Clinical manifestations of erythema chronicum migrans Afzelius in 161 patients. A comparison with Lyme disease.
Clinical symptoms were studied in 161 consecutive patients with erythema chronicum migrans Afzelius and in a follow-up study signs of late manifestations were investigated. General symptoms such as headache, fever, myalgia and/or arthralgia were found in about half of the patients with a disease duration of less than or equal to 3 weeks. Three patients had coexisting lymphadenosis benigna cutis. Two untreated patients developed meningitis/meningoradiculitis and one untreated patient arthritis. The importance of a sufficient antibiotic therapy to prevent late manifestations is stressed. Although there are many similarities between erythema chronicum migrans Afzelius and Lyme disease, the results of the present study also point to differences. Multiple skin lesions, pronounced general symptoms, laboratory abnormalities and major symptoms from the joints were less common in patients with erythema chronicum migrans Afzelius than reported in patients with Lyme disease, but a prolonged course of the skin eruption was more common.


Characterization of an Insecticidal Protein from Withania somnifera Against Lepidopteran and Hemipteran Pest.
Lectins are carbohydrate-binding proteins with wide array of functions including plant defense against pathogens and insect pests. In the present study, a putative mannose-binding lectin (WsMBP1) of 1124 bp was isolated from leaves of Withania somnifera. The gene was expressed in E. coli, and the recombinant WsMBP1 with a predicted molecular weight of 31 kDa was tested for its insecticidal properties against Hyblaea puera (Lepidoptera: Hyblaeidae) and Probergrothius sanguinolens (Hemiptera: Pyrrhocoridae). Delay in growth and metamorphosis, decreased larval body mass and increased mortality was recorded in recombinant WsMBP1-fed larvae. Histological studies on the midgut of lectin-treated insects showed disrupted and diffused secretory cells surrounding the gut lumen in larvae of H. puera and P. sanguinolens, implicating its role in disruption of the digestive process and nutrient assimilation in the studied insect pests. The present study indicates that WsMBP1 can act as a potential gene resource in future transformation programs for incorporating insect pest tolerance in susceptible plant genotypes.


Barrett's esophagus: endoscopic resection.
In experienced hands, ER is a safe method of resecting dysplastic lesions and early carcinomas of the GI tract, and it has decisive advantages compared with other local endoscopic treatment procedures (such as thermal destruction and PDT). The opportunity for histological processing of the resected specimen provides information regarding the depth of invasion of the individual layers of the GI tract wall. Additionally, it has advantages regarding excision with healthy margins. This means that even when there is infiltration of the submucosa that has not been detected before treatment--in which case local endoscopic therapy is no longer appropriate--a patient with early Barrett's cancer still is able to undergo surgical resection. As was shown recently, the morbidity and mortality of ER are significantly dependent on the frequency with which esophagectomy is performed in each center. When there were more than 20 procedures of this type per year, the surgical mortality was 8%, whereas in centers conducting fewer than 10 procedures per year the rate was 21%. In view of the consequent claim that ER should only be performed at high-volume centers, curative endoscopic treatment of early esophageal carcinomas also should be performed only in centers with a similar frequency to that of the surgical high-volume centers. It is only in these conditions that the conclusion is defensible that patients with HGIN or mucosal Barrett's carcinoma should undergo ER with curative intent instead of radical ER. Randomized and controlled studies comparing radical esophagectomy with endoscopic therapy are desirable, but they are difficult to conduct, not least because valid 5-year survival data show no significant difference between patients who have undergone endoscopic treatment for early Barrett's cancers and the average German population of the same age and sex.


Prostacyclin synthesis in irradiated endothelial cells cultured from bovine aorta.
Confluent monolayers of bovine aortic endothelial cells were examined 2-72 h after exposure to 0.5-5.0 Gy of 60Co gamma-rays. Accumulation of prostacyclin [PGI2, measured as 6-ketoprostaglandin F1 alpha (6-keto-PGF1 alpha)] in the culture media and PGI2 production stimulated by exogenous arachidonate were correlated with cell detachment and release of lactate dehydrogenase (LDH) activity. Platelet adherence to irradiated and control monolayers also was studied. There were simultaneous time- and dose-dependent increases in cell detachment and in the titers of 6-keto-PGF1 alpha and LDH activity in the culture medium. These changes were evident between 4 and 8 h after 5 Gy or at 24 h after 0.5 Gy. Four hours after 5 Gy, both adherent and detached endothelial cells showed a twofold increase in PGI2 production during a 15-min incubation with arachidonate (10 microM). However, by 72 h this increase was less significant. The accumulation of 6-keto-PGF1 alpha appeared to be related to cell destruction, but radiation also stimulated PGI2 synthesis independent of cell detachment. There was an increased platelet interaction with irradiated monolayers, as a result of platelet adherence to subendothelial matrix exposed after cell detachment. However, irradiation did not alter the nonadherent property of the endothelial cell surface toward platelets.


The structure of an ECF-sigma-dependent, light-inducible promoter from the bacterium Myxococcus xanthus.
Expression of the Myxococcus xanthus gene crtl is controlled by a light-inducible promoter. The activity of this promoter depends on CarQ, a sigma factor of the extracytoplasmic function (ECF) subfamily. Here, we show thatthe minimum DNA stretch reproducing normal expression of crtl extends from a few bases upstream of the -35 position to a site well downstream of the transcriptional start. The downstream DNA contains an enhancer-like element that remains active when displaced upstream of the promoter. Experimental evidence is provided for the activity of the crtl promoter being critically dependent on a pentanucleotide sequence centred at the -31 position. The similarity of this sequence with the consensus for ECF-sigma-dependent promoters from other bacteria is discussed. The activity of the crtl promoter also depends on certain basepairs at the -10 region. Hence, the operation of ECF-sigma-factors seems to require binding to two different DNA sites, although the -10 sequences of different ECF-sigma-dependent promoters are unrelated to one another, and the ECF-sigma-factors themselves lack the conserved domain known to mediate binding of other sigma-factors to the -10 DNA site.


In vitro biosynthesis of fatty acids inDrosophila melanogaster.
A new in vitro technique, utilizing ruptured larvae ofDrosophila melanogaster, was employed to study the incorporation of(3)H-acetate into long-chain fatty acids. Preparative gas-liquid chromatography and scintillation spectroscopy were used to determine the relative activity of each fatty acid from total lipid extracts. Quantitative changes were observed in the distribution of label during the course of the incubation times, which ranged from five minutes to nine hours. All fatty acids which were observed to incorporate acetate in previous in vivo studies also showed incorporation of label under these in vitro conditions. It is concluded that this system may be useful for studying aspects on insect metabolism for short intervals of time.


Chronic Scrotal Pain.
Chronic scrotal pain (CSP) is a common yet poorly understood condition, with significant impacts on overall quality of life. Many patients will have sought evaluation and management from multiple providers in an attempt to find a solution for their pain. Despite many emerging treatments for CSP and further understanding of the potential etiologies and pathophysiological basis of the condition, its natural history is poorly understood. It is also important to recognize the psychosocial impact of CSP and consider formal referral for psychological evaluation and treatment if the patient endorses significant psychiatric responses to pain. It is important to also recognize the neuropathic component of pain that may arise in patients with CSP. Neuropathic medications show promise as a narcotic-sparing pharmacological intervention. There are promising surgical options for CSP including microsurgical denervation of the spermatic cord. This article highlights the current best practice recommendations on the evaluation and management of chronic scrotal pain.


[In vitro activity of levofloxacin against Escherichia coli strains in acute pyelonephritis, in France in 2005].
The objective of this study was to assess the in vitro activity of levofloxacin compared to other antibiotics against Escherichia coli strains isolated from female patients with acute pyelonephritis in 23 French hospitals in 2005. Minimal inhibitory concentrations (MICs) were determined in a central laboratory, by agar dilution method in compliance with the recommendations of the Comité de l'antibiogramme de la Société française de Microbiologie (CA-SFM). The percentages of susceptible strains were calculated according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST) breakpoints approved by the CA-SFM (2005) for ciprofloxacin, levofloxacin, and ofloxacin and according to the CA-SFM breakpoints for the other antibiotics. Amongst the 231 strains collected, 46.3% of strains were isolated from urinary samples, 10.8% from blood culture, and 42.9% from both. Concerning fluoroquinolones, the percentages of susceptibility were 93.1%, 90.5%, and 92.7% for levofloxacin, ofloxacin, and ciprofloxacin, respectively. For the other antibiotics, a higher percentage of susceptibility was observed with ceftriaxone (99.6%) and amikacin (94.8%), whereas a lower percentage of susceptibility was observed with amoxiclav (68.8%), and cotrimoxazole (65.4%). Levofloxacin exhibited a good in vitro activity against E. coli strains isolated from acute pyelonephritis with 93.1% of susceptible strains.


Association of the Female Athlete Triad Risk Assessment Stratification to the Development of Bone Stress Injuries in Collegiate Athletes.
The female athlete triad (referred to as the triad) contributes to adverse health outcomes, including bone stress injuries (BSIs), in female athletes. Guidelines were published in 2014 for clinical management of athletes affected by the triad. This study aimed to (1) classify athletes from a collegiate population of 16 sports into low-, moderate-, and high-risk categories using the Female Athlete Triad Cumulative Risk Assessment score and (2) evaluate the predictive value of the risk categories for subsequent BSIs. Cohort study; Level of evidence, 3. A total of 323 athletes completed both electronic preparticipation physical examination and dual-energy x-ray absorptiometry scans. Of these, 239 athletes with known oligomenorrhea/amenorrhea status were assigned to a low-, moderate-, or high-risk category. Chart review was used to identify athletes who sustained a subsequent BSI during collegiate sports participation; the injury required a physician diagnosis and imaging confirmation. Of 239 athletes, 61 (25.5%) were classified into moderate-risk and 9 (3.8%) into high-risk categories. Sports with the highest proportion of athletes assigned to the moderate- and high-risk categories included gymnastics (56.3%), lacrosse (50%), cross-country (48.9%), swimming/diving (42.9%), sailing (33%), and volleyball (33%). Twenty-five athletes (10.5%) assigned to risk categories sustained ≥1 BSI. Cross-country runners contributed the majority of BSIs (16; 64%). After adjusting for age and participation in cross-country, we found that moderate-risk athletes were twice as likely as low-risk athletes to sustain a BSI (risk ratio [RR], 2.6; 95% confidence interval [95% CI], 1.3-5.5) and high-risk athletes were nearly 4 times as likely (RR, 3.8; 95% CI, 1.8-8.0). When examining the 6 individual components of the triad risk assessment score, both the oligomenorrhea/amenorrhea score ( P = .0069) and the prior stress fracture/reaction score ( P = .0315) were identified as independent predictors for subsequent BSIs (after adjusting for cross-country participation and age). Using published guidelines, 29% of female collegiate athletes in this study were classified into moderate- or high-risk categories using the Female Athlete Triad Cumulative Risk Assessment Score. Moderate- and high-risk athletes were more likely to subsequently sustain a BSI; most BSIs were sustained by cross-country runners.


