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transcatheter aortic valve implantation ( tavi ) is a minimally invasive and safe treatment alternative for severe symptomatic aortic valve stenosis in high - risk patients who are considered unsuitable for open heart surgery due to their increased risk profiles . based on the results of the partner trial , tavi proc...	transcatheter aortic valve implantation is a treatment alternative for high - risk patients with severe aortic stenosis who are not eligible for conventional open aortic valve replacement . we describe a case of a rare but serious complication in the form of ventricular embolization of an edwards sapien - xt aortic v...
the template thus generated contained a t7 promoter , followed sequentially by a shine - dalgarno ( sd ) sequence , a his6 tag , a termination codon ( tag ) , and a flag tag ( see fig 1 ) , with the sequence : 5-ggg aga gga ggc aac gac atg gcc gcc cac cac cac cac cac cac gcc ggc gcc gaa cag aag gaa gaa gac cgc gag ( ...	during normal translation , binding of a release factor to one of the three stop codons ( uga , uaa or uag ) results in termination of protein synthesis . however , modification of the initial uridine to a pseudouridine ( ) allows efficient recognition and read - through of these stop codons by a transfer rna ( trna...
laccases ( benzenediol : oxygen oxidoreductases [ ec 1.10.3.2 ] ) are copper - containing enzymes catalyzing the oxidation of a broad number of phenolic compounds and aromatic amines by using molecular oxygen as the electron acceptor , which is reduced to water . this group of enzymes has attracted increasing scien...	statistical approaches were employed for the optimization of different cultural parameters for the production of laccase by the white rot fungus fomes fomentarius mucl 35117 in wheat bran - based solid medium . first , screening of production parameters was performed using an asymmetrical design 2533//16 , and the va...
despite vigorous effort and substantial financial investments , we still do not have in hand a pluripotent stem cell ( psc ) that can be safely and efficiently employed to regenerate damaged tissues and organs . despite a lot of promises , it is difficult even in animal models to demonstrate , in a reproducible way , t...	the concept that adult tissue , including bone marrow ( bm ) , contains early - development cells with broader differentiation potential has again been recently challenged . in response , we would like to review the accumulated evidence from several independent laboratories that adult tissues , including bm , harbor ...
morbid obesity ( mo ) [ body - mass index ( bmi ) > 40 kg / m ] is considered the most serious stage of the disease , with a population prevalence of 68% in the us and 1 - 2% in spain . therefore , many people are living with a higher risk of dying from complications of their obese status , or living with a disab...	bariatric surgery is currently the most effective therapy to induce weight loss in morbidly obese patients . objective . this controlled , clinical trial with a two - year intervention was aimed at comparing the efficacy of two nonsurgical approaches versus bariatric surgery , on body weight changes and metabolic par...
during 20102011 , we enrolled 58 adults who sought care at queen elizabeth central hospital in blantyre , malawi , for unexplained paraplegia in this study . the study was approved by the college of medicine research and ethics committee ( p.99/00/92 ) . serum and csf samples obtained from 12 paraplegia patients we...	to identify unknown human viruses , we analyzed serum and cerebrospinal fluid samples from patients with unexplained paraplegia from malawi by using viral metagenomics . a novel cyclovirus species was identified and subsequently found in 15% and 10% of serum and cerebrospinal fluid samples , respectively . these da...
tennis players have to perceive and interpret information quickly and effectively , thereby providing sufficient time to plan , initiate and execute a successful shot ( filipcic et al . , 2009a ) . through specifically oriented tennis practices , tennis players also develop perception skills and anticipation , define...	abstractthe purpose of the study was to determine the timing of a split - step in three categories of tennis players in four groups of strokes . subjects were divided into three groups : male and female junior , and male professional tennis players . during two tournaments , all matches were recorded with two fixed...
scale - free brain activity ( he , 2014 ) has been examined and modeled on many levels , from neurotransmitter release ( lowen et al . , 1997 ) , neuronal spiking ( levina , a. , et al . , 2007 , rubinov , m. , et al . , 2011 ) and local field potentials ( bedard and destexhe , 2009 ) , slow cortical potentials ( he ...	backgroundmagnetic resonance imaging ( mri ) has highlighted the effects of chronic cocaine exposure on cerebral structures and functions , and implicated the prefrontal cortices in deficits of cognitive control . recent investigations suggest power spectrum scale invariance ( pssi ) of cerebral blood oxygenation lev...
intraoperative and postoperative bleeding remains a common major complication of surgery.15 an aging population with growing comorbidities and high anticoagulant use are important factors that contribute to high surgical bleeding risks.68 surgical bleeding can range from mild or moderate in intensity to severe or traum...	backgroundbleeding remains a common occurrence in surgery . data describing the burden of difficult - to - control bleeding and topical absorbable hemostat use are sparse . this study was conducted to estimate the clinical and economic impact that remains associated with uncontrolled surgical bleeding , even when h...
a 35-year - old woman with marfan syndrome was admitted at 37 weeks gestational age ( ga ) . a previous pregnancy at 33 years of age culminated in a missed abortion at 6 weeks ga , for which a dilatation and curettage was performed at our hospital under monitored anesthesia with propofol and remifentanil . she unde...	pregnancy is considered a period of high risk for cardiovascular complications in patients with marfan syndrome . therefore the choice of anesthetic technique for delivery should be focused on minimizing hemodynamic fluctuations , and preferably provide adequate post - operative pain control . for this purpose , neur...
in islet transplantation , the failure of insulin independence is brought about by the loss of islet grafts , caused by instant blood - mediated inflammatory reaction , immune rejection , non - specific inflammation or ischemia of the donor islets . therefore , monitoring the condition of transplanted islets is impor...	a 39-y - old man , who had an episode of pancreatic bleeding due to chronic pancreatitis , received total pancreatectomy with islet autotransplantation ( tp with iat ) . intraoperative ultrasound ( us ) examination was done to detect transplanted islets and evaluate the quality of us imaging . islet isolation from ...
total extraperitoneal repair ( tep ) of inguinal hernia repair is now a well recognised technique with similar recurrence and complication rates to open and transabdominal pre - peritoneal ( tapp ) laparoscopic repair ( 12 ) . here we present an unusual complication of the presentation of a strangulated femoral herni...	a 63 year old female underwent an uncomplicated total extraperitoneal repair of a right direct inguinal hernia . one week later she presented with a strangulated left femoral hernia . we believe the dissection of the extraperitoneal space caused bleeding which tracked down through the femoral canal resulting in a f...
