Genetic homogeneity coupled with morphometric variability suggests high phenotypic plasticity in the sea louse Caligus rogercresseyi (Boxshall and Bravo, 2000), infecting farmed salmon (Salmo salar) along a wide latitudinal range in southern Chile.
The sea louse Caligus rogercresseyi is the most important pathogen causing "caligidosis" in the Chilean salmon industry. In this study, using cox1 gene, we evaluate the genetic variation of C. rogercresseyi from farmed Salmo salar along a latitudinal range (40°-52°S) in south Chile to determine whether morphological differences are explained by genetic or environmental factors. Female parasites were randomly collected from S. salar at five farms. Body variation was examined using multivariate analyses and genetic heterogeneity was explored with AMOVA. C. rogercresseyi exhibited significant morphometric variability among sites and parasites collected from >54°S were the longest ones. Parasites did not show genetic structure among farms. Thus, C. rogercresseyi infesting salmons is panmictic along an extensive latitudinal range in south Chile. The same genetic pattern can be explained by the frequent movement of parasitized S. salar among farms in that region. Phenotypic plasticity in parasites could be explained by natural or aquaculture-mediated environment variability. C. rogercreseyi from 54°S could favor the local spread of this disease, suggesting an immediate health risk for the recent salmon industry in that region. Further research is required to confirm genetic homogeneity of this parasite along its geographical distribution using more powerful markers (e.g. SNPs).


Wavelet-based approach for diagnosing attention deficit hyperactivity disorder (ADHD).
Attention deficit hyperactivity disorder (ADHD) is a common cognitive disorder affecting children. ADHD can interfere with educational, social, and emotional development, so early detection is essential for obtaining proper care. Standard ADHD diagnostic protocols rely heavily on subjective assessments of perceived behavior. An objective diagnostic measure would be a welcome development and potentially aid in accurately and efficiently diagnosing ADHD. Analysis of pupillary dynamics has been proposed as a promising alternative method of detecting affected individuals effectively. This study proposes a method based on the self-similarity of pupillary dynamics and assesses its strength as a potential diagnostic biomarker. Localized discriminatory features are developed in the wavelet domain and selected via a rolling window method to build classifiers. The application on a task-based pupil diameter time series dataset of children aged 10-12 years shows that the proposed method achieves greater than 78% accuracy in detecting ADHD. Comparing with a recent approach that constructs features in the original data domain, the proposed wavelet-based classifier achieves more accurate ADHD classification with fewer features. The findings suggest that the proposed diagnostic procedure involving interpretable wavelet-based self-similarity features of pupil diameter data can potentially aid in improving the efficacy of ADHD diagnosis.


Sequential scapholunate and volar beak ligament reconstructions with flexor carpi radialis tendon grafts.
The flexor carpi radialis tendon is considered by many the workhorse tendon in hand and wrist surgery. Some have expressed concerns about altering the mechanics of the wrist by sacrificing part or all of the flexor carpi radialis tendon. We present an interesting case of sequential scapholunate and volar beak ligament reconstructions using a flexor carpi radialis tendon autograft where a slip of tendon was harvested twice within three years, achieving a satisfactory clinical outcome at five years following the initial surgery.


Na+/H+ exchanger-1 inhibitors decrease myocardial superoxide production via direct mitochondrial action.
The possibility of a direct mitochondrial action of Na(+)/H(+) exchanger-1 (NHE-1) inhibitors decreasing reactive oxygen species (ROS) production was assessed in cat myocardium. Angiotensin II and endothelin-1 induced an NADPH oxidase (NOX)-dependent increase in anion superoxide (O(2)(-)) production detected by chemiluminescence. Three different NHE-1 inhibitors [cariporide, BIIB-723, and EMD-87580] with no ROS scavenger activity prevented this increase. The mitochondria appeared to be the source of the NOX-dependent ROS released by the "ROS-induced ROS release mechanism" that was blunted by the mitochondrial ATP-sensitive potassium channel blockers 5-hydroxydecanoate and glibenclamide, inhibition of complex I of the electron transport chain with rotenone, and inhibition of the permeability transition pore (MPTP) by cyclosporin A. Cariporide also prevented O(2)(-) production induced by the opening of mK(ATP) with diazoxide. Ca(2+)-induced swelling was evaluated in isolated mitochondria as an indicator of MPTP formation. Cariporide decreased mitochondrial swelling to the same extent as cyclosporin A and bongkrekic acid, confirming its direct mitochondrial action. Increased O(2)(-) production, as expected, stimulated ERK1/2 and p90 ribosomal S6 kinase phosphorylation. This was also prevented by cariporide, giving additional support to the existence of a direct mitochondrial action of NHE-1 inhibitors in preventing ROS release. In conclusion, we report a mitochondrial action of NHE-1 inhibitors that should lead us to revisit or reinterpret previous landmark observations about their beneficial effect in several cardiac diseases, such as ischemia-reperfusion injury and cardiac hypertrophy and failure. Further studies are needed to clarify the precise mechanism and site of action of these drugs in blunting MPTP formation and ROS release.


The Gut Microbiota and Alzheimer's Disease.
The gut microbiota comprises a complex community of microorganism species that resides in our gastrointestinal ecosystem and whose alterations influence not only various gut disorders but also central nervous system disorders such as Alzheimer's disease (AD). AD, the most common form of dementia, is a neurodegenerative disorder associated with impaired cognition and cerebral accumulation of amyloid-β peptides (Aβ). Most notably, the microbiota-gut-brain axis is a bidirectional communication system that is not fully understood, but includes neural, immune, endocrine, and metabolic pathways. Studies in germ-free animals and in animals exposed to pathogenic microbial infections, antibiotics, probiotics, or fecal microbiota transplantation suggest a role for the gut microbiota in host cognition or AD-related pathogenesis. The increased permeability of the gut and blood-brain barrier induced by microbiota dysbiosis may mediate or affect AD pathogenesis and other neurodegenerative disorders, especially those associated with aging. In addition, bacteria populating the gut microbiota can secrete large amounts of amyloids and lipopolysaccharides, which might contribute to the modulation of signaling pathways and the production of proinflammatory cytokines associated with the pathogenesis of AD. Moreover, imbalances in the gut microbiota can induce inflammation that is associated with the pathogenesis of obesity, type 2 diabetes mellitus, and AD. The purpose of this review is to summarize and discuss the current findings that may elucidate the role of the gut microbiota in the development of AD. Understanding the underlying mechanisms may provide new insights into novel therapeutic strategies for AD.


Restructuring of an Orthopaedic Surgery Residency Research Rotation Correlates with Increased Academic Productivity in Teaching Faculty.
Contribution toward clinical research is paramount to the education of physician trainees and is required by the Accreditation Council for Graduate Medical Education. From 1987 through 2015, our single institution orthopaedic surgery residency research experience included 2 dedicated research rotations. Because few resident projects were pursued to completion, feedback was used to restructure the curriculum, including the appointment of 2 clinical orthopaedic faculty to serve as codirectors, development of a revised curriculum, use of research teams, and a centralized research database. Our group previously displayed increased resident productivity within 2 years after the 2015 implementation. The aim of this study was to investigate the impact of orthopaedic residency curricular changes on scholarly activity of orthopaedic teaching faculty. The curriculum vitae (CVs) of a single institution's orthopaedic teaching faculty were collected and retrospectively reviewed from 2014 through 2018 to determine academic productivity of clinical faculty. Indicators of academic productivity included peer-reviewed publications (including journal impact factors) and podium or poster presentations. Twenty-three of 27 faculty members responded to our request for CVs. One hundred three CVs were reviewed on 23 faculty. All academic indicators increased over 5 years. Multivariate analysis of variance (MANOVA) using a multivariate repeated measures analysis was completed. A sphericity χ2 test was violated for all measures, precluding us from using unadjusted univariate analysis. Univariate MANOVA with repeated measures displays significance regarding impact factor (f < 0.02, p < 0.05) and journal publications (f < 0.004, p < 0.05). Subsequent multivariate analysis shows similar results regarding impact factor (f < 0.0008), journal publications (0.0005), and poster presentations (f < 0.016). Improved structure of an established resident research rotation combined with enhanced faculty mentorship resulted in a significant increase in academic productivity for clinical teaching faculty of the department of orthopaedic surgery. This increase parallels that seen in orthopaedic resident research productivity; indicating a positive impact on teaching faculty scholarly activity. III.


Structural and Functional Disturbances of the Thoracic Aorta in Atherosclerosis of Various Gradations.
Aim To study global aortic circumferential strain in normal conditions and in atherosclerosis of various grades and to determine its role in prediction of structural and functional disorders of the thoracic aorta (TA) and coronary atherosclerosis using 2D speckle-tracking transesophageal echocardiography.Material and methods 182 patients with typical or probable angina were examined. The control group consisted of 11 healthy volunteers. TA was visualized along its entire length. The height of each atheroma was measured, and the total number of plaques in the TA was determined. Five stages of TA atherosclerosis were identified. In the descending TA, the global peak systolic circumferential strain (GCS, %) and the global peak systolic circumferential strain normalized to pulse arterial pressure (PAP) (GCS / PAP∙100) were calculated. All patients underwent coronary angiography. The number of coronary arteries (CAs) with >50 % stenosis was determined, and the SYNTAX Score was calculated.Results TA atherosclerosis was not detected in the control group. Among 182 patients, stage 1-5 TA atherosclerosis was found in 23 (12.6 %), 103 (56.6 %), 43 (23.6 %), 7 (3.8 %), and 6 (3.4 %) cases respectively. GCS and GCS / PAD decreased as the ultrasound stage of TA atherosclerosis increased as compared with the control group: 9.2 % and 15.3 for the control group; stage 1, 5.6 % and 8.9 (p<0.001); stage 2, 4.1 % and 5.9 (p<0.001); stage 3, 4 % and 5.8 (p<0.001); stage 4, 3.7 % and 4.9 (p<0.01); and stage 5, 2.6 % and 3.3 (p<0.01), respectively. ROC analysis showed that GCS ≥5.9 % (area under the curve, AUC, 0.94±0.03; p<0.001) and GCS / PAD ≥11.4 (AUC, 0.97±0.02; p <0.001) were predictors of intact TA. Also, GCS ≤4.85 % (AUC, 0.82±0.04; p<0.001) and GCS / PAD ≤8.06 (AUC, 0.87±0.03; p<0.001) were predictors of hemodynamically significant TA atherosclerosis (stages 3-5). GCS ≤4.05 % (AUC, 0.62±0.04; p=0.007) and GCS / PAD ≤5.95 (AUC, 0.61±0.04; p=0.018) were predictors of hemodynamically significant (>50 %) stenosing atherosclerosis of at least one CA. Furthermore, GCS ≤3.75 % (AUC, 0.67±0.07; p=0.039) and GCS / PAD ≤5.15 (AUC, 0.64±0.07; p=0.045) were predictors of severe and advanced coronary atherosclerosis (SYNTAX Score ≥22).Conclusion GCS and GCS / PAD are new diagnostic markers of structural and functional disorders of TA in atherosclerosis of various grades. GCS and GCS / PAD are independent predictors of high-grade TA atherosclerosis (stages 3-5) with GCS / PAD demonstrating the highest level of significance. GCS and GCS / PAD are non-invasive predictors of severe and advanced CA atherosclerosis.


