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Introduction: Demographics are important prognostic factors in malignant diseases. A nationwide analysis concerning the prognostic impact of demographics in head and neck cancer (HNC) patients (HNCP) has not been performed previously. Methods: A retrospective analysis of data from the Center for Cancer Registry Data (ZfKD) and the Federal Statistical Office (Destatis) between 2002 and 2017 was performed. A total of 212′920 HNCP were included. Incidence, tumor stage, age development, sex distribution, age‐, residence‐, and diagnosis‐time‐specific survival were examined. Results: Mean age of HNCP increased more rapidly than in the general population (slope coefficient: 0.29 vs. 0.20; p < 0.0001). Higher age and male sex were associated with a worse prognosis. Whereas overall survival (OS) increased from the early to the later observation period for HNCP <70 years, no OS improvement for HNCP >70 years was found. Furthermore, an OS disadvantage was observed for East Germany compared to West Germany (median 47 vs. 60 months; p < 0.0001). This disparity was associated with a disproportionately high ratio of men in East Germany (men/women: 4.4 vs. 3.1; p < 0.0001) and a lower mean age (61 vs. 63 years; p < 0.0001). In addition to stage, age and sex, residence in East Germany were confirmed as an independent factor for OS in a multivariate analysis. Conclusion: Finally, three decades after the German reunion, a survival disadvantage for patients in East Germany still exists. This discrepancy may be a result of socioeconomic disparities. [ABSTRACT FROM AUTHOR]

All land‐plant cell walls possess hemicelluloses, cellulose and anionic pectin. The walls of their cousins, the charophytic algae, exhibit some similarities to land plants' but also major differences. Charophyte 'pectins' are extractable by conventional land‐plant methods, although they differ significantly in composition. Here, we explore 'pectins' of an early‐diverging charophyte, Chlorokybus atmophyticus, characterising the anionic polysaccharides that may be comparable to 'pectins' in other streptophytes. Chlorokybus 'pectin' was anionic and upon acid hydrolysis gave GlcA, GalA and sulphate, plus neutral sugars (Ara≈Glc>Gal>Xyl); Rha was undetectable. Most Gal was the l‐enantiomer. A relatively acid‐resistant disaccharide was characterised as β‐d‐GlcA‐(1→4)‐l‐Gal. Two Chlorokybus 'pectin' fractions, separable by anion‐exchange chromatography, had similar sugar compositions but different sulphate‐ester contents. No sugars were released from Chlorokybus 'pectin' by several endo‐hydrolases [(1,5)‐α‐l‐arabinanase, (1,4)‐β‐d‐galactanase, (1,4)‐β‐d‐xylanase, endo‐polygalacturonase] and exo‐hydrolases [α‐ and β‐d‐galactosidases, α‐(1,6)‐d‐xylosidase]. 'Driselase', which hydrolyses most land‐plant cell wall polysaccharides to mono‐ and disaccharides, released no sugars except traces of starch‐derived Glc. Thus, the Ara, Gal, Xyl and GalA of Chlorokybus 'pectin' were not non‐reducing termini with configurations familiar from land‐plant polysaccharides (α‐l‐Araf, α‐ and β‐d‐Galp, α‐ and β‐d‐Xylp and α‐d‐GalpA), nor mid‐chain residues of α‐(1→5)‐l‐arabinan, β‐(1→4)‐d‐galactan, β‐(1→4)‐d‐xylan or α‐(1→4)‐d‐galacturonan. In conclusion, Chlorokybus possesses anionic 'pectic' polysaccharides, possibly fulfilling pectic roles but differing fundamentally from land‐plant pectin. Thus, the evolution of land‐plant pectin since the last common ancestor of Chlorokybus and land plants is a long and meandering path involving loss of sulphate, most l‐Gal and most d‐GlcA; re‐configuration of Ara, Xyl and GalA; and gain of Rha. [ABSTRACT FROM AUTHOR]

Background: Incidences of pilonidal sinus disease are rising. Guidelines rarely consider children and adolescents and evidence for their treatment is rare. The literature is divided on the choice of the preferable surgical procedure. Therefore, we aimed to assess recurrences and complications following different treatment approaches in our multi-centric cohort. Methods: We retrospectively assessed all patients treated for pilonidal sinus disease in the paediatric surgical departments of Bonn and Mainz between 01/01/2009 and 31/12/2020. Recurrences were defined according to the German national guidelines. The pre-specified analysis via logistic regression included the operative approach, age, sex, use of methylene blue, and obesity as independent predictors. Results: We included 213 patients, of which 13.6% experienced complications and 16% a recurrence. Median time to recurrence was 5.8 months (95% confidence interval: 4.2–10.3), which was slightly higher in children than adolescents (10.3 months, 95% confidence interval: 5.3–16.2 vs. 5.5 months, 95% confidence interval: 3.7–9.7). None of the investigated procedures, excision and primary closure, excision and open wound treatment, pit picking, and flap procedures had a decisive advantage in terms of complications or recurrence. Of the independent predictors, only obesity was associated to complications (adjusted odds ratio: 2.86, 95% confidence interval: 1.05–7.79, P = 0.04). Conclusions: We did not find a difference between the investigated procedures, but our analysis is limited by the small sample size in some subgroups. Our data corroborates that recurrences in paediatric pilonidal sinus disease occur early. Factors linked to these differences remain unknown. [ABSTRACT FROM AUTHOR]

