Prostate carcinoma detection and increased prostate-specific antigen levels after 4 years in Dutch and Japanese males who had no evidence of disease at initial screening.
In the current study, the authors set out to investigate the possibility that increased prostate-specific antigen (PSA) levels in Dutch and Japanese men without suspicious findings at initial prostate cancer screening were indicative of the risk of newly developing clinical malignancy in the Netherlands and Japan. Between 1992 and 2000, 2650 men ages 55-74 years who had PSA levels < 4.0 ng/mL and no suspicious findings on digital rectal examination were entered into the current study from a population-based prostate cancer screening cohort in Gunma Prefecture, Japan. In addition, between 1994 and 1997, 3163 men with the same clinical background were entered into the current study from the Rotterdam (Netherlands) Section of the European Randomized Study of Screening for Prostate Cancer (ERSPC). Prostate carcinoma incidence and the cumulative probability of freedom from PSA increases to levels > 2.0, 3.0, and 4.0 ng/mL, respectively, after 4 years of observation were compared between the Japanese and Dutch populations. The predictive value of initial PSA level, age at study entry, and geographic location also were investigated using Cox proportional hazards models. The overall risk of developing prostate carcinoma during the 4-year observation period was significantly higher for the ERSPC Rotterdam cohort (5.2%) compared with the Gunma cohort (1.6%). The cumulative probability of freedom from prostate carcinoma detection and freedom from an increase in PSA levels to >/= 4.0 ng/mL (PSA progression) decreased significantly with increasing initial PSA level and did not differ significantly between Japanese and Dutch patients whose initial PSA levels fell within the same range (0.0-0.9, 1.0-1.9, 2.0-2.9, or 3.0-3.9 ng/mL). Multivariate analysis also revealed that after controlling for age and initial PSA level, the probability of PSA progression was the same for Japanese and Dutch men. Initial PSA level was the only variable found to be significantly predictive of PSA progression on multivariate analysis (P < 0.0001). The risk of developing prostate carcinoma within a given 4-year period is greater for Dutch males ages 55-69 years compared with their Japanese counterparts, because the former have higher PSA levels. Nonetheless, there appears to be no significant difference in prostate carcinoma risk between Dutch and Japanese males whose baseline PSA levels fall within the same range.


Vitamin D concentrations among healthy children in Calgary, Alberta.
To examine the relationship between serum vitamin D concentrations, dietary intake and body mass index among healthy children living in Calgary, Alberta. The present cross-sectional study included healthy children two to 13 years of age who presented to the Alberta Children's Hospital for elective surgery during a 12-month period. Data including the child's weight, height, age, sex, ethnicity, dietary intake, use of vitamin supplements, physical activity and time spent outdoors were collected. Serum concentrations of 25-hydroxyvitamin D (25[OH]D) were measured using commercial immunoradiometric assay kits. Serum 25(OH)D concentrations were available for 1442 of 1862 participants, of whom 862 (59.8%) were boys. The mean (± SD) serum 25(OH)D concentration was 86.1±35.1 nmol/L (range 10 nmol/L to 323 nmol/L). Five hundred thirty-nine (37.4%) participants had insufficient vitamin D status (25[OH]D between 25 nmol/L and lower than 75 nmol/L), and vitamin D deficiency (25[OH]D 25 nmol/L or lower) was present in 29 subjects (2.0%). Children in the older age group (nine to 13 years) were more likely to have suboptimal vitamin D (P<0.001). Other risk factors significantly associated with suboptimal vitamin D status included overweight or obesity, nonwhite ethnicity, winter months, dietary vitamin D intake of less than 200 IU/day and less time spent outdoors. A high rate of suboptimal vitamin D concentrations was observed among the participants. Beyond promoting a vitamin D-enriched diet, physicians should also consider the body mass index and other risk factors to determine the optimal vitamin D intake for children living in the area studied.


Allogeneic CD4+CD25high T cells regulate obliterative bronchiolitis of heterotopic bronchus allografts in both porcinized and humanized mouse models.
Bronchiolitis obliterans syndrome is caused by a fibroproliferative process in lung allografts resulting in irreversible damage. In this study, we induced obliterative bronchiolitis and studied the contribution of regulatory T cells to its development in immune-deficient mice receiving heterotopic porcine bronchus transplants, and major histocompatibility complex-mismatched porcine peripheral blood mononuclear cell. Furthermore, we aimed to corroborate our findings in a humanized mouse model. Heterotopic bronchus transplantation was performed in 33 NOD.rag(−/−)γc(−/−) mice, using miniature pigs as tissue donors.The recipient mice then either received saline (negative control), unsorted MHC-mismatched PBMC (positive control), PBMC enriched with CD4(+)CD25(high) cells or PBMC depleted of CD4(+)CD25(high) cells for reconstitution. The results were validated in 28 NOD.rag(−/−)γc(−/−) mice undergoing heterotopic human bronchus transplantation and reconstitution with allogeneic human PBMC. Histological lesions similar to those typical for obliterative bronchiolitis developed in vivo after reconstitution with allogeneic PBMC and were more severe in animals engrafted with PBMC depleted of CD4(+)CD25(high) cells. In contrast, the group reconstituted with PBMC enriched with CD4(+)CD25(high) cells showed well-preserved histology. The results of the humanized model confirmed those obtained in the porcinized model. In conclusion, both porcinized and humanized mouse models of heterotopic subcutaneous bronchus transplantation imitate the in vivo development of bronchiolitis obliterans syndrome-like lesions and reveal its sensitivity to T-cell regulation.


Cross-cultural adaptation and patients' judgments of a question prompt list for Italian-speaking cancer patients.
Question Prompt Lists (QPLs) have proven very effective in encouraging cancer patients to ask questions, allowing them to take up a more active role during visits with the oncologist. As no such tool has yet been validated for Italian-speaking users, we carried out the cross-cultural adaptation and evaluation of an existing Australian Question Prompt List. Cross-cultural adaptation was performed in accordance with the five steps described by Guillemin and Beaton. Forward and back translations of the original tool were carried out, and the products discussed by an Expert Committee who agreed on a prefinal version of the Italian QPL, which was submitted to 30 volunteer patients for evaluation. They rated each question's adequacy of content, clarity of wording, usefulness, and generated anxiety, on a 3-point Likert scale. Based on the analysis of patient ratings, the final version of the Italian QPL was produced. Few discrepancies between the two back translations and the original version of the instrument were noted, indicating that the Italian translation (synthesis of the 2 forward translations) was substantially accurate. Most volunteer patients felt that the questionnaire was adequate, easy to understand and useful. Only a few minor criticisms were expressed. Certain questions on diagnosis and prognosis generated the highest level of anxiety. Patient comments and ratings on clarity highlighted the need to clarify common health care terms which are not widely used by the public (i.e. guideline, multidisciplinary team and clinical trial) This cross-cultural adaptation has produced an Italian Question Prompt List that is now available for multi-center international studies and can be safely used with Italian-speaking cancer patients.


Drug-Eluting vs Standard Balloon Angioplasty for Iliac Stent Restenosis: Midterm Results.
To assess the effectiveness of drug-eluting balloon (DEB) angioplasty for the treatment of iliac artery in-stent restenosis (ISR). Data from 18 patients (mean age 59.3±9.6 years; 11 men) treated with DEB for iliac ISR between October 2009 and August 2013 were retrospectively evaluated and compared with a control group of 22 patients (mean age 66.7±11.8 years; 16 men) treated with standard balloon angioplasty (BA). Primary endpoint of the study was the primary patency rate at 12 months. Secondary endpoints were 30-day and overall mortality, sustained clinical improvement [ankle-brachial index (ABI) and Rutherford category] and clinically driven target lesion revascularization (TLR). Follow-up examinations were performed by clinical examination, color duplex ultrasound, and ABI measurement at 12 months. Mean length of the 21 lesions in the DEB group was 27.1±19.2 mm vs 20.0±11.4 mm for the 25 lesions in the BA group (p=0.508), while the grade of restenosis was 70.4%±18.4% and 64.0%±16.1% (p=0.255), respectively. Primary patency rates were 90.5% vs 85.7% at 6 months and 71.4% vs 75.6% at 12 months for DEB and BA, respectively (p=0.784). Five BA patients died during follow-up for reasons unrelated to the procedure, while no patient in the DEB group died (p=0.035). In both groups, Rutherford category and ABI significantly improved compared to pretreatment levels; there were no differences between the groups regarding these variables (p=0.367 and p=0.898, respectively). The TLR rate was 28.6% (6/21) in the DEB group and 20.0% (4/20) in the BA cohort (p=0.434). Treatment of iliac ISR using DEBs is a safe procedure, with results comparable to BA treatment. Because of the limited number of patients in this study, further investigation of a larger cohort with longer follow-up is needed to define the role of DEBs in the treatment of iliac ISR.


USP8 and PARK2/parkin-mediated mitophagy.
The Parkinson disease (PD)-associated E3-ubiquitin (Ub) ligase PARK2/parkin plays a central role in many stress response pathways, and in particular, in mitochondrial quality control. Within this pathway, PARK2 activation is accompanied by a robust increase in its autoubiquitination, followed by clearance of the damaged mitochondria by selective autophagy (mitophagy). Yet, little is known about how this auto-ubiquitination is regulated during mitophagy. In our study, we demonstrate that PARK2 forms predominantly K6-linked Ub conjugates on itself. Moreover, PARK2 interacts with the deubiquitinating enzyme USP8 that preferentially removes these K6-linked conjugates, thereby regulating the activity and function of PARK2 in the pathway. When USP8 is silenced, a persistence of K6-linked Ub conjugates on PARK2 delays both its translocation to damaged mitochondria and successful completion of mitophagy. Taken together, these findings implicate a novel role for K6-linked Ub conjugates and USP8-mediated deubiquitination in the regulation of PARK2 in mitochondrial quality control.


Beleodaq approved for rare lymphomas.
On July 3, the FDA granted accelerated approval to Beleodaq, a histone deacetylase inhibitor, for the treatment of patients with relapsed or refractory peripheral T-cell lymphoma.


Hospitalisation for monkeypox in Milan, Italy.
During the current multi-country outbreak of human monkeypox the hospitalisation rate observed in Milan, Italy was 8.8%. Bacterial superinfection and severe perianal pain were the main cause of hospitalisation requiring antibiotic treatment and analgesic therapy. One patient was treated with Cidofovir. All hospitalised patients were discharged and the outcome was favourable with full recovery.


