In-vitro and in-vivo evaluation for the bio-natural Alginate/nano-Hydroxyapatite (Alg/n-HA) injectable hydrogel for critical size bone substitution

Currently, bio-natural injectable hydrogels are receiving a lot of attention due to their ability to control, adjust, and adapt to random bone defects, in addition, to their ability to mimic the composition of natural bones. From such a viewpoint, this study goal is to prepare and characterize the injectable hydrogels paste based on the natural alginate (Alg) derived from brown sea algae as a polysaccharide polymer, which coupled with nano biogenic-hydroxyapatite (n-HA) prepared from eggshells and enriched with valuable trace elements. The viscosity and mechanical properties of the paste were investigated. As well as the in-vitro study in terms of water absorption and biodegradability in the PBS, biocompatibility and the capability of the injectable Alginate/n-Hydroxyapatite (Alg/n-HA) to regenerate bone for the most suitable injectable form. The injectable hydrogel (BP -B sample) was chosen for the study as it had an appropriate setting time for injecting (13 mins), and suitable compressive strength reached 6.3 MPa. The in vivo study was also carried out including a post-surgery follow-up test of the newly formed bone (NB) in the defect area after 10 and 20 weeks using different techniques such as (SEM/EDX) and histological analysis, the density of the newly formed bone by Dual x-ray absorptiometry (DEXA), blood biochemistry and the radiology test. The results proved that the injectable hydrogels Alginate/n-Hydroxyapatite (Alg/n-HA) had an appreciated biodegradability and bioactivity, which allow the progress of angiogenesis, endochondral ossification, and osteogenesis throughout the defect area, which positively impacts the healing time and ensures the full restoration for the well-mature bone tissue that similar to the natural bone.

A split-mouth randomized controlled trial to compare the rate of canine retraction after a soft tissue procedure compared against a corticotomy procedure for accelerated tooth movement

Background and Aim

Various methods to accelerate the orthodontic tooth movement have been used, among which corticotomy is considered to be the most common one. The suggested reasoning for such acceleration was the regional acceleratory phenomenon (RAP). Since the RAP is a property of both the hard and soft tissues, we designed a soft tissue flap procedure to compare the effects with the conventional corticotomy procedure. A split-mouth study was conducted where the two procedures were assessed in a single participant.

Patients and Methods

The total sample size was calculated to be 40 with 20 participants in each group. The rate of tooth movement was the primary outcome measure, and the secondary outcomes were dentoalveolar changes, which were studied in both the conventional corticotomy and the flap-only procedure based on a cone-beam computed tomography (CBCT) wherein the alveolar bone density (BD) around canines, tipping, and rotational changes in canines, premolars, and molars were assessed.

Results

Corticotomy resulted in greater canine angulation, lesser canine rotation and premolar rotation, and greater molar rotation compared with flap elevation, but these differences were statistically insignificant.

Conclusion

Though the corticotomy resulted in higher BD, the differences were statistically insignificant. There was no significant difference in the rate of space closure assessed by the two techniques compared.

G-Quadruplex selectivity and cytotoxicity of a guanidine-encapsulated porphyrin-cyclodextrin conjugate

G-Quadruplex DNAs represent out-of-the-way nucleic acid conformations, frequently formed by guanine-rich sequences. They have emanated as cancer-associated targets for designed small molecules. The variation in the binding affinity of the synthesized compounds to duplex and quadruplex structures is an intriguing quest, solved by spectroscopic analysis. In this paper, we report the synthesis of a porphyrin-cyclodextrin conjugate, characterized by utilizing FT-IR, NMR, and mass spectrometry. Further, two benzimidazolylguanidines are synthesized which form host: guest complexes with the porphyrin-cyclodextrin conjugate. The structure of the complexes is optimized by analyzing their 2D ROESY spectra. The interactions of the host, guest, and the host: guest complexes with the duplex (calf thymus DNA) and quadruplex (kit22) nucleic acids are investigated employing UV-vis, fluorescence, circular dichroism, and DNA melting experiments. The calculated strengths of the compounds' binding with kit22 are in the order of 10⁶, which is larger than those observed for the duplex DNA binding. The significant G-quadruplex selectivity of the host: guest complex of anthracenyl-benzimidazolylguanidine is discussed in detail. Further, the in vitro cytotoxicity of the compounds on MCF-7 cell lines is examined. The host: guest complexes show enhanced half-maximal inhibitory concentration values compared to the un-complexed compounds.

