Being accepted for who we are: evidence that social validation of the intrinsic self reduces general defensiveness.
Three studies examined the possibility that being liked intrinsically by others--for who one is--reduces self-esteem defense, whereas being liked for what one has achieved does not. All 3 studies contrasted the effects on self-esteem defense of liking based on intrinsic or achievement-related aspects of self. Study 1 showed that thoughts of being liked intrinsically reduced defensive bias toward downward social comparison. Study 2 demonstrated that being liked for intrinsic aspects of self reduced participants' tendency to defensively distance themselves from a negatively portrayed other. Study 3 revealed that being liked for intrinsic aspects of self encouraged a preference for upward over downward counterfactuals for a negative event. In all 3 studies, similar reductions in defensiveness were not found when liking was based on achievements. Discussion focuses on implications for understanding the functional value of different bases of self-worth.


The effects of age on uptake, serum half-life and bioavailability of mouse [D-Leu-4]OB3, a synthetic peptide amide with leptin-like activity, in male C57BL/6J mice.
We have previously shown that the activity of a synthetic peptide amide corresponding to amino acid residues 116-130 of mouse leptin is contained in a restricted sequence at the amino terminus of the peptide, between residues 116 and 122 (Ser-Cys-Ser-Leu-Pro-Glu-Thr). This peptide was named mouse OB3. The potency of OB3 was improved by replacing the L-leucine residue at position four with its D-isomer. Intraperitoneal administration (i.p.) of mouse OB3 or [D-Leu-4]OB3 to ob/ob and db/db mice reduces food intake, body weight gain and serum glucose levels, and enhances insulin sensitivity. These effects of OB3 and [D-Leu-4]OB3 are very pronounced in young mice and diminish with age. In the present study, we measured uptake, serum half-life, and bioavailability of mouse [D-Leu-4]OB3 in mice of different ages. Groups of male C57BL/6J mice, six and 25 weeks of age, were given a single i.p. injection of 1 mg mouse [D-Leu-4]OB3 in PBS. Five, 10, 20, 40, 60, 120, or 180 min after injection, the mice were anesthetized and exsanguinated. Serum samples were prepared and assayed for mouse [D-Leu-4]OB3 content by competitive ELISA. In six week-old mice, the maximum concentration of mouse [D-Leu-4]OB3 was reached in 10 min, and the serum half-life was approximately 52.5 min. In 25 week-old mice, however, mouse [D-Leu-4]OB3 peaked in 5 min, and the serum half-life was approximately 30.6 min. The relative bioavailability of mouse [D-Leu-4]OB3 in six and 25 week-old mice was determined by measuring the area under the uptake curves. Bioavailability of mouse [D-Leu-4]OB3 was approximately 20% greater in six week-old mice than in 25 week-old mice. The results of this study indicate that at least some pharmacokinetic parameters of peptide uptake change as mice age. They also suggest that differences in uptake, serum half-life, and relative bioavailability of mouse [D-Leu-4]OB3 may contribute, at least in part, to the reduced efficacy of bioactive leptin-related peptides we have consistently observed in ob/ob and db/db mice as they age.


Allied industry approaches to alter intramuscular fat content and composition in beef animals.
Biochemical and biophysical research tools are used to define the developmental dynamics of numerous cell lineages from a variety of tissues relevant to meat quality. With respect to the adipose cell lineage, much of our present understanding of adipogenesis and lipid metabolism was initially determined through the use of these methods, even though the in vitro or molecular environments are far removed from the tissues of meat animals. This concise review focuses on recent cellular and molecular biology-related research with adipocytes, and how the research might be extended to the endpoint of altering red meat quality. Moreover, economic and policy impacts of such in animal production regimens is discussed. These issues are important, not only with respect to palatability, but also to offer enhanced health benefits to the consumer by altering content of bioactive components in adipocytes.


Complications of thoracic computed tomography-guided fiducial placement for the purpose of stereotactic body radiation therapy.
This study examined the complication rates associated with percutaneous fiducial placement for the purpose of stereotactic body radiation therapy of primary and metastatic lung neoplasms. This is a retrospective review of computed tomography (CT) scans and follow-up chest radiographs of 48 consecutive patients who underwent CT-guided percutaneous fiducial placement. The effect of age, sex, number of fiducials placed, and performance of a concomitant biopsy on the complication rates were assessed. Of 48 patients with a total of 221 fiducials placed, 16 (33%) had a procedure-related pneumothorax. There was no significant difference in pneumothorax rate based on age (P = 0.16), sex (P > 0.99), and number of fiducials placed (P = 0.21). Overall, 6 of 48 patients (12.5%) required a thoracostomy tube. Performance of a concomitant core needle biopsy at the time of fiducial placement was associated with pneumothorax rates of 64% compared with 26% without biopsies (P = 0.03). Postprocedural CT demonstrated hemorrhage in 9 patients (19%). Two patients had hemoptysis; one required admission. Patients' age, sex, number of fiducials placed, and performance of concomitant biopsy had no statistically significant implications on parenchymal hemorrhage incidence. Approximately one third of the patients develop a pneumothorax during CT-guided fiducial placement. Most are asymptomatic and do not require a thoracostomy. A concurrent biopsy at the time of fiducial placement is associated with an increased risk of pneumothorax. Hemorrhage occurs but is usually clinically insignificant.


Brain Breaks® Physical Activity Solutions in the Classroom and on Attitudes toward Physical Activity: A Randomized Controlled Trial among Primary Students from Eight Countries.
Classroom-based physical activity (PA) interventions have received considerable attention due to improvements seen in academic achievement, classroom behaviors, and attitude toward PA. The purpose of this study was to evaluate the effectiveness of the Brain Breaks® Physical Activity Solutions in changing children's attitudes toward PA. Students (N = 3036) aged 8-11 years from schools in Croatia, Lithuania, Macedonia, Poland, Romania, Serbia, South Africa, and Turkey were randomly assigned to either a control or an experimental group. The experimental group received Brain Breaks® videos during classroom sessions throughout the four months of intervention. Student attitudes toward PA were measured using the Attitudes toward Physical Activity Scale (APAS) before and after the intervention. Repeated measures ANOVA indicated a time interaction effect for all APAS variables except fitness. Time-by-group interaction effects with different effect sizes were found for most APAS variables, with the greatest gain effect noted in the experimental group for self-efficacy, followed by learning from the videos concerning PA benefits, exercise importance, and enjoyment from engaging in PA. This study provides evidence supporting Brain Breaks® in terms of learning experience, attitudes towards PA, and personal motivation. Using exercise videos is recommended as an interactive, technology-based PA solution that can be easily integrated into the school setting.


Understanding acceptability of and engagement with Web-based interventions aiming to improve quality of life in cancer survivors: A synthesis of current research.
This review sought to summarize existing knowledge to inform the development of an online intervention that aims to improve quality of life after cancer treatment. To inform our intervention, we searched for studies relating to Web-based interventions designed to improve quality of life in adults who have completed primary treatment for breast, prostate, and colorectal cancer (as these are 3 of the most common cancers and impact a large number of cancer survivors). We included a variety of study designs (qualitative research, feasibility/pilot trials, randomized trials, and process evaluations) and extracted all available information regarding intervention characteristics, experiences, and outcomes. Data were synthesized as textual (qualitative) data and analyzed by using thematic analysis. Fifty-seven full text articles were assessed for eligibility, and 16 papers describing 9 interventions were analyzed. Our findings suggest that cancer survivors value interventions that offer content specific to their changing needs and are delivered at the right stage of the cancer trajectory. Social networking features do not always provide added benefit, and behavior change techniques need to be implemented carefully to avoid potential negative consequences for some users. Future work should aim to identify appropriate strategies for promoting health behavior change, as well as the optimal stage of cancer survivorship to facilitate intervention delivery. The development of Web-based interventions for cancer survivors requires further exploration to better understand how interventions can be carefully designed to match this group's unique needs and capabilities. User involvement during development may help to ensure that interventions are accessible, perceived as useful, and appropriate for challenges faced at different stages of the cancer survivorship trajectory.


Competitive STDP Learning of Overlapping Spatial Patterns.
Spike-timing-dependent plasticity (STDP) is a set of Hebbian learning rules firmly based on biological evidence. It has been demonstrated that one of the STDP learning rules is suited for learning spatiotemporal patterns. When multiple neurons are organized in a simple competitive spiking neural network, this network is capable of learning multiple distinct patterns. If patterns overlap significantly (i.e., patterns are mutually inclusive), however, competition would not preclude trained neuron's responding to a new pattern and adjusting synaptic weights accordingly. This letter presents a simple neural network that combines vertical inhibition and Euclidean distance-dependent synaptic strength factor. This approach helps to solve the problem of pattern size-dependent parameter optimality and significantly reduces the probability of a neuron's forgetting an already learned pattern. For demonstration purposes, the network was trained for the first ten letters of the Braille alphabet.


Radiotherapy with or without androgen deprivation in the treatment of localized adenocarcinoma of the prostate.
This study analyzes the results of disease relapse and survival in two series of patients treated between 1974 and 1991 with definitive irradiation, with or without early androgen deprivation, for carcinoma of the prostate localized to the pelvis. All 264 patients were irradiated to the prostate and pelvic lymph nodes with a dose of 50 to 54 Gy in 25 to 27 fractions, followed by a 16- to 20-Gy boost in 8 to 10 fractions to the prostate and periprostatic region. Ninety percent of patients received a total dose to the prostate (pelvis + boost) of 70 Gy. Ninety-nine of the 264 patients underwent early androgen deprivation. The endocrine manipulation program was initiated 0 to 9 months before the beginning of the radiotherapy course and was continued for 2 or more years or until disease progression. All patients who relapsed after radiotherapy alone received late hormonal manipulation. After a median follow-up of 100 months, no difference in the incidence of local and distant failure rate and cancer-specific mortality was detected between the two treatment groups. The local and distant failure rates were, respectively, 19% and 40% in patients who had undergone radiotherapy and early androgen deprivation and 20% and 36% in patients who received radiotherapy alone. Cancer mortality was similar, with 35% and 30% of deaths in the former and latter group, respectively. Death for intercurrent disease, however, was significantly more frequent (p = 0.03) in patients treated with radiotherapy and hormones (19%) than in those who received radiotherapy alone (8%). Actuarial analysis of both metastasis-free and disease-free survival detected no difference between the two treatment groups, with 10-year rates of 53.3% and 42.5%, respectively, in the radiation-alone group and 45.5% and 47%, respectively, in the radiation-plus-androgen deprivation group. A statistically significant difference (p = 0.03) in overall survival in favor of patients treated with radiotherapy alone was noted, with a 10-year rate of 47%, compared with 26% observed in the radiotherapy-plus-androgen deprivation group. In conclusion, results of our study confirm numerous reports based on retrospective analyses that failed to show any benefit of hormonal management adjuvant to a definitive irradiation. The disappointing finding was the significantly better overall survival in patients who underwent radiotherapy alone.


