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Retriever2300
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Robustness to extinction and plasticity derived from mutualistic bipartite ecological networks.
Understanding the response of ecological networks to perturbations and disruptive events is needed to anticipate the biodiversity loss and extinction cascades. Here, we study how network plasticity reshapes the topology of mutualistic networks in response to species loss. We analyze more than one hundred empirical mutualistic networks and considered random and targeted removal as mechanisms of species extinction. Network plasticity is modeled as either random rewiring, as the most parsimonious approach, or resource affinity-driven rewiring, as a proxy for encoding the phylogenetic similarity and functional redundancy among species. This redundancy should be positively correlated with the robustness of an ecosystem, as functions can be taken by other species once one of them is extinct. We show that effective modularity, i.e. the ability of an ecosystem to adapt or restructure, increases with increasing numbers of extinctions, and with decreasing the replacement probability. Importantly, modularity is mostly affected by the extinction rather than by rewiring mechanisms. These changes in community structure are reflected in the robustness and stability due to their positive correlation with modularity. Resource affinity-driven rewiring offers an increase of modularity, robustness, and stability which could be an evolutionary favored mechanism to prevent a cascade of co-extinctions.
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No pos
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No neg
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Retriever2301
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DNA Replication Stress and Chromosomal Instability: Dangerous Liaisons.
Chromosomal instability (CIN) is associated with many human diseases, including neurodevelopmental or neurodegenerative conditions, age-related disorders and cancer, and is a key driver for disease initiation and progression. A major source of structural chromosome instability (s-CIN) leading to structural chromosome aberrations is "replication stress", a condition in which stalled or slowly progressing replication forks interfere with timely and error-free completion of the S phase. On the other hand, mitotic errors that result in chromosome mis-segregation are the cause of numerical chromosome instability (n-CIN) and aneuploidy. In this review, we will discuss recent evidence showing that these two forms of chromosomal instability can be mechanistically interlinked. We first summarize how replication stress causes structural and numerical CIN, focusing on mechanisms such as mitotic rescue of replication stress (MRRS) and centriole disengagement, which prevent or contribute to specific types of structural chromosome aberrations and segregation errors. We describe the main outcomes of segregation errors and how micronucleation and aneuploidy can be the key stimuli promoting inflammation, senescence, or chromothripsis. At the end, we discuss how CIN can reduce cellular fitness and may behave as an anticancer barrier in noncancerous cells or precancerous lesions, whereas it fuels genomic instability in the context of cancer, and how our current knowledge may be exploited for developing cancer therapies.
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No pos
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Retriever2302
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Longitudinal risk factors for intimate partner violence among men in treatment for alcohol use disorders.
OBJECTIVE
This study examined static and time-varying risk factors for perpetration of intimate partner violence (IPV) among men in treatment for alcohol use disorders.
METHOD
Participants were 178 men diagnosed with alcohol abuse or dependence and their partners. Most (85%) of the men were European American; their average age was 41.0 years. Participants completed measures assessing initial alcohol problem severity, baseline beliefs related to alcohol use, antisocial personality characteristics, alcohol and drug use, relationship adjustment, and IPV.
RESULTS
According to couples' reconciled reports, 42% of participants perpetrated IPV at baseline. Among this group, the IPV recurrence rate was 43% at 6-month follow-up and 36% at 12-month follow-up. For participants without IPV perpetration at baseline, new incidence of IPV was 15% and 7% at the 6-month and 12-month follow-up points, respectively. Fixed marker predictors of IPV rates included baseline alcohol problem severity variables, baseline beliefs related to alcohol use, and antisocial personality characteristics. Variable risk factor predictors included alcohol and drug use variables, relationship adjustment factors, and anger. Alcohol use variables and anger were associated with new incidents of IPV among those without reported IPV at baseline only.
CONCLUSIONS
Findings suggest that assessing and monitoring IPV occurrence by both partners is important for men in treatment for alcohol use disorders. Results indicate vulnerability factors that may identify individuals at risk for IPV and provide targets for IPV prevention among those with alcohol use disorders. These findings can aid in the development of more comprehensive models that more precisely predict IPV.
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No pos
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Retriever2303
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Liposome production by microfluidics: potential and limiting factors.
This paper provides an analysis of microfluidic techniques for the production of nanoscale lipid-based vesicular systems. In particular we focus on the key issues associated with the microfluidic production of liposomes. These include, but are not limited to, the role of lipid formulation, lipid concentration, residual amount of solvent, production method (including microchannel architecture), and drug loading in determining liposome characteristics. Furthermore, we propose microfluidic architectures for the mass production of liposomes with a view to potential industrial translation of this technology.
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No pos
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Retriever2304
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Pain acceptance and psychological inflexibility predict pain interference outcomes for persons with chronic pain receiving pain psychology.
OBJECTIVES
Awareness (being present), acceptance, and engagement (committed action) are three dimensions of psychological flexibility. Understanding these in the context of chronic pain may identify treatment targets to help refine individual treatment. Our objective was to test the predictive capacity of three dimensions within the psychological flexibility model on the longitudinal trajectory of pain interference.
METHODS
Patients receiving pain psychology treatment at a pain management center participated in this pragmatic clinical longitudinal study (n=86 with at least three assessments; Mean age=51 years; Gender=60 females, 26 males). Measures included the Five Facet Mindfulness Questionnaire (FFMQ-SF); Chronic Pain Acceptance Questionnaire (CPAQ-8); Psychological Inflexibility in Pain Scale (PIPS-12); and Committed Action Questionnaire (CAQ-8). The dependent variable was the Patient Reported Outcomes Information System (PROMIS) Pain Interference (PI). We used latent growth modelling to analyze scores assessed within 180 days of patient care.
RESULTS
Psychological inflexibility (PIPS-12) and pain acceptance (CPAQ-8) measured at baseline predicted PI outcomes (n=86). PIPS-12 showed a direct relationship with pain interference (PI), where higher PIPS-12 scores predicted significantly higher PI mean scores on average across the study period (ρ=0.422, r2=0.382) but also predicted significantly greater decreases in PI across time (ρ=-0.489, r2=0.123). Higher CPAQ-8 scores predicted significantly lower PI mean scores on average across the study period (ρ=-0.478, r2=0.453) but also significantly smaller decreases in PI across time (ρ=0.495, r2=0.076). Awareness (FFMQ-SF) and engagement (CAQ-8) were not predictive of PI outcomes.
CONCLUSIONS
Patients who entered pain psychology treatment with lower pain acceptance and higher psychological inflexibility showed the largest reductions in pain interference across time. These results contribute towards a novel prognostic understanding of the predictive roles of an enhancing dimension and limiting dimension of psychological flexibility.
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No pos
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Retriever2305
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A novel frameshift mutation (141delT) in exon 1 of the 21-hydroxylase gene (CYP21) in a patient with the salt wasting form of congenital adrenal hyperplasia. Mutation in brief no. 255. Online.
Congenital adrenal hyperplasia (CAH) is a common autosomal recessive disease with a wide range of clinical manifestation. In 90-95% of the cases it is caused by 21-hydroxylase deficiency (OMIM #201910) due to mutations of the CYP21 gene (GDB Accession #M12792). In most cases the CYP21-inactivating point mutations are transferred by apparent gene conversions from CYP21P to CYP21. In only a few cases point mutations have been described, which are not present in the pseudogene. Using Southern blot analysis and DNA sequencing we have identified a novel mutation (141delT) of the CYP21 gene in a patient suffering from the salt wasting form of CAH. This results in a premature termination of a truncated protein at amino acid position 51 (L51X), which is likely to result in an enzyme with no activity. This novel mutation has not been reported to occur in the CYP21P alleles and it was not found in the CYP21P alleles in this CAH family.
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No pos
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Retriever2306
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[Comparative sensitivity of I. F. A. T. using adult Schistosoma antigen and E. L. I. S. A. with ovular antigen in the immunodiagnosis of schistosomiasis (author's transl)].
The sensitivity of I. F. A. T. was compared with E. L. I. S. A. using the first method with cross-sections of adult Schistosoma mansoni (A. S. M.), and the second with ovular S. mansoni soluble extract (O. S. M.), the test sera from 86 schistosomiasis patients (32 with S. mansoni and 54 with S.haematobium) and 100 control sera. Despite the better response of S. mansoni sera in both methods, the significant level of antibody detection (maximum sensitivity for minimum non specificity) was higher for E. L. I. S. A., O. S. M. than for I. F. A. T., A. S. M., especially for urinary schistosomiasis.
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No pos
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Retriever2307
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Role of molecular chaperones in steroid receptor action.
Unliganded steroid receptors are assembled into heterocomplexes with heat-shock protein (hsp) 90 by a multiprotein chaperone machinery. In addition to binding the receptors at the chaperone site, hsp90 binds cofactors at other sites that are part of the assembly machinery, as well as immunophilins that connect the assembled receptor-hsp90 heterocomplexes to a protein trafficking pathway. The hsp90-/hsp70-based chaperone machinery interacts with the unliganded glucocorticoid receptor to open the steroid-binding cleft to access by a steroid, and the machinery interacts in very dynamic fashion with the liganded, transformed receptor to facilitate its translocation along microtubular highways to the nucleus. In the nucleus, the chaperone machinery interacts with the receptor in transcriptional regulatory complexes after hormone dissociation to release the receptor and terminate transcriptional activation. By forming heterocomplexes with hsp90, the chaperone machinery stabilizes the receptor to degradation by the ubiquitin-proteasome pathway of proteolysis.
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No pos
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Retriever2308
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A decade of improvement in pain education and clinical practice in developing countries: IASP initiatives.
1. Epidemiological studies, in the late 1990s and early 2000s, on the extent of pain in the community of western countries revealed a prevalence of around 18%, with significant effects on work and social activities despite 30 years of pain education programmes. 2. A survey by the International Association for the Study of Pain (IASP) Developing Countries on the extent of pain education and clinical training, and the barriers to them, was published as report in 2007 and confirmed significant deficiencies and problems in all areas. 3. An IASP Developing Countries Taskforce was established in 2002 to facilitate improvements in pain education and management in developing countries through a grants support programme for bottom-up projects from developing country members. 4. Clinical training posts in centres in Thailand, South America and South Africa have been established to improve the clinical training of pain clinicians and, through them, to develop pain services in their countries of origin in which services are poorly developed or absent. 5. There has been a major surge in the demand for and development of programmes and clinical training in developing countries since 2002, reflected in greatly increased local activity in various regions of the world. 6. Based on the ethical/moral belief that pain treatment is a human right, the IASP has recently increased its levels of advocacy to support this belief.
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No pos
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Retriever2309
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[Carbohydrate disturbances among women after gestational diabetes mellitus].
UNLABELLED
Gestational diabetes (GDM) is regarded as a predilecting factor for a subsequent development of diabetes or other disturbances in carbohydrate metabolism. The aim of the study was to evaluate the risk of occurrence of failures in carbohydrate metabolism in females who sufferred from GDM, as well as to determine the prognostic values of selected markers that were regarded as factors favouring the development of diabetes mellitus (DM).
MATERIAL AND METHODS
Patients who in the past suffered from GDM were subjected to this study. Out of 153 patients who responded positively to the written invitation to participate in this study, 74 had already been treated for DM. In 5 of them, abnormal glucose tolerance was found, and 74 of this group had been subjected to a 75g OGTT. The control group consisted of 153 subjects, who had given birth at least twice and in whom the metabolic diagnostics performed during the first pregnancy excluded GDM. Results of our study have revealed that patients who in the past had sufferred from GDM constituted a group with high risk for developing disturbances in carbohydrate metabolism or symptoms of metabolic syndrome after pregnancy. The main factors pro the development of the disturbances in carbohydrante metabolism were: overweight, increased fasting glycemia at the time of GDM diagnosis and insulin requirement during pregnancy.
CONCLUSION
High percentage of diagnosis of an impaired carbohydrate metabolism and DM, calls for a special attention toward a group of patients with previous GDM, for a properly directed treatment that would enable a considerable delay in the development of an overt diabetes, as well as would apply a rational therapy, that would result in an optimal control of existing diabetes.
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No pos
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Retriever2310
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Predictors of crossword puzzle proficiency and moderators of age-cognition relations.
Four studies, each with approximately 200 adults between the ages of 18 and 80, were conducted to address two major goals. The first goal was to examine the relative contributions of different factors to the successful solution of crossword puzzles. Correlations and structural equation analyses revealed that general knowledge is the strongest predictor of crossword puzzle proficiency. Surprisingly, abstract reasoning ability, as measured by several different tests, had no direct relation to puzzle proficiency. The second goal of the project was to examine moderators of the relations between age and measures of both fluid and crystallized cognition. The results provide no evidence to suggest that amount of crossword puzzle experience reduces age-related decreases in fluid cognition or enhances age-related increases in crystallized cognition.
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No pos
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Retriever2311
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[Intermixture of politics and science in the GDR. The investigation of deaths at the Department of Neurology and Psychiatry at Leipzig University under Müller-Hegemann in 1963].
This study presents archival sources that shed light on a topic still being discussed by psychiatrists in East Germany: the death of two patients at the Leipzig Department that occurred in 1960 and 1962 under the directorship of Dietfried Müller-Hegemann. These fatalities were supposed to have been induced by obsolete psychotropic drugs and were associated with Ivan Pavlov's hypnotherapy. The incidents were investigated both by highest administrative bodies and the General State Prosecutor of the former GDR. Archival sources suggest that lower party organs and the ministerial administration tried to make use of the proceedings to bring about the downfall of the head of the Leipzig Department, who had become ideologically suspicious. However, the official General State Prosecutor's investigation ascertained that both Müller-Hegemann and Christa Kohler, head of the psychotherapeutic ward, were not to be held responsible. Although the SED Central Committee at first tried to influence the outcome on the basis of ideological reservations made by the university party organisation, it finally accepted and confirmed the judgment of the General State Prosecutor. Hence, in this case, the highest party bodies followed arguments that were the result of an independent investigation and were not influenced by an individual bias or ideological motives.
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No pos
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No neg
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Retriever2312
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Distinct muscle apoptotic pathways are activated in muscles with different fiber types in a rat model of critical illness myopathy.
Critical illness myopathy (CIM) is associated with severe muscle atrophy and fatigue in affected patients. Apoptotic signaling is involved in atrophy and is elevated in muscles from patients with CIM. In this study we investigated underlying mechanisms of apoptosis-related pathways in muscles with different fiber type composition in a rat model of CIM using denervation and glucocorticoid administration (denervation and steroid-induced myopathy, DSIM). Soleus and tibialis anterior (TA) muscles showed severe muscle atrophy (40-60% of control muscle weight) and significant apoptosis in interstitial as well as myofiber nuclei that was similar between the two muscles with DSIM. Caspase-3 and -8 activities, but not caspase-9 and -12, were elevated in TA and not in soleus muscle, while the caspase-independent proteins endonuclease G (EndoG) and apoptosis inducing factor (AIF) were not changed in abundance nor differentially localized in either muscle. Anti-apoptotic proteins HSP70, -27, and apoptosis repressor with a caspase recruitment domain (ARC) were elevated in soleus compared to TA muscle and ARC was significantly decreased with induction of DSIM in soleus. Results indicate that apoptosis is a significant process associated with DSIM in both soleus and TA muscles, and that apoptosis-associated processes are differentially regulated in muscles of different function and fiber type undergoing atrophy due to DSIM. We conclude that interventions combating apoptosis with CIM may need to be directed towards inhibiting caspase-dependent as well as -independent mechanisms to be able to affect muscles of all fiber types.
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No pos
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Retriever2313
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Program Implementation and Church Members' Health Behaviors in a Countywide Study of the Faith, Activity, and Nutrition Program.
