Intravenous Iron Sucrose Therapy in Iron Deficiency Anemia in Antenatal and Postnatal Patients.
Dermatophytosis is a common superficial fungal infection of the skin, hair and nails caused by Trichophyton, Microsporum and Epidermophyton dermatophytic species. Identification of causative dermatophytic species tend to vary with time and place and antifungal sensitivity is of epidemiological concern as well as significant for the treatment with precision at the current scenario of increasing antifungal resistance. The objectives was to study clinicomycological profile and antifungal sensitivity pattern of commonly used azoles in dermatophytosis. The prospective analysis of 145 clinically suspected cases of dermatophytosis was conducted from January 2014 to January 2015 at Department of Dermatology of COMS, Bharatpur, Chitwan, Nepal. Cases were evaluated and data recorded as per proforma. Samples were collected for microscopy and culture from skin, hair and nail. Antifungal sensitivity pattern was evaluated by standard disk diffusion technique. Maximum numbers of cases with dermatophytosis were observed between June to September with male to female ratio of 1.4:1. The youngest patient was 3 years and the oldest was 76 years. Tinea corporis (25.5%) was the dominant clnical type observed. Overall direct microscopy (KOH) positivity and culture positivity was 64.8% and 57.2% respectively. Predominant species of dermatophyte isolated was T. mentagrophyte (23.4%). Out of five antifungals used in our study, fluconazole and ketoconazole were found 100% resistant. This study highlighted the increasing resistance of the antifungals, which is responsible for the treatment failure in dermatophye infections.


Molecular mechanism of substrate recognition by folate transporter SLC19A1.
Folate (vitamin B9) is the coenzyme involved in one-carbon transfer biochemical reactions essential for cell survival and proliferation, with its inadequacy causing developmental defects or severe diseases. Notably, mammalian cells lack the ability to de novo synthesize folate but instead rely on its intake from extracellular sources via specific transporters or receptors, among which SLC19A1 is the ubiquitously expressed one in tissues. However, the mechanism of substrate recognition by SLC19A1 remains unclear. Here we report the cryo-EM structures of human SLC19A1 and its complex with 5-methyltetrahydrofolate at 3.5-3.6 Å resolution and elucidate the critical residues for substrate recognition. In particular, we reveal that two variant residues among SLC19 subfamily members designate the specificity for folate. Moreover, we identify intracellular thiamine pyrophosphate as the favorite coupled substrate for folate transport by SLC19A1. Together, this work establishes the molecular basis of substrate recognition by this central folate transporter.


Fusobacterium: anaerobic occult amnionitis and premature labor.
Fusobacterium species are well established pathogens. Before the advent of effective anaerobic antimicrobial therapy, they were associated with prolonged, often fatal courses. Previously, fusobacterium had not been identified as a common perinatal pathogen. Three cases of occult amnionitis due to Fusobacterium are presented. Review of five series of occult amnionitis revealed 23 cases. In seven (30.4%), Fusobacterium was isolated. In 14 (60.8%), an anaerobic species was isolated. The average gestational age of patients from whom anaerobes were grown was 29.0 weeks. Of those that grew no anaerobes, the average gestational age was 32.3 weeks (P less than .05). The overall rate of maternal febrile morbidity was 35%. Fusobacterium accounted for 50% of the febrile cases while accounting for only 30.4% of the total cases.


The National Museum of Medicine of Ukraine as a scientific-educational centre.
The popularity of museums in Ukraine has been growing in recent times. This is due to the socio-economical changes in the country, to the increasing cultural and general educational level of the people, to interest in history and historical memories. Moreover, it is an aspiration for a great number of people to use information with the help of direct contact with their origins. The main idea of the article is to describe the central forms of scientific-research and cultural-educational work at the National Museum of Medicine of Ukraine, its characteristics as a social institution, the influence of medical collections and expositions on the consciousness of people, the analysis of conceptual approaches in the effective work of a museum with a great number of visitors.


Determinants of Pulmonary Emphysema Severity in Taiwanese Patients with Chronic Obstructive Pulmonary Disease: An Integrated Epigenomic and Air Pollutant Analysis.
Chronic obstructive pulmonary disease (COPD) continues to pose a therapeutic challenge. This may be connected with its nosological heterogeneity, broad symptomatology spectrum, varying disease course, and therapy response. The last three decades has been characterized by increased understanding of the pathobiology of COPD, with associated advances in diagnostic and therapeutic modalities; however, the identification of pathognomonic biomarkers that determine disease severity, affect disease course, predict clinical outcome, and inform therapeutic strategy remains a work in progress. Hypothesizing that a multi-variable model rather than single variable model may be more pathognomonic of COPD emphysema (COPD-E), the present study explored for disease-associated determinants of disease severity, and treatment success in Taiwanese patients with COPD-E. The present single-center, prospective, non-randomized study enrolled 125 patients with COPD and 43 healthy subjects between March 2015 and February 2021. Adopting a multimodal approach, including bioinformatics-aided analyses and geospatial modeling, we performed an integrated analysis of selected epigenetic, clinicopathological, geospatial, and air pollutant variables, coupled with correlative analyses of time-phased changes in pulmonary function indices and COPD-E severity. Our COPD cohort consisted of 10 non-, 57 current-, and 58 ex-smokers (median age = 69 ± 7.76 years). Based on the percentages of low attenuation area below - 950 Hounsfield units (%LAA-950insp), 36 had mild or no emphysema (%LAA-950insp < 6), 22 were moderate emphysema cases (6 ≤ %LAA-950insp < 14), and 9 presented with severe emphysema (%LAA-950insp ≥ 14). We found that BMI, lnc-IL7R, PM2.5, PM10, and SO2 were differentially associated with disease severity, and are highly-specific predictors of COPD progression. Per geospatial levels, areas with high BMI and lnc-IL7R but low PM2.5, PM10, and SO2 were associated with fewer and ameliorated COPD cases, while high PM2.5, PM10, and SO2 but low BMI and lnc-IL7R characterized places with more COPD cases and indicated exacerbation. The prediction pentad effectively differentiates patients with mild/no COPD from moderate/severe COPD cases, (mean AUC = 0.714) and exhibited very high stratification precision (mean AUC = 0.939). Combined BMI, lnc-IL7R, PM2.5, PM10, and SO2 levels are optimal classifiers for accurate patient stratification and management triage for COPD in Taiwan. Low BMI, and lnc-IL7R, with concomitant high PM2.5, PM10, and SO2 levels is pathognomonic of exacerbated/aggravated COPD in Taiwan.


Formative evaluation of the STAR intervention: improving teachers' ability to provide psychosocial support for vulnerable individuals in the school community.
The article describes the pilot phase of a participatory reflection and action (PRA) study. The longitudinal investigation explores teachers' ability to provide psychosocial support within the context of HIV/AIDS following an asset-based intervention. The study ensued from our desire to understand and contribute to knowledge about the changed roles of teachers due to adversity in the community, specifically in relation to HIV/AIDS and education. The supportive teachers, assets and resilience (STAR) intervention was facilitated from November 2003 to October 2005 and consisted of the research team undertaking nine field visits and facilitating 20 intervention sessions (2-3 hours each), and 12 post-intervention research visits have been conducted to date. Ten female teachers were selected for participation through random purposeful sampling at a primary school in an informal settlement outside Port Elizabeth, South Africa. Data-generation included PRA activities, observation, informal interactive interviews, and focus group discussions. The data were analysed by means of inductive thematic analysis. We found that the teachers did not view vulnerability as being related to children or HIV/AIDS in isolation, but rather that their psychosocial support to children and the school community was inclusive across a spectrum of vulnerabilities and services. We argue that teachers who are inclined to provide such support will fulfil this role irrespective of understanding policy or receiving training. We contend that teachers are well-positioned to manage school-based psychosocial support in order to create relevant and caring spaces for vulnerable individuals in the school community.


Review of periodic limb movement and restless leg syndrome.
Periodic limb movement (PLM) and Restless leg syndrome (RLS) are types of sleep disorders that are not very well recognized in clinical practice. While RLS is a clinical diagnosis, the diagnosis of PLM is made by polysomnography. They share the same pathophysiology and often respond to the same treatment. To date all the epidemiological studies have reported the prevalence between 2% and 15%. It has recently become known that mild obstructive sleep apnea and upper airway resistance syndrome (UARS) can masquerade as PLM syndrome. New discoveries have been made with regard to genetics and PLM and RLS. Detailed review on this subject should improve the awareness of these disorders, both among general physicians and specialists. Extensive review of journals in the past 20 years was made using Medline search.


A Partitioning Based Adaptive Method for Robust Removal of Irrelevant Features from High-dimensional Biomedical Datasets.
We propose a novel method called Partitioning based Adaptive Irrelevant Feature Eliminator (PAIFE) for dimensionality reduction in high-dimensional biomedical datasets. PAIFE evaluates feature-target relationships over not only a whole dataset, but also the partitioned subsets and is extremely effective in identifying features whose relevancies to the target are conditional on certain other features. PAIFE adaptively employs the most appropriate feature evaluation strategy, statistical test and parameter instantiation. We envision PAIFE to be used as a third-party data pre-processing tool for dimensionality reduction of high-dimensional clinical datasets. Experiments on synthetic datasets showed that PAIFE consistently outperformed state-of-the-art feature selection methods in removing irrelevant features while retaining relevant features. Experiments on genomic and proteomic datasets demonstrated that PAIFE was able to remove significant numbers of irrelevant features in real-world biomedical datasets. Classification models constructed from the retained features either matched or improved the classification performances of the models constructed using all features.


