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Although the literature shows rigid plate fixation has superior outcomes over wire cerclage techniques, a patient population clearly benefitting from initial sternal plating over standard closure has not been identified. Data on plating as primary sternal closure in the morbidly obese patient remains sparse. A single-center retrospective study was performed on 564 consecutive patients undergoing complete median sternotomy from July 2014 to July 2017. Postoperative outcomes of patients with a body mass index of 35 kg/m2 or more were compared between sternotomies with standard wire cerclage closure and those with sternal plate reinforcement. The primary endpoint was postoperative sternal complication defined as deep sternal wound infection, acute sternal dehiscence, chronic sternal disunion, or noninfectious sternal wound complication requiring operative intervention. In all, 32.6% of sternotomies (184 of 564) were performed on patients with a body mass index of 35 kg/m2 or greater. Of this group, 31.5% (58 of 184) underwent sternal closure with titanium plate reinforcement and 68.5% (126 of 184) underwent traditional chest closure. The overall sternal complication rate was 4.9% (9 of 184), consisting of 6 of 126 nonplated patients and 3 of 58 plated patients (4.8% vs 5.2%, P =.80). Sternal plate reinforcement for sternotomy closure of patients with a body mass index 35 kg/m2 or greater produced no difference in postoperative sternal complication rates. [ABSTRACT FROM AUTHOR]

Enhancing the sluggish kinetics of electrochemical hydrogen-oxidation reaction in high pH environments is of crucial importance considering its applications in alkaline-membrane fuel cells (AMFC) and regenerative hydrogen electrodes for energy storage. Alkaline H 2 -oxidation to form water involves reaction between H-adsorbed intermediates and hydroxide anions wherein the nature/source of the latter plays a crucial role. Here, we take a systematic approach to understand why H 2 -oxidation kinetics is slower in alkaline media compared to acid. While recently reported models focus on surface-adsorbate bond strength optimization, we herein show that the alkaline H 2 -oxidation mechanism is fundamentally different due to a complex interplay between electrocatalysis and electrochemical double-layer structure. A heretofore unknown modern rendition of the double-layer structure is proposed wherein specifically adsorbed (M-OH ad ) and quasi-specifically adsorbed (M-H ad/upd … OH q-ad ) reactive hydroxide-species localized in the compact part of the electrochemical double-layer is shown to define H 2 -oxidation kinetics on monometallic and bimetallic catalyst surfaces at high pH. [ABSTRACT FROM AUTHOR]

Degenerative mitral stenosis (DMS) is characterized by decreased mitral valve (MV) orifice area and increased transmitral pressure gradient due to chronic noninflammatory degeneration and subsequent calcification of the fibrous mitral annulus and the MV leaflets. The "true" prevalence of DMS in the general population is unknown. DMS predominantly affects elderly individuals, many of whom have multiple other comorbidities. Transcatheter MV replacement techniques, although their long-term outcomes are yet to be tested, have been gaining popularity and may emerge as more effective and relatively safer treatment option for patients with DMS. Echocardiography is the primary imaging modality for evaluation of DMS and related hemodynamic abnormalities such as increased transmitral pressure gradient and pulmonary arterial pressure. Classic echocardiographic techniques used for evaluation of mitral stenosis (pressure half time, proximal isovelocity surface area, continuity equation, and MV area planimetry) lack validation for DMS. Direct planimetry with 3-dimensional echocardiography and color flow Doppler is a reasonable technique for determining MV area in DMS. Cardiac computed tomography is an essential tool for planning potential interventions or surgeries for DMS. This article reviews the current concepts on mitral annular calcification and its role in DMS. We then discuss the epidemiology, natural history, differential diagnosis, mechanisms, and echocardiographic assessment of DMS. [ABSTRACT FROM AUTHOR]

