Performance of short implants in partial restorations: 3-year follow-up of Osseotite implants.
Short-length implants should be at a performance disadvantage because of the more limited surface area with which to resist occlusal forces. Nevertheless, anecdotal observations find many short implants performing well in different restorative conditions. This retrospective, multicenter study seeks to compare formally implant performance based on length. The success of 7 and 8.5-mm Osseotite implants (Implant Innovations, Inc., Palm Beach Gardens, FL) was determined as: absence of mobility; no persistent and/or irreversible signs or symptoms of pain, infection, paresthesia, or violation of the mandibular canal; no evidence of peri-implant radiolucency; and no progressive crestal bone loss. Implant location, restoration type, bone density, and smoking status of the patients were recorded. A total of 188 patients received 311 short Osseotite implants that were placed mostly in soft bone and supported 216 partially edentulous cases in the maxilla or mandible. Most restorations (95.2%) are short-span fixed partial dentures placed in the posterior sextants. During 3 years of follow-up, 13 implants failed, yielding a cumulative success rate of 95.8%. In 9 of these cases, failure occurred before prosthetic loading, and in 4, the patient was a smoker. The overall success rate compares favorably with the available literature for the performance of implants in general, and short implants in particular.


Fire as a driver of fungal diversity - A synthesis of current knowledge.
Fires occur in most terrestrial ecosystems where they drive changes in the traits, composition, and diversity of fungal communities. Fires range from rare, stand-replacing wildfires to frequent, prescribed fires used to mimic natural fire regimes. Fire regime factors, including burn severity, fire intensity, and timing, vary widely and likely determine how fungi respond to fires. Despite the importance of fungi to post-fire plant communities and ecosystem functioning, attempts to identify common fungal responses and their major drivers are lacking. This synthesis addresses this knowledge gap and ranges from fire adaptations of specific fungi to succession and assembly fungal communities as they respond to spatially heterogenous burning within the landscape. Fires impact fungi directly and indirectly through their effects on fungal survival, substrate and habitat modifications, changes in environmental conditions, and/or physiological responses of the hosts with which fungi interact. Some specific pyrophilous, or "fire-loving," fungi often appear after fire. Our synthesis explores whether such taxa can be considered cosmopolitan, and whether they are truly fire-adapted or simply opportunists adapted to rapidly occupy substrates and habitats made available by fires. We also discuss the possible inoculum sources of post-fire fungi and explore existing conceptual models and ecological frameworks that may be useful in generalizing fungal fire responses. We conclude with identifying research gaps and areas that may best transform the current knowledge and understanding of fungal responses to fire.


Hunting for the right research fellowship: the dos and don'ts.
Every year, thousands and thousands of people from Asia, most of them PhDs, make the ultimate transition in their lives when they travel to the west to take up fellowship positions (in this case a research fellowship position) in leading labs in North America and Europe. Many of these people travel with their families, not knowing what is coming their way. In this article, a number of issues have been discussed that might help these potential scientists of the future to plan ahead for such a shift and make their transition as smooth as possible.


Analysis of differential metabolites in lung cancer patients based on metabolomics and bioinformatics.
Aim: Based on metabonomics, the metabolic markers of lung cancer patients were analyzed, combined with bioinformatics to explore the underlying disease mechanism. Materials & methods: Based on case-control design, using UPLC-Q-TOF/MS, urine metabolites were detected in discovery and validation set. Multivariate statistical analysis were performed to identify potential markers for lung cancer. A network analysis was constructed to integrate lung cancer disease targets with the above metabolic markers, and its possible mechanism and biological significance were explained. Results: A total of 35 potential markers were identified, 11 of which overlapped. Five key markers have a good linear correlation with serum biochemical indicators. Conclusion: The occurrence and development of lung cancer are closely related to disturbance of D-Glutamine and D-glutamate metabolism, amino acid imbalance. This test was registered on China clinical trial registration center (www.chictr.org.cn/index.aspx), registration number was ChiCTR1900025543.


Time reversal focusing of elastic waves in plates for an educational demonstration.
The purpose of this research is to develop a visual demonstration of time reversal focusing of vibrations in a thin plate. Various plate materials are tested to provide optimal conditions for time reversal focusing. Specifically, the reverberation time in each plate and the vibration coupling efficiency from a shaker to the plate are quantified to illustrate why a given plate provides the best spatially confined focus as well as the highest focal amplitude possible. A single vibration speaker and a scanning laser Doppler vibrometer (SLDV) are used to provide the time reversal focusing. Table salt is sprinkled onto the plate surface to allow visualization of the high amplitude, spatially localized time reversal focus; the salt is thrown upward only at the focal position. Spatial mapping of the vibration focusing on the plate using the SLDV is correlated to the visual salt jumping demonstration. The time reversal focusing is also used to knock over an object when the object is placed at the focal position; some discussion of optimal objects to use for this demonstration are given.


Chemical composition of the essential oils of two Alpinia species from Hainan Island, China.
The essential oils of two Alpinia species, ie. A. hainanensis and A. katsumadai, from Hainan Island, China were analyzed by using GC-MS. The major constituents in the leaf oil of A. hainanensis were ocimene (27.4%), beta-pinene (10.1%), 9-octadecenoic acid (6.5%), n-hexadecanoic acid (5.8%), 9,12-octadecadienoic acid (5.4%), and terpinen (4.3%). The oil constituents obtained from the flowers of A. hainanensis were ocimene (39.8%), beta-pinene (17.7%), terpinene (5.5%), p-menth-1-en-ol (4.9%), caryophyllene (4.9%), and phellandrene (4.4%). In A. katsumadai, the major constituents in the leaf oil were p-menth-1-en-ol (22.0%), terpinen (19.0%), 4-carene (9.1%), 1,8-cineole (8.3%), and camphor (5.6%). The major constituents in the flower oil were p-menth-1-en-ol (21.3%), 1,8-cineole (20.2%), terpinen (12.6%), phellandrene (7.0%), 4-carene (6.4%), and beta-pinene (5.2%).


The Role of Body Mass Index and Hypoalbuminemia on Postoperative Outcomes in Patients Undergoing Total Knee Arthroplasty.
Obesity and malnutrition are modifiable risk factors associated with increased postoperative complications following total knee arthroplasty (TKA). Obesity is paradoxically associated with malnutrition. Previous studies have only evaluated the impact of body mass index (BMI) and hypoalbuminemia separately in relation to postoperative TKA outcomes and have attempted to compare the impact of these modifiable risk factors. Our study seeks to establish if increased BMI and decreased albumin levels have a compounding effect on postoperative outcomes. A retrospective analysis was conducted using the 2011-2014 American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) dataset. This study reaffirmed that increased BMI and low albumin levels are associated with increased postoperative complications following TKA. Moreover, this study demonstrated that they do not have a compounding effect, but rather only help predict outcomes when analyzed individually. (Journal of Surgical Orthopaedic Advances 32(2) 114-117, 2023).


Small bowel obstruction: sonographic evaluation.
Results of 54 sonographic examinations of patients referred for suspected or known small intestinal obstruction were retrospectively correlated with surgical findings, and the diagnostic value of sonography regarding presence, level, and cause of obstruction was compared with that of plain abdominal radiography. The diagnosis of obstruction was correct in 89% of cases with sonography and in 71% with plain radiography. The level of obstruction was correctly predicted in 76% of cases with sonography and in 51% with plain radiography. The cause of obstruction was correctly predicted in 20% of cases with sonography and in 2% with plain radiography. The authors conclude that use of sonography in evaluating patients with bowel obstruction may be helpful in confirmation of the presence of obstruction, in determination of the level of obstruction, and in identification of the cause of obstruction.


Kluyvera species soft tissue infection: case report and review.
A soft tissue infection caused by Kluyvera species in a previously healthy woman is described. Successful treatment required incision and drainage of the wound in addition to administration of antibiotics. Kluyvera species are indole positive, Voges-Proskauer negative members of the family Enterobacteriaceae. Previous reports of infection due to Kluyvera species suggest that the organism is never more than an opportunistic pathogen; however, we report the first case of infection in a previously healthy host.


CRP is or is not a reliable marker of ischaemic heart disease?
In recent years a growing body of evidence has emphasized the role of C-reactive protein (CRP) as a marker of future cardiovascular events. CRP is a pentameric molecule widely utilized as a marker of infections and inflammation. The evidence that inflammation plays an important role in the pathogenesis of coronary artery disease and in plaque destabilization has lead to use of CRP as a marker of cardiovascular disease as well. First described as a component of the inflammatory pathway in acute coronary syndromes, CRP has been consistently found to be associated with the risk of future events in no-ST elevation acute coronary syndromes, independently of other risk factors, including troponine. Subsequently CRP has been described as a powerful marker of risk of future events in large populations of apparently healthy subjects. So far there is very little doubt that CRP represents a reliable marker of cardiovascular events, but some issues remain unanswered such as why CRP is a good marker of cardiovascular events and whether or not a better inflammatory marker exists. It must be stressed that CRP, because of its analytical and biological properties and the large amount of available data, is the only inflammatory marker accepted for clinical use.


Cloning and characterization of a mammalian melatonin receptor that mediates reproductive and circadian responses.
The pineal hormone melatonin regulates seasonal reproductive function and modulates circadian rhythms in mammals. We now report the cloning and characterization of a high affinity receptor for melatonin from the sheep and human. The receptor cDNAs encode proteins that are members of a newly discovered group within the G protein-coupled receptor family. Expression of the sheep and human receptors in COS-7 cells results in high affinity 2-[125I]iodomelatonin binding and pharmacological characteristics similar to endogenous high affinity receptors. Functional studies of NIH 3T3 cells stably expressing the sheep receptor show that the mammalian melatonin receptor is coupled to inhibition of adenylyl cyclase through a pertussis toxin-sensitive mechanism. In situ hybridization studies of melatonin receptor mRNA in several mammals reveal hybridization signals in the hypophyseal pars tuberalis and hypothalamic suprachiasmatic nucleus. The cloned high affinity receptor likely mediates the reproductive and circadian actions of melatonin in mammals.


