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Expiratory central airway collapse (ECAC) comprising excessive central airway collapse (EDAC) and tracheobronchomalacia. Treatment is challenging for severe cases that are not candidates for surgical management. We report a case of severe ECAC successfully managed with continuous positive airway pressure (CPAP) therapy. A 75‐year‐old female patient status post right pneumonectomy, presented with chronic cough. Dynamic bronchoscopy evaluation showed severe EDAC which improved with intraprocedural noninvasive positive pressure (NIPPV) therapy. Due to patients' comorbidities, she was not a candidate to surgical tracheobronchoplasty. Therefore, we attempted pneumatic stenting with long‐term CPAP therapy resulting in improvement of symptoms and functional capacity. The long‐term efficacy of pneumatic stenting has not been clearly established yet. Literature review of management of ECAC with NIPPV consist primarily of case reports and there is only one clinical trial being conducted to assess the efficacy of CPAP therapy in ECAC. While NIPPV arises as a sufficient alternative for management of severe ECAC, larger scale studies are needed to prove the real efficacy of NIPPV in this setting. [ABSTRACT FROM AUTHOR]

Background and Objective: Shape‐sensing robotic‐assisted bronchoscopy (ssRAB) has expanded as an important diagnostic tool for peripheral pulmonary nodules (PPNs), with diagnostic yields ranging from 60% to 88%. However, sampling and diagnosing PPN less than 2 cm in size has historically been challenging. Mobile cone‐beam computed tomography (mCBCT) has been recently integrated into ssRAB to improve diagnostic accuracy, but its added value remains uncertain. We aim to describe the role of mCBCT and determine if it provides any diagnostic advantage. Methods: A multicentre, retrospective study on the use of ssRAB and mCBCT in two tertiary care institutions: Mayo Clinic Florida and Massachusetts General Hospital. The primary outcome was diagnostic yield and sensitivity for malignancy of ssRAB complemented with mCBCT, compared to ssRAB with the standard 2D fluoroscopy. Results: A total of 192 nodules were biopsied from 173 patients. mCBCT was used in 117 (60.9%) nodules. The overall diagnostic yield was 85.4%. Diagnostic yield between subgroups with and without mCBCT was 83.8% and 88% (p = 0.417), respectively. The mCBCT group had fewer solid nodules (65.8% vs. 81.3%, p = 0.020) and a higher number of ground‐glass nodules (10.3% vs. 1.3%, p = 0.016). Conclusion: Overall, diagnostic yield between subgroups with and without mCBCT was similar. The complementary use of mCBCT to ssRAB allows proceduralists to target more complex and subsolid PPNs with a diagnostic yield comparable to simple solid PPNs while maintaining an excellent safety profile. While the overall diagnostic yield with and without mobile cone‐beam CT for sampling small pulmonary nodules with shape‐sensing robotic bronchoscopy was similar, the use of mobile cone‐beam CT allows for safely biopsying more complex and subsolid nodules. See relatededitorial [ABSTRACT FROM AUTHOR]

In this study, a combination of X-ray excited optical luminescence (XEOL), time-resolved XEOL (TR-XEOL) and the Hanbury-Brown and Twiss (HB-T) interferometer at the Taiwan Photon Source (TPS) 23A X-ray nanoprobe beamline for exploring quantum materials is demonstrated. On the basis of the excellent spatial resolution rendered using a nano-focused beam, emission distributions of artificial micro-diamonds can be obtained by XEOL maps, and featured emission peaks of a selected local area can be obtained by XEOL spectra. The hybrid bunch mode of the TPS not only provides a sufficiently high peak power density for experiments at each beamline but also permits high-quality temporal domain (~200 ns) measurements for investigating luminescence dynamics. From TR-XEOL measurements, the decay lifetime of micro-diamonds is determined to be approximately 16 ns. Furthermore, the XEOL spectra of artificial micro-diamonds can be investigated by the HB-T interferometer to identify properties of single-photon sources. The unprecedented strategy of combining XEOL, TR-XEOL and the HB-T interferometer at the X-ray nanoprobe beamline will open new avenues with significant characterization abilities for unraveling the emission mechanisms of single-photon sources for quantum materials. [ABSTRACT FROM AUTHOR]

Background: The current NCCN guidelines recommend considering elective neck dissection (END) for early-stage oral cavity squamous cell carcinoma (OCSCC) with a depth of invasion (DOI) exceeding 3mm. However, this DOI threshold, determined by evaluating the occult lymph node metastatic rate, lacks robust supporting evidence regarding its impact on patient outcomes. In this nationwide study, we sought to explore the specific indications for END in patients diagnosed with OCSCC at stage cT2N0M0, as defined by the AJCC Eighth Edition staging criteria. Methods: We examined 4723 patients with cT2N0M0 OCSCC, of which 3744 underwent END and 979 were monitored through neck observation (NO). Results: Patients who underwent END had better 5-year outcomes compared to those in the NO group. The END group had higher rates of neck control (95% vs. 84%, p<0.0001), disease-specific survival (DSS; 87% vs. 84%, p=0.0259), and overall survival (OS; 79% vs. 73%, p=0.0002). Multivariable analysis identified NO, DOI ≥5.0 mm, and moderate-to-poor tumor differentiation as independent risk factors for 5-year neck control, DSS, and OS. Based on these prognostic variables, three distinct outcome subgroups were identified within the NO group. These included a low-risk subgroup (DOI <5 mm plus well-differentiated tumor), an intermediate-risk subgroup (DOI ≥5.0 mm or moderately differentiated tumor), and a high-risk subgroup (poorly differentiated tumor or DOI ≥5.0 mm plus moderately differentiated tumor). Notably, the 5-year survival outcomes (neck control/DSS/OS) for the low-risk subgroup within the NO group (97%/95%/85%, n=251) were not inferior to those of the END group (95%/87%/79%). Conclusions: By implementing risk stratification within the NO group, we found that 26% (251/979) of low-risk patients achieved outcomes similar to those in the END group. Therefore, when making decisions regarding the implementation of END in patients with cT2N0M0 OCSCC, factors such as DOI and tumor differentiation should be taken into account. [ABSTRACT FROM AUTHOR]

Kimura's disease (KD) is an immune‐mediated disorder which mainly affects Asian men. It appears as head and neck subcutaneous masses, with inflammatory infiltrate and elevated serum immunoglobulin E levels. The clinical presentation of KD resembles that of various diseases. Here, we report the case of a 30‐year‐old Filipino man with KD mimicking cavernous hemangioma who was treated by surgery. Careful survey for possible KD cases is crucial. Misdiagnoses are prone to futile interventions and unwanted effects. Surgery with adjuvant therapy is superior to other forms of KD treatment. [ABSTRACT FROM AUTHOR]