Purpose: To report visual and anatomical outcomes and determine predictors of good visual acuity (VA) recovery after macula‐off rhegmatogenous retinal detachment (RD). Methods: Prospective multicentre study including 115 eyes from 115 patients successfully operated on for RD, with assessment of VA and spectral‐domain optical coherence tomography (SD‐OCT) macular images at 1, 3, 6 and 12 months after surgery. Results: Over the follow‐up period, VA significantly improved from median [IQR] 62 [46; 72] ETDRS letters at 1 month to 75 [67; 80] ETDRS letters at 12 months (p < 0.001) with a concomitant decreased number of eyes with any SD‐OCT lesions (p < 0.001). The presence of subretinal fluid (SRF) significantly decreased (p < 0.001), as did the number of photoreceptor (PR) layer lesions (p = 0.04). At 12 months, lesions in the PR layer and poor VA recovery were significantly associated with a longer time to surgery (p = 0.007 and p < 0.001, respectively). The rate of patients without PR lesions increased from 40.9% at 1 month to 60.0% at 6 months and 73.9% at 12 months (p < 0.001). The incidence of epiretinal membrane (ERM) significantly increased (p < 0.001), while cystoid macular oedema (CME) remained stable over time. Visual acuity (VA) at 3 months postoperatively was a good reflection of final VA recovery (p < 0.001). Conclusion: Visual acuity (VA) improved in parallel with the decreasing number of eyes with SD‐OCT lesions after macula‐off rhegmatogenous RD. A long time to surgery was the only preoperative factor associated with poor VA recovery after retinal detachment surgery. [ABSTRACT FROM AUTHOR]

Background: Inflammatory pseudotumors (IPTs) are rare, idiopathic, and inflammatory lesions that are histopathologically benign. Here, we present three cases of labyrinthine destruction caused by an IPT. Methods: The first patient was a 74‐year‐old male with a mass lesion extending from the inner ear to the external ear canal. The second patient was a 62‐year‐old female with a foliated polycystic lesion in the petrous bone on the dorsal side of the left internal auditory canal. The third patient was a 68‐year‐old female with a mass extending from the inner ear to the middle ear, destroying the semicircular canal and cochlea. Results: In two cases, we performed surgical resection successfully with no recurrence. In the other case, the lesion showed shrinkage after chemotherapy for colorectal cancer incidentally found during the examination process. Conclusion: Surgical technique and indication for IPT should be based on the location and function of the lesion. In addition, there is room to consider pharmacotherapy as a treatment option for IPT of the temporal bone. Level of Evidence: 4. [ABSTRACT FROM AUTHOR]

Age‐related loss of muscle mass and strength is widely attributed to limitation in the capacity of muscle resident satellite cells to perform their myogenic function. This idea contains two notions that have not been comprehensively evaluated by experiment. First, it entails the idea that we damage and lose substantial amounts of muscle in the course of our normal daily activities. Second, it suggests that mechanisms of muscle repair are in some way exhausted, thus limiting muscle regeneration. A third potential option is that the aged environment becomes inimical to the conduct of muscle regeneration. In the present study, we used our established model of human muscle xenografting to test whether muscle samples taken from cadavers, of a range of ages, maintained their myogenic potential after being transplanted into immunodeficient mice. We find no measurable difference in regeneration across the range of ages investigated up to 78 years of age. Moreover, we report that satellite cells maintained their myogenic capacity even when muscles were grafted 11 days postmortem in our model. We conclude that the loss of muscle mass with increasing age is not attributable to any intrinsic loss of myogenicity and is most likely a reflection of progressive and detrimental changes in the muscle microenvironment such as to disfavor the myogenic function of these cells. [ABSTRACT FROM AUTHOR]

