BACKGROUND & AIMS: OBJECTIVE:Intervertebral Neck Injury Criterion (IV-NIC) hypothesizes that dynamic three-dimensional intervertebral motion beyond physiological limit may cause multiplanar soft-tissue injury. Present goals, using biofidelic whole human cervical spine model with muscle force replication and surrogate head in head-turned rear impacts, were to: (1) correlate IV-NIC with multiplanar injury, (2) determine IV-NIC injury threshold at each intervertebral level, and (3) determine time and mode of dynamic intervertebral motion that caused injury. METHODS:Impacts were simulated at 3.5, 5, 6.5, and 8 g horizontal accelerations of T1 vertebra (n = 6; average age: 80.2 years; four male, two female donors). IV-NIC was defined at each intervertebral level and in each motion plane as dynamic intervertebral rotation divided by physiological limit. Three-plane pre- and post-impact flexibility testing measured soft-tissue injury; that is significant increase in neutral zone (NZ) or range of motion (RoM) at any intervertebral level, above baseline. IV-NIC injury threshold was average IV-NIC peak at injury onset. RESULTS:IV-NIC extension peaks correlated best with multiplanar injuries (P < 0.001): extension RoM (R = 0.55) and NZ (R = 0.42), total axial rotation RoM (R = 0.42) and NZ (R = 0.41), and total lateral bending NZ (R = 0.39). IV-NIC injury thresholds ranged between 1.1 at C0-C1 and C3-C4 to 2.9 at C7-T1. IV-NIC injury threshold times were attained between 83.4 and 150.1 ms following impact. CONCLUSIONS:Correlation between IV-NIC and multiplanar injuries demonstrated that three-plane intervertebral instability was primarily caused by dynamic extension beyond the physiological limit during head-turned rear impacts.

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BACKGROUND & AIMS: -2

背景与目标： -2

BACKGROUND & AIMS: BACKGROUND:Left ventricular assist device (LVAD) therapy has revolutionized the treatment options for patients with advanced heart failure. Patient selection is essential for obtaining successful results. However, few data exist concerning the outcomes of patients evaluated for LVAD therapy but subsequently rejected or deferred. METHODS AND RESULTS:This is a retrospective review of all patients referred for LVAD therapy at our institution between January 2009 and December 2016. Baseline demographics and Interagency Registry for Mechanically Assisted Circulatory Support profiles were collected, and reasons for rejection or deferral for LVAD placement were investigated. A total of 669 patients were referred for LVAD therapy, and 228 patients (34%) were turned down. The yearly acceptance rate ranged between 57% and 75%. The average age of the turned-down cohort was 60.8 ± 12.5 years; 83% were men. Reasons for rejection included: patient being too sick (34%); psychosocial concerns (25%); patient declined (16%); decision was deferred for medical optimization (15%); or patient being too well (10%). The percentage of patients who were rejected due to psychosocial concerns has increased over time (P = 0.02), whereas the rate of deferral for medical optimization has remained stable (P = 0.10). One-year survival after initial LVAD consultation was 42% in those who were too sick, 64% in those with psychosocial concerns, 68% in patients who declined, 86% in those deferred for medical optimization; and 100% in those too well (P < 0.01). CONCLUSIONS:One-year survival is reduced among patients who were initially turned down for LVAD therapy, except for those in whom this decision was deferred for medical optimization or because the patient was too well. Psychosocial concerns have become a significant barrier to LVAD therapy.

背景与目标：

BACKGROUND & AIMS: PURPOSE:The aim of this study was to evaluate the influence of oxidized surface on bone-to-implant contact percentage (BIC%) as well as the bone density within the threads area (BD%) in human bone after 2 months of unloaded healing. MATERIALS:Seven subjects (mean age 45.57 +/- 10.45 years) received 2 micro-implants each during conventional implant surgery in the posterior maxilla. The implants that presented turned and oxidized surfaces served as control and test, respectively. After the healing period, the implants and the surrounding tissue were removed and prepared for ground sectioning and analysis. RESULTS:Two turned implants were found to be clinically unstable at the time of retrieval. Histometric evaluation showed that the mean of BIC% was 17.40 +/- 14.16% and 32.19 +/- 15.68% to turned and oxidized surfaces, respectively. The BD% was 22.13 +/- 19.06% for turned surface and 50.40 +/- 18.35% for oxidized surface. CONCLUSION:The histologic data from this preliminary study suggest that the oxidized micro-implants surface presented better mean values of BIC% and BD% than turned micro-implants after a short healing time.