Musical anhedonia, timbre, and the rewards of music listening.
Pleasure in music has been linked to predictive coding of melodic and rhythmic patterns, subserved by connectivity between regions in the brain's auditory and reward networks. Specific musical anhedonics derive little pleasure from music and have altered auditory-reward connectivity, but no difficulties with music perception abilities and no generalized physical anhedonia. Recent research suggests that specific musical anhedonics experience pleasure in nonmusical sounds, suggesting that the implicated brain pathways may be specific to music reward. However, this work used sounds with clear real-world sources (e.g., babies laughing, crowds cheering), so positive hedonic responses could be based on the referents of these sounds rather than the sounds themselves. We presented specific musical anhedonics and matched controls with isolated short pleasing and displeasing synthesized sounds of varying timbres with no clear real-world referents. While the two groups found displeasing sounds equally displeasing, the musical anhedonics gave substantially lower pleasure ratings to the pleasing sounds, indicating that their sonic anhedonia is not limited to musical rhythms and melodies. Furthermore, across a large sample of participants, mean pleasure ratings for pleasing synthesized sounds predicted significant and similar variance in six dimensions of musical reward considered to be relatively independent, suggesting that pleasure in sonic timbres play a role in eliciting reward-related responses to music. We replicate the earlier findings of preserved pleasure ratings for semantically referential sounds in musical anhedonics and find that pleasure ratings of semantic referents, when presented without sounds, correlated with ratings for the sounds themselves. This association was stronger in musical anhedonics than in controls, suggesting the use of semantic knowledge as a compensatory mechanism for affective sound processing. Our results indicate that specific musical anhedonia is not entirely specific to melodic and rhythmic processing, and suggest that timbre merits further research as a source of pleasure in music.


Research models to mimic Necrotizing Enterocolitis and Inflammatory Bowel Diseases: focus on Extracellular Vesicles action.
This review focuses on the crucial role of the Intestinal epithelium in maintaining intestinal homeostasis and its significance in the pathogenesis of necrotizing enterocolitis (NEC) and Inflammatory bowel diseases (IBD). NEC is a devastating neonatal disease, while IBD represents a global healthcare problem with increasing incidence. The breakdown of the intestinal barrier in neonates is considered pivotal in the development and progression of both disorders. This review provides an overview of the current state of in-vitro, ex-vivo and animal models to study epithelial injury in NEC and IBD, addressing pertinent questions that engage clinicians and researchers alike. Despite significant advancements in early recognition and aggressive treatment, no single therapy has been conclusively proven effective in reducing the severity of these disorders. Although early interventions have improved clinical outcomes, NEC and IBD continue to impose substantial morbidity, mortality and economic burdens on affected individuals and society. Consequently, exploring alternative therapeutic options capable of preventing and treating the sequelae of NEC and IBD has become a pressing necessity. In recent decades, extracellular vehicles (EVs) have emerged as a potential solution to modulate the pathogenic mechanism in these multifactorial and complex disorders. Despite the diverse array of proposed models, a comprehensive model to investigate and decelerate the progression of NEC and IBD remains to be established. To bridge the translational gap between preclinical studies and clinical applications, enhancements in the technical development of gut-on-a-chip models and EVs hold considerable promise.


Preparation of Ag@lignin nanotubes for the development of antimicrobial biodegradable films from corn straw.
Current environmental and energy issues have attracted considerable attention from industries, governments, and academia. Developing alternative diverse petrochemical-based plastics with biodegradable packaging materials from renewable resources is critical for ensuring both sustainability and safety. In this study, biodegradable films are fabricated from corn straw via a facile sol-gel process. Furthermore, these films are imbued with antimicrobial properties by coupling with silver@lignin nanotube hybrid antibacterial agents, formed via the in situ reduction of silver ions into elemental silver by lignin (mild reducing agent), followed by the self-assembly of lignin molecules into nanotubes assisted by an aqueous silver nitrate electrolyte solution. The developed antibacterial corn straw film exhibits strong mechanical and antibacterial properties, with a tensile strength and elongation at break of 68.7 MPa and 11.3 %, respectively, under optimum conditions and antibacterial activity against Escherichia coli and Staphylococcus aureus of 99.9 % and 97.2 %, respectively. The as-prepared corn straw films exhibit high hydrophobicity and ultraviolet resistance. The morphology, structure, and thermal properties of the corn straw films were characterized using Fourier transform infrared spectroscopy, scanning electron microscopy, energy-dispersive spectroscopy, X-ray diffraction, and thermogravimetric analysis. This study provides a straw-based biodegradable packaging film with antimicrobial properties.


Transendoscopic chemical ablation of progressive ethmoidal hematomas in standing horses.
To examine the response of horses with progressive ethmoidal hematoma (PEH) to intralesional injection of 4% formaldehyde solution. Nasal passages of horses affected with PEH were examined endoscopically at different intervals to determine the effects of intralesional injection of formaldehyde solution. 21 horses with PEH. PEHs were injected transendoscopically with 4% formaldehyde solution. Horses were examined endoscopically and retreated at different intervals until the PEH was eliminated or was so small that reinjection was not possible. Lesions diminished significantly in size or were eliminated after 1 to 18 injections (median, 5; mean, 7.0 +/- 5.62). Seventeen lesions (60.7%) resolved completely after 1 to 18 injections (median, 5; mean, 7.2 +/- 5.71). Five lesions decreased markedly in size but did not resolve after receiving 1 to 18 injections (median, 5; mean, 7.6 +/- 6.66). Injection of these lesions was discontinued 4.0 to 25.1 months (median, 9.5; mean, 11.02 +/- 8.446) after the first injection. The PEH of one horse was removed surgically after one injection. Three horses, one with bilateral PEH, were lost to follow-up. One horse developed signs of laminitis. No other complications were observed. Horses with a PEH can be treated effectively by transendoscopic, intralesional injection of 4% formaldehyde solution. Ablation of PEH using formaldehyde solution avoids general anesthesia and problems associated with ablation by conventional surgery or laser.


Medical Residents' and Practicing Physicians' e-Cigarette Knowledge and Patient Screening Activities: Do They Differ?
The purpose of this study was to compare medical residents and practicing physicians in primary care specialties regarding their knowledge and beliefs about electronic cigarettes (e-cigarettes). We wanted to ascertain whether years removed from medical school had an effect on screening practices, recommendations given to patients, and the types of informational sources utilized. A statewide sample of Florida primary care medical residents (n = 61) and practicing physicians (n = 53) completed either an online or paper survey, measuring patient screening and physician recommendations, beliefs, and knowledge related to e-cigarettes. χ2 tests of association and linear and logistic regression models were used to assess the differences within- and between-participant groups. Practicing physicians were more likely than medical residents to believe e-cigarettes lower cancer risk in patients who use them as an alternative to cigarettes (P = .0003). Medical residents were more likely to receive information about e-cigarettes from colleagues (P = .0001). No statistically significant differences were observed related to e-cigarette knowledge or patient recommendations. Practicing primary care physicians are accepting both the benefits and costs associated with e-cigarettes, while medical residents in primary care are more reticent. Targeted education concerning the potential health risks and benefits associated with the use of e-cigarettes needs to be included in the current medical education curriculum and medical provider training to improve provider confidence in discussing issues surrounding the use of this product.


Impacts of Shewanella putrefaciens strain CN-32 cells and extracellular polymeric substances on the sorption of As(V) and As(III) on Fe(III)-(hydr)oxides.
We investigated the effects of Shewanella putrefaciens cells and extracellular polymeric substances on the sorption of As(III) and As(V) to goethite, ferrihydrite, and hematite at pH 7.0. Adsorption of As(III) and As(V) at solution concentrations between 0.001 and 20 μM decreased by 10 to 45% in the presence of 0.3 g L(-1) EPS, with As(III) being affected more strongly than As(V). Also, inactivated Shewanella cells induced desorption of As(V) from the Fe(III)-(hydr)oxide mineral surfaces. ATR-FTIR studies of ternary As(V)-Shewanella-hematite systems indicated As(V) desorption concurrent with attachment of bacterial cells at the hematite surface, and showed evidence of inner-sphere coordination of bacterial phosphate and carboxylate groups at hematite surface sites. Competition between As(V) and bacterial phosphate and carboxylate groups for Fe(III)-(oxyhydr)oxide surface sites is proposed as an important factor leading to increased solubility of As(V). The results from this study have implications for the solubility of As(V) in the soil rhizosphere and in geochemical systems undergoing microbially mediated reduction and indicate that the presence of sorbed oxyanions may affect Fe-reduction and biofilm development at mineral surfaces.


Unusual location of a mitochondrial gene. Subunit III of cytochrome C oxidase is encoded in the nucleus of Chlamydomonad algae.
The algae of the family Chlamydomonadaceae lack the gene cox3 that encodes subunit III of cytochrome c oxidase in their mitochondrial genomes. This observation has raised the question of whether this subunit is present in cytochrome c oxidase or whether the corresponding gene is located in the nucleus. Cytochrome c oxidase was isolated from the colorless chlamydomonad Polytomella spp., and the existence of subunit III was established by immunoblotting analysis with an antibody directed against Saccharomyces cerevisiae subunit III. Based partly upon the N-terminal sequence of this subunit, oligodeoxynucleotides were designed and used for polymerase chain reaction amplification, and the resulting product was used to screen a cDNA library of Chlamydomonas reinhardtii. The complete sequences of the cox3 cDNAs from Polytomella spp. and C. reinhardtii are reported. Evidence is provided that the genes for cox3 are encoded by nuclear DNA, and the predicted polypeptides exhibit diminished physical constraints for import as compared with mitochondrial-DNA encoded homologs. This indicates that transfer of this gene to the nucleus occurred before Polytomella diverged from the photosynthetic Chlamydomonas lineage and that this transfer may have occurred in all chlamydomonad algae.


Leaching of the organophosphorus nematicide fosthiazate.
Fosthiazate is an organophosphorus nematicide which was recently included in Annex I of the Directive 91/414/EEC under the clause that it should be used with special care in soils vulnerable to leaching. Thus, the leaching of fosthiazate was investigated in columns packed with three different soils which represented situations of high (site 2), intermediate (site 1) and low (site 3) leaching potential. The recommended dose of fosthiazate was applied at the surface of the soil columns and fosthiazate fate and transport was investigated for the next two months. Fosthiazate concentrations in the leachate collected from the bottom of the columns packed with soil from site 2 exceeded 0.1 microgl(-1) in most cases. This soil was characterized as acidic, indicating longer fosthiazate persistence, with low organic matter content, indicating weak adsorption, thus representing a situation vulnerable to leaching. In contrast, the lowest concentrations of fosthiazate in the leachate were evident in the columns packed with soil from site 3. This soil was characterized as alkaline, indicating faster degradation, with higher organic matter content, indicating stronger adsorption, thus representing a situation not favoring leaching of fosthiazate. The highest concentration of fosthiazate in the leachate from the columns packed with soil from site 2 was 3.44 microgl(-1) compared to 1.17 and 0.16 microgl(-1), which were the corresponding maximum values measured in columns packed with soil from sites 1 and 3, respectively. The results of the current study further suggest that fosthiazate is mobile in soil and can leach under conducive soil conditions like acidic soils with low organic matter content.


