Concrescence of maxillary second molar and impacted third molar: A case report.
Morphological anomalies of teeth, including talon cusp, dens evaginatus, gemination, fusion, concrescence, root dilaceration, and taurodontism, always involve changes in the enamel, cementum and dentin. Diagnosing concrescent teeth through routine clinical examination alone is difficult, and most cases of concrescence are found accidentally during extraction. A definite preoperative diagnosis of concrescence would contribute to a better treatment plan and fewer undesirable complications. A 47-year-old woman who complained of left maxillary first molar loss for half a year presented to our department seeking treatment by dental implant restoration. Panoramic radiography and cone-beam computed tomography (CBCT) showed an unclear boundary between the distal root of the second molar and the mesial root of the third molar. The teeth were extracted under local anesthesia, and a definite diagnosis of concrescence was made by histopathological examination. CBCT is a useful tool for diagnosing and planning the management of tooth concrescence and may be beneficial for reducing unnecessary complications.


Diagnostic Reasoning and Cognitive Biases of Nurse Practitioners.
Diagnostic reasoning is often used colloquially to describe the process by which nurse practitioners and physicians come to the correct diagnosis, but a rich definition and description of this process has been lacking in the nursing literature. A literature review was conducted with theoretical sampling seeking conceptual insight into diagnostic reasoning. Four common themes emerged: Cognitive Biases and Debiasing Strategies, the Dual Process Theory, Diagnostic Error, and Patient Harm. Relevant cognitive biases are discussed, followed by debiasing strategies and application of the dual process theory to reduce diagnostic error and harm. The accuracy of diagnostic reasoning of nurse practitioners may be improved by incorporating these items into nurse practitioner education and practice. [J Nurs Educ. 2018;57(4):203-208.].


Racial and ethnic health disparities: evidence of discrimination's effects across the SEP spectrum.
Perceived discrimination is a psychosocial stressor that plays a role in explaining racial/ethnic disparities in self-reported physical and mental health. The purpose of this paper is: (1) to investigate the association between perceived discrimination in receiving healthcare and racial/ethnic disparities in self-rated health status, physical, and emotional functional limitations among a diverse sample of California adults; (2) to assess whether discrimination effects vary by racial/ethnic group and gender; and (3) to evaluate how the effects of discrimination on health are manifest across the socioeconomic position (SEP) spectrum. Data were drawn from the 2001 California Health Interview Survey adult file (n=55,428). The analytic approach employed multivariate linear and logistic regressions. Discrimination is qualitatively identified into two types: (1) discrimination due to race/ethnicity, language, or accent, and (2) other discrimination. Findings show that both types of discrimination negatively influenced self-rated health, and were associated with a two to three-fold odds of limitations in physical and emotional health. Further, these effects varied by racial/ethnic group and gender, and the effects were mixed. Most notably, for emotional health, racial/ethnic discrimination penalized Latinas more than non-Latina Whites, but for physical health, other discrimination was less detrimental to Latinas than it was to non-Latina Whites. At higher levels of SEP, the effects of racial/ethnic discrimination on self-rated health and other discriminations' effects on physical health were attenuated. Higher SEP may serve as an important mitigator, particularly when comparing the medium to the low SEP categories. It is also possible that SEP effects cannot be extracted from the relationships of interest in that SEP is an expression of social discrimination. In fact, negative health effects associated with discrimination are evident across the SEP spectrum. This study highlights the complexity of the relationships between discrimination and racial/ethnic identity, gender, and SEP.


Diagnostic performance of magnetic resonance imaging for degenerative temporomandibular joint disease.
Degenerative joint disease (DJD) of the temporomandibular joint (TMJ) is an important type of temporomandibular disorders (TMDs) potentially leading to orofacial pain and jaw dysfunction. Magnetic resonance imaging (MRI) is important in TMD diagnosis; however, its diagnostic ability for DJD remains unknown. To explore the utility of MRI in diagnosing DJD according to the latest diagnostic criteria for TMD and detecting condylar bone abnormalities and their severity. Overall, 122 participants were examined using cone-beam computed tomography (CBCT) and MRI. The sensitivity, specificity and accuracy of MRI for detecting DJD and different types of TMJ condylar bone abnormalities were calculated (considering CBCT as gold standard); in addition, we tested MRI and CBCT's consistency in scoring five types of condylar bone abnormalities. The sensitivity and specificity of MRI for DJD were 95.3% and 43.1%, respectively. The MRI sensitivities for condylar flattening, erosion, osteophytes, sclerosis and cysts were 98.6%, 96.2%, 79.4%, 50%, and 79.2% (specificity, 53.6%, 48.3%, 81.6%, 83.3%, and 88.2%, respectively), respectively. The consistency between MRI and CBCT in assessing the severity of condylar bone abnormalities was fair-to-moderate (kappa coefficient: 0.278-0.491). The inter-observer consistency for CBCT was good, whereas for MRI, it was relatively poor. MRI can detect DJD and condylar bone abnormalities. However, MRI could not efficiently detect the severity of condylar bone abnormalities.


Atomic Visualization of the 3D Charge Density Wave Stacking in 1T-TaS2 by Cryogenic Transmission Electron Microscopy.
Charge density waves (CDWs) in 1T-TaS2 maintain 2D ordering by forming periodic in-plane star-of-David (SOD) patterns, while they also intertwined with orbital order in the c axis. Recent theoretical calculations and surface measurements have explored 3D CDW configurations, but interlayer intertwining of a 2D CDW order remains elusive. Here, we investigate the in- and out-of-plane ordering of the commensurate CDW superstructure in a 1T-TaS2 thin flake in real space, using aberration-corrected cryogenic transmission electronic microscopy (cryo-TEM) in low-dose mode, far below the threshold dose for an electron-induced CDW phase transition. By scrutinizing the phase intensity variation of modulated Ta atoms, we visualize the penetrative 3D CDW stacking structure, revealing an intertwining multidomain structure with three types of vertical CDW stacking configurations. Our results provide microstructural evidence for the coexistence of local Mott insulation and metal phases and offer a paradigm for studying the CDW structure and correlation order in condensed-matter physics using cryo-TEM.


Individual differences in the subjective experience of pain: new insights into mechanisms and models.
Individual differences in pain sensitivity have long remained a perplexing and challenging clinical problem. How can one individual have a sensory experience that is vastly different than that of another, even when they have received similar sensory input? Developing an understanding of such differences and the mechanisms that support them has progressed substantially as psychophysical findings are integrated with measures of brain activation provided by functional brain imaging techniques. Continued delineation of these mechanisms will contribute substantially to the development of combined psychophysical/psychological models that can be used to optimize pain treatment on an individual-by-individual basis.


Quantitative evaluation of facet deflection, stiffness, strain and failure load during simulated cervical spine trauma.
Traumatic cervical facet dislocation (CFD) is often associated with devastating spinal cord injury. Facet fractures commonly occur during CFD, yet quantitative measures of facet deflection, strain, stiffness and failure load have not been reported. The aim of this study was to determine the mechanical response of the subaxial cervical facets when loaded in directions thought to be associated with traumatic bilateral CFD - anterior shear and flexion. Thirty-one functional spinal units (6 × C2/3, C3/4, C4/5, and C6/7, 7 × C5/6) were dissected from fourteen human cadaver cervical spines (mean donor age 69 years, range 48-92; eight male). Loading was applied to the inferior facets of the inferior vertebra to simulate the in vivo inter-facet loading experienced during supraphysiologic anterior shear and flexion motion. Specimens were subjected to three cycles of sub-failure loading (10-100 N, 1 mm/s) in each direction, before being failed in a randomly assigned direction (10 mm/s). Facet deflection, surface strains, stiffness, and failure load were measured. Linear mixed-effects models (α = 0.05; random effect of cadaver) accounted for variations in specimen geometry and bone density. Specimen-specific parameters were significantly associated with most outcome measures. Facet stiffness and failure load were significantly greater in the simulated flexion loading direction, and deflection and surface strains were higher in anterior shear at the non-destructive analysis point (47 N applied load). The sub-failure strains and stiffness responses differed between the upper and lower subaxial cervical regions. Failure occurred through the facet tip during anterior shear loading, while failure through the pedicles was most common in flexion.


Interferon-induced class II expression at the spongiotrophoblastic zone of the murine placenta is linked to fetal rejection and developmental abnormalities.
Type II interferon is known to induce a plethora of gene expression involved in the humoral and cellular immunity. One of the multiple sites of action of gamma-IFN is the fetoplacental unit, where its role has not yet been clearly defined. We have previously shown in vitro that gamma-IFN may induce expression of class II MHC antigens on the spongiotrophoblast layer of the murine placenta, which under physiological conditions is negative for these antigens. Indeed, the absence of class II antigens from the placenta could be part of a mechanism evoked by fetal tissues to escape a host vs. graft reaction. In the present study we show that intraperitoneal in vivo administration of low doses of recombinant gamma-IFN to pregnant females specifically induces class II antigens on the spongiotrophoblast zone, increases fetal abortion, causes retardation of eye development in the fetuses and decreases fetal weight. This treatment also affects the maternal pathology as we witness a prominent hypersplenism in the mother accompanied by low levels of haematocrit, elevated IgG production and decreased granulocytic and thrombocytic counts. These results are specifically linked to the pregnant state of the mother, since virgin females do not develop any of the above abnormalities. Our results not only point to a new dimension in gamma-IFN's role during pregnancy, but may be of clinical importance for prophylaxis since administration of gamma-IFN to a pregnant female may lead to abortion, fetal abnormalities or cause haematologic disorders to the mother.


Baicalin influences the dendritic morphology of newborn neurons in the hippocampus of chronically stressed rats.
Chronic stress models, established in adult Sprague-Dawley rats through a 14-day subcutaneous injection of 40 mg/kg corticosterone, once per day, were given a daily oral feeding of 50 mg/kg baicalin. The study was an attempt to observe the effect of baicalin on neurogenesis in chronically stressed rats. Results showed that subcutaneous injection of corticosterone significantly decreased the total number of doublecortin-positive neurons in the hippocampus. The reduced cell number caused by corticosterone was mainly due to the decrease of class II doublecortin-positive neurons, but the class I doublecortin-positive neurons were unaffected. Baicalin treatment increased the number of both class I and class II doublecortin-positive neurons. In addition, doublecortin-positive neurons showed less complexity in dendritic morphology after corticosterone injection, and this change was totally reversed by baicalin treatment. These findings suggest that baicalin exhibits a beneficial effect on adult neurogenesis.