Seismic tomography has revealed the existence of large‐scale velocity heterogeneities in the mantle. The interpretation of seismic velocity anomalies in terms of temperature and chemical composition is nonunique. We use geodynamic observations including gravity, plate motions, dynamic topography, and excess ellipticity of the core‐mantle boundary combined with seismic observations to investigate the thermo‐chemical structure of the mantle through joint inversions. An outstanding issue, however, is the physical connection between mantle density anomalies and the surface geodynamic observations, which requires knowledge of the mantle viscosity structure. Here we perform joint inversions assuming different viscosity profiles and examine the dependence of the results on the viscosity. We first assume that mantle heterogeneity is due to thermal variations, which places a constraint on the relation between seismic velocity and density, and we subsequently relax the constraint to allow for potential nonthermal effects. In all of our joint inversions, a nonthermal origin of density anomalies is required to explain the geodynamic data, though the amount varies with the assumed viscosity structure. A common observation is a high‐density chemical signal in the center of the large low‐shear‐velocity provinces at the base of the mantle resulting in a near neutral or slightly dense overall buoyancy there. Using the derived density models and their corresponding viscosity profiles, we also calculate instantaneous mantle flow fields. The predicted flow fields derived from joint inversions are generally similar but are quite different from flow fields using density models derived from a posteriori scaling of pure seismic tomography models. Plain Language Summary: The origin and evolution of Earth's mantle have been long‐standing fundamental questions in geosciences. We use both global seismological and geodynamical (gravity, topography, plate motions, and excess ellipticity of the core‐mantle boundary) data sets to investigate whether lateral changes in mantle structure can be explained solely by temperature variations or whether the mantle must also have significant chemical variations. Our results indicate the presence of chemically distinct mantle anomalies. In particular, we find two large regions at the base of the mantle that appear to be chemically distinct with hot mantle upwellings surrounding them. We also derived several models of 3D density variations in the mantle assuming different viscosity profiles. These models were then used to predict the present‐day mantle convective flow. We show that the mantle viscosity structure does not have a strong influence on the pattern of large‐scale mantle flow. We find, however, that 3D density models derived by simple (1D) a posteriori scaling of tomography models obtained only from seismic data yield predictions of significantly different mantle flow. Key Points: Thermal origin of density anomalies alone cannot explain observed geodynamic dataNonthermal density anomalies are found in the center of the large low‐shear‐velocity provincesDensity models derived from joint inversion and from pure seismic inversion lead to different predicted mantle flow fields [ABSTRACT FROM AUTHOR]

Objective: The purpose of this paper is to report on the implementation and evaluation of a Screening, Brief Intervention and Referral to Treatment (SBIRT) educational program into an undergraduate nursing curriculum and to recommend modifications for future trainings. Design and Sample: A one‐group pre‐test/post‐test design was used. The sample consisted of senior level undergraduate nursing students. Measures: Core knowledge, perceived competency, and program satisfaction were measured. Process evaluation activities were performed to gather feedback on the training and solicit ideas and recommendations for improvement. Results: Of the 354 nursing students enrolled in the training, 249 (70%) participated in the research portion, with 240 (96%) completed the pre‐ and post‐training evaluations. All four core knowledge components and 13 perceived competency indicators were statistically significant (p ≤.001) when comparing pre‐ and post‐t test values. Process evaluation data collected through 25 telephone interviews found that the training improved the students' confidence and ability to screen for substance misuse with patients. Conclusion: Findings support the implementation of SBIRT training into an undergraduate nursing curriculum. Modifications for future training and research are proposed. [ABSTRACT FROM AUTHOR]

Objective: Huntington disease (HD) is an autosomal dominantly inherited neurodegenerative disorder caused by a CAG repeat expansion in the huntingtin (HTT) gene. No disease-modifying therapy exists for the treatment of patients with HD. The purpose of this study was therefore to investigate early disease mechanisms that potentially could be used as a target therapeutically.Methods: Lymphocyte activity in cerebrospinal fluid (CSF) from 4 cohorts of HTT gene expansion carriers (n = 121 in total) and controls was analyzed by techniques based on flow cytometry and enzyme-linked immunosorbent assays.Results: The data of this study provide evidence of immune abnormalities before motor onset of disease. In CSF of HTT gene expansion carriers, we found increased levels of proinflammatory cytokines, including IL-17, and increased consumption of the lymphocyte growth factor IL-7 before motor onset of HD. In concordance, we observed an increased prevalence of IL-17-producing Th17.1 cells in the CSF of HTT gene expansion carriers, predominantly in pre-motor manifest individuals. The frequency of intrathecal Th17.1 cells correlated negatively with progression of HD and the level of neurodegeneration, suggesting a role of Th17.1 cells in the early disease stage. We also observed a skewing in the balance between proinflammatory and regulatory T cells potentially favoring a proinflammatory intrathecal environment in HTT gene expansion carriers.Interpretation: These data suggest that Th17.1 cells are implicated in the earliest pathogenic phases of HD and suggest that treatment to dampen T -cell-driven inflammation before motor onset might be of benefit in HTT gene expansion carriers. ANN NEUROL 2020;87:246-255. [ABSTRACT FROM AUTHOR]

Objective: Cryoglobulins are cold‐precipitating immunoglobulins. Through progress in techniques, we undertook this study to update information on the biologic characteristics of cryoglobulins in a very large population. Methods: A cohort of 13,439 patients was tested for cryoglobulins from January 2010 to December 2016. The analysis included cryoglobulin isotype, clonality, concentration, and IgM rheumatoid factor (IgM‐RF) in cryoprecipitate, as well as serum complement and RF. Markers of gammopathy, viral infection, and autoimmunity were also investigated. Results: Of the 13,439 patients, 1,675 (12.5%) tested positive for cryoglobulins: 155 patients (9.3%) with type I, 788 (47%) with type II, and 732 (43.7%) with type III cryoglobulins. Nine percent of patients who were retested after initially testing negative for cryoglobulins showed a positive result on a follow‐up test (196 of the 2,213 retested patients). In type I cryoglobulins, IgM was more frequent but occurred at lower concentrations than IgG. Mixed cryoglobulins were found in 34.8% of the tested patients who were positive for hepatitis C virus and <5% of those who were positive for hepatitis B virus or HIV. Of the patients with anti–double‐stranded DNA, anti‐SSA, or anti–cyclic citrullinated peptide autoantibodies, 25.4% tested positive for mixed cryoglobulins, with type III occurring more frequently than type II. Both cryoprecipitate and serum were RF‐positive in 21.6% of type II and 10.1% of type III cryoglobulins. A decrease of C4, with or without accompanying decreases of C3 and CH50, was found in 23.6% of cryoglobulin samples. Conclusion: Obtained with the use of modern assays, our findings from this very large collection of cryoglobulins provide an update on cryoglobulin distribution and characteristics, with minimal selection bias. Despite strict preanalytical conditions, a negative finding for the presence of cryoglobulin must be confirmed in a second sample. RF activity and complement decreases were rarely detected. [ABSTRACT FROM AUTHOR]

