Neurogenic tumors of the stomach. Report of 18 cases and review of the literature.
The general and radiologic features of neurogenic tumors of the stomach are reviewed in connection with 18 cases (16 benign and 2 malignant tumors). Such neurogenic tumors are rare in the stomach, representing less than 0.5% of all tumors. Solitary neurogenic tumors must be differentiated from those encountered during von Recklinghausen's disease. Radiological or endoscopic examination can generally determine the benign or malignant nature of solitary neurogenic tumors, which are essentially represented by schwannomas. Since these tumors are submucosal, a deep biopsy is imperative; furthermore, since such tumors are subject to hemorrhage, prior investigation by CT appears advisable to detect possible hypervascularization after injection of contrast material. For patients with von Recklinghausen's disease, a neurofibroma is usually diagnosed when faced with a digestive hemorrhage. Radiological exploration of the entire digestive tract appears essential to confirm the solitary nature of the gastric lesion and to be sure it is responsible for the clinical symptoms.


The effectivity of periprostatic nerve blockade for the pain control during transrectal ultrasound guided prostate biopsy.
Transrectal ultrasound (TRUS) guided prostete biopsy is accepted as a standard procedure in the diagnosis of prostate cancer. Many different protocoles are applied to reduce the pain during the process. In this study we aimed to the comparison of two procedure with intrarectal lidocaine gel and periprostatice nerve blockade respective- ly in addition to perianal intrarectal lidocaine gel on the pain control in prostate biop- sy by TRUS. 473 patients who underwent prostate biopsy guided TRUS between 2008-2012 were included in the study. 10-point linear visual analog pain scale(VAS) was used to evaluate the pain during biopsy. The patients were divided into two groups according to anesthesia procedure. In Group 1, there were 159 patients who had perianal-intrarectal lidocaine gel, in Group 2 there were 314 patients who had periprostatic nerve blockade in addition to intrarectal lidocain gel. The pain about probe manipulation was aseesed by VAS-1 and during the biopsy needle entries was evalu- ated by VAS-2. Results were compared with Mann-Whitney U and Pearson chi-square test. Mean VAS-2 scores in Group 1 and Group 2 were 4.54 ± 1.02 and 2.06 ± 0.79 respectively. The pain score was determined significantly lower in the Group 2 (p = 0.001). In both groups there was no significant difference in VAS-1 scores, patient's age, prostate volume, complication rate and PSA level. The combination of periprostatic nerve blockade and intrarectal lidocain gel provides a more meaningful pain relief compared to group of patients undergoing intrarectal lidocaine gel.


Increased sensitivity to stress in spontaneous recurrence of methamphetamine psychosis: noradrenergic hyperactivity with contribution from dopaminergic hyperactivity.
The significance of increased sensitivity to stress associated with noradrenergic hyperactivity involving dopaminergic change in spontaneous recurrences of methamphetamine (MAP) psychosis (flashbacks) was examined. Plasma monoamine metabolite levels were assayed in 18 subjects with flashbacks who had been exposed to stressful events plus MAP-induced frightening psychotic symptoms (N = 11) or frightening psychotic symptoms alone (N = 7) during previous MAP use, in 15 nonflashbackers with a history of MAP psychosis, in 8 subjects with persistent MAP psychosis, and in 27 control subjects. Monoaminergic values were subjected to a square-root transformation, rendering the distribution normal. The numbers of stressful events (mostly threatening events) and frightening psychotic symptoms were significantly higher in the flashbackers than in the nonflashbackers. Factors triggering flashbacks were mild psychosocial stressors (mostly a mild fear of other people). During flashbacks, plasma norepinephrine levels increased, and the flashbackers, 11 of whom had experienced stressful events plus frightening psychotic symptoms, had an additional small increase in plasma levels of 3-methoxytyramine, which is indicative of dopamine release. Thus, threatening stressful events, together with MAP use, may induce noradrenergic hyperreactivity to subsequent mild stressors. Threatening, stressful events plus frightening psychotic symptoms may further induce increased dopamine release in response to mild stressors. Increased sensitivity to stress associated with noradrenergic hyperactivity involving increased dopamine release may have elicited memories of MAP psychosis related to frightening, stressful experiences. The increased sensitivity may be critical for the development of flashbacks.


The degree to which physiotherapy literature includes physical activity as a component of health promotion in practice and entry level education: a scoping systematic review.
Physiotherapists are well positioned to use physical activity as a health promotion (HP) strategy. This review examines the degree to which physiotherapy literature includes physical activity as a component of HP in practice and education. Databases PubMed, Science Direct, CINAHL, Amed and Pedro were searched using a combination of keywords. If title, abstract or keywords were relevant, we proceeded to do a complete review. Only peer reviewed English work covering original research was included. Discussion and opinion papers, reviews, epidemiological studies, case studies or work not specifically addressing integration of HP were excluded. The information from 29 source articles was synthesized under the headings of acceptability of the HP role to physiotherapists and physiotherapy students; integration of HP into physiotherapy practice; HP interventions in physiotherapy practice; and HP in physiotherapy education and training. The findings were heterogenous, thereby limiting this review study to a scoping review. More interventional research is needed to develop efficacious strategies integrating physical activity as a HP strategy in physiotherapy practice. Contemporary physiotherapy entry-level education curricula need benchmark standards for HP training such as physical activity.


Circulating leukocyte heat shock protein 70 (HSP70) and oxidative stress markers in rats after a bout of exhaustive exercise.
A novel method to measure oxidative stress resulting from exhaustive exercise in rats is presented. In this new procedure we evaluated the erythrocyte antioxidant enzymes, catalase (CAT) and glutathione reductase (GR), the plasma oxidative attack markers, reactive carbonyl derivatives (RCD) and thiobarbituric reactive substances (TBARS). Muscular tissue damage was evaluated by monitoring plasma creatine kinase (CK) and plasma taurine (Tau) concentrations. Also, we monitored total sulphydryl groups (TSG) and uric acid (UA), and the level of the 70 kDa heat shock protein (HSP70) in leukocytes as a marker of oxidative stress. In the study we found a correspondence between erythrocyte CAT and GR activities and leukocyte HSP70 levels, principally 3 h after the acute exercise, and this suggested an integrated mechanism of antioxidant defense. The increase in levels of plasma Tau was coincident with the increasing plasma levels of CK and TBARS, principally after two hours of exercise. Thus tissue damage occurred before the expression of any anti-oxidant system markers and the monitoring of Tau, CK or TBARS may be important for the estimation of oxidative stress during exhaustive exercise. Furthermore, the integrated analyses could be of value in a clinical setting to quantify the extent of oxidative stress risk and reduce the need to perform muscle biopsies as a tool of clinical evaluation.


[Quality of life concept evolution: the subjective dimension as a relevant factor on drug addiction].
to analyze the Quality of Life Concept, is which currently used in drug addiction. We reviewed the studies published until April 2010, using two international databases: PubMed (key words: quality of life, addiction, drug dependence and dual diagnosis) and the Web of Knowledge (search by author). We identified 479 papers on quality of life and drugs abuse, of which were on: quality of life and addictions (433) and quality of life and dual pathology (37). the quality of life concept has evolved, from the forties decade till the present time, remains controversial and still subject to change. Most authors accept the multidimensionality of the quality of life concept, that includes the physical/biological, psychological and social dimension. Currently the patient's satisfaction concept is emerging. On the other hand, it is known that there are discrepancies in the patient's and therapist's view on the patient's quality of life, especially in dually diagnosed patients. The conceptual study of the quality of life is important. Quality of life components, as the perception of the disease, have been associated with treatment adherence and the disease's progress. For the previous reasons we believe. Quality of Life should be included in the regular evaluation.


Brain dysfunction in tubular and tubulointerstitial kidney diseases.
Kidney function has two important elements: glomerular filtration and tubular function (secretion and reabsorption). A persistent decrease in glomerular filtration rate (GFR), with or without proteinuria, is diagnostic of chronic kidney disease (CKD). While glomerular injury or disease is a major cause of CKD and usually associated with proteinuria, predominant tubular injury, with or without tubulointerstitial disease, is typically non-proteinuric. CKD has been linked with cognitive impairment, but it is unclear how much this depends on a decreased GFR, altered tubular function or the presence of proteinuria. Since CKD is often accompanied by tubular and interstitial dysfunction, we explore here for the first time the potential role of the tubular and tubulointerstitial compartments in cognitive dysfunction. To help address this issue we selected a group of primary tubular diseases with preserved GFR in which to review the evidence for any association with brain dysfunction. Cognition, mood, neurosensory and motor disturbances are not well characterized in tubular diseases, possibly because they are subclinical and less prominent than other clinical manifestations. The available literature suggests that brain dysfunction in tubular and tubulointerstitial diseases is usually mild and is more often seen in disorders of water handling. Brain dysfunction may occur when severe electrolyte and water disorders in young children persist over a long period of time before the diagnosis is made. We have chosen Bartter and Gitelman syndromes and nephrogenic diabetes insipidus as examples to highlight this topic. We discuss current published findings, some unanswered questions and propose topics for future research.


Theoretical analysis of error propagation in triple-energy absorptiometry: application to measurement of lead in bone in vivo.
We propose a three component tissue decomposition for quantifying lead in bone from a mixture of bone and muscle in vivo using a triple-energy absorptiometric method. The theoretical optimization of this method, by relating signal uncertainty to radiation dose, requires an expression of the signal variance. The error propagation was therefore theoretically modeled for a counting detector, assuming noise dominance by quantum statistics and neglecting covariance between energy levels. A final expression for the lead signal variance at each energy level was obtained via a Jacobian matrix. The Jacobian was maximized by choosing the first energy as low as permissible by dose constraints below the lead K edge. A second optimum was achieved when the upper energy was just above and the middle energy was just below the lead K edge. While the signal-to-noise ratio (SNR) had similar behavior to that of the Jacobian as a function of middle and upper energies, the SNR was almost constant as a function of lower energy in the 40-60 keV range. Hence, dose could be reduced without SNR loss. A simulated clinical measurement on an adult tibia using a 50 mCi 155Eu source and a 10 min acquisition time resulted in a standard deviation of 4 micrograms Pb/g bone mass. This approach can be applied to other systems containing three components, provided there is a K edge within the counting energy range.