The growth and loss terms of interacting populations, called functional responses, are known to have a significant impact on the extinction dynamics of ecological models. We are able to construct models that preclude extinction for any parameter value, simply through the use of particular combinations of functional responses. These structural coexistence (SC) models have functional responses where the per capita growth terms remain positive (non-vanishing), while the per capita loss terms tend to zero (vanishing) as the relevant population tends to zero. Any of the commonly used functional responses, such as Holling Types I, II, and III, lead to non-vanishing growth terms for nutrient uptake, while any type of nonlinearity such as Ivlev or density dependent mortality of the population leads to vanishing loss terms. In order for herbivore/carnivore feeding terms to simultaneously be a vanishing loss term for the prey and a non-vanishing growth term for the predator, the exponent on the predator population must be exactly one, whilst the exponent on the prey population must be greater than one (such as a Holling Type III response). Any SC system with at least one autotroph and (possibly many) heterotrophs will always possess an internal equilibrium point. We show that the inclusion of linear mortality terms are, however, sufficient to restore the possibility of population extinctions. This allows for the formulation of ‘mixed’ systems, where some populations are guaranteed to coexist, whilst others are subject to the possibility of extinction. SC models have use in studies of, for example, biogeochemical cycling or the plankton base of fisheries models, where extinction is not desirable or relevant. [ABSTRACT FROM AUTHOR]

In studies examining the health effects of household air pollution (HAP), lack of affordable monitoring devices often precludes collection of actual air pollution data, forcing use of exposure indicators, such as type of cooking fuel used. Among the most important pollutants is fine particulate matter (PM 2.5 ), perhaps the best single indicator of risk from smoke exposure. In this study, we deployed an affordable and robust device to monitor PM 2.5 in 824 households in Bhaktapur, Nepal. Four primary cooking fuels were used in roughly equal proportions in these households: electricity (22%), liquefied petroleum gas (LPG) (29%), kerosene (23%), and biomass (26%). PM 2.5 concentrations were measured in the kitchens using a light-scattering nephelometer, the UCB-PATS (University of California, Berkeley-Particle and Temperature monitoring System). The major predictors of PM 2.5 concentrations in study households were investigated. The UCB-PATS results were well correlated with the gravimetric results (R 2 = 0.84; for all fuels combined). The mean household PM 2.5 concentrations across all seasons of the year were 656 (standard deviation (SD):924) μg/m 3 from biomass; 169 (SD: 207) μg/m 3 from kerosene; 101 (SD: 130) μg/m 3 from LPG; and 80 (SD: 103) μg/m 3 from electric stoves. In the multivariate regression of PM 2.5 measures, compared with electric stoves, use of LPG, kerosene and biomass stoves were associated with increased indoor PM 2.5 concentrations of 65% (95% CI: 38–95%), 146% (103–200%), and 733% (589–907%), respectively. The UCB-PATS performed well in the field. Biomass fuel stoves without flues were the most significant sources of PM 2.5 , followed by kerosene and then LPG stoves. Outdoor PM 2.5 , and season influenced indoor PM 2.5 levels. Results support careful use of inexpensive light-scattering monitors for monitoring of HAP in developing countries. [ABSTRACT FROM AUTHOR]

• We estimate the impact of a learning community on first-year college retention at a four-year public research university using a randomized control trial. • Intent-to-treat and local-average-treatment-effect estimates reveal no discernable programmatic effects. • Observational approaches find impacts that are positive, large and statistically significant. • Decomposing the observational estimates reveal that non-random selection into the experimental sample accounts for the major difference in the two estimates. • This exercise cautions against generalizing the RCT result for populations outside the experiment. In this paper, we estimate the impact of a learning community on first-year college retention at a four-year public research university using a randomized control trial (RCT) for those students who opt into the experiment. Intent-to-treat and local-average-treatment-effect estimates reveal no discernable programmatic effects. We also generate estimates of program impact using observational techniques and find estimated impacts that are positive, large and statistically significant. We explore a variety of selection processes to better understand the differences between the RCT and observational estimates and to reflect on the generalizability of the RCT results for various other populations of interest. Non-random selection into the experimental sample accounts for the major difference in the two estimates and also cautions against generalizing the RCT result for populations outside the experiment. [ABSTRACT FROM AUTHOR]

