[Natural healing factors of Nalchik resort in medical rehabilitation of the patients with post-traumatic stress disorder. (Randomized controlled trial)]. / Prirodnye lechebnye faktory kurorta «Nal'chik¼ v meditsinskoi reabilitatsii patsientov s posttravmaticheskim stressovym rasstroistvom. (Randomizirovannoe kontroliruemoe issledovanie).

INTRODUCTION: In order to optimize rehabilitation measures for post-traumatic stress disorder (PTSD) it is advisable to use natural therapeutic factors in the medical rehabilitation programmes of this category of patients, which is due to the pronounced psycho-corrective effects of climatic landscape therapy and nitrogen-thermal waters. AIM: To study psycho-corrective effects of a new rehabilitation technique for the patients suffering from PTSD using natural therapeutic factors of Nalchik resort. MATERIAL AND METHODS: Thera has been carried out a randomized controlled trial that included 74 patients with PTSD. Two groups were formed by simple randomization: in the control group (CG/n=38) the patients had standardized pharmacotherapy, physical training and individual psychocorrection in accordance with federal clinical recommendations; in the main group (MG/n=36) terrencourt in the natural park of Nalchik resort and nitrogen-thermal baths were additionally prescribed. The effectiveness of rehabilitation measures was monitored using a questionnaire to assess the therapeutic dynamics of PTSD, the Beck Hopelessness scale, as well as the Neurotech Kolibri wireless BFB complex (Russia). RESULTS: A comparative analysis of monitoring of psycho-emotional status indicators proved the feasibility of the developed medical rehabilitation programme for PTSD patients. A significant improvement in psychoemotional status was observed according to the questionnaire for assessing the therapeutic dynamics of PTSD (on average by 2 times, p<0.01), according to the Beck hopelessness scale, according to which the clinically assessed suicidal risk and hopelessness level were reduced by 1.7 (p<0.01) times with the patients in the MG. According to the analysis of brain biopotentials during the primary training, the patients had insufficient control over the course of mental activity (63%), and at the end of the course the indicator improved to 97% (p<0.01). In the CG positive dynamics on both scales of psychological testing and analysis of brain biopotentials was significantly lower (by 12-15%, p<0.05-p<0.01). CONCLUSION: After including in the standardized rehabilitation programme controlled walking in the mid-mountain Natural Park and nitrogen-thermal baths of Nalchik resort, there was a significant improvement in the psycho-emotional status of the patients suffering from PTSD, which indicates their psychocorrective effects and provides great opportunities to improve the effectiveness of medical rehabilitation.

Observation of chemically protected polydimethylsiloxane: towards crack-free PDMS.

The current modification of polydimethylsiloxane (PDMS) substrates via oxygen plasma treatment causes surface cracks. Here, we demonstrate a method to prevent crack formation by chemical treatment. Chemical modification renders the surface hydrophilic for several days and is effective in preserving the elasticity of the PDMS surface at the nanoscale level.

Pinus ponderosa: A checkered past obscured four species.

PREMISE OF THE STUDY: Molecular genetic evidence can help delineate taxa in species complexes that lack diagnostic morphological characters. Pinus ponderosa (Pinaceae; subsection Ponderosae) is recognized as a problematic taxon: plastid phylogenies of exemplars were paraphyletic, and mitochondrial phylogeography suggested at least four subdivisions of P. ponderosa. These patterns have not been examined in the context of other Ponderosae species. We hypothesized that putative intraspecific subdivisions might each represent a separate taxon. METHODS: We genotyped six highly variable plastid simple sequence repeats in 1903 individuals from 88 populations of P. ponderosa and related Ponderosae (P. arizonica, P. engelmannii, and P. jeffreyi). We used multilocus haplotype networks and discriminant analysis of principal components to test clustering of individuals into genetically and geographically meaningful taxonomic units. KEY RESULTS: There are at least four distinct plastid clusters within P. ponderosa that roughly correspond to the geographic distribution of mitochondrial haplotypes. Some geographic regions have intermixed plastid lineages, and some mitochondrial and plastid boundaries do not coincide. Based on relative distances to other species of Ponderosae, these clusters diagnose four distinct taxa. CONCLUSIONS: Newly revealed geographic boundaries of four distinct taxa (P. benthamiana, P. brachyptera, P. scopulorum, and a narrowed concept of P. ponderosa) do not correspond completely with taxonomies. Further research is needed to understand their morphological and nuclear genetic makeup, but we suggest that resurrecting originally published species names would more appropriately reflect the taxonomy of this checkered classification than their current treatment as varieties of P. ponderosa.