Designing and optimizing new antimicrobial peptides: all targets are not the same.
Because the resistance of microorganisms to the available antibiotics is a growing healthcare problem worldwide, the search for new antimicrobial peptides (AMPs) that provide useful therapeutic options has been increasing in importance. Many initial candidates have had to be discarded after having advanced to the preclinical and clinical stages. This has led to substantial losses in terms of time and money. For that reason, the essential characteristics of AMPs (i.e. their activity, selectivity, stability in physiological conditions and low production cost) must be considered in their design. In addition, peptides could be active against several kinds of cells with activity and selectivity resulting from interaction with multiple target cell components, which sometimes are present in mammalian cells as well. Thus, the cellular composition is important in the AMP-target cell interaction and must be considered in the design of AMPs, too. This review describes general aspects of AMP design, limitations concerning their therapeutic application, and optimization strategies for overcoming such limitations.


Improved assessment of graft function by echocardiography in cynomolgus monkey recipients of hDAF-transgenic pig cardiac xenografts.
The current practice of evaluating heterotopic heart xenografts by palpation allows only detection of severe graft dysfunction, which indicates terminal graft failure. Therefore, we evaluated whether echocardiography is a better method of detecting early graft dysfunction as a marker of rejection in abdominal pig heart xenografts in cynomolgus monkeys. Six cynomolgus monkeys received heterotopic heart transplants from pig donors transgenic for human decay-accelerating factor (hDAF). Induction therapy consisted of either cyclophosphamide or rabbit anti-thymocyte globulin. Maintenance therapy consisted of cyclosporine or tacrolimus, steroids, and sodium mycophenolate or mycophenolate mofetil, GAS914 (alphaGal oligosaccharide containing glycoconjugate), and for some animals TP10 (soluble complement receptor type 1). Echocardiography was performed immediately after transplantation and 3 times a week after surgery. We scored contractility and measured left ventricular wall thickness. Impaired contractility or increased wall thickness were considered graft dysfunction and were treated with pulse steroids. Palpation score was recorded daily. We also obtained myocardial biopsy specimens. Palpation score remained at 4 out of 4 in all animals until 2 to 5 days before final graft failure, whereas echocardiography detected several episodes of impaired graft function, either decreased left ventricular contractility or increased left ventricular wall thickness before graft failure. Treatment with pulse steroids improved graft function only during early episodes of graft impairment. Final graft failure was steroid resistant and caused by severe vascular rejection. Echocardiography is a better method of assessing graft dysfunction than is palpation. Therefore, echocardiography may detect early rejection episodes of heterotopic heart xenografts in non-human primates.


Large segmental radius and ulna defect treated by bone transportation with the Ilizarov technique.
An 8-year-old male Boxer with a severely contaminated open fracture of the left radius and ulna fracture, produced by a helicopter propeller, was treated using bone transport by the Ilizarov method. Extensive diaphyseal bone loss and soft-tissue vascular damage were present. The radius and ulna were stabilised with an Ilizarov ring external fixator. The bone defect was partially shortened and restored by gradual transport of a bone segment created from proximal segments of the radius and ulna. The external fixator was removed 4 fi months after the beginning of the latency period, due to instability caused by osteolysis around the wires. A cast was placed for 3 weeks. Although the bone transport had resulted in formation of approximately 4 cm of bone, the antebrachium showed approximately 50% shortening when compared to the contralateral limb. The infection was eradicated, and the dog was able to bear weight on the operated limb when walking.


Assembly of the cell division protein FtsZ into ladder-like structures in the aerial hyphae of Streptomyces coelicolor.
In the filamentous bacterium Streptomyces coelicolor, the cell division protein FtsZ is required for the conversion of multinucleoidal aerial hyphae into chains of uninucleoidal spores, although it is not essential for viability. Using immunofluorescence microscopy, we have shown that FtsZ assembles into long, regularly spaced, ladder-like arrays in developing aerial hyphae, with an average spacing of about 1.3 microm. Within individual hyphae, ladder formation was relatively synchronous and extended for distances over 100 microm. These ladders were present only transiently, decreasing in intensity as chromosomes separated into distinct nucleoids and disappearing upon the completion of septum formation. Evidence from the overall intensity of immunofluorescence staining suggested that ladder formation was regulated in part at the level of the accumulation and degradation of FtsZ within individual aerial hyphae. Finally, FtsZ ladder formation was under developmental control in that long arrays of FtsZ rings could not be detected in certain so-called white mutants (whiG, whiH and whiB), which are blocked in spore formation. The assembly of FtsZ into ladders represents the earliest known molecular manifestation of the process of spore formation, and its discovery provides insight into the role of whi genes in the conversion of aerial hyphae into chains of spores. We have also described a novel use of a cell wall-staining technique to visualize apical tip growth in vegetatively growing hyphae.


Campylobacter enteritis in general practice.
The incidence and clinical features of campylobacter enteritis were studied in a defined general practice population over a period of three years. Specimens of faeces were cultured from a representative sample of patients suffering from acute enteritis. Of 168 patients submitting a specimen to the laboratory 34 (20.2%) were positive for thermophilic Campylobacter species. The projected campylobacter infection rate varied from 5.4% per annum in infancy to 0.3% per annum in the 5- to 14-year-olds with a mean of 1.1% per annum for the whole study population. During the same period campylobacters were isolated from 484 (14.9%) of 3250 patients suffering from acute enteritis whose general practitioners had sent faecal specimens to the laboratory, confirming the importance of this organism in the aetiology of acute enteritis in the community.


Radiology of the bladder and urethra in blunt pelvic trauma.
Appropriate radiologic studies are mandatory for assessing the extent and nature of lower urinary tract injuries following blunt pelvic trauma. A flow sheet summarizing these radiographic studies is presented in Figure 24. With pelvic fracture, two injuries may be found--extraperitoneal rupture of the bladder and rupture of the posterior urethra. In some patients, these injuries may be combined. Intraperitoneal rupture of the bladder occurs as a result of a blow to the lower abdomen or pelvis in patients whose urinary bladder is distended at the time of injury. A pelvic fracture may or may not be present. Anterior urethral injuries are more commonly associated with instrumentation in the male patient; they may, however, occur as a result of blunt injury to the external genitalia or perineum.


Case Report: Snake Venom Ophthalmia Caused by Cobra Exposure: A Report of 26 Cases.
We report 26 cases of eye injuries resulting from cobra venom sprayed by Naja atra. This accounts for 14.5% of patients (26/173) treated for cobra injuries who presented to the emergency department of a snakebite treatment center in Guangzhou, South China. Pain, blurred vision, lacrimation, photophobia, and foreign body sensation were the most common symptoms, found in 24 patients. Ophthalmic examination revealed eyelid swelling and conjunctival congestion. Eye slit lamp examination showed obvious punctate corneal epithelial defects in four patients. Five patients received an intravenous infusion of antivenom. All patients' eyes were rinsed completely with normal saline after their arrival at the hospital. Prophylactic topical antibiotics were given to all patients. All eyes were cured without long-term sequelae.


Pilot study evaluating use of lymphotrophic nanoparticle-enhanced magnetic resonance imaging for assessing lymph nodes in renal cell cancer.
To assess lymphotrophic nanoparticle-enhanced magnetic resonance imaging (LNMRI) in identifying malignant nodal involvement in patients with renal neoplasms. MRI was performed in 9 patients with renal masses. All patients were imaged on a GE 1.5T system with phased array body coil. Protocols included T2 and T2* weighted imaging before and after administration of ferumoxtran-10 (Combidex) for the evaluation of lymph node (LN) involvement. All 9 patients underwent nephrectomy. Lymph node dissection (LND) was performed in patients with stage 2 renal cell cancer (RCC), or transitional cell cancer (TCC), per routine clinical practice. Data analysis was performed by 2 radiologists, who were blinded to pathologic results. Nodes that lacked contrast uptake were deemed malignant, and those with homogeneous uptake were deemed benign. Quantitative, retrospective analysis was performed on primary tumors by quantifying T2* with a monoexponential fitting algorithm (Osirix). T2* was quantified before, immediately after, and 24 hours after the administration of ferumoxtran-10. MRI demonstrated 26 lymph nodes within the 9 patients imaged (24 benign and 2 malignant). Pathologic results allowed comparison in 22 of the 26 lymph nodes and demonstrated high sensitivity (100%) and specificity (95.7%). LNMRI demonstrated high sensitivity (100%) and specificity (95.7%) in patients with renal neoplasms. Although in a relatively small sample size, the results are encouraging and warrant a larger, prospective trial.


Effect of cigarette smoke and 2-mercaptoethanol administration on age-related alterations and immunological parameters.
In old CBA/Ca mice the effect of cigarette smoke was compared with that of 2-mercaptoethanol (2-ME) treatment. It could be stated that spontaneous death was more frequent in animals kept in cigarette smoke than in the control animals. Prevalence of hepatocellular carcinoma was higher in animals kept in cigarette smoke than in the controls. After 2-ME treatment the occurrence of hepatocellular carcinoma was significantly lower and animals without disorders were more frequent than in smokers. Body weights were lower in animals kept in cigarette smoke and differences in organ indices could be observed, too. Immunological changes were also demonstrated: in mice kept in cigarette smoke the reactivity against a foreign antigen such as sheep erythrocytes (SRBC) was lower, while after 2-ME treatment it was higher than in their controls using direct plaque formation technique. The ratio of normal reactivity (against SRBC) and autoreactivity (against mouse erythrocytes) showed a decrease in smoker animals, and an increase in the 2-ME-treated ones. The experiments showed a deleterious effect of cigarette smoke and a beneficial effect of 2-ME on age-related alterations.


