A Charged Coordination Cage-Based Porous Salt.
Metal-organic frameworks and porous coordination cages have shown incredible promise as a result of their high tunability. However, syntheses pursuing precisely targeted mixed functionalities, such as multiple ligand types or mixed-metal compositions are often serendipitous, require postsynthetic modification strategies, or are based on complex ligand design. Herein, we present a new method for the controlled synthesis of mixed functionality metal-organic materials via the preparation of porous salts. More specifically, the combination of porous ionic molecules of opposite charge affords framework-like materials where the ratio between cationic cage and anionic cage is potentially tunable. The resulting doubly porous salt displays the spectroscopic signatures of the parent cages with increased gas uptake capacities as compared to starting materials. This approach will be widely applicable to all families of porous ions and represents a new and powerful method for the synthesis of porous solids with tailored functionalities.


[Workers' view on the preventive needs for civilization diseases' in prophylactic care taken on employees].
Every year in Poland almost 5 million prophylactic examinations (PEs) are carried out by occupational medicine specialists (OMPs) among workers, for the purposes envisaged in the Polish Labour Code. The aim of this study was to collect workers' opinions on the possible extension of these check-ups in the field of prophylaxis and prevention of civilization diseases (CivDs), focusing also on the "healthy lifestyle" recommendations. The study group comprised 325 employees who filled out an anonymous questionnaire containing questions about the possible extension of the PE scope for CivD and cancer prophylaxis. During medical check-ups, evaluation of the incidental glucose (IG) and total cholesterol (TCh) levels, waist circumference measurement and electrocardiography (ECG) were proposed. The respondents were asked about the most interesting issues for discussing with OMPs. Screening tests for some cancers (69.5%) and risk factors for CivDs (61.5%) were indicated as the most interesting topics to discuss with OMPs. The possibility for evaluating the levels of IG and TCh during PEs was approved by approx. 94.8% and 95.3% of the respondents, respectively. Almost 96% accepted having ECG and 80% agreed to waist circumference measurement. As many as 89.5% of the respondents supported the idea of organizing physical activities at their workplaces, and 77.8% were eager to learn about "healthy lifestyles" during training sessions conducted at their workplaces. Restricting the aim of PEs just to certifying the ability to work, or identifying certain medical contraindications, means losing a chance for implementing the prophylaxis and prevention of diseases' development among active working subjects. The kinds of activities proposed by the authors of this publication have been approved by the employees. Med Pr. 2019;70(4):425-33.


Hyperconjugative Interactions of the Carbon-Halogen Bond that Influence the Geometry of Cyclic α-Haloacetals.
The analysis of the structures of low-energy conformers of different α-haloacetals reveals changes in bond lengths and geometries that correspond to stabilizing orbital interactions that contribute to the ground-state structures of these systems. Several factors, including the electron-donating and electron-accepting abilities of the substituents on the ring, affect the degree of the electronic interactions in these carbohydrate-like systems. The presence of an α-halogen atom that can participate in hyperconjugation has been shown to contribute to the structural characteristics of the low-energy conformer. The experimental evidence is supported by natural bond order (NBO) analysis to identify the types of interactions and to assess their relative importance.


High wholegrain barley β-glucan lowers food intake but does not alter small intestinal macronutrient digestibility in ileorectostomised rats.
Using barley cultivars differing widely in β-glucan content, we aimed to determine their effects on small intestinal macronutrient digestion in 24 ileorectostomised rats. The rats were fed 1 of 4 experimental diets, each containing a different barley variety, for 11 d. The diets had a content of 0, 2.1, 2.6 and 4.3 g of β-glucan/100 g. Feed intake and faecal excretion of fat, protein, starch, and non-starch polysaccharides were determined in the final 5 d of the study and apparent macronutrient digestibility calculated. Higher dietary levels of β-glucan (2.6% and 4.3%) lowered feed intake (by 15 and 19%, respectively) but final body weight was only lowered by the 4.3% β-glucan diet relative to rats fed the 0% β-glucan diet (all ps < 0.05). Protein, lipid and starch digestibility was unrelated to the dietary β-glucan content. Higher dietary levels of barley β-glucan lower feed intake of ileorectostomised rats, which is independent of intestinal fermentation and unrelated to macronutrient digestibility.


Uncoupling of PI3K from ErbB3 impairs mammary gland development but does not impact on ErbB2-induced mammary tumorigenesis.
The formation of ErbB2/ErbB3 heterodimers plays a critical role in ErbB2-mediated signaling in both normal mammary development and mammary tumor progression. Through 7 phosphoinositide 3-kinase (PI3K) phosphotyrosine-binding sites, ErbB3 is able to recruit PI3K and initiate the PI3K/AKT signaling pathway. To directly explore the importance of the ErbB3/PI3K pathway in mammary development and tumorigenesis, we generated a mouse model that carries a mutant ErbB3 allele lacking the seven known PI3K-binding sites (ErbB3(Δ85)). Mice homozygous for the ErbB3(Δ85) allele exhibited an initial early growth defect and a dramatic impairment of mammary epithelial outgrowth. Although homozygous adult mice eventually recovered from the growth defect, their mammary glands continued to manifest the mammary outgrowth and lactation defects throughout their adult life. Interestingly, despite the presence of a profound mammary gland defect, all of the female ErbB3Δ85 mice developed metastatic ErbB2-induced mammary tumors secondary to mammary epithelial expression of an activated ErbB2 oncogene capable of compensatory PI3K signaling from both EGF receptor and ErbB2. Our findings therefore indicate that, although ErbB3-associated PI3K activity is critical for mammary development, it is dispensable for ErbB2-induced mammary tumor progression.


[The use of antithyroid drugs should be reduced as much as possible in the first trimester].
The treatment of choice for hyperthyroidism in pregnancy is antithyroid drugs, but the potential risk of birth defects is of major concern. For the use of thiamazole and carbimazole, there is consistent evidence of an increased risk of birth defects, which are often severe. For the use of propylthiouracil, the evidence is less clear. These birth defects may be less severe, and a Danish study which included all birth defects diagnosed before the age of two years showed an increased risk of birth defects in the face and neck region and in the urinary system after the use of propylthouracil.


Lesbian, Gay, Bisexual, and Transgender (LGBT) View it Differently Than Non-LGBT: Exposure to Tobacco-related Couponing, E-cigarette Advertisements, and Anti-tobacco Messages on Social and Traditional Media.
LGBT populations use tobacco at disparately higher rates nationwide, compared to national averages. The tobacco industry has a history targeting LGBT with marketing efforts, likely contributing to this disparity. This study explores whether exposure to tobacco content on traditional and social media is associated with tobacco use among LGBT and non-LGBT. This study reports results from LGBT (N = 1092) and non-LGBT (N = 16430) respondents to a 2013 nationally representative cross-sectional online survey of US adults (N = 17522). Frequency and weighted prevalence were estimated and adjusted logistic regression analyses were conducted. LGBT reported significantly higher rates of past 30-day tobacco media exposure compared to non-LGBT, this effect was strongest among LGBT who were smokers (p < .05). LGBT more frequently reported exposure to, searching for, or sharing messages related to tobacco couponing, e-cigarettes, and anti-tobacco on new or social media (eg, Twitter, Facebook, etc.) than did non-LGBT (p < .05). Non-LGBT reported more exposure from traditional media sources such as television, most notably anti-tobacco messages (p = .0088). LGBT had higher odds of past 30-day use of cigarettes, e-cigarettes, and cigars compared to non-LGBT, adjusting for past 30-day media exposure and covariates (p ≤ .0001). LGBT (particularly LGBT smokers) are more likely to be exposed to and interact with tobacco-related messages on new and social media than their non-LGBT counterparts. Higher levels of tobacco media exposure were significantly associated with higher likelihood of tobacco use. This suggests tobacco control must work toward reaching LGBT across a variety of media platforms, particularly new and social media outlets. This study provides important information about LGBT communities tobacco-related disparities in increased exposure to pro-tobacco messages via social media, where the tobacco industry has moved since the MSA. Further, LGBT when assessed as a single population appear to identify having decreased exposure to anti-tobacco messages via traditional media, where we know a large portion of tobacco control and prevention messages are placed. The study points to the need for targeted and tailored approaches by tobacco control to market to LGBT using on-line resources and tools in order to help reduce LGBT tobacco-related health disparities. Although there have been localized campaigns, only just recently have such LGBT-tailored national campaigns been developed by the CDC, FDA, and Legacy, assessment of the content, effectiveness, and reach of both local and national campaigns will be important next steps.


Core-valence stockholder AIM analysis and its connection to nonadiabatic effects in small molecules.
A previous theory of separation of motions of core and valence fractions of electrons in a molecule [J. R. Mohallem et al., Chem. Phys. Lett. 501, 575 (2011)] is invoked as basis for the useful concept of Atoms-in-Molecules (AIM) in the stockholder scheme. The output is a new tool for the analysis of the chemical bond that identifies core and valence electron density fractions (core-valence stockholder AIM (CVSAIM)). One-electron effective potentials for each atom are developed, which allow the identification of the parts of the AIM which move along with the nuclei (cores). This procedure results in a general method for obtaining effective masses that yields accurate non-adiabatic corrections to vibrational energies, necessary to attain cm-1 accuracy in molecular spectroscopy. The clear-cut determination of the core masses is exemplified for either homonuclear (H2+, H2) or heteronuclear (HeH+, LiH) molecules. The connection of CVSAIM with independent physically meaningful quantities can resume the question of whether they are observable or not.


Src signaling regulates completion of abscission in cytokinesis through ERK/MAPK activation at the midbody.
Src family non-receptor-type tyrosine kinases regulate a wide variety of cellular events including cell cycle progression in G(2)/M phase. Here, we show that Src signaling regulates the terminal step in cytokinesis called abscission in HeLa cells. Abscission failure with an unusually elongated intercellular bridge containing the midbody is induced by treatment with the chemical Src inhibitors PP2 and SU6656 or expression of membrane-anchored Csk chimeras. By anti-phosphotyrosine immunofluorescence and live cell imaging, completion of abscission requires Src-mediated tyrosine phosphorylation during early stages of mitosis (before cleavage furrow formation), which is subsequently delivered to the midbody through Rab11-driven vesicle transport. Treatment with U0126, a MEK inhibitor, decreases tyrosine phosphorylation levels at the midbody, leading to abscission failure. Activated ERK by MEK-catalyzed dual phosphorylation on threonine and tyrosine residues in the TEY sequence, which is strongly detected by anti-phosphotyrosine antibody, is transported to the midbody in a Rab11-dependent manner. Src kinase activity during the early mitosis mediates ERK activation in late cytokinesis, indicating that Src-mediated signaling for abscission is spatially and temporally transmitted. Thus, these results suggest that recruitment of activated ERK, which is phosphorylated by MEK downstream of Src kinases, to the midbody plays an important role in completion of abscission.