Abstract: Dense gravity current overflows occur in several regions throughout the world and are an important process in the meridional overturning circulation. Overflows are poorly represented in coarse resolution level coordinate ocean climate models. Here, the embedded Lagrangian model formulated in the companion paper of Bates et al. (2012) is used in two idealised test cases to examine the effect on the representation of dense gravity driven plumes, as well as the effect on the circulation of the bulk ocean in the Eulerian model. The results are compared with simulations with no parameterisation for overflows, as well as simulations that use traditional hydrostatic overflow schemes. The use of Lagrangian “blobs” is shown to improve three key characteristics that are poorly represented in coarse resolution level coordinate models: (1) the depth of the plume, (2) the along slope velocity of the plume, and (3) the response of the bulk ocean to the bottom boundary layer. These improvements are associated with the more appropriate set of dynamics satisfied by the blobs, leading to a more physically sound representation. Experiments are also conducted to examine sensitivity to blob parameters. The blob parameters are examined over a large parameter space. [Copyright &y& Elsevier]

Abstract: A framework for embedding a Lagrangian model within ocean climate models that employ horizontal Eulerian grids is presented. The embedded Lagrangian model can be used to explicitly represent processes that are at the subgrid scale to the Eulerian model. The framework is applied to open ocean deep convection and gravity driven downslope flows, both of which are subgridscale in the present generation of level coordinate ocean climate models. In order to apply the embedded Lagrangian framework to these processes, it is necessary to partition the mass and momentum of the model into an Eulerian system and a Lagrangian system. This partitioning allows the Lagrangian model to transport seawater using a more appropriate set of dynamics. A number of schemes suitable for implementation in the embedded Lagrangian model are derived. Two dynamically passive schemes are derived that emulate existing parameterisations and two dynamically active schemes are also derived that evolve Lagrangian parcels of water (termed “blobs”) according to a set of physical equations. Some details of the implementation into the Geophysical Fluid Dynamics Modular Ocean Model are also given. Finally, results are presented that show that the dynamically passive schemes are able to emulate their Eulerian counterparts to within roundoff error in idealised test cases. [Copyright &y& Elsevier]

Hirschsprung disease (HD) and anorectal malformations (ARMs) result from alterations in hindgut development. It has long been recognized that both recur in families and thus result, at least in part, from genetic factors. Progress in the understanding of the genetic basis of HD has been made by the application of findings from genetic animal models of altered enteric nervous system development to human beings. Several genes have been shown to be important for human enteric nervous system development, and current work is progressing to identify genetic interactions that may explain the variable phenotype of HD. By contrast, understanding of the genetic factors underlying ARMs is much less developed. We and others have shown that genetic factors play an important role in the pathogenesis of ARMs, and many mouse genetic models suggest molecular pathways that may be altered in ARMs. [Copyright &y& Elsevier]

Background: The primary limitation to long-term survival after liver transplantation for hepatocellular carcinoma (HCC) is tumor recurrence. Pulmonary resection for metastatic HCC prolongs survival in patients after liver resection; this success may be extrapolated to the transplant population in the treatment of pulmonary recurrence of HCC after liver transplantation. Methods: Between January 2000 and January 2006, five patients who underwent orthotopic liver transplantation for HCC were identified on routine follow-up with pulmonary metastases. They all underwent resection of the pulmonary recurrence of HCC and were studied retrospectively. Results: The time from transplant to diagnosis of pulmonary recurrence ranged from 150 days to 880 days, with a mean of 500 days. All of the recurrences were amenable to complete resection. Two patients developed a second tumor. One patient had a new primary of squamous cell carcinoma. Another patient had a bony recurrence of HCC in the ninth rib. Four of the patients are still alive, and the fifth died from hepatic failure. The stage of the tumor in the explanted liver ranged from II to IVb. The average time for survival from transplant was 44 months, and the average time from pulmonary resection was 27.5 months. Conclusions: The patients in this study demonstrate survival times similar to patients with HCC treated with liver resection. Although the size of the study population is small, the long survival times in the patients is encouraging. The advanced stage and histologically invasive nature of the primary tumors may predispose to subsequent pulmonary recurrence. [Copyright &y& Elsevier]

