Sea surface temperature variability: patterns and mechanisms.
Patterns of sea surface temperature (SST) variability on interannual and longer timescales result from a combination of atmospheric and oceanic processes. These SST anomaly patterns may be due to intrinsic modes of atmospheric circulation variability that imprint themselves upon the SST field mainly via surface energy fluxes. Examples include SST fluctuations in the Southern Ocean associated with the Southern Annular Mode, a tripolar pattern of SST anomalies in the North Atlantic associated with the North Atlantic Oscillation, and a pan-Pacific mode known as the Pacific Decadal Oscillation (with additional contributions from oceanic processes). They may also result from coupled ocean-atmosphere interactions, such as the El Niño-Southern Oscillation phenomenon in the tropical Indo-Pacific, the tropical Atlantic Niño, and the cross-equatorial meridional modes in the tropical Pacific and Atlantic. Finally, patterns of SST variability may arise from intrinsic oceanic modes, notably the Atlantic Multidecadal Oscillation.


[The effect of hot air sterilization on the sharpness of bone knives].
The cutting edge of a bone-knife was examined with a Raster Electron Microscope before, after one and after six cycles of hot-air-sterilisation. No changes could be observed and no loss of sharpness was evident. Thus, sterilisation of unsterile but unused bone-knives is possible without impairment of sharpness.


Community or patient preferences for cost-effectiveness of cardiac rehabilitation: does it matter?
Few healthcare economic evaluations, and none in cardiac rehabilitation, report results based on both community and patient preferences for health outcomes. We published the results of a randomized trial of cardiac rehabilitation after myocardial infarction in 1994 in which preferences were measured using both perspectives but only patient preferences were reported. This secondary analysis uses both types of preference measurements. We collected community Quality of Well-Being (QWB) and patient Time Trade-off (TTO) preference scores from 188 patients (rehabilitation, n=93; usual care, n=95) on entry into the trial, at 2 months (end of the intervention) and again at 4, 8, and 12 months. Mean preference scores over the 12-month follow-up study period, estimates of quality-adjusted life years (QALYs) gained per patient, incremental cost-effectiveness ratios [costs inflated to 2006 US dollars] and probabilities of the cost-effectiveness of rehabilitation for costs per QALY up to USD100,000 are reported. Mean QWB preference scores were lower (P<0.01) than the corresponding mean TTO preference scores at each assessment point. The 12-month changes in mean QWB and TTO preference scores were large and positive (P<0.001) with rehabilitation patients gaining a mean of 0.011 (95% confidence interval, -0.030 to +0.052) more QWB-derived QALYs, and 0.040 (-0.026, 0.107) more TTO-derived QALYs, per patient than usual care patients. The incremental cost-effectiveness ratio for QWB-derived QALYs was estimated at $60 270/QALY (about euro50 600/QALY) and at $16 580/QALY (about euro13 900/QALY) with TTO-derived QALYs. With a willingness to spend $100 000/QALY, the probability of rehabilitation being cost-effective is 0.58 for QWB-derived QALYs and 0.83 for TTO-derived QALYs. This secondary analysis of data from a randomized trial indicates that cardiac rehabilitation is cost-effective from a community perspective and highly cost-effective from the perspective of patients.


Acute nonoliguric renal failure in the postoperative patient.
Fourteen patients with acute nonoliguric renal failure have been studied during the past 3 years. The mortality rate was 7% and the complication rate was 21%. Early recognition of the nonoliguric state and its maintenance with adequate volume replacement should decrease the mortality rate in postoperative acute renal failure. Reasons for the decrease in septic complications among this group of patients are not clear, but the absence of septic complications appears to be the major reason for the decreased morbidity and mortality in these patients.


Clinical comparison of tardive and idiopathic cervical dystonia.
It has been suggested that tardive cervical dystonia may be clinically indistinguishable from the idiopathic form and that the diagnosis rests solely on documenting an exposure to dopamine antagonist medications. To investigate this, we performed a retrospective evaluation of patient records on 102 patients with idiopathic and 20 patients with tardive cervical dystonia seen in our Movement Disorder Clinic over the past 8 years. Several clinical and demographic variables were compared and a number of differences were observed. The presence of extracervical involvement, retrocollis, and spasmodic head movements were individually found to be predictive of tardive cervical dystonia. Torticollis, laterocollis, and trick maneuvers were predictive of idiopathic cervical dystonia. Head tremor (42.2%) and family history of dystonia (9.8%) were present only in the idiopathic group. Cervical muscle hypertrophy was significantly more common in the idiopathic group (100% versus 75%). No difference was found between the two groups in their response to treatment with botulinum toxin A. These results indicate that clinical differences between idiopathic and tardive cervical dystonia exist. These differences may help to distinguish them in the clinical setting, improve diagnostic accuracy, and support the existence of a causal relationship between exposure to dopamine antagonist medications and chronic dystonia.


Simulated annealing and weight decay in adaptive learning: the SARPROP algorithm.
A problem with gradient descent algorithms is that they can converge to poorly performing local minima. Global optimization algorithms address this problem, but at the cost of greatly increased training times. This work examines combining gradient descent with the global optimization technique of simulated annealing (SA). Simulated annealing in the form of noise and weight decay is added to resiliant backpropagation (RPROP), a powerful gradient descent algorithm for training feedforward neural networks. The resulting algorithm, SARPROP, is shown through various simulations not only to be able to escape local minima, but is also able to maintain, and often improve the training times of the RPROP algorithm. In addition, SARPROP may be used with a restart training phase which allows a more thorough search of the error surface and provides an automatic annealing schedule.


Plk1 regulates both ASAP localization and its role in spindle pole integrity.
Bipolar spindle formation is essential for faithful chromosome segregation at mitosis. Because centrosomes define spindle poles, abnormal number and structural organization of centrosomes can lead to loss of spindle bipolarity and genetic integrity. ASAP (aster-associated protein or MAP9) is a centrosome- and spindle-associated protein, the deregulation of which induces severe mitotic defects. Its phosphorylation by Aurora A is required for spindle assembly and mitosis progression. Here, we show that ASAP is localized to the spindle poles by Polo-like kinase 1 (Plk1) (a mitotic kinase that plays an essential role in centrosome regulation and mitotic spindle assembly) through the γ-TuRC-dependent pathway. We also demonstrate that ASAP is a novel substrate of Plk1 phosphorylation and have identified serine 289 as the major phosphorylation site by Plk1 in vivo. ASAP phosphorylated on serine 289 is localized to centrosomes during mitosis, but this phosphorylation is not required for its Plk1-dependent localization at the spindle poles. We show that phosphorylated ASAP on serine 289 contributes to spindle pole stability in a microtubule-dependent manner. These data reveal a novel function of ASAP in centrosome integrity. Our results highlight dual ASAP regulation by Plk1 and further confirm the importance of ASAP for spindle pole organization, bipolar spindle assembly, and mitosis.


Patient risk factors for adverse drug events in hospitalized patients. ADE Prevention Study Group.
Adverse drug events (ADEs) are common in hospitalized patients, but few empirical data are available regarding the strength of patient risk factors for ADEs. We performed a nested case-control study within a cohort that included 4108 admissions to a stratified random sample of 11 medical and surgical units in 2 tertiary care hospitals during a 6-month period. Analyses were conducted on 2 levels: (1) using a limited set of variables available for all patients using computerized data available from 1 hospital and (2) using a larger set of variables for the case patients and matched controls from both hospitals. Case patients were patients with an ADE, and the matched control for each case patient was the patient on the same unit as the case patient with the most similar prevent length of stay. Main outcome measures were presence of an ADE, preventable ADE, or severe ADE. In the cohort analysis, electrolyte concentrates (odds ratio [OR], 1.7), diuretics (OR, 1.7), and medical admission (OR, 1.6) were independent correlates of ADEs. Independent correlates of preventable ADEs in the cohort analysis were low platelet count (OR, 4.5), antidepressants (OR, 3.3), antihypertensive agents (OR, 2.9), medical admission (OR, 2.2), and electrolyte concentrates (OR, 2.1). In the case-control analysis, exposure to psychoactive drugs (OR, 2.1) was an independent correlate of an ADE, and use of cardiovascular drugs (OR, 2.4) was independently correlated with severe ADEs. For preventable ADEs, no independent predictors were retained after multivariate analysis. Adverse drug events occurred more frequently in sicker patients who stayed in the hospital longer. However, after controlling for level of care and preevent length of stay, few risk factors emerged. These results suggest that, rather than targeting ADE-prone individuals, prevention strategies should focus on improving medication systems.


Using visual methods to uncover context.
The accurate assessment of physical activity and dietary intake is essential for assessing the relationships between physical activity, dietary intake, and health outcomes. However, the measurement of physical activity and dietary intake among women, particularly minority women, poses unique challenges related to gender, ethnicity, and social context. Measures that are not culturally relevant or sensitive to the experiences, traditions, or beliefs of ethnically diverse women might result in data that are unreliable, or which cannot be interpreted. Visual methods show promise for elucidating concepts that are important to refine established measures for assessing dietary intake and physical activity in diverse ethnic groups. Hispanic women, a largely understudied subgroup that experiences long-term health risks associated with dietary and physical activity behaviors, serves as the focal group for this discussion of the potential for visual methods to develop culturally and contextually relevant and valid approaches to outcome assessment.


18 GHz electromagnetic field induces permeability of Gram-positive cocci.
The effect of electromagnetic field (EMF) exposures at the microwave (MW) frequency of 18 GHz, on four cocci, Planococcus maritimus KMM 3738, Staphylococcus aureus CIP 65.8(T), S. aureus ATCC 25923 and S. epidermidis ATCC 14990(T), was investigated. We demonstrate that exposing the bacteria to an EMF induced permeability in the bacterial membranes of all strains studied, as confirmed directly by transmission electron microscopy (TEM), and indirectly via the propidium iodide assay and the uptake of silica nanospheres. The cells remained permeable for at least nine minutes after EMF exposure. It was shown that all strains internalized 23.5 nm nanospheres, whereas the internalization of the 46.3 nm nanospheres differed amongst the bacterial strains (S. epidermidis ATCC 14990(T) ~ 0%; Staphylococcus aureus CIP 65.8(T) S. aureus ATCC 25923, ~40%; Planococcus maritimus KMM 3738, ~ 80%). Cell viability experiments indicated that up to 84% of the cells exposed to the EMF remained viable. The morphology of the bacterial cells was not altered, as inferred from the scanning electron micrographs, however traces of leaked cytosolic fluids from the EMF exposed cells could be detected. EMF-induced permeabilization may represent an innovative, alternative cell permeability technique for applications in biomedical engineering, cell drug delivery and gene therapy.


