3,5-Diiodo-L-thyronine modulates the expression of genes of lipid metabolism in a rat model of fatty liver.
Recent reports demonstrated that 3,5-diiodo-l-thyronine (T(2)) was able to prevent lipid accumulation in the liver of rats fed a high-fat diet (HFD). In this study, we investigated how the rat liver responds to HFD and T(2) treatment by assessing the transcription profiles of some genes involved in the pathways of lipid metabolism: oxidation, storage and secretion. The mRNA levels of the peroxisome proliferator-activated receptors (PPARα, PPARγ and PPARδ), and of their target enzymes acyl-CoA oxidase and stearoyl-CoA desaturase were evaluated by real-time RT-PCR. Moreover, the expression of the adipose triglyceride lipase involved in lipid mobilisation, of the main PAT proteins acting in lipid droplet (LD) turnover, and of apoprotein B (apo B), the major protein component of very low-density lipoproteins (VLDLs) were analysed. Overall, our data demonstrated that T(2) administration to HFD rats counteracts most of the hepatic transcriptional changes that occurred in response to the excess exogenous fat. In particular, our results suggest that T(2) may prevent the pathways leading to lipid storage in LDs, promote the processes of lipid mobilisation from LDs and secretion as VLDL, in addition to the stimulation of pathways of lipid oxidation. In conclusion, our findings might give an insight into the mechanisms underlying the anti-steatotic ability of T(2) and help to define the potential therapeutic role of T(2) for preventing or treating liver steatosis.


Catalytic ozonation of ammonia using biomass char and wood fly ash.
Catalytic ozonation of gaseous ammonia was investigated at room temperature using wood fly ash (WFA) and biomass char as catalysts. WFA gave the best results, removing ammonia (11 ppmv NH(3), 45% conversion) at 23 degrees C at a residence time of 0.34 s, using 5 g of catalyst or ash at the lowest ozone concentration (62 ppmv). Assuming pseudo zero order kinetics in ozone, a power rate law of -r(NH3) = 7.2 x 10(-8) C(NH3)(0.25) (r, mol g(-1)s(-1), C(NH3)molL(-1)) was determined at 510 ppmv O(3) and 23 degrees C for WFA. Water vapor approximately doubled the oxidation rate using WFA and catalytic ozonation activity was not measured for the char without humidifying the air stream. Overall oxidation rates using the crude catalysts were lower than commercial catalysts, but the catalytic ozonation process operated at significantly lower temperatures (23 vs. 300 degrees C). Nitric oxide was not detected and the percentage of NO(2) formed from NH(3) oxidation ranged from 0.3% to 3% (v/v), with WFA resulting in the lowest NO(2) level (at low O(3) levels). However, we could not verify that N(2)O was not formed, so further research is needed to determine if N(2) is the primary end-product. Additional research is required to develop techniques to enhance the oxidation activity and industrial application of the crude, but potentially inexpensive catalysts.


Correlation between enhancement of [3H]flunitrazepam binding and suppression of pentylenetetrazol-induced seizures by L-lysine.
L-Lysine enhanced the specific [3H]flunitrazepam (FTZ) binding of bovine brain membranes in vitro. Inhibition of specific [3H]FTZ binding to brain membranes in vitro by pentylenetetrazol (PTZ) at concentrations 0.46 mM and below was reversed by increasing L-lysine concentrations in the incubation mixture; further increase of L-lysine concentration enhanced this binding. However, inhibition of [3H]FTZ binding by PTZ higher than 2.3 mM was reversed only partially by L-lysine. L-Lysine enhanced specific [35S]t-butylbicyclophosphorothionate (TBPS) binding on mouse brain membranes in a dose-dependent manner (EC approximately 5 microM). This enhancement was inhibited by PTZ dose dependently. Inhibition of [35S]TBPS binding by PTZ was attenuated slightly by L-lysine. L-Lysine enhanced [3H]FTZ binding in intact mice in a dose- or concentration-dependent manner with an ED50 of 6 mmol/kg body weight or EC50 of 3 mumol/g brain tissue, respectively. Similar effect was observed for L-lysine in ex vivo [3H]FTZ binding study when [3H]FTZ was incubated in vitro with an ED50 of 1 mmol/kg mouse or EC50 of 0.7 mumol/g brain. PTZ not only induced seizures, but also inhibited specific [3H]FTZ binding to brain membranes in a dose-dependent manner. L-Lysine, in a dose-dependent manner, suppressed seizures caused by PTZ at 50 or 60 mg/kg, or prolonged the time of seizure onset (seizure latency) caused by higher doses of PTZ (90 or 100 mg/kg). Pretreatment with L-lysine at 1, 5, 10 or 20 mmol/kg not only reversed the inhibition of the specific [3H]FTZ binding caused by PTZ at 50, 90 or 100 mg/kg, but also enhanced this binding above control level.(ABSTRACT TRUNCATED AT 250 WORDS)


High-CO2 tolerance in microalgae: possible mechanisms and implications for biotechnology and bioremediation.
Recent developments in the field of microalgal biotechnology, including CO2 biomitigation and the discovery of new species of microalgae that are tolerant to extremely high CO2 levels (40-100 vol%), have renewed interest in the physiological effects and mechanisms of high-CO2 tolerance in photoautotrophs. Photosynthetic apparatus state transitions that increase ATP generation, upregulation of H(+)-ATPases pumping protons out of the cell, rapid shutdown of CO2-concentrating mechanisms, and adjustment of membranes' fatty acid composition are currently believed to be the key mechanisms governing cellular pH homeostasis and hence microalgae's tolerance to high CO2 levels, which is especially characteristic of extremophile and symbiotic species. The mechanisms governing acclimation to high CO2 comprise the subject of this review and are discussed in view of the use of CO2 enrichment to increase the productivity of microalgal cultures, as well as the practice of carbon capture from flue gases.


Evaluation of electronic stability control effectiveness in Australasia.
Electronic stability control (ESC) is an in-vehicle technology aimed at improving primary safety by assisting the driver in avoiding loss of control of the vehicle. The aim of this study was to use available crash data from Australia and New Zealand to evaluate the effectiveness of ESC in reducing crash risk and to establish whether benefits estimated from overseas studies have translated to the Australian and New Zealand environments. The sample analysed included 7699 crashed vehicles fitted with ESC which comprised of 90 different models. Poisson regression was used to test whether the differences in the observed and expected crash counts for ESC fitted vehicles were significant, with exposure being induced from counts of rear end impacts. It was found that ESC reduced the risk of single vehicle crashes in which the driver was injured by 68% for 4WDs compared with 27% for passenger cars. The effect of ESC on multiple vehicle crashes in Australia and New Zealand was not clear. The long-term benefits of fitting ESC to all vehicles in Australia were also investigated based on the estimated single vehicle crash reductions.


Cycloalkanecarboxylic esters derived from lysergol, dihydrolysergol-I, and elymoclavine as partial agonists and antagonists at rat 5-HT2A receptors: pharmacological evidence that the indolo[4,3-fg]quinoline system of the ergolines is responsible for high 5-HT2A receptor affinity.
Three series of cycloalkanecarboxylic esters derived from the naturally occurring clavine alkaloids lysergol, dihydrolysergol-I, and elymoclavine were synthesized to study their interaction with 5-HT2A receptors and alpha1-adrenoceptors in rat tail artery and aorta, respectively. Especially cycloalkanecarboxylic esters derived from lysergol showed complex behavior as partial agonists and antagonists of the contractile effect of 5-HT. Within this group, partial 5-HT2A receptor agonist activity was most potent for cyclopropanecarboxylic ester 6a (pKP = 7.67, alpha = 0.21) and decreased as the volume requirement of the alicyclic ring increased. This tendency was echoed in experiments where the compounds were used as antagonists of the contractile effect of 5-HT. From the structure-activity study, the N-1-isopropyl homologue of 6a, compound 6b, emerged as the ligand with the highest affinity for rat 5-HT2A receptors (pA2 = 8.74). For cycloalkanecarboxylic esters derived from dihydrolysergol-I and elymoclavine, no clear structure-affinity relationship could be deduced, although those compounds that had smaller cycloalkyl rings in the acyl portion and an isopropyl substituent at N-1 showed the highest 5-HT2A receptor affinity. On the other hand, cycloalkanecarboxylic esters derived from lysergol, dihydrolysergol-I, and elymoclavine displayed low or marginal affinity at alpha1-adrenoceptors. A further aim of the study was to examine to what extent the complete removal of the acyl portion of the esters would affect 5-HT2A receptor affinity. The parent alcohols of the three series of N-1-isopropyl homologues, 1-isopropyllysergol (1b), 1-isopropyldihydrolysergol-I (2b), and 1-isopropylelymoclavine (3b), displayed higher affinity for 5-HT2A receptors (pA2 = 9.15, 8.50, 9.14) than the corresponding esters. Compounds 1b-3b had no contractile effects by themselves and displayed low affinity at guinea-pig 5-HT1B receptors and rat alpha1-adrenoceptors. The high affinity for rat 5-HT2A receptors was retained when clavines even more simple in structure than 1b-3b, compounds 4b and 5b, were examined as 5-HT2A receptor antagonists. The nanomolar antagonist activity of simple clavines (1b-5b) in the rat suggests that the indolo[4,3-fg]quinoline system of the ergolines is the molecular fragment that is responsible for 5-HT2A receptor affinity, and not the substituent at position C-8.


Beta band oscillatory deficits during working memory encoding in adolescents with attention-deficit hyperactive disorder.
Attention-deficit hyperactivity disorder (ADHD) is a neurobehavioural disorder, characterized by symptoms of inattention and/or hyperactivity/impulsivity, in addition to various cognitive deficits, including working memory impairments. This pathology arises from a complex constellation of genetic, structural and neurotransmission abnormalities, which give rise to the aberrant electrophysiological patterns evident in patients with ADHD. Among such, findings have consistently provided support in favour of weaker power across the beta frequency range. Evidence has also emerged that beta rhythmic decrements are linked to working memory encoding. The catecholaminergic modulation of both working memory and beta oscillations may suggest that the link between the two might be rooted at the neurotransmission level. Studies have consistently shown that ADHD involves significant catecholaminergic dysregulation, which is also supported by other clinical studies that demonstrate stimulant-induced amelioration of ADHD symptomology. In this study, we explore the possible ways that might relate ADHD, working memory, beta rhythms and catecholaminergic signalling altogether by investigating the integrity of encoding-relevant electroencephalographic beta rhythms in medication-naïve and stimulant-medicated adolescent patients. The aberrant parietal and frontal encoding-related beta rhythm revealed in the ADHD patients together with a working memory (WM) deficit as observed herein was reversed by methylphenidate in the latter case but not with regard to the beta rhythm. This finding per se raises the issue of the role played by beta rhythms in the WM deficits associated with ADHD.


