Influence of excess body weight on the surgical outcomes of total gastrectomy.
We conducted this retrospective study to identify the influence of excess body weight on the surgical outcome of total gastrectomy (TG) and to evaluate recent advances in this operation. The subjects were 644 consecutive gastric cancer patients who underwent TG between 1992 and 2008. Patients with a body mass index (BMI) of 25.0 kg/m(2) or greater were defined as overweight (overweight group) and those with a BMI less than 25.0 kg/m(2) as not overweight (non-overweight group). The operating times were longer (P = 0.005) and intraoperative blood loss was greater (P < 0.001) in the overweight group. The incidence of overall postoperative complications (P = 0.012) and of pancreatic fistula (P < 0.001) were significantly higher in the overweight group. In recent years, we achieved a reduction in operating time (P < 0.001), intraoperative blood loss (P = 0.033), and incidence of pancreatic fistula (P = 0.005), while maintaining curability, in the overweight group. Although TG for gastric cancer is technically more difficult in overweight patients, they should not be denied this operation. Conversely, we should make a greater effort to improve the surgical outcomes of overweight patients.


Analytical Performance Evaluation of Aptima Herpes Simplex Virus 1 and 2 Assay Using Hologic Panther Instrument.
Herpes simplex viruses 1 and 2 (HSV-1 and HSV-2) are responsible for a variety of human diseases. Therefore, rapid detection of these viruses in clinical laboratory is important. Recently Aptima Herpes Simplex 1 and 2 assay has been approved by the FDA. We evaluated analytical performance of this assay by comparing results obtained by analysis of cultures. Aptima Herpes Simplex assay is a nucleic acid amplification test that can be fully automated using the Hologic Panther instrument. This is a qualitative test providing either positive or negative result. We analyzed 115 specimens collected from anogenital locations using the new Aptima Herpes Simplex assay and our current tissue culture method. We observed good correlation between results obtained by using Aptima assay and the tissue culture method in 101 specimens but 14 specimens showed discordant results. Further testing in a reference laboratory using PCR (polymerase chain reaction) showed results in agreement with the Aptima assay but not the tissue culture method. The cause of discordance was misidentification of HSV-2 as HSV-1 by the tissue culture method. Aptima Herpes simplex assay on the Hologic Panther instrument is suitable for rapid detection of herpes simplex virus in clinical laboratory.


[Differential diagnosis of Raynaud's phenomenon--modern state of the problem].
Results of examination of 108 patients with the Raynaud's phenomenon were analyzed. The differential diagnosis algorhythm for the disease and the syndrome as well was elaborated. The leading role of the clinical features and the data of the physical examination methods in the diagnosis establishing was proved. Diagnostic complex for the functional state investigation of the upper extremity microvascular bed was elaborated.


Long term effect of surgery and radiotherapy for colorectal cancer on defecatory function and quality of life.
Survival from rectal cancer has improved substantially. Understanding the consequences of treatment is important to optimise patient support and minimise impact on daily life. We aimed to define the long-term prevalence of pelvic dysfunction following curative rectal cancer surgery (+/- radiotherapy) within the context of overall quality of life. We evaluated bowel, urinary and sexual function and quality of life using three validated questionnaires in patients treated for rectal cancer. This group was compared to patients undergoing abdominal surgery without pelvic dissection for colon cancer during the same time period. The response rate was 57% (381/667) with a median time interval of 4.4 years. A subset of rectal patients documented persistent problems with faecal leakage (16%); requiring to alter daily activities (18%); always needing to wear a protective pad (17%); rarely or never emptying their bowels fully (31%); difficulty controlling the passage of gas (32%) and requiring to modify diet (30%). Altered bowel function was found to impact on overall quality of life. Men reported increased erectile function difficulties. Pre-operative radiotherapy was associated with increased defecation problems as was low level of anastomosis (≤6 cm). In keeping with emergent evidence, this study has quantified the extent of late adverse effects with a sub-set of rectal cancer patients reporting persistent bowel function problems. The implications are now to consider current follow-up services and to 'trial' new models of comprehensive assessment and interventions in patients who are 'at risk' of experiencing late adverse effects of treatment.


Stereospecific Synthesis of Cyclohexenone Acids by [3,3]-Sigmatropic Rearrangement Route.
Herein we report a modular synthetic method for the preparation of diaryl-substituted cyclohexenone acids starting from phenyl pyruvate and suitable enones. When the reaction is carried out in alkaline tert-butanol or toluene solutions in microwave-assisted conditions mainly anti configuration products are obtained with up to 86% isolated yield. However, when the reaction is carried out in alkaline water, a mixture of products with anti and syn conformations is obtained with up to 98% overall isolated yield. Mechanistically the product with anti conformation forms by a hemiketal-oxy-Cope type [3,3]-sigmatropic rearrangement-intramolecular aldol condensation route and syn product by an intermolecular aldol condensation-electrocyclization (disrotatory type) route.


[Cardiac radiological investigations: what risks for the patients?].
The volume of diagnostic or therapeutic procedures in cardiology requiring the use of ionizing radiation is continuously increasing. While most examinations involve doses relatively low and thus add a low risk to the process itself, there are situations where the doses exceed the dose where excess risk of death from cancer has been statistically demonstrated. In addition, some complex procedures can result in the emergence of deterministic effects such as burns to the skin. The aim of this contribution is to provide general practitioners with the tools required to exercise the justification of the procedure with regard to the radiation hazard involved. This information may also be useful in the framework of the informed consent of the patient.


Comprehensive analysis of the expression of the IGF2BPs gene family in head and neck squamous cell carcinoma: Association with prognostic value and tumor immunity.
Head and neck squamous cell carcinoma (HNSCC) represents a predominant type of cancer found in the head and neck region, characterized by a high incidence and unfavorable prognosis. The IGF2BPs gene family, which belongs to the RNA-binding protein class, has been critically implicated in several cancers, and its involvement in HNSCC necessitates further exploration. To explore the clinical significance and potential biological functions of the IGF2BPs gene family in HNSCC. A bioinformatic methodology was employed to examine the expression profile, diagnostic and prognostic significance, and biological mechanisms of the IGF2BPs gene family in HNSCC, with a particular emphasis on its involvement in the immune function of HNSCC. This was followed by in vitro investigations to unravel the biological roles of the IGF2BPs gene family in HNSCC. This investigation has demonstrated that, in contrast with normal control tissue, HNSCC has a substantial elevation in the expression level of the IGF2BPs gene family. Patients with a high level of IGF2BPs gene family expression demonstrated higher prediction accuracy for HNSCC. Furthermore, patients with HNSCC and elevated IGF2BPs gene family expression levels exhibited poor survival outcomes. The IGF2BPs gene family displayed a significant association with a variety of immune infiltrating cells and immune genes in HNSCC. Studies conducted in vitro have confirmed that IGF2BP2 silencing suppressed the migration, proliferation, and invasion of HNSCC cells. It has been determined that the IGF2BPs gene family plays a crucial part in the onset and progression of HNSCC, and its association with tumor immunity has been established. The IGF2BPs gene family holds promising potential as a diagnostic and prognostic biomarker for HNSCC.


Laparoscopic retropubic cystourethropexy.
To evaluate the efficacy of laparoscopic retropubic urethrovesical suspension. Retrospective review of charts of 62 women over a follow-up period ranging from 8 to 30 months. A suburban hospital in a major metropolitan area. Sixty-two women, age 34 to 69 years, gravidity 0 to 8, and parity 0 to 7, with gynecologic abnormalities requiring surgical intervention and with pure genuine urinary stress incontinence. Each patient underwent a Burch or Marshall-Marchetti-Krantz procedure, modified to be performed at laparoscopy. Success was measured subjectively and objectively. Subjective success, determined by the lack of need to wear pads, was 100%. Objective success was assessed using several criteria: comparison of preoperative and postoperative symptom diaries; questionnaires; urine characteristics by straight catheter (office dipstick for nitrate, leukocyte estrace, bacteria, and white cell blood count, if suspicious urine culture and sensitivity); postvoid residual volume (<100 ml was considered complete); urethrovesical junction angle as determined by catheter or Q-Tip placement (upward, downward, or straight); bladder support; and negative standing stress test. All women reported satisfactory relief of symptoms, with subjective and objective improvement. None have noted urinary leakage during activities similar to those preoperatively associated with this condition. To date, the outcomes have been acceptable, although the limited numbers and relatively short follow-up prohibit any definitive conclusions.


Rare Compound Heterozygous Missense Mutation of the SCN5A Gene with Childhood-Onset Sick Sinus Syndrome in Two Chinese Sisters.
Sick sinus syndrome (SSS) is a group of syndromes characterized by pathological changes in the sinoatrial node and its adjacent tissues. Although several mutations in the SCN5A gene have been associated with early-onset SSS, pediatric patients are still less common. Here, we report a rare compound missense mutation in the SCN5A gene [c.2893C>T (p. R965C) and c.2431C>T (p. R811C) ] in two sisters with childhood-onset SSS in Chinese population. The proband (5 years and 5 months old) was the second child of a clinically normal and nonconsanguineous couple. Her elder sister was 12 years old and had been implanted with a pacemaker because of the diagnosis of SSS at another hospital one year ago. The proband was presented to the hospital with a slowed heart rate and reduced endurance exercise capacity for more than three months. After a comprehensive clinical examination, she was diagnosed with SSS and underwent pacemaker implantation. Exome and Sanger sequencing were used to determine the compound heterozygous missense mutation of [c.2893C>T (p. R965C) and c.2431C>T (p. R811C) ] in the SCN5A in the patient and her elder sister. Each healthy parent carried a different heterozygous missense mutation. The compound heterozygous mutation of c.2893C>T (p. R965C) and c.2431C>T (p. R811C) rather than the single mutation might be the primary cause of familial early-onset SSS in Chinese population. Our current findings expanded the current understanding of the SCN5A gene mutations. We further confirmed the essential role of the SCN5A gene on the diagnosis, family cascade screening, early intervention, and prognostic evaluation of SSS.