[Localization of hypoplastic kidney by enhanced computed tomography: experiences with five ectopic ureters with hypoplastic kidneys].
Five children with ectopic ureters and hypoplastic kidneys are reported. Hypoplastic kidneys in these cases could not be detected by excretory urography, renal scintigraphy or other routine examinations. Finally, in three cases we could diagnose the localization of hypoplastic kidney by enhanced computed tomography. Enhanced computed tomography is very valuable for diagnosis of localization of hypoplastic kidney.


Experiences of new tenure-track PhD-prepared faculty: a scoping review.
The purpose of this scoping review was to assess the state of the literature concerning the experiences of new PhD-prepared tenure-track faculty, with a keen interest in nursing faculty. Effective recruitment and retention strategies for new nursing academic faculty need to be found and implemented. A literature review based on Arksey and O'Malley's five-stage framework for scoping reviews was undertaken. Using the PRISMA protocol, a systematic literature search was conducted in seven databases of studies published in English. Based upon inclusion criteria and relevance, 13 studies out of 90 papers were included in this study. Themes identified from the studies were transitioning to academia, developing a research program, balancing work and life, and perceived inequity. The research was predominately American and Canadian based. Several gaps in the literature were identified. Further research is critical to make recommendations to key stakeholders for recruitment and retention strategies.


Safety profile of the RTS,S/AS01 malaria vaccine in infants and children: additional data from a phase III randomized controlled trial in sub-Saharan Africa.
A phase III, double-blind, randomized, controlled trial (NCT00866619) in sub-Saharan Africa showed RTS,S/AS01 vaccine efficacy against malaria. We now present in-depth safety results from this study. 8922 children (enrolled at 5-17 months) and 6537 infants (enrolled at 6-12 weeks) were 1:1:1-randomized to receive 4 doses of RTS,S/AS01 (R3R) or non-malaria control vaccine (C3C), or 3 RTS,S/AS01 doses plus control (R3C). Aggregate safety data were reviewed by a multi-functional team. Severe malaria with Blantyre Coma Score ≤2 (cerebral malaria [CM]) and gender-specific mortality were assessed post-hoc. Serious adverse event (SAE) and fatal SAE incidences throughout the study were 24.2%-28.4% and 1.5%-2.5%, respectively across groups; 0.0%-0.3% of participants reported vaccination-related SAEs. The incidence of febrile convulsions in children was higher during the first 2-3 days post-vaccination with RTS,S/AS01 than with control vaccine, consistent with the time window of post-vaccination febrile reactions in this study (mostly the day after vaccination). A statistically significant numerical imbalance was observed for meningitis cases in children (R3R: 11, R3C: 10, C3C: 1) but not in infants. CM cases were more frequent in RTS,S/AS01-vaccinated children (R3R: 19, R3C: 24, C3C: 10) but not in infants. All-cause mortality was higher in RTS,S/AS01-vaccinated versus control girls (2.4% vs 1.3%, all ages) in our setting with low overall mortality. The observed meningitis and CM signals are considered likely chance findings, that - given their severity - warrant further evaluation in phase IV studies and WHO-led pilot implementation programs to establish the RTS,S/AS01 benefit-risk profile in real-life settings.


Trimester-Specific Serum Fructosamine in Association with Abdominal Adiposity, Insulin Resistance, and Inflammation in Healthy Pregnant Individuals.
This study aimed to (1) characterize the variations in serum fructosamine across trimesters and according to pre-pregnancy BMI (ppBMI), and (2) examine associations between fructosamine and adiposity/metabolic markers (ppBMI, first-trimester adiposity, leptin, glucose homeostasis, and inflammation measurements) during pregnancy. Serum fructosamine, albumin, fasting glucose and insulin, leptin, adiponectin, interleukin-6 (IL-6), and C-reactive protein (CRP) concentrations were measured at each trimester. In the first trimester, subcutaneous (SAT) and visceral (VAT) adipose tissue thicknesses were estimated by ultrasound. In the 101 healthy pregnant individuals included (age: 32.2 ± 3.5 y.o.; ppBMI: 25.5 ± 5.5 kg/m2), fructosamine concentrations decreased during pregnancy whereas albumin-corrected fructosamine concentrations increased (p < 0.0001 for both). Notably, fructosamine concentrations were inversely associated with ppBMI, first-trimester SAT, VAT, and leptin (r = −0.55, r = −0.61, r = −0.48, r = −0.47, respectively; p < 0.0001 for all), first-trimester fasting insulin and HOMA-IR (r = −0.46, r = −0.46; p < 0.0001 for both), and first-trimester IL-6 (r = −0.38, p < 0.01). However, once corrected for albumin, most of the correlations lost strength. Once adjusted for ppBMI, fructosamine concentrations were positively associated with third-trimester fasting glucose and CRP (r = 0.24, r = 0.27; p < 0.05 for both). In conclusion, serum fructosamine is inversely associated with adiposity before and during pregnancy, with markers of glucose homeostasis and inflammation, but the latter associations are partially influenced by albumin concentrations and ppBMI.


Pleiotrophin is highly expressed by myeloma cells and promotes myeloma tumor growth.
Pleiotrophin (PTN) is an important developmental cytokine that is highly expressed during embryogenesis but shows very limited expression in adult tissues, where it is largely restricted to the brain. High PTN serum levels are associated with a variety of solid tumors. We recently showed that patients with multiple myeloma (MM) also have elevated serum levels of this protein and the amount of PTN correlated with the patients' disease status and response to treatment. In this study, we demonstrate that MM cell lines and the malignant cells from MM patients' bone marrow produced PTN and secreted PTN protein into the supernatants during short-term culture. Moreover, Ptn gene expression correlated with the patients' disease status. Inhibition of PTN with a polyclonal anti-PTN antibody reduced growth and enhanced apoptosis of MM cell lines and freshly isolated bone marrow tumor cells from MM patients in vitro. Importantly, this antibody also markedly suppressed the growth of MM in vivo using a severe combined immunodeficiency (SCID)-hu murine model. This represents the first study showing the importance of PTN in the growth of any hematological disorder. Because the expression of this protein is very limited in normal adult tissues, PTN may represent a new target for the treatment of MM.


Oscillatory dynamics serving visual selective attention during a Simon task.
Selective attention is an important component of cognitive control and is essential for day-to-day functioning. The Simon task is a common test of visual selective attention that has been widely used to probe response selection, inhibition and cognitive control. However, to date, there is a dearth of literature that has focused on the oscillatory dynamics serving task performance in the selective attention component of this task. In this study, 32 healthy adults (mean age: 33.09 years, SD: 7.27 years) successfully completed a modified version of the Simon task during magnetoencephalography. All magnetoencephalographic data were pre-processed and transformed into the time-frequency domain. Significant oscillatory brain responses were imaged using a beamforming approach, and peak task-related neural activity was extracted to examine the temporal dynamics. Across both congruent and Simon conditions, our results indicated robust decreases in alpha (8-12 Hz) activity in the bilateral occipital regions and cuneus during task performance, while increases in theta (3-6 Hz) oscillatory activity were detected in regions of the dorsal frontoparietal attention network, including the dorsolateral prefrontal cortex, frontal eye fields and insula. Lastly, whole-brain condition-wise analyses showed Simon interference effects in the theta range in the superior parietal region and the alpha range in the posterior cingulate and inferior frontal cortices. These findings provide network-specific insights into the oscillatory dynamics serving visual selective attention.


Evaluation of platelet-rich plasma applied in the coronary band of healthy equine hooves.
Platelet-rich plasma (PRP) is a widely used hemocomponent that holds great promise in equine medicine due to its feasible production and regenerative therapy potential. Its use has been considered as a treatment for chronic laminitis, mainly in terms of its analgesic properties and because it can induce growth in affected hooves. The aim of this study was to evaluate the effect on hoof growth attributable to PRP applied in the coronary band of clinically healthy horses by comparing the responses to PRP, saline, and trimming alone. After randomization, the forelimbs of 9 horses received specific treatment at intervals of 33 days and were trimmed, measured, and radiographed at the same time. Neither hoof growth nor hoof angles were different between the treatment groups at any time point. The application of PRP in the coronary band of horses may be a safe procedure; however, it had no effect on the growth or conformation of hooves in clinically healthy horses.


Highly efficient enzymatic synthesis of 3'-deoxyapionucleic acid (apioNA) having the four natural nucleobases.
The synthesis of the 3'-deoxyapionucleoside 3''-triphosphates (apioNTPs) having the four natural nucleobases and their enzymatic incorporation into a DNA-DNA primer-template have been tried. Therminator DNA polymerase was shown to incorporate these apioNTPs effectively giving 43mer DNA-apioNA chimera.


[Ethics and law in intensive therapy].
Intensive therapy is one of the newest areas of medicine. The patient who was thought to be hopeless yesterday is given a chance to survive. As in other fields of medicine parallel with their development, several ethical and legal problems arise and wait for solutions. Two areas need urgent solutions especially at first ethical then at legal levels. These are the questions of life and death: where is the boundary of euthanasia and can the so called DNR ("Do Not Resuscitate") strategy be applied, which partial therapy withdrawal can be done compatibly with the basic ethical and legal requirement of protection of life. Important question as well, is that where lies the boundary of free self determination. How can be living wills be given when is it necessary to ask for the patient's consent, how much information is to be given to the patient. Based on increasing experiences form Europe and the USA, some of the important fundamental principles of therapy withdrawal of intensive care therapy is outlined. Besides the above described questions, a short description of the Hungarian conditions will be given. Although the number of declarations given by professional corporations increase decisions of the jury help the medical practitioner in making his difficult decisions, but making the individual decision personal communication of the medical staff with the patient or his foster play an important role. Everything is the patient's right of free self determination based on the patient being properly informed. The ethical and even the legal attitude does not consider withdrawal of a widening circle of therapy to a form of euthanasia. In the mirror of international experiences concordance is reached in many aspects of therapy withdrawal in intensive care. In the mean time national regulations are not yet available, this is the reason, why based on the international declarations, keeping an eye on the Hungarian practice these regulations should be worked out in the near future.