Cerebrospinal fluid drainage as influenced by ventricular pressure in the rabbit.
Artificial cerebrospinal fluid (CSF) containing radioisotope iodinated (125I) serum albumin (RISA) and either blue dextran or indigo carmine was given to white New Zealand rabbits over 4 hours. In one group it was given by ventriculocisternal perfusion, in one by ventricular infusion, and in one by cisterna magna infusion. Blood was sampled continuously from the superior sagittal sinus (SSS) or intermittently from the systemic arterial circulation. Removal of CSF from the cisterna magna during the ventriculocisternal perfusion kept the intracranial pressure (ICP) at 0 to 5 torr, whereas ventricular or cisterna magna infusion raised the ICP to 20 to 30 torr and 15 to 20 torr, respectively. In the two groups with raised ICP, an increased concentration of RISA was present in the optic nerves, olfactory bulbs, episcleral tissue, and deep cervical lymph nodes; but this was not found in the group with normal ICP. In all three groups, the concentration of RISA in the SSS blood was the same as in the systemic arterial blood. The concentration gradient of RISA across the cerebral cortex was similar in both the ventriculocisternal perfusion and the ventricular infusion groups. With cisterna magna infusion, the concentration of RISA was the same on the cortical surface and less in the ventricles compared with the ventricular infusion. It is concluded that, with elevated ICP, CSF drained via pathways that are less evident under normal pressure. Drainage of CSF was similar irrespective of whether the infusion site was the ventricles or cisterna magna. It did not appear that acute dilatation of the ventricles during ventricular infusion compromised the subarachnoid space over the surface of the hemisphere, as the concentration of RISA on the convexities and in the SSS blood did not significantly differ between the groups. Transcortical bulk transfer of CSF was not evident with raised ICP.


Age and the association between apolipoprotein E genotype and Alzheimer disease: A cerebrospinal fluid biomarker-based case-control study.
The ε4 allele of apolipoprotein E (APOE) gene and increasing age are two of the most important known risk factors for developing Alzheimer disease (AD). The diagnosis of AD based on clinical symptoms alone is known to have poor specificity; recently developed diagnostic criteria based on biomarkers that reflect underlying AD neuropathology allow better assessment of the strength of the associations of risk factors with AD. Accordingly, we examined the global and age-specific association between APOE genotype and AD by using the A/T/N classification, relying on the cerebrospinal fluid (CSF) levels of β-amyloid peptide (A, β-amyloid deposition), phosphorylated tau (T, pathologic tau), and total tau (N, neurodegeneration) to identify patients with AD. This case-control study included 1,593 white AD cases (55.4% women; mean age 72.8 [range = 44-96] years) with abnormal values of CSF biomarkers from nine European memory clinics and the American Alzheimer's Disease Neuroimaging Initiative (ADNI) study. A total of 11,723 dementia-free controls (47.1% women; mean age 65.6 [range = 44-94] years) were drawn from two longitudinal cohort studies (Whitehall II and Three-City), in which incident cases of dementia over the follow-up were excluded from the control population. Odds ratio (OR) and population attributable fraction (PAF) for AD associated with APOE genotypes were determined, overall and by 5-year age categories. In total, 63.4% of patients with AD and 22.6% of population controls carried at least one APOE ε4 allele. Compared with non-ε4 carriers, heterozygous ε4 carriers had a 4.6 (95% confidence interval 4.1-5.2; p < 0.001) and ε4/ε4 homozygotes a 25.4 (20.4-31.2; p < 0.001) higher OR of AD in unadjusted analysis. This association was modified by age (p for interaction < 0.001). The PAF associated with carrying at least one ε4 allele was greatest in the 65-70 age group (69.7%) and weaker before 55 years (14.2%) and after 85 years (22.6%). The protective effect of APOE ε2 allele for AD was unaffected by age. Main study limitations are that analyses were based on white individuals and AD cases were drawn from memory centers, which may not be representative of the general population of patients with AD. In this study, we found that AD diagnosis based on biomarkers was associated with APOE ε4 carrier status, with a higher OR than previously reported from studies based on only clinical AD criteria. This association differs according to age, with the strongest effect at 65-70 years. These findings highlight the need for early interventions for dementia prevention to mitigate the effect of APOE ε4 at the population level.


Patient empowerment by the means of citizen-managed Electronic Health Records: web 2.0 health digital identity scenarios.
With the advent of more sophisticated and comprehensive healthcare information systems, system builders are becoming more interested in patient interaction and what he can do to help to improve his own health care. Information systems play nowadays a crucial and fundamental role in hospital work-flows, thus providing great opportunities to introduce and improve upon "patient empowerment" processes for the personalization and management of Electronic Health Records (EHRs). In this paper, we present a patient's privacy generic control mechanisms scenarios based on the Extended OpenID (eOID), a user centric digital identity provider previously developed by our group, which leverages a secured OpenID 2.0 infrastructure with the recently released Portuguese Citizen Card (CC) for secure authentication in a distributed health information environment. eOID also takes advantage of Oauth assertion based mechanisms to implement patient controlled secure qualified role based access to his EHR, by third parties.


Imaging of stroke: a comparison between X-ray fluorescence and magnetic resonance imaging methods.
A dual imaging approach, combining magnetic resonance imaging to localize lesions and synchrotron rapid scanning X-ray fluorescence (XRF) mapping to localize and quantify calcium, iron and zinc was used to examine one case of recent stroke with hemorrhage and two cases of ischemia 3 and 7 years before death with the latter showing superficial necrosis. In hemorrhagic lesions, more Fe is found accompanied with less Zn. In chronic ischemic lesions, Fe, Zn and Ca are lower indicating that these elements are removed as the normal tissue dies and scar tissue forms. Both susceptibility and T2* maps were calculated to visualize iron in hemorrhages and validated by XRF Ca and Fe maps. The former was superior for imaging iron in hemorrhagic transformation and necrosis but did not capture ischemic lesions. In contrast, T2* could not differentiate Ca from Fe in necrotic tissue but did capture ischemic lesions, complementing the susceptibility mapping. The spatial localization, accurate quantitative data and elemental differentiation shown here could also be valuable for imaging other brain tissue damage with abnormal Ca and Fe content.


Motor asymmetry reduction in older adults.
While cerebral lateralization has previously been well documented for many neurobehavioral functions, recent research has shown that as people age, formerly lateralized processes recruit more symmetric patterns of neural activity. Such findings provide the foundation for the model of hemispheric asymmetry reduction in older adults, or "HAROLD"[4]. Previous studies that have measured reaction time and movement time have suggested that aging does not affect manual asymmetries. However, whether these findings can be extended to kinematic variables associated with motor coordination remains largely unknown. The purpose of the current study is to determine whether asymmetries in intralimb coordination are also reduced during the aging process. We examined multidirectional reaching in two different right handed age groups, a younger group from 20 to 40 years of age, and an older group, from 60 to 80 years of age. Measures of final position accuracy, precision, and trajectory linearity showed robust asymmetries between the left and right arm groups of young adults. However, the trajectories and accuracies of the older subjects were symmetric, such that our dependent measures were not significantly different between the right and left arm groups. Our findings extend the HAROLD model to motor behavior, suggesting that aging results in decrements in motor lateralization.


Late results after unicoronal craniosynostosis correction.
The authors report nine patients with unicoronal synostosis who were treated with the same surgical protocol and who now have reached skeletal maturity. These patients all underwent surgery at the Australian Craniofacial Unit during a 2-year period by one of two craniofacial surgeons and one of two neurosurgeons. The operative procedure in all of these cases was the same technique, in which there was unilateral advancement of the affected side. No cases required reoperation; however, one case subsequently required revision of the coronal scar, and two cases required strabismus correction. All cases were reviewed to evaluate patient results by the clinical staff; recent photographs at skeletal maturity also were reviewed. Two patients had adult computed tomography scans available for skeletal assessment, and one additional patient had undergone serial computed tomography scans during childhood. The patients also completed an anonymous questionnaire to ascertain their assessment of their appearance. The results of the clinical and radiologic assessments and questionnaire suggest that the operative procedure undertaken in these cases has produced satisfactory results in the long term, with few individuals requiring (or even considering) additional surgery, despite some persistent asymmetry.


[Systemic chemotherapy with cisplatin, methotrexate, and vinblastine, and bladder preservation in T2/T3a bladder cancer].
We are currently witnessing a lively controversy over which should be the optimal treatment for patients with infiltrant urothelial carcinoma with muscle location (stage B Jewett's Grading or T2-T3 on the TNM Rating Scale, UICC 1992). This paper reports a randomized, prospective study in 37 patients with T2-T3a tumours. Arm A (n = 20) received systemic chemotherapy with cisplatin, methotrexate and vinblastine (CMV) after TUR, and was carefully followed aiming for vesical preservation. Arm B (n = 17) was given chemotherapy with CMV after TUR and then underwent cystectomy. Disease-free survival at 5 years for the overall series is 69%, 47% for group A and 88% for group B (log-rank, p = 0.14). No statistically significant differences in survival were detected relative to age (under or over 65 years), growth patterns (papillary or plain), histological grade (G2 or G3), and size (smaller or greater than 5 cm). Survival was different depending on the clinical suspicion of nodular involvement (log-rank, p < 0.001). In summary, although the number of patients in the series does not allow to draw conclusions in terms of statistical significance, there is enough evidence to consider that vesical preservation based on TUR and systemic chemotherapy as definitive treatment is a dangerous option without the good survival rates achieved by T2/T3a patients undergoing cystectomy.


Carotid artery stent placement for atherosclerotic disease: rationale, technique, and current status.
Carotid arterial endarterectomy is considered to be the standard for the treatment of atherosclerotic carotid arterial occlusive disease. This has been validated with results of several randomized controlled trials in which its effectiveness has been demonstrated over that of the best nonsurgical therapy. In the past several years, however, carotid angioplasty with stent placement has emerged as a potential alternative to carotid endarterectomy. This article represents a critical examination of the rationale for carotid revascularization; the history of endovascular techniques for the treatment of carotid atherosclerosis, beginning with balloon angioplasty and evolving to the use of stents; and the evidence supporting the effectiveness of the endovascular approach. A brief description of the current technical aspects of carotid artery stent placement is presented. The future status of the endovascular approach will be determined with randomized trials in which carotid artery stent placement is directly compared with endarterectomy, as well as by the potential for further innovation and improvement in endovascular devices, technique, and safety.