Tracheobronchial stenosis (TBS) in adults derives from congenital and acquired conditions, including prolonged mechanical intubation, expiratory central airway collapse, infectious or inflammatory disease, and malignancy. The most common clinical presentation is shortness of breath, recurrent infections, and chronic cough. TBS is usually diagnosed via computed tomography or bronchoscopy, with the latter doubling as a therapeutic tool. We present a case of an atypical fibrotic bridge connecting the walls of the distal trachea and fibrotic bronchial stenosis treated with electrocautery knife and balloon dilation, in an adult patient with bronchopulmonary dysplasia. [ABSTRACT FROM AUTHOR]

Robotic‐assisted bronchoscopy (RAB) improves endoscopic diagnostic yield of solitary pulmonary nodules (SPN). Needle‐based confocal laser endomicroscopy (nCLE) is an emerging technology that allows high‐resolution, in‐vivo, real‐time assessment of living tissues at a cellular and subcellular level. Their combined use has been scarcely reported. We used them simultaneously in three patients with SPNs. For each, the nodule was evaluated with nCLE and sampled for pathology, followed by mediastinal staging. Median age was 77 years (67% male). Median nodule minimum size was 1.8 cm and maximum was 2.1 cm. nCLE detected abnormal patterns suggestive of malignancy for all nodules and pathology confirmed primary lung adenocarcinomas in two patients and lung primary squamous cell carcinoma in the other. The combined use of RAB with nCLE may potentially enhance the differentiation of malignant cells in real‐time and increase sample adequacy, accuracy, and diagnostic yield when biopsying a suspicious pulmonary lesion. [ABSTRACT FROM AUTHOR]

Background and Objective: Currently, computed tomography‐guided transthoracic biopsy (CTTB) is the most accurate diagnostic approach for pulmonary nodules suspected of malignancy. Traditional bronchoscopy has shown suboptimal diagnostic sensitivity, but the emergence of robotic‐assisted bronchoscopy (RAB) has the potential to improve diagnostic accuracy, maximize diagnostic yield and complete mediastinal and hilar staging in a single procedure. We aim to assess the efficacy and diagnostic performance of RAB compared to CTTB for diagnosing pulmonary nodules suspected of lung cancer. Methods: A multicenter retrospective review of consecutive patients who underwent RAB and CTTB for evaluating pulmonary nodules from January 2019 to March 2021 at Mayo Clinic Florida and Mayo Clinic Rochester, United States. Clinical and demographic information, nodule characteristics, outcomes and complications were compared between RAB and CTTB. Results: A total of 225 patients were included: 113 in the RAB group and 112 in the CTTB group. Overall diagnostic yield was 87.6% for RAB and 88.4% for CTTB. For malignant disease, RAB had a sensitivity of 82.1% and a specificity of 100%, CTTB had a sensitivity of 88.5% and a specificity of 100%. Complication rate was significantly higher for CTTB compared to RAB (17% vs. 4.4%; p = 0.002). Conclusion: RAB, when available, can be as accurate as CTTB for sampling pulmonary nodules with similar or reduced complications and should be considered as a means for nodule biopsy, particularly when mediastinal staging is also clinically warranted. [ABSTRACT FROM AUTHOR]

Lung cancer is the deadliest cancer worldwide, therefore, early and prompt diagnosis is essential for better patient outcomes. It is known to have a high predilection for metastasis to the adrenal glands; however, two‐thirds of adrenal masses in patients with lung cancer will turn out to be benign, so timely detection is crucial. We present a case of a lung squamous cell carcinoma diagnosed by shape‐sensing robotic‐assisted bronchoscopy (ssRAB), negative mediastinal and hilar staging with endobronchial ultrasound (EBUS) and transbronchial needle aspiration (TBNA), and a pheochromocytoma diagnosed through endoscopic ultrasound with bronchoscope (EUS‐B) fine needle aspiration (FNA) all in the same endoscopic procedure. [ABSTRACT FROM AUTHOR]

An attenuator is generally used to decrease the power of an X-ray beam and prevent damage to detector sensors and other optical components. Therefore, attenuators are designed using foil or gas to absorb light source power. In this project, a large aperture and a water-cooling attenuator system are construed for the TPS 31A Projection X-ray Microscope and Transmission X-ray Microscope beamline. The source size of the wiggler is 300 mm × 7 mm on TPS 31A. The X-ray beam size at the sample position is 50 mm × 20 mm, located 49.5 m from the source. The light emission power is 1000 W in white-beam operation mode. The attenuator is needed to absorb energy for the light source and it has 12 foil carriers. The absorption foil size is 56 mm × 46 mm for the beam size across different beamline operation modes, and the cooling capacity is greater than 1000 W. This study applies a magnetic coupling-type attenuator system with foil carrier cooling carried out by the side chamber walls without the feedthrough having water enter the chamber to solve the thermal dissipation issue. [ABSTRACT FROM AUTHOR]

Pleural effusion is a common condition related to various diseases such as heart failure, malignancies, and pneumonia. Ovarian hemangioma is a rare type of female genital tumour and can rarely cause pleural effusion. In this case, we present a 48‐year‐old female with repeated episodes of recurrent right‐sided pleural effusion over 1 year with no clear aetiology. Abdominal computed tomography revealed a large left ovarian mass. After surgical removal of the mass, the repeated pleural effusion episodes ceased, and histopathology analysis reported a rare ovarian hemangioma. Pseudo Meigs' syndrome is a triad of an ovarian tumour, ascites, and hydrothorax that rarely presents with ovarian hemangioma; both effusions are eradicated after removing the tumour. [ABSTRACT FROM AUTHOR]

Introduction: Bronchoscopic lung volume reduction (BLVR) with endobronchial valves (EBVs) has emerged as an important treatment method for patients with severe chronic obstructive pulmonary disease (COPD). Acute exacerbations of COPD (AECOPD) are a frequent complication following BLVR with EBV. However, there is no consensus on the prevention of AECOPD. Objectives: Our study aims to compare the outcomes of different prophylactic measures on the occurrence of AECOPD after BLVR with EBV. Methods: We conducted a multicenter, retrospective study of patients who underwent BLVR with EBV at six different institutions. Emphasis was directed towards the specific practices aimed at preventing AECOPD: antibiotics, steroids, antibiotics plus steroids, or no prophylaxis. Subgroups were compared, and odds ratios (ORs) with corresponding 95% confidence intervals (CIs) were calculated. Results: A total of 170 patients were reviewed. The rate of AECOPD was 21.2% for the full cohort. Patients who received prophylaxis had a significantly lower rate of AECOPD compared with those who did not (16.7% vs. 46.2%; p = 0.001). The rate was lowest in patients who received antibiotics alone (9.2%). There was no significant difference in the rate of AECOPD between patients who received steroids alone or antibiotics plus steroids, compared with the other subgroups. The OR for AECOPD was 4.3 (95% CI: 1.8–10.4; p = 0.001) for patients not receiving prophylaxis and 3.9 (95% CI: 1.5–10.1; p = 0.004) for prophylaxis other than antibiotics alone. Conclusions: Administration of antibiotics after BLVR with EBV was associated with a lower rate of AECOPD. This was not observed with the use of steroids or in combination with antibiotics. [ABSTRACT FROM AUTHOR]