Characterization of the key aroma compounds in an american bourbon whisky by quantitative measurements, aroma recombination, and omission studies.
Thirty-one of the 45 odor-active compounds previously identified by us in an American Bourbon whisky were quantified by stable isotope dilution assays. Also for this purpose, new synthetic pathways were developed for the synthesis of the deuterium-labeled whisky lactone as well as for gamma-nona- and gamma-decalactone. To obtain the odor activity values (OAVs), the concentrations measured were divided by the odor thresholds of the odorants determined in water/ethanol (6:4 by vol.). Twenty-six aroma compounds showed OAVs >1, among which ethanol, ethyl (S)-2-methylbutanoate, 3-methylbutanal, 4-hydroxy-3-methoxybenzaldehyde, (E)-beta-damascenone, ethyl hexanoate, ethyl butanoate, ethyl octanoate, 2-methylpropanal, (3S,4S)- cis-whiskylactone, (E, E)-2,4-decadienal, 4-allyl-2-methoxyphenol, ethyl-3-methylbutanoate, and ethyl 2-methylpropanoate showed the highest values. The overall aroma of the Bourbon whisky could be mimicked by an aroma recombinate consisting of the 26 key odorants in their actual concentrations in whisky using water/ethanol (6:4 by vol.) as the matrix. Omission experiments corroborated the importance of, in particular, 4-hydroxy-3-methoxybenzaldehyde, (3S,4S)-cis-whiskylactone, ethanol, and the entire group of esters for the overall aroma of the Bourbon whisky.


Demethylation of somatic and testis-specific histone H2A and H2B genes in F9 embryonal carcinoma cells.
In contrast to many other genes containing a CpG island, the testis-specific H2B (TH2B) histone gene exhibits tissue-specific methylation patterns in correlation with gene activity. Characterization of the methylation patterns within a 20-kb segment containing the TH2A and TH2B genes in comparison with that in a somatic histone cluster revealed that: (i) the germ cell-specific unmethylated domain of the TH2A and TH2B genes is defined as a small region surrounding the CpG islands of the TH2A and TH2B genes and (ii) somatic histone genes are unmethylated in both liver and germ cells, like other genes containing CpG islands, whereas flanking sequences are methylated. Transfection of in vitro-methylated TH2B, somatic H2B, and mouse metallothionein I constructs into F9 embryonal carcinoma cells revealed that the CpG islands of the TH2A and TH2B genes were demethylated like those of the somatic H2A and H2B genes and the metallothionein I gene. The demethylation of those CpG islands became significantly inefficient at a high number of integrated copies and a high density of methylated CpG dinucleotides. In contrast, three sites in the somatic histone cluster, of which two sites are located in the long terminal repeat of an endogenous retrovirus-like sequence, were efficiently demethylated even at a high copy number and a high density of methylated CpG dinucleotides. These results suggest two possible mechanisms for demethylation in F9 cells and methylation of CpG islands of the TH2A and TH2B genes at the postblastula stage during embryogenesis.


[Indications for acupuncture and electropuncture in internal medicine].
The acupuncture and electropuncture are no polychrest method, but integrated into other approved forms of therapy a valuable supplementation of our possibilities of treatment, since expense, utility and risk are well proportionated. The author enters the importance, the hypotheses of action, the possibilities and limits, the contraindications and the insignificant risk of treatment. With the help of own investigations and on the basis of the results of the clinical experimental and basic researches of other authors in indicated diseases a portion of success is discussed which is transgressing a pure suggestive effect.


Posttransplant soluble CD30 as a predictor of acute renal allograft rejection.
Recent results have indicated that high prerenal and postrenal transplant soluble CD30 levels may be associated with an increased acute rejection and graft loss. The aim of this study was to evaluate the feasibility of using serum sCD30 as a marker for predicting acute graft rejection. In this prospective study,we analyzed clinical data of 80 patients, whose pretransplant and posttransplant serum levels of sCD30 were detected by enzyme-linked immunoassay. Eight patients developed acute rejection, 7 patients showed delayed graft function, and 65 recipients experienced an uncomplicated course group. The patients were followed for 12 months, and there were no deaths. Preoperative sCD30 levels of 3 groups were 96.2 -/+ 32.5, 80.2 -/+ 28.3, and 76.8 -/+ 29.8 U/mL (P = .28). After transplant, a significant decrease in the sCD30 level was detected in 3 groups on day 14 posttransplant (P < .001), while sCD30 levels of acute rejection group remained significantly higher than delayed graft function and nonrejecting patients (28.3 -/+ 5.2, 22.1 -/+ 3.2, and 19.8 -/+ 4.7 U/mL) (P = .02). Positive panel reactive antibody was not statistically different among groups (P = .05). Also, hemodialysis did not affect sCD30 levels (P = .05). Receiver operating characteristic curve demonstrated that the sCD30 level on day 14 posttransplant could discriminate patients who subsequently suffered acute allograft rejection (area under receiver operating characteristic curve, 0.95). According to receiver operating characteristic curve, 20 U/mL may be the optimal operational cutoff level to predict impending graft rejection (specificity 93.8%, sensitivity 83.3%). Measurement of the soluble CD30 level on day 14 after transplant might offer a noninvasive means for recognizing patients at risk of acute graft rejection during the early posttransplant period.


Vitamin d and cardiovascular disease.
Vitamin D has received widespread attention for its potential role in preventing cardiovascular disease (CVD) and type 2 diabetes mellitus. Several epidemiological studies have suggested that individuals with low blood levels of vitamin D have increased risks of heart disease, stroke, hypertension, and diabetes. Yet, the revised 2011 Institute of Medicine report for intake of calcium and vitamin D, which was guided by skeletal health alone, concluded that the evidence that vitamin D prevents CVD, diabetes, or other cardiometabolic outcomes was inconsistent and inconclusive and did not meet criteria for establishing a cause and effect relationship [1•, 2]. This finding was consistent with an earlier systematic review conducted by the Agency for Healthcare Research and Quality (AHRQ) in 2009 [3•]. Ongoing clinical trials seek to address the effects of vitamin D supplementation on CVD and other nonskeletal outcomes.


Topological entanglement Rényi entropy and reduced density matrix structure.
We generalize the topological entanglement entropy to a family of topological Rényi entropies parametrized by a parameter alpha, in an attempt to find new invariants for distinguishing topologically ordered phases. We show that, surprisingly, all topological Rényi entropies are the same, independent of alpha for all nonchiral topological phases. This independence shows that topologically ordered ground-state wave functions have reduced density matrices with a certain simple structure, and no additional universal information can be extracted from the entanglement spectrum.


Screening the receptorome for plant-based psychoactive compounds.
Throughout time, humans have used psychoactive plants and plant-derived products for spiritual, therapeutic and recreational purposes. Furthermore, the investigation of psychoactive plants such as Cannabis sativa (marijuana), Nicotiana tabacum (tobacco) and analogues of psychoactive plant derivatives such as lysergic acid diethylamide (LSD) have provided insight into our understanding of neurochemical processes and diseases of the CNS. Currently, many of these compounds are being used to treat a variety of diseases, such as depression and anxiety in the case of Piper methysticum Kava Kava (Martin et al., 2002; Singh and Singh, 2002). G-protein coupled receptors (GPCRs) are the most common molecular target for both psychoactive drugs and pharmaceuticals. The "receptorome" (that portion of the genome encoding ligand reception) encompasses more than 8% of the human genome (Roth et al., 2004) and as such provides a large number of possible targets for psychoactive drug interactions. A systematic, comprehensive study is necessary to identify novel active psychoactive plant-based compounds and the molecular targets of known compounds. Herein we describe the development of a high throughput system (HTS) to screen psychoactive compounds against the receptorome and present two examples (Salvia divinorum, the "magic mint" hallucinogen and Banisteriopsis caapi, the main component of Ayahuasca, a psychoactive beverage) where HTS enabled the identification of the molecular target of each compound.


Seasonal shifts in the thermal biology of the lizard Liolaemus tandiliensis (Squamata, Liolaemidae).
Small lizards can accommodate to constraints imposed by temporal changes in ambient temperature through a combination of adaptive evolution and behavioral and physiological plasticity. Thermal physiology plasticity may compensate for climate variation and favor performance while minimizing behavioral costs in sub-optimal conditions. The Tandilia's lizard, Liolaemus tandiliensis, occurs in an isolated mountain range of the Argentinean temperate Pampas. In this study, we compared the thermal biology of L. tandiliensis between late spring (December) and mid-summer (February). The habitats' thermal quality was lower in late spring than in mid-summer. The lizard's field-body temperature (Tb) was 2-3 °C higher than the operative temperature (Te). Overall, the mean preferred temperature (Tsel) was 37.4 °C [preferred range (Tset): 36.2-38.7 °C], and was similar to other Liolaemus species. The Tset and Tsel of females in late spring were 1.8 °C lower than in mid-summer. In the case of males, the Tsel did not vary among seasons, while the Tset had a difference of 2.5 °C between seasons. Adults were moderate thermoregulators, but females were more efficient only in late spring (Emales = 0.69; Efemales = 0.58), compared to mid-summer (Emales = 0.68; Efemales = 0.50). Juveniles did not show temporal differences in temperature preferences and had a relatively higher efficiency in late spring (E = 0.38) compared to mid-summer (E = 0.28). An increased proportion of juveniles and adults shifted their Tb near to the Tset in late spring respect to mid-summer. The adults also matched their preferred temperatures to their current body temperature. These results suggest that seasonal shifts in the thermoregulatory parameters of L. tandiliensis may improve their thermoregulatory efficiency. Although temporal variation in ambient temperatures might influence the thermal biology of the studied lizards, other factors such as changes in the reproductive status may have also interfered.


Interactions between nanocolloidal particles in polymer solutions: effect of attractive interactions.
We present a density-functional theory study of nanoparticle interactions in a concentrated polymer solution. The polymers are modeled as freely jointed tangent chains; all nonbonded interactions between polymer segments and nanoparticles are described by Lennard-Jones potentials. We test several recently proposed methods of treating attractive interactions within the density-functional theory framework by comparing theoretical results with recent simulation data. We find that the simple van der Waals approach provides the most accurate results for the polymer-mediated potential of mean force between two dilute nanoparticles. We employ this approach to study nanoparticle interactions as a function of nanoparticle-segment interaction strength and polymer solution density and temperature.


Fluoride-Catalyzed Esterification of Amides.
In recent years, it has been demonstrated that amide carbon-nitrogen bonds can be activated and selectively cleaved using transition metal catalysts. However, these methodologies have been restricted to specific amides; a one-to-one relationship exists between the catalytic system and the amides and also uses large amounts of transition-metal catalysts and ligands. Hence, we now report a general strategy for esterification of common amides using fluoride as a catalyst. This method shows high functional group tolerance, and notably it requires only a slight excess of the alcohol nucleophile, which is a rare case in transition-metal-free amide transformations. Moreover, this approach may provide a new understanding for further studies on esterification of amides and is expected to stimulate the development of alternative methods for direct functionalization of amides.