WHO informal consultation on revision of guidelines on evaluation of similar biotherapeutic products, virtual meeting, 30 June – 2 July 2021

The WHO informal consultation was held to promote the revision of WHO guidelines on evaluation of similar biotherapeutic products (SBPs) adopted by the Expert Committee on Biological Standardization (ECBS) in 2009. It was agreed in the past consultations that the evaluation principles in the guidelines are still valid, but a review was recommended to provide more clarity and case-by-case flexibility. The opportunity was therefore taken to review the experience and identify areas where the current guidance could be more permissive without compromising its basic principles, and where additional explanation could be provided regarding the possibility of reducing the amount of data needed for regulatory approval. The meeting participants applauded the leading role taken by the WHO in providing a much-needed streamlined approach for development and evaluation of SBPs which will provide efficient and cost-effective product development and increase patient access to treatments. It was recognized that the principles as currently described in the draft WHO guidelines are based on sound science and experience gained over the last fifteen years of biosimilar approvals. However, since these guidelines when finalised will constitute the global standard for biosimilar evaluation and assist national regulatory authorities in establishing revised guidance and regulatory practice in this complex area, it was felt that further revision and clarity on certain perspectives in specific areas was necessary to dispel uncertainties arising in the current revised version. This report describes the principles in the draft guidelines, including topics discussed and consensus reached.

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WHO guidelines serve as a basis for the development of national regulatory framework for biosimilars.

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Revision of guidelines is to provide more flexibility and clarification on data required for regulatory approval.

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Revised guidelines would contribute to improving consistency on regulatory decision and patient access to treatments.

An overview from simple host-guest systems to progressively complex supramolecular assemblies

Supramolecular chemistry involving macrocyclic hosts is a highly interdisciplinary and fast-growing research field in chemistry, biochemistry, and materials science. Host-guest based supramolecular assemblies, as constructed through non-covalent interactions, are highly dynamic in nature, and can be tuned easily using their responses to various external stimuli, providing a convenient approach to achieve excellent functional materials. Macrocyclic hosts, particularly cyclodextrins, cucurbit[n]urils, and calix[n]arenes, which have unique features like possessing hydrophobic cavities of different sizes, along with hydrophilic external surfaces, which are also amenable towards easy derivatizations, are versatile cavitands or host molecules to encapsulate diverse guest molecules to form stable host-guest complexes with many unique structures and properties. Interestingly, host-guest complexes possessing amphiphilic properties can easily lead to the formation of various advanced supramolecular assemblies, like pseudorotaxanes, rotaxanes, polyrotaxanes, supramolecular polymers, micelles, vesicles, supramolecular nanostructures, and so on. Moreover, these supramolecular assemblies, with varied morphologies and responsiveness towards external stimuli, have immense potential for applications in nanotechnology, materials science, biosensors, drug delivery, analytical chemistry and biomedical sciences. In this perspective, we present a stimulating overview, discussing simple host-guest systems to complex supramolecular assemblies in a systematic manner, aiming to encourage future researchers in this fascinating area of supramolecular chemistry to develop advanced supramolecular materials with superior functionalities, for their deployment in diverse applied areas.

Thromboembolic risk is potentially reduced in mitral stenosis shortly after percutaneous mitral valvotomy

Background

Rheumatic mitral stenosis (MS) is a problem in the developing countries. Left atrium (LA) and appendage (LAA) dysfunction are considered determinant factors for thrombus formation even in patients with sinus rhythm (SR). Percutaneous mitral valvotomy (PMV) is a well accepted therapeutic option. However, no available data considers patients with SR as a low risk group for the development of thrombus.

Purpose

Studying short term impact of PMV on P wave morphology, NT-pro BNP as well as LAA properties in patients with MS and SR.

Methods

A prospective study was conducted in a tertiary University hospital including 41 patients with symptomatic uncomplicated MS having favorable morphology with sinus Rhythm. P wave duration, amplitude and dispersion, NT-pro BNP, transthoracic and transesophageal echocardiography were carried out directly before and 1 month following PMV. Student t-test was used to compare the variables before and after PMV. Correlation was calculated using Pearson's correlation and multivariate regression analysis was used for prediction of unfavorable outcomes.