Expiratory central airway collapse (ECAC) is a pathology gaining recognition in the medical community due to its unspecific symptoms and diagnostic challenges. Its current gold standard for diagnosis, dynamic bronchoscopy, is invasive. Current non‐invasive techniques such as computed tomography (CT) protocols have shown limited reproducibility. We present a case of a 77‐year‐old man with suspected ECAC who underwent evaluation with two different expiratory CT protocols. The initial standard end‐expiratory CT could not detect airway collapsibility. However, dynamic bronchoscopy detected severe ECAC. Afterwards, we implemented a novel CT protocol, called dynamic forced expiratory CT (cinematic), comprising detailed, consecutive helical imaging of the central airway throughout the entire respiratory cycle, detecting severe ECAC, as proven by the earlier dynamic bronchoscopy. We hypothesize this may reduce the risks and need for performing multiple invasive procedures such as dynamic bronchoscopy. Extensive studies are required to evaluate the feasibility of its implementation for diagnosing ECAC. [ABSTRACT FROM AUTHOR]

Background: Endobronchial ultrasound transbronchial needle aspiration (EBUS‐TBNA) is a safe and minimally invasive procedure for evaluating hilar and mediastinal lymph nodes. The reported sensitivity and specificity of EBUS‐TBNA are 95% and 97%, respectively. A comparison of diagnostic sensitivity for lymph nodes suspected of lung cancer according to needle size in EBUS‐TBNA is needed. Objectives: To compare the diagnostic sensitivity of the 19‐G, 21‐G, 22‐G and 25‐G needles for lymph nodes suspected of non‐small cell lung cancer (NSCLC) using EBUS‐TBNA. Methods: A literature search from PubMed, EMBASE, LILACS, DOAJ and CENTRAL through October 2020 was performed by two reviewers. The extracted data were evaluated using STATA® and Open Meta Analyst software for meta‐analysis with a binary method model to compare sensitivity, specificity and summary receiver operating characteristic curve for each needle size. Results: Fourteen studies including 1296 participants were considered for the analysis. The overall sensitivity of EBUS‐TBNA was 88.2% (95% CI 84%, 91%) and 93% (95% CI 88%, 95%) for the 19‐G needle, 87.6% (95% CI 79.6%, 92.8%) for the 21‐G needle and 85% (95% CI 80%, 88%) for the 22‐G needle. The overall sensitivity of EBUS‐TBNA for diagnosing NSCLC was 88.3% (95% CI, 81%, 93%) and 92.9% (95% CI, 85%, 97%) for the 19‐G needle, 89.4% (95% CI 79.4%, 94.8%) for the 21‐G needle and 82.1% (95% CI 66%, 91%) for the 22‐G needle. Conclusion: The 19‐G, 21‐G and 22‐G needles present a similarly high diagnostic sensitivity in EBUS‐TBNA. The 19‐G needle provided better sample adequacy for molecular and immunohistochemical testing, improving diagnostic yield in this subgroup. [ABSTRACT FROM AUTHOR]

The National Institute of Standards and Technology uses borate fusion, wavelength dispersive X‐ray fluorescence (WDXRF) spectrometry and synthetic calibration standards for high performance, quantitative analyses of alloys reacted and partially dissolved for fusion into borate beads. Conversion from metal matrix to low Z glass preserves measurement sensitivity. Synthetic calibration standards closely match fused samples, yielding very low uncertainties in results. This approach was applied to zirconium alloys of ≥90% Zr and 17 elements: Al, Co, Cr, Cu, Fe, Hf, Mn, Mo, Nb, Ni, P, Pb, Sn, Ta, Ti, V, and W. To demonstrate capabilities, it was applied to Standard Reference Material (SRM) 360b Zirconium (Sn‐Fe‐Cr) Alloy, renewal SRM 360c, plus discontinued Zr alloy SRMs: 360, 360a, 1210 through 1215, and 1234 through 1239. Eleven elements exhibit biases ≤5% for these SRMs. Additional validation used comparative test methods of inductively coupled plasma (ICP) mass spectrometry, ICP optical emission spectrometry and prompt gamma‐ray activation analysis. This WDXRF method gives results of high enough quality to certify the valid elements in conjunction with results from one or more independent methods. Several phenomena complicate the approach. Normal Zr dissolution using HNO3 + HF, forms Zr(NO3)4 in solution and concentrates it on drying. Zr(NO3)4 sublimes at low temperatures, causing uncontrolled loss of Zr as the temperature exceeds 100°C. Rapidly heated Zr(NO3)4 may explode. Digestion with HF alone works well. High‐purity ZrO2 and LiF were used for matrix matching of calibration standards, requiring determinations of trace elements in the high‐purity ZrO2. [ABSTRACT FROM AUTHOR]

Reservoirs are active sites in the terrestrial environment in terms of carbon transformation and storage. Continuous reservoir construction reinforces the importance of such artificial storage; however, knowledge pertaining to the sources, cycling, and preservation of autochthonous/allochthonous particulate organic carbon (POC) in reservoirs remains incomplete. We monitored the flux and carbon isotope composition of sinking particles in a subtropical deep reservoir, and the results were compared with the isotopic signatures of potential POC sources (soil) and the sedimentary sink. We found that the typhoon-induced POC flux was transported laterally at intermediate water depths within the reservoir and that it contributed more than 70% of the annual deposition. An isotope ternary mixing model showed that over 87% of the POC preserved in sediments was allochthonous. Although the autochthonous POC from primary production was preferentially degraded, the preserved autochthonous POC (42 ± 14 gC m-2 yr-1) was comparable to the observed carbon dioxide uptake (35 gC m-2 yr-1) by the reservoir, suggesting a high efficiency of carbon preservation in subtropical deep reservoirs. [ABSTRACT FROM AUTHOR]

Key message: Diffuse pulmonary meningotheliomatosis (DPM) is an ultra‐rare pulmonary disease characterized by innumerable bilateral minute meningothelial‐like nodules, sometimes presenting a characteristic 'cheerio‐sign' on imaging. Most patients with DPM are asymptomatic and experience no disease progression. Although little is known about its nature, DPM may be associated with pulmonary malignancies, mostly lung adenocarcinoma. [ABSTRACT FROM AUTHOR]