GWASinspector: comprehensive quality control of genome-wide association study results.
Quality control (QC) of genome wide association study (GWAS) result files has become increasingly difficult due to advances in genomic technology. The main challenges include continuous increases in the number of polymorphic genetic variants contained in recent GWASs and reference panels, the rising number of cohorts participating in a GWAS consortium, and inclusion of new variant types. Here, we present GWASinspector, a flexible R package for comprehensive QC of GWAS results. This package is compatible with recent imputation reference panels, handles insertion/deletion and multi-allelic variants, provides extensive QC reports and efficiently processes big data files. Reference panels covering three human genome builds (NCBI36, GRCh37 and GRCh38) are available. GWASinspector has a user friendly design and allows easy set-up of the QC pipeline through a configuration file. In addition to checking and reporting on individual files, it can be used in preparation of a meta-analysis by testing for systemic differences between studies and generating cleaned, harmonized GWAS files. Comparison with existing GWAS QC tools shows that the main advantages of GWASinspector are its ability to more effectively deal with insertion/deletion and multi-allelic variants and its relatively low memory use. Our package is available at The Comprehensive R Archive Network (CRAN): https://CRAN.R-project.org/package=GWASinspector. Reference datasets and a detailed tutorial can be found at the package website at http://gwasinspector.com/. Supplementary data are available at Bioinformatics online.


Mini Review of the Cost-Effectiveness of Unilateral Osseointegrated Implants in Adults: Possibly Cost-Effective for the Correct Indication.
An osseointegrated implant (e.g. bone-anchored hearing aid, BAHA) is a surgically implantable device for unilateral sensorineural and unilateral or bilateral conductive hearing loss in patients who otherwise cannot use or do not prefer a conventional air conduction hearing aid (ACHA). The specific indications for an osseointegrated implant are evolving and dependent upon the country or regulatory body overseeing the provision of these devices. However, there are general groups of patients who would be likely to benefit, one such group being patients with congenital aural atresia. Given the anatomical aberrancies with aural atresia, these subjects cannot wear ACHAs. Another group of patients who may benefit from an osseointegrated implant over an ACHA are patients with chronically draining otological infections. As the provision of an osseointegrated implant requires a surgical procedure, there are inherent direct and indirect costs associated with its use beyond those required for an ACHA. Consideration of outcomes and cost-effectiveness for the osseointegrated implant versus the ACHA is prudent prior to making policy decisions in a setting of limited health care resources. We performed a mini review on all available cost-effectiveness analyses of osseointegrated implants published in Medline. There are only 2 contemporary cost-effectiveness analyses published to date. There is limited quality of life data available for patients living with an osseointegrated implant. As a result, the cost-effectiveness of the osseointegrated implant, specifically the BAHA, compared to conventional hearing aid devices remains unclear. However, there are clear indications for the BAHA when a standard hearing aid cannot be used (e.g. chronic draining ear) or in single-sided severe-to-profound hearing loss with reasonable hearing in the contralateral ear. The BAHA should not be considered interchangeable with the ACHA with regard to cost-effectiveness, but rather considered as an effective option for the patient for the correct indication.


Pharmacological and Expectancy Effects of a Low Amount of Alcohol Drinking on Outcome Valuation and Risk Perception in Males and Females.
The high-dose, alcohol-induced influences on risk perception and loss aversion depend on sex. On the other hand, low-dose alcohol has less effect on risky behavior. However, the effect of low-dose alcohol on subjective valuation of gain or loss and also the effect of placebo (expectancy of alcohol) on risk perception have not been fully investigated. We investigated the effects of low-dose alcohol (0.02 g/100 ml blood alcohol concentration) and placebo effects on subjective risk perception and subjective valuation of uncertain gain and loss in females and males. Participants in the control group and the placebo group were served alcohol-free, wine-flavored beverage and participants of alcohol group were served wine (14% alcohol). The placebo group was not informed that the drink was not alcohol but the control group was informed. Then paper-pencil tasks for subjective risk perception and valuation of gain or loss were performed 45 min after drinking the beverage. The participants were asked to draw the line on a 180 mm scale for each question. The placebo effects as well as the low-dose alcohol effects were observed in subjective valuations of gain or loss. Except for effect of beverages, a gender difference was also observed for subjective likelihood. The females estimated a low-probability loss as more likely and estimated a high-probability gain as less likely than did the males. From the Stevens' law fitting analysis, the placebo, not alcohol, significantly induced the psychophysical effect of the subjective valuation of gain or loss. These results indicate that the psychological effects of expectancy of alcohol (placebo) could be a major factor in changing the subjective valuation of gain or loss over the pharmacological effects of a small amount of alcohol (like a glass of wine). Furthermore, these results also indicate that gender differences should be taken into account when investigating pharmacological or psychological effect on decision-making.


Mechanisms of proton spin dephasing in a system of magnetic particles.
For protons diffusing among a system of magnetic particles, the process by which initial phase coherence is lost depends substantially on particle size. In this article, evidence for three dephasing mechanisms is presented: an incremental process at small particle sizes (motional averaging regime), a discrete process at intermediate particle sizes (visit limited regime), and a continuous process at large particle sizes (static dephasing regime). While motional averaging regime and static dephasing regime are well known, the distinct dynamics in visit limited regime are often overlooked. Revisiting earlier analytic treatments for the dynamics in this regime, Monte Carlo simulations are performed to extract the details of dephasing and to test the concept of an inner zone of rapid dephasing herein named the full dephasing zone. It is shown that the emergence of a full dephasing zone marks the transition from motional averaging regime to visit limited regime since protons can be fully dephased in a single encounter. Moving from the visit limited regime to the static dephasing regime, a crossover between a purely discrete process and a purely continuous process occurs. Developing a simple model of the dephasing process, the average dephasing time is demonstrated to be relatively constant thus giving insight into the long lasting plateau in the relaxation rate.


Evaluation of parkinsonism and striatal dopamine transporter loss in patients with spinocerebellar ataxia type 6.
It is unclear whether patients with spinocerebellar ataxia type 6 (SCA6) have parkinsonism and striatal dopamine transporter (DAT) loss, based on previously small size studies without well-matched controls. A study with a larger number of patients and both age- and gender-matched healthy controls (HCs) is needed for a better answer to this question. Twelve genetically confirmed ataxic SCA6 patients (six male six female, age 65.3 ± 11.2 years), and eight age- and gender-matched HCs (five male three female, age 71.3 ± 8.6 years) were enrolled during 2013-2015 from tertiary movement disorders and ataxia clinics. Clinical assessment for parkinsonism, and qualitative and quantitative assessment of DAT level on DaTscan™ imaging were conducted in SCA6 patients compared to HCs. We found no convincing parkinsonism in SCA6 patients, given generalized bradykinesia in the context of significant ataxia in all, with mild symmetric rigidity in five without resting tremor. Furthermore, we found no striatal DAT loss in anterior, posterior, and total putamen and caudate on imaging, assessed independently by qualitative visual inspection in a blinded manner by the nuclear medicine specialist and movement disorder specialist (kappa = 1). Additional quantitative analysis on these areas did not reveal significant DAT loss either in SCA6 patients compared to HCs. We conclude that there is no convincing parkinsonism or DAT loss in SCA6 patients in this unique study with a larger than previously reported number of patients compared to both age- and gender-matched HCs, suggesting that dopaminergic dysfunction is not usually involved in SCA6.


Acupuncture points of the brachial plexus.
This publication is the third of a total of six papers intended to name acupuncture points following the anatomic nomenclatures. In the first publication, acupuncture points in the head are named using terminal branches of the trigeminal nerve and the muscles of facial expression. In the second publication, acupuncture points in the neck are named using the cutaneous nerves of the cervical plexus and neuromuscular attachments formed by the spinal accessory nerve on the trapezius muscle. In this third publication, acupuncture points existing on the upper limbs are described following the terminal branches of the brachial plexus.


Glycosylation of proteins: a computer based method for the rapid exploration of conformational space of N-glycans.
Inspection of protein databases suggests that as many as 70% of proteins have potential N-glycosylation sites. Unfortunately glycoproteins often refuse to crystallize and NMR techniques do not allow an unambiguous determination of the complete conformation of the sugar part. Therefore, time-consuming complex simulation methods are often used to explore the conformational space of N-glycans. The generation of a comprehensive data base describing the conformational space of larger fragments of N-glycans taking into account the effects of branching is presented. High-temperature molecular dynamics simulations of essential N-glycan fragments are performed until conformational equilibrium has been reached. Free energy landscapes are calculated for each glycosidic linkage. All possible conformations for each N-glycan fragment are automatically assigned, ranked according to their relative population and stored in a database. These values are recalled for the generation of a complete set of all possible conformations for a given N-glycan topology. The constructed conformations are ranked according to their energy content. Since this approach allows to explore the complete conformational space of a given N-glycan within a few minutes of CPU-time on a standard PC, it is well suited to be used as a Web-Based application.


[Conceptualization and operationalization of social inequality in The Child and Adolescent Health Survey].
Poverty and social disadvantages are often accompanied by long-lasting social and psychosocial strain on the well-being and health of children and adolescents. From a health policy point of view the rising poverty quotas among young people indicate a high need for action. The status of empirical research is insufficient, so that it is difficult to plan and undertake political measures. The National Health Survey for Children and Adolescents will provide data permitting differentiated analysis of relations between poverty, social inequality and health in the adolescent generation. To get a first impression of possible analyses, the present article demonstrates which information on the living situation will be ascertained in the National Health Survey for Children and Adolescents, and which theoretical and methodological considerations have been playing a role.


