The tympanic membrane displacement test and tinnitus: preliminary report on clinical observations, applications, and implications.
The tympanic membrane displacement test (TMDT) is an attempt to record intracranial pressure (ICP) reflective of an intracranial pulse pressure amplitude wave (IPPA) transmitted to the inner ear and tympanic membrane with a probe placed into the external ear canal. Twelve tinnitus patients, divided into two groups, who were resistant to attempts to achieve tinnitus control or relief were selected for the TMDT. The group 1 TMDT recordings were obtained on one session test date, and group 2 (n = 6) recordings were obtained sequentially on different session test dates. Patient selection with the medical audiologic tinnitus patient protocol (MATPP) identified all to have a nonpulsatile, predominantly central-type severe disabling subjective idiopathic tinnitus (SIT) resistant to attempts for tinnitus relief with instrumentation or medication. Associated complaints in all selected SIT patients included persistent ear blockage in the SIT ear, normal middle-ear function, controlled secondary endolymphatic hydrops in the SIT ear, sensorineural hearing loss of high frequency, hyperacusis, occasional vertigo, and central nervous system complaints of headache, head pressure, and cognitive interference in memory and/or speech expression. Clinical concern is for the presence of an increased ICP reflecting an idiopathic intracranial hypertension (IIH) which, if not identified and treated, may be a factor influencing the clinical course of this particular cohort of SIT patients, highlighted by persistent ear blockage and associated complaints as described. We set out to accomplish a number of goals: (1) To identify abnormal intracranial pulse pressure (IPPA ICP) with the extracranial TMD in a preselected particular cohort of SIT patients clinically suspected (by use of the MATPP) to have an abnormal ICP (i.e., IIH); (2) to identify the abnormal IPPA ICP as a positive indicator for IIH and as a factor - not an etiology - influencing the clinical course of SIT in a preselected cohort of SIT patients; (3) to identify with the TMDT in SIT patients spontaneous nonevoked recordings of intra-aural pressure and test-retest reliability of the TMDT; (4) to identify with the TMDT levels of normal and abnormal IPPA ICP in real time in the clinical course of SIT (i.e., an objective diagnostic and treatment monitor function of the TMD targeting ICP and IIH before and after treatment); (5) to attempt to establish a correlation of treatment efficacy, targeting preand post-ICP as a manifestation of IIH, with SIT subjective tinnitus relief; (6) to identify the limitations and complications of the TMDT; and (7) to share with the reader the evolution of a new science of brain pulsatility and a technology having a clinical application for otology and neurotology complaints of hearing loss, tinnitus, ear blockage, and vertigo. The results reported in the literature complement and alter conventional medical teaching focusing on brain pulsation, absolute intracranial pressure, and brain disease. The Southampton Tympanic Membrane Displacement Analyzer was used to record spontaneous intra-aural pressure waves in 12 SIT patients. Patients selected for the TMDT were divided into two groups: Group 1 (n = 6) recordings were obtained on one session test date, and group 2 (n = 6) recordings were obtained sequentially on different session test dates. Multiple recordings were attempted in all patients to identify test-retest reliability in both groups. An attempt for treatment and control of an elevated ICP with or without reduced cerebral compliance (CC) was recommended in 4 patients. With single and multiple recordings using the TMDT, the IPPA (i.e., ICP) was demonstrated to be abnormal and to fluctuate in the clinical course of 10 of the 12 predominantly central-type tinnitus patients (SIT): abnormal IIPA with reduced CC in 8 of 12 patients and normal IPPA with reduced compliance in 2 of 12. Tinnitus treatment results targeting ICP as a manifestation of IIH with Diamox were positive in the short term in 2 patients and incomplete in 3. The SIT relief is reflective of fluctuation in the ICP and the overall issue of multifactorial brain pulsatility. (1) The TMDT demonstrated repeated and consistent spontaneous nonevoked recordings of displacement of the tympanic membrane, reflective of intra-aural pressure, abnormal IPPA ICP in a preselected particular cohort of SIT patients clinically suspected to have an abnormal ICP (i.e., IIH). (2) Test-retest reliability of the TMDT was positive. (3) The results of the TMDT application for identification of an elevated ICP and reduced CC were positive in 10 of 12 particular preselected patients with nonpulsatile, predominantly central-type SIT resistant to attempts for tinnitus relief with instrumentation or medication. These positive findings support clinical and basic science investigations previously reported in the literature. (4) The clinical significance of these preliminary results of an elevated ICP in a particular cohort of SIT patients supports the clinical impression of the presence of an IIH and its influence on the clinical course and overall treatment of SIT. (5) A final conclusion as to the clinical significance of an elevated ICP and reduced CC for IIH and the diagnosis and treatment of tinnitus remains to be established.


Transcranial Doppler Evaluation in Takayasu Arteritis With Oculo-Cerebrovascular Complications.
Takayasu arteritis is a large-vessel vasculitis that may cause oculo-cerebral ischemia. We report a patient with visual loss as initial manifestation, and discuss transcranial Doppler (TCD) findings before and after surgical revascularization. A 19-year-old female developed episodes of transient positional right vision loss, progressing to permanent right vision loss and bright light-induced left amaurosis. Examination demonstrated subclavian bruits, palpable epigastrium aortic pulsation, faint radial pulses, right retinal pallor, arteriolar narrowing, and bilateral boxcarring. Head and neck computed tomography angiogram demonstrated left subclavian origin and right common carotid artery occlusion, and severe innominate and left common carotid artery stenosis. TCD demonstrated right ophthalmic artery flow reversal and nonpulsatile waveforms with dampened spectra in the right anterior circulation. Corticosteroids, methotrexate, infliximab, and dual-antiplatelet therapy were initiated. Eleven weeks later, the patient underwent ascending aortic aneurysm repair and bilateral carotid artery bypass with an aortic graft. Pathology was consistent with chronic active Takayasu arteritis. Two weeks postoperatively, left eye visual symptoms resolved; right visual loss persisted. Postoperative TCD showed marked improvement in cerebral perfusion. Retinal ischemia in young women should prompt emergent inflammatory and systemic vascular evaluation. In our subject, prolonged right retinal ischemia had dismal prognosis despite carotid-aortic revascularization, whereas left retinal boxcarring reversed. Surgical revascularization is recommended for severely symptomatic oculo-cerebrovascular disease, once inflammation is better controlled with immunosuppressive therapy. TCD documented the presence and monitored the subsequent resolution of blood flow changes causing retinal and brain hypoxia.


[Doppler echocardiographic evaluation of fetal hemodynamics in the third trimester of uncomplicated pregnancy].
This paper discusses the evaluation of intracardiac fetal hemodynamics using Doppler cardiography. Reference values have been obtained for transvalvular blood flow for atrioventricular valves and valves of major fetal cardiac arteries. Hemodynamic fetal patterns and their normal changes in third-trimester uncomplicated pregnancy are demonstrated.


Fetal Cell Microchimerism; Normal and Immunocompromised Gestations in Mice.
Objective: To compare fetal cell microchimerism in normal and immunocompromised gestations. Materials and methods: The study consists of two groups of mature female mice. In the control group and the immunocompromised study group, 5 mg of saline and cyclosporine were injected intraperitoneally, respectively. In the second step, all female mice were mated with "Actine-Luc (+) green fluorescent protein (GFP)" transgenic male mice. Immunohistochemical studies (ALPL-antiluciferase, cytokeratin-antiluciferase, and CD 105-antiluciferase) were carried out on maternal liver, skin, and lung tissues at 6-7th and 14-15th gestational days, and postpartum 3-4th, 12th, and 18-24 months. Results: GFP (+) cells were detected in maternal liver and skin but not in lung tissue. Liver was the most affected tissue. GFP was found to be more intense in the immunocompromised group. Conclusion: Fetal microchimerism was demonstrated in maternal liver and skin and found to be more intensive in the immunocompromised group.


Interference phenomena in temporal evolution of accident probability in workplaces.
The aim of this article is to investigate some implications of complexity in workplace risk assessment. Workplace is examined as a complex system, and some of its attributes and aspects of its behavior are investigated. Failure probability of various workplace elements is examined as a time variable and interference phenomena of these probabilities are presented. Potential inefficiencies of common perceptions in applying probabilistic risk assessment models are also discussed. This investigation is conducted through mathematical modeling and qualitative examples of workplace situations. A mathematical model for simulation of the evolution of workplace accident probability in time is developed. Its findings are then attempted to be translated in real-world terms and discussed through simple examples of workplace situations. The mathematical model indicates that workplace is more likely to exhibit an unpredictable behavior. Such a behavior raises issues about usual key assumptions for the workplace, such as aggregation. Chaotic phenomena (nonlinear feedback mechanisms) are also investigated for in simple workplace systems cases. The main conclusions are (1) that time is an important variable for risk assessment, since behavior patterns are complex and unpredictable in the long term and (2) that workplace risk identification should take place in a holistic view (not by work post).


Characterization of human chromosomal DNA sequences which replicate autonomously in Saccharomyces cerevisiae.
We have characterised two restriction fragments, isolated from a "shotgun" collection of human DNA, which function as autonomously replicating sequences (ARSs) in Saccharomyces cerevisiae. Functional domains of these fragments have been defined by subcloning and exonuclease (BAL 31) deletion analysis. Both fragments contain two spatially distinct domains. One is essential for high frequency transformation and is termed the Replication Sequence (RS) domain, the other, termed the Replication Enhancer (RE) domain, has no inherent replication competence but is essential for ensuring maximum function of the RS domain. The nucleotide sequence of these domains reveals several conserved sequences one of which is strikingly similar to the yeast ARS consensus sequence.


High-Performance Sm-Doped Pb(Mg1/3Nb2/3)O3-PbZrO3-PbTiO3-Based Piezoceramics.
High-performance piezoelectric materials are pivotal to many electromechanical applications including piezoelectric actuators, sensors, and transducers. However, the general approach to achieve high piezoelectric properties by establishing morphotropic phase boundary (MPB) has limitation due to the weak anisotropy of the Gibbs free energy profile at the MPB region. Here, aliovalent Sm3+-doped 0.4Pb(Mg1/3Nb2/3)O3-(0.6-x)PbZrO3-xPbTiO3 piezoelectric ceramics were fabricated by a solid-state method, where the optimized piezoelectric coefficient d33 = 910 pC/N, dielectric constant εr = 4090, and Curie temperature TC = 184 °C were obtained at x = 0.352, being attributed to the synergistic contributions from the MPB and enhanced local structural heterogeneity. Rayleigh analysis was adopted to study the intrinsic and extrinsic contributions in Sm-doped PMN-PZ-PT ceramics, where the extrinsic contribution was found to be on the order of 25-67% at 4 kV/cm. Of particular significance is that a large signal d33* = 820 pm/V (at 20 kV/cm) with a minimal strain variation of 5% was achieved for a composition of x = 0.372 over the temperature range of 20-160 °C, being superior to those previously reported piezoelectric ceramic materials. This work offers a good paradigm to simultaneously achieve high piezoelectric properties with good temperature stability in ferroelectric ceramics, which have great potential for piezoelectric application at elevated temperatures.