Guide-wire versus conventional contrast cannulation of the common bile duct for the prevention of post-ERCP pancreatitis in patients with choledocholithiasis.
Inadvertent injection of a contrast agent into the pancreatic duct is an important contributor factor to post-ERCP pancreatitis. To compare the incidence of post-ERCP pancreatitis and the success rate of biliary cannulation using guide-wire cannulation or the standard contrast injection technique. A total of 128 patients with choledocholithiasis who underwent either guide-were cannulation (n=70) or contrast injection (n=58) were retrospectively reviewed. Outcome measurements were post-ERCP pancreatitis and rate of successful common bile duct (CBD) cannulation. Three patients (4.3%) in the guide-wire cannulation group and five patients (8.6%) in the contrast injection group had post-ERCP pancreatitis (p>0.05). Successful CBD cannulation was achieved in 91.4% with guide-wire cannulation and in 88% with conventional contrast cannulation (p>0.05). Our study failed to show significant reduction in the rate of post-ERCP pancreatitis with the use of guide-wire, although there was a downward trend. The success rate of cannulation was comparable between the two techniques.


[Advances on genetics and biological characteristics of Oncomelania hupensis].
This review focused on the research progress in genetic features of Oncomelania hupensis, including its relation to the snail distribution, susceptibility to Schistosoma japonicum. Series studies were done on genetic characteristics for snail distribution and its infectivity with S. japonicum by using population genetics and molecular biology approaches to explore the new avenue to block the transmission of schistosomiasis. However, limited progress has been achieved in this field inside in China comparing with global achievements. It is therefore recommended that future studies have to be focused on genetic features related to schistosome infections by referencing the study model of Biomphalaria glabrata/S. mansoni, and with assistance of modern technology on bionics, in order to improve investigations on genetics of Oncomelania hupensis in the country.


[Plasma lipid and lipoprotein levels among rural and urban populations in Poland in relation to risk factors of coronary disease].
There are significant differences in plasma total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides and blood pressure, prevalence of cigarette smoking, obesity, education level and alcohol consumption found between the rural and industrial populations in Poland. It was found that the differences in plasma lipids and lipoproteins concentration are related to the differences in age, sex, education level, alcohol consumption, obesity, cigarette smoking and blood pressure. Increase of education level was related to increase in plasma concentration of total cholesterol. LDL-cholesterol and triglycerides but it was related to decrease of HDL-cholesterol. After the adjustment to all above factors the differences in total cholesterol and LDL-cholesterol between the studied populations appeared insignificant. The differences in HDL-cholesterol and triglycerides remained significant.


[1st results of the DiaSiKa diagnostic system].
Clinical diagnoses of 61 psychiatric in-patients were compared with diagnoses obtained from the French version of a computer system for psychiatric diagnosis (DiaSiKa) based on the AMDP-rating scale. The concordance between diagnoses was comparable to the German original version of the diagnostic system. Its usefulness and practical advantages in psychiatric research are discussed.


CHL-1 provides an essential function affecting cell proliferation and chromosome stability in Caenorhabditis elegans.
A family of helicases that are important in maintaining genome stability is the iron-sulfur group. Members of this family include DOG-1/FANCJ, RTEL1, XPD and Chl1p/DDX11. In Caenorhabitis elegans, the predicted gene M03C11.2 has orthology to the CHL1 (Chromosome loss 1) gene in Saccharomyces cerevisiae and DDX11 (DEAD/H box polypeptide 11) in humans. In this paper, we show that the chl-1 gene in C. elegans is required for normal development and fertility. Mutants have lineage-independent cell proliferation defects that result in a Stu (sterile uncoordinated) phenotype, characterized by gonadal abnormalities and a reduced number of D motor neurons and seam cells. A chromosome stability defect is present in the germ cells, where an abnormal number of DAPI-staining chromosomes appear in diakinesis. CHL-1 function is required for the integrity of poly-guanine/poly-cytosine DNA in the absence of DOG-1/FANCJ: the loss of CHL-1 alone does not result in the deletion of G-tracts, but it does increase the number of deletions observed in the dog-1; chl-1 double mutant, indicating a role for CHL-1 during replication and repair. In addition, we observed that cohesin defects increased the number of deletions in the absence of DOG-1/FANCJ. Our results demonstrate a role for CHL-1 in cell proliferation and maintaining normal chromosome numbers, and implicate CHL-1 in chromosome stability and repair of unresolved secondary structures during replication.


Unsuspected damage to lumbar zygapophyseal (facet) joints after motor-vehicle accidents.
Three zygapophyseal joints from each of 31 lumbar spines of subjects who died of injuries (mostly as a result of motor-vehicle accidents) were sectioned for low-power histological study. Bony injuries, in the form of fractures of the superior articular process or infractions of the subchondral bone plate, were found in 11 of the 31 subjects and soft-tissue injuries to the capsule or articular cartilage were found in one-or-more joints in 24 of the 31 subjects, with capsular and articular-cartilage damage in 77% of cases. Healed injuries of a similar type, which were unrelated to the cause of death, were found in other lumbar spines. None of these lesions was diagnosed by standard radiological examination of the spine post mortem. It is suggested that, in survivors, bony and soft-tissue injuries to zygapophyseal joints may result in considerable pain and dysfunction and may predispose to early arthritis.


Indentation Modulus, Indentation Work and Creep of Metals and Alloys at the Macro-Scale Level: Experimental Insights into the Use of a Primary Vickers Hardness Standard Machine.
In this work, the experimental method and the calculation model for the determination of indentation moduli, indentation work, and indentation creep of metallic materials, by means of macroscale-level forces provided by a primary hardness standard machine at the National Institute of Metrological Research (INRIM) at the at room temperature were described. Indentation moduli were accurately determined from measurements of indentation load, displacement, contact stiffness and hardness indentation imaging and from the slope of the indentation unloading curve by applying the Doerner-Nix linear model; indentation work, representing the mechanical work spent during the force application of the indentation procedure, was determined by calculating the areas under the loading-unloading indentation curve, through fitting experimental data with a polynomial law. Measurements were performed with a pyramidal indenter (Vickers test). The applied force was provided by a deadweight machine, and the related displacement was measured by a laser interferometric system. Applied forces and the occurring indentation depths were simultaneously measured: the resulting loading-unloading indentation curve was achieved. Illustrative tests were performed on metals and alloy samples. Discussion and comments on the suitability of the proposed method and analysis were reported.


Hb Hekinan observed in three Chinese from Macau; identification of the GAG----GAT mutation in the alpha 1-globin gene.
Hb Hekinan, an alpha chain variant that is characterized by a Glu----Asp mutation at position alpha 27, was observed in three Chinese females attending a prenatal clinic in Macau. The relative quantities of the stable hemoglobin were 13-14% (average 13.3%); its identification was greatly aided by the separation and purification of the peptides by reversed phase high performance liquid chromatography. Dot-blot analysis of amplified DNA with 32P-labeled probes located the mutation in codon 27 of the minor alpha 1-globin gene; the change involved a GAG (coding for glutamic acid) to GAT (coding for aspartic acid) mutation.


Classical Gravitational Spinning-Spinless Scattering at O(G^{2}S^{∞}).
Making use of the recently derived, all-spin, opposite-helicity Compton amplitude, we calculate the classical gravitational scattering amplitude for one spinning and one spinless object at O(G^{2}) and all orders in spin. By construction, this amplitude exhibits the spin structure that has been conjectured to describe Kerr black holes. This spin structure alone is not enough to fix all deformations of the Compton amplitude by contact terms, but when combined with considerations of the ultrarelativistic limit we can uniquely assign values to the parameters remaining in the even-in-spin sector. Once these parameters are determined, much of the spin dependence of the amplitude resums into hypergeometric functions. Finally, we derive the eikonal phase for aligned-angular-momentum scattering.


In silico analysis to identify potential antitubercular molecules in Morus alba through virtual screening and molecular dynamics simulations.
A major obstacle in the treatment of tuberculosis (TB) is to combat the emerging resistant strains of its causing agent i.e. Mycobacterium tuberculosis (MTb). The emergence of multidrug-resistant and extensively drug-resistant -TB strains raise a requirement of new potential anti-tubercular compounds. In this direction, different plant parts of Morus alba were tested against MTb and found to be active with a minimum inhibitory concentration ranging between 125 µg/ml to 31.5 µg/ml. Further to identify the phytochompounds having anti-mycobacterium activity, phytocompounds of the plant were docked against the five MTb proteins (PDB ID: 3HEM, 4OTK, 2QO0, 2AQ1 and 6MNA). Among twenty-two tested phytocompounds, four phytocompounds with effective binding energy (kcal/mol): Petunidin-3-rutinoside (3HEM: -8.2, 4OTK: -6.9, 2QO0: -9.0, 2AQ1: -8.3 and 6MNA:-7.8), Quercetin-3'-glucoside (3HEM:-6.7, 4OTK:-7.6, 2QO0:-7.6, 2AQ1:7.6 and 6MNA:-6.4), Rutin (3HEM:-7.8, 4OTK:-7.5, 2QO0:-9.1, 2AQ1:9.3 and 6MNA:-6.9) and Isoquercitrin (3HEM:-7.3, 4OTK:-6.6, 2QO0:-7.7, 2AQ1:8.3 and 6MNA:-6.6) shows promising activity against all the five target proteins. Further molecular dynamics studies of Petunidin-3-rutinoside with three target proteins 3HEM, 2AQ1 and 2QO0 resulted with low values of average RMSD (3.723 Å, 3.261 Å, and 2.497 Å, respectively) show that the complexes have better conformational stability. The wet lab validation of the current study will pave the new dimensions for the cure of TB patients.Communicated by Ramaswamy H. Sarma.


Low-dose ionizing irradiation triggers apoptosis of undifferentiated spermatogonia in vivo and in vitro.
The present study aimed to investigate the mechanism of low-dose ionizing radiation (IR) induced apoptosis of undifferentiated spermatogonia in vivo and in vitro. Following 50 mGy IR, testicular tissues were collected from the adult DBA/2 mice at 1, 2 and 24 h; mice in the control group received pseudo-irradiation. Immunofluorescence (IF) staining and TUNEL were performed to assess DNA damage and apoptosis, respectively, in the irradiated testicular tissues. Furthermore, the spermatogonia were also irradiated in vitro, and the expression of apoptosis-related proteins was detected by Western blotting. TUNEL and flow cytometry were applied to assess cell apoptosis. γH2AX (a marker of DNA damage) was up-regulated in the seminiferous tubules at 1 and 2 h after IR, but it was reduced following the DNA repair. This was consistent with the finding that apoptosis of germline cells was present in the seminiferous tubules after IR, especially at 1 h (IF and TUNEL). Apoptosis was also present in the PLZF(+) spermatogonia, particularly at 1 h after IR. Apoptotic cells decreased with the increase in DNA repair time after IR. Moreover, the caspase-3 protein was expressed in the undifferentiated spermatogonia following IR. The expression of caspase-3, P53, Ku70 and DNA-PKcs in the cultured spermatogonia was also up-regulated following IR in vitro, but their expression decreased gradually over time after IR, which was supported by the findings from flow cytometry, and the apoptosis of spermatogonia peaked at 24 h post IR. IR may induce the apoptosis of spermatogonia at early stage in vivo, but the apoptosis of spermatogonia secondary to IR occurs at a relatively later time point (24 h) in vitro mainly. The apoptosis of spermatogonia is improved over time after IR.