Traumatic brain injury (TBI) has been linked to the development of numerous psychiatric diseases, including substance use disorder. However, it can be difficult to ascertain from clinical data whether the TBI is cause or consequence of increased addiction vulnerability. Surprisingly few studies have taken advantage of animal models to investigate the causal nature of this relationship. In terms of a plausible neurobiological mechanism through which TBI could magnify the risk of substance dependence, numerous studies indicate that TBI can cause widespread disruption to monoaminergic signaling in striatal regions, and also increases neuroinflammation. In the current study, male Long‐Evans rats received either a mild or severe TBI centered over the frontal cortex via controlled cortical impact, and were subsequently trained to self‐administer cocaine over 10 6‐hour sessions. At the end of the study, markers of striatal dopaminergic function, and levels of inflammatory cytokine levels in the frontal lobes, were assessed via western blot and multiplex ELISA, respectively. There was significantly higher cocaine intake in a subset of animals with either mild or severe TBI. However, many animals within both TBI groups failed to acquire self‐administration. Principal components analysis suggested that both dopaminergic and neuroinflammatory proteins were associated with overall cocaine intake, yet only an inflammatory component was associated with acquisition of self‐administration, suggesting neuroinflammation may make a more substantial contribution to the likelihood of drug‐taking. Should neuroinflammation play a causal role in mediating TBI‐induced addiction risk, anti‐inflammatory therapy may reduce the likelihood of substance abuse in TBI populations. [ABSTRACT FROM AUTHOR]

Maladaptive decision-making may play an integral role in the development and maintenance of an addiction. Substance-dependent individuals make riskier choices on the Iowa Gambling Task, and these deficits persist during withdrawal and are predictive of relapse. However, it is unclear from clinical studies whether this cognitive impairment is a cause or consequence of drug use. We trained male Long-Evans rats on the rat Gambling Task, a rodent analogue of the Iowa Gambling Task, to determine how choice preference influenced, and was influenced by, cocaine self-administration, withdrawal and incubation of craving. Rats that exhibited a preference for the risky, disadvantageous options at baseline were uniquely and adversely affected by cocaine self-administration. Risky choice was exacerbated in these rats when decision-making was assessed during the same diurnal period as cocaine self-administration, whereas the choice pattern of optimal decision-makers was unaffected. This decision-making deficit was maintained during 30 days of withdrawal and correlated with greater cue-induced incubation of craving. Risk-preferring rats also made more drug-seeking responses during cocaine self-administration. These data demonstrate that poor decision-making prior to contact with addictive drugs is associated with a pro-addictive behavioural phenotype, characterized by further increased risky choice and heightened responding for drug both during cocaine self-administration and withdrawal. Such findings indicate that the elevated risky decision-making observed in substance-dependent populations is not merely circumstantial, but makes an important contribution to addiction vulnerability and severity that can now be effectively modelled in laboratory rats. [ABSTRACT FROM AUTHOR]

Objectives To determine whether use of the Screening Tool of Older Persons' Prescriptions ( STOPP) and Screening Tool to Alert to Right Treatment ( START) criteria reduces incident hospital-acquired adverse drug reactions ( ADRs), 28-day medication costs, and median length of hospital stay in older adults admitted with acute illness. Design Single-blind cluster randomized controlled trial ( RCT) of unselected older adults hospitalized over a 13-month period. Setting Tertiary referral hospital in southern Ireland. Participants Consecutively admitted individuals aged 65 and older (N = 732). Intervention Single time point presentation to attending physicians of potentially inappropriate medications according to the STOPP/ START criteria. Measurements The primary outcome was the proportion of participants experiencing one or more ADRs during the index hospitalization. Secondary outcomes were median length of stay ( LOS) and 28-day total medication cost. Results One or more ADRs occurred in 78 of the 372 control participants (21.0%; median age 78, interquartile range ( IQR) 72-84) and in 42 of the 360 intervention participants (11.7%; median age 80, IQR 73-85) (absolute risk reduction = 9.3%, number needed to treat = 11). The median LOS in the hospital was 8 days ( IQR 4-14 days) in both groups. At discharge, median medication cost was significantly lower in the intervention group (€73.16, IQR €38.68-121.72) than in the control group (€90.62, IQR €49.38-162.53) (Wilcoxon rank test Z statistic = −3.274, P < .001). Conclusion Application of STOPP/ START criteria resulted in significant reductions in ADR incidence and medication costs in acutely ill older adults but did not affect median LOS. [ABSTRACT FROM AUTHOR]