Results

After PMV, 36 (87.8%) patients had a favorable outcome manifested with improvement of NYHA class, valve area, estimated systolic pulmonary artery pressure (sPAP) as well as grade of spontaneous echo contrast (SEC). P wave duration, P wave amplitude and P wave dispersion decreased after PMV (14.97±2.65 vs. 13.21±2.36 ms, 4.01±1.01 vs. 2.51±0.71 ms and 4.01±1.01 vs. 2.51±0.71mv; P<0.001 respectively). NT pro-BNP also reduced (2.90±2.19 vs. 2.01±1.31 Pg/L; P<0.001). TEE PW of LAA showed increase of early (E LAA) and late (A LAA) emptying velocities after PMV (41.70±19.50 vs. 48.82±20.18 and 31.31±21.99 vs. 38.48±19.86 cm/s; P<0.001 respectively). By TDI, late wall motion (LAA A) velocity increased (7.41±2.50 vs. 8.23±3.01 cm/s; P<0.001) with an improvement of LAA ejection fraction post procedural (50.80±13.11 vs. 55.75±10.12%; P<0.001). Negative correlation between LAA EF and P wave amplitude (r=−0.40; P<0.001) as well as a correlation between reduction in NT pro-BNP and the improvement of both LAA A velocity and E LAA wave were noticed (r=0.55; P=0.02 and 0.01 respectively). The grade of SEC was negatively correlated with E LAA (r=−0.55, P=0.02). Only 5 patients (12.2%) had an unfavorable outcome. Four patients had severe mitral regurge (7.8%), only one patient (2.4%) was indicated for surgery. AF developed in one patient (2.4%). The grade of SEC remains the same in 3 patients (7.3%). Both baseline estimated sPAP and Wilkins score were predictors for unfavorable outcome; sPAP (odd's ratio= 4.08; 95% CI=1.01- 7.17; P=0.04); Wilkins score (odd's ratio= 1.59; 95% CI=1.22- 5.98; P=0.01).

Conclusion

PMV has a favorable rapid impact on LA and LAA properties in patients with MS and SR. Our data suggests that PMV could potentially contribute to lowering the risk of future thromboembolic events in those patients.

Funding Acknowledgement

Type of funding sources: Public Institution(s). Main funding source(s): Assiut University Hospital

The prognostic value of cardiac magnetic resonance in assessment of right ventricular function after percutaneous balloon mitral valvuloplasty

Background

Mitral stenosis (MS) results in right ventricular (RV) dysfunction secondary to chronic pulmonary hypertension. Poor outcomes have been reported in patients with persistent chronic RV dysfunction. Persistence RV dysfunction can affect the clinical improvement after percutaneous balloon mitral valvuloplasty (PBMV). Cardiac Magnetic Resonance (CMR) is emerged as a highly sensitive technique for assessment of RV function (RVF).

Purpose

To investigate RV function 3 months after PBMV using a variety of robust parameters associated with prognosis.

Methods

A prospective observational study was conducted in a tertiary University hospital included 31 patients with symptomatic uncomplicated MS with favorable morphology and having sinus rhythm who underwent PBMV. All patients were subjected to TTE and CMR examination 24 hours directly before and 3 months after PBMV for assessment of RV size and function.

Results

CMR showed reduced RV myocardial mass (36.1±6.1 vs 28.0±5.4g, P<0.001), RV end-diastolic volume (RV EDV) (123.5±31.3 vs 109.5±22.7 ml, P=0.03) and TR regurgitant fraction (19.6±8.6 vs 14.7±4.9%, P<0.001) On the other hand, there were increase in each of RV ejection fraction (60.0±10.4 vs 63.13±7.8%, P<0.001), RV stroke volume (SV) (50.2±15.1 vs 33.2±12.2 ml, P<0.001) and RV stroke index (44.2±7.7 vs 50.3±8.6 ml/beat/m2 <0.001). TTE showed improved systolic RV function parameters measured by fractional area change (42.1±7.8 vs 51.7±5.4%, P<0.00), Tei Index (0.6±0.1 vs 0.5±0.1, P<0.001) and TAPSE (22.2±3.3 vs 25.7±5.1 mm, P=0.04). Among RV diastolic parameters, there were an increase in TV-TDI E' (12.0±3.0 vs 14.0±2.0 cm/s, P<0.001), TV-TDI A' (13.0±3.0 vs 11.0±2.0 cm/s, P<0.001) and TV-TDI E'/A' (1.0±0.5 vs 1.3±0.3, P<0.001) with significantly decreased RV wall thickness (5.7±0.7 vs 4.3±0.8 mm P<0.001) 3 months after PBMV. Among patients who showing improved RV parameters by TTE, ten patients (32,3%) showed non improved RV end systolic volume, EDV, SV and stroke index by CMR.