Abstract: Mate is a ‘tea’, made from Ilex paraguariensis, widely consumed in South America, as mate con bombilla and mate cocido. Mate consumption has been associated with esophageal, oral, lung, and bladder cancers. This bladder cancer case-control study involved 114 Argentinean case-control pairs. Mate consumption was recorded for time of interview, and 20 and 40 years previously. Mate con bombilla consumed 20 years ago was associated with bladder cancer in ever-smokers (odds ratio=3.77, 95% confidence interval: 1.17–12.1), but not in never-smokers. Mate cocido was not associated with bladder cancer. These results are consistent with a previous study in Uruguay. [Copyright &y& Elsevier]

Abstract: Purpose: Various lines of evidence point to genetic causes for the diverse spectrum of anorectal malformations (ARMs); we therefore studied patterns of heritability in a large case series. Methods: We searched our ARM database for all patients having family members with congenital anomalies. This group was analyzed to determine the type of ARM and the specific anomalies in affected family members. Results: Thirty-nine of 1606 patients (2.4%) had a family member with a congenital anomaly. The associated non-ARM anomalies included sacral masses and gynecologic, hematologic, esophageal, duodenal, renal, and spinal anomalies. Of these, 24 patients (1.4%) had 1 or more family members with an ARM. Among females with a positive family history, 73% of patients had either a vestibular or perineal fistula, compared with only 36% in patients without a family history (P = .0004). Among males, 35% had perineal fistulas compared with only 10% of those without affected family members (P = .0051). Conclusions: A positive family history in 1.4% is supportive of a strong genetic component to ARM. The risk of having an affected family member is significantly increased in the presence of a vestibular or perineal fistula. These new data allow for more informed counseling of families with an ARM and support the need for further genetic studies. [Copyright &y& Elsevier]

Abstract: Dental amalgam fillings containing approximately 50% mercury have been used for almost 200 years and have been controversial for almost the same time. Allegations of effects caused by amalgams have involved many diseases. Recent evidence that small amounts of mercury are continuously released from amalgam fillings has fuelled the controversy. This is a comprehensive review of the epidemiologic evidence for the safety of dental amalgam fillings, with an emphasis on methodological issues and identifying gaps in the literature. Studies show little evidence of effects on general chronic disease incidence or mortality. Limited evidence exists for an association with multiple sclerosis, but few studies on either Alzheimer''s or Parkinson''s diseases. The preponderance of evidence suggests no renal effects and that ill-defined symptom complexes, including chronic fatigue syndrome, are not caused by amalgams. There is little direct evidence that can be used to assess reproductive hazards. Overall, few relevant epidemiologic studies are available. Most prior assessments of possible amalgam health effects have been based on comparisons of dental mercury exposures with occupational exposures causing harm. However, the amalgam-exposed population contains a broader, possibly more susceptible, spectrum of people. Common limitations of population-based studies of dental amalgam effects include inadequate longitudinal exposure assessment and negative confounding by better access to dental care in higher socioeconomic groups. Better designed studies are needed, particularly for investigation of neurodegenerative diseases and effects on infants and children. [Copyright &y& Elsevier]

Background & Aims: Following massive small bowel resection (SBR), the remnant intestine undergoes an adaptive process characterized by increases in a number of physiologic and morphologic parameters. These changes are the result of a stimulus that increases crypt cell mitosis and augments cellular progression along the villus axis. To better define this process, we identified patterns of gene expression specifically within adapting intestinal crypt cells following SBR. Methods: Laser capture microdissection was used to isolate mouse intestinal crypt cells following SBR or sham operation. Multiple biological and technical complementary DNA microarray replicates allowed rigorous statistical analyses for identification of important expression profiles. Major groups of genes were classified as to site of action, functional pathway, and possible regulatory groups. Results: A total of 300 genes differentially expressed at significant levels within adapting crypt enterocytes were analyzed. Comparison of this list of differentially expressed adapting crypt cell genes with a generalized mouse gene expression database (from 82 developing and adult mouse tissues) showed the greatest overlap with developing and immature intestinal tissues. We identified prominent groups of genes involved with cell growth, signal transduction, and nucleic acid binding. Genes not previously shown to be involved with adaptation or development and maturation were identified. Conclusions: Identification of similar genes coordinately regulated during both adaptation and development, processes that share key morphologic features, provides a basis for new mechanistic insights into these shared characteristics. [Copyright &y& Elsevier]