Etv transcription factors functionally diverge from their upstream FGF signaling in lens development.
The signal regulated transcription factors (SRTFs) control the ultimate transcriptional output of signaling pathways. Here, we examined a family of FGF-induced SRTFs - Etv1, Etv 4, and Etv 5 - in murine lens development. Contrary to FGF receptor mutants that displayed loss of ERK signaling and defective cell differentiation, Etv deficiency augmented ERK phosphorylation without disrupting the normal lens fiber gene expression. Instead, the transitional zone for lens differentiation was shifted anteriorly as a result of reduced Jag1-Notch signaling. We also showed that Etv proteins suppresses mTOR activity by promoting Tsc2 expression, which is necessary for the nuclei clearance in mature lens. These results revealed the functional divergence between Etv and FGF in lens development, demonstrating that these SRTFs can operate outside the confine of their upstream signaling.


Protein-protein interactions between SWCNT/chitosan/EGF and EGF receptor: a model of drug delivery system.
Epidermal growth factor (EGF) was used as the targeting ligand to enhance the specificity of a cancer drug delivery system (DDS) via its specific interaction with the EGF receptor (EGFR) that is overexpressed on the surface of some cancer cells. To investigate the intermolecular interaction and binding affinity between the EGF-conjugated DDS and the EGFR, 50 ns molecular dynamics simulations were performed on the complex of tethered EGFR and EGF linked to single-wall carbon nanotube (SWCNT) through a biopolymer chitosan wrapping the tube outer surface (EGFR·EGF-CS-SWCNT-Drug complex), and compared to the EGFR·EGF complex and free EGFR. The binding pattern of the EGF-CS-SWCNT-Drug complex to the EGFR was broadly comparable to that for EGF, but the binding affinity of the EGF-CS-SWCNT-Drug complex was predicted to be somewhat better than that for EGF alone. Additionally, the chitosan chain could prevent undesired interactions of SWCNT at the binding pocket region. Therefore, EGF connected to SWCNT via a chitosan linker is a seemingly good formulation for developing a smart DDS served as part of an alternative cancer therapy.


Peripheral nerve regeneration using composite poly(lactic acid-caprolactone)/nerve growth factor conduits prepared by coaxial electrospinning.
Many neurotrophic factors have been shown to promote neurite outgrowth by improving the microenvironment that is required for nerve regeneration. However, the delivery of these bioactive agents to the nerve injury site, as well as effective and local release, remains a challenging problem. We have developed a novel composite nerve conduit comprised of poly(lactic acid-caprolactone) (P(LLA-CL)) and nerve growth factor (NGF). This was developed from core-shell structured biodegradable nanofibers, which were fabricated by coaxial electrospinning of P(LLA-CL) for the shell and bovine serum albumin (BSA) or BSA/NGF for the core. In rats, gaps of 10-mm long sciatic nerves were bridged using an autograft, an empty P(LLA-CL) conduit, a NGF injection P(LLA-CL) conduit, a P(LLA-CL)/NGF composite conduit, respectively. Regenerated nerve fibers were harvested and morphological and functional evaluation of nerve regeneration was performed at 12 weeks postsurgery. Although partial biodegradation and small cracks in the conduits were observed, the conduit outlines remained intact for 12 weeks after surgery. Based on functional and histological observations, the number and arrangement of regenerated nerve fibers, myelination, and nerve function reconstruction was similar in the P(LLA-CL)/NGF conduit group to that of the nerve autograft group (p > 0.05), but was significantly greater to the empty P(LLA-CL) and injection NGF P(LLA-CL) conduit groups (both p < 0.05). Therefore, the composite P(LLA-CL)/NGF conduit, which exhibited favorable mechanical properties and biocompatibility, could effectively promote sciatic nerve regeneration in rats.


Development of learned flavor preferences.
Rats, like humans, are born with only a few innate flavor preferences and aversions. Preferences retain great plasticity throughout the lifespan because they are sensitive to modification by experience. From an early age, rats can rapidly learn to prefer or avoid a flavor (conditioned stimulus, CS) that is associated with a positive or negative unconditioned stimulus (US). The US may be the mother's milk, social or thermotactile stimulation, or other food-related stimuli. Flavor-flavor learning occurs when the CS flavor is mixed with a naturally preferred (e.g., sweet) or avoided (e.g., bitter) US flavor. Flavor preferences and aversions are also produced by USs that have postoral positive (e.g., nutritious) or negative (e.g., toxic) actions. These types of learning appear to involve different behavioral and neural mechanisms as indicated by differences in conditioned responses, effective temporal parameters, resistance to extinction, and neurochemical mechanisms. New evidence indicates that flavor-nutrient preference learning can occur before weaning and influence food selection after weaning. Flavor conditioning not only affects food choice, but can also significantly increase food acceptance, that is, total consumption. Thus, from an early age, learning processes shape the feeding behavior of animals. While primarily serving an adaptive function, learning may play a role in biasing individuals towards excessive intake and weight gain.


Human dendritic cell interactions with whole recombinant yeast: implications for HIV-1 vaccine development.
Defects in number and function of dendritic cells (DCs) have been observed during HIV-1 infection, so therapeutic HIV-1 vaccine approaches that target or activate DCs may improve vaccine immunogenicity. To determine the potential of recombinant Saccharomyces cerevisiae yeast as an HIV-1 vaccine, we investigated interactions between yeast and human DCs. Yeast induced direct phenotypic maturation of monocyte-derived DCs (MDDCs) and enriched blood myeloid DCs (mDCs), but only indirectly matured blood plasmacytoid DCs (pDCs). Yeast-pulsed MDDCs and blood mDCs produced inflammatory cytokines and stimulated strong allo-reactive T cell proliferation. Both blood DC subsets internalized yeast, and when pulsed with yeast recombinant for HIV-1 Gag protein, both stimulated in vitro expansion of Gag-specific CD8+ memory T cells. These results suggest that S. cerevisiae yeast have potent adjuvant effects on human DCs. Furthermore, recombinant yeast-derived antigens are processed by human blood DCs for MHC class-I cross-presentation. These DC-targeting characteristics of yeast suggest that it may be an effective vaccine vector for induction of HIV-1-specific cellular immune responses.


Sticky Mittens Training to Improve Reaching Skills and Manual Exploration of Full-Term and At-Risk Infants: A Systematic Review.
To systematically review evidence of the effectiveness of sticky mittens training to improve reaching skills and manual exploration of full-term and at-risk infants and optimal training dosage. The Cochrane Collaboration and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guided this systematic review. The electronic search was performed from September 2017 to August 2021 on PubMed, Scopus, Science Direct, and Cochrane databases. Eligibility criteria followed PICO terms: clinical trials investigating the effects of sticky mittens training on reaching skills and manual exploration of full-term and at-risk infants. PEDro scale and GRADE assessed methodological quality and quality of evidence, respectively. Eight studies (313 children) were included. Five studies found statistically significant differences between experimental and control groups (62.6%). One study presented high methodological quality. Evidence synthesis showed very low and low evidence of the beneficial effects of sticky mittens training in full-term and at-risk infants, respectively. Findings suggest that sticky mittens training facilitates reaching skills and manual exploration. However, results should interpretation with caution because studies targeted full-term infants. Future research should focus on infants at risk or with motor impairments since sticky mittens training seems to show positive effects and is easy to apply.


Using theory to identify beliefs associated with support for policies to raise the price of high-fat and high-sugar foods.
Public policies designed to dramatically raise the price of high-fat and high-sugar foods have received substantial attention from researchers and the media. Although econometric studies suggest that these policies could reduce obesity rates, they are likely to face substantial public opposition. This study used the theory of perceived responsibility and social motivation as a framework to analyze data from a politically diverse convenience sample of 500 adults in upstate New York. The authors examined associations between attribution beliefs and policy support to identify what types of scientific evidence and accompanying messages appear most likely to generate public support for price-raising policies. Results suggest that public health advocates and health communicators could benefit from an increased emphasis on advertising for unhealthy foods as a cause of obesity and the food industry's (manufacturers, advertisers, markets, and restaurants) responsibility for addressing the problem.


Colorimetric sensor array for determination and identification of toxic industrial chemicals.
A low-cost yet highly sensitive colorimetric sensor array for the detection and identification of toxic industrial chemicals (TICs) has been developed. The sensor consists of a disposable array of cross-responsive nanoporous pigments whose colors are changed by diverse chemical interactions with analytes. Clear differentiation among 20 different TICs has been easily achieved at both their IDLH (immediately dangerous to life or health) concentration within 2 min of exposure and PEL (permissible exposure limit) concentration within 5 min of exposure with no errors or misclassifications. Detection limits are generally well below the PEL (in most cases below 5% of PEL) and are typically in the low ppb range. The colorimetric sensor array is not responsive to changes in humidity or temperature over a substantial range. The printed arrays show excellent batch to batch reproducibility and long shelf life (greater than 3 months).


Identification and expression of a novel class of glutathione-S-transferase from amphioxus Branchiostoma belcheri with implications to the origin of vertebrate liver.
Glutathione-S-transferases have been identified in all the living species examined so far, yet little is known to date about them in amphioxus, a model organism for insights into the origin and evolution of vertebrates. We have isolated a cDNA encoding an amphioxus (Branchiostoma belcheri) glutathione-S-transferase with a predicted molecular mass of approximately 26 kDa, from the gut cDNA library. The glutathione-S-transferase had 43.7-51.8% identity to most glutathione-S-transferases identified from aquatic organisms including fish and green alga, but it was much less identical (<27%) to other cytosolic glutathione-S-transferase classes. The phylogenetic analysis revealed that the glutathione-S-transferase was grouped together with most piscine and algal glutathione-S-transferases, separating from other cytosolic glutathione-S-transferase classes. Moreover, the glutathione-S-transferase had an exon-intron organization typical of zebrafish putative GST, red sea bream GSTR1 and plaice GSTA1 genes. The recombinant glutathione-S-transferase has been successfully expressed and purified, which showed a relatively high catalytic activity (3.37+/-0.1 unit/mg) toward 1-chloro-2, 4-dinitrobenzene and a moderate activity toward ethacrynic acid (0.41+/-0.01 unit/mg), although it had no detectable activity toward 1, 2-dichloro-4-nitrobenzene, 4-hydroxynonenal, 4-nitrobenzyl chloride and cumene hydroperoxide. In addition, we have revealed a tissue-specific expression pattern of the glutathione-S-transferase gene in B. belcheri, with the most abundant expression in the hepatic caecum. All these indicate that the amphioxus glutathione-S-transferase belongs to a novel rho-class of glutathione-S-transferases with a tissue-specific expression pattern. The relation between the glutathione-S-transferase expression in amphioxus hepatic caecum and the origin of vertebrate liver is also discussed.