Cholesterol transfer at endosomal-organelle membrane contact sites.
Cholesterol is delivered to the limiting membrane of late endosomes by Niemann-Pick Type C1 and C2 proteins. This review summarizes recent evidence that cholesterol transfer from endosomes to the endoplasmic reticulum and other organelles is mediated by lipid-binding proteins that localize to membrane contact sites (MCS). LDL-cholesterol in the late endosomal/lysosomes is exported to the plasma membrane, where most cholesterol resides, and the endoplasmic reticulum, which harbors the regulatory complexes and enzymes that control the synthesis and esterification of cholesterol. A major advance in dissecting these cholesterol transport pathways was identification of frequent and dynamic MCS between endosomes and the endoplasmic reticulum, peroxisomes and plasma membrane. Positioned at these MCS are members of the oxysterol-binding protein (OSBP) and steroidogenic acute regulatory protein-related lipid-transfer family of lipid transfer proteins that bridge the opposing membranes and directly or indirectly mediate cholesterol transfer. OSBP-related protein 1L (ORP1L), ORP5 and ORP6 mediate cholesterol transfer to the endoplasmic reticulum that regulates cholesterol homeostasis. ORP1L and STARD3 also move cholesterol from the endoplasmic reticulum-to-late endosomal/lysosomes under low-cholesterol conditions to facilitate intraluminal vesicle formation. Cholesterol transport also occurs at MCS with peroxisomes and possibly the plasma membrane. Frequent contacts between organelles and the endo-lysosomal vesicles are sites for bidirectional transfer of cholesterol.


Impaired memory and behavioral performance with fentanyl at low plasma concentrations.
Fentanyl is commonly administered to conscious patients by continuous epidural or intravenous (i.v.) infusions, or by the transdermal route, which result in relatively constant, low, concentrations of the drug. Previous studies of memory and cognitive effects have not been performed at constant plasma concentrations of fentanyl. Based on simulated infusions using the pharmacokinetic modeling program IV-SIM, we administered fentanyl or placebo to nine healthy volunteers (aged 21-45 yr) by continuous i.v. infusion, targeting plasma concentrations of 1, 1.5, and 2.5 ng/mL in succession. A battery of memory and psychomotor tasks was administered at each plasma concentration of fentanyl, and at two points in the recovery phase while drug levels were decreasing. At increasing plasma concentrations of fentanyl, we found the following effects on memory (in comparison with placebo): a progressive decline in verbal learning (P < 0.03); decreased delayed recognition of words presented at different test times (P < 0.02); and decreased spontaneous recall of pictures shown during infusion (P < 0.03). Fentanyl at concentrations above 2.5 ng/mL caused a performance decrement of 15%-30% relative to baseline on all the psychomotor tests administered. Plasma concentrations less than 2.25 ng/mL had negligible effects on performance with the exception of the critical flicker fusion frequency, which decreased by 5 Hz at plasma concentrations between 1.5 and 2.25 ng/mL. Visual analog scale (VAS) measures of mental and physical sedation were significantly affected by fentanyl, but euphoria was not demonstrable. All subjects receiving fentanyl experienced severe nausea and four of six had one or more episodes of emesis (P < 0.03).(ABSTRACT TRUNCATED AT 250 WORDS)


Cloning and polymorphism analysis of IL-4 proximal promoter in asthmatic children.
To clone and study the polymorphism within interleukin-4 (IL-4) proximal promoter of asthmatic children. The IL-4 proximal promoter segments were amplified and selected by polymerase chain reaction (PCR) and single strand conformation polymorphism (SSCP) with genomic DNA from ten healthy children and forty patients with dominantly allergic familial histories as templates. The selected PCR segments were cloned into recombinant plasmids pIL-4-Jx2. The PCR inserts were sequenced by dideoxy chain termination method. Seven aberrant bands were found in SSCP analysis from forty asthmatic patients. The sequencing results showed that four variant sites were found within or adjacent to the known IL-4 regulatory element. A C to A transversion located at -229 position was just within the positive regulatory element-I (PRE-I) in one patient. A C to T transition adjacent to the negative regulatory element-II (NRE-II) and an extra G adjacent to TATA box were found in two patients. A five base nucleotide deletion was found near signal transducers and activators of transcription-6 responsive element (STAT-6 RE) in one patient. There were polymorphisms within the IL-4 proximal promoter of allergic asthmatic patients and these polymorphisms might result in aberrant expression of IL-4 gene and asthma.


[Activation of nuclear factor-kappa B and expression of cytokine in intestinal epithelia stimulated by TNF-alpha].
To investigate the effect of nuclear factor-kappa B activation on proinflammatory cytokine expression in intestinal epithelia when intestinal epithelia are in inflammatory condition. Colonic adenocarcinoma HT29 cells were cultured in wells and TNF-alpha (10 ng/ml) was added into half of the wells. The supernatants were collected and measured for IL-8 after 3 hours, nuclear factor-kappaB (NF-kappaB) P65 and IL-8 mRNA were also examined by Western blotting and RT-PCR respectively. It was found that in the condition of no stimuli, there is little IL-8 mRNA expression of HT29 cells, P65 is seldom in HT29 cells' nuclei, and the concentration of IL-8 in supernatant is just 172 ng/L. However, after being stimulated by TNF-alpha, a lot of P65 expression in nuclei and a large number of IL-8 mRNA expression of HT29 cells are shown and the concentration of IL-8 in supernatant (639 ng/L) is significantly higher than that of control (P<0.01). The activation of nuclear factor-kappa B modulates the expression of some proinflammatory cytokine in intestinal epithelia, and regulates epithelia function in inflammatory reaction.


Underwater Image Enhancement With Hyper-Laplacian Reflectance Priors.
Underwater image enhancement aims at improving the visibility and eliminating color distortions of underwater images degraded by light absorption and scattering in water. Recently, retinex variational models show remarkable capacity of enhancing images by estimating reflectance and illumination in a retinex decomposition course. However, ambiguous details and unnatural color still challenge the performance of retinex variational models on underwater image enhancement. To overcome these limitations, we propose a hyper-laplacian reflectance priors inspired retinex variational model to enhance underwater images. Specifically, the hyper-laplacian reflectance priors are established with the l1/2 -norm penalty on first-order and second-order gradients of the reflectance. Such priors exploit sparsity-promoting and complete-comprehensive reflectance that is used to enhance both salient structures and fine-scale details and recover the naturalness of authentic colors. Besides, the l2 norm is found to be suitable for accurately estimating the illumination. As a result, we turn a complex underwater image enhancement issue into simple subproblems that separately and simultaneously estimate the reflection and the illumination that are harnessed to enhance underwater images in a retinex variational model. We mathematically analyze and solve the optimal solution of each subproblem. In the optimization course, we develop an alternating minimization algorithm that is efficient on element-wise operations and independent of additional prior knowledge of underwater conditions. Extensive experiments demonstrate the superiority of the proposed method in both subjective results and objective assessments over existing methods. The code is available at: https://github.com/zhuangpeixian/HLRP.


Use of isotopes in examining precipitation patterns in north-central Ukraine.
North-central Ukraine is vulnerable to temperature increases and precipitation pattern changes associated with climate change. With water management becoming increasingly important, information on current water sources and moisture recycling is critically needed. Isotope ratios of oxygen (δ18O) and hydrogen (δ2H) in precipitation are sensitive to these variables and allow comparisons across the region. The δ2H and δ18O values from collected precipitation in Kyiv and Cherkasy in 2020 and published 3H data for Kyiv from the year 2000 show an influence of the North Atlantic Oscillation (NAO) and provide information about processes affecting precipitation along the storm trajectory. The δ18O values also show a correlation with temperature, indicating that precipitation patterns may be affected by the rising temperatures in the region, as predicted by recent regional studies using Representative Concentration Pathway scenarios and the global climate model GFDL-ESM2M. When compared to backtracked storm trajectory and NAO data, clear relationships emerged between water isotope ratios, storm paths, and likely moisture recycling. Overall, δ2H, δ18O, 3H, and backtracked storm trajectory data provide more regional and local information on water vapour processes, improving climate-change-driven precipitation forecasts in Ukraine.


On-line sample cleanup and enrichment chromatographic technique for the determination of ambroxol in human serum.
A sensitive and efficient on-line clean up and pre-concentration method has been developed using column-switching technique and protein-coated µ-Bondapak CN silica pre-column for quantification of ambroxol (AM) in human serum. The method is performed by direct injection of serum sample onto a protein-coated µ-Bondapak CN silica pre-column, where AM is pre-concentrated and retained, while proteins and very polar constituents are washed to waste using a phosphate buffer saline (pH 7.4). The retained analyte on the pre-column is directed onto a C(18) analytical column for separation, with a mobile phase consisting of a mixture of methanol and distilled deionized water (containing 1% triethylamine adjusted to pH 3.5 with ortho-phosphoric acid) in the ratio of 50:50 (v/v). Detection is performed at 254 nm. The calibration curve is linear over the concentration range of 12-120 ng/mL (r(2) = 0.9995). The recovery, selectivity, linearity, precision, and accuracy of the method are convenient for pharmacokinetic studies or routine assays.


1JCH correlates with alcohol hydrogen bond strength.
The strength of the H-bond donation by alcohols is reflected in the carbon-hydrogen bond of the H-C-O-H functional group. The one-bond 13C-1H spin-spin coupling constant of hexafluoroisopropanol (HFIP) correlates with the strength of the H-bond in various HFIP-amine complexes with a slope of approximately -0.2 Hz in 1JCH per approximately 1 kJ mol(-1) increase in the H-bond enthalpy. The decrease in 1JCH is attributed to an increased overlap of the H-bonding sigma orbital with the antibonding sigma orbitals of the vicinal C-H bonds.


[Possibilities evaluation of organization and delivery of stomatological help to children in need of complex maxillofacial prosthetics].
The article is devoted to the analysis of conditions of the organization of maxillofacial prosthetic help for children in 32 of 83 administrative regions of Russian Federation. The investigation was carried out in 2006. The materials of the investigation include the opinions of 72 management leaders of stomatological organizations. Results show the problems of treatment of children with complex difficulties of maxillofacial prosthetic help such as affability of treatment, integrations with other specialists, provide with personal, organization of treatment, and so on.


Identification of a cAMP-response element in the regulator of G-protein signaling-2 (RGS2) promoter as a key cis-regulatory element for RGS2 transcriptional regulation by angiotensin II in cultured vascular smooth muscles.
Mice deficient in regulator of G-protein signaling-2 (RGS2) have severe hypertension, and RGS2 genetic variations occur in hypertensive humans. A potentially important negative feedback loop in blood pressure homeostasis is that angiotensin II (Ang II) increases vascular smooth muscle cell (VSMC) RGS2 expression. We reported that Group VIA phospholipase A(2) (iPLA(2)β) is required for this response (Xie, Z., Gong, M. C., Su, W., Turk, J., and Guo, Z. (2007) J. Biol. Chem. 282, 25278-25289), but the specific molecular causes and consequences of iPLA(2)β activation are not known. Here we demonstrate that both protein kinases C (PKC) and A (PKA) participate in Ang II-induced VSMC RGS2 mRNA up-regulation, and that actions of PKC and PKA precede and follow iPLA(2)β activation, respectively. Moreover, we identified a conserved cAMP-response element (CRE) in the murine RGS2 promoter that is critical for cAMP-response element-binding protein (CREB) binding and RGS2 promoter activation. Forskolin-stimulated RGS2 mRNA up-regulation is inhibited by CREB sequestration or specific disruption of the CREB-RGS2 promoter interaction, and Ang II-induced CREB phosphorylation and nuclear localization are blocked by iPLA(2)β pharmacologic inhibition or genetic ablation. Ang II-induced intracellular cyclic AMP accumulation precedes CREB phosphorylation and is diminished by inhibiting iPLA(2), cyclooxygenase, or lipoxygenase. Moreover, three single nucleotide polymorphisms identified in hypertensive patients are located in the human RGS2 promoter CREB binding site. Point mutations corresponding to these single nucleotide polymorphisms interfere with stimulation of human RGS2 promoter activity by forskolin. Our studies thus delineate a negative feedback loop to attenuate Ang II signaling in VSMC with potential importance in blood pressure homeostasis and the pathogenesis of human essential hypertension.