The study of inborn genetic errors can lend insight into mechanisms of normal human development and congenital malformations. Here, we present the first detailed comparison of cranial and neuro pathology in two exceedingly rare human individuals with cyclopia and alobar holoprosencephaly ( HPE) in the presence and absence of aberrant chromosome 18 ( aCh18). The aCh18 fetus contained one normal Ch18 and one with a pseudo-isodicentric duplication of chromosome 18q and partial deletion of 18p from 18p11.31 where the HPE gene, TGIF, resides, to the p terminus. In addition to synophthalmia, the aCh18 cyclopic malformations included a failure of induction of most of the telencephalon - closely approximating anencephaly, unchecked development of brain stem structures, near absence of the sphenoid bone and a malformed neurocranium and viscerocranium that constitute the median face. Although there was complete erasure of the olfactory and superior nasal structures, rudiments of nasal structures derived from the maxillary bone were evident, but with absent pharyngeal structures. The second non- aCh18 cyclopic fetus was initially classified as a true Cyclops, as it appeared to have a proboscis and one median eye with a single iris, but further analysis revealed two eye globes as expected for synophthalmic cyclopia. Furthermore, the proboscis was associated with the medial ethmoid ridge, consistent with an incomplete induction of these nasal structures, even as the nasal septum and paranasal sinuses were apparently developed. An important conclusion of this study is that it is the brain that predicts the overall configuration of the face, due to its influence on the development of surrounding skeletal structures. The present data using a combination of macroscopic, computed tomography (CT) and magnetic resonance imaging (MRI) techniques provide an unparalleled analysis on the extent of the effects of median defects, and insight into normal development and patterning of the brain, face and their skeletal support. [ABSTRACT FROM AUTHOR]

Heightened motor impulsivity and increased novelty-seeking commonly co-occur in psychiatric disorders, including drug addiction. However, the relationship between these two phenomena remains unclear. One-time tests of novelty sensitivity commonly used in preclinical experiments, such as the open-field or novel-object test, fail to capture the fact that novelty-seekers repeatedly experience novel, stimulating situations. The present study therefore investigated whether repeated exposure to a novel, stimulating environment (SE) altered impulsive action. Male Long-Evans rats were trained to perform the five-choice serial reaction time task (5CSRTT) which measures motor impulsivity in the form of premature responding as well as attention and motivation. Animals were then exposed to a novel SE (1 h/day for 16 days) immediately prior to the 5CSRTT. Significant increases in premature responding were observed in a subgroup of reactive animals termed high responders (HR-SE). These rats were not more impulsive at baseline, and levels of impulsivity normalised once exposure to the SE was discontinued. No other aspect of 5CSRTT performance was affected by the SE challenge. We also determined that HR-SE rats were hyperactive in a novel environment. Biochemical analyses revealed changes in gene and protein expression within the dorsal hippocampus of HR-SE rats, including decreases in mRNA encoding the dopamine D1 receptor and brain-derived neurotrophic factor. These results indicate a novel mechanism by which impulsivity and novelty-reactivity interact that may enhance addiction vulnerability synergistically. Furthermore, studying such context-induced impulsivity may provide insight into the process by which environmental load precipitates psychiatric symptoms in impulse control disorders. [ABSTRACT FROM AUTHOR]

Background: We sought to examine whether age at immigration and length of residence were associated with preterm and small-for-gestational age (SGA) delivery among immigrant women in Denmark. Methods: We included all live singleton deliveries from Danish-born women (1 626 880) and women from the five largest immigrant groups (68 936) from 1978 to 2007. Data from the Danish Medical Birth Registry were linked to: parental country of origin, length of residence and age at immigration. Linear and logistic regression models were used to estimate absolute and relative differences with Danish-born women as the reference group. Results: All immigrant groups had an increased risk of SGA delivery with the highest risk among Lebanese-, Somali- and Pakistani-born women: risk differences (RDs) and 95% confidence intervals [CI] per 1000 deliveries of 50.2 [95% CI 43.7, 56.7], 70.1 [95% CI 62.2, 77.9] and 85.7 [95% CI 78.5, 92.9]. Turkish- and Pakistani-born women had increased RDs of 1.8 [95% CI 0.5, 3.1] and 2.2 [95% CI 0.1, 4.2] for very preterm and RDs of 3.5 [95% CI 0.9, 6.1] and 10.2 [95% CI 5.9, 14.5] for moderate preterm delivery. Lebanese-born women had a decreased risk of very preterm delivery, RD of −1.9 [95% CI −3.5, −0.3] and Somali-born women a lower risk of moderate preterm delivery, RD of −7.8 [−12.0, −3.6]. No differences were seen for the remaining groups. The association with length of residence for most immigrant groups was U-shaped, with highest risks among recent and long-term residents. Conclusion: Immigration was more strongly related to SGA than to preterm delivery. Observed differences in birth outcomes varied by age at immigration and length of residency in Denmark. [ABSTRACT FROM AUTHOR]

