Synthesis and structure of polymeric networks of silver hexafluoroacetylacetonate complexes of THF, toluene, and vinyltrimethylsilane.
The reaction of 1,1,1,5,5,5-hexafluoroacetylacetone (Hhfac) with Ag2O in the presence of L=THF, toluene, and Me3SiCH=CH2 was studied to obtain [Ag(hfac)L]x complexes for use as chemical vapor deposition precursors. The structures and volatilities of these three complexes were compared to those of the previously synthesized Ag(hfac)(Me3SiC triple bond CSiMe3), 1, which was also crystallographically characterized for comparison. The reaction of Ag2O with Hhfac in THF forms the polymeric complex [Ag4(hfac)4(THF)2]infinity, 2, which has tetrametallic subunits with hfac ligands that bridge via oxygen and carbon. Both 4- and 5-coordinate silver metal centers are found in 2. Ag2O reacts with Hhfac in toluene to form a complex with a similar tetrametallic unit [Ag4(hfac)4(toluene)2]infinity, 3. In this case, the tetrametallic subunits are assembled via bridging toluene molecules, and each silver is 6-coordinate. In the presence of excess vinyltrimethylsilane (vtms), Ag2O and Hhfac form [Ag3(hfac)3(vtms)]infinity, 4, which contains trimetallic subunits assembled via oxygen atoms of bridging hfac ligands and 5- and 6-coordinate silver.


A spatial view of the CD8+ T-cell response: the case of HCV.
In viral infections, a memory T-cell population comprises multiple subtypes of cells, distributed in diverse anatomic compartments and possibly re-circulating among them. Accordingly, memory T cells display distinct phenotypes and functions, depending on the nature of the infecting virus, the anatomic location of the infection, and the differences between the sites of active infection and T-cell collection. This paper explores the body compartments where virus-specific CD8(+) T cells have been found during chronic hepatitis C virus infection, describes the cells' memory qualities, and discusses how they are spatially regulated, in comparison with other human viral infections. Understanding the role of compartmentalization and diversity of HCV-specific memory T-cell subsets may be the key to developing effective immunotherapies.


Noninvasive separation of large, medium, and small myocardial infarcts in survivors of reperfused ST-elevation myocardial infarction: a comprehensive tissue Doppler and speckle-tracking echocardiography study.
The objective of the study was to evaluate the ability of established and new parameters of global systolic left ventricle function to estimate myocardial infarct size. Increasing infarct extent is associated with impaired prognosis in chronic ischemic heart disease. Systolic myocardial deformation is a complex 3D process that is mainly influenced by the amount and transmural distribution of viable myocardium. Speckle-tracking echocardiography (2D-STE) enables deformation assessment along the 3 main cardiac axes independent of insonation angle. Global longitudinal, circumferential, and radial strain and left ventricle twist by 2D-STE, global longitudinal strain rate and strain by tissue Doppler imaging, and left ventricle ejection fraction and wall motion score index were assessed in 40 patients 8.5+/-5.4 months after a first myocardial infarct and compared with global myocardial infarct mass assessed by contrast-enhanced MRI. Longitudinal and circumferential strain by 2D-STE and longitudinal strain and strain rate by tissue Doppler imaging significantly separated medium-sized infarcts from small or large infarcts at the global level (P<0.05). All deformation indices correlated significantly with global infarct mass (P<0.01). Circumferential and longitudinal strains by 2D-STE demonstrated the best ability to identify medium-sized global myocardial infarcts. Circumferential and longitudinal strains by 2D-STE correlate with myocardial infarct mass and significantly differentiate among large, medium, and small myocardial infarcts.


The rapid molecular genetic diagnosis of cystic fibrosis by polymerase chain reaction: an experience report.
The authors report their experience with about two thousand DNA amplifications by polymerase chain reaction (PCR) in prenatal diagnosis of cystic fibrosis. The method is demonstrated on examples of diagnostic informativity and prenatal diagnosis examination in a family at 1 in 4 risk of the disease using closely CF-linked diagnostic polymorphisms: J3.11/MspI, MetH/MspI, CS7/HhaI, KM19/PstI, Mp6-d9/MspI and XV2c/TaqI, PCR methodology and safety precautions are discussed.


Prognostic significance of cyclooxygenase-2, epidermal growth factor receptor 1, and microvascular density in gastric cancer.
Gastric cancer remains a significant global health burden with poor treatment outcome. New treatment modalities that target inflammation, proliferation, and angiogenesis have been used in various cancers, including gastric cancer. We sought to study the pattern of expression of two important proteins, cyclooxygenase-2 and epidermal growth factor receptor, and their association with microvascular density, clinicopathological features, and survival in Arab Omani patients with gastric cancer. Formalin-fixed, paraffin-embedded tumors were studied by immunohistochemistry using monoclonal antibodies to cyclooxygenase-2, epidermal growth factor receptor, and CD34. The immunohistochemical results were correlated with clinicopathological features and survival. In our study population, we found a male/female ratio of 72:43, a median age of 59 years, stage III and IV incidence of 66.9%, and a median follow-up of 96 months. Positive expression rates of cyclooxygenase-2 and epidermal growth factor receptor were 89.6 and 23.5%, respectively. The median microvascular density value was 52.5. When this value was determined as the cut-off point, 50% of patients were found to have high microvascular density. Epidermal growth factor receptor over-expression correlated with high microvascular density values, advanced lymph node involvement (N3), and TNM stage presentation (III and IV). Similarly, lymph node involvement was associated with cyclooxygenase-2 over-expression and high microvascular density. Univariate analysis showed that epidermal growth factor receptor over-expression, pathological T3 and T4 disease, and overall stage III and IV disease were adverse prognostic factors. On multivariate analysis using a Cox regression model, expression of epidermal growth factor receptor, and advanced TNM stage were significant adverse prognostic factors for overall survival. Expression of epidermal growth factor receptor in Arab Omani patients with gastric cancer correlates with aggressive tumor characteristics and is an independent prognostic factor. Further clinical studies are needed to evaluate the utility of epidermal growth factor receptor immunohistochemistry as a tool for gastric cancer treatment.


Hand hygiene compliance rates after an educational intervention in a neonatal intensive care unit.
An observational study was performed at a level III neonatal intensive care unit to assess the impact of a hand hygiene promotion educational program on rates of compliance with hand hygiene on entrance into the unit. There was an initial improvement in the rate of compliance at 1 month after the intervention (from 89% [168 of 189 opportunities] to 100% [212 of 212 opportunities]; P<.001], but the rate decreased to the baseline rate at 3 months (89% [85 of 96 opportunities]).


Innovative tooth-colored CAD/CAM polycarbonate splint design for prosthetic rehabilitation of a young ectodermal dysplasia patient with permanent tooth aplasia.
Ectodermal dysplasia (ED) is one of the congenitally syndromic diseases with dental anomalies. This syndrome manifests in various forms and usually requires early restorative therapy to restore esthetics and function in young patients. The restorative approaches vary greatly and range from minimally invasive shape corrections using composite build-ups and removable partial or complete dental prostheses, to implantologic solutions, always based on the syndromic expression, the age of the patient, the residual growth, as well as the dentition itself. The present case report presents an innovative prosthetic management of a young patient suffering from ED with permanent tooth aplasia and persistent primary teeth using maxillomandibular individually veneered tooth-colored CAD/CAM polycarbonate splints. The CAD phase has been significantly improved by including the analysis of 3D face scans. This advanced technical development makes it possible to avoid any time-consuming try-in and start directly with the splint production, ensuring a much faster complete rehabilitation and support for the young patient.


Fast consensus in a large-scale multi-agent system with directed graphs using time-delayed measurements.
This article is on fast-consensus reaching in a class of multi-agent systems (MAS). We present an analytical approach to tune controllers for the agents based on the premise that delayed measurements in the controller can be preferable to standard controllers relying only on current measurements. Controller tuning in this setting is however challenging due to the presence of delays. To tackle this problem, we propose an analytic geometry approach. The key contribution is that the tuning can be implemented for complex eigenvalues of the arising graph Laplacian of the network, complementing the current state of the art, which is limited to real eigenvalues. Results, therefore, extend our knowledge beyond symmetric graphs and enable the study of the MAS under directed graphs. This article is part of the theme issue 'Nonlinear dynamics of delay systems'.


[In vivo anti-tumor activity of tumor-targeting pH-sensitive lipoprotein-mimic nanocarrier with paclitaxel loaded].
Paclitaxel( PTX) is used as a broad spectrum anti-tumor medicine. However,serious drawbacks restrict clinical application of PTX. In this study,we prepared tumor-targeting and pH-sensitive lipoprotein-mimic nanocarrier containing paclitaxel( BSALC/DOPE-PTX) to study the effective antitumor activity. The in vivo targeting ability of the nanocarrier in tumor bearing nude mice was evaluated by using a Kodak in vivo imaging system FX PRO. The in vivo anti-tumor activity was evaluated in MDA-MB-231 tumor bearing mice,and representative sections were stained with hematoxylin and eosin( H&E),and examined by light microscopy. The results showed that DiR-loaded FA-BSA-LC/DOPE selectively targeted tumor,and had a relatively long residence in the tumor tissue. According to the in vivo anti-tumor activity study,FA-BSA-LC/DOPE-PTX exhibited an outstanding tumor inhibition effect with a tumor growth inhibition rate of 79.3%,and tumor tissue sections stained by hematoxylin and eosin( HE) showed severe necrosis areas and many dead cells with condensed nuclei in the FA-BSA-LC/DOPE-PTX group. Therefore,FA-BSA-LC/DOPE-PTX is a biocompatible,tumor-targeting and pH-sensitive lipoprotein-mimic nanocarrier,with a very marked anti-tumor activity in tumor-bearing mice in vivo.


Use of Urodynamics by Gynecologists and Urologists in Brazil.
Urodynamic studies (UDSs) are a set of tests that assess the storage and emptying of urine, and they are widely used by gynecologists and urologists in the management of urinary incontinence (UI), despite the discussion about its indications. The objectives of the present study were to verify whether UDSs are routinely used in the conservative and surgical approaches to female UI, their other clinical indications, and to compare the responses of Brazilian gynecologists and urologists. The present is an opinion survey applied from August 2020 to January 2021 through a semistructured questionnaire about the clinical practice sent by e-mail to all participants. The responses were compared through statistical analyses. Of the 329 participants, 238 were gynecologists (72.3%) and 91, urologists (27.7%). Most gynecologists (73.5%) and urologists (86.6%) do not request UDSs before the conservative treatment of UI; but UDSs are indicated in the preoperative period of anti-incontinence surgeries. Most participants request UDSs in the initial approach to overactive bladder (gynecologists: 88.2%; urologists: 96.7%), and the urologist has greater chance to request this study (odds ratio [OR] = 3.9). For most participants, it is necessary to request uroculture before the UDSs. Most Brazilian gynecologists and urologists who participated in the present study do not request UDSs before the conservative treatment of UI, according to national and internacional guidelines, and often request it before the surgical treatment for female UI. The indication of this exam in the initial approach of idiopathic overactive bladder should be reviewed by the participants.