[Indices of bacterial contamination and natural resistance in wistar line laboratory rats].
Conventional laboratory rats of Wistar line are contaminated with bacterial flora. The predominating bacteria in the intestine were the rod-like forms, while in the mouth cavity and vagina predominated the coccal forms. The contamination level of the cavities and penetration of the contaminants into the internal organs depended on the state of the host natural resistance.


Capacity to consent to treatment.
A competent adult patient has an ethical and legal right to give, or withhold, consent to an examination, investigation or treatment. Depending on the nature and complexity of an intervention, a patient with an intellectual disability may be capable of consenting to their own medical treatment. In circumstances in which an adult patient does not have the capacity to consent, there is specific guardianship legislation enacted in each state and territory which provides for valid consent by a substitute decision maker.


Role of ABC transporters in fluoropyrimidine-based chemotherapy response.
Since over 50 years, 5-fluorouracil (5-FU) is in use as backbone of chemotherapy treatment regimens for a wide range of cancers including colon, breast, and head and neck carcinomas. However, drug resistance and severe toxicities such as mucositis, diarrhea, neutropenia, and vomiting in up to 40% of treated patients often lead to dose limitation or treatment discontinuation. Because the oral bioavailability of 5-FU is unpredictable and highly variable, 5-FU is commonly administered intravenously. To overcome medical complications and inconvenience associated with intravenous administration, the oral prodrugs capecitabine and tegafur have been developed. Both fluoropyrimidines are metabolically converted intracellularly to 5-FU, which then needs metabolic activation to exert its damaging activity on RNA and DNA. The low response rates of 10-15% of 5-FU monotherapy can be improved by combination regimens of infusional 5-FU and leucovorin together with oxaliplatin (FOLFOX) or irinotecan (FOLFIRI), thereby increasing response rates to 30-40%. The impact of metabolizing enzymes in the development of fluoropyrimidine toxicity and resistance has been studied in great detail. In addition, membrane drug transporters, which are critical determinants of intracellular drug concentrations, may play a role in occurrence of toxicity and development of resistance against fluoropyrimidine-based therapy as well. This review therefore summarizes current knowledge on the role of drug transporters with particular focus on ATP-binding cassette transporters in fluoropyrimidine-based chemotherapy response.


A simple method for matching electron beams in radiotherapy.
Many solutions have been proposed to solve the problem of 'hot' and 'cold' spots in the junction between abutting electron fields. Although some of these methods have proved satisfactory, the designs of the modifications to the applicators are generally applicator dependent and involve measuring data for individual fields. An idea which was originally proposed as a solution to a different problem is resurrected here because it happens to solve the beam-matching problem and because it is very simple to apply. The idea is to cover the end of the electron applicator completely with a slab of plastic, called a 'spoiler'. Formulae are proposed and tested for estimating the penumbra broadening and the extent of over- or underdosing at field junctions. The technique is applicator independent, and no extra beam-data measurements need be made for computer treatment planning of matching fields. The price paid for such simplicity is that consideration needs to be given to leading-off the other borders of the treatment fields because of the increased penumbra widths.


Absorption Kinetics of Berberine and Dihydroberberine and Their Impact on Glycemia: A Randomized, Controlled, Crossover Pilot Trial.
Berberine is a natural alkaloid used to improve glycemia but displays poor bioavailability and increased rates of gastrointestinal distress at higher doses. Recently, dihydroberberine has been developed to combat these challenges. This study was designed to determine the rate and extent to which berberine appeared in human plasma after oral ingestion of a 500 mg dose of berberine (B500) or 100 mg and 200 mg doses of dihydroberberine (D100 and D200). In a randomized, double-blind, crossover fashion, five males (26 ± 2.6 years; 184.2 ± 11.6 cm; 91.8 ± 10.1 kg; 17.1 ± 3.5% fat) completed a four-dose supplementation protocol of placebo (PLA), B500, D100, and D200. The day prior to their scheduled visit, participants ingested three separate doses with breakfast, lunch, and dinner. Participants fasted overnight (8-10 h) and consumed their fourth dose with a standardized test meal (30 g glucose solution, 3 slices white bread) after arrival. Venous blood samples were collected 0, 20, 40, 60, 90, and 120 minutes (min) after ingestion and analyzed for BBR, glucose, and insulin. Peak concentration (CMax) and area under the curve (AUC) were calculated for all variables. Baseline berberine levels were different between groups (p = 0.006), with pairwise comparisons indicating that baseline levels of PLA and B500 were different than D100. Berberine CMax tended to be different (p = 0.06) between all conditions. Specifically, the observed CMax for D100 (3.76 ± 1.4 ng/mL) was different than PLA (0.22 ± 0.18 ng/mL, p = 0.005) and B500 (0.4 ± 0.17 ng/mL, p = 0.005). CMax for D200 (12.0 ± 10.1 ng/mL) tended (p = 0.06) to be different than B500. No difference in CMax was found between D100 and D200 (p = 0.11). Significant differences in berberine AUC were found between D100 (284.4 ± 115.9 ng/mL × 120 min) and PLA (20.2 ± 16.2 ng/mL × 120 min, p = 0.007) and between D100 and B500 (42.3 ± 17.6 ng/mL × 120 min, p = 0.04). Significant differences in D100 BBR AUC (284.4 ± 115.9 ng/mL×120 min) were found between PLA (20.2 ± 16.2 ng/mL × 120 min, p = 0.042) and B500 (42.3 ± 17.6 ng/mL × 120 min, p = 0.045). Berberine AUC values between D100 and D200 tended (p = 0.073) to be different. No significant differences in the levels of glucose (p = 0.97) and insulin (p = 0.24) were observed across the study protocol. These results provide preliminary evidence that four doses of a 100 mg dose of dihydroberberine and 200 mg dose of dihydroberberine produce significantly greater concentrations of plasma berberine across of two-hour measurement window when compared to a 500 mg dose of berberine or a placebo. The lack of observed changes in glucose and insulin were likely due to the short duration of supplementation and insulin responsive nature of study participants. Follow-up efficacy studies on glucose and insulin changes should be completed to assess the impact of berberine and dihydroberberine supplementation in overweight, glucose intolerant populations.


'When you are homeless, you are not thinking about your medication, but your food, shelter or heat for the night': behavioural determinants of homeless patients' adherence to prescribed medicines.
This study aimed to explore behavioural determinants of homeless patients' adherence to prescribed medicines using Theoretical Domains Framework (TDF). A qualitative study using semi-structured, face-to-face interviews. Participants were recruited from a homelessness primary healthcare centre in Aberdeen, United Kingdom (UK). Face-to-face interviews were audio-recorded and transcribed verbatim. Thematic analysis of the interview data was conducted using the Framework Approach based on the Theoretical Domains Framework. National Health Service ethical and Research and Development (R&D) approval was obtained. Twenty-five patients were interviewed, at which point data saturation was achieved. A total of 13 out of 14 Theoretical Domains Framework domains were identified that explained the determinants of adherence or non-adherence to prescribed medicines. These included: 'beliefs about consequences' (e.g. non-adherence leading to poor health); 'goals' of therapy (e.g. being a 'normal' person with particular reference to methadone adherence); and 'environmental context and resources' (e.g. stolen medicines and the lack of secure storage). Obtaining food and shelter was higher priority than access and adherence to prescribed medicines while being homeless. Behavioural determinants of non-adherence identified in this study were mostly related to participants' homelessness and associated lifestyle. Results are relevant to developing behaviour change interventions targeting non-adherent homeless patients and to the education of healthcare professionals serving this vulnerable population.


Mechanisms of oral carcinogenesis induced by dibenzo[a,l]pyrene: an environmental pollutant and a tobacco smoke constituent.
We previously reported that dibenzo[a,l]pyrene (DB[a,l]P), the most potent known environmental carcinogen among polycyclic aromatic hydrocarbons (PAH) congeners, is carcinogenic in the oral tissues of mice. We have now developed a new mouse model which employs the oral application of the fjord region diol epoxide, (±)-anti-11,12-dihydroxy-13,14-epoxy-11,12,13,14-tetrahydrodibenzo[a,l]pyrene (DB[a,l]PDE), a metabolite of the tobacco smoke constituent DB[a,l]P, and we show its specific induction of oral squamous cell carcinoma (OSCC) in both tongue and other oral tissues. Groups of B6C3F1 mice (20/group) received 6 or 3 nmol of (±)-anti-DB[a,l]PDE administered into the oral cavity; 3 times per week for 38 weeks. Additional groups received the vehicle alone or were left untreated. Mice were sacrificed 42 weeks after the first carcinogen administration. The high dose induced 74 and 100% OSCC in the tongue and other oral tissues, respectively; the corresponding values at the lower dose were 45 and 89%. Using immunohistochemistry, we showed that DB[a,l]PDE resulted in overexpression of p53 and COX-2 proteins in malignant tissues when compared to normal oral tissues and tongues. Consistent with the carcinogenicity, we demonstrated powerful mutagenicity in cII gene in B6C3F1 (Big Blue) mouse tongue. The mutational profile in lacI reporter gene is similar to those detected in human head and neck cancer, and p53 mutations were observed in mouse oral tumor tissues. Taken together, we conclude that the formation of diol epoxides plays a major role among the mechanisms by which DB[a,l]P exerts its oral mutagenicity and tumorigenicity.


Nodular Lesion in Cheek With a Hair Tuft.
Trichostasis spinulosa is a rarely diagnosed disorder of the pilosebaceous unit, characterized by retention of telogen hairs within the dilated follicles. A hair tuft can be seen protruding from the follicles. We present a case of trichostasis spinulosa associated with intradermal melanocytic nevi, where dermoscopy helps to identify this entity.


Hepatic D-galactosamine toxicity studied with localized in vivo 31P magnetic resonance spectroscopy in intact rats.
Spatially resolved 31P magnetic resonance spectroscopy (MRS) at 4.7 T was applied to noninvasively assess liver phosphorus metabolites in a biochemically well-characterized model of hepatotoxicity induced by injection of a sublethal dose of D-galactosamine (galN). A newly developed hybrid method based on spectral localization with B0 and B1 gradients was employed to obtain multivoxel spectra in intact anesthesized rats. Spatially localized in vivo spectra were recorded 0 to 26 h after galN injection of female rats. In response to galN exposure, diphosphodiester peaks ascribed to UDP-hexosamines became detectable by 4 h and persisted up to 26 h. A metabolite coresonating with inorganic phosphate increased rapidly in intensity by 2 h after galN and returned to baseline by 18 h; this resonance was shown not to be Pi and was assigned to galN-1-phosphate by subsequent high resolution MRS experiments on extracts prepared from these livers. These results confirmed in vivo the metabolic perturbations described previously for this model of hepatotoxicity following biochemical studies based on classical extraction methods. Unlike the in vitro studies, however, these noninvasive experiments provided additional information on the time course of metabolic alterations on the same animal.