	although important to heterogeneous catalysis , the ability to accurately model reactions of polyatomic molecules with metal surfaces has not kept pace with developments in gas phase dynamics . partnering the specific reaction parameter ( srp ) approach to density functional theory with ab initio molecular ...
the human tear film coats the anterior surface of the eye and is composed of three distinct layers : an inner mucin coating , a middle aqueous component , and a lipid overlay . traditionally , the mucin layer was felt to be derived from goblet cells of the conjunctiva , the aqueous component from the lacrimal gland , a...	the human tear film is a 3-layered coating of the surface of the eye and a loss , or reduction , in any layer of this film may result in a syndrome of blurry vision and burning pain of the eyes known as dry eye . the lacrimal gland and accessory glands provide multiple components to the tear film , most notably the a...
fungi form a large and heterogeneous eukaryotic group of living organisms characterized by their lack of photosynthetic pigment and their chitinous cell wall . it has been estimated that the fungal kingdom contains more than 1.5 million species , but only around 100,000 have so far been described , with yeast , mold ...	plant pathogenic fungi cause important yield losses in crops . in order to develop efficient and environmental friendly crop protection strategies , molecular studies of the fungal biological cycle , virulence factors , and interaction with its host are necessary . for that reason , several approaches have been per...
chromium ( cr ) is the seventh most abundant available element on the earth and 21st in the earth 's crust , with an average concentration of 100 mg / kg . l due to the toxic effects of cr(vi ) and the potential for oxidation of cr(iii ) to cr(vi ) . the discharge of cr(vi ) to surface water the presence of an exc...	the distribution and mobility of chromium in the soils and sludge surrounding a tannery waste dumping area was investigated to evaluate its vertical and lateral movement of operational speciation which was determined in six steps to fractionate the material in the soil and sludge into ( i ) water soluble , ( ii ) excha...
it is very important to identify the underlying cause of ear symptoms such as tinnitus and hearing loss . if these symptoms present unilaterally , a retocochlear lesion , vascular lesion or inner ear anomaly should be considered in the diagnostic process . many diagnostic tools have been suggested for use in the ev...	background and objectivesunilateral auditory dysfunction such as tinnitus and hearing loss could be a warning sign of a retrocochlear lesion . auditory brainstem response ( abr ) and internal auditory canal magnetic resonance image ( mri ) are suggested as novel diagnostic tools for retrocochlear lesions . however ...
mindfulness - based therapies have been found to be effective in treating internalizing disorders;[14 ] reducing both the symptoms of anxiety and depression , and the cognitive biases that play a central role in the etiology and maintenance of these problems . given the marked increase in depression prevalence during a...	backgroundmindfulness - based therapies have been shown to be effective in treating depression and reducing cognitive biases . anxiety sensitivity is one cognitive bias that may play a role in the association between mindfulness and depressive symptoms . it refers to an enhanced sensitivity toward symptoms of anxie...
the iodine deficiency leads to goiter and a spectrum of health consequences like stillbirth , mental retardation , deaf mutism , squint , dwarfism , goiter , neuromotor defects etc . iodine deficiency disorder ( idd ) has been recognized as a major public health problem in india . in india , more than 200 million p...	background : iodine deficiency disorder ( idd ) is a public health problem in uttarakhand state.objective:the present study was conducted in district udham singh nagar , uttarakhand state with an objective to assess the status of iodine deficiency amongst school age children ( 6 - 12 years).materials and methods : thir...
dipyridamole was introduced in the early 1960s as a coronary vasodilator , most often administered orally , and is currently approved in the united states for prophylactic thromboembolism prevention following surgery . as a platelet inhibitor , indicated for the secondary prevention of transient ischemic attack , it in...	abstractdipyridamole was introduced decades ago as a treatment for angina , subsequently found to inhibit platelet aggregation . it is most commonly used , and approved for use in thromboembolism prevention , following surgery . some of its recognized effects such as adenosine uptake inhibition , elevation of camp ...
balance is a complex process involving coordination of multiple sensory , motor , and biomechanical components . an individual senses the position of his or her body in relation to gravity and the surroundings by combining visual , vestibular , and somatosensory inputs1 . balance movements also involve moti...	[ purpose ] this study investigated efficacy of virtual reality ( vr)-based balance training on enhancing balance and postural reactions of adults as a low - cost new modality compared to the established biodex balance system ( bbs ) . [ subjects ] thirty normal adults of both genders were divided randomly into...
the combination of cardiac and renal disease significantly increases the complexity and cost of health care . the chronic kidney disease associated with heart failure has been recognized as an independent risk factor for morbidity and mortality [ 25 ] . the rate of cardiovascular mortality in the chronic kidney dis...	imaging of the kidney and the heart can provide valuable information in the diagnosis and management of cardiorenal syndromes . ultrasound- ( us- ) based imaging ( echocardiogram and renal us ) is an essential component in the initial diagnostic workup of crs . echocardiography provides information on the structure...
osteochondromas are cartilage - capped bony protrusions originating juxta - cortically from the endochondral bones . it is considered as the most common tumor of the axial skeleton found mainly in the metaphysis of long bones . it commonly occurs in adolescence or childhood with 80% of the cases seen in the first t...	osteochondromas are benign bony tumors which are commonly believed to originate by the proliferation of epiphyseal cartilage into the surrounding tissues . however , this hypothesis can not explain the occurrence of this tumor in the intramembranous bones and soft tissue . since most of the craniofacial bones have ...
myoepithelial tumors consist of a family of morphologically similar lesions with an evolving nomenclature based on anatomic origin : pleomorphic adenoma of salivary gland , chondroid syringoma of skin and myoepithelioma or mixed tumor of somatic soft tissue and bone . malignant forms , though rare , have been describ...	we report a case of primary malignant mixed tumor ( mmt ) of bone in an 18-year - old boy with x - ray , ct , mr , scintigraphic , fdg pet , and pathologic correlation . primary mmt of bone is a highly aggressive tumor and presents both a diagnostic and clinical treatment challenge . this tumor is extremely rare an...
