'Getting control of Corona takes many angles': COVID-19 vaccine knowledge, attitudes and beliefs among refugee/immigrant/migrant communities in four US cities.

The objectives of the study were to (i) document refugee, immigrant and migrant (RIM) communities' knowledge, attitudes and beliefs (KABs) related to the Coronavirus disease (COVID-19) vaccine and (ii) identify best practices for developing and disseminating culturally and linguistically responsive health messaging addressing those KABs. Thirteen online focus groups (OFGs) in 10 languages were conducted. Each OFG was conducted in the participants' native language. OFGs were recorded, transcribed, translated and uploaded to qualitative software for coding. A thematic analysis was conducted. Results suggest that while there was some variation between different language groups (e.g. whether religious leaders were seen as trusted sources of information about COVID), there were also important commonalities. Most language groups (i) alluded to hearing about or having gaps in knowledge about COVID-19/the COVID-19 vaccine, (ii) reported hearing negative or conflicting stories about the vaccine and (iii) shared concerns about the negative side effects of the vaccine. There continues to be a need for health messaging in RIM communities that is culturally and linguistically concordant and follows health literacy guidelines. Message content about the COVID-19 vaccine should focus on vaccine importance, effectiveness and safety, should be multimodal and should be primarily delivered by healthcare professionals and community members who have already been vaccinated.

The Predictive Value of Peripheral Immune Cell Counts for the Presence of Brain Metastases in Stage IV Non-Small-Cell Lung Cancer (NSCLC).

Background High neutrophil-lymphocyte ratio (NLR) is associated with poor survival in lung cancer. This study evaluates whether NLR is associated with baseline brain metastasis in stage IV non-small cell lung cancer (NSCLC). Methods Medical records of stage IV NSCLC patients treated at King Hussein Cancer Center (Amman-Jordan) between 2006 and 2016 were reviewed. Patients with baseline brain imaging and complete blood count (CBC) were included. Receiver operating characteristic (ROC) curve was used to identify the optimal cutoff value for the association between NLR and baseline brain metastasis. Association between age, gender, location of the primary tumor, histology, and NLR was assessed using univariate and multivariate logistic regression analyses. Results A total of 722 stage IV NSCLC patients who had baseline brain imaging were included. Median age was 59 years. Baseline brain metastasis was present in 280 patients (39.3%). Nine patients had inconclusive findings about brain metastasis. The ROC curve value of 4.3 was the best fitting cutoff value for NLR association with baseline brain metastasis. NLR ≥ 4.3 was present in 340 patients (48%). The multivariate analyses showed that high baseline NLR (≥ 4.3) was significantly associated with higher odds of baseline brain metastasis (odds ratio [OR]: 1.6, 95% confidence interval [CI]: 1.2-2.2; p = 0.0042). Adenocarcinoma histology was also associated with baseline brain metastasis (OR: 0.4, 95% CI: 0.25-0.6; p = 0.001). Conclusion High NLR is associated with baseline brain metastasis in advanced-stage NSCLC. In the era of immunotherapy and targeted therapies, whether high NLR predicts response of brain metastasis to treatment is unknown.

Needle-free injectors for mass administration of fractional dose inactivated poliovirus vaccine in Karachi, Pakistan: A survey of caregiver and vaccinator acceptability.

The first large-scale vaccination campaign using needle-free jet injectors to administer fractional doses of inactivated poliovirus vaccine (fIPV) was conducted in Karachi, Pakistan, in February 2019. Data on acceptability of jet injectors were collected from 610 vaccinators and 4898 caregivers during the first four days of the campaign. Of those with prior needle and syringe experience, both vaccinators and caregivers expressed a strong preference for jet injectors (578/592 [97.6%] and 4792/4813 [99.6%], respectively), citing ease of use, appearance, and child's response to vaccination. Among caregivers, 4638 (94.7%) stated they would be more likely to bring their child for vaccination in a future campaign that used jet injectors. Mean vaccine coverage among towns administering fIPV was 98.7% - an increase by 18.4% over the preceding campaign involving full-dose IPV. Our findings demonstrate the strong acceptability of fIPV jet injectors and highlight the potential value of this method in future mass campaigns.

The Effect of Core and Veneering Design on the Optical Properties of Polyether Ether Ketone.