A 10-year follow-up study of 97 epileptics.
1) Of 267 patients with epilepsy who were examined in our clinic during the period between 1964 and 1966, 97 were investigated in a 10-year follow-up study. The patients were selected according to the following criteria: the age of onset of seizures was 10 years or older and the follow-up period was 10 years after the onset of seizures. Of the 97 patients, 36 were followed up by mail. 2) In the adult 10-year follow-up study, seizures disappeared in 43.3%, decreased in 34.0%, remained unchanged in 16.5%, and were aggravated in 6.2% of the 97 patients. Comparing the five-year follow-up study with the present study, the rate of cases which were free of seizures for three years was 22.7% in the five-year study and 43.3% in this study. The seizures were controlled for at least three years in 22.9% of the cases with partial seizure and in 63.3% of the cases with generalized seizure. The worst prognoses were found in cases with versive seizure in which the seizure was unchanged and/or aggravated in 4 (44.4%) of 9 cases. Of 16 cases with psychomotor seizure, 25% were unchanged or aggravated. 3) Comparing the impaired consciousness seizure with the psychomotor seizure, there was a tendency for the psychomotor seizures to remain as a single type of partial seizure, while the impaired consciousness seizure tended to develop easily into a secondarily generalized seizure. 4) Of the 97 patients, three were personality disorders in 19 cases (19.6%), episodic psychotic state in 2 cases (2.1%), and mental retardation in 6 cases (6.2%). Disorders of mood, irritability and explosiveness associated with personality disorders were improved in three of six cases whose seizures disappeared. Personality disorders were found in half of those cases with partial complex seizures. No correlation was found between mental symptoms and the prognosis of seizures. 5) The EEG was improved in 15 (27.8%) of a total of 54 cases, unchanged in 35 (64.8%) and aggravated in 4 (7.4%). In comparing the prognosis of clinical seizure with changes in the EEG, the seizures improved in 40 (74.1%) of the cases, whereas the EEG improved in only 15 (27.8%) of 54 cases. Most of the clinical seizures were controlled or decreased, whether the EEG improved or not.


Amiodarone and sustained ventricular arrhythmias: statistical evidence of drug effectiveness.
Previous studies have shown that amiodarone prevents sustained ventricular arrhythmias in 77% to 93% of patients. To date, a study using statistical analysis to verify the drug's effectiveness has not been reported. Amiodarone was given to 17 patients with drug refractory sustained ventricular arrhythmias. All patients had serious underlying heart disease including coronary artery disease (15 patients) or cardiomyopathy (two patients). Ten patients had angiographic evidence of a left ventricular aneurysm. All patients had left ventricular dysfunction. The mean left ventricular ejection fraction was 33%. In the 5.5 +/- 8.3 months prior to amiodarone, these 17 patients had documented sustained ventricular arrhythmias requiring countershock (41 episodes), overdrive pacing (four episodes), or intravenous drugs (three episodes). Amiodarone was given as a loading dose (1 gm/day for 10 days) and a maintenance dose (200 to 600 mg/day). During a follow-up period of 8.9 +/- 5.7 months, only eight episodes occurred requiring countershock (5) or overdrive pacing (2); one patient died suddenly. A statistical test constructed for this problem showed a significant (p greater than 0.001) reduced risk of experiencing a sustained ventricular arrhythmia after amiodarone. This statistical model confirms previous studies showing that amiodarone prevents sustained ventricular arrhythmias and prevents sudden cardiac death.


[Current aspects of premature labor].
Six to eight percent of all newborns are born prematurely. Preterm delivery remains the most severe event regarding morbidity and mortality of the premature infants. The most serious complications in the treatment of prematurity are intracerebral bleedings that lead to progressive hydrocephalus and neurological handicaps in those newborns who survive. To our knowledge, about 50% of premature births with cerebral bleedings of stage I-II show normal or slightly decreased postnatal development. Both, a sufficient oxygen utilisation and a regulation of cerebral blood perfusion are necessary to prevent periventricular leucomalacia and cerebral bleedings with impairment of parenchymatous tissue. Endothelial swellings with decreasing blood flow into the cerebral parenchyma were found only in cases of prolonged oxygen deficiency. Vasoconstriction may produce a circulus vitiosus. However, it is important to know that more than 50% of the premature infants probably suffer from initial cerebral bleedings already in the prenatal stage. During the last 10 years the infectious pathogenesis has resulted in better understanding of pathophysiologic factors for prematurity. The local cervical activation of interleukins (IL 1, 6, 8) caused by cervical infections stimulate the prostaglandin synthesis and cervical maturity.


Red blood cell-encapsulated L-asparaginase: potential therapy of patients with asparagine synthetase deficient acute myeloid leukemia.
Red blood cell (RBC) encapsulated L-asparaginase is a novel therapeutic for the treatment of asparagine auxotrophic malignancies. The enzyme-loaded red blood cells function as bioreactors to deplete bloodstream substrate. This delivery system provides improved pharmacodynamics with protection from circulating proteolytic enzymes and avoidance of early liver or renal clearance. The "drug" is manufactured with ABO and Rh compatible donor blood when a prescription is received. Because of the industrial scale manufacturing, the "drug" is transfused the day of receipt at the clinical site. Preliminary clinical studies show utility in childhood and adult acute lymphoblastic leukemia. Based on previous studies of applications in different diseases and assessment of different biomarkers, we propose this agent offers a safe and potentially effective treatment for a subset of chemotherapy refractory acute myeloid leukemia patients. The history, chemistry, biology, pharmacology, and relevant clinical experiences with L-asparaginase as well as the properties and proposed protocols with the red cell-encapsulated enzyme are reviewed.


Studies on the pathogenicity of chicken-maintained (virulent) and embryo-adapted (attenuated) strains of Eimeria mivati.
The pathogenicity of three strains of Eimeria mivati (two chicken-maintained strains and an embryo-adapted strain) and one strain of E. acervulina has been examined. Based on body weight changes of Light Sussex chickens, the chicken-maintained strains of E. mivati were more pathogenic than E. acervulina. The embryo-adapted strain of E. mivati which reproduced relatively poorly, was only mildly pathogenic but still possessed antigens capable of inducing protective immunity against challenge with a pathogenic strain of E. mivati.


Apolipoprotein synthesis in normal and abetalipoproteinemic intestinal mucosa.
The genetic disease abetalipoproteinemia is characterized by a total absence of apolipoprotein B-containing lipoproteins from plasma. A presumed synthetic defect in apolipoprotein B synthesis was thought to be responsible for this disorder. The present study quantitates apoprotein B synthesis and apolipoprotein B messenger RNA levels in duodenal mucosa from normal patients and four patients with abetalipoproteinemia. After in vitro [3H]leucine incorporation, small intestinal biopsy specimens from three of four patients with abetalipoproteinemia synthesized immunoprecipitable apolipoprotein B of identical mobility (on sodium dodecyl sulfate gel electrophoresis) to normal apolipoprotein B. In abetalipoproteinemia, the apolipoprotein B content of intestinal mucosa by radioimmunoassay was 15% of normal mucosal values, whereas apolipoprotein B messenger RNA quantitation showed 3-20-fold increased levels compared with normal mucosa. In one patient, smaller-molecular-weight fragments of apolipoprotein B were immunoprecipitated from duodenal biopsy specimens. The synthesis rates and messenger RNA levels of two other chylomicron apoproteins (apolipoprotein A-I and apolipoprotein A-IV) were found to be reduced by 50%. These results show the synthesis of immunologically recognizable apolipoprotein B48 in abetalipoproteinemia. The significance of mucosal apolipoprotein B content in abetalipoproteinemia is discussed in terms of factors controlling apolipoprotein B synthesis in normal mucosa and in abetalipoproteinemia.


Reproductive outcome following pre-implantation genetic diagnosis (PGD) in the UK.
In 2013, the National Health Service Commissioning board centralized the funding in England for up to three cycles of pre-implantation genetic diagnosis (PGD) for couples who have, or are carriers of, a specific genetic disorder. This study presents the historical data of PGD cycles and their clinical outcomes in UK as extrapolated from the national data registry. Retrospective analysis of outcome of cycles undergoing pre-implantation genetic diagnosis in the UK over the past 20 years was performed from the Human Fertilisation and Embryology Authority database (n = 2974). Binary logistic regression was used to determine trends over time and adjusted for maternal age. Briefly, the number of PGD cycles has risen 127-fold from 1991 to 2012 with 3.6-fold increase (360% rise) from 2004 to 2012. A total of one in four embryos following pre-implantation genetic diagnosis did not reach embryo transfer and 92% of these were due to a failure to survive. The live birth rate has risen over 20 years and there has been a steady decline in reported incidence of congenital abnormalities (p < 0.07). PGD has thus emerged as a safe and effective alternative to prenatal diagnosis but with ever evolving technological advances, a robust system of data collection that incorporates techniques used and reporting of mutation-specific clinical outcomes is suggested.


Huge pancreatic acinar cell carcinoma with high levels of AFP and fucosylated AFP (AFP-L3).
A 25-year-old Japanese woman with a large abdominal tumor (10 cm in diameter) and high level of serum alpha-fetoprotein (AFP, 1,222.4 ng/mL) was introduced and admitted to our hospital in January 2011. Pre-operative imaging modalities could not identify the tumor origin. There was no chronic hepatic viral disease, however, the elevated level of fucosylated AFP (87.8%) and connection with the left hepatic lobe led us to diagnose the tumor as a hepatocellular carcinoma. Surgical resection was performed in February. Histological findings revealed a pancreatic acinar cell carcinoma (ACC). Herein, we provide details of this difficulty to diagnose a case of ACC.


Supplementation with an antioxidant cocktail containing coenzyme Q prevents plasma oxidative damage induced by soccer.
The aim of the study was to determine the effects of an antioxidant supplementation, which includes coenzyme Q(10), on plasma and neutrophil oxidative stress and the antioxidant response after a soccer match. Nineteen voluntary male pre-professional footballers were randomly and double-blinded treated with either a multivitamin and mineral supplement (n = 8) or a placebo (n = 11). After the 3 months of supplementation, the sportsmen played a friendly soccer match of 60 min. The 3-month supplementation induced higher plasma ascorbate and coenzyme Q levels when compared to the placebo group. Antioxidant supplementation influenced plasma oxidative stress markers because they were lower in the supplemented group than in the placebo one after the match. The football match induced decreased neutrophil vitamin E levels and catalase and glutathione peroxidase activities but increased glutathione reductase activity. Antioxidant diet supplementation prevented plasma oxidative damage but did not influence the neutrophil response to a football match.