Aspirin protected against endothelial damage induced by LDL: role of endogenous NO synthase inhibitors in rats.
To study the protective effect of aspirin on damages of the endothelium induced by low-density lipoprotein (LDL), and whether the protective effect of aspirin is related to reduction of nitric oxide synthase inhibitor level. Vascular endothelial injury was induced by a single injection of native LDL (4 mg/kg) in rats. Vasodilator responses to acetylcholine (ACh) in the isolated aortic rings were determined, and serum concentrations of asymmetric dimethylarginine (ADMA), malondialdehyde (MDA), tumour necrosis factor-alpha (TNF-alpha), and the activity of dimethylaminohydrolase (DDAH) were measured. A single injection of LDL (4 mg/kg) significantly decreased vasodilator responses to ACh, increased the serum level of ADMA, MDA, and TNF-alpha, and decreased DDAH activity. Aspirin (30 or 100 mg/kg) markedly reduced the inhibition of vasodilator responses to ACh by LDL, and the protective effect of aspirin at the lower dose was greater compared with high-dose aspirin group. Aspirin inhibited the increased level of MDA and TNF-alpha induced by LDL. Aspirin at the dose of 30 mg/kg, but not at higher dose (100 mg/kg), significantly reduced the concentration of ADMA and increased the activity of DDAH. Aspirin at the lower dose (30 mg/kg) protects the endothelium against damages elicited by LDL in vivo, and the protective effect of aspirin on endothelium is related to reduction of ADMA concentration by increasing DDAH activity.


Effects of benidipine hydrochloride on autonomic nervous activity in hypertensive patients with high- and low-salt diets.
The effects of benidipine hydrochloride (CAS 91559-74-5, Coniel) on autonomic nervous activity in hypertensive patients with high- and low-salt diets were investigated. Six patients having a urinary sodium excretion of 80 mEq/day or less (low salt group) and 6 patients having a urinary sodium excretion of 200 mEq/day or more (high salt group) were orally given benidipine hydrochloride (4 mg). Before and four weeks after the treatment with benidipine, 24-h circadian variation in blood pressure and 24-h Holter electrocardiogram (ECG) were recorded. The low frequency power spectrum of heart rate (LF power; 0.04-0.15 Hz), high frequency power spectrum of heart rate (HF power; 0.15-0.40 Hz), and the ratio of LF to HF (LF/HF) were calculated, and these parameters were averaged every hour in every subject. HF power was significantly lower and LF/HF ratio was significantly higher in the high-salt group than in the low-salt group before the treatment. However, the benidipine treatment significantly increased the HF power in both groups, particularly in the high-salt group, and significantly decreased the LF/HF ratio in both groups. Moreover, there was no significant difference in the antihypertensive effect of benidipine between the high- and low-salt intake groups. These results suggest that benidipine favourably influences blood pressure and autonomic nervous activity in hypertensive patients with a high-salt intake. It is concluded that benidipine may be useful for improving the development of salt-induced hypertension and its accompanying haemodynamic responses.


Clinical results and development of variable-stiffness video colonoscopes.
This study was designed to assess the usefulness of variable-stiffness video colonoscopes, compared with conventional videoscopes. The first prototype XCF-QAY1 and the latter prototype XCF-Q240A1 used in this study can be varied to 4 levels of stiffness of tube insertion during examination. In 352 consecutive colonoscopic examinations performed using these and two conventional scopes, the following data were recorded: time for intubation to the cecum, frequency of changes in the patients' posture, frequency of abdominal pressure attempts, and pain score. The degree of stiffness of the insertion tube and the examiners' impressions score were recorded only in procedures where the variable-stiffness scopes were used. There was no significant difference between colonoscopes in the pain score. Total colonoscopy rate was 97.4%. The frequency of usage of the varying stiffness control in the colon according to site was as follows: descending colon, 57.3%; transverse colon, 32.8%, sigmoid colon, 7.6%; and ascending colon, 2.3%. A significant difference in the mean time for intubation to the cecum between the XCF-Q240A1 and conventional scopes was observed. Moreover, there were significant differences in the frequency of abdominal pressure attempts and changes in the patient's posture between conventional scopes and the new scopes. These results suggest that only one scope, the XCF-Q240A1, is needed for any colonic examination by any examiner.


Non-Invasive Assessment of Back Surface Topography: Technologies, Techniques and Clinical Utility.
(1) Background: Frequent exposure to ionising radiation is often used to determine the diagnosis of adolescent idiopathic scoliosis (AIS), a lateral curvature of the spine in those aged between 10 and 18 years, and a treatment plan according to Cobb angle. This narrative review outlines the clinical utility of surface topography (ST), a radiation-free imaging modality. (2) Methods: Publicly available databases were searched to yield literature related to ST. Identified articles were classified based on the equipment used and in order of how it was developed, i.e., historical, recent developments, and state-of-the-art developments. (3) Conclusions: ST is a reliable cost-effective non-invasive technique that provides an alternative to radiation-based imaging to aid with the diagnosis and potential screening of AIS. Several scanning methods are available, which allows ST to be used in several clinical environments. Limitations of inter-reliability and differences of apparatus resulting in variations of data have been noted through this narrative review.


[Experience with the use of amantadine for the control of an influenza outbreak at an Elderly Home].
A study of an outbreak of acute respiratory disease was done at the "Carlos Font Pupo" Old People's Home. Las Tunas Province, where 30 diseased old individuals were detected; grippe was diagnosed to two of them. General attack rate was 8.6%. Curative treatment with amantadine was administered to 29 old patients and chemoprophylaxis to 26, for a total of 55 old individuals treated. The evolution of the patients was satisfactory and none new case was observed. Diarrhea was the only one secondary reaction observed in a patient under chemoprophylactic treatment. The need to carry on performing similar studies is pointed out.


Bone allografts pretreated with a bisphosphonate are not resorbed.
Bisphosphonates bind to bone surfaces and inactivate osteoclasts when they start to resorb the bone. Therefore, immersion of a bone graft in a bisphosphonate solution before implantation may protect it from resorption. We implanted frozen cancellous bone allografts into bilateral bone chambers for 6 weeks in 10 rats. One graft in each pair had been immersed in an alendronate solution (1 mg/mL) for 10 minutes, and then rinsed in saline. Controls underwent the same treatment with saline only. Results were evaluated with histomorphometry. Control grafts were almost entirely resorbed, but alendronate-treated grafts seemed intact. In the treated specimens, two thirds of the space behind the bone ingrowth frontier consisted of graft or host bone, but in the controls, only one fifth. Local graft treatment with a bisphosphonate before insertion seems to be risk-free, and may prevent mechanical graft failure due to resorption in patients.


Fluorescing cells in sputum after parenteral HpD.
Cells exfoliated into sputum were examined for fluorescence after the intravenous injection of HpD. Malignant and non-malignant cells were seen to fluoresce up to 9 days post injection of HpD. Not all exfoliated squamous cell cancer cells or non-malignant cells fluoresced. Implications are discussed relative to imaging diagnostic fluorescence bronchoscopy and photoradiation therapy of obstructing endobronchial cancers and bronchial carcinoma in situ.


Written language disorders: speech-language pathologists' training, knowledge, and confidence.
This study examined speech-language pathologists' (SLPs') perceptions of their (a) educational and clinical training in evaluating and treating written language disorders, (b) knowledge bases in this area, (c) sources of knowledge about written language disorders, (d) confidence levels, and (e) predictors of confidence in working with written language disorders. A 6-part survey was developed and was mailed to 1,000 school-based SLPs. SLPs (n = 599) practicing in 47 states responded to the survey. A majority (60.3%) reported working with a child with a written language disorder either weekly or daily. SLPs described their educational and clinical training as "limited" in the evaluation and treatment of children with written language disorders. The average SLP stated feeling "somewhat confident" to evaluate and treat written language disorders, and 63.8% reported that they received most of their knowledge through "on-the job" training. Confidence was related to four variables: on-the-job training, general knowledge about written language disorders, attendance at conventions, and understanding of collaborative efforts. Our findings provide information about SLPs' training, knowledge, and confidence about written language beyond anecdotal reports and fill research gaps regarding SLPs' preservice and professional development needs. Predictors of confidence are discussed.


The Relationship between Nerve Conduction Study and Clinical Grading of Carpal Tunnel Syndrome.
Carpal Tunnel Syndrome (CTS) is the most common nerve entrapment. Subjective sensory symptoms are common place in patients with CTS, but sometimes they are not supported by objective findings in the neurological examination. Electrodiagnostic (EDx) studies are a valid and reliable means of confirming the diagnosis. The amplitudes along with the conduction velocities of the sensory nerve action potential and motor nerve action potential reflect the functional state of axons, and are useful parameters and complement the clinical grading in the assessment of severity of CTS. To conduct median nerve sensory and motor conduction studies on patients with carpal tunnel syndrome and correlate the relationship between nerve conduction study parameters and the clinical severity grading. Based on clinical assessment, the study patients were divided into 03 groups with mild CTS, moderate CTS and severe CTS respectively as per Mackinnson's classification. Median and ulnar nerve conduction studies were performed on bilateral upper limbs of 50 patients with symptoms of CTS and 50 age and sex matched healthy control subjects. The relationship between the clinical severity grade and various nerve conduction study parameters were correlated. In this prospective case control study, 50 patients with symptoms consistent with CTS and 50 age and sex matched healthy control subjects were examined over a 10 month period. A total of 30 patients had unilateral CTS (right upper limb in 19 and left upper limb in 11) and 20 patients had bilateral CTS. Female to male ratio was 3.54 to 1. Age ranged from 25 to 81 years. The mean age at presentation was 49.68±11.7 years. Tingling paresthesias of hand and first three fingers were the most frequent symptoms 48 (98%). Tinel's and Phalen's sign were positive in 36 (72%) and 44 (88%) patients respectively. The mean duration of symptoms at presentation was 52.68±99.81 weeks. 16 patients (32%) had mild CTS, 25 (50%) had moderate CTS and 9 (18%) had severe CTS clinically. Prolongation of motor latency, latency difference between median and ulnar amplitudes, motor and sensory nerve conduction velocities, sensory latency between median and ulnar nerves, sensory nerve conduction velocities showed significant changes in comparison with controls. Among them sensory latency difference between median and ulnar nerves and sensory nerve conduction velocities are the most sensitive and specific for diagnosing CTS. In this study, there was a graded deterioration of electrophysiological parameters along with the clinical severity grades, thus reiterating the fact that NCS provide additional, independent objective evidence in the diagnosis and severity assessment of CTS. The sensory conductions were more sensitive than motor conductions in assessing CTS.