Strain-specific tumorigenesis in mouse skin induced by the carcinogen, 15,16-dihydro-11-methylcyclopenta[a]phenanthren-17-one, and its relation to DNA adduct formation and persistence.
The incidence of skin tumors has been studied in three strains of mice, namely, TO, C57BL, and DBA/2, after treatment with the carcinogen 15,16-dihydro-11-methylcyclopenta[a]phenanthren-17-one. After either a single dose followed by croton oil promotion or a continual dose of the carcinogen, tumors were observed in the TO and C57BL strains, with the TO mice having the shorter mean latent period. The DBA/2 mice, however, appeared to be resistant to tumor formation by either treatment. To understand the mechanism of resistance, several criteria have been investigated. Metabolism of the carcinogen was assessed in terms of the total DNA adduct formation and the pattern of individual adducts after separation by high-pressure liquid chromatography, and no major differences between the three strains was found. Similarly, the rates of disappearance of the individual adducts when measured over 14 days posttreatment were not strain specific. Persistent binding of the carcinogen after 2 months was found in all three strains and could be reduced markedly if croton oil was administered throughout this period. The ability of the phorbol esters to cause biochemical changes in both sensitive and resistant strains was indicated by the induction of ornithine decarboxylase in each of the three strains after treatment with either croton oil or its active component, 12-O-tetradecanoylphorbol-13-acetate.


Relation of cumulative exposure to inorganic lead and neuropsychological test performance.
To determine if measures reflecting chronic occupational lead exposure are associated with performance on neuropsychological tests. 467 Canadian male lead smelter workers (mean (SD) age 43.4 (11.00) years, education 9.8 (3.18) years, years of employment 17.7 (7.43), and current blood lead concentration (B-Pb) 27.5 (8.4) micrograms dl-1) were given a neuropsychological screening battery. Time weighted average (TWA) and time integrated blood levels (IBL) were developed from B-Pb records obtained through regular medical monitoring (mean (range) TWA 40.1 (4.0-66.4) micrograms dl-1, mean IBL 765.2 (0.6-1625.7) micrograms-y dl-1). 14 neuropsychological variables were included in three multivariate analyses of covariance, with each exposure variable as the grouping variable (high, medium, and low) and age, education, score on a measure of depressive symptoms, and self reported alcohol use as the covariates. Groups did not differ in history of neurological conditions. Neither the B-Pb, TWA, nor IBL was significant by multivariate analyses of covariance (MANCOVA). When years of employment, a suppressor variable, was included as a covariate, IBL exposure groups differed significantly on digit symbol, logical memory, Purdue dominant hand, and trails A and B. A dose-effect relation was found between cumulative exposure (IBL) and neuropsychological performance at a time when current B-Pb concentrations were low and showed no association with performance.


Bacteremia and postmortem microbiology in burned children.
During a three-year period, Staphylococcus aureus and Pseudomonas aeruginosa were the organisms most commonly isolated from blood cultures of burned children. Microorganisms were considered to contribute to the cause of death in 17 of 20 patients who died from various complications of thermal injuries. Pseudomonas aeruginosa was involved in eight deaths, whereas other Gram-negative bacilli or fungi, or both, were involved in the deaths of the remaining nine patients. The microbiologic examination of cardiac blood and pulmonary tissue correlated reasonably well with clinical and anatomic judgments of cause of death, as well as with the defining of some cases of "terminal sepsis".


Hydration of ferric chloride and nitrate in aqueous solutions: water-mediated ion pairing revealed by Raman spectroscopy.
Iron is the most abundant transition metal in the earth's crust and is important for the proper functioning of many technological and natural processes. Despite the importance, a complete microscopic understanding of the hydration of ferric ions and water mediated ion pairing has not been realized. Hydrated Fe(iii) is difficult to study due to the process of complexation to the anion and hydrolysis of the hydrating water molecules leading to a heterogeneous solution with diverse speciation. Here, ferric chloride and nitrate aqueous solutions are studied using polarized Raman spectroscopy as a function of concentration and referenced to their respective sodium salt or mineral acid. Perturbed water spectra (PWS) were generated using multivariate curve resolution-alternating least squares (MCR-ALS) to show the residual spectral response uniquely attributable to the hydration of ferric speciation. The hydrogen bonding network associated with the hydrating water molecules in ferric chloride solutions are found to be more similar to hydrochloric acid solutions, whereas in ferric nitrate solutions, the network behaves more similar to sodium nitrate, despite increased acidity. Thus, in the FeNO3 and FeCl3 solutions, ion pairing and coordination, respectively, are significantly influencing the hydration spectra signature. These results further reveal concentration dependent changes to the hydrogen bonding network, hydrating water symmetry, and changes to the relative abundance of solvent shared ion pairs that are governed primarily by the ferric salt identity.


On model of angiogenesis and the mechanism in porous silk fibroin films.
The purpose of this paper is to explore the mechanism of the angiogenesis modes in the biomaterials implanted in vivo. By means of experimental observation and analysis of the capillary growing state in the porous silk fibroin film implanted into rats, we intended to develop a modeling expression on the growth mode of the capillaries in the biomaterials. Additionally, we proposed the response model of endothelial cells (ECs) resulting from vascular endothelial growth factor's concentrations at different stages after the implantation. With the implantation experiment, it was identified that angiogenesis developed in the way of capillary sprouting at the early stage of implantation and of intussusception at the late stage. Based on the response model of ECs, experimental results are explained.


The interaction of lead exposure and arylsulfatase A genotype affects sulfatide catabolism in human fibroblasts.
Lead exposure causes cognitive and behavioral deficits in some affected children. We propose that a contributing mechanism for the neurological damage is that lead induces critically low levels of arylsulfatase A (ASA) at sensitive stages of nervous system development. It is hypothesized that the combined effects of a single nucleotide polymorphism (SNP) in human ASA which results in reduced levels of the enzyme, and lead concentrations which decrease ASA activity culminate in cellular enzymic activity that is below a critical threshold required for the maintenance of normal nervous system function. Human fibroblasts grown in the presence of 20 microM lead acetate exhibit a more than 60% decrease of cellular ASA enzyme protein. Lead treatment of cells from individuals with the SNP(s) of pseudodeficient ASA, but not those from subjects with the normal gene, results in a significant decrease in ability of the cells to desulfate sulfatide, the substrate of ASA. The decrease in the degree of sulfatide catabolism is consistent with possible enhanced lead-induced neurobehavioral effects in individuals homozygous for the pseudodeficiency polymorphism(s) of ASA.


Spatial and temporal dissociation of AQP4 and Kir4.1 expression during induction of refractive errors.
Spatial co-localization of aquaporin water channels (AQP4) and inwardly rectifying potassium ion channels (Kir4.1) on the endfeet regions of glial cells has been suggested as the basis of functionally interrelated mechanisms of osmoregulation in brain edema. The aim of this study was to investigate the spatial and temporal changes in the expression of AQP4 and Kir4.1 channels in an avascular retina during the first week of the optical induction of refractive errors. Three-day-old hatchling chicks were randomly assigned to three groups and either did not wear lenses or were monocularly goggled with +/-10D lenses for varying times up to 7 days before biometric assessment. Retinal tissue was prepared either for western blot analysis to show the presence of the AQP4 and Kir4.1 protein in the chick retina or for immunolocalization using AQP4 and Kir4.1 antibodies to determine the regional distribution and intensity of labeling during the induction of refractive errors. As expected, ultrasonography demonstrated that all eyes showed rapid elongation post hatching. Negative lens-wearing eyes elongated faster than fellow eyes or normal non goggled eyes and became progressively more myopic with time post lensing. Positive lens-wearing eyes showed reduced ocular growth compared to normal controls and developed a hyperopic refraction. Quantitative immunohistochemistry revealed the upregulation of AQP4 channel expression on Müller cells in the retinal nerve fiber layer during the first 2 days of negative lens wear. Kir4.1 channel upregulation in the inner plexiform layer was only found on day 4 of positive lens wear during the development of refractive hyperopia. These results indicate that the expression of AQP4 and Kir4.1 channels on Müller cells is associated with the changes in ocular volume seen during the induction of refractive errors. However, the sites of greatest expression and the temporal pattern of the upregulation of AQP4 and Kir4.1 were dissimilar, indicating a dissociation of AQP4 and Kir4.1 function during refractive error development. Increased AQP4 expression in the nerve fiber layer is suggested to contribute to the rapid axial elongation and movement of fluid into the vitreous cavity in the presence of minus lenses; whereas, upregulation of Kir4.1 channels appears to play a role in limiting axial elongation in the presence of plus lenses.


Increased production of tumor necrosis factor-alpha induces apoptosis after traumatic spinal cord injury in rats.
We showed previously that, after spinal cord injury (SCI), tumor necrosis factor-alpha (TNF-alpha) may serve as an external signal, initiating apoptosis in neurons and oligodendrocytes. To further characterize the apoptotic cascade initiated by TNF-alpha after SCI, we examined the expression of TNF-alpha, inducible nitric oxide (NO) synthase (iNOS), and the level of NO after SCI. Western blots and reverse transcription polymerase chain reactions showed an early upregulation of TNF-alpha after injury. A peak TNF-alpha expression was observed within 1 h of injury. By 4 h after injury, the expression of iNOS and the level of NO were markedly increased in the injured spinal cord. Terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate-biotin nick end labeling (TUNEL)-positive cells were also first observed in the lesioned area 4 h after SCI. The largest number of TUNEL-positive cells was observed between 24-48 h after SCI. Injecting a neutralizing antibody against TNF-alpha into the lesion site after injury significantly reduced the expression of iNOS, the level of NO and the number of TUNEL-positive cells in the injured spinal cord. Injecting the NOS inhibitors, N(G)-monomethyl-L-arginine monoacetate and S-methylisothiourea sulfate, or an NO scavenger, carboxy-PTIO, into the lesion site also significantly reduced the level of NO and the degree of DNA laddering in the injured spinal cord. These data suggest that after SCI, apoptosis induced by TNF-alpha may be mediated in part by NO via upregulation of iNOS, induced in response to TNF-alpha.