Non-electrolytic microelectroporation.
Micro and nano technologies are of increasing importance in microfluidics devices used for electroporation (electroporation - the permeabilization of the cell membrane with brief high electric field pulses). Electrochemical reactions of electrolysis occur whenever an electric current flows between an electrode and an ionic solution. It can have substantial detrimental effects, both on the cells and solutions during the electroporation. As electrolysis is a surface phenomenon, between electrodes and solution, the extent of electrolysis is increased in micro and nano electroporation over macro-electroporation, because the surface area of the electrodes in micro and nano electroporation is much larger. A possible way to eliminate the electrolytic effect is to develop non-electrolytic microelectroporation by coating the microelectroporation devices with a dielectric insulating layer. In this study, we examine the effect of a dielectric insulating layer on the performance of a singularity microelectroporation device that we have recently designed. Using numerical analysis, we study the effects of various design parameters including, input sinusoidal voltage amplitude and frequency, geometrical configuration and material electrical properties on the electroporation performance of the non-electrolytic microelectroporation device. In the simulation, we used properties of four real dielectric materials and four solutions of interest for microelectroporation. We characterized the effect of various design parameters of relevance to singularity based microelectroporation, on non-electrolytic microelectroporation. Interestingly, we found that the system behaves in some aspects as a filter and in many circumstances saturation of performance is reached. After saturation is reached, changes in parameters will not affect the performance of the device.


Class III Malocclusion Surgical-Orthodontic Treatment.
The aim of the present case report is to describe the orthodontic-surgical treatment of a 17-year-and-9-month-old female patient with a Class III malocclusion, poor facial esthetics, and mandibular and chin protrusion. She had significant anteroposterior and transverse discrepancies, a concave profile, and strained lip closure. Intraorally, she had a negative overjet of 5 mm and an overbite of 5 mm. The treatment objectives were to correct the malocclusion, and facial esthetic and also return the correct function. The surgical procedures included a Le Fort I osteotomy for expansion, advancement, impaction, and rotation of the maxilla to correct the occlusal plane inclination. There was 2 mm of impaction of the anterior portion of the maxilla and 5 mm of extrusion in the posterior region. A bilateral sagittal split osteotomy was performed in order to allow counterclockwise rotation of the mandible and anterior projection of the chin, accompanying the maxillary occlusal plane. Rigid internal fixation was used without any intermaxillary fixation. It was concluded that these procedures were very effective in producing a pleasing facial esthetic result, showing stability 7 years posttreatment.


Effects of water immersion to the neck on pulmonary circulation and tissue volume in man.
Utilizing the rebreathing of a gas mixture containing C2H2, C180, He O2, and N2, we obtained serial measurements of the pulmonary capillary blood flow (Qc), diffusing capacity per unit of alveolar volume (DL/VA), functional residual capacity (FRC), pulmonary tissue plus capillary blood volume (VTPC), and O2 comsumption (VO2) in five normal subjects under the following conditions: 1) 6 h of sitting, 2) 4 h of sitting while immersed in thermoneutral water to the neck, and 3) 4 h of lying in thermoneutral water to the neck. Water immersion (NI) was preceded and followed by 1-h prestudy and 1-h recovery periods. The measurements were made at 30-min intervals. Seated NI produced a fourfold increase in sodium excretion (UNaV), a 25-36% increase in Qc, a 45-59% increase in DL/VA, and a 30-36% decrease in FRC. This occurred as early as the 1st h of NI and persisted throughout the 4-h period of study. Throughout the seated control and NI periods, VO2, heart rate, and VTPC remained constant. During supine NI, Qc, HR, DL/VA, FRC, and VO2 did not differ significantly from supine prestudy. These date demonstrate that seated NI causes a significant increase of Qc and DL/VA which persists throughout the immersion period. Furthermore, the lack of change of VTPC suggests that the central vascular engorgement induced by seated NI is not accompanied by extravasation of fluid into the pulmonary interstitial space.


Multi-focal Lytic Lesions in a Patient with Myelofibrosis: A Case Report.
Myelofibrosis is a rare disorder that is classified as one of the myeloproliferative disorders. This particular disorder results in the abnormal proliferation of hematopoietic stem cells in the bone marrow. In some cases, such as ours, pathologic fractures can occur due to skeletal manifestations. We report on a rare finding of rapidly progressive lytic lesions in multiple regions throughout the body. This presentation of myelofibrosis behaving in a metastatic-like fashion has not been previously described.


Mitigating risks related to facilities management.
By looking at metrics focusing on the functionality, age, capital investment, transparency, and sustainability (FACTS) of their organizations' facilities, facilities management teams can build potential business cases to justify upgrading the facilities. A FACTS analysis can ensure that capital spent on facilities will produce a higher or more certain ROI than alternatives. A consistent process for managing spending helps to avoid unexpected spikes that cost the enterprise more in the long run.


Comparative electrophysiological responses in anisometropic and strabismic amblyopic children.
To compare anisometropic hypermetropic amblyopic and strabismic amblyopic responses to pattern electroretinogram (PERG) and pattern visual evocated potential (PVEP). Fifty-six patients - 18 hypermetropic anisometropic amblyopic children (mean age 9.70±2.5 years), 19 strabismic amblyopic children (mean age 10.30±2.6 years) and 19 normal emetropic subjects (mean age 10.10±2.2 years) - were enrolled in this study. After routine ophthalmic examination, PERG and PVEP were recorded in response to checks reversed at the rate of two reversals/second stimulating macular area. The difference between hypermetropic anisometropic amblyopia and strabismus amblyopia with respect to P100/P50/N95 wave latencies (P=0.055/0.855/0.132) and P100/P50/N95 amplitudes (P=0.980/0.095/0.045) was not statistically significant. However, there was a significant statistical difference between strabismic amblyopia group and controls for P100/P50/N95 latencies (P=0.000/0.006/0.004). Our findings indicated that despite clinical differences between anisometropic amblyopic and strabismic amblyopic patients, no differences were found in the responses of PVEP and PERG. The abnormal components of the PVEP and PERG in amblyopic subjects could reflect a retinal dysfunction in the visual pathway.


Calcifying fibrous pseudotumor of mediastinum--a case report.
This report presents a case of calcifying fibrous pseudotumor arising in the posterior mediastinum of a 54-year-old woman. The histopathologic features of this case were identical to that of calcifying fibrous pseudotumor first designated in 1993. It is a distinctive benign fibrous lesion characterized by the presence of characteristics psammomatous or dystrophic calcification, abundant hyalinized collagen and lymphoplasmacytic cell infiltrate. Immunohistochemically most of the scattered fibroblasts were positive for vimentin, but not for CD-34 and cytokeratins, distinguishing it from solitary fibrous tumor of pleura and desmoplastic mesothelioma. The unusual site of the posterior mediastinum and the old age characterize this case.


IL-12-mediated NKRP1A up-regulation and consequent enhancement of endothelial transmigration of V delta 2+ TCR gamma delta+ T lymphocytes from healthy donors and multiple sclerosis patients.
Gamma delta T lymphocytes are thought to play a role in the pathogenesis of multiple sclerosis (MS) contributing to demyelinization and fibrosis in the central nervous system. In this study, we show that, in MS patients with active disease, the percentage of circulating V delta 2+ gamma delta T cells coexpressing NKRP1A is significantly increased compared with healthy donors. V delta 2+ and V delta 1+ T cells were sorted from MS patients and healthy volunteers and cloned. At variance with V delta 1+ clones, all V delta 2+ clones expressed NKRP1A, which was strongly up-regulated upon culture with IL-12; this effect was neutralized by specific anti-IL-12 Abs. No up-regulation of NKRP1A by IL-12 was noted on V delta 1+ clones. RNase protection assay showed that IL-12R beta 2 subunit transcript was significantly less represented in V delta 1+ than V delta 2+ clones. This finding may explain the different effect exerted by IL-12 on these clones. In transendothelial migration assays, V delta 2+ NKRP1A+ clones migrated more effectively than V delta 1+ clones, and this migratory potential was enhanced following culture with IL-12. Migration was strongly inhibited by the F(ab')2 of an anti-NKRP1A Ab, suggesting that this lectin is involved in the migration process. We also show that, in freshly isolated PBMC from MS patients, the migrated population was enriched for V delta 2+ NKRP1A+ cells. We conclude that the expression of NKRP1A on V delta 2+ cells is associated with increased ability to migrate across the vascular endothelium and that this phenomenon may be regulated by IL-12 present in the microenvironment.


Temporal and energetic characteristics of behavior predicting long-term job strain, job demands, and job control: a population-based study.
To examine whether temporal and energetic characteristics of behavior contribute to perceived job strain and its components. There were 611 participants (273 men) aged 30 to 45 years. Temperament traits were measured by Strelau's Formal Characteristics of Behavior-Temperament Inventory in 1997 and 2001. Job characteristics, education, and occupation were reported in 2001 and 2007. We found that higher emotional reactivity and perseveration, and lower briskness, endurance, and activity, predicted higher long-term perceived job strain in men and women. Higher job demands were predicted by lower endurance, higher emotional reactivity, and higher perseveration. Higher long-term job control was predicted by higher briskness, endurance, activity, and lower perseveration and emotional reactivity. Being emotionally highly reactive and having a persevering temperament may increase the likelihood of high job strain, whereas having a brisk, enduring, and active temperament may decrease it.


Epidemiology of Staphylococcus aureus in a burn unit of a tertiary care center in Ghana.
In developing countries, hospitalized burn victims are at high risk of nosocomial infections caused by Staphylococcus aureus. Risk factors include poor infection control practices, prolonged hospitalisation and limited capacity for laboratory microbiological analyses. These problems are compounded by widespread use of antibiotics that drives the spread of multi-drug resistant bacteria. During the study period (November 2014-June 2015), nasal and invasive S. aureus isolates were collected consecutively from patients and healthcare workers (HCWs) within the burn unit of the Reconstructive Plastic Surgery and Burn Center of Korle Bu Teaching Hospital in Ghana. Antibiotic prescription, antibiotic susceptibility and bacterial typing were used to assess antibiotic pressure, antibiotic resistance, and possible transmission events among patients and HCWs. Eighty S. aureus isolates were obtained from 37 of the 62 included burn patients and 13 of the 29 HCWs. At admission, 50% of patients carried or were infected with S. aureus including methicillin resistant S. aureus (MRSA). Antibiotic use per 100 days of hospitalization was high (91.2 days), indicating high selective pressure for resistant pathogens. MRSA isolates obtained from 11 patients and one HCW belonged to the same spa-type t928 and multi-locus sequence type 250, implying possible transmission events. A mortality rate of 24% was recorded over the time of admission in the burn unit. This study revealed a high potential for MRSA outbreaks and emergence of resistant pathogens amongst burn patients due to lack of patient screening and extended empirical use of antibiotics. Our observations underscore the need to implement a system of antibiotic stewardship and infection prevention where microbiological diagnostics results are made available to physicians for timely and appropriate patient treatment.