Characteristics of the labile neurotoxin associated with nervous coccidiosis.
Reported are the results of preliminary attempts to characterize the molecular weight, heat sensitivity and other features of a labile neurotoxin identified in the serum of calves exhibiting neurological signs in association with coccidial enteritis. The labile neurotoxin activity is heat labile (60 degrees C for 30 min) and is lost upon exposure to acidic pH (5.5) and cysteine (1.75 g/100 mL serum). Activity can be recovered from the precipitate of a 30% wt/vol solution of (NH4)2SO4 in serum. Ultrafiltration trials suggest that labile neurotoxin activity may be linked to a molecule of over 300,000 MW.


Research on the Professional Mentality of Hengdian Drifter's.
Hengdian drifters refer to outsiders who participate in shooting film and television dramas in Hengdian. It is a special group. Single access to information, precarious nature of work, unequal treatment of gender, constraints on development, and inadequate guarantee mechanisms are all to blame. This paper proposes to improve the ecology of the different actor industries by implementing a precise assessme. This study combines qualitative and quantitative research, adopts the questionnaire survey and semi-structured interview, and carries out fieldwork by personally experiencing the life of extras to study the ecological environment of the different actor industries and the professional mentality of extras. Before participating in the study, every participant would be offered an Informed Consent Form and all particpants were guaranteed anonymity and their response will be used for a specific academic study. The Ethics Committee of the Zhejiang Normal University's, Specific academic study that will be published online. College of Teacher Education approved the study and participation of concents under 18 and the study followed the Declaration of Helsinki. There are gaps in social support.Little relevant policy support and financial support have not been implemented. Industry assessment criteria are not standardized.The level of digital management is low.It is difficult to guarantee the rights of mass actors. Implement a precise assessment system,develop a refined talent evaluation mechanism,Ensure the accuracy and transparency of the evaluation process.Establish digital service platforms,provide a new channel for the employment of artistic talents.Strengthen media publicity,strengthen policy support,raise social awareness.


Predictors of Visual Acuity Outcomes Following Vitrectomy for Idiopathic Macular Hole.
To investigate predictors of visual outcomes in patients who underwent vitrectomy for full-thickness macular hole (FTMH) with at least 1 year of follow-up. Retrospective, noncomparative, consecutive case series of 132 eyes of 122 patients who underwent surgical repair of idiopathic FTMH with at least 1 year of follow-up. Predictors of visual acuity (VA) outcomes were analyzed using linear regression. Mean follow-up time was 22.2 months. Twenty-three eyes (17.4%) had age-related macular degeneration (AMD), of which 17 (73.9%) cases were mild and nonexudative. At final follow-up, poor preoperative VA (P < .001), perioperative complications (P < .001), AMD (P < .001), and delay from preoperative evaluation to surgery (P = .037) were significant predictors of final VA. In multiple regression, these variables remained significant (P < .001, P = .011, P < .001, and P = .002, respectively). Poor preoperative VA, perioperative complications, AMD, and delay to surgery were significant predictors of final VA following FTMH repair. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:566-570.].


Hormonal and metabolic response to recombinant human tumor necrosis factor in rat: in vitro and in vivo.
Tumor necrosis factor (TNF; cachectin) has been implicated as a mediator of the toxic manifestations of overwhelming bacterial infection as well as the chronic catabolic state of cancer cachexia. We have examined the acute metabolic and hormonal response after administration of recombinant human TNF in the rat. TNF given by intraperitoneal injection produced dose- and time-related increases in hepatic amino acid uptake, decreases in serum trace metal concentrations, and a pattern of endocrine hormone alterations characteristic of the acute phase response to tissue injury. In vitro zinc transport studies by rat hepatocytes cultured in the presence of TNF alone, or in combination with recombinant human interleukin 1, another mediator of the acute phase response, demonstrated that neither monokine was capable of directly stimulating zinc transport into cells. These findings suggest that TNF may function as an endogenous mediator of the early metabolic response to sepsis and that the trace metal changes induced by TNF in vivo may occur through a secondary mechanism.


Prospects for Future Methodological Development and Application of Magnetoencephalography Devices in Psychiatry.
Magnetoencephalography (MEG) is a functional neuroimaging tool that can record activity from the entire cortex on the order of milliseconds. MEG has been used to investigate numerous psychiatric disorders, such as schizophrenia, bipolar disorder, major depression, dementia, and autism spectrum disorder. Although several review papers on the subject have been published, perspectives and opinions regarding the use of MEG in psychiatric research have primarily been discussed from a psychiatric research point of view. Owing to a newly developed MEG sensor, the use of MEG devices will soon enter a critical period, and now is a good time to discuss the future of MEG use in psychiatric research. In this paper, we will discuss MEG devices from a methodological point of view. We will first introduce the utilization of MEG in psychiatric research and the development of its technology. Then, we will describe the principle theory of MEG and common algorithms, which are useful for applying MEG tools to psychiatric research. Next, we will consider three topics-child psychiatry, resting-state networks, and cortico-subcortical networks-and address the future use of MEG in psychiatry from a broader perspective. Finally, we will introduce the newly developed device, the optically-pumped magnetometer, and discuss its future use in MEG systems in psychiatric research from a methodological point of view. We believe that state-of-the-art electrophysiological tools, such as this new MEG system, will further contribute to our understanding of the core pathology in various psychiatric disorders and translational research.


Videofluoroscopic findings in dysphagic patients with cricopharyngeal dysfunction: before and after open cricopharyngeal myotomy.
Functional outcomes after open cricopharyngeal myotomy (CPM) for Zenker's diverticulum (ZD) and cricopharyngeal dysfunction without diverticulum (CPD) have not been uniformly measured by videofluorographic swallow study (VFSS). Here we characterize preoperative VFSS findings in these groups and evaluate the effect of CPM on swallowing via postoperative VFSS. We performed a retrospective review of paired preoperative and postoperative VFSS results from 50 patients (36 with ZD and 14 with CPD) over 6 years. Semiquantitative scales were used to assess 1) degree of stasis in the pharyngeal recesses; 2) degree of narrowing at the pharyngoesophageal sphincter (PES); 3) aspiration; and 4) diverticular size. Findings were compared between the groups and across subjects. Pharyngeal stasis was more severe in subjects with CPD than in subjects with ZD, both before and after CPM (p = .02 and p = .0002, respectively). The CPM improved PES narrowing in both groups (p = .03; p = .06) and reduced diverticular size in the ZD group (p < .001), but it did not significantly reduce the stasis severity or the proportion of patients with aspiration. According to VFSS, CPM opens up the PES and decreases diverticular size. More severe stasis in CPD suggests that diffuse pharyngeal weakness may play a role in this disease, and may partially explain the variable post-CPM outcomes that have been observed in CPD.


Cobaltoceniumethynyl gold(I) as an unusual heterodinuclear bioorganometallic fragment to study the biological properties of alkynyl gold complexes.
A cobaltoceniumethynyl gold(i) complex with a triphenylphosphane ligand triggered efficient cytotoxic effects in cancer cells in contrast to a derivative with two cobaltocenium moieties. The complex effectively inhibited the enzyme thioredoxin reductase (TrxR) suggesting this enzyme as a possible biological target. The cellular uptake of both metal fragments of the active complex was studied by atomic absorption spectroscopy and indicated a high biological stability of the complex.


Improving artificial intelligence pipeline for liver malignancy diagnosis using ultrasound images and video frames.
Recent developments of deep learning methods have demonstrated their feasibility in liver malignancy diagnosis using ultrasound (US) images. However, most of these methods require manual selection and annotation of US images by radiologists, which limit their practical application. On the other hand, US videos provide more comprehensive morphological information about liver masses and their relationships with surrounding structures than US images, potentially leading to a more accurate diagnosis. Here, we developed a fully automated artificial intelligence (AI) pipeline to imitate the workflow of radiologists for detecting liver masses and diagnosing liver malignancy. In this pipeline, we designed an automated mass-guided strategy that used segmentation information to direct diagnostic models to focus on liver masses, thus increasing diagnostic accuracy. The diagnostic models based on US videos utilized bi-directional convolutional long short-term memory modules with an attention-boosted module to learn and fuse spatiotemporal information from consecutive video frames. Using a large-scale dataset of 50 063 US images and video frames from 11 468 patients, we developed and tested the AI pipeline and investigated its applications. A dataset of annotated US images is available at https://doi.org/10.5281/zenodo.7272660.


Future climate response to Antarctic Ice Sheet melt caused by anthropogenic warming.
Meltwater and ice discharge from a retreating Antarctic Ice Sheet could have important impacts on future global climate. Here, we report on multi-century (present-2250) climate simulations performed using a coupled numerical model integrated under future greenhouse-gas emission scenarios IPCC RCP4.5 and RCP8.5, with meltwater and ice discharge provided by a dynamic-thermodynamic ice sheet model. Accounting for Antarctic discharge raises subsurface ocean temperatures by >1°C at the ice margin relative to simulations ignoring discharge. In contrast, expanded sea ice and 2° to 10°C cooler surface air and surface ocean temperatures in the Southern Ocean delay the increase of projected global mean anthropogenic warming through 2250. In addition, the projected loss of Arctic winter sea ice and weakening of the Atlantic Meridional Overturning Circulation are delayed by several decades. Our results demonstrate a need to accurately account for meltwater input from ice sheets in order to make confident climate predictions.


[Extended-spectrum beta-lactamase production and antimicrobial resistance patterns of Klebsiella pneumoniae strains isolated from nosocomial bacteremic patients: evaluation of the results of 2001-2005 period].
Extended spectrum beta-lactamase (ESBL) producing Klebsiella pneumoniae is a global health problem. This study was aimed to retrospectively evaluate the resistance patterns of K. pneumoniae strains, microbiologically proven as agents of nosocomial bacteremia, between 2001-2005 and also to compare the 2001-2002 and 2004-2005 data to investigate the effect of 2003 budget application on antimicrobial resistance in our country. Data of antimicrobial resistance and hospital admission dates were extracted from the hospital patient record database. 2003 data was excluded to better evaluate the probable effect of governmental antibiotic restriction policy, which was started in March 2003. Blood cultures were performed on Bact/Alert (bioMerieux, Durham, NC) automated system and bacterial identifications were done by conventional methods. Double or more isolates during each episode were counted as one episode. Antibacterial susceptibility testing was done by disc diffusion method according to the recommendations of Clinical Laboratory Standards Institute. Resistance patterns in the 2001-2002 and 2004-2005 periods were compared by chi-square test. No resistance to carbapenems were detected in the strains. The comparison of 2001-2002 and 2004-2005 periods revealed that resistance to amikacin (30% and 19%, respectively), cefuroxime (55% and 37%, respectively), amoxycillin/clavulonate (59% and 46%, respectively), piperacillin/tazobactam (51% and 39%, respectively) and cotrimoxazole (53% and 35%, respectively) were decreased significantly (p < 0.05). The rate of ESBL K. pneumoniae strains was 49% in 2001-2002 period while it decreased to 35% in 2004-2005 period (p < 0.025). The decrease in the resistance rates after the 2003 budget application suggested that this success could be attributed to the evaluation of each patient to be given an extended spectrum antibiotic, by an infectious disease specialist and also more active use of the clinical microbiology laboratory.