wrky proteins are key regulators of gene expression during sar . ( a , b ) the pr-1 gene is thought to be regulated by three transcription factors : a tga - bzip factor and an unknown factor that activate transcription , and a wrky factor that represses transcription . sni1 is a negative regulator of pr-1 gene expres...	dna microarrays are being used to comprehensively examine gene expression networks during the plant defense response that is triggered when a plant encounters a pathogen or an elicitor molecule . in addition to identifying new genes induced during defense , these studies are providing new insights into the complex pa...
the prodrug approach has often been used to overcome pharmaceutical , pharmacokinetic , and pharmacodynamic barriers that limit parent drug efficacy . maintaining the efficacy of the parent drug requires that the prodrug be transformed back to its pharmacologically active parent form in order to exert its t...	human cytomegalovirus ( hcmv ) is a prevalent virus that infects up to 90% of the population . the goal of this research is to determine if small molecular prodrug substrates can be developed for a specific hcmv encoded protease and thus achieve site - specific activation . hcmv encodes a 256 amino acid s...
in vietnam , despite prevention efforts and treatment programs to control the epidemic , hiv rates among men who have sex with men ( msm ) are increasing [ 13 ] . hiv / aids related stigmas are known barriers to prevention , care , and treatment efforts [ 46 ] . they also influence testing and treatment behaviors b...	objective . to develop and assess a homosexuality - related stigma scale among men who have sex with men ( msm ) in hanoi , vietnam . methods . we conducted a cross - sectional study using respondent - driven sampling in hanoi , vietnam , in 2011 . we used a cross - validation approach . factor analysis was per...
with 50 million neurons and several hundred kilometers of axons terminating in almost one trillion synapses for every cubic centimeter , yet consuming only about 20 w of energy for the entire cortex , the brain is arguably one of the most complex and highly efficient information processing systems known ( hart , 1975 ...	in recent years , predictive coding strategies have been proposed as a possible means by which the brain might make sense of the truly overwhelming amount of sensory data available to the brain at any given moment of time . instead of the raw data , the brain is hypothesized to guide its actions by assigning causal bel...
the formation of g - quadruplex folds by telomeric dna is thought to play a role in telomere regulation . it has been shown that g - quadruplex ligands binding specifically to the telomeric g - quadruplex structure effectively alter telomere capping and cause the senescence or apoptosis of cancer cells [ 15 ] . a var...	the binding mode of telomestatin to g - quadruplex dna has been investigated using electrospray mass spectrometry , by detecting the intact complexes formed in ammonium acetate . the mass measurements show the incorporation of one extra ammonium ion in the telomestatin complexes . experiments on telomestatin alone ...
ir spectroscopy has been an analytical tool available in some form since the 1930s ; however , it is only been within the last decade that the area of tissue imaging with ft - ir has exploded . the advances in ft - ir for tissue imaging have been driven in a large part by three key developments : 1 ) increased speed ...	high - definition fourier transform infrared ( ft - ir ) spectroscopic imaging is an emerging approach to obtain detailed images that have associated biochemical information . ft - ir imaging of tissue is based on the principle that different regions of the mid - infrared are absorbed by different chemical bonds ( e....
apart from the physical examination , endoscopy , computed tomography ( ct ) and magnetic resonance imaging ; positron emission tomography ( pet ) ct has evolved to become an integral component in the management of patients with head and neck pathologies . in head and neck , pet - ct is commonly used in the staging ,...	18-fluorodeoxyglucose positron emission tomography - computed tomography ( pet - ct ) is an integral part of imaging in the follow - up of head and neck malignancies . very often distinguishing inflammatory / infective from malignant recurrence can not be made confidently with standard uptake value ( suv ) alone , as...
the etiological factor for patients categorised as primary osteoarthrosis are not known in majority of the patients.1 various morphological and genetic factors have been implicated in the etiology of primary osteoarthritis of the hip.2 femoroacetabular impingement ( fai ) has been postulated as the important cause of p...	background : femoroacetabular impingement has been postulated as the important cause of primary osteoarthritis in non dysplastic hips . we postulated that the rarity of primary osteoarthritis of hip in indian population could be attributable to morphological differences , specifically to a lower prevalence of abnorma...
health care improvement and technological advances have extended the average life expectancy . as a result , aging populations and accompanying comorbid conditions are becoming increasingly serious , leading to increases in the use of health care including ventilator usage . in the united states , the number of patient...	background : it is not clear whether the benefits of tracheostomy remain the same in the population . this study aimed to better examine the effect of tracheostomy on clinical outcome among prolonged ventilator patients.methods:data were from the medical claims data in taiwan . a total of 3880 patients with ventila...
seroma is one of the most bothersome events that disturbs both the patient and surgeon with multiple visits that delay starting the adjuvant therapy and cause great patients ' discomfort with a possibility of increased surgical site infection [ 13 ] . postmastectomy seroma can be defined as a collection of serous flu...	background . postmastectomy seroma causes patients ' discomfort , delays starting the adjuvant therapy , and may increase the possibility of surgical site infection . objective . to evaluate quilting of the mastectomy flaps with obliteration of the axillary space in reducing postmastectomy seroma . methods . a ...
basal activity of the mammalian olfactory bulb is synchronized to breathing ; during odor sensing the principal neurons of the olfactory bulb , the mitral and tufted cells ( mtcs ) , are firing in repetitive bursts that are locked to the breathing rhythm [ 14 ] . this property is reminiscent of theta - gamma coupling...	during odor sensing the activity of principal neurons of the mammalian olfactory bulb , the mitral and tufted cells ( mtcs ) , occurs in repetitive bursts that are synchronized to respiration , reminiscent of hippocampal theta - gamma coupling . axonless granule cells ( gcs ) mediate self- and lateral inhibitory inte...
this was a cross - sectional study with 321(190 men and 131 women ) participants waiting at the medical centers of tehran . they were recruited through random cluster sampling from the second , third and seventh districts of tehran medical centers ( private , governmental and charity ) , hospitals and clinics . the...	objectivethis study aimed to develop and validate a questionnaire to measure waiting anxiety.methodsthis was a cross - sectional study . extensive review of literature and expert opinions were used to develop and validate the waiting anxiety questionnaire . a sample of 321 participants was recruited through random ...