Gene expression and biochemical changes of carbohydrate metabolism in in vitro micro-propagated apple plantlets infected by 'Candidatus Phytoplasma mali'.
'Candidatus Phytoplasma mali' (Ca. P. mali) is the disease agent causing apple proliferation (AP), which has detrimental effects on production in many apple growing areas of Central and Southern Europe. The present study investigated transcriptional and biochemical changes related to the sugar metabolism as well as expression of pathogenesis-related (PR) protein genes in in vitro micro-propagated AP-infected and healthy control plantlets with the aim of shedding light on host plant response to 'Ca. P. mali' infection. Expression changes between infected and control plantlets were detected by quantitative real-time PCR analysis. The most significant transcriptional changes were observed for genes coding for pathogenesis-related proteins and for heat shock protein 70, as well as for some genes related to the sugar metabolism, such as a sorbitol transporter (SOT5), hexokinase, sucrose-phosphate synthase or granule bound starch synthase. Furthermore, biochemical analyses revealed that infected plantlets were characterized by a significant accumulation of starch and sucrose, while hexoses, such as glucose and fructose, and sorbitol were present at lower concentrations. In summary, the present analysis provides an overview of a gene set that is involved in response to phytoplasma infection and, therefore, it may help for a better understanding of the molecular mechanisms involved in phytoplasma-host plant interaction in apple.


The development of MetAP-2 inhibitors in cancer treatment.
Methionine aminopeptidases (MetAPs), which remove methionine residue from newly synthesized polypeptide chains, are a class of metalloproteases ubiquitously distributed in both eukaryotes and prokaryotes. MetAP-2 inhibition can induce G1 cell cycle arrest, cytostasis in tumor cells in vitro and inhibition of tumor growth in vivo. The discovery of fumagillin with potent antiangiogenic and antiproliferative activities promoted the development of fumagillin analogues as a novel class of anticancer agents. Early drug discovery efforts have focused on analogs of fumagillin, which irreversibly inhibit MetAP-2 through covalent modification of an epoxide. Several fumagillin analogs, like CKD-732, TNP-470 and PPI-2458, were found to be potent selective inhibitors of MetAP-2 (proteolytic activity) and endothelial cell proliferation. Further, they have entered in clinical trials for the treatment of different types of tumors. Recently, attention has been paid to reversible human MetAP-2 inhibitors, such as bengamides, 2-hydroxy-3-aminoamides, anthranilic acid sulfonamides and triazole analogs, which have demonstrated their potential to inhibit angiogenesis and tumor growth in vivo as well. This review article mainly discussed the development of MetAP-2 inhibitors in cancer therapy and also summarized their structure-activity relationships.


Development and psychometric evaluation of the Environment-Behavior Interaction Code (EBIC).
Although the behavioral changes with progressive dementia are seen to increasingly depend on the environmental context until late stage disease, measurement has not reflected this interaction in real time to allow examination of antecedents to disruptive behavior. To develop and evaluate the psychometric properties of the Environment-Behavior Interaction Code (EBIC) for use in dementia care research with either sequential or nonsequential analyses of behavioral data. Development of the computer-based (sequential event format) EBIC provided an observational coding system to classify all behavior and environmental context in real time, so that the probability of social environmental antecedents to resident disruptive behavior could be estimated. A checklist (interval format) EBIC, based on the same behavioral taxonomy, was developed for clinical outcome research. A total of 158 elderly residents of dementia care units were purposively selected from three large long-term care facilities for the psychometric study components. Psychometric results indicated significant (p < 0.01) known-groups validity for the disruptive behavior construct, which was defined as a composite of aversive, harmful, and high intensity neutral behavior. Interrater agreement for the event format of the EBIC was estimated by average kappa (0.65) and percentage agreement (78%). For the interval format, the mean interrater kappa was 0.80 with 96% agreement. Stability of the event format using a 2-week retest interval ranged from r= .50 (positive behavior) to r = 0.73 (negative behavior, defined as aversive + harmful). On replication with a new sample, stability was higher for positive (r = 0.92) and negative (r = 0.95) components, and for composite scores of nondisruptive (positive + low intensity neutral; r = 0.65) and disruptive (r= 0.85) behavior. This research provided support for the reliability and validity of both event and interval EBIC formats. Measurement using the EBIC taxonomy has applicability to dementia care research questions that call for either sequential analysis of social interactions or nonsequential analysis of behavioral outcomes in intervention studies.


Evaluation of Local CYP17A1 and CYP19A1 Expression Levels as Prognostic Factors in Postmenopausal Invasive Ductal Breast Cancer Cases.
There is growing attention focused on local estrogen production in the breast tissue and its possible role in breast cancer initiation and progression. Understanding the underlying mechanisms for estrogen synthesis and the microenvironment consisting of tumor and its surrounding adipose tissue might open new avenues in breast cancer prevention, prognosis and treatment. In order to obtain insight, we compared peritumoral and tumor tissue expressions of CYP17A1 and CYP19A1 genes, which play an important role in estrogen biosynthesis. The paired tissue samples of 20 postmenopausal ER+/PR+ patients diagnosed with invasive ductal breast cancer were studied. In addition, 12 breast tissue samples obtained from premenopausal women without a history of breast cancer were also investigated as representative of normal conditions. Peritumoral adipose tissues expressed CYP19A1 approximately threefold higher than tumor itself (p = 0.001). A nonsignificant trend toward low expression of CYP17A1 was observed in peritumoral compared to tumor tissue (p = 0.687). Clinicopathological parameters and patient characteristics which are accepted as risk factors for breast cancer were also associated with individual and combined expressions of CYP17A1 and CYP19A1. This study offers that evaluation of CYP17A1 and CYP19A1 local expression levels might be useful for deciding on personalized treatment approaches and more accurate diagnosis, when evaluated together with several clinicopathological and disease risk factors. Considering the key role of these CYPs in estrogen synthesis, determining their expression levels may be useful as a postdiagnostic marker and for choosing the right treatment method in addition to the conventional approach.


The effect of different convection cooking methods on the instrumental quality and yield of pork Longissimus dorsi.
The effect of different cooking methods (natural convection, NC, forced convection, FC and forced convection/steam combined, FC/S) on selected physical properties of cooked pork Longissimus dorsi samples were compared. FC/S treatment was significantly faster (∼19 min) than NC and FC cooking treatments (∼27 min). The overall cook values at the center of all samples (calculated taking into consideration the cooling phase) were comparable and might explain the similar tenderness found among samples that underwent significantly different thermal histories. The weight loss of the FC/S samples was significantly higher than in the other cooking methods while the color of the surface was paler than the NC and FC ones.


Evaluation of waterborne exposure to oil spill 5 years after an accident in Southern Brazil.
Fish (Astyanax sp.) were exposed to water samples from the Arroio Saldanha, locality of an oil spill, and the Barigui River (upstream and downstream of the confluence of the river and Arroio Saldanha), Brazil. Histopathological and biochemical biomarkers, as acetylcholinesterase (AchE), ethoxyresorufin-O-deethylase (EROD), catalase (CAT), glutathione-S-transferase (GST) activities, lipid peroxidation (LPO) levels, and amounts of polynuclear aromatic hydrocarbon residues (PAHs) in bile were evaluated. PAHs, metals, and surfactants were investigated in the water samples. CAT and GST activities increased in the Arroio Saldanha sample, whereas CAT activity and LPO levels were increased in the upstream and downstream sites. The results suggested a toxic action of the free radicals and disturbance of the antioxidant defense mechanisms. However, the EROD and AchE activities were not affected. Histopathology studies showed severe lesions. The oil is still bioavailable to biota, moreover, other pollution sources continue to affect the water in the Barigui River.


Hepatitis: implications for dialysis personnel.
Hepatitis B and C are readily transmitted blood-borne viruses encountered in dialysis settings. The current recommendations for control of these hepatitis viruses are discussed in this article.


Complete determination of the stress tensor of a polarization-maintaining fiber by photoelastic tomography.
The use of photoelastic tomography to obtain the two-dimensional axial stress profile of a polarization-maintaining (PM) fiber with high resolution and accuracy is described. We illustrate, for what is believed to be the first time, the two-dimensional distribution of the local principal axes of the fiber's cross section, which is directly related to the fiber's PM ability. We demonstrate that the stress-induced anisotropy as well as all the stress tensor components of the fiber can be fully determined.


Hepatocellular carcinoma: findings on spiral CT during arterial portography.
To determine characteristic imaging features of hepatocellular carcinoma (HCC) on spiral CT during arterial portography (SCTAP) and to correlate the presence or absence of spontaneous portosystemic shunts with the degree of hepatic parenchymal enhancement during SCTAP in patients with HCC. SCTAP scans of 20 patients with HCC were retrospectively analyzed for tumor features, degree of hepatic parenchymal enhancement, and presence or absence of spontaneous portosystemic shunts. Nineteen tumors (95%) were hypoattenuating masses and one (5%) was isoattenuating compared with the liver on SCTAP. In seven patients (35%), the tumor was homogeneous in attenuation. Tumor margins were smooth and regular in 12 patients (60%). Vascular invasion and encapsulation were depicted in 10 patients (50%). A high degree of hepatic parenchymal enhancement was observed in 14 patients; one of them (7%) had spontaneous portosystemic shunts. Poor or moderate enhancement was observed in six patients; five of them (83%) had spontaneous portosystemic shunts (p < .001). The presence of a low attenuated homogeneous intrahepatic mass with associated vascular invasion on SCTAP scans should raise the possibility of HCC. The presence of spontaneous portosystemic shunts is associated with poor or moderate parenchymal enhancement.