[Hemobilia caused by biliary cyst].
Recurrent angiocholitis attacks occurred in an 80-year-old woman, and repeated investigations could not provide any diagnosis. Subsequently, the patient developed haematemesis. Angiography revealed haemobilia from an intrahepatic cause. Surgical constatations and pathological examination of the resected specimen revealed that haemobilia was due to a non-parasitic cyst of the liver. In this case, haemobilia resulted from two unusual complications of this hepatic lesion: intra-cystic bleeding and communication with an intrahepatic duct. Haemobilia has never been reported as a complication of non-parasitic cyst of the liver.


Regulatory roles of p21 and apurinic/apyrimidinic endonuclease 1 in base excision repair.
Many types of DNA damage induce a cellular response that inhibits replication but allows repair by up-regulating the p53 pathway and inducing p21(Cip1, Waf1, Sdi1). The p21 regulatory protein can bind proliferating cell nuclear antigen (PCNA) and prohibit DNA replication. We show here that p21 also inhibits PCNA stimulation of long patch base excision repair (BER) in vitro. p21 disrupts PCNA-directed stimulation of flap endonuclease 1 (FEN1), DNA ligase I, and DNA polymerase delta. The dilemma is to understand how p21 prevents DNA replication but allows BER in vivo. Differential regulation by p21 is likely to relate to the utilization of DNA polymerase beta, which is not sensitive to p21, in the repair pathway. We have also found that apurinic/apyrimidinic endonuclease 1 (APE1) stimulates long patch BER. Furthermore, neither APE1 activity nor its ability to stimulate long patch BER is significantly affected by p21 in vitro. We propose that APE1 serves as an assembly and coordination factor for long patch BER proteins. APE1 initially cleaves the DNA and then facilitates the sequential binding and catalysis by DNA polymerase beta, DNA polymerase delta, FEN1, and DNA ligase I. This model implies that BER can be regulated differentially, based upon the assembly of relevant proteins around APE1 in the presence or absence of PCNA.


Acute hemodynamic effects of medetomidine and clonidine in healthy volunteers: a noninvasive echocardiographic study.
Single intravenous (i.v.) doses of 4(5)-[1-(2,3-dimethylphenyl)ethyl]imidazole, medetomidine (MED), (25, 50, and 100 micrograms) and clonidine (CLO 200 micrograms) were administered to five healthy male volunteers in a randomized, double-blind, placebo-controlled, multiple cross-over study. The hemodynamic effects of the drugs were determined by a two-dimension Doppler-echocardiographic method. Blood pressure (BP) and heart rate (HR) were monitored noninvasively. Cardiac output (CO) was maximally reduced by 23% after 100 micrograms MED and 200 micrograms CLO. Dose-related decreases were observed in systolic BP (SBP) and diastolic BP (DBP) and HR. Maximal reductions were 18 and 11 mm Hg and 11 beats/min after 100 micrograms MED, and 18 and 13 mm Hg and 12 beats/min after CLO. Calculated total peripheral resistance (TPR) and the PR interval on ECG remained unchanged. Ejection fraction (EF) and stroke volume (SV) were not significantly affected by either drug, but mean circumferential fiber shortening velocity (VCF) and the preejection period/left ventricular ejection time (PEP/LVET) ratio indicated a tendency to slightly decreased myocardial performance. We conclude that the new selective alpha 2-adrenoceptor agonist, MED, resembles CLO in its acute hemodynamic actions in healthy humans.


Experience of combined tetravalent diphtheria, tetanus, whole-cell pertussis and hepatitis B vaccine in Thailand.
In 1992, hepatitis B (HB) vaccination of all newborns was officially included in the national expanded program on immunization (EPI), since satisfactory levels of immunity had been attained among the target populations of Chiang Mai and Chon Buri Province during the trial period, 1989 and 1992. In order to facilitate this process and to reduce the administrative costs created by integration of the additional vaccine, the option of combining HB vaccine with the DTP vaccine was investigated. Thus, in 1991 our group performed a clinical study of Smith Kline Beecham Biological's DTP-HB vaccine, administering it to 160 infants of HBsAg negative mothers at the age of 2, 4 and 6 months, respectively. We found the evoked immune responses to be at least equal to, if not higher, than those achieved with the monovalent vaccine. Likewise, any adverse reactions were comparable to those observed after administering either DTP or HB vaccine separately. According to our additional data, we consider HB vaccination at birth, followed by the combined DTP-HB vaccine at the ages of 2, 4, 6 and 18 months, respectively, most advantageous and we would recommend integrating this regimen into the basic immunization service. Thus, the possibility of eradicating hepatitis B infection altogether might eventually be provided.


Development, Pathogenesis, and Regeneration of the Intervertebral Disc: Current and Future Insights Spanning Traditional to Omics Methods.
The intervertebral disc (IVD) is the fibrocartilaginous joint located between each vertebral body that confers flexibility and weight bearing capabilities to the spine. The IVD plays an important role in absorbing shock and stress applied to the spine, which helps to protect not only the vertebral bones, but also the brain and the rest of the central nervous system. Degeneration of the IVD is correlated with back pain, which can be debilitating and severely affects quality of life. Indeed, back pain results in substantial socioeconomic losses and healthcare costs globally each year, with about 85% of the world population experiencing back pain at some point in their lifetimes. Currently, therapeutic strategies for treating IVD degeneration are limited, and as such, there is great interest in advancing treatments for back pain. Ideally, treatments for back pain would restore native structure and thereby function to the degenerated IVD. However, the complex developmental origin and tissue composition of the IVD along with the avascular nature of the mature disc makes regeneration of the IVD a uniquely challenging task. Investigators across the field of IVD research have been working to elucidate the mechanisms behind the formation of this multifaceted structure, which may identify new therapeutic targets and inform development of novel regenerative strategies. This review summarizes current knowledge base on IVD development, degeneration, and regenerative strategies taken from traditional genetic approaches and omics studies and discusses the future landscape of investigations in IVD research and advancement of clinical therapies.


Biological activity of 6,12-dihydro-1-benzopyrano[3,4-b][1,4]benzothiazin-6-ones.
Ten 6,12-dihydro-1-benzopyrano[3,4-b][1,4]benzothiazin-6-ones (Coumarins)[1-7] and related coumarins [8-10] were compared for their cytotoxic activity and radical intensity. Among these compounds, compound 7 showed highest cytotoxic activity against human promyelocytic leukemic HL-60 cells. Compound 7 produced radicals under alkaline conditions, and showed the lowest pi-spin density at S-atom of the molecule, suggesting the delocalization of pi-spin density. These data suggest the possible relation between radical intensity and biological activity.


Mental health literacy in primary care: Canadian Research and Education for the Advancement of Child Health (CanREACH).
The effectiveness of a continuing education programme in paediatric psychopharmacology designed for primary healthcare providers was objectively measured based on the assumption that training would lead to measurable changes in referral patterns and established clinical measures of referred patients. Using established, valid and reliable measures of clinical urgency embedded in to a regional healthcare system since 2002, the referrals to child and adolescent psychiatric services of physicians who participated in the training (n=99) were compared pretraining and post-training, and to non-participating/untrained referring physicians (n=7753) making referrals over the same time period. Referrals were analysed for evidence of change based on frequencies and measures of clinical urgency. Participants of the training programme also completed standardised baseline and outcome self-evaluations. Congruent with participants self-reported evaluative reports of improved knowledge and practice, analysis of referral frequency and the clinical urgency of referrals to paediatric psychiatric services over the study period indicated that trained physicians made more appropriate referrals (clinically more severe) and reduced referrals to emergency services. Quantitative clinical differences as completed by intake clinicians blind to referrals from the study group designations were observed within the trained physician group pretraining and post-training, and between the trained physician group and the unexposed physician group. The results illustrate a novel model for objectively measuring change among physicians based on training in paediatric mental health management.


Coexpression of sensory and autonomic neurotransmitter traits by avian neural crest cells in vitro.
This study shows that explants of quail neural crest cultured in a medium containing serum and chick embryo extract give rise to large numbers of cells expressing immunoreactivity for substance P (SP), a neuropeptide found in sensory neurons. These cells arise from cycling precursors, but do not appear to divide after expressing SP. The SP-positive cells in cranial neural crest cultures express both neurofilament and the Q211 antigen, but those in trunk cultures express only the Q211 antigen. In both cranial and trunk cultures, large subpopulations of the SP-positive cells express tyrosine hydroxylase and/or choline acetyltransferase, neurotransmitter markers characteristic of autonomic neurons. This finding argues against the idea that SP expression necessarily indicates commitment to the sensory neuron lineage. I further show that embryonic dorsal root ganglion (DRG) cells retain the ability to coexpress SP and tyrosine hydroxylase in vitro, although to a lesser extent than do neural crest cells.


A 30-year neglected foreign body mimicking a maxillary fracture.
A-50-year-old male patient presented with complaint of tenderness on the left malar area after traffic accident. Our first impression on him was zygomatic fracture, we did radiologic work-up and physical examination on him. But, on the computed tomography scan, there was no fracture or discontinuity on his facial bone. The computed tomography scan was revealed a 4-cm long foreign body in left maxillary sinus with a large amount of fluid collection. After thorough history taking from him, we reveal the patient had a history of trauma 30 years back on the left zygomatic area with a chopstick. The foreign body was removed via transoral approach with the endoscopic assist. There was no complication after operation.