This study aimed to evaluate the effect of core shade and core and veneering thickness on color parameters and translucency of polyether ether ketone (PEEK). Sixty PEEK discs (0.5 and 1 mm in thickness) with white and dentine shades were veneered with A2 shade indirect composite resin with 0.5, 1 and 1.5 mm thickness (n=5). Cores without the veneering material served as controls for translucency evaluation. Color parameters were measured by a spectroradiometer. Color difference (ΔE00) and translucency parameters (TP) were computed. Data were analyzed using one-way ANOVA and Tukey's test (for veneering thickness) and independent t-test (for core shade and thickness) via SPSS 20.0 (p⟨0.05). Regarding the veneering thickness, white cores of 0.5 mm thickness showed significant differences in all color parameters. In white cores of 1 mm thickness and dentine cores of 0.5 and 1 mm thickness, there were statistically significant differences only in L∗, a∗ and h∗. The mean TP was significantly higher in all white cores of 1 mm thickness than dentine cores of 1 mm. Considering ΔE00=3.7 as clinically unacceptable, only three groups had higher mean ΔE00 values. Core shade, core thickness, and the veneering thickness affected the color and translucency of PEEK restorations.

Knowledge and management of fever among Moroccan parents.

Parents often have misperceptions about childhood fever, and little information is available about the home management of feverish children in Morocco. In this study of the perceptions, knowledge and practices of families regarding children's fever, the parents of 264 febrile children aged 0-16 years were interviewed in a paediatric emergency department in Rabat in 2011. Only 3.5% of parents knew the correct temperature definition for fever, 54.4% determined their children's fever using a thermometer, and the preferred site was rectal. Most of them (96.8%) considered that fever was a very serious condition, which could lead to side-effects such as brain damage (28.9%), seizures (18.8%) paralysis (19.5%), dyspnoea (14.8%) and coma (14.8%). Paracetamol was used by 85.9% and traditional treatments by 45.1%. Knowledge about the correct definition of fever was significantly associated with parents' profession, educational level and receipt of previous information and advice from health professionals.

Knowledge and management of fever among Moroccan parents

كثرا ما يكون لدى الآباء أفكار خاطئة عن الحمى التي تصيب الأطفال، كما أن المعلومات المتاحة عن التدبير العلاجي المنزلي للطفل المصاب بالحمى قليلة في المغرب. وقد استهدفت هذه الدراسة معرفة مدركات ومعارف وممارسات الأسر حول الحمى التي تصيب الأطفال، فأجرى الباحثون مقابلات مع 264 من آباء الأطفال الذين أصيبوا بالحمى في أعمار تراوحت بين 0 - 16 عاما، وذلك في قسم طوارئ الأطفال في الرباط في عام 2011 . واتضح للباحثين أن 3.5 % فقط من الآباء يعرفون التعريف الصحيح لدرجة الحرارة أثناء الحمى، وأن 54.4 % منهم يتعرفون على إصابة الطفل بالحمى باستخدام مقياس الحرارة، وأن الموضع المفضل لقياس درجة الحرارة هو الشرج، وأن معظم الآباء [96.8 % منهم]يعترون الحمى حالة خطرة قد تقود إلى تأثرات جانبية مثل تخرب الدماغ [28.9 %]، والاختلاجات [18.8 %]، والشلل [19.5 %]، وضيق النفس [14.8 %]، والسبات [14.8 %]. وقد تم استخدام الباراسيتامول في 85.9 % من الحالات، والمعالجات التقليدية في % 45.1 من الحالات. وقد ترابطت المعرفة المتعلقة بالتعريف الصحيح للحمى بمقدار يعتد به إحصائيا مع مهنة الآباء، ومستواهم التعليمي ومع تلقيهم معلومات مسبقة ومنشورات من المهنيين الصحيين

ABSTRACT Parents often have misperceptions about childhood fever, and little information is available about thehome management of feverish children in Morocco. In this study of the perceptions, knowledge and practicesof families regarding children’s fever, the parents of 264 febrile children aged 0–16 years were interviewed in apaediatric emergency department in Rabat in 2011. Only 3.5% of parents knew the correct temperature definitionfor fever, 54.4% determined their children’s fever using a thermometer, and the preferred site was rectal. Most ofthem (96.8%) considered that fever was a very serious condition, which could lead to side-effects such as braindamage (28.9%), seizures (18.8%) paralysis (19.5%), dyspnoea (14.8%) and coma (14.8%). Paracetamol was usedby 85.9% and traditional treatments by 45.1%. Knowledge about the correct definition of fever was significantlyassociated with parents’ profession, educational level and receipt of previous information and advice from healthprofessionals.