A descriptive and comparative study of the prevalence of depressive and anxiety disorders in low-income adults with type 2 diabetes and other chronic illnesses.
To determine whether type 2 diabetes contributes to the presence of depressive and anxiety disorder diagnoses in low-income adults with hypertension, asthma, and/or arthritis. Using a cross-sectional design, this study administered a structured diagnostic interview to low-income primary care patients diagnosed with type 2 diabetes, hypertension, arthritis, and asthma, as well as to those with no chronic illness (n = 326), to determine the 12-month prevalence of depressive and anxiety disorders. A logistic regression (LR) model was used to assess whether a diagnosis of depression and/or anxiety was associated with type 2 diabetes after adjusting for known risk factors. A high prevalence rate of depressive and/or anxiety disorders was found in the total sample (29%) and in all three illness groups: type 2 diabetes (36%), other chronic illnesses (24%), and no chronic illness (31%). Using LR, a main effect was detected for illness group when age and education were controlled (chi(2) = 22.66, df 4, P = 0.000). Specifically, the odds of occurrence of a depressive and/or anxiety disorder in those with comorbid type 2 diabetes were twice that in the nondiabetic, chronically ill comparison group (odds ratio 2.26, 95% CI 1.28-4.01, P = 0.005). These results suggest a positive contribution of type 2 diabetes to increased rates of depressive and/or anxiety disorders in patients with hypertension, asthma, and/or arthritis and support prior research that type 2 diabetes may serve as an indicator of depression and anxiety in low-income adults treated in primary care clinics.


Molecular and morphological changes in the cat lateral geniculate nucleus and visual cortex induced by visual deprivation are revealed by monoclonal antibodies Cat-304 and Cat-301.
Monoclonal antibody Cat-301 recognizes a surface-associated proteoglycan on subsets of neurons in the mammalian CNS (Hockfield and McKay, 1983). The expression of Cat-301 immunoreactivity on Y cells in the cat LGN is sharply reduced by early visual deprivation (Sur et al., 1988). We employed an immunosuppression strategy (Hockfield, 1987) to further study alterations in the expression of experience-dependent molecules. Newborn BALB/c mice were injected with LGN from dark-reared cats to induce a suppression of the immune response to antigens expressed in visually deprived animals. These mice were then immunized with LGN from normal cats to elicit an immune response to antigens with an expression dependent on normal early visual experience. This strategy permitted the generation of monoclonal antibody Cat-304, which recognizes a surface-associated antigen on neuronal cell bodies and proximal dendrites, and which appears histologically identical to Cat-301. Further analyses show that Cat-304 and Cat-301 recognize different epitopes on the same 680-kDa chondroitin sulfate proteoglycan. We examined the effects of early visual deprivation on Cat-304 immunoreactivity in the LGN and visual cortex of cats. In LGN from normal cats, Cat-304 labels neurons in layers A, A1, and C, in interlaminar zones, and in the medial interlaminar nucleus. In LGN from dark-reared cats, the number of antibody-positive neurons is markedly reduced, and the cross-sectional area of the remaining positive neurons is smaller than normal. In cortical area 17 of normally reared cats, Cat 304-positive neurons are densely distributed in 2 bands, in layers IV and V/VI. Labeled neurons are also present in layers II and III. In area 17 of dark-reared cats, the number of antibody-positive neurons is reduced. The reduction in the number of labeled neurons is most pronounced in layers II/III and V/VI. Antibody-positive neurons are smaller in all cortical layers of dark-reared cats. The changes in the expression of Cat-301 immunoreactivity in dark-reared visual cortex and LGN are identical to those of Cat-304. The laminar differences in the effect of dark rearing on Cat-301 and Cat-304 expression in the visual cortex provides support for the suggestion that layer IV of cortical area 17 may be less susceptible to prolongation of plasticity by dark rearing than layers II/III and V/VI. Further, the biochemical and histological studies reported provide evidence that early visual experience regulates protein expression in the cat LGN and visual cortex.


Lipofuscin, homocysteine and tissue polypeptide specific antigen in gestational hypertension.
The aim of this study were to assess the levels of lipofuscin (parameter of oxidative stress), homocysteine (as a marker of vascular injury) and tissue specific antigen - TPS - (as a marker of cell proliferation) in relation to arterial pressure of pregnant woman. Healthy pregnant women (n=18), women with mild 140/90=< RR<160/100 (n=19), and severe 160/100=<RR (n=23) gestational hypertension were enrolled. Lipofuscin has been determined by fluorescence spectroscopy, homocysteine by MEIA commercial kit from Abbott IMx, TPS by EIA method using kit from BEKI. Mean duration of gestation was 34+/-5 weeks, and there were no differences between groups. Serum lipofuscin levels in mild form of pregnancy-induced hypertension were decreased comparing to normal pregnancy. Homocysteine levels were decreased and TPS levels increased in both mild and severe gestational hypertension. Our results suggest overestimation of the role of oxidative stress and hyperhomocysteinemia in gestational hypertension.


Rapid auditory processing and medial geniculate nucleus anomalies in Kiaa0319 knockout mice.
Developmental dyslexia is a common neurodevelopmental disorder characterized by difficulties in reading and writing. Although underlying biological and genetic mechanisms remain unclear, anomalies in phonological processing and auditory processing have been associated with dyslexia. Several candidate risk genes have also been identified, with KIAA0319 as a main candidate. Animal models targeting the rodent homolog (Kiaa0319) have been used to explore putative behavioral and anatomic anomalies, with mixed results. For example after downregulation of Kiaa0319 expression in rats via shRNA, significant adult rapid auditory processing impairments were reported, along with cortical anomalies reflecting atypical neuronal migration. Conversely, Kiaa0319 knockout (KO) mice were reported to have typical adult auditory processing, and no visible cortical anomalies. To address these inconsistencies, we tested Kiaa0319 KO mice on auditory processing tasks similar to those used previously in rat shRNA knockdown studies. Subsequent neuroanatomic analyses on these same mice targeted medial geniculate nucleus (MGN), a receptive communication-related brain structure. Results confirm that Kiaa0319 KO mice exhibit significant auditory processing impairments specific to rapid/brief stimuli, and also show significant volumetric reductions and a shift toward fewer large and smaller neurons in the MGN. The latter finding is consistent with post mortem MGN data from human dyslexic brains. Combined evidence supports a role for KIAA0319 in the development of auditory CNS pathways subserving rapid auditory processing functions critical to the development of speech processing, language, and ultimately reading. Results affirm KIAA0319 variation as a possible risk factor for dyslexia specifically via anomalies in central acoustic processing pathways.


Optimal approaches for balancing invasive species eradication and endangered species management.
Resolving conflicting ecosystem management goals-such as maintaining fisheries while conserving marine species or harvesting timber while preserving habitat-is a widely recognized challenge. Even more challenging may be conflicts between two conservation goals that are typically considered complementary. Here, we model a case where eradication of an invasive plant, hybrid Spartina, threatens the recovery of an endangered bird that uses Spartina for nesting. Achieving both goals requires restoration of native Spartina. We show that the optimal management entails less intensive treatment over longer time scales to fit with the time scale of natural processes. In contrast, both eradication and restoration, when considered separately, would optimally proceed as fast as possible. Thus, managers should simultaneously consider multiple, potentially conflicting goals, which may require flexibility in the timing of expenditures.


Patient-reported communications with pharmacy staff at community pharmacies: the Alabama NSAID Patient Safety Study, 2005-2007.
To examine the prevalence of patient-pharmacy staff communication about medications for pain and arthritis and to assess disparities in communication by demographic, socioeconomic, and health indicators. Descriptive, nonexperimental, cross-sectional study. Alabama between 2005 and 2007. 687 Patients participating in the Alabama NSAID Patient Safety Study (age >or=50 years and currently taking a prescription nonsteroidal anti-inflammatory drug [NSAID]). Not applicable. Communication with pharmacy staff about prescription and over-the-counter (OTC) NSAIDs was examined before and after adjustment for demographic, socioeconomic, and health indicators. For the entire cohort (n = 687), mean (+/-SD) age was 68.3 +/- 10.0 years, 72.8% were women, 36.4% were black, and 31.2% discussed use of prescription pain/arthritis medications with pharmacy staff. Discussing use of prescription pain/arthritis medications with pharmacy staff differed by race/gender (P < 0.001): white men (40.3%), white women (34.6%), black men (30.2%), and black women (19.8%). Even after multivariable adjustment, black women had the lowest odds of discussing their medications with pharmacy staff (odds ratio 0.40 [95% CI 0.24-0.56]) compared with white men. For the 63.0% of participants with recently overlapping prescription and OTC NSAID use, communication with pharmacy staff about OTC NSAIDs use was only 13.7% and did not vary significantly by race/gender group. Given the complex risks and benefits of chronic NSAID use, pharmacists, pharmacy staff, and patients all are missing an important opportunity to avoid unsafe prescribing and decrease medication adverse events.


Modulating Smart Mechanoluminescent Phosphors for Multistimuli Responsive Optical Wood.
Mechanoluminescence is a smart light-emitting phenomenon in which applied mechanical energy is directly converted into photon emissions. In particular, mechanoluminescent materials have shown considerable potential for applications in the fields of energy and sensing. This study thoroughly investigates the mechanoluminescence and long afterglow properties of singly doped and codoped Sr2 MgSi2 O7 (SMSO) with varying concentrations of Eu2+ and Dy3+ ions. Subsequently, a comprehensive analysis of its multimode luminescence properties, including photoluminescence, mechanoluminescence, long afterglow, and X-ray-induced luminescence, is conducted. In addition, the density of states mapping is acquired through first-principles calculations, confirming that the enhanced mechanoluminescence properties of SMSO primarily stem from the deep trap introduced by Dy3+ . In contrast to traditional mixing with Polydimethylsiloxane, in this study, the powders are incorporated into optically transparent wood to produce a multiresponse with mechanoluminescence, long afterglow, and X-ray-excited luminescence. This structure is achieved by pretreating natural wood, eliminating lignin, and subsequently modifying the wood to overall modification using various smart phosphors and epoxy resin composites. After natural drying, a multifunctional composite wood structure with diverse luminescence properties is obtained. Owing to its environmental friendliness, sustainability, self-power, and cost-effectiveness, this smart mechanoluminescence wood is anticipated to find extensive applications in construction materials and energy-efficient displays.