The wisdom of the body revisited: the adrenomedullary response to mild core hypothermia in humans.
In the 1920s, Walter B. Cannon first described the adrenomedullary response to cold, using an ingenious in vivo bioassay based on a denervated heart preparation. Studies in humans about antecubital venous plasma concentrations of norepinephrine, the sympathetic neurotransmitter, and of epinephrine, the main adrenomedullary hormone, have suggested sympathetic nervous system activation without adrenomedullary activation. The present study used arterial levels of these catecholamines, to determine whether adrenomedullary stimulation occurs in response to decreased body temperature. Eleven healthy volunteers underwent central intravenous infusion of warm (37 degreeC) physiological saline, followed by infusion of the same volume of cold (4 degreeC) saline. Brachial arterial and antecubital venous plasma concentrations of norepinephrine and epinephrine were measured by liquid chromatography with electrochemical detection. Antecubital venous concentrations of norepinephrine increased markedly during cold saline infusion, with smaller and statistically borderline increases in concentrations of epinephrine. In contrast, concurrently obtained arterial concentrations of both norepinephrine and epinephrine increased significantly. The results confirm Cannon's original inference that cold evokes adrenomedullary activation. Prior studies about antecubital venous levels of catecholamines did not take into account the local hemodynamic effects of cold, which would increase extraction of circulating catecholamines and underestimate the arterial epinephrine response.


[Glycemic control and lipoprotein profile in type I diabetes mellitus].
To analyze the relation between the degree of glycemic control and the lipoprotein profile in type I diabetes mellitus. Seventy-five diabetics were studied in whom the total glycohemoglobin (GHb), total triglycerides (TG), triglycerides of very low density lipoproteins (TG-VLDL), total cholesterol (TC), cholesterol of very low density lipoproteins (C-VLDL), cholesterol of high density lipoproteins (c-HDL), apolipoprotein AI (Apo AI) and apolipoprotein B (Apo B) were determined. Patients were classified according to their GHb: less than 9% (good glycemic control), 9-11% (moderate glycemic control) and greater than 11% (bad glycemic control). There was homogeneity in the 3 groups with regards to other variables which influenced the lipoprotein profile. The concentrations of TG, TG-VLDL, TC, C-VLDL and C-LDL were significantly higher in the groups of greater GHb while those of C-HDL, Apo I and Apo B were independent of the degree of glycemic control. The number of patients whose lipid profiles may be considered as atherogenic risk increases progressively in groups with greater GHb. In patients with type I diabetes mellitus, bad glycemic control is accompanied by decreases in TG, TC and C-LDL up to a magnitude which frequently reaches risk values for developing vascular disease. However, in these subjects, a less protector effect dependent on C-HDL is not to be expected since their concentrations are similar to those patients with good glycemic control.


Effects of acoustic trauma on the representation of the vowel "eh" in cat auditory nerve fibers.
A population study of cat auditory-nerve fibers was used to characterize the permanent deficits induced by exposure to 110-115 dB SPL, narrow-band noise. Fibers in the region of acoustic trauma (roughly 1-6 kHz) showed a loss of sensitivity at best frequency (BF) of about 50-60 dB and an increased tuning bandwidth. A correlation between weakened two-tone suppression and loss of sensitivity was found for fibers with BFs above 1 kHz. Single-fiber responses to the vowel "eh" were recorded at intensities ranging from near threshold to a maximum of about 110 dB SPL. In normal cochleas, the temporal response patterns show a capture phenomenon, in which the first two formant frequencies dominate the responses at high sound levels among fibers with BFs near the formant frequencies. After acoustic trauma, fibers in the region of threshold shift synchronized to a broad range of the vowel's harmonics and thus did not show capture by the second formant at any sound level used. The broadband nature of this response is consistent with the broadened tuning observed in the damaged fibers, but may also reflect a weakening of compressive nonlinearities responsible for synchrony capture in the normal cochlea.


Correction: Extracting accurate information from triplet-triplet annihilation upconversion data with a mass-conserving kinetic model.
Correction for 'Extracting accurate information from triplet-triplet annihilation upconversion data with a mass-conserving kinetic model' by Abhishek Kalpattu et al., Phys. Chem. Chem. Phys., 2022, 24, 28174-28190, https://doi.org/10.1039/D2CP03986A.


Liquid-crystal adaptive optics based on feedback interferometry for high-resolution retinal imaging.
A novel, to our knowledge, adaptive optical imaging system for high-resolution retinal imaging is described. The system is based on a feedback interferometer, in which two-dimensional output fringe intensity from a Mach-Zehnder interferometer with large radial shear is fed back, with the help of a video projector connected with a CCD camera, to an optically addressed phase-only liquid-crystal spatial light modulator. Experiments to verify the system performance have been conducted by use of an artificial eye consisting of a lens, an aberration plate, and a resolution test target. We observed that an image of the test target (mimicking a retina) blurred by the aberration plate (mimicking ocular aberrations) was successfully restored immediately after our adaptive optics system was activated.


Cannabis use predicts shorter duration of untreated psychosis and lower levels of negative symptoms in first-episode psychosis: a South African study.
Cannabis use/abuse is a common co-morbid problem in patients experiencing a first episode of psychotic illness (FEP). The relationship between the clinical presentation of FEP and cannabis abuse is complex and warrants further investigation, especially within the South African context. We tested associations between recent/current cannabis use and duration of untreated psychosis (DUP), age of onset (AO), PANSS-rated (Positive and Negative Syndrome Scale) positive, negative and general psychopathology symptoms and depressive symptoms (Calgary Depression Scale for Schizophrenia) in a sample of 54 patients with FEP. Mean DUP was 34.4 weeks, while mean AO was 24.7 years. Co-morbid cannabis use occurred in 35% of the sample and was significantly associated with shorter DUP (Mann-Whitney U, p=0.026). While not significant, there was also a trend association between cannabis use and lower negative symptoms (Mann-Whitney U, p=0.051). Current/recent cannabis use was associated with clinical features of psychosis onset that previously have been associated with better outcome. Medium and long-term outcome for cannabis users however, is likely to depend on whether or not cannabis use is ongoing.


Potential involvement of mt1 receptor and attenuated sex steroid-induced calcium influx in the direct anti-proliferative action of melatonin on androgen-responsive LNCaP human prostate cancer cells.
Melatonin, a pineal secretory product, has been shown to exert a direct anti-proliferative action on the androgen-sensitive LNCaP prostate cancer cell line through hitherto undefined mechanisms. In this communication, expression of mt1 melatonin receptor protein in human prostate cancer tissues and LNCaP cells was demonstrated by immunohisto(cyto)chemistry and western blotting, hence supporting the use of LNCaP cell line as a model for the study of melatonin signaling in prostate cancer cell growth. Using 3H-thymidine incorporation assay, LNCaP cell proliferation was inhibited by 2-iodomelatonin, a high-affinity melatonin receptor agonist. Furthermore, melatonin inhibited 3H-thymidine incorporation into LNCaP cells and attenuated 5alpha-dihydrotestosterone (DHT) or 17beta-estradiol (E2)-induced stimulation of LNCaP cell proliferation at physiological and pharmacological concentrations. Similar concentration-dependent inhibition of sex steroid-induced stimulation of thymidine incorporation into LNCaP cells by 2-iodomelatonin was also observed. Interestingly, attenuation of sex steroid-stimulated calcium influx into LNCaP cells by pharmacological concentrations of melatonin was recorded, whereas 2-iodomelatonin had no effect on cytosolic calcium changes induced by sex steroids. In addition, proliferative and cytosolic calcium changes were associated with inhibition of total prostate-specific antigen (PSA) production by LNCaP cells at high physiological and pharmacological concentrations of melatonin. Our data suggest that activated mt1 receptor and attenuated sex steroid-induced calcium influx are two important mechanisms mediating the direct anti-proliferative action of melatonin on androgen-responsive human prostate cancer cells.


Non-Abelian statistics of vortices with non-Abelian Dirac fermions.
We extend our previous analysis on the exchange statistics of vortices having a single Dirac fermion trapped in each core to the case where vortices trap two Dirac fermions with U(2) symmetry. Such a system of vortices with non-Abelian Dirac fermions appears in color superconductors at extremely high densities and in supersymmetric QCD. We show that the exchange of two vortices having doublet Dirac fermions in each core is expressed by non-Abelian representations of a braid group, which is explicitly verified in the matrix representation of the exchange operators when the number of vortices is up to four. We find that the result contains the matrices previously obtained for the vortices with a single Dirac fermion in each core as a special case. The whole braid group does not immediately imply non-Abelian statistics of identical particles because it also contains exchanges between vortices with different numbers of Dirac fermions. However, we find that it does contain, as its subgroup, genuine non-Abelian statistics for the exchange of the identical particles, that is, vortices with the same number of Dirac fermions. This result is surprising compared with conventional understanding because all Dirac fermions are defined locally at each vortex, unlike the case of Majorana fermions for which Dirac fermions are defined nonlocally by Majorana fermions located at two spatially separated vortices.


Magnesium deficiency in the pathogenesis of mitral valve prolapse.
Idiopathic mitral valve prolapse (MVP) is the commonest valvular disorder in industrialized nations. It is predominantly a familial condition, showing Mendelian dominance with delayed and variable penetrance. Although hyperkinesis and hypertrophy of the left ventricle have been described in MVP, its histopathology, somatic morphology and genetics support the leading theory that MVP results from a hereditary disorder of connective tissue. Latent tetany (LT) due to chronic Mg deficit (Mg-D) occurs in over 85% of MVP cases; MVP complicates 26% of LT. Mg-D can explain many clinical features of the MVP syndrome which are not easily explained by its genetics. Mg-D hinders the mechanism by which fibroblasts degrade defective collagen, increases circulating catecholamines, predisposes to cardiac arrhythmias, thromboembolic phenomena and dysregulation of the immune and autonomic nervous systems. Mg therapy provides relief of MVP symptoms.