RÉSUMÉ Les parents ont souvent des perceptions erronées concernant la fièvre chez l'enfant, et les informationssur la prise en charge des enfants fébriles à domicile sont rares au Maroc. Dans la présente étude sur lesperceptions, les connaissances et les pratiques des familles au sujet de la fièvre chez l'enfant, les parents de 264enfants fébriles âgés de 0 à 16 ans ont été interrogés au sein d'un service d'urgence pédiatrique de la ville deRabat en 2011. Seuls 3,5 % des parents connaissaient la température exacte définissant un état fébrile et 54,4 %déterminaient la fièvre de leur enfant à l'aide d'un thermomètre, de préférence par voie rectale. La plupartd'entre eux (96,8 %) considéraient que la fièvre était une affection très grave qui pouvait conduire à des effetssecondaires tels que des lésions cérébrales (28,9 %), des convulsions (18,8 %), une paralysie (19,5 %), une dyspnée(14,8 %) et un coma (14,8 %). Le paracétamol a été utilisé par 85,9 % des parents et les traitements traditionnelspar 45,1 %. La connaissance de la définition exacte de la fièvre était significativement associée à la profession desparents, à leur niveau d'études et à la prise de conseils et d'informations préalable auprès des professionnels desanté.

[Treatment by Bach flowers: magical potion or factual medicine? A review of the literature]. / Traitement par fleurs de Bach: pensée magique ou médecine factuelle? Revue de la littérature.

In 1930, Dr Edward Bach developed flower essences known as Bach flowers. Today, over 70 years later, they are becoming more and more popular and are used by many practitioners, despite a total lack of scientific support for their use. A review of the literature on the controversial use of this alternative treatment is discussed.

The effects of aggregation and protein corona on the cellular internalization of iron oxide nanoparticles.

Engineered inorganic nanoparticles are essential components in the development of nanotechnologies. For applications in nanomedicine, particles need to be functionalized to ensure a good dispersibility in biological fluids. In many cases however, functionalization is not sufficient: the particles become either coated by a corona of serum proteins or precipitate out of the solvent. In the present paper, we show that by changing the coating of iron oxide nanoparticles from a low-molecular weight ligand (citrate ions) to small carboxylated polymers (poly(acrylic acid)), the colloidal stability of the dispersion is improved and the adsorption/internalization of iron toward living mammalian cells is profoundly affected. Citrate-coated particles are shown to destabilize in all fetal-calf-serum based physiological conditions tested, whereas the polymer coated particles exhibit an outstanding dispersibility as well as a structure devoid of protein corona. The interactions between nanoparticles and human lymphoblastoid cells are investigated by transmission electron microscopy and flow cytometry. Two types of nanoparticle/cell interactions are underlined. Iron oxides are found either adsorbed on the cellular membranes, or internalized into membrane-bound endocytosis compartments. For the precipitating citrate-coated particles, the kinetics of interactions reveal a massive and rapid adsorption of iron oxide on the cell surfaces. The quantification of the partition between adsorbed and internalized iron was performed from the cytometry data. The results highlight the importance of resilient adsorbed nanomaterials at the cytoplasmic membrane.

Interactions between sub-10-nm iron and cerium oxide nanoparticles and 3T3 fibroblasts: the role of the coating and aggregation state.