Education at the Dittrick Museum of Medical History, Case Western Reserve University, Cleveland, Ohio, USA.
The Dittrick Museum of Medical History pursues an educational mission as being part of a major research university. While the Dittrick dates to 1899 as a historical committee of the Cleveland Medical Library Association, it first affiliated with Case Western Reserve University in 1966, and became a department of the College of Arts and Sciences of CWRU in 1998. The Dittrick maintains a museum exhibition gallery that is open to the public free of charge, and museum staff provide guided tours on appointment. Much of the teaching and instruction at the Dittrick is conducted by university professors; their classes meet in the museum and use museum resources in the form of artifacts, images, archives, and rare books. Class projects using Dittrick collections may take the form of research papers, exhibitions, and online presentations. Dittrick staff assist in these classes and are available to help researchers use museum resources.


Bioengineered periodontal tissue formed on titanium dental implants.
The ability to use autologous dental progenitor cells (DPCs) to form organized periodontal tissues on titanium implants would be a significant improvement over current implant therapies. Based on prior experimental results, we hypothesized that rat periodontal ligament (PDL)-derived DPCs can be used to bioengineer PDL tissues on titanium implants in a novel, in vivo rat maxillary molar implant model. Analyses of recovered implants revealed organized PDL tissues surrounding titanium implant surfaces in PDL-cell-seeded, and not in unseeded control, implants. Rat PDL DPCs also exhibited differentiative potential characteristic of stem cells. These proof-of-principle findings suggest that PDL DPCs can organize periodontal tissues in the jaw, at the site of previously lost teeth, indicating that this method holds potential as an alternative approach to osseointegrated dental implants. Further refinement of this approach will facilitate the development of clinically relevant methods for autologous PDL regeneration on titanium implants in humans.


Recombinant human thyroid peroxidase expressed in insect cells is soluble at high concentrations and forms diffracting crystals.
Human thyroid peroxidase (TPO), the key enzyme in thyroid hormone synthesis, can be produced in active form in the High Five insect cell line and when purified from the cell culture medium is soluble at concentrations of up to 18 mg/ml. This contrasts to a recent report in which human TPO produced in insect cells was found to be insoluble at high concentrations. Our concentrated TPO grows trigonal trapezohedral crystals of up to 0.5 mm in length in a vapour diffusion apparatus using polyethelene glycol as a precipitant. The crystals diffract X-rays to a 6 A resolution and the diffraction data from the crystals have been analysed giving unit cell dimensions. A potential molecular replacement solution has been identified using myeloperoxidase (MPO) as a phasing model.


One-year clinical outcome of dental implants placed in patients with type 2 diabetes mellitus: a case series.
Diabetes mellitus is a prevalent medical disorder. It is often accompanied with systemic adverse sequelae, such as wound healing alterations, which may affect osseointegration of dental implants. The use of dental implants in patients with diabetes mellitus remains controversial because altered bone healing around implants has been reported. The purpose of this study was to present 1-year clinical outcomes of 23 implants placed in 10 patients with well-, or moderately well, controlled type 2 diabetes mellitus. All implants were uneventfully placed in the mandible or maxilla. Three different types of definitive implant-supported prostheses, cement- or screw-retained fixed dental prostheses, and overdentures were delivered to the patients. At 1-year follow-up recall, no implants were lost, and 0.3 +/- 0.2 mm marginal bone loss was noted. No periapical radiolucencies, no bleeding on probing, or pathologic probing depth were recorded at these recalls. This clinical report supports the use of dental implants in patients with well-, or moderately well, controlled type 2 diabetes mellitus as a dental treatment modality. No evidence of diminished clinical success or significant complication related to implant treatment was found for this patient population.


Characterization of the polydnaviral 'T. rostrale virus' (TrV) gene family: TrV1 expression inhibits in vitro cell proliferation.
Tranosema rostrale ichnovirus (TrIV) is a polydnavirus (PDV) transmitted by the endoparasitic wasp T. rostrale to its host Choristoneura fumiferana during oviposition. PDV genes are expressed in infected caterpillars, causing physiological disturbances that promote the survival of the developing endoparasite. The previously sequenced genome of TrIV contains ~86 genes organized in multigene families and distributed on multiple segments of circular dsDNA. Among these, the 'T. rostrale virus' (TrV) family comprises seven genes that are absent in other PDV genomes examined to date and whose function(s) remain(s) unknown. Here, we initiated a functional analysis of the TrV family using qPCR, transfection and RNAi approaches. TrV family genes were weakly expressed in wasp ovaries, but some displayed high transcript abundance in parasitized caterpillars. Whilst TrV1 was the most highly transcribed TrV gene in infected caterpillars, transcript levels for TrV5 and TrV6 were nearly undetectable, indicating that they may be pseudogenes. Temporal and tissue-specific patterns of transcript abundance were similar for all expressed TrV family genes, indicative of an apparent lack of difference in function or tissue specificity. Infection of Cf-203 and Sf-21 insect cells with TrIV led to a dose-dependent inhibition of cell proliferation with no sign of apoptosis. Whilst similar inhibition was observed following transfection of cells with a cloned genome segment carrying the TrV1 gene, RNA interference targeting TrV1 largely restored cell growth in TrIV-infected cells, indicating that TrV1 expression was responsible for the observed inhibition. We suggest that TrV genes may contribute to host developmental disruption by interfering with host-cell proliferation during parasitism.


Erythrocyte membrane microviscosity and phospholipid composition in lead workers.
The microviscosity and fluidity of erythrocyte ghost membranes from lead workers and control subjects was measured by fluorescence polarisation using the fluorophore, 1,6-diphenyl-1,3,5-hexatriene (DPH). Increased lead was associated with a significant decrease in the average microviscosity of resealed and unsealed erythrocyte membranes. Since DPH fluorescence reflects the organisation of lipids in the central core of the membrane, two aspects of phospholipid metabolism were investigated. Phospholipids were extracted from red blood cell ghost membranes and identified by high performance liquid chromatography. The ratio of phosphatidyl choline to phosphatidyl ethanolamine, an established correlate of membrane fluidity, was significantly increased in lead workers. This is attributed to the known increases in red blood cell cholesterol in lead workers and the structural incompatibility of phosphatidyl ethanolamine and cholesterol, which result in a compensatory increase of phosphatidyl choline. Erythrocyte ghost membranes from control subjects were resealed with the intermediates in phospholipid synthesis that increase with a lead inhibited decrease in red blood cell pyrimidine 5'-nucleotidase. Membrane fluidity was not modified by incubation with cytidine triphosphate, uridine triphosphate, cytidine diphosphate choline, or cytidine diphosphate ethanolamine. Alterations in the microviscosity of the lipid regions of the hydrophobic core of the erythrocyte membrane bilayer and in the phospholipid composition of the membrane may be defects which contribute to the clinical and biochemical instability of the red blood cell on exposure to lead.


β-Sitosterol Shows Potential to Protect Against the Development of High-Fructose Diet-Induced Metabolic Dysfunction in Female Rats.
Metabolic syndrome (MetS) is a combination of risk factors that include insulin resistance, obesity, dyslipidemia, and hypertension. The consumption of high-fructose diets contributes to the development of MetS. β-sitosterol a naturally occurring phytosterol possesses antiobesogenic and antidiabetic effects. This study evaluated the potential protective effect of β-sitosterol against the development of metabolic dysfunction in growing female rats fed a high-fructose diet, mimicking children fed obesogenic diets. Thirty-five 21-day-old female Sprague Dawley rat pups were randomly allocated to and administered the following treatments: group 1-standard rat chow (SRC) + plain drinking water (PW) + plain gelatine cube (PC); group 2-SRC + 20% w/w fructose solution (FS) as drinking fluid + PC; group 3-SRC + FS + 100 mg/kg fenofibrate in gelatine cubes; group 4-SRC + FS + 20 mg/kg β-sitosterol gelatine cube (Bst); and group 5-SRC + PW + Bst. Following 12 weeks of feeding, the rats were fasted overnight, weighed, and then euthanized. Plasma cholesterol, insulin, glucose, triglyceride, and adiponectin concentrations were determined. Visceral fat was dissected out and weighed. The high-fructose diet increased (P < .05) visceral adiposity and plasma triglyceride concentration but decreased (P < .05) plasma adiponectin concentration. β-sitosterol prevented the high-fructose diet-induced visceral obesity, hypertriglyceridemia, and hypoadiponectinemia. β-sitosterol alone increased plasma adiponectin concentration and reduced plasma insulin concentration and homeostatic model assessment index. In conclusion, β-sitosterol could be potentially used to prevent high-fructose diet-induced metabolic dysfunction.


Urinary Bladder Matrix Does Not Improve Tenogenesis in an In Vitro Equine Model.
Extracellular matrix (ECM) is responsible for tendon strength and elasticity. Healed tendon ECM lacks structural integrity, leading to reinjury. Porcine urinary bladder matrix (UBM) provides a scaffold and source of bioactive proteins to improve tissue healing, but has received limited attention for treating tendon injuries. The objective of this study was to evaluate the ability of UBM to induce matrix organization and tenogenesis using a novel in vitro model. We hypothesized that addition of UBM to tendon ECM hydrogels would improve matrix organization and cell differentiation. Hydrogels seeded with bone marrow cells (n = 6 adult horses) were cast using rat tail tendon ECM ± UBM, fixed under static tension and harvested at 7 and 21 days for construct contraction, cell viability, histology, biochemistry, and gene expression. By day 7, UBM constructs contracted significantly from baseline, whereas control constructs did not. Both control and UBM constructs contracted significantly by day 21. In both groups, cells remained viable over time and changed from round and randomly oriented to elongated along lines of tension with visible compaction of the ECM. There were no differences over time or between treatments for nuclear aspect ratio, DNA, or glycosaminoglycan content. Decorin, matrix metalloproteinase 13, and scleraxis expression increased significantly over time, but not in response to UBM treatment. Mohawk expression was constant over time. Cartilage oligomeric matrix protein expression decreased over time in both groups. Using a novel ECM hydrogel model, substantial matrix organization and cell differentiation occurred; however, the addition of UBM failed to induce greater matrix organization than tendon ECM alone. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 37:1848-1859, 2019.