Mutational analyses of the Moloney murine sarcoma virus enhancer.
Retroviral enhancers seem to play an integral role in determining tissue tropism. In an attempt to define the sequences essential for Moloney murine sarcoma virus (Mo-MSV) enhancer activity, we have undertaken deletion and insertion mutational analyses of the 72-bp repeats. We demonstrate that, in contrast to simian virus 40 (SV40), the proximal 19 bp of the 72-bp unit of Mo-MSV are not essential for enhancer function in mouse fibroblasts. Our analysis further localizes the 5' boundary of the Mo-MSV enhancer to a 5'-CAGGAT-3' region.


Isotope hydrology and baseflow geochemistry in natural and human-altered watersheds in the Inland Pacific Northwest, USA.
This study presents a stable isotope hydrology and geochemical analysis in the inland Pacific Northwest (PNW) of the USA. Isotope ratios were used to estimate mean transit times (MTTs) in natural and human-altered watersheds using the FLOWPC program. Isotope ratios in precipitation resulted in a regional meteoric water line of δ(2)H = 7.42·δ(18)O + 0.88 (n = 316; r(2) = 0.97). Isotope compositions exhibited a strong temperature-dependent seasonality. Despite this seasonal variation, the stream δ(18)O variation was small. A significant regression (τ = 0.11D(-1.09); r(2) = 0.83) between baseflow MTTs and the damping ratio was found. Baseflow MTTs ranged from 0.4 to 0.6 years (human-altered), 0.7 to 1.7 years (mining-altered), and 0.7 to 3.2 years (forested). Greater MTTs were represented by more homogenous aqueous chemistry whereas smaller MTTs resulted in more dynamic compositions. The isotope and geochemical data presented provide a baseline for future hydrological modelling in the inland PNW.


Views of mental illness and mental health care in Thailand: a report of an ethnographic study.
This paper reports some of the findings of an ethnographic study carried out in Thailand over a 2-year period. Interviews were conducted with three clinical nurses, three student nurses, 14 nurse educators, one psychiatrist, one Buddhist monk and two lay people (n = 24) about their views of mental health and mental health care in Thailand. Data (comprising field notes and interview transcripts) were analysed with the aid of Atlas.ti. Data were also collected through observation and conversation. This paper reports only the findings from the interviews. Findings emerged under the following headings: Causes of mental illness; Status of the mentally ill; Karma; Merit making; Kwan; Treatment and care; Reasons for becoming a mental health nurse. A range of causes, including the effects of ghosts and spirits, were identified under the first heading. The stigma of mental illness was noted under the second. Karma and merit making are Buddhist concepts and were discussed by many respondents as was the animist concept of kwan. Treatment and care seemed to include both 'modern' and 'traditional' approaches. These findings are discussed and some tentative 'rules' that appear to exist within the culture are mooted. The study is descriptive in nature and the findings cannot be generalized; however, it is hoped that they go some way to illuminate aspects of Thai culture as they relate to the mental health and mental health nursing fields.


Thermosensitive Microgels Containing AIEgens: Enhanced Luminescence and Distinctive Photochromism for Dynamic Anticounterfeiting.
The proposal of the aggregation-induced emission (AIE) effect shines a light on the practical application of luminescent materials. The AIE-active luminescence microgels (TPEC MGs) with photo-induced color-changing behavior were developed by integrating positively charged AIE luminogens (AIEgens) into the anionic network of microgels, where AIEgens of TPEC were obtained from the quaternization reaction between tetra-(4-pyridylphenyl)ethylene (TPE-4Py) and 7-(6-bromohexyloxy)-coumarin. The aqueous suspensions of TPEC MGs exhibit a significant AIE effect following the enhancement of quantum yield. In addition, further increase in fluorescence intensity and blueshift occur at elevated temperatures due to the collapse of microgels. The distinctive photochromic behavior of TPEC MGs was observed, which presents as the transition from orange-yellow to blue-green color under UV irradiation, which is different from TPEC in good organic solvents. The phenomenon of color changing can be ascribed to the competition between photodimerization of the coumarin part and photocyclization of TPE-4Py in TPEC. The photochromic TPEC MG aqueous suspensions can be conducted as aqueous microgel inks for information display, encryption, and dynamic anticounterfeiting.


Elderly Chinese and their family caregivers' perceptions of good care: a qualitative study in Shandong, China.
This study aims to understand what older Chinese people with chronic illness and their family caregivers perceive to be good care, and to compare perspectives of those living in rural and urban areas. We conducted semistructured interviews with 24 care recipients and 23 caregivers in Shandong, China. Two major themes were identified: (a) filial piety as the standard, and (b) modifying cultural ideals to meet reality. There was overall consistency in perceptions of study participants. Variations between rural and urban elders' perceptions appear to reflect differences in socioeconomic development and institutional structures.


Iodoaryl analogues of dioctanoylglycerol and 1-oleoyl-2-acetylglycerol as probes for protein kinase C.
Analogues of dioctanoylglycerol (diC8) and 1-oleoyl-2-acetylglycerol (OAG) containing an iodoaryl group have been synthesized and shown to compete with [3H]phorbol dibutyrate [( ([3H]PDBu) for binding to protein kinase C in a crude rat brain preparation. Phorbol diesters have been shown to bind specifically to protein kinase C and the PDBu receptor has been copurified with protein kinase C activity. All three diacylglycerol analogues were comparable to OAG in binding affinity. In an assay of protein kinase C activation, the diC8 analogue was more active than the OAG analogues, thus demonstrating greater structural specificity under the conditions of this assay.


Adenoviral gene therapy for cancer: from vectors to targeted and replication competent agents (review).
Gene therapy is an exciting novel approach for treating cancers resistant to currently available modalities. Treatment approaches are based on taking advantage of molecular differences between normal and tumor cells. Various strategies are currently in clinical development, with some promising early results reported with mutation compensation, molecular chemotherapy and replication competent viruses. Adenoviruses are among the most popular vehicles and there is a wealth of clinical data suggesting excellent safety for treatment of cancer patients. Current developments include improving targeting strategies for gene delivery to tumor cells with tumor specific promoters. Another rapidly developing field is replication competent agents, which allow improved tumor penetration and local amplification of the anti-tumor effect. Further, infectivity enhancement strategies can overcome variable expression of the primary adenovirus receptor on tumor cells, which may have reduced the clinical efficacy of previous strategies. Adenoviral cancer gene therapy approaches lack cross-resistance with other treatment options and frequently synergistic effects can be observed. Therefore, the first routine clinical applications are likely to be combination treatments.


The binding characteristics of cholinergic sites in rabbit spermatozoa.
Binding of neurotrophic ligands to rabbit spermatozoa was studied. Nicotinic cholinergic antagonists, [3H]alpha-bungarotoxin and [3H]dihydro-beta-erythroidine (DE), bound with high affinity to different sites in the tails of rabbit spermatozoa with the former binding to 10,207 sites/cell and the latter to 562 sites/cell. alpha-Bungarotoxin and DE sites resemble nicotinic sites in brain in binding affinity and specificity. [3H]Quinuclidinyl benzilate (QNB), a muscarinic cholinergic antagonist, also bound with high affinity to a single class of sites located in the heads and tails of rabbit spermatozoa. The binding characteristics of the sperm muscarinic site are similar to muscarinic sites in both innervated and noninnervated cells. Rabbit spermatozoa incubated for 16-18 h in a medium which supported motility for an extended period possessed fewer binding sites than nonincubated spermatozoa for [3H] alpha-bungarotoxin and [3H]QNB and the KD for the latter ligand was also lower. Ligands specific for the kappa and delta opiate receptors showed no affinity for rabbit spermatozoa.


Loyalties Beyond Life: An Essay on the Film Coco From a Transgenerational Perspective.
The animated film Coco tells the story of the web of relationships of a multigenerational family that faces its history, myths, and loyalties. Miguel, the film's protagonist, is confronted with his family history when he expresses his dream of being a musician, and he goes through an adventure of finding himself in the midst of his family's loyalties to the past and its history with music, spanning several generations. The aim of this article is to analyze the film from a transgenerational approach, conversing with systemic theory as well, taking into consideration questions about the characters of the Rivera multigenerational family, the dynamics of their relationships, and the invisible loyalties that present themselves in the movie. Thus, the film was analysed as a case study, using also as instrument simplified genogram. The film reveals the loyalties that are passed on from generation to generation, derived from a myth and a family secret, unveiled in the plot, which will explain inter- and transgenerational relationships in the film's family. The role of the great-grandmother stands out as a hidden protagonist in the movie.


Use of a tunnelled pleural catheter for the management of refractory hepatic hydrothorax: a new therapeutic option.
Refractory hepatic hydrothorax poses a challenging therapeutic dilemma, as treatment options are limited. Herein, we describe the case of a 48-year-old lady with advanced cirrhosis and recurrent transudative pleural effusion despite a sodium-restricted diet, optimal diuretic therapy and transjugular intrahepatic portosystemic shunt. Given the patient's platelet and coagulation disorders, thoracoscopic pleurodesis was deemed unsafe. Instead, a tunneled pleural catheter (PleurX®) was inserted under local anesthesia. Pleural drainage was achieved at the time of catheter placement and subsequently according to the patient's symptoms. Symptomatic improvement and gradual decrease of drainage volumes were noted. Six months following placement of PleurX, methicillin-resistant Staphylococcus aureus cellulitis at the insertion site prompted catheter removal. No pleural effusion was seen on chest X-ray at that time. Subsequent follow-up revealed spontaneous pleurodesis, as no recurrence of pleural effusion was seen over a 6-month follow-up period. Very few data are available with regard to the use of indwelling pleural catheters for benign transudative pleural effusion, and more specifically hepatic hydrothorax. Herein, we present this novel potential indication of the indwelling pleural catheter and illustrate the successful clinical outcome.