from february 2006 to february 2007 , the senior author ( ybj ) performed one hundred seventy - two consecutive primary total knee arthroplasties in one hundred twenty - four patients . the bilateral total knee arthroplasties were performed in forty - eight patients ( 96 knees ) who received the low contact stress ro...	backgroundwe compared clinical outcomes after total knee arthroplasty with the low contact stress ( lcs ) rotating platform mobile bearing knee system and the press fit condylar sigma rotating platform high flexion ( pfc sigma rp - f ) mobile bearing knee system.methodsfifty cases of total knee arthroplasty were perfor...
noise is recognized as a major pollutant of the mining environment . due to improvement in mechanization and continuous operation in mines , the spatial distribution of mining activity also changes faster nowadays due to faster mining with more machines at work . the problems of noise in indian mines exist since lo...	background : noise mapping being an established practice in europe is hardly practiced for noise management in india although it is mandatory in indian mines as per guidelines of the directorate general of mines safety ( dgms ) . as a pilot study , noise mapping was conducted in an opencast mine with three different ...
the world health organization ( who ) , together with the joint united nations programmme on aids ( unaids ) and other partners have a stated goal of providing worldwide access to antiretroviral therapy ( art ) 1 . data worldwide show that there is increasing accessibility to hiv treatment . in 2011 , approximately 8 m...	key clinical messageacquired hiv drug resistance following poor adherence is common . we report a case of hiv - infected patient with poor cd4 gain and self reported poor adherence . investigations revealed high viral load and resistance to nrtis and nnrtis with sensitivity to boosted pis . hivdr mutations create...
health assessment is the most important issue in pediatrics field and the most valuable point in pediatric care . although normal growth and development are not necessarily a sign for lack of a serious or chronic disease , it can be used to have a general judgment about children 's health . in the past two decades ...	introduction : growth and development monitoring could lead to general judgment about children 's health . with advances in nicus establishment , the survival rate of very low birth weight ( vlbw ) neonates has increased in many countries including iran . because of the lack of studies about growth and development patt...
full - thickness gastrointestinal defects such as perforation , leak , and fistula arise from various causes and frequently require admission to the intensive care unit and a long hospital stay [ 1 - 5 ] . historically , full - thickness gastrointestinal defects have been treated with a combination of reoperation , d...	full - thickness gastrointestinal defects such as perforation , anastomotic leak , and fistula are severe conditions caused by various types of pathologies . they are more likely to require intensive care and a long hospital stay and have high rates of morbidity and mortality . after intentional full - thickness op...
sickle cell disease ( scd ) is a genetic disorder caused by the substitution of valine for glutamic acid at the sixth position of the amino acid -chain of the haem molecule [ 1 , 2 ] and is characterized by the possession of sickle haemoglobin . it is a significant cause of morbidity and mortality among black individ...	background . abnormal lipid homeostasis in sickle cell disease ( scd ) is characterized by defects in plasma and erythrocyte lipids and may increase the risk of cardiovascular disease . this study assessed the lipid profile and non - hdl cholesterol level of scd patients . methods . a hospital - based cross - s...
owing to the large variety of morphologies reported , the possibility of synthetically fine - tuning their structure and their documented application in chemical and electrical devices , nanowires have come to represent a major field of research interest in recent years . among the features that can be synthetically co...	zno nanowires have been grown by chemical vapour deposition ( cvd ) using pdzn bimetallic nanoparticles to catalyse the process . nanocatalyst particles with mean particle diameters of 2.6 0.3 nm were shown to catalyse the growth process , displaying activities that compare well with those reported for sputtered sys...
adhesion to extracellular matrix ( ecm ) proteins is involved in almost every aspect of tumor cell metastasis including adhesion of circulating tumor cells in the vascular bed , invasion through the basement membrane , and growth of the new metastasis at a distant site . in addition , contact with the ecm stimulates ...	thrombospondin-1 ( tsp-1 ) is involved in a variety of different cellular processes including cell adhesion , tumor progression , and angiogenesis . this paper reports the novel finding that tsp-1 upregulates integrin 6 subunit in human keratinocytes and human breast cancer cells resulting in increased cell adhesion ...
the metabolic syndrome describes a cluster of risk factors for the development of diabetes and cardiovascular disease . the latest clinical definition of the metabolic syndrome by the international diabetes federation and the american heart association / national heart , lung , and blood institute states that three...	the metabolic syndrome refers to a well defined group of risk factors , including central obesity and inflammation , for the development of diabetes and cardiovascular disease . interestingly , many studies have recently led to the emergence of somewhat unexpected relationships between several infectious diseases and...
till date to our knowledge and available literature only three cases of lymphangiosarcoma arising in post filarial lymphedema have been reported . cutaneous angiosarcoma is an uncommon aggressive tumor of the capillary and lymphatic endothelial cell origin . post mastectomy chronic lymphedema is the most frequent s...	we are reporting a case of 36 yr old female with chronic filarial lymphedema of both legs . subsequently she developed lymphangiosarcoma of her left leg which was confirmed histologically and on immunohistochemistry . only three more cases of lymphagiosarcoma occurring in patients with filarial lymphedema are revie...
cerebellar transcranial direct current stimulation ( cerebellar tdcs ) is increasingly used in neurophysiology laboratories , and its use begins in clinical research [ 1 , 2 ] . the technique consists in delivering for minutes through a surface scalp electrode a weak ( 12 ma ) direct current over the cerebellum . ...	cerebellar transcranial direct current stimulation ( cerebellar tdcs ) is a non - invasive technique for inducing prolonged functional changes in the human cerebellum . available data show that this simple and safe technique can modulate several motor and non - motor cerebellar functions in healthy humans . also , ...
with the introduction of lung cancer screening , pulmonary nodules will be encountered with increasing frequency , smaller sizes , and some of those will be located peripherally . the diagnosis of peripheral lung lesions is challenging as the yield of flexible bronchoscopy and sputum cytology is relatively low . fo...	background : computed tomography ( ct ) guided biopsies have long been the standard technique to obtain tissue from the thoracic cavity and is traditionally performed by interventional radiologists . ultrasound ( us ) guided biopsy of pleural - based lesions , performed by pulmonologists is gaining popularity and has...
it is well established that open cholecystectomy has worse outcomes than laparoscopic cholecystectomy [ 13 ] . in 1993 , the national institutes of health ( nih ) consensus conference on gallstones and laparoscopic cholecystectomy reported lower mortality , decreased disability , shorter los , and less patient discomfo...	introduction . the aim of this study was to characterize national trends in adoption of laparoscopic cholecystectomy and determine differences in outcome based on type of surgery and patient age . methods . retrospective cross - sectional study of patients undergoing cholecystectomy . trends in open versus lapa...