Effect of long-acting beta2 agonists on exacerbation rates of asthma in children.
The purpose of this analysis was to examine the effect of long-acting beta(2)-adrenoceptor agonists (LABAs) on the asthma exacerbation rate in pediatric patients. Randomized controlled trials (RCT) that included the use of LABAs to treat symptoms of pediatric asthma in children on inhaled corticosteroids, that reported asthma exacerbation rates, and that were published as full papers in peer-reviewed journals were retrieved from a search of the medical literature. Eight studies were identified that fulfilled these criteria. An exacerbation was defined as deterioration in a patient's asthma requiring a change in prescribed medication or not defined but reported as an asthma exacerbation or an asthma-related hospitalization. Analysis of data from the eight studies revealed no apparent protection from an asthma exacerbation among children on a LABA compared to patients on comparator treatment. The relative risk of an asthma exacerbation for LABA compared to placebo or short-acting beta(2)-adrenoceptor agonist (SABA) ranged from 0.95-1.86. The relative risk of hospitalization for asthma in patients treated with LABAs with regular maintenance with ICS ranged from 3.3-21.6 in the three studies that reported asthma-related hospitalizations. The lack of evidence for the control of asthma exacerbations in children regularly using a LABA should bring into question its general use as add-on therapy. Studies should be designed to directly explore the implications of these observations in pediatric patients.


[Chemical analysis of methacrylate plastics].
It was the object of this study to find quick but exact methods for determining the components of quickly setting methacrylate materials for dentures, dental fillings (PMMA) and for bone surgery. Furthermore, lower-molecular components still being present in the hardened resin were tested. By measuring refraction index and by infrared spectrum and gas-chromatographical analyses the composition of the liquid is obtained. Dimethyl-p-toluidine, hydrochinon and cross-linking agents were determined spectrophotometrically. Filling agents, pigments, plasticizers and soluble components of the powder were determined gravimetrically. The presence of polystyrol is established by infrared analysis, that of benzoyl peroxide by spectroscopic analysis. As to the hardened material, the molecular weight is determined by viscosity measurements and the molecular weight distribution by gel permeability measurements. Residual monomer is found by gas chromatography.


How close are we? An audit of biometry of a tertiary care hospital in Karachi.
To evaluate the accuracy of biometry in the post-op phase of cataract surgery. This study was conducted at Liaquat National Hospital, Karachi, from June 2015 to July 2016, and comprised the audit of patients who underwent cataract surgery during the period. Keratometry was done on Haag-Strait manual keratometer and A-scan was done by applanation contact method on SonoMed machine. Theoretic-T formula was used to calculate desired intraocular lens power for all kinds of axial lengths. A single surgeon operated upon the same Alcon Constellation phacoemulsification machine. Postoperative follow-up was done by monitoring auto refraction and visual acuity on days 1, 7, 30 and 90. SPSS 21 was used for data analysis.. Of 244 patients, 121(49.60%) were males and 123(50.40%) were females. There were 123(50.40%) right eyes and 121(49.60%) left eyes. Overall, 132(54.10%) achieved postoperative refraction within ±0.5 D of target and 193(79.10%) within ±1 D of target. Age, gender and laterality had no significant effect on outcomes (p>0.05 each). Postoperative refraction corresponded quite closely with global recommendations.


Multi-allergen challenge stimulates steriod-resistant airway inflammation via NF-κB-mediated IL-8 expression.
Neutrophilic airway inflammation associated with multiple allergens has been related to steroid-resistant asthma. However, most animal models use only one allergen, which cannot simulate asthma closely as seen in patients. To determine the mechanism of inflammatory process involved in this severe condition, BALB/c mice were repetitively challenged with the pooled extract of dust mite, ragweed, and Aspergillus species (DRA). We found that DRA increased interleukin (IL)-10 and TGF-β levels and neutrophil recruitment in bronchial alveolar lavage fluid. We also found that although dexamethasone suppressed the release of these two cytokines, mast cells recruitment, and mucus hypersecretion, it actually increased neutrophil infiltration and the level of keratinocyte-derived chemokine (mKC), a functional homolog of human IL-8. Treatment of human lung alveolar A549 cells with Der p1, an extract of house dust mite Dermatophagoides pteronyssinus, increased the expression of IL-8 and activity of NF-κB. The elevated IL-8 level was suppressed by BAY11-7082, a selective NF-κB inhibitor, but not by dexamethasone. These results suggest that increased IL-8 (mKC) levels may be involved in steroid-resistant neutrophilic airway inflammation through an NF-κB-dependent pathway.


Effects of angiotensins and catecholamines on the transmembrane potential and isometric force of rattib isolated atria.
The action of angiotensin II (ATII), 1-des-Asp-ATII (Hepta-2-8), angiotensin I (ATI), 1-Sar,8-Gly-ATII and catecholamines on isometric force and transmembrane potential were studied in rabbit isolated atria, driven electrically. In some experiments two microelectrodes were implated to record simultaneously cjamges of intracellular electrical events in the left and in the right atrium: changes of tension were recorded isometrically. In other experiments changes of transmembrane potential were measured with floating microelectrodes. Norepinephrine and epinephrine increased tension, prolonged the plateau phase of the action potential (A.P.) in both atria, while facilitating conduction. ATII and 1-des-Asp-ATII showed similar effects on tension and greater changes on the electrical events of the left than on the right atrium, while ATI was more effective on the right than on the left atrium. 1-Sar, 8-Gly-ATII had no direct effect but prevented or reduced the action of ATII, 1-des-Asp-ATII and ATI, without influencing norepinephrine and epinephrine. All angiotensions except 1-Sar,8-Gly-ATII slightly prolonged the time of conduction. The results indicate that: a)angiotensins and catecholamines prolong the duration of the action potential and induce minor changes of potential overshoot in atrial fibers; b) ATII and 1-des-Asp-ATII act preferentially on the left and ATI on the right atrium; c) 1-Sar,8Gly-ATII inhibits secifically the effects of ATII and ATI in this preparation.


Comparison of Upper Trapezius and Infraspinatus Myofascial Trigger Point Therapy by Dry Needling in Overhead Athletes With Unilateral Shoulder Impingement Syndrome.
Chronic musculoskeletal disorders in the shoulder joint are often associated with myofascial trigger points (MTrPs), particularly in the upper trapezius (UT) muscle. Dry needling (DN) is a treatment of choice for myofascial pain syndrome. However, local lesions and severe postneedle soreness sometimes hamper the direct application of DN in the UT. Therefore, finding an alternative point of treatment seems useful in this regard. To compare the efficacy of UT versus infraspinatus (ISP) DN on pain and disability of subjects with shoulder pain. The authors hypothesized that ISP DN could be as effective as the direct application of DN in UT MTrP. Single-blind randomized clinical trial. Sports medicine physical therapy clinic. A total of 40 overhead athletes (age = 36 [16] y; 20 females and 20 males) with unilateral shoulder impingement syndrome were randomly assigned to the UT DN (n = 21) and ISP DN (n = 19) groups. An acupuncture needle was directly inserted into the trigger point of UT muscle in the UT DN group and of ISP muscle in the ISP DN group. DN was applied in 3 sessions (2-day interval between each sessions) for each group. Pain intensity (visual analog scale), pain pressure threshold, and disability in the arm, shoulder, and hand were assessed before and after the interventions. Pain and disability decreased significantly in both groups (P < .001) and pain pressure threshold increased significantly only in the ISP group (P = .02). However, none of the outcome measures showed a significant intergroup difference after treatments (P > .05). Application of DN for active MTrPs in the ISP can be as effective as direct DN of active MTrPs in the UT in improving pain and disability in athletes with shoulder pain, and may be preferred due to greater patient comfort in comparison with direct UT needling.


Determinants of Smoking Cessation in Patients With COPD Treated in the Outpatient Setting.
The beneficial effects of smoking cessation on the progression of COPD are well established. Nevertheless, many patients with COPD continue to smoke. In this nationwide hospital-based prospective follow-up study, we examined rates of smoking cessation and clinical and sociodemographic determinants of smoking cessation in 3,233 patients with COPD who smoked on outpatient contact during 2008 to 2012. Using multivariate Cox regression, we calculated hazard ratios (HRs) of quitting. Within 1 and 5 years from first outpatient contact, the probability of quitting was 19% and 45%, respectively. In adjusted analyses, patients were less likely to quit if they were younger, with an HR of 0.84 (95% CI, 0.71-0.99) for patients aged 50 to 69 years and 0.53 (95% CI, 0.37-0.76) for patients aged 30 to 49, compared with those aged 70 years or older, who had lower income (HR, 0.79; 95% CI, 0.67-0.94), lived alone (HR, 0.75; 95% CI, 0.64-0.88), were unemployed (HR, 0.70; 95% CI, 0.54-0.90), had milder COPD with an HR of 0.67 (95% CI, 0.53-0.84) for Global Initiative for Chronic Obstructive Lung Disease (GOLD) A and 0.61 (95% CI, 0.47-0.80) for GOLD B compared with GOLD D, had Medical Research Council (MRC) dyspnea scale score < 4 (HR 0.80, 95% CI 0.68-0.95), or no history of exacerbations treated on an outpatient basis. (HR, 0.80; 95% CI, 0.68-0.93). These findings reinforce that young and socioeconomically disadvantaged patients have more difficulties achieving timely smoking cessation. A novel finding is that patients with milder COPD are less likely to quit. The findings suggest a need for interventional studies focusing on these subgroups to ensure abstinence to halt disease progression.


Relative survival following response to 7 + 3 versus azacytidine is similar in acute myeloid leukemia and high-risk myelodysplastic syndromes: an analysis of four SWOG studies.
Here we quantify and compare the absolute and relative overall survival (OS) benefits conveyed by complete remission (CR) in AML and high-risk MDS, and by CR with incomplete count recovery (CRi) in AML and by hematologic improvement (HI) in MDS, following treatment with 7 + 3 versus azacytidine. We compared patients receiving 7 + 3 in SWOG studies S0106 (n = 301) and S1203 (n = 261) enrolling adults ≤ 60 years, with patients receiving azacytidine therapies in S0703 (n = 133 AML patients ≥ 60) and S1117 (n = 277 MDS patients ≥ 18). Absolute survival benefit was evaluated with 1-year, 3-year, and median OS; relative benefit was evaluated with univariate and covariate-adjusted hazard ratios. CR conveyed a relative survival advantage in multivariable analysis, with a similar relative effect of CR across studies. CR also conferred an absolute survival benefit, but with a smaller magnitude of absolute benefit in the azacytidine trials. In AML, OS was similar for CRi and failure to achieve CR/CRi. In MDS, CR conferred a survival advantage versus HI and HI versus failure. The relative survival benefit of CR was similar regardless of initial therapy for AML or high-risk MDS. With both therapies, CR has a beneficial effect on survival compared with CRi or HI.