[Changes in hemograms of patients with epidemic typhoid].
In typhoid epidemy in Tadjikistan we studied hemograms obtained in 200 patients and 100 healthy controls matched by age. Though hematological shifts are considered to be typical of typhoid, most of the patients had no hematological disorders despite their severe condition. Hemograms were normal in half of the patients at the height of typhoid while other patients often (40-43%) had accelerated ESR, uneosinophilia and left shift of immature neutrophils.


Biochar application in organics and ultra-violet quenching substances removal from sludge dewatering leachate for algae production.
Algae production in nutrient rich sludge dewatering leachate after biogas production is a promising option for wastewater treatment plants. However, the ultra-violet (UV) absorbing characteristic of UV-quenching substances (UVQS) existing in these waters can notably reduce the light transmission within the liquid body. The present work demonstrates a comparative adsorptive removal of UVQS, and other organic substances (expressed as COD and TOC) onto the "acid catalyst" functionalised adsorbent (PPhA) and commercial activated carbon (CAC) from leachate originating from leftover sludge dewatering after biogas production. Laboratory scale column studies were performed to investigate the adsorption performance of selected parameters. The PPhA increased the UV transmittance of leachate more than 4 times and outperformed CAC. Bed Depth Service Time and Yan models were used on the experimental data in order to estimate the maximum adsorption capacity and evaluate the characteristics of the fixed-bed. The PPhA equilibrium uptake of COD and TOC amounted to 5.7 mg/g and 0.9 mg/g, respectively. The postulated removal mechanism in environmentally relevant conditions (e.g., pH neutral) suggested a complex interaction between the biochar and organic macromolecules. Diluted phosphoric acid solution (0.01 mol/L) was successfully used for the column regeneration. Beside the UVQS, PPhA showed affinity towards toxic heavy metals (e.g., Pb, Ni, Co) pointing out the rich surface chemistry of the PPhA. Based on the obtained results and successfully implemented scale-up methodology, the low-cost PPhA adsorbent might effectively compete with the CAC as a highly efficient platform in wastewaters leachate processing.


Drug utilization studies and drug monitoring in The Netherlands.
Drug utilization research is a research area of increasing importance, as well in the Netherlands as elsewhere. In this article on overview is given of the situation in the Netherlands. Three types of studies are distinguished, descriptive studies, studies of the determinants of drug use and studies of the impact of drug use. Descriptive studies are needed to understand the present situation and to detect problems. If these problems are to be solved it is important to understand the factors that determine drug use. By looking what the impact is, the value of drug use for health care can be assessed. It is also an important tool for developing systems for drug monitoring at a patient level. At present community pharmacists play an important role in drug monitoring at the patient level. A problem still awaiting a solution is how to implement such systems effectively.


Lack of expression of HLA antigens on choriocarcinoma cell lines.
A panel of monoclonal antibodies against HLA--A, B, C, DRw, beta 2 m and other determinants on human cells has been used in indirect trace binding and absorption assays to determine the distribution of these antigens on choriocarcinoma cell lines. HLA--A, B, C, DRw and beta 2 m were not found on these cell lines, while other human antigens expressed on most human tissues were expressed on all the lines.


Sjögren's syndrome and localized nodular cutaneous amyloidosis: coincidence or a distinct clinical entity?
To report 8 patients with Sjögren's syndrome (SS) and localized nodular cutaneous amyloidosis and to examine serologic and immunohistologic findings that may link the 2 diseases. The databases for 3 amyloidosis centers were searched for patients with localized nodular cutaneous amyloidosis and SS. Eight patients with this combination were identified, and clinical, serologic, and histologic parameters were retrospectively evaluated. Among the 8 patients with a clinical diagnosis of SS, 6 fulfilled the American-European Consensus Group criteria for SS. All of the patients were women in whom SS had been diagnosed at a median age of 47 years (range 30-61 years) and amyloid had been diagnosed at a median age of 60 years (range 42-79 years). The presence of the immunoglobulin light chain type of amyloid (AL amyloid) was confirmed in 4 patients. In 3 of these 4 patients as well as 2 other patients, a light chain-restricted plasma cell population was observed near the amyloid deposits. Progression to systemic amyloidosis was not observed in any patient during a median followup of 3.5 years. SS should be considered in patients with cutaneous amyloidosis. The combination of cutaneous amyloidosis and SS appears to be a distinct disease entity reflecting a particular and benign part of the polymorphic spectrum of lymphoproliferative diseases related to SS.


Kawasaki disease: an overview.
Kawasaki disease is an acute, self-limited vasculitis of childhood. The increasing frequency of the disease as well as the deficiency of specific diagnostic means renders its diagnosis and treatment an area of intense investigation. The purpose of this review is to summarize all the known features of Kawasaki disease and also give an insight to the latest findings. Kawasaki disease is one of the leading causes of acquired heart disease in children while its cause remains essentially unknown. Viruses, bacterial conventional as well as superantigens, and genetic polymorphisms have been implicated in the etiology of the disease. Markers of inflammation, such as CCL2 and CCXCL10, contribute to the pathology and the diagnosis of Kawasaki disease. Intravenous administration of immunoglobulin remains the mainstay of therapy for Kawasaki disease. Nevertheless, forms of the disease refractory to intravenous administration of immunoglobulin therapy may respond to aspirin, corticosteroids, cyclophosphamide, and/or plasmapheresis. The present review covers evidence regarding the history of Kawasaki disease, the epidemiology, etiology, pathology, genetic influences, and long-term sequela. It also includes an evaluation of contemporary diagnostic techniques and optimal therapeutic approaches with an emphasis on recent publications.


Spironolactone and Outcomes in Older Patients with Heart Failure and Reduced Ejection Fraction.
The efficacy of mineralocorticoid receptor antagonists or aldosterone antagonists in heart failure with reduced ejection fraction (HFrEF) is well known. Less is known about their effectiveness in real-world older patients with HFrEF. Of the 8206 patients with heart failure and ejection fraction ≤35% without prior spironolactone use in the Medicare-linked OPTIMIZE-HF registry, 6986 were eligible for spironolactone therapy based on serum creatinine criteria (men ≤2.5 mg/dL, women ≤2.0 mg/dL) and 865 received a discharge prescription for spironolactone. Using propensity scores for spironolactone use, we assembled a matched cohort of 1724 (862 pairs) patients receiving and not receiving spironolactone, balanced on 58 baseline characteristics (Creatinine Cohort: mean age, 75 years, 42% women, 17% African American). We repeated the above process to assemble a secondary matched cohort of 1638 (819 pairs) patients with estimated glomerular filtration rate (eGFR) ≥30 mL/min/1.73 m2 (eGFR Cohort: mean age, 75 years, 42% women, 17% African American). In the matched Creatinine Cohort, spironolactone-associated hazard ratios (95% confidence intervals) for all-cause mortality, heart failure readmission, and combined endpoint of heart failure readmission or all-cause mortality were 0.92 (0.81-1.03), 0.87 (0.77-0.99), and 0.87 (0.79-0.97), respectively. Respective hazard ratios (95% confidence intervals) in the matched eGFR Cohort were 0.87 (0.77-0.98), 0.92 (0.80-1.05), and 0.91 (0.82-1.02). These findings provide evidence of consistent, albeit modest, clinical effectiveness of spironolactone in older patients with HFrEF regardless of renal eligibility criteria used. Additional strategies are needed to improve the effectiveness of aldosterone antagonists in clinical practice.


A case of ARDS associated with influenza A - H1N1 infection treated with extracorporeal respiratory support.
After the first outbreak identified in Mexico in late March 2009, influenza A sustained by a modified H1N1 virus ("swine flu") rapidly spread to all continents. This article describes the first Italian case of life-threatening ARDS associated with H1N1 infection, treated with extracorporeal respiratory assistance (venovenous extracorporeal membrane oxygenation [ECMO]). A 24-year-old, previously healthy man was admitted to the Intensive Care Unit (ICU) of the local hospital for rapidly progressive respiratory failure with refractory impairment of gas exchange unresponsive to rescue therapies (recruitment manoeuvres, pronation and nitric oxide inhalation). An extracorporeal respiratory assistance (venovenous ECMO) was performed. It allowed a correction of the respiratory acidosis and made possible the transportation of the patient to the ICU (approximately 150 km from the first hospital). A nasal swab tested positive for H1N1 infection and treatment with oseltamivir was started. The chest computed tomography scan showed bilateral massive, patchy consolidation of lung parenchyma; lab tests showed leukopenia, elevated CPK levels and renal failure. The patient required high dosages of norepinephrine for septic shock and continuous renal replacement therapy. The clinical course was complicated by Pseudomonas aeruginosa superinfection, treated with intravenous and aerosolised colistin. ECMO was withheld after 15 days, while recovery of renal and respiratory function was slower. The patient was discharged from the ICU 34 days after admission. In this case, ECMO was life-saving and made the inter-hospital transfer of the patient possible.


Interrater reliability of injury coding in the Queensland Trauma Registry.
The capacity to accurately code injury event details and use the Abbreviated Injury Scale and Injury Severity Score to group injuries according to severity, underpins the audit and review activities of the trauma registries throughout the world. In the interests of transparency and benchmarking between registries, we aimed to assess the interrater reliability of coding in the Queensland Trauma Registry. One hundred and twenty injury cases were randomly selected from the Queensland Trauma Registry database, stratified by hospital, severity and the coder who originally coded the chart. Cases were then recoded by six coders employed by the Queensland Trauma Registry. Coding was carried out by all raters simultaneously and independently. Interrater agreement between coders was high for external cause, intent, and place of injury with kappa scores for all interrater pairs being greater than 0.80, 0.58 and 0.44. Agreement between the six raters for Injury Severity Score was found to be very high (intraclass correlation coefficient of 0.9). The accuracy of coding in the Queensland Trauma Registry is sufficiently high to ensure that quality data are available for research, audit and review.