myocardial bridging ( mb ) is a congenital anomaly in which a segment of a major epicardial coronary artery courses through the myocardium , and is covered by myocardial muscle fibers ( 1 ) . mb can cause clinical symptoms such as myocardial ischemia / infarction , arrhythmia , or even sudden death , despite the beli...	backgroundmyocardial bridging ( mb ) is a congenital anomaly in which a segment of a major epicardial coronary artery courses through the myocardium . this anomaly can lead to myocardial ischemia , arrhythmia , and even death . the effectiveness of coronary computed tomographic angiography ( ccta ) in the detection...
the fields of palliative and end - of - life care are plagued by semantic confusion . the confusion has resulted in conflation of these concepts around concerns about death and dying that limit understanding of their distinct and synergistic properties . this paper illustrates the distinctions between as well as th...	objective . to illustrate distinctions and intersections of palliative care ( pc ) and end - of - life ( eol ) services through examples from case - centered data of older adults cared for during a four - year ethnographic study of an acute care hospital palliative care consultation service . methods . qualitative na...
health systems provide a variety of services which can improve human health conditions ; however , using of these services may lead to catastrophic health expenditures or impoverishment for households ( 1 ) . the main purpose of health financing is to ensure that the required funding is available . in fact , health...	abstractbackgroundthis study aimed at identifying components of the household health costs.methodsthis study was a qualitative research conducted in two main phases . the first phase consisted of interviews with sample households selected in eight provinces of iran . they were to identify components of the househol...
clostridium difficile colitis is the most common cause of nosocomial - related diarrhea . in the united states , the incidence of hospital - acquired clostridium difficile infection ( cdi ) increased by 2 to 2.5-fold from the late 1990s to the early 2000s . even though , many attempts have been made to address this e...	intravenous immunoglobulin ( ivig ) has been utilized in patients with recurrent and refractory clostridium difficile colitis . it is increasingly being used in patients with initial clinical presentation of severe colitis . herein , we report a case of severe c. difficile colitis successfully treated with ivig wit...
the heart , as the primary organ for supplying body s blood , requires nutrition and oxygen . narrowing or blockage of coronary arteries , defects blood supply to the heart , and leads to heart failure and heart attack . the walls of blood vessels are normally characterized by flat , slick , and delicate surface ; ...	background : the incidence of restenosis in patients suffering from coronary artery disease after undergoing angioplasty is of paramount importance . accordingly , this study aimed to investigate factors affecting the time of the first incidence of restenosis in patients undergone angioplasty in the city of zanjan , ...
we report and describe the presentation and management of a rare case of symptomatic ureterosciatic hernia ( ush ) . the robot - assisted laparoscopic technique of repair of ush has not been reported in the english literature . to our knowledge , this is the first such reported case of symptomatic ush that was repair...	ureterosciatic hernia ( ush ) is a rarely described entity and is an extremely rare cause of refractory flank pain . we report the diagnostic dilemma , and sequential endourological and finally the successful robotic management of one such symptomatic ush in an elderly woman who had presented with ipsilateral refract...
a 55-year - old female without a history of coronary artery disease , hypertensive for 17 years duration was admitted with chest pain at rest . her electrocardiography revealed negative t - wave in anterior chest leads ( fig . 1 ) , and t waves were returned to normal fashion without medical treatment within 10 minut...	a 55-year - old female without a history of coronary artery disease , hypertensive for the past 17 years , was admitted with resting chest pain . electrocardiography revealed a negative t - wave in anterior chest leads . coronary angiography visualised anomalous coronary anatomy , with a common origin of the right ...
to define the incubation period for andes virus infection , we identified 20 patients with a well - defined period of exposure to a high - risk area among 106 persons with hcps enrolled in research protocols ( treatment interventions , contact studies , quantitative viremia during hcps ) or interviewed by 1 of the auth...	the potential incubation period from exposure to onset of symptoms was 739 days ( median 18 days ) in 20 patients with a defined period of exposure to andes virus in a high - risk area . this period was 1432 days ( median 18 days ) in 11 patients with exposure for < 48 hours .
renal transplantation is possibly the best form of renal replacement therapy that helps in reversal or amelioration of many effects of end - stage renal disease ( esrd ) , an important one of these being anemia and requirement of erythropoietin ( epo ) . post - transplantation anemia ( pta ) may still occur due to di...	anemia is not uncommon in the post - renal transplant period and has been reported in up to 40% of renal transplant recipients . it is commonly due to drugs and infections . while post - transplantation anemia is usually due to graft dysfunction and drugs such as mycophenolate and cotrimoxazole , tacrolimus is an unc...
continuous curvilinear capsulorhexis ( ccc ) is considered the standard and a critical step of anterior capsule opening in modern cataract surgery ( either phacoemulsification or manual sutureless extracapsular cataract extraction ) . cystotome and forceps are two of the most commonly used instruments for a ccc , des...	we modified a 2-bend cystotome for continuous curvilinear capsulorhexis ( ccc ) in manual or phacoemulsification cataract surgery to improve the safety and ease of performance . a 26 g needle was converted into a cystotome with 3 bends . in this retrospective study , the performance of modified 3-bend cystotome was c...
the processes of professionalisation and specialisation in health care have long been of interest to both historians and sociologists , among others . both can be seen as at least in part about laying claim to , developing and protecting knowledge and expertise that finally allows control over a particular domain . b...	significant attention has been paid to the history of public health in england during the final part of the twentieth century . within this , however , the field that came to be known as specialist health promotion ( shp ) has been relatively neglected . between 1980 and 2000 those working in this field , generally kno...
very few cases of pure , primary scc of the stomach are reported in world literature . an 80-year - old postmenopausal female presented with complaint of epigastric pain for 2 weeks . she gave a history of on and off fever 2 months back , which was diagnosed as typhoid and she received treatment for the same . pe...	very few case reports of pure squamous cell carcinoma ( scc ) of stomach are available in the world literature . the exact pathology of this uncommon carcinoma in stomach remains unknown . this is an additional case report of scc in an elderly female arising in the gastric antrum . she underwent distal gastrectom...