Lassen TH, Madsen M, Skovgaard LT, Strandberg-Larsen K, Olsen J, Andersen A-MN. Maternal use of nicotine replacement therapy during pregnancy and offspring birthweight: a study within the Danish National Birth Cohort. Paediatric and Perinatal Epidemiology 2010; 24: 272–281. Smoking is a well-established risk factor for fetal growth restriction and other adverse pregnancy outcomes, and nicotine may be one of the chemical compounds that drive these associations. Nicotine replacement therapy (NRT) is a smoking cessation aid, which can facilitate smoking cessation. It is, however, unknown whether NRT used during pregnancy impairs fetal growth. The aim of this study was to estimate the association between the use of NRT during pregnancy and offspring birthweight. The study population consisted of 72 761 women enrolled in the Danish National Birth Cohort between 1996 and 2002. Information on NRT and potential confounders was obtained from two computer-assisted telephone interviews conducted in the second and third trimesters, respectively. Multiple linear regression in a multilevel model was used to estimate the association between NRT use and birthweight adjusted for gestational age and potential confounders. The adjusted analyses showed no significant association between the duration of NRT use and birthweight (b = 0.25 g per week of NRT use [95% CI −2.31, 2.81]) and neither was the type of NRT product (patch, gum, inhaler) associated with reduced birthweight. However, simultaneous use of more than one NRT product was associated with reduced birthweight (b = −10.73 g per week of NRT use [95% CI −26.51, 5.05]), although the association was not statistically significant. The results of this study suggest that maternal use of NRT in pregnancy does not seriously affect birthweight, but there could be a negative effect on birthweight associated with simultaneous use of more than one type of NRT product. [ABSTRACT FROM AUTHOR]

Intrauterine exposure to artificial sex hormones such as oral contraceptives may be associated with an increased risk of fetal death. Between 1996 and 2002, a total of 92 719 women were recruited to The Danish National Birth Cohort and interviewed about exposures during pregnancy. Outcome of pregnancy was identified through linkage to the Civil Registration System and the National Discharge Registry. The authors analysed the risk of fetal death after recruitment to the cohort by using proportional hazards regression models with gestational age as the underlying time scale. In total, 1102 (1.2%) women took oral contraceptives during pregnancy. Use of combined oestrogen and progesterone oral contraceptives (COC) or progesterone-only oral contraceptives (POC) during pregnancy was not associated with increased hazard ratios of fetal death compared with non-users, HR 1.01 [95% CI 0.71, 1.45] and HR 1.37 [95% CI 0.65, 2.89] respectively. Neither use of COC nor POC prior to pregnancy was associated with fetal death. Stratification by maternal age and smoking showed elevated risks of fetal death for women <30 years and smokers using oral contraception during pregnancy, but the interactions were not significant. In conclusion, there was no evidence that oral contraceptive use before or during pregnancy is associated with an increased risk of fetal death. [ABSTRACT FROM AUTHOR]

Objectives. This study uses the Consumer Assessments of Healthcare Providers and Systems (CAHPS®) survey to examine the experiences of Hispanics enrolled in Medicare managed care. Evaluations of care are examined in relationship to primary language (English or Spanish) and region of the country. Data Sources. CAHPS 3.0 Medicare managed care survey data collected in 2002. Study Design. The dependent variables consist of five CAHPS multi-item scales measuring timeliness of care, provider communication, office staff helpfulness, getting needed care, and health plan customer service. The main independent variables are Hispanic primary language (English or Spanish) and region (California, Florida, New York/New Jersey, and other states). Ordinary least squares regression is used to model the effect of Hispanic primary language and region on CAHPS scales, controlling for age, gender, education, and self-rated health. Data Collection/Extraction Methods. The analytic sample consists of 125,369 respondents (82 percent response rate) enrolled in 181 Medicare managed care plans across the U.S. Of the 125,369 respondents, 8,463 (7 percent) were self-identified as Hispanic. The survey was made available in English and Spanish, and 1,353 Hispanics completed one in Spanish. Principal Findings. Hispanic English speakers had less favorable reports of care than whites for all dimensions of care except provider communication. Hispanic Spanish speakers reported more negative experiences than whites with timeliness of care, provider communication, and office staff helpfulness, but better reports of care for getting needed care. Spanish speakers in all regions except Florida had less favorable scores than English-speaking Hispanics for provider communication and office staff helpfulness, but more positive assessments for getting needed care. There were greater regional variations in CAHPS scores among Hispanic Spanish speakers than among Hispanic English speakers. Spanish speakers in Florida had more positive experiences than Spanish speakers in other regions for most dimensions of care. Conclusions. Hispanics in Medicare managed care face barriers to care; however, their experiences with care vary by language and region. Spanish speakers (except FL) have less favorable experiences with provider communication and office staff helpfulness than their English-speaking counterparts, suggesting language barriers in the clinical encounter. On the other hand, Spanish speakers reported more favorable experiences than their English-speaking counterparts with the managed care aspects of their care (getting needed care and plan customer service). Medicare managed care plans need to address the observed disparities in patient experiences among Hispanics as part of their quality improvement efforts. Plans can work with their network providers to address issues related to timeliness of care and office staff helpfulness. In addition, plans can provide incentives for language services, which have the potential to improve communication with providers and staff among Spanish speakers. Finally, health plans can reduce the access barriers faced by Hispanics, especially among English speakers. [ABSTRACT FROM AUTHOR]