IDH1 and IDH2 mutations are frequent in Chinese patients with acute myeloid leukemia but rare in other types of hematological disorders.
Frequent mutations in the isocitrate dehydrogenase 1 and 2 genes (IDH1 and IDH2) have been identified in gliomas and acute myeloid leukemia (AML). Our aim is to assess whether IDH mutations were presented in Chinese patients with various hematological disorders. In this study, we screened the IDH1 and IDH2 mutations in a cohort of 456 Chinese patients with various hematological malignancies and disorders. We found three missense (p.R132C, p.R132G, and p.I99M; occurred in five patients) and one silent mutation (c.315C>T; occurred in two patients) in the IDH1 gene and two missense mutations (p.R140Q and p.R172K; occurred in four AML patients) and one silent mutation (c.435G>A) in the IDH2 gene. Except for one non-Hodgkin lymphoma (NHL) patient harboring IDH1 mutation p.R132C, all IDH1 and IDH2 missense mutations were observed in patients with AML. Intriguingly, the IDH2 mutation p.R140Q and novel IDH1 mutation p.I99M co-occurred in a 75-year-old patient with AML developed from myelodysplastic syndromes (MDS). The frequency of IDH1 and IDH2 missense mutations in Chinese AML patients reached 5.9% and 8.3%, respectively. Our results supported the recent findings that IDH gene mutations were common in AML. Conversely, IDH mutations were rather rare in Chinese patients with other types of hematological disorders.


Epley's maneuver in benign paroxysmal positional vertigo associated with Meniere's disease.
The effects of Epley's maneuver in benign paroxysmal positional vertigo (BPPV) associated with Menière's disease are controversial. To evaluate the progression of positional vertigo and nystagmus after one or more of Epley's maneuvers in BPPV associated with Menière's disease, and the recurrence of BPPV. a retrospective study of 62 patients with BPPV associated with Menière's disease, that underwent Epley's maneuver, and that were monitored during 12 months after elimination of positional nystagmus. One Epley's maneuver was required to eliminate positional nystagmus in 80.7% of the patients, two in 16.1%, and three in 3.2%; after elimination of nystagmus, positional vertigo was suppressed in 71.0% of the patients, improved in 27.4% and remained unaltered in 1.6%. Four weeks after elimination of positional nystagmus, all patients were asymptomatic. Recurrence of BPPV was seen in 19.4% of the cases, with elimination of the positional vertigo and nystagmus by means of the specific maneuver for the involved canal. In BPPV associated with Menière's disease, vertigo and positioning nystagmus were eliminated with one, two or three Epley maneuvers. BPPV recurrence was resolved by using a specific maneuver for the affected canal.


[Ultrasound diagnosis of the locomotor system].
Improvements of ultrasound technology with knew equipments allowed enormous advances in all fields of medicine during the last years. Several conditions concerning technical equipment and training of the operator have to be fulfilled to guarantee sufficient quality of the diagnostic information obtained in musculoskeletal ultrasound, Ultrasound is most commonly used in the assessment of soft tissue disease, detection of fluid collection, but can also be used to visualise structures such as cartilage and bone surfaces. Bone surface changes like erosions may be seen before they are apparent on plain x ray or even magnetic resonance imaging. Dynamic assessment of joint and tendon movements allows better understanding of the functional disorders than mainly static imaging methods. Advantages of ultrasound include its non-invasiveness, portability, relative inexpensiveness, lack of ionising radiation, and its ability to be repeated as often as necessary, making it particularly useful in the monitoring of treatment. Guidance of diagnostic aspiration, biopsy and injection treatment improves quality and security of these interventions. Newer ultrasound techniques including colour and power Doppler imaging, as well as bubble contrast agents and three dimensional reconstructions are promising tools for the future.


Length, width, shape regularity, and chain structure: time series analysis of phytoplankton morphology from imagery.
Functional traits are increasingly used to assess changes in phytoplankton community structure and to link individual characteristics to ecosystem functioning. However, they are usually inferred from taxonomic identification or manually measured for each organism, both time consuming approaches. Instead, we focus on high throughput imaging to describe the main temporal variations of morphological changes of phytoplankton in Narragansett Bay, a coastal time-series station. We analyzed a 2-yr dataset of morphological features automatically extracted from continuous imaging of individual phytoplankton images (~ 105 million images collected by an Imaging FlowCytobot). We identified synthetic morphological traits using multivariate analysis and revealed that morphological variations were mainly due to changes in length, width, shape regularity, and chain structure. Morphological changes were especially important in winter with successive peaks of larger cells with increasing complexity and chains more clearly connected. Small nanophytoplankton were present year-round and constituted the base of the community, especially apparent during the transitions between diatom blooms. High inter-annual variability was also observed. On a weekly timescale, increases in light were associated with more clearly connected chains while more complex shapes occurred at lower nitrogen concentrations. On an hourly timescale, temperature was the determinant variable constraining cell morphology, with a general negative influence on length and a positive one on width, shape regularity, and chain structure. These first insights into the phytoplankton morphology of Narragansett Bay highlight the possible morphological traits driving the phytoplankton succession in response to light, temperature, and nutrient changes.


Purification and crystallization of mono-ubiquitylated ubiquitin receptor Rpn10.
Protein ubiquitylation controls nearly all cellular pathways in eukaryotes. A repertoire of proteins named ubiquitin (Ub) receptors harbouring ubiquitin-binding domains (UBDs) recognize ubiquitylated proteins. These Ub receptors decode the Ub signal by tethering a UBD or UBDs to a functional domain or domains, thus linking the ubiquitylated target to a specific function. The rapid dynamics of ubiquitylation/deubiquitylation has impeded the characterization of ubiquitylated proteins. To bypass this obstacle, a recently developed synthetic system that reconstructs the entire eukaryotic ubiquitylation cascade in Escherichia coli was used to purify the mono-ubiquitylated form of the regulatory proteasomal non-ATPase subunit (Ub-Rpn10) from Saccharomyces cerevisiae. Here, the first crystallization and data collection of Ub-Rpn10 is reported. Purified Ub-Rpn10 was crystallized in 12%(w/v) PEG 20,000, 0.1 M MES pH 6.5 and yielded thin rhombus-shaped crystals. X-ray analysis revealed that these crystals belonged to the monoclinic system C2, with unit-cell parameters a = 107.3, b = 49.7, c = 81.3 Å, α = γ = 90.0, β = 130.5°. A full synchrotron data set has been collected, merged and scaled with a diffraction limit of 3.14 Å.


Endo-anal ultrasound versus endo-anal magnetic resonance imaging for the depiction of external anal sphincter pathology in patients with faecal incontinence: a systematic review.
To evaluate the endo-anal ultrasound (EAUS) versus endo-anal magnetic resonance imaging (EAMRI) in the diagnosis of external anal sphincter defects (EAS) in patients with faecal incontinence (FI). Studies on EAUS and EAMRI were selected and analyzed to generate summative data. Five studies encompassing 347 patients of FI were included in this review. Three studies validated the results of EAUS and EAMRI by surgery (61 patients). In the fixed effect model, EAUS was superior to EAMRI in the depiction of EAS defects. On combined analysis of five studies using fixed effect model, both EAUS and EAMRI were equally effective. However, there was a significant heterogeneity between studies. EAUS and EAMRI are comparable in the diagnosis of EAS defects in patients of FI. Since EAUS is an economical, quicker and easily available imaging modality, it may be used a preferable investigation for the diagnosis of EAS defects in patients of FI.


A Structure-Activity Study of Aromatic Acid Modulators for the Synthesis of Zirconium-Based Metal-Organic Frameworks.
Acid modulation is among the most widely employed methods for preparing metal-organic frameworks (MOFs) that are both stable and highly crystalline, yet there exist few guiding principles for selecting the optimal modulator for a given system. Using the Zr-based MOFs UiO-66 and UiO-68-Me2 (UiO = Universitetet i Oslo) as representative materials, here we present for the first time an in-depth structure-activity study of acid modulators and identify key principles of modulation for the synthesis of highly crystalline Zr-MOFs. By applying whole pattern fitting of powder X-ray diffraction (PXRD) patterns as a technique for evaluating modulator efficacy, complemented by scanning electron microscopy (SEM), 1H NMR, and thermogravimetric analysis (TGA), we demonstrate that the key to effective modulation is competition between the linker and modulator for coordination to the Zr secondary building units (SBUs). Specifically, we illustrate that a close match in pK a and structure between the linker and modulator favors larger and more well-defined crystallites, particularly with sterically unhindered aromatic acid modulators. Based on our findings, we demonstrate that 5-membered heteroaromatic carboxylic acids are among the most efficient acid modulators identified to date for the synthesis of several representative Zr-MOFs with fcu net topologies. In addition, we find that coordination modulation is superior to exogenous acid modulation at higher modulator concentrations. Finally, we compare 1H NMR and TGA as data-driven methods for quantifying linker deficiencies in modulated MOF syntheses. The guiding principles established herein have critical implications for the scalable and controllable synthesis of highly crystalline and stable MOFs relevant to chemical separations, gas storage, and catalysis.


Clinical Features, Antiviral Treatment, and Patient Outcomes: A Systematic Review and Comparative Analysis of the Previous and the 2022 Mpox Outbreaks.
This study aims to comparatively analyze clinical features, treatment, and patient outcomes between the previous and the 2022 mpox (monkeypox) outbreaks. Five bibliographic databases were searched for studies reporting clinical features, management, and patient outcomes of mpox. Systematic review and meta-analysis were performed. In total, 73 studies were included in the systematic review, of which 33 studies were subjected to meta-analysis. Previous outbreaks substantially affected children, whereas the 2022 outbreak primarily affected male adults, of which 94.66% (95% confidence interval [CI], 88.03-98.95) were men who have sex with men. Furthermore, 72.47% (95% CI, 51.04-89.71) reported high-risk sexual activity and the overall human immunodeficiency virus (HIV) prevalence was 37.65% (95% CI, 30.09-45.50). Skin lesions remain the typical symptom; however, their anatomic distribution differed. Systemic manifestations were common, but rectal pain was unique to the 2022 outbreak. The estimated overall fatality during past outbreaks in Africa was 4.61% (95% CI, 2.39%-7.35%), whereas 6.34% (95% CI, 3.35%-10.10%) of patients from the 2022 outbreak required hospitalization. Antiviral treatment, in particular tecovirimat, has been prescribed for a subset of patients, but the efficacy remains inconclusive. These findings are important for better understanding the disease and guiding adequate response to mpox outbreaks.