Implementation research of health programs in faith-based organizations is lacking. The Faith, Activity, and Nutrition (FAN) program helps churches improve physical activity and fruit and vegetable behaviors of members. This study examined associations between implementation of FAN intervention components and church members' physical activity, fruit and vegetable behaviors, and self-efficacy for improving these behaviors. FAN was implemented in 35 churches in a southeastern US county. After attending in-person training, led by community health advisors, church committees received 12 months of telephone-delivered technical assistance to implement FAN according to 4 components: increasing opportunities, increasing guidelines and policies, increasing pastor support, and increasing messages for physical activity and healthy eating in their church. In this correlational study, FAN coordinators (n = 35) for each church reported baseline practices in 2015 and 12-month follow-up implementation of the 4 components for physical activity and healthy eating in 2016. Church members (n = 893) reported perceived implementation, physical activity and fruit and vegetable behaviors, and self-efficacy at 12-month follow-up in 2016. Independent variables were coordinator-reported baseline practices, baseline-adjusted 12-month implementation, and member-perceived 12-month implementation. Multilevel modeling examined associations between independent variables and member-reported 12-month physical activity and fruit and vegetable behaviors and self-efficacy. Coordinator-reported 12-month implementation of fruit and vegetable opportunities was associated with member fruit and vegetable consumption. Member perceptions at 12 months of church physical activity opportunities, pastor support, and messages were associated with higher self-efficacy for physical activity; pastor support and messages were positively associated with physical activity. Member perceptions at 12 months of fruit and vegetable opportunities, pastor support, and messages were associated with higher fruit and vegetable consumption and self-efficacy. Member-perceived implementation was more strongly associated with member behaviors than coordinator-reported implementation. Providing opportunities for healthy eating during already scheduled events may be an effective strategy for improving fruit and vegetable behavior.
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No pos
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No neg
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Retriever2314
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Stutterers' vocal reaction times to unilaterally presented high and low frequency verbs.
The current study investigated vocal reaction times of 11 stuttering participants to verbs with high and low frequencies of occurrence when these verbs were unilaterally visually presented. No significant main effects or interactions between stimuli and visual-half field were found. Reaction times were 16 msec. faster after right visual field presentations and the Pearson correlation coefficient between visual fields .71 (p=.02). These results were interpreted as suggesting that the left hemisphere was dominant for processing the current lexical items, findings which parallel those for normal speakers.
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No pos
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No neg
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Retriever2315
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Skin sterility after application of ethyl chloride spray.
BACKGROUND
Ethyl chloride topical anesthetic spray is labeled as nonsterile, yet it is widely used during injection procedures performed in an outpatient setting. The purpose of this study was to investigate the sterility of ethyl chloride topical anesthetic spray applied before an injection. Our a priori hypothesis was that application of the spray after the skin has been prepared would not alter the sterility of the injection site.
METHODS
We conducted a prospective, blinded, controlled study to assess the effect of ethyl chloride spray on skin sterility. Fifteen healthy adult subjects (age, twenty-three to sixty-one years) were prepared for mock injections into both shoulders and both knees, although no injection was actually performed. Three culture samples were obtained from each site on the skin: one before skin preparation with isopropyl alcohol, one after skin preparation and before application of ethyl chloride, and one after ethyl chloride had been sprayed on the site. In addition, the sterility of the ethyl chloride was tested directly by inoculating cultures with spray from the bottles.
RESULTS
Growth occurred in 70% of the samples obtained before skin preparation, 3% of the samples obtained after skin preparation but before application of ethyl chloride, and 5% of the samples obtained after the injection site had been sprayed with ethyl chloride. The percentage of positive cultures did not increase significantly after application of ethyl chloride (p = 0.65). Spraying of ethyl chloride directly on agar plates resulted in growth on 13% of these plates compared with 11% of the control plates; this difference was also not significant (p = 0.80).
CONCLUSIONS
Although ethyl chloride spray is not sterile, its application did not alter the sterility of the injection sites in the shoulder and knee.
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No pos
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No neg
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Retriever2316
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[Synthesis and 13C-NMR spectra of the N-terminal decapeptide sequence of human lymphoblast interferon].
The N-terminal sequence 1-10 of interferon HuIFN-alpha(Ly) from human lymphoblasts Ser-Asp-Leu-Pro-Gln-Thr-His-Ser-Leu-Gly (LIF[1-10]) was synthesized by the Merrifield method. N-tert-Butyloxycarbonylglycin was esterified via its cesium salt with a chloro-methylated polystyrene-1% divinylbenzene support yielding a loading of 0.3 mmol/g. Double couplings, each with a five-fold excess of N-protected amino acid, were performed with N,N'-dicyclohexylcarbodiimide and 1-hydroxybenzotriazole, followed by an acetylation step. N-tert-Butyloxycarbonyl-L-amino acids with O-benzyl protection for serine, threonine, and Nim-2,4-dinitrophenyl protection for histidine, and N-fluorenylmethyloxycarbonylaspartic acid beta-tert-butyl ester were used. N-tert-Butyloxycarbonyl-glutamine was coupled as 4-nitrophenyl ester in the presence of 1-hydroxybenzotriazole. The butyloxycarbonyl groups of the residues 3 to 10 were removed with trifluoroacetic acid in dichloromethane; the 9-fluorenylmethyloxycarbonyl group was split off with diethylamine. After quantitative hydrazinolysis in dimethylformamide, chromatography on Sephadex LH-20 with methanol and reversed-phase chromatography on silica gel RP-8 with methanol/water 9:1, the decapeptide hydrazide Boc-Ser(Bzl)-Asp(But)-Leu-Pro-Gln-Thr(Bzl)-His-Ser(Bzl)-Leu-Gly-NH-HN2 was isolated in pure state. The partially protected decapeptide was characterized by 13C-NMR spectroscopy, analysed, and linked with poly(L-lysine) (molecular mass 37 300) via its azide and also using m-xylylene diisocyanate. After a deprotection step the polylysine-LIF[1-10] antigens were dialyzed and lyophilized. Furthermore the free decapeptide LIF[1-10] was split-off from the resin using HBr/CF3CO2H, followed by mercaptoethanol treatment. After purification on Sephadex G-15 with 0.1 M acetic acid and on the reversed-phase silicagel RP-8 with methanol/water 9:1 water soluble LIF-[1-10] was obtained in pure state as shown by thin-layer-chromatography, electrophoreses amino acid analysis and 13C-NMR spectroscopy.
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No pos
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Retriever2317
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Speleothems reveal 500,000-year history of Siberian permafrost.
Soils in permafrost regions contain twice as much carbon as the atmosphere, and permafrost has an important influence on the natural and built environment at high northern latitudes. The response of permafrost to warming climate is uncertain and occurs on time scales longer than those assessed by direct observation. We dated periods of speleothem growth in a north-south transect of caves in Siberia to reconstruct the history of permafrost in past climate states. Speleothem growth is restricted to full interglacial conditions in all studied caves. In the northernmost cave (at 60°N), no growth has occurred since Marine Isotopic Stage (MIS) 11. Growth at that time indicates that global climates only slightly warmer than today are sufficient to thaw extensive regions of permafrost.
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No pos
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No neg
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Retriever2318
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Modeling nursing terminology using the GRAIL representation language.
OBJECTIVE
The purpose of the study is to explore the use of formal systems to model nursing terminology.
DESIGN
GRAIL is a formal, compositional terminologic language, closely related to frame-based systems and conceptual graphs, which allows concepts to be formed from atomic-level primitives and automatically classified in a multiple hierarchy. A formal model of the alpha version of the International Classification for Nursing Practice (ICNP) classification of nursing interventions was constructed in GRAIL.
MEASUREMENTS
The model was analyzed for completeness, coherence, clarity, expressiveness, usefulness, and maintainability.
RESULTS
GRAIL is capable of representing the complete set of atomic-level concepts within the ICNP as well as certain cross-mappings to other vocabularies. It also has the potential to represent many more concepts, to an arbitrary level of detail.
CONCLUSIONS
Formal systems such as GRAIL can overcome many of the difficulties associated with traditional nursing vocabularies without restricting the level of detail needed to describe nursing care.
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No pos
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No neg
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Retriever2319
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The gray zone of thyroid nodules: Using a nomogram to provide malignancy risk assessment and guide patient management.
BACKGROUND
Thyroid nodules have a low prevalence of malignancy and most proven cancers do not behave aggressively. Thus, risk-stratification of nodules is a critical step to avoid surgical overtreatment. We hypothesized that a risk management system superior to those currently in use could be created to reduce the number of clinically indeterminate nodules (i.e., the "gray zone") by concurrently considering the malignancy risks conferred by clinical, ultrasonographic, and cytologic variables.
METHODS
Thyroidectomy cases were reviewed from three institutions. Their benign versus malignant outcome was used to evaluate the variables for correlation. A binary logistic regression model was trained and, using indeterminate nodules with Bethesda III and IV results, validated. A scoring nomogram was designed to demonstrate the application of the model in clinical practice.
RESULTS
One hundred thirty thyroidectomies (28% malignant) met inclusion criteria. The final logistic regression model included difficulty in swallowing, hypothyroidism, echogenicity, hypervascularity, margins, calcification, and cytology diagnosis as input parameters. The model was highly successful in determining the outcome (p value: 0.001) with a R2 (Nagelkerke) score of 0.93. The area under the curve as determined by receiver operating characteristics was 0.91. The accuracy of the model on the training dataset was 93% (sensitivity and specificity 92% and 96%, respectively) and, on the validation dataset, 80% (sensitivity and specificity 91% and 67%, respectively).
CONCLUSIONS
We report a model for risk assessment of thyroid nodules that has the potential to significantly reduce indeterminates and surgical overtreatment. We illustrate its application via a straightforward nomogram, which integrates clinical, ultrasonographic, and cytologic data, and can be used to create clear, evidence-based management plans for patients.
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No pos
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No neg
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Retriever2320
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Ultrasonographic cervical length measurement is not a better predictor of preterm delivery than digital examination in a population of patients with idiopathic preterm labor.
OBJECTIVE
To compare digital and ultrasonographic cervical examination for the prediction of preterm delivery in patients hospitalized for preterm labor.
STUDY DESIGN
Fifty-nine patients were included. The Bishop score was evaluated upon admission, weeks gestational age. Ultrasonographic measurement of cervical length was done within 24h after entry. Delivery before 37 weeks gestational age was the primary endpoint. Attending obstetricians were blinded to the results of echography.
RESULTS
Preterm delivery rate was 39% (23/59). The risk of preterm delivery was significantly increased when the Bishop score was greater than or equal to 6 (OR = 4.45 [1.41-14.01]) or when ultrasonographic cervical length was less than or equal to 27 mm (OR = 4.04 [1.32-12.3]), but digital examination was the only independent risk factor in multivariate analysis. Sensitivity, specificity, positive and negative predictive value for digital examination and ultrasonography were respectively 74, 61, 55 and 79%, 70, 64, 55 and 77%. Combination of digital examination and ultrasonography did not yield better results.
CONCLUSION
In our series, prediction of preterm delivery was not improved by ultrasonography compared to digital examination. The size of the cervical shift observed in most patients hospitalized for preterm labor may render ultrasonography less relevant in identifying patients anticipated to deliver prematurely.
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No pos
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No neg
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Retriever2321
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Intramuscular triamcinolone acetonide: An undervalued option for refractory alopecia areata.
Severe alopecia areata (AA) can have an unpredictable clinical course and become refractory to contact immunotherapy. Novel treatment options include low-dose interleukin-2 and Janus kinase inhibitors; however, these treatments are still under investigation. Therefore, we evaluated the efficacy and safety of intramuscular (i.m.) triamcinolone acetonide (TAC) as a rescue therapy for refractory AA. We retrospectively analysed efficacy, adverse effects and relapse rate of i.m. TAC monthly in 27 patients with refractory AA. We defined AA as refractory if the patient showed an unsatisfactory response to both systemic treatment (not i.m. TAC) and the consecutive diphenylcyclopropenone immunotherapy. The initial systemic treatment of other forms of corticosteroids and/or cyclosporin was used to control extensive AA involving more than 25% of the scalp. Administration of i.m. TAC for 3-6 months resulted in a 63.0% response rate, and all patients showed inactive disease after treatment. Final hair regrowth negatively correlated with initial scalp involvement (Spearman r = -0.595, P = 0.001). All patients showed complete recovery of adrenocortical reserve within 3 months after the last injection. Adverse effects of systemic steroid therapy were observed only in female patients (dysmenorrhea and osteoporosis). i.m. TAC may provide a valuable therapeutic option to manage active hair loss and facilitate hair regrowth in refractory AA, especially in male patients.
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No pos
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No neg
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Retriever2322
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Effects of alpha lipoic acid and its R+ enantiomer supplemented to hyperbaric oxygen therapy on interleukin-6, TNF-α and EGF production in chronic leg wound healing.
CONTEXT
Lipoic acid (LA) and hyperbaric oxygenation therapy (HBOT) improve chronic wound healing.
OBJECTIVE
We compared the effects of LA or its enantiomer R-(+)-lipoic acid (RLA) on wound healing.
MATERIALS AND METHODS
Groups LA + HBOT (L), RLA + HBOT (R) and placebo + HBOT (P). Lesion areas measured before treatment and on 20th and 40th day. The biopsies and plasma were harvested before treatment and on 7th and 14th (measurements of VEGF, vascular endothelial growth factor; EGF, epidermal growth factor, TNF-α and IL-6).
RESULTS
Ulcers improved more on RLA. In both L and R groups, EGF and VEFG increased in time. RLA decreased IL-6 on T7 and T14, which did not happen with LA. TNF-α levels decreased on T14 in both LA and RLA.
DISCUSSION
The improved wound healing is associated with increased EGF and VEGF and reduced plasma TNF-α and IL-6.
CONCLUSION
RLA may be more effective than LA in improving chronic wound healing in patients undergoing HBO therapy.
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No pos
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No neg
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Retriever2323
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Relationship between the physical properties of Candida albicans cell well beta-glucan and activation of leukocytes in vitro.
We previously reported that the fungal particle 1,3-beta-D-glucan derived from Candida albicans, a pathogenic fungus, was obtained by oxidation of the cell wall with sodium hypochlorite (NaClO). It could be solubilized by treatment with dimethylsulfoxide (DMSO). In the present study, we prepared Candida 1,3-beta-D-glucan having different physical properties, and examined the relationship between leukocyte activation and the physicochemical properties. Beta-glucan activated leukocytes significantly more effectively in a particulate than solubilized form in terms of TNF-alpha production by RAW 264.7 cells, hydrogen peroxide production by murine PEC and IL-8 production by human PBMC. Furthermore, we compared the biological activity of the glucan particles oxidized under various conditions. Interestingly, inactive and antagonistic particles were obtained under strong oxidation conditions. However, the inactive particles showed significant agonistic activity on dissolution in DMSO and following lyophilization. These facts strongly suggested that the solubility and assembly of the components influence the immunopharmacological activities of 1,3-beta-D-glucans.
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No pos
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No neg
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Retriever2324
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Relapsed and/or Refractory Mantle Cell Lymphoma: What Role for Temsirolimus?
Mantle Cell Lymphoma (MCL) is associated with a dismal prognosis. Recently, along with the improved understanding of the pathophysiology of this disease, new first line regimens have been established and in addition novel treatment options have entered the clinical arena. In consequence, prognosis of the disease has fortunately improved. We here focus on the rationale, current clinical knowledge and future concepts of Temsirolimus, an inhibitor of mTOR, in the treatment of MCL. At this time this drug has been shown to be effective as single agent for relapsed disease and early combination data show promising results. In addition, with a brief outline of other treatment options, we aim to guide at which place in the current treatment algorithms Temsirolimus can be integrated into the treatment of MCL patients.
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No pos
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No neg
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Retriever2325
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Interactions of signaling proteins, growth factors and other proteins with heparan sulfate: mechanisms and mysteries.