Self-care under war conditions. The case of Beirut, Lebanon.
This article attempts to explain the choice of treatment plan made by individuals as a result of a perceived health problem in a war-afflicted population. The prevalence of self-care in Beirut was measured and the characteristics of individuals who choose self-care versus other responses to an illness determined. The study population consisted of all individuals who experienced an ailment during the 2-week period prior to the interview (N = 1,392). Using certain sociodemographic, economic, and need factors as the independent variables and the use of home remedies as the dependent variable, a series of t-tests and Multiple Classification Analysis were performed separately on two age groups. Overall, Beirut residents were found to use home remedies rather extensively. Among individuals younger than 18 years, the type of household, religion, intake of medicine on a regular basis, and the type of ailment were significant predictors of the use of self-care. In the older age group, however, only the last two need variables were significantly related to the use of home remedies.


Positive symptoms and white matter microstructure in never-medicated first episode schizophrenia.
We investigated cerebral structural connectivity and its relationship to symptoms in never-medicated individuals with first-onset schizophrenia using diffusion tensor imaging (DTI). We recruited subjects with first episode DSM-IV schizophrenia who had never been exposed to antipsychotic medication (n=34) and age-matched healthy volunteers (n=32). All subjects received DTI and structural magnetic resonance imaging scans. Patients' symptoms were assessed on the Positive and Negative Syndrome Scale. Voxel-based analysis was performed to investigate brain regions where fractional anisotropy (FA) values significantly correlated with symptom scores. In patients with first-episode schizophrenia, positive symptoms correlated positively with FA scores in white matter associated with the right frontal lobe, left anterior cingulate gyrus, left superior temporal gyrus, right middle temporal gyrus, right middle cingulate gyrus, and left cuneus. Importantly, FA in each of these regions was lower in patients than controls, but patients with more positive symptoms had FA values closer to controls. We found no significant correlations between FA and negative symptoms. The newly-diagnosed, neuroleptic-naive patients had lower FA scores in the brain compared with controls. There was positive correlation between FA scores and positive symptoms scores in frontotemporal tracts, including left fronto-occipital fasciculus and left inferior longitudinal fasciculus. This implies that white matter dysintegrity is already present in the pre-treatment phase and that FA is likely to decrease after clinical treatment or symptom remission.


Large herbivores in a partially migratory population search for the ideal free home.
Migration is a tactic used across taxa to access resources in temporally heterogenous landscapes. Populations that migrate can attain higher abundances because such movements allow access to higher quality resources, or reduction in predation risk resulting in increased fitness. However, most migratory species occur in partially migratory populations, a mix of migratory and non-migratory individuals. It is thought that the portion of migrants in a partial migration population is maintained either through (1) a population-level evolutionary stable state where counteracting density-dependent vital rates act on migrants and residents to balance fitness or (2) conditional migration, where the propensity to migrate is influenced by the individual's state. However, in many respects, migration is also a form of habitat selection and the proportion of migrants and residents may be the result of density-dependent habitat selection. Here, we test whether the theory of Ideal Free Distribution (IFD) can explain the coexistence of different migratory tactics in a partially migratory population. IFD predicts individuals exhibit density-dependent vital rates and select different migratory tactics to maximize individual fitness resulting in equal fitness (λ) between tactics. We tested the predictions of IFD in a partially migratory elk population that declined by 70% with 19 years of demographic data and migratory tactic switching rates from >300 individuals. We found evidence of density dependence for resident pregnancy and adult female survival providing a fitness incentive to switch tactics. Despite differences in vital rates between migratory tactics, mean λ (fitness) was equal. However, as predicted by the IFD, individuals switched tactics toward those of higher fitness. Our analysis reveals that partial migration may be driven by tactic selection that follows the ideal free distribution. These findings reinforce that migration across taxa may be a polymorphic behavior in large herbivores where migratory tactic selection is determined by differential costs and benefits, mediated by density dependence.


The Breast and Cervical Cancer Early Detection Program, Medicaid, and breast cancer outcomes among Ohio's underserved women.
As an organized screening program, the national Breast and Cervical Cancer Early Detection Program (BCCEDP) was launched in the early 1990s to improve breast cancer outcomes among underserved women. To analyze the impact of the BCCEDP on breast cancer outcomes in Ohio, this study compared cancer stages and mortality across BCCEDP participants, Medicaid beneficiaries, and "all others." This study linked data across the Ohio Cancer Incidence Surveillance System, Medicaid, the BCCEDP database, death certificates, and the US Census and identified 26,426 women aged 40 to 64 years who had been diagnosed with incident invasive breast cancer during the years 2002-2008 (deaths through 2010). The study groups were as follows: BCCEDP participants (1-time or repeat users), Medicaid beneficiaries (women enrolled in Medicaid before their cancer diagnosis [Medicaid/prediagnosis] or around the time of their cancer diagnosis [Medicaid/peridiagnosis]), and all others (women identified as neither BCCEDP participants nor Medicaid beneficiaries). The outcomes included advanced-stage cancer at diagnosis and mortality. A multivariable logistic and survival analysis was conducted to examine the independent association between the BCCEDP and Medicaid status and the outcomes. The percentage of women presenting with advanced-stage disease was highest among women in the Medicaid/peridiagnosis group (63.4%) and lowest among BCCEDP repeat users (38.6%). With adjustments for potential confounders and even in comparison with Medicaid/prediagnosis beneficiaries, those in the Medicaid/peridiagnosis group were twice as likely to be diagnosed with advanced-stage disease (adjusted odds ratio, 2.20; 95% confidence interval, 1.83-2.66). Medicaid/peridiagnosis women are at particularly high risk to be diagnosed with advanced-stage disease. Efforts to reduce breast cancer disparities must target this group of women before they present to Medicaid. Cancer 2017;123:3097-106. © 2017 American Cancer Society.


Abundance and Biogeochemical Impact of Cable Bacteria in Baltic Sea Sediments.
Oxygen depletion in coastal waters may lead to release of toxic sulfide from sediments. Cable bacteria can limit sulfide release by promoting iron oxide formation in sediments. Currently, it is unknown how widespread this phenomenon is. Here, we assess the abundance, activity, and biogeochemical impact of cable bacteria at 12 Baltic Sea sites. Cable bacteria were mostly absent in sediments overlain by anoxic and sulfidic bottom waters, emphasizing their dependence on oxygen or nitrate as electron acceptors. At sites that were temporarily reoxygenated, cable bacterial densities were low. At seasonally hypoxic sites, cable bacterial densities correlated linearly with the supply of sulfide. The highest densities were observed at Gulf of Finland sites with high rates of sulfate reduction. Microelectrode profiles of sulfide, oxygen, and pH indicated low or no in situ cable bacteria activity at all sites. Reactivation occurred within 5 days upon incubation of an intact sediment core from the Gulf of Finland with aerated overlying water. We found no relationship between cable bacterial densities and macrofaunal abundances, salinity, or sediment organic carbon. Our geochemical data suggest that cable bacteria promote conversion of iron monosulfides to iron oxides in the Gulf of Finland in spring, possibly explaining why bottom waters in this highly eutrophic region rarely contain sulfide in summer.


Mathematical diffraction of aperiodic structures.
Kinematic diffraction is well suited for a mathematical approach via measures, which has substantially been developed since the discovery of quasicrystals. The need for further insight emerged from the question of which distributions of matter, beyond perfect crystals, lead to pure point diffraction, hence to sharp Bragg peaks only. More recently, it has become apparent that one also has to study continuous diffraction in more detail, with a careful analysis of the different types of diffuse scattering involved. In this review, we summarise some key results, with particular emphasis on non-periodic structures. We choose an exposition on the basis of characteristic examples, while we refer to the existing literature for proofs and further details.


Acute neurogenic airway plasma exudation and edema induced by inhaled wood smoke in guinea pigs: role of tachykinins and hydroxyl radical.
We studied the mechanisms underlying the wood smoke-induced acute airway injury in 120 anaesthetized guinea pigs. Five minutes after airway exposure, various doses of wood smoke produced a dose-dependent increase in Evans blue dye contents at all airway levels measured. Additionally, inhaled wood smoke produced submucosal edema of the trachea and bronchus, and peribronchial edema. These acute airway responses were nearly abolished by pretreatment with CP-96,345 alone [a tachykinin NK(1) receptor antagonist; (2S, 3S)-cis-2-(diphenylmethyl)-N-((2-methoxyphenyl)-methyl)-1-azabicyc lo( 2.2.2.)-octan-3-amine] or with a combination of CP-96,345 and dimethylthiourea (a hydroxyl radical scavenger), and were attenuated by pretreatment with dimethylthiourea alone, yet were not affected by pretreatment with SR-48,968 [a tachykinin NK(2) receptor antagonist; (S)-N-methyl-N(4-(4-acetylamino-4-phenylpiperidino)-2-(3, 4-dichlorophenyl)-butyl)benzamide], with a combination of CP-96,344 and SR-48,965 (inactive enantiomers), with MK-886 [a leukotriene biosynthesis inhibitor; L-663, 536(3-(1-(4-chlorobenzyl)-3-t-butyl-thio-5-isopropylindol-2-yl)-2, 2-dimethylpropanoic acid], with indomethacin (a cyclooxygenase inhibitor), or with N(G)-nitro-L-arginine methyl ester (a nitric oxide (NO) synthase inhibitor). The activity of airway neutral endopeptidase (an enzyme for tachykinin degradation) was not influenced by wood smoke at 5-min post-exposure. We conclude that both endogenous tachykinins and hydroxyl radical play an important role in producing smoke-induced acute airway plasma exudation and airway edema in guinea pigs. The contribution of tachykinins to these neurogenic responses is mediated via the activation of tachykinin NK(1) receptors and partly via a hydroxyl radical mechanism, and is not associated with inactivation of neutral endopeptidase.