背景与目标：

BACKGROUND & AIMS: :Our understanding of biological processes in humans is often based on examination of analogous processes in other organisms. The nematode worm Caenorhabditis elegans has been a particularly valuable model, leading to Nobel prize winning discoveries in development and genetics. Until recently, however, the worm has not been widely used as a model to study transcription due to the lack of a comprehensive catalogue of its RNA transcripts. A recent study by Chen et al. uses next-generation sequencing to address this issue, mapping the transcription initiation sites in C. elegans and finding many unexpected similarities between the transcription of enhancers and promoters in the worm and mammalian genomes. As well as providing a valuable resource for researchers in the C. elegans community, these findings raise the possibility of using the worm as a model to investigate some key, current questions about transcriptional regulation that remain technically challenging in more complex organisms.

背景与目标： : 我们对人类生物过程的理解通常基于对其他生物中类似过程的检查。线虫线虫秀丽隐杆线虫是一种特别有价值的模型，导致了诺贝尔奖在发育和遗传学方面的发现。然而，直到最近，由于缺乏其RNA转录本的全面目录，该蠕虫尚未被广泛用作研究转录的模型。Chen等人最近的一项研究。使用下一代测序来解决这个问题，绘制了秀丽隐杆线虫中的转录起始位点，并在蠕虫和哺乳动物基因组中的增强子和启动子的转录之间发现了许多意想不到的相似之处。除了为秀丽隐杆线虫社区的研究人员提供宝贵的资源外，这些发现还提出了使用蠕虫作为模型来研究有关转录调控的一些关键的当前问题的可能性，这些问题在技术上仍然具有挑战性更复杂的生物体。

BACKGROUND & AIMS: :The presenilin (PS) proteins are polytopic integral membrane proteins that are critically involved in the development of Alzheimer's disease. The topography of the PS molecule in the endoplasmic reticulum membrane is widely accepted as exhibiting eight-hydrophobic-transmembrane (8-TM) helices. We have previously provided evidence, however, that the intact PS molecule is also present in the cell surface where it exhibits exclusively a 7-TM topography, which differs in significant structural features from the 8-TM model. This evidence, however, has been disparaged and generally rejected by researchers in Alzheimer's disease. The 7-TM model is definitively demonstrated in the present study for PS-1 at the surfaces of PS-1-transfected cells and for endogenous PS-1 at the surfaces of untransfected cells, by immunofluorescence studies using mAbs. These studies force substantial revision of current views of the structural and functional properties of the PS proteins.

背景与目标： : 早老素 (PS) 蛋白是多位整合膜蛋白，与阿尔茨海默氏病的发展密切相关。内质网膜中PS分子的形貌被广泛认为具有八个疏水跨膜 (8-TM) 螺旋。然而，我们以前已经提供了证据，表明完整的PS分子也存在于细胞表面，在那里它仅表现出7-TM形貌，其显着的结构特征与8-TM模型不同。然而，这一证据被阿尔茨海默氏病的研究人员贬低并普遍拒绝。通过使用mab的免疫荧光研究，在本研究中明确证明了在PS-1-transfected细胞表面的PS-1和在未转染细胞表面的内源性PS-1的7-TM模型。这些研究迫使对PS蛋白的结构和功能特性的当前观点进行了实质性修改。

BACKGROUND & AIMS: :MoS2 nanoribbons with armchair-terminated edges are semiconductors suitable for the tuning of electronic and magnetic properties. Our first-principles density function calculations reveal that a variety of transition-metal atomic chains deposited on some of the ribbons is able to transform the semiconductors into half metals, allowing transport of 100% spin-polarized currents. Furthermore, we found that a Si atomic chain is equally capable of achieving half metallicity when adsorbed on the same nanoribbon. These results should be useful for spintronic application.

背景与目标： : 带扶手椅端边的MoS2纳米带是适用于电子和磁性能调谐的半导体。我们的第一原理密度函数计算表明，沉积在某些带上的各种过渡金属原子链能够将半导体转变为半金属，从而允许传输100% 自旋极化电流。此外，我们发现，当吸附在同一纳米带上时，Si原子链同样能够实现半金属性。这些结果对于自旋电子应用应该是有用的。

BACKGROUND & AIMS: :On page 1667 of this issue, Stuart Smith and colleagues [1] demonstrate that the animal fatty acid synthase is a head-to-head dimer rather than the head-to-tail dimer depicted in textbooks. This has important ramifications for the mechanisms of other multifunctional enzymes such as polyketide synthases [2].