Conclusion

Follow-up of RV function by TTE after PBMV yielded nearly similar results compared to CMR. However, CMR identified a subgroup of patient with persistent RV dysfunction 3 months after PBMV. That contributes to define the role of cardiac MRI in the evaluation of the prognosis in patients with MS.

Funding Acknowledgement

Type of funding sources: Public Institution(s). Main funding source(s): Assiut University hospital and Al Orman Institute

Evaluation of Ti/Al alloy coated with biogenic hydroxyapatite as an implant device in dogs' femur bones

The main target of the present research was a full assessment of the toxicity effects and biocompatibility of a Ti/Al-alloy device coated with biogenic hydroxyapatite (bHA) when implanted in dogs in comparison with those of an uncoated Ti/Al-alloy device. The coating of the alloy was carried out using controlled high-velocity suspension flame spray (HVSFS) technique. Both coated and uncoated devices were implanted in dogs' femur bones for different time periods (45 days and 90 days). Bone-formation ability and healing were followed up, and blood analysis was performed, at Time zero (immediately post surgery), and then at 3 days, 45 days, and 90 days post surgery. Bone mineral density checks, radiological scans of the femur bone, and histological analysis were also conducted. The in-vivo study results proved that implantation of a device made from bHA-coated Ti/Al alloy in dogs' femur bones is completely safe. This is due to the high osteoconductivity of the coated alloy, which enables the formation of new bone and a full connection between new and original bone material. At 90 days post surgery, the coated alloy had been completely digested within the original bone; thus, it appeared as a part of the femur bone and not as a foreign body. Both the scanning electron microscopy with energy-dispersive X-ray and histology analysis findings affirmed the results. Furthermore, the blood tests indicated no toxicity effects during the 90 days of implantation.

Effects of Long-Acting Testosterone Undecanoate on Behavioral Parameters and Na + , K+-ATPase mRNA Expression in Mice with Alzheimer`s Disease

Previous studies have shown that testosterone attenuates stress-induced mood dysfunction and memory deterioration. However, the exact mechanism is still unknown. This study was conducted to investigate the role of long-term testosterone undecanoate on the behavioral responses in AD induced by AlCl3 + D-galactose administration and the possible alteration of the gene expression level of the Na/K ATPase pump. Adult male mice received AlCl3 in drinking water (10 mg/kg/day) and (D-gal 200 mg/kg/day), subcutaneously for 90 consecutive days, then received a single intramuscular (I.M) injection of castor oil (vehicle) on day 91, while treated groups received a single I.M injection of either low (100 mg/kg/45 days) or high dose (500 mg/kg/45 days) respectively of long-acting testosterone undecanoate on day 91. The time spent in the interaction zone during the open field test, preference index to novel objects in the novel object recognition test, spontaneous alternation percentage (SAP) in Y-maze test, and escape latency time in the Morris water maze test were used to measure the locomotor activity, long-term memory, and spatial memory in mice, respectively. The results showed that testosterone undecanoate treatment improved locomotor activity, improved preference to novel objects, improved spatial memory, and reversed anxiety and depression induced by AlCl3 + D-galactose administration in male mice, suggesting the enhancement of behavioral and memory functions brought by testosterone treatment. Moreover, testosterone undecanoate treatment did alter gene expression levels of Na/K ATPase isoforms in the brain hippocampus. In most cases, altered gene expression was significant and correlated with the observed behavioral changes. Taken together, our findings provide new insight into the effects of long-acting testosterone undecanoate administration on locomotor activity, long-term memory, anxiety, and spatial memory in male mice with Alzheimer's disease.