Clinical implication of complications on patient perceived health status following spinal fusion surgery.
Approximately 2% to 16% of patients undergoing spinal surgery suffer adverse events or complications. There is a paucity of studies evaluating the impact of complications on long-term outcomes. The purpose of this study was to assess the long-term effects of surgical complications on patient functional improvement and overall health status, using a multi-institutional, prospective spine outcomes registry. A total of 1498 patients undergoing primary lumbar fusion for low back pain and/or radiculopathy between January 2003 and December 2010 were enrolled. All patients completed the Oswestry Disability Index (ODI), Medical Outcome Study Short Form 36 (SF-36), and back and leg pain numerical rating scores (Visual Analog Scale [VAS]) before surgery and at 1 and 2 years post-operatively. Patients were stratified based on the occurrence of a peri or post-operative complication, and by major versus minor complications. Baseline and 2 year clinical outcome scores were compared between cohorts. Both groups were similar at baseline. Complications occurred in 115 (7.68%) patients. The most common complications were cerebrospinal fluid leak (49.18%), bleeding requiring transfusion (13.11%) and nerve root injury (9.83%). Compared to baseline, there was no significant difference in the extent of functional improvement (ODI, VAS, SF-36) between both patient groups at 1 and 2 years post-operatively. Furthermore, there was no significant difference in outcome scores between patients with minor versus major complications. Within the context of an ongoing debate on the consequences of complications, we observed no lasting effect of complications on the patient's interpretation of overall health status and functional improvement at 1 and 2 years following elective lumbar spine surgery.


Molecular and genetic analyses of Actinomyces spp.
Members of the genus Actinomyces are predominant primary colonizers of the oral cavity and play an important role in initiating plaque development. These bacteria have evolved unique mechanisms that favor colonization and persistence in this micro-environment. The expression of cell-surface fimbriae is correlated with the ability of these bacteria to adhere to specific receptors on the tooth and mucosal surfaces, and to interact with other plaque bacteria. The elaboration of sialidase is thought to enhance fimbriae-mediated adherence by unmasking the fimbrial receptors on mammalian cells. The presence of certain cell-associated or extracellular enzymes, including those involved in sucrose or urea metabolism, may provide the means for these bacteria to thrive under conditions when other growth nutrients are not available. Moreover, these enzyme activities may influence the distribution of other plaque bacteria and promote selection for Actinomyces spp. in certain ecological niches. The recent development of a genetic transfer system for Actinomyces spp. has allowed for studies the results of which demonstrate the existence of multiple genes involved in fimbriae synthesis and function, and facilitated the construction of allelic replacement mutants at each gene locus. Analyses of these mutants have revealed a direct correlation between the synthesis of assembled fimbriae and the observed adherence properties. Further genetic analysis of the various enzyme activities detected from strains of Actinomyces should allow for an assessment of the role of these components in microbial ecology, and their contribution to the overall success of Actinomyces spp. as a primary colonizer and a key player in oral health and disease.


Impact of delayed and infrequent administration of vasopressors on return of spontaneous circulation during out-of-hospital cardiac arrest.
Epinephrine and vasopressin are the only vasopressors associated with return of spontaneous circulation (ROSC). While current guidelines recommend rapid and frequent vasopressor administration during cardiac arrest, delays in their administration in the out-of- hospital setting remain a concern. This study evaluated delays in vasopressor administration and their effect on field ROSC. This retrospective review included all adult patients who experienced cardiac arrest of medical origin and received field resuscitative efforts among 10 emergency medical services (EMS) systems. Data were abstracted from the EMS medical record and included response time intervals, calculated first-dose and interdosing intervals of vasopressors, and ROSC. Data were analyzed using Mann-Whitney tests, chi-square tests, and t-tests, survival analysis, and logistic regression, with p ≤ 0.05 indicating significance. A total of 660 cardiac arrest patients were enrolled in the study. The mean EMS response time was 8.8 minutes; 52.7% of patients had witnessed cardiac arrests, 46.2% received bystander cardiopulmonary resuscitation (CPR), 23.0% had shockable initial rhythms, and 19.5% experienced field ROSC. In total, 1,913 doses of epinephrine and 111 doses of vasopressin were administered, with mean and 90th-percentile scene arrival-to-first drug intervals of 9.5 and 17 minutes, respectively. The mean and 90th-percentile interdosing intervals were 6.1 and 10 minutes, respectively. Patients experiencing ROSC had shorter scene arrival-to-first drug intervals than those without ROSC (8.1 vs. 9.8 min, p < 0.01), but there was no difference in the mean interdosing interval (6.8 vs. 6.0 min, p = 0.57). In the logistic regression analysis of ROSC, the adjusted odds ratio for call receipt-to-first drug interval ≤10 minutes was 1.91 (p = 0.04). Patients receiving advanced airway control prior to vasopressor administration were less likely to have a call receipt-to-first drug interval within 10 minutes (4.0% vs. 17.3%, p < 0.01) and were less likely to attain ROSC (15.7% vs. 25.4%, p < 0.01). The interval between scene arrival and first administration of vasopressors is significantly shorter among patients who experience ROSC compared with those who do not. Airway control procedures delay vasopressor administration and reduce the likelihood of ROSC. Although the interdosing intervals of most patients were not consistent with current recommendations, there was no difference in the mean interdosing times between those who achieved ROSC and those who did not.


Ovarian steroid cell tumors, not otherwise specified: a case report and literature review.
Steroid cell tumors, not otherwise specified, are rare ovarian sex cord-stromal tumors with malignant potential. The majority of these tumors produce steroids with testosterone being the most common. A case of a 46-year-old woman who presented with sudden onset of virilization and a pelvic mass is reported. Various aspects of the presentation, diagnosis, and treatment of these tumors are discussed.


A climate-driven mechanistic population model of Aedes albopictus with diapause.
The mosquito Aedes albopitus is a competent vector for the transmission of many blood-borne pathogens. An important factor that affects the mosquitoes' development and spreading is climate, such as temperature, precipitation and photoperiod. Existing climate-driven mechanistic models overlook the seasonal pattern of diapause, referred to as the survival strategy of mosquito eggs being dormant and unable to hatch under extreme weather. With respect to diapause, several issues remain unaddressed, including identifying the time when diapause eggs are laid and hatched under different climatic conditions, demarcating the thresholds of diapause and non-diapause periods, and considering the mortality rate of diapause eggs. Here we propose a generic climate-driven mechanistic population model of Ae. albopitus applicable to most Ae. albopictus-colonized areas. The new model is an improvement over the previous work by incorporating the diapause behaviors with many modifications to the stage-specific mechanism of the mosquitoes' life-cycle. monthly Container Index (CI) of Ae. albopitus collected in two Chinese cities, Guangzhou and Shanghai is used for model validation. The simulation results by the proposed model is validated with entomological field data by the Pearson correlation coefficient r (2) in Guangzhou (r (2) = 0.84) and in Shanghai (r (2) = 0.90). In addition, by consolidating the effect of diapause-related adjustments and temperature-related parameters in the model, the improvement is significant over the basic model. The model highlights the importance of considering diapause in simulating Ae. albopitus population. It also corroborates that temperature and photoperiod are significant in affecting the population dynamics of the mosquito. By refining the relationship between Ae. albopitus population and climatic factors, the model serves to establish a mechanistic relation to the growth and decline of the species. Understanding this relationship in a better way will benefit studying the transmission and the spatiotemporal distribution of mosquito-borne epidemics and eventually facilitating the early warning and control of the diseases.


Perspective Taking Reflects Beliefs About Partner Sophistication: Modern Computer Partners Versus Basic Computer and Human Partners.
We investigate partner effects on spatial perspective taking behavior in listeners, comparing behavior with a human versus a computer partner (Experiments 1 and 2), and with computer partners of different perceived capabilities (Experiment 3). Participants responded to spoken instructions from their partner which could be interpreted egocentrically (from their own perspective) or othercentrically (from their partner's perspective). In contrast to earlier work, we found that participants were more egocentric with a computer than a human partner. Participants were also more egocentric with a computer partner that appeared more modern and capable, compared to one that appeared outdated and limited in ability. Our results show that perspective taking behavior is sensitive to information about one's partner; in particular, listeners consider their partner's potential ability to collaborate, adjusting their egocentric tendencies accordingly. Moreover, we highlight what appears to be a shift in listeners' expectations regarding computers' collaborative capabilities, leading to greater willingness to push the burden of perspective taking onto a computer partner.


The apparent Km of ammonia for carbamoyl phosphate synthetase (ammonia) in situ.
Experiments with carbamoyl phosphate synthetase (ammonia) in solution and in isolated mitochondria are reported which show the following. NH3 rather than NH4+ is the substrate of the enzyme. The apparent Km of NH3 for the purified enzyme is about 38 microM. The apparent Km for NH3 measured in intact isolated mitochondria is about 13 microM. This value was obtained for both coupled and uncoupled mitochondria and was unchanged when the rate of carbamoyl phosphate synthesis was increased 2-fold by incubating uncoupled mitochondria in the presence of 5 mM-N-acetylglutamate. According to the literature, the concentration of NH3 in liver is well below the measured apparent Km. On the basis of this and previous work we conclude that, quantitatively, changes in liver [NH3] and [ornithine] are likely to be the most important factors in the fast regulation of synthesis of carbamoyl phosphate and urea. This conclusion is consistent with all available evidence obtained with isolated mitochondria, isolated hepatocytes, perfused liver and whole animals.