Abstract: Hlx is a homeobox transcription factor gene that is expressed in intestinal and hepatic mesenchyme of the developing mouse embryo and is essential for normal intestinal and hepatic development. Because of the morphological and molecular similarities in the development of the digestive system across species, we hypothesized that the Hlx gene and protein sequences and expression patterns would be conserved among vertebrates. Comparison of the Hlx gene orthologues of human, chimpanzee, mouse, rat, pufferfish (Fugu) and zebrafish demonstrates that these six genes share an identical organization with four exons and three introns. Comparison of the inferred Hlx protein sequences from these and three additional species (chick, Spanish ribbed newt and rainbow trout) reveals significant sequence identity, with identical homeodomains. The expression of Hlx in the mesenchyme of developing chick embryos is highly similar to that of mouse. Fugu Hlx is expressed in a tissue-specific manner that is similar though not identical to that of mouse, suggesting a conservation of Hlx function between mammals and birds. The mammalian and fish Hlx genes share a putative 5′ upstream enhancer as well as an inverted repeat containing CCAAT boxes on opposite strands that we have previously shown to be important for mouse Hlx gene expression. These results suggest that the function of Hlx and the mechanisms regulating its expression are highly conserved in mammals, birds, amphibians and fish. [Copyright &y& Elsevier]

Abstract: Key methodological aspects are presented for a study of concentrations of polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs), polychlorinated biphenyls (PCBs), and organochlorine pesticides in the serum of a sample of the New Zealand population aged 15 years and older. The study took advantage of the sampling frame and sample collection and interview processes of the National Nutrition Study (NNS). An additional blood sample for this organochlorines study was collected by the NNS and questions added to the NNS questionnaire. Serum was obtained from the blood and, based on responses to questions in the questionnaire, samples with possible occupational exposure to organochlorines were excluded. Remaining samples providing at least 2ml of serum were pooled within 80 strata defined according to geographic area, age group, sex and ethnicity. A minimum number of five individual serum samples was required for pooling within a stratum. Within strata with sufficient samples, two or three pooled samples were created for variance calculation. Eligible for inclusion in the study were 2497 individual serum samples. Sixty strata had sufficient serum samples for pooling and chemical analysis. This was the first study of organochlorine compounds with a national population-based sample. Two factors that made the study feasible deserve emphasis. First, being able to “piggy-back” on another study. Second, pooling of samples to reduce analytic expenses. It is hoped that the methods used in this study will form the basis for other studies investigating organochlorine concentrations in national populations. [Copyright &y& Elsevier]

Concentrations of polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs), polychlorinated biphenyls (PCBs), and organochlorine pesticides were measured in the serum of a sample of the New Zealand population aged 15 years and older. This was the first study to obtain representative measures of PCDDs, PCDFs and PCBs in the adult population of an entire country. Serum samples were obtained in 1996–1997. Potentially occupationally exposed individuals were excluded. Serum samples were pooled according to stratification criteria for area of residence, ethnicity, age, and sex. Of the 80 possible strata, sufficient serum for chemical analysis was available for 60, to which 1,834 individual samples contributed. For the PCDDs and PCDFs, most 2,3,7,8-chlorinated congeners were measured in all strata, with a mean toxic equivalents concentration across all strata of 12.8 ng TEQ kg−1 lipid. Seven PCB congeners were frequently measured, including the coplanar congeners #126 and #169, quantified in all strata. Of the pesticides and their metabolites, only β-HCH, dieldrin and pp′-DDE were consistently detected across strata. There was a general trend of increasing concentration with age. There were no consistent differences between the sexes, or between people of Maori (the indigenous people of New Zealand) and non-Maori ethnicity. Concentrations of PCDDs and PCDFs tended to increase in a North–South direction, possibly reflecting greater levels of industrialization and population concentration, and concentrations of the pesticide products were highest in the South, possibly reflecting historical use patterns. Results were consistent with a recent study of concentrations of these compounds in the milk of first-time mothers. [Copyright &y& Elsevier]