Home environment risk factors for falls in older people and the efficacy of home modifications.
Most homes contain potential hazards, and many older people attribute their falls to trips or slips inside the home or immediate home surroundings. However, the existence of home hazards alone is insufficient to cause falls, and the interaction between an older person's physical abilities and their exposure to environmental stressors appears to be more important. Taking risks or impulsivity may further elevate falls risk. Some studies have found that environmental hazards contribute to falls to a greater extent in older vigorous people than in older frail people. This appears to be due to increased exposure to falls hazards with an increase in the proportion of such falls occurring outside the home. There may also be a non-linear pattern between mobility and falls associated with hazards. Household environmental hazards may pose the greatest risk for older people with fair balance, whereas those with poor balance are less exposed to hazards and those with good mobility are more able to withstand them. Reducing hazards in the home appears not to be an effective falls-prevention strategy in the general older population and those at low risk of falls. Home hazard reduction is effective if targeted at older people with a history of falls and mobility limitations. The effectiveness may depend on the provision of concomitant training for improving transfer abilities and other strategies for effecting behaviour change.


The impact of colon cleanliness assessment on endoscopists' recommendations for follow-up colonoscopy.
Repeat colonoscopy is advocated for low-quality preparations. However, there are few data on how endoscopists assess the quality of bowel preparation. We aimed to investigate, in a visually reproducible manner, endoscopists' assessment of colon cleanliness, as reflected by their subsequent recommendations for follow-up. Gastroenterologists attending the Israeli Gastroenterology Association meeting were presented with photographs depicting varying degrees of colon cleanliness at a hypothetical screening colonoscopy. Endoscopists were requested to denote their recommendation for the timing of a follow-up procedure for each of the different preparations, both when no polyps were detected and when two small adenomas were found. Seventy-eight gastroenterologists were included. There was considerable interobserver variability in endoscopists' assessment of preparation adequacy, and recommended follow-up timing ranged from more than 5 yr to immediate repeat colonoscopy for identical preparations. Interestingly, even when repeat colonoscopy was not considered necessary, most endoscopists recommended progressively shorter follow-up intervals in line with reduced preparation quality (mean interval dropping from 9.2+/-1.7 to 6.3+/-2.8 to 2.5+/-2 yr, P<0.001 for trend). Similar findings were observed when two adenomas were hypothetically found on the index procedure, although follow-up intervals were shorter. No correlation was found between endoscopists' clinical experience or acquaintance with clinical guidelines and their actual recommendation. Clinical decisions derived from colon cleanliness assessment vary considerably among endoscopists, and there is little agreement on what constitutes a disqualifying preparation. Moreover, when confronted with an intermediate-quality preparation, most gastroenterologists recommend a shorter follow-up interval, rather than repeating the procedure. Further studies are required to validate this management approach and to standardize the assessment of preparation quality.


Transcriptional activation by human c-myb and v-myb genes.
The human c-myb proto-oncogene is the cellular progenitor of the viral v-myb oncogene and codes for a 75 kD protein involved in growth regulation and differentiation in a number of cells. Fusion proteins in which human c-myb sequences are linked to the DNA binding domain of the yeast transcriptional activator GAL4 can activate transcription from a reporter gene which carries the chloramphenicol acetyl transferase (CAT) gene linked in cis to a repeat of the GAL4 binding site. Deletions of carboxyterminal sequences allowed the identification of the domain responsible for transcriptional activation, which is located between amino acid residues 275 to 327. Deletion of this activator domain results in abrogation of the transcriptional activation. The GAL4-v-myb fusion protein can also activate transcription whereas no transactivation by GAL4-c-myb is observed, indicating that a carboxyterminal domain of c-myb which is absent from v-myb apparently negatively regulates transcriptional activation. Dimer formation which is required for transactivation by GAL4 fusion proteins can, when GAL4 is truncated, be mediated by a region of the c-myb protein upstream of the transactivator domain possibly including the transactivator domain itself but not a putative leucine zipper located downstream of this region.


Barrett's esophagus.
Barrett's esophagus continues to be a popular topic among clinicians and researchers alike. Population based studies have finally been undertaken to better identify subset populations at high risk of developing Barrett's esophagus, and possible better tolerated alternatives to standard endoscopy for cost-effective screening. In addition, several studies over the past year have marked a transition from identifying those with Barrett's esophagus and in need of intensive surveillance, to an increasing number of novel treatment therapies that are now primed to move from experimental protocols to clinical practice. Obesity's role as a risk factor for the development of Barrett's esophagus continues to be better defined. Various disorders affecting the motility of the gastrointestinal tract, such as celiac sprue and scleroderma, and their relationship with Barrett's esophagus development are becoming more widely recognized. The use of endoscopic mucosal resection and photodynamic therapy for treatment of dysplastic Barrett's esophagus continues to gain increased acceptance, with an additional wealth of supportive data for its effectiveness becoming available. The past year has brought many advances in the epidemiology and endoscopic treatment of those with Barrett's esophagus. Clinicians will benefit from this review of these advances to ensure better patient outcomes.


Novel Use of Fluorescence Lymphangiography During Robotic Groin Dissection for Penile Cancer.
To describe a novel technique of robotic inguinal lymphadenectomy with near infrared fluorescence imaging (NIRF) using indocyanine green (ICG) to facilitate lymph node identification during robotic groin dissection for penile cancer. The patient is placed in lithotomy position with access to the groin. Three robotic ports and 1 assist port are placed in a V configuration below the tip of femoral triangle. Intradermal ICG is injected at the base of the penis (0.5 mL of 2 mg/kg concentration in normal saline), and the lymphatic channels and nodes are visualized using NIRF in the robotic console approximately 15 minutes after injection. The surgical template established in the open approach is then replicated using NIRF to ensure complete resection of the affected nodes. A total of 10 groin dissections in 5 patients have been completed using this technique, with an average lymph node yield of 7 per groin (range 5-13 lymph nodes). Mean operative time per groin was 207 minutes (range 164-258 minutes) and estimated blood loss was 38 mL (range 25-50 mL). Mean length of hospital stay was 1.8 days (range 0-4 days). Identification of the lymphatic drainage pattern from the superficial to deep groin nodes to pelvic nodes underneath the inguinal ligament was identified in all patients. With a mean follow-up of 10 months (range 3-16 months), there have been no postoperative infections, lymphatic leaks, wound breakdown, or necrosis. Pathologically involved lymph nodes were identified using NIRF. Our novel technique of robotic inguinal lymphadenectomy with fluorescence lymphangiography allows for identification and excision of both superficial and deep groin nodes with a significant reduction in morbidity compared with the open approach. Prospective studies are required to ensure long-term efficacy and results of this procedure.


Assistive technology use by disability type and race: exploration of a population-based health survey.
To examine the relationships among Assistive Technology (AT) use, race, type of disability and selected other demographic characteristics. Using 2009 National Health Interview Survey, descriptive statistics, statistical interactions and binary logistic regression were performed to identify, contrast and predict the likelihood of using AT based on the type of disability among African Americans (AAs) and European Americans (EAs). We found that more AAs (10% within group proportion of total AAs) used AT compared to EAs (7.5% within group proportion of total EAs). Physical (p < 0.001), auditory (p = 0.028) and emotional (p = 0.008) impairments were statistically significant predictors of AT use. However, physical impairment as a predictor of AT use was greater among AAs (OR = 222.49, CI: 64.04-773.04, p < 0.001) than EAs (OR = 50.77, CI: 31.78-81.12, p < 0.001). EAs had a greater number of disabling conditions that predict the use of AT than AAs, whereas AAs had more demographic characteristics beyond race that predict AT use than EAs. Disparities were observed in AT usage by disability types and demographic characteristics between AAs and EAs. Moreover, the predictive strength of AT usage based on disability types and other demographic variables differed by races. Overall, the findings about the different relationships among race, disability type, and AT use are found. Implications for Rehabilitation The finding may inform the development of initiatives by rehabilitation leaders to encourage the use of AT by AAs and EAs according to their type of impairment. Having identified physical impairment as statistically significant predictor of AT use greater among AAs, rehabilitation leaders should ensure that people living with those types of disability have access to the corresponding type of AT and can use them effectively.


Anti-tuberculosis activity of quassinoids.
In vitro evaluation of anti-tuberculosis activity was conducted for fifty-six quassinoids isolated in our laboratory from Simaroubaceous plants, Ailanthus altissima (= Aa, 10 compounds), Brucea antidysenterica (= Ba, 16 compounds), Picrasma ailanthoides (= Pa, 14 compounds), and Brucea javanica (= Bj, 16 compounds). Of the compounds tested, shinjulactone K (1), ailanthone (2), shinjudilactone (3), and dehydrobruceantin (4) were the most potent. Although the activities were very low (0-19%), the resulting data provided a picture of structure-activity relationships.


[Transcatheter closure of atrial septal defects in a patient with lipomatous hypertrophy of the interatrial septum].
Lipomatous hypertrophy of the interatrial septum is a rare benign pathology characterized by fatty deposits in the septum and is mostly diagnosed incidentally. This accumulation mostly causes a globular thickening of the interatrial septum, commonly sparing the fossa ovalis. We report on a 65-year-old female patient who underwent successful transcatheter closure of atrial septal defects (ASD) accompanied by lipomatous hypertrophy of the septum. Both transthoracic and transesophageal echocardiography showed enlargement of the right heart cavities, thickening of the interatrial septum (16 mm) with bright echogenicity, and two separate secundum ASDs measuring 17 mm and 4 mm, respectively. Transcatheter closure of the defects was performed using a 24-mm Amplatzer septal occluder. There was no residual shunt and Holter monitoring was normal after the procedure. During a three-year follow-up, no complications were observed pertaining to the procedure or lipomatous tissue.