Rapid measurement of human milk macronutrients in the neonatal intensive care unit: accuracy and precision of fourier transform mid-infrared spectroscopy.
Although it is well established that human milk varies widely in macronutrient content, it remains common for human milk fortification for premature infants to be based on historic mean values. As a result, those caring for premature infants often underestimate protein intake. Rapid precise measurement of human milk protein, fat, and lactose to allow individualized fortification has been proposed for decades but remains elusive due to technical challenges. This study aimed to evaluate the accuracy and precision of a Fourier transform (FT) mid-infrared (IR) spectroscope in the neonatal intensive care unit to measure human milk fat, total protein, lactose, and calculated energy compared with standard chemical analyses. One hundred sixteen breast milk samples across lactation stages from women who delivered at term (n = 69) and preterm (n = 5) were analyzed with the FT mid-IR spectroscope and with standard chemical methods. Ten of the samples were tested in replicate using the FT mid-IR spectroscope to determine repeatability. The agreement between the FT mid-IR spectroscope analysis and reference methods was high for protein and fat and moderate for lactose and energy. The intra-assay coefficients of variation for all outcomes were less than 3%. The FT mid-IR spectroscope demonstrated high accuracy in measurement of total protein and fat of preterm and term milk with high precision.


Relation between the global burden of disease and randomized clinical trials conducted in Latin America published in the five leading medical journals.
Since 1990 non communicable diseases and injuries account for the majority of death and disability-adjusted life years in Latin America. We analyzed the relationship between the global burden of disease and Randomized Clinical Trials (RCTs) conducted in Latin America that were published in the five leading medical journals. We included all RCTS in humans, exclusively conducted in Latin American countries, and published in any of the following journals: Annals of Internal Medicine, British Medical Journal, Journal of the American Medical Association, Lancet, and New England Journal of Medicine. We described the trials and reported the number of RCTs according to the main categories of the global burden of disease. Sixty-six RCTs were identified. Communicable diseases accounted for 38 (57%) reports. Maternal, perinatal, and nutritional conditions accounted for 19 (29%) trials. Non-communicable diseases represent 48% of the global burden of disease but only 14% of reported trials. No trial addressed injuries despite its 18% contribution to the burden of disease in 2000. A poor correlation between the burden of disease and RCTs publications was found. Non communicable diseases and injuries account for up to two thirds of the burden of disease in Latin America but these topics are seldom addressed in published RCTs in the selected sample of journals. Funding bodies of health research and editors should be aware of the increasing burden of non communicable diseases and injuries occurring in Latin America to ensure that this growing epidemic is not neglected in the research agenda and not affected by publication bias.


Fish consumption and incidence of heart failure: a meta-analysis of prospective cohort studies.
The association between fish consumption and heart failure (HF) incidence is inconsistent. We performed a systematic search of Pubmed and Embase (from 1953 to June 2012) using key words related to fish and HF. Studies with at least three categories of fish consumption reporting both relative risk (RR) and corresponding 95% confidence interval (CI) for HF incidence were included. The pooled RR and 95%CI were calculated using a fixed or random-effects model. The generalized least squares regression model was used to quantify the dose-response relationship between fish consumption and HF incidence. Five prospective cohort studies including 4750 HF events of 170 231 participants with an average of 9.7-year follow-up were selected and identified. Compared with those who never ate fish, individuals with higher fish consumption had a lower HF incidence. The pooled RRs for HF incidence was 0.99 (95%CI, 0.91 to 1.08) for fish consumption 1 to 3 times per month, 0.91 (95%CI, 0.84 to 0.99) for once a week, 0.87 (95%CI, 0.81 to 0.95) for 2 to 4 times per week, and 0.86 (95%CI, 0.84 to 0.99) for 5 or more times per week. An increment of 20 g of daily fish intake was related to a 6% lower risk of HF (RR: 0.94, 95%CI, 0.90 to 0.97; P for trend = 0.001). This meta-analysis suggests that there is a dose-dependent inverse relationship between fish consumption and HF incidence. Fish intake once or more times a week could reduce HF incidence.


[Secondary-reinforcing effects of opiate agonists in the mouse].
Comparative examination of secondary-reinforcing properties of opiate agonists morphine, nalorphine, pentazocine and phencyclidine was carried out on mice using procedure of place preference conditioning in an automatic shuttle-box. Morphine, phencyclidine and pentaxocine (but not nalorphine) produced strong dose-dependent secondary-reinforcing effects. Special features of behavioural manifestations of their secondary-reinforcing action were analyzed in aspect of changes in temporal asymmetry and attendant locomotor activity of animals in the shuttle-box. On the basis of the obtained and literature data, it is suggested that mu- and sigma-opiate receptors mediate secondary-reinforcing effects of opiate agonists.


Mesenchymal chondrosarcoma: A Japanese Musculoskeletal Oncology Group (JMOG) study on 57 patients.
This study aimed to elucidate the clinical features and prognostic factors of mesenchymal chondrosarcoma (MCS) and investigate optimal treatment strategies. Data from 57 patients with MCS were collected from a Japanese Musculoskeletal Oncology Group (JMOG) and retrospectively analyzed. Data from 29 males and 28 females were collected. Primary tumor sites were the head and neck (7 patients), trunk (35 patients), and extremities (15 patients). The tumors originating in the trunk were significantly associated with a worse OS compared with those originating at the other sites in all patients and those with localized disease (P = 0.020 and P = 0.019, respectively). In patients with localized disease, the tumors originating in the head and neck were significantly associated with better OS and MFS compared with those originating in the trunk (P = 0.024 and P = 0.014, respectively). Positive surgical margin was significantly correlated with the worse LRFS (P = 0.018). Adjuvant chemotherapy exhibited a clear trend toward improved OS when MCS was localized in the trunk or extremities (P = 0.057). Adequate surgery is considered to be the mainstay of treatment for localized MCS. Prognosis was different depending on the site of tumor origin.


Disability, displacement and public health: a vision for Haiti.
Refugees and internally displaced persons (IDPs) with disabilities are some of the most neglected and socially excluded groups within any population. Natural disasters are events that cause bodily harm resulting in disability and that result in the displacement of people. Many predict a continual increase of natural disasters in the future due to changing climates. People with disabilities constitute one of the most vulnerable social groups in the case of a natural disaster. In 2010, Haiti suffered a devastating earthquake leading to great social, health and economic hardship including the displacement of people with disabilities. Due to the very extent of the structural devastation Haiti experienced and the international focus on assisting Haitians who suffered injuries leading to disabilities, there is an opportunity for Haiti to become a model for future disaster management in terms of mainstreaming the needs of people with disabilities in the restoration, resettlement and reintegration process.


Biphasic constitutive laws for biological interface evolution.
A model of tissue differentiation at the bone-implant interface is proposed. The basic hypothesis of the model is that the mechanical environment determines the tissue differentiation. The stimulus chosen is related to the bone-implant micromotions. Equations governing the evolution of the interfacial tissue are proposed and combined with a finite element code to determine the evolution of the fibrous tissue around prostheses. The model is applied to the case of an idealized hip prosthesis.


Promising nanogels loaded with usnic acid for oral ulcer treatment: development, characterization, and in vivo evaluation in rabbits.
This study aimed to present an effective formulation targeting oral ulcers that will remain in the application site for a longer period, reducing the frequency of administration. As a candidate formulation, usnic acid (UA) was loaded into the optimum nanogels. The characterization studies included physical, rheological, and bioadhesive properties as well as in vitro release and ex vivo studies. The rheological results revealed that the nanogels present pseudoplastic flow behavior. In vitro drug release showed a prolonged pattern. In further, the chosen UA nanogels showed very low percentages of penetration and permeation. F13, which showed the highest release, suitable bioadhesive properties (0.475 ± 0.033 N/cm2) and eligible particle size (250.22 ± 4.11 nm), PDI (0.089 ± 0.052), and zeta potential (20.56 ± 0.330 mV) values were chosen for in vivo experiments. The selected UA nanogels showed effective antimicrobial activity against Bacillus Cereus and great in vivo wound healing properties. The results indicated that suitable UA nanogels with desired properties could be prepared. The therapeutic potential of the nanogels for oral ulcers was assessed using an animal model and the histopathological findings suggested that the optimized formulation is a good choice for oral ulcer treatment. Nonetheless, further research is recommended to support its efficacy by applying pharmacodynamic and pharmacokinetic studies in human individuals.


Moving into a new hospital: strategies for success.
The work of moving into a new hospital does not end with construction. Planning a move must include preparing staff and physicians for the changes in their usual routines in care delivery. This bimonthly department expands nurse leaders' knowledge and competencies in health facility design and enables them to lead in transition planning for operations in a new setting. As editor of the Health Facility Design department, I asked the guest authors to describe their use of conceptual frameworks and change acceleration processes to ensure a successful transition to a new hospital tower.


Mitochondrial Ca2+ homeostasis in health and disease.
Although it has long been known that mitochondria possess a complex molecular repertoire for accumulating and releasing Ca2+, only in recent years has a large body of data demonstrated that these organelles promptly respond to Ca(2+)-mediated cell stimulations. In this contribution, we will review the principles of mitochondrial Ca2+ homeostasis and its signaling role in different physiological and pathological conditions.


Detection of bovine torovirus in fecal specimens from calves with diarrhea in Turkey.
Bovine torovirus (BToV), a member of the family Coronaviridae, is an established gastrointestinal infectious agent in cattle. In this study, we performed a survey to detect BToV in Turkey between 2009 and 2011 using 235 fecal samples from neonatal calves with diarrhea that were analyzed by the nested reverse transcription (RT) PCR method using primers located in the consensus sequences of the BToV membrane (M) gene. The BToV M gene was detected in 4.7 % (11/235) of the samples using the nested RT-PCR method. The nucleotide sequences of partial M fragments from the BToV isolates, including the newly identified Turkish isolates, showed more than 96 % identity. The result indicates that BToV is one of the pathogens that contribute to neonatal calf diarrhea cases in Turkey.