Pediatric otolaryngology, molecular diagnosis of hereditary hearing loss: next-generation sequencing approach.
Sensorineural hearing loss (SNHL) is the most common sensory birth defect. The purpose of this article is to review the advances in next-generation sequencing (NGS) and molecular diagnosis of hereditary hearing loss. Early diagnosis and detection of SNHL is critical for the development of appropriate speech and language, as neuroplasticity peaks in the first few years of life. There has been increased accuracy of NGS genetic testing, which has helped created a paradigm shift in the diagnosis of hearing loss. The diagnostic yield of genetic testing now approaches that of radiographic imaging; however, there remains a difference in cost and time delay. With the introduction of comprehensive genetic panels, 23-129 genes can be sequenced from the same blood sample. Diagnostic genetic testing of SNHL in the past has been confined to a few genes through Sanger sequencing. The advent of NGS allows for development of comprehensive genetic panels, which test for up to 129 genes while improving the accuracy and efficiency of testing. This type of testing may become more common as the costs decrease and more genes are discovered.


[Identification of specific peptides from Bubali Cornu by ultra-performance liquid chromatography-tandem mass spectrometry].
This paper explored the specific peptides from Bubali Cornu by ultra-performance liquid chromatography-tandem mass spectrometry and based on mathematics set theory. Following the profile analysis of peptides from Bubali Cornu, Bovis Grunniens Cornu, Caprae Hircus Cornu, and Suis Cornu by nano LC-LTQ-Obitrap-MS after digestion with trypsin, the relationship of peptide composition among different samples was analyzed using the mathematics set theory. The ones that existed only in the Bubali Cornu set rather than in any other set were considered as the specific peptides of Bubali Cornu. The further bioinformatic analysis revealed four specific peptides from Bubali Cornu, whose specificity was verified by UPLC-QQQ-MS. The results showed that these four peptides could be used for distinguishing Bubali Cornu from Caprae Hircus Cornu and Suis Cornu. This study has provided a rapid and simple method for seeking the specific peptides in animal medicines, which can be utilized for quality evaluation of animal medicines, thus making them authenticable and traceable.


Construction accident prevention: A systematic review of machine learning approaches.
The construction industry is an important productive sector worldwide. However, the industry is also responsible for high numbers of work-related accidents, which highlights the necessity for improving safety management on construction sites. In parallel, technological applications such as machine learning (ML) are used in many productive sectors, including construction, and have proved significant in process optimizations and decision-making. Thus, advanced studies are required to comprehend the best way of using this technology to enhance construction site safety. This research developed a systematic literature review using ten scientific databases to retrieve relevant publications and fill the knowledge gaps regarding ML applications in construction accident prevention. This study examined 73 scientific articles through bibliometric research and descriptive analysis. The results showed the publications timeline and the most recurrent journals, authors, institutions, and countries-regions. In addition, the review discovered information about the developed models, such as the research goals, the ML methods used, and the data features. The research findings revealed that USA and China are the leading countries regarding publications. Also, Support Vector Machine - SVM was the most used ML method. Furthermore, most models used textual data as a source, generally related to inspection reports and accident narratives. The data approach was usually related to facts before an accident (proactive data). The review highlighted improvement proposals for future works and provided insights into the application of ML in construction safety management.


Possibility of an unequivocal test of different models of the equation of state of aluminum in the coupling regime Gamma approximately 1-50.
The equation of state (EOS) in regimes of density (rho) and temperature (T) which are inaccessible to experiment has to be determined using theories which may themselves be out of their range of validity. Even for Al, the EOS in the region 0.1<rho<2 g cm(-3), and 1<T<50 eV, where the ionic coupling parameter Gamma ranges from 1- approximately 50, is not unknown. We present results for the EOS using the Thomas-Fermi model (TF), the quotidian equation of state, the Sesame tabulation, and using the density-functional neutral-pseudoatom (NPA) model which is a first-principles theory applicable at strong coupling. It is found that the NPA predictions are very different from the other models, and experiments could provide an unequivocal test of the validity of the different EOS models. We report theoretical results for the Hugoniot, and the electrical conductivity in the regime of interest.


Novel function of PERP-428 variants impacts lung cancer risk through the differential regulation of PTEN/MDM2/p53-mediated antioxidant activity.
Lung cancer is the leading cause of cancer-related deaths worldwide. Identifying genetic risk factors and understanding their mechanisms will help reduce lung cancer incidence. The p53 apoptosis effect is related to PMP-22 (PERP), a tetraspan membrane protein, and an apoptotic effector protein downstream of p53. Although historically considered a tumor suppressor, PERP is highly expressed in lung cancers. Stable knockdown of PERP expression induces CL1-5 and A549 lung cancer cell death, but transient knockdown has no effect. Interestingly, relative to the PERP-428GG genotype, PERP-428CC was associated with the highest lung cancer risk (OR = 5.38; 95% CI = 2.12-13.65, p < 0.001), followed by the PERP-428CG genotype (OR = 2.34; 95% CI = 1.55-3.55, p < 0.001). Ectopic expression of PERP-428G, but not PERP-428C, protects lung cancer cells against ROS-induced DNA damage. Mechanistically, PERP-428 SNPs differentially regulate p53 protein stability. p53 negatively regulates the expression of the antioxidant enzymes catalase (CAT) and glutathione reductase (GR), thereby modulating redox status. p53 protein stability is higher in PERP-428C-expressing cells than in PERP-428G-expressing cells because MDM2 expression is decreased and p53 Ser20 phosphorylation is enhanced in PERP-428C-expressing cells. The MDM2 mRNA level is decreased in PERP-428C-expressing cells via PTEN-mediated downregulation of the MDM2 constitutive p1 promoter. This study reveals that in individuals with PERP-428CC, CAT/GR expression is decreased via the PTEN/MDM2/p53 pathway. These individuals have an increased lung cancer risk. Preventive antioxidants and avoidance of ROS stressors are recommended to prevent lung cancer or other ROS-related chronic diseases.


Intra and Inter-Observer Variability of Transformation Zone Assessment in Colposcopy: A Qualitative and Quantitative Study.
Colposcopy is an important tool in the diagnosis of cervical precancer and early cancer. The assessment of women with abnormal cytology and selection of those who require further therapy or follow up depends on the colposcopic assessment of the Transformation Zone (TZ). Identification of the TZ is thus an important part of this examination. Intra and inter-observer variability is known to be relatively high in the colposcopic interpretation of abnormal features. However, there are hardly any studies on the observer variability in the assessment of the type of TZ. The present study was conducted with the aim to compare the intra and inter-observer variability of the TZ type classification and the Squamo-Columnar Junction (SCJ) visibility and to quantitatively measure the intra and inter-observer correlations of tracing of the TZ contours. Colposcopy images were obtained for a total of 170 cases. They were reviewed by three colposcopists independently. The colposcopists classified the TZ type and also marked the SCJ contours on the images. Each observer independently reviewed the cases on two different instances (few weeks apart) and the result was compiled for intra-observer variation. The intra and inter observer variability on the TZ type was compared using Cohen's Kappa. This was followed by a quantitative measurement of TZ observation variability using Hausdorff distance. The inter-observer agreement for the TZ type classification was moderate (Kappa= 0.53 to 0.66). The Intra-observer agreement was moderate to strong (0.60 to 0.86). Colposcopic in vivo examination increases the variability in the identification of the TZ when compared to the analysis of recorded images. The disagreement in the TZ type was mostly in categories Type 2 vs Type 3 followed by Type 1 vs Type 2. A computerized quantification method can be used for quality control and training purpose in colposcopy.


Endophytic Beauveria bassiana promotes plant biomass growth and suppresses pathogen damage by directional recruitment.
Entomopathogenic fungi (EPF) can colonize and establish symbiotic relationships with plants as endophytes. Recently, EPF have been reported to suppress plant pathogens and induce plant resistance to diseases. However, the potential mechanisms via which EPF as endophytes control major plant diseases in situ remain largely unknown. Pot and field experiments were conducted to investigate the mechanisms via which an EPF, Beauveria bassiana, colonizes tomato, under Botrytis cinerea infection stress. B. bassiana blastospores were inoculated into tomato plants by root irrigation. Tomato resistance to tomato gray mold caused by B. cinerea was evaluated by artificial inoculation, and B. bassiana colonization in plants and rhizosphere soil under B. cinerea infection stress was evaluated by colony counting and quantitative PCR. Furthermore, the expression levels of three disease resistance-related genes (OXO, CHI, and atpA) in tomato leaves were determined to explore the effect of B. bassiana colonization on plant disease resistance performance in pot experiments. B. bassiana colonization could improve resistance of tomato plants to gray mold caused by B. cinerea. The incidence rate, lesion diameter, and disease index of gray mold decreased in both the pot and field experiments following B. bassiana colonization. B. bassiana was more likely to accumulate in the pathogen infected leaves, while decreasing in the rhizosphere soil, and induced the expression of plant resistance genes, which were up-regulated in leaves. The results indicated that plants could "recruit" B. bassiana from rhizosphere soil to diseased plants as directional effects, which then enhanced plant growth and resistance against pathogens, consequently inhibiting pathogen infection and multiplication in plants. Our findings provide novel insights that enhance our understanding of the roles of EPF during pathogen challenge.


The pattern of gunshot injuries in a communal clash as seen in two Nigerian teaching hospitals.
The pattern of gunshot injury in the Ife-Modakeke communal clash between March 3 and May 23, 1999 was analyzed in this study. The history was recorded for each patient presenting at the hospital with gunshot injuries from the clash. Each was examined and followed up through subsequent treatment in the wards and clinics. The study included 185 patients. The male-to-female ratio was 22.1 to 1, and 45.9% of the patients ranged in age from 21 to 30 years. The mean age was 28.3 +/- 11.2 years, and the mortality rate was 8.6%. There were 120 warriors and 65 noncombatants. Government workers and students made up most of the noncombatants (42.5%), whereas drivers and farmers constituted the vast majority of the warriors (23.3%). Injury to the lower limbs was the most commonly seen injury (54.6%). Sustained fractures and femoral fractures were the most common fracture (n = 100, 54.1%). Head and colonic injuries were the greatest cause of mortality. For civilian gunshot injuries, morbidity and mortality rates are high in the less developed countries because of inadequate prehospital and hospital care. Efforts should be made to improve these facilities.