Further evidence that the tyrosine phosphorylation of glycogen synthase kinase-3 (GSK3) in mammalian cells is an autophosphorylation event.
Phosphorylation of the endogenous GSK3alpha (glycogen synthase kinase-3alpha) at Tyr279 and GSK3beta at Tyr216 was suppressed in HEK-293 or SH-SY5Y cells by incubation with pharmacological inhibitors of GSK3, but not by an Src-family inhibitor, 4-amino-5-(4-chlorophenyl)-7-(t-butyl)pyrazolo[3,4- d ]pyrimidine (PP2), or a general protein tyrosine kinase inhibitor (genistein). GSK3beta transfected into HEK-293 cells or Escherichia coli became phosphorylated at Tyr216, but catalytically inactive mutants did not. GSK3beta expressed in insect Sf 21 cells or E. coli was extensively phosphorylated at Tyr216, but the few molecules lacking phosphate at this position could autophosphorylate at Tyr216 in vitro after incubation with MgATP. The rate of autophosphorylation was unaffected by dilution and was suppressed by the GSK3 inhibitor kenpaullone. Wild-type GSK3beta was unable to catalyse the tyrosine phosphorylation of catalytically inactive GSK3beta lacking phosphate at Tyr216. Our results indicate that the tyrosine phosphorylation of GSK3 is an intramolecular autophosphorylation event in the cells that we have studied and that this modification enhances the stability of the enzyme.


Expression of a human liver cytochrome P-450 protein with tolbutamide hydroxylase activity in Saccharomyces cerevisiae.
The human liver cytochrome P-450 (P-450) proteins responsible for catalyzing the oxidation of mephenytoin, tolbutamide, and hexobarbital are encoded by a multigene family (CYP2C). Although several cDNA clones and proteins related to this "P-450MP" family have been isolated, assignment of specific catalytic activities remains uncertain. Sulfaphenazole was found to inhibit tolbutamide hydroxylation to a greater extent than mephenytoin or hexobarbital hydroxylation. The inhibition by sulfaphenazole was competitive for tolbutamide and hexobarbital hydroxylation but with much different Ki values (5 vs 480 microM, respectively). Inhibition of mephenytoin hydroxylase was not competitive. The results suggest that different P-450 proteins in the P450MP family may be involved in the metabolism of these compounds. A cDNA clone (MP-8) related to the P-450MP family, isolated from a bacteriophage lambda gt11 human liver library, was expressed in Saccharomyces cerevisiae by using the pAAH5 expression vector. Yeast transformed with pAAH5 containing the MP-8 sequence (pAAH5/MP-8) showed a ferrous-CO spectrum typical of the P-450 proteins. Immunoblotting with anti-P450MP revealed that pAAH5/MP-8 microsomes contained a protein with an Mr similar to that of P-450MP-1 (approximately 48,000) that was not present in microsomes from yeast transformed with pAAH5 alone (1.7 X 10(4) molecules of the expressed P-450 per cell). Microsomes from pAAH5/MP-8 contained no detectable mephenytoin 4'-hydroxylase activity but were more active in tolbutamide hydroxylation, on a nanomoles of P-450 basis, than human liver microsomes. The pAAH5/MP-8 microsomes also contained hexobarbital 3'-hydroxylase activity, although the enrichment compared to liver microsomes was not great with respect to the tolbutamide hydroxylase activity.(ABSTRACT TRUNCATED AT 250 WORDS)


Associations between multimorbidity and additional burden for working-age adults with specific forms of musculoskeletal conditions: a cross-sectional study.
Multiple health conditions are increasingly a problem for adults with musculoskeletal conditions. However, multimorbidity research has focused primarily on the elderly and those with a limited subset of musculoskeletal disorders. We sought to determine whether associations between multimorbidity and additional burden differ with specific forms of musculoskeletal conditions among working-age adults. Data were sourced from a nationally representative Australian survey. Specific musculoskeletal conditions examined were osteoarthritis; inflammatory arthritis; other forms of arthritis or arthropathies; musculoskeletal conditions not elsewhere specified; gout; back pain; soft tissue disorders; or osteoporosis. Multimorbidity was defined as the additional presence of one or more of the Australian National Health Priority Area conditions. Burden was assessed by self-reported measures of: (i) self-rated health (ii) musculoskeletal-related healthcare and medicines utilisation and, (iii) general healthcare utilisation. Associations between multimorbidity and additional health or healthcare utilisation burden among working-age adults (aged 18 - 64 years of age) with specific musculoskeletal conditions were estimated using logistic regression, adjusting for confounders. Interaction terms were fitted to identify whether there were specific musculoskeletal conditions where multimorbidity was more strongly associated with poorer health or greater healthcare utilisation than in the remaining musculoskeletal group. Among working-age adults, for each of the specified musculoskeletal conditions, multimorbidity was associated with similar, increased likelihood of additional self-rated health burden and certain types of healthcare utilisation. While there were differences in the relationships between multimorbidity and burden for each of the specific musculoskeletal conditions, no one specific musculoskeletal condition appeared to be consistently associated with greater additional health burden in the presence of multimorbidity across the majority of self-rated health burden and healthcare use measures. For working-age people with any musculoskeletal conditions examined here, multimorbidity increases self-reported health and healthcare utilisation burden. As no one musculoskeletal condition appears consistently worse off in the presence of multimorbidity, there is a need to better understand and identify strategies that acknowledge and address the additional burden of concomitant conditions for working-age adults with a range of musculoskeletal conditions.


Undergraduate perceptions on the educational value of a novel ENT e-Learning platform.
ENT is a consistently under-represented specialty in medical school curricula. With social distancing measures limiting face-to-face (FtF) teaching and clinical opportunities, we created an e-Learning platform to consolidate and improve knowledge on common ENT emergencies. Following invitation to medical students undergoing their rotation in ENT at University Hospital Wales (UHW) Cardiff, five focus groups were shown an e-Learning module and interviewed between June and July 2021. 13 medical students participated in total (9 female, 4 male, median age 22 years). These structured interviews were recorded and transcribed. Transcripts were analysed using the qualitative data analysis software NVivo (QSR International, UK). The modules were found to be concise, clinically relevant and beneficial to student confidence in recognising and managing ENT emergencies. While e-Learning will likely never replace face-to-face learning, it was perceived to be a beneficial resource both academically and practically- especially in the context of limited clinical opportunities.


The brain drain as viewed by an exporting country.
Philippines, a country of 57 million, graduates a substantial number of nurses each year. In 1989 alone, approximately 7,350 new nurses were successfully registered with the Professional Regulation Commission, bringing the total to over 160,000 nurses registered since 1922. Paradoxically, the country suffers from a shortage of nurses in the midst of a bountiful supply of "human resources". Below are the consequences.


The C-Reactive Protein May Not Detect Infections Caused by Less-Virulent Organisms.
The aim of the present study was to evaluate the influence of organism type on the performance of the synovial fluid C-reactive protein (CRP) test. We retrospectively reviewed the results of 21,422 synovial fluid samples sent to one common laboratory for the purpose of diagnostic testing for periprosthetic joint infection. Both a synovial fluid CRP result and a positive culture were present for 1789 submitted samples. The cultured organisms were grouped by species, virulence, and gram type; and the median CRP level was determined for each group. The median synovial fluid CRP level was significantly lower for less-virulent organisms, when compared to those organisms classified as virulent (15.10 mg/L vs 32.70 mg/L; P < .0001). Some less-virulent species such as yeast and Staphylococcus epidermidis were associated with a 4-10 times lower CRP response than those of virulent organisms such as Streptococcus agalactiae and Staphylococcus aureus (P < .0001). Bacterial gram type had no influence on the median CRP result. The rate of false-negative CRP values was 50.9% for yeast, 29.4% for S. epidermidis, 28.5% for all less-virulent organisms, and 11.6% for all virulent organisms. The CRP response appears to be highly dependent on the infecting organism and is more likely to provide false-negative results in the setting of less-virulent organisms. Although the use of a CRP level is an important part of the workup for periprosthetic joint infection, surgeons must be aware that this protein may yield a false-negative result in the setting of less-virulent organisms.


Eucapnic Voluntary Hyperpnea: Gold Standard for Diagnosing Exercise-Induced Bronchoconstriction in Athletes?
In athletes, a secure diagnos is of exercise-induced bronchoconstriction (EIB) is dependent on objective testing. Evaluating spirometric indices of airflow before and following an exercise bout is intuitively the optimal means for the diagnosis; however, this approach is recognized as having several key limitations. Accordingly, alternative indirect bronchoprovocation tests have been recommended as surrogate means for obtaining a diagnosis of EIB. Of these tests, it is often argued that the eucapnic voluntary hyperpnea (EVH) challenge represents the 'gold standard'. This article provides a state-of-the-art review of EVH, including an overview of the test methodology and its interpretation. We also address the performance of EVH against the other functional and clinical approaches commonly adopted for the diagnosis of EIB. The published evidence supports a key role for EVH in the diagnostic algorithm for EIB testing in athletes. However, its wide sensitivity and specificity and poor repeatability preclude EVH from being termed a 'gold standard' test for EIB.


[The effect of regulatory peptides on water absorption in the large intestine of the frog].
Preparation of isolated large intestine of the frog was filled with Ringer's solution diluted with distilled water (1:5) and was placed into the glass with normal Ringer's solution. The preparation was weighed within every 30 min and the osmotic permeability was determined for water of the mucous and serous layers of the intestine. Then one of the peptides was added to Ringer's solution and the experiment continued. It is stated that bombesin, neurotensin, encephalins, substance P, somatostatin, pituitrin are able to change liquid absorption from the large intestine cavity when the concentration of Ringer's solution in the cavity and from its serous surface is the same. Bombesin and neurotensin inhibited while encephalins stimulated liquid absorption and these effects depended on the transport of ions. Liquid absorption by the osmotic gradient decreased using bombesin, substance P and increased using somatostatin. More complex peptide-peptide relations are observed if using pituitrin and other peptides. cAMP is shown to participate in bombesin effects.