The interaction between cytosine methylation and processes of DNA replication and repair shape the mutational landscape of cancer genomes.
Methylated cytosines (5mCs) are frequently mutated in the genome. However, no studies have yet comprehensively analysed mutation-methylation associations across cancer types. Here we analyse 916 cancer genomes, together with tissue type-specific methylation and replication timing data. We describe a strong mutation-methylation association across colorectal cancer subtypes, most interestingly in samples with microsatellite instability (MSI) or Polymerase epsilon (POLE) exonuclease domain mutations. By analysing genomic regions with differential mismatch repair (MMR) efficiency, we suggest a possible role for MMR in the correction of 5mC deamination events, potentially accounting for the high rate of 5mC mutation accumulation in MSI tumours. Additionally, we propose that mutant POLE asserts a mutator phenotype specifically at 5mCs, and we find coding mutation hotspots in POLE-mutant cancers at highly-methylated CpGs in the tumour-suppressor genes APC and TP53. Finally, using multivariable regression models, we demonstrate that different cancers exhibit distinct mutation-methylation associations, with DNA repair influencing such associations in certain cancer genomes. Taken together, we find differential associations with methylation that are vital for accurately predicting expected mutation loads across cancer types. Our findings reveal links between methylation and common mutation and repair processes, with these mechanisms defining a key part of the mutational landscape of cancer genomes.


Absolute detector-based spectrally tunable radiant source using digital micromirror device and supercontinuum fiber laser.
High-accuracy absolute detector-based spectroradiometric calibration techniques traceable to cryogenic absolute radiometers have made progress rapidly in recent decades under the impetus of atmospheric quantitative spectral remote sensing. A high brightness spectrally tunable radiant source using a supercontinuum fiber laser and a digital micromirror device (DMD) has been developed to meet demands of spectroradiometric calibrations for ground-based, aeronautics-based, and aerospace-based remote sensing instruments and spectral simulations of natural scenes such as the sun and atmosphere. Using a supercontinuum fiber laser as a radiant source, the spectral radiance of the spectrally tunable radiant source is 20 times higher than the spectrally tunable radiant source using conventional radiant sources such as tungsten halogen lamps, xenon lamps, or LED lamps, and the stability is better than ±0.3%/h. Using a DMD, the spectrally tunable radiant source possesses two working modes. In narrow-band modes, it is calibrated by an absolute detector, and in broad-band modes, it can calibrate for remote sensing instrument. The uncertainty of the spectral radiance of the spectrally tunable radiant source is estimated at less than 1.87% at 350 nm to 0.85% at 750 nm, and compared to only standard lamp-based calibration, a greater improvement is gained.


The longitudinal relation between smoking and muscle strength in healthy adults.
To assess longitudinally whether smoking tobacco is related to muscle strength in healthy adults and to assess the influence of lifestyle covariates on this relation. Data were obtained from the observational Amsterdam Growth and Health Longitudinal Study, with four repeated measurements at the ages of 21 (n = 181), 27 (n = 144), 32 (n = 426) and 36 (n = 373) years. Knee muscle strength (KMS) was measured at an angle of 300° per second. Smoking and the covariates physical activity and dietary intake were assessed with a questionnaire. Other covariates included physical fitness and body fat percentage. Cardiopulmonary fitness was assessed with a maximal running test and body fatness with skinfold measurements. Sex-specific longitudinal analyses were carried out using generalized estimating equations. In men and women, an inverse relationship between smoking tobacco and KMS was found. Smoking 100 g of tobacco a week resulted in a reduction of 2.9% in KMS in men and a reduction of 5.0% in women. This relation existed largely independently of lifestyle covariates. This study indicates that smoking is inversely related to skeletal muscle strength in healthy adults.


Juvenile scleredema of Buschke.
To recognize a line of treatment for scleredema of Buschke in an adolescent. Scleredema of Buschke is an uncommon disorder characterized by induration of the skin, which includes a non pitting hardening of the skin around the neck, shoulders, and trunk sometimes the face. Three variants are recognized. The histopathologic features of scleredema are characterized by thickened collagen bundles within the reticular dermis that are separated by mucin containing fenestrations. No consistent treatment modality is currently followed. The present case report describes scleredema of Buschke in a 10-year-old female child reported with stiffness of facial skin and difficulty in opening the mouth. The patient was treated with antibiotics and vitamin supplements and there was drastic improvement with decrease in skin stiffness and increase in mouth opening. The stiffness of facial muscles decreased and mouth opening increased. Multiple treatment modalities for scleredema have been used. In the present case, high-dose antibiotic therapy was used with good prognosis. High-dose antibiotic therapy can be used for treatment of dermatologic disorders with reasonably good prognosis.


Surface electromagnetic wave coupling efficiencies for several excitation techniques.
The excitation efficiencies for coupling surface electromagnetic waves onto aluminum at a microwave frequency (f = 8.445 GHz, lambda = 3.55 cm) were studied experimentally for several different standard microwave techniques as well as two optical techniques (prism and grating) applied to the microwave frequency region and two new techniques (hump and valley). The peak measured efficiencies found were: for the standard rectangular waveguide, 92%; for the horn antenna, 73%; for the right angle prism properly gapped above the metal, 60%; for the hump of 10-wavelength radius of curvature, 35%; for the thin grating strips on polystyrene coated metal, 30%; for the grating bars gapped (1/2) wavelength above the metal, 26%; and, for the valley of 10-wavelength radius, 12%. The measurement of the excitation efficiencies for prism and grating coupling techniques sometimes required that the prism or grating be in the near field of the antenna. In addition to measuring peak efficiencies, the efficiencies were measured as functions of the gap heights, the angular orientations, the different diffraction modes, the shapes, and the materials of the grating bars. The coupling efficiencies for both prism and grating couplers show a strong dependence on gap height above the metal. Dielectric grating bars were found to be inefficient compared to solid or hollow metallic bars, or thin metallic strips. The distance between the target point of the center line of the microwave horn antenna and the corner of the prism was found to be about 1 wavelength for maximum prism coupling efficiency.


Factors associated with dropout in a long term observational cohort of fishing communities around lake Victoria, Uganda.
Fishing communities are potentially suitable for Human immunodeficiency virus (HIV) efficacy trials due to their high risk profile. However, high mobility and attrition could decrease statistical power to detect the impact of a given intervention. We report dropout and associated factors in a fisher-folk observational cohort in Uganda. Human immunodeficiency virus-uninfected high-risk volunteers aged 13-49 years living in five fishing communities around Lake Victoria were enrolled and followed every 6 months for 18 months at clinics located within each community. Volunteers from two of the five communities had their follow-up periods extended to 30 months and were invited to attend clinics 10-40 km (km) away from their communities. Human immunodeficiency virus counseling and testing was provided, and data on sexual behaviour collected at all study visits. Study completion was defined as completion of 18 or 30 months or visits up to the date of sero-conversion and dropout as missing one or more visits. Discrete time survival models were fitted to find factors independently associated with dropout. A total of 1000 volunteers (55% men) were enrolled. Of these, 91.9% completed 6 months, 85.2% completed 12 months and 76.0% completed 18 months of follow-up. In the two communities with additional follow-up, 76.9% completed 30 months. In total 299 (29.9%) volunteers missed at least one visit (dropped out). Dropout was independently associated with age (volunteers aged 13-24 being most likely to dropout), gender [men being more likely to dropout than women [adjusted hazard ratio (aHR) 1.4; 95% confidence interval (CI) 1.1-1.8)], time spent in the fishing community (those who stayed <1 year being most likely to dropout), History of marijuana use (users being more likely to dropout than non-users [1.7; (1.2-2.5)], ethnicity (non-Baganda being more likely to dropout than Baganda [1.5; (1.2-1.9)], dropout varied between the five fishing communities, having a new sexual partner in the previous 3 months [1.3 (1.0-1.7)] and being away from home for ≥2 nights in the month preceding the interview [1.4 (1.1-1.8)]. Despite a substantial proportion dropping out, retention was sufficient to suggest that by incorporating retention strategies it will be possible to conduct HIV prevention efficacy trials in this community.


Laboratory parameters as an alternative to performance status in prognostic stratification of patients with small cell lung cancer.
Pretreatment performance status (PS)is a major prognostic factor for both treatment response and survival duration in cancer clinical trials. PS is, however, a subjective index that may be markedly influenced by acute self-limited events. The objective of this study was to develop a prognostic index, based on pretreatment laboratory results, that might serve as an alternative to PS in patients with small cell anaplastic lung cancer. Results have been analyzed in 56 newly diagnosed patients with a minimum followup of 10 months and a median followup of 21 months. Patients were divided into high and low groups for each laboratory parameter based on readings either above or below the median value. Patients with high hemoglobin or albumin levels or low serum alpha-1 globulins, gamma globulins, or LDH survived significantly longer than patients with the opposite levels. When these factors were evaluated by multivariate analysis, albumin and hemoglobin were the most influential prognostic factors for survival. After inclusion of these two laboratory parameters, PS was no longer a significant prognosticator of survival. An objective prognostic index based on pretreatment laboratory results appears feasible in patients with small cell lung cancer.


Accounting for intraspecific diversity when examining relationships between non-native species and functional diversity.
Quantifying changes in functional diversity, the facet of biodiversity accounting for the biological features of organisms, has been advocated as one of the most integrative ways to unravel how communities are affected by human-induced perturbations. The present study assessed how functional diversity patterns varied among communities that differed in the degree to which non-native species dominated the community in temperate lake fish communities and whether accounting for intraspecific functional variability could provide a better understanding of the variation of functional diversity across communities. Four functional diversity indices were computed for 18 temperate lake fish communities along a gradient of non-native fish dominance using morphological functional traits assessed for each life-stage within each species. First, we showed that intraspecific variability in functional traits was high and comparable to interspecific variability. Second, we found that non-native fish were functionally distinct from native fish. Finally, we demonstrated that there was a significant relationship between functional diversity and the degree to which non-native fish currently dominated the community and that this association could be better detected when accounting for intraspecific functional variability. These findings highlighted the importance of incorporating intraspecific variability to better quantify the variation of functional diversity patterns in communities facing human-induced perturbations.