Morphologies of Surface Perforations and Parallel Cylinders Coexisting in Terraced Films of Block Copolymer/Homopolymer Blends with Oxygen Plasma Etching.
This study has demonstrated how oxygen plasma etching carves surface structures for thin films of polystyrene-block-poly(methyl methacrylate)/homopolystyrene blends. By tuning the weight-fraction ratio, blend films form perforations and cylinders on the SiOx/Si substrate. Since perforations exist only on the free surface and substrate interface, short exposure to oxygen plasma to quickly etch the PMMA component produces distorted hexagonal arrays of nanodots on the free surface. The interior of the blend films forms polygrain micro-structures composed of parallel cylinders with an in-plane random orientation. Oxygen plasma etching imposed on the fractured surfaces results in five morphologies: (i) distorted hexagonal arrays of nanoholes, (ii) layer-by-layer stacks, (iii) zigzag-like arrays, (iv) intertwined rectangular arrays of nanodots and nanoholes, and (v) intertwined parallelogram arrays of nanodots and nanoholes. The morphologies suggest synergic effects of grain orientations, stresses, spatial confinement, local segregation of chains, and etching kinetics on the terraced films with oxygen plasma etching.


Systematic review and meta-analyses of foodservice interventions and their effect on nutritional outcomes and satisfaction of adult oncology patients.
An understanding of effective foodservice interventions on nutrition outcomes in adult patients with cancer is required to support clinical decision making. This systematic review aimed to determine the effect of foodservice interventions across a range of nutritional outcomes and satisfaction of hospitalised and ambulatory adult oncology patients. The review protocol was registered with PROSPERO (CRD42016045772). Six databases were searched using search terms associated with the intervention and population. No date or language restrictions were applied. Authors applied the inclusion criteria to titles and abstracts and then full-text papers. The final library was assessed for risk of bias. Outcome data were combined narratively and, where possible, by meta-analysis. From the title and abstract review of 4414 studies, 12 studies testing the effect of foodservice interventions were included in this review. Meta-analyses demonstrated significantly greater energy (mean difference 1.54 MJ/day; 95% CI 0.85-2.23 MJ/day) and protein (mean difference 18.98 g/day; 95% CI 11.58-26.39 g/day) intake through the addition of oral nutrition supplements. Other positive effects on anthropometric outcomes were also recorded. Patient satisfaction was enhanced through other foodservice interventions. Limited original research was found exploring the effect of foodservice interventions in oncology patients. Significant findings were found in favour of the intervention across a range of nutritional outcomes, suggesting that foodservice interventions may improve clinical outcomes and satisfaction in this population. Effective foodservice interventions for oncology patients remain under-researched, so we encourage dietitians and foodservice staff to implement rigorous study designs to evaluate and publish interventions in this clinical group.


The afterlife of the slide: exploring emotional attachment to artefactualised bodily traces.
In this paper I explore the role of the slide, not as familiar scientific object, but rather as a fixed remnant that testifies to the lived experience of an individual. Returning to the scene of the public scandal that surrounded the unauthorised retention of children's organs and tissues at two British hospitals in the late 1990s, I investigate the emotional significance that here came to be attached to archived slides. In so doing I draw attention to the ways in which the facticity of the slide--its ability to testify to the fact, or the existence, not only of the person from whom it is drawn, but also, when created for histopathological reasons, the disease that ultimately killed them--acts to efface their presumed ephemerality. In the final section of the paper I turn to consider how the events that I describe have come to shape the ways in which this kind of highly artefactualised bodily material is now accommodated in the institutional setting of the tissue bank and with what implications for research and the wider dissemination of scientific knowledge. Specifically, I explore how and why slides have come to acquire a "personality" and, with it, something akin to legally constituted "personality rights" including rights relating to publicity and privacy.


[Interaction of annexin VI with actin].
Actin polymerization was investigated using fluorescence probe N-(1-pyrenyl)iodoacetamide, which was bound covalently to reactive sulfhydryl group, Cys-373. Labeled actin in the bulk was 0.5 to 1% of total actin concentration. Actin polymerization at concentration 12 mM was started by addition of 20 mM KCl and 2 mM MgCl2. The label fluorescence was excited at 365 nm and registered at 386 nm. Under actin polymerization the label fluorescence increased almost 10 times. Two main phases may be distinguished in the process of actin polymerization: 1) monomer activation and nucleus (trimer) formation, 2) growth of actin filaments on the nuclei. In our experimental conditions, both for pure actin and for that with added annexin VI, the 1st phase continued for about 3 min and after that the 2nd phase was perfectly approximated by exponential dependence. An analysis of the exponential curves showed that actin monomer lifetime increased from 327 s, at annexin absence, to about 373 s at 0.7 microM annexin and more. Calculation of rate constants at two ends of growing actin filament suggests that annexin VI binds with pointed ("slow") end so that at sufficient annexin concentration the filament grows only on barbed ("fast") end. Our results, together with data of other researchers showing that annexin VI binds with the inner membrane surface of smooth muscle cell through Ca2+, may indicate that, at Ca2+ entering the cell, this annexin binds actin filament pointed ends to cell surface making it ready for the act of contraction.


Relative sensitivity of gel diffusion, complement fixation, and immunoelectroosmophoresis tests for detection of hepatitis-associated antigen and antibody.
The immunoelectroosmophoresis (IEOP) test was compared with gel diffusion and complement fixation (CF) tests for sensitivity in detecting hepatitis-associated antigen (HAA) in the sera of hepatitis patients, for titration of HAA, and for detection of antibody to HAA. The IEOP test was found to be slightly more sensitive than either gel diffusion or CF tests for detection of antigen in the patients' sera. Titers of HAA demonstrated by IEOP were higher than those seen in gel diffusion tests but lower than CF titers. The gel diffusion test with an "enhancement" pattern was found to be more reliable than the other two procedures for detection of low levels of anti-HAA, due to the greater inhibitory effect of an antigen excess in the IEOP system and the possible masking of low levels of antibody by anticomplementary activity in the CF test system. Staining of immunoprecipitates in the IEOP test contributed little to the sensitivity of the test for detection of HAA.


Trends in child marriage, sexual violence, early sexual intercourse and the challenges for policy interventions to meet the sustainable development goals.
Child marriage remains a prevalent issue in low- and middle-income countries (LMIC) despite global declines. Girls are disproportionately affected, facing health risks, limited education, and restricted decision-making power. We aim to provide insights for child marriage prevalence across LMIC from 1990 to 2020, with a focus on sexual violence and early sexual intercourse for public health policy interventions. This study used World Bank datasets to assess progress in addressing child marriage in LMIC countries. Statistical analyses, including trend analysis and compound annual growth rate (CAGR), were conducted to evaluate indicators of first marriage, sexual violence, and sexual intercourse. Countries with sufficient data were categorized based on prevalence rates and trends, and detailed analysis focused on significant indicators. While significant reductions were observed in the prevalence of child marriage before the age of 15 and 18 and early sexual intercourse in most countries, few countries show increasing trends, and others could not demonstrate statistical trends due to data limitations, such as scarcity of data for boys. Overall, many countries showed a decline in sexual violence and early sexual intercourse before the age of 15, but some exhibited increasing trends. For instance, Zambia and Senegal showed a decreasing trend of sexual violence, while Nigeria exhibited an increasing trend. Notably, Uganda, Cameroon, and Sierra Leone for women, and Namibia, Zambia, and Kenya for men, experienced substantial decline in early sexual intercourse. There is a decline in child marriage, sexual violence, and early sexual intercourse in most countries independent from the income group. Only a few countries show slight increasing trends. The improvements confirm that policies that address education, employment, and deep-rooted gender inequality at the societal level seem to be effective and help reach the SDG. However, better data are needed to enhance the understanding of the development of child marriage in these countries to improve the effectiveness of policy intervention. Therefore, we recommend that policymakers not only include existing evidence that continues progress but also increase and improve the monitoring of relevant indicators.


The Influence of Social Media and Institutional Trust on Vaccine Hesitancy in France: Examining Direct and Mediating Processes.
Vaccine hesitancy (VH) remains an ongoing challenge in French society. This project explored how institutional trust and preference for information via social media (PISM) drive hesitancy. Across a large, nationally represented population, our findings show that PISM and trust are strongly correlated measures, with both independently predicting VH. Subsequent mediation tests show that social media operates as primarily an indirect contributor to VH through trust. Additional tests involving VH and non-VH typologies revealed that institutional trust consistently predicts greater general support for vaccines and reduced distrust in vaccination. Conversely, PISM directly drives vaccine distrust, with its impact on non-hesitancy fully mediated by institutional trust. Overall, these findings point to the relevance for researchers and public health deciders to address the nature by which people utilize social media information resources and how that interacts with levels of trust for national institutions.


Diagnostic accuracy and role of intraoperative biplane transesophageal echocardiography in pediatric patients with left ventricle outflow tract lesions.
To define the lesion-specific role of biplane transesophageal echocardiography in children with left ventricular outflow tract obstructive lesions, the diagnostic accuracy of transthoracic and transesophageal images were compared, and the impact of transesophageal echocardiography on perioperative management was evaluated. The reported high postoperative recurrence of left ventricular outflow tract obstructive lesion can be due to its incomplete surgical relief. A full preoperative definition of the lesions would aid in better surgical outcome. The complexity and spectrum of such lesions provide opportunity to evaluate the role of a recently available biplane transesophageal pediatric probe in its diagnosis and surgical management. In 16 consecutive patients (11 male patients) with left ventricular outflow tract obstructive lesions and with a mean age of 7.9 +/- 5.7 years (range 0.25 to 20.0 years) and a mean weight of 29 +/- 19 kg (range 4 to 66 kg), the morphologic and hemodynamic findings of standard preoperative transthoracic and intraoperative biplane transesophageal echocardiography were compared with surgical and cardiac catheterization findings (in seven patients) for the diagnostic accuracy and impact on the surgical management of the lesions. Based on the levels of agreement, transesophageal echocardiography demonstrated higher diagnostic sensitivity (chi-squared analysis = 13.4 < 0.001) to the presence and extent of associated lesions (septal hypertrophy, multiple fibromuscular insertions, involvement of aortic and mitral valves not revealed by transthoracic imaging) and trend toward higher sensitivity (Fisher's exact p = 0.17) to primary morphologic diagnoses (abnormal chordal attachments, prolapsed aortic cusp, and tunnel-like outflow tract obstructive lesions missed by transthoracic imaging). As a result of these factors, intraoperative transesophageal imaging changed the surgical plan in 25% of the patients and modified it in an additional 25% of the patients. Transesophageal echocardiography can be a reliable diagnostic tool and has an important role in the surgical management of left ventricular outflow tract lesions in children.