Association Between Meniscal Allograft Tears and Early Surgical Meniscal Allograft Failure.
Meniscal allograft transplantation (MAT) has become a viable treatment option for patients with symptomatic meniscal deficiency. Some patients experience early surgical meniscal allograft failure attributed to causes that have not yet been sufficiently clarified. To evaluate the prevalence, types, and distribution of arthroscopically confirmed meniscal allograft tears and the associated effect on surgical meniscal allograft survival. Cohort study; Level of evidence, 3. Patients undergoing MAT with a minimum 2-year follow-up were retrospectively reviewed. Descriptive and surgical data were collected. Type and location of arthroscopically confirmed meniscal allograft tears were recorded and compared between medial and lateral allografts and suture-only and bone block fixation. A survival analysis was conducted to evaluate the effect of meniscal allograft tears on surgical meniscal allograft survival. This study included 142 patients (54% male; mean ± SD age, 29.6 ± 10.4 years) with a mean follow-up of 10.3 ± 7.5 years. The prevalence of meniscal allograft tears was 32%, observed at a median of 1.2 years (interquartile range, 2.8 years) after MAT. The posterior horns were most frequently affected, followed by the posterior roots, midbodies, anterior horns, and anterior roots. The most frequently observed tear types were root tears (43%), followed by longitudinal, horizontal, radial, complex, bucket-handle, and meniscocapsular separation tears. A statistically significant association was found between meniscal allograft tear types and fixation techniques (P = .027), with root tears predominant after suture-only as compared with bone block fixation (57% vs 22%). Patients with meniscal allograft root tears were a mean of 5.4 years (95% CI, 1.6-9.2 years; P = .007) younger than were patients without root tears. The 1-year surgical meniscal allograft survival rate was significantly lower for torn versus intact meniscal allografts (75% vs 99%; P < .001). Meniscal allograft root tears were predominant, associated with younger patient age, and more often observed when using the suture-only fixation technique versus the bone block fixation technique. Torn meniscal allografts were associated with early surgical graft failure when compared with intact meniscal allografts, resulting in a significantly lower 1-year survival rate.


A simple method to measure the temperature and levitation height of devices rotating at cryogenic temperatures.
We describe a simple system to measure the temperature and levitation height of levitating cryogenic devices in rotation. Devices of this kind are the half-wave-plates rotating on superconducting magnetic bearings used in several cryogenic polarimeters for the cosmic microwave background. The temperature measurement is important to monitor the radiative background and potential systematic effects in the polarimeter. In our implementation, the temperature sensor is a thermistor, physically mounted on the rotating device. The sensor is biased with an AC current, which is transferred from the stationary electronics to the rotating device via capacitive coupling. The levitation height sensor is a network of capacitors, similar to the one used for the capacitive coupling of the thermistor. We describe the optimization of the readout system and its performance, which has been tested on a room-temperature prototype. We show that this system reaches an accuracy better than 3% for the measurement of the thermistor resistance and an accuracy of ∼10 μm for the measurement of its levitation height.


Glucose uptake in Saccharomyces cerevisiae grown under anaerobic conditions: effect of null mutations in the hexokinase and glucokinase structural genes.
Glucose uptake was investigated in a set of isogenic strains carrying a single glucose kinase structural gene, the other two kinase genes having been rendered nonfunctional through the construction of null mutations. Any one of the three kinases was sufficient for growth and glucose utilization aerobically or anaerobically. Under anaerobic conditions, substrate inhibition and regulation of carrier activity varied and depended upon the particular kinase present in the cell.


Traumatic pseudoaneurysm: a possible early lesion in the spectrum of epithelioid hemangioma/angiolymphoid hyperplasia with eosinophilia.
We describe a vascular lesion that develops secondary to trauma (pseudotraumatic aneurysm) and study its relation to epithelioid hemangioma (EH)/angiolymphoid hyperplasia with eosinophilia (ALHE). Four lesions are described, all with a distinct history of trauma to the site from which they arose. They presented with masses in the subcutaneous tissue of the head. They were studied by immunohistochemical methods to identify their component cells. The lesions all demonstrated marked thickening of the wall of small and medium-sized arteries, with capillary vascular proliferations. One lesion demonstrated increased eosinophils. Myxoid changes were noted in all lesions. We hypothesize that these lesions may represent an early form of EH/ALHE.


Loss of Feedback Regulation between FAM3B and Androgen Receptor Driving Prostate Cancer Progression.
Although the TMPRSS2-ERG fusion occurs frequently in prostate cancer (PC), its impact on clinical outcomes remains controversial. Roughly half of TMPRSS2-ERG fusions occur through intrachromosomal deletion of interstitial genes and the remainder via insertional chromosomal rearrangements. Because PCs with deletion-derived TMPRSS2-ERG fusions are more aggressive than those with insertional fusions, we investigated the impact of interstitial gene loss on PC progression. We conducted an unbiased analysis of transcriptome data from large collections of PC samples and employed diverse in vitro and in vivo models combined with genetic approaches to characterize the interstitial gene loss that imposes the most significant impact on clinical outcome. This analysis identified FAM3B as the top-ranked interstitial gene whose loss is associated with a poor prognosis. The association between FAM3B loss and poor clinical outcome extended to fusion-negative PCs where FAM3B downregulation occurred through epigenetic imprinting. Importantly, FAM3B loss drives disease progression in PC. FAM3B acts as an intermediator of a self-governing androgen receptor (AR) feedback loop. Specifically, AR upregulates FAM3B expression by binding to an intronic enhancer to induce an enhancer-RNA and facilitate enhancer-promoter looping. FAM3B, in turn, attenuates AR signaling. Loss of FAM3B in PC, whether through the TMPRSS2-ERG translocation or epigenetic imprinting, causes an exit from this autoregulatory loop to unleash AR activity and PC progression.These findings establish FAM3B loss as a new driver of PC progression and support the utility of FAM3B loss as a biomarker to better define aggressive PC.


Isolation of Antifungal Lactic Acid Bacteria (LAB) from "Kunu" against Toxigenic Aspergillus flavus.
The antifungal activity of isolated lactic acid bacteria (LAB) from a locally fermented cereal, "Kunu", was tested against toxigenic Aspergillus flavus. The liquid refreshment, "Kunu", was prepared under hygienic condition using millet, sorghum, and the combination of the two grains. The antifungal potential of isolated LAB against toxigenic A. flavus was carried out using both in vitro and in vivo antifungal assays. The LAB count from prepared "Kunu" ranged from 2.80 ×104 CFU/mL to 4.10×104 CFU/mL and Lactobacillus plantarum, Lactobacillus delbrueckii, Lactobacillus fermentum, Pediococcus acidilactici, and Leuconostoc mesenteroides were the isolated bacteria. Inhibitory zones exhibited by LAB against toxigenic A. flavus ranged from 5.0 mm to 20.0 mm. The albino mice infected with toxigenic A. flavus showed sluggishness, decrease in body weight, distortion of hair, and presence of blood in their stool, while those treated with LAB after infection were recovered and active like those in control groups. Except for the white blood cell that was increased in the infected mice as 6.73 mm3, the packed cell volume, hemoglobin, and red blood cell in infected animals were significantly reduced (P<0.05) to 29.28%, 10.06%, and 4.28%, respectively, when compared to the treated mice with LAB and control groups. The antifungal activity of LAB against toxigenic A. flavus can be attributed to the antimicrobial metabolites. These metabolites can be extracted and used as biopreservatives in food products to substitute the use of chemical preservatives that is not appealing to consumers due to several side effects.


New approach for enlargement of medical electronic endoscopic images.
To compensate for the imperfections of the endoscopic mechanical structure and the limitations of working space, a new technology based on the recursive minimum/maximum method is proposed to enlarge images obtained by the medical electronic endoscope. This method can be used repeatedly to obtain image enlargement to 2x by optimizing the neighborhood information of the pixels of interest in adjustable windows. In order to ensure the best evaluation of the pixel, the algorithm criterion is presented to decide whether the new gray value is assigned to the pixel. Experimental results from enlarged endoscopic images are presented that demonstrate that the recursive minimum/maximum method for image enlargement can preserve the fine details with rich edge information and with better visualization.


Five Year Follow up of Retrospective Cohort Comparing Structural and Functional Outcome of Arthroscopic Single-row ersus Double-row Suture Bridge Repair of Large Posterosuperior Rotator Cuff Tear in Patients Less than or Equal to 70 Years.
High re-tear rates after repairing large-sized posterosuperior rotator cuff tears remain a significant concern which may affect the clinical outcome. The most optimal type of repair (single versus double-row suture bridge) suited for large size tear remains debatable. In a retrospective cohort study with a minimum of five years follow up, the structural and functional outcome of 103 patients with large size cuff tear repaired with single row (SR) or double row suture bridge (DRSB) were evaluated. The structural outcome was assessed with ultrasonography whereas functional outcome was evaluated with Constant Murley (CM) and American shoulder elbow score (ASES). There were 55 patients in the SR group and 48 patients in the DRSB group with a mean follow-up of 74.2 months (range, 60-96 months). While comparing the structural integrity in two groups, we found significantly lower re-tear rates in the DRSB group as compared to the SR group (10.4% vs. 32.7%; P=0.006). Also, there were more focal defects in the SR group (25.4%) than the DRSB group (8.3%). Overall, there was no significant difference in CM and ASES scores when the SR group was compared to DRSB. However, subgroup analysis between those with intact and retorn tendon revealed significant difference (P=0.0001) in the clinical scores. At a minimum of five years follow-up, the DRSB repair of large posterosuperior cuff tear resulted in superior structural healing over SR repair. Nevertheless, overall there was no significant functional difference between both the techniques. However, the functional outcome of the healed tendon subgroup was superior to retear tendon subgroup.


The California Verbal Learning Test-II: normative data for two Italian alternative forms.
The aim of this study was to develop two versions of the California Verbal Learning Test-II (CVLT-II) and to administer them to a large sample of healthy controls representative of the normal Italian population for sex, age, and education levels. Two hundred and eighty healthy controls entered the study and were randomly assigned to one of the two forms of CVLT-II. No significant difference emerged between the two forms. Considering the significant weight of sex, age and education level, a regression model was developed through which it was possible to calculate the adjusted scores. The lower tolerance limits were also calculated.


Nurse-patient advocacy and the right to die.
This article examines the implications of the U.S. Supreme Court's decision to uphold Oregon's Death with Dignity Act, as well as three crucial cases, on nursing practice: Terri Schiavo, Karen Quinlan, and Nancy Cruzan. In addition, an individual example is provided to demonstrate how nurses can advocate for patients at the end of life, and specific suggestions are offered.