Effects of Beta-d-glucan on diabetic colon anastomosis.
The purpose of this study was to evaluate the effects of beta-D-glucan on the experimental diabetic rat colon anastomosis model. Beta-D-glucan is a commonly used macrophage activator and promotes wound healing by increasing macrophage infiltration into the wound. The decrease in the function of macrophages and impaired wound healing can be observed in diabetes mellitus (DM). Eighty Spraque-Dawley rats were divided into 4 groups: colon anastomosis (group 1); colon anastomosis + DM (group 2); colon anastomosis + beta-D-glucan (group 3); and colon anastomosis + beta-D-glucan + DM (group 4). Diabetes was induced with streptozotocin (85 mg/kg), and glycemia was assessed before induction at days 14 and 17. Colon anastomosis was performed at day 14. Beta-D-glucan (100 mg/kg/day) was administered 2 days before colon anastomosis and given orally for 5 days. Relaparotomies were done 3 days after colon anastomosis, and anastomotic bursting pressures, anastomotic hydroxyproline levels, malondialdehyde (MDA) levels, and histopathology examinations were studied. There were no differences among groups for hydroxyproline levels. The mean values of anastomotic bursting pressures in group 4 were significantly higher than those of group 2. The mean values of MDA levels in group 2 were significantly lower than those of group 4. Group 2 showed a significant difference in the amount of necrosis, accumulation of polmorphonuclear cells, and edema when compared with groups 1, 3, and 4 (P < 0.001, P < 0.002, and P < 0.001, respectively). This study indicates that oral administration of beta-D-glucan significantly improves the impaired anastomotic healing in rats with diabetes mellitus.


Cloning and characterization of micro-RNAs from moss.
Micro-RNAs (miRNAs) are one class of endogenous tiny RNAs that play important regulatory roles in plant development and responses to external stimuli. To date, miRNAs have been cloned from higher plants such as Arabidopsis, rice and pumpkin, and there is limited information on their identity in lower plants including Bryophytes. Bryophytes are among the oldest groups of land plants among the earth's flora, and are important for our understanding of the transition to life on land. To identify miRNAs that might have played a role early in land plant evolution, we constructed a library of small RNAs from the juvenile gametophyte (protonema) of the moss Physcomitrella patens. Sequence analysis revealed five higher plant miRNA homologues, including three members of the miR319 family, previously shown to be involved in the regulation of leaf morphogenesis, and miR156, which has been suggested to regulate several members of the SQUAMOSA PROMOTER BINDING-LIKE (SPL) family in Arabidopsis. We have cloned PpSBP3, a moss SPL homologue that contains an miR156 complementary site, and demonstrated that its mRNA is cleaved within that site suggesting that it is an miR156 target in moss. Six additional candidate moss miRNAs were identified and shown to be expressed in the gametophyte, some of which were developmentally regulated or upregulated by auxin. Our observations suggest that miRNAs play important regulatory roles in mosses.


Biotinylation: a nonradioactive method for the identification of cell surface antigens in immunoprecipitates.
A nonradioactive method was employed to detect different cell membrane antigens on human polymorphonuclear granulocytes, monocytes and platelets. We compared the reactivity of one monoclonal antibody, N1III10, assumed to be Fc gamma RII-specific by functional assays, with other well-characterized monoclonal antibodies and human sera. Intact cells were incubated with biotin N-hydroxysulfosuccinimide ester which preferentially reacts with lysine residues in polypeptides. Biotin-labeled cells were lysed and the antigen was isolated from the cell lysate by immunoprecipitation with the antibody bound to Protein A-Sepharose. The precipitates were separated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, transferred onto nitrocellulose membrane, and visualized by a streptavidin-alkaline phosphatase system with a suitable substrate. Using this biotin-labeling system we could show that N1III10 detects a 40 kDa antigen on monocytes and platelets, comparable to that expected of Fc gamma RII monoclonal antibodies.


Modeling the relationships between quality and biochemical composition of fatty liver in mule ducks.
The fatty liver of mule ducks (i.e., French "foie gras") is the most valuable product in duck production systems. Its quality is measured by the technological yield, which is the opposite of the fat loss during cooking. The purpose of this study was to determine whether biochemical measures of fatty liver could be used to accurately predict the technological yield (TY). Ninety-one male mule ducks were bred, overfed, and slaughtered under commercial conditions. Fatty liver weight (FLW) and biochemical variables, such as DM, lipid (LIP), and protein content (PROT), were collected. To evaluate evidence for nonlinear fat loss during cooking, we compared regression models describing linear and nonlinear relations between biochemical measures and TY. We detected significantly greater (P = 0.02) linear relation between DM and TY. Our results indicate that LIP and PROT follow a different pattern (linear) than DM and showed that LIP and PROT are nonexclusive contributing factors to TY. Other components, such as carbohydrates, other than those measured in this study, could contribute to DM. Stepwise regression for TY was performed. The traditional model with FLW was tested. The results showed that the weight of the liver is of limited value in the determination of fat loss during cooking (R(2) = 0.14). The most accurate TY prediction equation included DM (in linear and quadratic terms), FLW, and PROT (R(2) = 0.43). Biochemical measures in the fatty liver were more accurate predictors of TY than FLW. The model is useful in commercial conditions because DM, PROT, and FLW are noninvasive measures.


[The health care system in France and Germany].
The two countries have adopted the Bismarckian scheme for the organization and financing of their health care. In particular, the medical doctors are paid on a fee-for-service basis, by the sickness funds of which financial resources come from compulsory contributions of employers and employees. Nowadays, France and Germany are different as concerns a large number of features but they are facing similar challenges: * the health expenditures are steadily rising and threatening the equilibrium of all the national economy * since 1980, if not earlier, the two countries have experienced physician surplus: in France, a system of numerus clausus was imposed upon student intake since the early 70's; in Germany, in 1992, a system of geographical numerus clausus was imposed upon setting up new medical practices * as a result, but for different reasons, each country is now slowly entering an era of physician shortage * during the last two decades, each country has tried to implement various reforms but, so far, the results are not convincing.


The distribution and influence of calcitonin gene-related peptide (CGRP) on the perfusion pressure in the isolated ovarian artery in the pig.
A moderate number of delicate CGRP-immunoreactive (CGRP-IR) varicose nerve terminals were found at the adventitia-media border of the sexually mature porcine ovarian artery by means of a routine single immunolabelling technique. Additionally, a pharmacological analysis was performed of the function fulfilled by alpha-CGRP and its C-terminal fragment (Tyr27) alpha-CGRP(27-37) in the porcine isolated ovarian artery, collected on days 8-13 of the oestrous cycle. It was shown that alpha-CGRP (10(-8) M) caused a decrease in the perfusion pressure of the porcine isolated ovarian artery of 16% (p < 0.05), while (Tyr27) alpha-CGRP(27-37), added at the same concentration, reduced perfusion pressure by 13% (p > 0.05). Thus, we concluded that alpha-CGRP released from perivascular terminals may cause relaxation of the ovarian artery and, furthermore, that the potency of this action is dependent on the length of the chain of this peptide produced during the deactivation of the molecule by tissue proteases.


[Surgical relief of airway obstruction from a double aortic arch associated with corrected transposition of the great arteries, pulmonary atresia and bilateral patent ductus arteriosus in a neonate].
A rare 20-day-old male with double aortic arch, corrected transposition of the great arteries (cTGA), pulmonary atresia and bilateral patent ductus arteriosus (PDA) was transported to our institute because of severe respiratory dysfunction and cyanosis. The patient had been already intubated and ventilated on respirator. A echocardiography and cine-angiography demonstrated that the both sides aortic arch had almost identical sizes, originating common carotid arteries and subclavian arteries and PDAs respectively, and the descending aorta located on the left side of the mid-line. At the first surgery, the distal of the right aortic arch was divided just proximal to the descending aorta after complete tissue dissection around the arch. The divided right sided aortic arch was mobilized from posterior to anterior aspect of the bronchus. Then the right subclavian artery was divided and an original Blalock-Taussig shunt was employed. The right sided PDA was ligated. After the first surgery, respiratory dysfunction lasted for weeks mainly because of the PGE1 dependent left sided PDA. At the second surgery, left sided modified Blalock-Taussig shunt was constructed and the left sided PDA was divided. These procedures resulted in stable respiratory status and oxygen saturation. The patient was extubated three days later and now in satisfactory clinical condition.


Validation of PDQ-8 as an independent instrument in English and Chinese.
Previous validation studies on the PDQ-8, a brief disease-specific quality of life instrument, were performed with the PDQ-8 nested in the original PDQ-39. Such an approach may influence patient responses and the psychometric properties of the PDQ-8. We therefore undertook this study to validate the PDQ-8 when administered independently in English and Chinese and found good item-to-scale correlations (correlation coefficient: 0.44-0.68) and internal consistency (Cronbach's alpha: 0.81, 0.87). Factor analyses yielded a component on which all 8 questions were substantially loaded (loading range: 0.55-0.77). Scree plots also showed the one-factor solution thereby validating the PDQ-8 summary index. Construct validation against the Hoehn and Yahr stage and UPDRS motor scores showed significant correlations between higher PDQ-8 summary index and increased disease severity in both English and Chinese versions. Our results show the PDQ-8 to be a valid and reliable disease-specific HRQoL instrument for PD when used independently of the PDQ-39.


[Adjuvant interferon alpha in renal carcinoma with a high risk of recurrence. Multicenter pilot study].
Twenty-eight consecutive patients submitted to radical nephrectomy for Robson's stage II-III renal cell carcinoma underwent adjuvant recombinant a-2b interferon, 5 MUI s.c. 3 times a week, for 6 consecutive months. Home-feasibility of this therapy resulted easy. The most frequent acute (flu-like syndrome) and late (myalgia, fatigue, anorexia) side effects did not affect normal daily life of patients. Eight (28.5%) patients had WHO grade < or = 2 biochemical and hematological toxicity, that normalized after a reduction or a temporarily suspension of therapy. Twenty-seven patients were evaluable for response. Out of these, 7 (26%) relapsed after a 16 months median follow-up.