Inadequate left atrial cuff surrounding donor pulmonary veins may present a technical challenge for successful lung transplantation. A simple technique for construction of venous anastomoses during lung transplantation when donor atrial cuff is lacking involves circumferential incorporation of surrounding donor pericardium into the anastomosis without directly suturing or augmenting donor venous structures. [Copyright &y& Elsevier]

Constipation is a common problem in pediatrics and accounts for 3-5% of all pediatric office visits and 10-25% of all pediatric gastroenterology referrals. Functional constipation accounts for about 95% of constipation cases, but "red flag" symptoms that suggest organic causes need to be considered. A diagnosis of functional constipation can be made in absence of "red flag" symptoms and a normal physical assessment. Physical assessment should focus on growth, abdominal exam, inspection of the perianal region, and examination of the lumbosacral region. Abdominal x-rays are generally not useful to differentiate between functional and organic causes of constipation. Treatment of constipation includes dietary changes, medication use, and behavioral modification. Osmotic laxatives are used as first-line treatment, and stimulant laxatives can be added if there is no improvement with osmotic laxatives. Despite improvement with laxatives, 40-50% of children with constipation experience at least 1 relapse in 5 years. Quality improvement opportunities exist for improving care of children with functional constipation by specialists partnering with primary care. [ABSTRACT FROM AUTHOR]

Celiac disease (CD) is an immune-mediated gastrointestinal disorder that is relatively common in children. This paper describes the variety of clinical signs and symptoms associated with CD and provides current recommendations for the evaluation of CD and its co-morbidities and complications. The paper makes recommendations for a collaborative approach to care facilitated by primary care clinicians and pediatric gastroenterologists. [ABSTRACT FROM AUTHOR]

Use of fine-needle aspiration biopsy (FNAB) specimens on Xpert Breast Cancer STRAT4 Assay (STRAT4; Cepheid, Sunnyvale, CA, USA), a CE-marked in-vitro diagnostic medical device, could potentially increase access to breast cancer biomarker testing in resource-constrained settings. We aimed to assess the performance of a research use-only version of STRAT4 using FNAB specimens in Tanzania. In this prospective diagnostic accuracy study, patients aged 18 years or older with palpable breast masses presenting to the FNAB Clinic at Muhimbili National Hospital (Dar es Salaam, Tanzania) were recruited consecutively. Patients who were pregnant, lactating, or had a previous diagnosis of breast cancer were excluded. STRAT4 testing was performed on off-label FNAB samples using four protocols: the 1 × protocol (using the standard lysate method) on FNAB smears (1 × FNAB), quick lysis and Maui protocols (both on FNAB smears), and the 1 × protocol on formalin-fixed paraffin-embedded (FFPE) cell block material (1 × cell block). For 1 × FNAB and 1 × cell block, tissue was processed using FFPE lysis reagent, incubated at 80°C with proteinase K, and followed by addition of 95% or higher ethanol. Quick lysis was processed using FFPE lysis reagent and 95% or higher ethanol, whereas Maui was processed using a proprietary research-use only lysis reagent. The primary outcomes were overall concordance, sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) of STRAT4 as compared with immunohistochemistry or immunohistochemistry plus fluorescence in-situ hybridisation performed on cell blocks using clinically validated protocols in a Clinical Laboratory Improvement Amendments-accredited laboratory at the University of California, San Francisco (San Francisco, CA, USA). Between Nov 29, 2017, and Dec 17, 2020, 208 patients were enrolled. Of 208 cases, 51 (25%) were excluded from analysis because of insufficient tissue in the cell block or absent cell blocks, leaving 157 participants (all female) for analysis. For oestrogen receptor, 1 × FNAB had the best performance, with an overall concordance of 95% (95% CI 90–100), sensitivity of 94% (85–100), specificity of 97% (90–100), and AUC of 0·96 (0·81−1·00). For progesterone receptor, 1 × cell block had the best overall performance (overall concordance 89% [95% CI 84–95], sensitivity 91% [82–99], and specificity 89% [81–97], with an AUC of 0·93 [0·89−0·99]) and 1 × FNAB performed the best among the smear protocols, with a concordance of 84% (95% CI 74–93), sensitivity of 63% (43–82), specificity of 97% (92–100), and AUC of 0·91 (0·72−0·97). For HER2, Maui had the highest agreement, with an overall concordance of 93% (95% CI 89–98), sensitivity of 96% (88–100), specificity of 92% (87–98), and AUC of 0·95 (0·98–1·00). For Ki67, Maui had the best performance of smear protocols, with a concordance of 73% (95% CI 64–82), sensitivity of 70% (58–81), specificity of 81% (66–96), and AUC of 0·80 (0·54−0·82). Processing FNAB samples with STRAT4 is feasible in Tanzania, and performance for the oestrogen receptor is robust. Further optimisation of STRAT4 for FNAB has the potential to improve timely access to breast cancer diagnostics in resource-constrained settings. US National Institutes of Health; UCSF Global Cancer Program, Helen Diller Family Comprehensive Cancer Center; UCSF Department of Pathology; and Cepheid. [ABSTRACT FROM AUTHOR]