Mitochondrial coupling in vivo in mouse skeletal muscle.
The coupling of mitochondrial ATP synthesis and oxygen consumption (ratio of ATP and oxygen fluxes, P/O) plays a central role in cellular bioenergetics. Reduced P/O values are associated with mitochondrial pathologies that can lead to reduced capacity for ATP synthesis and tissue degeneration. Previous work found a wide range of values for P/O in normal mitochondria. To measure mitochondrial coupling under physiological conditions, we have developed a procedure for determining the P/O of skeletal muscle in vivo. This technique measures ATPase and oxygen consumption rates during ischemia with 31P magnetic resonance and optical spectroscopy, respectively. This novel approach allows the independent quantitative measurement of ATPase and oxygen flux rates in intact tissue. The quantitative measurement of oxygen consumption is made possible by our ability to independently measure the saturations of hemoglobin (Hb) and myoglobin (Mb) from optical spectra. Our results indicate that the P/O in skeletal muscle of the mouse hindlimb measured in vivo is 2.16 +/- 0.24. The theoretical P/O for resting muscle is 2.33. Systemic treatment with 2,4-dinitrophenol to partially uncouple mitochondria does not affect the ATPase rate in the mouse hindlimb but nearly doubles the rate of oxygen consumption, reducing in vivo P/O to 1.37 +/- 0.22. These results indicate that only a small fraction of the oxygen consumption in resting mouse skeletal muscle is nonphosphorylating under physiological conditions, suggesting that mitochondria are more tightly coupled than previously thought.


Kidney preservation using combinations of Belzer and Collins techniques.
A study was designed to test the advisability of using combined Belzer and Collins preservation in kidney-sharing programs. Dogs were randomly assigned to seven groups and no donor pretreatment was used. In group 1, left kidneys were removed from dogs; were flushed with Collins solution; and were autotransplanted immediately. In groups 2 through 7, dog kidneys were preserved for 24 hr using combined techniques. The percentage of Collins preservation included in each group was increased progressively until, in Group 7, Collins alone was used. Contralateral nephrectomies were performed at the time of autotransplantation. Between 4 and 8 dogs survived in each group, yielding 43 6-week survivors. Sixty-six per cent of group 7 animals and greater than 90% of animals in other groups survived 6 weeks after transplantation. Average creatinine and blood urea nitrogen values on days 3,7, and 42 showed a progressive increase in kidney damage from groups 1 through 7. As the percentage of time the kidneys were subjected to Collins preservation was increased, the quality of kidney preservation decreased in a progressive manner. This study suggests that Belzer and Collins techniques can be combined, but superior preservation was obtained when the majority of preservation was on the Belzer apparatus.


Machine Learning-Based Models for Prediction of Toxicity Outcomes in Radiotherapy.
In order to limit radiotherapy (RT)-related side effects, effective toxicity prediction and assessment schemes are essential. In recent years, the growing interest toward artificial intelligence and machine learning (ML) within the science community has led to the implementation of innovative tools in RT. Several researchers have demonstrated the high performance of ML-based models in predicting toxicity, but the application of these approaches in clinics is still lagging, partly due to their low interpretability. Therefore, an overview of contemporary research is needed in order to familiarize practitioners with common methods and strategies. Here, we present a review of ML-based models for predicting and classifying RT-induced complications from both a methodological and a clinical standpoint, focusing on the type of features considered, the ML methods used, and the main results achieved. Our work overviews published research in multiple cancer sites, including brain, breast, esophagus, gynecological, head and neck, liver, lung, and prostate cancers. The aim is to define the current state of the art and main achievements within the field for both researchers and clinicians.


Electroencephalographic evaluation in Sturge-Weber syndrome.
The most consistent electroencephalographic finding in 16 cases of Sturge-Weber syndrome was a unilateral reduction of background amplitude in the waking record. Comparable asymmetries were noted in those patients in whom sleep recording also was done. Physiologic responses (to hyperventilation and photic driving) usually were decreased on the involved side. These hemispheric electroencephalographic abnormalities are detectable in infancy even before the characteristic intracranial calification develops. Epileptiform activity, when focal, was limited to the involved hemisphere.


Physicochemical aspects and efficiency of albuterol nebulization: comparison of three aerosol types in an in vitro pediatric model.
Advances in nebulizer design have produced both ultrasonic nebulizers and devices based on a vibrating mesh (vibrating mesh nebulizers), which are expected to enhance the efficiency of aerosol drug therapy. The aim of this study was to compare 4 different nebulizers, of 3 different types, in an in vitro model using albuterol delivery and physical characteristics as benchmarks. The following nebulizers were tested: Sidestream Disposable jet nebulizer, Multisonic Infra Control ultrasonic nebulizer, and the Aerogen Pro and Aerogen Solo vibrating mesh nebulizers. Aerosol duration, temperature, and drug solution osmolality were measured during nebulization. Albuterol delivery was measured by a high-performance liquid chromatography system with fluorometric detection. The droplet size distribution was analyzed with a laser granulometer. The ultrasonic nebulizer was the fastest device based on the duration of nebulization; the jet nebulizer was the slowest. Solution temperature decreased during nebulization when the jet nebulizer and vibrating mesh nebulizers were used, but it increased with the ultrasonic nebulizer. Osmolality was stable during nebulization with the vibrating mesh nebulizers, but increased with the jet nebulizer and ultrasonic nebulizer, indicating solvent evaporation. Albuterol delivery was 1.6 and 2.3 times higher with the ultrasonic nebulizer and vibrating mesh nebulizers devices, respectively, than with the jet nebulizer. Particle size was significantly higher with the ultrasonic nebulizer. The in vitro model was effective for comparing nebulizer types, demonstrating important differences between nebulizer types. The new devices, both the ultrasonic nebulizers and vibrating mesh nebulizers, delivered more aerosolized drug than traditional jet nebulizers.


Development of the Croatian model of organ donation and transplantation.
During the past ten years, the efforts to improve and organize the national transplantation system in Croatia have resulted in a steadily growing donor rate, which reached its highest level in 2011, with 33.6 utilized donors per million population (p.m.p.). Nowadays, Croatia is one of the leading countries in the world according to deceased donation and transplantation rates. Between 2008 and 2011, the waiting list for kidney transplantation decreased by 37.2% (from 430 to 270 persons waiting for a transplant) and the median waiting time decreased from 46 to 24 months. The Croatian model has been internationally recognized as successful and there are plans for its implementation in other countries. We analyzed the key factors that contributed to the development of this successful model for organ donation and transplantation. These are primarily the appointment of hospital and national transplant coordinators, implementation of a new financial model with donor hospital reimbursement, public awareness campaign, international cooperation, adoption of new legislation, and implementation of a donor quality assurance program. The selection of key factors is based on the authors' opinions; we are open for further discussion and propose systematic research into the issue.


[Ultrastructural characteristics of gap junctions in human glial brain tumors].
to conduct an electron microscopic study of intercellular communication in the samples of gemistocytic astrocytoma, oligodendroglioma, and glioblastoma. Surgically resected tumor tissue fragments were fixed in 2.5% glutaraldehyde solution, afterfixed in 1% OsO4 solution, dehydrated, and embedded in epoxy resin. Ultrathin sections were examined using a Jem 1011 electron microscope (Jeol, Japan). Solitary and closely spaced gap junctions (GJs) formed by the thin processes that have the ultrastructure of an astroglial processes were identified in the astrocytoma samples. In this case, chemical synapses were noted to be completely absent in gemistocytic astrocytoma and glioblastoma. The identified GJs had a small length and deformed nexuses. The oligodendroglioma samples exhibited intact astroglial processes around the chemical synapses; however, interglial GJs were not found. The investigation showed the presence of intercellular GJs with some ultrastructural differences in the samples of low- and high-grade astroglial tumors. According to current data, astrocytomic GJs are able to create a stable self-sustaining network that promotes tumor progression and provides resistance to a therapeutic intervention. At the same time, the noticeable reduction in the number of GJs, which is most pronounced in the oligodendroglioma sample, can accelerate tumor cell migration into the surrounding parenchyma. The investigation of GJs should be, of course, continued using a group of a larger number of glial tumors to confirm the intercellular communication features revealed in this study.


Disabilities in older African-American women: understanding the current state of the literature.
The purpose of this review sought to address the following question: What does the current literature report regarding older African-American women with disabilities? A search of PubMed database was done for research on African-American women, ages 45 years and older, who have a disability. Sixty-one articles were reviewed and categorized into groups according to themes. The term disability was only defined in one of the studies. Overall, the studies reviewed revealed racial and ethnic disparities among African-American women with disabilities that included increased hospital days, poor health days, hospitalizations, being functionally totally dependent, and having increased primary and repeat amputations when compared to their White counterparts.


Growth kinetics, structure, and morphology of para-quaterphenyl thin films on gold(111).
The adsorption, desorption, and growth kinetics as well as the thin film morphology and crystal structure of p-quaterphenyl (4P) grown under ultrahigh vacuum conditions on single crystalline Au(111) have been investigated. Thermal desorption spectroscopy (TDS) reveals two distinct first-order peaks attributed to monolayer desorption followed by a zero-order multilayer desorption. The saturation coverage of the full 4P monolayer has been quantitatively measured with a quartz microbalance to be 8 x 10(13) molecules/cm2. Using low energy electron diffraction the structures of the 0.5 and 1 ML (monolayer) adsorbates have been studied, showing highly regular arrangements of the 4P molecules, which are affected by the (111) surface structure. At the transition from 0.5 to 1 ML a structural compression of the overlayer has been observed. The behavior of thicker 4P films has been investigated by combined TDS-XPS (XPS-x-ray photoelectron spectroscopy). A temperature-induced recrystallization process at about 270 K has been observed for a 7 nm thick 4P film grown at 93 K, corresponding to a transition from a disordered layerlike growth to a crystalline island growth. Ex situ optical microscopy and atomic-force microscopy investigations have revealed needle-shaped 4P islands. Applying x-ray diffraction the crystalline order and epitaxial relationship of the 4P films with 30 nm and 200 nm mean thicknesses have been determined.


