Biomaterials with permanent hydrophilic surfaces and low protein adsorption properties.
Low protein adsorbing polymer films have been prepared with which to fabricate intravenous containers, designed for compatibility with low concentrations of protein drugs. The material is economically manufactured utilizing physical melt blending of water-soluble surface-modifying polymers (PEO, PEOX, PVA, and PNVP) with a base polymer (EVA, PP, PETG, PMMA, SB, and nylon). Permanency of the hydrophilic surfaces so generated was confirmed by surface contact angle experiments and total organic carbon leachables analysis of the aqueous contacting solutions. Binding of IgG, albumin and insulin was studied. A sixfold reduction of protein adsorption was obtained by adding 5% PVA13K to EVA, for IgG at a bulk concentration of 2.5 ppm. Surface bound protein measured by micro-BCA colorimetry, agreed with the solution protein lost, as determined by the Fluoraldehyde procedure. Imaging of the protein exposed plastic surfaces by silver enhanced protein conjugated gold staining agreed with the quantitative assay determinations.


(1R*,11R*)-Bicyclo[9.4.1]hexadecane-12,16-dione.
The title compound, C(16)H(26)O(2), (I), prepared by oxidation of (1R*,11R*)-12-hydroxybicyclo[9.4.1]hexadecan-16-one using pyridinium dichromate, has a trans configuration of the two fused rings and represents an interesting precursor for the synthesis of macrocyclic structures.


Lead encephalopathy: CT and MR findings.
Lead is toxic to many organ systems, among them bone marrow, muscles, kidneys, endocrine glands, joints, and nervous system. Encephalopathy is a rare but severe complication of lead poisoning. Lead toxicity is much less common in adults. Adult lead poisoning results primarily from exposure by inhalation in the workplace. In this report, two cases of adult toxic encephalopathy due to lead poisoning are presented with CT and MR findings.


Urogenital syndromes and spondarthritis.
During the last 50 years there has been an obvious change in the relationship between Reiter's syndrome and spondarthritis, probably due to the introduction of antibiotics. Postgonorrhoeic prostatovesiculitis was formerly common: Romanus' spondylitics in the 1940s had a history of gonorrhoea in 35% of cases and 50% of my patients with chronic uro-arthritis in the 1950s had had gonorrhoea. Urogenital syndromes nowadays rarely develop into ankylosing spondylitis; on the other hand, sacroiliitis is still a rather common late sequela, especially in females, however often asymptomatic. The HLA-B27 tissue type is much less frequent in the urogenital syndromes than in ankylosing spondylitis. Accordingly one may postulate that patients with HLA-B27 negative sacroiliitis run a small risk that the disease will progress to ankylosing spondylitis.


Macromolecular Architecture-Dependent Polymorphous Crystallization Behavior of PVDF in the PVDF/γ-BL System via Thermally Induced Phase Separation.
This study investigates the effect of the macromolecular architecture of poly(vinylidene fluoride) (PVDF) on its thermally induced phase separation (TIPS) behavior and polymorphic crystallization in the PVDF/γ-butyrolactone (PVDF/γ-BL) system. Preparative PVDF fractions with specific macromolecular architecture and phase constitution are generated. The results show that PVDF's macromolecular architecture, particularly the degree of branching and regio-defects, plays a significant role in its temperature-dependent crystallization and resulting polymorphic phases. While regio-defects dominate crystallization in the temperature range between 30 and 25 °C, the degree of branching becomes decisive in the 25-20 °C interval. The developed fractions of PVDF are further analyzed in terms of their molecular weight distribution, revealing that the PVDF fractions crystallized out of solution have similar molecular weight distributions with lower dispersity compared with the feed polymer. These findings are crucial for macromolecular separation and adjustment of PVDF polymorphic properties and hence for the development of tailor-made PVDF matrix materials for composites and membranes. The findings suggest the possibility of polymorphous phase tailoring of PVDF based on macromolecular architecture due to temperature-controlled crystallization out of solution and strongly motivate further research to reveal deeper knowledge of regio-defect and branching influence of PVDF solution crystallization.


Effects of condensed tannin fractions of different molecular weights from a Leucaena leucocephala hybrid on in vitro methane production and rumen fermentation.
Molecular weights (MWs) and their chemical structures are the primary factors determining the influence of condensed tannins (CTs) on animal nutrition and methane (CH4 ) production in ruminants. In this study the MWs of five CT fractions from Leucaena leucocephala hybrid-Rendang (LLR) were determined and the CT fractions were investigated for their effects on CH4 production and rumen fermentation. The number-average molecular weight (Mn ) of fraction F1 (1265.8 Da), which was eluted first, was the highest, followed by those of fractions F2 (1028.6 Da), F3 (652.2 Da), F4 (562.2 Da) and F5 (469.6 Da). The total gas (mL g(-1) dry matter (DM)) and CH4 production decreased significantly (P < 0.05) with increasing MWs of the CT fractions, but there were no significant (P > 0.05) differences between the CT fractions and control on DM degradation. However, the in vitro N disappearance decreased significantly (P < 0.05) with the inclusion of CT fraction F1 (highest MW) compared with the control and other fractions (F2-F5). The inclusion of CT fraction F1 also significantly decreased (P < 0.05) total volatile fatty acid and acetic acid concentrations compared with the control. The acetic/propionic acid ratio was significantly decreased (P < 0.05) by fraction F1 but not by the control and other fractions (F2-F5). The CT fractions of different MWs from LLR could affect rumen fermentation and CH4 production, and the impact was more pronounced for the CT fraction with a higher MW.


[Gender composition in the medical profession in Europe. Social implications and criticalities.]
In the last twenty years there has been an increase in the proportion of women practicing the medical profession which has occurred in parallel with the increase in participation of women in the scientific professions. Italy has a stable percentage of women at 40% in 2016 compared to 60% in the Baltic countries, Romania and Croatia (1). This increase in the total number obtained did not automatically guarantee women doctors the right to access the roles of leaders and fair economic consideration in all the European countries analyzed. All this affects the quality of life of women and the authority of the knowledge expressed by them, with consequent implications on the economic and social context.


Hydrazino-methoxy-1,3,5-triazine Derivatives' Excellent Corrosion Organic Inhibitors of Steel in Acidic Chloride Solution.
The corrosion inhibition performance of 2-hydrazino-4,6-dimethoxy-1,3,5-tirazine (DMeHT), 2,4-dihydrazino-6-methoxy-1,3,5-triaizine (DHMeT), and 2,4,6-tridydrazino-1,3,5-triaizne (TH₃) on steel corrosion in acidic media was examined using electrochemical techniques. The results showed 2,4-Ddihydrazino-6-methoxy-1,3,5-triaizine (DHMeT) gave the best corrosion protection performance among the other hydrazino derivatives even at a low concentration of 25 ppm (95%). The number of hydrazino groups play an important role in the corrosion inhibition, where the two hydrazine groups increased the electrostatic interactions between the protonated tested compounds, the negatively charged steel surface resulted from the adsorption of the chloride anions, and the presence of the methoxy group made the compound more reliable for formation of film protection on the surface of steel through the lone pair of oxygen atoms. Electrochemical Impedance Spectroscopy (EIS) measurements suggested that the corrosion process of steel in presence of the hydrazino-s-triazine derivatives (TH₃, DMeHT and DHMeT) were being controlled by the charge transfer reaction. Polarization curves indicated that the examined TH₃, DMeHT and DHMeT behaved as mixed type inhibitors.