"Bariatric Beriberi": A Rare Case of Wernicke Encephalopathy Two Weeks After Laparoscopic Sleeve Gastrectomy.
Wernicke encephalopathy (WE) is an acute neurological syndrome caused by thiamine (vitamin B1) deficiency. This disorder manifests as a triad of gait ataxia, confusion, and vision abnormalities. The absence of a full triad does not rule out WE. Because of its vague presentation, WE is commonly missed in patients with no history of alcohol abuse. Other risk factors for WE include bariatric surgery, hemodialysis, hyperemesis gravidarum, and malabsorption syndromes. WE is a clinical diagnosis that can be confirmed with an MRI of the brain as hyperintensities in the mammillary bodies, periaqueductal area, thalami, and hippocampus. If suspected in a patient, WE must be immediately treated with intravenous thiamine to prevent evolution into Korsakoff syndrome, coma, or death. Currently, there is no consensus in the medical community as to how much thiamine must be given and for how long. Therefore, there is a need for more research in the diagnosis and management of WE after bariatric surgery. Herein, we report a rare case of a 23-year-old female with a history of morbid obesity who developed WE two weeks after a laparoscopic sleeve gastrectomy.


Major depression with ischemic heart disease: effects of paroxetine and nortriptyline on measures of nonlinearity and chaos of heart rate.
Depression is associated with increased cardiovascular mortality in patients with preexisting cardiac illness. A decrease in cardiac vagal function as suggested by a decrease in heart rate variability (HRV) or heart period variability has been linked to sudden death in patients with cardiac disease as well as in normal controls. Recent studies have shown decreased vagal function in cardiac patients with depression as well as in depressed patients without cardiac illness. In this study, we compared 20 h awake and sleep heart period nonlinear measures using quantification of nonlinearity and chaos in two groups of patients with major depression and ischemic heart disease (mean age 59-60 years) before and after 6 weeks of treatment with paroxetine or nortriptyline. Patients received paroxetine, 20-30 mg/day or nortriptyline targeted to 190-570 nmol/l for 6 weeks. For HRV analysis, 24 patients were included in the paroxetine treatment study and 20 patients in the nortriptyline study who had at least 20000 s of awake data. The ages of these groups were 60.4 +/- 10.5 years for paroxetine and 60.8 +/- 13.4 years for nortriptyline. There was a significant decrease in the largest Lyapunov exponent (LLE) after treatment with nortriptyline but not paroxetine. There were also significant decreases in nonlinearity scores on S(netPR) and S(netGS) after nortriptyline, which may be due to a decrease in cardiac vagal modulation of HRV. S(netGS) and awake LLE were the most significant variables that contributed to the discrimination of postparoxetine and postnortriptyline groups even with the inclusion of time and frequency domain measures. These findings suggest that nortriptyline decreases the measures of chaos probably through its stronger vagolytic effects on cardiac autonomic function compared with paroxetine, which is in agreement with previous clinical and preclinical reports. Nortriptyline was also associated with a significant decrease in nonlinearity scores, which may be due to anticholinergic and/or sympatholytic effects. As depression is associated with a strong risk factor for cardiovascular mortality, one should be careful about using any drug that adversely affects cardiac vagal function.


Exposure duration as a confounding methodological factor in projective testing.
Exposure duration has been found to have a strong impact on the affective value attributed to a variety of stimuli. The purpose of the study reported here was to examine the impact of this variable in projective testing, and im particular in the affective value subjects attribute to the TAT cards. Using 34 undergraduate students, a linear decrease in pleasantness was found as a function of exposure duration. Factors leading to variation in exposure duration might therefore be confounded with the interpretations made of a subject's protocol. It was suggested that the time a subject views a projective test stimulus should be controlled in the administration.


Evaluating the Benefits of a Family Support Program on the Health and Well-Being of Aging Family Caregivers of Adults with Intellectual and Developmental Disabilities.
Providing care to a family member with intellectual and developmental disabilities (I/DD) takes a toll on the health of the caregiver and the family, especially as they age. Research shows that peer mediated family support programs can improve caregiver health and well-being. To date, most family support programs have focused on family caregivers of children and youth with I/DD. The purpose of this study was to examine the benefits of participating in the Michigan Older Caregivers of Emerging Adults with Autism and Neurodevelopmental Disabilities (MI-OCEAN) family support program grounded in the Family Quality of Life (FQOL) framework. Specifically, we examined the effect of participation on health care utilization, caregiver well-being, and perceptions of global FQOL for older caregivers of adults with I/DD. Quantitative analysis of data gathered from 82 caregivers (age 50 and older) indicated that study participation was associated with increased use of Medicaid and improved caregiver well-being (reduced burden, stress, depression; increased health satisfaction and FQOL). Future research is needed to examine the long-term impact of the family support programs in improving the health and well-being of older caregivers of adults with I/DD.


In vivo antioxidant activity of methanol extract from quinoa fermented with Rhizopus oligosporus.
Previously, this author reported that the fermentation of quinoa with Rhizopus oligosporeus increased antioxidant activity, and the antioxidant activity of the 80% methanol extract of the fermented quinoa (Q-tempeh) was higher than the other extracts with n-hexane and water in vitro. In this paper, to clarify a beneficial effect of the fermentation of quinoa with R. oligosporus, the antioxidant activity of 80% methanol extract of Q-tempeh was investigated in rats ex vivo and in vivo. In the ex vivo experiment, the 80% methanol extract from Q-tempeh increased both activities of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) in the liver, and accelerated the production of 12-hydroxyeicosatetraenoic acid (12-HETE) in the lung. In rats fed vitamin E-free diets with 80% methanol extract of Q-tempeh, the alpha-tocopherol concentration, thiobarbituric acid-reactive substance (TBARS) value, and activities of GSH-Px and SOD in serum showed a similar concentration to those of the control rats fed a vitamin E-supplemented diet. However, the hepatic GSH-Px and SOD activities were higher than those in the control rats. On the other hand, in rats fed a vitamin E-free diet with the 80% methanol extract of quinoa, the serum alpha-tocopherol level was lower, and both TBARS values of serum and liver were higher than those in the control rats. From these results, the 80% methanol extract of Q-tempeh was inferred to be an active superoxide scavenger and peroxide reducer in vivo.


Invasive aspergillosis in children with acquired immunodeficiencies.
Invasive aspergillosis has emerged as an important cause of morbidity and mortality in immunocompromised children. It remains difficult to diagnose, and outcome depends on early diagnosis, appropriate treatment, and restoration of host defenses. Pediatric patients represent a unique population in their clinical presentation and epidemiology, particularly in respect to the utility of newer diagnostic tools and the pharmacokinetics of antifungal agents. This article reviews the presentation and epidemiology of invasive aspergillosis in children and adolescents with acquired immunodeficiencies and discusses the value of current diagnostic tools and the options for treatment and prevention in this population.


[Changes in the beta 2-microglobulin level during hemodialysis].
The authors studied changes of the beta 2-microglobulin level during hemodialysis with dialyzers AIP-02-02 (cuprophane membrane), E2 (cuprophane membrane), AIP-03-02 (polysulfone membrane), F60 (polysulfone membrane), and hemodiafiltration with dialyzer F60. The following data were obtained. The beta 2-microglobulin level in patients undergoing hemodialysis is approximately 20 times the normal level. No essential fluctuations of the level of this protein occurs during hemodialysis and hemodiafiltration. The cuprophane membrane does not cause increase of beta 2-microglobulin generation during hemodialysis. Standard hemodialysis with the cuprophane membrane and the highly-permeable polysulfone membrane does not lead to decrease of the beta 2-microglobulin level. Hemodiafiltration with the highly-permeable polysulfone membrane is an effective method for the elimination of this protein.


In vitro and in vivo evaluation of antifungal combinations against azole-resistant Aspergillus fumigatus isolates.
Azole resistance in Aspergillus fumigatus (Af) has become a widespread threat and a major concern for optimal management of patients with invasive aspergillosis (IA). Combination of echinocandins with azoles is an attractive alternative option for the treatment of IA due to azole-resistant Af strains. The aim of this study was to evaluate the in vitro and in vivo combination of caspofungin (CAS) with either voriconazole (VRZ) or posaconazole (PSZ). In vitro interactions were assessed by two methods, and an animal model of IA in Galleria mellonella was used for in vivo evaluation. Assessment of efficacy was based on larvae mortality. Groups of 10 larvae were infected by 3 clinical strains of Af (azole susceptible, AfS; PSZ resistant, AfR1; VRZ and PSZ resistant strain, AfR2). In vitro, combination of CAS and azoles was indifferent against AfS, and AfR2, and a synergy was found for AfR1. When compared to VRZ monotherapy, the combination of VRZ at 4 µg/larva with CAS at 4 µg/larva improved survival of AfR2-infected larvae (p=0.0066). Combination of PSZ at 4µg/larva with CAS at 4 µg/larva improved survival of AfR1-infected larvae compared to CAS (p=0.0002) and PSZ (0.0024) monotherapy. Antagonism was never observed. In conclusion, the combination of caspofungin with azoles is a promising alternative for the treatment of azole resistant strains of Af.


Occupational Therapy for People Living With Human T-Lymphotropic Virus 1: Importance and Effectiveness of an Intervention Plan at the Level of Prevention and Rehabilitation.
Human T-lymphotropic virus 1 (HTLV-1)-associated myelopathy (HAM) restricts activities of daily living (ADLs), affecting health and quality of life. Occupational therapy is used to promote independence during ADL in people living with HTLV (PLHTLV). To quantify the clinical aspects, levels of functionality, performance in ADLs and occupational roles of PLHTLV and propose an occupational therapeutic intervention. A cross-sectional, descriptive, observational study was designed with 40 PLHTLV monitored at two referral laboratories of the Federal University of Pará. The Evandro Chagas Research Institute Neurological Disability Scale (EIPEC-2), the Barthel Index and the Occupational Roles Identification List were applied. The G test and Fisher's exact test (to identify associations between qualitative variables), the Mann-Whitney test (to identify associations between quantitative variables) and Pearson correlation analysis (to identify associations between the total Barthel Index and EIPEC-2 scores) were performed with Microsoft Excel and BioEstat 5.0, and the significance level was set at p ≤ 0.05. Motor aspects, the presence of spasticity, sensory aspects, and pain in the lumbar region and lower limbs were significantly (p = 0.0002) higher among symptomatic individuals, who also had more difficulties urinating, traveling up and down stairs and transferring from a chair to a bed. Being a worker, performing housework and socializing (with friends or family members) were the most affected activities among HAM patients. The impact of HAM on PLHTLV should include an intervention plan with occupational therapists in rehabilitation programs to create an important third-level prevention initiative, which may help achieve short-, medium-, and long-term goals. Asymptomatic PLHTLV should also be able to prevent future ADL impairment.