European emissions of halogenated greenhouse gases inferred from atmospheric measurements.
European emissions of nine representative halocarbons (CFC-11, CFC-12, Halon 1211, HCFC-141b, HCFC-142b, HCFC-22, HFC-125, HFC-134a, HFC-152a) are derived for the year 2009 by combining long-term observations in Switzerland, Italy, and Ireland with campaign measurements from Hungary. For the first time, halocarbon emissions over Eastern Europe are assessed by top-down methods, and these results are compared to Western European emissions. The employed inversion method builds on least-squares optimization linking atmospheric observations with calculations from the Lagrangian particle dispersion model FLEXPART. The aggregated halocarbon emissions over the study area are estimated at 125 (106-150) Tg of CO(2) equiv/y, of which the hydrofluorocarbons (HFCs) make up the most important fraction with 41% (31-52%). We find that chlorofluorocarbon (CFC) emissions from banks are still significant and account for 35% (27-43%) of total halocarbon emissions in Europe. The regional differences in per capita emissions are only small for the HFCs, while emissions of CFCs and hydrochlorofluorocarbons (HCFCs) tend to be higher in Western Europe compared to Eastern Europe. In total, the inferred per capita emissions are similar to estimates for China, but 3.5 (2.3-4.5) times lower than for the United States. Our study demonstrates the large benefits of adding a strategically well placed measurement site to the existing European observation network of halocarbons, as it extends the coverage of the inversion domain toward Eastern Europe and helps to better constrain the emissions over Central Europe.


In vivo elastographic investigation of ethanol-induced hepatic lesions.
Ethanol-induced hepatic lesions were investigated in swine for in vivo use as a strain imaging animal model. Lesions (n = 25) were induced by injecting ethanol (doses 0.33 to 2.0 mL) directly into the surgically exposed liver at depths of 12, 15 or 25 mm. Lesions were imaged with a modified HDI 1000 scanner (Philips Medical Systems, Bothell, WA, USA). The elastograms (n = 91) characterized lesions as being areas harder than the surrounding soft hepatic tissue. Elastographic lesion sizes and the corresponding injected ethanol dose used to induce the lesions were shown to be statistically significant (r(2) = 0.22; p = 0.029) using a linear regression analysis. Additionally, lesion depth was shown to be statistically insignificant (r(2) < 0.12; p > 0.10) when regressed against elastographic lesion size. An analysis of elastographic and gross pathology lesion sizes indicated no correlation (r(2) < 0.01; p = 0.973). Subsequently, lesion types were sorted by size and regression lines were computed from quasilinear regions of the corresponding run charts. Trend lines indicate a four-to-three size relationship between the selected elastographic and pathology lesion sizes. Comparison of elastogram lesion sizes from two independent observers using a paired t-test resulted in no statistically significant difference (p = 0.14). In conclusion, ethanol-induced hepatic lesions in swine is a suitable animal model for evaluation of strain-based imaging systems, due to the ease of generation and repeatability.


Sequence-dependent toxicity profile in modified FAMTX (fluorouracil-adriamycin-methotrexate) chemotherapy with lenograstim support for advanced gastric cancer: a feasibility study.
For advanced irresectible gastric cancer, sequential high-dose methotrexate and 5-fluorouracil (both on day 1) combined with adriamycin on day 15 (FAMTX regimen), cycled every 28 days, is a fairly effective but toxic treatment, with a high incidence of neutropenic fever, dose reductions and dose delays. In order to improve FAMTX toxicity, we studied the feasibility of two modified FAMTX regimens with lenograstim support. Seven advanced gastric cancer patients were treated with all three FAMTX drugs on day 1 followed by lenograstim 150 microgm(-2)for 10 days, in 21-day cycles (FUMA regimen). The next seven patients were treated with the same drugs at the same doses, but with adriamycin 1 day prior to methotrexate and 5-fluorouracil administration (AFUM regimen). Patients were monitored for toxicity, response, and survival. The total number of courses was 27 for FUMA and 35 for AFUM with a median of four courses per patient in each cohort. In the FUMA regimen, considerable toxicity consisting of mucositis and fatigue as well as grade 4 neutropenia occurred, and forced four out of seven patients to stop treatment. The consecutive AFUM regimen showed only mild toxicity, and all patients could finish treatment without dose reductions or delays. We found unanticipated and probably sequence-dependent toxicity profiles in two investigational, modified FAMTX schedules with lenograstim support, leading to high rates of dose-limiting toxicity in the FUMA regimen as opposed to mild toxicity in the AFUM regimen, even though the same total drug doses and treatment cycle length (dose intensity) were employed.


Hypothalamic actions and interactions of alcohol and IGF-1 on the expression of glial receptor protein tyrosine phosphatase-β during female pubertal development.
Hypothalamic glial-neuronal communications are important for the activation of luteinizing hormone releasing hormone (LHRH) secretion at the time of puberty. As we have shown that alcohol (ALC) diminishes prepubertal LHRH secretion and delays puberty, we first assessed the effects of short-term ALC administration on the basal expression of a specific gene family involved in glial-neuronal communications. Second, as insulin-like growth factor-1 (IGF-1) is a critical regulator of LHRH secretion and the pubertal process, we then assessed whether IGF-1 could induce the expression of these signaling genes and determine whether ALC can block this affect. Immature female rats were fed a liquid diet containing ALC for 6 days beginning when 27 days old. Control animals received either the companion isocaloric liquid diet or rat chow and water. Animals were decapitated on day 33, in the late juvenile stage of development. Medial basal hypothalamic (MBH) tissues were obtained for gene and protein analyses of glial receptor protein tyrosine phosphatase-β (RPTPβ) and the 2 neuronal components, contactin and contactin-associated protein 1 (Caspr1). In the second experiment, IGF-1 was administered into the third ventricle (3V) and the MBH removed 6 hours after peptide delivery, and the above-mentioned 3 genes were analyzed by real-time PCR. To determine whether this action was affected by ALC, immature female rats were administered either ALC (3 g/kg) or water via gastric gavage at 0900 hours. At 1030 hours, the ALC and control groups were subdivided such that half of the animals were injected into the 3V with IGF-1 and the other half with an equal volume of saline. Rats were killed 6 hours after the IGF-1 injection and MBHs collected. Real-time PCR showed that when compared with control animals, ALC caused a marked decrease (p < 0.001) in the basal expression of the RPTPβ gene, but did not affect the expression of either contactin or Caspr1. Likewise, analysis by Western blotting demonstrated that ALC caused suppressed (p < 0.001) levels of the RPTPβ protein, with the expressions of both contactin and Caspr1 proteins being unaltered. In the second experiment, results showed that only the RPTPβ gene was stimulated (p < 0.05) by IGF-1 in the MBH 6 hours after peptide delivery. Assessments revealed that the IGF-1 induced increase (p < 0.01) in the expression of the RPTPβ gene was blocked by the presence of ALC. Prepubertal ALC exposure is capable of interfering with hypothalamic glial-neuronal communications by suppressing the synthesis of the glial product, RPTPβ, which is required for binding to the contactin-Caspr1 complex on LHRH neuronal terminals, thus suggesting that this action of ALC contributes to its detrimental effects on the pubertal process.


Directional selection and the evolution of sex and recombination.
Models of the evolutionary advantages of sex and genetic recombination due to directional selection on a quantitative trait are analysed. The models assume that the trait is controlled by many additive genes. A nor-optimal selection function is used, in which the optimum either moves steadily in one direction, follows an autocorrelated linear Markov process or a random walk, or varies cyclically. The consequences for population mean fitness of a reduction in genetic variance, due to a shift from sexual to asexual reproduction are examined. It is shown that a large reduction in mean fitness can result from such a shift in the case of a steadily moving optimum, under light conditions. The conditions are much more stringent with a cyclical or randomly varying environment, especially if the autocorrelation for a random environment is small. The conditions for spread of a rare modifier affecting the rate of genetic recombination are also examined, and the strength of selection on such a modifier determined. Again, the case of a steadily moving optimum is most favourable for the evolution of increased recombination. The selection pressure on a recombination modifier when a trait is subject to strong truncation selection is calculated, and shown to be large enough to account for observed increases in recombination associated with artificial selection. Theoretical and empirical evidence relevant to evaluating the importance of this model for the evolution of sex and recombination is discussed.


Effect of saccadic adaptation on localization of visual targets.
Objects flashed briefly around the time of a saccadic eye movement are grossly mislocalized by human subjects, so they appear to be compressed toward the endpoint of the saccade. In this study, we investigate spatial localization during saccadic adaptation to examine whether the focus of compression tends toward the intended saccadic target or at the endpoint of the actual (adapted) movement. We report two major results. First, that peri-saccadic focus of the compression did not occur at the site of the initial saccadic target, but tended toward the actual landing site of the saccade. Second, and more surprisingly, we observed a large long-term perceptual distortion of space, lasting for hundreds of milliseconds. This distortion did not occur over the whole visual field but was limited to a local region of visual space around the saccade target, suggesting that saccadic adaptation induces a visuo-topic remapping of space. The results imply that the mechanisms controlling saccadic adaptation also affect perception of space and point to a strong perceptual plasticity coordinated with the well-documented plasticity of the motor system.


[So-called infantile cerebral palsy].
On the basis of a comprehensive clinical study of 60 children and a pathomorphological study of the postmortem material the authors established, that in the so-called infantile cerebral paralysis the polymorphic neurological symptomatology is not fully reflected in the existing classifications. Separate clinical forms do not correspond to the pyramidal cerebral pathology, but have an extrapyramidal, cerebellar, hypothalamic and spinal character. The pathomorphological examination detected areas of devastation with a proliferation of the neuroglia, different forms and sizes of cavities in all the brain lobes, in the extrapyramidal system, in the hypothalamic area, cerebellum and spinal cord. The authors suggest that there should be a reconsideration of the terminology and classification of the so-called infantile cerebral paralysis.


Circulating Klotho Associates With Cardiovascular Morbidity and Mortality During Hemodialysis.
Klotho gene was identified as an aging suppressor. In animals, klotho overexpression extends life span, and defective klotho results in rapid aging and early death. The kidney is the main contributor to circulating klotho levels, and, during chronic kidney disease, renal klotho gene expression is drastically reduced in animals and humans as well. We aimed to determine the consequences of a serum klotho (seKL) defect on cardiovascular morbidity and mortality during chronic dialysis. The ARNOGENE study was designed to prospectively follow a cohort of hemodialysis patients for 2 years without specific intervention. A total of 769 patients was recruited and followed from the end of 2008 until January 2011. A total of 238 patients was analyzed due to a technical sample conservation issue with other samples. The median seKL was markedly reduced, 360.4 ng/L (interquartile range 176.5) as compared with nondialysis chronic kidney disease patients or healthy volunteers. Patients with a seKL above the first quartile (≥280 ng/L) had a significantly reduced occurrence of outcome combining cardiovascular events and cardiovascular death [odds ratio (OR) = 0.39; 0.19 to 0.78, P = 0.008] compared with patient with klotho <280 ng/L. This effect persisted (OR = 0.86; 0.76 to 0.99, P = 0.03) after adjustment on age, sex, diabetes, cardiac insufficiency, dialysis vintage, and serum hemoglobin, albumin, fibroblast growth factor-23, phosphate, and calcium. These results suggest that, during chronic hemodialysis, conservation of seKL >280 ng/L is associated with a better 2-year cardiovascular protection. Thus, a preserved klotho function supports cardiovascular protection and may represent a prognostic tool and therapeutic target for cardiovascular disease.