Heparan sulfate (HS) is a component of cell surface and matrix-associated proteoglycans (HSPGs) that, collectively, play crucial roles in many physiologic processes including cell differentiation, organ morphogenesis and cancer. A key function of HS is to bind and interact with signaling proteins, growth factors, plasma proteins, immune-modulators and other factors. In doing so, the HS chains and HSPGs are able to regulate protein distribution, bio-availability and action on target cells and can also serve as cell surface co-receptors, facilitating ligand-receptor interactions. These proteins contain an HS/heparin-binding domain (HBD) that mediates their association and contacts with HS. HBDs are highly diverse in sequence and predicted structure, contain clusters of basic amino acids (Lys and Arg) and possess an overall net positive charge, most often within a consensus Cardin-Weintraub (CW) motif. Interestingly, other domains and residues are now known to influence protein-HS interactions, as well as interactions with other glycosaminoglycans, such as chondroitin sulfate. In this review, we provide a description and analysis of HBDs in proteins including amphiregulin, fibroblast growth factor family members, heparanase, sclerostin and hedgehog protein family members. We discuss HBD structural and functional features and important roles carried out by other protein domains, and also provide novel conformational insights into the diversity of CW motifs present in Sonic, Indian and Desert hedgehogs. Finally, we review progress in understanding the pathogenesis of a rare pediatric skeletal disorder, Hereditary Multiple Exostoses (HME), characterized by HS deficiency and cartilage tumor formation. Advances in understanding protein-HS interactions will have broad implications for basic biology and translational medicine as well as for the development of HS-based therapeutics.
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No pos
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No neg
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Retriever2326
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[Protection of common peony from scarab damages].
The key to the protection of common peony from insect pests in the field is to control the damage done by Holotrichia oblita. An experimental study has been carried out on the prevention of adult pests in the field as well as on the prevention of pest larvae before planting and throughout the growing period of common peony. As a result a technological program for this particular pest prevention and elimination is proposed.
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No pos
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No neg
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Retriever2327
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Selective depletion of tumor neovasculature by microbubble destruction with appropriate ultrasound pressure.
Low-intensity ultrasound-microbubble (LIUS-MB) treatment is a promising antivascular therapy for tumors. We sought to determine whether LIUS-MB treatment with an appropriate ultrasound pressure could achieve substantial and persistent cessation of tumor perfusion without having significant effects on normal tissue. Further, we investigated the mechanisms underlying this treatment. Murine S-180 sarcomas, thigh muscles, and skin tissue from 60 tumor-bearing mice were subjected to sham therapy, an ultrasound application combined with microbubbles in four different ultrasound pressures (0.5, 1.5, 3.0, 5.0 MPa), or ultrasound at 5.0 MPa alone. Subsequently, contrast-enhanced ultrasonic imaging and histological studies were performed. Tumor microvessels, tumor cell necrosis, apoptosis, tumor growth, and survival were evaluated in 85 mice after treatment with the selected ultrasound pressure. We found that twenty-four hours after LIUS-MB treatment at 3.0 MPa, blood perfusion and microvessel density of the tumor had substantially decreased by 84 ± 8% and 84%, respectively (p < 0.01). Similar reductions were not observed in the muscle or skin. Additionally, an extreme reduction in the number of immature vessels was observed in the tumor (reduced by 90%, p < 0.01), while the decrease in mature vessels was not significant. Further, LIUS-MB treatment at 3.0 MPa promoted tumor cell necrosis and apoptosis, delayed tumor growth, and increased the survival rate of tumor-bearing mice (p < 0.01). These findings indicate that LIUS-MB treatment with an appropriate ultrasound pressure could selectively and persistently reduce tumor perfusion by depleting the neovasculature. Therefore, LIUS-MB treatment offers great promise for clinical applications in antivascular therapy for solid tumors.
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No pos
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No neg
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Retriever2328
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Association of SOX2 and Nestin DNA amplification and protein expression with clinical features and overall survival in non-small cell lung cancer: A systematic review and meta-analysis.
Up to now, the prognosis of non-small cell lung cancer (NSCLC) is poor. With progress of cancer biology, a number of genes have been investigated for predicting prognosis of NSCLC, such as cancer stem cell markers SRY (sex determining region Y)-box 2 (SOX2) and Nestin. Recently, a series of studies have been performed to examine the associations of SOX2 and Nestin with clinical parameters and prognosis in NSCLC, however, the results were not consistent. In the present study, we conducted a systematic review and meta-analysis to summarize the associations. Four English databases (PubMed, ISI web of science, Embase, and Ovid) were used to search the relevant studies with the last date of November 10, 2015. The pooling analyses were stratified by DNA amplification and protein expression. The pooling ORs or HRs were used to assess the strength of the associations. Finally, we included 19 articles for SOX2 and six articles for Nestin according to the inclusion and exclusion criteria. The pooling analyses revealed that there were significant associations between SOX2 DNA amplification and clinical features of NSCLC, gender, smoking status, squamous cell cancer (SCC) histology, and differentiations. And significant associations were also identified between SOX2 protein expression and clinical parameters, smoking status and SCC histology. For Nestin, its protein expression was correlated with lymph node metastasis and stage. Simultaneously, we found that high/positive SOX2 alterations, either DNA amplification or protein expression, were favorable for overall survival (OS) in NSCLC. On the contrary, high/positive Nestin protein expression was poor for OS.
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No pos
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No neg
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Retriever2329
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Normal values for urine renalase excretion in children.
BACKGROUND
The objective of this study was to establish age-dependent values for urinary renalase/creatinine (renalase/Cr) ratio in healthy children and adolescents.
METHODS
The study was conducted on a random sample of 157 healthy children and adolescents (0.1-17.9 years) divided into six age groups in 3-year intervals. Urine renalase concentration was measured using an enzyme-linked immunosorbent assay (ELISA) kit (Uscn Life Science, Wuhan, China).
RESULTS
We analyzed median urine renalase/Cr ratio in particular age groups with the use of analysis of variance (ANOVA). Renalase/Cr levels were significantly higher in the youngest children < 3 years in comparison with other age groups (4.07 ng/mg Cr, p < 0.05). There was a statistically significant negative correlation between urine renalase/Cr and body mass index (BMI) Z-score (r = -0.22, p < 0.05) and both systolic (r = -0.22, p < 0.05) and diastolic (r = -0.21, p < 0.05) blood pressure. We constructed the reference renalase/Cr percentiles according to age in 3-year intervals.
CONCLUSIONS
To the best of our knowledge, this study is the first to present reference values of urine renalase excretion in a healthy pediatric population. Further studies should concentrate on the influence of increased blood pressure or obesity on urine renalase excretion in children and teenagers.
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No pos
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No neg
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Retriever2330
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Grandparents use of new communication technologies in a European perspective.
This study examined the pattern of use of different forms of contact between grandparents and grandchildren, and especially the use of new technologies (SMS, e-mail) and factors affecting this. Questionnaire data are reported from 408 grandparents in the UK, Spain, Finland and Estonia, regarding contacts with grandchildren mostly in the 10-15-year age range. Face-to-face contact remained the most frequent mean, followed closely by landline telephone; there was moderate use of mobile phones, and many used letters/cards occasionally; and a minority used SMS and e-mails (about one-half to one-third of those with mobile phones, and networked computers, respectively). When contacting grandchildren, most grandparents accumulate different forms of contact, but others compensate some forms of contact. There were no differences by age of grandparent, but grandmothers made more use of e-mail than grandfathers, as did more highly educated grandparents and those with older grandchildren. Implications for use of Information and Communication Technology by older people are discussed.
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No pos
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No neg
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Retriever2331
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Long-Term Outcomes of Treatment with Biological Agents in Eyes with Refractory, Active, Noninfectious Intermediate Uveitis, Posterior Uveitis, or Panuveitis.
PURPOSE
To examine a large cohort of patients treated with biologic agents for active noninfectious intermediate uveitis, posterior uveitis, or panuveitis (NIPPU) and to compare their efficacy and long-term effect.
DESIGN
Retrospective, longitudinal study.
PARTICIPANTS
Eighty-two patients (156 eyes) with active NIPPU after failure of treatment with corticosteroids and a second-line immunosuppression drug and treated with biologic agents who were treated at Moorfields Eye Hospital between 2001 and 2016.
METHODS
Information was gathered from the clinical notes of all patients.
MAIN OUTCOME MEASURES
Time to first disease flare, rate of treatment failure, best-corrected visual acuity, and risk factors for treatment failure.
RESULTS
Patients were followed on average for 4.7±0.4 years (724 eye-years). All patients demonstrated active uveitis at baseline, and 34 patients (41.5%) demonstrated a coexisting active systemic disease. Control of ocular inflammation was achieved in 136 eyes (87.2%). The average oral prednisolone dose at baseline was 16.4±1.7 mg/day, and by 6 months reduced to 6.5±0.7 mg/day (P < 0.0001), remaining stable for up to 5 years follow-up. Best-corrected visual acuity at baseline was 0.5±0.1 logarithm of the minimum angle of resolution (logMAR), improved to 0.4±0.1 logMAR (P = 0.008) at 3 months, and remained stable during follow-up. After baseline, 42.3% of eyes experienced flares, and the average number of flares reduced from 1.8±0.1 flares/year to 0.6±0.1 flares/year (P < 0.0001). Median time to first flare was 5.4 years (95% confidence interval [CI], 2.2-5.4 years) with a 5-year survival rate of 58.7%. Treatment failed in 37 eyes (23.7%), with a 5-year survival rate of 68.0% and an estimated time to 75% survival of 2.9 years (95% CI, 2.1-4.4 years). The risk for treatment failure was lower when treatment used adalimumab (odds ratio, 0.4; 95% CI, 0.2-0.9; P = 0.03) but was greater when systemic disease also was active at baseline (odds ratio, 3.2; 95% CI, 1.5-7.1; P = 0.004).
CONCLUSIONS
Overall, eyes treated with biologic agents after failure of treatment with corticosteroids and a second-line immunosuppression drug experienced satisfactory disease control (87.2%), reduced use of systemic immunosuppression, stable visual acuity, and a 23.7% risk of disease relapse. After multivariate adjustment, older age, treatment with adalimumab (versus infliximab), and inactive concomitant systemic disease were associated with a lower risk of treatment failure.
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No pos
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No neg
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Retriever2332
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Rewarming rate of the myocardium during aortic cross-clamp time: variations with different levels of body hypothermia.
Twenty patients underwent elective cardiac valve replacement at 20 degrees C of body hypothermia. Temperatures of the ventricles of both walls were monitored on 12 different sites. Distribution of myocardial temperature ranged between 24.3 and 29.3 degrees C for patients of Group I before cardioplegia delivery and 13.2 degrees C in the septum after cardioplegic infusion. Average temperatures for the anterior and posterior wall were 13.6 C and 15 degrees C in the left ventricle and 14.7 and 15 degrees C in the right ventricle. Myocardial temperatures ranged from 26 to 28.7 degrees C for patients of Group II. After cardioplegic arrest, septal temperatures averaged 14.9 degrees C. The recorded sites of the anterior and posterior left ventricle were 14.1 and 13.1 degrees C. The effects of rewarming on the different myocardial areas occurred according to a logarithmic equation, which is faster in the first 10 minutes. The data suggest that the myocardium can be adequately protected with 25 degrees C hypothermia when the cross-clamp period is shorter than 60 minutes. When longer ischemic periods are expected, myocardial protection is best accomplished with 20 degrees C hypothermia.
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No pos
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No neg
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Retriever2333
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High-throughput behavioral phenotyping in the expanded panel of BXD recombinant inbred strains.
Genetic reference populations, particularly the BXD recombinant inbred (BXD RI) strains derived from C57BL/6J and DBA/2J mice, are a valuable resource for the discovery of the bio-molecular substrates and genetic drivers responsible for trait variation and covariation. This approach can be profitably applied in the analysis of susceptibility and mechanisms of drug and alcohol use disorders for which many predisposing behaviors may predict the occurrence and manifestation of increased preference for these substances. Many of these traits are modeled by common mouse behavioral assays, facilitating the detection of patterns and sources of genetic coregulation of predisposing phenotypes and substance consumption. Members of the Tennessee Mouse Genome Consortium (TMGC) have obtained phenotype data from over 250 measures related to multiple behavioral assays across several batteries: response to, and withdrawal from cocaine, 3,4-methylenedioxymethamphetamine; "ecstasy" (MDMA), morphine and alcohol; novelty seeking; behavioral despair and related neurological phenomena; pain sensitivity; stress sensitivity; anxiety; hyperactivity and sleep/wake cycles. All traits have been measured in both sexes in approximately 70 strains of the recently expanded panel of BXD RI strains. Sex differences and heritability estimates were obtained for each trait, and a comparison of early (N = 32) and recent (N = 37) BXD RI lines was performed. Primary data are publicly available for heritability, sex difference and genetic analyses using the MouseTrack database, and are also available in GeneNetwork.org for quantitative trait locus (QTL) detection and genetic analysis of gene expression. Together with the results of related studies, these data form a public resource for integrative systems genetic analysis of neurobehavioral traits.
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No pos
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No neg
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Retriever2334
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Effect of glaze thickness on the fracture toughness and hardness of alumina-reinforced porcelain.
STATEMENT OF PROBLEM
Although porcelain is the most esthetic restorative material available, it is subject to fracture during function. Glazing reduces the size of flaws in the surface of the porcelain and increases its resistance to crack propagation, but the optimum thickness of this glazed layer has not been determined.
PURPOSE
This study compared the fracture toughness (Kc ) and Vickers hardness number (VHN) of an alumina-reinforced porcelain at different thicknesses of glaze.
MATERIAL AND METHODS
Disks of feldspathic porcelain reinforced with 2% aluminum oxide were prepared and glazed for 0, 30, 60, 90, and 120 seconds. Fracture toughness and Vickers microhardness were determined with a microindentation technique. Thickness of the glazed layers was measured with a SEM.
RESULTS
Mean Vickers hardness number and fracture toughness values both decreased significantly with glazing times from 0 to 60 seconds, and increased significantly with glazing times from 60 to 120 seconds (P <.001, ANOVA). SEM examination revealed an increase in glazed layer thickness with increased glazing time.
CONCLUSIONS
Minimal and maximum thicknesses of glaze layers on alumina-reinforced porcelain resulted in a surface that was harder and more resistant to fracture than moderate glaze thicknesses.
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No pos
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No neg
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Retriever2335
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The effects of captopril in severe congestive heart failure. An echocardiographic study.
In 12 patients with severe congestive heart failure (CHF), captopril in doses of 25 to 150 mg, every 8 hours, was given for a period of 2 months, in addition to cardiac glycoside and diuretic drugs. After this treatment left ventricular end-diastolic diameter (EDD) decreased from 6.4 +/- 0.5 to 6.2 +/- 0.6 cm (p less than 0.05), left-ventricular end-systolic diameter (ESD) decreased from 5.7 +/- 0.5 to 5.4 +/- 0.6 cm (p less than 0.001), the ejection fraction increased from 30.8 +/- 7.0 to 36.2 +/- 6.9% (p less than 0.005) and mean velocity of circumferential fiber shortening (Vcf) increased from 0.51 +/- 0.12 to 0.62 +/- 0.13 circ/sec (p less than 0.001). Captopril markedly relieved dyspnea and fatigue. Three patients improved from class IV to class III, 4 patients from class IV to class II and 3 patients from class III to class II. These data suggest that captopril may be effective in the treatment of severe chronic CHF.
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No pos
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No neg
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Retriever2336
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Contractility assessment of human iPSC-derived cardiomyocytes by using a motion vector system and measuring cell impedance.