Etoposide, an anticancer drug involved in therapy-related secondary leukemia: Enzymes at play.
Etoposide is a semi-synthetic glycoside derivative of podophyllotoxin, also known as VP-16. It is a widely used anticancer medicine in clinics. Unfortunately, high doses or long-term etoposide treatment can induce therapy-related leukemia. The mechanism by which etoposide induces secondary hematopoietic malignancies is still unclear. In this article, we review the potential mechanisms of etoposide induced therapy-related leukemia. Etoposide related leukemogenesis is known to depend on reactive oxidative metabolites of etoposide, notably etoposide quinone, which interacts with cellular proteins such as topoisomerases II (TOP2), CREB-binding protein (CREBBP), and T-Cell Protein Tyrosine Phosphatase (TCPTP). CYP3A4 and CYP3A5 metabolize etoposide to etoposide catechol, which readily oxidizes to etoposide quinone. As a poison of TOP2 enzymes, etoposide and its metabolites induce DNA double-stranded breaks (DSB), and the accumulation of DSB triggers cell apoptosis. If the cell survives, the DSB gives rise to the likelihood of faulty DNA repair events. The gene translocation could occur in mixed-lineage leukemia (MLL) gene, which is well-known in leukemogenesis. Recently, studies have revealed that etoposide metabolites, especially etoposide quinone, can covalently bind to cysteines residues of CREBBP and TCPTP enzymes, . This leads to enzyme inhibition and further affects histone acetylation and phosphorylation of the JAK-STAT pathway, thus putatively altering the proliferation and differentiation of hematopoietic stem cells (HSC). In brief, current studies suggest that etoposide and its metabolites contribute to etoposide therapy-related leukemia through TOP2 mediated DSB and impairs specific enzyme activity, such as CREBBP and TCPTP.


[Nutritional Status of Liver Transplantation Recipients and Factors Influencing Nutritional Status].
This study aimed to investigate the nutritional status of liver transplantation (LT) recipients and explore certain factors that influence nutritional status, including dietary patterns and physical activities. This was a cross-sectional, descriptive study. The subjects included 211 LT recipients at a medical center outpatient clinic located in Seoul, Korea. The nutritional status, dietary patterns, and physical activities of each subject were measured using the body mass index (BMI), Mini Dietary Assessment (MDA), and Global Physical Activity Questionnaire. Independent t-test, one-way analysis of variance, and multiple linear regression analysis were used to analyze the data. The percentages of living and deceased donor LTs were 81.0% and 19.0%, respectively. The mean BMIs pre- and post-LT were 23.88 and 23.16 kg/m², respectively, and the average MDA score was 36.55. More than 60.0% of the subjects had a moderate or high level of physical activity. In multivariate analysis, a higher BMI before LT (β=.72, p<.001), a lower Model for End-stage Liver Disease (MELD) score (β=-.18, p<.001), and being male (β=-.10, p=.024) contributed to better nutritional status post-LT. Patients within six months of LT were less engaged in muscle exercises than those post six months of LT (p=.020). LT recipients in Korea have good nutritional status and a good level of physical activity. To improve recipients' post-LT nutritional status, the pre-LT nutritional status should be considered, particularly in those with a higher MELD score. In addition, physical activity including muscle-strengthening exercises should be encouraged from an earlier stage.


The water agar test: a new test to measure the bacteriological quality of cream.
A new test, the water agar test, is described that gives a qualitative index of the presence of bacteria that indicate contamination of the cream, poor storage conditions or both of these factors. The method is simple and requires little equipment. The bacteria grow in a film of diluted cream adsorbed on the surface of a non-nutrient base. After incubation at 30 +/- 0-5 degrees C. for 18-20 hr., a proteolytic and mucoid colony count is obtained which has the same percentage coefficient of variance as a standard plate count. An examination of the effect of storage at different temperatures on the types of bacteria present in cream showed that of all the tests done initially, only the water agar test could predict subsequent bacterial growth with any consistency. The multiplication of presumptive coliform organisms occurred even at 3-5 degrees C. Irrespective of the colony count, the methylene blue reduction time was not shorter than 7 1/2 hr. unless the bacteria were in the logarithmic phase of growth when sampled. A survey was made of the bacterial flora of 188 retail samples of double cream of 15 different brands. The age of the samples varied from freshly separated cream to cream that had been kept in the shop for a day longer than that recommended for sale. The water agar test was compared with the colony count, the presumptive coliform test, a confirmatory coliform count in violet red-bile agar, a lipolytic colony count, a staphylococcal count and the methylene blue reduction test.


Theranostic microwave applicator suitable for minimal invasive therapy of malignant tissue.
A microwave applicator is presented that realizes the theranostic approach by providing two operation modes to detect and treat tumor cells, exemplary in the liver. The tool is based on a planar sensor structure with Split Ring Resonators (SRR) as key elements. For the detection, changes in dielectric properties caused by tissue abnormalities are evaluated by analyzing shifts in the resonance frequency of the SRR. For the treatment mode, the input power is amplified to the specific resonance frequency and microwave ablation is performed. The device is designed to fit into a needle like operation tool for minimal invasive therapies. From this requirement, challenges concerning size limitation, packaging, and bio compatibility can be derived. Therefore, novel shapes of the SRR and substrate materials are investigated by full wave simulations and measurements. Material models and phantoms mimicking dielectric properties of healthy and malignant tissue are introduced. Clear resonance shifts of 100 MHz are detected for loading the sensor with corresponding phantoms. In order to examine the treatment mode characteristics, thermal simulations and measurements exhibit a significant temperature increase up to 62 °C for an input power of 500 mW.


Structural Elements of the Biomechanical System of Soft Tissue.
In living organisms, forces are constantly generated and transmitted throughout tissue. Such forces are generated through interaction with the environment and as a result of the body's endogenous movement. If these internally or externally originating forces exceed the ability of tissues to cope with the applied forces, (i.e. "tissue thresholds"), they will cause force-related tissue harm. However, biotensegrity systems act to prevent these forces from causing structural damage to cells and tissues. The mechanism and structure of soft tissues that enable them to maintain their integrity and prevent damage under constantly changing forces is still not fully understood. The current anatomical and physical knowledge is insufficient to assess and predict how, why, where, and when to expect force-related tissue harm. When including the concept of tensegrity and the related principles of the hierarchical organisation of the elements of the subcellular tensional homeostatic structure into current biomechanical concepts, it increases our understanding of the events in force handling in relation to the onset of force-related tissue harm: Reducing incident forces in tissue to a level that is not harmful to the involved structures is achieved by dissipation, transduction and transferring the force in multiple dimensions. To enable this, the biomechanical systems must function in a continuous and consistent way from the cellular level to the entire body to prevent local peak forces from causing harm. In this article, we explore the biomechanical system with a focus on biotensegrity concepts across several organisational levels, describing in detail how it may function and reflecting on how this might be applied to patient management.


The application of percutaneous endoscopic colostomy to the management of obstructed defecation.
We describe the case of a 52-year woman with a 17-year history of obstructed defecation in whom all other standard treatments had failed and the patient had refused a colostomy. Her symptoms were controlled by percutaneous endoscopic colostomy with antegrade colonic irrigation. A percutaneous endoscopic colostomy tube was placed in the sigmoid colon endoscopically using a colonoscope and the patient irrigated two liters of water through the percutaneous endoscopic colostomy twice each day and was able to successfully evacuate her rectum without excess straining or discomfort. Percutaneous endoscopic colostomy is an alternative option to colostomy in the management of obstructed defecation.


Implications of electronic health record downtime: an analysis of patient safety event reports.
We sought to understand the types of clinical processes, such as image and medication ordering, that are disrupted during electronic health record (EHR) downtime periods by analyzing the narratives of patient safety event report data. From a database of 80 381 event reports, 76 reports were identified as explicitly describing a safety event associated with an EHR downtime period. These reports were analyzed and categorized based on a developed code book to identify the clinical processes that were impacted by downtime. We also examined whether downtime procedures were in place and followed. The reports were coded into categories related to their reported clinical process: Laboratory, Medication, Imaging, Registration, Patient Handoff, Documentation, History Viewing, Delay of Procedure, and General. A majority of reports (48.7%, n = 37) were associated with lab orders and results, followed by medication ordering and administration (14.5%, n = 11). Incidents commonly involved patient identification and communication of clinical information. A majority of reports (46%, n = 35) indicated that downtime procedures either were not followed or were not in place. Only 27.6% of incidents (n = 21) indicated that downtime procedures were successfully executed. Patient safety report data offer a lens into EHR downtime-related safety hazards. Important areas of risk during EHR downtime periods were patient identification and communication of clinical information; these should be a focus of downtime procedure planning to reduce safety hazards. EHR downtime events pose patient safety hazards, and we highlight critical areas for downtime procedure improvement.


Photocatalytic Multielectron Reduction of Nitroarenes to Anilines by Utilizing an Electron-Storable Polyoxometalate-Based Metal-Organic Framework.
A powerful approach to generate photocatalysts for the highly selective reduction of nitrobenzene using light as the driving force is a combination of photosensitizers and electron-storable components in a cooperative photocatalysis fashion. Herein, a new precious metal-free photocatalyst, {ZnW-TPT}, was prepared by incorporating a Zn-substituted monovacant Keggin polyanion [SiZnW11O39]6- and a photoactive organic bridging link 2,4,6-tri(4-pyridyl)-1,3,5-triazine (TPT) into a framework. In this structure, the direct coordination bond between [SiZnW11O39]6- and the TPT ligand and the π-π interactions between TPT molecules help separate and migrate photogenerated carriers, which improves the photocatalytic activity of {ZnW-TPT}. The photoelectrochemical properties of {ZnW-TPT} were well studied by solid UV-vis absorption, fluorescence, transient photocurrent response, and electrochemical impedance spectroscopy tests. {ZnW-TPT} efficiently converts using hydrazine hydrate with 99% conversion and 99% selectivity for anilines under mild conditions.