[Variants of the use of hemosorption in patients with acute clofelin poisoning].
Indications to hemadsorption in patients with grave poisonings with clofelin have been defined. Two variants of hemadsorption for such patients have been developed and tried: hemadsorption in parallel with transesophageal electrocardiostimulation and that with blood stabilization with sodium citrate in the extracorporeal contour. Hemadsorption brought about a good clinical effect, normalized hemo- and cardiodynamics, removed depression of the sinus node function and the conduction tract of the heart. Sodium citrate stabilization of the blood did not exert a negative impact on the cardiovascular function and decreased the incidence of hemorrhagic complications.


[A new systemic combination chemotherapy to be provided at home for patients with unresectable recurrent colorectal cancer].
We compared the effectiveness of 5-FU + l-LV with CDDP + 5-FU as a systemic chemotherapy for unresectable recurrence of colorectal cancer. The protocol we carried out in one group was as follows: (Group 1) 5-FU 2,000 mg mixed with l-LV 100-200 mg in the disposable balloon pump was administered continuously for 1 week. In the other group, (Group 2) we administered CDDP 5 mg/day every 5 days for a week and continuous 5-FU 500 mg/day for 3 weeks in the hospital, and in the outpatient clinic CDDP 5 mg/day every 2 days for a week with UFT-E 300-600 mg/day, orally, everyday. The response rate of Group 1 was 18.8% and that of Group 2 was 19.3%; the median survival time (MST) was 10.8 months for Group 1 and 8.4 months for Group 2. There were no significant differences between the 2 groups regarding these parameters. Hand foot syndrome (HFS) was observed in 43.8% of the patients, and stomatitis in 37.5% of all cases as adverse effect of systemic chemotherapy using 5-FU + l-LV. But the grade of the adverse effect was low and patients could continue with this systemic chemotherapy.


A meta-analysis of differences in children's reports of single and repeated events.
When children report abuse, they often report that it occurred repeatedly. In most jurisdictions, children will be asked to report each instance of abuse with as many details as possible. In the current meta-analysis, we analyzed data from 31 experiments and 3099 children. When accuracy was defined as the number of correct details from the target instance (i.e., narrow definition), repeated-event children were less accurate than single-event children. However, we argue that defining accuracy as the number of reported details that were experienced across instances (i.e., broad definition) is more appropriate for repeated events. When a broad definition was applied, single- and repeated-event children were similarly accurate. Importantly, repeated-event children were less likely than single-event children to report details that had never been experienced and they were no more likely to say "I don't know." Overall, repeated-event children were more suggestible than single-event children, but this was moderated by length of delay to recall. In analyses of recognition data, single-event children's sensitivity score was higher than repeated-event children's, with no significant difference in response bias as a function of event frequency. We discuss these results in the context of how children's memory for repeated events is organized. We also consider the advantage of applying a broad definition of accuracy for victims of repeated abuse and charging repeated abuse as a continuous offense rather than discrete acts. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Spontaneous activity in the developing auditory system.
Spontaneous electrical activity is a common feature of sensory systems during early development. This sensory-independent neuronal activity has been implicated in promoting their survival and maturation, as well as growth and refinement of their projections to yield circuits that can rapidly extract information about the external world. Periodic bursts of action potentials occur in auditory neurons of mammals before hearing onset. This activity is induced by inner hair cells (IHCs) within the developing cochlea, which establish functional connections with spiral ganglion neurons (SGNs) several weeks before they are capable of detecting external sounds. During this pre-hearing period, IHCs fire periodic bursts of Ca(2+) action potentials that excite SGNs, triggering brief but intense periods of activity that pass through auditory centers of the brain. Although spontaneous activity requires input from IHCs, there is ongoing debate about whether IHCs are intrinsically active and their firing periodically interrupted by external inhibitory input (IHC-inhibition model), or are intrinsically silent and their firing periodically promoted by an external excitatory stimulus (IHC-excitation model). There is accumulating evidence that inner supporting cells in Kölliker's organ spontaneously release ATP during this time, which can induce bursts of Ca(2+) spikes in IHCs that recapitulate many features of auditory neuron activity observed in vivo. Nevertheless, the role of supporting cells in this process remains to be established in vivo. A greater understanding of the molecular mechanisms responsible for generating IHC activity in the developing cochlea will help reveal how these events contribute to the maturation of nascent auditory circuits.


Caffeine consumption and onset of alcohol use among early adolescents.
Preventing or delaying the onset of alcohol use among children and youth is an important public health goal. One possible factor in alcohol use onset among early adolescents is caffeine. The aim of this study was to assess the possible contribution of caffeine to the onset of alcohol use during early adolescence. We used data from the Young Mountaineer Health Study Cohort. Survey data were collected from 1349 (response rate: 80.7%) 6th grade students (mean age at baseline 11.5 years) in 20 middle schools in West Virginia during the fall of 2020, and again approximately 6 months later in spring of 2021. We limited our analyses to students reporting never having used any form of alcohol at baseline. Logistic regression was employed in multivariable analyses and both Odds Ratios and Relative Risks reported. At follow-up, almost 14% of participants reported having consumed alcohol at least once and 57% used caffeine of 100 mg + daily. In multivariable analyses we controlled for social and behavioral variables known to impact tobacco use. Caffeine use was operationalized as a three-level factor: no use, <100 mg per day, and 100 + mg per day, with the latter being the approximate equivalent of the minimum of a typical cup of coffee or can of energy drink. Caffeine use of 100 mg + per day was significantly related to alcohol use at 6-months follow-up (OR: 1.79, RR: 1.56, p = .037). We conclude that caffeine consumption among 11-12-year-old adolescents may be a factor in early onset of alcohol use.


The Use of Cementless Components Does Not Significantly Increase Procedural Costs in Total Knee Arthroplasty.
Modern cementless total knee arthroplasty (TKA) designs have shown promising early clinical success; however, concerns exist regarding the higher cost of the cementless implants. The purpose of this study is to evaluate the total facility cost of cementless vs traditional cemented TKA along with the effect of cementless fixation on short-term outcomes. We reviewed a consecutive series of patients between 2015 and 2017 who underwent either cementless or cemented primary TKA. Itemized facility costs were calculated for every procedure using a time-driven activity-based costing algorithm. Controlling for demographic variables and medical comorbidities, we performed a multivariate analysis to identify independent risk factors for facility costs following TKA. Short-term outcome metrics including complications, readmissions, and patient-reported outcomes were compared between groups. Among the 2426 primary TKA patients in this study, 119 (4.91%) were performed using cementless implants. When compared to cemented TKA, cementless TKA patients had higher implant costs ($3047.80 vs $2808.73, P < .0001), but lower supply costs ($639.49 vs $815.57, P < .0001) and lower operating room personnel costs ($982.01 vs $1238.26, P < .0001). When controlling for confounding variables, cementless fixation did not have a significant effect on total facility cost or outcomes. In conclusion, the use of cementless TKA implants did not significantly increase total procedural costs when compared to traditional cemented TKA components at our institution. Our data suggest that the increased cost of a cementless implant is recouped through savings in cost of cement and supplies, as well as shorter operative times. The authors encourage investigators at other institutions to use the authors' methodology to evaluate (preferably in a prospective manner) whether the findings from this study can be corroborated.


Effect of secreted Bacteroides proteases on human intestinal brush border hydrolases.
Selected bacteroides species secreted various amounts of protease and glycosidase into their growth medium. Bacteroides vulgatus, distasonis, and ovatus secreted the most (31-60% of total). The secreted protease was similar in action to the protease within the organism, in that it had a broad pH optimum of 6-9, a K(m app.) for casein of 0.1 muM, and was inhibited by benzamidine, phenylmethylsulfonyl fluoride, diisopropylfluorophosphate (DIFP), and by an elastase inhibitor, Ac(Ala)(3)AlaCH(2)Cl. Exposure of human brush border preparations to the secreted protease reduced maltase and sucrase activities; the reduction could be prevented by DIFP. In contrast, brush border alkaline phosphatase activity either did not change or increased after exposure to bacterial secretions. >90% inhibition of secreted glycosidase using EDTA and p-chloromercuribenzoic acid did not prevent the reduction of brush border maltase and sucrase activity, suggesting that glucosidases were not likely to be involved in the destruction of brush border enzymes. Moreover, the bacterial proteases caused only a small net release of active maltase or sucrase from the brush border. Most of the loss of activity was due to destruction of the enzyme. Proximal bowel fluid of three patients with overgrowth contained DIFP-inhibitable protease that destroyed sucrase in isolated brush borders. A Bacteroides species was isolated from each sample that secreted protease and destroyed brush border sucrase. We conclude that in bacterial overgrowth syndromes, brush border damage may occur from protease(s) secreted by Bacteroides.


The endoendothelial lining as studied by a fluorescent labeling technique in situ.
The microcirculatory blood vessels of the exposed rat mesentery were observed by intravital microscopy using incident fluorescence excitation and transmitting bright field illumination. Fibrinogen conjugated with the fluorescent dye Fluorescein-Isothiocyanate and injected intravenously was found to accumulate at the vessel wall mostly at the inner lining of venules. The accumulation did not occur in an uniform manner, but appeared as circumscribed streaks, nets and bands in some areas whereas other parts of the microcirculation remained free of any fibrinogen wall adherence. Heparin pretreatment did not influence the phenomena. Blocking the fibrinolytic activity of the blood increased the fibrinogen deposition. Fibronectin labeled with a second fluorescent dye, Rhodamin B-Isothiocyanate, could be differentiated from fibrinogen in the same animal. Both proteins accumulated at the same places of the vessels inner lining. Since albumin and gamma globulin did not show any affinities to the vessel wall, we postulate receptors for fibrinogen and fibronectin at the endoendothelial surface of the microcirculatory endothelial cells.