Oral labetalol compared to oral nifedipine for postpartum hypertension: A randomized controlled trial.
To determine whether oral labetalol is associated with a shorter time to blood pressure control compared to oral extended release nifedipine for management of persistent postpartum hypertension. This randomized controlled trial conducted between June 2014 and June 2015 included women who delivered at ≥32 weeks' gestation with persistent postpartum hypertension (sustained blood pressure ≥150/100 mmHg) requiring an oral antihypertensive agent. We included women with gestational hypertension, preeclampsia, or chronic hypertension not previously on medication. Women were randomized to labetalol or nifedipine, and the allocated study drug was incrementally increased to achieve blood pressure control. The primary outcome was time to sustained blood pressure control defined as the absence of severe hypertension for at least 12 hours. Secondary outcomes included postpartum length of stay, need for increased dosing, need for additional oral antihypertensive agents, and patient reported side effects. Twenty women were needed in each group as determined by the sample size calculation. We randomized 25 women to oral labetalol and 25 women to oral extended release nifedipine. The time to achieve BP control was similar between labetalol and nifedipine groups (37.6 hours versus 38.2 hours, p = 0.51). Secondary outcomes including postpartum length of stay, need for increased dosing, and need for additional oral antihypertensive agents were similar between groups. For women discharged on a single agent, significantly more subjects in the labetalol group (16/21) compared to the nifedipine group (10/22) achieved BP control with the initial starting dose (76% versus 46%, p = 0.04). No major side effects were observed. Minor side effects were significantly more common in women taking nifedipine compared to labetalol (48% versus 20%, p = 0.04). Both labetalol and nifedipine were effective for control of persistent postpartum hypertension. However, labetalol achieved control significantly more often with the starting dose and had fewer side effects. Oral nifedipine versus oral labetalol, NCT02168309. https://clinicaltrials.gov/ct2/show/NCT02168309?term=labetalol+versus+nifedipine&rank=2.


A look at food industry responses to the rising prevalence of overweight.
The role of the food industry in the response to the epidemic of obesity is guided by many factors, including the current state of knowledge of the problem. There have been efforts among food and beverage companies to help increase our knowledge about the factors contributing to overweight and to investigate product and marketing changes that may help reduce the risk of weight gain. The value of their future contributions is dependent on corporate resolve, but also on interactive guidance from government and health institutions on the best strategies to take and the best research to support. This is especially clear given the complex nature of the causes of obesity and approaches for treatment.


Genomic and comparative genomic analyses of Rickettsia heilongjiangensis provide insight into its evolution and pathogenesis.
Rickettsia heilongjiangensis, the causative agent of far eastern spotted fever, is an obligate intracellular gram-negative bacterium that belongs to the spotted fever group rickettsiae. To understand the evolution and pathogenesis of R. heilongjiangensis, we analyzed its genome and compared it with other rickettsial genomes available in GenBank. The R. heilongjiangensis chromosome contains 1333 genes, including 1297 protein coding genes and 36 RNA coding genes. The genome also contains 121 pseudogenes, 54 insertion sequences, and 39 tandem repeats. Sixteen genes encoding the major components of the type IV secretion systems were identified in the R. heilongjiangensis genome. In total, 37 β-barrel outer membrane proteins were predicted in the genome, eight of which have been previously confirmed to be outer membrane proteins. In addition, 266 potential virulence factor genes, seven partially deleted antibiotic resistance genes, and a genomic island were identified in the genome. The codon usage in the genome is compatible with its low GC content, and the amino acid usage shows apparent bias. A comparative genomic analysis showed that R. heilongjiangensis and R. japonica share one unique fragment that may be a target sequence for a diagnostic assay. The orthologs of 37 genes of R. heilongjiangensis were found in pathogenic R. rickettsii str. Sheila Smith but not in non-pathogenic R. rickettsii str. Iowa, which may explain why R. heilongjiangensis is pathogenic. Pan-genome analysis showed that R. heilongjiangensis and 42 other rickettsiae strains share 693 core genes with a pan-genome size of 4837 genes. The pan-genome-based phylogeny showed that R. heilongjiangensis was closely related to R. japonica.


Northward range expansion requires synchronization of both overwintering behaviour and physiology with photoperiod in the invasive Colorado potato beetle (Leptinotarsa decemlineata).
Photoperiodic phenological adaptations are prevalent in many organisms living in seasonal environments. As both photoperiod and growth season length change with latitude, species undergoing latitudinal range expansion often need to synchronize their life cycle with a changing photoperiod and growth season length. Since adaptive synchronization often involves a large number of time-consuming genetic changes, behavioural plasticity might be a faster way to adjust to novel conditions. We compared behavioural and physiological traits in overwintering (diapause) preparation in three latitudinally different European Colorado potato beetle (Leptinotarsa decemlineata) populations reared under two photoperiods. Our aim was to study whether behavioural plasticity could play a role in rapid range expansion into seasonal environments. Our results show that while burrowing into the soil occurred in the southernmost studied population also under a non-diapause-inducing long photoperiod, the storage lipid content of these beetles was very low compared to the northern populations. However, similar behavioural plasticity was not found in the northern populations. Furthermore, the strongest suppression of energy metabolism was seen in pre-diapause beetles from the northernmost population. These results could indicate accelerated diapause preparation and possibly energetic adjustments due to temporal constraints imposed by a shorter, northern, growth season. Our results indicate that behavioural plasticity in burrowing may have facilitated initial range expansion of L. decemlineata in Europe. However, long-term persistence at high latitudes has required synchronization of burrowing behaviour with physiological traits. The results underline that eco-physiological life-history traits of insects, such as diapause, should be included in studies on range expansion.


Spectral heterogeneity of PRODAN fluorescence in isotropic solvents revealed by multivariate photokinetic analysis.
This paper describes a multivariate analysis of the fluorescence emission of 6-propionyl-2-dimethylaminonaphthalene (PRODAN) in a series of isotropic solvents of differing polarity and hydrogen-bonding ability. Multivariate methods distill the essential features from spectral data matrices so that the structural details that are embedded within the data are revealed to the analyst. In the aprotic solvents investigated, the analysis reveals a pair of emission components that have emission maxima that scale with the orientational polarizability. In the alcohols, short-lived, polarity-independent blue bands tentatively attributed to neutral hydrogen-bonded solute-solvent complexes form and relax prior to emission from paired bands that have Stokes shifts that scale with the solvent hydrogen-bonding ability rather than the polarity. In water, the short-lived blue bands were not observed, but the shift in the paired bands did scale with the solvent hydrogen-bonding ability.


Effects of time, temperature and blood cell counts on levels of lactate in heparinized whole blood gas samples.
To investigate whether lactate levels may vary in relation to time, substrate concentration and blood cells counts. In this study 110 samples from the daily clinical routine blood samples were collected. Determinations of lactate were made at different times where the samples had not been left for more than 120 min at room temperature (24 degrees C) or in the fridge (4 degrees C). The influence of glucose and blood cells on lactate production was also estimated. The rate in change of concentration (slope) and the increase expected at the beginning (intercept) were estimated through linear regression using a longitudinal marginal method. The time-related change in lactate was significantly higher at room temperature (0.012 mmol L(-1) min(-1)) than at 4 degrees C (0.0035 mmol L(-1) min(-1)) (p<0.0001). There was a significantly positive relationship between blood cells (mainly leucocytes) and the rate of reaction at room temperature. A delay in the processing of a whole blood sample of more than 15 min at room temperature or an hour in the fridge entails an important overestimation of the initial lactate levels. Pronounced leucocytosis (higher than 6 x 10(10)/L) meaningfully cut down the stability period (10 min).


Why and how should we assess occupational health impacts in integrated product policy?
Integrated product policy (IPP) and life cycle assessment (LCA), one of the analytic tools used in IPP, focus traditionally on environmental impacts. However, in an attempt to consider other sustainability criteria and to avoid a shift from environmental health impacts to occupational health impacts one may want to include occupational health in IPP. Should and can occupational health impacts be included in LCA and IPP? Using published and unpublished occupational health data for injuries and illnesses and an economic input-output model of the United States, we provide attributional occupational health impacts measured in disability adjusted life years per dollars output for 491 industry sectors including supply chain impacts. Estimates for the "true" number of United States occupational health impacts suggest that this initial analysis underestimates the total impact 3-7-fold. A comparison suggests that United States occupational health impacts are about 10 times smaller than environmental health impacts and are, relatively speaking, important only for sectors with hazardous working environments but low environmental impacts. A consequential rather than attributional view suggests that a method to assess true consequences on long-term health impacts by product policies needs to be able to predict effects from present-day work place exposure and to account for likely changes in the labor market, including changes in unemployment rates and other substitution mechanisms.


[Effect of lysozyme suppression of factor XII activation on postadrenaline hypercoagulation].
Adrenaline administration (0.5 mg/kg) in rabbits shortened the blood clotting time for about 30 min, whereas under the lysozyme effect no shortening occurred. I. v. lysozyme administration (0.05 mg/kg) induced clear though transitory decrease of total and latent BAEE-esterase activity of the blood plasma. The data obtained emphasize the role of factor XII activation by adrenaline for physiological regulation of blood coagulability.


Arsenic accumulation in Brassicaceae seedlings and its effects on growth and plant anatomy.
We wished to evaluate the effects of arsenic on the morphology and anatomy of Brassica oleracea, Raphanus sativus, Brassica juncea, Brassica oleracea var. capitata and Brassica oleracea var. italica. Seeds were subjected to concentrations 0µM, 250µM, 350µM and 450µM arsenic in the form of sodium arsenate (Na2HAsO4·7H2O) during 12 days. All species accumulated more arsenic in the roots than in the shoots, except for B. oleracea var. capitata. There was no difference of translocation factor between species and treatments. Growth decrease was observed in roots of B. oleracea and R. sativus, and in shoots of R. sativus and B. oleracea var. italica. All species presented anatomical alterations in the roots, such as: cell hypertrophy, protoplast retraction, cellular plasmolysis, and necrotic regions. B. juncea presented collapse and hypertrophy of cells from the leaf blade tissues. Quantitative anatomical analyses performed on the root and leaves of B. oleracea and B. juncea revealed that arsenic interfered on the root vascular cylinder diameter and on height of epidermal cells of the adaxial leaf surface of both species. We concluded that arsenic was absorbed from the culture medium and induced alterations both on root and shoot growth of the seedlings. Retention of arsenic within the root was responsible for major damage in this organ.