Effects of manual lymph drainage on cardiac autonomic tone in healthy subjects.
This study was designed to investigate the effects of manual lymph drainage on the cardiac autonomic tone. Thirty-two healthy male subjects were randomly assigned to manual lymph drainage (MLD) (experimental) and rest (control) groups. Electrocardiogram (ECG) parameters were recorded with bipolar electrocardiography using standard limb lead positions. The pressure-pain threshold (PPT) was quantitatively measured using an algometer. Heart rate variability differed significantly between the experimental and control groups (p < 0.05), but the PPT in the upper trapezius muscle did not (p > 0.05). These findings indicate that the application of MLD was effective in reducing the activity of the sympathetic nervous system.


[The use of low-frequency ultrasound in the surgical treatment of pulmonary echinococcosis].
A convincing evidence is given that the low-frequency ultrasound (26.4-26.6 kHz) has pronounced parasiticidal and bactericidal effects and can completely replace the drugs commonly used for disinfection. The low-frequency ultrasound used for treatment of the parasitic cyst bed allows the indication for organ preserving operations to be wider, the complicated forms of the disease included.


Correction of mitral regurgitation in nonresponders to cardiac resynchronization therapy by MitraClip improves symptoms and promotes reverse remodeling.
This study evaluated the safety, efficacy, and effect of MitraClip treatment on symptoms and left ventricular (LV) remodeling in nonresponders to cardiac resynchronization therapy (CRT). Moderate to severe functional mitral regurgitation (FMR) frequently persists after CRT, contributing to reduced or no response to CRT. Percutaneous repair with the MitraClip has been proposed as an additional therapeutic option in select patients with significant FMR. Fifty-one severely symptomatic CRT nonresponders with significant FMR (grade ≥2, 100%) underwent MitraClip treatment. Changes in New York Heart Association functional class, degree of FMR, LV ejection fraction (EF), and LV end-diastolic/end-systolic volumes (EDV/ESV) before and after (3, 6, and 12 months) MitraClip implantation were recorded. Mortality data, including cause of death, were collected. MC treatment was feasible in all patients (49% 1 clip, 46% 2 clips). There were 2 periprocedural deaths. Median follow-up was 14 months (25th to 75th percentile: 8 to 17 months). New York Heart Association functional class improved acutely at discharge (73%) and continued to improve progressively during follow-up (regression model, p < 0.001). The proportion of patients with significant residual FMR (grade ≥2) progressively decreased during follow-up (regression model, p < 0.001). Reverse LV remodeling and improved LVEF were detected at 6 months, with further improvement at 12 months (regression model, p = 0.001, p = 0.008, and p = 0.031 for ESV, EDV, and LVEF, respectively). Overall 30-day mortality was 4.2%. Overall mortality during follow-up was 19.9 per 100 person-years (95% confidence interval: 10.3 to 38.3). Nonsurvivors had more compromised clinical baseline conditions, longer QRS duration, and a more dilated heart. FMR treatment with the MitraClip in CRT nonresponders was feasible, safe, and demonstrated improved functional class, increased LVEF, and reduced ventricular volumes in about 70% of these study patients.


In vitro inhibition of human leukemia THP-1 cells by Origanum syriacum L. and Thymus vulgaris L. extracts.
Natural products including, traditional medicinal plants have emerged as a tempting alternative to conventional chemotherapeutic protocols of leukemia because of their minimum side effects and less documented drug resistance. Ethanol extracts were prepared from Thymus vulgaris L. and Origanum syriacum L. plants and investigated against the THP-1 leukemia cell line and freshly isolated peripheral blood mononuclear cells (PBMCs). The 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl tetrazolium bromide (MTT) assay and the lactate dehydrogenase (LDH) assay were respectively used to determine the cellular viability and cytotoxicity in response to treatment with increasing extract concentrations. Both extracts exhibited a concentration dependent reduction in viability of the THP-1 cells (IC50 = 2.126 mg/mL for O. syriacum, and 0.1569 mg/mL for T. vulgaris). O. syriacum was more potent against the PBMCs (IC50 = 0.4247 mg/mL), while T. vulgaris was moderately selective (IC50 = 0.3345 mg/mL with PBMCs and SI = 2.1). Only in O. syriacum the reduction in cells viability was caused by cytotoxic effect against leukemic cells (LC50 = of 9.646 mg/mL). T. vulgaris and O. syriacum are both antileukemic in vitro. T. vulgaris represents a potential selective cytostatic and safe target for future anticancer agents' development. O. syriacum on the other hand is cytotoxic against the leukemia cell line THP-1.


[Paradoxical response of blood pressure to salt loading in renovascular hypertension].
We studied the effect of high salt intake on blood pressure in two cases with renovascular hypertension. They had hypertension with hyperreninemia and marked difference in plasma renin activity between both renal veins. Blood pressure significantly decreased after single oral administration of captopril. Renal arteriogram revealed significant stenosis in the main artery to the left (case 1) and right (case 2) kidney. Blood pressure response was evaluated after seven (case 1) and five (case 2) days of low salt and seven days (both cases) of high salt intake. Mean blood pressure in two patients was significantly decreased (case 1; 118 +/- 5.5 to 108 +/- 6.1 mmHg and case 2; 150 +/- 3.8 to 138 +/- 3.1 mmHg). Plasma renin activity was also decreased (case 1; 6.25 to 0.77 ng/ml/hr and case 2; 22.8 to 6.3 ng/ml/hr). In case 2, blood pressure elevated markedly during low salt intake, compared with blood pressure level during normal salt intake. The results suggest that excessive salt intake in patients with unilateral renovascular hypertension produces blood pressure reduction because of suppression of renin-angiotensin system. We concluded that in patients with unilateral renovascular hypertension dietary sodium depletion may be harmful, whereas salt supplement may have a beneficial effect.


Association of church-sponsored activity participation and prevalence of overweight and obesity in African American Protestants, National Survey of American Life, 2001-2003.
This study examines the relationships between participation in the African American church and overweight/obesity (body mass index (BMI) > or = 25 kg/m2). This cross-sectional analysis was based on the National Survey of American Life 2001-2003 and included 2,689 African American Protestant (AAP) adults. Multivariate logistic regression was used to calculate adjusted odds ratios (aOR) and 95% confidence intervals (CI) for overweight/obesity. Two practices were examined--frequency of participation in church activities (excluding services) and frequency of church service attendance. Each practice was analyzed in separate models. Each model included the following covariates: age, marital status, education, poverty, smoking, and region of country. We also adjusted models for sex. After adjustment, African American Protestant men (AAPM) who participated in church activities at least weekly were more likely to be overweight/obese (aOR=2.17; 95% CI = 1.25, 3.77) compared to AAPM who did not participate in church activities. There was no statistically significant association between overweight/obesity and participation in church activities for AAPW. There was no association between overweight/obesity and attendance of church services for AAP men and women combined. For AAPM, participation in church activities was significantly associated with overweight/obesity. Further studies are required to determine why this association occurs in AAPM but not AAPW. Studies looking at the wider application of the several successful health initiatives targeting the AAP community should also be considered.


Gender Differences Between Student-Student Relationship and Cyberbullying Perpetration: An Evolutionary Perspective.
With the development of Internet technology, cyberbullying has become a serious social issue and public concern in modern society. Based on the general aggression model and an evolutionary psychological perspective, the present study aimed to examine (a) whether student-student relationship would be significantly related to cyberbullying, (b) whether materialism would mediate the link between student-student relationship and cyberbullying, (c) whether boys would be more likely to engage in cyberbullying than girls, and (d) whether there would be gender differences among the links between student-student relationship and cyberbullying. The research hypotheses were tested among 712 Chinese middle school students (M age = 13.66 years, SD = 1.36; 50% of the participants were boys) with a moderated mediation model. The results showed that student-student relationship was negatively related to cyberbullying, with their link mediated by materialism. Furthermore, boys were more likely to engage in cyberbullying than girls. Moderated mediation analyses indicated that gender moderated the path between materialism and cyberbullying, with the effect being significant only among the male participants. Gender did not moderate the link between student-student relationship and materialism, and between student-student relationship and cyberbullying. This study highlighted the importance of uncovering the links between adolescents' offline interpersonal relationships and cyberbullying, as well as the benefits of applying the evolutionary psychological perspective to study cyberbullying.


Effects of a low-sodium diet in patients with idiopathic hyperaldosteronism: a randomized controlled trial.
Idiopathic hyperaldosteronism (IHA) is one of the most common types of primary aldosteronism (PA), an important cause of hypertension. Although high dietary sodium is a major risk factor for hypertension, there is no consensus on the recommended dietary sodium intake for IHA. This study investigated the effect of a low-sodium diet on hemodynamic variables and relevant disease biomarkers in IHA patients, with the aim of providing a useful reference for clinical treatment. Fifty IHA patients were evenly randomized into two groups and provided, after a 7-day run-in period (100 mmol/d sodium), either a low-sodium diet (50 mmol/d sodium) or a normal sodium diet (100 mmol/d sodium) for an additional 7 days. After the 14-day intervention (conducted without potassium supplementation), changes in blood pressure (BP) and serum potassium were evaluated in both groups. After the dietary intervention, the low sodium group exhibited, compared to the normal sodium group, decreased BP (SBP: 121.8 ± 12.8 vs. 129.9 ± 12.1 mmHg, p < 0.05; DBP: 82.6 ± 7.6 vs. 86.4 ± 8.2 mmHg, p < 0.05; MAP: 95.7 ± 8.8 vs. 100.9 ± 8.4 mmHg, p < 0.05) and increased serum potassium levels (3.38 ± 0.33 vs. 3.07 ± 0.27 mmol/L, p < 0.001). The low sodium group showed also better control of both BP and serum potassium: BP <140/90 mmHg in 70.0% of total patients (76.0% vs. 64.0%, in the low and normal sodium groups, respectively; p > 0.05), BP <130/85 mmHg in 38.0% of total patients (56.0% vs. 20.0%, p < 0.05), BP <120/80 mmHg in 28.0% of total patients (44.0% vs. 12.0%, p < 0.05); serum potassium ≥3.5 mmol/L in 22.0% of total patients (32.0% vs. 12.0% in the low and normal sodium groups, respectively; p = 0.088). There were differences between the controlled BP group (<120/80 mmHg) and the non-controlled BP group (≥120/80 mmHg) in gender, BP at baseline, and type of diet (low vs. normal sodium). Female gender and low-sodium diet were protective factors for BP control. A low-sodium diet is effective in lowering BP and elevating serum potassium in IHA patients. Female patients on a low-sodium diet are more likely to achieve BP control (<120/80 mmHg). We advocate a dietary sodium intake of 50 mmol/d for IHA patients. https://clinicaltrials.gov, Identifier NCT05649631.