Association of current smoking with airway inflammation in chronic obstructive pulmonary disease and asymptomatic smokers.
Inflammation in the airways and lung parenchyma underlies fixed airway obstruction in chronic obstructive pulmonary disease. The exact role of smoking as promoting factor of inflammation in chronic obstructive pulmonary disease is not clear, partly because studies often do not distinguish between current and ex-smokers. We investigated airway inflammation in sputum and bronchial biopsies of 34 smokers with chronic obstructive pulmonary disease (9 Global initiative for Chronic Obstructive Lung Disease stage 0, 9 stage I, 10 stage II and 6 stage III) and 26 asymptomatic smokers, and its relationship with past and present smoking habits and airway obstruction. Neutrophil percentage, interleukin-8 and eosinophilic-cationic-protein levels in sputum were higher in chronic obstructive pulmonary disease (stage I-III) than asymptomatic smokers. Inflammatory cell numbers in bronchial biopsies were similar in both groups. Current smoking correlated positively with macrophages: in bronchial biopsies in both groups, and in sputum in chronic obstructive pulmonary disease. Pack-years smoking correlated positively with biopsy macrophages only in chronic obstructive pulmonary disease. Inflammatory effects of current smoking may mask the underlying ongoing inflammatory process pertinent to chronic obstructive pulmonary disease. This may have implications for future studies, which should avoid including mixed populations of smokers and ex-smokers.


Anti-Angiogenic/Vascular Effects of the mTOR Inhibitor Everolimus Are Not Detectable by FDG/FLT-PET.
Noninvasive functional imaging of tumors can provide valuable early-response biomarkers, in particular, for targeted chemotherapy. Using various experimental tumor models, we have investigated the ability of positron emission tomography (PET) measurements of 2-deoxy-2-[(18)F]fluoro-glucose (FDG) and 3'-deoxy-3'-[(18)F]fluorothymidine (FLT) to detect response to the allosteric mammalian target of rapamycin (mTOR) inhibitor everolimus. Tumor models were declared sensitive (murine melanoma B16/BL6 and human lung H596) or relatively insensitive (human colon HCT116 and cervical KB31), according to the IC(50) values (concentration inhibiting cell growth by 50%) for inhibition of proliferation in vitro (<10 nM and >1 microM, respectively). Everolimus strongly inhibited growth of the sensitive models in vivo but also significantly inhibited growth of the insensitive models, an effect attributable to its known anti-angiogenic/vascular properties. However, although tumor FDG and FLT uptake was significantly reduced in the sensitive models, it was not affected in the insensitive models, suggesting that endothelial-directed effects could not be detected by these PET tracers. Consistent with this hypothesis, in a well-vascularized orthotopic rat mammary tumor model, other antiangiogenic agents also failed to affect FDG uptake, despite inhibiting tumor growth. In contrast, the cytotoxic patupilone, a microtubule stabilizer, blocked tumor growth, and markedly reduced FDG uptake. These results suggest that FDG/FLT-PET may not be a suitable method for early markers of response to antiangiogenic agents and mTOR inhibitors in which anti-angiogenic/vascular effects predominate because the method could provide false-negative responses. These conclusions warrant clinical testing.


Influence of electron donor/acceptor concentrations on hydrous ferric oxide (HFO) bioreduction.
Dissimilatory metal-reducing bacteria (DMRB) facilitate the reduction of Fe and Mn oxides in anoxic soils and sediments and play an important role in the cycling of these metals and other elements such as carbon in aqueous environments. Previous studies investigating the reduction of Fe(III) oxides by DMRB focused on reactions under constant initial electron donor (lactate) and electron acceptor (Fe oxide) concentrations. Because the concentrations of these reactants can vary greatly in the environment and would be expected to influence the rate and extent of oxide reduction, the influence of variable electron acceptor and donor concentrations on hydrous ferric oxide (HFO) bioreduction was investigated. Batch experiments were conducted in pH 7 HCO3 buffered media using Shewanella putrefaciens strain CN32. In general, the rate of Fe(III) reduction decreased with increasing HFO:lactate ratios, resulting in a relatively greater proportion of crystalline Fe(III) oxides of relatively low availability for DMRB. HFO was transformed to a variety of crystalline minerals including goethite, lepidocrocite, and siderite but was almost completely dissolved at high lactate to HFO ratios. These results indicate that electron donor and acceptor concentrations can greatly impact the bioreduction of HFO and the suite of Fe minerals formed as a result of reduction. The respiration driven rate of Fe(II) formation from HFO is believed to be a primary factor governing the array of ferrous and ferric iron phases formed during reduction.


Motor neuron disease associated with multiple myeloma.
The association between Amyotrophic Lateral Sclerosis or other Motor Neuron Diseases (MNDs) with Lymphoproliferative Disorders (LPDs) and plasma cell neoplasias (such as Hodgkin's or non-Hodgkin's lymphoma, Waldenstrom's macroglobulinemia, multiple myeloma, chronic lymphocytic leukemia) has been described. It is not clear whether LPDs play a role in the pathogenesis of MND; however it is possible that patients might have antibodies against motor neurons. An association between motor neuron disease and Multiple myeloma (MM) is rarely reported in the literature. This article reports a case of a 75-year-old male with MM and MND. Interestingly, the patient was in complete remission for MM when he was diagnosed as MND and he died due to progressive MND.


CytoLyt® fixation and decalcification pretreatments alter antigenicity in normal tissues compared with standard formalin fixation.
Immunohistochemistry is used on cell blocks constructed from cytopathology samples fixed in methanol-based fixatives, such as CytoLyt (Cytyc Corp), and on surgical pathology tissues exposed to decalcifying agents, often without technical validation. We evaluated a panel of commonly utilized antibodies in normal tissues exposed to differing preanalytic conditions as follows: CytoLyt fixation, formalin fixation followed by exposure to decalcifying agents (Leica Decalcifier I-10% formic acid or Leica Decalcifier II-5% hydrochloric acid), or standard formalin fixation. Altered expression was observed with several antibodies compared with standard formalin fixation. Specifically, there was absent or near absent expression of thyroid transcription factor 1 (TTF-1), D2-40, and CD20 in CytoLyt-fixed tissues, whereas reduced expression was observed for p63, estrogen receptor, S100 protein, CD3, calretinin, chromogranin, and synaptophysin. Absent or near absent expression of TTF-1 was also observed with exposure to hydrochloric acid, whereas reduced expression was observed for CK5/6, CK7, p63, estrogen receptor, leukocyte common antigen, CD3, CD20, and synaptophysin. Exposure to formic acid had less impact with reduced expression observed for only 3 antibodies (CK8/18, CK7, and TTF-1). The results of this study demonstrate the need to validate immunohistochemical protocols on control tissue treated in the same manner as test tissue, including CytoLyt fixation and exposure of tissue to decalcifying agents.


Cystic fibrosis decreases the apical membrane chloride permeability of monolayers cultured from cells of tracheal epithelium.
The tracheal mucosa from a 12-year-old girl was digested with collagenase 4 hr after her death from cystic fibrosis. Forty million viable cells were obtained. The cells, plated at 10(6) per cm2 onto four Nuclepore filters coated with human placental collagen, formed confluent monolayers after 1 day. Their ultrastructure was similar to that of normal human cells. They were studied in conventional Ussing chambers or with intracellular microelectrodes on days 5-7 after plating. The monolayers displayed resistance of 380 +/- 50 omega X cm2 and short-circuit current (Isc) of 1.8 +/- 0.4 microA X cm-2. This resistance is similar to that obtained for dog or normal human monolayers. The Isc is less than normal human (approximately 3 microA X cm-2) or dog (approximately 10 microA X cm-2) cells. The cystic fibrosis cells resembled normal monolayers in that serosal ouabain and mucosal amiloride inhibited Isc, while mucosal ouabain or serosal amiloride had no effect. They differed from normal human or dog cells in that Isc was not inhibited by bumetanide and the stimulation of Isc by isoproterenol or prostaglandin E2 was greatly reduced or abolished. Addition of isoproterenol depolarized apical membrane potential (psi a) and decreased fractional resistance (fR) in normal human and dog but had no effect on psi a or fR in cystic fibrosis cells. Reduction of mucosal chloride from 120 to 5 mM by replacement with gluconate increased fR of dog and normal human monolayers and depolarized psi a by 22 (dog) or 30 (human) mV. In cystic fibrosis monolayers, chloride replacement hyperpolarized psi a by 2 mV and had little effect on fR. These results suggest that the primary defect in cystic fibrosis is reduced apical membrane chloride conductance.


Successful Liver Transplants for Liver Failure Associated With Pyruvate Kinase Deficiency.
Pyruvate kinase deficiency (PKD) is the most common cause of congenital nonspherocytic chronic hemolytic anemia, and patients normally present with mild to severe anemia, unconjugated hyperbilirubinemia, and splenomegaly. Only a few reports of PKD have documented its association with severe, progressive liver failure. In all those cases, the patients died before liver transplant (LT) or immediately after transplant. We report 2 case patients with liver failure associated with PKD who successfully underwent LT and splenectomy: an infant who presented with neonatal cholestasis and a young adult with a severe form of PKD and having been transfusion dependent during childhood. After transplant, both patients have normal liver function test results and have considerably decreased their need for blood transfusion despite ongoing, mild hemolysis. We suggest that PKD can lead to severe liver dysfunction and that LT and splenectomy can be life-saving procedures in such cases.


