found in this and other magnetotactic bacteria.


Facebook Recruitment Using Zip Codes to Improve Diversity in Health Research: Longitudinal Observational Study.
Facebook's advertising platform reaches most US households and has been used for health-related research recruitment. The platform allows for advertising segmentation by age, gender, and location; however, it does not explicitly allow for targeting by race or ethnicity to facilitate a diverse participant pool. This study looked at the efficacy of zip code targeting in Facebook advertising to reach blacks/African Americans and Hispanics/Latinos who smoke daily for a quit-smoking web-based social media study. We ran a general market campaign for 61 weeks using all continental US zip codes as a baseline. Concurrently, we ran 2 campaigns to reach black/African American and Hispanic-/Latino-identified adults, targeting zip codes ranked first by the percentage of households of the racial or ethnic group of interest and then by cigarette expenditure per household. We also ran a Spanish language campaign for 13 weeks, targeting all continental US zip codes but utilizing Facebook's Spanish language targeting. The advertising images and language were common across campaigns. Costs were compared for advertisement clicks, queries, applications, and participants, and yields were compared for the final three outcomes. We examined outcomes before and after the Cambridge Analytica scandal that broke in March 2018. Finally, we examined 2 promoted Facebook features: lookalike audiences and audience network placement. Zip code targeting campaigns were effective for yielding the racial or ethnic groups of interest. The black-/African American-focused versus general market campaign increased black/African American weekly queries (mean 9.48, SD 5.69 vs general market mean 2.83, SD 2.05; P<.001) and applicants (mean 1.11, SD 1.21 vs general market mean 0.54, SD 0.58; P<.001). The Hispanic-/Latino-focused versus general market campaign increased Hispanic/Latino weekly queries (mean 3.10, SD 2.16 vs general market mean 0.71, SD 0.48; P<.001) and applicants (mean 0.36, SD 0.55 vs general market mean 0.10, SD 0.14; P=.001). Cost metrics did not differ between campaigns at generating participants (overall P=.54). Costs increased post- versus prescandal for the black-/African American-focused campaign for queries (mean US $8.51, SD 3.08 vs US $5.87, SD 1.89; P=.001) and applicants (mean US $59.64, SD 35.63 vs US $38.96, SD 28.31; P=.004) and for the Hispanic-/Latino-focused campaign for queries (mean US $9.24, SD 4.74 vs US $7.04, SD 3.39; P=.005) and applicants (mean US $61.19, SD 40.08 vs US $38.19, SD 21.20; P=.001). Zip code targeting in Facebook advertising is an effective way to recruit diverse populations for health-based interventions. Audience network placement should be avoided. The Facebook lookalike audience may not be necessary for recruitment, with drawbacks including an unknown algorithm and unclear use of Facebook user data, and so public concerns around data privacy should be considered. ClinicalTrial.gov NCT02823028; https://clinicaltrials.gov/ct2/show/NCT02823028.


[Skin diseases related to work: how to approach them?].
Work-related skin problems are frequent and mainly affect the hands. They can be approached by looking for indications of the 3 principal underlying types of dermatitis: irritant, allergic, or chronic. Irritation and contact allergy are closely associated: the irritation facilitates the flowering of the allergy. Skin irritation due to working conditions is often multi-causal and repetitive. Cutaneous atopy--but not that which is only respiratory or mucosal--is the main genetic risk factor for the development of a work-related skin disease. The characteristics of irritation and allergy tend to merge when the lesions become chronic. An 8-step process is suggested to establish the causal relationship between potentially damaging substances in the workplace and the resulting skin problems. In Switzerland, professional dermatitis falls under the purview of the accident insurance laws. These laws recognize causal responsibility whenever the work substances or activities are preponderant over non-professional causes.