Predicting drug-induced cardiotoxicity during the non-clinical stage is important to avoid severe consequences in the clinical trials of new drugs. Human iPSC-derived cardiomyocytes (hiPSC-CMs) hold great promise for cardiac safety assessments in drug development. To date, multi-electrode array system (MEA) has been a widely used as a tool for the assessment of proarrhythmic risk with hiPSC-CMs. Recently, new methodologies have been proposed to assess in vitro contractility, such as the force and velocity of cell contraction, using hiPSC-CMs. Herein, we focused on an imaging-based motion vector system (MV) and an electric cell-substrate impedance sensing system (IMP). We compared the output signals of hiPSC-CMs from MV and IMP in detail and observed a clear correlation between the parameters. In addition, we assessed the effects of isoproterenol and verapamil on hiPSC-CM contraction and identified a correlation in the contractile change of parameters obtained with MV and IMP. These results suggest that both assay systems could be used to monitor hiPSC-CM contraction dynamics.
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No pos
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No neg
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Retriever2337
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Influence of osmolality and ionic environment on the secretion of prolactin by human decidua in vitro.
The effects of extracellular osmolality and ions on the secretion of prolactin were examined in human decidual explants incubated for 4 h in modified Krebs-Ringer buffer. Explants incubated in media made hypersomotic (280-336 mosM/kg) with sodium, lithium or mannitol or in media made hypo-osmotic (280-224 mosM/kg) by decreasing the sodium concentration secreted the same amount of prolactin as explants incubated in control medium (280 mosM/kg). Explants incubated in calcium-deficient medium secreted 64 +/- 8% (P less than or equal to 0.001) less prolactin than controls (1.65 mmol Ca2+/1). Secretion was restored to control values by the addition of calcium (0.33 mmol/l) or barium (0.5, 1.0 or 2.0 mmol/l) to the medium. Prolactin secretion was unaffected by higher than control extracellular calcium concentrations, calcium ionophore A23187 (10-6, 10-9 mol/l) or lanthanum (0.5, 1.0 or 2.0 mmol/1). Changes in extracellular magnesium (0-20 mmol/l), potassium (0-55 mmol/l) or bicarbonate (0-32 mmol/l) had no effect on prolactin secretion. These results indicate that marked changes in extracellular osmolality and concentrations of sodium, magnesium and bicarbonate have no effects on decidual prolactin secretion. Calcium, however, is essential for the basal secretion of decidual prolactin.
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No pos
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No neg
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Retriever2338
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Age-associated changes of brain copper, iron, and zinc in Alzheimer's disease and dementia with Lewy bodies.
Disease-, age-, and gender-associated changes in brain copper, iron, and zinc were assessed in postmortem neocortical tissue (Brodmann area 7) from patients with moderate Alzheimer's disease (AD) (n = 14), severe AD (n = 28), dementia with Lewy bodies (n = 15), and normal age-matched control subjects (n = 26). Copper was lower (20%; p < 0.001) and iron higher (10-16%; p < 0.001) in severe AD compared with controls. Intriguingly significant Group*Age interactions were observed for both copper and iron, suggesting gradual age-associated decline of these metals in healthy non-cognitively impaired individuals. Zinc was unaffected in any disease pathologies and no age-associated changes were apparent. Age-associated changes in brain elements warrant further investigation.
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No pos
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No neg
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Retriever2339
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Impact of Procedural Bleeding in Peripheral Artery Disease: An Analysis From EUCLID Trial.
BACKGROUND
The relationship between invasive vascular procedures and bleeding in patients with peripheral artery disease has not been well described in the literature. This post hoc analysis from the EUCLID trial (Examining Use of Ticagrelor in Peripheral Artery Disease) aimed to describe the incidence of major and minor postprocedural bleeding and characterize the timing and severity of bleeding events relative to the procedure.
METHODS
EUCLID was a multicenter, randomized controlled trial of 13 885 patients with symptomatic peripheral artery disease that tested the efficacy and safety of ticagrelor compared with clopidogrel for the prevention of major adverse cardiovascular events. A total of 2661 patients underwent 3062 coronary revascularization, peripheral revascularization, and amputation during the study. The primary safety end point was Thrombolysis in Myocardial Infarction major or minor bleeding. All bleeding events were formally adjudicated by a clinical end point classification group.
RESULTS
Major bleeding events most often occurred ≤7 days following the procedure. The incidence of Thrombolysis in Myocardial Infarction major or minor bleeding ≤7 days following peripheral revascularization (3.3%; 95% CI, 2.5%-4.1%) was similar to rates after coronary revascularization (4.0%; 95% CI, 2.6%-5.4%) and lower extremity amputation (2.3%; 95% CI, 0.8%-3.8%). The severity of bleeding events (as graded by drop in hemoglobin, need for transfusion, bleeding in a critical location, and fatal bleeding) was also similar following peripheral, coronary revascularization, and lower extremity amputation.
CONCLUSIONS
The incidence of Thrombolysis in Myocardial Infarction major/minor bleeding following peripheral revascularization is comparable to rates after coronary revascularization and lower extremity amputation, and the majority of bleeding events occur within 7 days following the procedure. The severity of periprocedural bleeding is also similar after procedures, with the most frequently adjudicated reason being a drop in hemoglobin ≥2 g/dL. Future studies should be performed to enhance our understanding of bleeding risk related to revascularization and amputation procedures in peripheral artery disease patients.
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No pos
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No neg
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Retriever2340
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The toxicants and phosphorus content of some Nigerian vegetables.
The oxalate, hydrocyanic acid, phytic acid and phosphorus contents of twelve leafy vegetables were determined. The values ranged from 47.7-194.3 mg/100 g DM, 4.32-23.8 mg/100 g DM, 90-260 mg/100 g DM and 215-1110 mg/100 g DM, respectively. The ratio of phytic acid to phosphorus ranged from 13.9-90.7. The leaves contained low levels of hydrocyanic acid, while the oxalate, phytic acid and phosphorus contents were high. The results are discussed in terms of their clinical implications and nutritive values.
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No pos
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No neg
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Retriever2341
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Antigen-based therapy with glutamic acid decarboxylase (GAD) vaccine in patients with recent-onset type 1 diabetes: a randomised double-blind trial.
BACKGROUND
Glutamic acid decarboxylase (GAD) is a major target of the autoimmune response that occurs in type 1 diabetes mellitus. In animal models of autoimmunity, treatment with a target antigen can modulate aggressive autoimmunity. We aimed to assess whether immunisation with GAD formulated with aluminum hydroxide (GAD-alum) would preserve insulin production in recent-onset type 1 diabetes.
METHODS
Patients aged 3-45 years who had been diagnosed with type 1 diabetes for less than 100 days were enrolled from 15 sites in the USA and Canada, and randomly assigned to receive one of three treatments: three injections of 20 μg GAD-alum, two injections of 20 μg GAD-alum and one of alum, or 3 injections of alum. Injections were given subcutaneously at baseline, 4 weeks later, and 8 weeks after the second injection. The randomisation sequence was computer generated at the TrialNet coordinating centre. Patients and study personnel were masked to treatment assignment. The primary outcome was the baseline-adjusted geometric mean area under the curve (AUC) of serum C-peptide during the first 2 h of a 4-h mixed meal tolerance test at 1 year. Secondary outcomes included changes in glycated haemoglobin A(1c) (HbA(1c)) and insulin dose, and safety. Analysis included all randomised patients with known measurements. This trial is registered with ClinicalTrials.gov, number NCT00529399.
FINDINGS
145 patients were enrolled and treated with GAD-alum (n=48), GAD-alum plus alum (n=49), or alum (n=48). At 1 year, the 2-h AUC of C-peptide, adjusted for age, sex, and baseline C-peptide value, was 0·412 nmol/L (95% CI 0·349-0·478) in the GAD-alum group, 0·382 nmol/L (0·322-0·446) in the GAD-alum plus alum group, and 0·413 nmol/L (0·351-0·477) in the alum group. The ratio of the population mean of the adjusted geometric mean 2-h AUC of C-peptide was 0·998 (95% CI 0·779-1·22; p=0·98) for GAD-alum versus alum, and 0·926 (0·720-1·13; p=0·50) for GAD-alum plus alum versus alum. HbA(1c), insulin use, and the occurrence and severity of adverse events did not differ between groups.
INTERPRETATION
Antigen-based immunotherapy therapy with two or three doses of subcutaneous GAD-alum across 4-12 weeks does not alter the course of loss of insulin secretion during 1 year in patients with recently diagnosed type 1 diabetes. Although antigen-based therapy is a highly desirable treatment and is effective in animal models, translation to human autoimmune disease remains a challenge.
FUNDING
US National Institutes of Health.
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No pos
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No neg
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Retriever2342
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Learning the house officer role: reflections on the value of shadowing a PRHO.
In the new integrated undergraduate medical programme at the University of Manchester, fifth-year students spend several weeks shadowing the pre-registration house officer (PRHO) whose post they will take over. The concept of 'shadowing' emerged from a set of interviews conducted with graduates during their first PRHO job. Graduates felt that shadowing helped them to gain familiarity with the work environment; with orientation to the role of a PRHO; and with specific learning, such as disease management, on which they could then get feedback. We hypothesize that shadowing provides an opportunity for focused apprenticeship learning of the future PRHO role. Further research may clarify the specific values of shadowing and how it might lessen the stresses faced by new graduates during the transition from student to doctor.
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No pos
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No neg
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Retriever2343
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Mutations in mating-type genes of the heterothallic fungus Podospora anserina lead to self-fertility.
The heterothallic fungus Podospora anserina has two mating-type alleles termed mat+ and mat-. The mat+ sequence contains one gene, FPR1, while mat- contains three genes: FMR1, SMR1, and SMR2. FPR1 and FMR1 are required for fertilization, which is followed by mitotic divisions of the two parental nuclei inside the female organ. This leads to the formation of plurinucleate cells containing a mixture of parental mat+ and mat- nuclei. Further development requires a recognition between mat+ and mat- nuclei before migration of the mat+/mat- pairs into specialized hyphae in which karyogamy, meiosis, and ascospore formation take place. FPR1, FMR1, and SMR2 control this internuclear recognition step. Initial development of the dikaryotic stage is supposed to require SMR1; disruption of SMR1 results in barren perithecia. In a systematic search for suppressors restoring fertility, we isolated 15 suppressors-all of them mutations in the mating-type genes. These fmr1, smr2, and fpr1 mutants, as well as the strains disrupted for FMR1, SMR2, and FPR1, are weakly self-fertile. They are able to act as the male partner on a strain of the same mating type and give a mixture of biparental and uniparental progeny when crossed with a wild-type strain of opposite mating type. These observations lead us to propose that SMR2, FMR1, and FPR1 act as activators and repressors of fertilization and internuclear recognition functions.
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No pos
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No neg
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Retriever2344
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Effect of medium composition on the in vitro culture of bovine pre-antral follicles: morphology and viability do not guarantee functionality.
Summary This study investigated the effect of three different culture media (α minimum essential medium (α-MEM), McCoy or TCM199 during the in vitro culture (IVC) of bovine isolated pre-antral follicles. Pre-antral follicles greater than 150 μm in size were isolated and cultured for 0 (control), 8 or 16 days in one of the abovementioned culture media. Follicles were evaluated for survival, growth and antrum formation at days 8 and 16. The results showed that TCM199 was the most suitable medium to preserve follicular viability and ultrastructure, resulting in the highest rates of antrum formation. In conclusion, TCM199 promotes the in vitro development of isolated pre-antral follicles without hampering follicular functionality by sustaining in vitro growth and antrum formation.
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No pos
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No neg
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Retriever2345
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Polymorphisms of an oncogenic gene, mesothelin, predict the risk and prognosis of gastric cancer in a Chinese Han population.
Mesothelin (MSLN) is a cell surface protein associated with tumor invasion and metastasis. This study aims to explore the biological function of MSLN in gastric cancer and to evaluate the association of MSLN polymorphism (rs3764247, rs3764246, rs12597489, rs1057147, rs3765319) with the risk and prognosis of gastric cancer. Small interfering RNA (siRNA) transfection and MSLN overexpression were performed in human gastric cancer cell lines, respectively. The proliferation of tumor cells was evaluated by Cell counting kit 8(CCK-8) and colony formation assay. Wound healing assay and transwell assay were used to elucidate gastric cancer cell migration and invasion rates. We conducted a case-control study involving 860 patients with gastric cancer and 870 controls. All mutation sites were genotyped by PCR-LDR sequencing. First, our study revealed the cancer-promoting role of MSLN in gastric cancer. Second, we also demonstrated that rs3764247 and rs3764246 were associated with a reduced risk of gastric cancer (OR = 0.83, p = 0.010; OR = 0.84, p = 0.011; respectively). The clinicopathological analysis further showed that rs3764247 was closely related to T stage, vascular infiltration, and HER2 expression. In addition, in the survival analysis of 392 patients with gastric cancer, patients with rs3764247 CC genotype had poorer survival than patients with AA + AC genotype after adjusting for age, sex, TNM stage, and Lauren classification (HR = 2.07, p = 0.029). Our findings indicated that MSLN could be an oncogene whose polymorphisms were closely related to the risk and prognosis of gastric cancer.
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No pos
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No neg
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Retriever2346
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High GOLPH3 expression is associated with poor prognosis and invasion of hepatocellular carcinoma.
Golgi phosphoprotein 3 (GOLPH3) overexpression has previously been associated with the progression of several solid tumors, which resulted in adverse clinical outcomes. The present study aimed to determine the expression and prognostic significance of GOLPH3 in human hepatocellular carcinoma (HCC). GOLPH3 expression was examined using western blot analysis of 30 paired samples of HCC and adjacent non‑cancerous liver tissues. GOLPH3 expression levels were also assessed using immunohistochemistry in 180 HCC samples and paired controls. In addition, the association of GOLPH3 expression with clinicopathological features and clinical outcome was analyzed. Furthermore, the effect of GOLPH3 on HCC cell proliferation and invasion were determined. Western blot analysis revealed that GOLPH3 expression was significantly elevated in HCC tissue compared with that of the matched adjacent non‑cancerous liver tissue. In addition, the results of the immunohistochemical analysis demonstrated that GOLPH3 expression was positively correlated with the Edmondson‑Steiner grade (P=0.006), vascular invasion (P=0.002) and serum α feto‑protein levels (P=0.015). GOLPH3 expression was found to be an independent factor for predicting the poor overall survival of HCC patients (hazard ratio, 2.01; 95% confidence interval, 1.26‑3.64; P=0.025). In addition, GOLPH3 silencing inhibited the proliferation, invasion and migration of HCC cell lines in vitro. In conclusion, the results of the present study demonstrated that high GOLPH3 levels may be a potential biomarker for the poor prognosis of patients with HCC.
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No pos
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No neg
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Retriever2347
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Decreasing effect sizes for effectiveness studies- implications for the transport of evidence-based treatments: comment on curtis, ronan, and borduin (2004).
The most important finding from the N. M. Curtis, K. R. Ronan, and C. M. Borduin (2004) meta-analysis for the broader field is likely the difference in effect sizes between multisys- multisystemic therapy efficacy versus effectiveness studies. This difference has important implications for research on the transport of evidence-based treatments to community practice settings. For example, factors rarely considered in efficacy research (e.g., funding structures, organizational climate, program maturity, site characteristics) are emerging as important determinants of treatment fidelity and, in turn, clinical outcomes for practice in real-world settings. Current research is clearly demonstrating that evidence-based practices can be successfully transported, but much remains to be learned regarding the optimal parameters of such transport.
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No pos
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No neg
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Retriever2348
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Advances in resolving the heterogeneity and dynamics of keratinocyte differentiation.