Proteolysis, NaOH and ultrasound-enhanced extraction of anticoagulant and antioxidant sulfated polysaccharides from the edible seaweed, Gracilaria birdiae.
The sulfated polysaccharides (SP) from the edible red seaweed, Gracilaria birdiae, were obtained using five different extraction conditions: Gracilaria birdiae 1 (GB1)-water; GB1s-water/sonication; GB1sp-water/sonication/proteolysis; GB2s-NaOH/sonication; and GB2sp-NaOH/sonication/proteolysis. The yield (g) increased in the following order: GB2sp>GB1sp>GB2s>GB1s>GB1. However, the amount of SP extracted increased in a different way: GB2sp>GB1>GB1sp>GB1s>GB2s. Infrared and electrophoresis analysis showed that all conditions extracted the same SP. In addition, monosaccharide composition showed that ultrasound promotes the extraction of polysaccharides other than SP. In the prothrombin time (PT) test, which evaluates the extrinsic coagulation pathway, none of the samples showed anticoagulant activity. While in the activated partial thromboplastin time (aPTT) test, which evaluates the intrinsic coagulation pathway, all samples showed anticoagulant activity, except GB2s. The aPTT activity decreased in the order of GB1sp>GB2sp>GB1>GB1s>GB2s. The total capacity antioxidant (TCA) of the SP was also affected by extraction condition, since GB2s and GB1 showed lower activity in comparison to the other conditions. In conclusion, the conditions of SP extraction influence their biological activities and chemical composition. The data revealed that NaOH/sonication/proteolysis was the best condition to extract anticoagulant and antioxidant SPs from Gracilaria birdiae.


MR imaging of hip disorders.
Magnetic resonance (MR) imaging has been applied to the study of a variety of hip disorders, principally the evaluation of avascular necrosis. The authors reviewed their experience with MR imaging of a variety of pediatric and adult hip diseases. Attention to the details of the imaging technique is essential for maximizing the diagnostic potential of MR imaging in the work-up of hip disease. Specific protocols that incorporate surface coil imaging, oblique imaging planes, and alternative pulse sequences are the foundation of successful hip studies. Gradient-echo imaging is essential for evaluating cartilaginous disorders, particularly in pediatric patients. For patients to benefit from the diagnostic capabilities of MR imaging, an appreciation of the unique information it provides must be communicated to referring physicians. In addition, an awareness of the atypical and unique MR appearances of certain hip disorders is necessary for accurate interpretation.


Blood levels of hexavalent chromium in rats. "In vitro" and "in vivo" experiments.
For the Cr(VI) selective separation from biological materials we have developed a highly rapid extraction-separation method with liquid anion exchanger as Amberlite LA-1 or LA-2. The analytical determination of Cr(VI) in organic phase was carried out using electrothermal atomic absorption spectroscopy (ETA-AAS). After i.v. administration of 0.5 and 2.5 mg/kg b.w. of K2Cr2O7 in male Wistar rats the biological samples, collected at different times, were immediately analyzed. Cr(VI) was not detected in whole blood one minute after administration of the lower dose. In blood of rats receiving higher dose an incomplete reduction of Cr(VI) was observed. Such data demonstrate a highly rapid but limited metabolic capacity of hematic compartment to reduce Cr(VI) to trivalent status. "In vitro" incubation of K2Cr2O7 (4 microM) with rat erythrocytes or plasma at 37 degrees C showed a rapid reduction of Cr(VI) in red cells while plasma samples demonstrated a limited reductive power. These results obtained with a new and specific analytical method, confirmed a trigger role of red cells in Cr(VI) metabolism.


Pain management consultation for acute pancreatitis: impact on length of stay and opioid utilization.
Aim: The purpose of the study was to understand the impact of a pain management consult for acute pancreatitis patients on their inpatient length of stay, morphine milligram equivalences (MMEs) and pancreatitis severity. Materials & methods: Adult patient data were extracted from the electronic health records from 1 October 2016 to 31 December 2018. Results & conclusion: Of 277 patients with a single acute pancreatitis hospitalization, 23 had a pain consultation (treatment group), whereas 254 did not (control group). There were statistically significant differences in median length of stay, median MME total and median MME per day between the treatment and control groups with comparable severity and pain scores (6.8 vs 3.1 days, 196.5 vs 33.8 MMEs, 30.9 vs 12.1 MMEs, respectively, p < 0.0001). This study emphasizes the complexity of pain management and the importance of further research in the field.


Efficacy of single dose albendazole on the prevalence and intensity of infection of soil-transmitted helminths in Orang Asli children in Malaysia.
The efficacy of a single-dose 400 mg albendazole to treat Ascaris, Trichuris and hookworm infection was studied in Orang Asli community. Kato-Katz examination was performed on fecal samples which were collected before treatment, 1 and 4 months after treatment. A total of 123 children were involved in all three surveys. The cure rate of Ascaris infection was 97.4% and the egg reduction after treatment was 99.9%. The cure rate for hookworm infection was 93.1% with 96.6% egg reduction. Although the cure rate was low in Trichuris infection (5.5%), egg reduction was more evident (49.1%). The reinfection rate at 4 months after treatment was 54.5%, 3.6% and 10.3% for Ascaris, Trichuris and hookworm infection, respectively. Within 4 months after treatment almost one-fifth children with Ascaris and hookworm infection reached pre-treatment intensity infection. In Trichuris infection, however more than half of the children reached their pre-treatment intensity infection at 4 months after treatment. Findings suggest that 4-monthly targeted periodic treatment with 400 mg single-dose albendazole in highly endemic areas can have a significant impact on intensity infection of Ascaris and hookworm, but not on Trichuris infection.


Germinal sites and migrating routes of cells in the mesencephalic and diencephalic auditory areas in the African clawed frog (Xenopus laevis).
There is a clear core-shell organization in the auditory nuclei of amniotes. However, such organization only exists in the mesencephalic, but not in the diencephalic auditory regions of amphibians. To gain insights into how this core-shell organization developed and evolved, we injected a small dose of [(3)H]-thymidine into tadpoles of Xenopus laevis at peak stages of neurogenesis in the mesencephalic and diencephalic auditory areas. Following different survival times, the germinal sites and migrating routes of cells were examined in the shell (laminar nucleus, Tl; magnocellular nucleus, Tmc) and core (principal nucleus, Tp) regions of the mesencephalic auditory nucleus, torus semicircularis (Ts), as well as in the diencephalic auditory areas (posterior thalamic nucleus, P; central thalamic nucleus, C). Double labeling for [(3)H]-thymidine autoradiography and immunohistochemistry for vimentin was also performed to help determine the routes of cell migration. We found three major results. First, the germinal sites of Tp were intercalated between Tl and Tmc, arising from those of the shell regions. Second, although the germinal sites of Tl, Tmc, and Tp were located in the same brain levels (at rostromedial or caudomedial levels of Ts), neurogenesis in Tl or Tmc started earlier than that in Tp. Finally, the P and C were also generated in different ventricle sites. However, unlike Ts their neurogenesis showed no obvious temporal differences. These data demonstrate that a highly differentiated auditory region, such as Tp in Ts, is lacking in the diencephalon of amphibian. Our data are discussed from the view of the constitution and evolutionary origins of auditory nuclei in vertebrates.


Collective motions of fish originate from balanced local perceptual interactions and individual stochastics.
The movement of a group of biological individuals, such as fish schools, can evolve from disordered motions to synergistic movements or even ordered patterns. However, the physical origins behind such emergent phenomena of complex systems remain elusive. Here, we established a high-precision protocol for studying the collective behavior of biological groups in quasi-two-dimensional systems. Based on our video recording of ∼600h of fish movements, we extracted a force map of the interactions between fish from their trajectories using the convolution neural network. Presumably, this force implies the fish's perception of the surrounding individuals, the environment, and their response to social information. Interestingly, the fish in our experiments were predominantly in a seemingly disordered swarm state, but their local interactions were clearly specific. Combining such local interactions with the inherent stochasticity of the fish movements, we reproduced the collective motions of the fish through simulations. We demonstrated that a delicate balance between the specific local force and the intrinsic stochasticity is essential for ordered movements. This study presents implications for self-organized systems that use basic physical characterization to produce higher-level sophistication.


VISION AND TOUCH: AN EXPERIMENTALLY CREATED CONFLICT BETWEEN THE TWO SENSES.
Observers were presented with an object whose visual shape, because of optical distortion, differed considerably from its tactual shape. After simultaneously grasping and viewing the object, the observers were required to indicate their impression of it by drawing it or by matching another object to it. The results reveal that vision is strongly dominant, often without the observer's being aware of a conflict.


Systems 1 and 2 thinking processes and cognitive reflection testing in medical students.
Diagnostic decision-making is made through a combination of Systems 1 (intuition or pattern-recognition) and Systems 2 (analytic) thinking. The purpose of this study was to use the Cognitive Reflection Test (CRT) to evaluate and compare the level of Systems 1 and 2 thinking among medical students in pre-clinical and clinical programs. The CRT is a three-question test designed to measure the ability of respondents to activate metacognitive processes and switch to System 2 (analytic) thinking where System 1 (intuitive) thinking would lead them astray. Each CRT question has a correct analytical (System 2) answer and an incorrect intuitive (System 1) answer. A group of medical students in Years 2 & 3 (pre-clinical) and Years 4 (in clinical practice) of a 5-year medical degree were studied. Ten percent (13/128) of students had the intuitive answers to the three questions (suggesting they generally relied on System 1 thinking) while almost half (44%) answered all three correctly (indicating full analytical, System 2 thinking). Only 3-13% had incorrect answers (i.e. that were neither the analytical nor the intuitive responses). Non-native English speaking students (n = 11) had a lower mean number of correct answers compared to native English speakers (n = 117: 1.0 s 2.12 respectfully: p < 0.01). As students progressed through questions 1 to 3, the percentage of correct System 2 answers increased and the percentage of intuitive answers decreased in both the pre-clinical and clinical students. Up to half of the medical students demonstrated full or partial reliance on System 1 (intuitive) thinking in response to these analytical questions. While their CRT performance has no claims to make as to their future expertise as clinicians, the test may be used in helping students to understand the importance of awareness and regulation of their thinking processes in clinical practice.


HER2/neu Testing In 432 Consecutive Breast Cancer Cases using FISH and IHC - A Comparative Study.
The development of trastuzumab, a HER-2/neu targeted monoclonal antibody resulted in significant improvements in clinical response and survival in HER-2/neu gene amplified group of patients. Thus, accurate assessment of HER-2/neu status becomes critical. Fluorescence In Situ Hybridization (FISH) and Immunohistochemistry (IHC) are the most commonly used methods for this purpose and specific recommendations exist with regard to the concordance to be observed between the two tests. Here, we report and evaluate the concordance rate between FISH and IHC for HER-2/neu status in breast cancer specimens. Archival paraffin blocks of tumour tissue from 450 patients of breast cancer were analyzed for Her-2/neu status using FISH and IHC. There was a highly significant concordance between the results of FISH and IHC assays in HER-2/neu status assessment in invasive breast cancer cases. There were inverse associations between the expression of Oestrogen Receptors/Progesterone Receptors (ER/PR) and HER-2/neu amplification. Although, IHC gave significant concordant results with FISH in determining HER-2/neu status, its subjective grading system precludes its use as a gold standard. FISH should always be used to determine true gene amplification when the IHC results are equivocal.