Management Experiences of Post-Gastrectomy Severe Alkaline Reflux Esophagitis.
Alkaline reflux esophagitis is a recognized complication of procedures that compromise the lower esophageal sphincter (LES), including gastrectomy. Incidence of reflux is dependent on the reconstructive procedure, with Roux-en-Y (RY) esophagojejunostomy commonly accepted as the optimal method. The authors report their experience of 5 patients who underwent remedial intervention for severe alkaline reflux esophagitis following gastric cancer surgery, over a 6-year period (2014-2020). Primary diagnoses encompassed 4 gastric adenocarcinomas and 1 gastric neuroendocrine tumor. Four patients previously underwent total gastrectomy and 1 subtotal gastrectomy with RY reconstruction. Onset of postoperative reflux symptoms ranged from 2 weeks to 3 years. Failing medical management, all patients underwent jejunojejunal anastomosis and Roux limb length revision with surgical jejunostomy. At follow-up, 4 out of 5 patients had some degree of symptom resolution and one with unresolved symptoms. The authors report our experience of managing this complication following gastrectomy with jejunojejunal anastomosis and Roux limb length revision.


[Trends in indication of selected laboratory methods by general practitioners].
The indication of laboratory methods in general practice is significantly influenced by practical guidelines and protocols for preventive care. The financial regulation pushes on rationalisation of the use of laboratory methods. Point of care testing is more and more important in prevention, diagnostics and follow up in primary care settings.Based on the data available from Škoda Insurance Company authors aimed to describe trends in induction and cost of laboratory methods, the most frequent methods used in primary care and trends in the use of POCT methods within general practice.The expenditures for laboratory methods in general practice are stable for a long term and suggest a rational behaviour of general practitioners. The most frequently indicated methods in general practice are glycaemia, ALT and AST. From expensive methods the most frequent are PSA, troponin and tumormarkers. The number of general practices performing POCT methods and also the number of POCT examinations increase. More than one half of INR examinations and nearly half of all CRP examinations are performed in POCT regime. laboratory methods, clinical biochemistry, general practitioner, primary care, POCT.


Depression and anxiety in relation to catechol-O-methyltransferase Val158Met genotype in the general population: the Nord-Trøndelag Health Study (HUNT).
The catechol-O-methyltransferase (COMT) gene contains a functional polymorphism, Val158Met, which has been linked to anxiety and depression, but previous results are not conclusive. The aim of the present study was to examine the relationship between the Val158Met COMT gene polymorphism and anxiety and depression measured by the Hospital Anxiety and Depression Scale (HADS) in the general adult population. In the Nord-Trøndelag Health Study (HUNT) the association between the Val158Met polymorphism and anxiety and depression was evaluated in a random sample of 5531 individuals. Two different cut off scores (> or = 8 and > or = 11) were used to identify cases with anxiety (HADS-A) and depression (HADS-D), whereas controls had HADS-A <8 and HADS-D <8. The COMT genotype distribution was similar between controls and individuals in the groups with anxiety and depression using cut-off scores of > or = 8. When utilizing the alternative cut-off score HADS-D > or = 11, Met/Met genotype and Met allele were less common among men with depression compared to the controls (genotype: p = 0.017, allele: p = 0.006). In the multivariate analysis, adjusting for age and heart disease, depression (HADS-D > or = 11) was less likely among men with the Met/Met genotype than among men with the Val/Val genotype (OR = 0.37, 95% CI = 0.18-0.76). In this population-based study, no clear association between the Val158Met polymorphism and depression and anxiety was revealed. The Met/Met genotype was less likely among men with depression defined as HADS-D > or = 11, but this may be an incidental finding.


Boston Children׳s Hospital Cardiovascular Program.
The Cardiovascular program at Boston Children's Hospital has been characterized as a "great institution" by the editors. This designation is the result of a commitment to innovation interdisciplinary collaboration, rigorous review of results and continuous self-improvement, training the next generation, and an ability to "get the right people on the bus".


Influence of exercise amount and intensity on long-term weight loss maintenance and skeletal muscle mitochondrial ROS production in humans.
Sustaining a weight loss after a lifestyle intervention is challenging. The objective of the present study was to investigate if mitochondrial function is associated with the ability to maintain a weight loss. Sixty-eight former participants in an 11-12-week lifestyle intervention were recruited into 2 groups; weight loss maintenance (WLM; body mass index (BMI): 32 ± 1 kg/m2) and weight regain (WR; BMI: 43 ± 2 kg/m2) based on weight loss measured at a follow-up visit (WLM: 4.8 ± 0.4; WR: 7.6 ± 0.8 years after lifestyle intervention). Maximal oxygen consumption rate, physical activity level, and blood and muscle samples were obtained at the follow-up experiment. Mitochondrial respiratory capacity and reactive oxygen species (ROS) production were measured. Fasting blood samples were used to calculate glucose homeostasis index. WR had impaired glucose homeostasis and decreased maximal oxygen uptake and physical activity level compared with WLM. The decreased physical activity in WR was due to a lower activity level at vigorous and moderate intensities. Mitochondrial respiratory capacity and citrate synthase (CS) activity was higher in WLM, but intrinsic mitochondrial respiratory capacity (mitochondrial respiratory capacity corrected for mitochondrial content (CS activity)) was similar. ROS production was higher in WR compared with WLM, which was accompanied by a decreased content of antioxidant proteins in WR. Intrinsic mitochondrial respiratory capacity in skeletal muscle is not associated with the ability to maintain a long-term weight loss. WLM had a higher maximal oxygen uptake, physical activity level, mitochondrial respiratory capacity and CS activity compared with WR. The reduced glucose tolerance was concurrent with increased ROS production per mitochondria in WR, and could also be associated with the lower physical activity level in this group.


Assessing the global Alfvén wave power flow into and out of the auroral acceleration region during geomagnetic storms.
Geomagnetic storms are large space weather events with potentially tremendous societal implications. During these storms, the transfer of energy from the solar wind into geospace is largely increased, leading to enhanced energy flow and deposition within the magnetosphere and ionosphere. While various energy forms participate, the rate of total Alfvén wave energy flowing into the auroral acceleration region-where the magnetosphere and ionosphere couple-has not been quantified. Here, we report a fourfold increase in hemispherical Alfvénic power (from 2.59 to 10.05 GW) over a largely expanded oval band covering all longitudes and latitudes between 50° and 85° during the main storm phase compared with nonstorm periods. The Poynting flux associated with individual Alfvén waves reached values of up to about 0.5 W/m2 (mapped to ionospheric altitude). These results demonstrate that Alfvén waves are an important component of geomagnetic storms and associated energy flow into the auroral acceleration region.


Cancer Recurrence and Regional Anesthesia: The Theories, the Data, and the Future in Outcomes.
More than one million people each year in the United States are diagnosed with cancer. Surgery is considered curative, but the perioperative phase represents a vulnerable period for residual disease to spread. Regional anesthesia has been proposed to reduce the incidence of recurrence by attenuating the sympathetic nervous system's response during surgery, reducing opioid requirements thus diminishing their immunosuppressant effects, and providing antitumor and anti-inflammatory effects directly through systemic local anesthetic action. In this article, we present a description of the perioperative period, a summary of the proposed hypotheses and available literature on the effects of regional anesthesia on cancer recurrence, and put regional anesthesia in context in regard to its potential role in reducing cancer recurrence during the perioperative period. A literature review was conducted through PubMed by examining the following topics: effects of surgery on tumor progression, roles of multiple perioperative variables (analgesics, hypothermia, blood transfusion, beta-blockade) in cancer recurrence, and available in vitro, animal, and human studies regarding the effects of regional anesthesia on cancer recurrence. in vitro, animal and human retrospective studies suppport the hypothesis that in certain types of cancer, regional anesthesia may be associated with lower recurrence rates. A few well-planned human randomized clinical trials are currently under way that may provide more solid evidence to substantiate or refute the benefits of regional anesthesia in reducing cancer recurrence. The benefits of regional anesthesia in reducing cancer recurrence have a sound theoretical basis and, in certain cancers, are supported by the existing body of literature. This article outlines the current state of our knowledge on the relationship between cancer progression and regional analgesia.