The mammalian skin is equipped with a highly dynamic stratified epithelium. The maintenance and regeneration of this epithelium is supported by basally located keratinocytes, which display stem cell properties, including lifelong proliferative potential and the ability to undergo diverse differentiation trajectories. Keratinocytes support not just the surface of the skin, called the epidermis, but also a range of ectodermal structures including hair follicles, sebaceous glands, and sweat glands. Recent studies have shed light on the hitherto underappreciated heterogeneity of keratinocytes by employing state-of-the-art imaging technologies and single-cell genomic approaches. In this mini review, we highlight major recent discoveries that illuminate the dynamics and cellular mechanisms that govern keratinocyte differentiation in the live mammalian skin and discuss the broader implications of these findings for our understanding of epithelial and stem cell biology in general.
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No pos
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Retriever2349
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Pediatric and adolescent lymphoma: comparison of whole-body STIR half-Fourier RARE MR imaging with an enhanced PET/CT reference for initial staging.
PURPOSE
To compare the diagnostic performance of rapid whole-body anatomic magnetic resonance (MR) staging of pediatric and adolescent lymphoma to an enhanced positron emission tomographic (PET)/computed tomographic (CT) reference standard.
MATERIALS AND METHODS
Ethical permission was given by the University College London Hospital ethics committee, and informed written consent was obtained from all participants and/or parents or guardians. Thirty-one subjects (age range, 7.3-18.0 years; 18 male, 11 female) with histologically proved lymphoma were prospectively recruited. Pretreatment staging was performed with whole-body short inversion time inversion-recovery (STIR) half-Fourier rapid acquisition with relaxation enhancement (RARE) MR imaging, fluorine 18 fluorodeoxyglucose PET/CT, and contrast agent-enhanced chest CT. Twenty-six subjects had posttreatment PET/CT and compromised our final cohort. Eleven nodal and 11 extranodal sites per patient were assessed on MR imaging by two radiologists in consensus, with a nodal short-axis threshold of >1 cm and predefined extranodal positivity criteria. The same sites were independantly evaluated by two nuclear medicine physicians on PET/CT images. Disease positivity was defined as a maximum standardized uptake value >2.5 or nodal size >1 cm. An unblinded expert panel reevaluated the imaging findings, removing perceptual errors, and derived an enhanced PET/CT reference standard (taking into account chest CT and 3-month follow-up imaging) against which the reported and intrinsic performance of MR imaging was assessed by using the kappa statistic.
RESULTS
There was very good agreement between MR imaging and the enhanced PET/CT reference standard for nodal and extranodal staging (kappa = 0.96 and 0.86, respectively) which improved following elimination of perceptual errors (kappa = 0.97 and 0.91, respectively). The sensitivity and specificity of MR imaging (following removal of perceptual error) were 98% and 99%, respectively, for nodal disease and 91% and 99%, respectively, for extranodal disease.
CONCLUSION
Whole-body STIR half-Fourier RARE MR imaging of pediatric and adolescent lymphoma can accurately depict nodal and extranodal disease and may provide an alternative nonionizing imaging method for anatomic disease assessment at initial staging.
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No pos
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No neg
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Retriever2350
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Myocardial revascularization: the evolution of the STS database and quality measurement for improvement.
The Society of Thoracic Surgeons (STS) is a not-for-profit organization dedicated to helping clinicians and researchers provide optimal outcomes for patients undergoing heart, lung, and esophageal surgery. The organization was founded in 1964 and has grown to now include over 7300 members in over 90 countries. The STS created a national database that collects detailed clinical information on patients undergoing adult cardiac, pediatric and congenital cardiac, and general thoracic operations. The data collected are used to produce risk-adjusted, nationally benchmarked performance assessments and feedback; facilitate voluntary public reporting; support quality initiatives; develop evidence-based guidelines; monitor long-term clinical outcomes; track device performance; and promote high-quality research collaboratives.
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No pos
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Retriever2351
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Alone but feeling no pain: Effects of social exclusion on physical pain tolerance and pain threshold, affective forecasting, and interpersonal empathy.
Prior findings of emotional numbness (rather than distress) among socially excluded persons led the authors to investigate whether exclusion causes a far-reaching insensitivity to both physical and emotional pain. Experiments 1-4 showed that receiving an ostensibly diagnostic forecast of a lonesome future life reduced sensitivity to physical pain, as indicated by both (higher) thresholds and tolerance. Exclusion also caused emotional insensitivity, as indicated by reductions in affective forecasting of joy or woe over a future football outcome (Experiment 3), as well as lesser empathizing with another person's suffering from either romantic breakup (Experiment 4) or a broken leg (Experiment 5). The insensitivities to pain and emotion were highly intercorrelated.
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Retriever2352
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Knowledge regarding antibiotic use among students of three medical schools in Medellin, Colombia: a cross-sectional study.
BACKGROUND
The objective of the present study was to describe the knowledge regarding the antibiotic therapy of students of three medical schools in Medellín, Colombia.
METHODS
The study population comprised medical students who were enrolled in three universities. The instrument contained questions regarding their current academic term, the university, the perceived quality of the education received on antibiotic therapy and bacterial resistance, and specific questions on upper respiratory tract infections, pneumonia, urinary tract infections, and skin and soft tissue infections. The information was analyzed by calculating frequencies and measures of dispersion and central tendency. Knowledge regarding the treatment for each type of infection was compared using the Mann-Whitney U test and the Kruskal-Wallis H test.
RESULTS
We included 536 medical students, of which 43.5% students consider that the university has not sufficiently trained them to interpret antibiograms and 29.6% students consider that the quality of information received on the subject at their university ranges from regular to poor. The mean score for knowledge regarding antibiotic therapy for upper respiratory tract infections was 44.2 (9.9) on a scale from 0 to 100. The median score with regard to the treatment of pneumonia was 52.9 (14.7), that of urinary tract infection was 58.7 (14.8), and that of skin and soft tissue infections was 63.1 (19.4). The knowledge regarding antibiotic therapy for upper respiratory tract infections, pneumonia, and urinary tract infection does not improve with the academic term, the university, or perceived quality of the education received.
CONCLUSION
A large proportion of medical students perceive that the training received from the university is insufficient with regard to antibiotic use and bacterial resistance, which is consistent with the limited knowledge reflected in the selection of antibiotic treatment for respiratory, urinary tract, and skin and soft tissue infections. Overall, the situation was identical among all universities, and it did not significantly increase with the completion of an academic term.
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No pos
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No neg
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Retriever2353
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Involvement of glucocorticoid receptor in the induction of differentiation by ginsenosides in F9 teratocarcinoma cells.
We have previously reported that ginsenosides Rh1 and Rh2 induced the differentiation of F9 teratocarcinoma stem cells [Lee, Y. N., Lee, H. Y., Chung, H. Y., Kim, S. I., Lee, S. K., Park, B. C. and Kim, K. W., In vitro induction of differentiation by ginsenosides in F9 teratocarcinoma cells. Eur. J. Cancer 1996, 32, 1420-1428.]. Since the chemical structure of Rh1 and Rh2 is very similar to that of dexamethasone, a synthetic glucocorticoid, we investigated whether Rh1 and Rh2 act through the glucocorticoid receptor (GR). Immunocytochemistry showed that Rh1 or Rh2 increased the nuclear translocation of GR in the same manner of dexamethasone. In the gel shift assay, glucocorticoid response element (GRE) binding protein in F9 cells was increased by Rh1 or Rh2. To confirm whether the increased binding protein is GR, we performed the competition assay with unlabeled GRE as a specific competitor. Moreover, supershift assay with the GR antibody showed that the binding proteins are GR. In addition, to confirm the Rh1 or Rh2-induced transactivation of GRE promoter, we cotransfected GR expression vector and GRE-luciferase vector. In the luciferase assay, Rh1 or Rh2 potently induced luciferase activity and this induction was blocked by RU486, a potent GR antagonist. Taken together, we suggest that ginsenosides Rh1 and Rh2 may induce the differentiation of F9 cells by stimulating the nuclear translocation of GR.
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No pos
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No neg
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Retriever2354
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[Lymph flow following ligation of the ductus thoracicus in dogs].
Already few hours after artificial occlusion of the thoracic duct of dogs different communications appear between the lymphatic and the venous system: 1. Lymphovenous communications in the cervical area leading to the right venous angle. 2. Lymphovenous communications at heart level leading to the right venous angle. These lymphovenous communications seem to be preformed anastomoses, which are opened by an increase of the intralymphatic pressure.
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No pos
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No neg
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Retriever2355
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In vitro and in vivo synergy of fosmidomycin, a novel antimalarial drug, with clindamycin.
Fosmidomycin acts through inhibition of 1-deoxy-D-xylulose 5-phosphate (DOXP) reductoisomerase, a key enzyme of the nonmevalonate pathway of isoprenoid biosynthesis. It possesses potent antimalarial activity in vitro and in murine malaria. In a recent clinical study, fosmidomycin was effective and well tolerated in the treatment of patients with acute uncomplicated Plasmodium falciparum malaria but resulted in an unacceptably high rate of recrudescence. In order to identify a potential combination partner, the interaction of fosmidomycin with a number of antimalarial drugs in current use was investigated in a series of in vitro experiments. Synergy was observed between fosmidomycin and the lincosamides, lincomycin and clindamycin. The efficacy of a combination of fosmidomycin and clindamycin was subsequently demonstrated in the Plasmodium vinckei mouse model.
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No pos
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No neg
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Retriever2356
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On-line enhancement and separation of nanoparticles using capillary electrophoresis.
We describe a rapid, simple, and highly efficient capillary electrophoresis (CE)-based method for the analysis of nanoparticles (NPs). In this study, we used the reversed electrode polarity stacking mode (REPSM) of CE to assess the feasibility of enhancing the detection of Au NPs and Au/Ag NPs, optimizing parameters such as the length of time for which the REPSM was applied, the concentrations of the buffer and the sodium dodecylsulfate (SDS) surfactant, and the pH. Under the optimized on-line enhancement conditions [buffer: SDS (40 mM) and 3-cyclohexylamino-1-propanesulfonic acid (CAPS; 10 mM) at pH 10.0; applied voltage: 20 kV; REPSM applied for 24s], the detection limits of the Au NPs and Au/Ag NPs increased by ca. 30- and 140-fold, respectively. In addition, when the NPs were subjected to on-line enhancement and separation by CE using diode array detection (DAD), this approach allowed chemical characterization of the NP species. Our results suggest that such CE analyses will be useful for accelerating the rates of fabrication and characterization of future nanomaterials.
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No pos
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Retriever2357
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The clinical characteristics and hospital and post-hospital survival of patients with the obesity hypoventilation syndrome: analysis of a large cohort.
OBJECTIVE
The worldwide prevalence of obesity has reached epidemic proportions. Obesity hypoventilation syndrome (OHS) is a common yet largely undiagnosed and mistreated condition that likely carries a high mortality. The aim of this study was to determine the clinical characteristics, hospital outcome, outcome following hospital discharge and predictors of death in a large cohort of patients hospitalized with OHS. OHS is an important condition as many patients with this syndrome are misdiagnosed and receive inappropriate treatment.
METHODS
We reviewed the electronic medical records of patients with unequivocal OHS admitted to a 525-bed tertiary-care teaching hospital over a 5-year period. Demographic and clinical data as well as hospital disposition were recorded. In order to determine the patients' post-discharge status, we linked our database to the database of death certificates of the State Registrar of Vital Records.
RESULTS
We identified 600 patients who met the inclusion criteria for this study. The patients' mean age was 58 ± 15 years with a mean body mass index of 48.2 ± 8.3 kg m-2; 64% were women. Thirty-seven percent had a history of diabetes and 43% had been misdiagnosed as having chronic obstructive pulmonary disease, while none had been previously diagnosed with OHS. The most common admission diagnoses were respiratory failure, heart failure and sepsis. Ninety (15%) patients died during the index hospitalization. The patients' age, S-creatinine, respiratory failure, sepsis and admission to the ICU were independent predictors of hospital mortality. The hospital survivors were followed for a mean of 1,174 ± 501 d (3.2 ± 1.3 years) from the index hospitalization. On follow-up, 98 of the 510 (19%) hospital survivors died, with an overall cumulative mortality of 31.3%. The patients' age, S-creatinine and admission to the ICU were independent predictors of post-hospital mortality.
CONCLUSION
Obesity hypoventilation syndrome is a common disease that is frequently misdiagnosed and mistreated and carries a 3-year morality, which is significantly worse than that for most cancers combined. Considering the high mortality of this disease, all patients with a body mass index > 35 kg m-2 should be screened for OHS; those patients with both early and established OHS should be referred to a pulmonary and/or sleep specialist for evaluation for non-invasive positive pressure ventilation, to a dietician for dietary counseling and lifestyle modification and to a bariatric surgeon for evaluation for bariatric surgery.
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No pos
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No neg
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Retriever2358
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Activated carbon as an insoluble electron shuttle to enhance the anaerobic ammonium oxidation coupled with Fe(III) reduction process.
Anaerobic ammonium oxidation coupled with Fe(III) reduction (Feammox) is an autotrophic biological nitrogen removal (BNR) technique in treating low-C/N wastewater. However, the nitrogen removal rate of Feammox is limited by the extracellular electron transfer. In this study, wood activated carbon (AC) was chosen as electron shuttle to enhance the start-up of the Feammox process. Within an operational period of 150 days, the NH4+-N removal efficiency reached 97.9-99.5% with a volumetric loading rate (VLR) of 0.04-0.06 kg N m-3 d-1. Batch experiments indicated that compared with Fe2O3-AQDS and Fe2O3 groups, Fe2O3-AC group showed higher catalytic performance and TN removal efficiency reached 85.7%. Quinone (CO) and phenolic (-OH) chemical groups of AC were equipped with electron transfer capacity (76.51 ± 9.27 μmol e- g-1). Moreover, Fe(II)/Fe(III) species and the secondary iron minerals were found in our system. Microbial analysis showed that Proteobacteria and Acidobacteriota, which observed with relatively high abundance, were played an important role in the integrated Feammox system. This study demonstrates the significant influence of AC on Feammox process and provides an enhanced biological nitrogen removal strategy for practice engineering application.
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No pos
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Retriever2359
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[Sudeck's syndrome. Was Sudeck right?].
Reflex sympathetic dystrophy (RSD) is a syndrome affecting an extremity after a minor trauma or operation. At the moment there is no consensus about the pathogenesis of RSD. In 1942 Paul Sudeck suggested that the signs and symptoms of RSD may be provoked by an exaggerated inflammatory response to injury or operation of an extremity. His theory found no disciples, as most physicians believe that RSD is initiated by an hyperactive sympathetic system. We performed various clinical and experimental investigations, including the effects of antiinflammatory treatment. The results of these studies support the theory of Paul Sudeck.
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No pos
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Retriever2360
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Profile of GERD in the adult population of a northeast urban community.
STUDY
An observational, cross-sectional, epidemiology study of the characteristics of GERD in a large northeast urban population was performed using a self-responding 84-question survey. Four-hundred and ten surveys were completed from a population sample with demographics comparable to those of the 1990 US Census data.
RESULTS
No differences in heartburn frequency (monthly) were found between white or black, male or female respondents. Heartburn was significantly (P = 0.01) less common in those over age 60 (36.9%) than in young (47.7%) or middle-age (57.3%) respondents. Impact of heartburn on social activities was less (P = 0.002) in the over 60 group (4.9%) compared with the young (19.3%) or middle-age (20.0%) groups. Although 49.8% of respondents were familiar to the term GERD, few were aware that swallowing difficulty (17.3%), asthma (9.3%) or hoarseness (11.5%) were possible symptoms and similar numbers considered stroke (33.2%) and cancer (31.7%) to be complications of GERD.
CONCLUSIONS
Frequency of GERD symptoms in the United States is unaffected by gender or race but is lower in the elderly.
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No pos
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Retriever2361
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Epidermal Wnt controls hair follicle induction by orchestrating dynamic signaling crosstalk between the epidermis and dermis.