The burden of hospitalized sports-related injuries in children: an Australian population-based study, 2005-2013.
There is concern about recent increase and severity of sports-related injuries in children. Despite the benefits of sports participation, injuries may carry long-term health consequences. We aimed to evaluate the prevalence, characteristics and types of hospitalized sports-related injuries in children. Population-based study of all acute sports-related injuries requiring hospitalization in children 5 to 15 years of age in New South Wales (NSW), Australia, 2005-2013. Health information was obtained from the NSW Admitted Patient Data Collection, a census of all hospital admissions from public and private hospitals. Children with a recorded ICD10-AM injury code (S00-T79) and sport-related activity code (U50-U70) were included. Prevalence and trend in injuries by age group, sporting code, body region affected and type of injury were assessed. There was a total of 20,034 hospitalizations for sports-related injuries (2.7% of all hospitalizations in children aged 5-15 years), involving 21,346 recorded injuries in 19,576 children. The overall population hospitalization period prevalence was 227 per 100,000 children aged 5-15 years in 2005-2013, remaining stable over time (RR 0.99; 95% CI 0.98-1.00). Football codes such as rugby league/union and soccer combined represented nearly two thirds of the total (60%). The most common body regions affected were the forearm (31%) head (15%) and hand injuries (13%). Fractures accounted for 65% of injuries followed by dislocations (10%) and traumatic brain injury (10%). Compared to other age groups, children aged 5-8 years had double the proportion of shoulder (15% vs. 7%) while 13-15 year olds had higher proportion of lower-leg (14% vs. 8%) and knee (6% vs.2%) injuries. One in seven injuries sustained while playing rugby league/union, baseball and hockey were traumatic brain injuries. A total of 444 (2.2%) of children had more than one hospitalization for sports-related injuries. On average, six children were hospitalized every day for sports-related injuries in the last decade with trends remaining stable. The most common sports involved were football codes, one in three injuries involved the forearm and two thirds were fractures. These findings can be used to inform health policy and sporting governing bodies to target preventive interventions and promote safe sports participation in children.


Idiopathic distal small fiber neuropathy.
We describe the clinical details of 20 elderly patients with idiopathic small fiber neuropathy. This neuropathy is ubiquitous in practice but has not been well characterized. The clinical syndrome is relatively stereotyped and appears to be a frequent cause of burning feet in the elderly. The main features were burning, painful paresthesias and dysesthesias in the feet, lancinating pains, moderate to severe distal small fiber sensory loss, absent ankle reflexes, and minimal or no distal foot weakness. All but 2 had mild loss of vibration sense but none had significant proprioceptive loss or sensory ataxia. EMG was normal in 9 while the others had a mild sensorimotor axonal neuropathy. Sural nerve biopsy was normal in 3 and showed axonal loss in 6. Progression was slow, and although pain was a troublesome symptom, no patient became disabled. Symptoms were refractory to most symptomatic therapies but several patients improved with gammaglobulin infusions.


Adrenal necrosis in a dog receiving trilostane for the treatment of hyperadrenocorticism.
Clinical and biochemical changes suggestive of hypoadrenocorticism were observed in a 10-year-old male neutered Staffordshire bull terrier shortly after beginning therapy with trilostane for the treatment of hyperadrenocorticism. The dog's condition was stabilised with intravenous fluids, fludrocortisone and prednisolone. An exploratory laparotomy and excisional biopsy of the left adrenal gland were performed. Histopathological analysis showed adrenal cortical necrosis with reactive inflammation and fibrosis. Trilostane is a reversible inhibitor of steroid synthesis and this complication has not been reported previously. Clinicians should be aware that trilostane therapy may result in adrenal necrosis but that prompt treatment might correct a life-threatening situation.


The appendicitis inflammatory response score: a tool for the diagnosis of acute appendicitis that outperforms the Alvarado score.
The clinical diagnosis of appendicitis is a subjective synthesis of information from variables with ill-defined diagnostic value. This process could be improved by using a scoring system that includes objective variables that reflect the inflammatory response. This study describes the construction and evaluation of a new clinical appendicitis score. Data were collected prospectively from 545 patients admitted for suspected appendicitis at four hospitals. The score was constructed from eight variables with independent diagnostic value (right-lower-quadrant pain, rebound tenderness, muscular defense, WBC count, proportion neutrophils, CRP, body temperature, and vomiting) in 316 randomly selected patients and evaluated on the remaining 229 patients. Ordered logistic regression was used to obtain a high discriminating power with focus on advanced appendicitis. Diagnostic performance was compared with the Alvarado score. The ROC area of the new score was 0.97 for advanced appendicitis and 0.93 for all appendicitis compared with 0.92 (p = 0.0027) and 0.88 (p = 0.0007), respectively, for the Alvarado score. Sixty-three percent of the patients were classified into the low- or high-probability group with an accuracy of 97.2%, leaving 37% for further investigation. Seventy-three percent of the nonappendicitis patients, 67% of the advanced appendicitis, and 37% of all appendicitis patients were correctly classified into the low- and high-probability zone, respectively. This simple clinical score can correctly classify the majority of patients with suspected appendicitis, leaving the need for diagnostic imaging or diagnostic laparoscopy to the smaller group of patients with an indeterminate scoring result.


Deep Reconstruction of Least Significant Bits for Bit-Depth Expansion.
Bit-depth expansion (BDE) is important for displaying a low bit-depth image in a high bit-depth monitor. Current BDE algorithms often utilize traditional methods to fill the missing least significant bits and suffer from multiple kinds of perceivable artifacts. In this paper, we present a deep residual network-based method for BDE. Based on the different properties of flat and non-flat areas, two channels are proposed to reconstruct these two kinds of areas, respectively. Moreover, a simple yet efficient local adaptive adjustment preprocessing is presented in the flat-area-channel. By combining the benefits of both the traditional debanding strategy and network-based reconstruction, the proposed method can further promote the subjective quality of the flat area. Experimental results on several image sets demonstrate that the proposed BDE network can obtain favorable visual quality as well as decent quantitative performance.


The Impact of Generative Conversational Artificial Intelligence on the Lesbian, Gay, Bisexual, Transgender, and Queer Community: Scoping Review.
Despite recent significant strides toward acceptance, inclusion, and equality, members of the lesbian, gay, bisexual, transgender, and queer (LGBTQ) community still face alarming mental health disparities, being almost 3 times more likely to experience depression, anxiety, and suicidal thoughts than their heterosexual counterparts. These unique psychological challenges are due to discrimination, stigmatization, and identity-related struggles and can potentially benefit from generative conversational artificial intelligence (AI). As the latest advancement in AI, conversational agents and chatbots can imitate human conversation and support mental health, fostering diversity and inclusivity, combating stigma, and countering discrimination. In contrast, if not properly designed, they can perpetuate exclusion and inequities. This study aims to examine the impact of generative conversational AI on the LGBTQ community. This study was designed as a scoping review. Four electronic scholarly databases (Scopus, Embase, Web of Science, and MEDLINE via PubMed) and gray literature (Google Scholar) were consulted from inception without any language restrictions. Original studies focusing on the LGBTQ community or counselors working with this community exposed to chatbots and AI-enhanced internet-based platforms and exploring the feasibility, acceptance, or effectiveness of AI-enhanced tools were deemed eligible. The findings were reported in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews). Seven applications (HIVST-Chatbot, TelePrEP Navigator, Amanda Selfie, Crisis Contact Simulator, REALbot, Tough Talks, and Queer AI) were included and reviewed. The chatbots and internet-based assistants identified served various purposes: (1) to identify LGBTQ individuals at risk of suicide or contracting HIV or other sexually transmitted infections, (2) to provide resources to LGBTQ youth from underserved areas, (3) facilitate HIV status disclosure to sex partners, and (4) develop training role-play personas encompassing the diverse experiences and intersecting identities of LGBTQ youth to educate counselors. The use of generative conversational AI for the LGBTQ community is still in its early stages. Initial studies have found that deploying chatbots is feasible and well received, with high ratings for usability and user satisfaction. However, there is room for improvement in terms of the content provided and making conversations more engaging and interactive. Many of these studies used small sample sizes and short-term interventions measuring limited outcomes. Generative conversational AI holds promise, but further development and formal evaluation are needed, including studies with larger samples, longer interventions, and randomized trials to compare different content, delivery methods, and dissemination platforms. In addition, a focus on engagement with behavioral objectives is essential to advance this field. The findings have broad practical implications, highlighting that AI's impact spans various aspects of people's lives. Assessing AI's impact on diverse communities and adopting diversity-aware and intersectional approaches can help shape AI's positive impact on society as a whole.


Mesiodens: a radiographic study in children.
We analyzed the frequency and radiological features of mesiodens in a group of children in Turkey. The study was based on a radiographic review of 23,000 pediatric patients (male: 12,667 female; 10,333) who visited the Department of Oral Diagnosis and Radiology during the period 2003-2005 (3 years). The presence of an unerupted supernumerary tooth, or tooth bud between the 2 central incisors or as unilateral or bilateral teeth in the midline of the maxilla was noted as mesiodens on radiographs. Eighty-five cases of mesiodens in 69 patients were found. Complete documentation, including radiographs, for these 69 patients were studied and analyzed. In addition to gender and age, the following information about the mesiodens was recorded: 1) number; 2) shape; 3) position; 4) complications caused by the mesiodens; 5) treatment. Of the 69 patients, the ratio of boys (47 cases) to girls (22 cases) was 2.1:1. Fifty-three (76.8%) of the children had 1 mesiodens, and 16 (23.1%) had 2 mesiodentes bilaterally to the midline. Of the 85 mesiodentes, 67 (78.8%) were fully impacted, 6 (7%) were partially erupted, and 12 (14.1%) were fully erupted. Most of the mesiodentes (55.2%) were found in the vertical position, followed by inverted position (37.6%), and horizontal position (7%). The main complications were delayed eruption of the permanent incisors (38.8%), maxillary midline diastema (17.6%), axial rotation or inclination of erupted permanent incisors (16.4%), and resorption of the adjacent teeth (4.7%) The prevelance of mesiodens has been estimated to be 0.15% to 2.2% of the population.