背景与目标： : 在本期的第1667页上，Stuart Smith及其同事 [1] 证明了动物脂肪酸合酶是头对头二聚体，而不是教科书中描述的头对尾二聚体。这对其他多功能酶 (例如聚酮化合物合酶) 的机制具有重要影响 [2]。

BACKGROUND & AIMS: :The sepsis syndrome is thought to occur when microbial products activate Toll-like receptors stimulating widespread inflammation, in turn causing organ failure, shock and death. However, recent discoveries reveal that: (i) not only microbial substances but also endogenous molecules can trigger Toll-like receptors; (ii) Toll-like receptor-4, the endotoxin receptor, is constitutively suppressed; and (iii) the first step in sepsis could be the release of Toll-like receptor-4 from suppression. These discoveries suggest that endotoxin might not always initiate the sepsis syndrome and they explain why anti-endotoxin therapies fail. The discoveries also suggest new therapeutic targets - endogenous agonists and Toll-like receptor regulators - for treatment of sepsis.

背景与目标： : 当微生物产物激活Toll样受体刺激广泛的炎症，进而导致器官衰竭，休克和死亡时，就会发生败血症综合征。然而，最近的发现表明 :( i) 不仅微生物物质，而且内源性分子都可以触发Toll样受体; (ii) Toll样受体-4 (内毒素受体) 被组成性抑制; (iii) 败血症的第一步可能是从抑制中释放Toll样受体4。这些发现表明内毒素可能并不总是引发败血症综合征，它们解释了抗内毒素疗法失败的原因。这些发现还提出了治疗脓毒症的新的治疗靶点-内源性激动剂和Toll样受体调节剂。

BACKGROUND & AIMS: -2

背景与目标： -2

BACKGROUND & AIMS: :The chromosome of R6K contains multiple origins of replication. The origin gamma is infrequently used in the original plasmid and remains "silent" in certain miniplasmid derivatives. The inactivation of the origin is caused by a natural origin silencer located adjacent to the minimal ori gamma sequence. The silencer functions in cis and has no trans activity. It has functional polarity and works only in one orientation when present immediately downstream from ori gamma. The silencer apparently initiates an RNA that invades ori gamma and turns it off either by competing with a primer RNA or by disrupting ori gamma structure. As predicted, removal of the silencer blocks the synthesis of silencer RNA and derepresses the origin.

背景与目标： : R6K的染色体包含多个复制起源。原始质粒中很少使用origin γ，在某些小质粒衍生物中保持 “沉默”。原点的失活是由位于最小ori gamma序列附近的自然原点消音器引起的。消音器在顺式中起作用，没有反式活性。它具有功能性极性，并且在ori gamma下游立即存在时仅在一个方向上起作用。消音器显然会启动入侵ori gamma的RNA，并通过与引物RNA竞争或破坏ori gamma结构将其关闭。如预期的那样，去除消音器会阻止消音器RNA的合成并消除原点。

BACKGROUND & AIMS: :To evaluate the effectiveness of a cytological screening to prevent invasive cervical cancer in the province of Trento, a northern Italian area where a population-based cancer registry is active. The history of Pap test was evaluated through a case-control study in 61 population-based invasive cervical cancer patients, incident during 1995-2000, and in 244 age-matched (between 25 and 75 years old) controls. Women who had at least one Pap test had a reduced risk of invasive carcinoma of 80% (odds ratio=0.20; 95% confidence intervals 0.10-0.40). The protection of a previous Pap test for both squamous cell carcinoma (odds ratio=0.23; 95% confidence intervals 0.09-0.58) and adenocarcinoma (odds ratio=0.24; 95% confidence intervals 0.07-0.78) was similar. The overall protective effect of the Pap test was not seen among younger women (<40 years). The protective effect of the Pap test seems to be stronger for shorter intervals. Our study confirms that Pap-test screening, particularly in middle-aged and older women, is an effective public health intervention with encouraging results also for the prevention of cervical adenocarcinoma.

背景与目标： : 评估细胞学筛查在意大利北部特伦托省预防浸润性宫颈癌的有效性，特伦托省是一个基于人群的癌症登记处。通过病例对照研究评估了61例基于人群的浸润性宫颈癌患者的Pap测试史，这些患者在1995-2000期间发生，并且在244年龄匹配 (25至75岁) 的对照中。至少进行了一次巴氏试验的女性患80% 浸润性癌的风险降低 (比值比 = 0.20; 95% 置信区间0.10-0.40)。先前的Pap测试对鳞状细胞癌 (优势比 = 0.23; 95% 置信区间0.09-0.58) 和腺癌 (优势比 = 0.24; 95% 置信区间0.07-0.78) 的保护相似。巴氏试验的总体保护作用在年轻女性 (<40岁) 中未见。对于较短的间隔，巴氏试验的保护作用似乎更强。我们的研究证实，巴氏试验筛查 (尤其是中老年妇女) 是一种有效的公共卫生干预措施，在预防宫颈腺癌方面也取得了令人鼓舞的结果。

BACKGROUND & AIMS: The agouti locus was first identified as a result of its effects on the type and temporal deposition of coat color pigments in mammals. Many mutations at the murine agouti locus have now been found, some of which not only affect coat color, but also interfere with diverse biological processes leading to diabetes, obesity, tumor susceptibility and embryonic lethality. Correlations between the genotype and phenotype of agouti mutants, as well as reasons for the pleiotropy of effects caused by agouti mutations, have begun to unfold with the molecular cloning of the agouti gene and its surrounding genomic region.