[Echocardiography and Doppler echocardiography in mitral valve stenosis. A review].
One- and two-dimensional echocardiography are the most reliable methods of detecting mitral stenosis. Planimetry of the mitral valve area allows a reliable assessment of the degree of stenosis in 75% of all patients. Doppler echocardiography offers the possibility of measuring the transmitral pressure gradient and to determine pressure half-time, from which the mitral valve area can be calculated. The transmitral pressure gradient, however, undergoes considerable day-to-day variations and therefore its value for quantification is limited. The pressure half-time and planimetry of the mitral valve area are supplementary methods, for they allow the determination of the functional and the anatomic mitral valve area. These combined techniques allow a reliable quantification of the degree of mitral stenosis in about 90% of all patients. Doppler and color-coded Doppler echocardiography are sensitive tools in detecting accompanying disorders as mitral and aortic regurgitation or aortic stenosis. Subsequent disorders of mitral stenosis such as pulmonary hypertension or relative tricuspid incompetence can be assessed. In selected cases mitral valve surgery may be performed without prior catheterization.


[The development of a Nursing Research Agenda for Pediatrics for the years 2007 to 2017 as an integrative part of the national "Swiss Research Agenda"-project].
In the German-speaking part of Europe research in the pediatric field has been dominated by research with a biomedical focus. Nursing research investigating and evaluating the treatment and care process in the pediatric field has been marginal and, in the last decades, provided little evidence to enhance the development of specific criteria for nursing sensitive outcomes in this patient population. This fact is all the more problematic as the linear transfer of evidence from nursing research in the adult care setting is not feasible, i.e. the pediatric population has unique needs which are different from those of adults. Given that 22% of the Swiss population are children and adolescents up to 19 years, there is an urgent need for developing interdisciplinary nursing research projects in order to promote research which is oriented towards a bio-psychosocial model. Such research will provide the evidence needed to enhance the general well-being of children and adolescents with acute and chronic diseases as well as the well-being of their parents. To date, there has been no nursing research agenda based on the literature and on expert opinion in the pediatric field in Switzerland. This report aims to bridge this gap: it presents suggestions for a nursing research agenda in the pediatric field for the time from 2007 to 2017. Three research priorities emerged from the development process of the present agenda: 1) Evaluation of the effectiveness of nursing interventions, 2) Conceptualization and evaluation of practical impacts of family systems on the treatment process of children, 3) Research-based development of new nursing care services in a changing health care system. This report was developed in the context of the national project, "Swiss Research Agenda for Nursing". The presented agenda can be used as a basis for discussions on the strategic direction and for the development of an action plan to promote nursing research in the pediatric field in Switzerland.


Giant cell arteritis: a closer look at its ophthalmological manifestations.
Giant cell arteritis with ocular involvement is an ocular emergency. Arteritic anterior ischaemic optic neuropathy (AAION) is the most common ophthalmological manifestation associated with this disease. Visual loss is usually permanent with rare cases showing visual recovery. Visual improvement, if it occurs, is generally limited, and the visual field defects are persistent and severe. The main goal of AAION treatment is the preservation of vision in the fellow eye. In patients with neurophthalmological manifestations, high-dose corticosteroids should be initiated immediately and aggressively, and maintained thereafter. We present a case of AAION and severe vision loss where significant visual recovery was seen after treatment.


The effectiveness of cardiac telerehabilitation in comparison to centre-based cardiac rehabilitation programmes: A literature review.
Cardiac rehabilitation (CR) is an effective, yet under-utilised, form of secondary prevention in cardiac patients. Telemedicine is one method of overcoming barriers to accessing CR. Previous systematic reviews highlight variation in the effectiveness of telerehabilitation programmes and current literature lacks identification of which telemedicine interventions are most effective, despite differences in the results of primary studies. The objectives of this literature review were to: evaluate the effectiveness of cardiac telerehabilitation compared to centre-based programmes for managing cardiac risk factors, satisfaction and adherence in cardiac patients; identify the technologies used to deliver CR; identify the key components of effective interventions. A literature search was conducted using MEDLINE, EMBASE and Scopus. Randomised controlled trials (RCTs) involving an intervention group that received telerehabilitation and a control group that attended a CR centre were included. Twelve RCTs met the inclusion criteria. There is evidence to suggest that telerehabilitation programmes have similar effectiveness to centre-based CR. Phones were the most commonly used technology. Most studies used a combination of technologies including personal computers and self-monitoring equipment. Phase III telerehabilitation programmes using self-monitoring, motivational feedback and education were more effective than centre-based CR for increasing physical activity and functional capacity. Cardiac telerehabilitation is delivered by a range of technologies and has a similar effectiveness to centre-based programmes. While evidence suggests that additional health benefits are seen in patients who receive a telemedicine intervention in Phase III of CR, further evidence would be required to confidently draw this conclusion.


Subdural Empyema Caused by Neisseria meningitidis: A Case Report and Review of the Literature.
Subdural empyema complicating meningococcal meningitis is rare. We describe a case and 14 previously reported cases; all had persistent fever and 12 had seizures. Initial cerebrospinal fluid showed raised protein with low glucose values. Neuroimaging confirmed the diagnosis in all cases where undertaken. Ten children had neurosurgical intervention. Clinical outcome was available in 14 cases; a full recovery was reported in 10 and 1 child died.


Sydenham's chorea: a case showing reversible striatal abnormalities on CT and MRI.
Sydenham's chorea has not previously been associated with abnormal findings on CT scan, but there have been reports of abnormal MRI in affected patients. The authors describe a case of Sydenham's chorea in which striatal abnormalities were found on both CT and MRI. Repeat MRI when the patient's illness had resolved was virtually normal. This suggests that abnormal imaging is entirely compatible with a diagnosis of Sydenham's chorea in a patient with an appropriate clinical history. Resolution of such abnormalities on repeat scanning provides further support for the diagnosis.


Antiangiogenic therapy: targeting vascular endothelial growth factor and its receptors.
Angiogenesis is an important natural process occurring in the body, both in health and in infirmity, that is controlled by angiogenesis-stimulating growth factors and angiogenesis inhibitors. Uncontrolled angiogenesis in a tumor can result in both tumor growth and metastasis. Vascular endothelial growth factor (VEGF) and VEGF receptors (VEGFRs) are major players in many human malignancies and contribute directly to disease outcome. There is compelling evidence indicating that the beneficial effects of VEGF and VEGFR can be targeted as antiangiogenic therapy. Many of the agents have shown promising results in cell culture preclinical and animal models. Some of these agents have been tested in clinical trials as well. This review discusses the clinical significance of VEGF/VEGFR in human cancer, summarizes the more recent progress in the field, and further emphasizes the current development of agents that block VEGFR/VEGFR as angiogenesis inhibitors and the therapeutic significance of these agents in clinical trials.


Enhanced sampling of 2D interference patterns.
We propose a simple analysis to improve the resolution of interference patterns which consist of straight fringes. As the pattern is rotated with respect to the detector, each row or column in the camera perceives it in a slightly shifted manner. We support this proposed method by analyzing both simulated and experimental interference patterns, and verify it using an interferogram obtained from a spectrally complex light source. The results imply that this technique could be implemented in different aspects of image analysis common in many fields in physics.


[Control of infection in the odontostomatologic field. Possibility of decontamination of critical surfaces].
After a brief description of the sources and procedures of transmission of infections in the odontostomatological field, the Authors illustrate the degree of contamination of a range of surfaces presented by odontological instruments. This is followed by a description of the possibility of a disinfecting treatment using two products one based on iodoform and the other on quaternary ammonium. Prior to this disinfection treatment, the surfaces examined presented a level of microbial contamination (according to the Griffiths scale) for the most part defined as "acceptable with certain reservations" or as "unacceptable", with the almost constant finding of Staphylococci (S. Haemolyticus, aureus, hominis and cohnii) and very frequently of Acinetobacter calcoaceticus, as well as various types of Pseudomonas (Ps. cepacea, maltophilia, and aeruginosa). The disinfection treatment carried out on these same surfaces had a positive effect, leading to a reduction in microbial findings of at least 98% both using energetic disinfectants based on iodoform products, and also milder disinfectants based on quaternary ammonium. Accordingly since both substances used almost constantly reduced the microbial presence despite the different disinfecting action involved, the Authors conclude that not only the use of specific substances but even the mere action of mechanical cleaning may play a fundamental role in the decontamination of surfaces.


