A continuous mapping between space and valence with left- and right-handers.
In this research, we examined whether emotional valence could correspond to a continuous lateral bias in space, according to a mental metaphor that establishes the mapping between a concrete domain (space) and an abstract one (valence). Because acting with one's dominant hand is associated with fluency and positive valence (the bodily specificity hypothesis, or BSH), we asked strong right- and left-handers to perform two spatial location tasks using emotional faces with seven levels of valence. We hypothesized and showed through two studies that, according to the BSH, extreme valenced stimuli (as compared to moderate and weak ones) would be located more at the extremity of a horizontal line, according to the correspondences between handedness and the different valences of the stimuli. This research establishes that spatial and continuous mapping of emotions was obtained while controlling for motivational direction.


Citizen science reveals unexpected solute patterns in semiarid river networks.
Human modification of water and nutrient flows has resulted in widespread degradation of aquatic ecosystems. The resulting global water crisis causes millions of deaths and trillions of USD in economic damages annually. Semiarid regions have been disproportionately affected because of high relative water demand and pollution. Many proven water management strategies are not fully implemented, partially because of a lack of public engagement with freshwater ecosystems. In this context, we organized a large citizen science initiative to quantify nutrient status and cultivate connection in the semiarid watershed of Utah Lake (USA). Working with community members, we collected samples from ~200 locations throughout the 7,640 km2 watershed on a single day in the spring, summer, and fall of 2018. We calculated ecohydrological metrics for nutrients, major ions, and carbon. For most solutes, concentration and leverage (influence on flux) were highest in lowland reaches draining directly to the lake, coincident with urban and agricultural sources. Solute sources were relatively persistent through time for most parameters despite substantial hydrological variation. Carbon, nitrogen, and phosphorus species showed critical source area behavior, with 10-17% of the sites accounting for most of the flux. Unlike temperate watersheds, where spatial variability often decreases with watershed size, longitudinal variability showed an hourglass shape: high variability among headwaters, low variability in mid-order reaches, and high variability in tailwaters. This unexpected pattern was attributable to the distribution of human activity and hydrological complexity associated with return flows, losing river reaches, and diversions in the tailwaters. We conclude that participatory science has great potential to reveal ecohydrological patterns and rehabilitate individual and community relationships with local ecosystems. In this way, such projects represent an opportunity to both understand and improve water quality in diverse socioecological contexts.


Correlation between persistent forms of zeaxanthin-dependent energy dissipation and thylakoid protein phosphorylation.
High light stress induced not only a sustained form of xanthophyll cycle-dependent energy dissipation but also sustained thylakoid protein phosphorylation. The effect of protein phosphatase inhibitors (fluoride and molybdate ions) on recovery from a 1-h exposure to a high PFD was examined in leaf discs of Parthenocissus quinquefolia (Virginia creeper). Inhibition of protein dephosphorylation induced zeaxanthin retention and sustained energy dissipation (NPQ) upon return to low PFD for recovery, but had no significant effects on pigment and Chl fluorescence characteristics under high light exposure. In addition, whole plants of Monstera deliciosa and spinach grown at low to moderate PFDs were transferred to high PFDs, and thylakoid protein phosphorylation pattern (assessed with anti-phosphothreonine antibody) as well as pigment and Chl fluorescence characteristics were examined over several days. A correlation was obtained between dark-sustained D1/D2 phosphorylation and dark-sustained zeaxanthin retention and maintenance of PS II in a state primed for energy dissipation in both species. The degree of these dark-sustained phenomena was more pronounced in M. deliciosa compared with spinach. Moreover, M. deliciosa but not spinach plants showed unusual phosphorylation patterns of Lhcb proteins with pronounced dark-sustained Lhcb phosphorylation even under low PFD growth conditions. Subsequent to the transfer to a high PFD, dark-sustained Lhcb protein phosphorylation was further enhanced. Thus, phosphorylation patterns of D1/D2 and Lhcb proteins differed from each other as well as among plant species. The results presented here suggest an association between dark-sustained D1/D2 phosphorylation and sustained retention of zeaxanthin and energy dissipation (NPQ) in light-stressed, and particularly 'photoinhibited', leaves. Functional implications of these observations are discussed.


Phytoplasma Infection could Affect Chemical Composition of Artemisia sieberi.
Artemisia sieberi showing symptoms resembling those caused by phytoplasma were observed in Geno Mountain, Hormozgan Province, Iran, and were examined for phytoplasma presence by PCR assays. In addition, the essential oils hydrodistilled from the aerial parts of phytoplasma-infected and healthy plants have been analyzed and compared by GC and GC/MS. Phylogenetic and virtual RFLP analysis of the 16S rRNA gene sequences revealed that the phytoplasma associated with A. sieberi witches' broom (AsWB) was a strain of 'Candidatus Phytoplasma aurantifolia'. The presence of the disease, however, induced a further enrichment (from 4.9 to 45.2%, a relative increase of 90%) of the entire monoterpene class as compared to the abundance in healthy samples. Conversely, a matching decrease in monoterpenoid (from 48.7 to 2%, a relative decrease of 90.2%) was observed in the infected plants. Besides the first report of phytoplasma infection of A. sieberi, the changes of its essential oils are reported.


Esophageal Swallowing Timing Measures in Healthy Adults During Videofluoroscopy.
Establishing the range of normal esophageal bolus transit times (ETT) is valuable when distinguishing pathology from normal variance, especially in elderly patients, and has not been documented for paste or pill. The aim of this study was to measure esophageal transit of liquid, paste, and pill during upright videofluoroscopy. One hundred eighteen healthy adults (mean age 54; range 20-98 years; SD = 21.40) with no complaints of dysphagia completed a videofluoroscopy with esophageal visualization including 20 ml liquid barium, 5 ml paste, and pill. Mean ETTs were: 20 ml fluid, 10.7 seconds (SD = 13.6, median = 5.76, IQR = 4.33, range, 2.0-60.0); pill, 25.3 seconds (SD = 24.0, median = 12.70, IQR = 49.81, range, 1.0-60.0); paste, 28.6 seconds (SD = 23.31, median = 17.47, IQR = 53, range, 4.0-60.0). Age was significantly associated with increasing 20 ml fluid ETT (P < .001) but not pill (P = .58) or paste ETT (P = .12). Fluid ETT over 10 seconds occurred in 10% of participants between 20 and 59 years, in comparison to 35% over 60 years (P < .001). These normative values provide a standardized protocol and guidance in interpretation when completing esophageal visualization as part of videofluoroscopy. While measuring fluid ETT may support referral for further specialist investigations, slower paste and pill ETT may be normal findings. Age-related slowing in fluid ETT was seen in healthy adults. Further investigation of ETT is needed in both normal and dysphagic subjects.


Clinical Factors Associated With the Feeling of Incomplete Bladder Emptying in Women With Little Postvoided Residue.
To investigate the clinical factors associated with the feeling of incomplete bladder emptying in female patients with lower urinary tract symptoms (LUTS). Records were obtained from a prospectively maintained database for 353 female patients without a history of treatment for LUTS. Patients with comorbidities that may affect voiding function and with postvoid residual (PVR) volume >20 mL or PVR volume-to-bladder capacity ratio of >10% were excluded. Finally, 211 patients were eligible for the study. Patients were stratified according to the severity of the feeling of incomplete emptying: non-severe group (n=147, 69.7%) and severe group (n=64, 30.3%). The severe group showed longer time to maximum flow rate (Qmax) and greater total overactive bladder symptom score (OABSS). No differences in age, PVR volume, and diagnosis of overactive bladder (OAB) were found between the 2 severity groups. Multivariable analysis identified the severity of the feeling of incomplete emptying to be significantly associated with time to Qmax and minimum volume of voids. Time to Qmax was identified as a significant predictor of severe symptoms in women with OAB. In addition, the feeling of incomplete emptying, total OABSS, and minimum volume of voids were significantly associated with quality of life. Female patients with the feeling of incomplete emptying who have insignificant PVR volume exhibited severe voiding symptoms and low quality of life. The treatment strategy should be focused on improving the minimum volume of voids and shortening the time to Qmax.


Reducing bioaerosol dispersion from wastewater treatment and its land application: a review and analysis.
Wastewater treatment systems and spray irrigation of treated water may spread microorganisms such as bacteria and viruses through dispersion of aerosol particles. A recent review (Brooks, Josephson, Gerba, & Pepper, 2004) identifies appropriate reports. Teltsch and co-authors report findings that suggest effective management controls involve providing buffer zones, irrigating in the daytime and in times of low humidity, reducing microorganism levels in water used for spraying, and testing for multiple types of viruses and bacteria (Teltsch & Katzenelson, 1978; Teltsch, Shuval, & Tadmor, 1980; Teltsch, Kedmi, Bonnet, Borenzstajn-Rotem, & Katzenelson, 1980). Camann, Moore, Harding, and Sorber support these findings. They also note that fecal streptococci are hardier than fecal coliform and appear frequently in background samples, suggesting that this bacterium is a better indicator of background and downwind conditions than are fecal coliform bacteria. In their study, storage prior to spray irrigation reduced microorganism concentrations by 99 percent. Downwind concentrations of sprayed reservoir water were often comparable to background values (Camann, Moore, Harding, & Sorber, 1988). Italian researchers (Brandi, Sisti, & Amagliani, 2000; Carducci, Gemelli, Cantiani, Casini, & Rovini, 1999; Carducci et al., 2000) confirm variable die-away rates of microorganisms, observe a positive association between fecal streptococci and the presence of viruses, and recommend consideration of submerged aeration for sludge digestion at sewage treatment plants. No reports are available that measure dispersion of bioaerosols from wastewater consistently treated to meet contemporary disinfection standards.


Low dose vaccination with attenuated Francisella tularensis strain SchuS4 mutants protects against tularemia independent of the route of vaccination.
Tularemia, caused by the gram-negative bacterium Francisella tularensis, is a severe, sometimes fatal disease. Interest in tularemia has increased over the last decade due to its history as a biological weapon. In particular, development of novel vaccines directed at protecting against pneumonic tularemia has been an important goal. Previous work has demonstrated that, when delivered at very high inoculums, administration of live, highly attenuated strains of virulent F. tularensis can protect against tularemia. However, lower vaccinating inoculums did not offer similar immunity. One concern of using live vaccines is that the host may develop mild tularemia in response to infection and use of high inoculums may contribute to this issue. Thus, generation of a live vaccine that can efficiently protect against tularemia when delivered in low numbers, e.g. <100 organisms, may address this concern. Herein we describe the ability of three defined, attenuated mutants of F. tularensis SchuS4, deleted for FTT0369c, FTT1676, or FTT0369c and FTT1676, respectively, to engender protective immunity against tularemia when delivered at concentrations of approximately 50 or fewer bacteria. Attenuated strains for use as vaccines were selected by their inability to efficiently replicate in macrophages in vitro and impaired replication and dissemination in vivo. Although all strains were defective for replication in vitro within macrophages, protective efficacy of each attenuated mutant was correlated with their ability to modestly replicate and disseminate in the host. Finally, we demonstrate the parenteral vaccination with these strains offered superior protection against pneumonic tularemia than intranasal vaccination. Together our data provides proof of principle that low dose attenuated vaccines may be a viable goal in development of novel vaccines directed against tularemia.