popular american films penetrate nearly every aspect of contemporary western life , and to an only somewhat lesser degree most all cultures of the world . historically , there are powerful sociological , cultural , economic , and even political reasons for this , but we would also argue that hollywood - style film has ...	we measured 160 english - language films released from 1935 to 2010 and found four changes . first , shot lengths have gotten shorter , a trend also reported by others . second , contemporary films have more motion and movement than earlier films . third , in contemporary films shorter shots also have proportiona...
to report a case of bilateral bullous exudative retinal detachment in central serous chorioretinopathy ( csc ) which was attached by vitrectomy and internal drainage of the subretinal fluid . a 47-year - old man affected by bilateral atypical csc with a bullous retinal detachment with subretinal exudate . a fluores...	purposeto report a case of bilateral bullous exudative retinal detachment in central serous chorioretinopathy ( csc ) which was attached by vitrectomy and internal drainage of the subretinal fluid.methodsa 47-year - old man affected by bilateral atypical csc with a bullous retinal detachment with subretinal exudate . a...
in the first half of 20 century , mortality from colorectal surgery often exceeded 20% , mainly due to sepsis . infectious complications , however still are a major cause of morbidity and mortality in colorectal surgery . mechanical bowel preparation ( mbp ) bowel preparation by orthograde cleansing prior to colore...	background : in the first half of 20th century ; mortality from colorectal surgery often exceeded 20% , mainly due to sepsis . modern surgical techniques and improved perioperative care have significantly lowered the mortality rate . mechanical bowel preparation ( mbp ) is aimed at cleansing the large bowel of feca...
during the immediate period after solid organ transplantation , rejection of the transplanted organ as well as the short - term survival rate of the patient is of primary concern . overcoming the shortcomings of currently available surgical techniques and immunosuppressants accordingly , greater emphasis has been pla...	postrenal transplantation diabetes mellitus ( ptdm ) , or new - onset diabetes after organ transplantation , is an important chronic transplant - associated complication . similar to type 2 diabetes , decreased insulin secretion and increased insulin resistance are important to the pathophysiologic mechanism behind t...
epidemiological studies suggested that genetic susceptibility related to the inflammatory processes have been identified as a major contributing factor to inflammatory bowel diseases ( ibd ) . molecular data from total genome scans and from candidate gene studies have led to the identification of genetic determinants...	aimin this study , we determined the relationship between the serum level of il-23 and the severity of ulcerative colitis ( uc ) among our population.backgrounda recent major breakthrough for describing the pathogenesis of intestinal tissue injury in inflammatory bowel disease ( ibd ) is the pathway related to interleu...
cancer morbidity worldwide is growing . however in the united states , the overall morbidity slightly decreased in 2013 , ( by > 0.6%/yr in men , but it was stable in women ) , while the mortality rates decreased by 1.8%/yr in men and by 1.5%/yr in women . the lung was the site of the highest cancer mortality in both...	lung cancer is one of the most common malignant tumors , and it has the highest death rate . oncothermia is a feasible and successful treatment for lung cancer . results show a remarkable survival benefit for patients , with a good quality of life . the treatment has no , or in some cases mild , side - effects an...
the maldi - tof ms spectrum of ezakiella massiliensis is available at http://www.mediterranee-infection.com/article.php?laref=256&titre=urms-database . strain marseille p2951 was deposited both in the collection de souches de l'unit des rickettsies ( csur , wdcm 875 ) and in deutsche sammlung von mikroorganismen...	we report the primary characteristics of ezakiella massiliensis strain marseille p2951 (= dsm 103122 = csur p2951 ) , a new member of the ezakiella genus . strain marseille p2951 was isolated from a vaginal sample taken from an asymptomatic 20-year - old woman who had sex with another woman who had bacterial vagi...
otodental syndrome is a rare autosomal dominant disease characterized by generalized posterior teeth enlargement and sensorineural , high - frequency hearing loss . the condition has also been reported with various names , including otodental dysplasia and oculo - oto - dental ( ood ) syndrome . denes and csiba fir...	abstractotodental syndrome is a rare autosomal - dominant disease characterized by globodontia , associated with sensorineural , high - frequency hearing loss . here , we describe the clinical , pathological , and genetic evaluations of a 9-year - old girl with otodental syndrome and multiple complex odontoma.the patie...
although detection of the modified residues is crucial for understanding of the physiological roles of proteins as well as their mechanisms and pathways , it still represents a challenge . it is especially true in case of global proteome studies , in which hundreds or thousands of modified sites are monitored at the ...	strong cation exchange ( scx ) chromatography has been utilized as an excellent separation technique that can be combined with reversed - phase ( rp ) chromatography , which is frequently used in peptide mass spectrometry . although scx is valuable as the second component of such two - dimensional separation methods ...
marfan syndrome is an autosomal dominant connective tissue disorder characterized by a combination of clinical manifestations in different organ systems . patients with marfan syndrome ( mfs ) whose lifetimes are extended may be encountered as acute abdomen ( appendicitis ) cases apart from the obligatory reasons and...	introductionmarfan syndrome is an autosomal dominant connective tissue disorder characterized by a combination of clinical manifestations in different organ systems . patients with marfan syndrome ( mfs ) whose lifetimes are extended may be encountered as acute abdomen ( appendicitis ) cases apart from the obligatory...
coronary artery disease ( cad ) represents an important public health burden . aside from the traditional risk factors , compelling evidence has now accumulated in support of inflammation as an important risk factor . it has a pivotal role in all stages of atherosclerosis from endothelial dysfunction and plaque forma...	objective . to investigate the relationship between inflammatory markers and atherogenic lipoprotein subfractions . methods . we studied 520 eligible subjects who were not receiving any lipid - lowering therapy . the inflammatory markers including white blood cell ( wbc ) count , high - sensitivity c - reactive p...
orei et al . compared serum metabolite profiles between children who eventually developed t1d and those who remained healthy and autoantibody - free ( 6 ) . this analysis uncovered characteristic metabolic changes only in the children who later developed t1d , including reduced serum succinate , phoshatidylcholine , ...	a new study reveals distinctive metabolic changes that precede the development of type 1 diabetes ( t1d ) , tossing a stone into the quiet waters of t1d immunology and genetics . the causes of these metabolic changes and their relationship to autoimmunity and cell destruction are not yet known , but the identificati...