Ammonia-hydrogen bromide and ammonia-hydrogen iodide complexes: anion photoelectron and ab initio studies.
The ammonia-hydrogen bromide and ammonia-hydrogen iodide, anionic heterodimers were studied by anion photoelectron spectroscopy. In complementary studies, these anions and their neutral counterparts were also investigated via ab initio theory at the coupled cluster level. In both systems, neutral NH(3)...HX dimers were predicted to be linear, hydrogen-bonded complexes, whereas their anionic dimers were found to be proton-transferred species of the form, (NH(4)(+)X(-))(-). Both experimentally measured and theoretically predicted vertical detachment energies (VDE) are in excellent agreement for both systems, with values for (NH(4)(+)Br(-))(-) being 0.65 and 0.67 eV, respectively, and values for (NH(4)(+)I(-))(-) being 0.77 and 0.81 eV, respectively. These systems are discussed in terms of our previous study of (NH(4)(+)Cl(-))(-).


Differences in regulatory mechanisms of atrial and ventricular muscle contraction in bovine heart.
The purpose of this study was to characterize the regulatory mechanisms of atrial muscle contraction. Natural actomyosin (NAM) and tropomyosin-troponin (TM-TN) complex were prepared from atrial and ventricular muscle of the same bovine heart. The results were as follows: (1) Atrial NAM was more sensitive to Ca2+ than was ventricular NAM: the pCa required for 50% ATPase activation was 5.96 +/- 0.10 vs. 5.63 +/- 0.07, (mean +/- SE; n = 6; p less than 0.01); (2) reconstitution of desensitized actomyosin of rabbit skeletal muscle plus atrial or ventricular TM-TN complex produced higher Ca2+ sensitivity in atrial muscle than in ventricular muscle: the pCa required for 50% ATPase activation was 6.48 +/- 0.10 vs. 6.23 +/- 0.15 (n = 3; p less than 0.05); (3) the amount of inorganic phosphate covalently bound to atrial NAM was equivalent to that bound to ventricular NAM; (4) SDS-polyacrylamide gel electrophoresis of the two NAMs revealed several protein bands of different mobility from 16,000 to 30,000 daltons; and (5) the superprecipitation response of atrial NAM was characterized by a stepwise change in turbidity after the addition of MgATP, in contrast to the biphasic pattern of ventricular NAM. These data suggest that the free Ca ion concentration required for atrial muscle contraction is lower than that required for ventricular muscle contraction and that the difference is attributable to differences in atrial and ventricular regulatory proteins.


Controlling the Strong Metal-Support Interaction Overlayer Structure in Pt/TiO2 Catalysts Prevents Particle Evaporation.
Platinum nanoparticles (NPs) supported by titania exhibit a strong metal-support interaction (SMSI)[1] that can induce overlayer formation and encapsulation of the NP's with a thin layer of support material. This encapsulation modifies the catalyst's properties, such as increasing its chemoselectivity[2] and stabilizing it against sintering.[3] Encapsulation is typically induced during high-temperature reductive activation and can be reversed through oxidative treatments.[1] However, recent findings indicate that the overlayer can be stable in oxygen.[4, 5] Using in situ transmission electron microscopy, we investigated how the overlayer changes with varying conditions. We found that exposure to oxygen below 400 °C caused disorder and removal of the overlayer upon subsequent hydrogen treatment. In contrast, elevating the temperature to 900 °C while maintaining the oxygen atmosphere preserved the overlayer, preventing platinum evaporation when exposed to oxygen. Our findings demonstrate how different treatments can influence the stability of nanoparticles with or without titania overlayers. expanding the concept of SMSI and enabling noble metal catalysts to operate in harsh environments without evaporation associated losses during burn-off cycling.


An exponential effect persistence model for intensive longitudinal data.
We develop an effect persistence model for intensive longitudinal data under a general assumption of an exponential loss of association between exposure and outcome over time. The working model proposed may be useful for understanding the complexity of phenomena for which subjects can be repeatedly exposed to an intervention or a naturally occurring event, while, the effect of any one exposure is expected to diminish over time. Under the main assumption, we specify a semilinear model with extensions to generalized linear models. These methods are motivated by, and applied to, data from a study of adolescent exposure to prosmoking advertisement in which the impact of prosmoking media exposure on young adults' susceptibility to smoking is assessed along with the decay of the effect over time. We investigate the performance of the proposed method when the model assumptions are correctly specified or not. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Drug discovery and assay development in the ubiquitin-proteasome system.
The observation that tumour cells are more sensitive to pharmacological inhibition of the proteasome than normal cells has led to the development of the proteasome inhibitor bortezomib. To date, this is the only proteasome inhibitor that has been approved for clinical use. The clinical success of bortezomib, combined with the occurrence of adverse effects and the development of clinical resistance against this compound, has initiated the development of a broad range of second-generation proteasome inhibitors as well as of assays that can be used to establish a relationship between the extent and type of proteasome inhibition and the effectiveness of a particular drug. In the present paper, we discuss new strategies that may be used in the future to overcome drug resistance and to broaden the use of proteasome inhibitors for the treatment of both cancer and infectious and autoimmune disease.


Direct Targeting of Macrophages With Methylglyoxal-Bis-Guanylhydrazone Decreases SIV-Associated Cardiovascular Inflammation and Pathology.
Despite effective combination antiretroviral therapy, HIV-infected individuals develop comorbidities, including cardiovascular disease, where activated macrophages play a key role. To date, few therapies target activated monocytes and macrophages. We evaluated a novel oral form of the polyamine biosynthesis inhibitor methylglyoxal-bis-guanylhydrazone (MGBG) on cardiovascular inflammation, carotid artery intima-media thickness (cIMT), and fibrosis in a simian immunodeficiency virus infection model of AIDS. Eleven simian immunodeficiency virus-infected animals received MGBG (30 mg/kg) once daily and 8 received a placebo control both beginning at 21 days postinfection (dpi). Animals were time sacrificed at 49 days post infection (dpi), when their matched placebo controls developed AIDS (63, 70, 77, 80), or at the study end-point (84 dpi). Aorta, carotid artery, and cardiac tissues were analyzed. Quantitative analyses of macrophage populations and T lymphocytes were done and correlated with cIMT and fibrosis. MGBG treatment resulted in 2.19-fold (CD163), 1.86-fold (CD68), 2.31-fold (CD206), and 2.12-fold (MAC387) decreases in macrophages in carotid arteries and significant 2.07-fold (CD163), 1.61-fold (CD68), 1.95-fold (MAC387), and 1.62-fold (CD206) decreases in macrophages in cardiac tissues. cIMT (1.49-fold) and fibrosis (2.05-fold) also were significantly decreased with MGBG treatment. Numbers of macrophage and the degree of fibrosis in treated animals were similar to uninfected animals. A positive correlation between decreased macrophage in the carotid artery and cIMT, and cardiac macrophages and fibrosis was found. These data demonstrate that directly targeting macrophages with MGBG can reduce cardiovascular inflammation, cIMT, and fibrosis. They suggest that therapies targeting macrophages with HIV could be used in conjunction with combination antiretroviral therapy.


"Magic" Molecules and a New Look at Chemical Diversity of Hydrocarbons.
We address the question why among the multitude of imaginable CnHm compositions some are easily synthesizable and abundant in nature, while others are not. To shed light on this problem we borrow approaches from nanocluster study, where stability with respect to neighboring compositions is used as a criterion of "magic" (particularly stable) clusters. By merging this criterion with predictions of lowest-energy structures of all CnHm molecules in a wide range of compositions (n ≤ 20, m ≤ 42) we provide guidelines for predicting the presence or absence of certain hydrocarbon molecules in various environments, their relative abundance and reactivity/inertness. The resulting maps of stability show the increased stability of C2nH2 compounds, polyaromatic hydrocarbons, and diamondoids, which is supported by experimental studies of the interstellar medium, flames, and petroleum fractions. This approach can be applied to any other molecular system, rationalizing the diversity of known compounds and predicting new potentially synthesizable molecules.


Hematoporphyrin uptake in atherosclerotic plaques: therapeutic potentials.
Atherosclerotic plaques were induced in abdominal aortas of rabbits. At 8 weeks, 5 mg of dihematoporphyrin ether (Photofrin II) per kg was injected intravenously followed by sacrifice of the animal, fluorescence microscopy, and quantitative assay of porphyrin in the plaque-containing aortas at 1, 12, 24, 48, and 72 hours. Photofrin II was taken up preferentially by the plaque, with the highest plaque to normal wall ratio occurring at 48 hours. Phototherapy was carried out in 13 animals in each of which two plaques had been induced. With a 630-nm light source 48 hours after the infusion of Photofrin, one of the pair of plaques was treated while the other served as a control. Animals were killed at 2, 4, and 6 weeks. The 6-week specimens showed the most dramatic reduction in plaque in comparison to controls. Photodynamic therapy may provide an alternate strategy in dealing with focal atherosclerosis.