Putting Rings around Carbon Nanotubes.
In the last five years, we have developed synthetic methods towards encapsulation of single-walled carbon nanotubes (SWNTs) into organic macrocycles, to form rotaxane-type molecules. These are the first examples of mechanically interlocked SWNT derivatives (MINTs). In this article, the motivation to continue developing the chemistry of SWNTs at a time well past their hype is discussed and our synthetic strategy and characterization methodology is explained in detail, stressing the general aspects. In particular, special emphasis is placed on the importance of adequate control experiments and bulk spectroscopic and analytical data to determine the structure of SWNT derivatives, as opposed to relying only (or mostly) on microscopy. Also our experimental results are used as pretext to reflect on more general/conceptual issues pertaining to the chemistry of SWNTs and mechanically interlocked molecules.


Suppression of aldosterone mediates regression of left ventricular hypertrophy in patients with hypertension.
High circulating aldosterone levels stimulate myocardial fibrosis and left ventricular hypertrophy (LVH). However, it is not clear whether suppression of aldosterone directly contributes to LVH regression in hypertensive patients. The Aliskiren in Left Ventricular Hypertrophy (ALLAY) trial randomised 465 hypertensive overweight subjects with LVH to the direct renin inhibitor aliskiren 300 mg, losartan 100 mg or the combination and followed patients for 9 months. All patients were treated to standard blood pressure targets. Left ventricular (LV) mass index (LVMI) and LV wall thickness (LVWT) were assessed by cardiac magnetic resonance. A subset of 136 patients who had plasma aldosterone concentration (ALDO) measured at baseline and study end was analysed. At baseline, plasma ALDO was modestly related to systolic blood pressure, LVMI, and wall thickness (all, p < 0.05). Aliskiren, either alone or in combination, was associated with a significantly greater reduction from baseline to 9 months in plasma aldosterone than losartan alone (p < 0.02). Reduction in ALDO was related to reduction in LVMI even after adjustment for baseline ALDO, BP reduction and treatment group (p for trend = 0.042). In hypertensive patients with increased LVWT, aliskiren alone or in combination with the angiotensin receptor blocker losartan provides greater reduction in aldosterone compared to losartan alone. Moreover, suppression of aldosterone was associated with reduction of LVH, independently of the change in SBP, suggesting that suppression of aldosterone, a known mediator of LVH, may be particularly important for LVH regression and as a target for therapy.


Molecular profiling of heart endothelial cells.
Endothelial cells that line the vascular lumen can express cell-surface proteins that are specific to the endothelium of a particular tissue. In this study, we probed the heart vasculature for heart-specific endothelial markers by phage display. We used a novel combination of in vivo phage selection and a bacterial 2-hybridization scheme against a heart cDNA library, which allows simultaneous identification of peptides that specifically bind to the target endothelium, as well as the endothelial molecules (receptors) recognized by the peptides. We found 5 heart-targeting peptides and their receptors. We confirmed and quantified the selective expression of 4 of the proteins in heart endothelial cells by independent methods. The heart specificity of phages was as high as 300-fold greater than that of nonrecombinant control phages. The proteins selectively expressed by the heart endothelium were in most cases also expressed by cardiomyocytes and, at lower levels, in some other tissues. These findings provide new markers for the endothelium of heart vessels and reveal a commonality between parenchymal and endothelial gene expression in the heart. The heart-homing peptides provide a means of targeting diagnostic and therapeutic agents to the heart, and their receptors are potential drug discovery targets.


A set of BAC clones spanning the human genome.
Using the human bacterial artificial chromosome (BAC) fingerprint-based physical map, genome sequence assembly and BAC end sequences, we have generated a fingerprint-validated set of 32 855 BAC clones spanning the human genome. The clone set provides coverage for at least 98% of the human fingerprint map, 99% of the current assembled sequence and has an effective resolving power of 79 kb. We have made the clone set publicly available, anticipating that it will generally facilitate FISH or array-CGH-based identification and characterization of chromosomal alterations relevant to disease.


New platelet functional method for identification of pathogenic antibodies in HIT patients.
Heparin-induced thrombocytopenia (HIT) is a thrombotic complication of heparin therapy. The most used functional method for HIT diagnosis is serotonin release assay (SRA). A different functional method based on ATP release with luciferin/luciferase long-life and stable luminescent signal is used here, which is shown to be comparable for accuracy with SRA in both negative (patients 4Ts ≤3, and negative for both anti-PF4/heparin immunoassay and SRA) and positive (4Ts >3, and positive for both PF4/heparin antibodies and SRA) patients. Our results show that ATP release is higher in washed platelets activated by sera from positive patients than in platelets activated by sera from negative patients. In conclusion, we demonstrate that ATP release assay is a valid alternative method to SRA for the identification of pathogenic anti-PF4/heparin antibodies.


Unraveling the Mechanisms for Low-Level Acetaldehyde Production during Alcoholic Fermentation in Saccharomyces pastorianus Lager Yeast.
Acetaldehyde is produced by yeast during alcoholic fermentation, and its modification greatly affects beer flavor and quality. In the current study, we analyzed two yeast strains with a low level of acetaldehyde to reveal the potential mechanism underpinning the desirable low acetaldehyde production by these strains. We demonstrated that high alcohol dehydrogenase (ADH) activity and high NADH availability were the dominant factors for the low level of acetaldehyde in the fermentation liquor at the end of fermentation. High ADH activity resulted in reduced accumulation of acetaldehyde during the cell growth phase by increasing the flux to ethanol, whereas high NADH availability (in the cytosol or mitochondria) enhanced acetaldehyde reduction at the later phase of main fermentation. Furthermore, NADH availability is a more useful target trait than ADH activity for constructing yeast strains with a low level of acetaldehyde for industrial applications in terms of flavor contribution and unaltered fermentation period.


Longitudinal predictors of health-related quality of life in isolated dystonia.
To determine longitudinal predictors of health-related quality of life (HR-QoL) in an international multicenter cohort of patients with isolated dystonia. Out of 603 dystonia patients prospectively enrolled in the Natural History Dystonia Coalition study, 155 were assessed three times within 2 years for HR-QoL, symptoms of depression, generalized anxiety disorder (GAD), and social anxiety disorder (SAD), as well as dystonia severity and dystonic tremor. In addition, the impact of botulinum neurotoxin (BoNT) injections on HR-QoL was evaluated after 1 year. Depressive symptoms at baseline predicted lower HR-QoL on all subscales after 2 years (all p ≤ 0.001). Higher GAD scores at baseline predicted lower HR-QoL related to general health, pain and emotional well-being, whereas higher SAD scores predicted higher pain-related QoL after 2 years (all p ≤ 0.006). Dystonia severity at baseline predicted social functioning (p = 0.002). Neither dystonic tremor, age, or sex predicted HR-QoL at 2 years. Two latent categories were revealed across the three-time points: Category 1 with higher total HR-QoL scores (mean HR-QoL = 74.4% ± 16.1), susceptible to symptoms of depression and SAD, and Category 2 with lower total HR-QoL scores (mean HR-QoL = 45.5% ± 17.6), susceptible to symptoms of GAD. HR-QoL improved over the course of 1 year irrespective of the use of BoNT. The longitudinal impact of psychiatric symptoms on HR-QoL emphasizes the importance of incorporating mental health treatment, in particular also the therapy of anxiety disorders, into treatment regimens for dystonia.


Production of interleukin 6 from human liver cell lines: production of interleukin 6 is not concurrent with the production of alpha-fetoprotein.
The production of interleukin (IL) 6 from six human liver cell lines, including Chang liver, HLF, HLE, HepG2, PLC/PRF/5, and HuH-7, was investigated using enzyme-linked immunosorbent assay and Northern blot analysis. When cells were cultured in the presence of 12-O-tetradecanoylphorbol-13-acetate, significant amounts of IL6 were detected in the culture supernatants of Chang liver cells, HLF cells, and HLE cells. However, IL6 was not detected in the culture supernatants from HepG2 cells, PLC/PRF/5 cells, or HuH-7 cells which had been treated similarly. To further investigate the production of IL6, expression of the IL6 gene was studied. Results of Northern blot analysis using IL6 complementary DNA as a probe showed that the induction was initiated at the mRNA level. Moreover, IL6 mRNA was also induced by IL1 beta and tumor necrosis factor but not by a calcium ionophore (A23187) or IL6 itself in Chang liver cells. This is the first study to demonstrate the production of human IL6 in liver cells. Furthermore, when the production of alpha-fetoprotein (AFP) from the liver cell lines was examined, the three that were able to produce IL6 failed to produce AFP, whereas the other three cell lines succeeded in producing AFP. These observations may indicate the heterogeneous origin of the liver cell lines.


Self-Poisoning With Household Bleach in an Elderly Man.
Caustic self-poisoning is a major health hazard, which affects any age, but is particularly serious among the elderly. Household bleach is a caustic that contains 3% to 6% sodium hypochlorite solution, one of the most common agents in unintentional caustic poisoning. In this clinical case, we present a household bleach self-poisoning by an older man with no relevant medical history. He presented with extensive burns on the oral cavity mucosa and tongue, requiring orotracheal intubation by video laryngoscopy. He was then admitted to the intensive care unit, where he evolved poorly. Given the poor prognosis and the lack of physiological reserve for the invasiveness required for a surgical approach, a conservative strategy was chosen after a multidisciplinary team discussion. With the conservative strategy, the patient survived, being discharged to the general ward after one month, where he underwent a Stamm gastrostomy and placement of a percutaneous endoscopic gastrostomy. In the follow-up consultation three months later, the patient was found to be weakened, with high frailty status, presenting anxiety, depression, and causing high family burden.