Perspectives: some thoughts on the Adult Treatment Panel III report.
The guidelines of the Adult Treatment Panel III (ATP III) of the National Cholesterol Education Program are similar to prior recommendations in focusing on elevations of low-density lipoprotein (LDL) cholesterol as the primary target of therapy and in gauging the intensity of therapy to the degree of coronary heart disease risk. New elements in the current guidelines include: quantification of risk, heightened attention to the risk imparted by low high-density lipoprotein levels, utilization of non-high-density lipoprotein cholesterol levels in risk assessment for hypertriglyceridemic individuals, and emphasis on the metabolic syndrome. Nonetheless, the current guidelines are not perfect. The recommended algorithm for treatment is excessively complex; this complexity may keep the guidelines from being widely used. This complexity is generated by a hybrid scheme of risk assessment utilizing both counting of categorical coronary heart disease risk factors and calculation of coronary heart disease using the Framingham model. This hybrid method also results in undesirable inconsistencies in treatment. ATP III explicitly agrees that the therapeutic LDL goal should be determined by the burden of non-LDL risk factors. However, the current guidelines violate this principle by giving the baseline LDL cholesterol level a role in determining the therapeutic LDL goal. Additionally, the ATP III guidelines lead to under-treatment of women. Simplification should be a goal of the next iteration of the guidelines. Specific suggestions are given for simplification of the guidelines and for enhanced treatment of women. Furthermore, it is urged that the risk-assessing spreadsheet be provided in an "unlocked" form so that its details can be inspected.


Cartilage link protein 1 (Crtl1), an extracellular matrix component playing an important role in heart development.
To expand our insight into cardiac development, a comparative DNA microarray analysis was performed using tissues from the atrioventricular junction (AVJ) and ventricular chambers of mouse hearts at embryonic day (ED) 10.5-11.0. This comparison revealed differential expression of approximately 200 genes, including cartilage link protein 1 (Crtl1). Crtl1 stabilizes the interaction between hyaluronan (HA) and versican, two extracellular matrix components essential for cardiac development. Immunohistochemical studies showed that, initially, Crtl1, versican, and HA are co-expressed in the endocardial lining of the heart, and in the endocardially derived mesenchyme of the AVJ and outflow tract (OFT). At later stages, this co-expression becomes restricted to discrete populations of endocardially derived mesenchyme. Histological analysis of the Crtl1-deficient mouse revealed a spectrum of cardiac malformations, including AV septal and myocardial defects, while expression studies showed a significant reduction in versican levels. Subsequent analysis of the hdf mouse, which carries an insertional mutation in the versican gene (CSPG2), demonstrated that haploinsufficient versican mice display septal defects resembling those seen in Crtl1(-/-) embryos, suggesting that reduced versican expression may contribute to a subset of the cardiac abnormalities observed in the Crtl1(-/-) mouse. Combined, these findings establish an important role for Crtl1 in heart development.


The Role of Nutraceuticals and Functional Foods in Skin Cancer: Mechanisms and Therapeutic Potential.
Skin cancer is a prevalent type of cancer worldwide and has a high growth rate compared to other diseases. Although modern targeted therapies have improved the management of cutaneous neoplasms, there is an urgent requirement for a safer, more affordable, and effective chemoprevention and treatment strategy for skin cancer. Nutraceuticals, which are natural substances derived from food, have emerged as a potential alternative or adjunctive treatment option. In this review, we explore the current evidence on the use of omega-3 fatty acids and polyphenols (curcumin, epigallocatechin gallate, apigenin, resveratrol, and genistein) for the treatment of melanoma and non-melanoma skin cancer (NMSC), as well as in their prevention. We discuss the mechanisms of action of the aforementioned nutraceuticals and their probable therapeutic benefits in skin cancer. Omega-3 fatty acids, curcumin, epigallocatechin gallate, apigenin, resveratrol, and genistein have several properties, among which are anti-inflammatory and anti-tumor, which can help to prevent and treat skin cancer. However, their effectiveness is limited due to poor bioavailability. Nanoparticles and other delivery systems can improve their absorption and targeting. More research is needed to evaluate their safety and effectiveness as a natural approach to skin cancer prevention and treatment. These compounds should not replace conventional cancer treatments, but may be used as complementary therapy under the guidance of a healthcare professional.


Patient knowledge of anaesthesia and peri-operative care.
One hundred and sixty six patients were questioned by means of a multiple choice questionnaire, to determine their knowledge of peri-operative care, anaesthesia and the rôle of anaesthetists. In general, knowledge was good, but there were some important misconceptions; in particular, 28.3% of respondents thought that fasting referred to food only, and not to fluid intake. In addition, 47.6% of respondents considered pain to be a necessary part of the healing process and 38.6% believed that it was something that just had to be endured. When forthcoming anaesthesia is discussed, anaesthetists need to ascertain that patients really do understand the language used.


One session of exercise regulates cathepsin B activity in the livers of trained and untrained rats.
Physical exercise causes adaptive changes, mainly in muscles, but it also influences other organs, including liver. Most changes are beneficial; however, strenuous exercise is a strong stressor, and it can result in splanchnic hypoperfusion with subsequent disturbances in liver homeostasis and energy. Cathepsin B is a protease linked to protein turnover and extracellular matrix degradation. It is also involved in autophagy and the activation of proinflammatory and profibrotic pathways. This study investigated the influences of one session of exercise and endurance training on the mRNA, protein level, and activity of cathepsin B in rat liver. Healthy rats were randomly divided into two groups (n = 30, each); one group was untrained and the other received 6-weeks of endurance training with an increasing load. For each group, rats were sacrificed before (controls, n = 10), immediately after (n = 10), and 3 h after (n = 10) an acute bout of intense exercise. Liver gene expression was evaluated with quantitative real-time PCR. Liver protein content was measured with ELISA. Liver enzyme activity was measured fluorometrically. One session of exercise or training did not influence cathepsin B gene expression or protein concentration at any investigated time point. In untrained rats, cathepsin B activity decreased 3 hours after (P = 0.027) one session of exercise. In trained rats, cathepsin B activity increased immediately (P = 0.005) after one session of exercise. Training did not influence baseline cathepsin B activity. In conclusion, one session of exercise differentially influenced cathepsin B activity in the liver, depending on training status.


Secondary prevention of heart disease amongst patients with lipid abnormalities: practice and trends in the United States.
Patients with established coronary disease and abnormalities of lipid metabolism represent a particularly important subgroup, since their mortality risk is typically 10 times greater than that amongst-subjects with comparable risk factors but no clinical history. Such patients are commonly treated initially with anti-anginal therapy; if ischaemic symptoms persist they often undergo revascularization (bypass or angioplasty). While invasive procedures restore blood flow and relieve ischemia, they do not, in most cases, reduce risk of subsequent MI or death, or alter the underlying atherogenic process(es). Despite this, there has been a progressive 54% decline in age-adjusted cardiac mortality over the period 1960-1995, which appears best attributable to US lifestyle changes. In particular, the past decade has provided compelling evidence for the merits of a fourth approach: comprehensive risk factor management. Clinical outcome studies have confirmed the substantial merit of aspirin prophyllaxis and of intensive lipid-lowering therapy in secondary prevention. Prospective angiographic trials and evidence from studies of vascular biology have provided insight into mechanisms of benefit. As a consequence, lipid therapy and aspirin use have increased greatly among middle aged and older US citizens, especially those with CAD. The growth of comprehensive medical management now rivals that of invasive revascularization in secondary prevention.


Spontaneous periduodenal hematoma: a rare surgical and radiological conundrum.
This is a case of a 68-year-old female with spontaneous and rare periduodenal hematoma of unknown origin without any signs or symptoms of duodenal stenosis. All causes of known precipitating factors, such as trauma, intervention, anticoagulation, pancreatitis or malignant processes, were ruled out. She was managed conservatively, with a series of radiological investigations performed throughout her 7-day admission to further define stability and investigate the possible cause for the periduodenal hemorrhage. A repeat magnetic resonance imaging 4 weeks later showed near resolution of the hematoma. The underlying cause in this case remains unclear.


Treatment of Atopic Dermatitis in the United States: Analysis of Data from the National Ambulatory Medical Care Survey.

Introduction: Atopic dermatitis (AD) affects both adult and pediatric patients, and multiple practitioners encounter and manage AD. However, differences with regard to the treatment of AD between specialties are not well characterized. The primary objective of this study was to determine if there is a difference between dermatologists and non-dermatology specialties with regard to treatment strategies for AD and to describe those differences. Data from the 1993-2010 National Ambulatory Medical Care (NAMCS) and National Hospital Ambulatory Care (NHAMCS) Surveys were used to characterize outpatient visits made for AD. Differences in demographic, geographic and seasonal characteristics were obtained and compared. Additionally, the frequency of medications prescribed at dermatologist visits were compared to other specialties. Frequency of modalities used in the treatment of atopic dermatitis between dermatologists and non-dermatology specialties. An estimated 3.7 million visits for AD were made to outpatient offices and hospital departments from 1993 to 2010. The rates per capita of visits for atopic dermatitis were similar when evaluated by gender and season. However, Caucasians were almost 50% less likely than African Americans or individuals of other minority races to have visits for AD. Topical corticosteroids (TCS) were mentioned at 52% of visits, and dermatologists were more likely than non-dermatologists to prescribe TCS, emollients, and topical calcineurin inhibitors. Dermatologists were more likely to recommend TCS, emollients, and topical calciuneurin inhibitors for the treatment of AD. Dermatologists were also more likely to prescribe higher potency TCS in comparison to non-dermatology specialties, and these differences may ultimately affect patient care. As a result, there remains a disparity between dermatologists and non-dermatology specialties with regard to evidence-based approaches to the treatment of AD.