A cluster of immunoresolvents links coagulation to innate host defense in human blood.
Blood coagulation is a protective response that prevents excessive bleeding upon blood vessel injury. We investigated the relationship between coagulation and the resolution of inflammation and infection by lipid mediators (LMs) through metabololipidomics-based profiling of human whole blood (WB) during coagulation. We identified temporal clusters of endogenously produced prothrombotic and proinflammatory LMs (eicosanoids), as well as specialized proresolving mediators (SPMs). In addition to eicosanoids, a specific SPM cluster was identified that consisted of resolvin E1 (RvE1), RvD1, RvD5, lipoxin B4, and maresin 1, each of which was present at bioactive concentrations (0.1 to 1 nM). Removal of adenosine from the coagulating blood markedly enhanced the amounts of SPMs produced and further increased the biosynthesis of RvD3, RvD4, and RvD6. The cyclooxygenase inhibitors celecoxib and indomethacin, which block the production of thromboxanes and prostanoids, did not block the production of clot-driven SPMs. Unbiased mass cytometry analysis demonstrated that the SPM cluster produced in human blood targeted leukocytes at the single-cell level, directly activating ERK and CREB signaling in neutrophils and CD14+ monocytes. Treatment of human WB with the components of this SPM cluster enhanced both the phagocytosis and killing of Escherichia coli by leukocytes. Together, these data identify a proresolving LM circuit, including endogenous molecular brakes and accelerators, which promoted host defense. These temporal LM-SPM clusters can provide accessible metabolomic profiles for precision and personalized medicine.


Patterning of nano-scale arrays by table-top extreme ultraviolet laser interferometric lithography.
Arrays of nanodots were directly patterned by interferometric lithography using a bright table-top 46.9 nm laser. Multiple exposures with a Lloyd's mirror interferometer allowed to print arrays of 60 nm FWHM features. This laser-based extreme ultraviolet interferometric technique makes possible to print different nanoscale patterns using a compact table-top set up.


Cloning of a novel protein overexpressed in human mammary carcinoma.
A novel Mr 150,000 protein (p150), which was found to be preferentially expressed in virally and oncogene transformed mouse cells, was partially purified, and the cDNA was cloned. p150 is the largest member of a putative protein family, the molecular function of which is as yet unknown. Its pattern of expression correlates well not only with transformation but also with the dedifferentiated state of several mouse cell lines and cells. Furthermore, human breast carcinoma specimens and normal tissue from the same breast were screened for the presence of the p150 antigen. In all carcinoma samples, Western blotting revealed higher p150 expression levels than that in control tissue from the same patient. Immunohistochemical analyses of the same specimens displayed specific staining of the carcinoma cells.


Comparisons of Postoperative Complications and Nutritional Status After Proximal Laparoscopic Gastrectomy with Esophagogastrostomy and Double-Tract Reconstruction.
The purpose of this study was to compare postoperative complications and nutritional status between esophagogastrostomy and double-tract reconstruction in patients who underwent laparoscopic proximal gastrectomy, and assess the advantages of both surgical procedures. Between 2010 and 2018, 47 cases underwent proximal gastrectomy with esophagogastrostomy (n = 23) or double-tract reconstruction (n = 24) at our institution for the treatment of clinical T1N0 adenocarcinoma located in the upper third of the stomach. Patient clinical characteristics, short-term outcomes, nutrition status, and skeletal muscle index were compared among the two groups. There was no significant difference between esophagogastrostomy and double-tract reconstruction in terms of operation time, blood loss, and length of postoperative hospital stay. Reflux symptoms and anastomotic stenosis were significantly higher in the esophagogastrostomy group compared with the double-tract reconstruction group (P < 0.001 and P = 0.004, respectively). There was no significant difference in anastomotic leakage, surgical site infection, and pancreatic fistula. For the nutritional status, the decrease rate of cholinesterase was significantly higher in the esophagogastrostomy group compared with the double-tract reconstruction group at 6 months (P = 0.008) There was no significant difference in the decrease rate of skeletal muscle mass index at 1 year after surgery. Compared with esophagogastrostomy, double-tract reconstruction tends to have better short-term nutritional status and postoperative outcomes in terms of preventing the occurrence of gastroesophageal reflux and anastomosis stenosis. These findings suggest that double-tract reconstruction may be a useful method in laparoscopic proximal gastrectomy.


Cellular profiles in asthmatic airways: a comparison of induced sputum, bronchial washings, and bronchoalveolar lavage fluid.
Analysis of bronchoalveolar lavage fluid has improved our understanding of the pathogenesis of asthma. Safety issues and access to expert resources limit this techniques as a research tool. Induced sputum is a non-invasive method of collecting airway fluid which is applicable to subjects with a range of severity of airflow obstruction. The method of sputum collection and processing differs between groups. A study was undertaken to compare induced sputum with bronchoscopically collected fluid. Sixteen patients with mild stable asthma underwent both sputum induction and bronchoscopic examination with bronchial washings and bronchoalveolar lavage (BAL) in random order, with each procedure being separated by an interval of 12 days. Airway fluid was processed and stained for differential cell counting. Induced sputum was relatively rich in neutrophils and eosinophils compared with bronchial washings and BAL fluid (mean (SE) 1.3 (0.4)%, 5.0 (2.7)%, and 36.4 (3.7)% neutrophils and 0.6 (0.1)%, 1.6 (0.6)%, and 3.3 (1.1)% eosinophils in BAL fluid, bronchial washings, and induced sputum, respectively). The proportions of cells obtained at sputum induction correlated with those in bronchial washings but not BAL fluid (r = 0.6 and 0.7 for neutrophils and eosinophils, respectively, p < 0.05). By contrast, induced sputum had a lower proportion of lymphocytes and macrophages than bronchial washings or BAL fluid, without any correlation. Induced sputum is rich in neutrophils and eosinophils and poor in lymphocytes, suggesting an origin in the larger airways. Induced sputum adequately reflects the findings in fluid collected by direct bronchoscopy.


Highly efficient and ultra-narrow bandwidth orange emissive carbon dots for microcavity lasers.
Luminescent materials with high efficiency, narrow emission bandwidth and long emission wavelength have attracted extensive attention in recent years. However, for novel luminescent carbon dots, it is still a major challenge to obtain these properties simultaneously. Here, this type of carbon dot was proposed using 1,4-diaminonaphthalene as the initial source. The carbon dots demonstrate strong orange emission with the highest quantum yield of 82% and an extremely narrow emission bandwidth of 30 nm. It is found that the orange emission of carbon dots is attributed to the high defect amounts including nitrogen and oxygen doping. The high carboxyl group content leads to a high efficiency and the uniform size distribution results in a narrow bandwidth. The carbon dots are used as the gain medium of a whispering gallery mode microcavity laser. A low excitation threshold of 12 kW cm-2 and a high quality factor of ∼3600 can be obtained from the microcavity lasers. This work has provided a didactic example to develop high-quality long emission-wavelength carbon dots with strong emission and an ultra-narrow emission bandwidth, which makes it possible to expand the application of original and high-performance lasers or other optical devices.


Comparative Morphologic Evaluation and Occluding Effectiveness of Nd: YAG, CO2 and Diode Lasers on Exposed Human Dentinal Tubules: An Invitro SEM Study.
Dentinal hypersensitivity is one of the most common problem, encountered in dental practice but has least predictable treatment outcome. The advent of lasers in dentistry has provided an additional therapeutic option for treating dentinal hypersensitivity. Although various lasers have been tried over a period of time to treat dentinal hypersensitivity, but still the doubt persist as to which laser leads to maximum dentinal tubular occlusion and is most suitable with minimal hazardous effects. To compare the effects of Nd: YAG, CO2 and 810-nm diode lasers on width of exposed dentinal tubule orifices and to evaluate the morphologic changes on dentinal surface of human tooth after laser irradiation by scanning electron microscope (SEM). Forty root specimens were obtained from ten freshly extracted human premolars, which were randomly divided into four groups of ten each. Group I: control group treated with only saline, Group II: Nd:YAG laser, Group III: CO2 laser and Group IV: 810-nm diode laser. The specimens were examined using SEM. After calculating mean tubular diameter for each group, the values were compared statistically using parametric one-way ANOVA test and Turkey's post hoc multiple comparison test. All the three lased groups showed a highly statistical significant result with p-value of <0.001 as compared to non-lased group. On intergroup comparison within the lased groups, all the three groups showed statistically significant difference in the reduction of dentinal tubular diameter (p-value < 0.001). Nd: YAG laser was found to be most effective, followed by the CO2 laser and 810-nm diode laser was found to be least effective. The morphologic changes like craters, cracks and charring effect of the dentine were seen maximum by the use of CO2 laser.


Knowledge and attitudes towards cervical cancer and human papillomavirus: a Nigerian pilot study.
This study aimed to ascertain the knowledge and attitudes of urban and rural dwellers to cervical cancer and HPV in Gwagwalada Area Council of Nigeria. 400 participants aged 15-45 years were selected from Gwagwalada town and the adjourning Giri village to respond to a multi-choice-free response questionnaire designed to obtain information on respondents' biodata, knowledge of STIs, human papilloma virus and cervical cancer, health and communication resources in their communities. This was supplemented by focus group discussions among religious and tribal groups within the urban and rural communities. We found a low level of awareness about HPV and cervical cancer which majority felt could not be prevented. Although awareness of STDs was high in both urban and rural dwellers, condom use was low. The study underscores the need for a well planned and implemented health communication and education program on STIs, HPV and cervical cancer in Nigeria.


The therapeutic relationship and deviations in technique.
This paper is a study of the framework and boundaries of the patient-analyst and patient-therapist relationships, and is based on the thesis that the manner in which the therapist manages these ground rules implicitly conveys important information about him to the patient, and influences both the patient's ongoing incorporative identification with the therapist and the "field" or person onto whom he projects his intrapsychic fantasies and with whom he interacts. After a review of the relevant literature, a series of fifteen postulates, drawn from previous observations in this area, are presented; each relates to the boundaries of the therapeutic relationship, and to the consequences of deviations and modifications of these boundaries and of the techniques of psychotherapy and psychoanalysis. The main clinical presentation is drawn from the psychotherapy of a patient whose therapist made several deviations in technique, and this is supplemented by the review of several vignettes from the psychotherapeutic and psychoanalytic literature. In concluding, the following are discussed: the manner in which maintenance of the ground rules reflects the intrapsychic state of the therapist; the consequences of deviations in these ground rules, especially on the patient's incorporative identification with the therapist; the manner in which deviations in technique are antithetical to a sound therapeutic alliance, unless a clearcut emergency exists; the unconscious meanings of unneeded deviations in technique for both the patient and therapist; the technical measures needed to modify as far as possible the consequences of an unnecessary deviation in technique; the need for flexibility and humanity within the basic ground rules of therapy and analysis; and the importance of the actualities of the therapist in the therapeutic relationship.