The paramyxovirus fusion protein C-terminal region: mutagenesis indicates an indivisible protein unit.
Paramyxoviruses enter host cells by fusing the viral envelope with a host cell membrane. Fusion is mediated by the viral fusion (F) protein, and it undergoes large irreversible conformational changes to cause membrane merger. The C terminus of PIV5 F contains a membrane-proximal 7-residue external region (MPER), followed by the transmembrane (TM) domain and a 20-residue cytoplasmic tail. To study the sequence requirements of the F protein C terminus for fusion, we constructed chimeras containing the ectodomain of parainfluenza virus 5 F (PIV5 F) and either the MPER, the TM domain, or the cytoplasmic tail of the F proteins of the paramyxoviruses measles virus, mumps virus, Newcastle disease virus, human parainfluenza virus 3, and Nipah virus. The chimeras were expressed, and their ability to cause cell fusion was analyzed. The chimeric proteins were variably expressed at the cell surface. We found that chimeras containing the ectodomain of PIV5 F with the C terminus of other paramyxoviruses were unable to cause cell fusion. Fusion could be restored by decreasing the activation energy of refolding through introduction of a destabilizing mutation (S443P). Replacing individual regions, singly or doubly, in the chimeras with native PIV5 F sequences restored fusion to various degrees, but it did not have an additive effect in restoring activity. Thus, the F protein C terminus may be a specific structure that only functions with its cognate ectodomain. Alanine scanning mutagenesis of MPER indicates that it has a regulatory role in fusion since both hyperfusogenic and hypofusogenic mutations were found.


Ultrahigh affinity Raman probe for targeted live cell imaging of prostate cancer.
Precise visualization of tumor margins with characterization of microscopic tumor invasion are unmet needs in prostate oncology that demand approaches with high sensitivity and specificity. To address those needs we report surface-enhanced Raman scattering (SERS) based optical imaging for prostate cancer using a combination of live cell Raman microscopy, optimally engineered SERS tags and a urea-based small-molecule inhibitor of prostate-specific membrane antigen (PSMA) as a targeting moiety. We develop gold nanostar based SERS agents that offer ultrahigh binding affinity to PSMA with nearly four orders of magnitude lower IC50 values in relation to existing clinical imaging agents. This combination enables selective recognition of prostate cancer cells, and facilitates quantitative and photostable Raman measurements. Using Raman microscopy to analyze phenotypically similar prostate cancer cell lines differing only in PSMA expression, we demonstrate facile, site-selective recognition using as low as 20 pM of the SERS agent for imaging, opening the door for spectroscopic detection of prostate and other PSMA-expressing tumors in vivo.


Finite element analysis of ceramic abutment-restoration combinations for osseointegrated implants.
All-ceramic restorations can solve many esthetic problems associated with implant-supported prostheses. This study evaluated stress concentration and distribution in implant abutments under normal masticatory forces using computer simulations. Two-dimensional finite element analysis was used to study four different abutment-restoration combinations using Brånemark implants. The models considered two positions of the fastening screw, two positions of the crown margins, cemented versus screw-retained prostheses, and clinical loads of 200 N. Models having screws on top of abutments had the lowest stresses (3.1 to 4.8 MPa) and best stress distribution. Screw-retained prostheses and short crown margins increased overall stresses (9.9 to 11.4 MPa).


[Echocardiographic assessment of alcohol consumers in different clinical stages].
In relation to the importance of cardiac damage in alcohol drinkers this study aims to check the modifications of some cardiac sonographic parameters in drinkers examined at different stages of alcohol intoxication. Seventy-seven male subjects (43 +/- 9 years old) were divided into 3 groups in relation to the biohumoral alterations used for the diagnosis of chronic alcoholism (increase of GGT and MGV). EF, interventricular septum hypertrophy, LVEdD and the presence of left ventricular diastolic failure were considered. All these cardiac sonographic parameters "in toto" were first compared with the same parameters of a group of normal subjects and then the differences of these sonographic parameters between the 3 groups of drinkers were evaluated. These data confirm the early onset of cardiac damage and also that the cardiac alterations may occur before the modifications of the biohumoral parameters considered too. The alterations of the cardiac sonographic parameters considered in this study seem to be a good marker for the identification, quantification and staging of cardiac damage. Interventricular septum hypertrophy, EF and EDV (in this sequence) are to be considered usefull for the diagnosis of cardiac damage in alcohol drinkers. However also LVEdD and the presence of left ventricular diastolic failure are to be evaluated before any therapy.


Unusual manifestations of pulmonary aspergillosis.
Pulmonary aspergillosis is being diagnosed with increasing frequency, particularly in larger referral centers. The spectrum of lung pathology can be classified into 3 major groups: A) non-invasive mycetoma; B) allergic bronchopulmonary aspergillosis and C) invasive aspergillosis. Five patients with pulmonary aspergillosis are presented, illustrating unusual features of each major group. Transthoracic needle aspiration biopsy was diagnostic in 3 patients. It is important to differentiate a mycetoma developing in a pre-existing cavity from a cavitating Aspergillus abscess. The radiologic appearances may be similar, but evolution of the 2 lesions is entirely different.


Influence of clove oil and eugenol on muscle contraction of silkworm (Bombyx mori).
Clove oil is used in fish anesthesia and expected to have a mechanism via glutamic receptor. The present study explores the activities of clove oil and its major compound, eugenol, in comparison with L-glutamic acid on glutamic receptor of silkworm muscle and fish anesthesia. It was found that clove oil and eugenol had similar effects to L-glutamic acid on inhibition of silkworm muscle contraction after treated with D-glutamic acid and kainic acid. Anesthetic activity of the test samples was investigated in goldfish. The results demonstrated that L-glutamic acid at 20 and 40 mM could induce the fish to stage 3 of anesthesia that the fish exhibited total loss of equilibrium and muscle tone, whereas clove oil and eugenol at 60 ppm could induce the fish to stage 4 of anesthesia that the reflex activity of the fish was lost. These results suggest that clove oil and eugenol have similar functional activities and mechanism to L-glutamic acid on muscle contraction and fish anesthesia.


Pediatric melanoma: risk factor and survival analysis of the surveillance, epidemiology and end results database.
To evaluate risk factors for the development of and factors influencing survival in pediatric melanoma. We evaluated 1,255 children (age < 20 years) and 2,673 young adults (age 20 to 24 years) with melanoma in the 2001 National Cancer Institute (NCI) Surveillance, Epidemiology and End Results (SEER) database. We estimated exposure to UV radiation based on Environmental Protection Agency (EPA) measurements. The incidence of pediatric melanoma increased 46% (95% CI, 40 to 52) per year of age and 2.9% (95% CI, 2.1 to 3.6) per year from 1973 to 2001. Incidence rates were lower in black patients (-95%; 95% CI, -98 to -90) compared with white patients and in male patients (-39%; 95% CI -46 to -31) compared with females. Increased ambient UV radiation was associated with elevated risk (19% per kJ; 95% CI, 9 to 30). Children with melanoma had a 5-year melanoma-specific survival of 93.6% (95% CI, 91.9 to 94.9), which improved from 1973 to 2001. The hazard ratio of death from melanoma increased with male sex; older age; advanced disease; location of the primary other than extremities or torso; earlier year of diagnosis; and previous cancer. The incidence of melanoma in the United States is increasing rapidly in children. Risk factors for pediatric melanoma include being white, being female, increasing age, and environmental UV radiation. Survival is decreased for children and adolescents with unfavorable prognostic factors (male sex, unfavorable site, and/or second primary or regional or distant metastasis). More effective therapeutic strategies are needed for these groups.


Executive Functioning Moderates Responses to Appetitive Cues: A Study in Severe Alcohol Use Disorder and Alcoholic Liver Disease.
To examine subjective and psychophysiological responses to appetitive cues during an alcohol cue reactivity task, and its relation to alcoholic liver disease and assess whether executive functioning is associated with appropriate regulation of cue-elicited responses in individuals with severe alcohol use disorder (AUD). Seventeen treatment-seeking alcoholic liver disease patients and a control group of treatment-seeking severe AUD participants completed neuropsychological executive functioning measures (Stroop task; Trail-making test) and the cue reactivity task, whereby control (water) and alcohol beverage cues were presented, followed by respective recovery periods. Subjective alcohol craving and heart rate variability were recorded across the task. Overall cue reactivity and consequent recovery after cue offset during the cue reactivity task was observed, and alcoholic liver disease participants demonstrated a reduced overall recovery effect. Better Stroop performance related to greater overall and alcohol-specific cue reactivity within the control AUD group, and alcoholic liver disease participants showed dysfunctional activity regardless of executive functioning performance. No group differences in recovery effects according to executive functioning performance were seen. Among patients with AUD, having alcoholic liver disease seems to reduce overall regulation of responses to eliciting cues. Executive functioning moderated the magnitude of responses during cue exposures in our AUD sample overall; having alcoholic liver disease did not appear to affect regulation related to executive functioning during recovery.