Functionality of Selected Aromatic Lamiaceae in Attracting Pollinators in Central Spain.
Planting floral margins in agricultural landscapes has been shown to increase the abundance of pollinators in agro-ecosystems. However, to create efficient margins, it is necessary to use attractive, not weedy native plants with different blooming periods to prolong the availability of floral resources. Six native perennial plants of the Lamiaceae with different blooming periods were studied in a randomized block design, with the final aim to select the most efficient plants in floral mixtures by studying relationships between their floral phenology, floral density, and attractiveness to pollinators in Central Spain. In addition, their spatial expansion, i.e., potential weediness, was estimated under the field conditions, as the final purpose of the plants is to be implemented within the agro-ecosystems. The results showed that plant species with higher floral density (Nepeta tuberosa L. and Hyssopus officinalis L.) showed significantly higher attractiveness to pollinators and enhanced the attractiveness of floral mixtures. Species that bloomed in early spring (Salvia verbenaca L.) and in summer (Melissa officinalis L. and Thymbra capitata L.) did not efficiently contribute to the attractiveness of the mixtures to pollinators. In addition, besides high floral density of Salvia officinalis L. and N. tuberosa in the spring, warm and dry weather in spring 2012 enhanced the activity of bees, while cold and rainy weather in spring 2013 enhanced the activity of hoverflies. None of the plants showed weedy growth and so posed no danger of invading adjacent crops.


Effect of a contact-based education intervention on reducing stigma among community health and care staff in Beijing, China: Pilot randomized controlled study.
The aim was to assess the feasibility of an intervention to reduce stigma among primary care and community healthcare staff in Beijing, China through a contact-based education intervention. Participants were randomly assigned to: (i) "education only" group, a lecture-based education; or (ii) "education and contact" group, lectures plus contact with people with lived experience of mental illness. Each participant completed an assessment of mental health stigma related: knowledge (mental health knowledge schedule, MAKS); attitudes (mental illness: clinicians' attitudes scale, MICA-4); and behavior (reported and intended behavior scale, RIBS) before and after the intervention, with follow up at 1 month and 3 months after the intervention. A total of 121 healthcare staff were recruited. Both "education only" group and "education and contact" group showed improved knowledge after the intervention, MAKS scores increased by 1.77 ± 3.15 VS 2.46 ± 2.49 (both p < 0.001), respectively. There was no between-group difference in MAKS score. The "education and contact" group showed a significantly greater improvement for MICA and RIBS score than the "education only" group: the MICA score decreased by 4.43 ± 9.42 VS 8.41 ± 7.48 (p = 0.027), and the RIBS score increased by 2.28 ± 3.89 VS 4.57 ± 3.53 (p = 0.003), in the "education only" and the "education and contact" groups respectively, but the between group differences disappeared at 1 month and 3 months follow-up points. The positive effects on stigma levels (knowledge, attitudes and behaviours) in both groups were sustained at 3 months. The intervention to reduce stigma among the primary and community healthcare staff through a contact-based education intervention was feasible in Beijing.


Systematic errors in annotations of truncations, loss-of-function and synonymous variants.
Description of genetic phenomena and variations requires exact language and concepts. Vast amounts of variation data are produced with next-generation sequencing pipelines. The obtained variations are automatically annotated, e.g., for their functional consequences. These tools and pipelines, along with systematic nomenclature, mainly work well, but there are still some problems in nomenclature, organization of some databases, misuse of concepts and certain practices. Therefore, systematic errors prevent correct annotation and often preclude further analysis of certain variation types. Problems and solutions are described for presumed protein truncations, variants that are claimed to be of loss-of-function based on the type of variation, and synonymous variants that are not synonymous and lead to sequence changes or to missing protein.


Perceived burden in adherence of antiretroviral treatment in rural China.
To determine the level of antiretroviral treatment adherence and explore the correlated factors of perceived burden of taking antiretroviral medications among people living with HIV (PLH) in a rural area of China. Data were collected from 66 PLH who were currently receiving antiretroviral treatment. Face-to-face interviews were conducted during August to October, 2009. Approximately 18.2% of participants failed to adhere to antiretroviral treatment in the previous 30 days. A majority of PLH reported that taking antiretroviral medications posed a burden to them. Those who perceived a higher level of burden were more likely to be women, to have lower annual income, and to report a high level of depressive symptoms, poor physical health, and strained family interactions. Findings suggest that future programs in promoting adherence to antiretroviral treatment should address issues related to psychosocial well-being and PLH's interactions with their family members.


New method for the fixation of the endotracheal tube in patients with facial hair.
A problem faced by anaesthetists in Islamic countries is the unwillingness of patients to shave their facial hair. Adhesive tapes may not adequately secure an endotracheal tube in these patients, and a cotton band around the neck may cause obstruction of the venous return. A new device, a synthetic leather mask, was compared with the two other methods in a randomized trial on 900 patients undergoing general anaesthesia. No displacement of the endotracheal tube, pressure on the neck veins, or skin reaction were observed in the mask group compared with the adhesive tape and the cotton band groups. The mask can be reused, autoclaved and made in several sizes, prevents allergies to adhesive tape and is suitable for laryngoscopy, suctioning and inserting the oral airway.


[Plastic surgical management of large cicatricial scalp alopecia].
To investigate the proper ways to manage a large cicatricial scalp alopecia. Based on the location, size and condition of the scarring lesions, 218 patients with 20 - 75% scarring alopecia were selected and treated with either dense-packing hair grafting technique (136 cases) or tissue expansion (82 cases). There were 209 in burn, 5 in avulsed injury and 4 in tumor excision. The lesions with thick, stable scars in the frontal or/and temporal areas undergoing either hair grafting or tissue expansion process as desired by the patients. In addition, the alopecia in an unstable scar on the skull, with skull defect under the lesion and the lesion involved in the back of the head was only treated with tissue expansion. The hair-grafting technique was carried out by harvesting a scalp strip from the back of the head, then dividing it into a series of 1 - 3 hair grafts and finally implanting them into the prepared recipient holes of the lesion with a desired hair direction. Ten areas with 1 cm(2) size in 10 patients were randomly selected to examine the hair survival over 8 months post-operation. Tissue expansion was performed by firstly positioning a tissue expander in the subgaleal pocket of the scalp and serially inflating it with normal saline in 5 - 7 days intervals for about 3 months. Thereafter, an expanded scalp flap was designed, with the combination of advancement and rotation flap transplantation principles, to be transferred to the recipient site after lesion removal. In patients with hair-grafting technique, hair density reaching 60 - 80 hairs/cm(2) per session. Over 8-months following-up, the grafted hairs grew good with 98% hair survival. Forty-five patients with 20% - 30% scalp hair loss were reaching very satisfactory results with only one session while 91 patients with 31% - 50% hair loss were needed a second session to improve their appearance. In those with tissue expansion, 56 patients with 20% - 50% scalp loss were managed in one session and 26 patients with 51% - 75% scalp loss needed secondary tissue expansion. All of the expanded hair-bearing flaps survived well with only minimal complications (9.8%) of the infective dome explosion in 3, slight skull depression in 2, seroma in 5 and early infection in 1. Either hair grafting or tissue expansion is proven as a safe and effective technique for restoration of large cicatricial scalp alopecia. The former technique could be of benefits to simple, mini-surgical procedure, natural hair growth and good for lesion size under 30%. And the letter technique shows wider clinical indications, especially for the patients with unstable scar, skull defect under lesion and lesion over 50%. But the obvious drawbacks are multi-clinic visiting, disfigurement and long-term procedures.


New Item Selection Method Accommodating Practical Constraints in Cognitive Diagnostic Computerized Adaptive Testing: Maximum Deviation and Maximum Limitation Global Discrimination Indexes.
Maximum deviation global discrimination index (MDGDI) is a new item selection method for cognitive diagnostic computerized adaptive testing that allows for attribute coverage balance. We developed the maximum limitation global discrimination index (MLGDI) from MDGDI, which allows for both attribute coverage balance and item exposure control. MLGDI can realize the attribute coverage balance and exposure control of the item. Our simulation study aimed to evaluate the performance of our new method against maximum global discrimination index (GDI), modified maximum GDI (MMGDI), standardized weighted deviation GDI (SWDGDI), and constraint progressive with SWDGDI (CP_SWDGDI). The results indicated that (1a) under the condition of realizing the attribute coverage balance, MDGDI had the highest attribute classification accuracy; (1b) when the selection strategy accommodated the practical constraints of the attribute coverage balance and item exposure control, MLGDI had the highest attribute classification accuracy; (2) adding the item exposure control mechanism to the item selection method reduces the classification accuracy of the attributes of the item selection method; and (3) compared with GDI, MMGDI, SWDGDI, CP_SWDGDI, and MDGDI, MLGDI can better achieve the attribute-coverage requirement, control item exposure rate, and attribute correct classification rate.


Release of nitrous oxide and dinitrogen from a transition bog under drained and rewetted conditions due to denitrification: results from a [15N]nitrate-bromide double-tracer study.
Denitrification is well known being the most important nitrate-consuming process in water-logged peat soils, whereby the intermediate compound nitrous oxide (N(2)O) and the end product dinitrogen (N(2)) are ultimately released. The present study was aimed at evaluating the release of these gases (due to denitrification) from a nutrient-poor transition bog ecosystem under drained and three differently rewetted conditions at the field scale using a (15)N-tracer approach ([(15)N]nitrate application, 30 kg N ha(-1)) and a common closed-chamber technique. The drained site is characterized by a constant water table (WT) of -30 cm (here referred to as D30), while rewetted sites represent a constant WT of -15 cm, a constant WT of 0 cm (i.e. waterlogged), and an initial WT of 0 cm (which decreased slightly during the experiment), respectively, (here referred to as R15, R0, and R0(d), respectively). The highest N(2)O emissions were observed at D30 (291 µg N(2)O-N m(-2) h(-1)) as well as at R0d (665 µg N(2)O-N m(-2) h(-1)). At the rewetted peat sites with a constant WT (i.e. R15 and R0), considerably lower N2O emissions were observed (maximal 37 µg N(2)O-N m(-2) h(-1)). Concerning N(2) only at the initially water-logged peat site R0d considerable release rates (up to 3110 µg N(2)-N m(-2) h(-1)) were observed, while under drained conditions (D30) no N(2) emission and under rewetted conditions with a constant WT (R15 and R0) significantly lower N(2) release rates (maximal 668 µg N(2)-N m(-2) h(-1)) could be detected. In addition, it has been found that natural WT fluctuations at rewetted peat sites, in particular a rapid drop down of the WT, can induce high emission rates for both N(2)O and N(2).