Fine structure of the mandibular gland in Japanese field vole (Microtus montebelli).
The mandibular glands of the Japanese field vole were examined by light microscopy, and transmission and scanning electron microscopies. The acinar cells contained light and coarse secretory granules, and reacted with PAS and stained slightly with AB; they were considered to be seromucous in nature. The acinar epithelium was composed of light and dark cells containing many secretory granules. The intercalated duct cells consisted of light cells possessing a few dense granules. A few cytoplasmic crystalloides of moderate density were observed in occasional light cells. The striated ducts were comprized of two distinct portions, a secretory portion and a typical striated portion without secretory granules. The epithelium secretory portion consisted of light and dark cells containing acidophilic granules and exhibited a sexual dimorphism in these granules: The male epithelia contained the granules of low to high densities, while the female epithelia had only dense granules being smaller than those in the males. The epithelium of typical striated portion was composed of light and dark cells containing fine vacuoles and vesicles.


[Syncope and work: role of the occupational physician and global risk stratification].
Safety risk for subjects suffering from syncope while working has not been as yet addressed by occupational medicine. The present study was aimed at evaluating a new developed methodology for job tasks risk stratification in patients with syncope. During a work-shop on syncope and occupational risk, 149 occupational physicians (OP) with about 10 years of clinical experience were asked to fulfil a Visual Analogue Scale (VAS) concerning the doctor's estimated potential damage (D) to the worker and the probability of a damage to occur (P) should syncope take place during the job task. Five job tasks characterized by different risk for safety (1, driving; 2, toxic products handling; 3, job performed closed to hot surfaces o free flames; 4, surgical activity; 5, office job) were identified. OP correctly stratified the risk associated to the different job tasks in patients with syncope. Unexpectedly, task #3 was given a risk similar to that obtained in drivers. This might be of paramount clinical and social importance when patients with syncope have to return to their job tasks.


Pitfalls and valid approaches to pharmacokinetic analysis of mean concentration data following intravenous administration.
Pharmacokinetic analysis fo arithmetic mean concentration data can lead us to selection of an inappropriate deterministic compartmental model and biased pharmacokinetic parameter estimates. The terminal phase disposition rate constant estimated by fitting a deterministic model to mean data is in all cases an underestimate of the expected value of this rate constant. The area under the mean data curve calculated via the linear trapezoidal rule from time zero to the last detectable concentration sampling point is equal to the mean of the individual subject areas under the curve for the same time span. This equality supports the use of mean data for determination of model-independent pharmacokinetic parameters.


Error, rather than its probability, elicits specific electrocortical signatures: a combined EEG-immersive virtual reality study of action observation.
Detecting errors in one's own actions, and in the actions of others, is a crucial ability for adaptable and flexible behavior. Studies show that specific EEG signatures underpin the monitoring of observed erroneous actions (error-related negativity, error positivity, mid-frontal theta oscillations). However, the majority of studies on action observation used sequences of trials where erroneous actions were less frequent than correct actions. Therefore, it was not possible to disentangle whether the activation of the performance monitoring system was due to an error, as a violation of the intended goal, or to a surprise/novelty effect, associated with a rare and unexpected event. Combining EEG and immersive virtual reality (IVR-CAVE system), we recorded the neural signal of 25 young adults who observed, in first-person perspective, simple reach-to-grasp actions performed by an avatar aiming for a glass. Importantly, the proportion of erroneous actions was higher than correct actions. Results showed that the observation of erroneous actions elicits the typical electrocortical signatures of error monitoring, and therefore the violation of the action goal is still perceived as a salient event. The observation of correct actions elicited stronger alpha suppression. This confirmed the role of the alpha-frequency band in the general orienting response to novel and infrequent stimuli. Our data provide novel evidence that an observed goal error (the action slip) triggers the activity of the performance-monitoring system even when erroneous actions, which are, typically, relevant events, occur more often than correct actions and thus are not salient because of their rarity. NEW & NOTEWORTHY Activation of the performance-monitoring system (PMS) is typically investigated when errors in a sequence are comparatively rare. However, whether the PMS is activated by errors per se or by their infrequency is not known. Combining EEG-virtual reality techniques, we found that observing frequent (70%) action errors performed by avatars elicits electrocortical error signatures suggesting that deviation from the prediction of how learned actions should correctly deploy, rather than its frequency, is coded in the PMS.


Role of yoga in modifying anxiety level in women.
Anxiety leads to derangement in physical and mental health. Anxiety levels are more in full time housewives than working women. There is a need for simple, easy treatment for anxiety to alleviate the burden on health caused by anxiety. Yoga is among the top ten complementary and alternative medicine therapies. Our study aimed to determine the anxiety levels in apparently healthy full time housewives and to study the effects of Yoga on anxiety levels among them. Present study is a comparative interventional study. Study was conducted on 50 apparently healthy full time housewives (20-50 years) who attended one month Yoga camp. Hamilton Anxiety (HAMA) Scale was used to evaluate anxiety levels before and at the end of the yoga camp. Statistical analysis was done by Paired t test using SPSS 9.0. The baseline pulse rate, SBP, DBP were 82.90 ± 4.25 bpm, 124.84 ± 11.022 mm Hg, 85.20 ± 10.81 mm Hg respectively. After four weeks yoga camp there was statistically significant lowering of pulse rate (77.58 ± 3.86 bpm), SBP (117.92 ± 6.76 mm Hg), DBP (78.68 ± 6.62 mm Hg). Before yoga training, percentage distributions of subjects with mild, moderate and severe anxiety were 6%, 18% and 76% respectively. At the end of four week yoga training, percentage distributions of subjects with mild, moderate and severe anxiety were 44.23%, 19.23% and 36.53% respectively. There was highly significant (p = 0.000) difference in the mean values of total score before (33.71 ± 4.90) and after (26.93 ± 4.53) yoga. These results indicate that there was a reduction in the severity of anxiety from severe to moderate and mild indicating decrease in anxiety following yoga. Based on the results of our study, we conclude that regular yogic practices and adapting and implementing the principals and philosophy of yoga in day to day life may decrease the anxiety level.


Right-to-left interatrial shunt causing platypnea after pneumonectomy. A recent experience and diagnostic value of dynamic magnetic resonance imaging.
Shortness of breath after pneumonectomy is a common finding that has multiple causes. We report the cases of two patients with shortness of breath on assuming an upright posture (platypnea) that followed pneumonectomy; these individuals developed right-to-left shunt across a patent foramen ovale (PFO) with normal right-sided intracardiac pressures. Both contrast echocardiography and magnetic resonance imaging (MRI), including a recently introduced dynamic ultrafast imaging technique, proved helpful in diagnosing this condition noninvasively.


Synthesis of water soluble bis-triazenoquinazolines: an unusual predicted mode of binding to the epidermal growth factor receptor tyrosine kinase.
A novel type of 3,3-disubstituted bis-triazenes containing an ethylaminoethyl linker flanked by two identical anilinoquinazoline ring was synthesized. These model molecules contained an N-ethylaminomorpholine moiety designed to enhance water solubility. Despite their significant bulkiness, they blocked epidermal growth factor receptor (EGFR) tyrosine kinase in a dose-dependent manner with IC(50) values in low micromolar range. Molecular modeling to predict the interactions of the molecule with the ATP binding site of EGFR suggests that the N-ethylaminomorpholine side chain plays a binding role.


Phylogenetic characterization of canine distemper virus isolates from naturally infected dogs and a marten in Korea.
We sequenced the hemagglutinin (H) genes from four canine distemper virus (CDV) isolates obtained from three dogs and a marten in Korea. These sequences were included in subsequent H gene-focused phylogenetic tree analysis of 89 CDV strains. This analysis revealed eight clades designated as EU1, EU2, EU3, NA1, NA2, Asia 1, Asia 2 and Vaccine. Three of the Korean isolates (97Jindo, 98Marten and 07D111) occurred in the Asia 2 group that also contains many Japanese CDV strains isolated in 1998. The remaining Korean strain (07Q72) fell into the Asia 1 group. The 21 H protein sequences of 25 Asia 1 strains are generally predicted to bear nine potential N-linked glycosylation sites. In contrast, the 9 H protein sequences of 12 Asia 2 strains had eight potential N-linked glycosylation sites. The remaining strains had six (98Marten and 07D111) and seven (97Jindo) potential N-linked glycosylation sites.


Synthesis and in Vitro Anti-Tumor Activity of A New Class of Acyclic Thioglycosides.
The reaction of sodium 2-cyano-ethylene-1-thiolate salts with 2,3,4,6-tetra-O-acetyl-D-gluco- and D-galactopyranosyl bromides and with 2,3,4-tri-O-acetyl-D-xylo-. and L-arabinopyranosyl bromides, respectively, afforded new thioglycosides. Heating of the resultout glycosides with hydrazine produced pyrazole derivatives. The cytotoxicities toward the hepatoma cell line (HEPG2) of some synthesized compounds were tested. Some compounds showed high cytotoxic activity against (HEPG2) cell line. The OH moieties in the free glycosides were vital for potency. The synthesis procedures, spectroscopic data and antitumor activities for the prepared compounds are reported herein.


Prediction of mass transfer coefficients in non-Newtonian fermentation media using first-principles methods.
Bubble flows in non-Newtonian fluids were analyzed using first-principles methods with the aim to compute and predict mass transfer coefficients in such fermentation media. The method we used is a Direct Numerical Simulation (DNS) of the reactive multiphase flow with deformable boundaries and interfaces. With this method, we are able for the first time to calculate mass transfer coefficients in non-Newtonian liquids of different rheologies without any experimental data. In the current article, shear-thinning fluids are considered. However, the results provide the basis for further investigations, such as the study of viscoelastic fluids.


Antileishmanial potential of a marine sponge, Haliclona exigua (Kirkpatrick) against experimental visceral leishmaniasis.
In this study, we are reporting antileishmanial activity of a marine sponge Haliclona exigua, belonging to phylum Porifera. The crude methanol extract and its three fractions were tested both in vitro and in vivo. The crude extract exerted almost complete inhibition of promastigotes at 50 microg/ml and 76.4 +/- 6.5% inhibition of intracellular amastigotes at 100 microg/ml concentration with IC50 values of 18.6 microg/ml and 47.2 microg/ml, respectively. When administered to Leishmania donovani infected hamsters at a dose of 500 mg/kg x 5, p.o., it resulted in 72.2 +/- 10.4% inhibition of intracellular amastigotes. At a lower dose (250 mg/kg), it exhibited 43.9 +/- 5.1% inhibition. Among the fractions, highest antileishmanial activity both in vitro (>90%) and in vivo (60.9 +/- 18.3%) was observed in n-butanol (soluble) fraction with IC50 values of 8.2 mug/ml and 31.2 microg/ml against promastigotes and intracellular amastigotes, respectively. Hexane fraction also showed comparatively good activity against both the stages of parasites in vitro but was moderately active in leishmania-infected hamsters. Chloroform fraction resulted in 45 +/- 10.2% inhibition in vivo at a dose of 500 mg/kg x 5, p.o., whereas it was inactive in vitro. n-Butanol (insoluble) fraction was inactive both in vitro and in vivo. Araguspongin C, an alkaloid isolated from n-butanol (soluble) fraction exhibited moderate inhibition of promastigotes and intracellular amastigotes at 100 microg/ml but showed weak antileishmanial action in vivo. Our findings indicate that this marine sponge has the potential to provide new lead toward development of an effective antileishmanial agent and, hence, calls for more exhaustive studies for exploiting the vast world of marine resources to combat the scourge of several parasitic diseases.