Pregnancy zone protein, a proteinase-binding macroglobulin. Interactions with proteinases and methylamine.
Human pregnancy zone protein (PZP) is a major pregnancy-associated plasma protein, strongly related to alpha 2-macroglobulin (alpha 2M). Its properties and its reactions with a number of enzymes, particularly chymotrypsin, and with methylamine have been investigated. It is concluded that native PZP molecules are dimers of disulfide-bridged 180-kDa subunits and that proteinase binding results in covalent 1:1 (tetrameric)PZP-enzyme complexes. Native PZP is unstable, and storage should be avoided, but when kept unfrozen at 0 degree C most PZP preparations stay native 1-3 months. The reaction of PZP with chymotrypsin involves (i) proteolysis of bait regions, (ii) cleavage of beta-cysteinyl-gamma-glutamyl thiol ester groups, (iii) some change of the conformation and quaternary structure of PZP, and (iv) the formation of covalent 1:1 chymotrypsin-PZP(tetramer) complexes in which chymotrypsin is active but shows less activity than free chymotrypsin. The emission spectra of intrinsic fluorescence show significant differences between the PZP-chymotrypsin complex and its native components, whereas no differences are observed between methylamine-reacted PZP and native PZP. Methylamine reacts with the beta-cysteinyl-gamma-glutamyl thiol ester groups of PZP in a second-order process with k = (13.6 +/- 0.5) M-1 s-1, pH 7.6, 25 degrees C. The reaction product is PZP(dimers); no PZP(tetramers) are formed. The proteinase-binding specificity of PZP is far more restricted than that of alpha 2M. Certain chymotrypsin-like and trypsin-like enzymes are bound much less efficiently than is chymotrypsin itself.(ABSTRACT TRUNCATED AT 250 WORDS)


Routine platelet transfusion in patients undergoing emergency coronary bypass surgery after receiving abciximab.
Abciximab has been shown to reduce the ischemic complications of high-risk angioplasty procedures. The appropriate management of patients who have received abciximab and require emergency coronary artery bypass surgery after failed coronary angioplasty is as yet undetermined. We present the outcomes of a small series of such patients who were given platelet transfusions before or during cardiopulmonary bypass.


Sensitivity to photoperiod in Aelia acuminata (L.) after adult diapause.
The sensitivity to photoperiod of Aelia acuminata after diapause was proved. In order to reproduce females need a continuous stimulation by a diapause averting photoperiod. If kept under a diapause promoting photoperiod they stop ovipositing after about 3 weeks.


Primary biliary and pancreatic carcinoma after renal transplantation.
Renal transplant recipients have an increased risk of malignancies. We have described a 41-year-old man in whom adenocarcinoma of the gallbladder developed during the first year after renal transplantation. He also had a nonfunctioning pancreatic islet cell tumor during the fifth year after transplantation. He was the first known renal transplant recipient to be a long-term survivor of adenocarcinoma of the gallbladder.


Quality improvement of functional diagnostics in dentistry through computer-aided diagnosis: a randomized controlled trial.
Functional diagnostic examinations such as clinical functional analysis and manual structural analysis ('orthopedic tests') allow the dentist to establish a structured diagnosis. Previously, the process of correlating findings with the appropriate diagnoses was guided by human thought processes alone. The experimental diagnostic randomized controlled trial (RCT) in this study investigated whether computer-aided diagnosis (CADx) of temporomandibular disorders (TMD) offers quality advantages over traditional diagnosis (TRAD). Thirty-nine 5th-year dental students (examiners) at a university in Hamburg, Germany, received joint training in the diagnosis of TMD by clinical functional analysis and manual structural analysis ('orthopedic tests'). This study is based on anonymized data from 10 patients who were consecutively recruited at a specialized TMJ treatment center. The examiners were randomly allocated to two groups. Each examiner established a structured diagnosis through a traditional diagnostic method and by computer-aided diagnosis (CMDfact 4 functional diagnostics software) of five cases, each using the AB/BA crossover design. The diagnoses established by each individual examiner were then compared with the corresponding reference diagnoses (gold standard) and with those of the other examiners. Cohen's kappa coefficient analysis showed that median agreement with the reference diagnoses was significantly higher (P < 0.001) with computer assistance (median 0.692) than without it (0.553). Fleiss' kappa showed that the median interexaminer consistency of diagnoses was significantly higher (P < 0.001) with computer assistance (0.497) than with traditional diagnostic methods alone (0.271). Likewise, the number of false-positive and false-negative diagnoses was significantly lower with computer assistance (P < 0.001). This study determined that dentists who are less experienced and not specialized in dental functional diagnostics achieve a significantly better and more consistent diagnostic quality with computer assistance by means of the system used in this study. Therefore, it seems advisable to extend computer-aided diagnostics to further functional examination techniques (condylar position analysis and jaw motion analysis).


Importance of energy level matching for bonding in Th(3+)-Am(3+) actinide metallocene amidinates, (C(5)Me(5))(2)[(i)PrNC(Me)N(i)Pr]An.
The synthesis of a rare trivalent Th(3+) complex, (C(5)Me(5))(2)[(i)PrNC(Me)N(i)Pr]Th, initiated a density functional theory analysis on the electronic and molecular structures of trivalent actinide complexes of this type for An = Th, Pa, U, Np, Pu, and Am. While the 6d orbital is found to accommodate the unpaired spin in the Th(3+) species, the next member of the series, Pa, is characterized by an f(2) ground state, and later actinides successively fill the 5f shell. In this report, we principally examine the evolution of the bonding as one advances along the actinide row. We find that the early actinides (Pa-Np) are characterized by localized f orbitals and essentially ionic bonding, whereas the f orbitals in the later members of the series (Pu, Am) exhibit significant interaction and spin delocalization into the carbon- and nitrogen-based ligand orbitals. This is perhaps counter-intuitive since the f orbital radius and hence metal-ligand overlap decreases with increasing Z, but this trend is counter-acted by the fact that the actinide contraction also leads to a stabilization of the f orbital manifold that leads to a near degeneracy between the An 5f and cyclopentadienyl π-orbitals for Pu and Am, causing a significant orbital interaction.


Development of a real-time PCR for Escherichia coli based on gadE, an acid response regulatory gene.
Increasingly, molecular methods have become important in identification and confirmation of bacteria at the species level. Rapid molecular methods provide sensitivity and specificity while reducing cost and resources. The primary goal of this study was to develop a real-time PCR assay for identification of Escherichia coli from an agar plate. GadE (gadE) directly regulates the glutamate-dependent acid response system (GDAR) in E. coli and is responsible for survival of at pH 2. Based on gene sequence data, a real-time PCR assay targeting gadE was developed for this purpose. Seventy bacterial isolates recovered from ground beef enrichments and 714 isolates from caecal contents were identified biochemically and tested with the real-time PCR assay developed in this study. The PCR assay and the biochemical identification had 100% agreement on the tested isolates. The gadE real-time PCR assay was demonstrated in this study to be an inexpensive, reliable method for confirming E. coli colonies within 1.5 h from an agar plate, thereby saving on final identification time.


[Obesity, diabetes mellitus, and gas gangrene: a major therapeutic challenge].
Soft tissue infections are uncommon but prognosis is severe (20 to 50%). Management consists in surgical debridement, antibiotic therapy against anaerobic and aerobic bacteria, and appropriate intensive care. When available, hyperbaric oxygen therapy is an integral part of the treatment. We report the case of 56-year-old female patient with diabetes (150 kg) was hospitalized in our unit a few days after surgical treatment of a buttocks abscess for clinical signs of peripheral gas gangrene. Surgical exploration showed necrotizing soft tissue infection with fasciitis. Adequate therapy using antibiotics, surgery daily and hyperbaric oxygen was given. Therapy had to be adapted to the patient's obesity. Outcome was good with recovery and few sequelae, allowing transfer to a medical ward.


Final analysis of the pilot trial of diaphragm pacing in amyotrophic lateral sclerosis with long-term follow-up: diaphragm pacing positively affects diaphragm respiration.
Respiratory insufficiency is the major cause of mortality in patients with amyotrophic lateral sclerosis or Lou Gehrig's disease. This is the final report of the diaphragm pacing (DP) pilot trial. Patients underwent laparoscopic diaphragm electrode implantations and subsequent conditioning of diaphragms. Serial respiratory function tests were performed in the initial year and followed until death. Sixteen patients were implanted with no perioperative or unanticipated device-related adverse events. There were 452 implant-months of follow-up. DP allowed greater movement of the diaphragm under fluoroscopy, increased muscle thickness, and decreased the decline in forced vital capacity. Median survival from implant was 19.7 months with the cause of death respiratory in only 31%. Long-term analysis of DP in amyotrophic lateral sclerosis showed no safety issues and can positively influence diaphragm physiology and survival. This formed the initial basis for subsequent US Food and Drug Administration approval.


Polymorphism of complement component I in Mongoloid populations: a new genetic variant IF A2.
The genetic polymorphism of the complement component I (IF) was investigated in 282 Chinese, 239 Koreans and 198 Japanese. The 3 common IF phenotypes (A, AB and B) and a new rare IF phenotype (BA2) were observed. The obtained allele frequencies are as follows: IF*A = 0.0993 and IF*B = 0.9007 in Chinese; IF*A = 0.0921 and IF*B = 0.9079 in Koreans; IF*A = 0.0985, IF*B = 0.8990 and IF*A2 = 0.0025 in Japanese. These 3 Mongoloid populations showed a much higher degree of IF polymorphism than Caucasian populations.


Neonatal antigen-presenting cells are functionally more quiescent in children born under traditional compared with modern environmental conditions.
One explanation for the high burden of allergic and autoimmune diseases in industrialized countries is inappropriate immune development under modern environmental conditions. There is increasing evidence that the process of immune deviation already begins in utero, but the underlying immunologic mechanisms are not clear. We sought to identify differences in the function of neonatal antigen-presenting cells (APCs) in children born in settings that are more traditional versus those of modern societies. Cord blood mononuclear cells were collected from newborns from Papua New Guinea (PNG; traditional) and Australia (modern) and compared for differences in APCs and T-cell phenotype and function. Australian cord naive T cells (CD4(+)CD25(-)CD127(+) cells) showed an enhanced and more rapid proliferative response in an autologous, APC-dependent culture system, a result of differences in neonatal APCs rather than T-cell function. This included an increased capacity to process antigen and to upregulate activation markers after stimulation. In contrast, resting PNG APCs exhibited higher baseline levels of activation and inhibitory markers and were less responsive or nonresponsive to stimulation in vitro. This study supports the hypothesis that prenatal environments can influence the developing immune system in utero. Children born under modern environmental conditions exhibit increased APC reactivity at birth compared with children born under traditional environmental conditions. The functionally more quiescent nature of PNG neonatal APCs might protect against the development of harmful inflammatory responses in early life.