Amelia/ectromelia in association with scoliosis in three commercial layer hens (Gallus gallus forma domestica).
Three wingless "healthy" pullet hens were serendipitously discovered at a grow-out facility for an egg-production ranch. Two of the birds were amelic and one was ectromelic. The defect in these chickens differs from the previously reported wingless mutations in that all three affected birds also had scoliosis. The birds also differed from previously reported scolitic mutant chickens in that they were wingless. Although the combination of amelia and scoliosis has been reported in humans, this is the first report of the combination in an animal species.


Clinical factors impacting on late dysphagia following radiotherapy in patients with head and neck cancer.
Patient and treatment characteristics of patients with head and neck cancer (HNSCC) were correlated with dysphagia scored on swallowing-videofluoroscopy (VFS) and with patient- and physician-scored dysphagia. 63 HNSCC patients treated with radiotherapy (RT) were evaluated at baseline, and 6 and 12 months post-RT. VFS was scored with Penetration Aspiration Scale (PAS) and Swallowing Performance Scale (SPS). Physician- and patient-scored dysphagia were prospectively recorded according to Common Terminology Criteria for Adverse Events scoring system, Radiation Therapy Oncology Group/EORTC scoring system and European Organization for Research and Treatment of Cancer Quality of Life questionnaire (EORTC-QLQ H&N35). Univariable analysis revealed a significant association between tumour-subsite and higher SPS (p = 0.02) and patient-scored dysphagia (p = 0.02) at baseline. At 12 months, tumour-subsite was significantly associated with higher PAS and SPS. Multivariable analysis and pairwise comparison showed that hypopharyngeal cancer and carcinoma of unknown primary were associated with higher SPS at baseline and at 12 months, respectively (p = 0.03 and p = 0.01). Upfront neck dissection (UFND) was significantly associated with higher SPS and physician-scored dysphagia in univariable analysis at all timepoints. At 12 months, there was also a significant association with higher PAS (p < 0.01) and patient-scored dysphagia (p < 0.01). After multivariable analysis, the association between UFND and higher PAS (p < 0.01) and SPS (p < 0.01) remained significant at 12 months. Hypopharyngeal tumours and carcinoma of unknown primary were related to more dysphagia at baseline and at 12 months, respectively. Furthermore, UFND was associated with more severe dysphagia scored by physicians and patients and on VFS at 12 months. Advances in knowledge: This is the first paper reporting a significant link between UFND and late dysphagia scored with VFS. We advocate abandoning UFND and preserving neck dissection as a salvage option post-RT.


Domestic violence and elderly dementia sufferers.
Domestic violence is a serious national public health issue, and elderly dementia sufferers are not exempt from this form of aggression. This manuscript discusses the general nature of domestic violence, reviews the empirical findings of domestic violence in dementia sufferers, and outlines some of the warning signs and intervention strategies that could be considered for remediation in the presence of such abuse.


Intensive care medicine: finding its way in the "European labyrinth".
The European Union (EU) has created recent directives to facilitate the free movement of medical specialists in its member states. Analysis of two recent surveys performed in European countries. Intensive Care Medicine training and accreditation have changed quickly over time. There is no harmonisation among European countries. Young specialists might face several difficulties in the future. Nations providing a national examination for intensive care medicine and a national register for specialists in intensive care medicine facilitate the free movement of specialists, regardless of European regulations and directives. Intensive care medicine is currently not a mother speciality. A long process needs to occur before complete harmonization of training and accreditation and free movement of specialists in Europe will happen.


Therapeutic activity of chlorhexidine-poloxamer antiseptic gel on wound healing in rats: a preclinical study.
Despite the progress in curative and preventive medicine, skin lesions after injuries or surgical interventions are still a big problem. The aim of wound care is to get damaged tissues to heal as soon as possible. A gel-forming material helps to maintain proper humidity in the wound and promotes the healing process. For this purpose, a healing gel containing the active substance chlorhexidine based on poloxamer was prepared. The aim of this study was to assess in vivo the therapeutic efficacy of chlorhexidine-poloxamer gel in treatment of wounds caused experimentally and inoculated with bacteria, and the effect of an antiseptic gel applied on a healthy rat skin. Wistar albino rats were selected for these studies. The effect of an antiseptic gel on the healing excision and incision wounds, as well as the irritating effect on the healthy skin were assessed. Cross-sectional full-thickness specimens from each group were collected at the end of the experiment to assess the histopathological alterations. Chlorhexidine-poloxamer gels accelerate the healing of infected skin wounds because the active ingredient chlorhexidine remains at the application site, and systemic effects are avoided. Moreover, chlorhexidine-poloxamer gels are easy to use because they can be easily washed off from the wound surface by water. The present study has revealed that chlorhexidine-poloxamer gels promote healing of full-thickness skin wounds without skin irritation. This makes it possible to plan further clinical trials in the target species.


Pathobiology of classical Hodgkin lymphoma.
The World Health Organization has acknowledged the malignant nature of classical Hodgkin lymphoma (cHL), which encompasses four histological subtypes. The diagnosis of cHL is based on the detection of malignant Hodgkin and Reed-Sternberg cells (HRSC) confirmed by immunophenotyping and the detection of growth patterns specific to each histological subtype. The pathologic HRSC arise from germinal center or immediate postgerminal cells that lack detectable immunoglobulin/B-cell antigen receptor expression, with a consequent loss of B-cell identity; very few cHL cases are of T-cell origin. To escape apoptosis, which normally occurs in B cells with nonfunctioning antigen receptor machinery, HRSC develop concurrent antiapoptotic mechanisms by activation of nuclear factor-kappaB or are rescued by Epstein-Barr virus infection. HRSC are characterized by a variable and inconstant immunophenotype, with a remarkable loss of lineage-specific cell antigens and expression of antigens of other cell lineages. The master plan of B-cell identity in HRSC is disturbed not only at the immunoglobulin expression level, but also at the transcriptional factor level. HRSC are further characterized by profound cell cycle deregulation with futile replication, multinucleation and poly- and aneuploidy. Here, we review pathobiological aspects of cHL with respect to lymphomagenesis and routine diagnostics.


Psychological autopsies in court.
The crucial concept for defining suicide is intention. A major purpose of the psychological autopsy is to clarify the pre-mortem intentions of the victim, now deceased. This article reports cases in which the issue of suicide vs. accident came to trial because insurance benefits were at issue. Currently, the courts, in considering to what extent mental disorders impair the capacity for intentional self destruction, evaluate each case independently according to its own unique set of facts.


Traditional Chinese medicine as targeted treatment for epithelial-mesenchymal transition-induced cancer progression.
The epithelial-mesenchymal transition (EMT) program, which loosens cell-cell adhesion complexes, endows cells with enhanced migratory and invasive properties. Furthermore, this process facilitates both the development of drug resistance and immunosuppression by tumor cells, which preclude the successful treatment of cancer. Recent research has demonstrated that many signaling pathways are involved in EMT progression. In addition, cancer stem cells (CSCs), vasculogenic mimicry (VM) and the tumor-related immune microenvironment all play important roles in tumor formation. However, there are few reports on the relationships between EMT and these factors. In addition, in recent years, traditional Chinese medicine (TCM) has developed a unique system for treating cancer. In this review, we summarize the crucial signaling pathways associated with the EMT process in cancer patients and discuss the interconnections between EMT and other molecular factors (such as CSCs, VM, and the tumor-related immune microenvironment). We attempt to identify common regulators that might be potential therapeutic targets to thereby optimize tumor treatment. In addition, we outline recent research on TCM approaches that target EMT and thereby provide a foundation for further research on the exact mechanisms by which TCMs affect EMT in cancer.


[Ultrasonic diagnosis in appendiceal perforation].
In a prospective study comprising 154 patients, the efficacy of clinical, sonographic and combined assessment of appendiceal perforation was evaluated. 39 patients had appendiceal perforation, 44 no signs of inflammation and 71 chronic appendicitis as proven by histologic examination. Cases of 'simple' acute appendicitis were excluded. Clinical assessment yielded with respect to appendicitis a sensitivity of 87%, a specificity of 97% and an accuracy of 94%. With respect to appendiceal perforation a sensitivity of 74%, a specificity of 97% and an accuracy of 91% were observed. Sonographic diagnosis of acute appendicitis as the cause of complaints gave a sensitivity of 85%, a specificity of 98% and an accuracy of 95%, and with special respect to real appendiceal perforation a sensitivity of 69%, a specificity of 98% and accuracy of 91%. By overlap of clinical and sonographic findings, diagnosis of perforation was feasible in 80%, diagnosis of acute appendicitis in 92%. Our results indicate that sonography is a valuable adjunct to clinical assessment, whereas clinical assessment alone seems to be superior to ultrasonography as an isolated procedure.


Treatment of methicillin-resistant Staphylococcus aureus (MRSA): updated guidelines from the UK.
These evidence-based guidelines are an updated version of those issued in 2008. They have been produced following a review of the published literature (2007-18) pertaining to the treatment of infections caused by MRSA. The guidelines update, where appropriate, previous recommendations, taking into account changes in the UK epidemiology of MRSA, ongoing national surveillance data and the efficacy of novel anti-staphylococcal agents licensed for use in the UK. Emerging therapies that have not been licensed for use in the UK at the time of the review have also been assessed.