Role of Deficient DNA Mismatch Repair Status in Patients With Stage III Colon Cancer Treated With FOLFOX Adjuvant Chemotherapy: A Pooled Analysis From 2 Randomized Clinical Trials.
The prognostic impact of DNA mismatch repair (MMR) status in stage III colon cancer patients receiving FOLFOX (folinic acid, fluorouracil, and oxaliplatin) adjuvant chemotherapy remains controversial. To determine the association of MMR status with disease-free survival (DFS) in patients with stage III colon cancer treated with FOLFOX. The evaluated biomarkers for MMR status were determined from prospectively collected tumor blocks from patients treated with FOLFOX in 2 open-label, phase 3 randomized clinical trials: NCCTG N0147 and PETACC8. The studies were conducted in general community practices, private practices, and institutional practices in the United States and Europe. All participants had stage III colon adenocarcinoma. They were enrolled in NCCTG N0147 from February 2004 to November 2009 and in PETACC8 from December 2005 to November 2009. Patients in the clinical trials were randomly assigned to receive 6 months of chemotherapy with FOLFOX or FOLFOX plus cetuximab. Only those patients treated with FOLFOX alone were included in the present study. Association of MMR status with DFS was analyzed using a stratified Cox proportional hazards model. Multivariable models were adjusted for age, sex, tumor grade, pT/pN stage, tumor location, ECOG (Eastern Cooperative Oncology Group) performance status, and BRAF V600E mutational status. Among 2636 patients with stage III colon cancer treated with FOLFOX, MMR status was available for 2501. Of these, 252 (10.1%) showed deficient MMR status (dMMR; 134 women, 118 men; median age, 59 years), while 2249 (89.9%) showed proficient MMR status (pMMR; 1020 women, 1229 men; median age, 59 years). The 3-year DFS rates in the dMMR and pMMR groups were 75.6% and 74.4%, respectively. By multivariate analysis, patients with dMMR phenotype had significantly longer DFS than those with pMMR (adjusted hazard ratio, 0.73; 95% CI, 0.54-0.97; P = .03). The deficient MMR phenotype remains a favorable prognostic factor in patients with stage III colon cancer receiving FOLFOX adjuvant chemotherapy. clinicaltrials.gov Identifier: NCT00079274 for the NCCTG N0147 trial and EudraCT identifier: 2005-003463-23 for the PETACC8 trial.


Intracellular and extracellular factors influencing the genotoxicity of nitric oxide and reactive oxygen species.
A number of factors affect cellular responses to nitric oxide (NO•) and reactive oxygen species (ROS), including their source, concentration, cumulative dose, target gene and biological milieu. This limits the extrapolation of data to in vivo pathological states in which NO• and ROS may be important. The present study investigated lethality and mutagenesis in the HPRT and TK1 genes of human lymphoblastoid TK6 cells exposed to NO• and ROS derived from two delivery methods: A reactor system and a Transwell™ co-culture. The delivery of NO• into the medium at controlled steady-state concentrations (given in µM/min) and the production of NO• and ROS by activated macrophages, resulted in a time-dependent decrease in total cell numbers, and an increase in mutation frequency (MF), compared with untreated controls. This increase in MF was effectively suppressed by N-methyl-L-arginine monoacetate. Single base substitutions were the most common type of spontaneous and NO• induced mutations in HPRT, followed by exon exclusions and small deletions in both delivery systems. Among the single base pair substitutions, an equal frequency of four types of single base substitutions were identified in TK6 cells exposed to NO• delivered by the reactor system, whereas G:C to T:A transversions and A:T to G:C transitions were more frequent in the co-culture system. Taken together, these results demonstrate that both the delivery method of NO• and ROS, and the target genes are determinants of observed cytotoxic and mutagenic responses, indicating that these parameters need to be considered in assessing the potential effects of NO• and ROS in vivo.


Innovative techniques for thread lifting of face and neck.
To investigate the efficacy and outcomes associated with eyebrow, midface, mandibular, and neck lifting using the innovative techniques. In this prospective review chart study, a total of 151 patients, were included in the study from January 2016 to May 2017. All participants underwent thread lifting using our innovative thread-lift technique for head and neck. The patients were followed up first week, first, third, and sixth month after lifting surgery. Outcomes were assessed by two surgeon and patients based on the GAIS score. All data were analyzed by SPSS-17 software with chi-square test. A total of 151 patients (mean age: 52.49 ± 10.67, range: 27-78 years), 16 (10.6%) men and 135 (89.4%) women, were included in the study. The most common sites for the face-lifting surgery were the mandible (49.7%), midface (37.1%), neck (7.9%), and eyebrow (5.3%), respectively. The level of satisfaction increased from 77.5% in the first week after surgery to 89.4% in the sixth month after surgery for patients, remained unchanged, 96% for the surgeon, and increased from 74.8% to 94.7% for the independent surgeon. The highest rate of potential complications after the lifting surgery was related to ecchymosis (23.2%), followed by complications of tumefaction (6.6%), pain (6.6%), and pain (5.2%). The results showed that the level satisfaction of patients and surgeons increased over time. It seems that facial rejuvenation thread lifting with this innovative technique is effectiveness, safe, and cosmetically more acceptance with minor complications than other face-lifting techniques.


Muscle Fitness to Visceral Fat Ratio, Metabolic Syndrome and Ideal Cardiovascular Health Metrics.
This study aimed to investigate the association between the muscle fitness to visceral fat level (MVF) ratio and the prevalence of metabolic syndrome (MetS) and ideal cardiovascular health (CVH) metrics among college students. A total of 1467 young adults recruited from the FUPRECOL study (Asociación de la Fuerza Prensil con Manifestaciones Tempranas de Riesgo Cardiovascular en Jóvenes y Adultos Colombianos), were categorized into four quartiles based on their MVF ratio. Muscular fitness was assessed using a digital handgrip dynamometer and visceral fat level was determined through bioelectrical impedance analysis. Ideal CVH was assessed, including lifestyle characteristics, anthropometry, blood pressure, and biochemical parameters. The body weight, waist circumference, body mass index (BMI), fat mass, fat mass index, and visceral fat level were significantly higher in subjects in Q1 (lower MVF ratio) than those in Q2, Q3, or Q4 (p < 0.001). The muscle fitness (handgrip and normalized grip strength (NGS)) of the subjects in Q4 was significantly greater than that of those in Q1 to Q2 (p < 0.001). Subjects with a medium-high MVF ratio (i.e., 3⁻4th quartiles) had an odds ratio of 2.103 of ideal CVH metrics after adjusting for age, gender, university, and alcohol intake (95% confidence interval (CI) 1.832 to 2.414; p < 0.001). A lower MVF ratio is associated with worse CVH metrics and a higher prevalence of MetS in early adulthood, supporting the hypothesis that the MVF ratio could be used as a complementary screening tool that could help clinicians identify young adults with unfavorable levels of CVH and metabolic risk.


Inheritance of L1014F and M918T sodium channel mutations associated with pyrethroid resistance in Myzus persicae.
Two amino acid substitutions (L1014F and M918T) in the voltage-gated sodium channel confer target-site resistance to pyrethroid insecticides in the peach potato aphid, Myzus persicae. Pyrethroid-resistant and -susceptible M. persicae clones with various combinations of these mutations were crossed under laboratory conditions, and the genotypes of aphid progeny were analysed by direct DNA sequencing of the IIS4-S6 region of the sodium channel gene. Segregation patterns showed that in aphids heterozygous for both L1014F and M918T, both mutations were present in the same resistance allele. Despite these mutations appearing largely recessive in other pest species, such aphids exhibited strong resistance to pyrethroids in leaf-dip bioassays. These results have important implications for the spread and management of pyrethroid resistance in field populations.


Unravelling the helix--a physician's guide to spiral computed tomography.
The introduction of spiral technology to computed tomography (CT) scanners in the late 1980s has revolutionised the field of CT. Spiral CT offers definite practical benefits over conventional scanners and has expanded the role of CT through the development of new scanning techniques. CT scanning now rivals magnetic resonance imaging in many areas of investigation, and for some situations is the clear investigation of choice. This review is aimed at those clinicians who have access to spiral scanning services but wish to have a greater understanding of the technique and its clinical applications. The concept of spiral CT, and the differences between spiral and conventional scanning are discussed. The various clinical applications of the technique are illustrated.


Profiling receptor tyrosine kinase activation by using Ab microarrays.
Signal transduction in mammalian cells is mediated by complex networks of interacting proteins. Understanding these networks at a circuit level requires devices to measure the amounts and activities of multiple proteins in a rapid and accurate manner. Ab microarrays have previously been applied to the quantification of labeled recombinant proteins and proteins in serum. The development of methods to analyze intracellular signaling molecules on microarrays would make Ab arrays widely useful in systems biology. Here we describe the fabrication of multiplex Ab arrays sensitive to the amounts and modification states of signal transduction proteins in crude cell lysates and the integration of these arrays with 96-well microtiter plate technology to create microarrays in microplates. We apply the Ab arrays to monitoring the activation, uptake, and signaling of ErbB receptor tyrosine kinases in human tumor cell lines. Data obtained from multicolor ratiometric microarrays correlate well with data obtained by using traditional approaches, but the arrays are faster and simpler to use. The integration of microplate and microarray methods for crude cell lysates should make it possible to identify and analyze small molecule inhibitors of signal transduction processes with unprecedented speed and precision. We demonstrate the future potential of this approach by characterizing the action of the epidermal growth factor receptor inhibitor PD153035 on cells by using Ab arrays; direct scale-up to array-based screening in 96- and 384-well plates should allow small molecules to be identified with specific inhibitory profiles against a signaling network.


Treatment of chronic hepatitis D patients with pegylated interferon: a real-world experience.
Published experience of treating chronic hepatitis D patients with pegylated interferon (PEG-IFN)-α is limited. The aim of this study was to determine the efficacy of 48 weeks of treatment with PEG-IFN in naive patients outside the clinical trial setting, in the real world. Patients with chronic hepatitis D were treated with PEG-IFN. The primary end points were sustained clearance of HDV RNA and normal alanine aminotransferase (ALT) at 24 weeks post-treatment. The total number of patients treated with PEG-IFN was 104; 91 males, mean age ±SD 30.1 ±10.0 years (range 15-55). Cirrhosis was present in 41 patients. With an intention-to-treat analysis, end of treatment virological response (ETR) was achieved in 44 (42.3%), normalization of ALT in 38 (35%) and a combined response in 23 (22.1%) patients. Sustained virological response (SVR) at 24 weeks post-treatment was seen in 24 (23.1%) patients each for the virological and biochemical responses and in 13 (12.5%) as combined response. Both ETR and SVR were associated with a negative HDV RNA at 24 weeks of treatment (P=0.001 and P=0.000, respectively). Detectable HDV RNA at this point had a positive predictive value of 0.95 (range 0.85-0.99) for detectable RNA at 6 months post-treatment. End of treatment biological response, that is, normal ALT at the end of treatment was also a predictor of ETR and SVR (P=0.004 and P=0.041, respectively). Treatment with PEG-IFN for hepatitis D is of limited efficacy. Detectable HDV RNA at 24 weeks of treatment is a predictor for a failed SVR.