New Technique for Human Sperm Cryopreservation Using Emptied Sheep's Ovarian Follicles.

This study aimed to investigate the efficacy of emptied ovarian follicles of sheep as a container for cryopreservation of human spermatozoa to preserve the presence of low concentrations of spermatozoa at the post-thawing stage. This research was performed on 30 semen samples from oligozoospermic patients and 10 samples from normozoospermic males. They were diagnosed according to the standard criteria of the World Health Organization 2010. Semen samples were classified into four groups of G1-G4 according to sperm concentration: 3-5 million/mL, 6-10 million/mL, 11-15 million/mL, and 16-20 million/mL, respectively. Each sample was divided into two equal parts. One part was cryopreserved without cryoprotectant, while the other was diluted 1:1 with 10% glycerol-based cryosolution. The ovarian follicles of sheep were obtained from a local slaughterhouse and prepared by slicing the ovaries and evacuating the follicular fluid and oocyte. The emptied follicles were injected with the prepared semen samples. After cryopreservation and thawing, the semen mixture aspired outside the follicles, and sperm parameters were measured, namely concentration, progressive motility, total motility, and normal morphology. Sperm concentration and progressive and total sperm motility were significantly (P<0.01) decreased in all groups at the post-thawing stage, compared to the pre-freezing stage. The sperm concentration was significantly higher (P<0.01) in samples cryopreserved without cryoprotectant, compared to that in those cryopreserved with glycerol. However, progressive and total motility were significantly (P<0.01) higher in samples cryopreserved with glycerol, compared to that in the samples cryopreserved without cryoprotectant in all groups. Moreover, no significant difference was found between the pre-freezing and post-thawing stages in terms of normal morphology. Emptied ovarian follicles are an appropriate carrier for cryopreservation of human sperms, especially for patients with oligozoospermia. The best sperm survival rate in this technique was observed when using glycerol-based cryosolution.

An optimization method for studying fractional-order tuberculosis disease model via generalized Laguerre polynomials.

Tuberculosis (TB) is a deadly contagious disease that affects vital organs of the body, especially the lungs. Although the disease is preventable, there are still concerns about its continued spread. Without effective prevention or appropriate treatment, TB infection can be fatal to humans. This paper presents a fractional-order TB disease (FTBD) model to analyze TB dynamics and a new optimization method to solve it. The method is based on the basis functions of generalized Laguerre polynomials (GLPs) and some new operational matrices of derivatives in the Caputo sense. Finding the optimal solution to the FTBD model is reduced to solving a system of nonlinear algebraic equations with the aid of GLPs using the Lagrange multipliers method. A numerical simulation is also carried out to determine the impact of the presented method on the susceptible, exposed, infected without treatment, infected with treatment, and recovered cases in the population.

Unveiling the Electronic Structure of Pseudotetragonal WO3 Thin Films.

WO3 is a 5d compound that undergoes several structural transitions in its bulk form. Its versatility is well-documented, with a wide range of applications, such as flexopiezoelectricity, electrochromism, gating-induced phase transitions, and its ability to improve the performance of Li-based batteries. The synthesis of WO3 thin films holds promise in stabilizing electronic phases for practical applications. However, despite its potential, the electronic structure of this material remains experimentally unexplored. Furthermore, its thermal instability limits its use in certain technological devices. Here, we employ tensile strain to stabilize WO3 thin films, which we call the pseudotetragonal phase, and investigate its electronic structure using a combination of photoelectron spectroscopy and density functional theory calculations. This study reveals the Fermiology of the system, notably identifying significant energy splittings between different orbital manifolds arising from atomic distortions. These splittings, along with the system's thermal stability, offer a potential avenue for controlling inter- and intraband scattering for electronic applications.