Monogenic and Monoallelic Expression of Odorant Receptors.
Odorant receptors (ORs) belong to a large gene family of rhodopsin-like G protein-coupled receptors (GPCRs). The mouse OR gene family is composed of ∼1000 OR genes, and the human OR gene family is composed of ∼400 OR genes. The OR genes are spread throughout the genome, and can be found in clusters or as solitary genes in almost all chromosomes. These chemosensory GPCRs are expressed in highly specialized cells, the olfactory sensory neurons of the nose. Each one of these neurons expresses a single OR gene out of the complete repertoire of genes. In addition, only one of the two homologous alleles of the chosen OR gene, the maternal or the paternal, is expressed per neuron. Here we review recent findings that help to elucidate the mechanisms underlying monogenic and monoallelic expression of OR genes.


A novel modification of the Turing test for artificial intelligence and robotics in healthcare.
The increasing demands of delivering higher quality global healthcare has resulted in a corresponding expansion in the development of computer-based and robotic healthcare tools that rely on artificially intelligent technologies. The Turing test was designed to assess artificial intelligence (AI) in computer technology. It remains an important qualitative tool for testing the next generation of medical diagnostics and medical robotics. Development of quantifiable diagnostic accuracy meta-analytical evaluative techniques for the Turing test paradigm. Modification of the Turing test to offer quantifiable diagnostic precision and statistical effect-size robustness in the assessment of AI for computer-based and robotic healthcare technologies. Modification of the Turing test to offer robust diagnostic scores for AI can contribute to enhancing and refining the next generation of digital diagnostic technologies and healthcare robotics.


Distribution of A, B, and mixed pancreatic islets in two bird species (Anas platyrhincus Gallus gallus, Linné, 1758)--a morphometric study.
The structural configuration of the duck and chicken pancreas was studied using a morphometric technique and 3 different sampling types. The distribution and percentage of the various types of pancreatic islets are reported. Contrary to reports by other investigators, a larger proportion of type A islets was observed in each of the pancreatic lobes, and the established conclusion that A cells are present only in the splenic portion of the organ was not confirmed.


Energetic cost of sexual attractiveness: ultrasonic advertisement in wax moths.
Pair formation in the lesser wax moth, Achroia grisella (Lepidoptera: Pyralidae), is initiated by male ultrasonic signals that attract receptive females. Individual males vary in attractiveness to females, and the most attractive males are distinguished by exaggeration of three signal characters: pulse rate, peak amplitude and asynchrony interval (temporal separation between pulses generated by movements of the left and right wings during a given wing upstroke or downstroke). Using flow-through respirometry, we measured the resting and signalling metabolic rates of males whose relative attractiveness was known. Acoustic recordings and metabolic measurements were made simultaneously, and we calculated net metabolic rates and factorial metabolic scopes as measures for the energetic cost of signalling. On average, attractive males had higher net metabolic rates and factorial metabolic scopes than unattractive ones, but many unattractive males also had high values. Thus, high expenditure of energy on signalling is necessary but not sufficient for attractiveness. This may result because only one of the three signal characters critical for female preference, pulse rate, is correlated with energy expenditure. Although the results are consistent with the good genes model of sexual selection, they do not conflict with other indirect or direct mechanisms of female choice. Copyright 1998 The Association for the Study of Animal Behaviour. Copyright 1998 The Association for the Study of Animal Behaviour.


Apparent endocytosis of fluorescein isothiocyanate-conjugated dextran by Saccharomyces cerevisiae reflects uptake of low molecular weight impurities, not dextran.
Concurrent with Riezman's report (Riezman, H. 1985, Cell. 40:1001-1009) that fluid-phase endocytosis of the small molecule Lucifer yellow occurs in the yeast Saccharomyces cerevisiae, Makarow (Makarow, M. 1985. EMBO [Eur. Mol. Biol. Organ.] J. 4:1861-1866) reported the endocytotic uptake of 70-kD FITC-dextran (FD) and its subsequent compartmentation into the yeast vacuole. Samples of FD synthesized and purified here failed to label yeast vacuoles under conditions that allowed labeling using commercial FD. Chromatography revealed that the commercial FD was heavily contaminated with at least three low molecular weight fluorescent compounds. Dialysis was ineffective for removing the contaminants. After purification (Sephadex G25, ethanol extraction), commercial FD was incapable of labeling vacuoles. Extracts of cells labeled with partially purified FD contained FITC, not FD, based on Sephadex and thin layer chromatography. In either the presence or absence of unlabeled 70-kD dextran, authentic FITC (10 micrograms/ml) was an effective labeling agent for vacuoles. The rapid kinetics (0.28 pmol/min per 10(6) cells at pH 5.5) and the pH dependence of FITC uptake suggest that the mechanism of FITC uptake involves diffusion rather than endocytosis. In view of these results, labeling experiments that use unpurified commercial FD should be interpreted with caution.


All trans retinoic acid nanodisks enhance retinoic acid receptor mediated apoptosis and cell cycle arrest in mantle cell lymphoma.
Mantle cell lymphoma (MCL) is characterized by translocation t(11;14)(q13;q32), aggressive clinical behaviour, and poor patient outcomes following conventional chemotherapy. New treatment approaches are needed that target novel biological pathways. All trans retinoic acid (ATRA) is a key retinoid that acts through nuclear receptors that function as ligand-inducible transcription factors. The present study evaluated cell killing effects of ATRA-enriched nanoscale delivery particles, termed nanodisks (ND), on MCL cell lines. Results show that ATRA-ND induced cell death more effectively than naked ATRA (dimethyl sulphoxide) or empty ND. ATRA-ND induced reactive oxygen species (ROS) generation to a greater extent than naked ATRA. The antioxidant, N-acetylcysteine, inhibited ATRA-ND induced apoptosis. Compared to naked ATRA, ATRA-ND enhanced G1 growth arrest, up-regulated p21and p27, and down regulated cyclin D1. At ATRA concentrations that induced apoptosis, expression levels of retinoic acid receptor-alpha (RARalpha) and retinoid X receptor-gamma (RXRgamma) were increased. Compared to naked ATRA, ATRA-ND significantly stimulated transcriptional activity of RARA in a model carcinoma cell line. Furthermore, the RAR antagonist, Ro 41-5253, inhibited ATRA-ND induced ROS generation and prevented ATRA-ND induced cell growth arrest and apoptosis. In summary, incorporation of ATRA into ND enhanced the biological activity of this retinoid in cell culture models of MCL.


Low-intensity extracorporeal shock wave therapy--a novel effective treatment for erectile dysfunction in severe ED patients who respond poorly to PDE5 inhibitor therapy.
Low-intensity shock wave therapy (LI-ESWT) has been reported as an effective treatment in men with mild and moderate erectile dysfunction (ED). The aim of this study is to determine the efficacy of LI-ESWT in severe ED patients who were poor responders to phosphodiesterase type 5 inhibitor (PDE5i) therapy. This was an open-label single-arm prospective study on ED patients with an erection hardness score (EHS) ≤ 2 at baseline. The protocol comprised two treatment sessions per week for 3 weeks, which were repeated after a 3-week no-treatment interval. Patients were followed at 1 month (FU1), and only then an active PDE5i medication was provided for an additional month until final follow-up visit (FU2). At each treatment session, LI-ESWT was applied on the penile shaft and crus at five different anatomical sites (300 shocks, 0.09 mJ/mm(2) intensity at 120 shocks/min). Each subject underwent a full baseline assessment of erectile function using validated questionnaires and objective penile hemodynamic testing before and after LI-ESWT. Outcome measures used are changes in the International Index of Erectile Function-erectile function domain (IIEF-ED) scores, the EHS measurement, and the three parameters of penile hemodynamics and endothelial function. Twenty-nine men (mean age of 61.3) completed the study. Their mean IIEF-ED scores increased from 8.8 ± 1 (baseline) to 12.3 ± 1 at FU1 (P = 0.035). At FU2 (on active PDE5i treatment), their IIEF-ED further increased to 18.8 ± 1 (P < 0.0001), and 72.4% (P < 0.0001) reached an EHS of ≥ 3 (allowing full sexual intercourse). A significant improvement (P = 0.0001) in penile hemodynamics was detected after treatment and this improvement significantly correlated with increases in the IIEF-ED (P < 0.05). No noteworthy adverse events were reported. Penile LI-ESWT is a new modality that has the potential to treat a subgroup of severe ED patients. These preliminary data need to be reconfirmed by multicenter sham control studies in a larger group of ED patients.


Human intestinal schistosomiasis in communities living near three rivers of jimma town, South Western ethiopia.
Schistosoma mansoni is one of the parasites with high public and medical importance in Ethiopia. However, information is scarce about S. mansoni epidemiology in people living with higher risk of infection in Jimma town. This study was designed to determine point prevalence, intensity and risk factors of S. mansoni infection among residents nearby three rivers of Jimma town and assess the rate of Biomphalaria species shading cercariae from January to April, 2007. A cross-sectional study was conducted in communities residing nearby three rivers of Jimma town. Structured questionnaires were used to collect data on socio- demographic and behavioral risk factors. After physical examination, stool samples were collected from 517 study participants and processed with Kato-Katz technique for microscopic examination and quantification of egg load. Snails were collected for identification of Biomphalaria species and then checked for cercarial shading. The prevalence of S. mansoni was 26.3 % with intensity ranging 24 to 936 eggs per gram of stool. Participants in the age group 10-19 years, OR = 2.19 (95% CI; 1.10 - 4.34), and those living near the Awetu River, OR = 2.67 (95% CI; 1.06 - 6.75), had higher risk of S. mansoni infection. Moreover, water contact while crossing a river, OR = 3.77 (95% CI; 1.79 - 7.95), and swimming, OR = 2.59 (95% CI; 1.37 - 4.91, was significantly associated with infection. Biomphalaria snails collected from Chore and Awetu Rivers shaded higher rate of cercariae compared with Kito River. A moderate prevalence of S. mansoni infection was shown in the study population. Infection rate among the residents correlated with rate of cercarial shading Biomphalaria snails. Treatment of targeted groups, appropriate health education and environmental measures (e.g. snail control) are needed to improve the situation.