Mobility and contamination assessment of mercury in coal fly ash, atmospheric deposition, and soil collected from Tianjin, China.
Samples of class F coal fly ash (levels I, II, and III), slag, coal, atmospheric deposition, and soils collected from Tianjin, China, were analyzed using U.S. Environmental Protection Agency (U.S. EPA) Method 3052 and a sequential extraction procedure, to investigate the pollution status and mobility of Hg. The results showed that total mercury (HgT) concentrations were higher in level I fly ash (0.304 µg/g) than in level II and level III fly ash and slag (0.142, 0.147, and 0.052 µg/g, respectively). Total Hg in the atmospheric deposition was higher during the heating season (0.264 µg/g) than the nonheating season (0.135 µg/g). Total Hg contents were higher in suburban area soils than in rural and agricultural areas. High HgT concentrations in suburban area soils may be a result of the deposition of Hg associated with particles emitted from coal-fired power plants. Mercury in fly ash primarily existed as elemental Hg, which accounted for 90.1, 85.3, and 90.6% of HgT in levels I, II, and III fly ash, respectively. Mercury in the deposition existed primarily as sulfide Hg, which accounted for 73.8% (heating season) and 74.1% (nonheating season) of HgT. However, Hg in soils existed primarily as sulfide Hg, organo-chelated Hg and elemental Hg, which accounted for 37.8 to 50.0%, 31.7 to 41.8%, and 13.0 to 23.9% of HgT, respectively. The percentage of elemental Hg in HgT occurred in the order fly ash > atmospheric deposition > soils, whereas organo-chelated Hg and sulfide Hg occurred in the opposite order. The present approach can provide a window for understanding and tracing the source of Hg in the environment in Tianjin and the risk associated with Hg bioaccessibility.


Modulation of anaerobic energy metabolism of Bacillus subtilis by arfM (ywiD).
Bacillus subtilis grows under anaerobic conditions utilizing nitrate ammonification and various fermentative processes. The two-component regulatory system ResDE and the redox regulator Fnr are the currently known parts of the regulatory system for anaerobic adaptation. Mutation of the open reading frame ywiD located upstream of the respiratory nitrate reductase operon narGHJI resulted in elimination of the contribution of nitrite dissimilation to anaerobic nitrate respiratory growth. Significantly reduced nitrite reductase (NasDE) activity was detected, while respiratory nitrate reductase activity was unchanged. Anaerobic induction of nasDE expression was found to be significantly dependent on intact ywiD, while anaerobic narGHJI expression was ywiD independent. Anaerobic transcription of hmp, encoding a flavohemoglobin-like protein, and of the fermentative operons lctEP and alsSD, responsible for lactate and acetoin formation, was partially dependent on ywiD. Expression of pta, encoding phosphotransacetylase involved in fermentative acetate formation, was not influenced by ywiD. Transcription of the ywiD gene was anaerobically induced by the redox regulator Fnr via the conserved Fnr-box (TGTGA-6N-TCACT) centered 40.5 bp upstream of the transcriptional start site. Anaerobic induction of ywiD by resDE was found to be indirect via resDE-dependent activation of fnr. The ywiD gene is subject to autorepression and nitrite repression. These results suggest a ResDE --> Fnr --> YwiD regulatory cascade for the modulation of genes involved in the anaerobic metabolism of B. subtilis. Therefore, ywiD was renamed arfM for anaerobic respiration and fermentation modulator.


[Pain-related parental behavior : Maternal and paternal responses to chronic pain of their child and modifications following inpatient interdisciplinary pain treatment].
There is a dearth of research studies regarding the pain-related behavior of parents with children suffering from chronic pain. This study examined the pain-related reactions of mothers and fathers, analyzed changes in these reactions following the child's inpatient interdisciplinary pain treatment and identified predictors for these changes. Using validated questionnaires 40 mothers and 40 fathers of children suffering from chronic pain reported their pain-related responses and cognitive distortions at treatment commencement, immediately following therapy as well as at follow-up after 6 and 12 months. At treatment commencement there were neither differences between maternal and paternal behavior nor in their reactions towards the sons and daughters. Immediately after treatment both parents showed increased distracting behavior and decreased solicitous behavior. Only the change in solicitous behavior showed long-term stability. The study identified the extent of parental catastrophizing at treatment commencement as well as changes in this reaction during treatment as predictors for reduction in solicitous behavior. The more parents reported catastrophizing thoughts at treatment commencement, the less they changed their solicitous behavior and strong changes in catastrophizing during treatment correlated with strong changes in solicitous reactions. Pain-related solicitous behavior can be modified by the interdisciplinary inpatient treatment of chronic pain in children and changes in solicitous behavior seem to be closely related to parental catastrophizing. This association should be considered when dealing with parents of children with chronic pain and also within the framework of future research projects.


Transcriptomic Analysis of Early Flowering Signals in 'Royal' Flax.
Canada is one of the world's leading producers and exporters of flax seed, with most production occurring in the Prairie Provinces. However, reduced season length and risk of frost restricts production in the northern grain belt of the Canadian Prairies. To expand the growing region of flax and increase production in Canada, flax breeders need to develop earlier-flowering varieties capable of avoiding the risk of abiotic stress. A thorough understanding of flowering control of flax is essential for the efficient breeding of such lines. We identified 722 putative flax flowering genes that span all major flowering-time pathways. Frequently, we found multiple flax homologues for a single Arabidopsis flowering gene. We used RNA sequencing to quantify the expression of genes in the shoot apical meristem (SAM) at 10, 15, 19, and 29 days after planting (dap) using the 'Royal' cultivar. We observed the expression of 80% of putative flax flowering genes and the differential expression of only 30%; these included homologues of major flowering regulators, such as SOC1, FUL, and AP1. We also found enrichment of differentially expressed genes (DEGs) in transcription factor (TF) families involved in flowering. Finally, we identified the candidates' novel flowering genes amongst the uncharacterized flax genes. Our transcriptomic dataset provides a useful resource for investigating the regulatory control of the transition to flowering in flax and for the breeding of northern-adapted varieties.


A simple fall in the elderly: not so simple.
The goal of this study was to evaluate the burden of falls in the elderly in a Canadian tertiary trauma center. Patients admitted to Charles-LeMoyne Hospital with a low velocity fall (LVF) from April 1, 1993 to March 31, 2000 were individually reviewed. Elderly was defined as age 65 years and older. A region was considered to be injured if Abbreviated Injury Scale was greater than or equal to 2. There were 2,333 patients with LVF, 41.4% of all blunt trauma admissions. Median Injury Severity Score was 9 for elderly compared with 5 for young (p < 0.001). Injuries were significantly more frequent to head, face, thorax, and lower limbs in the elderly. Mortality (13.4% versus 0.9%; p < 0.001), length of stay (median = 15 versus 3 days; p < 0.001) and long-term care facility reference (19.3% versus 1.1%, p < 0.001) were significantly higher in the elderly. LVF is a frequent cause of admission for trauma in the elderly. Despite the apparent benign nature of the mechanism, LVF is associated with more severe injuries and worse outcome.


Sodium-dependent nitrate transport at the plasma membrane of leaf cells of the marine higher plant Zostera marina L.
NO(3)(-) is present at micromolar concentrations in seawater and must be absorbed by marine plants against a steep electrochemical potential difference across the plasma membrane. We studied NO(3)(-) transport in the marine angiosperm Zostera marina L. to address the question of how NO(3)(-) uptake is energized. Electrophysiological studies demonstrated that micromolar concentrations of NO(3)(-) induced depolarizations of the plasma membrane of leaf cells. Depolarizations showed saturation kinetics (K(m) = 2.31 +/- 0.78 microM NO(3)(-)) and were enhanced in alkaline conditions. The addition of NO(3)(-) did not affect the membrane potential in the absence of Na(+), but depolarizations were restored when Na(+) was resupplied. NO(3)(-)-induced depolarizations at increasing Na(+) concentrations showed saturation kinetics (K(m) = 0.72 +/- 0.18 mM Na(+)). Monensin, an ionophore that dissipates the Na(+) electrochemical potential, inhibited NO(3)(-)-evoked depolarizations by 85%, and NO(3)(-) uptake (measured by depletion from the external medium) was stimulated by Na(+) ions and by light. Our results strongly suggest that NO(3)(-) uptake in Z. marina is mediated by a high-affinity Na(+)-symport system, which is described here (for the first time to our knowledge) in an angiosperm. Coupling the uptake of NO(3)(-) to that of Na(+) enables the steep inwardly-directed electrochemical potential for Na(+) to drive net accumulation of NO(3)(-) within leaf cells.


Role of Mesenchymal Stem Cells and Extracellular Vesicles in Idiopathic Pulmonary Fibrosis.
Idiopathic pulmonary fibrosis (IPF) is a progressive interstitial fibrotic disease that leads to disability and death within 5 years of diagnosis. Pulmonary fibrosis is a disease with a multifactorial etiology. The concept of aberrant regeneration of the pulmonary epithelium reveals the pathogenesis of IPF, according to which repeated damage and death of alveolar epithelial cells is the main mechanism leading to the development of progressive IPF. Cell death provokes the migration, proliferation and activation of fibroblasts, which overproduce extracellular matrix, resulting in fibrotic deformity of the lung tissue. Mesenchymal stem cells (MSCs) and extracellular vesicles (EVs) are promising therapies for pulmonary fibrosis. MSCs, and EVs derived from MSCs, modulate the activity of immune cells, inhibit the expression of profibrotic genes, reduce collagen deposition and promote the repair of damaged lung tissue. This review considers the molecular mechanisms of the development of IPF and the multifaceted role of MSCs in the therapy of IPF. Currently, EVs-MSCs are regarded as a promising cell-free therapy tool, so in this review we discuss the results available to date of the use of EVs-MSCs for lung tissue repair.


Evolution of Laparoscopic Pancreatic Resections for Pancreatic and Periampullary Diseases: Perioperative Outcomes of 605 Patients at a High-Volume Center.
Background: Laparoscopic pancreatectomy (LP) is increasingly performed with several institutional series and comparative studies reported. We have applied LP to a variety of pancreatic resections since 2004. This article is to report results of 15-year practice of 605 LPs for pancreatic and periampullary diseases. Methods: Patients with benign or malignant diseases in the pancreas and periampullary region, who underwent LP from June 2004 to June 2018, were retrospectively reviewed. The demographics and indications, and intraoperative and perioperative outcomes were evaluated. Results: A total of 605 consecutive LPs were analyzed, including 237 (39.2%) distal pancreatectomy with splenectomy (DPS), 116 (19.2%) spleen-preserving distal pancreatectomy (SPDP), 30 (5.0%) enucleation (EN), 30 (5.0%) central pancreatectomy (CP), 186 (30.7%) pancreatoduodenectomy (PD), and 6 (1.0%) pancreatoduodenectomy with total pancreatectomy (PDTP). The most common pathologic finding was pancreatic ductal adenocarcinomas (146, 24.1%). Conversion to open procedure was required in 22 patients (3.6%) (12 with PD, 8 with DPS, 1 with CP, and 1 with PDTP). The mean operative time was 241.5 ± 105.5 minutes (range 50-550 minutes) for the entire population and 367.1 ± 61.8 minutes (range 230-550 minutes) for PD. Clinically significant pancreatic fistula (ISGPF grade B and C) rate was 12.4% for the entire cohort and 16.1% for PD. Rate of Clavien-Dindo III-V complications was 17.4% for the entire cohort and 23.7% for PD. Ninety-day mortality was observed only in the cohort of patients undergoing PD (n = 4). Conclusions: The LP procedure appears to be technically safe and feasible, with an acceptable rate of morbidity when performed at our experienced, high-volume center. However, PD has less favorable outcomes and needs further evaluation.