A signal first arising in the dermis to initiate the development of hair follicles has been described for many decades. Wnt is the earliest signal known to be intimately involved in hair follicle induction. However, it is not clear whether the inductive signal of Wnt arises intradermally or intraepidermally. Whether Wnt acts as the first dermal signal to initiate hair follicle development also remains unclear. Here we report that Wnt production mediated by Gpr177, the mouse Wls ortholog, is essential for hair follicle induction. Gpr177, encoding a multipass transmembrane protein, regulates Wnt sorting and secretion. Cell type-specific abrogation of the signal reveals that only epidermal, but not dermal, production of Wnt is required. An intraepidermal Wnt signal is necessary and sufficient for hair follicle initiation. However, the subsequent development depends on reciprocal signaling crosstalk of epidermal and dermal cells. Wnt signals within the epidermis and dermis and crossing between the epidermis and dermis have distinct roles and specific functions in skin development. This study not only defines the cell type responsible for Wnt production, but also reveals a highly dynamic regulation of Wnt signaling at different steps of hair follicle morphogenesis. Our findings uncover a mechanism underlying hair follicle development orchestrated by the Wnt pathway.
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No pos
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No neg
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Retriever2362
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Imaging live cell membranes via surface plasmon-enhanced fluorescence and phase microscopy.
This paper demonstrates the first combination for wide-field surface plasmon (SP) phase microscopy and SP-enhanced fluorescence microscopy to image living cells' contacts on the surface of a bio-substrate simultaneously. The phase microscopy with a phase-shift interferometry and common-path optical setup can provide high-sensitivity phase information in long-term stability. Simultaneously, the fluorescence microscopy with the enhancement of a local electromagnetic field can supply bright fluorescent images. The combined microscope imposes a high numerical aperture objective upon the excitation of surface plasmon through a silver film with a thickness of 30 nm. The developed SP microscope is successfully applied to the real-time bright observation of the transfected fluorescence of living cells localized near the cell membrane on the bio-substrate and the high-sensitivity phase image of the cell-substrate contacts at the same time.
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No pos
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No neg
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Retriever2363
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The enhanced immune responses induced by Salmonella enteritidis ghosts loaded with Neisseria gonorrhoeae porB against Salmonella in mice.
Human health has been seriously endangered by highly prevalent salmonellosis and multidrug-resistant Salmonella strains. Current vaccines suffer from variable immune-protective effects, so more effective ones are needed to control Salmonella infection : Bacterial ghosts have been produced by the expression of lysis gene E from bacteriophage PhiX174 and can be filled with considerable exogenous substances such as DNA or drugs as a novel platform. In this study, Salmonella enteritidis (SE) ghosts were developed and loaded with Neisseria gonorrhoeae porin B (porB) to construct a novel inactive vaccine. Our new studies show that SE ghosts loaded with porB displayed increased production of pro-inflammatory cytokines (IL-1β, IL-6, IL-10 and IL-12p70) in bone marrow-derived dendritic cells (BMDCs), and elicited significantly higher specific systemic and mucosal immune responses to Salmonella than SE ghosts alone. In addition, the novel porB-loaded ghosts conferred higher protective effects on virulent Salmonella challenge. For the first time, we demonstrate that N. gonorrhoeae porB, as a novel adjuvant, can increase the immunogenicity of SE ghosts. Our studies suggested that Salmonella enteritidis ghosts loaded with Neisseria gonorrhoeae porin B might be a useful mucosal Salmonella vaccine candidate for practical use in the future.
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No pos
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Retriever2364
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Validation of the Barcelona Bipolar Eating Disorder Scale for bipolar patients with eating disturbances.
BACKGROUND
Eating disturbances are frequent in bipolar disorder and are associated with poor outcome. Our objective is to assess the psychometric properties of a specific scale for the evaluation of eating disturbances in bipolar patients.
SAMPLING AND METHODS
Validation study of 2 groups with a 6-month follow-up (90 patients diagnosed with bipolar and eating disturbances and 40 healthy controls).
RESULTS
The scale showed: (1) adequate feasibility (non- response <2.5%); (2) adequate reliability (Cronbach's alpha coefficients = 0.79 and 0.57 in groups A and B; intraclass correlation coefficient = 0.79 in group A); (3) adequate discriminant validity between patients and controls [AUC = 0.85; moderate correlations with the Bulimic Investigatory Test Edinburgh (r = 0.32-0.64); low correlations with the Barratt Impulsiveness Scale, Young Mania Rating Scale and Hamilton Depression Rating Scale 17 (r < 0.3)]; (4) adequate sensitivity to changes.
CONCLUSIONS
The Barcelona Bipolar Eating Disorder Scale showed adequate psychometric properties to assess eating disturbances in bipolar patients in clinical practice and research.
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No neg
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Retriever2365
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Computational Study of Reduction Potentials of Th4+ Compounds and Hydrolysis of ThO2(H2O)n, n = 1, 2, 4.
The stability of Th4+ to reduction in water is studied by DFT methods. The standard reduction potential (SRP) of homoleptic complexes including Th(H2O)94+, Th(H2O)104+, Th(NO3)4, Th(NO2)62-, Th(NO3)62-, Th(COT)2, Th(acac)4, ThCp4, ThF4, and ThCl4 have been investigated. The values vary widely (from -3.50 V for Th(OH)4 to -0.62 V for Th(NO3)4 depending on whether the ligands are redox active (noninnocent) or not. Several additional topics of thorium chemistry are explored, including the hydrolysis mechanism of ThO2(H2O)n, n = 1, 2, 4, and the solution phase nonzero dipole moment of ThCp4. Dinuclear complexes are also characterized, including Th2O4, Th2O2(OH)4, Th2O2(H2O)8, Th2(OH)8(H2O)4, and Th2(OH)2(NO3)6(H2O)4 and condensed thorium complexes as [Th4(OH)6(H2O)12]10+ and [Th6(OH)14(H2O)12]10+. For the Th2(OH)2(NO3)6(H2O)4 dinuclear complex, the first SRP is -0.82 V and the second is 1.59 V. The first SRP corresponds to the reduction of the ligand NO3-, and the second SRP corresponds to dissociative electron transfer to the NO32- ligand. The calculated formation constant of Th(EDTA)(H2O)4 is in reasonable agreement with experiment. The different stereochemistries of the bidentate ligands NO2-, NO3-, and acetylacetonate (acac) around the thorium center have very similar stabilities.
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Retriever2366
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Destructive processes of salivary gland parenchyma and development of epimyoepithelial islands assessed by immunohistochemistry.
Thirteen salivary gland lesions showing destructive features and development of epimyoepithelial islands were studied using a panel of monoclonal antibodies to B cell (Dako, CD20 L26), T cell (UCHL1), macrophage histiocyte MH cell (Dako, MAC387), cytokeratin PKK1, KL1, K8.12, actin, vimentin and Von Willebrand factor (v WF). B cells were distributed closely in some limited areas and T cells were scattered throughout the lesion. MH cells were located particularly in the periductal tissue as well as in ducts and acini. Actin staining was positive in myoepithelium around acini but was negative or weak around degenerative acini. Endothelial cells of blood vessels stained strongly with v WF. Cytokeratin KL1 and K8.12 were positive in duct cells of the unaffected area while in the degenerative region they were negative or weak. K8.12 was positive in epimyoepithelial islands, indicating that the epimyoepithelial cells in lymphoepithelial lesions may originate from duct basal cells.
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Retriever2367
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Correction: Antidepressant and Neurocognitive Effects of Isoflurane Anesthesia versus Electroconvulsive Therapy in Refractory Depression.
[This corrects the article DOI: 10.1371/journal.pone.0069809.].
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Retriever2368
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Prognostic significance of ZP3 in hepatocellular carcinoma.
OBJECTIVE
The study aims to explore the prognostic significance of zona pellucida glycoprotein 3 (ZP3) in hepatocellular carcinoma (HCC) tissues.
METHODS
The expression of ZP3 protein in HCC tissues was detected by immunohistochemistry (IHC) to study its effects on the clinicopathological characteristics and prognosis of HCC patients. The Cancer Genome Atlas (TCGA) database was used to confirm the expression of ZP3 in HCC tissues and Gene set enrichment analysis (GSEA) was performed to obtain potential ZP3-related pathways in HCC.
RESULTS
IHC detection found that ZP3 had a high expression in HCC tissues and was associated with cirrhosis, and hepatitis B virus infection of HCC patients (P<0.05). TCGA database also showed that ZP3 was up-regulated in HCC tissues. Further survival evaluation confirmed that ZP3 expression caused an impact on the overall survival time and disease-free survival time of HCC patients (P<0.05), implying a potential role in HCC prognosis. GSEA analysis indicated that the 187 differential gene sets were mainly involved in 10 signaling pathways, including 5 up-regulated and 5 down-regulated pathways.
CONCLUSION
High expression of ZP3 in HCC tissues shows an important role in HCC development and prognosis.
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No pos
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No neg
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Retriever2369
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pH-responsive Astragalus polysaccharide-loaded PLGA nanoparticles as an adjuvant system to improve immune responses.
Modern medical science believes that astragalus polysaccharides (APS) have the efficacy of strengthening immune system, while their peculiarities greatly reduced clinical applications. Poly(lactic-co-glycolic acid) (PLGA) is a synthetic carrier material with outstanding biochemical properties. In this study, PLGA materials were used to prepare the novel pH-responsive targeting drug delivery carriers which were encapsulated APS inside. The OVA-loaded pH-responsive APS-encapsulated PLGA Nanoparticles (OVA-loaded pH-responsive APSPs) and the OVA-loaded APSPs were constructed by multiple emulsion solvent evaporation method. Characterization and immunoenhancing activities of PLGA nanoparticles (NPs) were evaluated in vitro and in vivo. The size of NPs ranged from 142.6 to 194.6 nm, and all NPs were negatively charged. Additionally, pH-responsive APSPs shown violent release behaviors in an acidic environment. pH-responsive APSPs had low cytotoxicity, and significantly enhanced expression of MHC-II, CD80, CD86, and phagocytosis ability of macrophages. Both OVA-loaded NPs could stimulate greater Th1-biased immune responses compared with APS alone, and they could significantly promote proliferation, differentiation, and maturity of splenic lymphocytes and dendritic cells in mice respectively. NPs induced significantly greater antigen-specific IgG antibody responses and expression of IL-4, IL-6, IFN-γ, and TNF-α. Moreover, OVA-loaded pH-responsive APSPs had an aptitude for both cellular and humoral immunity reinforcement during early immunization, while OVA-loaded APSPs had advantages on later stages of immune responses.
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No pos
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No neg
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Retriever2370
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Exercise and lumbar spine bone mineral density in postmenopausal women: a meta-analysis of individual patient data.
BACKGROUND
Low bone mineral density (BMD) at the lumbar spine is a major public health problem among postmenopausal women. We conducted a meta-analysis of individual patient data (IPD) to examine the effects of exercise on lumbar spine BMD in postmenopausal women.
METHODS
IPD were requested from a previously developed database of summary means from randomized and nonrandomized trials dealing with the effects of exercise on BMD. Two-way analysis of variance tests with pairwise comparisons (p < or =.05) and 95% confidence intervals (CIs) were used to determine the statistical significance for changes in lumbar spine BMD.
RESULTS
Across 13 trials that included 699 subjects (355 exercise, 344 control), a statistically significant interaction was found between test and group (F = 15.232, p =.000). Pairwise comparisons (Bonferroni t tests) revealed a statistically significant increase in final minus initial BMD for the exercise group ( +/- SD = 0.005 +/- 0.043 g/cm(2), t = 2.46, p =.014, 95% CI = 0.001-0.009) and a statistically significant decrease in final minus initial BMD for the control group ( +/- SD = -0.007 +/- 0.045 g/cm(2), t = -3.051, p =.002, 95% CI = -0.012--0.002). Changes were equivalent to an approximate 2% benefit in lumbar spine BMD (exercise, +1%, control, -1%).
CONCLUSIONS
The results of this IPD meta-analysis suggest that exercise helps to improve and maintain lumbar spine BMD in postmenopausal women.
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No pos
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No neg
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Retriever2371
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In Vitro and Ex Vivo Evaluation of Novel Curcumin-Loaded Excipient for Buccal Delivery.
This study aimed to develop a mucoadhesive polymeric excipient comprising curcumin for buccal delivery. Curcumin encompasses broad range of benefits such as antioxidant, anti-inflammatory, and chemotherapeutic activity. Hyaluronic acid (HA) as polymeric excipient was modified by immobilization of thiol bearing ligands. L-Cysteine (SH) ethyl ester was covalently attached via amide bond formation between cysteine and the carboxylic moiety of hyaluronic acid. Succeeded synthesis was proved by H-NMR and IR spectra. The obtained thiolated polymer hyaluronic acid ethyl ester (HA-SH) was evaluated in terms of stability, safety, mucoadhesiveness, drug release, and permeation-enhancing properties. HA-SH showed 2.75-fold higher swelling capacity over time in comparison to unmodified polymer. Furthermore, mucoadhesion increased 3.4-fold in case of HA-SH and drug release was increased 1.6-fold versus HA control, respectively. Curcumin-loaded HA-SH exhibits a 4.4-fold higher permeation compared with respective HA. Taking these outcomes in consideration, novel curcumin-loaded excipient, namely thiolated hyaluronic acid ethyl ester appears as promising tool for pharyngeal diseases.
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No pos
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No neg
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Retriever2372
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Establishing Bedding Requirements during Transport and Monitoring Skin Temperature during Cold and Mild Seasons after Transport for Finishing Pigs.
The broad aim of this study was to determine whether bedding level in the transport trailer influenced pig performance and welfare. Specifically, the objective was to define the bedding requirements of pigs during transportation in commercial settings during cold and mild weather. Animals (n = 112,078 pigs on 572 trailers) used were raised in commercial finishing sites and transported in trailers to commercial processing plants. Dead on arrival (DOA), non-ambulatory (NA), and total dead and down (D&D) data were collected and skin surface temperatures of the pigs were measured by infrared thermography. Data were collected during winter (Experiment 1) and fall/spring (Experiment 2). Total D&D percent showed no interaction between bedding level and outside air temperature in any experiments. Average skin surface temperature during unloading increased with outside air temperature linearly in both experiments (P < 0.01). In conclusion, over-use of bedding may be economically inefficient. Pig skin surface temperature could be a useful measure of pig welfare during or after transport.
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No pos
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No neg
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Retriever2373
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Reduced antiretroviral drug susceptibility among patients with primary HIV infection.
CONTEXT
The transmission of drug-resistant human immunodeficiency virus (HIV) has been documented, but the prevalence of such transmission is unknown.
OBJECTIVE
To assess the spectrum and frequency of antiretroviral susceptibility among subjects with primary HIV infection.
DESIGN, SETTING, AND PATIENTS
Retrospective analysis of 141 subjects identified from clinical research centers in 5 major metropolitan areas, enrolled from 1989 to 1998, with HIV seroconversion within the preceding 12 months and no more than 7 days' prior antiretroviral (ARV) therapy.
MAIN OUTCOME MEASURES
Phenotypic and genotypic ARV susceptibility of HIV from plasma samples.
RESULTS
The transmission of drug-resistant HIV as assessed by a greater than 10-fold reduction in ARV susceptibility to 1 or more drugs was observed in 3 (2%) of 141 subjects, including to a nonnucleoside reverse transcriptase inhibitor in 1 patient and to a nucleoside reverse transcriptase inhibitor and a protease inhibitor in 2 patients. Population-based sequence analysis of these 3 samples identified multidrug-resistance mutations in reverse transcriptase (M184V, T215Y, K219K/R) and protease (L101/V, K20R, M361, M46I, G48V, L63P, A71T, V771, V82T, 184V, L90M) in the 2 latter patient samples, along with numerous polymorphisms. A reduction in susceptibility of greater than 2.5- to 10-fold to 1 or more drugs was observed in viral isolates from 36 patients (26%). Sequence analysis of these 36 samples identified well-characterized drug resistance mutation in reverse transcriptase and protease in only 1 of these patients.