Neuroimaging of working memory dysfunction and the dilemma with brain reorganization hypotheses.
There is a growing literature examining working memory deficits using functional imaging and there has been great convergence in the findings, to date, but interpretations have varied. Investigators consistently observed recruitment of neural resources in clinical samples, with some examiners attributing these findings to neural inefficiency and others attributing differences to neural compensation and/or brain reorganization. It is the goal of this paper to address the current interpretation of altered brain activation in clinical imaging studies of working memory dysfunction with specific emphasis on findings in prefrontal cortex (PFC). Throughout this review, the methods used to examine brain reorganization associated with working memory dysfunction are critiqued with the goal of understanding how study design has influenced data interpretation. It is proposed that much of what has been considered "aberrant" neural activity is not indicative of neural compensation, as it has been typically defined, and does not represent brain reorganization. Instead, recruitment of neural resources in PFC can be explained by a natural, and largely overlooked, role of cognitive control in accommodating neural dysfunction secondary to brain injury and disease. This paper provides predictions based on this proposition and a critique of the current methods available for testing these predictions.


Assisted reproductive technology in Europe, 2010: results generated from European registers by ESHRE†.
The 14th European IVF--monitoring (EIM) report presents the results of medically assisted reproduction treatments including assisted reproductive technology (ART) cycles and intrauterine insemination (IUI) cycles initiated in Europe during 2010: are there changes in the trends compared with previous years? Despite some fluctuations in the number of countries reporting, the overall number of ART cycles has continued to increase year by year, and while pregnancy rates in 2010 remained similar to those reported in 2009, the number of transfers with multiple embryos (three or more) further declined. Since 1997, ART data in Europe have been collected and reported in 13 manuscripts, published in Human Reproduction. Retrospective collection of European ART data by the EIM Consortium for ESHRE; data were collected from cycles started between 1st January and 31st December 2010 by the National Registries of individual European countries, or on a voluntary basis by personal information for European countries without a national registry. Out of 31 countries, 991 clinics reported 550 296 ART treatment cycles: IVF (125 994), ICSI (272 771), frozen embryo replacement (FER, 114 593), egg donation (ED, 25 187), in vitro maturation (493), preimplantation genetic diagnosis/preimplantation genetic screening (6399) and frozen oocyte replacements (4859). European data on IUI using husband/partner's semen (IUI-H) or donor semen (IUI-D) were reported from 22 and 19 countries, respectively. A total of 176 512 IUI-H (+8.4% compared with 2009) and 38 124 IUI-D (+30.4% compared with 2009) cycles were included. In 16 countries where all clinics reported to the national ART registry, a total of 267 120 ART cycles were performed in a population of 219 million inhabitants, corresponding to 1221 cycles per million inhabitants. For IVF, the clinical pregnancy rates per aspiration and per transfer increased to 29.2 and 33.2%, respectively, and for ICSI, the corresponding rates also increased to 28.8 and 32.0%, when compared with the rates of 2009. In FER cycles, the pregnancy rate per thawing was 20.3%; in ED cycles the pregnancy rate per fresh transfer was 47.4% and per thawed transfer 33.3%. The delivery rate after IUI-H was 8.9 and 13.8% after IUI-D. In IVF and ICSI cycles, one, two, three and four or more embryos were transferred in 25.7, 56.7, 16.1 and 1.5%, respectively. The proportions of singleton, twin and triplet deliveries after IVF and ICSI (combined) were 79.4, 19.6 and 1.0%, respectively, resulting in a total multiple delivery rate of 20.6% compared with 20.2% in 2009, 21.7% in 2008, 22.3% in 2007, 20.8% in 2006. In FER cycles, the multiple delivery rate was 12.8% (12.5% twins and 0.3% triplets). Twin and triplet delivery rates associated with IUI cycles were 9.6/0.5 and 8.5/0.2%, following treatment with husband and donor semen, respectively. The method of reporting is not standardized in Europe but varies among countries. Furthermore registries from a number of countries have been unable to provide some of the relevant data such as initiated cycles and deliveries. Therefore, results should be interpreted with caution. The 14th ESHRE report on ART and IUI treatments shows a continuing expansion of the number of ART treatment cycles in Europe, with more than half a million of cycles reported in 2010. The use of ICSI may have reached a plateau. When compared with 2009/2008, pregnancy and (multiple) delivery rates after IVF and ICSI remained relatively stable. The number of multiple embryo transfers (three or more embryos) has shown a decline. The study has no external funding; all costs are covered by ESHRE. There are no competing interests.


Genome-wide linkage analysis of pulse pressure in Mexican Americans.
Pulse pressure, a measure of aortic stiffness, is a strong predictor of cardiovascular mortality. To locate genes that affect pulse pressure, we performed genetic analysis on randomly ascertained families in the San Antonio Family Heart Study. Pulse pressure was defined as the difference between systolic and diastolic blood pressures. Likelihood methods were used to construct a model that had both single-locus and polygenic components for 46 families (1308 individuals). The single-locus component included sex-specific and genotype-specific effects of both age and body mass index. Using this model, we then performed 2-point linkage analysis in 10 families (440 individuals) that were among the largest of the 46 families and that had been genotyped for 399 polymorphic markers. The model that contained only the polygenic component and simple effects of the covariates showed pulse pressure heritability of 0.21. When the single-locus component was added, the sex-specific and genotype-specific effects of age and body mass index were highly significant (P<0.002). The full model accounted for 73% of the total variation of pulse pressure. Linkage analysis using this model with each marker revealed 4 markers with lod scores >1.9, which is the Lander-Kruglyak suggestive linkage standard. D21S1440 had a lod score of 2.78 with a recombination fraction (theta) of 0.02. D7S1799 had a lod score of 2.04 (theta=0.01), D8S1100 had a lod score of 1.98 (theta=0.08), and D18S844 had a lod score of 1.95 (theta=0.11). These results are highly correlated with results involving systolic blood pressure, indicating that pulse pressure may not be genetically distinct from systolic blood pressure.


Disentangling the Possible Drivers of Indri indri Microbiome: A Threatened Lemur Species of Madagascar.
Research on the gut microbiome may help with increasing our understanding of primate health with species' ecology, evolution, and behavior. In particular, microbiome-related information has the potential to clarify ecology issues, providing knowledge in support of wild primates conservation and their associated habitats. Indri (Indri indri) is the largest extant living lemur of Madagascar. This species is classified as "critically endangered" by the IUCN Red List of Threatened Species, representing one of the world's 25 most endangered primates. Indris diet is mainly folivorous, but these primates frequently and voluntarily engage in geophagy. Indris have never been successfully bred under human care, suggesting that some behavioral and/or ecological factors are still not considered from the ex situ conservation protocols. Here, we explored gut microbiome composition of 18 indris belonging to 5 different family groups. The most represented phyla were Proteobacteria 40.1 ± 9.5%, Bacteroidetes 28.7 ± 2.8%, Synergistetes 16.7 ± 4.5%, and Firmicutes 11.1 ± 1.9%. Further, our results revealed that bacterial alpha and beta diversity were influenced by indri family group and sex. In addition, we investigated the chemical composition of geophagic soil to explore the possible ecological value of soil as a nutrient supply. The quite acidic pH and high levels of secondary oxide-hydroxides of the soils could play a role in the folivorous diet's gut detoxification activity. In addition, the high contents of iron and manganese found the soils could act as micronutrients in the indris' diet. Nevertheless, the concentration of a few elements (i.e., calcium, sulfur, boron, nickel, sodium, and chromium) was higher in non-geophagic than in geophagic soils. In conclusion, the data presented herein provide a baseline for outlining some possible drivers responsible for the gut microbiome diversity in indris, thus laying the foundations for developing further strategies involved in indris' conservation.


Surrogacy: is there a case for legal prohibition?
Surrogacy arrangements are a complex and challenging issue for legal regulation. On the one hand, if we wish to promote personal autonomy and enable the infertile to experience parenthood, there is a case for allowing these arrangements to proceed. However, objections to legal sanctioning of surrogacy include concerns for the surrogate and the child born through the surrogacy arrangement. Legally sanctioning surrogacy may also adversely affect social conceptions of women's roles or may be considered a form of commodifying women's reproductive capacities. This article examines these challenges to allowing surrogacy, but concludes that surrogacy should not be legally prohibited.


Depression and Anxiety Symptoms Relate to Distinct Components of Pain Experience among Patients with Breast Cancer.
Breast cancer is a leading cancer diagnosis among women worldwide, with more than 210,000 new cases and 40,000 deaths per year in the United States. Pain, anxiety, and depression can be significant factors during the course of breast cancer. Pain is a complex experience with sensory, affective, and cognitive dimensions. While depression and anxiety symptoms are relatively common among breast cancer patients, little is known about the relation between these psychiatric factors and distinct components of the pain experience. In the present study 60 females presenting to an NCI-designated Cancer Center with newly diagnosed breast cancer completed the Center for Epidemiological Studies 10-item Depression Scale, the State Instrument of the Spielberger State-Trait Anxiety Inventory, and the McGill Pain Questionnaire. Findings indicate that anxiety and depression are common among newly diagnosed breast cancer patients; furthermore, patients experience an appreciable amount of pain even before oncologic treatment starts. State anxiety serves as a predictor of the sensory dimension of the pain experience, whereas depression serves as a predictor of the affective dimension of the pain experience.