Reed's Syndrome.
Multiple cutaneous and uterine leiomyomatosis (MCUL), also known as Reed's syndrome, is a rare genodermatosis, with an autosomal dominant pattern of inheritance. It results from a germline heterozygous mutation of fumarate hydratase gene, that is classified as a tumor suppressor gene. Hereditary leiomyomatosis and renal cell cancer is characterized by the association of MCUL with renal cell carcinoma. We report a case of a 57-year-old woman, with multiple cutaneous leiomyomas as the presenting sign of Reed's syndrome.


Plasma carnitine levels in liver cirrhosis: relationship with nutritional status and liver damage.
The plasma level of carnitine, a co-factor involved in many metabolic reactions, is high in alcoholic liver cirrhosis, due to an increased amount of esterified carnitine. To determine if this alteration is linked to alcoholic liver disease or to liver cirrhosis per se. total carnitine, free carnitine, total esterified carnitine, short chain acylcarnitine and long chain acylcarnitine were measured in 41 patients suffering from liver cirrhosis of different aetiology and severity. In 19 of these patients, acetylcarnitine was also measured. Moreover, multivariate analysis was performed to assess the association of carnitine plasma levels with nutritional and liver disease indices. Of the nutritional indices (creatinine/height ratio, mid upper arm muscle circumference and triceps skinfold) only triceps skinfold appeared to be weakly correlated with carnitine (with long chain acylcarnitine). Significantly high levels of acetylcarnitine, short chain acylcarnitine, total esterified carnitine and total carnitine were found in cirrhotics independently of the aetiology of cirrhosis, even though a trend towards higher levels of acetylcarnitine was evident in heavy drinkers. Direct correlations of gamma-glutamyltransferase with acetylcarnitine, acetylcarnitine/free carnitine, short chain acylcarnitine/free carnitine and total esterified carnitine/free carnitine were found. Carnitine plasma levels did not differ in the three Pugh-Child's classes; however, a trend towards higher levels of acetylcarnitine was found in Pugh-Child's class C. In conclusion, the high levels of acetylcarnitine, short chain acylcarnitine, total esterified carnitine and total carnitine found in cirrhosis were linked to liver disease. Alcohol abuse seemed only to be an exacerbating factor.


Romantic relationship trajectories among young African American men: The influence of adverse life contexts.
The development of supportive and committed romantic relationships during emerging adulthood forecasts relationship quality later in adulthood. Many emerging adult African American men are exposed to challenging socioeconomic environments that are known to undermine romantic relationships. Studies of African American men's romantic relationship quality and its antecedents during this developmental period are scarce. The present study investigates longitudinal trajectories of romantic relationship quality among African American emerging adult men and then tests a model linking them to adverse childhood experiences, socioeconomic instability, community disadvantage, and defensive relational schemas. The analytic sample included 331 African American men who reported having a romantic partner, observed during three waves of data collection from ages 19 to age 26. Using men's reports of romantic relationship support, conflict, and dyadic trust, parallel growth mixture modeling was conducted to identify romantic relationship trajectory profiles. We identified three romantic relationship trajectory profiles: Normative, Uncertain, and Conflictual. Structural equation analyses revealed that adverse childhood experiences were associated positively with contemporaneous contextual risk factors (i.e., socioeconomic instability and community disadvantage), which in turn, were associated significantly with membership in Uncertain and Conflictual trajectories through defensive relational schemas. The present study reveals heterogeneous romantic relationships among African American emerging adult men. Findings support the conjoint influences of early adversity and contemporaneous stressors as robust antecedents of African American men's romantic relationship behaviors over time. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Structure-based design, synthesis, and structure-activity relationship studies of HIV-1 protease inhibitors incorporating phenyloxazolidinones.
A series of new HIV-1 protease inhibitors with the hydroxyethylamine core and different phenyloxazolidinone P2 ligands were designed and synthesized. Variation of phenyl substitutions at the P2 and P2' moieties significantly affected the binding affinity and antiviral potency of the inhibitors. In general, compounds with 2- and 4-substituted phenyloxazolidinones at P2 exhibited lower binding affinities than 3-substituted analogues. Crystal structure analyses of ligand-enzyme complexes revealed different binding modes for 2- and 3-substituted P2 moieties in the protease S2 binding pocket, which may explain their different binding affinities. Several compounds with 3-substituted P2 moieties demonstrated picomolar binding affinity and low nanomolar antiviral potency against patient-derived viruses from HIV-1 clades A, B, and C, and most retained potency against drug-resistant viruses. Further optimization of these compounds using structure-based design may lead to the development of novel protease inhibitors with improved activity against drug-resistant strains of HIV-1.


[Substance use and risk behaviors of out-of-treatment cocaine base paste and cocaine hydrochloride users].
In Chile, cocaine base paste (CBP) is the illegal substance that produces the highest rate of addiction. Nonetheless, a marginal number of users receive treatment each year. To compare the consumption patterns and risk behavior of CBP and cocaine hydrochloride (CH) users who do not attend rehabilitation services. In a prospective research design, through a study methodology called Privileged Access Interview of hidden populations, 28 surveyors recruited 231 CBP users (group 1) and 236 CH users (group 2). The Risk Behavior Questionnaire was applied in four communities of Metropolitan Santiago, that have the highest prevalence of PBC and CH use. CBP users showed higher schools drop-out and unemployment rates. Subjects of both groups were predominantly polysubstance and polyaddicted users. The severity of addiction to CBP of group 1 was significantly higher than the severity of addiction to CH of group 2 (5.5 versus 5.1: p<0.001). CBP users showed significantly higher rates of sexual risk behaviors, antisocial behavior, self infliction of injuries, suicide attempt and child neglect. A higher vulnerability was shown for users of CBP than those of CH. Attention is drawn to the need for developing community interventions in order to alter substance abuse and the risk behavior of these vulnerable groups.


Prenatal diagnostics in TESA/PESA pregnancies in Denmark 1995-2007: a shift from invasive procedures to nuchal translucency examination.
Evidently, children born after intracytoplasmic sperm injection (ICSI) are at an increased risk of having sex chromosomal abnormalities. Here we evaluate the change in methods used for prenatal diagnostics in patients having ICSI with epididymal or testicular sperm from the introduction of the procedure in 1995 until December 2007. Four hundred and fifty pregnancies resulted in the birth of 553 children. Of the Danish subpopulation 115 (34.2%) received nuchal translucency examination (NT) and 43 (12.8%) received invasive prenatal diagnostics (IPD). IPD was carried out in 11 out of 23 couples (48%) during the period 1995-1998. Since 2002, less than 10% chose to receive IPD. Twenty-one (57%) of 37 Danish women 37-44 years of age underwent IPD compared to only 22 (7.4%) of the 299 women less than 37 years of age (p < 0.001). Conversely, since 1999 the use of NT has gradually increased to a frequency of 88.9% in 2007. The partners of vasectomized men had significantly more often NT performed compared to those of non-vasectomized men. IPD were not otherwise associated with the etiology of azoospermia. This study documents a shift in prenatal diagnostics from IPD to NT for testicular sperm aspiration/percutaneous epididymal sperm aspiration (TESA/PESA) couples.


Immunomodulatory Effect of Human Lactoferrin on Toll-like Receptors 2 Expression as Therapeutic Approach for Keratoconus.
Keratoconus (KC) is a corneal disorder whose etiology shares a close relationship with Lactoferrin (LTF) dysregulation and Toll-like Receptors 2 (TLR2) overexpression. This study shows how these two important biomarkers are clinically and molecularly interrelated, increasing knowledge about KC pathophysiology, and opening the door to future therapies. In this prospective clinical study, serum and tear LTF concentrations were quantified in 90 KC patients and 60 controls. A correlation analysis with multiple blood and tear immunoinflammatory mediators, and KC-associated tomographic parameters, was performed. An in vitro study using HEK-BlueTMhTLR2 cell cultures was also conducted to determine the expression and functionality of TLR2 under the influence of LTF treatment. As a result, a LTF decreased was observed in KC patients compared to controls (p < 0.0001), evidencing the strong correlation with TLR2 overexpression at systemic and ocular surface level, with inflammatory mediator upregulation and with KC severity. In stimulated cell cultures, TLR2 expression was decreased using 2 mg/mL of LTF. The levels of secreted embryonic alkaline phosphatase (SEAP) and interleukin-8 (IL-8) were also reduced in supernatants after LTF treatment. As conclusions, the dysregulation of LTF and TLR2 in the ocular surface of KC patients contributes to KC severity by maintaining a detrimental chronic immune−inflammatory state. The immunomodulatory properties of LTF on TLR2 expression suggest its potential as a therapeutic approach for KC.


Measuring SARS-CoV-2 aerosolization in rooms of hospitalized patients.
Airborne spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains a significant risk for healthcare workers. Understanding transmission of SARS-CoV-2 in the hospital could help minimize nosocomial infection. The objective of this pilot study was to measure aerosolization of SARS-CoV-2 in the hospital rooms of COVID-19 patients. Two air samplers (Inspirotec) were placed 1 and 4 m away from adults with SARS-CoV-2 infection hospitalized at an urban, academic tertiary care center from June to October 2020. Airborne SARS-CoV-2 concentration was measured by quantitative reverse transcription polymerase chain reaction and analyzed by clinical parameters and patient demographics. Thirteen patients with COVID-19 (eight females [61.5%], median age: 57 years old, range 25-82) presented with shortness of breath (100%), cough (38.5%) and fever (15.4%). Respiratory therapy during air sampling varied: mechanical ventilation via endotracheal tube (n = 3), high flow nasal cannula (n = 4), nasal cannula (n = 4), respiratory helmet (n = 1), and room air (n = 1). SARS-CoV-2 RNA was identified in rooms of three out of three intubated patients compared with one out of 10 of the non-intubated patients (p = .014). Airborne SARS-CoV-2 tended to decrease with distance (1 vs. 4 m) in rooms of intubated patients. Hospital rooms of intubated patients had higher levels of aerosolized SARS-CoV-2, consistent with increased aerosolization of virus in patients with severe disease or treatment with positive pressure ventilation through an endotracheal tube. While preliminary, these data have safety implications for health care workers and design of protective measures in the hospital. 2.