Six-year results of a cementless stem with prophylaxis against heterotopic bone.
The hypothesis of a possibly diminished bony ingrowth revealed by the development of radiolucency or a radiodense line with time around a cementless femoral stem subsequent to indomethacin administration for prevention of heterotopic ossification was investigated. Eighty prospective patients with indomethacin prophylaxis were compared with 82 patients without indomethacin prophylaxis chosen retrospectively. The same cementless implant was used in all cases, and patients were observed clinically and radiologically for a minimum of 6 years. The mean postoperative Harris hip score at 6 years was 91 versus 88 points, respectively, and there were significantly more excellent results (Harris hip score > 90) in the indomethacin group. None of the patients underwent revision surgery. Radiologic signs such as loss of bone density and radiodense lines were observed around the shoulder of the prosthesis in a similar percentage in both groups. Significant subsidence of the stem was observed in one instance in the indomethacin group and in three instances in the control group. The results of this study are a strong indication that indomethacin does not influence the development of radiolucency or other radiologic changes around a cementless stem after 6 years.


Performance enhancement of organic photovoltaic devices enabled by Au nanoarrows inducing surface plasmonic resonance effect.
The surface plasmon resonance (SPR) effect of metal nanoparticles is widely employed in organic solar cells to enhance device performance. However, the light-harvesting improvement is highly dependent on the shape of the metal nanoparticles. In this study, the significantly enhanced performance upon incorporation of Au nanoarrows in solution-processed organic photovoltaic devices is demonstrated. Incorporating Au nanoarrows into the ZnO cathode buffer layer results in superior broadband optical absorption improvement and a power conversion efficiency of 7.82% is realized with a 27.3% enhancement compared with the control device. The experimental and theoretical results indicate that the introduction of Au nanoarrows not only increases optical trapping by the SPR effect but also facilitates exciton generation, dissociation, and charge transport inside the thin film device.


[High intracellular Mg²⁺ affects the activities of L-type calcium channel in guinea- pig ventricular myocytes].
This study is aimed to investigate the effects of high intracellular Mg²⁺ on L-type calcium channel in guinea-pig ventricular myocytes. The cardiomyocytes were acutely isolated with enzyme digestion method. By adopting inside-out configuration of patch clamp technique, single channel currents of the L-type calcium channel were recorded under different intracellular Mg²⁺ concentrations ([Mg²⁺]i). In control group, which was treated with 0.9 mmol/L Mg²⁺, the relative activity of calcium channel was (176.5 ± 34.1)% (n = 7). When [Mg²⁺]i was increased from 0.9 to 8.1 mmol/L (high Mg²⁺ group), the relative activities of calcium channel decreased to (64.8 ± 18.1)% (n = 6, P < 0.05). Moreover, under 8.1 mmol/L Mg²⁺, the mean open time of calcium channel was shortened to about 25% of that under control condition (P < 0.05), but the mean close time of calcium channel was not altered. These results suggest that high intracellular Mg²⁺ may inhibit the activities of L-type calcium channel, which is mainly due to the shortening of the mean open time of single L-type calcium channel.


Financial Fraud among Older Americans:Evidence and Implications.
The consequences of poor financial capability at older ages are serious and include making mistakes with credit, spending retirement assets too quickly, and being defrauded by financial predators. Because older persons are at or past the peak of their wealth accumulation, they are often the targets of fraud. Our project analyzes a module we developed and fielded on persons age 50+ in the 2016 Health and Retirement Study (HRS). Using this dataset, we evaluated the incidence and prospective risk factors (measured in 2010) for investment fraud and prize/lottery fraud using logistic regression (N=1,220). Relatively few HRS respondents mentioned any single form of fraud over the prior five years, but 5.0% reported at least one form of investment fraud and 4.4% recounted prize/lottery fraud. Greater wealth (non-housing) was associated with investment fraud, whereas lower housing wealth and symptoms of depression were associated with prize/lottery fraud. Hispanics were significantly less likely to report either type of fraud. Other suspected risk factors-low social integration and financial literacy-were not significant. Fraud is a complex phenomenon and no single factor uniquely predicts victimization across different types, even within the category of investment fraud. Prevention programs should educate consumers about various types of fraud and increase awareness among financial services professionals.


Processing typical objects in scenes: effects of photographs versus line-drawings.
The main purpose of this paper is the description of our research into the influence of stimuli (photographs or line-drawing pictures) in perception of scenes. Many researchers have been using the concept of "typically" in an attempt to explain the influence of knowledge structures on processing visual stimuli. We have also tried to examine the influence of typicality on processing objects in environmental scenes. An experiment was carried out using photographs and their equivalent line-drawings. Subjects had to identify objects and associate them with environmental scenes. Our results show that the typicality factor was significant but not the kind of stimuli used (photographs versus line-drawings). We also discussed the use of photographs and line-drawing pictures as stimuli in the identifying process of visual perception.


Quality assessment of systematic reviews on vertical bone regeneration.
The aim of this study was to evaluate and compare the quality of systematic reviews of vertical bone regeneration techniques, using two quality-assessment tools (AMSTAR and ROBIS). An electronic literature search was conducted to identify systematic reviews or meta-analyses that would evaluate at least one of the following outcomes: implant survival, success rates, complications or bone gain after vertical ridge augmentation. Methodological quality assessment was performed by two independent evaluators. Results were compared between reviewers, and reliability measures were calculated using the Holsti's method® and Cohen's kappa. Seventeen systematic reviews were included, of which seven presented meta-analysis. Mean ±95% confidence interval AMSTAR score was 6.35 [4.74;7.97], with higher scores being correlated with a smaller risk of bias (Pearson's correlation coefficient=-0.84; P<0.01). Cohen's inter-examiner kappa showed substantial agreement for both checklists. From the available evidence, we ascertained that, regardless of the technique used, it is possible to obtain vertical bone gains. Implant success in regenerated areas was similar to implants placed in pristine bone with results equating between 61.5% and 100% with guided bone regeneration being considered the most predictable technique regarding bone stability, while distraction osteogenesis achieved the biggest bone gains with the highest risk of possible complications.


Mechanistic Origin of the Combined Effect of Surfaces and Mechanical Agitation on Amyloid Formation.
Interactions between proteins and surfaces in combination with hydrodynamic flow and mechanical agitation can often trigger the conversion of soluble peptides and proteins into aggregates, including amyloid fibrils. Despite the extensive literature on the empirical effects of surfaces and mechanical forces on the formation of amyloids, the molecular details of the mechanisms underlying this behavior are still elusive. This limitation is, in part, due to the complex reaction network underlying the formation of amyloids, where several microscopic reactions of nucleation and growth can occur both at the interfaces and in bulk. In this work, we design a high-throughput assay based on nanoparticles and we apply a chemical kinetic platform to analyze the mechanisms underlying the effect of surfaces and mechanical forces on the formation of amyloid fibrils from human insulin under physiological conditions. By considering a variety of polymeric nanoparticles with different surface properties we explore a broad range of repulsive and attractive interactions between insulin and surfaces. Our analysis shows that hydrophobic interfaces induce the formation of amyloid fibrils by specifically promoting the primary heterogeneous nucleation rate. In contrast, mechanical forces accelerate the formation of amyloid fibrils by favoring mass transport and further amplify the number of fibrils by promoting fragmentation events. Thus, surfaces and agitation have a combined effect on the kinetics of protein aggregation observed at the macroscopic level but, individually, they each affect distinct microscopic reaction steps: the presence of interfaces generates primary nucleation events of fibril formation, which is then amplified by mechanical forces. These results suggest that the inhibition of surface-induced heterogeneous nucleation should be considered a primary target to suppress aggregation and explain why in many systems the simultaneous presence of surfaces and hydrodynamic flow enhances protein aggregation.


Crystal structure analysis of a bacterial aryl acylamidase belonging to the amidase signature enzyme family.
The atomic structure of a bacterial aryl acylamidase (EC 3.5.1.13; AAA) is reported and structural features are investigated to better understand the catalytic profile of this enzyme. Structures of AAA were determined in its native form and in complex with the analgesic acetanilide, p-acetaminophenol, at 1.70 Å and 1.73 Å resolutions, respectively. The overall structural fold of AAA was identified as an α/β fold class, exhibiting an open twisted β-sheet core surrounded by α-helices. The asymmetric unit contains one AAA molecule and the monomeric form is functionally active. The core structure enclosing the signature sequence region, including the canonical Ser-cisSer-Lys catalytic triad, is conserved in all members of the Amidase Signature enzyme family. The structure of AAA in a complex with its ligand reveals a unique organization in the substrate-binding pocket. The binding pocket consists of two loops (loop1 and loop2) in the amidase signature sequence and one helix (α10) in the non-amidase signature sequence. We identified two residues (Tyr(136) and Thr(330)) that interact with the ligand via water molecules, and a hydrogen-bonding network that explains the catalytic affinity over various aryl acyl compounds. The optimum activity of AAA at pH > 10 suggests that the reaction mechanism employs Lys(84) as the catalytic base to polarize the Ser(187) nucleophile in the catalytic triad.


The preoperative placement of transjugular intrahepatic portosystemic shunt for treatment of a patient with portal hypertension and gastric cancer.
The case report describes the placement of a TIPSS preceding surgery of the upper gastrointestinal tract in a patient with liver cirrhosis and gastric carcinoma. Following two unsuccessful exploratory laparotomies, the decreased portal hypertension facilitated a curative resection of the tumor.