Severe preeclampsia is associated with postpartum diastolic dysfunction and non-dipping blood pressure profile pattern

Background

Left ventricular diastolic dysfunction and non-dipping profile, detected by ambulatory blood pressure monitoring (ABPM), are two features recorded to be associated with sustained hypertension. Both are predictors of an increased cardiovascular morbidity later in life. Complete normalization of blood pressure (BP) in preeclampsia is detected over a variable period of time.

Methods

A prospective cohort study was conducted in a tertiary university hospital including normotensive women with a history of preeclampsia in the current pregnancy enrolled within the first week postpartum. All cases were subjected to 24 h-ABPM and 2D trans-thoracic echocardiography three months post postpartum concomitantly with a clinical evaluation. Chi2-test was used to compare the qualitative data while student t-test was used to compare the quantitative data. Multivariate regression analysis was used for prediction of non-dippers and diastolic dysfunction in our cohort.

Results

Hundred twenty eight women were included in the study. Their mean age was 28.6±5.1 years and the mean basal BP was 123.1±6.4/74.6±5.9 mm Hg. Out of the studied women, 90 (70.3%) women were dippers and 38 (29.7%) women were non-dippers. It was noticed that diastolic dysfunction was presented in 28 (73.7%) of non-dippers while none of dippers had diastolic dysfunction. Women with severe preeclampsia had higher frequency of non-dipper (35.5% vs. 24.2%; P=0.02) and diastolic dysfunction (29% vs. 15%; P=0.01) in comparison to those women with mild preeclampsia. Severe preeclampsia and previous history of preeclampsia were significant predictors for non-dipping status (OR=1.1, 95% CI: 0.05–10.56 and 1.4, 95% CI: 0.30–4.26 respectively, R2 = 0.7; P<0.001). They were also predictors for diastolic dysfunction in our studied population (OR = 1.6, 95% CI: 1.1–2.2 and 1.3, 95% CI: 1.2–2.2 respectively, R2 = 0.6; P<0.05).

Conclusion

Women with a history of preeclampsia have the risk for developing cardiovascular events later in life. The severity and recurrence of preeclampsia were significant predictors for both non-dipping profile and diastolic dysfunction.

Funding Acknowledgement

Type of funding source: Public hospital(s). Main funding source(s): Orman Heart Hospital-Assiut University; Women Health Hospital-Assiut University

Influence of the thermal treatment on the characteristics of porous geopolymers as potential biomaterials

Highly porous sodium geopolymer structures were successfully produced through the chemical direct foaming approach at ambient temperature. The impact of the thermal treatment, as well as the influence of various additions of hydrogen peroxide, as a foaming agent, on the porosity, microstructure and mechanical characteristics of the produced geopolymers was investigated. The evaluation of bioactivity was carried out by assessing the formation of an apatite layer on the samples' surface, using scanning electronic microscopy and inductively coupled plasma spectrometry for the simulated body fluid solution, in which the geopolymer samples were kept up to 28 days. In addition, the biodegradability was estimated through the weight change of the samples and pH-measurements. The results demonstrated that the geopolymer foams, produced using 4.5 vol% H₂O₂ and heat-treated at 500 °C for 1 h, possessed a high open porosity (71 vol %), excellent compressive strength (3.56 ± 0.27 MPa), and suitable chemical stability. The pH value of SBF solutions, in which these geopolymers were immersed for 28 days, remained close to the physiological one. The in vitro study indicated that the developed geopolymer foams possessed bioactivity, as demonstrated by the formation of apatite particles on their surface after immersion in the simulated body fluid solution for 28 days.

Multimode binding and stimuli responsive displacement of acridine orange dye complexed with p-sulfonatocalix[4/6]arene macrocycles