CONCLUSIONS
Reductions in drug susceptibility of more than 10-fold were rare among this cohort of recently HIV-infected subjects and were distributed among each of the 3 major classes of ARV drugs tested. Reductions in susceptibility of more than 2.5- to 10-fold to certain ARV drugs of unknown clinical significance were highly prevalent among newly infected patients. Resistance testing may be warranted to monitor the frequency of drug resistance over time and to assess the potential for geographic variability.
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No pos
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No neg
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Retriever2374
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Progression of antral and body gastritis in patients with active and healed duodenal ulcer and duodenitis.
The dynamics of the antral and body mucosa has been studied in biopsy specimens obtained during endoscopy of patients with duodenal ulcer (103 cases), patients with duodenal ulcer scars (108 cases), and patients with duodenitis (44 cases). A representative Finnish population sample consisting of 434 subjects was used as reference material. The antral mucosa of all patient series showed an increase in the severity and prevalence of gastritis similar to that of the general population, whereas virtually no progression of gastritis with age was seen in the body mucosa, which remained normal or at the stage of superficial gastritis up to geriatric age. In contrast, in the present controls and in all earlier population samples studied by us so far, there was a significant and steady increase in the severity and prevalence of body gastritis with age. It is concluded that the age behavior of the antral and body mucosa was in duodenal ulcer scars and duodenitis similar to that of patients with active duodenal ulcer. The persistence of normal conditions in the acid-secreting area may serve as one explanation of the strong tendency of the disease to recur. In addition, it is tentatively concluded that in duodenal ulcer disease there are factors that have a 'protecting' influence on the body glands and which are abolished by antrectomy, according to our earlier studies.
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No pos
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No neg
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Retriever2375
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Doxycycline-Induced Changes in Circulating MMP or TIMP2 Levels Are Not Associated with Skeletal-Related Event-Free or Overall Survival in Patients with Bone Metastases from Breast Cancer.
Doxycycline is often used as a promoter of inducible gene expression in preclinical models; however, it can also have direct effects on tumor growth and survival. This is due in part to its ability to inhibit cell invasion and regulate matrix metalloproteinase (MMP) expression. Given that doxycycline is also osteotropic, a clinical study to assess its effects on modulation of tumor progression or prevention of skeletal-related events (SRE) in patients with bone metastases from breast cancer (the Achilles trial) was undertaken. Patients received 100 mg of oral doxycycline twice daily for 12 weeks, with serum obtained at baseline and 4, 8 and 12 weeks post-initiation of doxycycline treatment. Exploratory analysis of the effects of doxycycline on circulating levels of MMP or tissue inhibitor of matrix metalloproteinase 2 (TIMP2) was performed in enrolled patients. Statistically significant associations were observed between MMP2, MMP9 and TIMP2 at baseline with significant associations maintained between absolute levels and changes in levels of MMP2 and TIMP2 at weeks 4-12 post initiation of doxycycline. Treatment with doxycycline generally resulted in decreases in MMP2 and MMP9 levels with concurrent upregulation of TIMP2 at 12 weeks post-initiation of doxycycline treatment. Despite this, we observed no association with the levels of any of these factors with either SRE-free or overall survival in this patient cohort. In summary, despite observing hypothesized effects of doxycycline administration on surrogate markers of its anti-tumor activity, measures of circulating levels of these biomarkers were not prognostic in this patient population.
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No pos
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No neg
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Retriever2376
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Long-term regulation of contractility and calcium current in smooth muscle.
Longitudinal smooth muscle strips from guinea pig ileum were cultured in vitro for 5 days, and the relationship between extracellular Ca2+ and force in high-K+ medium was evaluated. In strips cultured with 10% fetal calf serum (FCS), this relationship was shifted to the right (50% effective concentration changed by 2-3 mM) compared with strips cultured without FCS. The shift was prevented by inclusion of verapamil (1 microM) during culture and mimicked by ionomycin in the absence of FCS. The intracellular Ca2+ concentration ([Ca2+]i) during stimulation with high-K+ solution or carbachol was reduced after culture with FCS, whereas the [Ca2+]i-force relationship was unaffected. Cells were isolated from cultured strips, and whole cell voltage-clamp experiments were performed. Maximum inward Ca2+ current (10 mM Ba2+), normalized to cell capacitance, was almost three times smaller in cells isolated from strips cultured with FCS. Culture with 1 microM verapamil prevented this reduction. These results suggest that increased [Ca2+]i during culture downregulates Ca2+ current density, with associated effects on contractility.
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No pos
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No neg
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Retriever2377
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Interventional Management of Vascular Complications after Renal Transplantation.
BACKGROUND
Kidney transplantations are increasing due to demographic changes and are the treatment of choice for end-stage renal disease. Non-vascular and vascular complications may occur in the early phase after transplantation and at later stages. Overall postoperative complications after renal transplantations occur in approximately 12 % to 25 % of renal transplant patients. In these cases, minimally invasive therapeutic interventions are essential to ensure long-term graft function. This review article focuses on the most critical vascular complications after renal transplantation and highlights current recommendations for interventional treatment.
METHOD
A literature search was performed in PubMed using the search terms "kidney transplantation", "complications", and "interventional treatment". Furthermore, the 2022 annual report of the German Foundation for Organ Donation and the EAU guidelines for kidney transplantation (European Association of Urology) were considered.
RESULTS AND CONCLUSION
Image-guided interventional techniques are favorable compared with surgical revision and should be used primarily for the treatment of vascular complications. The most common vascular complications after renal transplantation are arterial stenoses (3 %-12.5 %), followed by arterial and venous thromboses (0.1 %-8.2 %) and dissection (0.1 %). Less frequently, arteriovenous fistulas or pseudoaneurysms occur. In these cases, minimally invasive interventions show a low complication rate and good technical and clinical results. Diagnosis, treatment, and follow-up should be performed in an interdisciplinary approach at highly specialized centers to ensure the preservation of graft function. Surgical revision should be considered only after exhausting minimally invasive therapeutic strategies.
KEY POINTS
· Vascular complications after renal transplantation occur in 3 % to 15 % of patients.. · Image-guided interventional procedures should be performed primarily to treat vascular complications of renal transplantation.. · Minimally invasive interventions have a low complication rate with good technical and clinical outcomes..
CITATION FORMAT
· Verloh N, Doppler M, Hagar MT et al. Interventional Management of Vascular Complications after Renal Transplantation. Fortschr Röntgenstr 2023; DOI: 10.1055/a-2007-9649.
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No pos
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No neg
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Retriever2378
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Cucurbita-5,23-diene-3beta,25-diol from Sicana odorifera.
The spectral data of a new triterpene, cucurbita-5,23-diene-3beta,25-diol, isolated from the seeds of Sicana odorifera, are reported.
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No pos
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No neg
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Retriever2379
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A retrospective analysis of 25% human serum albumin supplementation in hypoalbuminemic dogs with septic peritonitis.
This study describes the influence of 25% human serum albumin (HSA) supplementation on serum albumin level, total protein (TP), colloid osmotic pressure (COP), hospital stay, and survival in dogs with septic peritonitis. Records of 39 dogs with septic peritonitis were evaluated. In the HSA group, initial and post-transfusion TP, albumin, COP, and HSA dose were recorded. In the non-supplemented group, repeated values of TP, albumin, and COP were recorded over their hospitalization. Eighteen dogs survived (53.8% mortality). Repeat albumin values were higher in survivors (mean 23.9 g/L) and elevated repeat albumin values were associated with HSA supplementation. Repeat albumin and TP were higher in the HSA supplemented group (mean 24 g/L and 51.9 g/L, respectively) and their COP increased by 5.8 mmHg. Length of hospitalization was not affected. Twenty-five percent HSA increases albumin, TP, and COP in canine patients with septic peritonitis. Higher postoperative albumin levels are associated with survival.
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No pos
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No neg
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Retriever2380
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Maxillary sinus elevation for implant placement using calcium sulfate with and without DFDBA: six cases.
Maxillary sinus lift is a surgical procedure performed to increase the volume of bone mass so that dental implants can be placed in the maxillary arch. Several materials have been suggested to be used for this procedure. The purpose of this study was to present the clinical and histologic results of using calcium sulfate with and without demineralized freeze-dried bone allograft (DFDBA) in sinus lift. Medical-grade sterile calcium sulfate was used alone or in combination with DFDBA in 6 patients undergoing sinus lift surgery for implant placement. Bone biopsies were taken at different times ranging from 6 to 24 months. All samples examined showed bone growth with some possible remnants of the grafted DFDBA. Implants were inserted either at the time of the lift or 6 months later. All of them were secure with primary stability. The cases reported indicate that calcium sulfate can be successfully used alone or in combination with DFDBA for sinus lift procedures and that possible residues of DFDBA can be found within newly generated bone. (Implant Dent 2004;13:270-277)
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No pos
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No neg
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Retriever2381
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Cyclic variation in women's preferences for masculine traits : Potential hormonal causes.
Women's preferences for several male traits, including voices, change over the menstrual cycle, but the proximate causes of these changes are unknown. This paper explores relationships between levels of estradiol, progesterone, luteinizing hormone, follicle stimulating hormone, prolactin, and testosterone (estimated using menstrual cycle information) and women's preferences for male vocal masculinity in normally cycling and hormonally contracepting heterosexual females. Preferences for vocal masculinity decreased with predicted progesterone levels and increased with predicted prolactin levels in normally cycling-but not hormonally contracepting-women. Adaptive explanations for menstrual variation in women's preferences for masculine traits are discussed and evaluated in light of these findings.
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No pos
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No neg
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Retriever2382
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MAGETabulator, a suite of tools to support the microarray data format MAGE-TAB.
The MAGE-TAB format for microarray data representation and exchange has been proposed by the microarray community to replace the more complex MAGE-ML format. We present a suite of tools to support MAGE-TAB generation and validation, conversion between existing formats for data exchange, visualization of the experiment designs encoded by MAGE-TAB documents and the mining of such documents for semantic content.
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No pos
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No neg
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Retriever2383
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Molecular structure of proline.
The molecular structures of the two lowest-energy conformers of proline, Pro-I and Pro-II, have been characterized by ab initio electronic structure computations. An extensive MP2/6-31G* quartic force field for Pro-I, containing 62,835 unique elements in the internal coordinate space, was computed to account for anharmonic vibrational effects, including total zero-point contributions to isotopomeric rotational constants. New re and improved r0 least-squares structural refinements were performed to determine the heavy-atom framework of Pro-I, based on experimentally measured (A. Lesarri, S. Mata, E. J. Cocinero, S. Blanco, J. C. Lopez, J. L. Alonso, Angew. Chem. 2002, 114, 4867; Angew. Chem. Int. Ed. 2002, 41, 4673) rotational constant sets of nine isotopomers and our ab initio data for structural constraints and zero-point vibrational (ZPV) shifts. Without the ab initio constraints, even the extensive set of empirical rotational constants cannot satisfactorily fix the molecular structure of the most stable conformer of proline, a 17-atom molecule with no symmetry. After imposing the ab initio constraints, excellent agreement between theory and experiment is found for the heavy-atom geometric framework, the root-mean-square (rms) residual of the empirical rotational constant fit being cut in half by adding ZPV corrections. The most significant disparity, about 0.07 A, between the empirical and the best ab initio structures, concerns the r(N...H) distance of the intramolecular hydrogen bond. Some of the experimental quartic centrifugal distortion constants assigned to Pro-II have been corrected based on data obtained from a theoretical force field.
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No pos
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No neg
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Retriever2384
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Félix Voisin and the genesis of abnormals.
This article traces the genealogy of the category of 'abnormals' in psychiatry. It focuses on the French alienist Felix Voisin (1794-1872) who played a decisive role in the creation of alienist knowledge and institutions for problem children, criminals, idiots and lunatics. After a presentation of the category of 'abnormals' as understood at the end of the nineteenth century, I identify in the works of Voisin a key moment in the concept's evolution. I show how, based on concepts borrowed from phrenology and applied first to idiocy, Voisin allows alienism to establish links between the medico-legal (including penitentiary) and medical-educational fields (including difficult childhood). I stress the extent to which this enterprise is related to Voisin's humanism, which claimed to remodel pedagogy and the right to punish on the anthropological particularities of individuals, in order to improve them.
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No pos
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No neg
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Retriever2385
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Parental stress in families of children with special educational needs: a systematic review.
Background
This systematic review aimed to identify the risk factors and protective factors for parental stress in families with children with special educational needs. Studies have indicated that the wellbeing of families is related to the physical, psychological, and social conditions of the children, as well as the family functioning, stress coping strategies, and social and professional support of their parents. The parents of children with special educational needs experience high levels of parental stress. Identifying the associated risk factors and protective factors may shed light on the provision of interventions to promote the mental wellbeing of these parents.
Methods
Boolean operators were used to search multiple online databases, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were applied in this systematic review. Data were extracted into categories of population, age, region, the child's diagnosis, the stress-measuring instrument, and the risk factors and protective factors.
Results
Twenty-six studies, including 5,169 parents and 3,726 children, were reviewed. The following four major risk factors and protective factors were found to be associated with parental stress: the sex of the parents, diagnosis-related coping issues, socioeconomic characteristics, and social isolation of the parents.
Conclusions
This systematic review identified four significant risk factors and protective factors related to social support from couples, family members, and social circles. Various agencies may provide financial and manpower assistance and professional support and services to improve the parents' knowledge and coping skills, as well as affectional support, early screening, and continuous assessment of the parents' progress. Social policies and interventions offering continuous and diagnosis-related support to the parents of children with special educational needs are highly recommended.
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No pos
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No neg
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Retriever2386
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SpSld3 is required for loading and maintenance of SpCdc45 on chromatin in DNA replication in fission yeast.
Initiation of DNA replication in eukaryotic cells is regulated through the ordered assembly of replication complexes at origins of replication. Association of Cdc45 with the origins is a crucial step in assembly of the replication machinery, hence can be considered a target for the regulation of origin activation. To examine the process required for SpCdc45 loading, we isolated fission yeast SpSld3, a counterpart of budding yeast Sld3 that interacts with Cdc45. SpSld3 associates with the replication origin during G1-S phases and this association depends on Dbf4-dependent (DDK) kinase activity. In the corresponding period, SpSld3 interacts with minichromosome maintenance (MCM) proteins and then with SpCdc45. A temperature-sensitive sld3-10 mutation suppressed by the multicopy of the sna41+ encoding SpCdc45 impairs loading of SpCdc45 onto chromatin. In addition, this mutation leads to dissociation of preloaded Cdc45 from chromatin in the hydroxyurea-arrested S phase, and DNA replication upon removal of hydroxyurea is retarded. Thus, we conclude that SpSld3 is required for stable association of Cdc45 with chromatin both in initiation and elongation of DNA replication. The DDK-dependent origin association suggests that SpSld3 is involved in temporal regulation of origin firing.
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No pos
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No neg
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Retriever2387
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Prediction of BCG responses in non-muscle-invasive bladder cancer in the era of novel immunotherapeutics.
Bacillus Calmette-Guerin (BCG) instillations are considered as a gold standard of therapy in high- and intermediate-risk non-muscle-invasive bladder cancer (NMIBC). Unfortunately, up to 40% of patients might experience treatment failure and even 15% of patients initially diagnosed with NMIBC will progress to muscle-invasive disease. Since patients, who fail to respond to BCG, are at particular risk of progression, immediate radical cystectomy (RC) is currently recommended to provide cancer control. However, immunotherapy in NMIBC management still evolves. Immune checkpoint inhibitors emerge as new immunotherapeutics, which in the future might be combined with BCG and may serve as an alternative to radical cystectomy in patients, who failed to respond to BCG alone or are at particular a priori risk of BCG failure, especially if RC is not a safe option. Therefore, there is an urgent need to identify NMIBC patients that will not benefit from BCG therapy and demand radical cystectomy. In the following review, we attempt to focus on several clinical and molecular factors and demonstrate the efforts directed to unravel their significance in BCG-failure risk assessment.