A multicenter cross sectional study on bone mineral density in rheumatoid arthritis. Italian Study Group on Bone Mass in Rheumatoid Arthritis.
To determine the frequency of osteoporosis in a large cohort of women with rheumatoid arthritis (RA) and to investigate the main determinants of bone mineral density (BMD) and risk factors for vertebral fractures in this population. We recruited 925 consecutive female patients with RA at 21 Rheumatology Centers in Italy. For each patient pre-registered demographic, disease, and treatment-related variables were collected. BMD was measured at lumbar spine and proximal femur by dual x-ray absorptiometry technique. Collected variables underwent a univariate and multivariate statistical procedure. Osteoporosis was defined as BMD > -2.5 T score. The frequency of osteoporosis in the whole sample was 28.8% at lumbar spine and 36.2% at femoral neck and increased linearly from Steinbrocker's functional stage I to IV (p = 0.0001). Patients with spinal or femoral osteoporosis were significantly older (p = 0.0001), had a lower body mass index (BMI) (p < 0.02), a significantly longer disease duration (p < 0.02) and a significantly higher Health Assessment Questionnaire (HAQ) score (p = 0.0001). These differences were significant, even after adjusting for age. Steroid use was associated with significantly lower lumbar and femoral BMD (p = 0.0001) even after adjusting for the main confounding covariates. Analysis of lateral spine radiographs revealed 74 women with at least one vertebral fracture. These women had a significantly lower lumbar and femoral BMD (p = 0.0001). The generalized linear model showed that steroid use, menopause, BMI, age, and HAQ were all significant independent predictors of lumbar and femoral BMD. The logistic procedure showed that age (OR 1.05, 95% CI 1.03-1.07), HAQ (OR 1.3, 95% CI 1.07-1.7), menopause (OR 1.9, 95% CI 1.1-3.2), use of steroids (OR 1.5, 95% CI 1.07-2.1), and BMI (OR 0.8, 95% CI 0.8-0.9) were significantly associated with the risk for osteoporosis. The only variables associated with an increased risk for vertebral fracture were age (OR 1.04, 95% CI 1.01-1.08), HAQ (OR 1.7, 95% CI 1.08-2.09), and cumulative steroid intake (OR for 1 g of prednisone 1.03, 95% CI 1.006-1.07). To prevent osteoporosis and its dramatic complications in RA the therapeutic challenge is to preserve functional capacity using the lowest possible dosage of corticosteroids.


Early Gastric Cancer Exfoliating into Gastric Lavage (GL1 EGC) Shows a More Aggressive Behavior and Poorer Survival Compared to the Non-Exfoliative Counterpart (GL0 EGC).
Early gastric cancer (EGC) is usually associated with excellent prognosis. Some cases, however, entail a poorer survival. Our aim was to assess if EGC exfoliating into gastric lavage (GL) has a more aggressive behavior than the non-exfoliative counterpart. Between April 2012 and April 2017, 96 gastric cancer patients were prospectively submitted to preoperative GL to detect the presence (GL1) or absence (GL0) of exfoliated malignant cells. A total of 16 patients had EGC. T1b cases had significantly poorer overall (OS), progression-free (PFS) and disease-free survival (DFS) than their GL0 counterpart (16.3 vs. 61 months, p=0.0032). Similarly, the entire T1 class (T1a plus T1b EGCs) showed worse OS, PFS, DFS (15.5 vs. 61 months, p=0.0008) and time-to-tumor progression (17 vs. 61 months, p=0.0103). In the case of EGC, the GL0-GL1 classification should become a routine clinical practice to identify the aggressive tumor phenotypes requiring for closer follow-up or additional treatment.


[Congenital hepatic fibrosis disclosed late by hepatic encephalopathy].
A case of hepatic encephalopathy revealing congenital hepatic fibrosis in a 47-year-old woman is reported. The characteristic features of this observation were: a) the long clinical latency of a congenital disease usually discovered in childhood or in adolescence; b) the existence of hepatocellular insufficiency which appeared without any other reason than an ordinary infection; c) the absence of digestive bleeding or portacaval shunt, factors always found in the rare, previously described cases of encephalopathy in congenital hepatic fibrosis.


Lack of an aging effect on responses to disopyramide in rabbit ventricle. A brief note.
The hearts of older animals, including man, undergo physiological changes and exhibit an increased sensitivity to antiarrhythmic drugs which may be due in part to an increased sensitivity of the heart to the drug. Isolated perfused hearts from young (2-4 months) and old (43-63 months) rabbits were driven at 3 Hz and the electrical strength-interval relationship was determined by interposing a test stimulus at known intervals after every tenth driving stimulus. This revealed the diastolic threshold for stimulation and the effective refractory period. Disopyramide at therapeutic concentrations increased the effective refractory period in both young and old hearts to the same extent without significantly altering the diastolic threshold. Thus, the increased sensitivity of older animals to type I antiarrhythmic drugs is probably due to some factor other than increased cardiac electrophysiologic effects.


Localized inflammatory skin disease following inducible ablation of I kappa B kinase 2 in murine epidermis.
Skin inflammation is a complex process that involves interactions between various cell types residing in different skin compartments. Using mice with conditionally targeted I kappa B kinase 2 (IKK2) alleles, we have previously shown that epidermal keratinocytes can play a dominant role in the initiation of an inflammatory reaction. In order to investigate long-term consequences of IKK2 deletion in adult skin, we have generated mice with floxed IKK2 alleles in which expression of a Tamoxifen-inducible Cre recombinase construct is targeted to epidermal keratinocytes (K14-Cre-ER(T2)IKK2(fl/fl) mice). K14-Cre-ER(T2)IKK2(fl/fl) mice are born normally and do not show signs of a skin disease until the age of 6 months. Deletion of IKK2 can be observed after Tamoxifen application to the back skin or spontaneously, without Tamoxifen application, in mice older than 6 months. This deletion is accompanied by dramatic, localized skin changes that are characterized by invasion of inflammatory cells, hair follicle disruption, and pseudoepitheliomatous hyperplasia of the epidermis, but not by tumor formation. The hyperplastic epithelium shows increased phosphorylation of signal transducer and activator of transcription 3 and extracellular signal-regulated protein kinase 1/2, typical features of psoriatic epidermis. Our results identify a primary role for IKK2 in the development of skin inflammation and confirm its requirement for the maintenance of skin homeostasis.


[Acute injuries of lateral ankle joint ligaments].
Acute injuries of the lateral ankle ligaments are one of the most common form of injury involving the musculoskeletal apparatus. Treatment usually range from cast immobilisation or acute surgical repair to functional rehabilitation. The aim of our study was to evaluate the incidence of different grades of acute injuries of lateral ligaments of the ankle joint in our patients group and to compare the results of non surgical versus surgical treatment of third grade injuries. 3148 patients were treated for acute lateral ankle sprain in a period of 5 years at our department. Each patient had stress X-ray of the ankle for evaluation of instability at the first visit. From the 234 patients with third grade injury, 39 were enrolled in our study with non surgical treatment and 18 with surgical treatment. Each group was divided regarding to the age in two subgroups. Functional outcome was evaluated 12 and 24 months after injury with AOFAS clinical rating scale and Sports Ankle Rating System--Single Assessment Numeric Evaluation. Statistical analysis was done with Pearson's Chi quadrate test with P < 0.05. First grade injury was present in 62%, second grade in 31% and only 7% of the patients had third grade injury of the lateral ankle ligaments. Further only third grade injuries were studied. Statistically significant better results were seen in patients under the age of 25, in the patient group with surgical treatment compared to patients over 25 years of age. Also statistically significant better results were seen in patient with surgical treatment to non surgical treatment in each age group. No significant difference was observed in the non surgical treatment group regarding to age. Although the injuries of the ankle ligaments belong to the most common injuries of the musculoskeletal system, there is no consensus in the treatment of such disorders. Our experiences and the results of our study show, that surgical treatment in indicated cases provides better results in residual pain and instability of the ankle joint after acute injury of the lateral ankle ligaments.;


Dopamine and serotonin imbalances in the left anterior cingulate and pyriform cortices following the repeated intermittent administration of cocaine.
Studies on the neurobiology of cocaine abuse suggest that cocaine directly modifies the activity of dopamine neurons projecting from the dopamine-synthesizing cells of the ventral tegmental area to the nucleus accumbens. The repeated use of cocaine produces persistent adaptations within the mesocorticolimbic system and the resulting changes in monoamine neurotransmission may lead to behavioral sensitization. The present series of experiments sought to determine the effects of the repeated, intermittent challenge that took place two days after discontinuation of the pretreatment regimen; (ii) the ex vivo levels of biogenic monoamines, choline and acetylcholine in the nucleus accumbens, the dorsolateral caudate nucleus, as well as the anterior cingulate, frontal motor, frontal somatosensory and pyriform cortices; and (iii) the degree of neurochemical relationship between the left and right hemispheres. The repeated administration of cocaine produced sensitized behavioral responses to a subsequent challenge. Neurochemical correlates of repeated cocaine administration were observed at the cortical level and included a significant decrease in serotonin levels in the left anterior cingulate and pyriform cortices and an increase in dopamine metabolism in the left pyriform cortex. Furthermore, a shift in the interhemispheric coupling coefficient matrix for dopamine neurotransmission was observed in both the pyriform cortex and nucleus accumbens of cocaine-sensitized animals suggesting that, in these structures, the two hemispheres are operating independently. These results demonstrate that cocaine produces alterations in specific dopaminergic and serotonergic pathways that arise from the mesencephalon and project towards both the anterior cingulate and pyriform cortices.


Vaccines against seasonal and pandemic influenza and the implications of changes in substrates for virus production.
Influenza virus changes constantly, making vaccine production challenging. Changing the growth substrate from eggs to cell culture raises issues at all stages of the process, from surveillance to the assay of vaccines. The pandemic threat-first H5N1, then H1N1-encouraged a review of methods and brought issues into sharp relief.


Nuclear and radiological emergencies: Building capacity in medical physics to support response.
Medical physicists represent a valuable asset at the disposal of a structured and planned response to nuclear or radiological emergencies (NREs), especially in the hospital environment. The recognition of this fact led the International Atomic Energy Agency (IAEA) and the International Organization for Medical Physics (IOMP) to start a fruitful collaboration aiming to improve education and training of medical physicists so that they may support response efforts in case of NREs. Existing shortcomings in specific technical areas were identified through international consultations supported by the IAEA and led to the development of a project aiming at preparing a specific and standardized training package for medical physicists in support to NREs. The Project was funded through extra-budgetary contribution from Japan within the IAEA Nuclear Safety Action Plan. This paper presents the work accomplished through that project and describes the current steps and future direction for enabling medical physicists to better support response to NREs.


Melatonin alleviates memory deficits and neuronal degeneration induced by intracerebroventricular administration of streptozotocin in rats.
In the present study the effect of melatonin on intracerebroventricularly administered streptozotocin (STZ)-induced neurodegeneration was investigated in rats. STZ (3mg/kg), administered twice with an interval of 48 h between the two doses, showed impairment in spatial memory tested by water maze test after 14 days of 1st dose. Administration of melatonin (2.5, 5.0 and 10mg/kg, i.p.) was started 1h prior to 1st dose of STZ and continued up to 14 days. Glutathione and malondialdehyde were used as biochemical markers of oxidative stress in different brain regions. Histopathological changes were examined by using hematoxylin and eosin stain. STZ administration caused significant decrease in glutathione and increase in malondialdehyde as compared to control and artificial Cerebrospinal Fluid treated rats indicating oxidative stress. Brain sections of STZ-treated rats showed increased vacuoles in the periventricular cortical area, damaged periventricular cells and damaged cells in the hippocampal CA4 region as compared to control and artificial Cerebrospinal Fluid treated groups. Melatonin treatment significantly attenuated the effect of STZ-induced oxidative stress and histopathological changes. The results indicate that melatonin is effective in providing protection against memory deficit, oxidative stress and neuronal damage induced by STZ.