Effect of Potent P2Y12 Inhibitors on Ventricular Arrhythmias and Cardiac Dysfunction in Coronary Artery Disease: A Systematic Review and Meta-Analysis.
Previous studies have shown that P2Y12 receptor inhibitors might prevent ventricular arrhythmias and cardiac dysfunction in patients with coronary artery disease. However, few studies have focused on comparison of the efficacy of novel oral potent P2Y12 receptor inhibitors with clopidogrel on these outcomes. We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) that were published in electronic databases of MEDLINE, EMBASE, Cochrane Central Register of Clinical Trials, and ClinicalTrials.gov before June 20, 2018. We compared the effect of prasugrel and ticagrelor with clopidogrel on outcomes of ventricular tachycardia (VT), ventricular fibrillation (VF), heart failure (HF), and cardiogenic shock (CS). Data were combined using both the fixed-effects models and the random-effects models, and the heterogeneity was assessed with the I 2 statistic. Nine RCTs (6 with prasugrel and 3 with ticagrelor) with 45,227 patients were included. Patients receiving prasugrel were associated with a lower risk of combined VT and VF (rate ratio [RR]: 0.72, 95% confidence interval [CI]: 95% CI: 0.52-0.99, p=0.043), as well as combined HF and CS (RR: 0.81, 95% CI: 0.70-0.94, p=0.005), compared with clopidogrel. Patients receiving ticagrelor were also associated with a reduced risk of VT and VF (RR: 0.85, 95% CI: 0.72-1.02, p=0.077), although without statistical significance, but not of HF and CS (RR: 0.96, 95% CI: 0.81-1.13, p=0.620). This meta-analysis of RCTs shows that, compared with clopidogrel, novel oral P2Y12 inhibitors, especially prasugrel, might have better effect on improving ventricular rhythm and cardiac function.


Influence of sensor ingestion timing on consistency of temperature measures.
The validity and the reliability of using intestinal temperature (T int) via ingestible temperature sensors (ITS) to measure core body temperature have been demonstrated. However, the effect of elapsed time between ITS ingestion and T int measurement has not been thoroughly studied. Eight volunteers (six men and two women) swallowed ITS 5 h (ITS-5) and 29 h (ITS-29) before 4 h of varying intensity activity. T int was measured simultaneously from both ITS, and T int differences between the ITS-5 and the ITS-29 over the 4 h of activity were plotted and compared relative to a meaningful threshold of acceptance (+/-0.25 degrees C). The percentage of time in which the differences between paired ITS (ITS-5 vs ITS-29) were greater than or less than the threshold of acceptance was calculated. T int values showed no systematic bias, were normally distributed, and ranged from 36.94 degrees C to 39.24 degrees C. The maximum T int difference between paired ITS was 0.83 degrees C with a minimum difference of 0.00 degrees C. The typical magnitude of the differences (SE of the estimate) was 0.24 degrees C, and these differences were uniform across the entire range of observed temperatures. Paired T int measures fell outside of the threshold of acceptance 43.8% of the time during the 4 h of activity. The differences between ITS-5 and ITS-29 were larger than the threshold of acceptance during a substantial portion of the observed 4-h activity period. Ingesting an ITS more than 5 h before activity will not completely eliminate confounding factors but may improve accuracy and consistency of core body temperature.


Risk of second primary malignancies in women with breast cancer: Results from the European prospective investigation into cancer and nutrition (EPIC).
Women with a diagnosis of breast cancer are at increased risk of second primary cancers, and the identification of risk factors for the latter may have clinical implications. We have followed-up for 11 years 10,045 women with invasive breast cancer from a European cohort, and identified 492 second primary cancers, including 140 contralateral breast cancers. Expected and observed cases and Standardized Incidence Ratios (SIR) were estimated using Aalen-Johansen Markovian methods. Information on various risk factors was obtained from detailed questionnaires and anthropometric measurements. Cox proportional hazards regression models were used to estimate the role of risk factors. Women with breast cancer had a 30% excess risk for second malignancies (95% confidence interval-CI 18-42) after excluding contralateral breast cancers. Risk was particularly elevated for colorectal cancer (SIR, 1.71, 95% CI 1.43-2.00), lymphoma (SIR 1.80, 95% CI 1.31-2.40), melanoma (2.12; 1.63-2.70), endometrium (2.18; 1.75-2.70) and kidney cancers (2.40; 1.57-3.52). Risk of second malignancies was positively associated with age at first cancer, body mass index and smoking status, while it was inversely associated with education, post-menopausal status and a history of full-term pregnancy. We describe in a large cohort of women with breast cancer a 30% excess of second primaries. Among risk factors for breast cancer, a history of full-term pregnancy was inversely associated with the risk of second primary cancer.


Ophthalmic manifestations of induced sickling of erythrocytes in Japanese sika deer (Cervus nippon).
Nine female Japanese sika deer (Cervus nippon) were used in a total of 25 experiments in which sickling was chemically induced. During these experiments, color fundic and color fluorescein photographs were taken. Fundic changes included retinal vascular attenuation, blood column pallor, and decreased tapetal reflectivity. These changes were most likely directly associated with a decreased hematocrit and a generalized shocklike condition. Three deer had a congested appearance in retinal blood vessels and tapetum lucidum. Two of the 3 deer developed serous detachment of the retina. These changes seemingly were associated with severe venous statis; all 3 deer died shortly after the experiment was terminated. These experiments yielded data only for the acutely affected deer. None of the ocular changes could be considered the result of chronic sickling because of the reversal of sickling that occurred despite continued intravenous administration of bicarbonate. None of the deer developed ocular changes characteristic of sickle cell retinopathy in human beings. The changes in human beings probably result from continued stress and prolongation of sickling, and especially from a multiplicity of repeated severe episodes of sickling occurring over many years.


Dental Care for Patients With Childhood Cancers.
Childhood cancer is the second most common cause of death in children in the United States. Treatments for childhood cancers usually incorporate chemotherapy, radiation therapy, immunotherapy, and/or surgery. This review of contemporary literature highlights the necessity for interprofessional care to achieve the best dental outcomes for this patient population during cancer treatment, as well as for children who are long-term cancer survivors. A literature search at PubMed identified research and review articles about oral and dental complications in children diagnosed with cancer. Also included were evidence and current best practices from guidelines published by the American Academy of Pediatric Dentistry on dental management of pediatric patients receiving chemotherapy, hematopoietic cell transplantation, and/or radiation therapy. Finally, clinical recommendations from the European Society for Medical Oncology Guidelines Working Group on management of oral and gastrointestinal mucositis were included. The literature search was limited to articles published in the English language. Children with a new diagnosis of cancer should have dental care provided by a pediatric dentist to mitigate the oral complications from cancer treatment as well as to avoid dental infections during immunosuppressed states. An individualized oral care program can be developed for each patient to manage and treat acute and long-term oral complications related to cancer treatment. Childhood cancer survivors present with unique challenges for dental management because of dental anomalies caused by cancer therapy. Interprofessional collaborative care between the pediatric dentist and the oncologist during and after cancer therapy will enable best outcomes for the pediatric patient. In addition, dental professionals must be prepared to meet the unique needs of long-term cancer survivors because of the increasing survival rates of childhood cancers.


Treatment of spontaneously hypertensive rats with rosiglitazone ameliorates cardiovascular pathophysiology via antioxidant mechanisms in the vasculature.
Oxidative stress contributes to cardiovascular complications of diabetes, in part, by reducing the bioavailability of nitric oxide (NO). We investigated the mechanisms whereby the insulin sensitizer rosiglitazone may ameliorate oxidative stress in the vasculature of spontaneously hypertensive rats (SHR). Nine-week-old SHR were treated by gavage for 7 wk with rosiglitazone (5 mg x kg(-1) x day(-1)) or vehicle control. Treatment of SHR with rosiglitazone lowered systolic blood pressure, reduced fasting plasma insulin and asymmetrical dimethylarginine, and increased insulin sensitivity (when compared with vehicle treatment). In vessel homogenates and serum from rosiglitazone-treated SHR, SOD activity was enhanced, while 8-iso-PGF(2alpha) (lipid peroxidation product) was reduced (when compared with samples from vehicle-treated SHR). Moreover, expression of p22phox (catalytic subunit of NADPH oxidase) as well as nitrotyrosine and superoxide content were all reduced in the aortas of rosiglitazone-treated SHR. In mesenteric vascular beds (MVB) isolated ex vivo from rosiglitazone-treated SHR, NO-dependent vasodilator actions of insulin were improved when compared with MVB from vehicle-treated SHR. Acute pretreatment of MVB from vehicle-treated SHR with apocynin (NADPH oxidase inhibitor) enhanced vasodilator actions of insulin (results comparable to those in MVB from rosiglitazone-treated SHR). In Langendorff heart preparations from rosiglitazone-treated SHR, ischemia/reperfusion injury caused infarcts 40% smaller than in hearts from vehicle-treated SHR. Acute pretreatment of hearts from vehicle-treated SHR with apocynin produced similar results. Finally, rosiglitazone treatment of endothelial cells in primary culture reduced superoxide induced by insulin-resistant conditions. We conclude that rosiglitazone therapy in SHR increases SOD activity and decreases p22phox expression in the vasculature to reduce oxidant stress leading to an improved cardiovascular phenotype.


Dual Sequential Short Anterior Correction in Double Major Adolescent Idiopathic Scoliosis.
retrospective comparative study. The standard surgical technique for double major adolescent idiopathic scoliosis (AIS) has been the fusion of both thoracic and thoracolumbar/lumbar curves from the posterior approach. Although short anterior correction is established in AIS with single thoracic or thoracolumbar/lumbar curves, anterior correction in double major curves has not yet been described. The purpose of this study is to compare this novel technique with standard posterior pedicle screw instrumentation in double major AIS. 19 consecutive patients with a double major AIS were treated surgically either with pedicle screw instrumentation and posterior fusion (n = 11) or dual anterior short instrumentation and fusion (n = 8) of both curves. The mean follow-up was 5.6 ± 3 years (2-10 years). Clinical and radiologic results, results of pulmonary function, and Scoliosis Research Society (SRS) questionnaire are analyzed and compared. The length of fusion was 7.6 ± 0.7 vertebrae with the anterior technique and 12 ± 1 vertebrae with the posterior technique (p < .001). Cobb angle correction was 78% and 53% in thoracic curves, and 80% and 59% in lumbar curves with posterior and anterior technique respectively (p < .05). The preoperative pulmonary function remained unchanged to the last follow-up in both groups. The scores of SRS-24 questionnaire were similar preoperatively and at the last follow-up in both groups. This novel technique of dual sequential short anterior correction is an alternative to the standard posterior long fusions in the double major AIS. A significantly less amount of mobile segments needs to be fused leaving the thoracolumbar junction mobile and saving at least one lumbar mobile segment distally. Level III.