The safety of a mixture of bupivacaine and lidocaine in children after urologic inguinal and scrotal surgery.
Local anesthetic agents such as bupivacaine and lidocaine are commonly used after surgery for pain control. The aim of this prospective study was to evaluate the safety of a mixture of bupivacaine and lidocaine in children who underwent urologic inguinal and scrotal surgery. Fifty-five patients who underwent pediatric urologic outpatient surgeries, were prospectively enrolled in this study. The patients were divided into three groups according to age (group I: under 2 years, group II: between 3-4 years, and group III: 5 years and above). Patients were further sub-divided into unilateral and bilateral groups. All patients were injected with a mixture of 0.5% bupivacaine and 2% lidocaine (2:1 volume ratio) at the surgical site, just before the surgery ended. Hemodynamic and electrocardiographic parameters were measured before local anesthesia, 30 minutes after administration of local anesthesia, and 60 minutes after administration. The patients' mean age was 40.5±39.9 months. All patients had normal hemodynamic and electrocardiographic parameters before local anesthesia, after 30 minutes, and after 60 minutes. Also, results of all intervals were within normal values, when analyzed by age and laterality. No mixture related adverse events (nausea, vomiting, pruritus, sedation, respiratory depression) or those related to electrocardiographic parameters (arrhythmias and asystole) were reported in any patients. A mixture of bupivacaine and lidocaine can be safely used in children undergoing urologic inguinal and scrotal surgery. An appropriate dose has no clinically significant hemodynamic or cardiac changes and adverse effects.


Is color Doppler ultrasonography reliable in diagnosing adnexal torsion? A large cohort analysis.
Color Doppler ultrasonography (CDU) is widely used to diagnose adnexal torsion (AT). However, its validity remains questionable due to its low sensitivity. Our study aimed to evaluate the accuracy of CDU for the preoperative diagnosis of AT. The electronic medical records of patients who were taken to the operating room with the diagnosis of suspected AT were reviewed. Patients having surgically/pathologically-proven AT were compared with patients who were found to have a different pathology at the time of surgery. CDU validity was assessed using a 2 × 2 table and compared with a diagnostic model that consists of the Doppler findings, patient's age, and previous surgical history. AT was diagnosed correctly in 74.6% of cases. Absent Doppler flow was seen in only 18.6% of cases. Although its specificity and positive predictive value were high, CDU had very low sensitivity and negative predictive value. The combined diagnostic model exceeded CDU alone in terms of diagnostic accuracy. The use of CDU alone is not a reliable modality to exclude AT. Absent Doppler flow is a sign of ovarian necrosis. Clinical correlation between CDU findings and the patient's symptoms makes the diagnosis of AT more timely and accurate.


Quantifying error in occurrence data: Comparing the data quality of iNaturalist and digitized herbarium specimen data in flowering plant families of the southeastern United States.
iNaturalist has the potential to be an extremely rich source of organismal occurrence data. Launched in 2008, it now contains over 150 million uploaded observations as of May 2023. Based on the findings of a limited number of past studies assessing the taxonomic accuracy of participatory science-driven sources of occurrence data such as iNaturalist, there has been concern that some portion of these records might be misidentified in certain taxonomic groups. In this case study, we compare Research Grade iNaturalist observations with digitized herbarium specimens, both of which are currently available for combined download from large data aggregators and are therefore the primary sources of occurrence data for large-scale biodiversity/biogeography studies. Our comparisons were confined regionally to the southeastern United States (Florida, Georgia, North Carolina, South Carolina, Texas, Tennessee, Kentucky, and Virginia). Occurrence records from ten plant families (Gentianaceae, Ericaceae, Melanthiaceae, Ulmaceae, Fabaceae, Asteraceae, Fagaceae, Cyperaceae, Juglandaceae, Apocynaceae) were downloaded and scored on taxonomic accuracy. We found a comparable and relatively low rate of misidentification among both digitized herbarium specimens and Research Grade iNaturalist observations within the study area. This finding illustrates the utility and high quality of iNaturalist data for future research in the region, but also points to key differences between data types, giving each a respective advantage, depending on applications of the data.