Swelling, NEM, and A23187 activate Cl(-)-dependent K+ transport in high-K+ sheep red cells.
In low K+ (LK) sheep red cells a significant fraction of the total ouabain-resistant (OR) K+ flux is inhibited when Cl- is replaced by other anions of the Hofmeister series except Br- (Cl(-)-dependent K+ flux). In contrast, high K+ (HK) sheep red cells in isosmotic media did not possess any significant OR Cl(-)-dependent K+ flux when Cl- was replaced by NO3- or I-. However, exposure to hyposmotic solutions, treatment with the sulfhydryl (SH) group reagent N-ethylmaleimide (NEM) or with the bivalent metal ion (Me2+) ionophore A23187 in absence of external Me2+ caused a significant activation of Cl(-)-dependent K+ transport as measured with Rb+ as K+ congener. There was no Cl(-)-dependent Rb+ flux in A23187-treated cells when Mn2+, Mg2+, and Ca2+ were present at 1 mM concentrations, suggesting that cellular accumulation of these Me2+ is inhibitory. Similar to LK red cells, HK red cells failed to respond to A23187 when pretreated with NEM supporting the hypothesis proposed recently (Lauf, P. K. J. Membr. Biol. 88: 1-13, 1985) of a common mechanism of Cl(-)-dependent K+ transport activation. The magnitudes of the Cl(-)-dependent Rb+ fluxes in HK cells were much smaller than those elicited by identical treatments in LK red cells, and the effect of all interventions was not due to the presence of reticulocytes known to possess Cl(-)-dependent K+ transport.(ABSTRACT TRUNCATED AT 250 WORDS)


A cancer-associated DNA polymerase delta variant modeled in yeast causes a catastrophic increase in genomic instability.
Accurate DNA synthesis by the replicative DNA polymerases alpha, delta, and epsilon is critical for genome stability in eukaryotes. In humans, over 20 SNPs were reported that result in amino-acid changes in Poldelta or Polepsilon. In addition, Poldelta variants were found in colon-cancer cell lines and in sporadic colorectal carcinomas. Using the yeast-model system, we examined the functional consequences of two cancer-associated Poldelta mutations and four polymorphisms affecting well-conserved regions of Poldelta or Polepsilon. We show that the R696W substitution in Poldelta (analog of the R689W change in the human cancer-cell line DLD-1) is lethal in haploid and homozygous diploid yeast. The cell death results from a catastrophic increase in spontaneous mutagenesis attributed to low-fidelity DNA synthesis by Poldelta-R696W. Heterozygotes survive, and the mutation rate depends on the relative expression level of wild-type versus mutant alleles. Based on these observations, we propose that the mutation rate in heterozygous human cells could be regulated by transient changes in gene expression leading to a temporary excess of Poldelta-R689W. The similarities between the mutational spectra of the yeast strains producing Poldelta-R696W and DLD-1 cells suggest that the altered Poldelta could be responsible for a significant proportion of spontaneous mutations in this cancer cell line. These results suggest that the highly error-prone Poldelta-R689W could contribute to cancer initiation and/or progression in humans.


The interactive effects of acute exercise and hypoxia on cognitive performance: A narrative review.
Acute moderate intensity exercise has been shown to improve cognitive performance. In contrast, hypoxia is believed to impair cognitive performance. The detrimental effects of hypoxia on cognitive performance are primarily dependent on the severity and duration of exposure. In this review, we describe how acute exercise under hypoxia alters cognitive performance, and propose that the combined effects of acute exercise and hypoxia on cognitive performance are mainly determined by interaction among exercise intensity and duration, the severity of hypoxia, and duration of exposure to hypoxia. We discuss the physiological mechanism(s) of the interaction and suggest that alterations in neurotransmitter function, cerebral blood flow, and possibly cerebral metabolism are the primary candidates that determine cognitive performance when acute exercise is combined with hypoxia. Furthermore, acclimatization appears to counteract impaired cognitive performance during prolonged exposure to hypoxia although the precise physiological mechanism(s) responsible for this amelioration remain to be elucidated. This review has implications for sporting, occupational, and recreational activities at terrestrial high altitude where cognitive performance is essential. Further studies are required to understand physiological mechanisms that determine cognitive performance when acute exercise is performed in hypoxia.


Eye-Closure Enhances Creative Performance on Divergent and Convergent Creativity Tasks.
In today's world of rapid changes and increasing complexity, understanding and enhancing creativity is of critical importance. Studies investigating EEG correlates of creativity linked power in the alpha frequency band to creativity, and alpha-power has been interpreted as reflecting attention on internal mental representations and inhibition of external sensory input. Thus far, however, there is no direct evidence for the idea that internally directed attention facilitates creativity. The aim of the current study was to experimentally investigate the relationship between eye-closure-a simple and effective means to stimulate internally directed attention-and creativity. Moreover, to test whether the potential beneficial effect of eye-closure is specific for creativity, or whether it improves general cognitive functioning, the current study tested the effect of eye-closure on creativity and on working memory (WM). Participants completed four tasks to measure divergent and convergent creativity (Adapted Alternative Uses (AAU) Test, Remote Associates Test (RAT), Sentence Construction Test, and Word Construction Test), and one task to measure WM (Digit Span Test). For each task, participants had to perform two versions, one version with eyes open and one version with eyes closed. Eye-closure facilitated creative performance on the classical divergent and convergent creativity tasks (AAU Test and RAT). No effect of eye-closure was observed on the WM task. These findings provide a novel and easily applicable means to enhance divergent and convergent creativity through eye-closure.


How does the short-wavelength-sensitive contrast sensitivity function for detection and resolution change with age in the periphery?
To determine the age-related change in the peripheral short-wavelength-sensitive (SWS) grating contrast sensitivity function (CSF), cut-off spatial frequency (acuity) and contrast sensitivity for both a detection and resolution task were measured at 8 degrees eccentricity under conditions of SWS-cone isolation for 51 subjects (19-72 years). The acuity for both the detection and resolution task declined with age, the detection acuity being significantly higher than the resolution acuity at all ages (p<.01). The CSF for both detection and resolution shifted towards lower spatial frequencies with increasing age. The contrast sensitivity for detection remained higher than that for resolution for all ages at the highest spatial frequencies. The age-related loss in the SWS resolution CSF at high spatial frequency probably reflects a loss occurring at the ganglion cells level.


A systematic review of screening tools for the detection of autism spectrum disorder in mainland China and surrounding regions.
Screening for autism spectrum disorder is the first step toward early detection and diagnosis, thereby impacting the likelihood of children accessing early intervention and, importantly, improving long-term outcomes. This systematic review aimed to (a) establish a clear baseline of autism spectrum disorder screening tools currently used throughout mainland China and surrounding regions, (b) identify the strengths and limitations of these instruments, and (c) develop specific recommendations regarding screening for autism spectrum disorder throughout Chinese-speaking countries. Databases were searched for recent (2015-2018) articles published in Chinese or English languages. Twenty-two studies (13 Chinese, 9 English) met inclusion criteria; two from Taiwan and the remainder from mainland China. Studies varied greatly in the extent of psychometric analyses and reported autism spectrum disorder prevalence. The majority of diagnoses were based on Diagnostic and Statistical Manual of Mental Disorders (4th ed. (DSM-IV) or 5th ed. (DSM-5)) criteria, although a small number of studies utilized gold-standard diagnostic assessment instruments. It is recommended that a systematic, multi-tiered, screening network be established to improve the identification of autism spectrum disorder in China and surrounding regions. Assessment and diagnosis need to be culturally appropriate, and amenable to low-resource settings. In addition, increased public awareness programs to reduce stigma will be important in improving outcomes for children with autism spectrum disorder.


Assessment of Attitudes Toward the Emergency Triage System in Belize.
Objective. Triage in resource-limited settings (RLS) improves outcomes. Emergency Triage Assessment and Treatment (ETAT) is a simple triage algorithm that improves assessment and initial management of children in RLS. In Belize, pediatric triage varies with setting, from a 5-level Emergency Severity Index (ESI) used at the National Referral Hospital to a lack of triage at government health centers (GHC). Most data on ETAT implementation are in settings where no triage system existed; data on how to integrate ETAT into existing, heterogeneous triage systems are lacking. The aim of this study is to explore health care providers' (HCPs) attitudes toward the current triage system prior to national pediatric triage process implementation. Methods. A qualitative study was performed via convenience sampling of HCPs who participated in an ETAT training course using focus groups immediately and 1 year after an initial ETAT training. Focus groups were digitally recorded and transcribed. Three coders analyzed all transcripts to identify emerging themes. Constant comparison analysis was performed until achieving thematic saturation. Results. The following principal themes emerged: (1) importance of triage education and implementation to standardize and improve communication; (2) major limitations of ESI include its complexity, lack of pediatric-specific criteria, and dependence on equipment not consistently available; and (3) desire to implement a simple, low-resource pediatric-specific triage system. Conclusions. Participants believe triage education and process implementation is essential to improve communication and pediatric emergency care. Simple, low-resource pediatric-specific triage systems, like ETAT, may improve utilization by providing faster recognition and improved care for acutely ill children.


Outlook from the soil perspective of urban expansion and food security.
The use of soil as support for built-up areas represents only one of its several functions. Farmlands at the fringe of conurbations have more chance of being converted into built-up areas due to the favourable topography and the accessibility to existing infrastructure, being in the vicinity of urban areas. We analysed the global land-take during the period 2000-2014. The data are based on a global dataset describing the spatial evolution of human settlements using the Global Human Settlement Layer, which was derived from Landsat images collected in 1975, 1990, 2000 and 2014. Although the global land-take represents roughly 0.1% of the global terrestrial Earth, it affects 1% of the naturally fertile soils, according to the proposed Soil Productivity Indexes (SPI), based upon the potential soil productivity, calculated on the basis of the Harmonized World Soil Database. We have found that, few large conurbations develop on potentially high productive soil, while scarcely productive soils sustain the expansion of several megalopolises. On a global scale and through the centuries, considered comparatively as individual overall age of settlements, a trend between the intrinsic quality of the soils and its use for settlement purposes as major competitor, was not observed.


The total artificial heart in patients with congenital heart disease.
While ventricular assist devices (VADs) remain the cornerstone of mechanical circulatory support (MCS), the total artificial heart (TAH-t) has gained popularity for certain patients in whom VAD support is not ideal. Congenital heart disease (CHD) patients often have barriers to VAD placement due to anatomic and physiological variation and thus can benefit from the TAH-t. The purpose of this study is to analyze the differences in TAH application and outcomes in patients with and without CHD. The SynCardia Department of Clinical Research provided data upon request for all TAH-t implantations worldwide from December 1985 to October 2019. These patients were divided into two groups by pre-implantation diagnosis of CHD and non-CHD. A total of 1,876 patients were identified. Eighty (4%) of these patients also carried a diagnosis of CHD. There was a higher proportion of children in the CHD cohort (16.3% vs. 2.1%, P<0.001) and this translated into a lower average age amongst the two groups (34±13 vs. 49±13 years, P<0.001). There were also significantly more females in the CHD group (22.8% vs. 12.8%, P=0.010). CHD patients were more likely to be supported with a 50 cc TAH-t (11.3% vs. 4.5%, P=0.005) while all other support characteristics, including duration of support, were similar between the groups. All measured outcomes were similar between CHD and non-CHD patients including positive outcome (alive on device or transplanted), 1-month conditional survival, and rate of Freedom Driver use. TAH-t is an effective means to support patients with CHD. Patients with CHD had similar survival, support characteristics, and frequency of discharge compared to patients without CHD. As MCS continues to grow, its indications broadened, and its contraindications narrowed, more patient populations will see the benefit of the TAH's continuously developing technology.