An Alu-based, MGB Eclipse real-time PCR method for quantitation of human DNA in forensic samples.
The forensic community needs quick, reliable methods to quantitate human DNA in crime scene samples to replace the laborious and imprecise slot blot method. A real-time PCR based method has the possibility of allowing development of a faster and more quantitative assay. Alu sequences are primate-specific and are found in many copies in the human genome, making these sequences an excellent target or marker for human DNA. This paper describes the development of a real-time Alu sequence-based assay using MGB Eclipse primers and probes. The advantages of this assay are simplicity, speed, less hands-on-time and automated quantitation, as well as a large dynamic range (128 ng/microL to 0.5 pg/microL).


[Experiences with surgical fusion of the lumbar spine].
Authors report on the results of the operative fusion of the lumbar spine performed by them between 1 March 1987 through 31 December 1990. Based on the assessment of 243 cases they call attention to the importance of the correct indication and operative technique and of the close supervision. It is stated that the use of the internal fixation improves the results of the operative fusions.


Prevalence of Periodontal Pathogens in a Group of Participants from the Middle East and North Africa Geographic Region with Minimal Periodontal Disease.
To assess the prevalence of the three putative periodontal pathogens such as Aggregatibacter actinomycetemcomitans (A. a), Porphyromonas gingivalis (P. g), and Prevotella intermedia (P. i) in a group of Arab participants from the Middle East and North Africa (MENA) region who had minimal periodontal disease and no history of periodontal treatment and further to analyze the association among these three microorganisms. Eighty-four participants of varied demographics and oral/dental care habits were screened for this study. Twenty-one participants who eventually gave their consent to fully participate in the study provided a balanced representation of the screened universe. Seventy-eight microbiological samples were taken from the deepest pockets. Twenty-three percent of all samples were found to be A. a positive and so were 79% for P. g and 82% for P. i. A highly remarkable association was observed between the presence of P. i along with P. g (P < 0.00l; Fisher's exact test). Of all samples, merely six cases were P. i positive but not P. g and eight cases were vice versa. There was a statistically significant association between A. a and P. g (P = 0.016). No significant relationship was detected between P. i and A. a. This qualitative study shows very high frequency of the three periodontal pathogens (A. a, P. g, and P. i) in a group of Arab nationals with minimal periodontal disease. The lack of oral hygiene, minimal use of antimicrobial drugs and antiseptics, and the absence of dental care may partly explain the high prevalence of periodontal pathogens.


Psychotherapy research at the start of the 21st century: the persistence of the art versus science controversy.
This article offers an overview of prominent general trends in the field of psychotherapy research. We consider 3 areas of the literature: metaanalytic reviews addressing the effectiveness of psychotherapy, the movement to identify empirically supported treatments (EST), and research on the "common factor" or "contextual" models of psychotherapy. We present narrative reviews of selected literature associated with each area. The reviews highlight several issues currently confronting the field. Metaanalytic reviews underscore 2 conclusions: psychotherapy is superior to the absence of treatment, and different approaches to psychotherapy yield equivalent effects. In counterpoint to these findings, the EST movement emphasizes the empirical demonstration that specific psychotherapies have efficacy for specific disorders. Misinterpretation of EST findings has led to considerable controversy. Although EST research can identify causal effects of therapy, it has less capacity to explain how these effects come about. We suggest an appropriate perspective on EST findings. Considerable evidence supports the importance of common factors as mechanisms of change; at present, however, this evidence is predominantly correlational. We conclude that a blending of EST studies and research on the common factors represents the greatest potential for advancing the field. Studies to identify specific ESTs are key to validating the efficacy of psychotherapy approaches and need to be undertaken with the psychodynamic and experiential therapies. Greater emphasis on common factors in research, training, and practice can advance understanding about change processes in efficacious therapies, facilitate the development of sensitive clinicians, and increase the effectiveness of mental health services.


Significance of 14-3-3 self-dimerization for phosphorylation-dependent target binding.
14-3-3 proteins via binding serine/threonine-phosphorylated proteins regulate diverse intracellular processes in all eukaryotic organisms. Here, we examine the role of 14-3-3 self-dimerization in target binding, and in the susceptibility of 14-3-3 to undergo phosphorylation. Using a phospho-specific antibody developed against a degenerated mode-1 14-3-3 binding motif (RSxpSxP), we demonstrate that most of the 14-3-3-associated proteins in COS-7 cells are phosphorylated on sites that react with this antibody. The binding of these phosphoproteins depends on 14-3-3 dimerization, inasmuch as proteins associated in vivo with a monomeric 14-3-3 form are not recognized by the phospho-specific antibody. The role of 14-3-3 dimerization in the phosphorylation-dependent target binding is further exemplified with two well-defined 14-3-3 targets, Raf and DAF-16. Raf and DAF-16 can bind both monomeric and dimeric 14-3-3; however, whereas phosphorylation of specific Raf and DAF-16 sites is required for binding to dimeric 14-3-3, binding to monomeric 14-3-3 forms is entirely independent of Raf and DAF-16 phosphorylation. We also find that dimerization diminishes 14-3-3 susceptibility to phosphorylation. These findings establish a significant role of 14-3-3 dimerization in its ability to bind targets in a phosphorylation-dependent manner and point to a mechanism in which 14-3-3 phosphorylation and dimerization counterregulate each other.


Roadmap for developing and validating therapeutically relevant genomic classifiers.
Oncologists need improved tools for selecting treatments for individual patients. The development of therapeutically relevant prognostic markers has traditionally been slowed by poor study design, inconsistent findings, and lack of proper validation studies. Microarray expression profiling provides an exciting new technology for relating tumor gene expression to patient outcome, but it also provides increased challenges for translating initial research findings into robust diagnostics that benefit patients and physicians in therapeutic decision making. This article attempts to clarify some of the misconceptions about the development and validation of multigene expression signature classifiers and highlights the steps needed to move genomic signatures into clinical application as therapeutically relevant and robust diagnostics.


Femoral vessel injuries in modern warfare since Vietnam.
The incidence of lower extremity injuries is high in modern warfare; however the mortality rate from these injuries is low. Despite the overall low mortality of lower extremity injuries, many deaths in modern conflicts are due to femoral vessel injury. The modern warfare literature was reviewed. In Somalia, 1 of the 14 reported deaths was due to a laceration of the superficial femoral artery. In the Persian Gulf, three deaths were reported in an Army field hospital, one resulted from uncontrolled hemorrhage from a profunda femoris artery wound and two others resulted from traumatic amputations with consequent major arterial injury. Despite the advances in modern body armor, the groin is left unprotected. A strategy to help minimize U.S. casualties in modern warfare may be a method of field hemostasis specifically designed for femoral vessel injury.


Developing Dental Students' Awareness of Health Care Disparities and Desire to Serve Vulnerable Populations Through Service-Learning.
Service-learning in dental education helps students integrate knowledge with practice in an underserved community setting. The aim of this study was to explore how a service-learning experience affected a small group of dental students' beliefs about cultural competence, professionalism, career development, desire to practice in a community service setting, and perceptions about access and disparities issues. Prior to beginning their first year of dental school, five first-year dental students at one U.S. dental school participated in a six-week service-learning program in which they interned at one of three at-risk settings in order to experience health care delivery there. After the program, 60 reflective writing assignments completed by the participants were analyzed using grounded theory methods; interviews with the students were used to corroborate the findings from that analysis. Seven themes identified in the journal reflections and interview findings showed enhanced awareness of social health care issues and patient differences, as well as a social justice orientation and desire to address disparities. Building on this study, future research should explore the curricular components of service-learning programs to ensure students receive ample opportunity to reflect upon their experiences in order to integrate previously held assumptions with their newfound knowledge.


Transmission electron microscopy of intra-tegumental sensory receptors in the forebody of Crepidostomum metoecus (Digenea: Allocreadiidae).
In the adult fish trematode Crepidostomum metoecus (Braun, 1900), four types of sensory receptors were observed inside the forebody tegument and one type beneath the tegument basal lamina. Two types of sensory receptors extend through the thickness of tegument and have a free cilium inside a pit (types I and II). Two types (III and IV) are nonciliate and entirely intra-tegumental in location. Type IV receptor with large horizontal and thin vertical rootlets was described earlier in aspidogastreans only. Below the basal lamina, nerve endings in close association with muscle fibres, comparable with those in the Aspidogastrea, were detected.


Biomarker for Antitumor Immunity Identified.
Investigators have discovered that a certain type of immune cell in tumors, known as tissue-resident memory cells, are associated with a strong immune response and improved prognosis in lung cancer. The findings may aid in selecting appropriate immunotherapies and developing more effective vaccines for a wide range of cancers.


Perioperative outcomes of total laparoscopic hysterectomy at a regional hospital in New Zealand.
Total laparoscopic hysterectomy (TLH) is established as a safe method of hysterectomy, with a satisfactory patient experience. However, most published data derive from high-volume centres with experienced teams. It is not clear whether these data translate to smaller centres? To evaluate the implementation of a minimally invasive option for hysterectomy at a regional public hospital in New Zealand. Prospective audit of 120 cases of TLH over three years. We retrospectively compared outcomes to the same number of abdominal (AH) and vaginal hysterectomy (VH). TLH and AH were predominantly performed for heavy menstrual bleeding (65 and 64%) and VH for prolapse (54%). The largest uteri were AH (range 30-3400 g), TLH (35-550) then VH (21-256). Compared to TLH, both AH and VH had shorter mean operating theatre times (TLH 126.8 ± 44.8 min, AH 103.2 ± 32.8 and VH 93 ± 26.9), longer mean hospital stay (TLH 51.3 ± 21.3 h, AH 101.9 ± 36.6 and VH 75.1 ± 31.3) and increased mean blood loss (TLH 153 ± 116.1 mL, AH 517 ± 672.3 and VH 244 ± 206.8). One TLH was converted to laparotomy and one required interval laparoscopy. Major complications (2.5%) were lowest in the TLH group and were consistent with large international series. TLH would appear to be a safe and effective local option. The outcomes for patients at a regional general hospital can replicate the results of larger centres.