Lymphocyte phenotypes in cervical intraepithelial neoplasia and human papillomavirus infection.
Lymphocyte phenotypes in cervical mucosa were studied using a panel of monoclonal antibodies. T lymphocytes were predominant both within the epithelium and in the subepithelial stroma. In the normal cervix, both the T4+ (helper/inducer) and T8+ (suppressor/cytotoxic) subsets were present in a ratio similar to that in the peripheral circulation. In human papillomavirus (HPV) infection and cervical intraepithelial neoplasia (CIN) there was depletion of intraepithelial lymphocytes, especially of T4+ subset, with reversal of the ratio of T4+ to T8+ subsets to less than one. In contrast, there was no significant reduction in the number of lymphocytes in the subepithelial stroma. Tac+ (antigen primed and clonal expanding) lymphocytes were absent both within the epithelium and in the subepithelial stroma. These findings support our suggestion that there is a localized immunodeficiency in HPV infection and CIN. The aetiological and therapeutic implications are discussed.


Modelling spinal circuitry involved in locomotor pattern generation: insights from the effects of afferent stimulation.
A computational model of the mammalian spinal cord circuitry incorporating a two-level central pattern generator (CPG) with separate half-centre rhythm generator (RG) and pattern formation (PF) networks has been developed from observations obtained during fictive locomotion in decerebrate cats. Sensory afferents have been incorporated in the model to study the effects of afferent stimulation on locomotor phase switching and step cycle period and on the firing patterns of flexor and extensor motoneurones. Here we show that this CPG structure can be integrated with reflex circuits to reproduce the reorganization of group I reflex pathways occurring during locomotion. During the extensor phase of fictive locomotion, activation of extensor muscle group I afferents increases extensor motoneurone activity and prolongs the extensor phase. This extensor phase prolongation may occur with or without a resetting of the locomotor cycle, which (according to the model) depends on the degree to which sensory input affects the RG and PF circuits, respectively. The same stimulation delivered during flexion produces a temporary resetting to extension without changing the timing of following locomotor cycles. The model reproduces this behaviour by suggesting that this sensory input influences the PF network without affecting the RG. The model also suggests that the different effects of flexor muscle nerve afferent stimulation observed experimentally (phase prolongation versus resetting) result from opposing influences of flexor group I and II afferents on the PF and RG circuits controlling the activity of flexor and extensor motoneurones. The results of modelling provide insights into proprioceptive control of locomotion.


Mass and size effects in three-dimensional vibrofluidized granular mixtures.
We examine the steady state properties of binary systems of driven inelastic hard spheres. The spheres, which move under the influence of gravity, are contained in a vertical cylinder with a vibrating base. We computed the trajectories of the spheres using an event-driven molecular dynamics algorithm. In the first part of the study, we chose simulation parameters that match those of experiments published by Wildman and Parker. Various properties computed from the simulation including the density profile, granular temperature, and circulation pattern are in good qualitative agreement with the experiments. We then studied the effect of varying the mass ratio and the size ratio independently while holding the other parameters constant. The mass and size ratio are shown to affect the distribution of the energy. The changes in the energy distributions affect the packing fraction and temperature of each component. The temperature of the heavier component has a nonlinear dependence on the mass of the lighter component, while the temperature of the lighter component is approximately proportional to its mass. The temperature of both components is inversely dependent on the size of the smaller component.


The loss of sensitization of mouse and rat mast cells by acid pH treatment.
Short incubation of sensitized mouse and rat peritoneal mast cells at 37 degrees C in well defined acid pH (3.5 for mouse and 4.5 for rat mast cells) induces the loss of sensitization, as indicated by antigen-induced histamine release. The acid pH pretreatment of normal mouse and rat mast cells seems to facilitate their subsequent sensitization with mouse IgE antibodies. The possibility, that acid pH treatment removes non-specific IgE from the cells and thus facilitates the binding of specific IgE antibodies is discussed.


[In situ hybridization--an expansion of dermatologic histopathology].
By means of in-situ-hybridization, we are able to detect specifically the mRNAs of defined proteins at a cellular level in frozen sections. This technique not only makes it possible to characterize the biosynthesis of defined proteins at a pretranslational level but can also identify activated cells in their histological surroundings. We employed this technique in order to detect collagen mRNAs in fibrotic diseases of the skin. Using cDNA clones for collagen type I, we proved that in early stages of scleroderma the fibrosis starts in the deep dermis and the subcutaneous fatty tissue. In addition, the regulation of the collagen synthesis seems to be disturbed at a pretranslational level and accompanied by dramatically increased levels of collagen mRNA in fibroblasts. This technique offers objective parameters for collagen mRNA and may be especially useful to estimate the activity of fibrotic diseases in individual patients as well as during therapeutical trials.


Characterization of the Palyam serogroup viruses (Reoviridae: Orbivirus).
31 Palyam serogroup viruses were examined by complement-fixation and plaque-reduction neutralization tests and by PAGE of the segmented, double-stranded (ds) RNA genome. Although the viruses were indistinguishable by complement-fixation tests, 10 distinct virus serotypes were identified by plaque-reduction neutralization methods. Palyam group viruses which were distinct by the neutralization test had unique dsRNA profiles, whereas those agents which were indistinct by the neutralization test had identical dsRNA profiles. 20 isolations of 3 Palyam serotypes were made from bovines and Culicoides midges in Australia over a 9-year period. When the genome of these isolates was examined electrophoretically, the dsRNA profiles of virus isolates within a given serotype were identical.


Improvement of recombinant hGM-CSF production by suppression of cysteine proteinase gene expression using RNA interference in a transgenic rice culture.
Recombinant proteins have been previously synthesized in a transgenic rice cell suspension culture system with the rice amylase 3D promoter, which can be induced via sugar starvation. However, the secreted recombinant proteins have been shown to be rapidly decreased as the result of proteolytic degradation occurring during prolonged incubation. The secreted proteases were identified via two-dimensional electrophoresis (2-DE) and ESI/Q-TOF mass spectrometry analyses. The internal amino acid sequences of 8 of 37 spots corresponded to cysteine proteinase (CysP), which is encoded for by Rep1 and EP3A. This result shows that CysP is a major secreted protease in rice cell suspension cultures following induction via sugar starvation. Intron-containing self-complementary hairpin RNA (ihpRNA)-mediated post-transcriptional gene silencing (PTGS) was applied to suppress the expression of CysP in rice cell suspension cultures. The reduction of rice CysP mRNA and the detection of siRNA specific to CysP, an initiator of RNAi, were verified via Northern blot analysis and RNase protection assays, respectively, thereby indicating that PTGS operated successfully in this system. The analysis of total secreted protease and CysP activities evidenced lower activity than was observed with the wild-type. Furthermore, suspension cultures of rice cells transformed with both hGM-CSF and the gene expressing the ihpRNA of CysP evidenced a reduction in total protease and CysP activities, and an up to 1.9-fold improvement in hGM-CSF production as compared to that observed in a rice cell line expressing hGM-CSF only. These results demonstrate the feasibility of the suppression of CysP via RNA interference to reduce protease activity and to increase target protein accumulation in rice cell suspension cultures.


[Comparative study on ecotoxicological indexes of crops exposure to reactive X-3B red dye].
Ecotoxicological indexes of wheat, Chinese cabbage and rice exposed to reactive X-3B red dye were studied using the experimental method of crop seed exposure. The results showed that reactions of the three crops to reactive X-3B red dye were different from each other. Based on the inhibition of seed gemination, the half effect concentration(IC50) of wheat, Chinese cabbage and rice was 8965, 7010 and 7514 mg.L-1. Based on the inhibition of root elongation, the IC50 of wheat, Chinese cabbage and rice was 6534, 5882 and 4570 mg.L-1. When seedlings were cultured for seven days after the gemination of seeds and the remaining seeds or husks were discarded, fresh and dry growing biomass of the three crops exposed to the dye was both decreased with the increasing the concentration of reactive X-3B red dye. However, the decrease rate of fresh biomass was higher than that of dry biomass. Biomass index of wheat was most sensitive to reactive X-3B red dye, followed by rice, and Chinese cabbage was most inertia when the crops were exposed to reactive X-3B red dye with the high concentration of 4500 and 5000 mg.L-1. As far as the tolerance of wheat, Chinese cabbage and rice to reactive X-3B red dye was concerned, wheat had the strongest tolerance, on the contrary rice had the wakestone.


Grief Symptoms in Relatives Who Experienced Organ Donation Requests in the ICU.
Studies show that the quality of end-of-life communication and care have a significant impact on the living long after the death of a relative and have been implicated in the burden of psychological symptoms after the ICU experience. In the case of organ donation, the patient's relatives are centrally involved in the decision-making process; yet, few studies have examined the impact of the quality of communication on the burden of psychological symptoms after death. To assess the experience of the organ donation process and grief symptoms in relatives of brain-dead patients who discussed organ donation in the ICU. We conducted a multicenter longitudinal study in 28 ICUs in France. Participants were the relatives of brain-dead patients who were approached to discuss organ donation. Relatives were followed-up by phone at three time points: at 1 month, to complete a questionnaire describing their experience of the organ donation process; at 3 months, to complete the Hospital Anxiety and Depression Scale and the Impact of Event Scale-Revised; and at 9 months, to complete the Impact of Event Scale-Revised and the Inventory of Complicated Grief. In total, 202 relatives of 202 patients were included, of whom 158 consented to and 44 refused organ donation. Interviews were conducted at 1, 3, and 9 months with 78%, 68%, and 58% of relatives, respectively. The overall experience of the organ donation process was significantly more burdensome for relatives of nondonors. They were more dissatisfied with communication (27% vs. 10%; P = 0.021), more often shocked by the request (65% vs. 19%; P < 0.0001), and more often found the decision difficult (53% vs. 27%; P = 0.017). However, there were no significant differences in grief symptoms measured at 3 and 9 months between the two groups. Understanding of brain death was associated with grief symptoms; our results show a higher prevalence of complicated grief symptoms among relatives who did not understand the brain death process than among those who did (75% vs. 46.1%; P = 0.026). Experience of the organ donation process varied between relatives of donor versus nondonor patients, with relatives of nondonors experiencing lower-quality communication, but the decision was not associated with subsequent grief symptoms. Importantly, understanding of brain death is a key element of the organ donation process for relatives.