Dual Reproductive Cell-Specific Promoter-Mediated Split-Cre/LoxP System Suitable for Exogenous Gene Deletion in Hybrid Progeny of Transgenic Arabidopsis.
Genetically modified (GM) crops possess some superior characteristics, such as high yield and insect resistance, but their biosafety has aroused broad public concern. Some genetic engineering technologies have recently been proposed to remove exogenous genes from GM crops. Few approaches have been applied to maintain advantageous traits, but excising exogenous genes in seeds or fruits from these hybrid crops has led to the generation of harvested food without exogenous genes. In a previous study, split-Cre mediated by split intein could recombine its structure and restore recombination activity in hybrid plants. In the current study, the recombination efficiency of split-Cre under the control of ovule-specific or pollen-specific promoters was validated by hybridization of transgenic Arabidopsis containing the improved expression vectors. In these vectors, all exogenous genes were flanked by two loxP sites, including promoters, resistance genes, reporter genes, and split-Cre genes linked to the reporter genes via LP4/2A. A gene deletion system was designed in which NCre was driven by proDD45, and CCre was driven by proACA9 and proDLL. Transgenic lines containing NCre were used as paternal lines to hybridize with transgenic lines containing CCre. Because this hybridization method results in no co-expression of the NCre and CCre genes controlled by reproduction-specific promoters in the F1 progeny, the desirable characteristics could be retained. After self-crossing in F1 progeny, the expression level and protein activity of reporter genes were detected, and confirmed that recombination of split-Cre had occurred and the exogenous genes were partially deleted. The gene deletion efficiency represented by the quantitative measurements of GUS enzyme activity was over 59%, with the highest efficiency of 73% among variable hybrid combinations. Thus, in the present study a novel dual reproductive cell-specific promoter-mediated gene deletion system was developed that has the potential to take advantage of the merits of GM crops while alleviating biosafety concerns.


In eNOS knockout mice skeletal muscle arteriolar dilation to acetylcholine is mediated by EDHF.
The mechanisms that account for acetylcholine (ACh)-induced responses of skeletal muscle arterioles of mice lacking endothelial nitric oxide (NO) synthase (eNOS-KO) were investigated. Isolated, cannulated, and pressurized arterioles of gracilis muscle from male eNOS-KO (74.1 +/- 2.3 microm) and wild-type (WT, 87.2 +/- 2.1 microm) mice developed spontaneous tone accounting for 63 and 61% of their passive diameter (116.8 +/- 3.4 vs. 143.2 +/- 2.8 microm, respectively) and dilated dose-dependently to ACh (10(-9)-10(-7) M). These dilations were significantly smaller in vessels of eNOS-KO compared with WT mice (29.2 +/- 2.0 microm vs. 46.3 +/- 2.1 microm, at maximum concentration) but responses to the NO donor, sodium nitrite (NaNO(2), 10(-6)-3 x 10(-5) M), were comparable in the vessels of the two strains. N(G)-nitro-L-arginine (L-NNA, 10(-4) M), an inhibitor of eNOS, inhibited ACh-induced dilations by 60-90% in arterioles of WT mice but did not affect responses in those of eNOS-KO mice. In arterioles of eNOS-KO mice, dilations to ACh were not affected by indomethacin but were essentially abolished by inhibitors of cytochrome P-450, clotrimazole (CTZ, 2 x 10(-6) M) or miconazole (MCZ, 2 x 10(-6) M), as well as by either high K(+) (40 mM) or iberiotoxin [10(-7) M, a blocker of Ca(2+)-dependent K(+) channels (K(Ca) channels)]. On the other hand, in WT arterioles CTZ or MCZ inhibited ACh-induced dilations only by approximately 10% and only in the presence of L-NNA. These results indicate that in arterioles of eNOS-KO mice, endothelium-derived hyperpolarizing factor (EDHF), synthesized via cytochrome P-450, accounts entirely for the mediation of ACh-induced dilation via an increase in K(Ca)-channel activity. In contrast, in arterioles of WT mice, endothelium-derived NO predominantly mediates ACh-induced dilation in which participation of EDHF becomes apparent only after inhibition of NO synthesis.


Signal transduction pathways underlying the expression of tissue factor and thrombomodulin in promyelocytic cells induced to differentiate by retinoid acid and dibutyryl cAMP.
Acute promyelocytic leukaemia (APL) may be associated with disseminated intravascular coagulation, as a result of increased tissue factor (TF) expression and reduced thrombomodulin (TM) expression by APL blast cells. During retinoid acid (RA)- and dibutyryl cAMP (dbcAMP)-induced differentiation of the APL cells, there is a marked up-modulation of both the protein kinase A (PKA) and C (PKC) activities. In order to further assess whether these kinases are intimately associated with both the differentiation process and the regulation of TF and TM expression, we have correlated the modulation of their respective pathways with the extent of differentiation and modulation of these cellular receptors. NB4 cells were incubated with all-trans-RA (ATRA) or dbcAMP for up to 48 h. The contribution of phospholipase C (PLC), inositol phosphate (IP), PKC and PKA in the expression of CD11b, TF and TM was studied by the use of specific inhibitors. Myo-inositol uptake and PKC activity increased in cells induced to differentiate by ATRA but the retinoid did not affect cAMP levels or PKA activity. Under treatment with dbcAMP, PKA activity was increased while inositol uptake and PKC activity remained unchanged. Our results show that the effects of ATRA and dbcAMP on promyelocytic cells are closely related, respectively, to the PLC/IP/PKC and the cAMP/PKA pathways. In cells induced to differentiate by ATRA, CD11b expression seems more closely related to inositol uptake than to PKC activity while the expression of TF and TM show the opposite pattern, which suggests cellular events regulated at a different level within a common signal transduction pathway.


Natural occurrence of ochratoxin A in musts, wines and grape vine fruits from grapes harvested in Argentina.
In this study, ochratoxin A (OTA) occurrence in Argentinean musts, wines and dried vine fruits was evaluated, alongside with the performance of OchraStar(TM) columns for OTA extraction. In all the three matrices analyzed, the OchraStar(TM) columns showed good performance. The analysis of natural occurrence of OTA in the red must and the red wine samples showed low incidence with low levels of mean OTA contamination (0.12 ng/mL and 0.37 ng/mL, respectively), while 60% of the dried vine fruit samples were contaminated with OTA, in levels ranging from 0.26 to 20.28 ng/g.


Pneumomediastinum and subcutaneous emphysema in a child with ulcerative colitis.
We discuss the case of a young adolescent boy with ulcerative colitis who developed pneumomediastinum and subcutaneous emphysema in the neck and surrounding cervical soft tissues secondary to a probable retroperitoneal perforation of the colon. To our knowledge, this is the first reported case of this complication in the pediatric literature. Our experience provides insight into this unusual complication, how it may present, and its clinical significance in young patients with ulcerative colitis. The literature on this complication is also discussed.


High telomerase activity and high HTRT mRNA expression differentiate pure myxoid and myxoid/round-cell liposarcomas.
Molecular markers characterizing the transition of a myxoid to a more round-cell liposarcoma have not been described. To examine whether telomerase activity, hTRT and hTR mRNA expression were associated with tumor progression in myxoid liposarcoma, we investigated a total of 28 myxoid liposarcomas (13 pure myxoid tumors, 14 mixed-type tumors, and 1 pure round-cell variant) from 19 patients. Telomerase activity was detected by using the fluorescent PCR-based TRAP-assay. Expression of hTRT and hTR mRNAs was determined by the semi-quantitative RT-PCR. On the basis of only one tumor sample per patient, telomerase activity was found in 9 of 9 myxoid/round-cell liposarcomas and in 3 of 10 pure myxoid tumors. Elevated hTRT expression was found in 13 of 17 liposarcomas. All telomerase-positive tumors showed hTRT expression, whereas there were 3 cases showing hTRT expression without telomerase activity. HTR mRNA expression was elevated in all 19 liposarcomas. Thus, only the levels of telomerase activity and of hTRT mRNA expression differentiated pure myxoid liposarcoma and myxoid/round-cell liposarcoma (p < 0.003 and p = 0.029, respectively). We believe that high levels of telomerase activity and of hTRT expression are associated with tumor progression from low-grade pure myxoid to higher-grade malignant round-cell liposarcoma, and may consequently represent a useful prognostic marker for this histological sub-type of soft-tissue tumors.


Improved survival with therapeutic hypothermia after cardiac arrest with cold saline and surfacing cooling: keep it simple.
Aim. To evaluate whether the introduction of a therapeutic hypothermia (TH) protocol consisting of cold saline infusion and surface cooling would be effective in targeting mild therapeutic hypothermia (32-34°C). Additionally, to evaluate if TH would improve survival after cardiac arrest. Design. Before-after design. Setting. General Intensive Care Unit (ICU) at an urban general hospital with 470 beds. Patients and Methods. Patients admitted in the ICU after cardiac arrest between 2004 and 2009 were included. Effectiveness of the TH protocol to achieve the targeted temperature was evaluated. Hospital mortality was compared before (October 2004-March 2006) and after (April 2006-September 2009) the protocol implementation. Results. Hundred and thirty patients were included, 75 patients were not submitted to TH (before TH group), and 55 were submitted to TH (TH group). There were no significant differences concerning baseline, ICU, and cardiac arrest characteristics between both groups. There was a significant reduction in hospital mortality from 61% (n = 46) in the before TH group to 40% (n = 22) in the TH group. Conclusion. Our protocol consisting of cold saline infusion and surface cooling might be effective in inducing and maintaining mild therapeutic hypothermia. TH achieved with this protocol was associated with a significant reduction in hospital mortality.


Fokker-Planck-Kramers equations of a heavy ion in presence of external fields.
In this work, we use the same strategy studied in our previous work [J. I. Jiménez-Aquino and M. Romero-Bastida, Phys. Rev. E 74, 041117 (2006)] to solve exactly the Fokker-Planck (FP) and Fokker-Planck-Kramers (FPK) equations of a charged Brownian particle in a fluid (a heavy ion in a light gas) under the influence of external fields: a constant magnetic field and, in general, time-varying mechanical and electric fields. In our proposal, a time-dependent rotation matrix is introduced to transform the Langevin equation in the phase-space (r,u) to a new space (r',u') . As a result, the transformed Langevin equations are very similar to those of ordinary Brownian motion in the presence of those time-varying external forces only, without the magnetic field; therefore, the associated FP and FPK equations can easily be solved in those transformed spaces. To solve these equations, we use the methods of solution developed by Chandrasekhar in the field-free case of ordinary Brownian motion. We also calculate a more general transition probability density in the velocity space by assuming an initial heavy-ion Maxwellian distribution at a temperature generally different from that corresponding to equilibrium, the same as that used by Ferrari [Physica A 163, 596 (1990)].


[Antitoxic activity of interferon preparations].
The antitoxic activity of leucocytic injection interferon I and immune interferon was shown in experimental erythrocyte hemolysis in the presence of staphylococcus alpha-toxin. The antitoxic effect was directly proportional to the interferon concentration in the medium and inversely proportional to the toxin concentration. Neutralization of the antiviral activity of leucocytic interferon did not lower its antitoxic effect. The highly purified and concentrated preparation of leucocytic injection interferon I and recombinant interferon had no antitoxic effect.