Normal feeding behavior, body weight and leptin response require the neuropeptide Y Y2 receptor.

Neuropeptide Y (NPY), a 36-amino-acid peptide widely expressed in the brain is involved in many physiological responses, including hypothalamic control of food intake and cardiovascular homeostasis. NPY mediates its effects through binding to the Y1, Y2 and Y5 G-protein-coupled receptors. Little is known of the role of the Y2 receptor in mediating the different NPY effects. We inactivated the Y2 receptor subtype in mice and found that these mice developed increased body weight, food intake and fat deposition. The null mutant mice showed an attenuated response to leptin administration but a normal response to NPY-induced food intake and intact regulation of re-feeding and body weight after starvation. An absence of the Y2 receptor subtype also affected the basal control of heart rate, but did not influence blood pressure. These findings indicate an inhibitory role for the Y2 receptor subtype in the central regulation of body weight and control of food intake.

Optimal solution of the fractional order breast cancer competition model.

In this article, a fractional order breast cancer competition model (F-BCCM) under the Caputo fractional derivative is analyzed. A new set of basis functions, namely the generalized shifted Legendre polynomials, is proposed to deal with the solutions of F-BCCM. The F-BCCM describes the dynamics involving a variety of cancer factors, such as the stem, tumor and healthy cells, as well as the effects of excess estrogen and the body's natural immune response on the cell populations. After combining the operational matrices with the Lagrange multipliers technique we obtain an optimization method for solving the F-BCCM whose convergence is investigated. Several examples show that a few number of basis functions lead to the satisfactory results. In fact, numerical experiments not only confirm the accuracy but also the practicability and computational efficiency of the devised technique.

[Twinkling artifact on Doppler US: clinical presentations]. / L'artefact de scintillement en écho-Doppler et situations cliniques.

Twinkling artifact characterized by a rapidly fluctuating mixture of Doppler signals occurs behind a strongly reflecting granular interface such as urinary tract stones or gallstones. It may occurs in association with several clinical situations, and may sometimes be helpful for diagnosis while it may sometimes be a pitfall that must be recognized by the sonographer. After reviewing the technical nature of this artifact, several cases will be presented to illustrate the advantages and pitfalls related to this artifact.

[Diabetes and erectile dysfunction in Morocco: epidemiological study among outpatients]. / Diabète et dysfonction erectile au Maroc : etude epidémiologique auprès d'une population de consultants.

We studied the relationship between erectile dysfunction (ED) and diabetes among 189 men (> 40 years) attending primary health care centres in Morocco. Of the 89 diabetic men, 82% had ED while only 17% of the 100 non-diabetic men had ED. The frequency of ED among diabetic men increased with age, from 60% in those aged 40-49 years to 94.95% in those aged > or = 60 years (from 6.3% to 35.4% in men without diabetes for similar ages). ED was reported by 93.3% of diabetic men who had had diabetes for > 15 years. The frequency of ED did not differ with type of diabetes but it was significantly commoner in diabetic men with a low level of education and with hypertension.

Environmental hydro-refugia demonstrated by vegetation vigour in the Okavango Delta, Botswana.