How the reduction of working hours could influence health outcomes: a systematic review of published studies.
The health effects of work-time arrangements have been largely studied for long working hours, whereas a lack of knowledge remains regarding the potential health impact of reduced work-time interventions. Therefore, we conducted this review in order to assess the relationships between work-time reduction and health outcomes. Systematic review of published studies. Medline, PsycINFO, Embase and Web of Science databases were searched from January 2000 up to November 2019. The primary outcome was the impact of reduced working time with retained salary on health effects, interventional and observational studies providing a quantitative analysis of any health-related outcome were included. Studies with qualitative research methods were excluded. A total of 3876 published articles were identified and 7 studies were selected for the final analysis, all with a longitudinal interventional design. The sample size ranged from 63 participants to 580 workers, mostly from healthcare settings. Two studies assessed a work-time reduction to 6 hours per day; two studies evaluated a weekly work-time reduction of 25%; two studies evaluated simultaneously a reduced weekly work-time reduction proportionally to the amount of time worked and a 2.5 hours of physical activity programme per week instead of work time; one study assessed a reduced weekly work-time reduction from 39 to 30 hours per week. A positive relationship between reduced working hours and working life quality, sleep and stress was observed. It is unclear whether work time reduction determined an improvement in general health outcomes, such as self-perceived health and well-being. These findings suggest that the reduction of working hours with retained salary could be an effective workplace intervention for the improvement of employees' well-being, especially regarding stress and sleep. Further studies in different contexts are needed to better evaluate the impact of work-time reduction on other health outcomes.


A Generative Image Inpainting Model Based on Edge and Feature Self-Arrangement Constraints.
At present, the image inpainting method based on deep learning has achieved a better inpainting effect than traditional methods, but the inpainting results still have problems such as local structure disorder and blurred texture when the images involving a large defect area are processed. This paper proposes a second-order generative image inpainting model based on edge and feature self-arrangement constraints. The model consists of two parts: edge repair network and image repair network. Based on the self-encoder, the edge repair network generates the edges in the defect area according to the known information of the image and improves the edge repair effect by minimizing the adversarial loss and feature matching loss. The image inpainting network fills the defect area with the edge repair result as a priori condition. On the basis of U-Net, the feature self-arrangement module (FSM) is proposed to reconstruct the coding features of a specific scale, and the reconstructed feature skips to connect the decoding layer of the same scale, and it is fused with the upper layer underlying features for decoding. Meanwhile, guide loss, adversarial loss, and reconstruction loss are introduced to narrow the difference between the repaired image and the original image. The experimental results show that the inpainting results of the proposed model have stronger structural connectivity and clearer textures and the performance of PSNR, SSIM, and mean L1 loss in the Celeba, Facade, and Places2 is better than other inpainting methods, indicating that the algorithm can produce an inpainting effect with highly connected structure, reasonable semantics, and fine details.


Updating the chemistry and biology of cannabinoid CB2 receptor-specific inverse agonists.
The cannabinoid CB(2) receptor continues to be an intriguing target for the potential therapeutic benefit of cannabinoids. Because this receptor is significantly found outside the brain, compounds specific for the CB(2) receptor may be free of the side effects that have plagued cannabinoid CB(1) receptor-based therapeutics. In this review, we will discuss a class of compounds which modulate the constitutive activity of the cannabinoid CB(2) receptor, the inverse agonists. We will discuss recent chemical advances that provide new compounds to investigate the biology based on this pharmacology. We will then discuss new biology associated with the cannabinoid CB(2) receptor for hints of how these compounds can best be utilized in vivo.


High concentrations of protein test substances may have non-toxic effects on Daphnia magna: implications for regulatory study designs and ecological risk assessments for GM crops.
Laboratory testing for possible adverse effects of insecticidal proteins on non-target organisms (NTOs) is an important part of many ecological risk assessments for regulatory decision-making about the cultivation of insect-resistant genetically modified (IRGM) crops. To increase confidence in the risk assessments, regulatory guidelines for effects testing specify that representative surrogate species for NTOs are exposed to concentrations of insecticidal proteins that are in excess of worst-case predicted exposures in the field. High concentrations in effects tests are achieved by using protein test substances produced in microbes, such as Escherichia coli. In a study that exposed Daphnia magna to a single high concentration of a microbial test substance containing Vip3Aa20, the insecticidal protein in MIR162 maize, small reductions in growth were observed. These effects were surprising as many other studies strongly suggest that the activity of Vip3Aa20 is limited to Lepidoptera. A plausible explanation for the effect on growth is that high concentrations of test substance have a non-toxic effect on Daphnia, perhaps by reducing its feeding rate. A follow-up study tested that hypothesis by exposing D. magna to several concentrations of Vip3Aa20, and a high concentration of a non-toxic protein, bovine serum albumin (BSA). Vip3Aa20 and BSA had sporadic effects on the reproduction and growth of D. magna. The pattern of the effects suggests that they result from non-toxic effects of high concentrations of protein, and not from toxicity. The implications of these results for regulatory NTO effects testing and ERA of IRGM crops are discussed.


Pain management following new and long-standing spinal cord injury: a pilot study of changes in pain intensity experienced during the day.
The aim of the study was to examine variations in pain intensity during the day experienced by patients with spinal cord injury. Fourteen consecutive patients had clinical and demographic data recorded. Pain intensity was recorded using a Graphic Rating Scale (GRS) at 2-3-h intervals. Patients were grouped according to maximum GRS into mild and severe groups at assessment (T0). Changes of one-third in GRS were deemed clinically significant. Eight men and six women (mean age 53.1; SD 16.5; range 28-75) were studied. Seven patients with mild pain tended to deteriorate and those with severe pain to improve. Eight patients demonstrated clinically significant changes. These findings suggest inadequate pain control early morning for one group and increasing pain during the day for another. Use of such simple scores over time would enhance pain rehabilitation for all spinal cord injury patients. Usual GRS reporting may mask clinically significant, treatable, changes in pain.


Diagnostic value of circulating miR-21 for colorectal cancer: a meta-analysis.
MicroRNA-21 (miR-21) is highly expressed in the plasma of colorectal cancer (CRC) patients. Thus, miR-21 may be a useful novel diagnostic biomarker for CRC. This meta-analysis aims to verify the diagnostic value of circulating miR-21 in CRC patients. A literature search was conducted for publications that evaluated the diagnostic value of miR-21 for CRC. The quality of each study was scored with the Quality Assessment of Diagnostic Accuracy Studies. The bivariate meta-analysis model was employed to summarize the sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR). Receiver operating characteristic curves were used to check the overall test performance. Five publications with six studies involving 579 patients and 266 controls were included in this meta-analysis. The pooled sensitivity was 77.4% [95% confidence interval (CI): 67.2%-85.1%], specificity was 84.6% (95% CI: 79.7%-88.5%), PLR was 5.02 (95% CI: 3.73-6.75), NLR was 0.27 (95% CI: 0.18-0.40), and DOR was 18.77 (95% CI: 10.41-33.83). The area under the summary ROC curve was 0.86. In addition, the results became prominent in the CRC group when a study that explored the advanced adenoma was excluded. Circulating miR-21 may be a suitable diagnostic biomarker for CRC with moderate sensitivity and specificity. Further studies should evaluate the diagnostic value of miR-21 for CRC in the future.


[Improved outcome with sirolimus-cyclosporine regimen in high-risk renal transplant recipients].
The immunosuppressive agents have a broad spectrum of adverse effects. In the absence of selective and specific drugs the decrease incidence and severity of side effects can be achieved by the combination of synergistic drugs only. Without wise selection and use of the combination of the potent immunosuppressive agents for the immunosuppressive maintenance therapy better results cannot be achieved without or fewer toxicities particularly in high-risk patients who lose their grafts prematurely. Therefore, a good combination will allow not only to reduce individual immunosuppressive drug induced toxicities but will also allow to achieve better graft and patient survival. To assess the 6-year impact of a sirolimus-based regimen with, modest exposures to cyclosporine among three ethnic groups with different rejection risk, the authors performed a retrospective analysis of 470 renal transplant recipients who were treated contemporaneously: Group 1, high risk African Americans (n = 122); Group 2, moderate risk Hispanics (n = 132); Group 3, mild risk Caucasians (n = 216). Multivariate models were used to compare the outcomes in Group 1 with those of the other two groups. The cumulative incidence of acute rejection episodes over the entire follow-up period was similar among the groups: Group 1, 22.0%, Group 2, 24.2% and Group 3, 23.0%. Although there were no significant differences in overall or individual infection rates, Group 1 and 2 recipients displayed a significantly lower incidence of diarrhea at all times during follow-up compared with Group 3. All recipients showed similar rates of lymphocele formation. However, Group 1 displayed a reduced incidence and decreased severity of hypertriglyceridemia than Group 2 or Group 3 (89.3% vs. 97.2% vs. 93.2%), a similar incidence of hypercholesteremia (94.3% vs. 97.2% vs. 98.5%) was observed. The occurrence of post-transplant diabetes mellitus was greater in Group 1. than Group 3. but similar to Group 2. A concentration-controlled sirolimus-cyclosporine-prednisone regimen (with steroid withdrawal by 3 months) reduced the incidence of acute rejection episodes and increased 6-year graft survivals among high-risk African Americans to rates similar to other ethnic groups without an augmented toxicity profile.


Conservative management of amlodipine influenced gingival enlargement.
Gingival enlargement is a well recognized unwanted effect associated mainly with anticonvulsant drugs, immunosuppressant drugs and calcium channel blockers. Amlodipine influenced gingival enlargement is comparatively less prevalent amongst calcium channel blockers. It causes aesthetic disfigurement, speech disturbances, abnormal tooth movement and difficulty in mastication. The management of drug influenced gingival enlargement is a challenge for the periodontist, mainly due to less understanding of its pathogenesis, difficulties in selection of proper line of management and recurrence of the enlargement. This report discusses the importance of conservative approach (scaling and root planning along with drug replacement) in the management of a case of amlodipine influenced gingival enlargement. The need for extensive surgery was decreased after this approach.


Interferon effects on osteoinduction.
Xenografts of human osteosarcoma growing in athymic mice are inhibited in growth rate by human interferon-alpha (IFN-alpha) treatment. In addition, differentiation of trabecular bone occurs external to the osteosarcomatous tissue and this is entirely dependent on IFN treatment. We have used species-specific anticollagens and antivimentin antibodies to determine the species origins of this trabecular bone. By using immunohistochemical procedures, it was found that this bone is host-derived. These results suggest that IFN provoked the production of a bone-inducing agent by the human osteosarcomas.