Reactivation of a hematopoietic endocrine program of pregnancy contributes to recovery from thrombocytopenia.
Regulation of blood platelet levels involves an array of cytokines, including the placental hormone PRL-like protein E (PLP-E). The PLP-E receptor is present on megakaryocytes in pregnant mice, nonpregnant female mice, and male mice. Other known megakaryocytic cytokines do not share the PLP-E receptor, and thus the presence of this receptor in nonpregnant animals suggests that PLP-E may be expressed in tissues other than the placenta. Consistent with this prediction, PLP-E is produced in thrombocytopenic mouse bone marrow, primarily in granulocytes, but not in normal mouse bone marrow. Serum from thrombocytopenic mice, purified thrombopoietin or IL-6, or pregnancy can induce bone marrow cell expression of PLP-E. The induction of PLP-E gene expression in response to thrombocytopenia is physiologically significant, as injection of PLP-E into thrombocytopenic mice restores normal platelet levels with no effect on granulocytes, erythrocytes, and total white blood cell counts. We conclude that inducible expression of PLP-E in bone marrow is part of the mechanism of recovery from thrombocytopenia. These results also suggest a more general concept: that the endocrine program of pregnancy, which in mammals has evolved to support the intrauterine growth and development of the fetus, can also be harnessed to respond to pathophysiology.


Biological aspects of human migration and mobility.
This paper reviews how migration, both geographical and social, impacts on variation in some human biological traits. Migration and mobility are considered in relation to anthropometric traits and indices, psychometric traits, health, disease and nutrition, temperature regulation and metabolism, mental health and gene flow. It is well known that migration is important in disease transmission but, as this paper demonstrates, migration can have both positive and negative impacts on both donor and recipient populations for a wide range of human traits.


Iodine-Mediated C2,3-H Aminoheteroarylation of Indoles.
A metal-free one-pot oxidative cross-dehydrogenation coupling reaction for the formation of C-N/C-C bonds at the C2,3-positions of indoles with azoles and quinoxalinones has been developed. The proposed method has several notable features, including metal-free catalysis, the use of N-H free indoles as substrates, ease of operation, mild reaction conditions, and compatibility with a wide range of substrates.


Effects of phenytoin and valproic acid on cognitive functions of Thai epileptic patients: a pilot study.
Effects of valproic acid (VPA) and phenytoin (PHT), as monotherapy, on cognitive functions and mood of Thai epileptic patients were investigated. Thai Mental Status Examination (TMSE) and Alcohol Use Disorder Identification Test (AUDIT) were used to screen for eligible subjects. Cognitive performance was assessed by neuropsychological tests including Stroop Color Word Test (SCWT), Wechsler Abbreviated Scale of Intelligence (WASI) test, Profiles of Mood States (POMS) and Adverse Event Profiles (AEP). Thirty epileptic patients, 15 taking PHT and 15 taking VPA, and 15 age and sex matched normal comparators were enrolled. In contrast to the effects of VPA, a statistically significant difference in T-score of WASl similarities and WASI-matrix reasoning subtests was observed between PHT and normal comparator group indicating poorer performance in intellectualfunctioning especially in executive function of the brain in patients taking PHT Vigor is the only mood dimension that demonstrated significant difference between epileptic patients and normal comparators. VPA appears to be more appropriate than PHT when executive brain function is mostly concerned, however, further investigation is needed to gain better insight into the effects of AEDs on cognitive domain of the Thai epileptic patients.


Noradrenergic Hypothesis Linking Neurodegeneration-Based Cognitive Decline and Astroglia.
In the past, manipulation of the cholinergic system was seen as the most likely therapeutic for neurodegeneration-based cognitive decline in Alzheimer's disease (AD) (Whitehouse et al., 1982). However, targeting the noradrenergic system also seems a promising strategy, since more recent studies revealed that in post-mortem tissue from patients with AD and other neurodegenerative disorders there is a robust correlation between cognitive decline and loss of neurons from the Locus coeruleus (LC), a system with diffuse noradrenaline (NA) innervation in the central nervous system (CNS). Therefore, the hypothesis has been considered that increasing NA signaling in the CNS will prevent, or at least halt the progression of neurodegeneration and cognitive decline. A hallmark of the age- and neurodegeneration-related cognitive decline is reduced neurogenesis. We here discuss noradrenergic dysfunction in AD-related cognitive decline in humans and its potential involvement in AD pathology and disease progression. We also focus on animal models to allow the validation of the noradrenergic hypothesis of AD, including those based upon the immunotoxin-mediated ablation of LC based on saporin, a protein synthesis interfering agent, which offers selective and graded demise of LC neurons, Finally, we address how astrocytes, an abundant and functionally heterogeneous cell type of neuroglia maintaining homeostasis, may participate in the regulation of neurogenesis, a new strategy for preventing LC neuron loss.


[Effect of agrochemicals and bio-control productions on soil nematode community dynamics].
Dynamics of soil nematode communities amended with agrochemicals and bio-control preparations were investigated in a soybean field. The results showed that the frequency of plant non-parasitic nematodes were obviously higher in soil amended with bio-control preparations (Doufeng 1) than with urea and herbicide, however, that of plant parasitic nematodes exhibited an inverse trend.


Beta-adrenoceptor stimulation-mediated preconditioning-like cardioprotection in perfused rat hearts.
To determine whether adrenergic stimulation induces preconditioning-like cardioprotection, rat hearts were perfused for 2 min with either norepinephrine, phenylephrine, or isoproterenol followed by 10-min drug-free perfusion. Then the hearts were subjected to 40-min ischemia and 30-min reperfusion. Little recovery of left ventricular developed pressure (LVDP) and loss of the myocardial creatine kinase (CK) during reperfusion were observed in the drug-untreated heart. Preperfusion with norepinephrine (0.25 microM) or isoproterenol (0.25 microM), but not phenylephrine (10 microM), resulted in a better recovery of LVDP in the postischemic reperfused heart and a reduction in CK release during reperfusion. A similar improvement of postischemic cardiac contractile dysfunction and CK loss was seen in the heart subjected to 5-min ischemia followed by 5-min reperfusion (ischemic preconditioning) before the prolonged period of ischemia/reperfusion. Pretreatment with timolol, a beta-adrenoceptor blocker, abolished the protective effect of norepinephrine, whereas pretreatment with bunazosin, an alpha 1-adrenoceptor blocker, did not affect the protective effect of isoproterenol. The results suggest that a brief period of stimulation of cardiac beta-adrenoceptor exerts the preconditioning-mimetic protective effect against postischemic contractile dysfunction in perfused rat hearts.


Laparoscopic management of organic ovarian cysts: is there a place for frozen section diagnosis?
Only benign ovarian cysts can be treated by laparoscopic surgery. Although clinical examination and the results of pre-operative work-up do make a real contribution in indicating the benign or malignant nature of cysts, only histology can provide the absolute diagnosis. In this context, the goal of this study was to establish whether there is any advantage in performing frozen section during laparoscopic surgical management of organic ovarian cysts. Between January 1989 and March 1996, 228 patients underwent an adnexectomy for an ovarian mass. After the pre-operative work-up and the diagnostic phase of laparoscopy, 26 patients (11.4%) presented with suspected signs of malignancy restricted purely to the ovary. These 26 patients underwent a laparoscopic adnexectomy with extraction of the excised tissues using an endoscopic bag, followed by frozen section. For all these patients the results of the frozen section concluded that the lesion was benign. In every case the definitive histological results confirmed the frozen section findings. This strategy enabled us to avoid laparotomy, especially for the nine post-menopausal patients whose adnexal masses appeared to be complex by ultrasound. These encouraging preliminary results need to be confirmed by a larger series of patients, so as to specify the place of frozen section in the laparoscopic surgical management of organic ovarian cysts.