Bovine Acellular Dermal Matrix-Based Breast Reconstruction in Previously Irradiated Breasts: Complications and Outcomes From a Single-Center Experience.
Radiation therapy is considered today an integral part of the management of breast cancer. However, radiotherapy significantly increases the incidence of total complications in breast reconstruction. Several procedures have been adopted to reduce complication rates in irradiated fields, including the use of acellular dermal matrices (ADMs). We conducted a retrospective analysis of our single-center experience with ADM-assisted implant-based reconstruction or revision surgeries for capsular contracture treatment in irradiated breasts. We divided our population into 4 groups based on prior surgical history: group A (previous quadrantectomy), group B (previous mastectomy and expander reconstruction), group C (previous mastectomy and implant reconstruction), and group D (prior quadrantectomy followed by mastectomy and implant reconstruction). At the European Oncology Institute in Milan, Italy, between June 2017 and April 2019, we identified 84 patients for a total of 86 irradiated breasts reconstructed with implant and ADM. We observed a total of 12 reconstructive failure, with the highest rate of failure in group B (16.6%) and in group D (15.38%). Overall, we recorded 22 total complications (24.4%): 12 major complications and 10 minor complications. The most common complication was infection, with 9 cases (10.4%), 6 of which were classified as severe and required implant removal. In group B, we observed the highest complication rate, both major and minor, with 7 of 42 patients (16.6%) experiencing each. Before reconstruction with ADM, the Baker grade ranged from 3 to 4, with a mean of 3.25. At the 2-year follow-up, the Baker grade ranged from 1 to 4, with a mean of 1.9. Surgeons were highly satisfied with the aesthetic result in 72.1% of cases, moderately in 8.1% and unsatisfied in 5.81%, and in 13.9%, the outcome was not assessable because of reconstructive failure. The worst aesthetic result was in group B. We observed significant reduction in capsular contracture in revision surgeries despite a moderately high rate of complications in previous quadrantectomy and radiotherapy. In our experience, breast reconstruction with implant and ADM is not the primary surgical indication in case of prior irradiation, but it can be considered as a valid alternative with reasonable safety profile, to be used in selected cases.


Ocurrence of male morphotypes of Macrobrachium amazonicum (Caridea, Palaemonidae) in a population with an entirely freshwater life cycle.
This study records, for the first time, the occurrence of all four male morphotypes in a population of Macrobrachium amazonicum from a continental environment, with an entirely freshwater life cycle. The specimens studied came from the Tietê River, state of São Paulo, Brazil, and were collected in a lotic environment downstream from Ibitinga Dam. This population was compared with other continental populations, including a population from the dam itself, collected in a previous study. Four samples of 30 minutes were taken monthly, using a trap, from January to April 2011. Each male specimen was measured with respect to seven body dimensions as follows: carapace length (CL), right cheliped length (RCL), dactyl length (DCL), propodus length (PPL), carpus length (CRL), merus length (ML) and ischium length (IL). The relative growth was analyzed based on the change in growth patterns of certain body parts in relation to the independent variable CL. The four male morphotypes proposed for the species were found using morphological and morphometric analyses. Different biological characteristics were found between the populations studied. The male population of the lake of Ibitinga and from Pantanal presented mean sizes and number of morphotypes lower than the population studied here. These differences seem to be closely related to ecological characteristics of the environments inhabited by these populations. Our results supported the hypothesis that coastal and continental populations of M. amazonicum belong to the same species.


[Results and prognostic factors in the treatment of chronic active hepatitis with prednisone and azathioprine].
Fifty-two patients with active chronic hepatitis (A.C.H.) were treated with prednisone and azathioprine simultaneously. Seventy-three per cent of the patients were cured. Healing was obtained in 94% of the patients who did not reveal necrotic bridging prior to treatment, while only 43% of the patients who had this sign was cured. Eighty-one per cent of the cases with no A- no B active chronic hepatitis was cured, while only in 66% of patients with B A.C.H. remission was obtained. All the Non A- Non B A.C.H. patients who recovered did so in less than 3 years, while only 40% of the B + A.C.H. patients obtained complete remission in the same period of time. The remaining 60% of the B + A.C.H. group recovered in a period ranging from 3 to 12 years. In the B + A.C.H. group 75% patients of the male sex were cured, while only 33% of the females recovered. Active cirrhosis was seen in 7.6% of cases. All of them were B+. Mortality rate was 3.8 and only the B + group was affected. In conclusion it must be remarked that the presence of necrotic bridging, virus B and female sex were the factors that revealed the worst prognosis as response of A.C.H. to the combined treatment of prednisone and azathioprine.