Recent nanotoxicity studies revealed that the physico-chemical characteristics of engineered nanomaterials play an important role in the interactions with living cells. Here, we report on the toxicity and uptake of cerium and iron oxide sub-10-nm nanoparticles by NIH/3T3 mouse fibroblasts. Coating strategies include low-molecular weight ligands (citric acid) and polymers (poly(acrylic acid), M(W) = 2000 g mol(-1)). Electrostatically adsorbed on the surfaces, the organic moieties provide a negatively charged coating in physiological conditions. We find that most particles were biocompatible, as exposed cells remained 100% viable relative to controls. Only the bare and the citrate-coated nanoceria exhibit a slight decrease in mitochondrial activity at very high cerium concentrations (>1 g l(-1)). We also observe that the citrate-coated particles are internalized/adsorbed by the cells in large amounts, typically 250 pg/cell after 24 h incubation for iron oxide. In contrast, the polymer-coated particles are taken up at much lower rates (<30 pg/cell). The strong uptake shown by the citrated particles is related to the destabilization of the dispersions in the cell culture medium and their sedimentation down to the cell membranes. In conclusion, we show that the uptake of nanomaterials by living cells depends on the coating of the particles and on its ability to preserve the colloidal nature of the dispersions.

Diaphragmatic stimulation: a case of atrial lead dislodgement and right atrium perforation.

We report a 48 year old male who presented with diaphragmatic stimulation. The biventricular implantable cardioverter and defibrillator (CRT-D) was implanted two weeks before admission and active fixation lead caused perforation of the right atrial wall. Echocardiography did not demonstrate pericardial effusion but Chest X-ray and computed tomography (CT) visualized the atrial screw helix outside the right atrial wall, penetrating through the right lung middle lobe. There was no atrial capture. After changing the pace mode DDDR to VVIR, diaphragmatic stimulation was disappeared. The atrial lead was repositioned and fixed again. During the hospital admission and after that the patient was well and free of any symptoms.

Grey water characteristics and treatment options for rural areas in Jordan.

Low water consumption in rural areas in Jordan had resulted in the production of concentrated grey water. Average COD, BOD and TSS values were 2568mg/l, 1056mg/l and 845mg/l, respectively. The average grey water generation was measured to be 14L/c.d. Three different treatment options were selected based on certain criterions, and discussed in this article. The examined treatment systems are septic tank followed by intermittent sand filter; septic tank followed by wetlands; and UASB-hybrid reactor. Advantages and disadvantages of each system are presented. It was concluded that UASB-hybrid reactor would be the most suitable treatment option in terms of compactness and simplicity in operation. The volume of UASB-hybrid reactor was calculated to be 0.268m(3) with a surface area of 0.138m(2) for each house having 10 inhabitants on average. Produced effluent is expected to meet Jordanian standards set for reclaimed water reuse in irrigating fruit trees.

Sulfadoxine-pyrimethamine, chlorproguanil-dapsone, or chloroquine for the treatment of Plasmodium vivax malaria in Afghanistan and Pakistan: a randomized controlled trial.

CONTEXT: In areas where Plasmodium falciparum and Plasmodium vivax coexist and treatments for the 2 species differ, misdiagnosis can lead to poor outcomes in either disease. A unified therapy effective against both species would reduce reliance on species-specific diagnosis, which in many areas is difficult to maintain. The antifolates are an important and affordable antimalarial class to which it is often assumed P vivax malaria is intrinsically resistant. OBJECTIVE: To test the relative efficacy and safety of 2 antifolate drugs against P vivax malaria and compare each with chloroquine. DESIGN, SETTING, AND PATIENTS: An open-label randomized controlled trial comparing chloroquine, sulfadoxine-pyrimethamine, and chlorproguanil-dapsone for the treatment of P vivax malaria was conducted in eastern Afghanistan and northwestern Pakistan, areas in which P vivax malaria predominates. A total of 20,410 patients older than 3 years were screened; 767 patients (315 in Pakistan and 452 in Afghanistan) with confirmed P vivax malaria were enrolled and followed up daily for 4 days, then weekly for 28 days, between March 2004 and June 2006. MAIN OUTCOME MEASURES: Complete clearance of parasites with no recrudescence by day 14. Secondary outcomes included being parasite-free by day 28, clinical failure, and anemia. RESULTS: By day 14, only 1 patient in the sulfadoxine-pyrimethamine group had parasites. By day 28, failure rates were found in 2 of 153 patients (1.3%) in the chloroquine group, 5 of 290 patients (1.7%) in the sulfadoxine-pyrimethamine group, and 27 of 272 patients (9.9%) in the chlorproguanil-dapsone group. Chlorproguanil-dapsone was less effective than sulfadoxine-pyrimethamine (adjusted odds ratio [OR], 6.4; 95% confidence interval [CI], 2.4-17.0; P<.001) and chloroquine (adjusted OR, 8.4; 95% CI, 2.0-36.5; P = .004). Chloroquine and sulfadoxine-pyrimethamine were equivalent in efficacy at day 28 (adjusted OR, 1.3; 95% CI, 0.3-7.0; P = .73). Chloroquine cleared gametocytes and asexual parasites more rapidly than sulfadoxine-pyrimethamine or chlorproguanil-dapsone did. All drugs were well tolerated. CONCLUSIONS: Although chloroquine remains the drug of choice, antifolates are effective against P vivax malaria in South Asia. These drugs may be appropriate for unified treatment where species-specific diagnosis is unavailable, most likely in combination with other drugs. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00158561.