Breaking and restoring the hydrophobic core of a centromere-binding protein.
The ribbon-helix-helix (RHH) superfamily of DNA-binding proteins is dispersed widely in procaryotes. The dimeric RHH fold is generated by interlocking of two monomers into a 2-fold symmetrical structure that comprises four α-helices enwrapping a pair of antiparallel β-strands (ribbon). Residues in the ribbon region are the principal determinants of DNA binding, whereas the RHH hydrophobic core is assembled from amino acids in both the α-helices and ribbon element. The ParG protein encoded by multiresistance plasmid TP228 is a RHH protein that functions dually as a centromere binding factor during segrosome assembly and as a transcriptional repressor. Here we identify residues in the α-helices of ParG that are critical for DNA segregation and in organization of the protein hydrophobic core. A key hydrophobic aromatic amino acid at one position was functionally substitutable by other aromatic residues, but not by non-aromatic hydrophobic amino acids. Nevertheless, intramolecular suppression of the latter by complementary change of a residue that approaches nearby from the partner monomer fully restored activity in vivo and in vitro. The interactions involved in assembling the ParG core may be highly malleable and suggest that RHH proteins are tractable platforms for the rational design of diverse DNA binding factors useful for synthetic biology and other purposes.


Remote sensing of surface ocean circulation with satellite altimetry.
The Geodynamics Experimental Ocean Satellite (GEOS-3) radar altimeter has provided some information on the dynamic sea-surface topography of the global oceans. Regional studies of the densely surveyed Sargasso Sea indicate that the average nontidal variability of the oceans is +/- 28 centimeters. Sea-surface highs and lows determined from GEOS-3 altimetry correlate favorably with eddy structures inferred from Nimbus-6 infrared imagery.


Five years renal transplantation data: Single-center experience from Iraq.
Renal transplantation is the treatment of choice for patients with end-stage renal disease. In Iraq, renal transplantation started in 1973 and has continued until now with live donor transplantation, since deceased donor transplant program is not approved as yet. Long-term transplant data are still scarce. The aim of our study is to present data on transplantation and medical follow-up at one year and, survival analysis at one, three and five years. A total of 250 renal transplantations were performed at the Nephrology and Renal Transplantation Center, Baghdad between January 2009 and January 2014. It is a living donor, blood group compatible donor program. All patients received triple immunosuppression (calcineurine inhibitor, mycophenolate mofetil or mycophenolic acid, and steroid). The Kaplan-Meier method was used to determine the survival rate. There were 92 live related donors, 143 unrelated donors, and 15 spouse donors. The mean age was 34.07 ± 12.2 years. The one-year graft survival for related and unrelated donor transplants was 98.9% and 91.8%, respectively. Graft survival was lower (82.9%) in recipients with acute rejection episodes. The patient survival at one-year was 94%. The three-year graft and patient survival was 91% and 90%, respectively, and five-year survival for grafts and patients was 87.1% and 88%, respectively. The outcome of the renal transplantation in Iraq is improving. Long-term patient follow-up needs more meticulous attention. The development of renal transplant registry is critical for future planning. Moreover, renal transplantation practice in Iraq needs more social, religious, and governmental support.


[Biochemical parameters in the diagnosis of nephrotoxicity of antineoplastic chemotherapy in children].
The investigation was concerned with the role of enzymouria in the assessment of nephrotoxic effects identified in 19 children with malignant solid tumors who received cisplatin polychemotherapy in a dose of 100 mg/sq.m or iphosphamide in a dose 9 g/sq.m. Chemotherapy application was followed by a persistent hyperenzymouria involving significantly higher levels of N-acetyl-beta-D-hexosaminidase, beta-glutamyl transferase and alanine aminopeptidase in the urine, as compared with basal indices. Iphosphamide treatment showed significantly higher levels of enzymouria than those in cisplatin-treated patients. Higher than normal creatinine and urea concentrations were recorded only in 2 out of 9 patients receiving iphosphamide. Enzymouria evaluation was shown to be an effective method of nephrotoxic diagnosis.


Production of anti-W24 xenoantisera in rabbits.
One out of four rabbits injected with partially purified soluble HL-A antigen from serum produced cytotoxic antibodies to human lymphocytes. These antibodies appear to be directed to the specificity W24 as determined by correlation studies with HL-A alloantisera and by absorption-inhibition experiments with human platelets and with serum soluble HL-A antigens. In the sera from the other three immunized rabbits, no antibodies to human lymphoid cells could be detected by the cytotoxic test, blocking of T cell rosette formation, stimulation of DNA synthesis and inhibition of mixed lymphocyte reaction.


Assessing the quality, efficiency and usefulness of the Western Australian population-based Intellectual Disability Exploring Answers (IDEA) surveillance system: a surveillance system evaluation.
Our overall aim was to evaluate the Western Australian Intellectual Disability Exploring Answers (IDEA) surveillance system. The primary objective was to evaluate the attributes of the system. The secondary objective was to provide recommendations to data custodians and stakeholders to strengthen the system. The IDEA system was evaluated using process observation, interviews and secondary data analysis of system attributes: usefulness, simplicity, data quality, acceptability, representativeness, timeliness and stability. 2001 US Centers for Disease Control and Prevention guidelines were used. We found that the IDEA system was useful, simple, flexible, acceptable, representative, timely and stable. We compared individuals from the IDEA system (n=10 593) with those with cerebral palsy and intellectual disability (ID) (n=582) from another surveillance system. Of the 582 with cerebral palsy and ID, 501 (86.1%) were in the IDEA system and 81 (13.9%) were not. In total, 0.7% of cases (81/10674) with ID were not identified in the IDEA system. There were little differences in cases that were not identified in the IDEA system between Indigenous status, sex and place of residence. The strengths of the IDEA system include having a high data quality resource contributing to national and international data on ID, strong government support and a dedicated management team. Output from studies linking to IDEA data have had major contributions to the international literature about ID. However, limited resources have prevented it from realising its full potential in relation to translational activities. The IDEA system is a valuable resource to address the needs of people living with ID.


Relationship between piperacillin concentrations, clinical factors and piperacillin/tazobactam-associated acute kidney injury.
Piperacillin/tazobactam, a commonly used antibiotic, is associated with acute kidney injury (AKI). The relationship between piperacillin concentrations and AKI remains unknown. Estimate piperacillin exposures in critically ill children and young adults administered piperacillin/tazobactam to identify concentrations and clinical factors associated with piperacillin-associated AKI. We assessed piperacillin pharmacokinetics in 107 patients admitted to the paediatric ICU who received at least one dose of piperacillin/tazobactam. Piperacillin AUC, highest peak (Cmax) and highest trough (Cmin) in the first 24 hours of therapy were estimated. Piperacillin-associated AKI was defined as Kidney Disease: Improving Global Outcomes (KDIGO) Stage 2/3 AKI present >24 hours after initial piperacillin/tazobactam dose. Likelihood of piperacillin-associated AKI was rated using the Naranjo Adverse Drug Reaction Probability Scale. Multivariable logistic regression was performed to identify patient and clinical predictors of piperacillin-associated AKI. Out of 107 patients, 16 (15%) were rated as possibly or probably having piperacillin-associated AKI. Estimated AUC and highest Cmin in the first 24 hours were higher in patients with piperacillin-associated AKI (2042 versus 1445 mg*h/L, P = 0.03; 50.1 versus 10.7 mg/L, P < 0.001). Logistic regression showed predictors of piperacillin-associated AKI included higher Cmin (OR: 5.4, 95% CI: 1.7-23) and age (OR: 1.13, 95% CI: 1.05-1.25). We show a relationship between estimated piperacillin AUC and highest Cmin in the first 24 hours of piperacillin/tazobactam therapy and piperacillin-associated AKI, suggesting total piperacillin exposure early in the course is associated with AKI development. These data could serve as the foundation for implementation of model-informed precision dosing to reduce AKI incidence in patients given piperacillin/tazobactam.


Role of proopiomelanocortin neurons and peptides in the regulation of energy homeostasis.
The purpose of this brief review is to highlight recent studies from our laboratory and collaborators based on the analysis of novel strains of mutant mice that further our understanding of the complex regulatory roles of proopiomelanocortin (POMC) neurons and POMC peptides in energy homeostasis. Mouse models that are considered include a transgenic strain with expression of enhanced green fluorescent protein in POMC neurons, facilitating analyses of the cell intrinsic membrane and synaptic properties, and two gene knockout strains exhibiting either a selective absence of beta-endorphin production or a complete loss of all POMC peptides from the pituitary gland and nervous system. Together these studies demonstrate the wide variety of hormonal, metabolic, and transsynaptic signals that converge on the arcuate hypothalamic nucleus and nucleus tractus solitarius to regulate the activity of POMC neurons. Both melanocortin peptides and the opioid beta-endorphin processed from POMC mediate the homeostatic and behavioral responses linked to POMC neuronal circuits.


Arabidopsis thaliana glyoxalase 2-1 is required during abiotic stress but is not essential under normal plant growth.
The glyoxalase pathway, which consists of the two enzymes, GLYOXALASE 1 (GLX 1) (E.C.: 126.96.36.199) and 2 (E.C.184.108.40.206), has a vital role in chemical detoxification. In Arabidopsis thaliana there are at least four different isoforms of glyoxalase 2, two of which, GLX2-1 and GLX2-4 have not been characterized in detail. Here, the functional role of Arabidopsis thaliana GLX2-1 is investigated. Glx2-1 loss-of-function mutants and plants that constitutively over-express GLX2-1 resemble wild-type plants under normal growth conditions. Insilico analysis of publicly available microarray datasets with ATTEDII, Mapman and Genevestigator indicate potential role(s) in stress response and acclimation. Results presented here demonstrate that GLX2-1 gene expression is up-regulated in wild type Arabidopsis thaliana by salt and anoxia stress, and by excess L-Threonine. Additionally, a mutation in GLX2-1 inhibits growth and survival during abiotic stresses. Metabolic profiling studies show alterations in the levels of sugars and amino acids during threonine stress in the plants. Elevated levels of polyamines, which are known stress markers, are also observed. Overall our results suggest that Arabidopsis thaliana GLX2-1 is not essential during normal plant life, but is required during specific stress conditions.