Effect of distillery effluent on seed germination in some vegetable crops.
A laboratory experiment was conducted to study the effect of different concentrations (0%, 5%, 10%, 15%, 20%, 25%, 50%, 75% and 100%) of distillery effluent (raw spent wash) on seed germination (%), speed of germination, peak value and germination value in some vegetable crops: tomato, chilli, bottle gourd, cucumber and onion. The distillery effluent did not show any inhibitory effect on seed germination at low concentration except in tomato, but in onion the germination was significantly higher (84%) at 10% concentration as against 63% in the control. Irrespective of the crop species, at highest concentrations (75% and 100%), complete failure of germination was observed. The speed of germination, peak value and germination value also followed a similar trend. We found that a concentration of 5% was critical for seed germination in tomato and bottle gourd, and 25% in the rest of the crops. Based on the tolerance to distillery effluent, the crops studied have been arranged in the following order: cucumber > chilli > onion > bottle gourd > tomato. We conclude that the effect of the distillery effluent is crop-specific and due care should be taken before using the distillery effluent for pre-sowing irrigation purposes.


Hand schuller christian disease: a rare case report with oral manifestation.
Langerhan's Cell Histiocytosis (LCH) is disorders which include abnormalities that result from abnormal proliferation of langerhan's cells or their precursors. LCH is clinically classified into three types-eosinophilic granuloma, Hand Schuller Christian disease and Abt-Letterer- Siwe disease. It is usually manifested in childhood as well as in adulthood. The clinical manifestations are the result of the accumulation and infilteration of the langerhan cells in organs and tissues. Here is a rare case report of 6-year-old boy with extraoral manifestation of exopthalmic right eye and oral manifestation of mobility of teeth and with typical radiological findings. Basing on the clinical, radiological and histopathological examination the diagnosis of Hand Schuller Christian Disease was given.


Uncovering subdominant cytotoxic T-lymphocyte responses in lymphocytic choriomeningitis virus-infected BALB/c mice.
The cytotoxic T-lymphocyte response against lymphocytic choriomeningitis virus (LCMV) in BALB/c mice is predominantly directed against a single, Ld-restricted epitope in the viral nucleoprotein (residues 118 to 126). To investigate whether any Kd/Dd-restricted responses were activated but did not expand during the primary response, we used a BALB/c mutant, BALB/c-H-2dm2, which does not express the Ld molecule. Splenocytes from LCMV-infected BALB/c mice were transferred into irradiated BALB/c-H-2dm2 mice and rechallenged with LCMV. Thus, they were exposed to an antigenic stimulus without the involvement of the immunodominant Ld-restricted epitope. In this adoptive transfer model, the donor splenocytes protected the recipient mice against chronic LCMV infection by mounting a potent Kd- and/or Dd-restricted secondary antiviral response. Analysis of a panel of Kd binding LCMV peptides revealed that residues 283 to 291 from the viral glycoprotein (GP(283-291)) comprise a major new epitope in the adoptive transfer model. Because the donor splenocytes were first activated during the primary infection in BALB/c mice, the GP(283-291) epitope is a subdominant epitope in BALB/c mice that becomes dominant after rechallenge in BALB/c-H-2dm2 mice. This study makes two points. First, it shows that subdominant CTL responses can be protective, and second, it provides a general experimental approach for uncovering subdominant CTL responses in vivo. This strategy can be used to identify subdominant T-cell responses in other systems.


Aloe vera enhances the innate immune response of pacu (Piaractus mesopotamicus) after transport stress and combined heat killed Aeromonas hydrophila infection.
In this study, pacu (Piaractus mesopotamicus) were fed with diets containing Aloe vera for 10 days prior to transport stress and infection with heat killed Aeromonas hydrophila. A. vera is popular around the world due to its medicinal properties, including immunostimulatory effects which was observed in this study. The results show that transport causes immunosuppression, an effect that was prevented by A. vera. Specifically, A. vera prevented reductions of both leukocyte respiratory burst and hemolytic activity of complement system caused by transport. Further, fish fed with A. vera also showed significantly higher leukocyte respiratory burst, serum lysozyme concentrations and activity of complement system 24 h after bacterial infection. Additionally, we observed that A. vera may modulate the innate response through activation of complement system during bacterial immune stimulation. In summary, A. vera extract enhanced innate immune parameters and consequently the ability of fish to cope with pathogens following transport stress. These findings show that A. vera has promise for use in aquaculture and add further evidence that medicinal herbs added to fish feed assist to prevent disease outbreaks.


Elevated asthma morbidity in Puerto Rican children: a review of possible risk and prognostic factors.
Latino children represent a significant proportion of all US children, and asthma is the most common chronic illness affecting them. Previous research has revealed surprising differences in health among Latino children with asthma of varying countries of family origin. For instance, Puerto Rican children have a higher prevalence of asthma than Mexican American or Cuban American children. In addition, there are important differences in family structure and socioeconomic status among these Latino populations: Cuban Americans have higher levels of education and family income than Mexican-Americans and Puerto Ricans; mainland Puerto Rican children have the highest proportion of households led by a single mother. Our review of past research documents differences in asthma outcomes among Latino children and identifies the possible genetic, environmental, and health care factors associated with these differences. Based on this review, we propose research studies designed to differentiate between mutable and immutable risk and prognostic factors. We also propose that the sociocultural milieus of Latino subgroups of different ethnic and geographic origin are associated with varying patterns of risk factors that in turn lead to different morbidity patterns. Our analysis provides a blue-print for future research, policy development, and the evaluation of multifactorial interventions involving the collaboration of multiple social sectors, such as health care, public health, education, and public and private agencies.


Acute myocardial infarction: an easy diagnosis in general practice?
In the imminent myocardial infarction Rotterdam (IMIR) study, contacts by patients with their general practitioners for symptoms of potential coronary artery disease were registered. Those who had acute myocardial infarction were diagnosed on the basis of the modified World Health Organization criteria, and those with this definite diagnosis were then compared with the initial diagnosis made by the general practitioner at the moment of contact without laboratory assistance.Of the 1,343 patients included in the study, 93 (seven per cent) had ;definite' acute myocardial infarction and another 37 (three per cent) had ;possible' acute myocardial infarction according to the diagnostic criteria used.At the time of contact with the general practitioner 41 (44 per cent) of the 93 patients with definite myocardial infarction were recognized as such by the general practitioner, while in another 31 (33 per cent) the general practitioner diagnosed ;imminent' myocardial infarction.Of the 1,213 patients free of acute myocardial infarction at the time, 40 (three per cent) were incorrectly diagnosed by the general practitioner as having ;acute' myocardial infarction.In the 22 patients who in fact had acute myocardial infarction but in whom the general practitioner did not make this diagnosis at the time, it was found that there was an absence of physical signs and, similarly, in patients who subsequently did not have infarction the presence of physical signs was related to a falsepositive general practitioner diagnosis of myocardial infarction.In view of the inaccuracy of the general practitioner's provisional diagnosis of acute myocardial infarction, we believe that electrocardiogram and enzyme tests should be carried out systematically in all patients who present to general practitioners with symptoms of potential coronary artery disease. Laboratory support should be readily available and we support the idea of having a special diagnostic service.


Prevalence of Chlamydia trachomatis and Neisseria gonorrhea and associated factors among women living with Human Immunodeficiency Virus in Brazil: a multicenter study.
Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) cause infections in the female genital tract, increasing susceptibility to and infectiousness of HIV. The objectives of the present study were to determine the prevalence and associated factors of CT and GC infection among HIV-infected women in Brazil. Cross-sectional study conducted from March to December 2015, including HIV-infected women attending referral centers in nine states of Brazil, aged 18-49 years, nonpregnant. An interview was conducted including socio-demographic, epidemiological and clinical characteristics. After the interview, gynecological examination was conducted to collect cervical cytology and vaginal secretion to C. trachomatis and N. gonorrhoeae tests through molecular biology. A total of 802 (89.1%) women participated. The prevalence of CT was 2.1% (17/802) and CG was 0.9% (7/802). The prevalence of a positive test for both CT and/or GC was 2.7%. The factors associated with positive CT/GC test in the multivariate logistic regression analysis were abnormal Papanicolau smear (OR 4.1; 95% CI: 1.54-11.09) and the presence of abnormal cervical discharge (OR 2.6; 95% CI: 1.02-6.71). Among 377 women who reported previous STI 245 (65.0%) reported using condom more frequently after being diagnosed. 62 (16.4%) discovered the STI after the partner told he was infected; 157 (41.6%) had STI symptoms and looked for care, and 158 (41.9%) discovered it in a routine consultation for another reason. The control of STI represents a unique opportunity to improve reproductive health of women living with HIV. STI diagnosis can change their behavior and reduce the sexual transmission of HIV and bacterial STI.


[Congenital cysts of the nasopharynx. Report of a case].
Congenital nasopharyngeal cysts are uncommon and usually located on the lateral wall of the nasopharynx. The literature groups lateral and medial cysts although they have different origins. A congenital nasopharyngead cyst in a 67-year-old man was diagnosed and treated. His only symptom was right hearing loss caused by secretory otitis. After cyst excision using a transpalatine approach, his hearing loss resolved within 4 days. Nasopharyngeal cyst types and their histological and anatomic differentiation are discussed. Therapeutic options and approaches are considered, and the need for total exeresis of the cyst with its capsule is noted.


Could Brain-Computer Interface Be a New Therapeutic Approach for Body Integrity Dysphoria?
Patients suffering from body integrity dysphoria (BID) desire to become disabled, arising from a mismatch between the desired body and the physical body. We focus here on the most common variant, characterized by the desire for amputation of a healthy limb. In most reported cases, amputation of the rejected limb entirely alleviates the distress of the condition and engenders substantial improvement in quality of life. Since BID can lead to life-long suffering, it is essential to identify an effective form of treatment that causes the least amount of alteration to the person's anatomical structure and functionality. Treatment methods involving medications, psychotherapy, and vestibular stimulation have proven largely ineffective. In this hypothesis article, we briefly discuss the characteristics, etiology, and current treatment options available for BID before highlighting the need for new, theory driven approaches. Drawing on recent findings relating to functional and structural brain correlates of BID, we introduce the idea of brain-computer interface (BCI)/neurofeedback approaches to target altered patterns of brain activity, promote re-ownership of the limb, and/or attenuate stress and negativity associated with the altered body representation.