The histone acetyltransferase PCAF associates with actin and hnRNP U for RNA polymerase II transcription.
Actin is a key regulator of RNA polymerase (pol) II transcription. In complex with specific hnRNPs, it has been proposed that actin functions to recruit pol II coactivators during the elongation of nascent transcripts. Here, we show by affinity chromatography, protein-protein interaction assays, and biochemical fractionation of nuclear extracts that the histone acetyltransferase (HAT) PCAF associates with actin and hnRNP U. PCAF and the nuclear actin-associated HAT activity detected in the DNase I-bound protein fraction could be released by disruption of the actin-hnRNP U complex. In addition, actin, hnRNP U, and PCAF were found to be associated with the Ser2/5- and Ser2-phosphorylated pol II carboxy-terminal domain construct. Chromatin and RNA immunoprecipitation assays demonstrated that actin, hnRNP U, and PCAF are present at the promoters and coding regions of constitutively expressed pol II genes and that they are associated with ribonucleoprotein complexes. Finally, disruption of the actin-hnRNP U interaction repressed bromouridine triphosphate incorporation in living cells, suggesting that actin and hnRNP U cooperate with PCAF in the regulation of pol II transcription elongation.


Resilience of the larval slipper limpet Crepidula onyx to direct and indirect-diet effects of ocean acidification.
Ocean acidification (OA) is known to directly impact larval physiology and development of many marine organisms. OA also affects the nutritional quality and palatability of algae, which are principal food sources for many types of planktonic larvae. This potential indirect effect of OA via trophic interactions, however, has not been fully explored. In this study, veligers of Crepidula onyx were exposed to different pH levels representing the ambient (as control) and low pH values (pH 7.7 and pH 7.3) for 14 days, and were fed with Isochrysis galbana cultured at these three respective pHs. pH, diet, nor their interactions had no effect on larval mortality. Decrease in pH alone had a significant effect on growth rate and shell size. Structural changes (increased porosity) in larval shells were also observed in the low pH treatments. Interactions between acidification and reduced diet quality promoted earlier settlement. Unlike other calcifying molluscs, this population of slipper limpets introduced to Hong Kong in 1960s appeared to be resilient to OA and decreased algal nutritional value. If this robustness observed in the laboratory applies to the field, competition with native invertebrates may intensify and this non-native snail could flourish in acidified coastal ecosystems.


Immunohistochemical, tomographic, and histological study on onlay bone graft remodeling. Part III: allografts.
In the last decades aroused the interest for bone tissue bank as an alternative to autogenous grafting, avoiding donor sites morbidity, surgical time, and costs reduction. The purpose of the study was to compare allografts (ALg) with autografts (AUg) using histology, immunochemistry, and tomographic analysis. Fifty-six New Zealand White rabbits were submitted to surgical procedures. Twenty animals were donors and 36 were actually submitted to onlay grafting with ALg (experimental group) and AUg (control group) randomly placed bilaterally in the mandible. Six animals of each group were sacrificed at 3, 5, 7, 10, 20, and 60 postoperative days. Immunolabeling was accomplished with osteoprotegerin (OPG); receptor activator of nuclear factor-k ligand (RANKL); alkaline phosphatase (ALP); osteopontin (OPN); vascular endothelial growth factor (VEGF); tartrate-resistant acid phosphatase (TRAP); collagen type I (COL I); and osteocalcin (OC). Density and volume of the grafts was evaluated on tomography obtained at the surgery and sacrifice. The ALg and AUg exhibited similar patterns of density and volume throughout the experiments. The intra-group data showed statistical differences at days 7 and 60 in comparison with other time points (P = 0.001), in both groups. A slight graft expansion from fixation until day 20 (P = 0.532) was observed in the AUg group and then resorbed significantly at the day 60 (P = 0.015). ALg volume remained stable until day 7 and decreased at day 10 (P = 0.045). The light microscopy analysis showed more efficient incorporation of AUg onto the recipient bed if compared with the ALg group. The immunohistochemical labeling picked: at days 10 and 20 with OPG in the AUg group and at day 7 with TRAP in the ALg group (P = 0.001 and P = 0.002, respectively). ALg and AUg were not differing in patterns of volume and density during entire experiment. Histological data exhibit more efficient AUg incorporation into recipient bed compared with the ALg group. Immunohistochemistry outcomes demonstrated similar pattern for both ALg and AUg groups, except for an increasing resorption activity in the ALg group mediated by TRAP and in the AUg group by higher OPG labeling. However, this latter observation does not seem to influence clinical outcomes.


Effects of carbon sources on chemical composition of cell envelopes of Pseudomonas aeruginosa in association with polymyxin resistance.
Cells of Pseudomonas aeruginosa 015 were grown in basal medium with isobutyrate, DL-2-methylbutyrate, isovalerate, L-valine, L-isoleucine, L-leucine, D-glucose, or L-glutamate as the carbon source. Their resultant susceptibility to polymyxin B varied from a minimal inhibitory concentration of 2 U of polymyxin per ml for isobutyrate-grown cells to 975 U/ml for L-glutamate-grown cells. Cell envelopes from cells grown with each carbon source were compared with cell envelopes from cells grown in Mueller-Hinton broth as to their content of total protein, carbohydrate, and 2-keto-3-deoxyoctonate and as to their protein composition as determined by slab polyacrylamide gel electrophoresis. No pattern of cell envelope content of total protein, carbohydrate, 2-keto-3-deoxyoctonate, or outer membrane protein concentrations could be correlated with the degree of resistance to polymyxin. In these cells increased resistance to polymyxin was not associated with the loss of outer membrane proteins and lipopolysaccharide by the cell envelope.


Environmental accommodations for a child with traumatic brain injury.
Children with severe TBI frequently demonstrate language and cognition challenges and require accommodations to succeed academically. However, minimal research exists about accommodation efficacy for this population. This study examined the effect of environmental accommodations (reduced visual and auditory distractions) on the redirections, task variability and accuracy of a child with severe TBI when performing cognitive-linguistic activities. The researchers hypothesized no differences in variability between accommodation conditions; poorest task performance and most frequent task redirections given no environmental accommodations; comparable task performance and redirections with visual accommodation and auditory accommodation; and highest task performance and fewest redirections with combined visual and auditory accommodations. The researchers used an alternating treatment, single case design to compare task performance, variability and redirection averages across conditions. They used visual inspection, linear growth curve analyses and repeated measure analyses for data interpretation. Data collection occurred during label-object association, oral directions and divided attention tasks over 22 sessions varying in accommodation provision. Findings showed visual plus auditory accommodations resulted in fewer redirections and superior average performance on all tasks although substantial variability persisted. Significant differences emerged across conditions only for the oral directions task.


Metric Learning for High-Throughput Combinatorial Data Sets.
Materials design and discovery through the high-throughput exploration of materials space has been recognized as a new paradigm in materials science. However, typical high-throughput exploration methods deliver high-dimensional and very diverse data sets that pose the challenge of extracting the key features and patterns that could guide the discovery process. Unraveling patterns is a nontrivial task as quite often the underlying physical phenomena are uncertain and latent variables governing the performance are mainly unknown. In this paper, we discuss challenges related to designing a data analytics tool for clustering high-throughput measurements performed on the compositional library of materials. The critical aspects of our methodology are (i) learning the similarity measures, as opposed to using fixed similarity measures (e.g., Euclidean distance, dynamic time warping), while (ii) imposing the similarity in the composition space. Our methodology is based on the multitask learning approach that is formulated to account for the composition neighborhoods that are specific to the compositional libraries. We demonstrate the advantages of our methodology for the library of cyclic voltammetry curves generated for model multimetal catalysts, as well as X-ray diffraction patterns from experimental studies. We also compare our approach with the current state-of-the-art methods used in similar problems. This work has important implications for designing high-throughput exploration including catalysts for electrochemical systems, such as fuel cells and metal-air batteries.


Children's parasympathetic reactivity to specific emotions moderates response to intervention for early-onset aggression.
Following theories that individual differences in respiratory sinus arrhythmia (RSA) denote differential sensitivity to environmental influences, this study examines whether differences in RSA reactivity to specific emotional challenges predict differential response to intervention. We present data from a randomized clinical trial of a targeted intervention for early onset aggression. In collaboration with a high-risk urban school district, 207 kindergarten children (73% African American, 66% male), identified by their teachers as having high levels of aggressive and disruptive behavior, were recruited. All children received a universal social-emotional curriculum. One hundred children were randomly assigned to an additional intervention consisting of weekly peer-based social skills training. Complete RSA data were available for 139 of the children. Teacher-reported externalizing symptoms and emotion regulation in 1st grade (post intervention) were examined controlling for baseline levels. First-grade peer nominations of aggressive behavior, controlling for baseline nominations, were also examined as outcomes. No effect of resting RSA was found. However, greater reactivity to anger was associated with higher externalizing symptoms and lower emotion regulation skills in 1st grade relative to low reactive children. Lower reactivity to fear was associated with greater improvement over time, an effect that was enhanced in the targeted intervention condition. Results suggest that measures of affective reactivity may provide insight into children's capacity to benefit from different types of interventions.


[New pathogenetic and therapeutic aspects of mast cell-dependent inflammatory reactions].
Urticaria is the prototype of diseases dependent on mast cells. Thus a thorough understanding of its pathogenesis is the basis of its specific therapy. The most important therapeutic means regarding the treatment of urticaria is the removal of its cause; drug therapy of the symptoms is to follow. Since histamine is the main mediator in most forms of urticaria, excellent symptomatic relief can be obtained by treatment with modern, nonsedating antihistamines. Certain types of urticaria, which are partly not dependent on histamine, have to be treated with other, more effective drugs, according to the specific pathogenesis involved. Examples of such drugs are corticosteroids, antimalarials, and beta-adrenergic antagonists.


How are WEEE doing? A global review of the management of electrical and electronic wastes.
This paper presents and critically analyses the current waste electrical and electronic equipment (WEEE) management practices in various countries and regions. Global trends in (i) the quantities and composition of WEEE; and (ii) the various strategies and practices adopted by selected countries to handle, regulate and prevent WEEE are comprehensively examined. The findings indicate that for (i), the quantities of WEEE generated are high and/or on the increase. IT and telecommunications equipment seem to be the dominant WEEE being generated, at least in terms of numbers, in Africa, in the poorer regions of Asia and in Latin/South America. However, the paper contends that the reported figures on quantities of WEEE generated may be grossly underestimated. For (ii), with the notable exception of Europe, many countries seem to be lacking or are slow in initiating, drafting and adopting WEEE regulations. Handling of WEEE in developing countries is typified by high rate of repair and reuse within a largely informal recycling sector. In both developed and developing nations, the landfilling of WEEE is still a concern. It has been established that stockpiling of unwanted electrical and electronic products is common in both the USA and less developed economies. The paper also identifies and discusses four common priority areas for WEEE across the globe, namely: (i) resource depletion; (ii) ethical concerns; (iii) health and environmental issues; and (iv) WEEE takeback strategies. Further, the paper discusses the future perspectives on WEEE generation, treatment, prevention and regulation. Four key conclusions are drawn from this review: global amounts of WEEE will continue unabated for some time due to emergence of new technologies and affordable electronics; informal recycling in developing nations has the potential of making a valuable contribution if their operations can be changed with strict safety standards as a priority; the pace of initiating and enacting WEEE specific legislation is very slow across the globe and in some cases non-existent; and globally, there is need for more accurate and current data on amounts and types of WEEE generated.