Study of Adiponectin Level in Diabetic Adolescent Girls in Relation to Glycemic Control and Complication of Diabetes.
To study the relation between adiponectin level with glycemic control and complication of diabetes. The study included 40 female adolescent type 1 diabetic patients and 40 healthy volunteers of the same age and sex. Blood sample was taken for assessment of glycosylated hemoglobin, lipid profile and adiponectine. Urine sample was taken for assessment of albumin/creatinine ratio. Diabetic patients had a significantly higher diastolic blood pressure, triglyceride, total cholesterol, LDL and adiponectin than controls. Patients with diabetes complication had a significant lower BMI and HDL. On the other hand, they had higher disease duration, total cholesterol, HbA1, albumin/creatinine ratio and adiponectin. Patients with microalbuminuria had a lower BMI, higher disease duration, diastolic blood pressure and adiponectin. Patients with diabetic retinopathy had higher disease duration, insulin dose, HbA1, microalbuminuria and adiponectin. Adiponectin in diabetic patients had a significant negative correlation with BMI and positive correlation with systolic blood pressure and microlabuminuria. Serum adiponectin level is high in adolescent type 1 diabetic girls. It can be used as a predictor of diabetes complications rather than a sensitive biochemical marker for glycemic control.


Multisensory Facial Stimulation Implicitly Improves Evaluations of the Goodness of Attractive Others.
It has been well demonstrated that shared multisensory experiences between the self and others can influence the social perception of out-group members. Previous research has shown that the illusion of ownership over a dark-skinned rubber hand or full virtual body generated less negative implicit bias against people with dark skin. However, less is known about how perceived attractiveness difference between self and other affects social perception toward those others after shared multisensory experience. The present study assessed whether shared multisensory experience between the self and attractive others would affect the implicit evaluation of goodness of others. Seventy-three women participated in the study. After the visuotactile multisensory stimulation procedure, participants were administered the Single Category Implicit Association Test (SC-IAT), which presents two attributes (good and bad) and one concept (other). Results showed that the more attractive the faces are, the more positive their implicit evaluation becomes after the synchronous tactile stimulation. This result suggests that shared multisensory experience makes people feel more positive toward others who have positive attribute. This finding suggests that self-other blurring in social contexts might be a compelling factor in evaluating other people positively.


Role of a new member of IGFBP superfamily, IGFBP-rP10, in proliferation and differentiation of osteoblastic cells.
Bone regeneration is critically regulated by various molecules. To identify the new genes involved in bone regeneration, we performed microarray-based gene expression analysis using a mouse bone regeneration model. We identified a new member of the IGFBP superfamily, designated IGFBP-rP10, whose expression is up-regulated at the early phase of bone regeneration. IGFBP-rP10 consists of an IGFBP homologous domain followed by a Kazal-type protein inhibitor domain and an immunoglobulin G-like domain. A real-time-based RT-PCR analysis demonstrated that various tissues including bone expressed IGFBP-rP10 mRNA in various degrees, and confirmed an up-regulation at the early phase of bone regeneration. In situ hybridization revealed that osteoblastic cells expressed IGFPB-rP10 mRNA during bone regeneration. Bone morphogenetic protein-2 increased the expression level of IGFBP-rP10 mRNA in various cells including C3H10T1/2, MC3T3-E1, C2C12, and primary murine osteoblastic cells. The addition of recombinant mouse IGFBP-rP10 promoted the proliferation of these cells but failed to stimulate alkaline phosphatase activity. These results suggest that IGFBP-rP10 is involved in the proliferation of osteoblasts during bone formation and bone regeneration.


Nurturing Women and the BRCA Genes: Gender, Activism and the Paradox of Health Awareness.
This paper explores the relationship between breast cancer activism and a newly emergent arena of 'predictive' medicine, breast cancer genetics. Drawing on ethnographic research in UK cancer genetic clinics, it explores the way the goals and gendered values of a certain kind of breast cancer activism operate at the interface between patients and practitioners. It examines how the morality of health awareness and the value female nurturance are implicated in and configured by clinical encounters. Outlining the dense and dynamic 'traffic' around the work of transmission, the paper examines how the same gendered values that may enable this field of practice can also result in uneasy consequences for patients, their kin, as well as practitioners. Exploring these intersections demonstrates the scope and challenges for knowledge and care, as well as the paradoxical value of health awareness in an emerging field of genetic medicine.


Differential Functional Connectivity in Anterior and Posterior Hippocampus Supporting the Development of Memory Formation.
Neuroimaging evidence suggests that the development of the hippocampus, a brain structure critical for memory function, contributes to the improvements of episodic memory between middle childhood to adulthood. However, investigations on age differences in hippocampal activation and functional connectivity and their contributions to the development of memory have yielded mixed results. Given the known structural and functional heterogeneity along the long axis of the hippocampus, we investigated age differences in the activation and functional connectivity in hippocampal subregions with a cross-sectional sample of 96 participants ages 8-25 years. We found that anterior and posterior hippocampus supported memory formation, and there was overall stability in memory-related hippocampal activation with age. Without taking account of memory outcome, direct contrast between subregions showed higher functional connectivity of anterior, compared to the posterior hippocampus, with regions in the inferior frontal and lateral temporal lobes, and higher functional connectivity of posterior, compared to the anterior hippocampus, with regions in the medial and superior frontal, inferior parietal, and occipital lobes. A direct contrast between the memory-related connectivity patterns of anterior and posterior hippocampus identified a region in the medial frontal cortex, with which anterior and posterior hippocampus was differentially functionally connected. Finally, we identified age differences in memory-related differential hippocampal functional connectivity with several frontal and visual/sensory cortices, underscoring the importance of examining age differences in the patterns of hippocampal connectivity. Moreover, the specific patterns of differential anterior and posterior functional connectivity indicate an increase in the functional specialization along the long axis of the hippocampus and a dynamic shift in hippocampal connectivity patterns that supports memory development.


[Five-year clinical outcomes of patients with in-stent chronic total occlusion undergoing percutaneous coronary intervention].
Objective: To evaluate the safety and long-term clinical efficacy of percutaneous coronary intervention (PCI) in patients with in-stent chronic total occlusion (IS-CTO) lesions. Metheds: This is a retrospective analysis. Patients with IS-CTO who underwent PCI in Fuwai hospital from January 2010 to December 2013 were enrolled. A total of 212 patients who met the inclusion criteria were included in the IS-CTO group, 212 matched patients with primary CTO lesions were included in the de novo CTO group. The incidence of complications and the success rate of PCI were compared between the two groups. Successful PCI was defined as successfully implantation of stent(s) at target CTO lesions. The primary endpoint was defined as a composite event of cardiac death and myocardial infarction (MI). Secondary endpoints including PCI success, all-cause death, cardiac death, MI, target vessel related MI, revascularization, target vessel revascularization, heart failure for rehospitalization. The patients were followed up for 5 years after PCI. Results: A total of 424 cases were included. The mean age was (57.8±10.5) years, there were 364 males in this cohort. The left ventricular ejection fraction was significantly lower ((58.7±9.2)% vs. (61.0±7.7)%, P=0.01) and the SYNTAX scores was significantly higher (19.4±8.3 vs. 15.3±10.0, P<0.01) in IS-CTO group than that in de novo CTO group. The proportion of patients with target CTO lesions in left anterior descending artery was significantly higher (42.9% (50/212) vs. 23.6% (91/212), P<0.01) in IS-CTO group than that in de novo CTO group. The rate of successful PCI (71.7% (152/212) vs. 69.8% (148/212), P=0.70) and complication (40.6% (86/212) vs. 36.3% (77/212), P=0.37) was similar between the two groups. The incidence of primary endpoint at 5 years was significantly higher in IS-CTO group (10.8% (23/212) vs. 4.7% (10/212), P=0.02), which was driven by higher incidence of MI (9.0% (19/212) vs. 4.2% (9/212), P=0.05). There were a trend of higher secondary endpoints in IS-CTO group (all P>0.05). Conclusion: The safety and effectiveness of PCI are acceptable in patients with IS-CTO, but the risk of long-term cardiac death and MI is higher among patients with IS-CTO as compared to patients with primary CTO lesions.


Preclinical testing of a wedge-rod system for fusionless correction of scoliosis.
Biomechanical study. This paper describes the biomechanical comparison of calf spines instrumented with a wedge alone versus a wedge-rod construct for the fusionless correction of scoliosis. Current techniques for the correction of scoliosis require either anterior or posterior spinal fusion for correction. We propose a technique allowing correction via vertebral body osteotomies along with fixation using a wedge-rod construct without the requirement of intervertebral segment fusion. Calf spines were used to test the biomechanical difference between the intact spine, transverse osteotomized spine with wedge-rod reconstruction, and transverse osteotomized spine with wedge alone reconstruction. Unconstrained segments (L1-L5) were first tested under five nondestructive static loading conditions to evaluate the intact stability of the operative motion segments in axial compression (-600 N), axial rotation (+/-5.0 Nm, 150 axial preload), flexion and extension (+/-5.0 Nm), and lateral bending (+/-5.0 Nm). Following the intact analysis, vertebral wedge osteotomies in the transverse plane were performed at the L2, L3, and L4 levels. The defects were reconstructed using the Sofamor Danek Wedge Spacer, and stainless steel TSRH one-quarter inch single rod with modified CD HORIZON 6.5-mm diameter vertebral body screws at each level (L2-L4). Standard CD HORIZON 6.5-mm bone screws and staples were used at the superior and inferior ends of the five-level construct. The wedge was on the left side and the rod and screw heads on the right side. After testing the reconstructed specimen, the TSRH rod was removed and the construct retested to evaluate the stability of the wedge alone reconstruction. Construct stiffness was calculated as the peak applied load (N or Nm) divided by the corresponding segmental displacement (mm or degrees) normalized to the intact specimen. Reconstruction static data are expressed as a percentage change from the intact condition. Statistical analysis included descriptives, a one-way analysis of variance, and the Student-Newman-Keuls test for multiple comparisons among the reconstruction groups. Axial compression: under axial compressive loads, the stiffness of the wedge-rod construct was approximately equal to that of the intact group. The stiffness of the wedge alone construct was 56% less than that of the intact group except for extension and left lateral bending. For the other modes of loading (right rotation, left rotation, flexion, extension, right lateral bending, and left lateral bending), the wedge-rod construct was stiffer than that of the intact group. The stiffness of the wedge alone construct was consistently less than that of the intact group. Based on the results of this biomechanical comparison, the calf spines instrumented with the wedge-rod system for fusionless correction were significantly stiffer as compared to the intact calf spine. The wedges alone were not as stiff as the intact spine. This suggests that the theory of performing transverse osteotomies of vertebral bodies with fixation with wedge-rod construct for 8 to 12 weeks, followed by removal of the rod, could provide adequate fixation and correction of a scoliotic deformity without requiring fusion of motion segments.