Clinical outcomes and prognostic factors of patients with severe influenza receiving intravenous peramivir salvage therapy in intensive care units.
Few studies have investigated patients with severe influenza who receive intravenous peramivir for salvage therapy. We retrospectively analyzed data from 71 patients with severe influenza who received intravenous peramivir therapy in the intensive care units of three medical centers between 2012 and 2016. All patients received oseltamivir or zanamivir before the administration of peramivir. A total of 44 men and 27 women with a median age of 55 years were enrolled. Fifty-five (78%) had underlying comorbidities and 57 (80%) patients were infected with influenza type A. Forty-four (62%) patients survived and 27 (38%) died. Five patients (7%) had attributable adverse events, including elevated hepatic aminotransferase levels (n = 2), hyperbilirubinemia (n = 2), leukopenia (n = 1), and skin rash (n = 1). Multivariable logistic regression analysis revealed that initial bacteremia (odds ratio [OR], 27.59; 95% confidence interval [95% CI], 2.36-322.07; P = 0.008) and septic shock (OR, 8.00; 95% CI, 1.69-37.90; P = 0.009) were the independent predictors of mortality. However, there was also a trend towards a positive correlation between mortality and steroid use (OR, 11.29; 95% CI, 0.67-188.86; P = 0.092). As a salvage therapy, intravenous peramivir provided a survival rate of 62% and was well tolerated in patients with severe influenza. The initiation of effective antiviral treatment as early as possible within 48 h is recommended for hospitalized patients.


[Rupture of the dissecting vertebral arterial aneurysm].
The paper describes a rare case of a patient with dissecting vertebral arterial aneurysmal rupture. The patient was operated on--the aneurysmal wall was reinforced with surgical gauze. The intraoperative signs of the dissecting aneurysm are described in detail. The angiographic signs of dissecting aneurysms are given.


A case of prenatally detected left isomerism and hemiazygos continuation of inferior vena cava.
Heterotaxy syndromes are defined as the disorders that involve abnormal arrangement of viscera. We present a case of prenatally diagnosed left isomerism in a 30-year-old primigravida woman referred to our hospital for complex cardiac abnormality. Sonographic findings included heart block, unbalanced atrioventricular septal defect, interruption of the inferior vena cava with hemiazygos continuation, double superior vena cava, a right-sided stomach, and biliary atresia. The hemiazygos vein drained into the right atrium by the persistent left superior vena cava. This type of inferior vena cava interruption and continuation is rarely reported in prenatally detected cases of left isomerism. © 2017 Wiley Periodicals, Inc. J Clin Ultrasound 45:430-433, 2017.


Pulmonary Embolism: The Astute Interventional Radiology Clinician.
There has been a resurgence of interest in defining the optimal treatment for severe pulmonary embolism (PE), fueled by pivotal and provocative trials, new catheter-based medical devices, and growing evidence of deleterious short- and long-term outcomes. In this environment, and especially given the multidisciplinary nature of PE care, the interventional radiologist (IR) needs to become an astute, disease-specific expert. This review article describes the following "steps" an IR can take to reach this level: (1) understand PE stratification and epidemiology; (2) recognize the treatment goals for massive PE; (3) recognize the wide range of attitudes toward therapeutic escalation for submassive PE; (4) recognize what we do not know about the treatment of submassive PE and the limitations of current studies; (5) know the literature surrounding inferior vena cava filter insertion for severe PE; (6) integrate into the longitudinal care of the patient; and (7) be at the leading edge of new trials and technologies.


Neonatal sex-steroid hormones and muscular strength of boys and girls in the first three years.
Five sex-steroid hormones were assayed in umbilical cord blood. Strength was assessed in children in three samples at several ages from birth to 33 months. At different ages, different strength measures were taken, viz., at birth, prone head responses; at 3 months, leg strength; from 6 to 33 months, grip strength. Boys had higher average strength scores than girls but the sex differences were small and did not increase or decrease over the age period studied. Across-age strength scores showed a significant relation to androstenedione and a significant interaction of sex and progesterone. Both boys and girls with higher strength scores had lower androstenedione. Girls with high cord blood progesterone showed low strength while boys with high progesterone showed high strength. There were no sex differences in androstenedione or progesterone level. The androstenedione finding did not replicate across samples but the Progesterone X Sex interaction was replicated in all three samples. No relationship was found between strength and other hormones assayed: testosterone, estradiol, and estrone.


A deterministic approach for design of supervisory control of LPV systems with delay.
Linear Parameter Varying (LPV) systems and their control have gained attraction recently as they approximate nonlinear systems with higher order than ordinary linear systems. On the other hand, time delay is an inherent part of various real-life applications. A supervisory control structure is proposed in this paper for LPV systems subject to time delays. In the proposed control structure, a supervisor selects the most suitable controller from a bank of controllers; which desires to enhance the performance of closed-loop system in contrast with using a single robust controller. The analysis is based on the celebrated Smith predictor for time delay compensation and we provide a sufficient condition to assure the stability of the closed-loop switched system in terms of dwell time. Simulations on blood pressure control of hypertension patients in postoperative scenario are used to exemplify the effectiveness of the utilized technique. The operating region of the system is partitioned into five smaller operating regions to construct corresponding robust controllers and perform hysteresis switching amongst them. Simulation results witnessed that the proposed control scheme demonstrated a pressure undershoot less than the desired value of 10 mmHg while the Mean Arterial Pressure (MAP) remains within ±5 mmHg of the desired value.


Detection of Methicillin-Resistant Coagulase-Negative Staphylococci and Surveillance of Antibacterial Resistance in a Multi-Center Study from Iran.
Coagulase-negative staphylococci (CNS) are a common cause of nosocomial infections. In recent years, an increase in the incidence of methicillin-resistant coagulase-negative staphylococci (MRCNS) has led to the severity of the disease. The aim of this study was to isolate and identify MRCNS strains by oxacillin disk agar diffusion, oxacillin agar screening, and polymerase chain reaction (PCR) and to evaluate their antibacterial resistance patterns. Totally, 122 CNS isolates were collected from the clinical specimens of four hospitals in Iran. Susceptibility testing was performed by disk agar diffusion against 15 antimicrobial agents. Then, disk agar diffusion, agar screening, and PCR were applied to determine susceptibility to oxacillin. Out of the 122 isolates, 92 isolates were found to be MRCNS by PCR. The sensitivities and specificities of disk agar diffusion and agar screening were 89.2% and 69% and 93.8% and 96.3%, respectively. Also, 93 CNS isolates were resistant to Methicillin according to disk agar diffusion. Our results indicated that agar screening was superior to oxacillin disk agar diffusion. A comparison between the antibiotic sensitivity patterns of the MRCNS and the Methicillin-Susceptible Coagulase-Negative Staphylococci (MSCNS) showed that the MRCNS were predominantly multiple-drug resistant isolates as the simultaneous resistance rate to 4 or more antibiotics in the MRCNS and MSCNS was 93% and 56%, respectively.


Ameliorating effect of anti-Alzheimer's drugs on the bidirectional association between type 2 diabetes mellitus and Alzheimer's disease.
Mild to severe forms of nervous system damage were exhibited by approximately 60-70% of diabetics. It is important to understand the association between type 2 diabetes mellitus and Alzheimer's disease. The aim of the present work is to understand the bidirectional association between type 2 diabetes and Alzheimer's disease pathogenesis, that was monitored by glycaemic status, lipid profile, amyloid beta 40 and 42 (Aβ40 and Aβ42), C-reactive protein, total creatine kinase, total lactate dehydrogenase, D-dimer and magnesium measurements, to assess the association between theses biochemical markers and each other, to estimate the possibility of utilizing the amyloid beta as biochemical marker of T2D in Alzheimer's patients, and to evaluate the effect of piracetam and memantine drugs on diabetes mellitus. This study involved 120 subjects divided into 20 healthy control (group I), 20 diabetic patients (group II), 20 Alzheimer's patients (group III), 20 diabetic Alzheimer's patients with symptomatic treatment (group IV), 20 diabetic Alzheimer's patients treated with memantine (group V), and 20 diabetic Alzheimer's patients treated with piracetam (group VI). The demographic characteristics, diabetic index, and lipid profile were monitored. Plasma amyloid beta 40 and amyloid beta 42, C-reactive protein, total creatine kinase, total lactate dehydrogenase, D-dimer, and magnesium were assayed. The levels of amyloid beta 40 and amyloid beta 42 were significantly elevated in diabetic Alzheimer's patients with symptomatic treatment (group IV) compared to group II (by 50.5 and 7.5 fold, respectively) and group III (by 25.4 and 2.8 fold, respectively). In groups II, III, IV, V and VI, significant and positive associations were monitored between insulin and amyloid beta 40, amyloid beta 42, C-reactive protein, total creatine kinase, and D-dimer. Diabetic markers were significantly decreased in diabetic Alzheimer's patients treated with anti-Alzheimer's drugs (especially piracetam) compared to group IV. This study reveals the role of amyloid beta 40, amyloid beta 42, insulin, HbA1c, lipid profile disturbance, C-reactive protein, D-dimer, and magnesium in the bidirectional correlation between T2D and pathogenesis of Alzheimer's disease, that is powered by their correlations, and therefore the possibility of utilizing Aβ as a biochemical marker of T2D in Alzheimer's patients is recommended. Impact statement Several aspects associated with T2D that contribute to AD and vice versa were investigated in this study. Additionally, this work reveals the role of Aβ40, Aβ42, insulin, HbA1c, lipid profile disturbance, CRP, D-dimer, and magnesium in the bidirectional association between T2D and the pathogenesis of AD, that is powered by their correlations, and therefore the possibility of utilizing Aβ as a biochemical marker of T2D in Alzheimer's patients is recommended. Furthermore, the ameloriating effect of anti-Alzheimer's drugs on diabetes mellitus confirms this association. Hereafter, a new approach for treating insulin resistance and diabetes may be developed by new therapeutic potentials such as neutralization of Aβ by anti-Aβ antibodies.


The capture of ·H and ·OH radicals by vitamin C and implications for the new source for the formation of the anion free radical.
To gain a better understanding of the antioxidation behaviors of vitamin C, the reactions between vitamin C (monoanionic form, AAH(-)) and two radicals, (·)H and (·)OH, have been investigated employing the B3LYP and BHandHLYP methods in combination with the atoms in molecules (AIM) theory and energy decomposition analyses (EDA). Both the radical additions to the five-membered ring of AAH(-) and H-abstraction reactions are explored. The reaction profiles of various reactions have been obtained. The most favorable active site to be attacked by radical addition has been confirmed to be the C2 site of AAH(-), which is different from that of the C3 site in the neutral vitamin C. The (·)OH addition reactions are essentially diffusion-controlled processes, which is in contrast to the previous reports. A new source for the formation of the principal anion free radical (AFR) of AAH(-) has been observed in the (·)OH attack process, i.e., AFR can be formed mainly from the H13 abstraction reaction involving two types of concerted proton-electron transfer (CPET) mechanisms. Moreover, the binding characters and formation mechanisms of the stable reaction complex formed during the formation of AFR have been systematically investigated.