Summary: Adult neurogenesis declines with aging due to the depletion and functional impairment of neural stem/progenitor cells (NSPCs). An improved understanding of the underlying mechanisms that drive age‐associated neurogenic deficiency could lead to the development of strategies to alleviate cognitive impairment and facilitate neuroregeneration. An essential step towards this aim is to investigate the molecular changes that occur in NSPC aging on a genomewide scale. In this study, we compare the transcriptional, histone methylation and DNA methylation signatures of NSPCs derived from the subventricular zone (SVZ) of young adult (3 months old) and aged (18 months old) mice. Surprisingly, the transcriptional and epigenomic profiles of SVZ‐derived NSPCs are largely unchanged in aged cells. Despite the global similarities, we detect robust age‐dependent changes at several hundred genes and regulatory elements, thereby identifying putative regulators of neurogenic decline. Within this list, the homeobox gene Dbx2 is upregulated in vitro and in vivo, and its promoter region has altered histone and DNA methylation levels, in aged NSPCs. Using functional in vitro assays, we show that elevated Dbx2 expression in young adult NSPCs promotes age‐related phenotypes, including the reduced proliferation of NSPC cultures and the altered transcript levels of age‐associated regulators of NSPC proliferation and differentiation. Depleting Dbx2 in aged NSPCs caused the reverse gene expression changes. Taken together, these results provide new insights into the molecular programmes that are affected during mouse NSPC aging, and uncover a new functional role for Dbx2 in promoting age‐related neurogenic decline. [ABSTRACT FROM AUTHOR]

This study addresses the problem of recovering the three-dimensional depth data from the images taken by a lightfield camera. Unlike the conventional approach to extract the depth information from the spatial and the angular gradients in the epipolar plane images (EPIs), this study proposes to check the similarity between the pixels for the estimation of EPI slopes and use a wavelet transformation augmented multi-scale analysis to perform smart segmentations. The Markov random field is then applied for surface reconstruction. The proposed algorithm offers significant improvement to the depth estimation, especially for noise contaminated images. Application of the method on the light-field images and on synthesised data show that the proposed method is robust against the noise and achieves better estimation results compared with the available literature. [ABSTRACT FROM AUTHOR]

The embryonic pattern of global DNA methylation is first established in the inner cell mass (ICM) of the mouse blastocyst The methyl donor S-adenosylmethionine (SAM) is produced in most cells through the f olate cycle, but only a few cell types generate SAM from betaine (N, N,N-trimethylglycine) via betaine-homocysteine meth-yltransferase (BHMT), which is expressed in the mouse ICM. Here, mean ICM cell numbers decreased from 18-19 in controls to 11-13 when the f olate cycle was inhibited by the antifolate methotrexate and to 12-14 when BHMT expression was knocked down by antisense morpholinos. Inhibiting both pathways, however, much more severely affected ICM development (7-8 cells). Total SAM levels in mouse blastocysts decreased significantly only when both pathways were inhibited (from 3.1 to 1.6 pmol/100 blastocysts). DNA methylation, detected as 5-methylcytosine (5-MeC) immunofluorescence in isolated ICMs, was minimally affected by inhibition of either pathway alone but decreased by at least 45-55% when both BHMT and the folate cycle were inhibited simultaneously. Effects on cell numbers and 5-MeC levels in the ICM were completely rescued by methionine (immediate SAM precursor) or SAM. Both the f olate cycle and betaine/BHMT appear to contribute to a methyl pool required for normal ICM development and establishing initial embryonic DNA methylation. [ABSTRACT FROM AUTHOR]

Background: Customized zirconia abutments are increasingly applied for the fabrication of esthetic implant restorations aimed at imitating the natural situation. These abutments are individually shaped according to the anatomical needs of the respective implant site. Purpose: This study sought to compare the fracture resistance and fit accuracy of prefabricated and customized zirconia abutments using an internal hexagonal implant system (TSV®, Zimmer, Carlsbad, CA, USA). Materials and Methods: Two zirconia abutment groups were tested: prefabricated zirconia abutments (ZirAce, Acucera, Seoul, Korea) and customized zirconia abutments milled by the Zirkonzahn milling system. Twenty zirconia abutments per group were connected to implants on an acrylic resin base with 30-Ncm torque. The fracture resistance of zirconia abutments was measured with an angle of 30° at a crosshead speed of 1 mm/min using the universal testing machine (Z020, Zwick, Ulm, Germany). Marginal and internal gaps between implants and zirconia abutments were measured after sectioning the embedded specimens using a digital microhardness tester (MXT70, Matsuzawa, Tokyo, Japan). Results: The customized abutments were significantly stronger (1,430.2 N) than the prefabricated abutments (1,064.1 N). The mean marginal adaptation of customized abutments revealed a microgap that was increased (11.5 µm) over that in prefabricated abutments (4.3 µm). Conclusion: Within the limitations of this study, the customized abutments are significantly stronger than prefabricated abutments, but the fit is less accurate. The strength and fit of both abutments are within clinically acceptable limit. [ABSTRACT FROM AUTHOR]

Background The precise fit of an implant prosthesis is considered to be a prerequisite for the success and maintenance of osseointegration. It is unknown how much static stress can be tolerated at the implant-bone interface with ill-fitting prostheses for the two different types of retention (cement vs screw). Purpose The purpose of this study was to evaluate the stress pattern and magnitude in the supporting tissues around I TI (Straumann AG, Waldenburg, Switzerland) implants with screw- or cement-retained prostheses with marginal gaps by photoelastic analysis. Materials and Methods A photoelastic model of a human mandible, partially edentulous distal to the canine, was made of PL-2 resin. Three ITI implants (4.1 × 10 mm, Straumann AG, Waldenburg, Switzerland) were placed in the posterior edentulous region, and screw- or cement-retained three-unit fixed partial dentures ( FPDs) were fabricated. Ill-fitting prostheses were made by placing a 100-μm gap between the abutments and the superstructures on the second premolar or the first molar. A static vertical force of 134 N was applied at three loading points on each prosthesis. Photoelastic stress analysis was carried out to measure the fringe order around the implant-supporting structures. Results Even in the unloaded condition, low-level stresses were generated around the implants after screw tightening or cementing the three-unit FPDs with marginal gaps. Loading on the terminal implants developed high concentrated stresses around the loaded implant, regardless of the types of restorations or the presence of gaps. However, when the middle implant was loaded, moderate stresses were distributed to the anterior and posterior implants. Conclusions Screw-retained FPDs with gaps exhibited a wider range of stresses on the interproximal region of adjacent implants than cement-retained FPDs. However, severe misfit in the prosthesis caused the nonaxial stress transfer to the adjacent implants in the cement-retained FPDs with gaps. [ABSTRACT FROM AUTHOR]