We investigated the role of glutathione S-transferase (GST) enzymes (M1, T1), methylenetetrahydrofolate (MTHFR) 677 and 1298, and the NAD(P)H:quinone oxidoreductase (NQO1) polymorphisms in a population-based bladder cancer case–control study in Argentina. Buccal cell DNA was obtained from 106 cases and 109 controls. The strongest evidence was for an interaction between NQO1 genotype and smoking. For ever smoking vs. never smoking the odds ratio was 8.6 (95% confidence interval (CI) 2.7–27), in the CC genotype, and 1.3 (95% CI 0.5–3.5) in the CT and TT genotypes combined. Also, elevated bladder cancer risks associated with GSTM1 and GSTT1 null genotypes were found in smokers. Having both null polymorphisms conferred the highest risks. The MTHFR 677 CT and TT polymorphisms appeared protective against bladder cancer. [Copyright &y& Elsevier]

Compared to the global average, extinction risk for mainland African reptiles, particularly for South Africa, appears to be relatively low. Despite this, African reptiles are under threat primarily due to habitat loss as a result of agriculture, resource extraction, and urbanisation, and these pressures are expected to increase into the future. South Africa's reptile fauna is relatively well-studied, allowing an investigation of whether threat status assessment limitations are driving the comparably low threat status for the country, a large component of Africa's reptile fauna (ca. 25% of mainland African reptiles are found in South Africa). Extinction risk of South African reptiles was assessed as of 2018 using IUCN criteria and we 'backcast' these assessments to infer extinction risk circa 1990. A Red List Index (RLI: a measure of the extinction risk for a group of species) for 1990 and 2018 was estimated, and the protection level afforded to South African reptiles was investigated by intersecting reptile distributions with the network of protected areas. Finally, a coarse estimate of extinction rate was made. Level of extinction risk for South African reptiles (ca. 5.4%) is lower than the global average, and most currently threatened species would have already been at risk by 1990. The RLI was slightly lower for 2018 than for 1990, and the decrease was more prominent for endemic reptiles than for all reptiles combined. Most South African reptiles fall into the Well Protected category, implying that the protected area network has substantial conservation impact. However, many threatened reptile species are Poorly Protected or Not Protected. The current extent of the protected area network therefore, does not adequately mitigate extinction risk for reptiles. Furthermore, the protected area expansion plan for South Africa would not capture any additional threatened species within its boundaries. Despite the lower level of extinction risk indicated by IUCN assessments, it would be premature to assume that South African reptiles are faring better than reptiles globally based only on this one measure. Notably, two South African reptiles are Critically Endangered and theses are not found in protected areas, two others are already classified as Extinct, and rough estimates of extinction rates are similar to values estimated for other vertebrates. By considering additional metrics that are directly guided by our in-depth knowledge of the species, their distributions and the threats, we demonstrate that South African reptiles are under pressure and that risk of extinction is tangible for several species. [ABSTRACT FROM AUTHOR]