The Meningioma Vascularity Index: a volumetric analysis of flow voids to predict intraoperative blood loss in nonembolized meningiomas.
OBJECTIVEMeningiomas that appear hypervascular on neuroimaging could be amenable to preoperative embolization. However, methods for measuring hypervascularity have not been described, nor has the benefit of preoperative embolization been adjudicated. The objective of this study was to show a relationship between flow void volume (measured on MRI) and intraoperative estimated blood loss (EBL) in nonembolized meningiomas.METHODSThe authors performed volumetric analyses of 51 intracranial meningiomas (21 preoperatively embolized) resected at their institution. Through the use of image segmentation software and a voxel-based segmentation method, flow void volumes were measured on T2-weighted MR images. This metric was named the Meningioma Vascularity Index (MVI). The primary outcomes were intraoperative EBL and perioperative blood transfusion.RESULTSIn the nonembolized group, the MVI correlated with intraoperative EBL when controlling for tumor volume (r = 0.55, p = 0.002). The MVI also correlated with perioperative blood transfusion (point-biserial correlation [rpb] = 0.57, p = 0.001). A greater MVI was associated with an increased risk of blood transfusion (odds ratio [OR] 5.79, 95% confidence interval [CI] 1.15-29.15) and subtotal resection (OR 7.64, 95% CI 1.74-33.58). In the embolized group, those relationships were not found. There were no significant differences in MVI, intraoperative EBL, or blood transfusion across groups.CONCLUSIONSThis study clearly shows a relationship between MVI and intraoperative EBL in nonembolized meningiomas when controlling for tumor volume. The MVI is a potential biomarker for tumors that would benefit from embolization.


[Aspiration pH-metry of the stomach by the Linar technic--an optimal method of studying gastric secretion].
Discussion is devoted to the advantages of intragastric pH-metry and gastric probe study in aspiration pH-metry of the stomach. Data are given on the means of decoding the results of pH-metry. Aspects of the examination of gastric secretion that contribute both to research and clinical practice are discussed.


Pulmonary paracoccidioidomycosis associated with the use of natalizumab in multiple sclerosis.
Natalizumab (NTZ) is a monoclonal antibody with an immunosuppressive effect that reduces the inflammation of the central nervous system, and it has been used for the treatment of relapsing-remitting multiple sclerosis (RRMS). In patients with low cellular immune response, systemic mycosis arising from endemic areas may occur. In this article, we will describe a case of paracoccidioidomycosis as a complication to treatment with NTZ in an RRMS patient.


Underestimation of smoking hazards and smoking cessation intervention efficiency among healthcare professionals: A cross-sectional study among Korean occupational health nurses.
Occupational health nurses (OHNs) in South Korea who visit the workplace periodically could play a key role in smoking cessation. It would be helpful to assess their understanding of smoking hazards and smoking cessation methods to encourage them to provide smoking intervention services at the workplace. This study aimed to investigate the knowledge of smoking hazards and perceptions of smoking cessation methods among OHNs. We conducted an anonymous self-administered cross-sectional questionnaire survey of 108 OHN nurses employed in an occupational health service outsourcing specialized agency with 19 regional branches in Korea from July to August 2019. We assessed the perceptions of the OHNs about smoking interventions, hazards of smoking, and perceived competence to counsel smokers according to training experience, using chi-squared tests and Fisher's exact tests. The majority of the nurses underestimated the smoking-attributable fraction for lung cancer (78.7%), chronic obstructive pulmonary disease (64.8%), and mortality (49.0%), regardless of training experience on smoking cessation, while more than half perceived their skill and knowledge to counsel patients concerning smoking as inadequate (56.5%). However, those trained in smoking cessation interventions felt more competent in smoking cessation counselling, with 52.2% and 29.3% in the trained and non-trained groups, respectively (p=0.019). The OHNs in this study underestimated smoking hazards and perceived themselves as lacking counselling skills regarding smoking cessation interventions. It is necessary to encourage OHNs to promote smoking cessation by increasing their knowledge, skills and competence in smoking cessation interventions.


Association of IL-6 -174G > C Polymorphism with Susceptibility to Childhood Sepsis: A Systematic Review and Meta-Analysis.
BackgroundThis meta-analysis evaluates the correlation between the IL-6 -174 G > C polymorphism and susceptibility of childhood sepsis. Methods: We searched PubMed, ISI Web of Knowledge, Scopus, CNKI, SID, SciELO databases until December 30, 2019 to identify all eligible studies. Results: A total of 17 studies with 1,287 cases and 2,482 controls were identified. Pooled data revealed that there was no significant association between the IL-6 -174 G > C polymorphism and risk childhood sepsis in the overall population. When stratified analysis was carried out by age group of cases, no associations were found in neonates and pediatrics. However, in ethnicity-based subgroups, a significant association was found in Caucasians and Africans. Conclusions: There was no significant association of the IL-6 -174G > C polymorphism with susceptibility to sepsis in childhood overall, but there was an association with the Caucasian and African ethnic subgroups.


Glucose tolerance in the obese surgical patient.
Intraoperative glucose metabolism was studied in seven grossly obese patients during an intestinal bypass surgical procedure. Preoperative fasting plasma glucose levels were in the low normal range. Results of intravenous glucose tolerance studies during the preoperative period suggested that three patients demonstrated a diabetic utilization of glucose. Fasting awake plasma glucose levels were increased after premedication for anesthesia and surgical treatment. Following induction of anesthesia, laryngoscopy and intubation, there was a further increase in glucose concentrations. In five patients, a 25 gram glucose load was given intravenously during the anesthetic period and prior to operation; glucose utilization was severely impaired in all patients. When the glucose load was not administered to two patients, a slow uptake of glucose was suggested. Surgical trauma did not further decrease glucose utilization after anesthesia. In patients with no glucose load, surgical treatment resulted in a gradual rise in glucose levels. These results suggested that intraoperative glucose utilization is impaired in the obese. Although a marked osmotic diuresis leading to hypovolemia is not apparent in the present study, decreased intraoperative glucose utilization demonstrates that cautious intraoperative administration of glucose should be considered in the obese patient.


Van Gogh's fantasies of replacement: being a double and a twin.
The replacement child, often given the name of the deceased, is prone to fantasies that he or she is the embodiment of the dead child. Vincent van Gogh was born one year to the day after a stillborn brother of the identical name, including the middle name, Willem. In the parish register van Gogh was given the same number twenty-nine as his predecessor brother. Van Gogh's fantasies of death and rebirth, of being a double and a twin, contributed to both his psychopathology and his creativity. The replacement theme in van Gogh's life and work is evident in his voluminous correspondence containing drawings and references to his art. His parents and his brother Theo are viewed as having shared a familial fantasy system. Van Gogh's self-portraits are regarded as relevant to his being a replacement child. No single fantasy or theme can account for the complexities of development, disorder, or creativity. Van Gogh's art was vastly overdetermined, including extraordinary endowment and the motivation of a replacement child to justify his survival, surpass his rival double/twin through great achievement, repair parental depression, and defy death through immortality.


[Multidisciplinary treatment in advanced stages of spinocellular carcinoma of the oral cavity. Initial results].
As in almost all forms of tumour, the best therapeutic results for those of the oral cavity is obtained following the first treatment which must be incisive and appropriate because it often represents the sole decisive possibility of recovery. In advanced forms (stages III and IV) it is best to establish a close collaboration between surgeon, cancer specialist and radiotherapist: this paper reports the authors' experience over the past 5 years with regard to advanced stages of spinocellular carcinoma of the oral cavity treated according to a chemoradiosurgical therapeutic protocol. Of the 134 cases treated by our unit, 77 were included in the protocol showing a 78% actuarial survival rate over 40 months.


Climate resilient crops for improving global food security and safety.
Food security and the protection of the environment are urgent issues for global society, particularly with the uncertainties of climate change. Changing climate is predicted to have a wide range of negative impacts on plant physiology metabolism, soil fertility and carbon sequestration, microbial activity and diversity that will limit plant growth and productivity, and ultimately food production. Ensuring global food security and food safety will require an intensive research effort across the food chain, starting with crop production and the nutritional quality of the food products. Much uncertainty remains concerning the resilience of plants, soils, and associated microbes to climate change. Intensive efforts are currently underway to improve crop yields with lower input requirements and enhance the sustainability of yield through improved biotic and abiotic stress tolerance traits. In addition, significant efforts are focused on gaining a better understanding of the root/soil interface and associated microbiomes, as well as enhancing soil properties.


Television based fourier holographic system.
A system for recording Fourier transform holograms on a television camera for use with an existing realtime reconstruction device is described. Measurements of the system's visibility, associated efficiency measurements, and a general procedure for determining the system's optimum operating point are presented. Initial off-line reconstructions and a comparison of various optical synthesis systems for television based Fourier transform holograms are included.


Investigations of cortical and cancellous clavicle bone patterns reveal an explanation for the load transmission and the higher incidence of lateral clavicle fractures in the elderly: a CT-based cadaveric study.
Clavicle fracture is known to be one of the injuries frequently occurring in the elderly. The purpose of this study was to characterise the internal structures that might correlate with the higher incidence of lateral clavicle fracture in the elderly. Twenty clavicles were collected from ten Japanese cadavers ranging from 70 to 99 years (83.6 ± 7.6), scanned, and three-dimensional computed tomography (3D CT) images reconstructed. The clavicle lengths were divided into five equal segments. The four demarcation lines from the acromial end of the clavicle were defined as the observation points A, B, C, and D. The clavicles were then measured and analysed. It was shown that along the clavicles observation point A was the widest and points B and C the narrowest. Regarding the thickness, point D was the thickest among all four points, and there was no significant difference among the points A, B, and C. No male-female difference was found in either the cortical or cancellous bone ratio at all four points. Interestingly, the highest cortical bone ratio was observed at point B and the ratio was significantly decreased toward either end. The cancellous bone ratio was highest at point C and decreased toward both ends. Further observations showed that there were rays of trabeculae around point A, spreading from the superior-posterior edge or anterior edge toward each other and toward the lateral end and point B. Characteristics in the cortical and cancellous bone ratios and cancellous bone patterns might shed light on understanding the fractures in the lateral portion of the clavicle in the elderly.