Adiponectin and Cardiovascular Risk. From Pathophysiology to Clinic: Focus on Children and Adolescents.
Adiponectin (Ad) is a cytokine produced by adipocytes that acts on specific receptors of several tissues through autocrine, paracrine, and endocrine signaling mechanisms. Ad is involved in the regulation of cell survival, cell growth, and apoptosis. Furthermore, Ad plays an important pathophysiological role in metabolic activities by acting on peripheral tissues involved in glucose and lipid metabolism such as skeletal muscle, and the liver. Adiponectin has anti-inflammatory, anti-atherogenic, and insulin-sensitizing effects. For this reason, low levels of Ad are associated with the development of cardiovascular complications of obesity in adulthood. Numerous studies have shown that, even in children and adolescents, Ad is associated with risk factors for cardiovascular diseases. In obese children, reduced levels of Ad have been reported and Ad plasma levels are inversely related with abdominal obesity. Moreover, lower Ad concentrations are associated with the development of metabolic syndrome, insulin resistance and hypertension in pediatric subjects. In addition to a higher prevalence of cardiovascular risk factors, plasma values of Ad are also inversely associated with early organ damage, such as an increase in carotid intima-media thickness. It has been suggested that low Ad levels in childhood might predict the development of atherosclerosis in adulthood, suggesting the possibility of using Ad to stratify cardiovascular risk in obese children. Some evidence suggests that lifestyle modification may increase Ad plasma levels. The aim of this review is to summarize the evidence on the relationship between Ad, obesity, metabolic alterations and hypertension in children and adolescents, and to address the possibility that Ad represents an early marker of cardiovascular risk in pediatric subjects. Furthermore, the effects of non-pharmacological treatment (weight loss and physical activity) on Ad levels are considered.


[Lithotripsy in the conservative treatment of salivary stones].
Otolaryngologists and generalists as well are commonly involved in the evaluation and management of salivary gland stones. Most patients present with a history of recurrent swelling and pain in the gland, associated with eating. Up to date conservative therapy was limited to the treatment of the acute sialadenitis, which may develop as a consequence of the obstruction and often recurs until the function of the salivary gland ceases. Surgical treatment depends on the location of the calculus. Distal stones can be removed trans-orally by dilatation or incision of the duct, whereas those near the hilus and intraglandular stones required excision of the gland, including the disadvantage of a scar and the risk of injury to cranial nerves. Extracorporal shock wave lithotripsy is a new noninvasive method, which allows to destroy intra- and extraglandular salivary stones, mostly without the need of local or general anesthesia. Reported disintegration rates vary from 14% to 85%, depending on site and size of the calculus. About 80% of the patients remain symptomless Lithotripsy of salivary stones is a cost-effective, additional treatment modality to surgery and may be employed on an outpatient basis.


Factors related to early mortality after transjugular intrahepatic portosystemic shunt for failed endoscopic therapy in acute variceal bleeding.
Uncontrolled variceal haemorrhage is the main indication for transjugular intrahepatic portosystemic shunt. However, mortality is 50% for this high-risk group. We have evaluated clinical and laboratory variables prior to transjugular intrahepatic portosystemic shunt in order to establish predictors of mortality, validated prospectively. Over a 4-year period, 367 patients were admitted with variceal bleeding. In 54 patients endoscopic therapy for acute variceal bleeding failed and they had emergency transjugular intrahepatic portosystemic shunt. Failure of therapy was defined as continued bleeding after 2 endoscopy sessions (n=39) or vasoconstrictor-resistant bleeding from gastric/ectopic varices (n=15). Thirty-three variables were analysed from data available immediately prior to transjugular intrahepatic portosystemic shunt. Twenty-six patients died within 6 weeks. In a multivariate analysis, 6 factors had independent prognostic value: moderate/severe ascites, requirement for ventilation, white cell blood count (WBC), platelet count (PLT), partial thromboplastin time with kaolin (PTTK) and creatinine. A prognostic index (PI) score was derived, in which presence of moderate/severe ascites, or need for ventilation, scored 1: PI=1.54 (Ascites)+1.27 (Ventilation)+1.38 Ln (WBC)+2.48 ln (PTTK)+1.55 Ln (Creat)-1.05 Ln (PLT). Using this equation, 42% (n=10) of deaths occurred in the fifth quintile (PI > or = 18.52), where the mortality was 100%. The score was prospectively validated in a further 31 patients, giving 100% positive predictive value. Eleven further patients died, including all seven with a PI >18.5. No survivors had a PI >18.3. Despite immediate control of bleeding by transjugular intrahepatic portosystemic shunt, patients with uncontrolled variceal haemorrhage have a high mortality, particularly when associated with markers of advanced liver disease, sepsis and multi-organ failure. The use of transjugular intrahepatic portosystemic shunt is probably not justified in this subgroup. Our prognostic index can help identify such patients, and, if validated elsewhere, will help in deciding when to use transjugular intrahepatic portosystemic shunt.


[The development and the reversion of spheroplasts of a diaminopimelic acid-auxotrophic mutant of Escherichia coli].
1. The formation and reversion of spheroplasts of the diaminopimelic acid-auxotrophic mutant Escherichia coli K 12, 335, DAP-, R+TEM in a medium lacking diaminopimelic acid have been investigated by microphotography: During their development from rod form cells to spheroplasts cells on slide-surface-agar preparations underwent two successive cell divisions in the course of which the cells retained their rod form. The cells formed by these divisions partitioned into a varying number of spheroplasts of different size. The reversion of spheroplasts to rod form cells, started by the addition of diaminopimelic acid showed two characteristic steps: Each spheroplast partitioned again into several spheroplast-like cell bodies; most of them reverted directly to rod form cells. 2. The release of the R-factor mediated periplasmic TEM-beta-lactamase, E. C. 188.8.131.52., into the growth medium during the development of spheroplasts attained more than 50% of the entire TEM-beta=lactamase activity. The spheroplasts showed a multiple enhancement of TEM-beta-lactamase activity per mg cell protein compared with rod form cells.


Enhanced phagocytosis, killing, and serum sensitivity of Escherichia coli and Staphylococcus aureus treated with sub-MICs of imipenem.
The influence of pretreatment of Escherichia coli and Staphylococcus aureus with sub-MICs of the new beta-lactam antibiotic imipenem on phagocytosis and killing by murine peritoneal macrophages and the susceptibility of these organisms to serum bactericidal activity were studied. The effects of imipenem, a round form inducer in gram-negative rods, and piperacillin, a filamentous form inducer, were compared. Bacteria grown in the presence of sub-MICs of imipenem or piperacillin were incubated for 30 min with macrophage monolayers in the absence of antibiotic. Phagocytosis, killing, and survival within macrophages were evaluated by microbiological and fluorescence microscope assays. Bacteria grown in the presence of a sub-MIC of imipenem were phagocytized and killed in numbers significantly higher than untreated or piperacillin-treated bacteria were. Intracellular bacteria pretreated with a sub-MIC of imipenem were also readily killed by lymphokine-activated macrophages. Prior treatment with a sub-MIC of imipenem resulted in an increased susceptibility of E. coli but not S. aureus to the bactericidal activity of immune serum. Imipenem treatment and immune serum acted synergistically to enhance phagocytosis and killing. The data indicate that exposure of E. coli and S. aureus to a sub-MIC of imipenem enhances the susceptibility of these potential pathogens to cellular and humoral host defense mechanisms.


Pre-clinical pharmacokinetics and anti-chlamydial activity of salicylidene acylhydrazide inhibitors of bacterial type III secretion.
Salicylidene acylhydrazides belong to a class of compounds shown to inhibit bacterial type III secretion (T3S) in pathogenic Gram-negative bacteria. This class of compounds also inhibits growth and replication of Chlamydiae, strict intracellular bacteria that possess a T3S system. In this study a library of 58 salicylidene acylhydrazides was screened to identify inhibitors of Chlamydia growth. Compounds inhibiting growth of both Chlamydia trachomatis and Chlamydophila pneumoniae were tested for cell toxicity and seven compounds were selected for preliminary pharmacokinetic analysis in mice using cassette dosing. Two compounds, ME0177 and ME0192, were further investigated by individual pharmacokinetic analysis. Compound ME0177 had a relatively high peak plasma concentration (C(max)) and area under curve and therefore may be considered for systemic treatment of Chlamydia infections. The other compound, ME0192, had poor pharmacokinetic properties but the highest anti-chlamydial activity in vitro and therefore was tested for topical treatment in a mouse vaginal infection model. ME0192 administered vaginally significantly reduced the infectious burden of C. trachomatis and the number of infected mice.