Hemoglobin-carbon nanotube derived noble-metal-free Fe5C2-based catalyst for highly efficient oxygen reduction reaction.
High performance non-precious cathodic catalysts for oxygen reduction reaction (ORR) are vital for the development of energy materials and devices. Here, we report an noble metal free, Fe5C2 nanoparticles-studded sp(2) carbon supported mesoporous material (CNTHb-700) as cathodic catalyst for ORR, which was prepared by pyrolizing the hybrid adduct of single walled carbon nanotubes (CNT) and lyophilized hemoglobin (Hb) at 700 °C. The catalyst shows onset potentials of 0.92 V in 0.1 M HClO4 and in 0.1 M KOH which are as good as commercial Pt/C catalyst, giving very high current density of 6.34 and 6.69 mA cm(-2) at 0.55 V vs. reversible hydrogen electrode (RHE), respectively. This catalyst has been confirmed to follow 4-electron mechanism for ORR and shows high electrochemical stability in both acidic and basic media. Catalyst CNTHb-700 possesses much higher tolerance towards methanol than the commercial Pt/C catalyst. Highly efficient catalytic properties of CNTHb-700 could lead to fundamental understanding of utilization of biomolecules in ORR and materialization of proton exchange membrane fuel cells for clean energy production.


An 802.11 wireless blood pulse-oximetry system for medical response to disasters.
In a mass casualty situation, medical personnel at the disaster site and other field treatment settings may need to monitor the vital signs of hundreds of seriously injured patients with minimal staffing. The conditions may be primitive and personnel may have to improvise infrastructure. As part of our research to enhance medical response to disasters with Internet-enabled systems, we have developed a prototype Wireless Blood Pulse Oximeter system for mass casualty events designed to operate in WiFi hotspots. Pulse ox units were designed using low-cost embedded system technologies to operate in integrated or stand alone environments. Units can report data to a command post on the scene or any remote location with Internet access. The entire system is potentially capable of tracking and monitoring several hundred patients.


Cis-acting elements of the sea urchin histone H2A modulator bind transcriptional factors.
Functional tests, performed by microinjection into Xenopus laevis oocytes, show that a DNA fragment containing the modulator of the early histone H2A gene of Paracentrotus lividus enhances transcription of a reporter gene when located, in the physiological orientation, upstream of the tk basal promoter. Gel retardation and DNase I footprinting assays further reveal that the H2A modulator contains at least two binding sites [upstream sequence elements 1 and 2 (USE 1 and USE 2)] for nuclear factors extracted from sea urchin embryos, which actively transcribe the early histone gene set. Interestingly, USE 1 is highly homologous to a cis-acting element previously identified in the H2A modulator of Psammechinus miliaris [Grosschedl, R., Mächler, M., Rohrer, U. & Birnstiel, M. L. (1983) Nucleic Acids Res. 11, 8123-8136]. Finally, a cloned oligonucleotide containing the USE 1 sequence competes efficiently in Xenopus oocytes with the H2A modulator to prevent enhancement of transcription of the reporter gene. From these results, we conclude that USE 1 and perhaps USE 2 in the H2A modulator are upstream transcriptional elements that are recognized by trans-acting factors common to Xenopus and sea urchin.


Percutaneous transperitoneal nephrolithotomy.
The removal of a recurrent calculus from the pyeloureteral junction of a malrotated kidney by means of laparoscopically controlled percutaneous transperitoneal nephrolithotomy is described.


Paucity of muscle metastasis in otherwise widely disseminated cancer: a conundrum.
Despite widespread dissemination of cancer to multiple organs, muscle metastasis remains a rare occurrence. Limiting factors in this regard include, among others, repetitive muscle contraction, increased lactic acid, and decreased pH as well as protease metabolism. With the approval of hospital's research committee, a 10-yr review of histopathologic and imaging studies of patients diagnosed as having muscle metastasis was attempted. A review of the literature dealing with this phenomenon was also initiated. The review of the literature with reference to muscle metastasis highlighted its rare occurrence, which in turn correlated with our own 40-yr clinical experience (M.M.L.). As a potential target, muscle tissue remains an "infrequent soil" for metastasis because of its unique mechanical and metabolic qualities.


Burkholderia gladioli CGB10: A Novel Strain Biocontrolling the Sugarcane Smut Disease.
In this study, we isolated an endophytic Burkholderia gladioli strain, named CGB10, from sugarcane leaves. B. gladioli CGB10 displayed strong inhibitory activity against filamentous growth of fungal pathogens, one of which is Sporisorium scitamineum that causes sugarcane smut, a major disease affecting the quality and production of sugarcane in tropical and subtropical regions. CGB10 could effectively suppress sugarcane smut under field conditions, without itself causing any obvious damage or disease, thus underscoring a great potential as a biocontrol agent (BCA) for the management of sugarcane smut. A toxoflavin biosynthesis and transport gene cluster potentially responsible for such antifungal activity was identified in the CGB10 genome. Additionally, a quorum-sensing gene cluster was identified too and compared with two close Burkholderia species, thus supporting an overall connection to the regulation of toxoflavin synthesis therein. Overall, this work describes the in vitro and field Sporisorium scitamineum biocontrol by a new B. gladioli strain, and reports genes and molecular mechanisms potentially involved.


Tris(8-hydroxyquinoline)aluminum nanoribbons: facile solvothermal preparation and photoconductivity studies.
Large-scale, high-purity and uniform tris(8-hydroxyquinoline)aluminium nanoribbons, with average width of 120 nm, thickness of 30 nm, and length up to tens of micrometers, are synthesized via a facile solvothermal route. X-ray powder diffraction, scanning electron microscopy, Fourier transform infrared spectrum, and thermogravimetric analysis--differential thermal analysis are employed to characterize the morphology and structure of the as-prepared products. The excellent photosensitivity and photoresponse of a bundle of nanoribbons are also investigated, which showed that the photoconductivity enhanced by 50 times under irradiation of an incandescence lamp (12 V, 10 W). This work might be useful in the fabrication of photosensor and photoswitch microdevices or nanodevices in the future.


Efficacy of injection vaccines against Flavobacterium psychrophilum in rainbow trout, Oncorhynchus mykiss (Walbaum).
Efficacy of mineral oil-based experimental injection vaccines against Flavobacterium psychrophilum were tested in rainbow trout, Oncorhynchus mykiss (Walbaum), under laboratory and field conditions. The vaccines consisted of formalin- or heat-inactivated whole bacterium cell preparations of two different serotypes (Fd and Th) or a combination of serologically different F. psychrophilum (Fd and/or Th and/or Fp(T);Th). Specific antibody responses against the bacterium in plasma and skin mucus were evaluated post-vaccination with enzyme-linked immunosorbent assay. Efficacy of the vaccinations was determined by challenge trials to F. psychrophilum with the vaccinated rainbow trout. Significantly higher antibody levels in plasma were detected in vaccinated fish compared with mock-vaccinated fish. Injection vaccination did not trigger specific antibody production in the skin mucus. Significantly higher survival of i.p. vaccinated fish compared with non-vaccinated fish was observed during the challenge. The results suggest that mineral oil-based injectable vaccines containing formalin- or heat-inactivated virulent cells of F. psychrophilum effectively triggered specific antibody production and protected the fish against bacterial cold water disease.


Comparison between auditory steady-state responses and pure-tone audiometry.
A more recent method, the auditory steady-state response (ASSR), has become more and more important test method due to difference that was found in previous investigations between hearing thresholds determined by the ASSR and the pure-tone audiometry (PTA). The aim of this study was to evaluate the reliability of the ASSR in determining the frequency specific hearing thresholds by establishing a correlation between the thresholds determined by PTA, as well as to evaluate the reliability of ASSR in determining the hearing threshold with respect to the level of hearing loss and the configuration of the PTA findings. The prospective study included 46 subjects (92 ears) which were assigned to groups based on their level of hearing loss and audiometric configuration. All the subjects underwent determination of hearing thresholds by PTA and ASSR without insight into their previously obtained PTA results. The overall sample differences between the ASSR and PTA thresholds were 4.1, 2.5, 4.4, and 4.2 dB at 0.5, 1, 2, and 4 kHz, respectively. A high level of correlation was achieved in groups with different configurations of PTA findings. The correlation coefficients between the hearing thresholds determined by ASSR and PTA were significant in subjects with all levels of hearing loss. The differences between hearing thresholds determined by ASSR and PTA were less than 10 dB in 85% of subjects (ranging from 4 dB for moderately severe hearing loss to 7.2 dB for normal hearing). The ASSR is an excellent complementary method for the determination of hearing thresholds at the 4 carrier frequencies, as well as determination of the level of hearing loss and the audiometric configuration.


Viscosity of the 1-ethyl-3-methylimidazolium bis(trifluoromethylsulfonyl)imide ionic liquid from equilibrium and nonequilibrium molecular dynamics.
This work deals with the determination, using equilibrium and nonequilibrium molecular dynamics, of the viscosity of an ionic liquid: 1-ethyl-3-methylimidazolium bis(trifluoromethylsulfonyl)imide ([emim][Tf2N]). A first method consists in computing the shear viscosity using the Green-Kubo formalism from the pressure tensor correlation function obtained from equilibrium simulations. On the other hand, the Newtonian viscosity can be extracted from the shear rate dependence of the viscosity in nonequilibrium simulations using the mode-coupling theory and the standard Cross and Carreau equations. We show that both methods lead to the same viscosity value, provided that the simulation time is long enough for the first method (much longer than advocated in the literature) and that special care is taken in the extrapolation procedure of the latter (simulations must be performed at very low shear rate). The force field employed in this work leads to an overestimation of the viscosity, with respect to experiment, by a factor ranging between 6 and 4 in the 293 K to 500 K temperature domain.


Hepatitis C virus genotypes: special reference to the Indian scene.
The heterogeneity observed between different isolates of the hepatitis C virus has led to stratification of these isolates into different genotypes. Clinically the genetic diversity of the virus has important implications as genotypes respond variably to antiviral therapy and can influence disease prognosis. This article attempts to summarize current knowledge about the different biological properties of HCV genotypes, and their geographical distribution, with special reference to the Indian scenario.


Heterotopic cervical pregnancy with preservation of the intrauterine gestation.
We present a case of heterotopic cervical pregnancy where intrauterine gestation was preserved successfully. A 40-year-old Japanese woman presented with heterotopic cervical pregnancy after intracytoplasmic sperm injection with elongated spermatid. An ultrasound examination showed heterotopic cervical pregnancy. Intrauterine gestation was preserved successfully with the use of local vasopressin injection, followed by curettage of cervical implantation and local methotrexate injection. The cervical pregnancy resolved, and a healthy full-term infant was delivered. When early diagnosis of a heterotropic cervical pregnancy is made, selective reduction of a cervical implantation might allow preservation of the intrauterine gestation, without hysterectomy. (Reprod Med Biol 2005; 4: 221-223).