Proliferative activity of neokyotorphin-related hemoglobin fragments in cell cultures.
alpha-Hemoglobin fragments alpha-(133-141), alpha-(134-141), alpha-(135-141), alpha-(137-141), alpha-(134-140), alpha-(133-138), alpha-(134-140) and alpha-(137-138) stimulate L929 tumor cell proliferation, alpha-(134-141) being the most active. alpha-(134-141) stimulates proliferation of M3 melanoma cells, murine embryonic fibroblasts, primary cultures of red bone marrow and spleen cells. In L929 cells the effect of alpha-(134-141) is cell density independent; in M3 cells alpha-(137-141) and alpha-(134-141) are most active at density 10,000 cells/well (96 well plate) independently on FBS content.


Mantel test in population genetics.
The comparison of genetic divergence or genetic distances, estimated by pairwise FST and related statistics, with geographical distances by Mantel test is one of the most popular approaches to evaluate spatial processes driving population structure. There have been, however, recent criticisms and discussions on the statistical performance of the Mantel test. Simultaneously, alternative frameworks for data analyses are being proposed. Here, we review the Mantel test and its variations, including Mantel correlograms and partial correlations and regressions. For illustrative purposes, we studied spatial genetic divergence among 25 populations of Dipteryx alata ("Baru"), a tree species endemic to the Cerrado, the Brazilian savannas, based on 8 microsatellite loci. We also applied alternative methods to analyze spatial patterns in this dataset, especially a multivariate generalization of Spatial Eigenfunction Analysis based on redundancy analysis. The different approaches resulted in similar estimates of the magnitude of spatial structure in the genetic data. Furthermore, the results were expected based on previous knowledge of the ecological and evolutionary processes underlying genetic variation in this species. Our review shows that a careful application and interpretation of Mantel tests, especially Mantel correlograms, can overcome some potential statistical problems and provide a simple and useful tool for multivariate analysis of spatial patterns of genetic divergence.


Telemedicine: Strabismus e-consultation.
Volunteer ophthalmologists can achieve success with teaching and service programs working with high intensity over a short term. Continuation of initially successful programs may be limited by lack of timely, effective communication and follow-up. In an attempt to overcome these limitations, a total of 6 telemedicine programs were established after a successful trial program at the Ramon Pando Ferrer Hospital in Havana, Cuba. Two pediatric ophthalmology-strabismus clinics, one in Cuba and one in Romania, were provided a digital camera and a computer in order to obtain and then transmit by e-mail patient images obtained according to a prescribed format. Ophthalmologists in both of these programs were instructed personally during an orientation period in their clinics. Training included use of a digital camera and computer, patient examination, and surgical technique in the operating room. Four additional programs referred patients via digital images after receiving only written and oral instruction. The diagnosis and treatment plan determined by one of us (E.M.H.) for each of the first 15 Cuban patients after study of digital images sent by e-mail was the same as the diagnosis and treatment plan determined by the same observer after in-person examination of the patients. On the basis of the level of confidence attained in these patients, 35 additional patients from a total of 6 clinics were seen by digital consultation only. A store-and-forward telemedicine consultation technique that uses digital images and e-mail holds promise to be an effective means for carrying out consultation for patients with strabismus.


Vanadyl(IV) complexes with saccharides. Bioactivity in osteoblast-like cells in culture.
Complexes of vanadyl(IV) with 4 monosaccharides and 5 disaccharides were tested in 2 osteoblast-like cell lines (MC3T3E1 and UMR106). Many complexes caused stimulation of UMR106 proliferation (120% basal) in the range of 2.5 to 25 micromol/L. In the nontransformed osteoblasts, some vanadyl-saccharide complexes stimulated the mitogenesis (115% basal) in the same range of concentration. The glucose and sucrose complexes were the most efficient inhibitory agents (65% and 88% of inhibition vs. basal, respectively) for tumoral cells at 100 micromol/L. The galactose and turanose complexes exerted a similar effect in the nontransformed osteoblasts. On the other hand, all the complexes promoted the phosphorylation of the extracellular regulated kinases (ERKs). All together, these results indicate that the stimulation of ERKs is not the only factor that plays a role in the proliferative effects of vanadium derivatives since some compounds were inhibitory proliferating agents. Cell differentiation was evaluated by alkaline phosphatase specific activity and collagen synthesis in UMR106 cells. All the complexes inhibited alkaline phosphatase activity, with galactose complex as the most effective compound (IC50 = 43 micromol/L). The complex with the trehalose TreVO was the most effective agent to stimulate collagen synthesis (142% basal) and glucose consumption (132% basal). A cytosolic tyrosine protein kinase and the kinase-3 of glycogen synthase seem to be involved in the stimulation of glucose consumption by vanadium derivatives. In this series, only TreVO gathered the characteristics of a good insulin mimetic and osteogenic drug. In addition, this complex was a good promoting agent of nontransformed osteoblast proliferation, whereas it inhibited tumoral osteoblasts. GluVO, the complex with glucose, was also more toxic for tumoral than for nontransformed cells. These 2 vanadium derivatives are good potential antitumoral drugs. All the results suggest that the biological effects of vanadium compounds are a complex phenomenon influenced by the complexation, the dose, and the nature of the ligands and the cells.


Enhancement of dengue virus infection in monocytes by flavivirus antisera.
Enhanced dengue 2 virus (D2V) infection in suspension cultures of human peripheral blood mononuclear phagocytes (PBL) produced by subneutralizing concentrations of dengue antisera has been described previously. In this study, the enhancement phenomenon was found to be a general property of representative flavivirus antisera. All except one of 24 antisera, which had been raised by 1-3 injections of flaviviruses in rabbits, enhanced the growth of dengue 2 virus in human PBL. Flavivirus antisera showing the greatest level of cross-reactivity against a battery of 42 flavivirus antigens in the hemagglutination-inhibition test were most potent in enhancing dengue replication in PBL cultures. Cross-neutralizing reactivity did not relate to enhanced D2V infection. However nearly one-half of studied flavivirus antisera neutralized D2V at dilutions of 1:10 or 1:20. Heterotypic D2V neutralizing antibody could serve as a "brake" on infection enhancement in vivo. Observations should be made in the field to look for possible enhancement of dengue infection in heterotypic flavivirus immunes.


Identification and in vitro biological activities of hop proanthocyanidins: inhibition of nNOS activity and scavenging of reactive nitrogen species.
Oligomeric proanthocyanidins constitute a group of water-soluble polyphenolic tannins that are present in the female inflorescences (up to 5% dry wt) of the hop plant (Humulus lupulus). Humans are exposed to hop proanthocyanidins through consumption of beer. Proanthocyanidins from hops were characterized for their chemical structure and their in vitro biological activities. Chemically, they consist mainly of oligomeric catechins ranging from dimers to octamers, with minor amounts of catechin oligomers containing one or two gallocatechin units. The chemical structures of four procyanidin dimers (B1, B2, B3, and B4) and one trimer, epicatechin-(4beta-->8)-catechin-(4alpha-->8)-catechin (TR), were elucidated using mass spectrometry, NMR spectroscopy, and chemical degradation. When tested as a mixture, the hop oligomeric proanthocyanidins (PC) were found to be potent inhibitors of neuronal nitric oxide synthase (nNOS) activity. Among the oligomers tested, procyanidin B2 was most inhibitory against nNOS activity. Procyanidin B3, catechin, and epicatechin were noninhibitory against nNOS activity. PC and the individual oligomers were all strong inhibitors of 3-morpholinosydnonimine (SIN-1)-induced oxidation of LDL, with procyanidin B3 showing the highest antioxidant activity at 0.1 microg/mL. The catechin trimer (TR) exhibited antioxidant activity more than 1 order of magnitude greater than that of alpha-tocopherol or ascorbic acid on a molar basis.


Efficacy of itraconazole versus fluconazole in vaginal candidiasis.
To compare the efficacy of fluconazole 150mg single dose and itraconazole 200mg twice for one day in the treatment of acute vulvovaginal candidiasis. The study was carried out at the Department of Dermatology, PNS Shifa Hospital, Karachi, from March, 2008 to February 2009 and comprised 60 women with clinical and mycological diagnosis of vaginal candidiasis. Diagnosis was based on history, clinical examination and relevant investigations. The women were divided into two equal groups. After initial assessment, Group 1 was treated with capsule fluconazole 150mg stat, and Group 2 with capsule itraconazole 200mg twice for one day. They were assessed clinically for cure and relapse on day 7 and 21 respectively. All findings were recorded in the proforma. Data was analysed using SPSS 12. The overall clinical evaluation showed 70% (n = 21) cure rate with itraconazole and 50% (n = 15) with fluconazole. In Group-1, 7 (23.33%) and in Group-2 8 (26.6%) showed some improvement, while 2 (6.66%) in Group 1, and 7 (23%) in Group 2 failed to respond. Relapse was observed in 9 (28.5%) and 16 (53%) of the cured cases in Group 1 and Group 2 respectively. Itraconazole was found to be more effective in the treatment of vulvovaginal candidiasis compared to fluconazole with high cure and low relapse rate.


[Peripheral neuropathies revealing HIV infection at the Hospital Center of Bobo-Dioulasso (Burkina Faso)].
Several peripheral neuropathies are associated with human immuno-deficiency virus (HIV) infection. In Africa, certain diseases are of particular importance. In the present work, we report peripheral neurological involvement as revealing signs of HIV infection within the internal medicine unit of a large city over a 2-year period. All adult subjects with a positive HIV serology revealed by a peripheral neuropathy observed in the National Hospital Centre of Bobo-Dioulasso over a two-year period (1 January 1999 and 31 December 2000) were included in the study. 46 cases of peripheral neuropathies revealing HIV infection were screened. Peripheral facial paralysis concerned 25 patients, 15 women and 10 men, in the early stages of HIV infection. The average age was 34 years. For 80% of the patients, he CD4 count was over 200. 5/10 cases of polyneuropathy occurred at the early stage of the HIV infection. Herpes zoster occurred in the early stages in 5/7 cases. 3/4 cases of polyradiculopathy occurred at a later stage with CD4 count under 200. Our study indicates clearly that isolated peripheral facial paralysis, sensitive polyneuropathy, herpes zoster and polyradiculopathy in young adults should lead to HIV testing.