Antinuclear antibodies in rheumatic disease: a proposal for a function-based classification.
Antinuclear antibodies (ANAs) are a diverse group of autoantibodies that bind macromolecular components of the cell nucleus. While some ANAs occur in normal individuals, others are expressed almost exclusively in patients with rheumatic disease and serve as markers for diagnosis and prognosis. Despite the clinical associations of ANAs, the relationship of these antibodies to specific disease manifestations is often unknown because the target antigens are intracellular molecules that are ubiquitously expressed. In systemic lupus erythematosus, the role of ANAs in disease manifestations is better understood, especially for antibodies to DNA and related nucleosomal antigens. These antibodies can promote nephritis by the formation of immune complexes that are deposited in the kidney. In addition, anti-DNA, along with antibodies to RNA-binding proteins such as anti-Sm, can induce non-specific immune abnormalities based on the induction of type interferon 1 by plasmacytoid dendritic cells. Despite ANA expression in rheumatic disease, studies in animal models of inflammation and tissue injury indicate that antibodies to certain nuclear molecules such as HMGB1 have protective effects. Together, these considerations suggest a function-based classification of ANAs based on their expression in normal and autoimmune individuals as well as their capacity to induce or attenuate immunological disturbances. This classification provides a framework to elucidate the serological features of rheumatic disease and the often uncertain relationship between ANA expression and disease manifestations.


The interactive effects of cerebral perfusion and depression on cognitive function in older adults with heart failure.
Depression is common among persons with heart failure (HF) and has been linked to cognitive impairment in this population. The mechanisms of this relationship are unclear, and the current study examined whether cerebral perfusion moderates the association between depressive symptoms and cognitive impairment in patients with HF. Persons with HF (n = 89; mean [standard deviation] age = 67.61 [11.78] years) completed neuropsychological testing and impedance cardiography. Depressive symptoms were assessed using the Beck Depression Inventory II, and transcranial Doppler was used to quantify cerebral perfusion. Depression was associated with reduced performance on tasks assessing attention/executive function (r = -0.28), language (r = -0.0.30), and motor function (r = -0.28) in unadjusted models (p values <.05). Global cerebral blood flow was correlated with memory performance (r = 0.22, p = .040) but not with other tasks. A moderation analysis was performed using hierarchical regression models for attention/executive function, memory, language, and motor function. For each model, medical and demographic characteristics were entered into the initial blocks, and the final block consisted of an interaction term between global cerebral blood flow velocity and the Beck Depression Inventory II. The interaction between greater depressive symptoms and decreased global cerebral blood flow velocity was associated with greater deficits in attention/executive function (β = .32, ΔR(2) = 0.08, p = .003). Depressive symptoms and cerebral hypoperfusion interact to adversely affect cognitive performance in older adults with HF. Longitudinal studies are needed to clarify this relationship and elucidate subsequent neuropathology.


Toward a useful mass movement.
Psychology has failed to reach its full potential as either a science or a profession. The inability of psychologists to generate a shared, general understanding of their subject matter and fundamental differences between scientific and nonscientific views of human behavior in society at large interact to render psychology's contributions to the world's most pressing problems much less potent than might otherwise be the case. The Tree of Knowledge (ToK) System affords new opportunities both to define the discipline of psychology and to examine the epistemological interrelations between the institution of science and other societal institutions, such as law, governance, health care, the arts, and religion. In this article I articulate how the foundation can be laid for the development of a useful mass movement that could transform the discipline of psychology in a manner that unleashes its constructive potential, while at the same time it attempts to address many of the concerns about the proposal raised by the contributors to these two special issues.


Case report of unexplained hypocalcaemia in a slightly haemolysed sample.
The case presented highlights a common pre-analytical problem identified in the laboratory that was initially missed. It concerns a young, generally healthy adult patient with no significant medical history and no significant family history. They presented with common flu like symptoms to their primary care clinician who considered this was most likely a viral problem that would pass with time. The clinician, however, did some routine bloods to reassure the patient despite a lack of clinical indication. When the sample was analysed the sample was haemolysed with strikingly low calcium. This led to the patient being called into hospital for urgent repeat investigations, all of which turned out to be within normal ranges. On further investigation the original sample was found to be contaminated. This result would normally have been flagged but was missed due to the complication of haemolysis.


An SEM approach to validating the psychological model of musical groove.
In music psychology, the experience of wanting to move in response to music is commonly known as feeling the groove. According to the psychological model of musical groove by Senn et al., the causes for the urge to move are linked to the properties of the music itself, to the personal background of the listener, to the listening situation, and to feedback loops between body movement and cognition. The model formulates eight hypotheses stating that the music affects a listener's urge to move mediated through a variety of cognitive processes. This study develops a method based on structural equation modeling (SEM) to empirically test the model hypotheses. It evaluates five of the model hypotheses using data from an online listening experiment with 135 participants and 16 stylistically diverse musical stimuli (n = 2,160 observations). The SEM model had a good fit with the data (CFI = 0.958, RMSEA = 0.051) and explained a large proportion of the variance in the latent urge to move variable (R² = .737). Results show that music affects the urge to move mediated through listeners' experiences of energetic arousal, listening pleasure, and temporal regularity. The stimuli themselves showed direct effects on the urge to move that were not mediated through the hypothesized mediation pathways. This suggests that the model is incomplete. The current study demonstrates that the mediation structure of the psychological groove model can successfully be implemented using an SEM approach. The methodology may be adapted to investigate different repertoires, populations, and hypotheses in the future. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Pathologic findings in breast, fallopian tube, and ovary specimens in non-BRCA hereditary breast and/or ovarian cancer syndromes: a study of 18 patients with deleterious germline mutations in RAD51C, BARD1, BRIP1, PALB2, MUTYH, or CHEK2.
Germline BRCA mutations account for a significant proportion of genetic/familial risk of breast and ovarian cancer (GBOC) susceptibility, but a broader spectrum of GBOC susceptibility genes has emerged in recent years. Genotype-to-phenotype correlations are known for some established forms of GBOC; however, whether such correlations exist for less common GBOC variants is unclear. We reviewed our institution's experience with non-BRCA GBOC, looking specifically for trends in pathologic and clinical features. Eighteen women with deleterious germline mutations in RAD51C (5 patients), BARD1 (1 patient), BRIP1 (2 patients), PALB2 (3 patients), MUTYH (2 patients), or CHEK2 (5 patients) were identified between January 2011 and December 2016. Thirteen (72%) of 18 patients developed carcinoma of the breast, fallopian tube, or ovary, with 1 patient developing 2 separate primary neoplasms. Twelve (86%) of 14 tumors occurred in the breast. One (7%) arose in the fallopian tube and another (7%) arose in the ovary. Evidence of genotype-phenotype correlation was not identified. However, some data suggest that the type of alteration in select genes may influence tumor behavior and patient outcome. In our PALB2 mutation cohort, 2 patients with frameshift mutations led to early onset and rapid progression to stage IV breast cancer in contrast to stage IA breast cancer in 1 patient with a nonsense mutation. Despite no apparent genotype-phenotype trends, our data indicate that some loss-of-function variants in PALB2 may lead to differences in tumor behavior and patient outcome.