Protein acetylation has been implicated in playing an important role during mitotic progression. Aurora B kinase is known to play a critical role in mitosis. However, whether Aurora B is regulated by acetylation is not known. Using IP with an anti-acetyl lysine antibody, we identified Aurora B as an acetylated protein in PC3 prostate cancer cells. Knockdown of HDAC3 or inhibiting HDAC3 deacetylase activity led to a significant increase (P<0.01 and P<0.05, respectively) in Aurora B acetylation as compared to siLuc or vehicle-treated controls. Increased Aurora B acetylation is correlated with a 30% reduction in Aurora B kinase activity in vitro and resulted in significant defects in Aurora B-dependent mitotic processes, including kine-tochore-microtubule attachment and chromosome con-gression. Furthermore, Aurora B transiently interacts with HDAC3 at the kinetochore-microtubule interface of congressing chromosomes during prometaphase. This window of interaction corresponded with a transient but significant reduction (P=0.02) in Aurora B acetylation during early mitosis. Together, these results indicate that Aurora B is more active in its deacetylated state and further suggest a new mechanism by which dynamic acetylation/deacetylation acts as a rheostat to fine-tune Aurora B activity during mitotic progression. [ABSTRACT FROM AUTHOR]

It is common sense that refill packs can increase the repeated use of durable goods, reduce resource waste and be conducive to environmental protection. However, their existence also has an economic effect. For instance,.we find that the profit of a monopolistic firm will increase as a result of selling the refill packs when the depreciation rate of the durable good is low. In an extension of the model, we point out that there is an entrant that competes with the incumbent in relation to the composite goods and the refillpacks. In order to compete in terms of the prices of the composite goods, the incumbent sells the refill packs not only to increase profit, but also to reduce the amount of waste resulting from the durable goods. As for competing in regard to the prices of the refill packs, if the cost of the composite goods is small, then the incumbent's profit from selling the composite goods will increase. By comparing two extensions of the model, we find that the environmental effect of the price competition in regard to the refill packs is greater than the environmental effect of the price competition in relation to the composite goods. [ABSTRACT FROM AUTHOR]

Background: The periodontal status and effects of non-surgical periodontal treatment in patients with type 2 diabetes mellitus and periodontal disease are assessed. Methods: One-hundred patients with type 2 diabetes (mean ± SD hemoglobin (Hb)Alc level: 7.3% ± 0.94%) and periodontal disease were recruited for this study. The group with moderate-to-severe periodontal disease included patients with >1 tooth with a probing depth (PD) ≥5 mm and >2 teeth with a clinical attachment loss (AL) ≥6mm, and the group with mild periodontal disease included patients with <1 affected tooth, and >2 affected with a clinical AL ≥6mm. Patients (28 patients in the mild group and 72 patients in the moderate-to-severe group) underwent non-surgical periodontal treatments. We analyzed differences in serum concentrations of metabolic parameters (glycated hemoglobin and low-density lipoprotein), inflammatory parameters (interleukin [IL]-1β and C-reactive protein [CRP]), and periodontal parameters between the two groups before treatment and at 3, 6, 9, and 12 months post-therapy. Results: Seventy-five patients with diabetes (21 patients in the mild group and 54 patients in the moderate-to-severe group) completed the study. Significant differences in the plaque index (PI), gingival index (GI), PD, and clinical AL at examination times were observed in the whole cohort (P<0.05). We observed significant differences in the PI, GI, and PD in the moderate-to-severe group (P<0.05), whereas there was only a significant difference in PD in the mild group (P<0.05) between baseline and 12 months post-treatment. Both groups experienced improved glycemic control, but the difference was insignificant. CRP and IL- 1β levels were significantly different at examination times for the whole cohort (P<0.05). No significant positive association among metabolic and inflammatory parameters at 12 months post-therapy were found. Conclusion: Non-surgical periodontal treatment improved and maintained the periodontal health of patients with well-controlled diabetes, but no significant reduction of metabolic parameters was observed over a 1 -year period. [ABSTRACT FROM AUTHOR]

OBJECTIVE • To determine the effectiveness of the Resonance ureteral stent and clarify the risk factors that lead to stent failure. In the present study, we review our clinical experiences using Resonance stent in treating malignant and benign ureteral obstruction. PATIENTS AND METHODS • Nineteen patients with extrinsic malignant ureteral obstruction ( n = 15) and benign stricture ( n = 4) were retrospectively evaluated. • All patients had received Resonance stent insertion through antegrade or cystoscopic retrograde approaches. The pre-insertion and follow-up interventions included image studies and biochemical tests. The insertion success rate, obstruction patency rate and complications were reviewed. • For categorical variables, the chi-square test and Fisher's exact test were carried out to determine associations between variables. RESULTS • The technical success rate of stent insertion was 84.6%. The mean follow-up was 5 months (range 1-10.5 months). • Five stents failed to alleviate the obstruction, and the patency rate was 77.3% (17/22). • Patients who had had previous radiation therapy had a lower ureter patency rate in comparison with non-radiation patients (50% vs 92.3% respectively, P = 0.039). • The 6- and 9-month patency rates were 81.0% with 11 stents and 27.0% with 3 stents, respectively. CONCLUSIONS • The results of the present study demonstrated that malignant or benign ureteral obstruction could be treated safely and sufficiently with the Resonance metallic stent. • Careful patient selection is critical to achieve successful results. • For malignant ureteral obstruction, previous radiation therapy is a risk factor for stent failure. [ABSTRACT FROM AUTHOR]

Background. This study was undertaken to identify the genes in response to areca nut extract, a potential carcinogen of oral cancer. Methods. Two oral cancer sublines chronically treated with areca nut extract were established. Methods such as microarray and immunohistochemistry were used to screen and validate the genes' altered expressions in areca nut extractsublines or in cancer tissues. Results. A total of 35 genes were differentially expressed in both sublines. Several functional pathways were significantly altered. Six genes were confirmed over 2-fold of changes, including Ches1. Functional analyses showed that overexpression of Ches1 suppressed cell growth and arrested cells in the G2/M phase. Consistently, this gene has reduced expression in 52% of oral cancer tissues, which was significantly correlated with the areca nut chewing habit of patients (p = .04). Conclusion. We identified 35 candidates and validated 6 genes that may be associated with areca nut-induced oral cancer. Loss of Ches1 may be attributed to areca nut extract- induced oral carcinogenesis. [ABSTRACT FROM AUTHOR]

One of the major components of a photoresist formulation is polymer resin. Well‐defined diblock and random copolymer of tert‐butyl acrylate (tBA) and 4‐acetoxystyrene (StyOAc), as well as triblock and random tertpolymer of tBA, StyOAc, and Sty were prepared by reversible addition fragmentation chain transfer polymerization (RAFT) process. The polymers all possess Mwabout ten thousand and PDI less than 1.23. After hydrolysis under basic condition, the hydroxystyrene (StyOH) analogs are obtained and then are formulated as photoresist. Lithographic evaluation under KrF excimer laser shows that random copolymer based photoresist exhibits better S/L patterns according to SEM images. However, the lithographic performance of the terpolymer based resists is similar. © 2010 Wiley Periodicals, Inc. J Appl Polym Sci, 2010 [ABSTRACT FROM AUTHOR]