Image segmentation based on GrabCut framework integrating multiscale nonlinear structure tensor.
In this paper, we propose an interactive color natural image segmentation method. The method integrates color feature with multiscale nonlinear structure tensor texture (MSNST) feature and then uses GrabCut method to obtain the segmentations. The MSNST feature is used to describe the texture feature of an image and integrated into GrabCut framework to overcome the problem of the scale difference of textured images. In addition, we extend the Gaussian Mixture Model (GMM) to MSNST feature and GMM based on MSNST is constructed to describe the energy function so that the texture feature can be suitably integrated into GrabCut framework and fused with the color feature to achieve the more superior image segmentation performance than the original GrabCut method. For easier implementation and more efficient computation, the symmetric KL divergence is chosen to produce the estimates of the tensor statistics instead of the Riemannian structure of the space of tensor. The Conjugate norm was employed using Locality Preserving Projections (LPP) technique as the distance measure in the color space for more discriminating power. An adaptive fusing strategy is presented to effectively adjust the mixing factor so that the color and MSNST texture features are efficiently integrated to achieve more robust segmentation performance. Last, an iteration convergence criterion is proposed to reduce the time of the iteration of GrabCut algorithm dramatically with satisfied segmentation accuracy. Experiments using synthesis texture images and real natural scene images demonstrate the superior performance of our proposed method.


Effect of pulvinar lesions on visual pattern discrimination in monkeys.
This study compares the performance (percent correct responses and reaction times) of three unoperated control monkeys with the postoperative performance of eight monkeys with pulvinar lesions, either inferior pulvinar or medial and lateral pulvinar, on a tachistoscopically presented visual pattern-discrimination task highly demanding of attention. To further emphasize and assess the attentional factor in visual pattern discrimination, all monkeys who attained criterion performance (90% correct response on three consecutive sessions of 100 trials each) were tested for the effects of visually distracting interference stimuli added to the original discriminative stimuli. In addition, retention of postoperatively learned discriminations was tested after a 6-wk interval withou training and compared with the performance of control monkeys. Four monkeys with only inferior pulvinar lesions and one monkey with inferior pulvinar plus medial and lateral pulvinar lesions were markedly impaired in the postoperative learning of a visual pattern discrimination. Three of these monkeys failed to acquire criterion perfromance in 9,000 or more training trials, while two learned to ceiterion level only after prolonged training (7,400 and 6,900 trials). In contrast, monkeys with medial and lateral pulvinar lesions showed no deficit in learning ability compared to unoperated control monkeys. Furthermore, the performance of the two monkeys with inferior pulvinar lesions, who attained the criterion level of learning only with difficulty, was further impaired by the addition of distracting interference stimuli, where the performance of monkeys with medial and lateral pulvinar lesions as well as the control monkeys was only temporarily disrupted by this procedure. None of the monkeys with pulvinar lesions, who were tested for retention of the postoperatively learned discrimination, showed appreciable deficits in comparison to control monkeys. All monkeys, including controls and those uith pulvinar lesions who were able to learn the visual pattern discrimination, showed a common pattern of reaction time (RT) change during the course of the learning; that is, RT was low during change-level performance, increased during learning, and decreased once criterion performance was achieved. Reaction times of monkeys with inferior pulvinar lesions tended to be longer than for controls or for those with medial and lateral pulvinar lesions. These results provide the first behavior evidence that the inferior pulvinar of monkeys is involved in visual pattern discrimination and add further support to the concept of a second visual system in which the inferior pulvinar plays a role. The attentional aspects of the visual pattern-discrimination task employed in this study and the additional effects obtained with distracting stimuli suggest that the impairments arising from inferior pulvinar lesions may be dependent in part on visual attentional factors.


An integrated stroke model with a consistent penumbra for the assessment of neuroprotective interventions.
A longer period of vessel occlusion reduces the coefficient of variation of the infarct lesion size ['infarct variation coefficient' (IVC)] due to a gradual expansion of the lesion within a limited territory defined by the vascular anatomy, but it increases the mortality rate. A crucial issue in the induction of experimental focal cerebral ischemia has been to achieve a low IVC value and a low mortality rate. We attempted to improve IVC and mortality using the 3-vessel occlusion model. We introduced a new, transtemporal fascia approach to expose the zygomatic arch, in which the fascia of the temporal muscle is cut and retracted dorsally together with the facial nerve and the vein en bloc. The approach avoided traumatic venous bleeding around the zygomatic arch. We established a bloodless model of focal ischemia that can produce a consistent degree of reduction in the regional cerebral blood flow within the ischemic penumbra. The model, characterized by a 15-min ischemia, an IVC of 15-21%, and low mortality after ischemia, is expected to produce reliable preclinical evidence in the assessment of neuroprotective interventions for ischemic stroke. The entire procedure is presented in the online supplementary video (www. karger.com/doi/10.1159/000356048).