Are presentations of abstracts at EGPRN meetings followed by publication?
Research presented at scientific meetings is inaccessible to clinicians, unless the findings are subsequently published in a journal. To assess the publication rate of studies presented at 10 European General Practice Research Network (EGPRN) meetings between 1999 and 2006. Survey by e-mail or postal questionnaire among all presenters. Information was obtained on 251 presentations (response rate 60%). In total, 113 out of these 251 (45%) presentations had been published. However, only 60% of the research findings were published in English Medline-listed journals, whereas 20% were not Medline-listed. The most frequently cited reason for non-publication was that the paper had not been submitted yet at time of follow up (103 responses). The main reason for non-submission was that the research presented had not been completed yet. Presentations at EGPRN meetings commonly concern research ideas or ongoing research. In this light, the ratio of published work to presented work compares well with the corresponding ratios found for international meetings in other specialist fields. This survey was also meant as an audit of the EGPRN meetings and gives better insight in needs for future strategy.


[Non-small cell lung cancer simultaneously metastatic to the brain treated by lobectomy and stereotactic irradiation].
We performed left upper lobectomy in 64-year-old man with non-small cell lung cancer (NSCLC) simultaneously metastatic to the brain. He was treated by stereotactic irradiation (STI) 2 months later after lobectomy. He has been doing well now without recurrence for 5 years after the operation. We think that STI and radical lobectomy are good alternatives for patients with NSCLC metastatic to the brain.


Cooperation of p53 loss of function and v-Ha-ras in transformation of mouse keratinocyte cell lines.
We previously demonstrated that after transduction with the v-Ha-ras oncogene and grafting onto nude mouse hosts, primary epidermal keratinocytes with a null mutation in the p53 gene form tumors with increased growth rates and predisposition to malignant conversion relative to p53 wild-type keratinocytes (Weinberg WC, et al., Cancer Res 54:5584-5592, 1994). To further explore the cooperation between p53 loss of function and activation of the ras oncogene, cell lines were established from the normal epidermises of newborn and adult p53-null mice, and parallel subclones were reconstituted with the p53val135 temperature-sensitive mutant. Reconstituted lines C, G, N, and V demonstrated functional p53 transcriptional activator activity at the wild-type-permissive temperature of 32 degrees C, compared with the hygromycin-selected control line X and parental p53-null lines NHK4 and AK1b. Hygromycin-selected subclones, but not the parental lines, made normal skin in vivo; all cell lines made carcinomas after introduction of v-Ha-ras, independent of p53 status. These cell lines were compared in vitro at 32 degrees C to maximize the amount of p53val135 in the wild-type conformation. Expression of v-Ha-ras did not consistently alter p53-mediated transcriptional activity, suggesting tat ras acts downstream or independently of p53. No correlation was observed between p53-mediated transcriptional activity and in vitro growth rates, colony formation after exposure to ultraviolet light, or suppression by normal neighboring keratinocytes. However, keratinocyte cell lines devoid of p53 and expressing v-Ha-ras formed colonies in soft agar; this was blocked at 32 degrees C in all cell lines reconstituted with p53val135. These keratinocyte lines provide a model for exploring the role of p53 and the interaction of p53 and ras in keratinocyte transformation.


Early L2 Spoken Word Recognition Combines Input-Based and Knowledge-Based Processing.
This study examines the perceptual trade-off between knowledge of a language's statistical regularities and reliance on the acoustic signal during L2 spoken word recognition. We test how early learners track and make use of segmental and suprasegmental cues and their relative frequencies during non-native word recognition. English learners of Mandarin were taught an artificial tonal language in which a tone's informativeness for word identification varied according to neighborhood density. The stimuli mimicked Mandarin's uneven distribution of syllable+tone combinations by varying syllable frequency and the probability of particular tones co-occurring with a particular syllable. Use of statistical regularities was measured by four-alternative forced-choice judgments and by eye fixations to target and competitor symbols. Half of the participants were trained on one speaker, that is, low speaker variability while the other half were trained on four speakers. After four days of learning, the results confirmed that tones are processed according to their informativeness. Eye movements to the newly learned symbols demonstrated that L2 learners use tonal probabilities at an early stage of word recognition, regardless of speaker variability. The amount of variability in the signal, however, influenced the time course of recovery from incorrect anticipatory looks: participants exposed to low speaker variability recovered from incorrect probability-based predictions of tone more rapidly than participants exposed to greater variability. These results motivate two conclusions: early L2 learners track the distribution of segmental and suprasegmental co-occurrences and make predictions accordingly during spoken word recognition; and when the acoustic input is more variable because of multi-speaker input, listeners rely more on their knowledge of tone-syllable co-occurrence frequency distributions and less on the incoming acoustic signal.


Effect of biofilm formation on virulence factor secretion via the general secretory pathway in Streptococcus mutans.
To investigate the role of SecA in protein secretion, and to evaluate the effect of biofilm formation on protein secretion in Streptococcus mutans. S. mutans strains UA159 and GS-5 were used in this study. Cells grown in biofilm and planktonic conditions were observed using immunogold electron microscopy. The mRNA levels of ftf, gtfB, gtfC, gtfD, Pac and secA were analysed in different growth conditions using real-time quantitative polymerase chain reaction. The levels of wall proteins and whole-cell protein extracts were examined using Western blot analysis. A microdomain colocalised with SecA and virulence factors such as Pac (AgI/II) and glucosyltransferase (GTF) was observed. The mRNA level of secA was upregulated in the biofilm condition. The level of protein expression of SecA and wall protein levels of GTF, fructosyltransferase (FTF) and Pac (AgI/II) in the biofilm condition were significantly higher than in the planktonic condition. These data suggest that S. mutans utilises the Sec pathway to secrete virulence factor proteins such as Pac (AgI/II), GTF and FTF, and protein secretion occurred at a distinct microdomain. The level of SecA, the key factor in the Sec pathway, was influenced significantly by biofilm formation in S. mutans.


Curative treatment of clinical stage II endometrial carcinoma.
In a retrospective study of 54 patients we compared three treatment policies of clinical stage II endometrial carcinoma: One group of patients (n = 29) was surgically staged with histological examination made at surgery and treated by abdominal total hysterectomy with bilateral salpingo-oophorectomy. In case of cervical infiltration by tumour, a pelvic node sampling was added. The second group was treated by radical hysterectomy (n = 9) and the third group of patients (n = 16) was treated by abdominal total hysterectomy with bilateral oophorectomy only. The median follow-up time was 68 months. The overall five year-survival was 64%. The overall five year-survival rates according to surgical procedure were not significantly different. The survival curves were significantly different from each other as were those according to surgical stage and age. In a multivariant analysis stage, grading and age proved to have an independent relation with the survival rate whereas type of surgical procedure, depth of myometrial infiltration and type of radiotherapy had no influence on survival. Intraoperative histological staging allows adaption of treatment to the true stage, thus minimising treatment-related morbidity.


Temporal Association of Rotavirus Vaccine Introduction and Reduction in All-Cause Childhood Diarrheal Hospitalizations in South Africa.
The public health impact of rotavirus vaccination in African settings with a high human immunodeficiency virus (HIV) infection prevalence is yet to be established. We evaluated trends in all-cause diarrheal hospitalizations in Soweto, Johannesburg, before and after the introduction of rotavirus vaccine into South Africa's national immunization program in August 2009. Hospitalizations in children <5 years of age with a diagnosis of diarrhea, defined byInternational Classification of Diseases, Tenth Revisioncodes A00-A05, A06.0-A06.3, A06.9, A07.0-A07.2, A07.9, and A08-A09, were identified at the Chris Hani Baragwanath Academic Hospital from 1 January 2006 to 31 December 2014. The median annual prevaccine (2006-2008) hospitalization incidence was compared to that of the vaccine era (2010-2014), and stratified by age group and HIV infection status. Incidence reductions (per 1000 population) were greatest in children aged <12 months: 54.4 in the prevaccine era vs 30.0, 23.6, 20.0, 18.8, and 18.9 in the postvaccine years 2010-2014, respectively (a 44.9%-65.4% reduction). Lower incidence reductions (39.8%-49.4%) were observed among children aged 12-24 months from the second year post-vaccine introduction onward. Reductions were observed in both HIV-infected and HIV-uninfected children. There was a change in the seasonal pattern of diarrheal hospitalizations post-vaccine introduction, with flattening of the autumn-winter peaks seen in the prevaccine years. An accelerated and sustained decline in all-cause diarrheal hospitalizations, temporally associated with rotavirus vaccine introduction, was observed in children <2 years of age. However, the impact of other interventions such as improved sanitation and changes in HIV management cannot be discounted.


Assessment of meat quality defect genes in indigenous pigs of Bareilly region.
This investigation was undertaken to assess the population of indigenous (Bareilly local) pigs for meat quality genes (RYR1, PRKAG3, HFABP, MYF-5, and MC4R). The results showed that indigenous pigs were monomorphic at RYR1locus (100% NN genotype), HFABP locus (100% HH genotype), and MYF-5 locus (100% DD genotype). Homozygote RR and heterozygote QR genotypes were observed at PRKAG3 (c.599 G>A) SNP locus with 89 and 11% frequency. The frequency of wild (R) and mutant (Q) allele at the said locus was 95 and 5%. The MC4R SNP had three genotypes; homozygote AA with 5% frequency, heterozygote AG with 53% frequency, and homozygote GG with 42% frequency. Corresponding frequency of A and G allele was 32 and 68%, respectively. Monomorphic status at RYR1locus for NN genotype, HFABP locus for HH genotype, and MYF-5 locus for DD genotype indicated that favorable genes for quality pork production have been fixed in the population. The higher frequency of RR genotype (89%) at PRKAG3 and GG genotype (42%) at MC4R locus further explained the existence of favorable genotypes in indigenous pigs.