Background. Our aim was to examine the potential role of glucose-regulated protein (GRP)78 during oral cancer progression and the prognostic value in oral precancerous lesions. Methods. A total of 204 patients with oral cancer and 86 with precancerous lesions were investigated. GRP78 expression was determined in the lesion tissues by Western blot analysis. Association of GRP78 with clinicopathology or disease prognosis was examined using Fisher's exact, Kaplan–Meier, or Cox regression method. Results. Hyperexpression of GRP78 was found to be correlated with increasing malignant potential of oral lesions, with 14% in leukoplakia, 27% in erythroplakia, 50% in verrucous lesion, and 74% in oral cancer (p < .0001), suggesting this molecule plays a crucial role in the early steps of oral oncogenesis. In patients with precancerous lesions of the oral cavity, GRP78 expression predicts poorer same-site premalignancy-free survival (p = .002) and malignancy-free survival rates (p = .002). Conclusion. Determination of GRP78 expression levels might enable a better risk stratification for patients with oral premalignant lesions. © 2009 Wiley Periodicals, Inc. Head Neck, 2010 [ABSTRACT FROM AUTHOR]

Men with castration-resistant prostate cancer (PCa) frequently develop metastasis in bone. The reason for this association is unclear. We have previously shown that cadherin-11 (also known as OB-cadherin), a homophilic cell adhesion molecule that mediates osteoblast adhesion, plays a role in the metastasis of PCa to bone. Here, we report that androgen-deprivation therapy up-regulates cadherin-11 expression in PCa. In human PCa specimens, immunohistochemical staining showed that 22/26 (85%) primary PCa tumours from men with castration-resistant PCa expressed cadherin-11. In contrast, only 7/50 (14%) androgen-dependent PCa tumours expressed cadherin-11. In the MDA-PCa-2b xenograft animal model, cadherin-11 was expressed in the recurrent tumours following castration. In the PCa cell lines, there is an inverse correlation between expression of cadherin-11 and androgen receptor (AR), and cadherin-11 is expressed in very low levels or not expressed in AR-positive cell lines, including LNCaP, C4-2B4 and VCaP cells. We showed that AR likely regulates cadherin-11 expression in PCa through an indirect mechanism. Although re-expression of AR in the AR-negative PC3 cells led to the inhibition of cadherin-11 expression, depletion of androgen from the culture medium or down-regulation of AR by RNA interference in the C4-2B4 cells or VCaP cells only produced a modest increase of cadherin-11 expression. Promoter analysis indicated that cadherin-11 promoter does not contain a typical AR-binding element, and AR elicits a modest inhibition of cadherin-11 promoter activity, suggesting that AR does not regulate cadherin-11 expression directly. Together, these results suggest that androgen deprivation up-regulates cadherin-11 expression in prostate cancer, and this may contribute to the metastasis of PCa to bone. Our study suggests that therapeutic strategies that block cadherin-11 expression or function may be considered when applying androgen-ablation therapy. Copyright © 2010 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Lissencephaly is a devastating neurological disorder caused by defective neuronal migration. The LIS1 (or PAFAH1B1) gene was identified as the gene mutated in lissencephaly patients, and was found to regulate cytoplasmic dynein function and localization. In particular, LIS1 is essential for anterograde transport of cytoplasmic dynein as a part of the cytoplasmic dynein–LIS1–microtubule complex in a kinesin-1-dependent manner. However, the underlying mechanism by which a cytoplasmic dynein–LIS1–microtubule complex binds kinesin-1 is unknown. Here, we report that mNUDC (mammalian NUDC) interacts with kinesin-1 and is required for the anterograde transport of a cytoplasmic dynein complex by kinesin-1. mNUDC is also required for anterograde transport of a dynactin-containing complex. Inhibition of mNUDC severely suppressed anterograde transport of distinct cytoplasmic dynein and dynactin complexes, whereas motility of kinesin-1 remained intact. Reconstruction experiments clearly demonstrated that mNUDC mediates the interaction of the dynein or dynactin complex with kinesin-1 and supports their transport by kinesin-1. Our findings have uncovered an essential role of mNUDC for anterograde transport of dynein and dynactin by kinesin-1. [ABSTRACT FROM AUTHOR]

Aim: To report our experience of the tension-free vaginal tape-obturator (TVT-O) procedure for the treatment of severe female urodymanic stress incontinence (USI) during 2 years of follow-up. Methods: Between January 2005 and June 2007, 67 women with severe USI who underwent the TVT-O procedure were enrolled in the study. Pelvic examination, pad test, urodynamic study, and quality of life (QoL) assessment were performed pre- and post-operatively. Regular follow-up was arranged for analysis. Results: The median duration of follow-up was 24 months. The objective cure rate was 76.2%. The postoperative pad test revealed significant reduction of leakage. The subjective cure rate was 83.5%, and improvement occurred in 14.9%. The postoperative QoL showed significant improvement. One (1.5%) extrusion of tape occurred and three cases of de novo detrusor overactivity were detected. Three patients (4.4%) had immediate postoperative urine retention. No major complications occurred. Conclusion: Our results show that the TVT-O procedure is an effective and safe surgical procedure for severe female USI with satisfactory outcomes, significant improvement in quality of life, and few complications during 2 years of follow-up. [ABSTRACT FROM AUTHOR]

Sclerosing angiomatoid nodular transformation (SANT) is a peculiar splenic vascular lesion that is characterized by marked stromal sclerosis and the presence of plasma cells, which shares histopathological features associated with IgG4-related sclerosing disease. The cinicopathological features of 10 cases of SANT were reviewed and immunohistochemistry with IgG4 and IgG antibodies was performed. Nine other various splenic lesions served as controls. Five cases of SANT were found incidentally. Three cases of SANT had multiple tumors and five had associated abdominal disseminated calcifying fibrous tumors (CFT). IgG4+ plasma cells were found in all of the cases of SANT and in calcifying fibrous tumors. The densities of IgG4+ and IgG+ cells and the IgG4/IgG ratios were significantly higher in SANT than in control spleens ( P= 0.001, 0.006, and 0.028, respectively). Serum IgG4 concentration was elevated in one case. In conclusion, SANT can occur either as a solitary or as multiple tumors. Frequent association with abdominal disseminated CFT simulating carcinomatosis was observed. A statistically significant number of IgG4+ plasma cells was found in all of the cases of SANT and the associated CFT. Whether they are related to the IgG4-related sclerosing disease or not is debatable and warrants further investigation. [ABSTRACT FROM AUTHOR]