Observation of kinetic and structural scalings during slow coalescence of nanobubbles in an aqueous solution.
The addition of salt can induce the slow coalescence of nanobubbles (approximately 100 nm) in an aqueous solution of alpha-cyclodextrin (alpha-CD). A combination of static and dynamic laser light scattering was used to follow the coalescence. Our results reveal that its kinetic and structural properties follow some scaling laws; namely, the average size (<zeta>) of the nanobubbles is related to their average mass (<M>) and the coalescence time (t) as <M> approximately <zeta>(d(f)) and <zeta> approximately t(gamma) with two salt-concentration-dependent scaling exponents (d(f) and gamma). For a lower sodium chloride concentration (C(NaCl) = 40 mM), gamma = 0.13 +/- 0.01 and d(f) = 1.71 +/- 0.02. The increase of C(NaCl) to 80 mM results in gamma = 0.32 +/- 0.01 and d(f) = 1.99 +/- 0.01. The whole process has two main stages: the aggregation and the coalescence. At the lower C(NaCl), the process essentially stops in the aggregation stage with some limited coalescence. At higher C(NaCl), coalescence occurs after the aggregation and results in large bubbles.


Bioinformatical identification of key pathways and genes in human hepatocellular carcinoma after CSN5 depletion.
Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer. It has been previously reported that CSN5 depletion is an effective method in human HCC. In the current study, we aimed to uncover gene signatures and key pathways during HCC. Gene expression profiles of GSE26485 were downloaded from GEO database. Totally, 101 differentially expressed genes (DEGs) were up-regulated and 146 ones were down-regulated. Biological processes (BP) and Kyoto Encyclopedia of Genes and Genomes pathway (KEGG) analysis showed that the DEGs were mainly enriched in regulation of cell growth, oxidation-reduction process, mitotic cytokinesis, negative regulation of macroautophagy, endosome organization, lysosome, biosynthesis of antibiotics, small cell lung cancer and glutathione metabolism and so on (P < 0.05). Protein-protein interaction (PPI) network, Kaplan-Meier, log-rank method, western blot, immunohistochemistry and encyclopedia of DNA elements (ENCODE) analysis showed that CSN5 depletion took effects through down-regulation of SMAD5-related pathways which include EXO1, CENPA and NCAPG, resulting in the inactivation of H3K4me3 and H3K36me3. Those genes represent the promising targets for therapeutic intervention in HCC patients.


Describing pharmacy student participation in an international, interprofessional medical mission trip as part of an advanced pharmacy practice experience (APPE).
Several schools of pharmacy across the United States have taken steps to incorporate international medical mission trips into the doctor of pharmacy (PharmD) curriculum. This study aims to describe the impact of advanced pharmacy practice experience (APPE)-level student pharmacists on an interprofessional team during an international medical mission trip to Jamaica. The Jamaica Medical Mission (JMM) trip is an annual event involving healthcare professionals from several disciplines across multiple universities and healthcare systems. At this institution, the JMM trip is included as part of a rural health elective APPE rotation. Students electing to participate in this rotation are provided with the opportunity to serve as active participants on an interprofessional healthcare team in underserved and under-resourced communities throughout Jamaica. The JMM trip that took place during June 2016 included healthcare professionals and students in the fields of medicine, dentistry, optometry, nursing, and pharmacy. A total of five pharmacist preceptors and 10 pharmacy students attended the JMM trip in June 2016. Approximately three to five clinic sites per day were conducted simultaneously on each of the seven clinic days at various locations throughout Jamaica. The interprofessional healthcare teams provided free medical care, including physical exams and access to prescription and non-prescription medications. The interprofessional healthcare team saw a total of 1014 patients and dispensed 1879 prescriptions during the seven clinic days. A total of 811 clinical recommendations were made by student pharmacists and/or pharmacy preceptors. Of these recommendations, 561 (69%) were made by student pharmacists without pharmacy preceptor prompting, 103 (13%) were made by the student pharmacist with preceptor prompting, and 147 (18%) were made by pharmacy preceptors. Over 70% of recommendations made by student pharmacists without pharmacy preceptor prompting were accepted by prescribers. This study sought to describe the impact of APPE-level student pharmacists on an interprofessional team during an international medical mission trip. Our findings demonstrate that APPE-level student pharmacists were capable of making a substantial number of clinical recommendations without preceptor prompting. The number of recommendations made by students without preceptor prompting were consistently greater than the number of recommendations made with preceptor prompting throughout the trip. Future studies should address student competence in achieving learning objectives associated with international, interprofessional APPE rotations.


Diabetes and cancer, common threads and missing links.
Diabetes mellitus is a serious and growing health problem worldwide and is associated with severe acute and chronic complications. Accruing epidemiological and clinical evidence have suggested that an increased cancer incidence is associated with diabetes as well as certain diabetes risk factors and diabetes medications. Several pathophysiological mechanisms for this relationship have been postulated, including insulin resistance and hyperinsulinemia, enhanced inflammation, aberrant metabolic state, endoplasmic reticulum stress, and deregulation of autophagy. In addition to these potential mechanisms, a number of common risk factors, including obesity, may be behind the association between diabetes and cancer. Furthermore, different anti-diabetic medications may modify cancer risk and mortality in patients with diabetes. This Review discusses evidence to support the relationship between diabetes and cancer development as well as the underlying mechanisms. We also discuss the relationship of current diabetes treatments and cancer risk or prognosis. Understanding the mechanisms that connect type 2 diabetes or diabetes treatments to cancer are crucial for establishing the fundamental strategies concerning about primary prevention, early detection and effective therapy against these diseases.


Thermolithographic patterning of sol-gel metal oxides on micro hot plate sensing arrays using organosilanes.
Sol-gel-derived SnO2 and Fe2O3 were selectively deposited on elements of micro hot plate (microHP) arrays. The silicon micromachined microHP arrays contain heating elements (100 microm x 100 microm) that are electronically addressable and thermally isolated from each other. Thin films of (tridecafluoro-1,1,2,2-tetrahydrooctyl)trichlorosilane (TFS) or hexyltrichlorosilane (HFS) assembled on surfaces of the arrays served as thermally sensitive resists whereby heating of specific microHPs resulted in removal of organosilane films only in heated areas. TFS-masked surfaces were characterized with condensation figures and secondary ion mass spectrometry (SIMS) imaging. TFS was removed from regions heated above 400 degrees C to expose hydrophilic surfaces, while TFS films in unheated areas were unaffected and remained hydrophobic. Sol-gel tin oxide spin-coated on the thermally patterned arrays adhered only to the hydrophilic regions and was repelled from the hydrophobic areas masked by the TFS films. By using HFS films, it was possible to selectively deposit two sol-gel materials, SnO2 and Fe2O3, on different microHPs in the same array as confirmed by SIMS imaging. Both materials showed varying degrees of electrical response to hydrogen and methanol in gas-sensing measurements.


Respiratory effects of combined truncal and abdominal support in patients with spinal cord injury.
To determine whether a custom girdle, designed to provide truncal stability and abdominal support, will improve pulmonary function, enhance inspiratory muscle activity, and reduce the sensation of respiratory effort in patients with spinal cord injury (SCI). Pulmonary function, transdiaphragmatic pressure time product (PTP di ), twitch (Tw Pdi) and maximal transdiaphragmatic pressures (Pdi), and perception of respiratory effort (Borg Rating of Perceived Exertion score) were measured with and without an abdominal girdle in a seated position. Rehabilitation hospital. Ten patients with posttrauma SCI (injury level, C5-T6). Application of the abdominal girdle. Borg score and measures of lung volumes, dynamic abdominal compliance, and Tw Pdi and maximal Pdi. Wearing of the girdle was associated with a lower Borg score (P = .002) and reduced functional residual capacity (P = .006) but increased inspiratory capacity (P = .02) and forced vital capacity (P = .02). Although there was a decrease in dynamic abdominal compliance (P < .001) and an increase in PTP di (P = .02), this was accompanied by an increase in both Tw Pdi (P = .02) and maximal Pdi (P = .03). CONCLUSIONS The custom girdle reduced the sensation of respiratory effort in patients with SCI by optimizing the operating lung volumes and decreasing abdominal compliance, which enhanced diaphragm performance.


Tourette Syndrome and comorbid ADHD: current pharmacological treatment options.
Attention Deficit Hyperactivity Disorder (ADHD) is the most common co-morbid condition encountered in people with tics and Tourette Syndrome (TS). The co-occurrence of TS and ADHD is associated with a higher psychopathological, social and academic impairment and the management may represent a challenge for the clinicians. To review recent advances in management of patients with tic, Tourette Syndrome and comorbid Attention Deficit Hyperactivity Disorder. We searched peer reviewed and original medical publications (PUBMED 1990-2012) and included randomized, double-blind, controlled trials related to pharmacological treatment for tic and TS used in children and adolescents with comorbid ADHD. "Tourette Syndrome" or "Tic" and "ADHD", were cross referenced with the words "pharmacological treatment", "α-agonist", "psychostimulants", "selective norepinephrine reuptake inhibitor", "antipsychotics". Three classes of drugs are currently used in the treatment of TS and comorbid ADHD: α-agonists (clonidine and guanfacine), stimulants (amphetamine enantiomers, methylphenidate enantiomers or slow release preparation), and selective norepinephrine reuptake inhibitor (atomoxetine). It has been recently suggested that in a few selected cases partial dopamine agonists (aripiprazole) could be useful. Level A of evidence supported the use of noradrenergic agents (clonidine). Reuptake inhibitors (atomoxetine) and stimulants (methylphenidate) could be, also used for the treatment of TS and comorbid ADHD. Taking into account the risk-benefit profile, clonidine could be used as the first line treatment. However only few studies meet rigorous quality criteria in terms of study design and methodology; most trials have low statistical power due to small sample size or short duration. Treatment should be "symptom targeted" and personalized for each patient.