Developmental changes in inhibin alpha and inhibin/activin betaA and betaB mRNA levels in the gonads during post-hatch prepubertal development of male and female chickens.

Dimeric inhibins and activins are barely detectable in the plasma during prepubertal development of male and female chickens. This may be misconstrued to indicate that the proteins are not produced in the gonads and have no functional significance during this period. Very few studies have actually determined the mRNA expression profile of the inhibin and activin subunits in the gonads prior to puberty in order to establish their secretion at the local level and postulate potential roles for the inhibin and activins at this developmental stage. In this study, the expression of the mRNA for the alpha-, betaA-, and betaB-subunits was determined in the ovary and testis of chickens during prepubertal development. Gene expression was determined at 3, 5, 6, 8, 10, 12, 16, and 18 weeks of age by RT-PCR. Messenger RNA level was quantified by competitive RT-PCR at 3, 6, 12, and 18 weeks of age in order to detect any changes with development, suggest potential relationship to the profile of dimeric inhibins and activins reported previously and to suggest potential paracrine and endocrine roles for them. The results show that all the inhibin/activin subunit mRNAs are expressed in the testis of the chicken throughout the period of prepubertal development up to 18 weeks of age. However, in the ovary, only the betaA- and betaB-subunits were detected at all ages whereas the alpha-subunit mRNA could only be detected just before puberty. Quantification of the mRNA levels showed variation of each subunit with age. These temporal changes suggest relationship with paracrine functional role in the ovary or the testis. Quantitative changes in expression levels also suggests that there may be some relationship between mRNA levels and the type and amount of dimeric inhibins and activins produced at any developmental stage. There are major differences between the male and female gonads in the timing of the expression of different subunits. In conclusion, the expression of the mRNA subunits in the testis and ovary suggests that inhibins and activins are being produced but may be principally involved in autocrine/paracrine function within the gonads.

Regulation of inhibin alpha- and beta(A)-subunit messenger ribonucleic acid levels by gonadotropins and IGF-I in cultured chicken granulosa cells.

A quantitative competitive reverse transcription polymerase chain reaction assay (QC RT-PCR) for quantifying the absolute levels of the expression of inhibin alpha- and beta(A)-subunits in chicken granulosa cells showed that these subunits are expressed in different amounts depending on follicular maturation. The present study determined the regulation of the expression of these subunits. The individual effect of different doses of IGF-I, LH or FSH (1-100 ng/ml) or the combination of IGF-I with either LH or FSH at different concentrations, on the expression of inhibin alpha- and beta(A)-subunit was determined on cultured granulosa cells of F(1) and the combined F(4)+F(5) follicle. Cells were cultured for 48 h in 6-well plates with or without added hormones. Culture medium was discarded, cells were washed and total RNA was extracted from the cells. Five hundred nanograms of total RNA was reverse transcribed using specific primers and coamplified with an internal standard, as described previously, to determine expression level in the cells. IGF-I, LH, and FSH enhanced the inhibin alpha-subunit mRNA levels in a dose dependent manner in both F(1) and the combined F(4)+F(5) whereas inhibin beta(A)-subunit was not affected. The effects of FSH, LH were more expressed in F(1) follicles compared to F(4)+F(5) on the alpha-subunit. The addition of IGF-I and either LH or FSH during the culture period significantly increased the stimulatory effects of both LH and FSH on the expression of inhibin alpha-subunit in F(1) follicles but had no significant effect on the inhibin beta(A)-subunit. The results suggest that the changing expression levels of inhibin alpha-subunit during follicular development are the result of the regulatory effect of the interaction between IGF-I and the gonadotropins and that the regulation of this subunit may be the main factor for the regulation of the protein inhibin levels. Other factors may be also implicated in the changing expression levels of the beta(A)-subunit.