Aim: The aim of the present study was to assess by urodynamic study and chain urethrocystography the functional and anatomic changes before and after transobturator vaginal tape inside-out (TVT-O) operation. Methods: From January 2005 to February 2006, 35 women were enrolled who had urodynamic stress incontinence, with or without intrinsic sphincter deficiency, and had undergone TVT-O with regular follow-up. Investigations, including pelvic examination, pad test, urodynamic study, chain urethrocystography and questionnaire with short forms of Urogenital Distress Inventory and Incontinence Impact Questionnaire, were performed pre- and postoperatively. Results: The mean follow-up period was 12.8 months. The subjective and objective cure rates were 80 and 71.4%, respectively. The maximal urethral pressure was significantly decreased (from 67.0 to 58.9 cmH2O) after surgery and bladder neck mobility was reduced. Quality of life assessment revealed significant improvement after TVT-O. Conclusion: TVT-O is an effective operation for female urodynamic stress incontinence. Improved postoperative bladder neck mobility showed anatomic correction, indicating a hammock effect. The decreased maximal urethral pressure may reflect neurogenic damage during surgery; thus, minimal dissection and avoidance of unnecessary dissection to prevent periurethral damage are advised. [ABSTRACT FROM AUTHOR]

Background: Cutaneous Rosai-Dorfman disease (CRDD) shares the histopathological features of abundant plasma cells and stromal fibrosis with IgG4-related sclerosing disease. The possible role of IgG4+ plasma cells in CRDD was investigated. Methods: Twelve cases of CRDD were reviewed, and their lesions were immunostained with anti-IgG4 and anti-IgG antibodies. The number of IgG4+ and IgG+ plasma cells and their ratios were estimated. Serum IgG4 and IgG concentrations were measured in two recent cases. Results: Many IgG4+ and IgG+ plasma cells were found in all 12 cases. IgG4+ plasma cells ranged from 21 to 204 per high-power field (HPF) (mean 117/HPF), and IgG+ plasma cells ranged from 114 to 759/HPF (mean 349/HPF). All cases had more than 30 IgG4+ cells/HPF, except one case. The IgG4/IgG ratio ranged from 16% to 51% (mean 34%). Serum IgG4 concentration and serum IgG4/IgG ratio were increased in one recent case. Various degrees of stromal fibrosis were present in all cases. Conclusions: The presence of many IgG4+ plasma cells and stromal fibrosis suggests that CRDD may be related to IgG4-related sclerosing disease. Many IgG4+ plasma cells is another feature of CRDD, and serum IgG4 may be elevated. [ABSTRACT FROM AUTHOR]

Purpose: To explore the experiences of first-generation Chinese American parents while their infants are cared for in intensive care units (ICUs). Design: Because the study focus was on understanding the experiences of parents, a phenomenological approach was used, with open-ended questions that encouraged participants to describe events they perceived to be important. The data analysis procedure suggested by van Manen was used for the qualitative data analysis. Participants/Setting: A convenience sample of 25 first-generation Chinese American families, with infants hospitalized in the intensive care units of three teaching hospitals in the San Francisco area. Results: Seven themes were identified: perceived incompetence, self-blame, blame from others, filial piety, lack of support in the US, communication issues, and cultural differences. Conclusions: Both fathers and mothers experienced stress related to all identified themes. Findings suggest the need for more resources to educate and support families as well as culturally competent care within pediatric ICUs. Further study is critical to understand how the Chinese American's personal and family characteristics may influence stress perceptions when coping with their children's hospitalization. Clinical Relevance: This study can help healthcare providers to understand Chinese American parents’ perceptions while their infants are hospitalized in the ICU, which can enhance cultural competence care services. [ABSTRACT FROM AUTHOR]

Background: Several studies have suggested that the serotonin receptor 1B gene ( 5HT1B) may be important in the pathogenesis of alcohol dependence (alcoholism; ALC; AD). We examined whether 5HT1B gene A-161T polymorphisms (rs130058) are a susceptibility factor for total AD and subgroups of AD. We further explored correlation of this 5HT1B gene variant between anxiety–depression alcoholism (ANX/DEP ALC) and antisocial alcoholism (antisocial ALC) subgroups because of the high comorbidity of anxiety–depression, antisocial personality disorder, and AD. Methods: We recruited 522 Han Chinese in Taiwan for this study: 322 AD patients and 200 controls. The patient group was recruited primarily from medical teaching hospitals; patients with antisocial alcoholism were recruited from Taiwanese prisons. Individuals with AD were classified into 3 homogeneous clinical subgroups—pure alcoholism (pure ALC), ANX/DEP ALC, and antisocial ALC—using DSM-IV diagnosis. The 5HT1B gene A-161T polymorphism was determined using PCR–RFLP. Results: No significant differences in genotypic and allelic frequencies were found between controls and the total AD group or between controls and the 3 AD subgroups. However, there were significant differences in the 5HT 1B gene A-161T polymorphism at both the genotype and allelic levels between the ANX/DEP ALC and antisocial ALC subgroups. Conclusions: This study suggests that the 5HT1B gene A-161T polymorphism alone is not a risk factor for increasing susceptibility to either AD or its subtypes. However, 5HT1B gene A-161T polymorphisms might be one of the common genetic factors between the ANX/DEP ALC and antisocial ALC subgroups. [ABSTRACT FROM AUTHOR]

Background: Antisocial alcoholism is related to dopamine and serotonin which are catalyzed by monoamine oxidase A (MAOA) and acetaldehyde dehydrogenase 2 (ALDH2). The objective of this study is to determine whether the interaction between the MAOA and the ALDH2 genes is associated with subjects with antisocial personality disorder (ASPD) having alcoholism. Methods: A total of 294 Han Chinese men in Taiwan including 132 ASPD with alcoholism (Antisocial ALC) and 162 without alcoholism (Antisocial Non-ALC) were recruited in this study. Alcohol dependence and ASPD were diagnosed according to DSM-IV criteria. Genotypes of ALDH2 and MAOA-uVNTR were determined using PCR-RFLP. Results: A significant difference of ALDH2 polymorphisms ( p = 3.39E-05), but not of MAOA, was found among the 2 study groups. However, only after the stratification of the MAOA-uVNTR (variable number of tandem repeat located upstream) 3-repeat, a significant association between Antisocial Non-ALC and ALDH2*1/*2 or *2/*2 genotypes was shown ( p = 1.46E–05; odds ratio = 3.913); whereas stratification of MAOA-uVNTR 4-repeat revealed no association. Multiple logistic regression analysis further revealed significant interaction of MAOA and ALDH2 gene in antisocial ALC (odds ratio = 2.927; p = 0.032). Conclusion: The possible interaction of MAOA and ALDH2 gene is associated with Antisocial ALC in Han Chinese males in Taiwan. However, the protective effects of the ALDH2*2 allele against alcoholism might disappear in subjects with ASPD and carrying MAOA-uVNTR 4-repeat allele in the Han Chinese male population. [ABSTRACT FROM AUTHOR]

Mycobacterium tuberculosis generally reside in phagosomes within human macrophages that resist maturation and acidification, but exhibit significant heterogeneity. In this study we have constructed an IPTG-inducible GFP expression system in M. tuberculosis to assess the relationship between the metabolic status of M. tuberculosis and the degree of phagosomal maturation. Using these recombinant bacteria, we have found that, in human macrophages, M. tuberculosis that respond to IPTG with expression of GFP fluorescence, and hence are metabolically active, reside in non-acidified phagosomes that have not fused with Texas red dextran pre-labelled lysosomes. In contrast, M. tuberculosis that fail to express GFP in response to IPTG, and hence are metabolically inactive, reside within acidified phagosomes that have fused with Texas red dextran labelled lysosomes. These studies demonstrate that metabolic activity of M. tuberculosis correlates strongly with phagosomal maturation and that the inducible GFP expression system is useful for assessing metabolic activity of intracellular M. tuberculosis. [ABSTRACT FROM AUTHOR]

The article focuses on study which determined prognostic factors that predict which patients with relapse squamous cell carcinoma of the oral cavity may benefit from salvage therapy. The five-year disease-specific survival (DSS) and overall survival were the basis in choosing the optimum cutoff point for relapse. The study found that 10 months was the optimal cutoff value for relapse and late relapses were associated with a better prognosis than relapses that occurred within the first 10 months.