Providers issue brief: scope of practice and prescriptive authority: year end report-2003.
Nonphysician providers continue to achieve enhanced stature, in part by gaining more autonomy in prescribing drugs. There is growing support for the concept that the public health is best served by the broadest access to primary care along with the safe use of pharmaceuticals. The states continue in their efforts to find ways to promote the use of less specialized and less costly providers to help serve the ever-growing population who have access to health care services.


Efficacy of narrow band imaging for detection and surveillance of potentially malignant and malignant lesions in the oral cavity and oropharynx: a systematic review.
Narrow band imaging (NBI) is an endoscopic technique that enhances the mucosal surface texture, and mucosal and submucosal vascular morphology. This paper systematically reviews the available literature regarding the efficacy of NBI for the detection and monitoring of potentially malignant and malignant lesions in the oral cavity and oropharynx. Databases searched included PubMed, EMBASE, Web of Science and Scopus (to September 2013). Additional articles were found by conducting an author publication search using PubMed and by scanning the reference lists of relevant articles. Only trials that investigated and evaluated the effectiveness of both white light (WL) and NBI for aiding the detection of only oral potentially malignant lesions, oral squamous cell carcinomas and/or oropharyngeal squamous cell carcinomas were considered for this review. Two reviewers (ANV and CSF) independently assessed retrieved articles against the criteria, and included articles underwent data extraction and risk of bias assessment. Two studies, one retrospective and one prospective, met the inclusion criteria. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy for WL ranged between 56-96%, 60-100%, 33-100%, 87-99% and 66-89% respectively, whereas it was 87-96%, 94-98%, 73-96%, 97-98% and 92-97% respectively for NBI. While more research is required to determine the full value of NBI, it has great potential in accurately aiding the detection and assessment of neoplastic lesions, and influencing how these lesions are managed.


T lymphocyte subsets and NK cell cytotoxicity in chronic hemodialysis patients. The effect of recombinant human erythropoietin (rHu-EPO) treatment.
We investigated subpopulations of T lymphocytes, NK cell number and cytotoxic activity in 14 chronic uremic patients on regular hemodialysis treatment. We observed a significantly decreased absolute lymphocyte number and percentage of CD3 cells. Relative numbers of CD16 cells were significantly elevated, but NK cell cytotoxic activity was within a normal range. Nine patients with chronic renal anemia on maintenance hemodialysis were enrolled in rHu-EPO treatment trial. The treatment was continued till the hematocrit level reached 30%. Each of the patients had corrected anemia and well-being. After 12 weeks of the treatment we observed in these patients decreases in CD3, CD4, CD8 and CD16 cell numbers and elevation of CD4/CD8 ratio. Cytotoxic activity of NK cells did not change significantly. Presented results indicate that chronic hemodialysis patients have significantly diminished lymphocyte number. rHu EPO treatment affects the T lymphocyte subsets inducing a deep decrease of CD8 and CD16 cell percentage leading to normalisation of the CD4/CD8 ratio.


[Unstable angina pectoris: definition, pathology, clinical course].
Unstable angina pectoris signifies an ischemic heart condition intermediate between chronic stable angina and acute myocardial infarction. Numerous descriptive terms have been used and therefore a definition has been selected which helps in making therapeutic decisions. The cause of instability may be either a fixed coronary lesion or probably more often, dynamic events such as spasm. The course under medical treatment appears to be better than is commonly thought.


Development and psychometric evaluation of the patient knowledge of, and attitudes and behaviours towards pressure ulcer prevention instrument (KPUP).
The Patient Knowledge of, and Attitude and Behaviour towards Pressure Ulcer Prevention Instrument (KPUP) was developed and validated using a two-stage prospective psychometric instrument validation study design. In Stage 1, the instrument was designed, and it is psychometrically evaluated in Stage 2. To establish content validity, two expert panels independently reviewed each item for appropriateness and relevance. Psychometric evaluation included construct validity and stability testing of the instrument. The questionnaire was administered to a convenience sample of 200 people aged more than 65 years, living independently in the community; reliability and stability were assessed by test/retest procedures, with a 1-week interval. Mean knowledge scores at 'test' were 11.54/20 (95% CI = 11.10-11.99, SD: 3.07), and 'retest' was 12.24 (95% CI = 11.81-12.66, SD: 2.93). For knowledge, correlation between the test/retest score was positive (r=. 60), attitude section-inter-item correlations ranged from r = -.31 to r = .57 (mean intraclass correlation coefficient of r = .42), and internal consistency for the retest was the same as the test (α = .41 for the eight items). For health behaviours, individual inter-item correlations for test items ranged from r = -.21 to r = .41 for the 13 standardised items. Psychometric testing of the KPUP in a sample of older persons in the community provided moderate internal consistency and general high test-retest stability.


Direct electron transfer between cytochrome P450scc and gold nanoparticles on screen-printed rhodium-graphite electrodes.
This paper is concerned with an investigation of electron transfer between cytochrome P450scc (CYP11A1) and gold nanoparticles immobilised on rhodium-graphite electrodes. Thin films of gold nanoparticles were deposited onto the rhodium-graphite electrodes by drop casting. Cytochrome P450scc was deposited onto both gold nanoparticle modified and bare rhodium-graphite electrodes. Cyclic voltammetry indicated enhanced activity of the enzyme at the gold nanoparticle modified surface. The role of the nanoparticles in mediating electron transfer to the cytochrome P450scc was verified using ac impedance spectroscopy. Equivalent circuit analysis of the impedance spectra was performed and the values of the individual components estimated. On addition of aliquots of cholesterol to the electrolyte bioelectrocatalytic reduction currents were obtained. The sensitivity of the nanoparticle modified biosensor to cholesterol was 0.13 microA microM-1 in a detection range between 10 and 70 microM of cholesterol. This confirms that gold nanoparticles enhance electron transfer to the P450scc when present on the rhodium-graphite electrodes.


'Female condoms give women greater control': a qualitative assessment of the experiences of commercial sex workers in Swaziland.
To explore commercial sex workers' experiences with the female condom in Swaziland. This is a qualitative study that draws on two focus group discussions and ten individual in-depth interviews with female commercial sex workers in Lavumisa, Swaziland. The findings suggest that the majority of female sex workers prefer to use the female condom with their clients because it offers them greater control over the sexual encounter. Other factors that facilitate its use include the absence of side effects, the enhancement of sexual pleasure and protection against the risk of STIs (including HIV). In addition, the women reported that the female condom is stronger and more resistant to breakage than the male condom. Moreover, the female condoms can be inserted well in advance of sexual intercourse. Difficulties of insertion, partner objection and limited product availability were some of the barriers to the use of the device. There was also a tendency to reuse the female condoms because of lack of product availability and privacy to insert it. Although female condom use involves negotiation with clients, the fact that it offers sex workers an independent method of protection gives them more power and also, increases their ability to control their sexual and reproductive health.


Electrode effectiveness during transcutaneous motor stimulation.
Four types of electrodes were evaluated for clinical effectiveness in electrically stimulating the quadriceps muscles to gain knee extension for time periods lasting up to 4 days. These electrodes included self-adhering pregelled pads, solvent-activated conductive tape, carbonized conductive silicone rubber, and felt-covered metal plates. The electrodes were compared for ability to produce knee extension torque, electrical impedance, ease of application, durability, comfort, and skin reactivity. Felt-pad electrodes soaked in tap water or saline produced the highest mean torque and lowest electrical impedance, which made them excellent choices for single session stimulation. Carbon-rubber electrodes with either gel produced slightly less torque, slightly higher impedances, and only minor skin reactions. They were relatively easy to apply, and the majority remained intact for the duration of the study period. They were found to be most suitable for prolonged functional electrical stimulation of the quadriceps. Stimulation using pregelled electrodes produced the lowest torque, and they displayed consistently higher electrical impedance. Even though they were easiest to apply and survived better than the other electrodes, they also produced the most skin reactions. The torque and electrical impedance of the activated-tape electrodes were extremely variable and unpredictable, and the process of application was long and involved, making them clinically impractical for either long or short stimulation.


Assessment of topographic brachial plexus nerves variations at the axilla using ultrasonography.
The aim of this study was to describe topographic variations in the arrangement of the four main brachial plexus nerves at the junction of the axilla and the upper part of the arm. In 153 patients undergoing upper arm surgery using axillary block, we studied nerve arrangements with a three-step approach, combining: (A) cross-sectional ultrasound imaging using a 12 MHz linear ultrasound probe; (B) distal shift of the ultrasound scanhead from the axilla to the elbow joint following the paths of individual nerves; and (C) identifying the distal motor response to electrical nerve stimulation of each nerve. These results were then converted into a 12-section pie chart with the axillary artery (AA) as the axis. The order of the nerves around the AA was median, ulnar, radial, and musculocutaneous in all cases. The most frequent arrangement was observed in 65% of the patients. Five less frequent variations were observed in 4-20% of the patients, with four other variations seen in <2% of the patients. In 78% of the cases, the four nerves were seen separately using static ultrasound imaging. The musculocutaneous nerve was close to the artery in 18% of the patients. Topographic variations of the four main nerves at the axilla were found to be numerous, the most frequent arrangement being seen in less than two-thirds of the patients. Four separate nerves were seen on static ultrasound imaging at this sectional level of the axilla in only 78% of the cases.


Histological structure of antlers in castrated male fallow deer (Dama dama).
Antlers are periodically replaced cranial appendages that, except for the reindeer, are grown only by male deer. The annual antler cycle is controlled by seasonal fluctuations of sex steroid concentrations in the blood, and accordingly castration of male deer causes deviations from normal antler growth. The present study investigated antler histology of castrated fallow bucks (Dama dama). Castration in early spring was followed by casting of the hard antlers carried by the bucks and the growth of a new set of antlers, which remained in velvet permanently. In the following year, numerous bony protuberances developed from the original antler surface. Further growth of these protuberances, which were formed by subperiosteal intramembranous ossification, led to a marked increase in antler diameter in the affected areas. Compared to antlers of intact bucks, the antlers of the castrates showed histological signs of immaturity, suggestive of a reduced bone remodeling and an impairment of the mineralization process. These changes point to the dependence of the above processes on a stimulation by higher levels of sex steroids. Two years after castration, the antlers also developed integumental thickening and showed an initial formation of skin outgrowths. Cystic structures were present in the skin, which were often filled with a presumably sebaceous and/or keratinous material. Formation of intradermal bone or cartilage was not observed in the antlers of the castrated fallow bucks. The histological structure of the skin outgrowths suggested that they were caused by a hypertrophy of the dermal component of the velvet. Due to the localized bone overgrowth, resulting from the periosteal bone apposition onto the original antler surface, skin-lined infoldings originated, which reached deep into the newly formed bone. Our study revealed no indication of invasive/destructive bone growth in the antlers, i.e., of a penetration of the newly formed bone tissue into the pre-existing bone. The hypertrophic bone growth in the antlers of the castrates is compared with other forms of periosteally derived hypertrophic bone formation, including osteomas, in the mammalian skeleton. It is discussed whether the skin and bone outgrowths of the antlers of castrated fallow bucks may be classified as benign tumors.