Developmental expression of activin/inhibin alpha- and beta(A)-subunit genes in the gonads of male and female chick embryos.

The expression of inhibin alpha- and beta(A)-subunits was investigated in gonads of male and female chick embryos during the last week of their 21-day incubation period. Fertilized Hisex brown laying hen eggs were incubated at 37.8 +/- 0.2 degrees and 60% relative humidity in an automatic forced-draft incubator with constant lighting. Embryos were killed after 14, 18, and 21 days of incubation, sexed by macroscopical inspection of the gonadal phenotype, and further dissected to obtain the gonads. Total RNA was isolated using the ultraspec RNA method. The expression of alpha- and beta(A)-subunits was evaluated by competitive RT-PCR. Significant differences were found within and between sexes in the expression of the alpha- and beta(A)-subunits. The level of the alpha-subunit in the testis was about 23-fold higher than that in the ovary at all ages. Testicular content of inhibin alpha mRNA levels was similar at days 14 and 18 but declined significantly at day 21 of incubation, whereas no significant differences were observed between the three age groups in the ovary. Testicular and ovarian inhibin beta(A)-subunit increased significantly from day 14 to day 18 followed by a significant decline before hatch. However, inhibin beta(A) level at day 14 was significantly higher in the ovary than in the testis. At days 18 and 21, there were no differences in the levels of the inhibin beta(A) in the sexes. The expression of inhibin beta(A)-subunit in the ovary was significantly higher than that of the alpha-subunit at all ages. In the testis, however, the expression of the beta(A)-subunit was higher at days 18 and 21 than at day 14. The sex difference in gonadal inhibin subunits expression suggests differential roles of inhibin/activin in the development of the chicken gonads. The changing level of expression during incubation also suggests changing biological roles within sexes.

Insulin-like growth factors in the regulation of avian ovarian functions.

In the past three decades, overwhelming evidence has accumulated to show that insulin-like growth factor (IGF)-I and -II, their receptors and binding proteins (IGFBP) (the IGF system), have major roles to play in the regulation of ovarian function in mammals. Although studies in birds did not start until 5-6 years ago, the limited information thus far available suggests that the IGFs act as autocrine/paracrine regulators of follicular growth and differentiation, just as observed in mammals. The genes for IGF-I and -II, type-I IGF receptor, IGFBP-2, and IGFBP-5 are expressed in both granulosa and theca cells of the chicken ovary. The mechanisms by which the IGF system controls ovarian function in the avian species are complex and involve interactions with the gonadotrophins (LH and FSH), growth hormone, and even other growth factors. Effects are different between strains and nutritional status.

Effects of timing and duration of feed restriction during rearing on reproductive characteristics in broiler breeder females.

The objective of this study was to determine whether there exists a critical period during rearing when restricted feeding of broiler breeder hens can be most beneficial on subsequent egg production. Broiler breeder pullets were subjected to combinations of either ad libitum or restricted feeding during three periods before sexual maturity. Body weight gain, feed intake, and egg production were recorded. Ovary and oviduct weights were noted at age of first oviposition. At 15 and 18 wk of age and at age of first oviposition, chicken luteinizing hormone releasing hormone-I (cLHRH-I) in the median eminence and the levels of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) in the pituitary and plasma were determined. The results demonstrated that alternation between ad libitum and restricted feeding during rearing changed the growth curves of the birds. Feed restriction from 7 to 15 wk followed by either ad libitum or restricted feeding led to improved reproductive performance, suggesting that long-term feed restriction may not be necessary to attain good reproductive performance. The birds restricted from 7 to 15 wk of age had higher proportional weights of ovary (> or = 1.7%) and oviduct (> or = 1.58%) at age of sexual maturity. The cLHRH-I levels in the median eminence and gonadotrophin contents in the pituitary followed that of growth in response to feeding levels and timing of feeding and could be related to the timing of the onset of lay. At age of first egg, all groups had similar levels of cLHRH-I, LH, and FSH. However, no clear effect of level of feed intake or time period of restriction could be observed for plasma LH or FSH concentrations.

Quantitative evaluation of a comprehensive motion, resolution, and attenuation correction program: initial experience.