The effect of surface roughness on ceramics used in dentistry: A review of literature.
Long term clinical success of modern dental ceramics depends on a number of factors. These factors include the physical properties of the material, the laboratory fabrication process, the laboratory fabrication technique and clinical procedures that may damage these brittle materials. The surface structure and composition of a dental restorative material influences the initial bacterial adhesion, and a rough material surface will accumulate more plaque. Biomaterials for the restoration of oral function are prone to biofilm formation, affecting oral health. An up to date online database search was performed using the keywords "bacterial biofilm," "ceramic strength," "dental ceramics" and "surface roughness." The searches were performed on Medline/PubMed, and Scopus and the cross references were further searched in the databases to verify further studies. The relevant papers included original articles, systemic reviews, case reports and letters to the editor. All the papers were reviewed, and the most relevant studies were selected for referencing by the author. The aim of this paper is to highlight the influence of rougher surfaces on the ceramic strength and plaque accumulation leading to bacterial biofilm formation.


Assessment of pulmonary dynamics in normal newborns: a pneumotachographic method.
A pneumotachographic method for assessment of pulmonary dynamics in critically ill newborns in an intensive care setting was developed in our laboratory. Before the results obtained with this method could be applied, the normal range of values were determined in 48 normal term and preterm newborns. Their body weight ranged between 1200 and 4100 g, and postnatal ages between 24 hours and 21 days. In three infants, two determinations were performed after an interval of 7 days. The studies were performed with a pneumotachograph applied to the upper airway by means of an inflatable face mask or latex nasal prongs. The air flow signal was electronically integrated to time to produce a volume signal. Airway pressure was determined proximal to the pneumotachograph. Esophageal pressure was determined with a water filled catheter placed in the lower third of the esophague. Tidal volume (VT), minute ventilation (V), Dynamic compliance (Cdyn), total pulmonary resistance (R), total pulmonary work (Wt), Elastic work (We), and flow resistive work (Wv), were determined. A significant linear correlation was found between Cdyn and body weight (r = 0.50, p less than 0.01) whereas no significative correlation was found between body weight and VT, V or R. Values for VT, V and Cdyn were corrected for body weight and means (X), standard deviation (SD) so as 10th and 90th percentiles are shown in table III. X, SD and percentiles for R were shown in table III. Wt, We and Wv were corrected for V, and X, SD and percentiles shown in table III. Values of VT/Kg, Cdyn/Kg and R are similar to those found by other authors with pneumotachography and plethysmography. The V/Kg values obtained by us were higher than those reported by other authors, which together with the lack of correlation of VT and V with body weight, question the reliability of V values in our study. This could be explained by: 1) excessive increase in dead space in cases in which a face mask was used; 2) nocioceptive stimulus produced by face mask or nasal prongs; 3) inadequate selection of the moment at which the record was obtained. Whichever the explanation, our values of V cannot be considered as basal, and should be interpreted with caution. The results obtained allow us to continue with our program and apply this method to the study of newborn infants with RDS.


Energy metabolism during chronic endotoxin infusion in the rat, with special reference to free fatty acid turnover.
We have studied various aspects of whole-body energy metabolism during chronic endotoxin infusion in the rat. In particular, we studied free fatty acid kinetics using bolus injections of 14C-palmitate. The general response to 7 days of chronic endotoxin infusion could be divided into an initial 3- to 4-day period of illness with loss of appetite, followed by rapid recovery. Using saline-infused, pair-fed controls, the following observations were made throughout the 7-day period of endotoxin infusion: 1) Plasma free fatty acids, glycerol and 3-hydroxybutyrate concentrations were reduced; 2) plasma glucose concentrations were elevated; 3) free fatty acid production rates were unaffected; 4) metabolic clearance of free fatty acids was unaffected on day 1 but was significantly greater on days 3 and 7; 5) haematocrits and plasma volumes were elevated. The results suggest that the observed changes in circulating free fatty acid concentrations are more likely to be a consequence of haemodynamic alterations than of metabolic alterations.


Mono- and dinuclear metal complexes containing the 1,5,9-triazacyclododecane ([12]aneN3) unit and their interaction with DNA.
The ability of mononucleating and dinucleating macrocylic polyamines and their novel nickel, copper and zinc complexes to induce the left-handed form of poly d(GC) was evaluated. The influence of the nuclearity, the presence or absence of metals ions, the linker length in the case of dinucleating ligands and the metal ion was determined. Almost all dinuclear metal complexes efficiently induced Z-DNA, the zinc ones being the least and the copper ones the most efficient ones. Additionally, the X-ray structures of three dinuclear metal complexes and one partially protonated ligand could be determined.


Melatonin reduced endometrial hyperplasia induced by estradiol in female albino rats.
Melatonin, the pineal gland hormone, plays a crucial role in regulation of neuroendocrine and defensive functions, free radicals neutralization, and suppresses angiogenesis, proliferation and cancer. The purpose of designing our study is to assess the effect of estradiol benzoate and its combination with melatonin on uteri of female albino rats. For 4 weeks, the present study was conducted on thirty six female rats separated into 3 groups: Control group (rats received the vehicle), EB group (rats were treated by estradiol benzoate (600 μg/kg intramuscular) for induction of endometrial hyperplasia), and EB+Mel group (rats were treated with estradiol benzoate (600 μg/kg) plus melatonin (50 µg/ml) added to drinking water. Melatonin administration reduced estradiol benzoate-induced endometrial hyperplasia and prevented the occurrence of atypia associated with a significant reduction in lipid peroxide level and NF-κB mRNA and a significant rise in immune-expression of caspase-3, interleukin-2 (IL-2) mRNA and total antioxidant levels in uterine tissues. The results demonstrated that melatonin reduced estradiol benzoate action on the endometrium.


Boron-MgO composite as an X-ray transparent pressure medium in the multi-anvil apparatus.
X-ray transparent materials are very beneficial for in situ X-ray experiments in the multi-anvil apparatus. We sintered machinable blocks of boron-MgO composites at 800-1000 °C under atmospheric pressure from a mixture of amorphous boron and brucite or Mg(OH)2. The machinability of composite blocks improved with an increase in the brucite content in the starting material; a brucite content higher than 15 wt. % showed reasonable machinability in forming various shapes such as octahedron, cylinder, and sleeve. We confirmed the feasibility of the boron-MgO pressure medium by successfully generating lower mantle pressure (>23 GPa); its pressure generation efficiency is comparable to that of a Cr2O3 doped MgO pressure medium. The boron-MgO composite is expected to be an excellent thermal insulator owing to the extremely low thermal conductivity of amorphous boron; we confirmed its better thermal insulation performance through a comparative heating test with a zirconia sleeve in a Cr2O3 doped MgO pressure medium. Constituting light elements, the boron-MgO composite has high X-ray transparency, which enables us to conduct various cutting edge X-ray measurements in the large volume multi-anvil apparatus.


Helminth antigens selectively differentiate unsensitized CD45RA+ CD4+ human T cells in vitro.
Human filarial helminth infections are characterized by type 2 immune responses to parasite Ag that can persist for the life of the individual; one possible cause for this may be prenatal exposure to the blood-borne microfilarial (Mf) stage of the parasite. To examine the relationship between early exposure to filarial Ag and subsequent immune responsiveness, CD45RA+ CD4+ cells frp, normal unsensitized donors were stimulated in vitro with soluble microfilarial Ag (MfAg) from the filarial parasite Brugia malayi in the presence of APCs. MfAg alone induced proliferation and IFN-gamma and IL-5 production in unsensitized CD45RA+ CD4+ cells, demonstrating the ability of filarial Ags to prime naive T cells in the absence of exogenous cytokines and dendritic cells. Adding exogenous cytokine(s) (particularly IL-12 and IL-4) during priming was able to alter the MfAg-specific responses of CD45RA+ CD4+ cells as well as subsequent responses to Ag. Interestingly, priming solely with MfAg led to enhanced IL-5 production following Ag restimulation, suggesting that MfAg preferentially primes for type 2 responses. These data demonstrate that filarial Ags by themselves can specifically prime CD45RA+ CD4+ cells in vitro and do so in such a way as to deviate the immune response.


Modular and hierarchically modular organization of brain networks.
Brain networks are increasingly understood as one of a large class of information processing systems that share important organizational principles in common, including the property of a modular community structure. A module is topologically defined as a subset of highly inter-connected nodes which are relatively sparsely connected to nodes in other modules. In brain networks, topological modules are often made up of anatomically neighboring and/or functionally related cortical regions, and inter-modular connections tend to be relatively long distance. Moreover, brain networks and many other complex systems demonstrate the property of hierarchical modularity, or modularity on several topological scales: within each module there will be a set of sub-modules, and within each sub-module a set of sub-sub-modules, etc. There are several general advantages to modular and hierarchically modular network organization, including greater robustness, adaptivity, and evolvability of network function. In this context, we review some of the mathematical concepts available for quantitative analysis of (hierarchical) modularity in brain networks and we summarize some of the recent work investigating modularity of structural and functional brain networks derived from analysis of human neuroimaging data.


Slow dynamics, aging, and crystallization of multiarm star glasses.
Multiarm star polymers are model systems with tunable intermediate colloid to polymerlike character, exhibiting rich phase behavior, internal relaxations, and flow properties. An important puzzle for several years has been the lack of clear experimental proof of crystalline states despite strong theoretical predictions. We present unambiguous evidence via multispeckle dynamic light scattering (MSDLS) and small-angle neutron scattering (SANS) for such crystallization in a solvent of intermediate quality. An unexpected speed up of the short-time star diffusion observed in MSDLS was attributed by SANS to crystallization, via aging, of the multiam star glass. This delayed glass to crystal transition establishes a pathway for star crystallization that might be generic in colloidal glasses.


Ganglioglial differentiation in medulloblastoma.
A case of cerebellar medulloblastoma with clusters of mature ganglion cells and glial cells is described. The patient, a 15-year-old girl, underwent three operations followed each time by radiation and chemotherapy during the four-year clinical course. Histologically, the ganglion cells were clearly identifiable by their abundant eosinophilic cytoplasm, round nuclei with prominent nucleoli, tigroid granules, and argyrophilic fibrils and axons. Immunohistochemically, the cells were NSE- and NF-positive, and ultrastructurally they contained abundant tubules and filaments, neurosecretory granules and well developed rough endoplasmic reticulum. There were many cells transitional in appearance between primitive cells and mature ganglion cells. The tumor also had many mature yet atypical astrocytes and oligodendrocytes. The exact mechanism of the extensive neuronal and glial maturation of medulloblastoma cells is unclear, but the repetitive surgical interventions, radiation and chemotherapy might have had certain cytostatic effects on rapidly dividing medulloblastoma cells, giving them a chance to mature into postmitotic cells with potential for neuronal and glial differentiation.