Objective To demonstrate a role for microsatellite analysis in the evaluation of prenatal cases with possible placental mesenchymal dysplasia (PMD). Methods We present a case report in which several molecular analyses of amniocytes and products of conception were used in combination with cytogenetic and ultrasound studies to evaluate a pregnancy with a clinical suspicion of PMD. A combination of Southern blotting analysis, methylation-sensitive polymerase chain reaction (PCR) and multiplex ligation-dependent probe amplification (MLPA) was utilized to evaluate methylation patterns in the Beckwith-Wiedemann syndrome (BWS) and Prader-Willi/Angelman syndrome (PW/AS) critical regions. A series of microsatellite markers were used to evaluate the possibility of an androgenetic cell line. Results Methylation studies performed for the BWS and PW/AS critical regions were abnormal and consistent with a molecular diagnosis of BWS and Angelman syndrome. Further studies of amniocytes using microsatellite markers identified androgenetic and biparental cell lines in approximately a 10:1 ratio, respectively. Conclusions Prenatal ultrasonography, karyotyping and molecular genetic evaluation for BWS alone were not sufficient to identify the underlying etiology of PMD in this case. The androgenetic cell line was only identified after microsatellite analysis. Copyright © 2007 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Objective To assess cystoscopic transurethral resection (TUR) for the palliative management of dogs with neoplastic infiltration of the urethra. Study Design Prospective clinical trial. Animals Six client-owned dogs. Methods Cystoscopic examination and electrosurgical TUR were performed in dogs with urination difficulties caused by prostatic or urethral neoplasia. TUR was performed in a retrograde manner in female dogs and antegrade in male dogs via exploratory celiotomy and ventral cystotomy. Cystoscopic examination was used to determine the extent of neoplastic involvement of the urethra. TUR involved piecemeal removal of neoplastic tissue from the urethral lumen using an electrocautery cutting loop. Hemorrhage was controlled with a cystoscopic cauterized roller-ball. In 2 male dogs, intraoperative radiation therapy (IORT) was used to treat both prostatic neoplasia and the sublumbar lymph node bed. Surgical technique, complications, adjuvant treatment, and outcome were recorded. Results TUR was performed in 3 male dogs with prostatic carcinoma and 2 female dogs with urethral transitional cell carcinoma (TCC). In 1 female dog, TUR was attempted but not successful because of cystoscope diameter. Iatrogenic urethral perforation occurred during TUR in 3 dogs. In 2 dogs, prolonged exposure to lavage fluid resulted in clinical and biochemical abnormalities consistent with TUR syndrome. Dysuria resolved in 5 dogs within 10 days of TUR. Treatment-related complications included urinary tract infection and tumor seeding. Local tumor progression and metastasis occurred in all dogs. Conclusions TUR (in combination with chemotherapy±IORT) resulted in rapid palliation of urination difficulties in male dogs with prostatic carcinoma. In female dogs with urethral TCC, however, electrosurgical TUR cannot be recommended because of a high intra- and postoperative complication rate with no improvement in postoperative management compared with historical reports of tube cystostomy. Clinical Relevance TUR is a novel alternative for the palliation of male dogs with prostatic carcinoma. In female dogs with urethral TCC, electrosurgical TUR does not provide any advantages compared with tube cystostomy. [ABSTRACT FROM AUTHOR]

Background: It has been suggested that locally produced immunoglobulin (Ig)A could be more protective than IgG and that there could be a relationship between crevicular fluid-specific: IgA levels and the onset of periodontal disease. This study was designed to investigate this hypothesis regarding specific immune responses towards 4 plaque anaerobes in gingival crevicular fluid and saliva from patients with periodontopathies arid controls. Methods: Gingival crevicular fluid (GCF) and whole saliva were collected from 35 adults with periodontitis and 24 periodontally healthy adults (controls). Antigens were extracted from Actinomyces actinomycetemcomitans, Porphyromonas gingivalis Prevotella intermedia, and Fusobacterium nucleatum and used to set up specific enzyme-linked immunosorbent assay (ELISA) tests to assess IgA and IgG levels to these microorganisms in the fluids collected. Results: The crevicular fluid of periodontitis patients contained significantly higher levels of IgG to the 4 microorganisms tested than that of controls (P <10-6 for all comparisons). IgA levels to the 4 bacteria were statistically significantly much higher in control crevicular fluid (P <10-7 for all comparisons). Controls also had statistically significantly higher levels of specific salivary IgA than patients (P <0.02 for oil comparisons). Conclusions: These data support the potentially protective role of specific IgA directed to oral microorganisms involved in the onset and development of periodontal disease. [ABSTRACT FROM AUTHOR]