Characterising the mechanism of airway smooth muscle β2 adrenoceptor desensitization by rhinovirus infected bronchial epithelial cells.
Rhinovirus (RV) infections account for approximately two thirds of all virus-induced asthma exacerbations and often result in an impaired response to β2 agonist therapy. Using an in vitro model of RV infection, we investigated the mechanisms underlying RV-induced β2 adrenoceptor desensitization in primary human airway smooth muscle cells (ASMC). RV infection of primary human bronchial epithelial cells (HBEC) for 24 hours produced conditioned medium that caused β2 adrenoceptor desensitization on ASMCs without an effect on ASMCs viability. Less than 3 kDa size fractionation together with trypsin digestion of RV-induced conditioned medium did not prevent β2 adrenoceptor desensitization, suggesting it could potentially be mediated by a small peptide or lipid. RV infection of BECs, ASMCs and fibroblasts produced prostaglandins, of which PGE2, PGF2α and PGI2 had the ability to cause β2 adrenoceptor desensitization on ASMCs. RV-induced conditioned medium from HBECs depleted of PGE2 did not prevent ASMC β2 adrenoceptor desensitization; however this medium induced PGE2 from ASMCs, suggesting that autocrine prostaglandin production may be responsible. Using inhibitors of cyclooxygenase and prostaglandin receptor antagonists, we found that β2 adrenoceptor desensitization was mediated through ASMC derived COX-2 induced prostaglandins. Since ASMC prostaglandin production is unlikely to be caused by RV-induced epithelial derived proteins or lipids we next investigated activation of toll-like receptors (TLR) by viral RNA. The combination of TLR agonists poly I:C and imiquimod induced PGE2 and β2 adrenoceptor desensitization on ASMC as did the RNA extracted from RV-induced conditioned medium. Viral RNA but not epithelial RNA caused β2 adrenoceptor desensitization confirming that viral RNA and not endogenous human RNA was responsible. It was deduced that the mechanism by which β2 adrenoceptor desensitization occurs was by pattern recognition receptor activation of COX-2 induced prostaglandins.


Inter-α inhibitor proteins maintain neutrophils in a resting state by regulating shape and reducing ROS production.
The plasma levels of inter-α inhibitor proteins (IAIPs) are decreased in patients with sepsis and the reduced levels correlate with increased mortality. In the present study, we examined the effects of IAIPs on human neutrophils to better understand the beneficial effects of IAIPs in the treatment of sepsis. We demonstrated that IAIPs induced a spherical shape that was smaller in size with a smooth cellular surface in a concentration-dependent manner. These changes were inhibited by a specific antibody against IAIPs. In contrast, bikunin, light chain of IAIP, had no effect on neutrophil morphology. The neutrophils treated with IAIPs could easily pass through the artificial microcapillaries and were prevented from entrapment inside the capillaries. Coincubation of human blood neutrophils with a confluent human vascular endothelial monolayer showed that adhesion of neutrophils on endothelial cells was suppressed by treatment with IAIPs. IAIPs inhibited the spontaneous release of reactive oxygen species (ROS) in a concentration-dependent fashion. ROS inhibition was associated with reductions in p47phox phosphorylation on Ser328. These results suggest that IAIP-induced morphological changes that render neutrophils quiescent, facilitate passage through the microvasculature, and reduce adhesion to vascular endothelial cells and production of ROS. Thus, IAIP plays a key role in controlling neutrophil activation.


5-Chloro-N-(4,5-dihydro-1H-imidazol-2-yl)-2,1,3-benzothia-diazol-4-amine (tizanidine).
There are two independent mol-ecules (A and B) with similar conformations in the asymmetric unit of the title compound, C(9)H(8)ClN(5)S. The benzothia-diazole ring systems of both mol-ecules are essentially planar [maximum deviation = 0.021 (2) Å in mol-ecule A and 0.022 (1) Å in mol-ecule B] and make dihedral angles of 68.78 (9) and 54.39 (8)°, respectively, with the mean planes of their 4,5-dihydro-1H-imidazole rings. An intra-molecular N-H⋯Cl hydrogen bond occurs in mol-ecule B. In the crystal, both mol-ecules form centrosymmetric dimers through π-stacking of their benzothia-diazole rings, with inter-planar distances of 3.3174 (7) and 3.2943 (6) Å. These dimers are further linked via pairs of N-H⋯N hydrogen bonds with the dihydro-imidazole rings as the hydrogen-bonding donors and one of the benzothia-diazole N atoms as the acceptors, generating R(2) (2)(16) ring motifs. The A(2) and B(2) dimers in turn form additional N-H⋯N hydrogen bonds with the secondary amine as the H-atom donor and the dihydro-imidazole N atom as the acceptor. These R(2) (2)(8)-type inter-actions connect the A(2) and B(2) dimers with each other, forming infinite chains along [1[Formula: see text]1].


The detection of alpha-fetoprotein in HBs Ag and HBe Ag carriers.
We detected the alpha-fetoprotein (AFP) in 100 sera of HBsAg and HBeAg carriers, by radioimmunoassay (RIA). High values of AFP in 12 HBsAg carriers (mean value: 168,5 ng/ml) were found. Lower values were found in 3 HBeAg carriers (mean value: 22,5 ng/ml). We will study the prognostic and diagnostic value of this carcinoembryonic antigen in HBsAg and HBeAg carriers, and will consider the possible role of AFP in the development of primary hepatocellular carcinoma. We believe that the increased AFP levels seen during hepatic parenchymal regeneration may depress immunity in some cases, or alter immunosupervision in others, and this facilitates the development of neoplasia in liver.


Transrectal fine-needle aspiration biopsy for cytologic diagnosis and grading of prostatic carcinoma.
In this article, the Karolinska experience of transrectal fine-needle aspiration biopsy of prostatic carcinoma, which now extends over more than twenty years, is evaluated. The cytologic criteria for diagnosing prostatic carcinoma in aspirates are well defined. While accuracy for cytodiagnosis is similar to that of histopathologic diagnosis, fine-needle aspiration is a less traumatic, cheaper procedure compared with histologic biopsy methods. Accuracy depends very much upon the skill of the examiner taking the cell samples and on the alertness of the cytopathologist for possible diagnostic pitfalls. Cytologic grading of prostatic carcinoma into well, moderately, and poorly differentiated types has been shown to be correlated significantly not only to histopathologic grading, but also to clinical stage, response to hormonal therapy and survival. The degree of tumor differentiation is well reproduced by independent observers. Cytochemical parameters, such as DNA measurement, constitute a potential refinement of cytologic grading, especially in moderately differentiated carcinomas. In medical centers with long experience of fine-needle aspiration biopsy, the method has a central role in diagnosis and management of prostatic carcinoma, including posttherapy follow-up.


The value added by electrodiagnostic testing in the diagnosis of carpal tunnel syndrome.
There is no clear-cut consensus on the best diagnostic criteria for carpal tunnel syndrome. The objective of this study was to compare the probability of carpal tunnel syndrome being present following electrodiagnostic testing with the probability of it being present after the diagnosis was established on the basis of a clinical evaluation alone. The study sample included patients with any peripheral nerve diagnosis who had been referred to the electrodiagnostic laboratory of an academic health-care center. The probability of carpal tunnel syndrome before electrodiagnostic testing (pretest probability) was estimated with use of the CTS-6, a validated clinical diagnostic aid that is used to estimate the probability of carpal tunnel syndrome on the basis of the presence or absence of six clinical findings recorded as part of the history or noted on physical examination. All patients then underwent a standard electrodiagnostic assessment of the median nerve by a neurologist blinded to the result of the CTS-6 evaluation. Sensory nerve conduction velocity was used to classify the result of the electrodiagnostic testing as either positive or negative for carpal tunnel syndrome with use of two different criteria (one stringent and one lax) derived from the literature. The main outcome measure was the difference between the pretest and posttest probabilities of carpal tunnel syndrome. One hundred and forty-three patients were studied. The pretest probability of carpal tunnel syndrome ranged between 0.10 and 0.99 (mean [and standard deviation], 0.81 +/- 0.22). Seventy-three percent of the patients had a pretest probability of at least 0.80. The average change in probability for these patients was -0.02 when the stringent electrodiagnostic criterion was used and -0.06 when the lax criterion was used. With either electrodiagnostic criterion, the majority of the large changes in probability were for patients for whom the pretest probability was < or =0.50. The probability of carpal tunnel syndrome was lowered after the electrodiagnostic testing in most of these cases. For the majority of patients who are considered to have carpal tunnel syndrome on the basis of their history and physical examination alone, electrodiagnostic tests do not change the probability of diagnosing this condition to an extent that is clinically relevant.


Insights into Regulation of the miR-17-92 Cluster of miRNAs in Cancer.
Overexpression of the miR-17-92 cluster is a key oncogenic event in various cancer types. The oncogenic effect of the miR-17-92 cluster is enhanced by cooperation between its members in targeting tumor-suppressive proteins and pathways such as PTEN and TGFβ signaling. However, in the case of miR-19a and miR-19b, these have been shown to have a preponderant role in the cluster's oncogenicity. Important studies have revealed the influence of the Myc proto-oncogene family in the transcriptional regulation of miR-17-92. Recent findings show that other oncogenic signaling pathways, such as those of Notch and Sonic Hedgehog, activate miR-17-92 in cancer. Notwithstanding, another layer of complexity has been added by the influence of the relevant primary miR-17-92 tertiary structure during processing to mature miRNA. In this review, we attempt to integrate current transcriptional and post-transcriptional knowledge to enhance our global understanding of the coordinated up-regulation of miR-17-92 in cancer.