The tungsten carbide-carbon monoxide-tungsten buffer and its use for synthesizing iron-bearing silicates in muffle furnaces.
A new "solid-state" oxygen buffering reaction (WC-COW), WC + 1/2O2 ⇌ CO + W, is presented. At atmospheric pressure, the oxygen fugacity in equilibrium with this buffer is approximated in the range of 600-1200 °C by logfO2 =1.53-21008TK±0.13bar. A simple method for maintaining oxygen fugacity in standard muffle furnaces using this buffer in off-the-shelf ceramic crucibles is described. The utility of the experimental arrangement in controlling oxygen fugacity during solid-state synthesis of iron-bearing silicates is demonstrated by rapid synthesis of fayalite, Fe2SiO4, from oxide starting mixtures at 1050 °C.


Pediatric Laparoscopy and Adaptive Oxygenation and Hemodynamic Changes.
Adaptive changes in oxygenation and hemodynamics are evaluated during pediatric laparoscopy. The children underwent laparoscopy (LAP Group, n=20) or open surgery (Open Group, n=10). Regional cerebral (rScO2) and peripheral oxygen saturation (SpO2), heart rate (HR), diastolic (DP) and systolic pressure (SP) were monitored at different intervals: basal (T0); anesthesia induction (T1); CO2PP insufflation (T2); surgery (T3); CO2PP cessation (T4); before extubation (T5). At T1, in both the LAP and Open groups significant changes in rScO2, DP and SP were recorded compared with T0; a decrease in SatO2 was also observed at T5. In the LAP group, at T2, changes in HR related to CO2PP pressure and in DP and SP related to IAP were noted; at T4, a SP change associated with CO2PP desufflation was recorded. Open group, at T3 and T5 showed lower rScO2 values compared with T1. Pneuperitoneum and anesthesia are influent to induce hemodynamics changes during laparoscopy.


The synthesis of recombinant membrane proteins in yeast for structural studies.
Historically, recombinant membrane protein production has been a major challenge meaning that many fewer membrane protein structures have been published than those of soluble proteins. However, there has been a recent, almost exponential increase in the number of membrane protein structures being deposited in the Protein Data Bank. This suggests that empirical methods are now available that can ensure the required protein supply for these difficult targets. This review focuses on methods that are available for protein production in yeast, which is an important source of recombinant eukaryotic membrane proteins. We provide an overview of approaches to optimize the expression plasmid, host cell and culture conditions, as well as the extraction and purification of functional protein for crystallization trials in preparation for structural studies.


Development and validation of a questionnaire on the feelings of undergraduate dental students regarding child dental care.
This study aimed to develop and test a questionnaire's validity and reliability to evaluate undergraduate dental students' feelings regarding child dental care. The questionnaire was developed using a focus group of 10 undergraduate dental students. This questionnaire was then structured and applied digitally via Google Forms to 90 dental students aged 22.95 years (±0.89) who had already completed or were enrolled in a pediatric dentistry discipline. The test-retest was conducted with 15 students. Descriptive analysis, exploratory factorial analysis (EFA), and intraclass correlation coefficient were performed to evaluate the test-retest reliability, Cronbach's alpha (α) to measure the internal consistency, and Mann-Whitney test was used to determine the discriminant validity (p < 0.05). The final version of the questionnaire concerning the feelings of dental students when faced with pediatric dental treatment comprised three items, which evaluated anxiety, fear, and insecurity. The visual analog scale was used to evaluate the answer for each item. The questionnaire resulted in a total score that varied from 0 to 10. The higher the score on the questionnaire, the greater the negative feelings regarding pediatric dental treatment. The results of the EFA were satisfactory (Bartlett's sphericity = 0.001; Kayser-Meyer-Olkin measure = 0.725). The EFA extracted a single dimension with an eigenvalue of 2.4 and a total explained variance of 80%. The internal consistency of the questionnaire was satisfactory (α = 0.877), and the test-retest reliability was good (intraclass correlation coefficient = 0.691). Students who felt confident about carrying out invasive procedures in children demonstrated more positive feelings related to the pediatric dental treatment (average = 3.50 ± 2.73) than those who did not feel such confidence (average = 5.00 ± 2.35; p = 0.007). The unidimensional questionnaire proposed by this study is valid and reliable in evaluating the feelings of undergraduate dental students regarding child dental care.


Complement activation and immune complexes in children with polyarticular juvenile rheumatoid arthritis: a longitudinal study.
To determine whether levels of either circulating immune complexes (IC) or complement activation fragments change as disease activity changes in children with polyarticular juvenile rheumatoid arthritis (JRA). Twenty-six children with polyarticular JRA were examined over a time course of 4-21 months. Plasma complement activation fragments and IC were measured by commercially available enzyme linked immunoabsorbant assays. Both complement activation fragments and IC levels were lower in individual children when their articular disease was inactive. Children with persistently active disease had no change in any of these measures. Elevated levels of plasma IC and complement activation fragments are features of active polyarticular JRA. We believe our data support a role for the complement system in the pathophysiology of polyarticular JRA.


Oral pigmentation as an adverse effect of chloroquine and hydroxychloroquine use: A scoping review.
Chloroquine and hydroxychloroquine are 2 medications used to treat some systemic diseases. The aim of this scoping review was to assess the occurrence of oral pigmentation induced by chloroquine or hydroxychloroquine and to understand the pathogenic mechanism behind this phenomenon. The review was performed according to the list of PRISMA SrC recommendations and the JBI Manual for Evidence Synthesis for Scoping Reviews. MEDLINE (PubMed), Scopus, EMBASE, SciELO, Web of Science, Lilacs, and LIVIVO were primary sources, and "gray literature" was searched in OpenThesis and Open Access Thesis and Dissertations (OATD). Studies that screened the occurrence of oral pigmentation associated to the use of chloroquine or hydroxychloroquine were considered eligible. No restrictions of year and language of publication were applied. Study selection and data extraction were performed by 2 independent reviewers. The risk of bias was assessed through the JBI tool, depending on the design of the selected studies. The initial search resulted in 2238 studies, of which 19 were eligible. Sixteen studies were case reports, 2 had case-control design and 1 was cross-sectional. Throughout the studies, 44 cases of oral pigmentation were reported. The hard palate was the anatomic region most affected with pigmentation (66%). According to the case reports, most of the lesions (44%) were bluish-gray. The minimum time from the beginning of treatment (chloroquine or hydroxychloroquine) to the occurrence of pigmentation was 6 months. The mean treatment time with the medications was 4.9 years, and the mean drug dosage was 244 mg. Most of the studies (63.1%) had low risk of bias (high methodological quality). The outcomes of this study suggest that hyperpigmentation depend on drug dosage and treatment length. Hyperpigmentation was detected after a long period of treatment with chloroquine or hydroxychloroquine.


T-cell receptor and B-cell receptor repertoire profiling in adaptive immunity.
B-cell receptors and T-cell receptors are the key molecules responsible for specific antigen recognition in adaptive immunity. The huge diversity of immune receptor repertoires constrained their comprehensive studies in the past. More recently, however, high-throughput sequencing based techniques have revolutionized the field of immune receptor repertoire profiling enabling new insights into the development and function of the adaptive immune system. In this review we describe current methods for immune receptor profiling and software tools used for repertoire reconstruction from raw sequencing data. We also provide examples of how immune repertoire profiling can be used to study adaptive immunity in disease and in the course of organ and bone marrow transplantation.


Cheese and cheese infusions: ecological traps for mosquitoes and spotted wing Drosophila.
Harnessing insect ecology for insect control is an innovative concept that seeks to exploit, among others, insect-microbe ecological interactions for improved control of pest insects. Microbe-produced cheese odour attracts several dipterans, including host-seeking mosquitoes, but this phenomenon has not been thoroughly explored for mosquito control. Here we tested the hypothesis that attraction of mosquitoes to cheese odour can be exploited as an ecological trap for mosquito control. In laboratory and/or field experiments, we show that (i) each of five cheese varieties tested (Raclette, Pecorino, Brie, Gruyere, Limburger) strongly attracts female Aedes aegypti and Culex pipiens; (ii) cheese infusions, or headspace odourant extracts (HOEs) of cheese infusions, significantly affect oviposition choices by mosquitoes, (iii) HOEs contain at least 13 odourants; (iv) in field settings, cheese infusions more effectively stimulate mosquito oviposition than positive bluegrass infusion controls, and also capture (by drowning) the spotted wing Drosophila, Drosophila suzukii; and (v) home-made cheese infusions modulate oviposition choices by mosquito females and affect the survivorship of their offspring larvae. Our data show that microbial metabolites associated with cheese are attractive to mosquito females seeking hosts and oviposition sites and are likely toxic to mosquito larvae. These microbes and their metabolites could thus be co-opted for both the attract, and the kill, function of 'attract & kill' mosquito control tactics. Implementation of customizable and non-conventional nutritional media as microbe-based ecological traps presents a promising concept which exploits insect ecology for insect control. © 2021 Society of Chemical Industry.


An Update on MYBPC3 Gene Mutation in Hypertrophic Cardiomyopathy.
Hypertrophic cardiomyopathy (HCM) is the most prevalent genetically inherited cardiomyopathy that follows an autosomal dominant inheritance pattern. The majority of HCM cases can be attributed to mutation of the MYBPC3 gene, which encodes cMyBP-C, a crucial structural protein of the cardiac muscle. The manifestation of HCM's morphological, histological, and clinical symptoms is subject to the complex interplay of various determinants, including genetic mutation and environmental factors. Approximately half of MYBPC3 mutations give rise to truncated protein products, while the remaining mutations cause insertion/deletion, frameshift, or missense mutations of single amino acids. In addition, the onset of HCM may be attributed to disturbances in the protein and transcript quality control systems, namely, the ubiquitin-proteasome system and nonsense-mediated RNA dysfunctions. The aforementioned genetic modifications, which appear to be associated with unfavorable lifelong outcomes and are largely influenced by the type of mutation, exhibit a unique array of clinical manifestations ranging from asymptomatic to arrhythmic syncope and even sudden cardiac death. Although the current understanding of the MYBPC3 mutation does not comprehensively explain the varied phenotypic manifestations witnessed in patients with HCM, patients with pathogenic MYBPC3 mutations can exhibit an array of clinical manifestations ranging from asymptomatic to advanced heart failure and sudden cardiac death, leading to a higher rate of adverse clinical outcomes. This review focuses on MYBPC3 mutation and its characteristics as a prognostic determinant for disease onset and related clinical consequences in HCM.