Dendrimer-Encapsulated Halide Perovskite Nanocrystals for Self-Powered White Light-Emitting Glass.
Perovskite nanocrystals (PNCs) have attracted substantial attention due to their inspiring intrinsic merits such as low cost, high performance, and solution processability, but when it comes to the usage of blends of different colored PNCs with the purpose of covering the broadband spectrum field, the high degree of instability remains a major bottleneck. Herein, we report a family of dendritic ammonium ligands that act as stiff shell-encapsulating PNCs for improving their stability and suppressing ion permeability in mixed colloidal PNC solutions. The as-synthesized ligand-encapsulated PNCs notably achieve near-unity photoluminescence quantum yields (PLQYs) and strongly resist the unwanted ion exchange reaction under aggressive anion source attack. To fabricate self-powered white-emitting glass, the stabilized mixed colored PNCs were embedded into the laminated glass, which simultaneously acted as absorbers-emitters for luminescent solar concentrators (LSCs) and emitters for white light-emitting glass.


Moringa oleifera Supplemented Diets Prevented Nickel-Induced Nephrotoxicity in Wistar Rats.
Background. The Moringa oleifera plant has been implicated for several therapeutic potentials. Objective. To evaluate whether addition of M. oleifera to diet has protective effect against nickel-induced nephrotoxicity in rats. Methodology. Male Wistar rats were assigned into six groups of five. The rats were given oral exposure to 20 mg/kg nickel sulphate (NiSO4) in normal saline and sustained on either normal diet or diets supplemented with Moringa oleifera at different concentrations for 21 days. 24 hours after cessation of treatments, all animals were sacrificed under slight anesthesia. The blood and kidney samples were collected for biochemical and histopathology analyses, respectively. Results. NiSO4 exposure reduced the kidney-to-body weight ratio in rats and caused significant elevation in the levels of plasma creatinine, urea, and potassium. Also, the plasma level of sodium was decreased by NiSO4 exposure. However, addition of M. oleifera to diets averted the nickel-induced alteration to the level of creatinine and urea. The histopathology revealed damaged renal tubules and glomerular walls caused by NiSO4 exposure. In contrast, the damages were ameliorated by the M. oleifera supplemented diets. Conclusion. The addition of M. oleifera to diet afforded significant protection against nickel-induced nephrotoxicity.


Complex Pathology and Management in the Obstetric Patient: A Narrative Review for the Anesthesiologist.
Pregnant patients may present with multiple complex comorbidities that can affect peripartum management and anesthetic care. The preanesthesia clinic is the ideal setting for early evaluation of high-risk pregnant patients. Comorbidities may include cardiovascular pathology such as valvular abnormalities, septal defects, aortopathies, arrythmias and cardiomyopathies. Additional comorbidities include pulmonary conditions such as obstructive sleep apnea as well as preexisting neuromuscular and skeletal disorders that may impact anesthetic management. Hematologic conditions involving both bleeding diathesis and thrombophilias may present unique challenges for the anesthesiologist. Patients may also present with endocrinopathies including diabetes and obesity. While not as common, high-risk patients may also have preexisting gastrointestinal conditions such as liver dysfunction, renal failure, and even post-transplant status. Ongoing and prior substance abuse, obstetric conditions such as placenta accreta spectrum disorders, and fetal conditions needing ex utero Intrapartum treatment also require advanced planning. Preanesthesia evaluations also help address important ethical and cultural considerations. Counseling patients regarding anesthetic considerations as well as addressing concerns will play a role in reducing racial and ethnic disparities. Anticipatory guidance by means of pre-anesthetic planning can facilitate multidisciplinary communication and planning. This can allow for an impactful and meaningful role in the care provided, allowing for safe maternal care and optimal outcomes.


A Group Visit Initiative Improves Advance Care Planning Documentation among Older Adults in Primary Care.
Group visits for advance care planning (ACP) may help patients document preferences for decision makers and future care. We assessed the impact of a primary care-based ACP group visit (ACP-GV) intervention on older adults' ACP documentation and why patients participated. Older adults (>65 years) in primary care participated in a 2-session ACP-GV intervention that promotes group dynamics, peer-based learning, and goal setting. Charts were reviewed at baseline, 3 months, and 12 months for documentation of decision makers and ACP forms. We described patients' reasons for participating through analysis of transcripts. 118 patients (mean age 76 years; 62% female and 82% white) participated in 16 ACP-GV cohorts. From baseline to 3-month follow-up, documentation of decision maker preferences increased from 39% to 81%, and was 89% at 12-month follow-up. Patients with completed ACP forms increased from 20% to 57% at 3 months, and was 67% at 12 months. Reasons for participating included recognizing the importance of ACP, curiosity, participation recommended by primary care provider, desire to talk with family/friends, and desire to complete advance directives. This ACP-GV intervention increased ACP documentation among patients with diverse reasons for participating. This is a patient-centered approach to ACP in primary care.


Human Umbilical Cord Mesenchymal Stem-Cell Therapy to Increase the Density of Osteoporotic Mandibular Bone.
The aim of this study is to evaluate the feasibility of human umbilical cord mesenchymal stem-cell (hUCMSC) therapy in increasing osteoporotic mandibular bone density in a rat model by determining changes in alkaline phosphatase (ALP), osteocalcin, type 1 collagen, and trabecular bone area after treatment. This research adopted an experimental posttest-only control group design. Thirty female Wistar rats were randomly divided into six groups, namely, a control group with rats postsham surgery (T1), osteoporotic model postovariectomy rats (T2), postovariectomy rats 4 weeks after gelatin injection (T3), postovariectomy rats 8 weeks after gelatin injection (T4), postovariectomy rats 4 weeks after hUCMSC injection (T5), and postovariectomy rats 8 weeks after hUCMSC injection (T6). The rats were all sacrificed for histological and immunohistochemical examinations of ALP, osteocalcin, type 1 collagen, and trabecular bone area. Increased expression of ALP, type 1 collagen, and osteocalcin, as well as increased trabecular bone area, was observed in the treatment groups compared with that in the osteoporotic groups. hUCMSCs produce significant osteogenic effects and increase osteoporotic mandibular bone density in the animal model. Increases in bone density are demonstrated by the higher levels of ALP, osteocalcin, and type 1 collagen, as well as increases in the trabecular bone area.


Low serum dehydroepiandrosterone is associated with diabetic dyslipidemia risk in males with type 2 diabetes.
Sex steroid hormones are associated with the advancement of metabolic diseases such as dyslipidemia. This cross-sectional study aimed to investigate the relationship between dehydroepiandrosterone, dehydroepiandrosterone sulfate, androstenedione, and testosterone levels and the risk of dyslipidemia in people with type 2 diabetes mellitus. The analysis included 1,927 patients with type 2 diabetes mellitus. Serum dehydroepiandrosterone, dehydroepiandrosterone sulfate, androstenedione, and testosterone levels were determined using lipid chromatography-tandem mass spectrometry. Multivariable analyses were performed to investigate the association between the variables and dyslipidemia. The multivariable-adjusted odds ratio (OR) and 95% confidence interval (CI) of dyslipidemia across DHEA tertiles were 0.39 and 0.24-0.64, respectively (p trend = 0.001). This relationship was still maintained when analyzed as a continuous variable (odds ratio, 0.96; 95% confidence interval, 0.92-0.99; P < 0.01). However, in males with type 2 diabetes mellitus, no significant correlations were found between rising levels of dehydroepiandrosterone sulfate, androstenedione, and total testosterone and the risk of dyslipidemia (all P > 0.05). Furthermore, there was no significant association between androgen precursors and total testosterone with regard to the risk of developing dyslipidemia (all P > 0.05). Serum dehydroepiandrosterone levels were substantially and adversely correlated with dyslipidemia in adult men with T2DM. These results indicated that dehydroepiandrosterone may have an essential role in the development of dyslipidemia. More prospective research is required to validate this link.


A Clinical Study of Noninvasive Assessment of Lung Lesions in Patients with Coronavirus Disease-19 (COVID-19) by Bedside Ultrasound.
This study was conducted to explore the clinical value of noninvasive assessment of bedside ultrasound in the diagnosis of lung lesions of Coronavirus Disease-19. In this retrospective study, 30 patients with Coronavirus Disease-19 admitted to our hospital from January 18 to February 5, 2020, were selected as the research subjects. All cases were examined by lung ultrasound and CT. Lung lesions were reviewed by blinded observers, with imaging scores being used to analyze the ultrasound findings of lung lesions in patients with Coronavirus Disease-19 and with chest CT being used as the reference standard. The clinical value of ultrasound in the noninvasive assessment of lung lesions was evaluated. Lung ultrasound signs in patients with Coronavirus Disease-19 were mainly manifested as interstitial pulmonary edema (90.0 %, 27/30) and pulmonary consolidations (20.0 %, 6/30). The lung lesions were mainly distributed in the subpleural and peripheral pulmonary zones. The lower lobe and the dorsal region had a greater tendency to be involved. There was moderate agreement (Kappa = 0.529) between the noninvasive assessment of bedside ultrasound for lung lesions in patients with Coronavirus Disease-19 and CT. The ultrasound scores to evaluate mild, moderate and severe lung lesions exhibited sensitivity of 68.8 % (11/16), 77.8 % (7/9), 100.0 % (2/2), specificity of 85.7 % (12/14), 76.2 % (16/21), 92.9 % (26/28), and diagnostic accuracy of 76.7 % (23/30), 76.7 % (23/30), 93.3 % (28/30), respectively. The follow-up dynamic ultrasound examination showed that the condition of all patients worsened gradually, with the ultrasound scores of lung lesions increasing to varying degrees. Though the diagnostic efficacy of bedside ultrasound is relatively low for mild to moderate patients, it is high for severe patients. Bedside ultrasound has important clinical significance for noninvasive assessment and dynamic observation of lung lesions in patients with Coronavirus Disease-19, which is worth further consideration.


Poleward transport of TPX2 in the mammalian mitotic spindle requires dynein, Eg5, and microtubule flux.
TPX2 is a Ran-regulated spindle assembly factor that is required for kinetochore fiber formation and activation of the mitotic kinase Aurora A. TPX2 is enriched near spindle poles and is required near kinetochores, suggesting that it undergoes dynamic relocalization throughout mitosis. Using photoactivation, we measured the movement of PA-GFP-TPX2 in the mitotic spindle. TPX2 moves poleward in the half-spindle and is static in the interzone and near spindle poles. Poleward transport of TPX2 is sensitive to inhibition of dynein or Eg5 and to suppression of microtubule flux with nocodazole or antibodies to Kif2a. Poleward transport requires the C terminus of TPX2, a domain that interacts with Eg5. Overexpression of TPX2 lacking this domain induced excessive microtubule formation near kinetochores, defects in spindle assembly and blocked mitotic progression. Our data support a model in which poleward transport of TPX2 down-regulates its microtubule nucleating activity near kinetochores and links microtubules generated at kinetochores to dynein for incorporation into the spindle.