Incidental findings with cardiac CT evaluation: should we read beyond the heart?
Cardiac computed tomographic angiography (CTA) allows for simultaneous evaluation of the lung fields and associated structures. There is a debate as to the benefit of or need for routine overread of the lung fields for incidental findings. The possible improvement in cancer diagnosis with routine overreads is balanced against the major limitations of CT lung screening. Current limitations include (a) a high rate of nodule detection given that >50% of participants may have at least one noncalcified nodule; (b) the increased costs and radiation exposure associated with the resulting follow-up CT scans; (c) the cost and the morbidity of follow-up, including further testing, as well as biopsy or resection of benign noncalcified nodule (at least 25% of such procedures in several trials); (d) a small but difficult to quantify potential risk of cancer associated with multiple follow-up CT scans; and (e) a potential for increased anxiety of both the patient and the physician about nonsignificant pathology. All of these limitations are balanced against a possibility that this could lead to an earlier detection of lung cancer with the consequent improvement in the chances of the patients' survival. Extensive studies of screening CT in older smokers have revealed the prevalence of cancer to be between 0.3 and 1%. However, when applied to an ambulatory population of patients presenting for an evaluation of angina, the prevalence of lung cancer or significant non-cardiac findings may be significantly lower. We have reviewed all the relevant literature and sought to determine the potential benefits and harms of specifically overreading CTA for non-cardiac pathology. The weight of the evidence suggests that it is most prudent to not specifically reconstruct and re-read CTA scans for lung nodules. If a non-cardiac abnormality is visualized by the primary interpreter of the cardiac CT, appropriate referral or follow-up is prudent.


Paramagnetic spin seebeck effect.
We report the observation of the longitudinal spin Seebeck effect in paramagnetic insulators. By using a microscale on-chip local heater, we generate a large thermal gradient confined to the chip surface without a large increase in the total sample temperature. Using this technique at low temperatures (<20 K), we resolve the paramagnetic spin Seebeck effect in the insulating paramagnets Gd3Ga5O12 (gadolinium gallium garnet) and DyScO3 (DSO), using either W or Pt as the spin detector layer. By taking advantage of the strong magnetocrystalline anisotropy of DSO, we eliminate contributions from the Nernst effect in W or Pt, which produces a phenomenologically similar signal.


THYROID EXPOSURE DURING 18F-FDG PRODUCTION PROCEDURES.
The production of radiopharmaceuticals for the needs of positron emission tomography (PET), in particular 18F-FDG, is a multi-step process performed most often by physicists and chemists. The monitoring of occupational exposure of staff employed in radiopharmaceutical production centres includes the measurement of the Hp(10) and Hp(0.07) values. Occupational exposure to ionising radiation means that the thyroid may be, among others, affected by the radiation field. This work analyses the exposure of the thyroid gland of employees of centres that produce the isotopes for PET, in particular fluorine-18. The analysis take into account the employment structure and work system of the discussed centres. Measurements were carried out by using high-sensitivity thermoluminescence detectors (MCP-N). The measurements covered 17 employees. Our results show that the estimated maximum annual thyroid gland exposure will not exceed 30 mSv.


Infrared A radiation promotes survival of human melanocytes carrying ultraviolet radiation-induced DNA damage.
The link between solar radiation and melanoma is still elusive. Although infrared radiation (IR) accounts for over 50% of terrestrial solar energy, its influence on human skin is not well explored. There is increasing evidence that IR influences the expression patterns of several molecules independently of heat. A previous in vivo study revealed that pretreatment with IR might promote the development of UVR-induced non-epithelial skin cancer and possibly of melanoma in mice. To expand on this, the aim of the present study was to evaluate the impact of IR on UVR-induced apoptosis and DNA repair in normal human epidermal melanocytes. The balance between these two effects is a key factor of malignant transformation. Human melanocytes were exposed to physiologic doses of IR and UVR. Compared to cells irradiated with UVR only, simultaneous exposure to IR significantly reduced the apoptotic rate. However, IR did not influence the repair of UVR-induced DNA damage. IR partly reversed the pro-apoptotic effects of UVR via modification of the expression and activity of proteins mainly of the extrinsic apoptotic pathway. In conclusion, IR enhances the survival of melanocytes carrying UVR-induced DNA damage and thereby might contribute to melanomagenesis.


Recommended distributions for exposure factors frequently used in health risk assessment.
Although there has been nearly complete agreement in the scientific community that Monte Carlo techniques represent a significant improvement in the exposure assessment process, virtually all state and federal risk assessments still rely on the traditional point estimate approach. One of the rate-determining steps to a timely implementation of Monte Carlo techniques to regulatory decision making is the development of "standard" data distributions that are considered applicable to any setting. For many exposure variables, there is no need to wait any longer to adopt Monte Carlo techniques into regulatory policy since there is a wealth of data from which a robust distribution can be developed and ample evidence to indicate that the variable is not significantly influenced by site-specific conditions. In this paper, we propose several distributions that can be considered standard and customary for most settings. Age-specific distributions for soil ingestion rates, inhalation rates, body weights, skin surface area, tapwater and fish consumption, residential occupancy and occupational tenure, and soil-on-skin adherence were developed. For each distribution offered in this paper, we discuss the adequacy of the database, derivation of the distribution, and applicability of the distribution to various settings and conditions.


Personal experiences of returning to work following stroke: An exploratory study.
A quarter of stroke survivors are of working age; information about the impact of stroke on those who are working is limited. We investigated the expectations and experiences of stroke survivors in relationship to return to work. This qualitative tudy used semi-structured, in-depth interviews with 13 patients working at onset of cerebrovascular disease. Interviews were conducted between 3 months and 8 years post stroke in order to gain an insight into both individuals' initial expectations and their actual experiences in relation to return to work. Full thematic analysis of the interview transcripts was undertaken, findings reported focus on the data relating to work. Work related sub-themes included continuing symptoms affecting plans to return to work, experiences of returning to work (including uncertainty over timing of return and fears about coping at work), changing job or career and the emotional impact of enforced retirement. Information provision, return to work support systems and potential changes in life roles are important aspects to consider when assessing the impact of stroke and managing the consequences in people of working age.


Integration of hexavalent diphtheria, tetanus, acellular pertussis, hepatitis B virus, inactivated poliomyelitis and Haemophilus influenzae type b conjugate vaccine within existing national recommendations following a birth dose of monovalent hepatitis B virus vaccine: results of a systematic review in the Asia Pacific region.
Introduction: In Asia Pacific, most countries recommend a monovalent hepatitis B virus (HBV) vaccine dose at birth followed by primary vaccination series including three or four doses of combination vaccines against diphtheria, tetanus, and pertussis, with or without Haemophilus influenzae type b (Hib), HBV or poliomyelitis antigens. If hexavalent conjugate vaccines against diphtheria-tetanus-acellular pertussis-HBV-inactivated poliovirus-Hib (DTPa-HBV-IPV/Hib) replace the vaccines included in the primary vaccination series, co-administration of lower-valent vaccines would be avoided but infants would receive ≥4 doses of HBV-containing vaccines before the age of 2 years. Areas covered: We searched for clinical trials conducted in the South-East Asia and Western Pacific Regions (World Health Organization geographic definition), investigating vaccination regimens with >3 doses of HBV-containing vaccines in infants, including a monovalent HBV vaccine birth dose and ≥1 dose of GSK's hexavalent DTPa-HBV-IPV/Hib vaccine. Expert opinion: The six clinical trials included in this review showed that infants who received the monovalent HBV vaccine at birth and three or four doses of DTPa-HBV-IPV/Hib vaccine achieved protective immunogenic titers with a clinically acceptable safety profile. Our results support the integration of hexavalent DTPa-HBV-IPV/Hib vaccine within existing national recommendations in the Asia Pacific region to reduce the number of injections during infancy.


Management of HIV: a swing back to the future.
During the last 15 years, there have been numerous advancements in the development of antiretroviral drug therapies for people with HIV/AIDS. More drugs and more classes of drugs are now available to treat the disease, and they have fewer side effects than older therapies. This article provides an overview of the current management guidelines for HIV infection in adults in the United States. It also highlights the rationale behind HIV treatment, including when to start it, what therapies to use, and details about key drugs and regimens.


Pregnancy Outcomes in Patients After Completion of the mRNA Coronavirus Disease 2019 (COVID-19) Vaccination Series Compared With Unvaccinated Patients.
To compare frequency of perinatal death between pregnant patients who completed the mRNA coronavirus disease 2019 (COVID-19) vaccination series and unvaccinated patients. This retrospective cohort study included 15,865 pregnant patients who delivered 16,132 newborns after 20 weeks of gestation within a large regional health system between January 1, 2021, and December 31, 2021. Patients who received two doses of mRNA vaccine (Pfizer-BioNTech [BNT162b2] or Moderna [mRNA-1273]) were included in the vaccinated group and were compared with unvaccinated patients. Exclusions included partial vaccination, viral-vector vaccine, major congenital anomalies, and higher-order multiple gestation. Our primary outcome was perinatal death, including stillbirth and neonatal death, which was evaluated by logistic regression. Unadjusted odds ratios and adjusted odds ratios (aORs) were reported, controlling for age, body mass index (BMI), diabetes, hypertension, smoking, twin gestation, and insurance status. Propensity score matching was also performed. A total of 15,865 patients were included in the final analysis: 2,069 in the vaccination group and 13,796 in the control group. Only 13.0% of the cohort was included in the vaccination group; however, the vaccination rate increased over the course of the study period as the vaccine became more widely available and accepted. Vaccinated patients were older, with higher rates of people of non-Black racial non-Hispanic ethnic backgrounds, people with private insurance, and those with higher BMIs. Vaccination was associated with a lower incidence of perinatal death (0.5% vaccinated group vs 0.8% unvaccinated group, aOR 0.20 0.05-0.88). Vaccination against COVID-19 was also associated with lower rates of preterm delivery (aOR 0.63, 0.48-0.82), neonates with very low birth weight (aOR 0.35, 0.15-0.84), and neonatal intensive care unit (NICU) admission (aOR 0.66, 0.52-0.85). The association between vaccination and lower rates of perinatal death was no longer significant after propensity score matching. In a large retrospective cohort study, receipt of the primary mRNA COVID-19 vaccination series was associated with a lower rate of several adverse pregnancy outcomes, including perinatal death, preterm delivery, neonates with very low birth weight, and NICU admission. Although the decreased rates of perinatal death did not remain significant after propensity score matching, there was evidence of directional benefit for vaccinated patients.