Summary The multipartite genome of the nanovirus Faba bean necrotic yellows virus , which consists of one gene on each DNA component, was exploited to construct a series of virus-based episomal vectors designed for transient replication and gene expression in plants. This nanovirus based expression system yields high levels of protein which allows isolation of recombinant protein and protein complexes from plant tissues. As examples, we demonstrated in planta interaction between the nanovirus F-box protein Clink and SKP1, a constituent of the ubiquitin-dependent protein turnover pathway. Thus, replicative nanovirus vectors provide a simple and efficient means for in planta characterization of protein-protein interaction. [ABSTRACT FROM AUTHOR]

Information regarding consumer awareness of imports has been an ongoing concern of the textile and apparel industries. This study was undertaken to provide additional information about attitudes of apparel imports from the viewpoints of college students. The results support those of earlier studies for the most part. Data analysis, in contrast to other studies, showed no clear preference toward either domestic or imported apparel. However, there was concern and strong support for the U.S. textile and apparel industries. Most students indicated that they would purchase domestic apparel over imported apparel to help the U.S. economy. [ABSTRACT FROM AUTHOR]

Prior to World war II, marriage among college students was not widespread. Indeed, on some campuses students who married were immediately dismissed. In the middle 1940's the veterans of the war began to return to college, some to begin and others to continue their education. In light of the lack of precedent, the phenomenon of married students on campuses was not encompassed by the college norms of the time; however, it seems that these students were permitted to remain for a combination of reasons. Another condition of considerable significance was the introduction of the pattern by a special group for whom institutional expectations were' still in abeyance, and this in a time characterized by a kind of generalized "war psychology," when certain traditional behavior patterns and values were in a relative state of flux. The diffusion of this pattern to and adoption of it by the nonveteran student, in retrospect, at least, seems to have proceeded in a rapid and orderly manner.

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Self‐cross‐linkable ferrocenyl‐containing polymethylhydrosiloxanes were synthesized. Karstedt's catalyst and cis‐[PtCl2(BnCN)2] were examined as cross‐linking catalysts at room temperature for the reaction between Si–H groups of the ferrocenyl‐containing polymethylhydrosiloxanes. Cis‐[PtCl2(BnCN)2] is an effective catalyst that allows cross‐linked ferrocenyl‐containing silicones (silicone rubbers) to be obtained with no visible mechanical defects (bubbles or cracks) compared with Karstedt's catalyst. The ferrocene content of the ferrocenyl‐containing silicone rubbers was found to be approximately 50 wt.% by energy‐dispersive X‐ray analysis. Compared with cross‐linked non‐modified polymethylhydrosiloxanes, the ferrocenyl‐containing silicone rubbers exhibited improved tensile properties (the tensile strength increased from 0.47 to 0.75 MPa) and a 1.5–2.5 times lower cross‐linking degree. The surface resistivity of the ferrocenyl‐containing silicone rubbers (50 wt.% ferrocenyl units) was approximately 7 × 109 Ω/□, which was 10,000 times lower than that of pure polymethylhydrosiloxane. The obtained flexible electroactive ferrocenyl‐containing silicone rubbers can potentially be applied as coatings for electronic and electrostatic‐sensitive devices, interfaces, and sensors. [ABSTRACT FROM AUTHOR]

The fragmentation patterns of thiazolotriazoles are in agreement with the individual character of each heterocycle but there are also peaks arising both from their combined influence and from the nature of the substituents in positions 5 and 6. [ABSTRACT FROM AUTHOR]

The metabolism of mannose was examined in resting cells in vivo using [sup 13]C-NMR and [sup 31]P-NMR spectroscopy, in cell-free extracts in vitro using [sup 31]P-NMR spectroscopy, and by enzyme assays. Plesiomonas shigelloides was shown to transport mannose by a phosphoenolpyruvate-dependent phosphotransferase system producing mannose 6-phosphate. However, a toxic effect was observed when P. shigelloides was grown in the presence of mannose. Investigation of mannose metabolism using in vivo[sup 13]C NMR showed mannose 6-phosphate accumulation without further metabolism. In contrast, glucose was quickly metabolized under the same conditions to lactate, ethanol, acetate and succinate. Extracts of P. shigelloides exhibited no mannose-6-phosphate isomerase activity whereas the key enzyme of the Embden–Meyerhof pathway (6-phosphofructokinase) was found. This result explains the mannose 6-phosphate accumulation observed in cells grown on mannose. The levels of phosphoenolpyruvate and P[sub i] were estimated by in vivo[sup 31]P-NMR spectroscopy. The intracellular concentrations of phosphoenolpyruvate and P[sub i] were relatively constant in both starved cells and mannose-metabolizing cells. In glucose-metabolizing cells, the phosphoenolpyruvate concentration was lower, and about 80% of the P[sub i] was used during the first 10 min. It thus appears that the toxic effect of mannose on growth is not due to energy depletion but probably to a toxic effect of mannose 6-phosphate. [ABSTRACT FROM AUTHOR]