Global identification and mapping of socio-ecological production landscapes with the Satoyama Index.
Production landscapes play an important role in conserving biodiversity outside protected areas. Socio-ecological production landscapes (SEPL) are places where people use for primary production that conserve biodiversity. Such places can be found around the world, but a lack of geographic information on SEPL has resulted in their potential for conservation being neglected in policies and programs. We tested the global applicability of the Satoyama Index for identifying SEPL in multi-use cultural landscapes using global land use/cover data and two datasets of known SEPL. We found that the Satoyama Index, which was developed with a focus on biodiversity and tested in Japan, could be used globally to identify landscapes resulting from complex interactions between people and nature with statistical significance. This makes SEPL more relevant in the global conservation discourse. As the Satoyama Index mapping revealed that approximately 80% of SEPL occur outside recognized conservation priorities, such as protected areas and key biodiversity areas, identifying SEPL under the scheme of other area-based conservation measures (OECM) may bring more conservation attention to SEPL. Based on the issues identified in the SEPL mapping, we discuss ways that could improve the Satoyama Index mapping at global scale with the longitudinal temporal dimension and at more local scale with spatial and thematic resolution.


Principles for the ethical analysis of clinical and translational research.
Statistical analysis is a cornerstone of the scientific method and evidence-based medicine, and statisticians serve an increasingly important role in clinical and translational research by providing objective evidence concerning the risks and benefits of novel therapeutics. Researchers rely on statistics and informatics as never before to generate and test hypotheses and to discover patterns of disease hidden within overwhelming amounts of data. Too often, clinicians and biomedical scientists are not adequately proficient in statistics to analyze data or interpret results, and statistical expertise may not be properly incorporated within the research process. We argue for the ethical imperative of statistical standards, and we present ten nontechnical principles that form a conceptual framework for the ethical application of statistics in clinical and translational research. These principles are drawn from the literature on the ethics of data analysis and the American Statistical Association Ethical Guidelines for Statistical Practice.


MIGRATION PATTERNS AND THE DEVELOPMENT OF MULTILOCUS ASSOCIATIONS IN A SELFING ANNUAL, TRITICUM DICOCCOIDES.
Migration patterns in wild emmer wheat, Triticum dicoccoides, were inferred from single-locus and multilocus genetic distributions based primarily on expectations derived from single-locus and multilocus cline theory. Populations from five collections displayed a large amount of multilocus structuring, as indicated by high values of gametic-phase disequilibrium between pairs of loci and by high values of multilocus associations. Analyses of the distributions of individual alleles, however, indicated that alleles had apparent independent centers of origin and that at least some independent dispersal within regions occupied by ecotypes or races of wild emmer had occurred. The distribution of the degrees of multilocus association suggests that there has been a net migration of the northern or Qazrin race south and west into the pocket occupied by the Yehudiyya race. The results suggest that ecotypic differentiation may be independent and may antedate electrophoretically determined differentiation in these populations. There is no convincing evidence that the multilocus associations represent coadapted complexes; rather they appear to involve associations of mutant alleles that have been accentuated and preserved by low recombination rates and gene-flow barriers within previously differentiated ecotypes.


Binding of chlormadinone acetate to cytosol from human benign prostatic hypertrophy.
Chlormadinone acetate was bound to cytosol from the human benign prostatic hypertrophy in a high affinity fashion. The kd and number of maximum binding site of the binding were 5.4 +/- 0.7 X 10(-9) M and 67.9 +/- 5.8 fmol/mg protein, respectively. When compared with the binding to dihydrotestosterone, the Kd for chlormadinone acetate was greater. The number of maximum binding site for chlormadinone acetate was observed to be smaller than that for dihydrotestosterone, but these two values were not different statistically. The binding of chlormadinone acetate was inhibited significantly by the addition of R 1881 or cyproterone acetate. However, dihydrotestosterone revealed itself to be a weak inhibitor of the binding. The cytosol prelabelled with chlormadinone acetate was not bound to the nuclei of the human prostate.


The imported fire ant: dimensions of the urban problem.
Although the imported fire ant is a known rural problem, the problem it may pose to urban dwellers has not been documented. A telephone survey of 240 households selected by a probability sample of an upper middle class suburb of New Orleans was carried out to ascertain the experiences of residents with fire ants from June to August 1973. Overall, ant stings were reported for 29% of the study population, with sting rates of 55% among children under 10 years old. Among those stung, at least minimal allergic reactions were reported for 17%, and 4.4% required medical consultation. Of households with outdoor premises, 55% reported fire ant infestation, 86% of these used pesticides for fire ant control, and few felt that community assistance was needed for private property. Half of the respondents, however, favored a community control program for public grounds. These data may provide a basis for decision as to the need for community efforts in fire ant control.


Single stage surgical management of a sigmoid gallstone ileus case.
Bowel obstruction/ileus is a relatively common occurrence in surgical practice with a predictable clinical presentation and management course. Rarely are these cases found consistent with gallstone etiology. Known as gallstone ileus (GI), this uncommon presentation is found primarily in elderly females (age > 65 years old) with multiple comorbid conditions; usually with coinciding presence of a cholecystoenteric fistula. Surgical management remains controversial due to the rarity of presentation and complexity of related pathological process. We present a case of a 69-year-old female who presented with typical signs/symptoms of bowel obstruction but found to have sigmoid GI on computed tomography imaging evaluation. A single stage exploratory laparotomy with simple enterolithotomy was performed with a positive outcome and uncomplicated postoperative recovery. The primary goal in reporting this case is to continue emphasizing the efficacy of a single stage simple enterolithotomy as the most ideal surgical management of this rare condition.


African American ethnicity as a risk factor for respiratory complications following adenotonsillectomy.
To evaluate whether African American ethnicity is a risk factor for major respiratory complications following adenotonsillectomy (T&A). Retrospective cohort study. A Canadian tertiary care center. PATIENTS Children aged 0 to 18 years who underwent T&A at our institution from 2002 to 2006 with planned or unplanned postoperative admissions. We evaluated the association between ethnicity and our main outcome measure, major perioperative respiratory complications of T&A. Parental report of ethnicity was available for 23% of our cohort. At our institution, African American children undergo a routine preoperative sickle cell test (TestSC). Data on TestSC were included for all children. We established that having a TestSC was an accurate proxy for African American ethnicity (sensitivity, 96%; specificity, 93%; positive predictive value, 77%; negative predictive value, 99%). Seventy-four of 594 children experienced major respiratory complications (12.5%). Compared with children who did not have major respiratory complications, those who did had a TestSC (P = .01), were 2 years or younger (P < .001) and had lower weight-for-age z scores (P = .04), moderate to severe obstructive sleep apnea (P = .003), and comorbidities (P < .001). When controlling for these variables in a multivariate analysis, children of African American ethnicity (TestSC used as a proxy) were at higher risk of having major perioperative respiratory complications (adjusted odds ratio, 1.82 [95% CI 1.05-3.14]) (P = .003). Children of African American ethnicity (TestSC used as a proxy) are nearly twice as likely to experience major respiratory complications related to T&A. Ethnicity may be an additional independent risk factor for clinicians to consider when planning for T&A.


Utility of p16INK4a, CEA, Ki67, P53 and ER/PR in the differential diagnosis of benign, premalignant, and malignant glandular lesions of the uterine cervix and their relationship with Silverberg scoring system for endocervical glandular lesions.
Early detection of premalignant and malignant glandular lesions of the uterine cervix and their distinction from benign mimics is crucial but sometimes difficult. In this study, we investigated utility of expression of p16, CEA, Ki67, p53 and ER/PR in evaluating the benign, premalignant, and malignant glandular lesions of the uterine cervix. A total of 35 cervical cone or LEEP cases were collected including 14 adenocarcinoma in situ (AIS), 7 endocervical glandular dysplasia (EGD), and 14 benign mimics (BM). A histological score for each case according to the criteria proposed by Silverberg group was assigned independently by 4 pathologists. Formalin-fixed, paraffin-embedded sections were immunostained with p16, CEA, p53, Ki67, and ER/PR. Immunoreactivity was scored based on intensity (0 = none, 1 = mild, 2 = moderate, 3 = marked) and percentage of cells staining (0 = <1%,1 = 2-10%, 2 = 11-40%, 3 = >40%). A comparison of histological scores and immunoscores in 3 diagnostic categories was analysed. The histological scores assigned independently by 4 pathologists were all equal or above 6 for AIS, between 3 and 5 for EGD, and equal or below 3 for BM. There was increased expression of p16 and CEA in EGD compared with BM (P < 0.05), with further increase in expression of these markers in AIS compared with EGD (P < 0.05). Ki67 expression was significantly increased in AIS compared to EGD (P < 0.05) as well as compared to BM (P < 0.05). Ki67 expression was only slightly increased in EGD as compared to BM. There was a loss of ER/PR in cervical AIS, but not in EGD. Our results indicate that the Silverberg scoring system is a useful tool in differential diagnosis of cervical glandular lesions for increased diagnostic accuracy and interobserver agreement. Most cervical glandular lesions can be differentiated by using a combination of histological scores with a panel of immunomarkers.


Sequential Contribution of Parenchymal and Neural Stem Cell-Derived Oligodendrocyte Precursor Cells toward Remyelination.
In the adult mammalian forebrain, oligodendrocyte precursor cells (OPCs), also known as NG2 glia are distributed ubiquitously throughout the gray and white matter. They remain proliferative and continuously generate myelinating oligodendrocytes throughout life. In response to a demyelinating insult, OPCs proliferate rapidly and differentiate into oligodendrocytes which contribute to myelin repair. In addition to OPCs, neural stem cells (NSCs) in the subventricular zone (SVZ) also contribute to remyelinating oligodendrocytes, particularly in demyelinated lesions in the vicinity of the SVZ, such as the corpus callosum. To determine the relative contribution of local OPCs and NSC-derived cells toward myelin repair, we performed genetic fate mapping of OPCs and NSCs and compared their ability to generate oligodendrocytes after acute demyelination in the corpus callosum created by local injection of α-lysophosphatidylcholine (LPC). We have found that local OPCs responded rapidly to acute demyelination, expanded in the lesion within seven days, and produced oligodendrocytes by two weeks after lesioning. By contrast, NSC-derived NG2 cells did not significantly increase in the lesion until four weeks after demyelination and generated fewer oligodendrocytes than parenchymal OPCs. These observations suggest that local OPCs could function as the primary responders to repair acutely demyelinated lesion, and that NSCs in the SVZ contribute to repopulating OPCs following their depletion due to oligodendrocyte differentiation.