Climate shifts at decadal scales can have environmental consequences, and therefore, identifying areas that act as environmental refugia is valuable in understanding future climate variability. Here we illustrate how, given appropriate geohydrology, a rift basin and its catchment can buffer vegetation response to climate signals on decadal time-scales, therefore exerting strong local environmental control. We use time-series data derived from Normalised Difference Vegetation Index (NDVI) residuals that record vegetation vigour, extracted from a decadal span of MODIS images, to demonstrate hydrogeological buffering. While this has been described previously it has never been demonstrated via remote sensing and results in relative stability in vegetation vigour inside the delta, compared to that outside. As such the Delta acts as a regional hydro-refugium. This provides insight, not only to the potential impact of future climate in the region, but also demonstrates why similar basins are attractive to fauna, including our ancestors, in regions like eastern Africa. Although vertebrate evolution operates on time scales longer than decades, the sensitivity of rift wetlands to climate change has been stressed by some authors, and this work demonstrates another example of the unique properties that such basins can afford, given the right hydrological conditions.

Adenosine and neuropathic pain.

Recent studies have reported the possibilities of relieving neuropathic pain by administering adenosine or its analogs. In order to determine if there exists a metabolic anomaly of this nucleoside in patients with neuropathic pain, circulating adenosine levels were compared in three patient groups. The first was composed of individuals suffering from neuropathic pain, the second of patients with nervous system lesions in the absence of pain, and the third was composed of patients suffering from pain resulting from excessive nociception. The adenosine blood levels of these patients were compared to those of a control group. Finally, adenosine in the cerebrospinal fluid (CSF) of some patients was also assayed. The results show that there are reduced levels of blood and CSF adenosine in patients with neuropathic pain. This adenosine deficiency could explain the potential therapeutic effects of administering adenosine or its analogs.

Neuropeptide y targets in the hypothalamus: nitric oxide synthesizing neurones express Y1 receptor.

Neuropeptide Y (NPY)-expressing neurones in the arcuate nucleus densely innervate many hypothalamic nuclei. To determine the neurochemical phenotype of target neurones for NPY, we studied the immunohistochemical localization of the NPY Y1 receptor (Y1R) in discrete subpopulations of neurones in the rat hypothalamus. Among several tested populations, including hypocretin/orexin-, melanin-concentrating hormone (MCH)- and nitric oxide synthase (NOS)-positive neurones, only the latter were found to coexpress the Y1R. Numerous Y1R/NOS-positive neurones were found as a densely packaged group of cells located ventrolateral to the ventromedial nucleus, forming a band ascending towards the fornix. Lower numbers of Y1R/NOS-positive neurones were found in the perifornical area and in the peri- and paraventricular nuclei. Expression of the Y1R gene was found in the same locations in the mouse by colocalizing beta-galactosidase, a Y1R gene reporter, with NOS in a Y1R knockout mouse. To explore possible downstream targets of NO in the rat hypothalamus, the NO-regulated molecule cGMP was analysed immunohistochemically after incubation of brain slices with sodium nitroprusside, an NO donor. We observed several cGMP-positive cell bodies in the arcuate nucleus, cGMP-positive blood vessels and a cGMP-positive network of thin fibres, some of which colocalized with choline acetyltransferase.

Efficacy of naratriptan tablets in the acute treatment of migraine: a dose-ranging study. Naratriptan S2WB2004 Study Group.