Fluticasone-formoterol: a systematic review of its potential role in the treatment of asthma.
The purpose of this systematic review is to summarize and evaluate the available published data regarding the efficacy and safety of a combination product containing fluticasone propionate/formoterol (FP-F) in order to establish its potential role compared with other inhaled combination corticosteroid/long-acting beta2 receptor agonists for the maintenance treatment of asthma. A PubMed and EMBASE search was conducted using the terms "fluticasone propionate", "formoterol fumarate", "Flutiform(®)", and "asthma" in July 2014 to identify trials using this combination specifically for the treatment of asthma. Additional information was gathered from references cited in the identified publications, the package insert, and the ClinicalTrials. gov registry. All randomized controlled clinical trials for humans in asthma were evaluated for inclusion. Data from animal trials, clinical trials for chronic obstructive pulmonary disease, and non-English sources were excluded. Seven short-term safety and efficacy trials of FP-F compared with its individual components and two comparison trials of FP-F versus other combination products were identified. Generally, the incidence of drug-related adverse events was low and consistent with previously reported drug class-related adverse events (ie, pharyngitis, dysphonia, and headache). The combination of FP-F was shown to be noninferior to fluticasone propionate/salmeterol for improving predose forced expiratory volume at one second (FEV1) and 2 hours post dose FEV1. FP-F was also noninferior to budesonide/formoterol in improving predose FEV1. Other clinical endpoints, including various symptom scores, asthma control, quality of life, and subjects' assessment of the medications were not significantly different. Poor asthma control is common. The data from short-term studies indicate that this inhaled corticosteroid and long-acting beta2 receptor agonist combination product is non-inferior to similar combination products available. As FP-F is available in different strengths, the corticosteroid dose can be titrated without changing devices. A potential advantage is that those with good technique, the same type of device could be used for both their controller and rapid relief inhaler medicines. The choice of this combination versus other similar products may be based primarily on cost.


Abuse of medicines for performance enhancement in sport: why is this a problem for the pharmaceutical industry?
The misuse of medicines for performance enhancement in sport (doping) is not approved by regulatory agencies, and is illegal in many countries. In addition to the 'traditional' doping agents such as steroids, β-blockers and blood transfusions, the list of agents and techniques used in doping is increasing and now includes newer medicines such as erythropoiesis-stimulating agents and growth hormones. Innovative new medicines are of particular interest as would-be dopers may believe them to be undetectable by current methods. Close collaboration between the biopharmaceutical industry and anti-doping agencies such as the World Anti-Doping Agency is critical to a successful anti-doping strategy. Industry is ideally placed to identify the doping potential of new medicines at early stages and to support early development of detection assays. A strong, united front between the biopharmaceutical industry and anti-doping agencies is essential to counter the misuse of medicines for performance enhancement, as well as to promote fair play and clean sport.


Platinum redispersion on metal oxides in low temperature fuel cells.
We have analyzed the aptitude of several metal oxide supports (TiO(2), SnO(2), NbO(2), ZrO(2), SiO(2), Ta(2)O(5) and Nb(2)O(5)) to redisperse platinum under electrochemical conditions pertinent to the Proton Exchange Membrane Fuel Cell (PEMFC) cathode. The redispersion on oxide supports in air has been studied in detail; however, due to different operating conditions it is not straightforward to link the chemical and the electrochemical environment. The largest differences reflect in (1) the oxidation state of the surface (the oxygen species coverage), (2) temperature and (3) the possibility of platinum dissolution at high potentials and the interference of redispersion with normal working potential of the PEMFC cathode. We have calculated the PtO(x) (x = 0, 1, 2) adsorption energies on different metal oxides' surface terminations as well as inside the metal oxides' bulk, and we have concluded that NbO(2) might be a good support for platinum redispersion at PEMFC cathodes.


Evaluation of the microbiological quality of natural processed products for medicinal use marketed in Quito, Ecuador.
To determine the microbiological quality of samples from processed natural products used for medicinal purposes and marketed in Quito, Ecuador. Aerobic microorganisms, molds and yeasts were counted by conventional standardized techniques, according to the United States Pharmacopoeia (USP), in samples from 83 products. The microorganisms found were identified and their antimicrobial sensitivity was determined using the agar diffusion method. The total aerobic microorganism count exceeded the specified limits in 17.0% of syrups, 27.0% of topical products and 43.0% of oral solids; the molds and yeasts count exceeded the limit in 33.0% of syrups, 7.0% of topical products and 36.0% of oral solids. Products for eye use did not pass the sterility test. The most frequently isolated bacterial genus was Bacillus, followed by Escherichia coli, Klebsiella and Enterobacter. Salmonella and Staphylococcus aureus were not found in any product, but potentially pathogenic microorganisms such as Pseudomonas were isolated in 40.0% of the eye drops. Enterobacter and Escherichia coli showed resistance to multiple compounds and Pseudomonas was not resistant to any antibiotic. The microbiological quality of the products examined was not adequate. Potentially pathogenic and antibiotic resistant microorganisms were isolated from the samples. These products may not be suitable for distribution and consumption, even though many of them have sanitary registration. Control and regulation by the corresponding authorities is essential.


Hemodynamic and colloid osmotic pressure alterations in the surgical patient.
Colloid osmotic pressure (COP) was measured simultaneously with cardiorespiratory measurements in 103 surgical patients suspected of having circulatory problems. In a small subset of 28 patients, measurements were taken before, during, and after surgical operations. Similarly, data sets were taken before, during, and after infusions of colloids and crystalloids to assess the interactions of these variables during the stress of surgery and the administration of fluid therapy. COP was found to decrease during and shortly after surgical operations despite reasonably well-maintained pressure, volume, and flow variables. Concentrated (25%) albumin and plasma protein fraction (PPF) increased COP, cardiac index (CI), CVP, pulmonary capillary wedge pressure (WP), and blood volume, whereas crystalloids transiently increased CI, CVP, and WP but did not significantly change COP and blood volume. Low COP values were weakly related to survival, and COP-WP differences less than or equal to 3 mm Hg were roughly related to ARDS and pulmonary edema.


Multiple connexin expression in regenerating arterial endothelial gap junctions.
Endothelial cells form gap junctions that, according to vessel type, may be composed of up to 3 types of connexin, connexin37, connexin40, and connexin43. Although changes in connexin expression have been linked to growth and injury in cultured endothelial cells, information on connexin expression in regenerating endothelium in situ is lacking. We investigated gap junction distribution and expression of all 3 endothelial connexins during healing in rat carotid artery after denudation injury. En face viewing of the vascular luminal surface by means of immunoconfocal microscopy was used to examine the spatial and temporal expression pattern of the endothelial connexins. Gap junction spots labeled by specific antisera against connexin37, connexin40, and connexin43 were quantified 7, 14, and 28 days after injury, and the relations among the connexins were examined by using colocalization analysis. Complementary electron microscopy was also conducted. After injury, the regenerating endothelium initially expressed small, sparse gap junctions, the numbers of which progressively increased to values equivalent to those of controls. Although connexin40 gap-junctional spot size and area returned to uninjured levels by 28 days after injury, connexin37 and connexin43 spot size and area exceeded those of the uninjured artery (P<0.05). Double-label analysis showed that even though colocalization of connexins to the same gap-junctional spot is a common feature, the extent of colocalization was time dependent (>80% in the intact artery at postinjury day 28 and <70% at postinjury days 7 and 14, P<0.01). We conclude that distinct alterations in expression of the 3 connexins are associated with regeneration of the arterial endothelium in situ, implying different intercellular communication requirements during the various phases of the healing process.


Towards intraoperative surgical margin assessment: Validation of an electrical impedance-based probe with ex vivo bovine tissue.
Radical prostatectomy (RP) is a common surgical therapy to treat prostate cancer. The procedure has a high positive surgical margin (PSM) rate ranging from 4-48%. Patients with PSMs have a higher rate of cancer recurrence and often undergo noxious adjuvant therapy. Intraoperative surgical margin assessment (SMA) with an electrical impedance-based probe can potentially identify PSMs in real-time. This would enable surgeons to make data-based decisions in the operating room to improve patient outcomes. This paper focuses on characterizing an impedance sensing SMA probe with specialized electrodes to improve speed and bandwidth while maintaining accuracy. 3D electrical impedance tomography (EIT) reconstructions were generated from ex vivo bovine tissue to characterize probe imaging and to determine an optimal applied pressure range (15 Pa to 38 Pa). Classification accuracy of adipose and muscle tissue was evaluated by comparing the experimental data set to simulated data based on a ground truth binary map of the tissue. Experimental AUCs ≥0.83 were maintained up to 50 kHz. The developed impedance sensing probe successfully classified between muscle and adipose tissue in an ex vivo bovine model. Future work includes improving performance of the SMA probe with custom hardware and collecting data from ex vivo and in vivo prostatic tissues.Clinical Relevance-This technology is expected to reduce the rate of PSMs in RP and decrease the use of post-surgical adjuvant therapies. It is also anticipated that intraoperative impedance measurements will increase efficacy of nerve sparing procedures and reduce complications such as incontinence and erectile dysfunction.


The development of phase I cancer trial methodologies: the use of pharmacokinetic and pharmacodynamic end points sets the scene for phase 0 cancer clinical trials.
Although the concept of a phase 0 trial is a relatively new one, there has been a slowly increasing trend toward basing early clinical trial designs on pharmacokinetic and pharmacodynamic end points that has been developing over many years. This article will review the early cancer trial methodologies and the various techniques that have been used to refine them. Several illustrative examples will be presented showing their relevance to trial designs using pharmacodynamic end points and targeted agents. Some criteria for characterizing suitable phase 0 end points are suggested. Four trial designs that are essentially developed for cytotoxic agents using the maximal tolerated dose as an end point are described. Although these trials were not designed with the use of more sophisticated pharmacodynamic end points (such as the measurement of the effect of a targeted agent on its target), they have been developed to optimize the speed with which a dose needed to achieve a particular effect can be determined and are, to this extent, relevant to the design of studies with pharmacodynamic end points.


[Münchausen syndrome by proxy].
Münchausen syndrome by proxy (MSBP), is a psychiatric disorder, a particular form of child abuse. An impaired emotional relationship exists mainly between the mother and her child. According to the variety of victims' symptoms, all medicine doctors may deal with this syndrome in every day clinical practice. Still insufficient knowledge about the syndrome and its' rare consideration in the differential diagnosis result in only severe, potentially lethal cases recognition. For many years the rest remains a source of a long-term physical and mental injuries in victims. About 30 years from the first attempt to precisely point the signalling symptoms for a proper diagnosis, we present the current knowledge on epidemiology, aetiology, diagnostic criteria, advised management and psychological portrait of the mother with the syndrome and her child, the syndrome's victim.