The genetics of urinary microbiome, an exploration of the trigger in calcium oxalate stone.
Background: Kidney stone disease is a global disease; however, it has not been totally understood. Calcium oxalate (CaOx) stone is the dominant type of kidney stone, and the potential factors involved in its formation are yet to be explored. Clinically, we found that the CaOx stones in patients were mainly unilateral; therefore, systemic factors cannot explain them, although some local factors must be involved. Urinary microbiota is involved in stone formation. Therefore, this study aimed to explore the association between the urinary microbiota and CaOx stones and provide insight into the medical treatment and prevention of CaOx stones. Methods: Sixteen pelvic urine samples were collected from the stone and non-stone sides of patients with unilateral CaOx stones following strict criteria. The 16S rRNA gene sequencing was performed on each pair of pelvic urine samples at the species level. Many bioinformatic analyses were conducted to explore the potential factors affecting CaOx stone formation. Results: Although no statistically significant difference was found between the overall microbiota of the pelvis urine from the two sides. Many biologically distinct taxa were observed, including many bacteria found in previous studies, like Proteobacteria, Actinobacteria, Firmicute and Enterobacter cloacae and so on. What's more, despite these common bacteria, our current study added to these bacterial communities with additional identification of Deinococcus-Thermus, Coriobacteriia, Porphyromonas and Ralstonia. To predict the functions of these microbiota, Kyoto Encyclopedia for Genes and Genomes and MetaCyc analysis were conducted and immunometabolism might be an important pathway. Moreover, a random forest predictor was constructed to distinguish the stone side from the non-stone side, with an accuracy of 62.5%. Conclusion: Our research profiled the microbiome in the pelvis urine from both the stone and non-stone sides of patients with unilateral CaOx stones, provided insight into the dominant role of urinary dysbiosis in CaOx stones formation. Furthermore, this study also predicted the potential crosstalk among urinary microbiota, immunometabolism, and CaOx stones.


Advanced Structural Determination of Diterpene Esters Using Molecular Modeling and NMR Spectroscopy.
Three new jatrophane esters (1-3) were isolated from Euphorbia amygdaloides ssp. semiperfoliata, including an unprecedented macrocyclic jatrophane ester bearing a hemiketal substructure, named jatrohemiketal (3). The chemical structures of compounds 1-3 and their relative configurations were determined by spectroscopic analysis. The absolute configuration of compound 3 was determined unambiguously through an original strategy combining NMR spectroscopy and molecular modeling. Conformational search calculations were performed for the four possible diastereomers 3a-3d differing in their C-6 and C-9 stereocenters, and the lowest energy conformer was used as input structure for geometry optimization. The prediction of NMR parameters ((1)H and (13)C chemical shifts and (1)H-(1)H coupling constants) by density functional theory (DFT) calculations allowed identifying the most plausible diastereomer. Finally, the stereostructure of 3 was solved by comparison of the structural features obtained by molecular modeling for 3a-3d with NMR-derived data (the values of dihedral angles deduced from the vicinal proton-proton coupling constants ((3)JHH) and interproton distances determined by ROESY). The methodology described herein provides an efficient way to solve or confirm structural elucidation of new macrocyclic diterpene esters, in particular when no crystal structure is available.


The calm before the storm: clinical observations of Middle East respiratory syndrome (MERS) patients.
Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection emerged in 2012. The majority of cases occurred in the Kingdom of Saudi Arabia and the disease carries a high case fatality rate. We present three MERS-CoV cases and highlight the salient clinical features and laboratory, and radiographic characteristics. Although all nasopharyngeal samples were negative, MERS CoV infection was confirmed by reverse transcription-polymerase chain reaction of the E gene (UpE) and open reading frame (ORF1b) on sputum samples. The Ct value of the ORF1 gene was 24.8-29.11. One patient had been on immune suppressive agent and two patients had diabetes mellitus. The average length of hospital stay was 10.6 days. Two patients received ribavirin and IFN-a2b in addition to supportive management. The clinical course for these patients started with a febrile period lasting five days, a reduction in fever was coinciding with increased respiratory rate and oxygen requirements. All patients were discharged home. None of the 50 contacts tested positive for MERS-CoV. Resolution of the fever was accompanied by an increase in oxygen requirements and respiratory rate also lasting several days. This was followed by resolution of all symptoms and return to normal.


[Molecular cloning and expression of Nattokinase gene in Bacillus subtilis].
In order to characterize biochemically the nattokinase,the nucleotide sequence of the nattokinase gene was amplified from the chromosomal DNA of B.subtilis (natto) by PCR. The expression plasmid pBL NK was constructed and was used to transform Bacillus subtilis containing a chromosomal deletion in its subtilisin gene. The supernatant of the culture was collected after 15 h culture. The target proteins were identified by SDS-PAGE. Nattokinase was purified by a method including ultrafiltration, Sephacryl S-100 gel filtration and S-Sepharose ion-exchange chromatography, and 100 mg of purified nattokinase was obtained from one liter of culture. The purity of the protein and the specific activity were 95% and 12 000 u/mg (compared to tPA), respectively.


[Effect of external abdominal aorta compression on circulation during anesthesia induction in elderly patients].
To investigate the effect of external abdominal aorta compression on circulation during anesthetic induction in elderly patients. A prospective randomized controlled trial was conducted. Patients with age of 60-75 years old, requiring a general anesthesia for non-abdominal surgery, and with II-III class of American Society of Anesthesiologists (ASA) physical status classification, and admitted to General Hospital of Chinese People's Armed Police Forces from January to April in 2017 were enrolled. They were divided into abdominal aorta pressure group and control group according to random number method, with 20 patients in each group. In both groups, anesthesia was induced with midazolam, propofol, fentanyl and cisatracurium, and was maintained with propofol, remifentanil and cisatracurium. After successful intubation, the anesthesia machine was changed into mechanical ventilation. The patients in abdominal aorta pressure group were given abdominal aorta pressure 1 minute after induction of general anesthesia with midazolam till 5 minutes after intubation. The mean arterial pressure (MAP), heart rate (HR) and blood oxygen saturation (SpO2) were observed before anesthesia induction, immediately after anesthesia induction, immediately after intubation, 5 minutes and 10 minutes after intubation, respectively. The incidence of hypotension or bradycardia, and usage of ephedrine or atropine were recorded. There were no significant differences in MAP [mmHg (1 mmHg = 0.133 kPa): 83.6±4.7 vs. 82.9±4.7], HR (bpm: 67.3±5.9 vs. 65.9±5.7) and SpO2 (0.962±0.007 vs. 0.960±0.009) before anesthesia induction between abdominal aorta pressure group and control group (all P > 0.05). Immediately after anesthesia induction, the MAP and HR in control group were significantly decreased as compared with those before anesthesia induction [MAP (mmHg): 70.0±8.7 vs. 82.9±4.7, HR (bpm): 60.7±6.7 vs. 65.9±5.7, both P < 0.05], and they were also significantly lower than those of abdominal aorta pressure group [MAP (mmHg): 83.1±3.9, HR (bpm): 66.8±4.9, both P < 0.05]. Immediately after intubation, the MAP and HR in control group were significantly increased as compared with those immediately after anesthesia induction [MAP (mmHg): 78.9±7.9 vs. 70.0±8.7, HR (bpm): 67.3±2.7 vs. 60.7±6.7, both P < 0.05], but the changes in MAP and HR in abdominal aorta pressure group were not obvious. During the anesthesia induction period, there was no statistical difference in SpO2 change between the two groups. During induction of anesthesia, no adverse reaction was found in the abdominal aorta pressure group, but 4 patients with hypotension and 2 patients with bradycardia were found in the control group. Two patients with hypotension were treated with ephedrine, and 2 patients with bradycardia were treated with atropine. Anesthesia induction of elderly patients with abdominal aorta pressure can help maintain hemodynamic stability.


High Throughput Screening of Dynamic Silk-Elastin-Like Protein Biomaterials.
The need for dynamic, elastomeric polymeric biomaterials remains high, with few options with tunable control of mechanical properties, and environmental responses. Yet the diversity of these types of protein polymers pursued for biomaterials-related needs remains limited. Robust high-throughput synthesis and characterization methods will address the need to expand options for protein-polymers for a range of applications. To address this need, a combinatorial library approach with high throughput screening is used to select specific examples of dynamic protein silk-elastin-like polypeptides (SELPs) with unique stimuli responsive features, including tensile strength, and adhesion. Using this approach 64 different SELPs with different sequences and molecular weights are selected out of over 2,000 recombinant E. coli colonies. New understanding of sequence-function relationships with this family of proteins is gained through this combinatorial-screening approach and can provide a guide to future library designs. Further, this approach yields new families of SELPs to match specific material functions.


Efficacy of measuring the invasive diameter of lung adenocarcinoma using mediastinal window settings: A retrospective study.
The recently published 8th edition of the tumor node and metastasis Classification of Lung Cancer proposes using the maximum dimension of the solid component of a ground glass nodule (GGN) for the T categorization. However, few studies have investigated the collection of this information when using mediastinal window settings. In this study, we evaluated tumor measurement data obtained from computed tomography (CT) scans when using mediastinal window settings.This study included 202 selected patients with persistent, partly solid GGNs detected on thin-slice CT after surgical treatment between 2004 and 2013. We compared the differences in tumor diameters measured by 2 different radiologists using a repeated-measures analysis of variance. We divided the patients into 2 groups based on the clinical T stage (T1a+T1b vs T1c) and estimated the probability of overall survival (OS) and disease-free survival (DFS) using Kaplan-Meier curves.The study included 94 male and 108 female patients. The inter-reviewer differences between tumor diameters were significantly smaller when the consolidation to maximum tumor diameter ratio was ≤0.5. The 2 clinical groups classified by clinical T stage differed significantly with respect to DFS when using the mediastinal window settings. However, no significant differences in OS or DFS were observed when using the lung window setting.Our study yielded 2 major findings. First, the diameters of GGNs could be measured more accurately using the mediastinal window setting. Second, measurements obtained using the mediastinal window setting more clearly depicted the effect of clinical T stage on DFS.


Traumatic dislocation of the hip in a child. A case report.
A case of traumatic posterior dislocation of the hip in a child in which the diagnosis was initially missed is presented. The fact that the condition may follow extremely mild trauma is demonstrated, and the need for two-plane radiography is stressed. A review of the literature emphasizes that prompt recognition and treatment may markedly reduce the incidence of avascular necrosis of the femoral head, the commonest and most severe complication. Reduction of a traumatically dislocated hip in a child is usually easy and need not be performed only at specialist centres.