Comparative Histomorphometric Analysis of Bone Regeneration According to Bone Graft Type.
To use histomorphometric analysis to evaluate bone reconstruction in rabbit calvaria with autogenous bone, anorganic bovine bone, undecalcified human tooth bone (UdTB), and decalcified human tooth bone (dTB) grafts. Extracted human teeth were crushed, and tooth bone with and without decalcification was prepared. Bony defects were made in 10 rabbit calvaria and allocated to one of the following four groups: group 1, in which UdTB was grafted; group 2, in which dTB was grafted; group 3, in which anorganic bovine bone was grafted; group 4, in which autogenous bone was grafted. The rabbits were sacrificed at 2 or 8 weeks postoperatively, and histomorphometric comparison was performed. Histologically, new bone formation was observed at the defect margin and around all graft materials. The dTB group revealed significantly greater new bone areas at 2 and 8 weeks compared to the UdTB group and the anorganic bovine bone group (P < .05). The dTB group revealed no significant difference in the new bone area at 2 weeks but revealed significantly less new bone area at 8 weeks compared to the autogenous bone group (P < .05). The dTB group also revealed significantly less graft material area compared to the anorganic bovine bone group at 8 weeks (P < .05). The autogenous bone group revealed significantly less graft material area and significantly greater bone marrow area compared to other groups at 8 weeks (P < .05). Grafting with dTB resulted in better bone regeneration than UdTB and anorganic bovine bone grafting at 8 weeks and addresses the potential disadvantages of autogenous bone grafting.


Ontogenic and morphological study of gonadal formation in genetically-modified sex reversal XY(POS) mice.
Mammalian sexual fate is determined by the presence or absence of sex determining region of the Y chromosome (Sry) in the "bipotential" gonads. Recent studies have demonstrated that both male and female sexual development are induced by distinct and active genetic pathways. Breeding the Y chromosome from Mus m. domesticus poschiavinus (POS) strains into C57BL/6J (B6J) mice (B6J-XY(POS)) has been shown to induce sex reversal (75%: bilateral ovary, 25%: true hermaphrodites). However, our B6N-XY(POS) mice, which were generated by backcrossing of B6J-XY(POS) on an inbred B6N-XX, develop as males (36%: bilateral testis with fertility as well as bilateral ovary (34%), and the remainder develop as true hermaphrodites. Here, we investigated in detail the expressions of essential sex-related genes and histological features in B6N-XY(POS) mice from the fetal period to adulthood. The onsets of both Sry and SRY-box 9 (Sox9) expressions as determined spatiotemporally by whole-mount immunohistochemistry in the B6N-XY(POS) gonads occurred 2-3 tail somites later than those in B6N-XY(B6) gonads, but earlier than those in B6J-XY(POS), respectively. It is possible that such a small difference in timing of the Sry expression underlies testicular development in our B6N-XY(POS). Our study is the first to histologically show the expression and ectopic localization of a female-related gene in the XY(POS) testes and a male-related gene in the XY(POS) ovaries. The results from these and previous experiments indicate that the interplay between genome variants, epigenetics and developmental gene regulation is crucial for testis development.


Content coding for contextualization of care: evaluating physician performance at patient-centered decision making.
. Adapting best evidence to the care of the individual patient has been characterized as "contextualizing care" or "patient-centered decision making" (PCDM). PCDM incorporates clinically relevant, patient-specific circumstances and behaviors, that is, the patient's context, into formulating a contextually appropriate plan of care. The objective was to develop a method for analyzing physician-patient interactions to ascertain whether decision making is patient centered. . Patients carried concealed audio recorders during encounters with their physicians. Recordings and medical records were reviewed for clues that contextual factors, such as an inability to pay for a medication or competing responsibilities, might undermine an otherwise appropriate care plan, rendering it ineffective. Iteratively, the team refined a coding process to achieve high interrater agreement in determining (a) whether the clinician explored the clues-termed "contextual red flags"-for possible underlying contextual factors affecting care, (b) whether the presence of contextual factors was confirmed and, if so, (c) whether they were addressed in the final care plan. . A medical record data extraction instrument was developed to identify contextual red flags such as missed appointments or loss of control of a treatable chronic condition which signal that contextual factors may be affecting care. Interrater agreement (Cohen's kappa) for coding whether the clinician explored contextual red flags, whether a contextual factor was identified, and whether the factors were addressed in the care plan was 88% (0.76, P < 0.001), 94% (0.88, P < 0.001), and 85% (0.69, P < 0.001) respectively. . PCDM can be assessed with high interrater agreement using a protocol that examines whether essential contextual information (when present) is addressed in the plan of care.


Multiplex PCR approach to simultaneously identify several mutations in fine needle cytology thyroid samples.
The most frequent initial manifestation of thyroid cancer is the appearance of a nodule. More than 20% of the general population has a palpable thyroid nodule and the percentage rises to 70% based on ultrasound identification. In 95% of cases the nodule is simply a hyperplastic or benign lesion. The most reliable diagnostic test for thyroid nodules is fine needle aspiration (FNA), but cytological discrimination between malignant and benign follicular neoplasms remains difficult. Cytological analysis is now, almost routinely, being combined with molecular genetics to enable the pathologist to make a more objective diagnosis. In this study, we performed the molecular analysis using a new simplified procedure that involves a panel of BRAF, RAS, RET and RET/PTC gene mutations in easily obtainable FNA samples, in the attempt to improve the efficacy of the FNA diagnosis of thyroid nodules and thus patient management. In this new procedure, PCR and sequencing analysis are used to detect point mutations, and, in parallel, RT-PCR is used to detect the chimeric RET/PTC1 and RET/PTC3 transcripts in RNA extracted from FNA.


Influenza and COVID-19 coinfection: Report of six cases and review of the literature.
Coronavirus disease 2019 (COVID-19) pandemic caused infection in a season when influenza is still prevalent. Both viruses have similar transmission characteristics and common clinical manifestations. Influenza has been described to cause respiratory infection with some other respiratory pathogens. However, the information of COVID-19 and influenza coinfection is limited. In this study, we reported our coinfected cases and reviewed the literature. We included all COVID-19 diagnosed patients. All patients with a presumed diagnosis of COVID-19 were routinely screened for influenza. Their thorax radiology was reviewed for COVID-19-influenza differentiation. During the study period, 1103 patients have been diagnosed with COVID-19. Among them, six patients (0.54%) were diagnosed coinfected with influenza. There have been 28 more coinfected patients reported. Laboratory-based screening studies reported more patients. Thorax radiology findings were compatible with COVID-19 in five and with influenza in one of our patients. Our cases were mild to moderate in severity. The reported cases in the literature included patients died (n = 2) and those living ventilator dependent or under mechanical ventilation. COVID-19 and influenza coinfection is rare. Screening studies report more cases, suggesting that unless screening patients with COVID-19, the coinfection remains undiagnosed and underestimated. Increasing experience in thoracic radiology may contribute to diagnose the responsible virus(es) from the clinical illness. Influenza vaccine for larger population groups can be recommended to simplify clinicians' work.


Circulating fibroblast growth factor 23 in patients with end-stage renal disease treated by peritoneal dialysis is intact and biologically active.
Fibroblast growth factor 23 (FGF23) regulates phosphorus homeostasis and vitamin D metabolism. Circulating FGF23 levels are elevated in inherited and acquired hypophosphatemic disorders that can cause rickets or osteomalacia. Particularly increased concentrations of FGF23 are observed in patients with chronic kidney disease (CKD), in which increased FGF23 is associated with more rapid disease progression, improved bone mineralization, the development of left ventricular hypertrophy, and increased mortality. Our objective was to determine whether the markedly elevated levels of immunoreactive FGF23 in CKD represent accumulation of intact, biologically active hormone, C-terminal cleavage fragments, or both. Biologically active FGF23 in plasma from CKD patients treated by peritoneal dialysis was quantified using a cell-based Egr-1 reporter assay; bioactive FGF23 levels were compared with those measured with immunometric FGF23 assays detecting either intact hormone alone or intact hormone and C-terminal fragments. Adult and pediatric patients with end-stage renal disease treated with peritoneal dialysis participated in the study at a tertiary referral center. Serially diluted patient samples revealed levels of bioactive FGF23 that ran in parallel to CHO cell-derived recombinant human FGF23. FGF23 bioactivity was inhibited by an anti-FGF23 antibody. Levels of bioactive and immunoreactive FGF23 were tightly correlated, and Western blot analysis of FGF23 immunoprecipitated with anti-FGF23 antibodies from plasma of dialysis patients revealed only a single prominent protein band, which was indistinguishable from recombinant intact FGF23, without clear evidence for FGF23 fragments. Our results provide strong evidence for the conclusion that virtually all circulating FGF23 in dialysis patients is intact and biologically active.


Exploring How People Affected by Methamphetamine Exchange Social Support Through Online Interactions on Facebook: Content Analysis.
Methamphetamine is an illicit and addictive psychostimulant that remains to be a significant cause of economic burden in Australia. Social media is increasingly being used by nongovernment organizations and health services to encourage the growth of social support networks among people with health-related issues. Several studies have investigated the utility of social media in providing social support to groups of people with health-related issues. However, limited research exists that explores how people who have been directly or indirectly affected by methamphetamine use social media for social support. This study aimed to determine the types of social support being sought and provided by people affected by methamphetamine when interacting with others on a Facebook page. A total of 14,777 posts were collected from a Facebook page and transferred into an Excel document for content analysis. The posts were manually coded into categories of social support using an adapted version of Cutrona and Suhr's Social Support Behavior Code. Posts could be coded into more than one category. Saturation was reached at 2000 posts, which were used to draw inferences. Emotional support was the most offered support type, with 42.05% (841/2000) of posts providing this form of support. This is followed by esteem support, which was provided in 40.40% (808/2000) of posts. Overall, 24.20% (484/2000) of posts offered informational support. Network support and tangible support were the least offered support types, with 2.25% (45/2000) and 1.70% (34/2000) of posts offering these types of support, respectively. This study suggests that online social support groups can be effective in challenging stigma by encouraging people affected by methamphetamine to connect with each other and talk about their struggles. This in turn represents an important step toward successful rehabilitation.