in this paper i will develop a fair description of the structure of suicidal mental life and of lived self - determination from the first - person - perspective applying a phenomenological method . this should allow us to achieve a profound description of the intricate linkages between a person s sense of self - dete...	in this paper phenomenological descriptions of the experiential structures of suicidality and of self - determined behaviour are given ; an understanding of the possible scopes and forms of lived self - determination in suicidal mental life is offered . two possible limits of lived self - determination are described ...
quadricuspid aortic valve ( qav ) , a rare congenital heart defect with an incidence range of 0.008 % to 0.033%,1 , 2 was first reported by balington et al.3 in former years , qav was an accidental finding during surgery or necropsy , but recent improvements in echocardiographic imaging techniques have conferred an eas...	quadricuspid aortic valve ( qav ) is an uncommon congenital anomaly which was an incidental finding during surgery or autopsy in the past . we present the case of a 44-year - old woman with moderately severe aortic regurgitation due to unequal cusp size qav diagnosed via transesophageal echocardiography . due to ec...
a : amyloid beta ; ad : alzheimer 's disease ; est : expressed sequence tag ; fad : familial alzheimer 's disease ; gwas : genome - wide association studies ; ld : linkage disequilibrium ; nsaid : non - steroidal anti - inflammatory drug ; snp : single nucleotide polymorphism ; ucsc : university of california santa cru...	alzheimer 's disease is a progressive neurodegenerative disorder with high prevalence in old age . it is the most common cause of dementia , with a risk reaching 50% after the age of 85 years , and with the increasing age of the population it is one of the biggest healthcare challenges of the 21st century . genetic...
	cortical development involves synaptic formation and elimination . while synaptogenesis predominates earlier and pruning later , the two processes are thought to happen concurrently . since in adults synaptic strength is modulated by behavioral state , we asked if synaptic remodeling may be affected by sleep and wake...
p. p. george thanks the bar - ilan research authority for a post - doctoral fellowship .	the reaction of pentaethoxy niobate , nb(oet)5 , at elevated temperature ( 800 c ) under autogenic pressure provides a chemical route to niobium oxide nanorods coated with amorphous carbon . this synthetic approach yielded nanocrystalline particles of nb2o5@c . as prepared nb2o5@c core - shell nanorods is annealed un...
by the end of the 20 century , embryology of female urogenital system was accepted to be a truly - settled issue . while the utero - cervical development was believed to be from paired paramesonephric ducts ; sinovaginal bulb from urogenital sinus was thought to develop into lower vagina ; the kidneys and ureters wer...	we present here a case of an uncommon complex uterine anomaly obstructed hemivagina with ipsilateral renal agenesis ( ohvira ) , also known as herlyn - werner - wunderlich syndrome in a 14-year - old girl along with sonographic ( trans - abdominal and trans labial ) , and mri findings . the patient underwent surgery...
the national health and nutrition examination survey ( nhanes ) iii is an ongoing survey of the national center for health statistics that includes both interview and physical examination components . approximately 10,000 nationally representative civilian adults and children are sampled annually , with an oversampli...	objectivetwo lower - extremity diseases ( leds ) , including peripheral neuropathy and peripheral vascular disease ( pvd ) , are leading causes of disability in the u.s . although leds can be complications of diabetes , their prevelances and risk factors apart from diabetes are poorly described . this study describ...
the hemispheric asymmetry reduction in older adults ( harold ) model , describing the finding that older adults ( 65 + years of age ) demonstrate increased bilateral prefrontal cortex recruitment across different memory and cognitive tasks , was originally proposed by cabeza ( 2001 ) a decade ago . in the interim , the...	there is a fundamental gap in understanding how brain structural and functional network connectivity are interrelated , how they change with age , and how such changes contribute to older adults sensorimotor deficits . recent neuroimaging approaches including resting state functional connectivity mri ( fcmri ) and di...
fluoride has become a recurring theme in discussing water issues and particularly water quality issues in india . in karnataka , where much of groundwater sources are concentrated with fluorides and nitrates , the impact is devastating . dental and spine - related ailments are showing up in many cities and villages ....	background : fluoride has become a recurring theme in discussing water issues in india . in karnataka , where groundwater sources are concentrated with fluorides the impact is devastating . dental and spine - related ailments are showing up in many cities and villages . several villages in pavagada taluk in tumku...
e2 is an endogenous female sex steroid hormone and very important in the estrous cycle and the development of reproductive organs in human and animals . as a hormone binding to its ers are expressed in the estrogen - dependent organs such as endometrium , breast and ovary . there are two forms of ers , er and er , ...	acting as hormone mimics or antagonists in the interaction with hormone receptors , endocrine disrupting chemicals ( edcs ) have the potentials of disturbing the endocrine system in sex steroid hormone - controlled organs and tissues . these effects may lead to the disruption of major regulatory mechanisms , the onse...
two hundred five alk - positive cases identified using ihc or fish on biopsied and resected specimens from samsung medical center were enrolled from january 2007 to may 2013 . the basic characteristics of these cases ( age , sex , and tumor stage ) , method of sampling ( biopsy or operation ) , and results of ihc and...	background : since 2007 when anaplastic lymphoma kinase ( alk ) rearrangements were discovered in non - small cell lung cancer , the alk gene has received attention due to alk - targeted therapy , and a notable treatment advantage has been observed in patients harboring the eml4/alk translocation . however , using al...
diabetes is a chronic disease that approximately involves 350 million people ( 6.5% ) worldwide , with an increasing trend to some 440 million ( 7.8% ) by 2030 . it is burdened by microangiopathic ( nephropathy , retinopathy , and neuropathy ) and macroangiopathic complications ( cardiovascular disease and fatal or n...	introduction . critical limb lschemia ( cli ) and particularly diabetic foot ( df ) are still considered cinderella in our departments . anyway , the presence of arterial obstructive disease increases the risk of amputation by itself ; when it is associated with foot infection , the risk of amputation is greatly...
polycythemia vera ( pv ) is a hematologic disease that is characterized by accumulation of phenotypically normal red blood cells , white blood cells , and platelets . the disease is diagnosed by a combined approach of laboratory investigations , bone marrow histology , and detection of characteristic mutations.1,2 a ...	polycythemia vera is a rare myeloproliferative disease . cutaneous symptoms are uncommon . we report about a 72-year - old female patient with jak2v617f - positive polycythemia who developed peripheral sensorimotor axonal neuropathy and erythromelalgia . possible causes and treatment are discussed .