Microbiological baseline study of broiler chickens at Swedish slaughterhouses.
This 1-year study was conducted to estimate the prevalence and concentrations of pathogenic and indicator bacteria on Swedish broiler chickens. A total of 636 chilled carcasses were collected from 10 slaughterhouses and sent to the National Food Administration for analyses of carcass rinses. No carcasses were positive for Salmonella. Campylobacter, predominantly Campylobacter jejuni, were detected on 15% (by enrichment) or 14% (by direct plating) of the carcasses. With one exception, all samples from late December through April were Campylobacter negative. The 10th and 90th percentiles of Campylobacter numbers per carcasses were 3.0 and 5.0 log CFU, respectively, and the maximum was 7.1 log CFU. Coagulase-positive staphylococci were detected on 68% of the carcasses, with a maximum of 3.5 log CFU/cm2. The 10th and 90th percentiles were 3.4 and 4.4 log CFU/cm2 for total aerobic microorganisms, 1.8 and 3.3 log CFU/cm2 for Enterobacteriaceae, and 2.0 and 3.6 log CFU/cm2 for Escherichia coli. No correlation was found between numbers of any indicator bacteria and numbers of pathogenic bacteria. Subsets of the samples were analyzed for Listeria monocytogenes, Clostridium perfringens, pathogenic Yersinia enterocolitica, and Enterococcus, resulting in prevalence estimates of 29, 18, 9 (as determined by a PCR assay), and 97%, respectively. L. monocytogenes was most common at slaughterhouses with a low prevalence of coagulase-positive staphylococci, and vice versa. These results will improve the ability of researchers to assess the importance of chicken as a source of foodborne pathogens and can serve as a basis for risk management actions.


Simple sequence repeat markers useful for sorghum downy mildew (Peronosclerospora sorghi) and related species.
A recent outbreak of sorghum downy mildew in Texas has led to the discovery of both metalaxyl resistance and a new pathotype in the causal organism, Peronosclerospora sorghi. These observations and the difficulty in resolving among phylogenetically related downy mildew pathogens dramatically point out the need for simply scored markers in order to differentiate among isolates and species, and to study the population structure within these obligate oomycetes. Here we present the initial results from the use of a biotin capture method to discover, clone and develop PCR primers that permit the use of simple sequence repeats (microsatellites) to detect differences at the DNA level. Among the 55 primers pairs designed from clones from pathotype 3 of P. sorghi, 36 flanked microsatellite loci containing simple repeats, including 28 (55%) with dinucleotide repeats and 6 (11%) with trinucleotide repeats. A total of 22 microsatellites with CA/AC or GT/TG repeats were the most abundant (40%) and GA/AG or CT/TC types contribute 15% in our collection. When used to amplify DNA from 19 isolates from P. sorghi, as well as from 5 related species that cause downy mildew on other hosts, the number of different bands detected for each SSR primer pair using a LI-COR- DNA Analyzer ranged from two to eight. Successful cross-amplification for 12 primer pairs studied in detail using DNA from downy mildews that attack maize (P. maydis & P. philippinensis), sugar cane (P. sacchari), pearl millet (Sclerospora graminicola) and rose (Peronospora sparsa) indicate that the flanking regions are conserved in all these species. A total of 15 SSR amplicons unique to P. philippinensis (one of the potential threats to US maize production) were detected, and these have potential for development of diagnostic tests. A total of 260 alleles were obtained using 54 microsatellites primer combinations, with an average of 4.8 polymorphic markers per SSR across 34 Peronosclerospora, Peronospora and Sclerospora spp isolates studied. Cluster analysis by UPGMA as well as principal coordinate analysis (PCA) grouped the 34 isolates into three distinct groups (all 19 isolates of Peronosclerospora sorghi in cluster I, five isolates of P. maydis and three isolates of P. sacchari in cluster II and five isolates of Sclerospora graminicola in cluster III). To our knowledge, this is the first attempt to extensively develop SSR markers from Peronosclerospora genomic DNA. The newly developed SSR markers can be readily used to distinguish isolates within several species of the oomycetes that cause downy mildew diseases. Also, microsatellite fragments likely include retrotransposon regions of DNA and these sequences can serve as useful genetic markers for strain identification, due to their degree of variability and their widespread occurrence among sorghum, maize, sugarcane, pearl millet and rose downy mildew isolates.


[Invasive myocardial perfusion scan with (131)I-MAA and (99m)Tc-Microspheres (author's transl)].
Hemodynamic evaluation of coronary artery stenosis is indicated in patients with ischemic heart disease. For this purpose myocardial perfusion scans are performed. In our study myocardial scans were performed by selective injection of 60 to 80 muCi of (131)I-MAA in the right coronary artery and of 3 mCi of (99m)Tc-microspheres in the left coronary artery. Four views (RAO, LAO, AP, LLAT) were taken with an Anger-Camera and a computer-control-led color-coded display system (Picker Dyna-Came-ra 3C/12 and Kruppe Atlas Elektronik EPR 1100, medium energy collimator). Right and left coronary artery perfusion images were stored and two-colour image produced. Following computer processing (smoothing, normalization) the images were added and photographed in color. In comparision with scans and left-ventricular and coronary angiography the sensitivity of the nuclear medicine method was shown in cases with reduced perfusion. Therefore the perfusion scans seem to be useful in combination with angiography for the determination of therapy.


Rethinking natural altruism: simple reciprocal interactions trigger children's benevolence.
A very simple reciprocal activity elicited high degrees of altruism in 1- and 2-y-old children, whereas friendly but nonreciprocal activity yielded little subsequent altruism. In a second study, reciprocity with one adult led 1- and 2-y-olds to provide help to a new person. These results question the current dominant claim that social experiences cannot account for early occurring altruistic behavior. A third study, with preschool-age children, showed that subtle reciprocal cues remain potent elicitors of altruism, whereas a fourth study with preschoolers showed that even a brief reciprocal experience fostered children's expectation of altruism from others. Collectively, the studies suggest that simple reciprocal interactions are a potent trigger of altruism for young children, and that these interactions lead children to believe that their relationships are characterized by mutual care and commitment.


Probing coiled-coil assembly by paramagnetic NMR spectroscopy.
Here a new method to determine the oligomeric state and orientation of coiled-coil peptide motifs is described. Peptides K and E, which are designed to form a parallel heterodimeric complex in aqueous solution, were labeled with the aromatic amino acids tryptophan and tyrosine on the C-terminus respectively as 'fingerprint' residues. One of the peptides was also labeled with the paramagnetic probe MTSL. One dimensional proton NMR spectroscopy was used to study the peptide quaternary structure by monitoring the signal suppression of the aromatic labels due to proximity of the nitroxyl radical. 1D-NMR confirmed that the peptides K and E form a heterodimeric coiled coil with a parallel orientation. In addition, fluorescence emission quenching of the aromatic labels due to electron exchange with a nitroxyl radical confirmed the parallel coiled coil orientation. Thus, paramagnetic nitroxide and aromatic fluorophore labeling of peptides yields valuable information regarding the quaternary structure from 1D-NMR and steady-state fluorescence measurements. This convenient method is useful not only to investigate coiled coil assembly, but can also be applied to any defined supramolecular assembly.


Predicting failure to rescue after abdominal aortic aneurysm repair in elderly patients.
We aim to describe trends in failure to rescue (FTR) among elderly patients undergoing elective open aortic aneurysm repair (OAR) and endovascular aortic aneurysm repair (EVAR). All patients aged ≥80 y recorded in the Vascular Quality Initiative database (2002-2014) undergoing nonruptured infrarenal AAA repair were included. Primary outcome was FTR, defined as percentage of deaths in patients who had a complication within 30 d of surgery. Univariable and multivariable statistics were used to identify risk factors for FTR following OAR and EVAR procedures. 975 elderly patients underwent AAA repair during the study period (EVAR = 667, OAR = 308). Overall FTR was 10%, most commonly related to acute kidney injury (62%) and respiratory failure (53%). Independent predictors of FTR included female gender (odds ratio [OR] 1.95), multiple comorbidities (OR 1.98), renal insufficiency (OR 1.97), peripheral vascular disease (OR 2.42), and perioperative vasopressor use (OR 4.49) (all, P < 0.02). Obesity was protective (OR 0.58, P = 0.02). FTR was higher following OAR versus EVAR (14% versus 9%; P = 0.02) on univariable analysis, but there was no significant difference between operative approaches after risk adjustment (OR 1.15, P = 0.60). Comparing elderly versus younger patients (n = 2854), FTR was significantly higher for the elderly for both OAR (OR 2.0, 95% CI 1.36-3.01) and EVAR (OR 1.60, 95% CI 1.07-2.40). FTR after AAA repair is not uncommon among elderly patients and could explain the higher mortality observed in this group compared to the general population. Overall health status should be carefully considered when weighing the risks versus benefits of performing AAA repair in patients aged ≥80 y.


Determination of the Potential of Drug Candidates to Cause Severe Skin Disorders Using Computational Modeling.
Efficient and accurate prediction for drugs' potential to cause rare and severe adverse drug reactions (ADRs) is needed to facilitate the evaluation of risk-benefit ratio of drug candidates during drug development. Severe skin disorders like the Stevens Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), which are life-threatening dermatological conditions, are such ADRs that have not received sufficient attention so far. In this study, a total of 1127 marketed drugs were screened for their potential to cause SJS/TEN, of which 255 were found to cause SJS/TEN and 239 were unlikely to cause SJS/TEN. One-class classification method was used to develop multiple prediction models. An applicability domain was determined to define the applicability of the model. Ensemble method was used to develop ensemble models to improve prediction ability. The final ensemble model achieved a sensitivity and specificity of 81 % and 67.4 %, respectively, when estimated using the external 5-fold cross validation method, and a sensitivity of 66.7 % when assessed using an external positive set. The results suggest the methods used in this study are potentially useful for facilitating the prediction of rare and severe ADRs.


Early CD4+ T cell reconstitution as predictor of outcomes after allogeneic hematopoietic cell transplantation.
An association between early CD4+ T cell immune reconstitution (CD4+ IR) and survival after T-replete allogeneic hematopoietic cell transplantation (HCT) has been previously reported. Here we report validation of this relationship in a separate cohort that included recipients of ex vivo T-cell-depleted (TCD) HCT. We studied the relationship between CD4+ IR and clinical outcomes. A retrospective analysis of children/young adults receiving their first allogeneic HCT for any indication between January 2008 and December 2017 was performed. We related early CD4+ IR (defined as achieving >50 CD4+ T cells/µL on two consecutive measures within 100 days of HCT) to overall survival (OS), relapse, non-relapse mortality (NRM), event-free survival (EFS) and acute graft-versus-host disease (aGVHD). Fine and Gray competing risk models and Cox proportional hazard models were used. In this analysis, 315 patients with a median age of 10.4 years (interquartile range 5.0-16.5 years) were included. The cumulative incidence of CD4+ IR at 100 days was 66.7% in the entire cohort, 54.7% in TCD (N = 208, hazard ratio [HR] 0.47, P < 0.001), 90.0% in uCB (N = 40) and 89.6% in T-replete (N = 47) HCT recipients. In multi-variate analyses, not achieving early CD4+ IR was a predictor of inferior OS (HR 2.35, 95% confidence interval [CI] 1.46-3.79, P < 0.001) and EFS (HR 1.80, 95% CI 1.20-2.69, P = 0.004) and increased NRM (HR 6.58, 95% CI 2.82-15.38, P < 0.001). No impact of CD4+ IR on relapse or aGVHD was found. Within the TCD group, similar associations were observed. In this HCT cohort, including recipients of TCD HCT, we confirmed that early CD4+ IR was an excellent predictor of outcomes. Finding strategies to predict or improve CD4+ IR may influence outcomes.