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No pos
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No neg
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Retriever2388
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Reduced internalization of TNF-ɑ/TNFR1 down-regulates caspase dependent phagocytosis induced cell death (PICD) in neonatal monocytes.
Phagocytosis-induced cell death (PICD) is diminished in cord blood monocytes (CBMO) as compared to cells from adults (PBMO) due to differences in the CD95-pathway. This may support a prolonged pro-inflammatory response with sequels of sustained inflammation as seen in neonatal sepsis. Here we hypothesized that TNF-α mediated induction of apoptosis is impaired in CBMO due to differences in the TNFR1-dependent internalization. Monocytes were infected with Escherichia coli-GFP (E. coli-GFP). Monocyte phenotype, phagocytic activity, induction of apoptosis, and TNF-α/TNF-receptor (TNFR) -expression were analysed. In the course of infection TNF-α-secretion of CBMO was reduced to 40% as compared to PBMO (p<0.05). Neutralization of TNF-α by an αTNF-α antibody reduced apoptotic PICD in PBMO four-fold (p < 0.05 vs. infection with E. coli). PICD in CBMO was reduced 5-fold compared to PBMO and showed less responsiveness to αTNF-α antibody. CBMO expressed less pro-apoptotic TNFR1, which, after administration of TNF-α or infection with E. coli was internalized to a lesser extent. With similar phagocytic capacity, reduced TNFR1 internalization in CBMO was accompanied by lower activation of caspase-8 (p < 0.05 vs. PBMO). Stronger caspase-8 activation in PBMO caused more activation of effector caspase-3 and apoptosis (all p < 0.05 vs. PBMO). Our results demonstrate that TNFR1 internalization is critical in mediating PICD in monocytes after infection with E.coli and is reduced in CBMO.
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No pos
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No neg
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Retriever2389
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Stimulated emission double depletion nanoscopy with background correction at the single-pixel level.
Fluorescence microscopy images are inevitably tainted by background contributions including emission from out-of-focus planes, scattered light, and detector noise. In stimulated emission depletion (STED) nanoscopy, an additional, method-specific background arises from incomplete depletion and re-excitation by the depletion beam. Various approaches have been proposed to remove the background from a STED image, some of which rely on the acquisition of a separate background image that is subtracted from the STED image with a weighting factor. Using stimulated emission double depletion (STEDD) nanoscopy, we observed that the weighting factor varies locally in densely labeled samples, so that background removal with a single (global) weighting factor generates local image artifacts due to incorrect background subtraction. Here we present an algorithm that computes the optimal weighting factor at the single-pixel level, yielding a difference image with excellent suppression of low-frequency background.
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No pos
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No neg
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Retriever2390
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Extinction, renewal, and spontaneous recovery of a spatial preference in the water maze.
Four experiments with C57BL/6 mice investigated extinction of a spatial preference in the Morris water maze. In Experiment 1, a spatial preference was extinguished by exposing mice to the water maze in the absence of a platform but in the presence of the distal spatial cues. In Experiment 2, extinction occurred when the platform was removed from the pool, when it was presented in random locations, or when it was presented consistently in the opposite location. Contextual renewal (Experiment 3) and spontaneous recovery (Experiment 4) of spatial preferences argue against an interpretation of extinction in terms of unlearning and instead suggest that extinction in the water maze, like extinction in Pavlovian conditioning, suppresses the original association. Implications of these findings for theories of spatial learning and hippocampal function are discussed.
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No pos
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No neg
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Retriever2391
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Identification of a Novel Gene Signature Based on Kinesin Family Members to Predict Prognosis in Glioma.
Background and Objectives: Extensive research indicates that the kinesin superfamily (KIFs) regulates tumor progression. Nonetheless, the potential prognostic and therapeutic role of KIFs in glioma has been limited. Materials and Methods: Four independent cohorts from The Cancer Genome Atlas (TCGA) database and the Chinese Glioma Genome Atlas (CGGA) database were generated into a large combination cohort for identification of the prognostic signature. Following that, systematic analyses of multi-omics data were performed to determine the differences between the two groups. In addition, IDH1 was selected for the differential expression analysis. Results: The signature consists of five KIFs (KIF4A, KIF26A, KIF1A, KIF13A, and KIF13B) that were successfully identified. Receiver operating characteristic (ROC) curves indicated the signature had a suitable performance in prognosis prediction with the promising predictive area under the ROC curve (AUC) values. We then explored the genomic features differences, including immune features and tumor mutation status between high- and low-risk groups, from which we found that patients in the high-risk group had a higher level of immune checkpoint modules, and IDH1 was identified mutated more frequently in the low-risk group. Results of gene set enrichment analysis (GSEA) analysis showed that the E2F target, mitotic spindle, EMT, G2M checkpoint, and TNFa signaling were significantly activated in high-risk patients, partially explaining the differential prognosis between the two groups. Moreover, we also verified the five signature genes in the Human Protein Atlas (HPA) database. Conclusion: According to this study, we were able to classify glioma patients based on KIFs in a novel way. More importantly, the discovered KIFs-based signature and related characteristics may serve as a candidate for stratification indicators in the future for gliomas.
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No pos
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No neg
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Retriever2392
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Expression of 5-lipoxygenase and 5-lipoxygenase activation protein in glomerulonephritis.
The gene transcription of 5-lipoxygenase (5-LO) and 5-lipoxygenase-activating protein (FLAP) in renal tissue of patients with IgA nephropathy and mesangial proliferative glomerulonephritis were analyzed by amplification of reverse transcribed mRNA with polymerase chain reaction (PCR). The level of expression was determined by analysis of the PCR products of 5-LO, FLAP, and beta-actin. Forty percent of the patients expressed both 5-LO and FLAP. Relative to beta-actin, FLAP expression (0.42 +/- 0.21) was higher than 5-LO (0.14 +/- 0.10). Comparison of clinical data showed that patients who expressed 5-LO and FLAP had a lower glomerular filtration rate and an increased level of blood urea nitrogen, serum creatinine, and proteinuria. The results suggest arachidonic acid metabolism by inflammatory cells in renal tissue may play an important role in human glomerulonephritis.
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No pos
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No neg
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Retriever2393
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Carboxyterminal protein processing in health and disease: key actors and emerging technologies.
Carboxypeptidases are important mediators of cellular behavior. Through C-terminal truncations, they alter protein functionality and participate in proteome turnover. Similarly, carboxypeptidases shape the human peptidome by targeting neuroendocrine and vasoactive peptides, thereby regulating signaling pathways in the nervous and cardiovascular systems as well as in embryonic development. Carboxypeptidases are widely connected to various pathological processes such as carcinogenesis and neurodegenerative and cardiovascular diseases. The repertoire of carboxypeptidase in vivo substrates still remains poorly defined, largely due to the lack of suitable experimental approaches. Understanding the precise role of carboxypeptidases is pivotal in the future development of diagnostic/prognostic markers in such diseases. To date, very little attention has been paid to the implication of carboxypeptidases in shaping the proteome as well as the peptidome. This review focuses on the patho-physiological function of carboxypeptidases and highlights the approaches by which proteomics-based technologies can be applied to characterize carboxypeptidases and to quantify the differential regulation of proteins by carboxypeptidases in a proteome-wide manner.
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No pos
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No neg
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Retriever2394
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Neurofibromatosis 1 French national guidelines based on an extensive literature review since 1966.
Neurofibromatosis type 1 is a relatively common genetic disease, with a prevalence ranging between 1/3000 and 1/6000 people worldwide. The disease affects multiple systems with cutaneous, neurologic, and orthopedic as major manifestations which lead to significant morbidity or mortality. Indeed, NF1 patients are at an increased risk of malignancy and have a life expectancy about 10-15 years shorter than the general population. The mainstay of management of NF1 is a patient-centered longitudinal care with age-specific monitoring of clinical manifestations, aiming at the early recognition and symptomatic treatment of complications as they occur. Protocole national de diagnostic et de soins (PNDS) are mandatory French clinical practice guidelines for rare diseases required by the French national plan for rare diseases. Their purpose is to provide health care professionals with guidance regarding the optimal diagnostic and therapeutic management of patients affected with a rare disease; and thus, harmonizing their management nationwide. PNDS are usually developed through a critical literature review and a multidisciplinary expert consensus. The purpose of this article is to present the French guidelines on NF1, making them even more available to the international medical community. We further dwelled on the emerging new evidence that might have therapeutic potential or a strong impact on NF1 management in the coming feature. Given the complexity of the disease, the management of children and adults with NF1 entails the full complement healthcare providers and communication among the various specialties.
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No pos
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No neg
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Retriever2395
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Burden, epidemiology, and outcomes of microbiologically confirmed respiratory viral infections in solid organ transplant recipients: a nationwide, multi-season prospective cohort study.
Solid organ transplant (SOT) recipients are exposed to respiratory viral infection (RVI) during seasonal epidemics; however, the associated burden of disease has not been fully characterized. We describe the epidemiology and outcomes of RVI in a cohort enrolling 3294 consecutive patients undergoing SOT from May 2008 to December 2015 in Switzerland. Patient and allograft outcomes, and RVI diagnosed during routine clinical practice were prospectively collected. Median follow-up was 3.4 years (interquartile range 1.61-5.56). Six hundred ninety-six RVIs were diagnosed in 151/334 (45%) lung and 265/2960 (9%) non-lung transplant recipients. Cumulative incidence was 60% (95% confidence interval [CI] 53%-69%) in lung and 12% (95% CI 11%-14%) in non-lung transplant recipients. RVI led to 17.9 (95% CI 15.7-20.5) hospital admissions per 1000 patient-years. Intensive care unit admission was required in 4% (27/691) of cases. Thirty-day all-cause case fatality rate was 0.9% (6/696). Using proportional hazard models we found that RVI (adjusted hazard ratio [aHR] 2.45; 95% CI 1.62-3.73), lower respiratory tract RVI (aHR 3.45; 95% CI 2.15-5.52), and influenza (aHR 3.57; 95% CI 1.75-7.26) were associated with graft failure or death. In this cohort of SOT recipients, RVI caused important morbidity and may affect long-term outcomes, underlying the need for improved preventive strategies.
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No pos
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No neg
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Retriever2396
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Classification and occurrence of abnormally developed Paradiplozoon homoion (Monogenea, Diplozoinae) parasitising gudgeon Gobio gobio.
Morphological analyses of the attachment apparatus (clamps and central hooks) of Paradiplozoon homoion (Bychowsky & Nagibina, 1959) (Diplozoinae, Monogenea) parasitising gills of Gobio gobio (L.) showed a high percentage of abnormally developed parasite specimens. Four different localities in the Vlára River basin, Czech Republic, were investigated for the presence of such abnormal individuals. The highest percentage of abnormalities in the attachment apparatus (over 39%) was recorded in the Vlára River, at Bohuslavice. This study provides a comprehensive classification of these abnormalities with 7 types of abnormalities described and illustrated. Abnormalities of parts of the attachment apparatus that form in the later stage of ontogenetic development were the most frequent, the most frequent types of abnormalities being clamps with abnormal sclerites, and combinations of abnormalities. Abnormalities of the central hooks were also found in our material. The abnormalities found in diplozoids are probably connected with environmental pollution; however, this point requires further investigation.
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No pos
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No neg
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Retriever2397
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Cardiac BIN1 folds T-tubule membrane, controlling ion flux and limiting arrhythmia.
Cardiomyocyte T tubules are important for regulating ion flux. Bridging integrator 1 (BIN1) is a T-tubule protein associated with calcium channel trafficking that is downregulated in failing hearts. Here we find that cardiac T tubules normally contain dense protective inner membrane folds that are formed by a cardiac isoform of BIN1. In mice with cardiac Bin1 deletion, T-tubule folding is decreased, which does not change overall cardiomyocyte morphology but leads to free diffusion of local extracellular calcium and potassium ions, prolonging action-potential duration and increasing susceptibility to ventricular arrhythmias. We also found that T-tubule inner folds are rescued by expression of the BIN1 isoform BIN1+13+17, which promotes N-WASP-dependent actin polymerization to stabilize the T-tubule membrane at cardiac Z discs. BIN1+13+17 recruits actin to fold the T-tubule membrane, creating a 'fuzzy space' that protectively restricts ion flux. When the amount of the BIN1+13+17 isoform is decreased, as occurs in acquired cardiomyopathy, T-tubule morphology is altered, and arrhythmia can result.
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No pos
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No neg
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Retriever2398
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Line scan diffusion tensor MRI at low magnetic field strength: feasibility study of cervical spondylotic myelopathy in an early clinical stage.
PURPOSE
To implement line scan diffusion tensor MR imaging (LSDTI) on a 0.2 Tesla MR imager, and investigate the findings in the spinal cord of patients with cervical spondylotic myelopathy in an early clinical stage.
MATERIALS AND METHODS
Fourteen patients with clinical symptoms of cervical myelopathy underwent LSDTI. The signal-to-noise ratio (SNR) in the spinal cord and cerebrospinal fluid (CSF) was evaluated. The apparent diffusion coefficient (ADC) and fractional anisotropy (FA) were measured. We classified the ROIs into two groups: 1) unaffected (no clinical symptoms and no abnormality on conventional images) and 2) affected (some clinical symptoms but no abnormal signal on conventional images). Three-dimensional (3D) fiber-tracking was also studied.
RESULTS
The isotropic ADC values (10(-3)mm2/sec) were 1.28 +/- 0.11 in group 1 and 1.59 +/- 0.23 in group 2. The FAs were 0.55 +/- 0.07 in group 1, and 0.47 +/- 0.11 in group 2. The ADC value in group 2 increased (P < .001, Mann-Whitney U-test) and the FA in group 2 decreased (P = 0.24) on average, compared to those in group 1. 3D fiber-tracking was successful in 64% (9/14) of the cases.
CONCLUSION
LSDT images at low field strength may be a sensitive method for elucidating the structural characteristics of spinal cord pathology in vivo. However, clinical correlation and a long-term follow-up study will be needed.
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Retriever2399
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Idarucizumab and factor Xa reversal agents: role in hospital guidelines and protocols.
As expected with all antithrombotic agents, there is a risk of bleeding complications in patients receiving direct oral anticoagulants (DOACs) because of the DOAC itself, acute trauma, invasive procedures, or underlying comorbidities. For many bleeding events, a prudent course of action will be to withdraw the DOAC, then "wait and support" the patient, with the expectation that the bleeding event should resolve with time. Likewise, DOAC therapy may be interrupted ahead of a planned procedure, the stopping time being dependent on the agent involved and the patient's renal function. However, urgent reversal of anticoagulation is required in patients with serious or life-threatening bleeding or in those requiring urgent surgery or procedures. Novel specific reversal agents, either under development or recently approved, will need to be incorporated into local anticoagulation reversal protocols. For dabigatran-treated patients, idarucizumab recently has been approved for clinical use in cases of life-threatening or uncontrolled bleeding or when patients require emergency surgery or urgent procedures, both associated with a high risk of bleeding. As clinical experience with individual specific reversal agents grows, their roles in managing major bleeding events in DOAC-treated patients will become better defined. Future research, as well as ongoing use of idarucizumab, should help establish when it is appropriate to re-dose with idarucizumab, coadminister with prothrombin complex concentrates, or re-initiate DOAC after idarucizumab use. Ongoing trials should help identify the appropriate doses and expected durations of effect for andexanet alfa and ciraparantag, which are likely to vary depending on the individual oral anticoagulants.
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No pos
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