The article focuses on a study that aims to determine the clinical outcome of patients with distant metastases (DM) from head and neck cancer. The authors conducted a clinicopathologic review of 899 patients with oral cavity squamous cell carcinoma (OSCC) to identify independent predictors of the 5-year DM rate. It concludes that the different risk factor categories according to locoregional control may be used to facilitate the selection of appropriate management for patients with OSCC.

The article provides information on a study that sought to identify accurate prognosticators in patients with stage III/IVA oral cavity squamous cell carcinoma (OSCC). It describes methodology used in the study. It concludes that the survival rates for pT4 NO OSCC in patients with stage IVA OSCC are better than those for NO pT4 NO and similar to those of patients with pstage III.

A physics-based model is provided for predicting the impact of climate change on stream temperature and, in turn, on Formosan landlocked salmon (Oncorhynchus masouformosanus) habitat. Because upstream watersheds on Taiwan Island are surrounded with high and steep mountains, the influence of mountain shading on solar radiation and longwave radiation is taken into account by using a digital elevation model. Projections using CGCM2 and HADCM3 models and CCCM and GISS models provided information on future climatic conditions. The results indicate that annual average stream temperatures may rise by 0.5°C (HADCM3 short term) to 2.9°C (CGCM2 long term) due to climate change. The simulation results also indicate that the average suitable habitat for the Formosan landlocked salmon may decline by 333 m (HADCM3 short term) to 1633 m (CGCM2 long term) and 166 m (HADCM3 short term) to 1833 m (CGCM2 long term) depending on which thermal criterion (17°C and 18°C respectively) is applied. The results of this study draw attention to the tasks of Formosan landlocked salmon conservation agencies, not only with regard to restoration plans of the local environment, but also,to the mitigation strategies to global climate change that are necessary and require further research. [ABSTRACT FROM AUTHOR]

Lean is about getting more out of a company's resources, which leads to increased output at slower rates of investment in growing markets or the ability to meet relatively constant or declining demand with fewer resources than otherwise needed. © 2006 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Objective: This study investigates the change in new diastolic indices in uremic patients who undergo regular hemodialysis (H/D). Materials and Methods: We studied uremic patients receiving regular H/D. All patients were sinus rhythm before H/D. They had normal left ventricular systolic performance without regional wall motion abnormality. Patients were separated into two groups according to whether they had significant aortic or mitral regurgitation (AR or MR) or not. They received complete transthoracic echocardiographic examinations. Stroke volume (SV) was calculated as the product of the time-velocity integral (TVI) and cross-sectional area of aortic annulus. Flow propagation velocity (FPV) was measured by color M-mode echocardiography in apical four-chamber view. Mitral annulus tissue Doppler velocities—peak systolic (Sa), early diastolic, and late diastolic—were measured from septal and lateral wall. All these parameters were obtained immediately before and after H/D. Paired data were compared. Result: H/D amount was strongly correlated with the change of SV. After H/D, the reduction of SV in patients without AR or MR (control group) was obvious but it was not significant in patients with significant AR or MR (study group). There were significant differences in mitral inflow velocities, FPV, and mitral annular velocities (except septal Sa) in the control group. In the study group, predialytic and postdialytic parameters of new diastolic indexes had no statistical difference. Conclusion: New echocardiographic indexes of uremic patients with significant AR or MR were relatively preload-independent. The phenomenon was possibly related to insignificant change of SV after H/D. [ABSTRACT FROM AUTHOR]

In this article we discuss the interplay between extended producer responsibility (EPR) and technological change and innovation (TCI) in Norway. We ask whether Norwegian EPR policy has an effect on TCI and, if so, whether it makes any difference how the EPR policies are designed. By carrying out a comparative study between the plastic packaging (PP) sector and electrical and electronic (EE) sector in Norway, we conclude that there is a correlation between Norwegian EPR policy and TCI, but the causality is rather weak. EPR has an effect on downstream activities through increased recycling and indirectly through institutional innovation and learning. It does not, however, make a significant difference how the policies are designed, because they are considered similar by a majority of actors contributing financially to the EPR schemes. As for technological change and innovation upstream, the role of Norwegian EPR policies in the observed trends is not significant. Other factors such as the EPR-based Restriction on Hazardous Substances (RoHS) Directive promulgated by the European Union (EE sector) and the need for competitiveness (PP sector) seem far more important. In order to make collective EPR policies more powerful in inducing technological change and innovation, decision-makers should consider more specific measures that directly address the core businesses of the producers. [ABSTRACT FROM AUTHOR]

An 84-year-old Asian woman with hypertension and chronic renal failure was evaluated for incoherent speech, followed by intermittent interruptions of consciousness, and then status epilepticus after ingesting one star fruit (Averrhoa carambola) each day for 3 days. Conventional first-line anticonvulsants and hemodialysis were administered without significant control of the patient's seizures. Treatment was started with propofol, an intravenous agent that induces anesthesia with rapid onset and elimination from the central nervous system; this resulted in complete control of the seizures. Propofol may be an effective alternative when dialysis and conventional first-line anticonvulsants are unsuccessful in treating the symptoms of neurotoxicity. [ABSTRACT FROM AUTHOR]

Molecular-genetic technology and statistical methods based on principles of population genetics provide valuable information to wildlife managers. Genetic data analyzed in a hierarchical, spatial context among individuals and among populations at micro- and macro-geographic scales has been widely used to provide information on the degree of population structure and to estimate rates of dispersal. Our goals were to (1) provide an overview of spatial statistics commonly used in empirical population genetics, and (2) introduce analytical designs that can be employed to extend hypothesis-testing capabilities by incorporating space-time interactions and by using information on habitat quality, distribution, and degree of connectivity. We show that genetics data can be used to quantify the degree of habitat permeability to dispersal and to qualify the negative consequences of habitat loss. We highlight empirical examples that use information on spatial genetic structure in areas of harvest derivation for admixed migratory species, wildlife disease, and habitat equivalency analysis. [ABSTRACT FROM AUTHOR]