Coordination of transcriptional and translational regulations in human epithelial cells infected by Listeria monocytogenes.
The invasion of mammalian cells by intracellular bacterial pathogens reshuffles their gene expression and functions; however, we lack dynamic insight into the distinct control levels that shape the host response. Here, we have addressed the respective contribution of transcriptional and translational regulations during a time-course of infection of human intestinal epithelial cells by an epidemic strain of Listeria monocytogenes, using transcriptome analysis paralleled with ribosome profiling. Upregulations were dominated by early transcriptional activation of pro-inflammatory genes, whereas translation inhibition appeared as the major driver of downregulations. Instead of a widespread but transient shutoff, translation inhibition affected specifically and durably transcripts encoding components of the translation machinery harbouring a 5'-terminal oligopyrimidine motif. Pre-silencing the most repressed target gene (PABPC1) slowed down the intracellular multiplication of Listeria monocytogenes, suggesting that the infected host cell can benefit from the repression of genes involved in protein synthesis and thereby better control infection.


Analysis of related factors of orolingual angioedema after rt-PA intravenous thrombolytic therapy.
Orolingual angioedema (OA) is a rare clinical complication with a potentially fatal risk that occurs after the intravenous application of alteplase (rt-PA) in patients with acute ischemic stroke. The purpose of this work is to investigate the related factors of OA in patients with acute ischemic stroke after the administration of intravenous thrombolytic therapy, to improve the predictive ability of OA during intravenous thrombolytic therapy, and to reduce the prevalence of complications. We recruited 1223 cases of patients with acute ischemic stroke that were treated in the Department of Neurology No. 4 of the Tianjin Huanhu Hospital from June 2014 to April 2015. The clinical manifestations of rt-PA related OA were recorded, the clinical prevalence was counted, related factors of OA after intravenous thrombolytic therapy were analyzed, and the risk assessment of rt-PA related OA was conducted. 14 cases of patients developed OA, with a prevalence rate of 1.14%. Among them, 5 had a history of urticaria, 4 of drug allergy, and 3 of food allergy. Among the 14 cases of patients, 10 developed OA in the process of intravenous thrombolysis and 4 after intravenous thrombolysis, 12 showed lip edema, 9 showed extensive swelling of tongue, 3 showed swelling of lateral tongue, 3 were complicated by respiratory distress, 10 showed infarction in the middle cerebral artery territory, and 6 had previously been given oral ACEI drugs. Orolingual angioedema is a rare complication that occurs after rt-PA intravenous thrombolytic therapy; when serious, it may endanger a patient's life. If patients take an oral hypotension such as ACEI drugs before the onset of OA, they have a history of allergies, or the lesion is an infraction in the dominated area of the middle cerebral artery, the risk of OA after rt-PA intravenous thrombolytic therapy will be increased. The prevalence of OA should be monitored during the rt-PA intravenous thrombolytic therapy process; timely detection and early intervention should be conducted, which can avoid serious adverse consequences.


Roast level and brew temperature significantly affect the color of brewed coffee.
Beverage color significantly affects perceived sensory quality and consumer preference. Although the color of coffee beans is well known to vary strongly with roast level, little work has examined how roast level and brewing conditions affect the color of the final beverage. Here, we report that the color of full immersion brewed coffee is significantly affected by both roast level and brewing temperature. Coffees from three different origins were each roasted to three different levels (light, medium, and dark) and then brewed at three different temperatures (4, 22, and 92°C). Each sample was brewed toward full extraction and then diluted to precisely 2% total dissolved solids so that differences in concentration would not confound color measurements. Absorbance spectra (UV-vis) and color tristimulus values (L*a*b*) were then collected and analyzed. We find that roast level had the strongest impact on brew color, and that brew temperature had a significant impact on color for light and medium roasts, with less impact on dark roasts. Qualitatively, the cold brewed coffees tended to be redder, while the hot brewed coffees were blacker. The results suggest that there is an opportunity to manipulate and brand brewed coffee color through judicious choices of roast level and brewing temperature. PRACTICAL APPLICATION: Color serves as an indicator of coffee quality and potentially could affect perceived sensory characteristics. Our results suggest that appropriate control of roast level and brew temperature could yield desired colors for novel coffee products.


April 2017 Letter to the Editor-in-Chief.
Letter to the Editor-in-Chief of JOSPT as follows: "Subgrouping Patients With Low Back Pain" with Authors' Response J Orthop Sports Phys Ther 2017;47(4):295. doi:10.2519/jospt.2017.0203.


Evaluation of transforaminal ligaments by magnetic resonance imaging.
Three-part study to (1) identify and describe transforaminal ligaments (TFLs), (2) determine the best low-field-strength magnetic resonance imaging (MRI) technique for TFLs, and (3) determine the ability of low-field-strength MRI to obtain images of TFLs. Part I-descriptive anatomic study; part II-descriptive MRI study; part III-blinded comparison of diagnostic test against gold standard (MRI vs anatomic dissection). Chiropractic college gross anatomy laboratory and MRI facilities. Three anatomic specimens of male cadavers age 60 to 85 years; a fourth specimen was used for training radiologists in part III. Part I-number and size of TFLs; part II-subjective grading of highest quality MRI images; part III-specificity, sensitivity, positive predictive value, negative predictive value, percent agreement, and accuracy of identifying TFLs from MRI scans. Part I-19 TFLs identified in 30 intervertebral foramina (IVFs) (60% of IVFs had TFLs), thick = 4 (21%), medium thickness = 12 (63.2%), thin = 3 (15.8%); part II-TFLs demonstrated to best advantage with pure sagittal plane, T(1)-weighted MRI; part III-average: specificity = 88.9%, sensitivity = 45.6%, positive predictive value = 86.7%, negative predictive value = 50.8%, percent agreement = 78%, and accuracy = 62.4%. The number of TFLs was in general agreement with previous research. Images of TFLs can be successfully imaged with low-field-strength MRI. If a trained radiologist identifies a TFL, there is an 87% chance that one is present, and if a trained radiologist does not identify a TFL in an intervertebral foramen, there remains a 51% chance that one is present.


A hydrogen-evolving enzyme is present in Frankia sp. R43.
The ability to evolve hydrogen using methyl viologen as an electron donor was assayed in the nitrogen-fixing actinomycetes Frankia sp. R43 and Frankia sp. KB5. To further examine the nature of hydrogen-evolving enzymes that may be present in these organisms immunological studies were performed. Under anaerobic conditions (both nitrogen-limiting and nitrogen-containing) Frankia sp. R43 but not Frankia sp. KB5 evolved hydrogen,which was not linked to NAD-reducing activity. Immunological analysis of total protein from Frankia sp. R43 and Frankia sp. KB5 using an antiserum raised against Ralstonia eutropha HoxF, recognized an antigen in Frankia sp. R43 but not in Frankia sp. KB5. Immunogold labeling using antibodies raised against the R. eutropha HoxH recognized sites in both hyphae and vesicles of Frankia sp. R43, but not in Frankia sp. KB5. Based on these physiological and immunological findings, we conclude that Frankia sp. R43 has a hydrogen-evolving hydrogenase.


Metallothionein isoforms as double agents - Their roles in carcinogenesis, cancer progression and chemoresistance.
Metallothioneins (MTs) are small cysteine-rich intracellular proteins with four major isoforms identified in mammals, designated MT-1 through MT-4. The best known biological functions of MTs are their ability to bind and sequester metal ions as well as their active role in redox homeostasis. Despite these protective roles, numerous studies have demonstrated that changes in MT expression could be associated with the process of carcinogenesis and participation in cell differentiation, proliferation, migration, and angiogenesis. Hence, MTs have the role of double agents, i.e., working with and against cancer. In view of their rich biochemical properties, it is not surprising that MTs participate in the emergence of chemoresistance in tumor cells. Many studies have demonstrated that MT overexpression is involved in the acquisition of resistance to anticancer drugs including cisplatin, anthracyclines, tyrosine kinase inhibitors and mitomycin. The evidence is gradually increasing for a cellular switch in MT functions, showing that they indeed have two faces: protector and saboteur. Initially, MTs display anti-oncogenic and protective roles; however, once the oncogenic process was launched, MTs are utilized by cancer cells for progression, survival, and contribution to chemoresistance. The duality of MTs can serve as a potential prognostic/diagnostic biomarker and can therefore pave the way towards the development of new cancer treatment strategies. Herein, we review and discuss MTs as tumor disease markers and describe their role in chemoresistance to distinct anticancer drugs.


The perception of integrality: remembering through the validation of expectation.
Five experiments investigated the role of sentence context in influencing recognition decisions. Sentence stems were presented only in the study phase, only in the test phase, or in both; in addition, the coherence of the sentences was varied, such that terminal words were highly constrained by, merely consistent with, or actually incongruous with their stems. These stimulus combinations produced 4 unique patterns of response. These patterns are difficult to explain through encoding and retrieval alone; they seem also to require an understanding of the principles by which people react subjectively to their own processing. The results are discussed in terms of the differential effects of definite expectations developed in past experiences versus indefinite expectations developed in the moment of remembering.


How the electronic health record did not measure up to the demands of our medical home practice.
The American Recovery and Reinvestment Act (ARRA) of 2009 will soon provide billions of dollars to small physician practices nationwide to encourage adoption of electronic health records. Although shifting from paper to computers should lead to better and cheaper care, the transition is complex. In this paper we describe our struggles to adapt a commercial electronic health record to an innovative practice serving high-cost patients with chronic diseases. Limitations in the technology gave rise to medication errors, interruptions in work flow, and other problems common to paper systems. Our experience should encourage providers and policy makers to consider alternative software and informatics models before investing in currently available systems.