J Drugs Dermatol. 2017;16(3):250-255.
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A meta-analysis of artificial total disc replacement versus fusion for lumbar degenerative disc disease.
Lumbar fusion has been developed for several decades and became the standard surgical treatment for symptomatic lumbar degenerative disc disease (DDD). Artificial total disc replacement (TDR), as an alternative for spinal arthrodesis, is becoming more commonly employed treating lumbar DDD. It is still uncertain whether TDR is more effective and safer than lumbar fusion. To systematically compare the effectiveness and safety of TDR to that of the fusion for the treatment of lumbar DDD, we performed a meta-analysis. Cochrane review methods were used to analyze all relevant randomized controlled trials published up to July 2009. Five relevant randomized controlled trials involving 837 patients were identified. Patients in TDR group have slightly better functioning and less back or leg pain without clinical significance, and significantly higher satisfaction status in TDR group compared with lumbar fusion group at the 2-year follow-up. But these outcomes are highly influenced by the study with BAK cage interbody fusion, the function/pain and patient satisfaction status are no longer significantly different between two groups after excluding this study. At 5 years, these outcomes are not significantly different between comparing groups. The complication and reoperation rate of two groups are similar both at 2 and at 5 years. In conclusion, TDR does not show significant superiority for the treatment of lumbar DDD compared with fusion. The benefits of motion preservation and the long-term complications are still unable to be concluded. More high-quality RCTs with long-term follow-up are needed.


Levey-Jennings Analysis Uncovers Unsuspected Causes of Immunohistochemistry Stain Variability.
Almost all clinical laboratory tests use objective, quantitative measures of quality control (QC), incorporating Levey-Jennings analysis and Westgard rules. Clinical immunohistochemistry (IHC) testing, in contrast, relies on subjective, qualitative QC review. The consequences of using Levey-Jennings analysis for QC assessment in clinical IHC testing are not known. To investigate this question, we conducted a 1- to 2-month pilot test wherein the QC for either human epidermal growth factor receptor 2 (HER-2) or progesterone receptor (PR) in 3 clinical IHC laboratories was quantified and analyzed with Levey-Jennings graphs. Moreover, conventional tissue controls were supplemented with a new QC comprised of HER-2 or PR peptide antigens coupled onto 8 μm glass beads. At institution 1, this more stringent analysis identified a decrease in the HER-2 tissue control that had escaped notice by subjective evaluation. The decrement was due to heterogeneity in the tissue control itself. At institution 2, we identified a 1-day sudden drop in the PR tissue control, also undetected by subjective evaluation, due to counterstain variability. At institution 3, a QC shift was identified, but only with 1 of 2 controls mounted on each slide. The QC shift was due to use of the instrument's selective reagent drop zones dispense feature. None of these events affected patient diagnoses. These case examples illustrate that subjective QC evaluation of tissue controls can detect gross assay failure but not subtle changes. The fact that QC issues arose from each site, and in only a pilot study, suggests that immunohistochemical stain variability may be an underappreciated problem.


Radiomic Features at CT Can Distinguish Pancreatic Cancer from Noncancerous Pancreas.
Purpose To identify distinguishing CT radiomic features of pancreatic ductal adenocarcinoma (PDAC) and to investigate whether radiomic analysis with machine learning can distinguish between patients who have PDAC and those who do not. Materials and Methods This retrospective study included contrast material-enhanced CT images in 436 patients with PDAC and 479 healthy controls from 2012 to 2018 from Taiwan that were randomly divided for training and testing. Another 100 patients with PDAC (enriched for small PDACs) and 100 controls from Taiwan were identified for testing (from 2004 to 2011). An additional 182 patients with PDAC and 82 healthy controls from the United States were randomly divided for training and testing. Images were processed into patches. An XGBoost (https://xgboost.ai/) model was trained to classify patches as cancerous or noncancerous. Patients were classified as either having or not having PDAC on the basis of the proportion of patches classified as cancerous. For both patch-based and patient-based classification, the models were characterized as either a local model (trained on Taiwanese data only) or a generalized model (trained on both Taiwanese and U.S. data). Sensitivity, specificity, and accuracy were calculated for patch- and patient-based analysis for the models. Results The median tumor size was 2.8 cm (interquartile range, 2.0-4.0 cm) in the 536 Taiwanese patients with PDAC (mean age, 65 years ± 12 [standard deviation]; 289 men). Compared with normal pancreas, PDACs had lower values for radiomic features reflecting intensity and higher values for radiomic features reflecting heterogeneity. The performance metrics for the developed generalized model when tested on the Taiwanese and U.S. test data sets, respectively, were as follows: sensitivity, 94.7% (177 of 187) and 80.6% (29 of 36); specificity, 95.4% (187 of 196) and 100% (16 of 16); accuracy, 95.0% (364 of 383) and 86.5% (45 of 52); and area under the curve, 0.98 and 0.91. Conclusion Radiomic analysis with machine learning enabled accurate detection of PDAC at CT and could identify patients with PDAC. Keywords: CT, Computer Aided Diagnosis (CAD), Pancreas, Computer Applications-Detection/Diagnosis Supplemental material is available for this article. © RSNA, 2021.


The calcium connection: exploring the intricacies of calcium signaling in plant-microbe interactions.
The process of plant immune response is orchestrated by intracellular signaling molecules. Since plants are devoid of a humoral system, they develop extensive mechanism of pathogen recognition, signal perception, and intricate cell signaling for their protection from biotic and abiotic stresses. The pathogenic attack induces calcium ion accumulation in the plant cells, resulting in calcium signatures that regulate the synthesis of proteins of defense system. These calcium signatures induct different calcium dependent proteins such as calmodulins (CaMs), calcineurin B-like proteins (CBLs), calcium-dependent protein kinases (CDPKs) and other signaling molecules to orchestrate the complex defense signaling. Using advanced biotechnological tools, the role of Ca2+ signaling during plant-microbe interactions and the role of CaM/CMLs and CDPKs in plant defense mechanism has been revealed to some extent. The Emerging perspectives on calcium signaling in plant-microbe interactions suggest that this complex interplay could be harnessed to improve plant resistance against pathogenic microbes. We present here an overview of current understanding in calcium signatures during plant-microbe interaction so as to imbibe a future direction of research.


Oxidative Self-Polymerization of Dopamine in an Acidic Environment.
A weak alkaline condition (pH > 8) is a general requirement for oxidative self-polymerization of dopamine. Here, we first demonstrated the generation of polydopamine in an acidic environment via a hydrothermal method. The pH scope of self-polymerization of dopamine is extended to pH ∼ 1 in a hydrothermal process. Polydopamine generated via a hydrothermal method shows similar chemical features and radical scavenging activity with that generated in a basic environment.


Adipose tissue-derived extracellular fraction characterization: biological and clinical considerations in regenerative medicine.
Adipose tissue-derived stem cells are considered to be a promising source in the field of cell therapy and regenerative medicine. In addition to direct cell replacement using adipose tissue or purified stem cells, intercellular molecule exchange by the adipose tissue complex, a vast array of bioactive secretory factors, demonstrated beneficial effects by reducing tissue damage and stimulation of endogenous repair. However, for therapeutic purposes, the use of secretome derivatives, such as full conditioned media or purified exosomes generated in vitro, may present considerable disadvantages for cell manufacturing, storage, product safety, and their potential as a ready-to-go therapeutic product. In this study, the effect of a liquid fraction of lipoaspirates isolated intraoperatively from 28 healthy donors was evaluated for their protective effect against oxidative stress and senescence, proliferation, and migration in vitro on normal human melanocytes, keratinocytes, and fibroblasts. Immunoenzymatic quantification of several growth factors and important signal molecules was used to define the biological profile of physiological adipose tissue secretome. Adipose tissue extracellular fraction (AT-Ex), isolated from lipoaspirate, exhibited significant potential for skin repair. AT-Ex augmented dermal and epidermal cell proliferation in a dose-dependent manner without promoting cancer cell growth. Moreover, migration of dermal fibroblasts, an important phenomenon implicated in endogenous repair, was enhanced by AT-Ex treatment. AT-Ex has a positive impact on oxidative stress damage when cells are exposed to extrinsic hostile factors and prevent a fibroblast senescence phenotype including paracrine functions associated with skin aging. Collectively, our findings propose natural systems carrying the physiological balance of in-vivo produced secretome that could improve cutaneous wound healing and tissue repair. This approach, representing an innovative perspective and therapeutic strategy in regenerative medicine, could also be combined with autologous stem cell grafts to treat chronic nonhealing wounds, stable vitiligo, severe burns, and post-oncological scarring.


[RovoIving ultrasonic probe for medical endoscope imaging system based on USB2.0].
This paper mainly introduces the design and implementation of rotary scanning imaging for Endoscopic Ultrasonography System based on USB2.0. The ultrasonic pulse-echo imaging technique has been used. In the paper, we simply introduce the emission circuit, receiving circuit and isolation circuit. According to the character of rotary scanning, we design the synchronous control circuit based on FPGA and data transmission circuit based on USB2.0. Finally the original polar coordinate image is transformed to rectangular coordinate grey image through coordinate transformation. The system performances have been validated by the experimental result gotten by scanning a specific object with continuous rotary motor.


Neurofibromatosis type 1: from presentation and diagnosis to vascular and endovascular therapy.
Neurofibromatosis type 1, also called von Recklinghausen's disease, is an autosomal dominant disorder linked to chromosome 17, characterized by growth impairment of the neural crest cells (ectoderm) manifested by multiple neural tumors, cutaneous pigmentations, and Lisch nodules. Disease phenotype develops with time, making its penetrance almost complete by 5 years of age. Compression of the gastro-intestinal, urinary, or pulmonary tracts by visceral neurofibromas may generate serious complications. Neurofibromatosis type 1 is remarkable for its association with occlusive (stenoses) or aneurysmal arterial disease affecting predominantly the renal arteries and less often the abdominal aorta (middle aortic syndrome), and mesenteric and peripheral arteries. Appraisal of existing literature reveals that timely vascular intervention by way of conventional surgery and/or endovascular therapy may provide patients with effective and durable treatment. The far greater propensity for malignant connective/soft-tissue neoplasms and vascular disease in neurofibromatosis type 1, amid potential complications from the gastro-intestinal, urinary, and pulmonary tracts, leads to a significantly increased morbidity and decreased life expectancy. Neurofibromatosis type 1, from presentation and diagnosis to its treatment, is reviewed, with emphasis on vascular disease and its management with open vascular surgery and endovascular therapy.