Detection rate of quadruple-marker screening determined by clinical follow-up and registry data in the statewide California program, July 2007 to February 2009.
To evaluate the efficiency of California's quadruple-marker screening program and construct receiver-operating characteristic (ROC) curves. This study included the screening records of 552 941 women during July 2007 to February 2009. The screen-positive women received clinical follow-up services at state-approved centers. We used the California Chromosome Defect Registry which includes clinical, laboratory, and demographic data from the prenatal diagnostic centers, cytogenetic laboratories, hospitals, and prenatal care providers. Risk calculations, screen-positive rates (SPRs), detection rates (DRs) for chromosomal abnormalities, and 95% confidence intervals (95% CIs) were determined. ROC curves comparing the quadruple-marker to triple-marker screening were constructed. The DR and SPR for trisomy 21 (N = 827) during the quadruple-marker time period were 75.7% (95% CI 72.8-78.6%) and 3.75% (95% CI 3.70-3.80%) compared with 77.4% (95% CI 75.0-79.7%) and 5.4% during the triple-marker phase. The DRs were 78.2% (95% CI 75.0-81.4%) with ultrasound dating and 66.9% (95% CI 59.7-74.0%) for last-menstrual-period-dated pregnancies. For trisomy 18, triploidy, and trisomy 13, the DRs were 84.3, 95.7, and 43.5%, respectively. The DR for trisomy 21 in California's statewide quadruple-marker screening is very similar to the Program's previously reported DR using triple-marker screening. However, this was achieved at a lower SPR, demonstrating improved screening performance.


Photochemical processes in ionic liquids on ultrafast timescales.
The number of investigations of room temperature ionic liquids (RTILs) has been developing rapidly in recent years, e.g., due to their potential use as "green solvents" in many industrial applications. A large body of data has been accumulated on physico-chemical properties including ultrafast dynamics of these liquids. This review deals both with the generation and the subsequent relaxation dynamics of selected transient species following photolysis or pulse radiolysis of RTILs with special emphasis on the exceptional character of imidazolium based systems. Although considerable progress has been made, the understanding of the photochemistry of ionic liquids is just at its embryonic stage. Nevertheless, a brief comparison with high temperature ionic liquids (HTILs) such as alkali metal doped alkali halide mixtures already reveals important differences.


Vessel Density Loss of the Deep Peripapillary Area in Glaucoma Suspects and Its Association with Features of the Lamina Cribrosa.
To investigate the association of decreased vessel density (VD) in the deep peripapillary region and structural features of the lamina cribrosa (LC). 70 eyes of glaucoma suspects with enlarged cup-to-disc ratio were scanned and 51 eyes with adequate image quality were included in this study. All subjects had localized VD defects in the deep layer but intact VD in the superficial layer around the peripapillary region using optical coherence tomography angiography (OCTA). Only single-hemizone OCTA results from one eye of each subject had to fulfill the distinctive feature mentioned above to perform inter-eye and inter-hemizone comparisons. The thickness and depth of the LC, and prelaminar thickness were measured using enhanced depth imaging OCT (EDI-OCT). Paired t-tests were performed to evaluate differences in measurements of the LC and prelaminar thickness within each individual. p-values lower than 0.05 was considered to be statistically significant. Eyes with deep VD defects in the peripapillary region in OCTA had thinner LC than the fellow eyes. The hemizone with the deep VD defects in the peripapillary region had a thinner LC and a deeper depth of LC than the other hemizone in the same eye. According to logistic regression analysis, a thin LC was a significant factor associated with deep VD defect in the peripapillary region. Glaucoma suspect eyes with deep VD defects in the peripapillary area exhibited structural differences in the LC. The structural changes of the LC was associated with the vessel density in the deep peripapillary layer at the stage of suspected glaucoma.


Effects of Hg and Cu on hemocytes-mediated functions in the prawn, Macrobrachium malcolmsonii.
Sublethal effects of Hg (9.6, 14.5 and 24.1 microg/l) and Cu (60.5, 90.8 and 150.5 microg/l) on the hemocytes-mediated functions in the juveniles of the economically important freshwater prawns, Macrobrachium malcolmsonii were investigated. The population of total hemocytes, percentile phagocytosis and superoxide anion production were found to be increased in test prawns exposed to the lowest sublethal concentration of these two metals in comparison to controls. This indicates the fact that a mechanism of host-defence was in an active state to encounter metal toxicity. The total hemocytes population, percentile phagocytosis and superoxide anion production were found to be decreased in test prawns exposed to intermediate as well as the highest sublethal concentrations of Hg and Cu when compared with controls. This suggests that high concentrations of both Hg and Cu have inhibitory effects on the immune functions of the hemocytes in the prawn, M. malcolmsonii.


Crystallographic study of the interaction of the anti-HIV lectin actinohivin with the α(1-2)mannobiose moiety of gp120 HMTG.
Actinohivin (AH) is a new potent anti-HIV lectin of microbial origin. In order to modify it to produce a more efficient drug, its three-dimensional structure has previously been determined with and without the target α(1-2)mannobiose moiety of the high-mannose-type glycan (HMTG) attached to HIV-1 gp120. However, ambiguity remained in the structures owing to packing disorder that was possibly associated with peptide fragments attached at the N-terminus. To resolve these problems, the duration of cultivation of the AH-producing strain was examined and it was found that in a sample obtained from a 20 d culture the heterogeneous fragments were completely removed to produce mature AH with high homogeneity. In addition, the purification procedures were simplified in order to increase the yield of AH and the addition of solvents was also examined in order to increase the solubility of AH. AH thus obtained was successfully crystallized with high reproducibility in a different form to the previously obtained crystals. The crystal diffracted well to beyond 1.90 Å resolution and the crystallographic data suggested that it contained no packing disorder.


Circadian Clock Regulates Bone Resorption in Mice.
The circadian clock controls many behavioral and physiological processes beyond daily rhythms. Circadian dysfunction increases the risk of cancer, obesity, and cardiovascular and metabolic diseases. Although clinical studies have shown that bone resorption is controlled by circadian rhythm, as indicated by diurnal variations in bone resorption, the molecular mechanism of circadian clock-dependent bone resorption remains unknown. To clarify the role of circadian rhythm in bone resorption, aryl hydrocarbon receptor nuclear translocator-like (Bmal1), a prototype circadian gene, was knocked out specifically in osteoclasts. Osteoclast-specific Bmal1-knockout mice showed a high bone mass phenotype due to reduced osteoclast differentiation. A cell-based assay revealed that BMAL1 upregulated nuclear factor of activated T cells, cytoplasmic, calcineurin-dependent 1 (Nfatc1) transcription through its binding to an E-box element located on the Nfatc1 promoter in cooperation with circadian locomotor output cycles kaput (CLOCK), a heterodimer partner of BMAL1. Moreover, steroid receptor coactivator (SRC) family members were shown to interact with and upregulate BMAL1:CLOCK transcriptional activity. Collectively, these data suggest that bone resorption is controlled by osteoclastic BMAL1 through interactions with the SRC family and binding to the Nfatc1 promoter. © 2016 American Society for Bone and Mineral Research.


Clinical study of disseminated tumor cells in bone marrow of patients with gastric cancer.
Tumor micrometastasis usually occurs at early stage. Therefore, we aimed to investigate the morphology of disseminated tumor cells (DTCs) and its clinical significance in bone marrow (BM) of patients with gastric cancer. Forty patients with gastric cancer were enrolled and mononuclear cells were separated from BMs. After labeled by MACS microbeads conjugated with human epithelial antigen (HEA) antibodies, tumor cells were viably enriched twice by MS+/RS+ positive separation column. Parts of the cells from the patients were stained with CK-FITC, DAPI and EB. Then, morphology of the stained tumor cells was observed under fluorescence microscope. Six hundred and eighty eight CK positive cells in 18 cases (45%) were detected, including 384 (55.8%) medium-sized cells, 102 (14.8%) large-sized cells, 46(6.7%) stem-cell-like cells, 8 (1.2%) M-phase cells, 84 (12.2%) nuclear debris and 64 (9.3%) non-nuclear debris. The number of tumor cells in BM was significantly correlated with TNM stage (p=0.038), but not with gender, age, histological differentiation and lymph node metastasis. The DTCs in BM of patients with gastric cancer show various morphological characteristics. The existence of these tumor cells suggests a poor prognosis.


Deriving fuel-based emission factor thresholds to interpret heavy-duty vehicle roadside plume measurements.
Remote sensing devices have been used for decades to measure gaseous emissions from individual vehicles at the roadside. Systems have also been developed that entrain diluted exhaust and can also measure particulate matter (PM) emissions. In 2015, the California Air Resources Board (CARB) reported that 8% of in-field diesel particulate filters (DPF) on heavy-duty (HD) vehicles were malfunctioning and emitted about 70% of total diesel PM emissions from the DPF-equipped fleet. A new high-emitter problem in the heavy-duty vehicle fleet had emerged. Roadside exhaust plume measurements reflect a snapshot of real-world operation, typically lasting several seconds. In order to relate roadside plume measurements to laboratory emission tests, we analyzed carbon dioxide (CO2), oxides of nitrogen (NOX), and PM emissions collected from four HD vehicles during several driving cycles on a chassis dynamometer. We examined the fuel-based emission factors corresponding to possible exceedances of emission standards as a function of vehicle power. Our analysis suggests that a typical HD vehicle will exceed the model year (MY) 2010 emission standards (of 0.2 g NOX/bhp-hr and 0.01 g PM/bhp-hr) by three times when fuel-based emission factors are 9.3 g NOX/kg fuel and 0.11 g PM/kg using the roadside plume measurement approach. Reported limits correspond to 99% confidence levels, which were calculated using the detection uncertainty of emissions analyzers, accuracy of vehicle power calculations, and actual emissions variability of fixed operational parameters. The PM threshold was determined for acceleration events between 0.47 and 1.4 mph/sec only, and the NOX threshold was derived from measurements where after-treatment temperature was above 200°C. Anticipating a growing interest in real-world driving emissions, widespread implementation of roadside exhaust plume measurements as a compliment to in-use vehicle programs may benefit from expanding this analysis to a larger sample of in-use HD vehicles. Regulatory agencies, civil society, and the public at large have a growing interest in vehicle emission compliance in the real world. Leveraging roadside plume measurements to identify vehicles with malfunctioning emission control systems is emerging as a viable new and useful method to assess in-use performance. This work proposes fuel-based emission factor thresholds for PM and NOx that signify exceedances of emission standards on a work-specific basis by analyzing real-time emissions in the laboratory. These thresholds could be used to prescreen vehicles before roadside enforcement inspection or other inquiry, enhance and further develop emission inventories, and potentially develop new requirements for heavy-duty inspection and maintenance (I/M) programs, including but not limited to identifying vehicles for further testing.