Interaction of acridine orange (AOH+) dye with water soluble anionic p-sulfonatocalix[n]arene (SCXn) hosts, SCX4 and SCX6, having different cavity dimensions, has been investigated using multispectroscopic techniques. Intriguing modulation in the photophysical properties of AOH+ upon interaction with SCXn hosts indicate the formation of different host-guest complexes at different regions of the host concentrations. At lower host concentrations, AOH+ undergoes SCXn assisted aggregation, causing a drastic reduction in fluorescence intensity. At higher host concentrations, aggregated-AOH+-SCXn complexes disintegrate and monomeric-AOH+-SCXn exo and inclusion complexes are eventually formed, leading to a huge fluorescence enhancement finally. Observed effects are more pronounced with SCX6 as compared to SCX4 host. Time-resolved fluorescence studies indicate that at very high host concentrations, there is also a diffusion-controlled dynamic quenching for both monomeric-AOH+-SCXn exo and inclusion complexes, caused by the free SCXn present in the solution, a phenomenon not reported before for such host-guest systems. The aggregated-AOH+-SCXn complexes at lower host concentration were employed to investigate displacement study using an antiviral drug, 1-adamantanamine (AD) and a neurotransmitter, acetylcholine (AcCh), as the competitive binders cum external stimuli, which resulted in a drastic recovery of the fluorescence reduced initially due to aggregation process. Though both the AOH+-SCXn systems act as efficient supramolecular assemblies in sensing AD and AcCh as the analytes through fluorescence "OFF-ON" mechanism, the effect is more pronounced for AOH+-SCX4 system as compared to AOH+-SCX6. SCXn induced interesting modulation in the photophysical properties of AOH+ and the stimulus responsive dye displacement observed for aggregated-AOH+-SCXn systems can expectedly find applications in fluorescence OFF-ON sensing, supramolecular functional materials and similar others.

Contrasting interactions of DNA-intercalating dye acridine orange with hydroxypropyl derivatives of β-cyclodextrin and γ-cyclodextrin hosts

The present study demonstrates contrasting binding interactions of acridine orange dye with HPβCD and HPγCD hosts, always illustrating fluoresence “turn on” in the case of HPβCD and showing an interesting fluorescence “off/on switching” in the case of the HPγCD host.

Investigation the impact of ZTA addition on the properties of nano biogenic hydroxyapatite

The target of the recent study is to achieve a significant inexpensive and eco-friendly way for getting ZTA/HA composites, based on the nano-HA derived from the eggshell biogenic source. Combining simultaneously the porous structure; which is considered as a bone formation key, with developed mechanical properties and adequate biocompatibility, is another purpose of this study. Furthermore, the impact of ZTA addition from 10-30 mass-%, fabricated by uniaxial pressing and sintering at 1200-1300 °C for 2 h, on the physical and mechanical properties, microstructure and phase composition of ZTA/HA composite bodies was investigated. The results demonstrated that the increasing of ZTA content increases the bodies' apparent porosity and decreases the bulk density due to the decomposition of HA into β-TCP. Where the formation of β-TCP possessed the predominant impact on the mechanical properties of the sintered ZTA/HA composites. ICP, SEM, EDX and thin film XRD results of composites containing 20 mass-% ZTA affirmed the excellent bioactivity of the bodies.

Complexation induced aggregation and deaggregation of acridine orange with sulfobutylether-β-cyclodextrin

The present study illustrates intriguing switching of multi-mode binding interactions of acridine orange dye with a sulfobutylether-β-cyclodextrin host.

Unraveling multiple binding modes of acridine orange to DNA using a multispectroscopic approach

The interaction of acridine orange (AOH(+)) with calf thymus DNA (ct-DNA) under different dye-DNA conditions has been investigated in detail using multispectroscopic techniques, unraveling a number of hitherto unexplored intricacies of dye-DNA binding. The observed results intriguingly show contrasting binding features when low (2.4 μM) and significantly high (23 μM) dye concentrations are used. It is conclusively inferred from absorption, steady-state fluorescence, circular dichroism, fluorescence decay and anisotropy decay studies that at low [DNA] to [dye] ratio, especially with higher dye concentration, dimeric AOH(+) predominantly binds externally to DNA surfaces through electrostatic interactions. At sufficiently high [DNA] to [dye] ratios, however, the interaction intriguingly changes to monomeric AOH(+) bound to DNA, predominantly in the intercalative mode between DNA base pairs, with partly an electrostatic binding on DNA surfaces. With very low initial dye concentration, monomeric (AOH(+)) mostly binds to DNA through intercalative and electrostatic modes for most DNA to dye ratios. The present study demonstrates a systematic correlation of the striking changes in the photophysical properties of the dye upon multimode binding with DNA. The observed results are of great significance in understanding the fundamental insights of dye/drug binding to DNA hosts, of use in the design of effective therapeutic agents.

Circulating Tumor Cells and Cancer Stem Cells: Clinical Implications in Nonmetastatic Breast Cancer

Purpose

Despite the therapeutic advances, disease recurrence remains an ever-present threat to the health and well-being of breast cancer survivors. Assessment of circulating tumor cells (CTCs) and cancer stem cells (CSCs) during and after treatment may be of value in refining treatment.