Gene profiling in anaplastic large-cell lymphoma-derived cell lines with cDNA expression arrays.
Comparative hybridization of cDNA arrays is a powerful high-throughput tool for the measurement of gene expression between two or more tissues. Moreover, cDNA array technology permits detection of genes involved in carcinogenesis and prospective targets for diagnosis or therapy in the future. We used this technique in cell lines to discover genes possibly involved in the pathogenesis of the large-cell anaplastic lymphoma (ALCL). CD30(+) lymphoma cells are characteristic for this lymphoma entity and were first described 16 years ago. Still, little is known about the biology of this aggressive lymphoma. Identical arrays covering 1176 genes (Clontech Human Cancer 1.2) were hybridized with labeled first-strand cDNA from five ALCL cell lines and stimulated T cells. We found overlapping gene expression patterns in the five cell lines. Three genes, tissue inhibitor of metalloproteinases 1 (TIMP-1), nm23-H4, and interferon-induced 56K protein (IFI-56K) were strongly overexpressed in all ALCL cell lines compared with stimulated T cells. Whereas interleukin-2 precursor, interleukin-9 precursor, interferon-gamma precursor, T cell surface glycoprotein CD3 epsilon subunit, 40S ribosomal protein SA, and protein-tyrosine phosphate 1C were underexpressed, Reverse transcription polymerase chain reaction and Northern blot analysis were employed to confirm the expression patterns of the genes identified by Atlas hybridization.


Robust nanogenerators based on graft copolymers via control of dielectrics for remarkable output power enhancement.
A robust nanogenerator based on poly(tert-butyl acrylate) (PtBA)-grafted polyvinylidene difluoride (PVDF) copolymers via dielectric constant control through an atom-transfer radical polymerization technique, which can markedly increase the output power, is demonstrated. The copolymer is mainly composed of α phases with enhanced dipole moments due to the π-bonding and polar characteristics of the ester functional groups in the PtBA, resulting in the increase of dielectric constant values by approximately twice, supported by Kelvin probe force microscopy measurements. This increase in the dielectric constant significantly increased the density of the charges that can be accumulated on the copolymer during physical contact. The nanogenerator generates output signals of 105 V and 25 μA/cm2, a 20-fold enhancement in output power, compared to pristine PVDF-based nanogenerator after tuning the surface potential using a poling method. The markedly enhanced output performance is quite stable and reliable in harsh mechanical environments due to the high flexibility of the films. On the basis of these results, a much faster charging characteristic is demonstrated in this study.


[Superiority of three-dimensional quantitative analysis technique and automatic cardiac motion quantification technique in evaluating left ventricular systolic function in patients with chronic kidney disease].
Objective: To investigate the value of three-dimensional quantitative analysis (3DQA) and automatic cardiac motion quantification (aCMQ) in evaluating the left ventricular systolic function in patients with different stages of chronic kidney disease (CKD). Methods: A total of 127 cases of CKD patients between June 2016 and December 2017 who were admitted to Department of Nephrology of Wuxi No.2 People's Hospital were divided into three groups: Group A (44 cases in CKD stage 1 and 2), Group B (38 cases in CKD stage 3) and Group C (45 cases in CKD stage 4 and 5). Another 50 age and sex matched normal controls were selected during the same period. The left ventricular segments and global longitudinal strain (GLS), left ventricular segments and global three-dimensional displacement (3DD) obtained by aCMQ and 3DQA techniques were compared and analyzed. Results: Compared with the control group, as for the longitudinal strain (LS) of each segment of left ventricular 5 (17 in all) segments in Group A, 10 segments in Group B and all segments in Group C decreased (P<0.05). As for the 3DD of each segment of left ventricular, 6 segments in Group A, 12 segments in Group B and all segments in group C decreased (P<0.05). As for the GLS, there was no statistically significant difference in group A, however, absolute value of GLS in group B and C [(19.82±3.62)%, (16.62±5.48)% vs (21.98±4.32)%] decreased statistically significantly (both P<0.05). As for the left ventricular global 3DD, the global 3DD of group A, group B and group C [(6.24±0.51) mm, (5.54±0.29) mm, (4.62±0.55) mm vs (7.11±0.51) mm] decreased (all P<0.05). Conclusions: Three-dimensional quantitative analysis and automatic cardiac motion quantification can detect the abnormality of left ventricular systolic function in patients with chronic kidney disease at an early stage. And the global 3DD of left ventricle of 3DQA is more sensitive than the global longitudinal strain of left ventricle of aCMQ.


A histidin alanine rich recombinant antigen protects Aotus monkeys from P. falciparum infection.
We have isolated a cDNA clone coding for 165 amino acids of a histidine alanine rich protein. An extended repeat region of this clone codes for the tripeptide Ala-His-His, which is extremely conserved, and for the tripeptide Ala-Ala-Asp, which shows only slight variability among the repeat units. This antigen exhibits high homology to the HRPII antigen described by Wellems and Howard (1986). The coding region was expressed in E. coli as a MS2-polymerase fusion protein, which was purified and used for immunization of Aotus monkeys. The animals immunized with this fusion protein showed only low parasitemias (less than 2%) after infection with P. falciparum, while animals from the control group or animals immunized with a MS2-fusion protein carrying other malaria specific sequences were not protected. The result suggests that this antigen is a good candidate for a malaria vaccine.


MicroRNA miR-147b promotes tumor growth via targeting UBE2N in hepatocellular carcinoma.
As the subfamily of noncoding RNA, microRNAs (miRNAs) broadly regulate the development of cancers, while their dysregulation and function in human hepatocellular carcinoma (HCC) remains largely unclear. Here, we found the expression level of microRNA-147b (miR-147b) is increased aberrantly in HCC tumor tissues, and its expression positively correlates to the tumor severity. In both MTT and colony formation assay, knockdown of miR-147b dramatically inhibits in vitro proliferation of HCC cell lines. More interestingly, we also performed in vivo tumorigenesis assay and found that miR-147b can regulate in vivo tumorigenesis in nude mice xenograft models. The ubiquitin-conjugating enzyme E2N (UBE2N) was identified directly and functionally targeted by miR-147b. The mRNA level of UBE2N is increased in HCC tumors or cell lines. Restoring UBE2N expression level in tumor cells leads to inhibition of cell proliferation, which mimics the effect upon miR-147b knockdown in the same cells. These data elucidated the oncogenic role of miR-147b in HCC development and progression with therapeutic target potentials.


Subchronic toxicity of Sideritis scardica, Lamiaceae on male Wistar rats.
Sideritisscardica, Lamiaceae, is a plant with anti-inflammatory, antirheumatic, digestive, and antimicrobial properties that is widely used in folk medicine throughout the Balkan Peninsula. The name derives from the Greek word 'sideros', meaning iron, and it is believed that the plant was also used by soldiers to heal wounds caused by cutting weapons.


An experience with intubating laryngeal mask airway for difficult airway management: report on 38 cases.
A retrospective study was performed on 38 patients (23 males and 15 females) in whom the intubating laryngeal mask airway (ILMA) was used for airway management at Srinagarind and Siriraj Hospital in 2003. The patients 'age and weight ranged between 12 and 75 years and 40 and 94 kg, respectively. Difficult tracheal intubation was suspected before starting general anesthesia in 17 patients, whereas it was found difficult after induction of general anesthesia in 21. The ILMA was successfully placed in all patients with airway patency classified as 'good' and 'acceptable' in 36 patients (94.7%), and 'poor' in two. Oxygen saturation during intubation was maintained above 95 percent in all patients. Tracheal intubation through the ILMA was successful in 34 patients (89.5%), which was described as 'easy' in 27 of 34 patients (79.4%). In the remaining 7, 2-5 attempts were required for successful tracheal intubation. The types of endotracheal tubes used were: 1) the pre-formed silicone tube in 55.9 percent, 2) the pre-formed flexible tube in 41.2 percent; and, 3) the standard polyvinyl tube in 2.9 percent. In the four patients with failed tracheal intubation through the ILMA, three were successfully intubated with conventional laryngoscopy and one with gum elastic bougie. There were no serious complications following the use of the ILMA in these patients. The ILMA proved a safe, very useful and easy to use device with a high success rate for difficult airway management.


Body composition of mice of different body condition score and sex.
After a critical review of recent research on the whole body chemical composition of laboratory animals, especially that of the mouse, the authors present data on the body composition of a mouse line of different body condition score, varying from normal to double-muscled ("culard", "compact") type. One hundred male and 100 female mice of different compact categories were measured in vivo, using total body electrical conductivity (TOBEC method), then by direct chemical analysis performed on day 77 of life. In male mice, body weight and protein content were found to increase while fat content decreased parallel to the increase in phenotypic condition score. Female mice showed a rather constant fat, protein and ash content in the dry matter of the body. The precision and validity of TOBEC data under 40 grams of body weight proved to be insufficient.


Comparative analysis of vaginal microbiota sampling using 16S rRNA gene analysis.
Molecular methods such as next-generation sequencing are actively being employed to characterize the vaginal microbiota in health and disease. Previous studies have focused on characterizing the biological variation in the microbiota, and less is known about how factors related to sampling contribute to the results. Our aim was to investigate the impact of a sampling device and anatomical sampling site on the quantitative and qualitative outcomes relevant for vaginal microbiota research. We sampled 10 Finnish women representing diverse clinical characteristics with flocked swabs, the Evalyn® self-sampling device, sterile plastic spatulas and a cervical brush that were used to collect samples from fornix, vaginal wall and cervix. Samples were compared on DNA and protein yield, bacterial load, and microbiota diversity and species composition based on Illumina MiSeq sequencing of the 16S rRNA gene. We quantified the relative contributions of sampling variables versus intrinsic variables in the overall microbiota variation, and evaluated the microbiota profiles using several commonly employed metrics such as alpha and beta diversity as well as abundance of major bacterial genera and species. The total DNA yield was strongly dependent on the sampling device and to a lesser extent on the anatomical site of sampling. The sampling strategy did not affect the protein yield or the bacterial load. All tested sampling methods produced highly comparable microbiota profiles based on MiSeq sequencing. The sampling method explained only 2% (p-value = 0.89) of the overall microbiota variation, markedly surpassed by intrinsic factors such as clinical status (microscopy for bacterial vaginosis 53%, p = 0.0001), bleeding (19%, p = 0.0001), and the variation between subjects (11%, p-value 0.0001). The results indicate that different sampling strategies yield comparable vaginal microbiota composition and diversity. Hence, past and future vaginal microbiota studies employing different sampling strategies should be comparable in the absence of other technical confounders. The Evalyn® self-sampling device performed equally well compared to samples taken by a clinician, and hence offers a good-quality microbiota sample without the need for a gynecological examination. The amount of collected sample as well as the DNA and protein yield varied across the sampling techniques, which may have practical implications for study design.