Reorientation time of DNA molecules in pulsed-field gel electrophoresis.
The precise determination of the influence of an electric field strength E on the resolution of DNA molecules during a pulsed-field gel electrophoresis shows that the maximal molecular size Nmax of still resolved DNA molecules is described by the equation Nmax = k tau E alpha, where k is a coefficient, tau is a pulse time, and alpha is an exponent (calculated as approximately 3/2). We assume that the best estimation of the reorientation time tau R for each DNA fragment is such a pulse time in which this DNA molecule is the largest separated one.


The enhancement of TXA2 receptors-mediated contractile response in intrarenal artery dysfunction in type 2 diabetic mice.
Thromboxane A2 (TXA2) has been implicated in the pathogenesis of diabetic vascular complications, although the underlying mechanism remains unclear. The present study investigated the alterations in TXA2 receptor signal transduction in type 2 diabetic renal arteries. The contraction of renal arterial rings in control (db/m+) mice and type 2 diabetic (db/db) mice was measured by a Multi Myograph System. Intracellular calcium concentration ([Ca2+]i) in vascular smooth muscle cells was measured by Fluo-4/AM dye and confocal laser scanning microscopy. Quantitative real-time PCR and Western blot analysis were used to determine gene and protein expression levels, respectively. A stable TXA2 mimic U46619 caused markedly stronger dose-dependent contractions in the renal arteries of db/db mice than in those of db/m+ mice. This response was completely blocked by a TXA2 receptor antagonist GR32191 and significantly inhibited by U73122. U46619-induced vasoconstriction was increased in the presence of nifedipine in db/db mice compared with that in db/m+ mice, whereas the response to U46619 did not differ between the two groups in the presence of SKF96365. Sarcoplasmic reticulum Ca2+ release-mediated and CaCl2-induced contractions did not differ between the two groups. In db/db mice, store-operated Ca2+(SOC) entry-mediated contraction in the renal arteries and SOC entry-mediated Ca2+ influx in smooth muscle cells were significantly increased. And the gene and protein expressions of TXA2 receptors, Orai1 and Stim1 were upregulated in the diabetic renal arteries. Therefore the enhancement of U46619-induced contraction was mediated by the upregulation of TXA2 receptors and downstream signaling in the diabetic renal arteries.


Interactions between polymerized human albumin, hepatitis B surface antigen, and complement: I. Binding of polyalbumin to Clq.
There is considerable evidence that substances other than immunoglobulins can bind human Clq. Utilizing purified human Clq immobilized on polystyrene beads, we have demonstrated that polymerized human albumin (PHALB-125I) binds to human Clq in a direct binding assay. This interaction required a high degree of albumin polymerization as the percentage of binding was proportional to the polymer size and monomeric albumin was unreactive. Binding was species specific in the human Clq bound only human, and not xenogeneic, polyalbumins. Similarly, polymers of various other human plasma proteins were unreactive. To demonstrate that this interaction was not unique to immobilized Clq, soluble Clq was shown to inhibit PHALB-125I binding to solid phase Clq. Because aggregated IgG, poly(I):poly(C), dextran sulfate, polyglutamic acid, and polylysine have been previously shown to bind Clq, we used them in further blocking experiments and found them also to inhibit the interaction between Clq and PHALB. Anti-human Clq and, to a lesser extent, anti-PHALB antibodies inhibited the interaction. The Clq-PHALB binding was pH, ionic strength, and temperature dependent. In addition, human Clq was not observed to bind hepatitis B surface antigen (HBsAg) directly; however, in the presence of sufficiently polymerized human albumin a Clq-PHALB-HBsAg complex was formed. These interactions may be implicated in hepatocyte-HBsAg receptor function as well as in the host defense mechanisms involved in hepatitis B virus infection.


[Specimen carriers for blood sugar determinations].
The use of boric acid-impregnated filter paper has proven to be a useful and reliable means of absorbing capillary blood samples for determining glucose concentration. In this method a circular piece of filter paper (6.36 mm radius) infiltrated with the blood sample is punched out with a commercially available punch, glucose is eluted from the filter paper with a haemolyzing solution and subsequently glucose concentration determined by whatever method is available. Using the hexokinase method, this gives satisfactory precision and unimpaired accuracy. It compared well with the frequently used sampling with capillary tubes, correlating with an r value of 0.9932. The sample, obtained as described, is insensitive to light, temperature, humidity and time interval until measurement. Glucose concentration remains stable under various conditions for at least four weeks.


Clinical characteristics and microbiota of progressing slight chronic periodontitis in adults.
This study sought clinical and microbial risk indicators for progressing slight periodontitis. One hundred and seventeen periodontally healthy or slight periodontitis adults (20-40 years) were monitored clinically at 6-month intervals followed by supragingival cleaning. Inter-proximal sites with >1.5 mm increase in clinical attachment over 18 months were considered disease active. Subgingival plaque was analysed by 78 16S rDNA and 38 whole-genomic DNA probes and by PCR to Porphyromonas gingivalis and Tannerella forsythia. Characteristics were compared between active and inactive subjects. Twenty-two subjects showed disease activity principally at molars. Mean baseline gingival and plaque indices, bleeding on probing, probing depth and clinical attachment level (CAL) were higher in active subjects. DNA probes detected species and not-yet-cultivated phylotypes from chronic periodontitis, although few species were associated with active subjects. By PCR P. gingivalis (p=0.007) and T. forsythia (p=0.075) were detected more frequently during monitoring in active subjects. Stepwise logistic analysis associated baseline levels of gingival index, clinical attachment and bleeding with subsequent clinical attachment loss. Gingivitis and CAL were significantly associated with progressing slight periodontitis in 20--40-year-old adults. Species associated with moderate and advanced chronic periodontitis were detected in slight periodontitis.


Evidence of elevated heavy metals concentrations in wild and farmed sugar kelp (Saccharina latissima) in New England.
Seaweed farming in the United States is gaining significant financial and political support due to prospects to sustainably expand domestic economies with environmentally friendly products. Several networks are seeking appropriate synthesis of available science to both inform policy and substantiate the sector's sustainability claims. Significant knowledge gaps remain regarding seaweed-specific food hazards and their mitigation; a resource-intensive challenge that can inhibit sustainable policies. This is particularly concerning for rapidly expanding Saccharina latissima (sugar kelp) crops, a brown seaweed that is known to accumulate heavy metals linked to food hazards. Here, we present baseline information about concentrations of arsenic, cadmium, lead, and mercury, in both wild and farmed sugar kelp from the New England region. We interpret our findings based on proximity to potential sources of contamination, location on blade, and available heavy metals standards. Contrary to our expectations, high concentrations were widespread in both wild and farmed populations, regardless of proximity to contamination. We find, like others, that cadmium and arsenic consistently reach levels of regulatory concern, and that dried seaweeds could harbor higher concentrations compared to raw products. We also share unique findings that suggest some toxins concentrate at the base of kelp blades. Our results are one step towards aggregating vital data for the region to expand its seaweed farming footprint.


Precision Medicine With Point-of-Care Ultrasound: The Future of Personalized Pediatric Emergency Care.
The Precision Medicine Initiative spearheaded by the National Institute of Health has pioneered a new model of health care focused on health care delivery that is tailored to an individual. Medical advances have already provided clinicians with the tools to better predict treatment outcomes based on the individual needs of each patient's disease process. Three-dimensional printing allows medical devices and implants to be custom made-to-order. Technological advances in preoperative imaging have augmented the ability for surgeons to plan a specific surgical approach for each patient. In a similar vein, point-of-care ultrasound offers the emergency care provider an opportunity to move beyond protocols and provide precise medical care tailored to the acute needs of each ill or injured emergent patient. In this article, we explore several cutting-edge applications of point-of-care ultrasound that can help providers develop a personalized approach to resuscitation and emergent procedures in pediatrics.