Methods

Three 5 mL blood samples were taken from each patient: the first, at diagnosis; the second, after completion of neoadjuvant anthracyclin-based chemotherapy; and the third, a month after surgery and completion of adjuvant radiotherapy. The absolute numbers of CTCs were identified as CD45-cytokeratin+ cells. CTCs per 5 mL of blood were determined by recording all events in the whole suspension. CSCs were identified as cytokeratin⁺CD44⁺CD24-/CD45- cells. The CSCs were expressed as a percentage of CTCs.

Results

Univariate analysis identified the measurements of baseline CTCs and CSCs, taken after chemotherapy and one month after the cessation of radiotherapy, as prognostic factors for both four-year disease-free survival and four-year overall survival. Multivariable analysis identified the third measurement of CSCs, taken one month after the completion of radiotherapy, as the only independent prognostic factor for the four-year disease-free survival (P < 0.002, hazard ratio [HR] = 1.231, 95% CI 1.077–1.407). The initial CTC measurement was the one factor that reached significance on multivariate analysis (P < 0.03, HR 1.969, 95% CI 1.092–3.551) for the four-year overall survival. Correlation was higher between CTC and CSC counts at diagnosis (r = 0.654, P < 0.001) than after chemotherapy (r = 0.317, P < 0.03), because of the more rapid decrease in the mean CTC count with chemotherapy.

Conclusion

The CTC count could be suitable as one of the measures for monitoring response to chemotherapy, while persistence of CSC after cessation of the treatment of nonmetastatic breast cancer, except hormonal therapy when indicated, may be a reason to consider additional therapy in the future. These findings need confirmation in larger randomized trials.

[Effectiveness and Cost-Effectiveness of Daily School Sport in the Primary School--Project: "fit for pisa"]

The "fit for pisa" intervention implemented daily physical education at five primary schools in Göttingen. The results of the evaluation show an increase in physical activity among the students participating in the programme. At the same time sedentary behaviour, like watching television, decreased remarkably. In the long run the promotion of an active lifestyle had improved the body mass index. The study emphasises the need for government funding to implement the programme across the country.

pH-Assisted control over the binding and relocation of an acridine guest between a macrocyclic nanocarrier and natural DNA

Controlled binding and relocation of a dye–drug between a macrocyclic nanocarrier and natural DNA is demonstrated using pH as a stimulus.

Triple emission from p-dimethylaminobenzonitrile-cucurbit[8]uril triggers the elusive excimer emission

The intriguing dual-emission behavior of p- dimethylaminobenzonitrile (DMABN) and the identity of the associated excited states is, arguably, the most extensively investigated and also controversially discussed molecule- specific phenomenon of modern photochemistry. We have now found a new, third fluorescence band when DMABN is encapsulated within the water-soluble molecular container cucurbit[8]uril (CB8). It is centered between the previously observed emissions and assigned to the elusive excimer emission from DMABN through 1:2 CB8:DMABN complex formation. Heating of the CB8⋅(DMABN)2 complex from 0 to 100 °C results in the dissociation of the ternary complex and restoration of the dual-emission properties of the monomer. Alternatively, monomer emission can be obtained by selecting cucurbit[7]uril (CB7), a host homologue that is too small to accommodate two DMABN molecules, or by introducing ethyl instead of methyl groups at the amino terminus of the aminobenzonitrile guest.

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.

[Acute osteomyelitis in children: early MRI diagnosis]

PURPOSE

To assess the value of MRI for early diagnosis of osteomyelitis in children presenting with sepsis and acute onset of musculoskeletal pain.

MATERIALS AND METHODS

MRI including fat suppressed T2W, and fat suppressed pre- and postcontrast T1W sequences was performed within 48 hours of admission in 26 children with clinical (fever and acute musculoskeletal pain) and biological (elevated WBC count and ESR in all cases, and elevated CRP in 12 patients) suspicion of acute osteomyelitis. None of the patients had sickle cell disease.

RESULTS

MRI was normal in 7 children (26%). Bone marrow signal abnormality was noted in 19 cases (74%) consistent with acute osteomyelitis in 18 cases and metastatic neuroblastoma in 1 case.