Anti-CD3 antibody decreases inflammation and improves outcome in a murine model of Pneumocystis pneumonia.
The T cell-mediated immune response elicited by Pneumocystis plays a key role in pulmonary damage and dysfunction during Pneumocystis carinii pneumonia (PcP). Mice depleted of CD4(+) and CD8(+) T cells prior to infection are markedly protected from PcP-related respiratory deficit and death, despite progressive lung infection. However, the therapeutic effectiveness of Ab-mediated disruption of T cell function in mice already displaying clinical symptoms of disease has not been determined. Therefore, a murine model of PcP-related immune reconstitution inflammatory syndrome was used to assess whether Ab to the pan-T cell molecule CD3 is effective for reducing the severity of PcP when administered after the onset of disease. Mice that received anti-CD3 Ab exhibited a rapid and dramatic halt in the PcP-associated pulmonary function decline within 1 week after treatment, and a striking enhancement of survival rate compared with mice receiving the control Ab. Physiologic improvement in anti-CD3 treated mice was associated with a significant reduction in the number of CD4(+) and CD8(+) T cells recovered in lung lavage fluid. This effectiveness of anti-CD3 was noted whether the mice also received antibiotic therapy with trimethoprim-sulfamethoxazole. These data suggest that monoclonal Ab-mediated disruption of T cell function may represent a specific and effective adjunctive therapy to rapidly reverse the ongoing pathologic immune response occurring during active PcP. Thus, the anti-human CD3 monoclonal Ab OKT3, which is already in clinical use, has the potential to be developed as an adjunctive therapy for PcP.


TEM in the treatment of recurrent rectal cancer in elderly.
Transanal microscopic surgery is an important application of minimally invasive surgery of rectum, allowing realization of complex transanal intervention. During the period between January 2002 and December 2010, seven patients, five men and two women, average age 75 years, with early rectal cancer recurrence were selected for this type of surgical palliative procedure. The selection of the patients is made by: transrectal ultrasonografy, colonoscopy and abdominal ultrasonografy, to rule out liver metastases, CT with and without enema, PET CT. Follow-up is approximately 12-30 months. The pathologic staging confirms the complete excision of recurrences. Then patients are referred for more complementary therapies. The significance of conservative treatment for local recurrence of rectum adenocarcinoma is still controversial because the recurrence is an expression of tumor spread not controlled by oncological surgical and radio/chemo therapy. In selected subjects such as the elderly, based on equal oncological treatment, the reduction of surgical trauma, preservation of anatomical integrity and resolution of symptoms are important results.


Epidemiology of amyotrophic lateral sclerosis in Minnesota: a year-long population based study.
This is the largest population based study of ALS in the U.S., encompassing the population of Minnesota (> 5.4 million people) from July 2013 to July 2014. Data on gender, age at diagnosis, and residential county were collected for all Minnesota residents who registered with the Minnesota/North Dakota/South Dakota chapter of the ALS Association from July 2013 to July 2014. Incidence rates were calculated as the number of new cases of ALS per 100,000 people per year. The standardized incidence rates for the 2013 U.S. population and the 2013 European standard population were also reported. Results showed that the crude incidence rate of ALS was 2.2 cases per 100,000 person-years. Incidence increased with age, peaking at 70-79 years (8.3 per 100,000) with mean age at diagnosis 64 years, and was greater in males (2.4 per 100,000) than in females (1.5 per 100,000). Standardized incidence rates for the 2013 U.S. and European standard population were 2.2 and 2.39 cases per 100,000 person-years, respectively. In conclusion, the overall incidence and age and gender patterns of ALS in Minnesota are comparable to those reported by European studies ( 1-5 ).


[Genetic characteristics and trends in the spread of a new Shigella flexneri subserovar with the antigenic formula IV:7,8].
As the result of experiments with the conjugation of S. flexneri strains 4 belonging to an unusual subserovar (IV: 7,8) with Escherichia coli donor strains K12 Hfr C and Hfr H, as well as experiments with converting phages IV and 7,8, this new subserovar of S. flexneri 4, similarly to other S. flexneri subserovars, was proved to be the Y-variant of shigellae rendered lysogenic by the two above phages. The experiments also revealed that 97.9% of all S. flexneri strains 4 (IV: 7,8) under study possessed invasive properties and were capable of inducing specific keratoconjunctivitis in guinea pigs. Observations on the isolation of S. flexneri strains 4 belonging to the new serovar (IV: 7,8), carried out by the All-Union Shigelloses Center on its basal territories in 1980-1984, made it possible to establish the tendency towards a wider circulation of this infective agent in the USSR.


Modelling the electrophysiological endothelial cell response to bradykinin.
The goal of the present study is to construct a biophysical model of the coronary artery endothelial cell response to bradykinin. This model takes into account intracellular Ca2+ dynamics, membrane potential, a non-selective cation channel, and two Ca(2+)-dependent K+ channels, as well as intra- and extracellular Ca2+ sources. The model reproduces the experimental data available, and predicts certain quantities which would be hard to obtain experimentally, like the individual K+ channel currents when the membrane potential is allowed to freely evolve, the implication of epoxyeicosatrienoic acids (EETs), and the total K+ released during stimulation. The main results are: (1) the large-conductance K+ channel participates only very little in the overall response; (2) EETs are required in order to explain the experimental current-potential relationships, but are not an essential component of the bradykinin response; and (3) the total K+ released during stimulation gives rise to a concentration in the intercellular space which is of millimolar order. This concentration change is compatible with the hypothesis that K+ contributes to the endothelium-derived hyperpolarizing factor phenomenon.


Vaccine safety monitoring systems in developing countries: an example of the Vietnam model.
Only few health intervention programs have been as successful as vaccination programs with respect to preventing morbidity and mortality in developing countries. However, the success of a vaccination program is threatened by rumors and misunderstanding about the risks of vaccines. It is short-sighted to plan the introduction of vaccines into developing countries unless effective vaccine safety monitoring systems are in place. Such systems that track adverse events following immunization (AEFI) is currently lacking in most developing countries. Therefore, any rumor may affect the entire vaccination program. Public health authorities should implement the safety monitoring system of vaccines, and disseminate safety issues in a proactive mode. Effective safety surveillance systems should allow for the conduct of both traditional and alternative epidemiologic studies through the use of prospective data sets. The vaccine safety data link implemented in Vietnam in mid-2002 indicates that it is feasible to establish a vaccine safety monitoring system for the communication of vaccine safety in developing countries. The data link provided the investigators an opportunity to evaluate AEFI related to measles vaccine. Implementing such vaccine safety monitoring system is useful in all developing countries. The system should be able to make objective and clear communication regarding safety issues of vaccines, and the data should be reported to the public on a regular basis for maintaining their confidence in vaccination programs.


Sickle cell disease status and outcomes of African-American men presenting with priapism.
Priapism is associated with sickle cell disease (SSD); however, few men receive education about this condition, which contributes to attenuated return of functional erections. To define the demographics, SSD status, and treatment outcomes of African-American men presenting with priapism. Demographics, medical history, self-report of sickle cell status, and outcome assessment using International Inventory of Erectile Function (IIEF) of men with priapism were retrospectively reviewed. A review of 39 cases of venocclusive priapism in African-American men was conducted. Charts were reviewed for demographics, medical history including SSD status by patient self-report, serum hemoglobin electrophoresis results, and priapism treatment and outcome. Mean duration of presenting priapism episode was 22 +/- 12 hours (6-70 hours). Eight percent of men had priapism for <12 hours, 59% 12-24 hours, 22% 24-36 hours, and 11% >36 hours. All patients with priapism events of >12 hours complained of reduction in erectile rigidity. No patients with priapism >36 hours duration had return of spontaneous functional erections, but 44% (24-36 hours), 78% (12-24 hours) and 100% (<12 hours) were able to generate functional erections with or without the use of sildenafil. Follow-up IIEF erectile function domain scores paralleled incidence of functional erections. Penile shunt surgery was required in 28%. Only 5% of men recalled learning that priapism was a complication of SSD. Six men denied a history of SSD; however, hemoglobin electrophoresis revealed abnormal hemoglobin S and elevated hemoglobin F levels in four of these men. The association of SSD and venocclusive priapism is well known in the medical community, yet few patients ever receive education regarding the emergency nature of the condition. The majority of men presents in a delayed fashion, and a significant proportion requires shunt surgery leading to long-term erectile dysfunction. Of those who denied having SSD, two-thirds had SSD by hemoglobin electrophoresis.


The sustainable impact of an educational approach to improve the appropriateness of laboratory test orders in the ICU.
Few studies described strategies to improve the use of diagnostic tests in intensive care units (ICU). No study assessed whether their impact was sustained or not. In this study, we assessed whether a multi-faceted intervention for more appropriate use of laboratory testing can decrease the number of tests, is sustainable, is not associated with additional morbidity and represents a potential cost saving. An open-label prospective cohort study in two separated units of the same medical intensive care unit (ICU) including respectively 3315 and 2392 consecutive patients. After the observation period (2010), a reduction in ICU A of unnecessary diagnostics tests as part of a program including senior supervisory of juniors' orders, encouragements for orders containment at each everyday round discussions (period 2; 2011). Period 3 (2012) consisted in the prolongation of the protocol as a routine care without supervision; Period 4 (2013) was a new period of observation without intervention. No modification was implemented in ICU B in periods 2-4. After the intervention, a decrease in the overall number of tests per ICU-patient-days (37.3±5.5 (baseline) to 15.2±3.2 (- 59%); p<0.0001) was observed. The total cost of the tests decreased from 239±41 to 104±28 euros per ICU-patient days; p<0.0001. The effect on laboratory test orders was sustainable in period 3 (-49%) and 4 (-30%). No significant secondary effect of the intervention was observed in period 2. In ICU B, there was no significant change in the overall laboratory test orders in between the periods. Laboratory test containment is effective, likely safe and sustainable provided that an educational program is repeatedly promoted, that it makes sense for the whole team, that senior and junior physicians are both committed in the program, and that encouragements for laboratory orders containment at each everyday round discussions.