Antarctic Bottom Water (AABW) and North Atlantic Deep Water (NADW) control the abyssal limb of the global overturning circulation and play a major role in oceanic heat uptake and carbon storage. However, current general circulation models are unable to resolve the observed AABW and NADW formation and transport processes. One key process, that of overflows, motivates the application of overflow parameterisations. We present a sensitivity study of both AABW and NADW properties to three current parameterisations using a z ∗ -coordinate ocean-sea ice model within a realistic-topography sector of the Atlantic Ocean. Overflow parameterisations that affect only tracer equations are compared to a fully dynamical Lagrangian point particle method. An overflow parameterisation involving partial convective mixing of tracers is most efficient at transporting dense NADW water downslope. This parameterisation leads to a maximum mean increase in density in the north of 0.027 kg m −3 and a decrease in age of 525 years (53%). The relative change in density and age in the south is less than 30% of that in the north for all overflow parameterisations. The reduced response in the south may result from the differing dense water formation and overflow characteristics of AABW compared to NADW. Alternative approaches may be necessary to improve AABW representation in z ∗ -coordinate ocean climate models. [ABSTRACT FROM AUTHOR]

Abstract: Background: Exposures to hydrogen sulfide gas (H2S) have been inconclusively linked to a variety of negative cognitive outcomes. We investigated possible effects on cognitive function in an urban population with chronic, low-level exposure to H2S. Methods: Participants were 1637 adults, aged 18–65years from Rotorua city, New Zealand, exposed to ambient H2S from geothermal sources. Exposures at homes and workplaces were estimated from data collected by summer and winter H2S monitoring networks across Rotorua in 2010/11. Metrics for H2S exposure at the time of participation and for exposure over the last 30years were calculated. H2S exposure was modeled both as continuous variables and as quartiles of exposure covering the range of 0–64ppb (0–88μg/m3). Outcomes were neuropsychological tests measuring visual and verbal episodic memory, attention, fine motor skills, psychomotor speed and mood. Associations between cognition and measures of H2S exposure were investigated with multiple regression, while covarying demographics and factors known to be associated with cognitive performance. Results: The consistent finding was of no association between H2S exposure and cognition. Quartiles of H2S exposure had a small association with simple reaction time: higher exposures were associated with faster response times. Similarly, for digit symbol, higher H2S exposures tended to be marginally associated with better performance. Conclusion: The results provide evidence that chronic H2S exposure, at the ambient levels found in and around Rotorua, is not associated with impairment of cognitive function. [Copyright &y& Elsevier]

Highlights: [•] miR-221/222 accelerate cell proliferation and intimal thickening. [•] miR-221/222 are elevated in the internal mammary arteries of diabetic subjects. [•] Diabetic subjects on metformin therapy exhibit normal miR-221/222 levels. [Copyright &y& Elsevier]

Our knowledge of the conservation status of reptiles, the most diverse class of terrestrial vertebrates, has improved dramatically over the past decade, but still lags behind that of the other tetrapod groups. Here, we conduct the first comprehensive evaluation (~92% of the world's ~1714 described species) of the conservation status of skinks (Scincidae), a speciose reptile family with a worldwide distribution. Using International Union for Conservation of Nature (IUCN) criteria, we report that ~20% of species are threatened with extinction, and nine species are Extinct or Extinct in the Wild. The highest levels of threat are evident in Madagascar and the Neotropics, and in the subfamilies Mabuyinae, Eugongylinae and Scincinae. The vast majority of threatened skink species were listed based primarily on their small geographic ranges (Criterion B, 83%; Criterion D2, 13%). Although the population trend of 42% of species was stable, 14% have declining populations. The key threats to skinks are habitat loss due to agriculture, invasive species, and biological resource use (e.g., hunting, timber harvesting). The distributions of 61% of species do not overlap with protected areas. Despite our improved knowledge of the conservation status of the world's skinks, 8% of species remain to be assessed, and 14% are listed as Data Deficient. The conservation status of almost a quarter of the world's skink species thus remains unknown. We use our updated knowledge of the conservation status of the group to develop and outline the priorities for the conservation assessment and management of the world's skink species. • 20% of skink species are threatened with extinction, and nine species are extinct. • Key threats to skinks are agriculture, invasive species and biological resource use. • Most species listed under IUCN Red List Criterion B • Taxonomic and geographic biases in extinction risk are evident in skinks. • 8% of skink species remain unassessed, and 14% are listed as Data Deficient. [ABSTRACT FROM AUTHOR]