	in hydroformylation , phosphorus - based directing groups have been consistently successful at placing the aldehyde on the carbon proximal to the directing group . the design and synthesis of a novel catalytic directing group are reported that promotes aldehyde formation on the carbon distal relative to the...
synovial cysts with neurologic symptoms are common in the lumbar spine , but rare in the cervical spine . most cervical synovial cysts are found incidentally , but may cause cervical radiculopathy or myelopathy due to compression of the spinal cord or nerve roots . a review of the literature revealed only 31 cases of...	synovial cysts of the cervical spine , although they occur infrequently , may cause acute radiculopathy or myelopathy . here , we report a case of a cervical synovial cyst presenting as acute myelopathy after manual stretching . a 68-year - old man presented with gait disturbance , decreased touch senses , and increa...
surgical and prosthetic rehabilitation can offer functional and aesthetic improvements to post - maxillectomy patients . despite advances in surgical procedures , surgical reconstruction of maxillectomy defects is not always possible because of the general health condition of the patient.1 in addition , the ability t...	the majority of maxillary defects can be rehabilitated with conventional simple obturator prosthesis . however , inadequate retention , stability and support may be associated with the use of an obturator . precision attachments have been used to retain obturators for some time . the use of precision attachments in...
the international nucleotide sequence database collaboration ( insdc ; http://www.insdc.org ) represents one of the most celebrated global initiatives in public domain data sharing . growing from efforts in the early 1980s to capture and present the increasing volumes of sequence and annotation that arose from the emer...	under the international nucleotide sequence database collaboration ( insdc ; http://www.insdc.org ) , globally comprehensive public domain nucleotide sequence is captured , preserved and presented . the partners of this long - standing collaboration work closely together to provide data formats and conventions that e...
	exposure to estrogens during various stages of development has been shown to irreversibly influence responsive target organs . the recent finding of the presence of estrogen receptor in both osteoblasts and osteoclasts has suggested a direct role of steroid hormones on bone tissue . furthermore , estrogens have imp...
	in natural settings , microbes tend to grow in dense populations [ 14 ] where they need to push against their surroundings to accommodate space for new cells . the associated contact forces play a critical role in a variety of population - level processes , including biofilm formation [ 57 ] , the colonization of por...
inflammatory bowel disease ( ibd ) is a multifactorial disorder of the gastrointestinal tract including crohn 's disease ( cd ) and ulcerative colitis ( uc ) . although considerable progress has been made in the field of ibd research , the underlying etiopathogenesis is still under investigation . it is assumed tha...	inflammatory bowel diseases ( ibd ) are multifactorial disorders resulting from environmental and genetic factors . polymorphisms in mdr1 and gsts genes might explain individual differences in susceptibility to ibd . we carried out a case - control study to examine the association of mdr1 ( c1236 t and c3435 t ) , ...
telomeres are located at the end of linear eukaryotic chromosomes and consist of repetitive ttaggg dna sequences and specific interacting proteins that together form a capping structure that prevents chromosomal damage and degradation . a small amount of telomere length is normally lost during each cell division , with...	abnormal telomere attrition has been found to be closely related to patients with saa in recent years . to identify the incidence of telomere attrition in saa patients and investigate the relationship of telomere length with clinical parameters , saa patients ( n = 27 ) and healthy controls ( n = 15 ) were enrolled i...
modern preventive dentistry advancements , the widespread public acceptance of fluoridation and the greater emphasis on dental hygiene have considerably affected the nature of dental care profession . although fluoride application has led to significant caries decrease in smooth surfaces of enamel and cementum , it h...	background : marginal seal has a principal role in durability and clinical success of fissure sealants . the aim of this study was to compare the microleakage of two materials used as pit and fissure sealant with different methods of application.methods:the 55 extracted premolars were assigned randomly to one of the ...
dissection of cervical vessels is generally uncommon in the population , but unfortunately , it is a relatively frequent cause of stroke in young patients . in recent years , an interesting correlation was noticed between scuba diving and the dissection of the major arteries of the neck , promoting the identification o...	carotid and vertebral artery dissection are relatively frequent and risky conditions . in the last decade , different patients with extracranial ( and in 1 case also intracranial ) dissections associated with the practice of scuba diving were reported . the connection between the two conditions has not been fully exp...
spontaneous coronary artery dissection ( scad ) is an unusual cause of acute coronary syndrome ( acs ) or sudden cardiac death . here , we present a case of scad in a young man who presented with stroke , followed by a review of the literature on this rare clinical entity . a 26-year - old right - handed caucasian ...	spontaneous coronary artery dissection ( scad ) is an unusual cause of acute coronary syndrome or sudden cardiac death . scad has most frequently been described as presenting as an acute coronary syndrome in females during the peripartum period . it may also be associated with autoimmune and collagen vascular disea...
circulating alloantibodies are found in a substantial number of renal allograft recipients , and the presence of these alloantibodies is significantly correlated with the development of allograft injury and later graft loss [ 13 ] . in renal allograft tissue , chronic injury is represented microscopically as transplant...	the treatment for chronic active antibody - mediated rejection ( camr ) remains controversial . we investigated the efficacy of rituximab ( rtx ) and intravenous immunoglobulin ( ivig ) for camr . eighteen patients with camr were treated with rtx ( 375 mg / m2 ) and ivig ( 0.4 g / kg ) for 4 days . the efficacy...
the ultimate aim of periodontal plastic surgery is the coverage of gingival recession which may lead to patient esthetic problem , root caries , or dentinal hypersensitivity , or when it hampers proper plaque removal . various surgical techniques have been proposed for the correction of dental root exposition like fr...	various etiological factors are associated with gingival recession which may be anatomical , physiologic , or pathologic factors . several root coverage procedures have been described to manage the gingival recession . however , it has been found that root coverage procedures in miller 's class iii and iv gingival ...
of all smooth muscle tumours originating from uterus are leiomyomas are the most common ones . benign nature and smooth muscle origination of leiomyomas can be easily documented via histological examination.1 moreover leiomyomas , which are the most common neoplasm of uterus , malignant tumours only constitutes 1% of u...	background : of all smooth muscle tumours originating from uterus are leiomyomas are the most common ones . benign nature and smooth muscle origination of leiomyomas can be easily documented via histological examination . in present study it was tried to examine immunohistochemical profile of leiomyomas with differ...

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