Neonatal human foreskin keratinocytes produce 1,25-dihydroxyvitamin D3.
Primary cultures of neonatal human foreskin keratinocytes converted 25-hydroxyvitamin D in high yield to a metabolite with the chromatographic behavior of 1,25-dihydroxyvitamin D3. The identity of this metabolite as 1,25-dihydroxyvitamin D3 was confirmed both by its potency in displacing 1,25-dihydroxyvitamin D3 in the chick cytosol receptor assay and by mass spectral analysis. These results suggest that 1,25-dihydroxyvitamin D3 may be formed in the epidermis to regulate vitamin D production by the epidermis and to provide an alternative to 1,25-dihydroxyvitamin D3 production by the kidneys.


Results of treatment of high risk childhood acute lymphoblastic leukemia.
Sixteen children with high risk acute lymphoblastic leukemia (ALL) who had one or more of the following risk factors: white cell count over 50 X 10(9)/liter, mediastinal mass, age under 2 or over 10 years, extramedullary involvement, or T-cell markers, were treated by a new protocol. All attained complete remission and 11 are still in their continuous first remission for 6-53 months. High activity of adenosine deaminase (ADA) in the leukemic cells seems to be an independent risk factor, as in the high ADA level group, 4 out of 7 patients relapsed and died, while none of the 8 patients with low ADA levels relapsed or died.


Metaphase karyotypes of Anopheles of Thailand and Southeast Asia: V. The Myzomyia Series, subgenus Cellia (Diptera:Culicidae).
Metaphase karyotypes of 9 species of the Myzomyia Series show intra- and interspecific differences based on quantitative variation and distribution of constitutive heterochromatin in the sex chromosomes or the centromeric regions of the autosome pairs or both. Anopheles jeyporiensis and Anopheles aconitus each exhibit 4 forms of mitotic karyotypes, which may reflect interspecific differences within each taxon. The well-defined genetic species within the Anopheles minimus and the Anopheles culcifacies complexes clearly exhibit distinctive metaphase karyotypes that can be used as diagnostic characters for separating these sibling species, which are difficult to identify by morphological criteria alone. Our analysis on metaphase karyotypes of Anopheles pampanai, Anopheles varuna, and Anopheles flavirostris also confirms their morphological identification based on heterochromatin differences in the sex chromosomes and autosome 2.


Eating and body image: Does food insecurity make us feel thinner?
Body image distortions are common in healthy individuals and a central aspect of serious clinical conditions, such as eating disorders. This commentary explores the potential implications of body image and its distortions for the insurance hypothesis. In particular, we speculate that body image may be an intervening variable mediating the relationship between perceived food scarcity and eating behavior.


Maternal serum markers for Down's syndrome pregnancies.
Down's syndrome is the most common chromosomal abnormality whose incidence increases with advancing maternal age. However, approximately 70% of all Down's syndrome foetuses occur in mothers aged less than 35. Maternal serum markers have been used in an attempt to identify Down's syndrome pregnancies in these low risk mothers. Numerous second trimester maternal serum markers have been documented in the literature and these are reviewed. The Triple test which uses second trimester maternal serum levels of alpha-feto protein, human chorionic gonadotrophin and unconjugated oestriol is the most popular combination in use today. Although it is associated with a 58% detection rate for Down's syndrome pregnancies at a false positive rate of 5%, the Triple test has its problems and these are discussed. The cost-effectiveness of Down's syndrome screening using the Triple test and its role in mothers aged 35 years or more are also explored. Several workers have reported on first trimester serum markers of foetal Down's syndrome but more data is needed before a first trimester serum screening programme for Down's syndrome is possible.


Antimicrobial activity of an iron triple helicate.
The prevalence of antibiotic resistance has resulted in the need for new approaches to be developed to combat previously easily treatable infections. Here we investigated the potential of the synthetic metallomolecules [Fe(2)L(3)](4+) and [Cu(2)(L')(2)](2+) as antibacterial agents. Both molecules have been shown to bind DNA; [Fe(2)L(3)](4+) binds in the major groove and causes DNA coiling, whilst [Cu(2)(L')(2)](2+) can act as an artificial nuclease. The work described here shows that only [Fe(2)L(3)](4+) is bactericidal for Bacillus subtilis and Escherichia coli. We demonstrate that [Fe(2)L(3)](4+) binds bacterial DNA in vivo and, strikingly, that it kills B. subtilis cells very rapidly.


Repetition of previously novel melodies sometimes increases both remember and know responses in recognition memory.
Recognition memory for previously novel melodies was tested in three experiments in which subjects usedremember andknow responses to report experiences of recollection, or of familiarity in the absence of recollection, for each melody they recognized. Some of the melodies were taken from Polish folk songs and presented vocally, but without the words. Others were taken from obscure pieces of classical music, presented as single-line melodies. Prior to the test, the melodies were repeated for varying numbers of study trials. Repetition of the Polish melodies increased both remember and know responses, while repetition of classical melodies increased remember but not know responses. When subjects were instructed to report guesses, guess responses were inversely related to remember and know responses and there were more guesses to lures than to targets. These findings establish that remembering and knowing are fully independent functionally and, by the same token, they provide further evidence against the idea that response exclusivity causes increases in remembering to force decreases in knowing. The findings also suggest that simultaneous increases in remembering and knowing occurred because the Polish melodies came from a genre for which the subjects had relatively little previous experience.


Postconditioning's protection of THSG on cardiac ischemia-reperfusion injury and mechanism.
2,3,5,4'-tetra-hydroxystilbene-2-O-glucoside (THSG), the water-soluble active components extracted from dried tuber root of Polygonum multiflorum (Polygonaceae), can promote the release of nitric oxide (NO) from vascular endothelial cells and has strong antioxidation. The postconditioning's protection of THSG on cardiac ischemia-reperfusion injury and the mechanism were investigated. After reperfusion for 3 h following occlusion of rat left anterior descending coronary artery (LAD) for 30 min, SalphaT recovery speed, arrhythmia and cardiac infarct size were observed. The ischemic size and infarct size was identified by using Evans blue and TTC staining methods respectively. The results showed that the infarct size in THSG 7. 5 mg/kg postconditioning group was significantly decreased from 43.6% +/- 9.1% in mode group to 16.5% +/- 6.5% (P < 0.01). SalphaT recovery was quicker and the incidence of arrhythmia (55.6% vs 100%, P < 0.05) was significantly lower than in control group. The infarct size in THSG+glybenclamide group was greater than in THSG group, but equivalent to that in control group (46.8% +/- 9.8% vs 43.6% +/- 9.1%, P > 0.05), SalphaT recovery speed slower and the incidence of arrhythmia also lower (33.3% vs 100%, P < 0.01), suggesting that glybenclamide could abolish the effects of THSG postconditioning reducing the cardiac infart size. It was concluded that THSG administration before reperfusion could effectively alleviate the cardiac reperfusion injury and possessed the postconditioning effects of reducing cardiac infarct size, which might be related with the K(ATP) channel opening.


[The prognostic value of the dexamethasone suppression test for the course of anorexia nervosa--comparison with depressive diseases].
In the light of studies in affective disorders the predictive potential of the Dexamethasone Suppression Test was investigated in 31 patients with anorexia nervosa. According to the Morgan and Russell general outcome score the follow-up was conducted one year after each patient's discharge from hospital. There was a highly significant association between the post-dexamethasone-cortisol-plasma-value in weight-corrected patients at discharge and the one year follow-up. Patients who did not normalize their DST responses were at higher risk for a poor outcome. In contrast to patients with pure malnutrition a number of weight-restored anorexic patients continue to show or return to nonsuppression. It appears that reversion to a positive DST result might reflect a stress response in patients who failed to recover completely though weight stabilisation during inpatient treatment. Stress may lead to hypersecretion of CRH, which is known to be a potent anorexic agent. The present study does not point to a common etiology of anorexia nervosa and affective disorders as nonsuppression in the DST might be an unspecific response to stress-related factors.


Extent of alcohol prohibition in civil policy in Muslim majority countries: the impact of globalization.
Many policies have been introduced to reduce alcohol harm in different countries. However, Muslim majority countries (MMCs), where the major religion (Islam) prohibits alcohol consumption, have less well-developed civil alcohol policies. Overall, MMCs have low prevalence of alcohol consumption, although recently most MMCs have been undergoing transition, which has sometimes increased pressure for alcohol availability and impacted on social practices, alcohol policies and broader public health. Globalization, the influence of the global alcohol industry, recent governmental transition or political instability and the presence of immigrants from non-Muslim countries can all affect civil alcohol policy. In this context, consumption overall has increased compared with two decades ago. This paper presents an overview of current civil alcohol policy, with regard to the presence or absence of alcohol prohibition, and provides an insight into the legal availability of alcohol in MMCs and the challenges facing policymakers. English, Arabic and Persian language sources were examined, using PubMed, government websites for each country and the World Health Organization (WHO). Some of the challenges MMCs may face in developing alcohol policies are explored, including the need to interact with the global economy and the potential influence of the alcohol industry. Muslim majority countries have adopted a range of civil alcohol policies in recent decades. There is a pressing need for better data and to support Muslim majority countries in alcohol policy development. Lessons from Muslim majority countries can help to inform other parts of the world.