Evidence-based practice, research, peer review, and publication.
For about a quarter of a century, concerns have been expressed about published biomedical research. It became more acute after some published research and broad dissemination was found fraudulent. With the emphasis now being placed on scientifically validated or evidence-based practice, it has become more imperative that clinical guidelines be based on credible information in our textbooks and research literature. Since the early 1990s, it has been found that much of the research in our electronic databases does not meet quality standards and often is irrelevant, calling into questions problems with peer review, including the selection and publication process of our journals. This column is devoted to calling attention to these problems not only to CRNAs and other researchers, but also to the consumers of research who often use it to make changes in their practice. It also calls attention to the CRNA community about the movement toward calls for greater accountability in practice, both as to quality and cost, from which the movement toward evidence-based practice, the identification and benchmarking of best practices, and the development and implementation of clinical practice guideline has evolved. To feel ownership in anesthesia-related clinical practice guidelines, CRNAs must become involved in their development and implementation.


Extracting noun phrases for all of MEDLINE.
A natural language parser that could extract noun phrases for all medical texts would be of great utility in analyzing content for information retrieval. We discuss the extraction of noun phrases from MEDLINE, using a general parser not tuned specifically for any medical domain. The noun phrase extractor is made up of three modules: tokenization; part-of-speech tagging; noun phrase identification. Using our program, we extracted noun phrases from the entire MEDLINE collection, encompassing 9.3 million abstracts. Over 270 million noun phrases were generated, of which 45 million were unique. The quality of these phrases was evaluated by examining all phrases from a sample collection of abstracts. The precision and recall of the phrases from our general parser compared favorably with those from three other parsers we had previously evaluated. We are continuing to improve our parser and evaluate our claim that a generic parser can effectively extract all the different phrases across the entire medical literature.


[Prevention and treatment of procedural pain in pediatric wards: collected guidelines].
Present knowledge and available pharmacological agents allow for adequate prevention and treatment of pain in children. We present guidelines we prepared for the prevention and treatment of procedural pain in children in our general pediatric ward. This followed extensive review of the literature, participation in scientific meetings, discussions with experts and consultation with interested clinicians. Successful implementation of the guidelines requires increased appreciation of the importance of pain prevention, participation of the nursing, as well as medical staff, and ability to evaluate pain in children of various ages.


Resveratrol inhibits K(v)2.2 currents through the estrogen receptor GPR30-mediated PKC pathway.
Resveratrol (REV) is a naturally occurring phytoalexin that inhibits neuronal K⁺ channels; however, the molecular mechanisms behind the effects of REV and the relevant α-subunit are not well defined. With the use of patch-clamp technique, cultured cerebellar granule cells, and HEK-293 cells transfected with the K(v)2.1 and K(v)2.2 α-subunits, we investigated the effect of REV on K(v)2.1 and K(v)2.2 α-subunits. Our data demonstrated that REV significantly suppressed Kv2.2 but not Kv2.1 currents with a fast, reversible, and mildly concentration-dependent manner and shifted the activation or inactivation curve of Kv2.2 channels. Activating or inhibiting the cAMP/PKA pathway did not abolish the inhibition of K(v)2.2 current by REV. In contrast, activation of PKC with phorbol 12-myristate 13-acetate mimicked the inhibitory effect of REV on K(v)2.2 by modifying the activation or inactivation properties of Kv2.2 channels and eliminated any further inhibition by REV. PKC and PKC-α inhibitor completely eliminated the REV-induced inhibition of K(v)2.2. Moreover, the effect of REV on K(v)2.2 was reduced by preincubation with antagonists of GPR30 receptor and shRNA for GPR30 receptor. Western blotting results indicated that the levels of PKC-α and PKC-β were significantly increased in response to REV application. Our data reveal, for the first time, that REV inhibited K(v)2.2 currents through PKC-dependent pathways and a nongenomic action of the oestrogen receptor GPR30.


Role of Calpain in Spinal Cord Injury: Effects of Calpain and Free Radical Inhibitorsa.
The demonstration of increased calpain activity, immunostaining, and expression at the gene (mRNA) and protein levels concomitant with ultrastructural degeneration and loss of axon and myelin proteins in lesioned cord have implicated a pivotal role for calpain in tissue destruction in spinal cord injury (SCI). Calpain, stimulated by free radicals, also mediates apoptotic cell death. These findings suggested that the use of calpain and lipid peroxidation drugs as therapeutic agents would protect cells and maintain the axon-myelin structural unit by preventing protein degradation. In order to examine this hypothesis, we treated SCI animals with calpain inhibitors (calpeptin) and/or methylprednisolone (MP), an antiinflammatory and free-radical inhibitor. SCI (40 g/cm) was induced by weight-drop, and 1 mg calpeptin or 165 mg MP/kg were given intravenously (i.v.) for 24 hours. Untreated injured animals receiving vehicle served as controls. Lesion 68-kDa and 200-kDa neurofilament proteins (NFPs) were analyzed by sodium dodecylsulfate polyarcylamide gel electrophoresis (SDS-PAGE) and chemiluminescence, and the extent of protein loss was quantitated. Loss of protein in the lesion of untreated cord amounted to 47% compared to sham control, while that for calpeptin- or MP-treated rats was 25-30%. Combination treatment with calpeptin and MP was slightly more effective in preventing NFP degradation, compared to either when used alone. Apopotic cell death in SCI as characterized by internucleosomal DNA fragmentation was also reduced following treatment with the inhibitors. The inhibition of cytoskeletal protein degradation suggests that calpain and free-radical inhibitors may rescue cells and preserve and maintain membrane structure by preventing protein breakdown, preserving motor function, and being neuroprotective.


Medication as a Cause of Acute Pancreatitis.
BACKGROUND Acute pancreatitis is an inflammatory condition of the pancreas characterized clinically by epigastric abdominal pain and elevated levels of pancreatic enzymes in the blood. Drug-induced pancreatitis has recently gained more attention and as a result, physicians are screening more frequently for medications as a cause of acute pancreatitis. CASE REPORT We report the case of a 74-year-old man with a significant past medical history for coronary artery disease, sleep apnea, and gastroesophageal reflux disease who presented with epigastric pain radiating to the back. After a careful history was taken, it was found the patient recently started furosemide; therefore, a diagnosis of furosemide-induced acute pancreatitis was made. CONCLUSIONS Furosemide and other medications should be strongly considered in the differential diagnosis of patients presenting with acute pancreatitis.


Management and Treatment of Hepatocellular Carcinoma with Immunotherapy: A Review of Current and Future Options.
With mortality rates of liver cancer doubling in the last 20 years, this disease is on the rise and has become the fifth most common cancer in men and the seventh most common cancer in women. Hepatocellular carcinoma (HCC) represents approximately 90% of all primary liver cancers and is a major global health concern. Patients with HCC can be managed curatively with surgical resection or with liver transplantation, if they are diagnosed at an early stage. Unfortunately, most patients with HCC present with advanced stages of the disease and have underlying liver dysfunction, which allows only 15% of patients to be eligible for curative treatment. Several different treatment modalities are available, including locoregional therapy radiofrequency ablation, microwave ablation, percutaneous ethanol injection, trans-arterial chemoembolization, transarterial radio-embolization, cryoablation, radiation therapy, stereotactic radiotherapy, systemic chemotherapy, molecularly targeted therapies, and immunotherapy. Immunotherapy has recently become a promising method for inhibiting HCC tumor progression, recurrence, and metastasis. The term "Immunotherapy" is a catch-all, encompassing a wide range of applications and targets, including HCC vaccines, adoptive cell therapy, immune checkpoint inhibitors, and use of oncolytic viruses to treat HCC. Immunotherapy in HCC is a relatively safe option for treating patients with advanced disease in the USA who are either unable to receive or failed sorafenib/lenvatinib therapy and thus may offer an additional survival benefit for these patients. The purpose of this review is to elaborate on some of the most recent advancements in immunotherapy.


History of successful ballot initiatives--Arizona.
In this article, the author, a key architect of the successful tobacco control program in Arizona, examines the stages of preparing an initiative campaign and the major issues in recruiting hospital associations to antitobacco campaigns. The article provides important lessons for coalitions and hospital associations, potential key players in other statewide campaigns.


Seizure detection devices: Exploring caregivers' needs and wishes.
User preferences for seizure detection devices (SDDs) have been previously assessed using surveys and interviews, but these have not addressed the latent needs and wishes. Context mapping is an approach in which designers explore users' dreams and fears to anticipate potential future experiences and optimize the product design. A generative group session was held using the context mapping approach. Two types of nocturnal SDD users were included: three professional caregivers at a residential care facility and two informal caregivers of children with refractory epilepsy and learning disabilities. Participants were invited to share their personal SDD experiences and briefed to make their needs and wishes explicit. The audiotaped session was transcribed and analyzed together with the collected material using inductive content analysis. The qualitative data was classified by coding the content, grouping codes into categories and themes, and combining those into general statements (abstraction). "Trust" emerged as the most important theme, entangling various emotional and practical factors that influence caregiver's trust in a device. Caregivers expressed several factors that could help to gain their trust in an SDD, including integration of different modalities, insight on all parameters overnight, personal adjustment of the algorithm, recommendation by a neurologist, and a set-up period. Needs regarding alerting seemed to differ between the two types of caregivers in our study: professional caregivers preferred to be alerted only for potentially dangerous seizures, whereas informal caregivers emphasized the urge to be alerted for every event, thus indicating the need for personal adjustment of SDD settings. In this explorative study, we identified several key elements for nocturnal SDD implementation including the importance of gaining trust and the possibility to adjust SDD settings for different types of caregivers.


Pathogenesis of angina pectoris.
There are two broad classes of angina pectoris, related to two fundamentally different pathogenetic mechanisms: in classic angina, atherosclerotic narrowings limit the ability of the coronary arteries to augment myocardial blood flow in response to increases in demand, and in variant angina, a primary reduction in coronary blood flow occurs, unrelated to changes in demand. Over the last decade, major advances have been made in our understanding of the factors that control coronary blood flow and how they interact in each of the major classes of angina. The present review examines these advances, as well as their relation to the syndromes of rest angina, postprandial angina, and exertional coronary artery spasm. Current knowledge about the mechanisms by which myocardial ischemia produces the sensation of angina is discussed, along with the application of pathogenetic principles to medical therapy.