[Protective and antiedema effect of heat shock HSP70 protein in hemorrhagic stroke model in vitro].
An in vitro model of hemorrhagic stroke in live olfactory cortex slices under long-term influence of autoblood has been used and the development of edema in the samples has been studied with simultaneous monitoring of bioelectric activity of the nervous cells. Protection of the nervous cells in the olfactory cortex slices of the spontaneously hypertensive (SHR) rats from consequences of the hemorrhagic stroke was achieved by incubating brain slices for 20 min in glass vials with 1 ml of incubation solution containing heat shock protein HSP70 at a concentration of 10 mg/ml. Then the incubation medium was replaced by 3 ml of autoblood, the action of which on the nervous cells modeled the hemorrhagic stroke. After 360-min incubation in autoblood, the slices were extracted, placed in a perfusion chamber, and washed from autoblood in a flow of pure incubation solution. Then the amplitudes of separate components of the focal potentials (FPs) evoked by electrostimulation of the slices were measured and their changes analyzed. A comparison of the FP amplitudes after the action of HSP70 and autoblood to those in control group of slices showed the degree of injury and the possibility of recovery. The antiedema effects of HSP70 on the hemorrhagic stroke model was evaluated by weighing brain slices with and without the preincubation with protein, and after the subsequent exposure in autoblood. The slices were weighed on a torsion balance. The difference in weights before and after the exposure in autoblood characterized the extent of swelling and edema development in brain slices. It was established that HSP70 produced a pronounced protective antiedema effect on the slices kept in autoblood.


Review of complementary and alternative medical treatment of arrhythmias.
Complementary and alternative medical (CAM) therapies are commonly used by patients for the treatment of medical conditions spanning the full spectrum of severity and chronicity. The use of alternative remedies, both herbal and others, for conditions lacking effective medical treatment, is on the increase. Included within this categorization, arrhythmic disease-absent effective catheter-based therapy or with medical therapy limited by the toxicities of contemporary antiarrhythmic agents is frequently managed by patients with CAM therapies without their practitioner's knowledge and in the face of potential herb-drug toxicities. This study reviews 9 CAM therapies: 7 individual herbal therapies along with acupuncture and yoga that have been studied and reported as having an antiarrhythmic effect. The primary focuses are the proposed antiarrhythmic mechanism of each CAM agent along with interactions between the CAM therapies and commonly prescribed medical therapy for arrhythmia patients. We stress persistent vigilance on the part of the provider in discussing the use of herbal or other CAM agents within the arrhythmia population.


Features of spatial and functional segregation and integration of the primate connectome revealed by trade-off between wiring cost and efficiency.
The primate connectome, possessing a characteristic global topology and specific regional connectivity profiles, is well organized to support both segregated and integrated brain function. However, the organization mechanisms shaping the characteristic connectivity and its relationship to functional requirements remain unclear. The primate brain connectome is shaped by metabolic economy as well as functional values. Here, we explored the influence of two competing factors and additional advanced functional requirements on the primate connectome employing an optimal trade-off model between neural wiring cost and the representative functional requirement of processing efficiency. Moreover, we compared this model with a generative model combining spatial distance and topological similarity, with the objective of statistically reproducing multiple topological features of the network. The primate connectome indeed displays a cost-efficiency trade-off and that up to 67% of the connections were recovered by optimal combination of the two basic factors of wiring economy and processing efficiency, clearly higher than the proportion of connections (56%) explained by the generative model. While not explicitly aimed for, the trade-off model captured several key topological features of the real connectome as the generative model, yet better explained the connectivity of most regions. The majority of the remaining 33% of connections unexplained by the best trade-off model were long-distance links, which are concentrated on few cortical areas, termed long-distance connectors (LDCs). The LDCs are mainly non-hubs, but form a densely connected group overlapping on spatially segregated functional modalities. LDCs are crucial for both functional segregation and integration across different scales. These organization features revealed by the optimization analysis provide evidence that the demands of advanced functional segregation and integration among spatially distributed regions may play a significant role in shaping the cortical connectome, in addition to the basic cost-efficiency trade-off. These findings also shed light on inherent vulnerabilities of brain networks in diseases.


Automated Compression Device for Viscoelasticity Imaging.
Noninvasive measurement of tissue viscoelastic properties is gaining more attention for screening and diagnostic purposes. Recently, measuring dynamic response of tissue under a constant force has been studied for estimation of tissue viscoelastic properties in terms of retardation times. The essential part of such a test is an instrument that is capable of creating a controlled axial force and is suitable for clinical applications. Such a device should be lightweight, portable, and easy to use for patient studies to capture tissue dynamics under external stress. In this paper, we present the design of an automated compression device for studying the creep response of materials with tissue-like behaviors. The device can be used to apply a ramp-and-hold force excitation for a predetermined duration of time and it houses an ultrasound probe for monitoring the creep response of the underlying tissue. To validate the performance of the device, several creep tests were performed on tissue-mimicking phantoms, and the results were compared against those from a commercial mechanical testing instrument. Using a second-order Kelvin-Voigt model and surface measurement of the forces and displacements, retardation times T1 and T2 were estimated from each test. These tests showed strong agreement between our automated compression device and the commercial mechanical testing system, with an average relative error of 2.9% and 12.4%, for T1 and T2, respectively. Also, we present the application of compression device to measure local retardation times for four different phantoms with different size and stiffness.


Molecular orientation and femtosecond charge transfer dynamics in transparent and conductive electrodes based on graphene oxide and PEDOT:PSS composites.
The conducting polymer, poly(3,4-ethylenedioxythiophene)-polystyrenesulfonic acid (PEDOT:PSS), is certainly one of the most important substitute materials for indium tin oxide in organic devices. Its metallic conductivity and transmittance bring favorable perspectives for organic photovoltaic applications. Although graphene oxide (GO) is not a good conductor, it can form high-quality thin films and can be transparent, and additionally, GO is an inexpensive material and can be easily synthesized. This study investigated how the conductivity of a composite film of graphene oxide (GO) and different amounts of PEDOT:PSS can be modified. The effects of GO:PEDOT:PSS composites with several PEDOT:PSS proportions were analyzed in regards to the composite molecular structure and ordering, charge transfer dynamics (in the femtosecond range), electrical properties and morphology. For the best conductivity ratio GO found with 5% PEDOT:PSS, a solvent treatment was also performed, comparing the resistivity of the film when treated with dimethyl sulfoxide (DMSO) and with ethylene glycol.


Social media and dentistry: some reflections on e-professionalism.
The proliferation of digital technology is impacting on the training and development of healthcare professionals. Research on the online behaviour of medical and pharmacy students indicates that social media poses a number of risks to the professional practice of healthcare professionals. General Dental Council guidelines on the use of social media also suggest that it has the potential to expose dental professionals to a variety of breaches of professional conduct. This paper explores the various ways social media can help, as well as hinder, the practice of dental professionalism. However, the lack of primary research on the social media behaviour of dental students and qualified dental practitioners alike acts as a barrier to increasing social media awareness within dentistry. The paper concludes by calling for more research-led discussion on the role social media plays in shaping our understanding of dental professionalism in the twenty-first century.


Digital image processing: a primer for JVIR authors and readers: Part 3: Digital image editing.
This is the final installment of a three-part series on digital image processing intended to prepare authors for online submission of manuscripts. In the first two articles of the series, the fundamentals of digital image architecture were reviewed and methods of importing images to the computer desktop were described. In this article, techniques are presented for editing images in preparation for online submission. A step-by-step guide to basic editing with use of Adobe Photoshop is provided and the ethical implications of this activity are explored.


Cytokine profile of CD4+CD25-FoxP3+ T cells in tumor-draining lymph nodes from patients with breast cancer.
A T cell subtype with the CD4+CD25-FoxP3+ phenotype was recently described. We aimed to investigate the frequency of these cells and their ability to produce cytokines in tumor-draining lymph nodes from patients with breast cancer (BC). Mononuclear cells from lymph nodes of 20 patients with BC were activated and stained for appropriate markers. The cells were assayed with four-color flow cytometry. A very small fraction of CD4+CD25-FoxP3+ cells produced cytokines at levels that were significantly lower than in the regulatory (CD4+CD25+FoxP3+) and effector cell (CD4+CD25+FoxP3-) subpopulations. The expression of IFNγ and IL-2 in the CD4+CD25-FoxP3+ subset was significantly higher than in Treg cells, but lower than in the effector subset. Conversely, IL-22 expression in Treg cells was significantly higher than in the CD4+CD25-FoxP3+ subpopulation. The expression of IL-10 in the CD4+CD25-FoxP3+ subset was also significantly higher than in effector cells. We suggest that CD4+CD25-FoxP3+ cells in patients with BC are exhausted cells with an intermediate phenotype between effector and regulatory cells.


Brexpiprazole blocks post-traumatic stress disorder-like memory while promoting normal fear memory.
A cardinal feature of post-traumatic stress disorder (PTSD) is a long-lasting paradoxical alteration of memory with hypermnesia for salient traumatic cues and amnesia for peri-traumatic contextual cues. So far, pharmacological therapeutic approach of this stress-related disorder is poorly developed mainly because of the lack of animal model for this paradoxical memory alteration. Using a model that precisely recapitulates the two memory components of PTSD in mice, we tested if brexpiprazole, a new antipsychotic drug with pro-cognitive effects in rodents, may persistently prevent the expression of PTSD-like memory induced by injection of corticosterone immediately after fear conditioning. Acute administration of brexpiprazole (0.3 mg/kg) 7 days' post-trauma first blocks the expression of the maladaptive fear memory for a salient but irrelevant trauma-related cue. In addition, it enhances (with superior efficacy when compared to diazepam, prazosin, and escitalopram) memory for the traumatic context, correct predictor of the threat. This beneficial effect of brexpiprazole is overall maintained 1 week after treatment. In contrast brexpiprazole fully spares normal/adaptive cued fear memory, showing that the effect of this drug is specific to an abnormal/maladaptive (PTSD-like) fear memory of a salient cue. Finally, this treatment not only promotes the switch from PTSD-like to normal fear memory, but also normalizes most of the alterations in the hippocampal-amygdalar network activation associated with PTSD-like memory, as measured by C-Fos expression. Altogether, these preclinical data indicate that brexpiprazole could represent a new pharmacological treatment of PTSD promoting the normalization of traumatic memory.


Methodology for the Development of the Australian National Nursing and Midwifery Digital Health Capability Framework.
Internationally healthcare organisations and governments are grappling with the issue of upskilling healthcare workforces in relation to digital health. Significant research has been undertaken in relation to documenting essential digital health capability requirements for the workforce. In 2019 the Australian Digital Health Agency funded work by the Australasian Institute of Digital Health to develop a National Nursing and Midwifery Digital Health Capability Framework. This paper describes the methodological approach used in the development of the Framework.