Development of a risk prediction model among professional hockey players with visible signs of concussion.
Little research examines how to best identify concussed athletes. The purpose of the present study was to develop a preliminary risk decision model that uses visible signs (VS) and mechanisms of injury (MOI) to predict the likelihood of subsequent concussion diagnosis. Coders viewed and documented VS and associated MOI for all NHL games over the course of the 2013-2014 and 2014-2015 regular seasons. After coding was completed, player concussions were identified from the NHL injury surveillance system and it was determined whether players exhibiting VS were subsequently diagnosed with concussions by club medical staff as a result of the coded event. Among athletes exhibiting VS, suspected loss of consciousness, motor incoordination or balance problems, being in a fight, having an initial hit from another player's shoulder and having a secondary hit on the ice were all associated with increased risk of subsequent concussion diagnosis. In contrast, having an initial hit with a stick was associated with decreased risk of subsequent concussion diagnosis. A risk prediction model using a combination of the above VS and MOI was superior to approaches that relied on individual VS and associated MOI (sensitivity=81%, specificity=72%, positive predictive value=26%). Combined use of VS and MOI significantly improves a clinician's ability to identify players who need to be evaluated for possible concussion. A preliminary concussion prediction log has been developed from these data. Pending prospective validation, the use of these methods may improve early concussion detection and evaluation.


[The effect of galodif on the electrical excitability of the brain formations in the rabbit].
In chronic experiments on conscious rabbits with bipolar electrodes implanted into the brain it was found that galodiph suppresses the spontaneous bioelectrical activity of the motor and visual regions of the brain cortex and somewhat decreases electrical excitability of the cortical motor region, basolateral nuclei of the amygdala and dorsal hippocampus.


[For discussion: funding options for digital applications in long-term care].
The difficulties of funding digitalization in long-term care according to the German Social Security Code XI (SGB XI) lie in the tasks of providing care, which at the core remain personnel-related. A reduction in personnel or an increase in production revenues, which is the goal of commercial enterprises through digitalization, is only possible in a few fields in the current regulatory framework for care services. Economic effects are lacking both from the point of view of the companies and from the point of view of the community of solidarity. Only through the transformation of long-term care toward collaborative production in local networks will digitalization attain greater significance and generate added value.


Transvaginal sonography combined with saline contrast sonohysterography to evaluate the uterine cavity in patients with abnormal uterine bleeding and postmenopausal endometrium more than 5 mm.
To determine whether saline contrast sonohysterography (SCSH) gives additional information to that obtained by transvaginal sonography (TVS) for predicting endometrial abnormality in premenopausal, menopausal and postmenopausal patients with abnormal uterine bleeding and postmenopausal patients with endometrial thickness > 5 mm. This was a prospective study at the Ege University Obstetrics and Gynecology Clinic in Izmir, Turkey. Patients presenting with abnormal bleeding related to uterine pathologies, postmenopausal patients with endometrial thickness more than 5 mm and scheduled for surgical treatment were prospectively included in our study conducted between 1 July, 2000 and 31 January, 2002. The uterine cavity was first evaluated with TVS in 53 premenopausal, menopausal, postmenopausal patients with abnormal uterine bleeding and postmenopausal patients whose endometrial thickness was > 5 mm measured by conventional ultrasound examination. SCSH was carried out later with the intention of establishing further surgical management (hysterectomy). Twenty of the patients had operative hysterectomy within the 1.5 year period of time. The presence of focally growing lesions and the type of lesion (endometrial polyp, submucous myoma, malignancy or unclear focal lesion) were noted at ultrasound examination and at hysteroscopy, and then hysterectomy material was examined by Ege University's Pathology Department which provided a detailed evaluation of the uterine cavity. Based on normal endometrial morphology alone, the results for detection of an abnormal uterine cavity were as follows: sensitivity of TVS 0.94, SCSH 0.97; specificity of TVS 0.56, SCSH 0.62; positive predictive value of TVS 0.79, SCSH 0.81; negative predictive value of TVS 0.83, SCSH 0.93. Transvaginal sonography combined with SCSH was superior to TVS for detection of intracavitary abnormalities. When normal endometrial morphology was combined with an endometrial thickness of < 12 mm for evaluation of all abnormalities including hyperplasia, the diagnostic potential of TVS or SCSH was almost unchanged. Transvaginal sonography missed 24% of the polyps. Sonohysterography was a sensitive tool and was superior to TVS used alone for evaluation of the uterine cavity in patients who underwent operative surgery for abnormal uterine bleeding.


[The use of the universal theory of hygienic standards in military hygiene].
On the basis of an abound practice of hygiene standardization, the authors have elaborated a system of fundamental tenets and premises that correspond to the requirements of a universal theory. It includes norms and standards for a living organisms and the environment. The hygiene standardization foundation is based on the principles of guarantee, social-biological balance, complex and dynamics. The tenets stated in the article confirm interrelation and character of the hygiene standards theory formulation and its prognostic function.


[Organization, functioning and expectations of organizations representing patients. Survey of key informants].
To explore patient organizations and their scope in terms of patient and user participation in decisions affecting their health. Semi-structured questionnaire survey of key informants from 21 patient organizations. Most of the patient organizations were regional or national private organizations. Their main objectives include improving quality of life and representing the interests of patients and their families, developing information triage and dissemination activities, and providing additional services not offered by the public health service. The main methods of communicating with members were electronic mail, open meetings and forums. Most patient organizations considered health professionals to be the most important group of stakeholders. The sources of funding most frequently quoted were membership fees, public grants and contributions from the pharmaceutical industry. The most important factor for enhancing patient co-responsibility was considered to be involving patients in health care as a way to improve the quality of the heath services. The proposed future scenario that received the most support was the creation of a legal forum in which the patient's voice could be heard and demonstrably taken into account. Patient organizations can play an important role in providing patients and health professionals with information, promoting self care and improving the effectiveness of health care. These features require visible commitment by the health authorities to facilitate opportunities for patient decisions and choice within the system.


Metabolic syndrome and coronary artery disease in Ossabaw compared with Yucatan swine.
Metabolic syndrome (MetS), a compilation of associated risk factors, increases the risk of type 2 diabetes and coronary artery disease (CAD, atherosclerosis), which can progress to the point of artery occlusion. Stents are the primary interventional treatment for occlusive CAD, and patients with MetS and hyperinsulinemia have increased restenosis. Because of its thrifty genotype, the Ossabaw pig is a model of MetS. We tested the hypothesis that, when fed high-fat diet, Ossabaw swine develop more features of MetS, greater native CAD, and greater stent-induced CAD than do Yucatan swine. Animals of each breed were divided randomly into 2 groups and fed 2 different calorie-matched diets for 40 wk: control diet (C) and high-fat, high-cholesterol atherogenic diet (H). A bare metal stent was placed in the circumflex artery, and pigs were allowed to recover for 3 wk. Characteristics of MetS, macrovascular and microvascular CAD, in-stent stenosis, and Ca(2+) signaling in coronary smooth muscle cells were evaluated. MetS characteristics including, obesity, glucose intolerance, hyperinsulinemia, and elevated arterial pressure were elevated in Ossabaw swine compared to Yucatan swine. Ossabaw swine with MetS had more extensive and diffuse native CAD and in-stent stenosis and impaired coronary blood flow regulation compared with Yucatan. In-stent atherosclerotic lesions in Ossabaw coronary arteries were less fibrous and more cellular. Coronary smooth muscle cells from Ossabaw had impaired Ca(2+) efflux and intracellular sequestration versus cells from Yucatan swine. Therefore, Ossabaw swine are a superior model of MetS, subsequent CAD, and cellular Ca(2+) signaling defects, whereas Yucatan swine are leaner and relatively resistant to MetS and CAD.


Left bundle-branch block induced by transcatheter aortic valve implantation increases risk of death.
Transcatheter aortic valve implantation (TAVI) is a novel therapy for treatment of severe aortic stenosis. Although 30% to 50% of patients develop new left bundle-branch block (LBBB), its effect on clinical outcome is unclear. Data were collected in a multicenter registry encompassing TAVI patients from 2005 until 2010. The all-cause mortality rate at follow-up was compared between patients who did and did not develop new LBBB. Of 679 patients analyzed, 387 (57.0%) underwent TAVI with the Medtronic CoreValve System and 292 (43.0%) with the Edwards SAPIEN valve. A total of 233 patients (34.3%) developed new LBBB. Median follow-up was 449.5 (interquartile range, 174-834) days in patients with and 450 (interquartile range, 253-725) days in patients without LBBB (P=0.90). All-cause mortality was 37.8% (n=88) in patients with LBBB and 24.0% (n=107) in patients without LBBB (P=0.002). By multivariate regression analysis, independent predictors of all-cause mortality were TAVI-induced LBBB (hazard ratio [HR], 1.54; confidence interval [CI], 1.12-2.10), chronic obstructive lung disease (HR, 1.56; CI, 1.15-2.10), female sex (HR, 1.39; CI, 1.04-1.85), left ventricular ejection fraction ≤50% (HR, 1.38; CI, 1.02-1.86), and baseline creatinine (HR, 1.32; CI, 1.19-1.43). LBBB was more frequent after implantation of the Medtronic CoreValve System than after Edwards SAPIEN implantation (51.1% and 12.0%, respectively; P<0.001), but device type did not influence the mortality risk of TAVI-induced LBBB. All-cause mortality after TAVI is higher in patients who develop LBBB than in patients who do not. TAVI-induced LBBB is an independent predictor of mortality.


National Nutrition Survey in Japan--its methodological transition and current findings.
The National Nutrition Survey in Japan (J-NNS), an annual nationwide survey on nutrition and diet of the Japanese people, is reviewed. J-NNS was started in the Tokyo Metropolitan area in 1945 following the end of World War II. The survey area was gradually expanded and became nationwide in 1948. The current survey obtains data from more than 12,000 persons of approximately 5,000 randomly selected households. The survey consists of three parts: a physical examination, a dietary intake survey and a dietary habit questionnaire. The physical examination includes anthropometric measurements and a blood test, the dietary intake survey examines nutrient/food intake with a semi-weighed recording method, and the dietary habit questionnaire monitors nutrition/diet-consciousness and dietary habits. In this review, the aim and brief history of the survey are outlined in the first section. The following section, explains its administrative framework, target population, sampling method, annual schedule and question items, focusing on their historical transition. Then the findings of the J-NNS are summarized, which highlights annual changes in the intake of energy, macronutrients, micronutrients and food groups. The current findings of the dietary habit questionnaire are also given in brief.