CONCLUSION

MRI is useful for evaluation of children presenting with sepsis and acute musculoskeletal pain, early diagnosis of osteomyelitis and to prevent unnecessary hospital admission and work-up.

Identification of the autophosphorylation sites and characterization of their effects in the protein kinase DYRK1A

Protein kinases of the DYRK ('dual-specificity tyrosine-regulated kinase') family are characterized by a conserved Tyr-Xaa-Tyr motif (Tyr-319-Tyr-321) in a position exactly corresponding to the activation motif of the mitogen-activated protein kinase (MAP kinase) family (Thr-Xaa-Tyr). In a molecular model of the catalytic domain of DYRK1A, the orientation of phosphorylated Tyr-321 is strikingly similar to that of Tyr-185 in the known structure of the activated MAP kinase, extracellular-signal-regulated kinase 2. Consistent with our model, substitution of Tyr-321 but not of Tyr-319 by phenylalanine markedly reduced the enzymic activity of recombinant DYRK1A expressed in either Escherichia coli or mammalian cells. Direct identification of phosphorylated residues by tandem MS confirmed that Tyr-321, but not Tyr-319, was phosphorylated. When expressed in COS-7 cells, DYRK1A was found to be fully phosphorylated on Tyr-321. A catalytically inactive mutant of DYRK1A contained no detectable phosphotyrosine, indicating that Tyr-321 is autophosphorylated by DYRK1A. MS identified Tyr-111 and Ser-97 as additional autophosphorylation sites in the non-catalytic N-terminal domain of bacterially expressed DYRK1A. Enzymic activity was not affected in the DYRK1A-Y111F mutant. The present experimental data and the molecular model indicate that the activity of DYRK1A is dependent on the autophosphorylation of a conserved tyrosine residue in the activation loop.

Protein kinase CK2 is involved in G2 arrest and apoptosis following spindle damage in epithelial cells

p53 undergoes phosphorylation on several residues in response to cellular stresses that include UV and ionizing radiation, however the influence of spindle damage on this parameter is relatively unclear. Consequently, the effect of nocodazole on serine 392 phosphorylation was examined in two epithelial cell lines. We show that this process is dependent upon the stepwise activation of p38 mitogen-activated protein kinase (p38 MAPK) and protein kinase casein kinase 2 (CK2). Furthermore, this activation correlated with the biochemical regulation of the maturation-promoting factor (MPF, cdc2/cyclin B), as both DRB and antisense depletion of CK2, as well as SB203580 were associated with an inhibition of its activation in response to nocodazole. Strikingly, when the cell cycle characteristics of nocodazole treated cells were examined, we observed that depletion or inhibition of the catalytic subunit of CK2, in the presence of microtubule inhibitors, resulted in a compromise of the G2 arrest (spindle checkpoint). Furthermore, CK2-depleted, nocodazole treated cells demonstrated a dramatic reduction in the apoptotic cell fraction, confirming that these cells had been endowed with oncogenic properties. These changes were observed in both HeLa cells and HCT116 cells. We also show that this effect is dependent on the presence of functional wild-type p53, as this phenomenon is not apparent in HCT116 p53(-/-) cells. Collectively, our results indicate two novel roles for CK2 in the spindle checkpoint arrest, in concert with p53. Firstly, to maintain increased cyclinB/cdc2 kinase activity, as a component of G2 arrest, and secondly, a role in p53-mediated apoptosis. These findings may have implications for an improved understanding of abnormalities of the spindle checkpoint in human cancers, which is a prerequisite for defining future therapies.

How was this story told in the mother tongue? An integrative perspective

Most of the psychoanalytic literature on the mother tongue has focused on the clinical therapeutic encounter. The authors applied findings from therapy research using the Thematic Apperception Test (TAT) to tease out differences and similarities in how stories are told in the mother tongue versus the acquired language. This projective test provides a rich medium to explore the individual's inner world, fantasies, thoughts, wishes, sense of self, and self-in-relation-to-other via a narrative that is spontaneously produced in response to standardized stimuli. The TAT was administered to four participants in both the mother tongue and the acquired language. The narratives were then analyzed using two different rating systems. Differences in sense of self, self-in-relation-to-other, and level of pathology were identified using one participant's narratives. Although no global generalizations can be made from one study, the authors suggest that people tell their story differently when speaking in the mother tongue versus the acquired language.