[Appropriate antibiotic prophylaxis and treatment in surgery--comparison of concepts in North America and Japan].
Three principles must be followed to maximize the benefits of antimicrobial prophylaxis (AMP): 1) use an AMP agent that is bactericidal with a spectrum that covers the most probable intraoperative contaminants; 2) the initial dose of AMP agents should be given no more than 30 min before the skin is incised: and 3) maintain effective levels of antibiotics throughout the surgery and until at most a few hours after the incision is closed in the operating room. These recommendations have become standardized in North America and Europe. A few controversies, however, persist in Japan, especially concerning the duration of AMP. Most practitioners recommend that prophylaxis be continued until postoperative day 3 to 4. However, some authors reported that the administration of AMP agents for 3 to 4 days causes the development of resistant strains. It is thus necessary to formulate national guidelines for appropriate AMP which are validated by the results of randomized, controlled trials conducted in Japan. In the treatment of postoperative infections, Gram-stain-based antibiotic selection is necessary and full knowledge of the interrelationships between pharmacokinetics and pharmacodynamics is important for determining effective regimens. The time that serum levels exceed the minimum inhibitory concentration is the most significant parameter determining the efficacy of beta-lactams, whereas the log area under the curve and peak serum level are the major parameters for aminoglycosides and new quinolones, respectively. Careful application of these concepts should allow surgeons to use more optimal dosing regimens in Japan.


Improvement in family physician recognition and treatment of hypercholesterolemia.
Physician management of hypercholesterolemia has been poor in the past. This study investigates the effect of education and laboratory report changes on cholesterol management. Three chart audits were performed on 146 patients with cholesterol levels above 6.21 mmol/L. The first audit occurred before and the second audit shortly after the National Cholesterol Education Program (NCEP) issued their new recommendations. The recognition rate of hypercholesterolemia improved significantly after the NCEP guidelines were released. A similar significant improvement was noted in the number of patients asked to have a repeated cholesterol determination, and the number treated with diet. The third audit, after the laboratory changed its normal cholesterol range, showed a smaller improvement that was statistically insignificant. These results suggest that the NCEP guidelines are affecting physician practice.


[Importance of thoracic trauma in the multi-traumatized child].
The rate of thoracic trauma in multitraumatized children was assessed on the basis of two series of investigations: thoracic injuries increased from 8% to 34%. Severe injury to the thorax is seen in spite of a decrease in multitraumata. Thoracic trauma is a central lesion with only occasional involvement of the peripheral extremities. To assess such injuries it is essential to pay attention to factors like age-related blood volume, specific fluid metabolism, different periods of thoracic elasticity, and the relation of lung volume to the child's age.


New horizons in the ageing autonomic nervous system: orthostatic hypotension and supine hypertension.
Blood pressure regulation is an automatic, moment-by-moment buffering of the blood pressure in response to physiological changes such as orthostasis, exercise and haemorrhage. This finely orchestrated reflex is called the baroreflex. It is a regulated arc of afferent, central and efferent arms. Multiple physiological changes occur with ageing that can disrupt this reflex, making blood pressure regulation less effective. In addition, multiple changes can occur with ageing-related diseases such as neurodegeneration, atherosclerosis, deconditioning and polypharmacy. These changes commonly result in orthostatic hypotension, hypertension or both, and are consistently associated with multiple adverse outcomes. In this article, we discuss the healthy baroreflex, and physiological and pathophysiological reasons for impaired baroreflex function in older people. We discuss why the common clinical manifestations of orthostatic hypotension and concomitant supine hypertension occur, and strategies for balancing these conflicting priorities. Finally, we discuss strategies for treating them, outlining our practice alongside consensus and expert guidance.


Effectiveness of a trauma-focused group intervention for young refugees: a randomized controlled trial.
As access to evidence-based treatments for young refugees with posttraumatic stress symptoms (PTSS) is limited, we developed the trauma-focused group intervention Mein Weg to be delivered by trained social workers. A recently published pilot study delivered preliminary evidence of the intervention with regard to symptom reduction and its feasibility. The aim of this study was, therefore, to determine whether the intervention, in addition to usual care (UC), is more effective in reducing PTSS (primary outcome) compared to UC alone. A parallel group randomized controlled trial was conducted in seven German child and adolescent welfare agencies. Participants were randomly assigned to either six sessions Mein Weg (n = 50; Mage = 17.00, 94% male) or UC (n = 49; Mage = 16.92, 92% male). Mixed effect models, with fixed effects of group and time as well as their interaction, were performed on the relevant outcome measures. This trial was registered in the German Clinical Trials Registry (#DRKS00010915, https://www.drks.de/drks_web/). Intention-to-treat analyses showed that Mein Weg was significantly superior to UC regarding symptom improvement of self-reported PTSS (Mein Weg: d = .61, UC: d = .15) and depression (Mein Weg: d = .63, UC: d = -.06), but not regarding caregiver-reported symptoms and self-reported dysfunctional posttraumatic cognitions. Mein Weg is effective for young refugees according to self-reports and can be viewed as a valuable component in a stepped care approach for this vulnerable population. The findings need to be replicated with independent clinical assessments.


Hypoxia Decreases Diagnostic Biomarkers for Aspergillosis In Vitro.
The aim of the study was to evaluate the influence of hypoxia on galactomannan and (1,3)-β-d-glucan release of clinically relevant Aspergilli in vitro. Hypoxia decreased biomass and consequently led to lower biomarker release. However, when normalized to biomass, hypoxia led to increased levels of biomarkers at early growth stages (24 h). Antifungals (amphotericin B and voriconazole) decreased the galactomannan amount of A. fumigatus, even more prominently in hypoxia.


Sample preparation with fiber-in-tube solid-phase microextraction for capillary electrophoretic separation of tricyclic antidepressant drugs in human urine.
Solid-phase microextraction (SPME) is a solvent-free sample preparation technique using a thin coating attached to the surface of a fused silica-fiber as the extraction medium, which has been successfully applied to the analysis of a wide variety of compounds by coupling to gas chromatography (GC). In recent years, in-tube SPME using GC capillary column as the extraction medium has also been developed and coupled with liquid chromatography (LC) for the preconcentration of nonvolatile compounds. In this study, an on-line interface between the fiber-in-tube SPME and capillary electrophoresis (CE) has been developed, and the preconcentration and separation of four tricyclic antidepressant (TCA) drugs, amitriptyline, imipramine, nortriptyline, and desipramine, were performed with the hyphenated system. Under the optimized condition, a better extraction performance than conventional in-tube SPME was obtained, even the length of the extraction medium was much shorter. The results clearly indicated that the fiber was working effectively as an extraction medium. For the separation of these four TCAs, capillary electrophoretic separation with beta-cyclodextrin as the buffer additive has been employed and the application of the developed system to the analysis of complex sample mixtures in a biological matrix is also demonstrated.


Risk of continued institutionalization after hospitalization in older adults.
Little is known about the role of hospitalization as a risk factor for placement into long-term care. We therefore sought to estimate the percentage of long-term care nursing home stays precipitated by a hospitalization and factors associated with risk of nursing home placement after hospitalization. We studied a retrospective cohort of a 5% sample of Medicare enrollees aged ≥ 66 years. The study included 762,243 patients admitted 1,149,568 times in January-April of 1996-2008, with 3,880,292 nonhospitalized controls. We measured residence in a nursing home 6 months after hospitalization. From 1996 through 2008, 5.55% of hospitalized patients resided in a nursing home 6 months later compared with 0.54% of nonhospitalized control patients. Three quarters of new nursing home placements were precipitated by a hospitalization. Independent risk factors for long-term care placement after hospitalization included advanced age (odds ratio [OR] = 3.56 for age 85-94 vs. 66-74 years), female gender (OR = 1.41), dementia (OR = 6.15), and discharge from the hospital to a skilled nursing facility (SNF; OR = 10.83). Having a primary care physician was associated with reduced odds (OR = 0.75). In the adjusted analyses, risk of institutionalization after hospitalization decreased 4% per year from 1996 to 2008. There were very large geographic variations in rates of long-term care after hospitalization, from < 2% in some hospital referral regions to > 13% in others for patients > 75 years in 2007-2008. Most placements in nursing homes are preceded by a hospitalization followed by discharge to a SNF. Discharge to a SNF is associated with a high risk of subsequent long-term care.


Polyarticular Neurogenic Heterotopic Ossification in a Spinal Cord Injury: A Case Report from Saudi Arabia.
A 33-year-old male victim of a motor vehicle accident, who presented with a T12 (thoracic 12 vertebra) burst fracture (ISNCSCI T11 AIS-A: International Standards for Neurological Classification of Spinal Cord Injury T11 ASIA Impairment Scale), was admitted to a rehabilitation hospital. A stage-II left ischial pressure ulcer was also reported. An X-ray of the pelvis revealed bilateral neurogenic heterotopic ossification (NHO) in both hips and knees, which was further confirmed by TC-99m methylene diphosphonate (MDP) bone scintigraphy. Interventions included indomethacin and conservative management. Surgery was not preferred, as NHO was still immature. Moreover, patient transfer and lower body dressing were unaffected by NHO. It is important to consider an early radiological screen in selected high-risk cases for NHO, to minimize the risk of associated complications.


Effect of dental care programme and fluoridation in the prevention of dental caries in asthmatic children.
To investigate the effect of a regular dental care programme on the dental health of asthmatic children. This prospective, controlled study was conducted at Dokuz Eylul University, Izmir, Turkey, between 2012 and 2014, and comprised asthmatic and non-asthmatic children between 4 and 16 years of age who used inhaler corticosteroid treatment for at least 1 year. Patients were examined for dental caries, gingival index, salivary flow rate, and salivary pH values at baseline, 6 months, and at the end of the first year. Demographic features and tooth-brushing habits of the asthmatic and non-asthmatic children were also analysed. SPSS 20 was used for data analysis. Of the 102 patients, there were 51(50%) each in asthmatic and non-asthmatic groups. Besides, 38(70.6%) participants were boys and 15(29.4%) were girls in the first group compared to 30(58.8%) boys and 21(41.2%) girls in the second group. The mean age was 11.16±3.10 years and 10.33±2.62 years, respectively, in the two groups. The number of asthmatic patients was 45(88.2%) in visit 2 and 37(72.5%) in visit 3, whereas the number of participants for the control group was 41(80.4%) in visit 2 and 36(70.4%) in visit 3. During the first visit, mean values for salivary pH and flow rate were 7.135 0.15 and 3.878 0.71 mL/min among asthma patients, and 7.158 0.14 and 4.684 0.50 among controls. In the first visit, the rate of gingivitis was 31(60.8%) in asthmatic children and 12(23.5%) in the control group. During the third visit, the rate was 4(11.1%) and 5(13.5%) among the two groups, respectively. Decreased salivary flow rates associated with the drugs used by asthmatic patients caused an increase in the rate of dental caries and gingival disorders.