Acyclovir-resistant herpes simplex virus 1 infection early after allogeneic hematopoietic stem cell transplantation with T-cell depletion.
We previously reported that oral low-dose acyclovir (200 mg/day) for the prevention of herpes simplex virus (HSV) infections after allogenic hematopoietic stem cell transplantation (HSCT) is effective without the emergence of acyclovir-resistant HSV infections. However, HSV infections are of significant concern because the number of allogeneic HSCT with T-cell depletion, which is a risk factor of the emergence of drug-resistant HSV infections, has been increasing. We experienced a 25-year-old female who received allogenic HSCT from an unrelated donor with 1-antigen mismatch using anti-thymocyte globulin. Despite acyclovir prophylaxis (200 mg/day), she developed the right palatal ulcer that was positive for HSV-1 specific antigen by fluorescent antibody on day 20 and developed new hypoglossal and tongue ulcers on day 33. Replacement of acyclovir with foscarnet improved her ulcers. We isolated 2 acyclovir-resistant and foscarnet-sensitive strains from the right palatal and hypoglossal ulcers, which had the same frame shift mutation in the thymidine kinase genes. The rate of proliferation of the isolate from the hypoglossal ulcer was faster than that from the right palatal ulcer in the plaque reduction assay. HSV strains that acquired acyclovir-resistant mutations at the right palatal ulcer with larger plaque might spread to the hypoglossal ulcer as the secondary site of infection because of better growth property. Second-line antiviral agents should be considered when we suspect treatment failure of HSV infection, especially in HSCT with T-cell depletion. Further studies are required whether low-dose acyclovir prophylaxis leads to the emergence of virological resistance.


Dielectric Elastomer Based "Grippers" for Soft Robotics.
The use of few stiff fibers to control the deformation of dielectric elastomer actuators, in particular to break the symmetry of equi-biaxial lateral strain in the absence of prestretch, is demonstrated. Actuators with patterned fibers are shown to evolve into unique shapes upon electrical actuation, enabling novel designs of gripping actuators for soft robotics.


Implications of attitude-behavior studies for population research and action.
Results of many family planning surveys do not suggest that attitudes are strongly predictive of family planning practices. An inquiry into methodological issues suggests two recommendations for improvement of research procedures. First, more attention must be paid to the reliability of the questionnaires by which attitudes and practices are measured. Second, questions on attitudes and practices should refer to the same action or object and to the same period of time. The available evidence suggests that implementation of these procedures can lead to identification of stronger linkages between family planning attitudes and practices, and to survey results having greater practical utility.


Authenticity assessment of dairy products by capillary electrophoresis.
Milk and derivatives are a very important part in the diet of the world population. Products from goat, buffalo, and sheep species have a greater economic value than the cow ones, therefore, authenticity frauds by improperly adding cow's milk occur frequently: dairy products are among the seven more attractive foods for adulteration. Milk from each of the above-cited animal species has its own definite profile of whey proteins (variants of α-lactalbumin and β-lactoglobulin) and its definite profile of caseins (variants of αS1 -, αS2 -, β-, and κ-casein). Such proteins can be usefully exploited as markers of authenticity by using capillary electrophoresis which is the technique of choice for the analysis of proteins. Due to the multiple adjustable parameters that are unknown to other analytical techniques, capillary electrophoresis is able to detect frauds in milk mixtures and cheese with little use of solvents, fast analysis time, and ease of operation. This makes it attractive and competitive for routine checks that are very important to fight the adulteration market. Advantages and limitations are discussed.


Interleukin-16 network in inflammation and allergy.
Interleukin (IL)-16 is a homotetramer of 14-kDa subunits discovered in 1982 as a T-cell-specific chemoattractant factor. IL-16 plays a role in trafficking of several immune cells and may be a major chemotactic signal for CD4+ cells. Here, we review some of the key biological actions of IL-16. Because this cytokine has been shown to affect the levels of many inflammatory mediators such as histamine, serotonin, regulated upon activation, normal T cell expressed and secreted (RANTES), and monocyte chemotactic protein-1 (MCP-1), and other cytokines such as IL-2, we investigated the effect of IL-16 on control and stimulated human umbilical cord blood-derived cultured mast cells after antigen challenge. We found that human recombinant IL-16 (0.2-200 ng/mL) does not affect either basal tryptase or IL-8 release or that induced by anti-immunoglobulin E activation. In accordance with other data in the medical literature, we conclude that the most important function of IL-16 is the chemoattraction of CD4+ cells.


Glioma-associated hyaluronan induces apoptosis in dendritic cells via inducible nitric oxide synthase: implications for the use of dendritic cells for therapy of gliomas.
As a means of enhancing immunity to gliomas, we investigated local delivery of rat, bone marrow-derived dendritic cells (DCs) into rat 9L gliosarcoma tumors and into 9L tumors induced to undergo apoptosis by gamma knife radiosurgery. Contrary to other tumors, local delivery of DCs had no therapeutic effect on 9L gliomas, even when tumor apoptosis was induced via radiosurgery, which leads to efficient "loading" of the DCs with tumor antigen. To determine whether antigen-presenting cells, such as DCs, were viable in tumors, we carried out multiparametric staining of 9L tumors, using phycoerythrin-conjugated OX6 (MHC class II) or OX62 (DC specific) and FITC-labeled Val-Ala-Asp-fluoromethyl ketone (FITC-VAD-FMK; activated caspases). It was determined that DCs were undergoing apoptosis in these tumors. We therefore sought to determine which glioma cell surface receptors or components of the extracellular matrix in gliomas influenced DC viability. Hyaluronan (HA) is a major component of glioma extracellular matrix and has been found to support tumor cell migration and metastasis. However, its influence on the immune system, and particularly on DCs, via its receptor CD44 is not well documented. Using reverse transcription-PCR, Northern blot, and Western blot analyses, we determined that HA stimulated production of inducible nitric oxide synthase (iNOS) in DCs. NO production by HA-stimulated DCs was then verified biochemically. NO production was dependent on the size of HA; intermediate HA fragments had the greatest capacity to induce NO production in DC, whereas completely digested HA oligosaccharides failed to induce NO. Furthermore, N-monomethyl-L-arginine, an inhibitor of iNOS, completely blocked HA-induced NO production by DCs. Because induction of NO results in the induction of apoptosis in macrophages as well as other cells, DCs treated with HA were examined for apoptosis in terminal deoxynucleotidyl transferase (TdT)-mediated dUTP biotin nick-end labeling assays. It was demonstrated that HA induced apoptosis in DCs and that induction of apoptosis was dependent on the production of NO because it was entirely inhibited by N-monomethyl-L-arginine. Using flow cytometric analyses with FITC-VAD-FMK, which is specific for activated caspases, we also determined that induction of apoptosis in DCs with HA could be titrated. Coincubation of 9L tumor cells with DCs was found to induce apoptosis in DCs as indicated by fluorescent staining with FITC-VAD-FMK. Specificity of this reaction for CD44-HA interactions was determined by pretreatment of DCs with anti-CD44 or pretreatment of 9L tumor cells with hyaluronidase, which blocked the induction of apoptosis in DCs. These data indicate that HA expressed by gliomas may contribute to their immunosuppressive effects by promoting apoptosis among professional antigen-presenting cells such as DCs via iNOS induction after CD44-HA interactions.


Immunohistochemical examination of 25 cases of Merkel cell carcinoma: a comparison with small cell carcinoma of the lung and oesophagus, and a review of the literature.
Merkel cell carcinomas (MCC) were compared to small cell carcinomas of the lung (SCCL) and oesophagus (SCCO). Most MCC were of the intermediate cell type while SCCL and SCCO were usually of the small cell type. Only MCC of trabecular type could be separated from SCCL and SCCO by means of histopathological examination alone. All MCC (25) stained with cytokeratin CAM 5.2, 20 of which in a "paranuclear globular" or combined "paranuclear globular"/diffuse pattern while 17 MCC stained with cytokeratin AE1/AE3. Cytokeratin CAM 5.2 reacted with 60 percent of the SCCL and 86 percent of the SCCO, and cytokeratin AE1/AE3 with 33 and 28 percent respectively. Neurofilament stained 17 MCC in a "paranuclear globular" pattern but none of the SCCL and SCCO. All MCC with a diffuse staining pattern for cytokeratin CAM 5.2 were negative for neurofilament. The results of this study and review of the literature indicate that in most instances Merkel cell carcinoma can be separated from other SCC, pulmonary as well as extrapulmonary, by means of histopathological and, above all, immunohistochemical examinations.


Introduction of new process technology into the wastewater treatment sector.
Innovative wastewater treatment technologies are developed to respond to changing regulatory requirements, increase efficiency, and enhance sustainability or to reduce capital or operating costs. Drawing from experience of five successful new process introductions from both the inventor/developer's and adopter's viewpoints coupled with the application of marketing analysis tools (an S curve), the phases of new technology market penetration can be identified along with the influence of market drivers, marketing, patents and early adopters. The analysis is used to identify measures that have increased the capture of benefits from new technology introduction. These have included funding by the government for research and demonstrations, transparency of information, and the provision of independent technology evaluations. To reduce the barriers and speed the introduction of new technology, and thereby harvest the full benefits from it, our industry must develop mechanisms for sharing risks and any consequences of failure more broadly than just amongst the early adopters. WEF and WERF will continue to have the central role in providing reliable information networks and independent technology evaluations.