OBJECTIVE: This study sought to compare the efficacy of several doses of naratriptan tablets with that of sumatriptan tablets and placebo in the acute treatment of a single migraine attack. METHODS: This was a randomized, double-blind, placebo-controlled, parallel-group, dose-ranging study. Patients received either naratriptan tablets (1, 2.5, 5, 7.5, or 10 mg), sumatriptan tablets (100 mg), or placebo. RESULTS: A total of 643 patients took part in the study. Two hours after dosing, headache relief was reported by significantly more patients treated with any dose of naratriptan (52%-69%) or sumatriptan (60%) than with placebo (31%) (P < 0.05). Four hours after dosing, headache relief was reported by significantly more patients treated with any dose of naratriptan (63%-80%) or sumatriptan (80%) than with placebo (39%) and by significantly more patients treated with sumatriptan 100 mg (80%) than with naratriptan 1 mg (64%), 2.5 mg (63%), or 5 mg (65%) (P < 0.05). Twenty-four-hour overall efficacy (headache relief maintained through 24 hours postdose with no worsening, no use of rescue medication, and no recurrence) was reported by more patients treated with any dose of naratriptan (39%-58%) or sumatriptan (44%) than with placebo (22%). Headache recurrence was reported in 17% to 32% of naratriptan-treated patients, 44% of sumatriptan-treated patients, and 36% of placebo recipients. The overall incidence of adverse events was similar in patients treated with naratriptan 1 mg (20%), naratriptan 2.5 mg (21%), and placebo (23%). For naratriptan 5, 7.5, and 10 mg, the incidence of adverse events was 32%, 37%, and 35%, respectively, and for sumatriptan 100 mg it was 26%. CONCLUSIONS: Our results suggest that the 2.5-mg dose of naratriptan tablets offers the optimal efficacy-to-tolerability ratio at the dose range between 1 and 10 mg. Although naratriptan 2.5 mg was less effective than sumatriptan 100 mg at 4 hours after dosing, the 2 medications showed similar efficacy at 24 hours.

Early clinical experience with subcutaneous naratriptan in the acute treatment of migraine: a dose-ranging study.

Naratriptan is a novel, potent agonist at the 5HT1B/1D receptor. A total of 335 migraine patients were treated in this randomized, double-blind, placebo-controlled, dose-ranging, in-clinic study, to evaluate the efficacy, safety and tolerability of five doses of subcutaneous (sc) naratriptan (0.5, 1, 2.5, 5 or 10 mg) in comparison with sc sumatriptan (6 mg) and placebo in the acute treatment of a moderate/severe migraine attack. Headache relief [reduction of headache severity from moderate or severe (grade 2/3) to mild or none (grade 1/0)] at 1 and 2 h after each dose, was reported by a statistically significantly higher proportion of patients for all doses of sc naratriptan and sc sumatriptan (6 mg) than for placebo. The percentages of patients with headache relief at 2 h post-dose were: naratriptan (0.5 mg) 65%, (1 mg) 75%, (2.5 mg) 83%, (5 mg) 94% and (10 mg) 91%; sumatriptan (6 mg) 89%; placebo 41%, (P < 0.005). The earliest report of a statistically significant difference compared with placebo for the times assessed was with sc naratriptan (10 mg) at 10 min post-dose (P = 0.023). The percentages of patients reporting adverse events were dose-related; sc naratriptan (0.5 mg) 33%, (1 mg) 29%, (2.5 mg) 43%, (5 mg) 59% and (10 mg) 71%; sc sumatriptan 53%; placebo 22%. There were no clinically significant changes in electrocardiogram (ECG), vital signs or laboratory parameters. Systemic exposure increased proportionally to the dose, the absorption of sc naratriptan was rapid (tmax = 10 min) and the half-life was 5 h. In conclusion, sc naratriptan was an effective and well-tolerated acute treatment for migraine. Copyright 1998 Lippincott Williams & Wilkins

Dose-related protection against histamine-induced bronchoconstriction by inhaled salmeterol.

A double-blind crossover study was carried out in 8 subjects to compare the effect of inhaled salmeterol 12.5, 50 and 100 micrograms with inhaled salbutamol 200 micrograms on resting lung function and on bronchoconstriction in response to inhaled histamine up to 12 hours following each treatment. Changes in resting lung function were measured using forced expiratory volume in one second (FEV1) and flow at 70% of vital capacity taken from partial expiratory flow volume curves (pEFR70). The concentrations of histamine which produced a 15% fall in FEV1 (PC15) and a 40% fall in pEFR70 (PC40) were also measured. The peak bronchodilator effect after salmeterol 50 and 100 micrograms was similar in magnitude to salbutamol 200 micrograms. Salmeterol produced dose-related changes in lung function and protection against histamine-induced bronchoconstriction. The duration of the effect of salmeterol (50 and 100 micrograms) was longer than that for salbutamol (200 micrograms). Although pEFR70 is a more sensitive measure of lung function there was no greater separation between different doses of salmeterol than with FEV1. Both salmeterol and salbutamol were well tolerated.