A practical and efficient method for the resolution of 3-phospholene 1-oxides via coordination complex formation.
A simple, efficient, and economical method based on the combination of the exceptional behavior of o,o'-dibenzoyl- or o,o'-di-p-toluyl-(2R,3R)-tartaric acid in chiral recognition processes, and the coordination ability of calcium or magnesium ion was developed for the resolution of phospholene oxides 1. The calcium or magnesium salt of (-)-o,o'-dibenzoyl-(2R,3R)-tartaric acid 2,4-6 or calcium hydrogen (-)-o,o'-di-p-toluyl-(2R,3R)-tartrate 3 may form crystalline diastereomeric coordination complexes with the appropriate antipode of substituted 3-phospholene oxides 1 that makes possible efficient resolutions. Optically active phospholene oxides 1 were prepared directly by simply crystallization and digestion of the corresponding diastereomeric complexes so formed. Thermal behavior of the crystalline diastereomeric complexes was studied by simultaneous TG/DTA. The novel method may be of more general value in respect of the resolution of tertiary phosphine oxides.


Evaluating diagnostic tests with imperfect standards.
New diagnostic tests frequently are evaluated against gold standards that are assumed to classify patients with unerring accuracy according to the presence or absence of disease. In practice, gold standards rarely are perfect predictors of disease and tend to misclassify a small number of patients. When an imperfect standard is used to evaluate a diagnostic test, many commonly used measures of test performance are distorted. It is not widely appreciated that these distortions occur in predictable directions and that they may be of considerable magnitude, even when the gold standard has a high degree of accuracy. The diagnostic powers of clinical tests will be more accurately reported if consideration is given to the types of biases that result from the use of imperfect standards. Several different approaches may be used to minimize these distortions when evaluating new tests.


Goal-directed haemodynamic therapy and gastrointestinal complications in major surgery: a meta-analysis of randomized controlled trials.
Postoperative gastrointestinal (GI) dysfunction is one of the most frequent complications in surgical patients. Most cases are associated with episodes of splanchnic hypoperfusion due to hypovolaemia or cardiac dysfunction. It has been suggested that perioperative haemodynamic goal-directed therapy (GDT) may reduce the incidence of these complications in cardiac surgery, and other surgery, but clear evidence is lacking. We have undertaken a meta-analysis of the effects of GDT on postoperative GI and liver complications. A systematic search, using MEDLINE, EMBASE, and The Cochrane Library databases, was performed. Sixteen randomized controlled trials (3410 participants) met the inclusion criteria. Data synthesis was obtained using odds ratio (OR) with 95% confidence interval (CI) by random-effects model. Statistical heterogeneity was assessed by Q and I2 statistics. GI complications were ranked as major (required radiological or surgical intervention or life-threatening condition) or minor (no or only pharmacological treatment required). Major GI complications were significantly reduced by GDT when compared with a control group (OR, 0.42; 95% CI, 0.27-0.65). Minor GI complications were also significantly decreased in the GDT group (OR, 0.29; 95% CI, 0.17-0.50). Treatment did not reduce hepatic injury rate (OR, 0.54; 95% CI, 0.19-1.55). Quality sensitive analyses confirmed the main overall results. In patients undergoing major surgery, GDT, by maintaining an adequate systemic oxygenation, can protect organs particularly at risk of perioperative hypoperfusion and is effective in reducing GI complications.


Effects of Intraoperative Opioid Administration on Postoperative Pain and Pain Threshold: A Randomized Controlled Study.
Fentanyl and short-acting remifentanil are often used in combination. We evaluated the effect of intraoperative opioid administration on postoperative pain and pain thresholds when the two drugs were used. Patients who underwent gynecological laparoscopic surgery were randomly assigned into two groups (15 patients each) to receive either sufficient (group A) or minimum (group B) fentanyl (maximum estimated effect site concentration: A: 7.86 ng/mL, B: 1.5 ng/mL). The estimated effect site concentration at the end of surgery was adjusted to the same level (1 ng/mL). Patients in both groups also received continuous intravenous remifentanil during surgery. The primary outcome was the pressure pain threshold, as evaluated by a pressure algometer 3 h postoperatively. The pressure pain threshold at 3 h postoperatively was 51.1% (95% CI: [44.4-57.8]) in group A and 56.6% [49.5-63.6] in group B, assuming a preoperative value of 100% (p = 0.298). There were no significant differences in pressure pain threshold and numeric rating scale scores between the groups after surgery. The pain threshold decreased significantly in both groups at 3 h postoperatively compared to preoperative values, and recovered at 24 h. Co-administration of both opioids caused hyperalgesia regardless of fentanyl dose.


Pharmacy students' intention to practise in a rural setting: measuring the impact of a rural curriculum, rural campus and rural placement on a predominantly metropolitan student cohort.
To compare pharmacy students' intention to practise in a rural setting expressed in their first year of university with that expressed during their final year. Longitudinal survey of students in their first and final years. Tertiary educational institution. Predominantly metropolitan pharmacy students. Students were exposed to a rural curriculum, rural campus and rural placement or rural placement alone during their degree. Change in proportion of students expressing an intention to practise in a rural setting following registration. The proportion of respondents who indicated an intention to practise in a rural setting was 21.6% (27/125) in 2006 compared with 11.2% (14/125) in 2003. This was a statistically significant increase of 10.4% (P = 0.001) over the four years. Positive influences on students' intention to practise in a rural setting were: rural background (P = 0.012); rural placement (either two weeks or 12 weeks) (P = 0.002); having been enrolled in the BPharm (Rural) (P = 0.001). This study confirmed the work of others in that the students most likely to express an intention to practise in a rural setting were those from a rural background who elected to undertake and complete a rural degree involving a rural placement. A follow-up survey will be conducted to establish whether their stated intention as students has translated to rural practice in reality.


[A case of type 2 diabetes mellitus associated with familial hypercholesterolemia confirming the improvement of blood glucose control by colestimide].
A 65-year-old woman had been treated for type 2 diabetes mellitus, familial hypercholesterolemia and old myocardial infarction. Combination therapy of atorvastatin (40 mg/day), ethyl icosapentate (1,200 mg/day), probucol (500 mg/day) and colestimide (1 g/day) had never reached an ideal low-density lipoprotein cholesterol (LDL-C) level. However the conversion to high dose of colestimide (4 g/day) with the same dose of atorvastatin, ethyl icosapentate, and probucol obviously decreased her LDL-C level from 181.2 mg/dl to 148 mg/dl. Reduction of LDL-C level was also associated with the lowering of glycohemoglobin A1c from 10.7% to 8.7% simultaneously. Challenge tests by the cessation and resumption of only colestimide treatment clearly indicated that colestimide has both cholesterol and blood glucose lowering effect. Her body weight and appetite did not change by colestimide treatment. We think that colestimide therapy might provide a beneficial effect on atherosclerotic disease in diabetes mellitus with dyslipidemia through reduction of cholesterol and blood glucose.


Correlation of arterial stiffness to left ventricular function in patients with reduced ejection fraction.
Heart failure has been divided into heart failure with preserved left ventricular (LV) ejection fraction (EF) and heart failure with reduced EF, because the pathophysiologies of the two conditions are different. Cardio-ankle vascular index (CAVI) is a new indicator of arterial stiffness, and the most conspicuous feature of CAVI is its independence of blood pressure at the time of measurement. Arterial stiffness has been considered to increase LV afterload, which requires special care to avoid the onset of heart failure. We compared the correlation of arterial stiffness as assessed by CAVI to LV function in 44 hypertensive patients with preserved EF (EF: 71 ± 7%) and 31 patients with reduced EF (48 ± 8%). All of patients with reduced EF had history of both hypertension and myocardial infarction. Using Doppler echocardiography, LV diastolic and systolic function was evaluated by measuring peak early diastolic mitral annular velocity (e') and global LV peak systolic longitudinal strain (GPSLS), respectively. In patients with preserved EF, CAVI was correlated with e' (r = -0.313, p = 0.038), but not with GPSLS (r = 0.207). By contrast, CAVI was correlated with GPSLS (r = 0.604, p < 0.001) as well as e' (r = -0.393, p = 0.029) in patients with reduced EF. Thus, patients with reduced EF showed a closer correlation of arterial stiffness to LV function compared with patients with preserved EF. Therefore, hypertensive patients with reduced EF require a stricter regimen for treating arterial stiffness than their counterparts with preserved EF.


An Injectable Hyaluronic Acid-Based Composite Hydrogel by DA Click Chemistry With pH Sensitive Nanoparticle for Biomedical Application.
Hydrogels with multifunctional properties attracted intensively attention in the field of tissue engineering because of their excellent performance. Also, object-oriented design had been supposed to an effective and efficient method for material design as cell scaffold in the field of tissue engineering. Therefore, a scaffold-oriented injectable composite hydrogel was constructed by two components. One was pH-sensitive bifunctional nanoparticles for growth factor delivery to improve biofunctionability of hydrogel scaffold. The other was Diels-alder click crosslinked hyaluronic acid hydrogel as matrix. pH dependent release behavior of nanoparticle component was confirmed by results. And, its bioactivity was verified by in vitro cell culture evaluation. In consideration of high-efficiency and effectiveness, low toxicity, controllability and reversibility, dynamic covalent and reversible Diels-alder click chemistry was used to design a HA hydrogel with two kinds of crosslinking points. The properties of hydrogel like gelation time and swelling ratio were influenced by pH value and polymer concentration. Composite hydrogel was formed by in situ polymerization, which exhibited acceptable mechanical property as a scaffold for biomedical field. Lastly, in vitro evaluation from results of viability, DNA content and cell morphology confirmed that hydrogels could maintain cell activity and support cell growth. Compared with pure hydrogel, composite hydrogel possessed better properties.


Theory of optical heterodyne detection using the pyroelectric effect.
Up to this time, thermal detectors have been limited to a minimum detectable power of 10(-10) W Hz(-(1/2)) at very low frequencies. It is shown theoretically in this paper that by using the pyroelectric effect in a heterodyne detection mode of operation, a factor of 10(7) improvement is possible in the minimum detectable power and that 1-GHz frequencies are attainable with sacrifice in sensitivity. The detector is quantum and temperature noise limited for large local oscillator power. These theoretical limits in the minimum detectable power do not seem to be practically attainable at present. The room temperature pyroelectric detector in the heterodyne mode of operation described in the paper would be very useful for special communication and ir radar applications.