Performance of Barki Lambs Fed on Rations Containing Olive Cake with or Without Polyethylene Glycol.
Olive by-products could be a suitable alternative feedstuffs ingredient in ruminants rations. This study was carried out to evaluate effects of replacing clover hay by olive cake with or without addition of poly ethylene glycol in growing lambs ration. Thirty five Barki lambs averaged 34 kg body weight and 5 months old were divided into 5 groups (7 animals of each) according to live weight for 90 days feeding trial. Olive cake was treated mechanically by hummer mill, screened to produce screening olive cake (treated olive cake, TOC). Data of dry matter and organic matter digestibility were decreased with ration containing 20% TOC from ration or 67% from clover hay comparing with others. No significant differences were observed among groups in crude protein digestibility. Total digestible nutrients (TDN) as an energy measurement for the experimental rations cleared that replacing process of clover hay by TOC up to 20% of DM intake or 67% of clover hay, given lower values (65.32 and 66.80%). The rumen pH values were not affected by the different experimental rations including control. The highest rumen NH3 was recorded with lambs fed ration containing 33% TOC without PEG instead of clover hay, while the lowest values was recorded with that group fed ration containing 33% TOC with PEG. No significant differences were detected in total gain, ADG as well as feed efficiency among the experimental rations. Dry matter intake slightly increased with feeding growing lambs on TOC containing rations except R5 compared to the control group. Summing up partially de-stoned olive cake by screening could be used in replacing clover hay for growing lamb rations, at inclusion levels up to 33 and 67% with or without poly ethylene glycol, with no adverse on performance of growing lambs.


Cigarette smoking in the early course of bipolar disorder: association with ages-at-onset of alcohol and marijuana use.
Despite the high prevalence of smoking among individuals with bipolar disorder, few studies have attempted to identify correlates of smoking status in this group. We examined illness characteristics of bipolar disorder as well as co-occurring alcohol and marijuana use as correlates of cigarette smoking, including the developmental timing of the onset of regular alcohol and cannabis use (i.e., three or more times per week for a month or more). Demographic and clinical characteristics of 134 patients with bipolar I disorder, the majority of whom were adolescents, who were hospitalized for their first manic episode were analyzed to identify correlates of smoking status. A total of 61 (45.5%) of the patients were smokers at the time of their first hospitalization. Smokers were significantly more likely than nonsmokers to report recent use of marijuana (55.7% versus 18.1%) and alcohol (67.2% versus 25.4%). Among those who had ever used marijuana (48.5%) or alcohol (45.5%) regularly, current cigarette smokers reported a significantly earlier age-at-onset of regular use of both substances than reported by nonsmokers. Earlier age-at-onset of marijuana use was the only significant predictor of current smoking in a multivariate analysis. None of the bipolar disorder characteristics examined (i.e., symptom severity, age-at-onset of illness, rapid cycling, and psychosis) were correlated with smoking status. Smoking status in the early course of bipolar disorder is related to both current and past alcohol and marijuana use, but not to characteristics of bipolar illness. Earlier initiation of regular marijuana use is associated with an increased risk of smoking cigarettes.


Shifting Needs and Preferences: Supporting Young Adult Cancer Patients During the Transition from Active Treatment to Survivorship Care.
This study was designed to identify and explore the social support needs and preferences of young adult cancer patients during the transition process from active treatment to survivorship care. Semi-structured qualitative interviews were conducted with study participants (n = 13, ages 17-25 at the time of cancer diagnosis) within ∼6 months of completion of active treatment and again 3 months later. Participants completed a sociodemographic questionnaire at the first study visit. Applied thematic analysis was used to identify themes from participant interviews. Six key themes and 12 subthemes emerged regarding participant interactions with their support system ("Being there," "Staying strong," and "Treat me the same") and health care team ("Connection and relationship building" and "Seeking knowledge and engaging in advocacy"), as well as treatment effects ("Uncertainty, Loss, & Changes in Identity" and "Ups & Downs of Physical Symptoms"), coping strategies ("Keep busy" and "Keep a positive vibe"), support resources ("Support needs change over time"), and post-treatment experiences ("Trying new things to cope with losses" and "Managing expectations with realities"). Study findings suggest that supportive care needs can change during the transition process from active treatment to survivorship care. Young adult life transitions, such as finding employment and making new friendships, are more stressful when complicated by ongoing physical and psychological treatment effects. Social stressors and potential barriers to participation in supportive care services should be discussed openly with patients and caregivers, especially prior to transitions in care.


[Suicidality in mental illness – prevention and therapy].
The great majority of suicides and suicide attempts are related to mental illness. Special risk has been attributed to depression, psychosis, substance use, personality, and trauma-related disorders. Many affected persons seek medical attention prior to taking action. Primary care therefor plays an outstanding role in suicide prevention. Doctors should pay attention to potential risk constellations and actively address the issue. This paper presents possibly helpful models and instruments for everyday use. Most importantly, however, professionals' empathy and time are required as well as appropriate decisions concerning a referral to a psychiatrist or psychiatric inpatient treatment.


The clinical significance of antibody screening test including Dia+ panel cell in Asian-Mongoloid populations.
The Di(a) antigen is well known as one of the antigens with low incidence among Caucasians; however, it has been discovered with a relatively higher incidence among Mongoloid populations. Thus, it has been speculated that the incidence of unexpected antibody against the Di(a) antigen might be relatively higher among these populations. Hemolytic transfusion reactions (HTRs) and hemolytic disease of the newborns (HDNs) caused by anti-Di(a) have been reported sporadically. However, there has been no prospective study on the incidence of anti-Di(a) in Mongoloid populations particularly. The authors conducted a series of antibody screening tests on 11,219 Korean individuals for 25 months, by using three kinds of screening cells including Di(a) cell. Anti-Di(a) was detected in 8 patients, seven of whom had a history of transfusions or were multigravida. The incidence of anti-Di(a) measured in this study was higher than expected, ranked third among unexpected antibodies identified during the period of the study, so it is strongly recommended that the Di(a+) panel cell must be incorporated into antibody screening test for safer transfusion in Asian-Mongoloid populations.


CMS's proposed rule implementing the ACA-mandated Medicaid DSH reductions.
State Medicaid programs make Medicaid disproportionate share hospital (DSH) payments to hospitals to help offset costs of uncompensated care for Medicaid and uninsured patients. Unlike most Medicaid spending, annual DSH allotments for each state are capped. Under the Patient Protection and Affordable Care Act of 2010 (ACA), DSH payments will decrease starting in fiscal year (FY) 2014 and continuing through FY 2020. This paper describes the proposed rule for reducing these federal allotments, which was released on May 15, 2013, by the Centers for Medicare & Medicaid Services (CMS). Comments on the proposed rule are due July 12, 2013.


Effect of valproic acid on body weight, food intake, physical activity and hormones: results of a randomized controlled trial.
The objective of this study was to identify mechanisms through which valproic acid (VPA) causes weight gain. Healthy participants (N = 52) were randomized to VPA or placebo in a double-blind study. Energy intake (EI) was measured in the laboratory at lunch and dinner, and physical activity (PA) was measured with accelerometry. Glucose levels and hormones [Peptide YY(3-36), glucagon-like peptide-1 (GLP-1), leptin, ghrelin, insulin] that regulate EI were measured. Assessments occurred at baseline and week 3. Change from baseline was evaluated with mixed models (alpha = 0.05). Weight significantly increased in the VPA group (+0.49 kg), but not the placebo group. The VPA group increased fast food fats cravings and decreased glucose levels compared with placebo. Change in weight, EI and PA did not differ by group. Within group analyses indicated that the VPA group increased PA, hunger, binge eating, depression and GLP-1. VPA-associated weight gain is not likely due to changes in PA or the gut hormones studied. Although EI did not increase when measured after 3 weeks of treatment, VPA decreased glucose levels and increased motivation to eat; hence, EI might have increased in the short-term. Research testing VPA on short-term (1 week) EI, metabolism, and substrate partitioning is warranted.


Tumor-pH-Responsive Dissociable Albumin-Tamoxifen Nanocomplexes Enabling Efficient Tumor Penetration and Hypoxia Relief for Enhanced Cancer Photodynamic Therapy.
Despite the promises of applying nano-photosensitizers (nano-PSs) for photodynamic therapy (PDT) against cancer, severe tumor hypoxia and limited tumor penetration of nano-PSs would lead to nonoptimized therapeutic outcomes of PDT. Therefore, herein a biocompatible nano-PS is prepared by using tamoxifen (TAM), an anti-estrogen compound, to induce self-assembly of chlorin e6 (Ce6) modified human serum albumin (HSA). The formed HSA-Ce6/TAM nanocomplexes, which are stable under neutral pH with a diameter of ≈130 nm, would be dissociated into individual HSA-Ce6 and TAM molecules under the acidic tumor microenvironment, owing to the pH responsive transition of TAM from hydrophobic to hydrophilic. Upon systemic administration, such HSA-Ce6/TAM nanoparticles exhibit prolonged blood circulation and high accumulation in the tumor, where it would undergo rapid pH responsive dissociation to enable obviously enhanced intratumoral penetration of HSA-Ce6. Furthermore, utilizing the ability of TAM in reducing the oxygen consumption of cancer cells, it is found that HSA-Ce6/TAM after systemic administration could efficiently attenuate the tumor hypoxia status. Those effects acting together lead to remarkably enhanced PDT treatment. This work presents a rather simple approach to fabricate smart nano-PSs with multiple functions integrated into a single system via self-assembly of all-biocompatible components, promising for the next generation cancer PDT.


Further testing of morphometric grading in T(A,1) urothelial carcinomas of the urinary bladder and the additional value of p53 immunoquantitation.
To analyze the value for grading of a previously developed quantitative morphometric/cytometric multivariate grading model (consisting of the mean nuclear area of the 10 largest nuclei (MNA-10, mitotic activity index = MAI and Ki-67 area% = Ki-67) in two new independent test sets of urothelial carcinomas (UCs) of the urinary bladder and to evaluate the additional value of p53 area% (p53) in this model. Ki-67 immunoquantitation, morphometric MAI and MNA-10 assessments using a previously described, strict protocol and matching of the resulting morphometric grade with subjective grade in two test sets of 154 T(A,1) UCs of the bladder (consensus grade between two independent observers). Further testing of this morphometric grading model was performed in 57 cases that lacked initial interobserver agreement on grade. Single and multivariate analysis of all features (including p53) was performed. With the previously developed morphometric/cytometric grading model, 93% (grade 1 vs. 2) and 91% (grade 2 vs. 3) of the consensus cases were correctly classified. These percentages were very similar to previous results, suggesting that the model is robust. Of the 57 cases that lacked initial interobserver agreement on grade, 53/57 (93%) were classified unambiguously as grade 1, 2 or 3 with the quantitative morphometric/ cytometric grading model. In the exploratory analysis, p53 was significant but with more overlap than the other features had. In multivariate analysis p53 did not improve the overall classification result of the original morphometric/cytometric model. The value of MNA-10, MAI and Ki-67 for grading in T(A,1) urothelial carcinomas of the urinary bladder was confirmed. p53 Did not improve overall grading classification of this combination.