Cytopathological grading, as a predictor of histopathological grade, in ductal carcinoma (NOS) of breast, on air-dried Diff-Quik smears.

Fine-needle aspiration cytology (FNAC) is a widely practiced technique in the diagnosis of breast carcinoma, and it is the only diagnostic procedure performed before definitive treatment, at most institutions. While the histological grading of breast carcinoma has become routine in many centers worldwide, the cytopathological grading of breast carcinoma is not commonly used. Grading of breast carcinoma, while the tumor is still in vivo, would be the most ideal and desirable situation, as it would be helpful in the selection of patients for appropriate therapy. The objective of this study, therefore, was to devise a simple system for grading breast carcinoma, based on the cytological features alone. We reviewed 125 cases of breast carcinoma retrospectively, which were initially diagnosed by FNAC, with subsequent histopathological confirmation. These included 105 ductal, 6 lobular, 2 tubular, 1 papillary, and 1 medullary carcinoma. There was 1 ductal carcinoma in situ. Nine cases were rendered insufficient for grading. Thus 105 cases of ductal carcinoma (NOS) were evaluated for final cytological grading. Air-dried Diff-Quik-stained smears were reviewed at least twice independently by four histopathologists and were then compared with the original histological grades. Six cytological features used for grading were found to be statistically significant: cellular pleomorphism, nuclear size, nuclear margin, nucleoli, naked tumor nuclei, and mitoses. A scoring system based on these six essential parameters was used, to classify ductal carcinoma into three cytological grades, which showed close correlation with the established histological grades. In addition, two less consistent, but still important, features were the presence or absence of necrosis and stromal invasion. Another six parameters, including smear cellularity, degree of cell dispersion or clustering, lymphoplasmacytic infiltrate, presence of tubular structures, cytoplasmic appearance of the tumor cells, and smear background, were not statistically significant. However, these additional parameters were found helpful in assigning the correct grade, in cases with borderline scores. The concordance rate with histology was 100% for grade 1, 98% for grade 2, and 93% for grade 3.

Patient preference for oral sumatriptan 25 mg, 50 mg, or 100 mg in the acute treatment of migraine: a double-blind, randomized, crossover study. Sumatriptan Tablets S2CM11 Study Group.

BACKGROUND: Dosing recommendations for oral sumatriptan have ranged from 25 mg to 100 mg. Patient dose preferences are clinically relevant (perhaps moreso than traditional efficacy endpoints) and deserve study. METHODS: A multinational randomized double-blind crossover study was conducted over 18 weeks to assess patient dose preference, efficacy, and tolerability for oral sumatriptan (25 mg, 50 mg, and 100 mg) in the acute treatment of migraine; 257 patients treated three attacks, using a different dose for each. RESULTS: The 100 mg dose was preferred by 35% of patients, 31% the 50 mg dose, and 25% the 25 mg dose. Efficacy and speed of action were the two main reasons given for preferring the higher doses. Compared with the 25 mg dose, the 100 mg and 50 mg doses were significantly more likely to provide headache relief at 2, 3, and 4 h after dosing and complete headache resolution at 3 and 4 h after dosing (P < 0.027). Recurrence rates were similar for the three doses, ranging from 33% to 38%, though the median time to recurrence increased with dose, from 8.5 to 11.8 h. The 25 mg, 50 mg, and 100 mg doses were all well tolerated, with adverse event incidences of 19%, 21%, and 30%, respectively. CONCLUSIONS: Patients preferred the 50 mg and 100 mg doses of oral sumatriptan to the 25 mg dose, and the higher doses were more effective against migraine; however, the 25 mg and 50 mg doses were better tolerated than the 100 mg dose. Though the 50 mg dose probably has the best effectiveness-to-tolerability ratio, some patients clearly prefer a higher dose.