Biochemical studies on a case of feline mannosidosis.
Evidence is presented for the biochemical diagnosis of the first case of feline mannosidosis. A marked deficiency of acidic alpha-D-mannosidase in the brain, kidney and liver and excessive excretion of mannose-rich oligosaccharides in the urine were found in a kitten suffering from a nervous disorder. Residual acidic alpha-D-mannosidase, ranging from 2 to 5.5% of the normal activity, was observed in the tissues of the affected kitten. It has similar kinetic and physicochemical properties to the normal activity. The amount of mannose in the urine of the affected kitten was 19-fold greater than in a comparable control, and the molar ratio of mannose to N-acetylglucosamine was approx. 6 : 1. High concentrations of neutral oligosaccharides were detected in the urine. The predominant oligosaccharide appeared to be a hexasaccharide. The biochemical features of bovine, feline and human mannosidosis are compared, and it is concluded that feline mannosidosis may be a useful animal model for studying the human disease.


[Metastases of prostatic cancer].
Among 600 necropsy cases of prostatic carcinoma metastases were found in 425 (70,8%). Solitary metastasis was found in 11 cases only, in the rest multiple metastases were observed. The most frequent site of metastases were lymph nodes (42,7%), bone (29,6%), liver (19,8%), lungs (14,5%), pleura (9,2%). Bone metastases were most frequently osteoplastic, localized mainly in the vertebral column (19,7% of all carcinomas), pelvic bones (8,5%), ribs (8,5%). In 4 out of 118 cases of metastases to the vertebral column, a pathologic fracture was observed, this being much rarer than in metastases of a clear-cell carcinoma of the kidney (11,1%) when metastases are generally osteolytic.


Supramolecular polymerization: challenges and advantages of various methods in assessing the aggregation mechanism.
Oligothiophenes with branched alkyl end groups show distinct aggregation in organic solvents. The process of supramolecular polymerization is assessed by three different methods (UV-vis absorption and fluorescence emission spectroscopy and dynamic light scattering) to exclude artifacts. An apparent dependence of the degree of aggregation on the concentration of the oligomers is observed. Above the upper limit of concentration (a lower micromolar range for the present class of compounds), experimental data delivered conflicting results and the concentration should not therefore be exceeded. Scanning force microscopy and molecular dynamics simulations confirm the formation of one-dimensional aggregates with presumably helical arrangement of the achiral monomers.


Integrins and cadherins as therapeutic targets in fibrosis.
Fibrosis is the excessive deposition of extracellular matrix proteins into tissues leading to scar formation, disruption of normal tissue architecture and organ failure. Despite the large clinical impact of fibrosis, treatment options are limited. Adhesion molecules, in particular αvβ6 and α3β1 integrins and cadherin-11, have been demonstrated to be important mediators of tissue fibrosis. These data are reviewed here and provide the foundation for these molecules to be potential therapeutic targets for patients with fibrotic diseases.


Different eplet software programs give discordant and incorrect results: An analysis of HLAMatchmaker vs Fusion Matchmaker Eplet calling software.
HLA eplet matching is a novel approach to define acceptable HLA mismatches for transplant recipients. We performed an eplet analysis of three different transplant case-series to determine if the available software programs gave accurate results. Eplet analysis was performed for three different transplant case-series typed by NGS for all HLA class I and II loci. The three different HLA datasets were entered into both the HLAMatchmaker program (v2.1) and OLI Fusion MatchMaker (v4.2) software tools. Eplet results which were discordant were cross referenced against eplet registry and published HLA allele sequence data to determine the correct assignments. The comparison reveals that there was poor concordance between the two eplet programs. Analysis of the same donor/recipient pair often gave rise to different total eplet scores, incorrect eplet mismatches and antibody verification status, and both programs have eplets assigned to incorrect HLA alleles. Overall, the OLI Fusion MatchMaker eplet tool gave more accurate and useful eplet results. Eplet matching is still primarily a research tool. Before eplet matching can enter routine clinical practice further work is required to validate the accuracy of available eplet software programs. Incorrect eplet assignment could have serious adverse consequences in the clinical transplant setting.


Soft material adhesion characterization for in vivo locomotion of robotic capsule endoscopes: Experimental and modeling results.
The objective of this work is to validate an experimental method and nondimensional model for characterizing the normal adhesive response between a polyvinyl chloride based synthetic biological tissue substrate and a flat, cylindrical probe with a smooth polydimethylsiloxane (PDMS) surface. The adhesion response is a critical mobility design parameter of a Robotic Capsule Endoscope (RCE) using PDMS treads to provide mobility to travel through the gastrointestinal tract for diagnostic purposes. Three RCE design characteristics were chosen as input parameters for the normal adhesion testing: pre-load, dwell time and separation rate. These parameters relate to the RCE׳s cross sectional dimension, tread length, and tread speed, respectively. An inscribed central composite design (CCD) prescribed 34 different parameter configurations to be tested. The experimental adhesion response curves were nondimensionalized by the maximum stress and total displacement values for each test configuration and a mean nondimensional curve was defined with a maximum relative error of 5.6%. A mathematical model describing the adhesion behavior as a function of the maximum stress and total displacement was developed and verified. A nonlinear regression analysis was done on the maximum stress and total displacement parameters and equations were defined as a function of the RCE design parameters. The nondimensional adhesion model is able to predict the adhesion curve response of any test configuration with a mean R(2) value of 0.995. Eight additional CCD studies were performed to obtain a qualitative understanding of the impact of tread contact area and synthetic material substrate stiffness on the adhesion response. These results suggest that the nondimensionalization technique for analyzing the adhesion data is sufficient for all values of probe radius and substrate stiffness within the bounds tested. This method can now be used for RCE tread design optimization given a set of environmental conditions for device operation.


Handling agents and patients: representational cospeech gestures help children comprehend complex syntactic constructions.
Gesture is an important precursor of children's early language development, for example, in the transition to multiword speech and as a predictor of later language abilities. However, it is unclear whether gestural input can influence children's comprehension of complex grammatical constructions. In Study 1, 3- (M = 3 years 5 months) and 4-year-old (M = 4 years 6 months) children witnessed 2-participant actions described using the infrequent object-cleft-construction (OCC; It was the dog that the cat chased). Half saw an experimenter accompanying her descriptions with gestures representing the 2 participants and indicating the direction of action; the remaining children did not witness gesture. Children who witnessed gestures showed better comprehension of the OCC than those who did not witness gestures, both in and beyond the immediate physical context, but this benefit was restricted to the oldest 4-year-olds. In Study 2, a further group of older 4-year-old children (M = 4 years 7 months) witnessed the same 2-participant actions described by an experimenter and accompanied by gestures, but the gesture represented only the 2 participants and not the direction of the action. Again, a benefit of gesture was observed on subsequent comprehension of the OCC. We interpret these findings as demonstrating that representational cospeech gestures can help children comprehend complex linguistic structures by highlighting the roles played by the participants in the event.


A multiple-trainee, multiple-level, multiple-competency (multi-TLC) simulation-based approach to training obstetrical emergencies.
Competency-based education requires that programs increase the breadth of direct observation and assessment to improve resident training. To achieve these goals, the authors developed and executed a multiple-trainee, multiple-level, multiple-competency (Multi-TLC) obstetrical emergencies simulation curriculum. Depending upon their training level (PGY1-PGY5), obstetrics and gynaecology residents participated in various roles (i.e., first responder, second responder, confederates, and evaluators) within four simulation scenarios designed to provide opportunities for education, direct observation, and assessment across a number of competencies (i.e., medical expert, communicator, collaborator, leader, advocate, and scholar). The curriculum was carried out over 8 h spread evenly across 2 days (i.e., 4 h/day) and involved periods of pre-briefing, live simulation, and debriefing. An evaluation of the Multi-TLC was operationalised via a context-input-process-product model. This report presents the outcomes of that evaluation derived from quasi-experimental comparisons of the new and previous curricula across four priorities for simulation-based education identified by the Department of Obstetrics and Gynecology at McMaster University (Hamilton, ON, Canada): increasing learning opportunities, maintaining or improving resident learning, maintaining or reducing program costs, and improving resident satisfaction. The evaluation revealed that the Multi-TLC curriculum permitted a greater breadth of direct observation and assessment across competencies, maintained the previous learning objectives while also addressing additional ones, and was done so in a way that reduced the overall financial and human resource costs associated with the department's obstetrical emergency simulation curriculum. A Multi-TLC organisation of simulation curricula can facilitate efficient application of competency-based education principles.


[The use of eurespal for the treatment of chronic laryngitis].
The author provides a rationale for the use of eurespal for the treatment of chronic laryngitis based on the pathogenetic concept of pathological condition. The results of a clinical study designed to evaluate the efficiency and safety of eurespal therapy in patients with chronic laryngitis are presented.


Ameliorative Effects of Testosterone Administration on Renal Redox Homeostasis in Naturally Aged Rats.
Testosterone biosynthesis gradually decreases with age. Impaired redox homeostasis-related oxidative damage in cellular macromolecules has a high risk for the development of renal insufficiency. Our aim was to study the effects of testosterone replacement therapy on redox homeostasis. We investigated various oxidative damage biomarkers in kidney. Experimental animals were separated into three groups-naturally aged rats, testosterone-administered naturally aged rats (single dose of 25 mg/kg testosterone enanthate), and their respective young controls. Our results showed that the testosterone-administered naturally aged group shared significant similarities with the young rats with respect to their redox status. In testosterone-administered naturally aged rats, kynurenine, protein carbonyl, advanced oxidation protein products, lipid peroxidation markers, and xanthine oxidase activities were significantly lower and Cu-Zn superoxide dismutase activities and testosterone levels were higher than naturally aged rats. In testosterone-administered naturally aged rats, catalase activities, ferric reducing anti-oxidant power, and testosterone levels were significantly lower and dityrosine, N-formyl kynurenine, protein carbonyl, and protein hydroperoxides were significantly higher than in young rats. On the other hand, in naturally aged rats, Cu-Zn superoxide dismutase, catalase activities, ferric reducing anti-oxidant power, and testosterone levels were lower and dityrosine, kynurenine, protein carbonyl, protein hydroperoxide, advanced oxidation protein products, lipid peroxidation markers, advanced glycation end products, and xanthine oxidase activities were higher than controls. Our results showed that a single dose of testosterone administration has a positive effect on the redox status of the aged kidney. Future studies are needed to clarify the exact molecular mechanism(s) involved in the action of testosterone in maintaining kidney redox homeostasis.