BACKGROUND: Tomographic myocardial imaging is widely used in the diagnosis and evaluation of patients with coronary artery disease. However, its specificity remains suboptimal because of attenuation, resolution, and motion artifacts. The purpose of this study was to optimize and assess the value of attenuation, blur, and motion correction of myocardial single photon emission computed tomographic data. METHODS AND RESULTS: Forty-seven studies were selected for analysis to provide 3 patient groups. Group A consisted of 18 patients with a low likelihood of coronary artery disease who were used to construct a quantitative normal database and assess changes in the normal bull's-eye produced by filtering and by attenuation correction. Group B consisted of 13 patients with a high probability of normal results, and group C consisted of 16 patients with coronary artery disease defined on angiography. The effects of attenuation correction, especially in conjunction with RESTORE (a depth-dependent deblurring filter), have been quantitated. Analysis indicates a trend to improved sensitivity and specificity for detecting individual vessel disease in this retrospective study. The motion correction program was successfully applied to 93% of patients but detected significant motion requiring correction in only 11 (24%) patients. CONCLUSION: This preliminary retrospective study indicates a potential for improved myocardial single photon emission computed tomography imaging with the use of attenuation and motion correction together with a restorative deblurring filter. Confirmation by a multicenter study and larger patient numbers remain necessary to assess fully the prospective value of the technique.

Quantification of inhibin/activin alpha and betaA subunit messenger ribonucleic acid by competitive reverse transcription-polymerase chain reaction in chicken granulosa cells during follicular development.

The very sensitive quantitative competitive reverse transcription-polymerase chain reaction (RT-PCR) was used to investigate the expression of inhibin/activin subunits in the granulosa cells of developing ovarian follicles of the hen. Two competitors specific to inhibin alpha and betaA subunits were constructed. In one study, the expression of inhibin alpha and betaA genes was determined in the granulosa cells of the five largest yellow follicles (F1, F2, F3, F4/5), the small yellow follicles (SYF), and the large white follicles (LWF) of a layer strain of chickens. Competitive RT-PCR for inhibin alpha subunit revealed 10.35 +/- 2.15 pg/ microg total RNA in the LWF. The expression increased 40-fold in the SYF and remained at that level in the F4/5 but decreased markedly thereafter up to the F1 stage. Inhibin/activin betaA subunit was also detected in the LWF in low amounts and showed no significant increase until the F2 stage. The highest level was found in the F1. The pattern of the mRNA for alpha and betaA subunits in the five largest follicles (F1, F2, F3, F4/5) of a broiler breeder strain of chicken was compared with that in the layer strain. Expression of the alpha subunit was significantly higher in the three largest follicles (F1, F2, F3) of the broiler breeder hens, but only in the F2 for the betaA. The results suggest that inhibin alpha may play an important role in the recruitment and differentiation of follicles and that differences between broiler breeders and layers may have consequences at both the pituitary and ovarian levels.

A phase I study of paclitaxel and 5-fluorouracil in advanced gastric cancer.

This is a phase I study to determine the maximum tolerated dose (MTD) and toxicity of a combination of paclitaxel and 5-Fluorouracil (5-FU) in advanced gastric cancer patients. The patients, refractory to the PELF regimen (5-FU, leucovorin, cisplatin, epidoxorubicin), received weekly 5-FU at the fixed dose of 500 mg/m2, and escalating doses of paclitaxel every 3 weeks with a starting dose of 150 mg/m2 given as in 3-h infusion. The dose was escalated by 25 mg/m2 every 3 patients. Fifteen patients entered the study. The upper paclitaxel dose (225 mg/m2) was given to 6 patients. Up to this dose, no severe toxicity (grade 3-4) was recorded. Apart from alopecia, grade 1-2 leukopenia occurred in 5 patients and grade 1-2 neurotoxicity in 2 patients. All patients were evaluable for response (at least 2 cycles): 2 patients achieved an objective response (200 and 225 mg/m2). In 6 patients, treatment resulted in notable relief from symptoms. Out-patient paclitaxel given over 3 h and 5-FU may be combined safely for the treatment of patients with advanced gastric cancer. The recommended doses for phase II study are paclitaxel 225 mg/m2 and 5-FU 500 mg/m2.