In situ electrochemical distance tunneling spectroscopy of ds-DNA molecules.
The electrical conductance of ds-DNA duplexes containing 8-14 base pairs modified at both ends with a -(CH(2))(6)-SH linker was measured in a buffered aqueous solution using electrochemically controlled distance tunneling spectroscopy. The tunneling experiment with self-complementary 5'-(GC)(n)()-3'-(CH(2))(6)-SH (n = 4-7) duplexes attached covalently to a gold STM tip and a Au(111) electrode shows a wide distribution of currents independent of the ds-DNA length. The voltage-induced horizontal orientation of ds-DNA within the junction results in decreased electrical conductance. The lower currents are also observed for ds-DNA molecules containing a single CA base mismatch.


Diskectomy in treatment of disk derangement. A one and three year follow-up.
Diskectomy for treatment of temporomandibular joint disk derangements was evaluated clinically. The study comprised 40 consecutive patients (50 joints) with pain in the joint area and functional impairment not alleviated with nonsurgical therapy for at least 6 months. Diskectomy was performed in 32 joints. In 18 joints both diskectomy and minor arthroplasty were performed. No disk substituting implants were used. At 1 year follow-up 85% of the patients were free of symptoms from the temporomandibular joint area and showed normalized mandibular movements. Twenty patients were followed for 3 years. Two patients with arthrosis showed recurrence of symptoms. It was concluded that diskectomy is an effective surgical procedure for treatment of temporomandibular joint disk derangements.


Functional specialization of the epithelium in the mesonephric tubules.
An electron microscopy study was aimed to correlate structural differentiation of the epithelium in mesonephric proximal tubules (PT) with the expression of membrane activities of alkaline phosphatase (AP) and 5'-nucleotidase (AMP). Tissue samples of mesonephros were taken from 5 to 16 days old chick embryos. Both enzymes were detected with cerium technique, Mayahara modification of lead capture method was used also for localization of AP. Control incubation was performed with levamisole. The formation of absorptive apparatus was characterized by the differentiation of PT epithelium. Activities of AP and AMP appeared to increase rapidly with the differentiation of epithelium. Reaction products of AP and AMP were detected on brush border as well as on membranes of tubular invaginations, transport tubules and endocytotic vacuoles. The basolateral cell surfaces of epithelium were projected in short interdigitating microvilli and the expression of AP and AMP activities on their membranes suggested the transport role of this structural specialization.


Mother-to-child transmission of and multiple-strain colonization by Bacteroides fragilis in a cohort of mothers and their children.
Bacteroides fragilis represents an early infant colonizer with important host interactions. Our knowledge about the diversity, transmission, and persistence of this bacterium, however, is limited. Here, we addressed these questions using a combination of multilocus sequence typing (MLST) and variable-number tandem repeat (VNTR) sequence analyses. We used both culture-dependent and -independent typing. We genotyped B. fragilis in fecal samples from a cohort of 93 mothers and their children, with samples taken from the mothers and from the children at the ages 1 to 10 days, 4 months, 1 year, and 2 years. By MLST we found two main B. fragilis groups, which we denoted clades A and B. Direct typing of stool samples using the icd gene revealed seven sequence types, five within clade A and two within clade B. A single clade A sequence type, however, represented 79% of all the sequences. This sequence type was further subtyped using VNTR. VNTR subtyping revealed 16 different VNTR types. Based on the distribution patterns of these, we show mother-to-child transmission and multiple-strain colonization. We argue that negative host selection promotes the coexistence of multiple strains. The significance of our findings is that we have started unraveling the transmission and persistence patterns of one of the most important human gut colonizers.


Potassium fluxes in bovine adrenal cells during adrenocorticotropin stimulation.
Active (ouabain-sensitive) and passive (ouabain-insensitive) fluxes of 43K were measured in isolated bovine zona fasciculata/reticularis cells. ACTH inhibited passive influx in a dose-dependent manner and, at a concentration that maximally stimulated steroidogenesis (10(-8) M), also inhibited passive efflux. ACTH did not affect active potassium transport. Angiotensin II (10(-6) M) and cAMP (10(-2) M) inhibited passive influx to the same extent as did 10(-8) M ACTH. Angiotensin II (10(-6) M) also reduced active potassium uptake, although this did not appear to be related to changes in cortisol biosynthesis. Increases in cortisol synthesis by ouabain-treated cells in response to angiotensin II and ACTH were proportional to decreases in potassium influx. The addition of cortisol (1 microgram/ml) to cells slightly reduced passive potassium uptake, but not to the same extent as did 10(-8) M ACTH. Frusemide, an inhibitor of passive sodium/potassium cotransport, did not wholly abolish the effects of ACTH on potassium influx. These changes in flux are probably related to electrophysiological changes in membrane potential. Their significance in the regulation of ACTH actions has yet to be determined.


Recurrent Listeria monocytogenes infection: relapse or reinfection with a unique strain confirmed by molecular subtyping.
We report a case of recurrent listeriosis for which molecular subtyping by automated ribotyping and pulsed-field gel electrophoresis confirmed either relapse of infection or reinfection due to a common source almost 9 months after initial infection due to a unique Listeria monocytogenes strain in a patient with colorectal cancer. This case report illustrates the potential use of molecular subtyping to further understand the pathogenesis and epidemiology of listeriosis and the potential for relapse of Listeria infections in humans.


Decreases in Iron Oxide Reducibility during Microbial Reductive Dissolution and Transformation of Ferrihydrite.
Ferrous iron formed during microbial ferric iron reduction induces phase transformations of poorly crystalline into more crystalline and thermodynamically more stable iron (oxyhydr)oxides. Yet, characterizing the resulting decreases in the reactivity of the remaining oxide ferric iron toward reduction (i.e., its reducibility) has been challenging. Here, we used the reduction of six-line ferrihydrite by Shewanella oneidensis MR-1 as a model system to demonstrate that mediated electrochemical reduction (MER) allows directly following decreases in oxide ferric iron reducibility during the transformation of ferrihydrite into goethite and magnetite which we characterized by X-ray diffraction analysis and transmission electron microscopy imaging. Ferrihydrite was fully reducible in MER at both pHMER of 5.0 and 7.5. Decreases in iron oxide reducibility associated with ferrihydrite transformation into magnetite were accessible at both pHMER because the formed magnetite was not reducible under either of these conditions. Conversely, decreases in iron oxide reducibility associated with goethite formation were apparent only at the highest tested pHMER of 7.5 and thus the thermodynamically least favorable conditions for iron oxide reductive dissolution. The unique capability to adjust the thermodynamic boundary conditions in MER to the specific reducibilities of individual iron (oxyhydr)oxides makes this electrochemical approach broadly applicable for studying changes in iron oxide reducibility in heterogeneous environmental samples such as soils and sediments.


A developmental perspective on the Imperfective Paradox.
Imperfective or progressive verb morphology makes it possible to use the name of a whole event to refer to an activity that is clearly not a complete instance of that event, leading to what is known as the Imperfective Paradox. For example, a sentence like 'John was building a house' does not entail that a house ever got built. The Imperfective Paradox has received a number of different treatments in the philosophical and linguistic literature, but has received less attention from the perspective of language acquisition. This article presents developmental evidence on the nature of the Imperfective Paradox, based on a series of four experiments conducted with Russian-speaking 3 to 6 year olds. Despite the fact that Russian is a language in which the morphological form of imperfectives is highly salient and used appropriately at a very young age, younger children show a clearly non-adultlike pattern of comprehension in our experiments. The results from Experiments 1 and 2 suggest that Russian-speaking children incorrectly ascribe completion entailments to imperfectives. However, Experiments 3 and 4 indicate that the children recognize that imperfectives can describe incomplete events, and that their problem instead concerns their inability to find a suitable temporal interval against which to evaluate imperfective statements. Specifically, children are only willing to accept an imperfective predicate as a description of a past incomplete event when the sentence contains an explicit temporal modifier that highlights a time interval that ends before the failure point of the event. These findings are taken as support for an account of the imperfective that makes use of temporal perspectives in solving the Imperfective Paradox.


Method for improved secondary ion yields in cluster secondary ion mass spectrometry.
A method to increase useful yields of organic molecules is investigated by cluster secondary ion mass spectrometry (SIMS). Glycerol drops were deposited onto various inkjet-printed arrays and the organic molecules in the film were rapidly incorporated into the drop. The resulting glycerol/analyte drops were then probed with fullerene primary ions under dynamic SIMS conditions. High primary ion beam currents were shown to aid in the mixing of the glycerol drop, thus replenishing the probed area and sustaining high secondary ion yields. Integrated secondary ion signals for tetrabutylammonium iodide and cocaine in the glycerol drops were enhanced by more than a factor of 100 compared with an analogous area on the surface, and a factor of 1000 over the lifetime of the glycerol drop. Once the analyte of interest is incorporated into the glycerol microdrop, the solution chemistry can be tailored for enhanced secondary ion yields, with examples shown for cyclotrimethylenetrinitramine (RDX) chloride adduct formation. In addition, depositing localized glycerol drops may enhance analyte secondary ion count rates to high enough levels to allow for site-specific chemical maps of molecules in complex matrices such as biological tissues.


Polycystic kidney disease presenting with hypertension and hypokalemia.
Hypokalemic hypertension is a common condition leading to the diagnosis of secondary hypertension. We report the case of a 60-year-old woman for whom the diagnosis of autosomal dominant polycystic kidney disease arose during the investigation of possible hyperaldosteronism. Activation of the renin system, as supported by recent studies, can explain the mechanism of hypokalemia and hypertension in this inherited cystic kidney disorder. Clinicians should be aware of this relatively uncommon clinical phenomenon of secondary hypertension in polycystic kidney disease. Increased understanding of the disorder's underlying mechanism should lay the foundation for better appreciation of potentially effective blood pressure treatments. The availability of a direct renin inhibitor may redirect research toward finding a remedy for this troublesome disease.


Molecular evolution of magellan, a maize Ty3/gypsy-like retrotransposon.
The magellan transposable element is responsible for a spontaneous 5.7-kb insertion in the maize wx-M allele. This element has the sequence and structural characteristics of a Ty3/gypsy-like retrotransposon. The magellan element is present in all Zea species and Tripsacum andersonii; it is absent, however, in the genomes of all other Tripsacum species analyzed. The genetic distances between magellan elements suggest that this retrotransposon is evolving faster than other Zea nuclear loci. The phylogeny of magellan within Zea and T. andersonii also reveals a pattern of interspecies transfers, resulting in the movement of magellan subfamilies between different species genomes. Interspecific hybridization may be a major mechanism by which this retrotransposon invades and establishes itself in new taxa.