Genomic DNA enrichment using sequence capture microarrays: a novel approach to discover sequence nucleotide polymorphisms (SNP) in Brassica napus L.
Targeted genomic selection methodologies, or sequence capture, allow for DNA enrichment and large-scale resequencing and characterization of natural genetic variation in species with complex genomes, such as rapeseed canola (Brassica napus L., AACC, 2n=38). The main goal of this project was to combine sequence capture with next generation sequencing (NGS) to discover single nucleotide polymorphisms (SNPs) in specific areas of the B. napus genome historically associated (via quantitative trait loci -QTL- analysis) to traits of agronomical and nutritional importance. A 2.1 million feature sequence capture platform was designed to interrogate DNA sequence variation across 47 specific genomic regions, representing 51.2 Mb of the Brassica A and C genomes, in ten diverse rapeseed genotypes. All ten genotypes were sequenced using the 454 Life Sciences chemistry and to assess the effect of increased sequence depth, two genotypes were also sequenced using Illumina HiSeq chemistry. As a result, 589,367 potentially useful SNPs were identified. Analysis of sequence coverage indicated a four-fold increased representation of target regions, with 57% of the filtered SNPs falling within these regions. Sixty percent of discovered SNPs corresponded to transitions while 40% were transversions. Interestingly, fifty eight percent of the SNPs were found in genic regions while 42% were found in intergenic regions. Further, a high percentage of genic SNPs was found in exons (65% and 64% for the A and C genomes, respectively). Two different genotyping assays were used to validate the discovered SNPs. Validation rates ranged from 61.5% to 84% of tested SNPs, underpinning the effectiveness of this SNP discovery approach. Most importantly, the discovered SNPs were associated with agronomically important regions of the B. napus genome generating a novel data resource for research and breeding this crop species.


Exploring educational and social inequality through the polyphonic voices of the poor: A habitus listening guide for the analysis of family-schooling relations.
The aim of this methodological article is to contribute a new form of qualitative data analysis that is relevant for the comparative study of family cultures and schooling. We describe the development of our Habitus Listening Guide linking Bourdieu's theory of social reproduction to critical narrative theory. The interpretative tool outlines (a) social-structural (b) horizontal intergenerational (c) vertical gender and (d) mythic-ritual listenings which can be used to explore the engagement of youth and their families with schooling. Such listenings reveal the dispositional positioning of schooling in family values and the complex structural and human relational effects of schooling on family members' livelihood and wellbeing. It offers the possibility of comparing families in terms of their gendered and generational relations and the ways in which religious and mythic-ritual discourses legitimate their aspirations in the context of changing communities. The Guide offers a way of accessing and comparing subjective micro level experiences of social inequality and the contribution that schooling plays, or is expected to play, in relation to individual and/or family social mobility.


Biometric Indicators for Maximizing Intermediate Vision with a Monofocal IOL.
To determine refractive or biometric variables that might be predictive of increased intermediate vision in patients receiving an Eyhance monofocal intraocular lens (IOL). This prospective, single-center, bilateral, non-randomized, open-label, observational study included a total of 110 subjects (220 eyes). Subjects had been previously bilaterally implanted with an Eyhance monofocal IOL (Johnson & Johnson Vision Care, Inc.) and were later divided into 2 groups based on their postoperative visual acuity. Subjects that had binocular distance corrected intermediate visual acuity (DCIVA) of 0.2 logMAR or better were classified into the Enhanced Group, and the remaining subjects were classified into the Non-Enhanced Group. Refractive outcomes and biometric measurements were compared between groups. The number of subjects in each group was 61 for the Enhanced Group, and 49 for the Non-Enhanced Group. There were significant differences in pupil size between groups, with pupil sizes in the Enhanced Group significantly smaller than in the Non-Enhanced Group (p < 0.01). Subjects also reported significantly more dysphotopsias in the Non-Enhanced Group compared to the Enhanced Group (p = 0.03). Multiple regression analysis identified pupil size and axial length as significant predictors of increased monocular intermediate vision. The results of this study suggest that pupil size could be a predictor of increased intermediate vision in a patient receiving an Eyhance monofocal IOL.