Hospital admissions associated with medication non-adherence: a systematic review of prospective observational studies.
Medication non-adherence in ambulatory care has received substantial attention in the literature, but less so as it affects acute care. Accordingly, we aimed to estimate the frequency with which non-adherence to medication contributes to hospital admissions. We searched the Cochrane Library, EMBASE, Cumulative Index to Nursing and Allied Health Literature, International Pharmaceutical Abstracts and PubMed (until December 2017) to identify prospective observational studies that examined prevalence rates of hospital admissions associated with medication non-adherence. A quality assessment was performed using an expanded Crombie checklist. Data extraction covered patterns, circumstances, and patient and other key characteristics of non-adherence. Pooled estimates were obtained using a random-effect model. Of 24 included studies, 8 were undertaken in North America, 7 from Europe, 6 from Asia and 3 from Australia. Most studies (79%) were rated as low risk of bias. All but three studies used combination measures to detect non-adherence, but approaches to assess preventability varied considerably. Across the studies, there was high heterogeneity among prevalence estimates (χ2=548, df 23, p<0.001, I2=95.8%). The median prevalence rate of hospital admissions associated with non-adherence was 4.29% (IQR 3.22%-7.49%), with prevalence rates ranging from 0.72% to 10.79%. By definition, almost all of these admissions were considered preventable. The underlying causes contributing to these admissions included medication cost and side effects, and non-adherence most often involved cardiovascular medicines. Hospital admissions associated with non-adherence to medication are a common problem. This systematic review highlights important targets for intervention. Greater attention could be focused on adherence to medication during the hospital stay as part of an enhanced medication reconciliation process. Standardisation in study methods and definitions is needed to allow future comparisons among settings; future studies should also encompass emerging economies.


[Anticardiolopin antibodies as a risk factor in stroke].
The level of anticardiolipin antibodies (aCL) in sera of 53 patients with ischemic cerebrovascular disease aged 35-55 years with mean age 48.4 +/- 5.03, was studied using a solid phase enzyme immunosorbent assay (ELISA). The investigation was done half year after the ischemic stroke. The control group consisted of 21 healthy participants matched for age and sex. The presence of aCL was found in sera of 17 persons (32.1%), in 9 it was IgG class antibodies. It was indicated that the risk of repeated cerebral ischemic events was relatively higher in aCL positive patients than in aCL negative. Relapses were found in 6 aCL positive patients (35.3%) (in 5 cases from the group of 9 IgG positive) and in 2 persons (5.6%) aCL negative patients. The existence of aCL can be helpful to determine pathogenesis of the disease and its prognosis.


Sexuality education in a state mental hospital.
The issue of whether sex education programs should be offered in public psychiatric facilities is delicate and complex. It raises a number of questions about the sexual rights of patients and whether the programs help or harm them. The authors discuss such issues and describe a sex education program for patients in the adult transitional living program at Western State Hospital. They believe such a program is necessary for patients who will be released from the hospital and thus expected to cope with the complexities of society. Staff members also attended educational sessions to give them an opportunity to discuss sexual issues. Recommendations for others interested in setting up a sex education program are included.


Comparison of maternal and fetal effects of vacuum extraction with forceps or cesarean deliveries.
Results of 90 vacuum extraction (VE) deliveries were compared with effects on the mother and fetus of forceps delivery or cesarean section. Forceps delivery increased the incidence of birth canal trauma threefold and the incidence of anemia sevenfold (18% for VE versus 48% for forceps delivery, and 4 versus 30%, respectively) (P less than or equal to .001). When cesarean section was the alternative operation, the incidence of blood loss was significantly increased (72%, versus 18% with VE), as was febrile morbidity (48%, versus 6% with VE) (P less than or equal to .001). Hospitalization time and costs in the present and future for cesarean section deliveries are markedly higher than for VE. Maternal requirements for anesthesia are markedly reduced with VE because of the gentleness of the operation. A failed trial of VE in 7 patients did not constitute any greater hazard to the mother than initial management by cesarean section. However, babies born by cesarean section after failed VE had a slightly lower Apgar score at 1 minute (P less than or equal to .05) but not at 5 minutes, as compared with babies born by cesarean section attempted initially. Otherwise, Apgar scores of infants born by VE did not differ from those of infants delivered by forceps or cesarean section. Infants delivered by VE had a higher incidence of transient cosmetic deformations, including "chignon" and cephalhematoma, whereas infants delivered by forceps had forceps marks and facial lacerations more frequently. Neither perinatal mortality nor serious traumatic complications were attributable to VE, due to its judicious use for a limited time of approximately 15 minutes.


Co-occurrence of radiological features of progressive supranuclear palsy and corticobasal degeneration.
We report an interesting case demonstrating co-occurrence of radiological features of progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD). The clinical features were typical of PSP but magnetic resonance imaging (MRI) showed both typical brainstem changes of PSP and an atypical pattern of cortical atrophy. While the MRI had markers of CBD, the clinical features were not classical of CBD.


Visual Vibrometry: Estimating Material Properties from Small Motions in Video.
The estimation of material properties is important for scene understanding, with many applications in vision, robotics, and structural engineering. This paper connects fundamentals of vibration mechanics with computer vision techniques in order to infer material properties from small, often imperceptible motions in video. Objects tend to vibrate in a set of preferred modes. The frequencies of these modes depend on the structure and material properties of an object. We show that by extracting these frequencies from video of a vibrating object, we can often make inferences about that object's material properties. We demonstrate our approach by estimating material properties for a variety of objects by observing their motion in high-speed and regular frame rate video.


Injury to the infrapatellar branch of the saphenous nerve during tendon graft harvesting for knee ligament reconstruction: An ultrasound simulation study.
The clinical anatomy of the infrapatellar branch of the saphenous nerve (IPBSN) is of particular importance during operations in the area of the knee, especially when material for anterior cruciate ligament reconstruction is harvested. The nerve can easily be injured during the harvesting procedure, leading to postoperative complications that reduce quality of life. Three different skin incisions are commonly used during hamstring tendon harvesting: horizontal, vertical, and oblique. The aim of this ultrasound simulation study was to assess the risk of IPBSN injury associated with the type of skin incision and the point-of-emergence of the IPBSN relative to the sartorius muscle. Thirty healthy volunteers (60 lower limbs) were recruited for identification of the IPBSN. When it was found, using a high-frequency ultrasound probe, three different 3 cm skin incisions over the pes anserinus were simulated. Vertical, horizontal, or oblique lines simulating incisions were marked over the pes anserinus and ultrasound was used to visualize the structures that could be injured during the marked incisions. The IPBSN was visualized in 58 lower limbs (96.7%). The results of the simulation study indicated that the vertical incision should be avoided during hamstring tendon harvesting, as it is associated with a significantly higher risk of injury (25.9%) to the IPBSN than the horizontal (3.5%) or oblique (8.6%) incisions. We recommend that a preoperative ultrasound assessment of IPBSN anatomy be performed to minimize the risk of iatrogenic injury to the nerve and associated complications. Clin. Anat. 30:868-872, 2017. © 2017 Wiley Periodicals, Inc.


Cognitive and social learning models of drug dependence: implications for the assessment of tobacco dependence in adolescents.
This paper is part of a series that has the goal of identifying potential approaches toward developing new instruments for assessing tobacco dependence among adolescents. The fundamental assumption underlying the series is that contemporary theories of drug dependence offer a rich source of opportunities for the development of theoretically based assessment tools. The present paper focuses on cognitive and social-learning models of drug dependence and the implications of these models for novel assessment instruments. In particular, the paper focuses on Mark Goldman's model of drug expectancies, Albert Bandura's model of self-efficacy, Thomas Wills's model of stress and coping and Stephen Tiffany's cognitive-processing model of drug urges and cravings. In addition to traditional self-report measures, naturalistic and laboratory-based assessments are identified that may yield information relevant to multi-dimensional measurement of tobacco dependence.


A mixed-ligand approach for spin-crossover modulation in a linear Fe(II) coordination polymer.
In this work, we present a family of Fe(II) coordination polymers of general formula [Fe(btzx)(3-3x)(btix)(3x)](ClO4)2 with interesting spin-crossover properties. These coordination polymers have been synthesized using chemical mixtures of two different but closely related ligands, 1,4-bis(tetrazol-1-ylmethyl)benzene (btzx) and 1,4-bis(triazol-1-ylmethyl)benzene (btix), and the effect of a gradual substitution of the ligand in the spin transition temperature has been investigated. Several chemical mixtures have been structurally characterized by X-ray powder diffraction indicating a clear critical amount in the composition of the mixture after which mixed phases rather than a single phase comprising mixed components are observed. Importantly, this approach causes the appearance of a new transition at lower temperatures that is not present in the pure [Fe(L)3](ClO4)2 systems.


Amygdala-hippocampus relationships in temporal lobe seizures: a phase-coherence study.
We analyzed temporal lobe seizures in patients with intracerebral electrodes to assess which of hippocampus and amygdala have a predominant role at seizure onset. Seizures were divided into those of mesial temporal onset, in which amygdala and hippocampus were involved but the neocortex was not (77 seizures from 17 patients), and those of regional onset in which mesial structures and neocortex were involved (89 seizures from 16 patients). We measured coherence and phase between one amygdala channel and one or two hippocampal channels during the first 10 s to determine which structure was leading the discharge. The following results are from 33 focal-mesial seizures and 30 regional seizures in which amygdala-hippocampus coherence was sufficiently high to measure time delays: the amygdala was leading in 21.2% of focal-mesial and 53.3% of regional seizures, and the hippocampus was leading in 48.5% of focal-mesial and 26.7% of regional seizures (chi-square, P < 0.02); in the remaining seizures, discharges were synchronous in the two structures. We conclude that the amygdala is more likely to lead when seizures are of regional onset, whereas the hippocampus is more likely to lead in focal-mesial seizures. This is probably due to the many connections of the amygdala with surrounding temporal neocortex.


Dietary zinc intake and sex differences in taste acuity in healthy young adults.
Previous research suggests that adequate dietary zinc intake may be important in determining the sensory experience of food, appetite and consequently, dietary quality. The aim of this pilot study was to explore relationships between taste sensitivity and dietary zinc intake in healthy young adults (age 20-40 years: 24 male, mean age +/- SD = 27 +/- 4.86 years; 26 female, mean age +/- SD = 23 +/- 2.10). A signal detection method was used to assess taste acuity for the four basic tastes: sweet (glucose), sour (citric acid), salt (sodium chloride) and bitter (quinine). A 4-day food diary was used to determine dietary intakes of zinc (mg day(-1)) and salt. Males reported a higher zinc intake than females (P=0.001). Higher dietary zinc intake was associated with better taste acuity for salt in females (P=0.017) but not in males. Acuity for bitter taste appeared to be related to zinc intake in males (P=0.007) but not females. Among those whose average daily zinc intake was below the RNI, males were less sensitive than females to sour (P=0.02) and bitter (P=0.014) taste. These findings suggest that zinc is more important for taste acuity in males than females and indicate the importance of taking sex differences into account when studying taste acuity.