Pulmonary vascular manifestations of hereditary hemorrhagic telangiectasia (rendu-osler disease).
Hereditary hemorrhagic telangiectasia (HHT) or Rendu-Osler-Weber disease is a genetic disorder with autosomal dominance and variable penetrance, characterized by epistaxis, telangiectasia and visceral manifestations of the disease. The estimated minimal prevalence is 1/10,000 inhabitants. The diagnosis is established on clinical criteria, and may be further confirmed by the identification of causative mutations in either the ENG or the ACVRL1 gene coding for endoglin and ALK1, respectively. Pulmonary vascular manifestations of HHT include pulmonary arteriovenous malformations (PAVMs; especially in patients with ENG mutations) and less frequently pulmonary hypertension (especially in patients with ACVRL1 mutations). In 15-33% of patients with HHT, PAVMs consist of abnormal communications between pulmonary arteries and pulmonary veins, causing right-to-left shunting, and thus, frequently hypoxemia and dyspnea on exertion, although PAVMs may remain asymptomatic and frequently undiagnosed unless complications occur. PAVMs result in severe and frequent complications often at a young age, which may reveal the diagnosis, e.g. transient ischemic attack and cerebral stroke (10-19% of patients), systemic severe infections and abscesses (including cerebral abscess in 5-19% of patients), and rarely massive hemoptysis or hemothorax. Infections in HHT are related to the right-to-left shunting that bypasses the pulmonary capillaries and facilitates the passage of septic or aseptic emboli into the systemic and especially cerebral circulation, and potentially to minor defects in innate immunity. Treatment of PAVMs based on transcatheter coil vaso-occlusion of the feeding artery significantly decreases right-to-left shunting, hypoxemia and dyspnea on exertion, and reduces the risk of systemic complications. Long-term follow-up is warranted after transcatheter vaso-occlusion of PAVMs due to frequent recanalization of treated PAVMs and development or growth of untreated PAVMs. Patients with HHT should be informed of the risk of PAVM and potentially severe complications occurring in heretofore asymptomatic subjects. All adult patients with HHT should be proposed systematic screening for PAVM, by contrast echocardiography (preceded by anteroposterior chest radiograph) or computed tomography of the chest. Pulmonary hypertension is rare in HHT, and may be due either to systemic arteriovenous shunting in the liver increasing cardiac output or be clinically and histologically indistinguishable from idiopathic pulmonary arterial hypertension. Pulmonary hypertension is detected by systematic examination of right cardiac cavities and tricuspid regurgitation flow at echocardiography, and the diagnosis is established by right heart catheterization.


[Gender difference in association between smoking and metabolic risks among community adults].
Cigarette smoking is a risk factor for the development of insulin resistance. However, whether a smoker has a lesser waist circumference (WC) and whether the potential changes in WC may reduce the benefits of smoking cessation remains in dispute. The aims of this study are to re-examines the relationships between smoking and metabolic risk factors by the data from Beijing adults. A total of 3710 men and 6344 women, aged 18 - 92 years old, were sampled from community centers in Beijing for this cross-sectional clinical study between April and August 2007. Their concentrations of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C) and plasma glucose (PG) were measured. And the anthropometric parameters (WC, body weight and height) and blood pressure (BP) were record according to a standard protocol. Their social, demographic, personal medical history and behavioral characteristics were collected by the well-trained staff. Metabolic syndrome was defined according to the International Diabetes Federation (IDF) criteria. The relationships between smoking and metabolic syndrome were analyzed by χ(2) test and logistic regression. The mean age and glucose concentration were similar in both genders. Males tended to have a higher mean BP (systolic and diastolic), a higher level of TG and a lower HDL-C. Among the obesity indices, the mean WC was higher in males than that in females whereas the mean BMI higher in females. The means of BMI and WC were 24.99 kg/m(2) and 89.13 cm for males and 25.49 kg/m(2) and 85.49 cm for females respectively. Smoking was an independent risk factor of metabolic syndrome in male subjects. It was mainly due to a higher prevalence of dyslipidemia, i.e. a higher level of TG and a lower level of HDL-C in smokers. And the trough prevalence of central obesity was higher in former smokers than current smokers. With adjustment for age, alcohol intake, and regular physical activity, the odds ratios [OR (95%CI)] of never smokers, ex-smokers, and current smokers were 1.00, 1.10 (0.92 - 1.47), and 1.36 (1.02 - 1.69) for hypertriglyceridemia (P < 0.05) and 1.00, 1.08 (0.79 - 1.32), and 1.59 (1.13 - 1.89) for low HDL-C respectively (P < 0.05). The odds ratios of the MS were 1.00 (referent), 1.10 (0.76 - 1.43), and 1.49 (1.06 - 1.89) for never smokers, ex-smokers, and current smokers respectively (P < 0.05). Cessation of smoking had a general trend of lowering the risk of metabolic syndrome in a year-dependent manner in males. In females, the prevalence of metabolic syndrome and obesity was similar between smokers and nonsmokers. Among the features of metabolic syndrome, only a low HDL-C was associated with chronic smoking in females. Although smokers tend to have a lower waist circumference than nonsmokers, the males have higher risk factors for metabolic disorders. There is no significant relationship between smoking and metabolic syndrome in female subjects.


Cell kinetics analysis in patients affected by squamous cell carcinoma of the head and neck treated with primary surgery and adjuvant radiotherapy.
The increasing complexity of management strategies for patients with head and neck squamous cell carcinoma (HN-SCC) calls for the investigation of new objective prognostic parameters to subdivide patients according to the tumor's biological aggressiveness. We evaluated in 35 HN-SCC patients the pretreatment cell kinetics parameters and DNA ploidy after in vivo infusion of bromodeoxyuridine and flow cytometric analysis. Patients were treated with radical surgery followed by conventional radiation therapy. Locoregional control data are available for follow-up times above five years. We found that the likelihood of locoregional control for patients with rapidly proliferating HN-SCC characterized by a short potential doubling time (Tpot <5 days) was significantly smaller than for HN-SCC patients with slow tumor proliferation (Tpot >5 days). Moreover, when patients were stratified according to DNA ploidy and Tpot value, we found that the locoregional failure rate for rapidly proliferating tumors was significantly higher for diploid HN-SCCs than for aneuploid HN-SCCs. The present data suggest that patients with resectable HN-SCC characterized by fast growth might have a worse prognosis after surgery and adjuvant conventional radiotherapy and might benefit from more aggressive radiotherapeutic modalities.


Physiological and Histological Evaluations of the Cochlea between 3xTg-AD Mouse Model of Alzheimer's Diseases and R6/2 Mouse Model of Huntington's Diseases.
Patients with Alzheimer's diseases (AD) and Huntington's diseases (HD) are known to have abnormal auditory processing, but the physiological and histological evaluations of the cochlea between AD and HD have not been thoroughly assessed. Thus we assessed the auditory brainstem response (ABR) and distortion product otoacoustic emissions (DPOAE), and then examined spiral ganglion neurons (SGNs) and hair cells in the cochlea using 3xTg-AD mouse model of AD and R6/2-HD mouse model of HD. We found that the threshold of ABR, but not DPOAE, was significantly increased in AD mice from 9 months of age and thereafter. The significant loss of SGNs, but not hair cells, was observed in the cochlea of 9- and 12-month AD mice. On the other hand, we found that both ABR and DPOAE thresholds were significantly increased in HD mice from 2 months of age and thereafter. The large loss of hair cells and the small loss of SGNs were observed in the cochlea of 3-month HD mice. Furthermore, the prestin expression in outer hair cells (OHCs) was significantly decreased in HD mice from 2 months of age and thereafter, and the loss of prestin expression was earlier before OHCs death in HD mice. Different from HD mice, the prestin expression in OHCs in AD mice was not changed even at 12 months of age. Our data suggest that cochlear pathology contributing to hearing loss is quite different between transgenic mice of AD and HD. More detailed pathological mechanisms for hearing loss between AD and HD need further study.


Newborn hearing screening in Hawaii.
Hawaii has been a pioneer and national leader in implementing universal newborn hearing screening. In fact, Hawaii is one of only two states (Rhode Island is the other) which have a statewide newborn hearing screening program in which 95% or more of all newborns are screened. Hawaii is the best example of a truly integrated system of services to provide effective intervention for all infants and toddlers who are identified as having a hearing loss. The success of the newborn hearing screening program is measurable in two ways: 1) all available information indicates that not a single infant with hearing loss has been missed by the screening process and not a single infant has been misdiagnosed as having a hearing loss; and 2) many of the children identified with hearing loss by the newborn hearing screening program have transitioned out of the early intervention program with age-appropriate developmental and communication skills. The success of Hawaii's program is a tribute to the enthusiastic support and collaboration of legislators, pediatricians, hospital staff, and DOH personnel.


Effect of restricted spinal motion on gait.
Spinal orthoses are common in the treatment of various conditions that affect the spine. They encompass both the spine and pelvis and thus have implications for pelvic and lower-limb motion during walking in addition to a direct effect on spinal motion. The role of the spine in walking is largely ill-defined, and the consequences of restricted spinal motion on walking have yet to be explored. This study investigated the effect of spinal restriction on gait in able-bodied persons. Gait analyses were performed on 10 able-bodied subjects as they walked at five different speeds that were distributed across their comfortable range of speeds. Data were collected during walking with and without spinal restriction by a fiberglass body jacket, which is similar to a thoracolumbosacral orthosis (TLSO). With spinal restriction, peak-to-peak (PP) pelvic obliquity and rotation were significantly reduced across all walking speeds (p < 0.001), while PP pelvic tilt was significantly reduced at only the fastest walking speeds (p = 0.017). PP hip abduction-adduction motion was significantly reduced with spinal restriction across all speeds (p < 0.001), while PP hip flexion-extension significantly increased at only the slow and very slow speeds (p < 0.001 and p = 0.023, respectively). A better understanding of the effects of restricted spinal motion on gait may help clinicians predict and avoid development of additional problems from TLSO use or surgical restriction of spinal motion. An awareness of these issues will enable clinicians to monitor patients for problems that may result from decreased spine and pelvic motion.