[Impact of protamine sulfate on hemostasis system after operations with artificial circulation].
Effects of different doses and lots of protamine sulfate on hemostasis system after cardiac operations with artificial circulation are analyzed. Overall 982 patients underwent cardiac operations with artificial circulation. Quality and purity of protamine may be the causes of side effects. Negative effect of high doses of protamine on hemostasis system is demonstrated. Thrombocyte dysfunction is the main cause of intensive postoperative bleeding after administration of protamine high doses.


Two linked pairs of Arabidopsis TNL resistance genes independently confer recognition of bacterial effector AvrRps4.
Plant immunity requires recognition of pathogen effectors by intracellular NB-LRR immune receptors encoded by Resistance (R) genes. Most R proteins recognize a specific effector, but some function in pairs that recognize multiple effectors. Arabidopsis thaliana TIR-NB-LRR proteins RRS1-R and RPS4 together recognize two bacterial effectors, AvrRps4 from Pseudomonas syringae and PopP2 from Ralstonia solanacearum. However, AvrRps4, but not PopP2, is recognized in rrs1/rps4 mutants. We reveal an R gene pair that resembles and is linked to RRS1/RPS4, designated as RRS1B/RPS4B, which confers recognition of AvrRps4 but not PopP2. Like RRS1/RPS4, RRS1B/RPS4B proteins associate and activate defence genes upon AvrRps4 recognition. Inappropriate combinations (RRS1/RPS4B or RRS1B/RPS4) are non-functional and this specificity is not TIR domain dependent. Distinct putative orthologues of both pairs are maintained in the genomes of Arabidopsis thaliana relatives and are likely derived from a common ancestor pair. Our results provide novel insights into paired R gene function and evolution.


Current status of corneal transplantation.
Corneal transplantation offers the cure for those with blinding corneal disease. Sourcing of a shortage of corneas are important. Graft survival depends on a number of factors, the most important of which is the recipient bed. The management of graft failure by rejection includes tissue matching, local and systemic immunosuppression.


Attitudes and practices of postnatal mothers and their accompanying relatives to breastfeeding in public at a university hospital in Turkey.
Mothers face social and cultural obstacles to breastfeeding in public. This study evaluated the attitudes and practices of Turkish women regarding breastfeeding in public. This cross-sectional, descriptive study was carried out in a university hospital among 200 new postnatal mothers and their 200 accompanying female relatives. Data were obtained using a questionnaire and the Infant Feeding Attitude Scale (IIFAS). Respondents mostly believed that there was nothing wrong with breastfeed in public and almost half of them thought the society would perceive breastfeeding in public negatively. Some 56.5% of the mothers who had previously had children and 37.2% of their relatives had breastfed in public before. The acceptance of breastfeeding in public increased "if the breast is covered" and "if a private space is provided". The mean total IIFAS score was 61.53 (6.19) in the mothers and 60.65 (6.69) in their relatives. Based on IIFAS, the mothers (92.0%) and their relatives (89.5%) were neutral to breastfeeding, but age, education, employment status, and opinions regarding breastfeeding in public affected the IIFAS scores. IIFAS score was significantly higher in women who had breastfed in public before. Although the women knew the importance of breastfeeding, they mostly did not breastfeed in public because of the cultural implications and the lack of private breastfeeding areas. Awareness-raising, availability of breastfeeding rooms, and education of supporting relatives can help the increase willingness of mothers to breastfeed even if it is in public.


Concomitant effects of Ramadan fasting and time-of-day on apolipoprotein AI, B, Lp-a and homocysteine responses during aerobic exercise in Tunisian soccer players.
To examine the time-of-day and Ramadan fasting (RF) effects on serum apolipoprotein-AI (Apo-AI) and B (Apo-B), lipoprotein particles-a (Lp-a), high-sensitive C-reactive-protein (hs-CRP), and homocysteine (Hcy) during the Yo-Yo intermittent recovery test (YYIRT). Performance and biochemical measures were completed at two times-of-day (07:00 and 17:00 h), 1-week before RF (BR), the second week of RF (SWR), and the fourth week of RF (ER). For each session, subjects performed the YYIRT, and blood samples were taken before and 3-min after the test for biochemical measures. Fifteen soccer players. Total distance during the YYIRT, core temperature, body composition, dietary intakes, lipid (HDL-C, LDL-C, Apo-AI, B and Lp-a) and inflammatory (hs-CRP and Hcy) profiles. Performances during the YYIRT were higher in the evening than the morning BR (P < 0.05), but this fluctuation was not observed during RF. Moreover, LDL-C, ApoB, and Lp-a were stable throughout the daytime BR. However, during RF, they decreased at 17:00 h (P < 0.05). Likewise, HDL-C and Apo-AI increased after the exercise and were higher at 17:00 h BR (P < 0.001). Moreover, these parameters increased during RF (P < 0.01). Furthermore, Hcy and hs-CRP increased during the exercise (P < 0.01) with higher evening levels BR. During ER, the diurnal pattern of Hcy was inversed (P < 0.001). This study concluded that caloric restriction induced by RF seems to ameliorate lipid and inflammatory markers of cardiovascular health during intermittent exercise performed in the evening.


Reliability and Accuracy of MRI in Orthopedics: A Survey of Its Use and Perceived Limitations.
Over the past decade, the use of magnetic resonance imaging (MRI) as a diagnostic tool has been increasing significantly in various fields of medicine due to its wide array of applications. As a result, its diagnostic efficacy and reliability come into question. Specifically, in the field of orthopedics, there has been little discussion on the problems many physicians face while using MRIs in practice. To gauge the perceived limitations of MRI, we designed a decision analysis to analyze the utility of MRIs and estimate the number of inconclusive MRIs ordered within an orthopedic practice to explore potential alternative avenues of diagnosis. A survey of 100 board-certified practicing orthopedic surgeons given at 2 national conferences was designed to assess the value, reliability, and diagnostic utility of MRIs in preoperative planning in shoulder and knee surgery. Of those surveyed, 93% reported that there was believed to be a problem with the accuracy of an MRI in the setting of a prior surgery and/or if previous hardware was present specifically pertaining to the knee or shoulder. The most common indications of concern regarding knee or shoulder MRI reliability among this sample group were previous patient hardware (19%), a previous surgery (16%), and a chondral defect (11%). In addition, when asked how many MRIs were believed to be inconclusive based on previous surgery/hardware alone in the last 6 months of practice, an average of 19 inconclusive MRIs was reported. This study summarizes some of the concerns of MRI use in the orthopedic community and attempts to add a unique perspective on the attitudes, decision-making, and apparent economic problems that they face as well as uncover specific instances where MRIs were determined to be unreliable and incomplete in aiding the diagnosis and treatment algorithm.


Medical radiation exposure from radiological and interventional procedures in Austria.
The aim of the study was to systematically evaluate the frequency of diagnostic and interventional X‑ray procedures and the corresponding population exposure in Austria. A methodology based on 107 selected procedures was adopted in accordance with European Commission recommendations. Frequencies were calculated based on an Austrian nationwide standardized database for the outpatient and inpatient sectors. The collective effective dose was estimated by linking the procedure frequencies to results from previous studies on doses per procedure and correction factors from the European Commission. In Austria, 1468 diagnostic and interventional X‑ray procedures per 1000 inhabitants were conducted in 2015. Plain radiography procedures were performed most frequently, with approximately 40% being dental radiographs. The estimated extrapolated collective effective dose for 2015 was approximately 12,890 man-sievert (1.5 mSv per head). Although computed tomography only constitutes about 11% of the total number of procedures, its contribution to the collective effective dose is by far the largest at 74%, followed by plain radiography at almost 10%. This study provides a comprehensive estimate of procedure frequencies in Austria based on annually available, routinely collected data and of the corresponding collective effective dose. The results show that the frequency of computed tomography in Austria more than doubled within the last 14 years and is high compared to Germany and Switzerland. As in other countries, computed tomography is the largest contributor to the collective effective dose, identifying it as an area that deserves special attention for dose optimization.


Ancient Mitogenomes Reveal the Evolutionary History and Biogeography of Sloths.
Living sloths represent two distinct lineages of small-sized mammals that independently evolved arboreality from terrestrial ancestors. The six extant species are the survivors of an evolutionary radiation marked by the extinction of large terrestrial forms at the end of the Quaternary. Until now, sloth evolutionary history has mainly been reconstructed from phylogenetic analyses of morphological characters. Here, we used ancient DNA methods to successfully sequence 10 extinct sloth mitogenomes encompassing all major lineages. This includes the iconic continental ground sloths Megatherium, Megalonyx, Mylodon, and Nothrotheriops and the smaller endemic Caribbean sloths Parocnus and Acratocnus. Phylogenetic analyses identify eight distinct lineages grouped in three well-supported clades, whose interrelationships are markedly incongruent with the currently accepted morphological topology. We show that recently extinct Caribbean sloths have a single origin but comprise two highly divergent lineages that are not directly related to living two-fingered sloths, which instead group with Mylodon. Moreover, living three-fingered sloths do not represent the sister group to all other sloths but are nested within a clade of extinct ground sloths including Megatherium, Megalonyx, and Nothrotheriops. Molecular dating also reveals that the eight newly recognized sloth families all originated between 36 and 28 million years ago (mya). The early divergence of recently extinct Caribbean sloths around 35 mya is consistent with the debated GAARlandia hypothesis postulating the existence at that time of a biogeographic connection between northern South America and the Greater Antilles. This new molecular phylogeny has major implications for reinterpreting sloth morphological evolution, biogeography, and diversification history.