背景与目标： 最初是由于其对哺乳动物毛色色素的类型和时间沉积的影响而确定的。现在已经发现了鼠agouti基因座的许多突变，其中一些不仅影响毛色，而且还干扰导致糖尿病，肥胖，肿瘤易感性和胚胎致死率的各种生物学过程。随着agouti基因及其周围基因组区域的分子克隆，agouti突变体的基因型和表型之间的相关性以及由agouti突变引起的多效性影响的原因已开始展开。

BACKGROUND & AIMS: The inflammatory component associated with blackening and subsequent regression of plantar warts has been little appreciated in the literature. Two patients with plantar warts in whom one of the warts showed prominent, clinically evident inflammation were observed. Blackening and subsequent regression of all plantar warts then occurred. In one patient, microscopic examination of biopsy specimens of two lesions that were taken within 24 and 72 hours, respectively, after they had turned black demonstrated the following histologic findingsblood clots and hemorrhage in the stratum corneum, degeneration and necrosis of epidermal cells, eosinophilic cytoplasmic masses within degenerating epidermal cells, thrombosis of superficial and deeper dermal blood vessels, a mononuclear cell infiltrate in and around dermal blood vessels, and a mixed polymorphonuclear and lymphocytic infiltration in the areas of hemorrhage and degenerating epidermis. This constellation of histopathologic changes suggests that involution was in progress long before blackening of the warts occurred.

背景与目标： 与变黑和随后的足底疣消退有关的炎症成分在文献中很少得到重视。观察到两名足底疣患者，其中一个疣表现出明显的临床明显炎症。然后发生所有足底疣的黑化和随后的消退。在一名患者中，分别在变黑后的24和72小时内对两个病变的活检标本进行显微镜检查，结果显示以下组织学发现角质层的血凝块和出血，表皮细胞的变性和坏死，退化的表皮细胞内的嗜酸性细胞质团块，浅表和深层真皮血管的血栓形成，单个核细胞在真皮血管内及其周围浸润，并在出血和表皮退化区域混合多形核和淋巴细胞浸润。这种组织病理学变化的星座表明，在疣变黑之前很久就在进行中。

BACKGROUND & AIMS: BACKGROUND:The optimal surgical strategy for the correction of double outlet right ventricle (DORV, transposition of the great arteries [TGA] type) or TGA with ventricular septal defect (VSD), pulmonary stenosis (PS), and borderline small left ventricle (LV) is still controversial. The half-turned truncal switch operation (HTTSO) introduced by Yamagishi and colleagues is a good option, but it is still challenging in a patient with borderline small LV. We aimed to describe our experience of a case of HTTSO conversion from single ventricle palliation. CASE PRESENTATION:A 5-year-old girl with single ventricle physiology was referred to our hospital from Kazakhstan for a Fontan operation. At the time of birth, she was diagnosed with DORV (TGA type), PS, and situs inversus totalis, with moderate valvar and subvalvar stenosis and a relatively small LV cavity. Her LV volume was not adequate to support the systemic circulation; therefore, doctors in Kazakhstan selected the single ventricle palliation course of treatment for the infant. At 4 months of age, she underwent left-sided modified Blalock-Taussig shunt, patent ductus arteriosus ligation, and atrial septectomy. At 2 years of age, shunt takedown, left bidirectional cavopulmonary shunt, and main pulmonary artery division were performed. Annual echocardiography of the patient showed that the LV size was growing too adequately to persist with the single ventricle palliation course of treatment. Via a multidisciplinary approach, we considered her LV to be suitable for biventricular repair and HTTSO was planned. The operation and postoperative course were uneventful. The patient was discharged on postoperative day 6 and went back to Kazakhstan. CONCLUSIONS:Based on our successful surgical outcome, in patients diagnosed with DORV (TGA type) or TGA with VSD, PS, and borderline LV, HTTSO after achieving adequate LV growth by single ventricle palliation may be considered a good alternative to conventional operations in patients at a high risk for initial biventricular repair.

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