Ovarian ornithine decarboxylase regulation in the immature, the pubescent, and the pseudopregnant rat.
Ovarian ornithine decarboxylase (L-ornithine carboxy-lyase, EC 188.8.131.52) regulation was investigated in immature, pubescent, and pseudopregnant rats. After initial induction of the enzyme by injection of lutropin in the immature rat, continued daily injections resulted in a graded decrease in the activity of the enzyme. In the 32-day-old rat, the induction and subsequent decline in enzymic activity after a single injection of lutropin could only be partially reversed by injections of the hormone at 4-hr intervals. This decrease could not be attributed to a decrease in ovarian in vivo uptake of the hormone. In the pseudopregnant rat, ovarian ornithine decarboxylase is highly refractory to induction by either a single injection or repeated injections of lutropin. This refractoriness occurs despite a 2- to 3-fold increase in ovarian in vivo uptake of the hormone compared to that in the 32-day-old rat. It is suggested that the refractoriness observed with all three tissues is a function of cell differentiation.


Intralobar pulmonary sequestration: a masqurader in tuberculosis prevalent population.
Intra pulmonary sequestration is a rare congenital disorder that is characterized by malformation of pulmonary tissue having no connection to normal tracheobronchial tree and pulmonary arteries. This is a case history of 20 years old man initially misdiagnosed as Tuberculosis and later diagnosis of intra-lobar pulmonary sequestration was confirmed. There are few reports of this rare disorder globally and we are reporting the first case of Intrapulmonary Sequestration in Pakistan.


Corneal deturgescence during organ culture.
A simple method is described to monitor rabbit and human corneal deturgescence while the tissue is suspended in tissue culture media. The composition of the media is such that the cornea slowly thickens at 4 degrees but exhibits the classic "temperature reversal" thinning phenomenon when incubated at 23 degrees-37 degrees. Each cornea is cultured in a closed eye bank corneal viewing chamber during swelling and deswelling phases of an experiment, minimizing direct handling of the tissue. Optimal conditions for observing corneal deturgescence are described. This protocol has several advantages over corneal perfusion techniques and could be further developed for routine use in eye banks as a functional test of donor suitability for keratoplasty.


Aesthetic management of traumatized anterior teeth.
The emergency of a traumatically injured tooth occurs frequently in a general dental practice. Patients, staff, and dentist should know what restorative techniques are available to manage the crisis. When the emergency occurs, the patient is probably going to call the dental office. The staff must be prepared for triage of the emergency so that the dentist can plan on the best course of action to manage the clinical circumstance. One method of triaging an emergency caused by traumatic injury to the tooth is by using a short questionnaire that can be completed either by the office staff member taking the telephone call or by the patient if present. This can provide important information for the treatment of the situation. Clinically, the traumatized anterior tooth needs immediate attention. The pulpal status of the tooth needs to be assessed and in the case of tooth or restoration fracture, the circumstances many times dictate an immediate restorative treatment to correct an unaesthetic situation. This article provides the dentist and staff with a variety of restorative techniques that address the aesthetic management of anterior teeth that have been traumatized.


Ultraviolet electroluminescence from ZnO/polymer heterojunction light-emitting diodes.
We report ultraviolet electroluminescence at 390 nm from diode structures consisting of electrodeposited ZnO nanorods sandwiched between a transparent SnO(2) film and a p-type conducting polymer. The nanorods are embedded in an insulating polystyrene layer. ZnO deposition occurs at 90 degrees C and produces vertically oriented nanorods with very high uniformity over areas of approximately 20 cm(2). Electron diffraction shows the nanorods to be single crystalline wurtzite ZnO. As-grown films show a broad electroluminescence band over the visible spectrum. Annealing at moderate temperatures (T = 300 degrees C) increases the emission and strongly raises the excitonic contribution. Optimally processed films show a narrow ultraviolet electroluminescence line at approximately 390 nm.


Effects of oversulfated and fucosylated chondroitin sulfates on coagulation. Challenges for the study of anticoagulant polysaccharides.
We report the effects of a chemically oversulfated chondroitin sulfate and a naturally fucosylated chondroitin sulfate on the coagulation system. The former has been recently identified as a contaminant of heparin preparations and the latter has been proposed as an alternative anticoagulant. The mechanism of action of these polymers on coagulation is complex and target different components of the coagulation system. They have serpin-independent anticoagulant activity, which preponderates in plasma. They also have serpin-dependent anticoagulant activity but differ significantly in the target coagulation protease and preferential serpin. Their anticoagulant effects differ even more markedly when tested as inhibitors of coagulation proteases using plasma as a source of serpins. It is possible that the difference is due to the high availability of fucosylated chondroitin sulfate whereas oversulfated chondroitin sulfate has strong unspecific binding to plasma protein and low availability for the binding to serpins. When tested using a venous thrombosis experimental model, oversulfated chondroitin sulfate is less potent as an antithrombotic agent than fucosylated chondroitin sulfate. These highly sulfated chondroitin sulfates activate factor XII in in vitro assays, based on kallikrein release. However, only fucosylated chondroitin sulfate induces hypotension when intravenously injected into rats. In conclusion, the complexity of the regulatory mechanisms involved in the action of highly sulfated polysaccharides in coagulation requires their analysis by a combination of in vitro and in vivo assays. Our results are relevant due to the urgent need for new anticoagulant drugs or alternative sources of heparin.


Local plasmon resonance at metal wedge.
A local plasmon resonance on a metal wedge is studied by using the Meixner approach [J. Meixner, IEEE Trans. Antennas Propag.AP-20, 442 (1972)]. It is found that the singular field behavior of a local plasmon resonance as a function of the distance from the edge of the wedge is sensitive to the wavelength and wedge angle, and ranges from a dramatic increase in amplitude close to its theoretical limit to pure oscillatory behavior with only minor amplitude variation. Field singularities for gold, silver, and aluminum wedges are calculated. It is shown that, unlike an ideal-conductor wedge, the real part of the power index of the electric field singularity does not decrease monotonically as a function of the wedge angle, but has a minimum for some angle depending on the wavelength and material parameters. If the dielectric surrounding the wedge has a positive permittivity equal to the absolute value of that of the metal, and hence satisfies the plasmon resonance condition, then the electric field has a peculiar behavior for a wedge whose shape is close to the flat surface.


Variations in fat and fatty acid intakes of adult males from three regions of India.
Fat and fatty acid intakes of 25 healthy adult urban males from Ghaziabad, U.P.; Goa and Kolkata, W.Bengal, respectively were studied. Fat intakes were estimated using dietary records, food frequency questionnaires and chemical analysis of the diets consumed. Fatty acid intakes were estimated by gas chromatography. Total fat intakes ranged from 26.9 g/day to 163.2g/ day. Percent subjects having intakes above the desirable level were 72% in Kolkata, 36% in Ghaziabad, U.P. and only 10% in Goa. Visible fat constituted more than 60 percent of total fat. In all 3 areas, SFA intakes were higher and MUFA lower than desirable levels. Palmitic acid constituted at least 50% of SFA intakes. In Goa, lauric acid, in Ghaziabad and Kolkata, stearic acid and myristic acid were major dietary SFAs, In Kolkata, erucic acid was 17.3+/-8.3%. Overall 60% of subjects had n-6:n-3 intakes close to the desirable ratio. Linoleic acid constituted almost the entire n-6 intake. Alpha linolenic acid constituted most of the n-3 intakes in Ghaziabad, U.P. and Kolkata. The ratios of SFA:MUFA--PUFA vaned widely and percent subjects with intakes close to the desirable ratios were 12% in Goa, 23% in Ghaziabad and 40% in Kolkata. The data highlights the need for limiting fat intakes and modifying diets to provide fatty acids in desirable ratios.


Use of δ15N and δ18O Values for Nitrate Source Identification under Irrigated Crops: A Cautionary Vadose Zone Tale.
Source nitrogen (N) identification of leachate or groundwater nitrate is complicated by N source mixing and N and oxygen (O) isotope fractionation caused by microbial N transformations. This experiment examined the δN and δO values in leachate collected over 1 yr at 55 cm below raspberry ( L.) plots receiving either synthetic fertilizer (FT) or poultry manure (MT). The large ranges of δN (FT: -2.4 to +8.7‰, MT: +1.6 to +9.6‰) and δO (FT: -9.9 to -0.3‰, MT: -10.9 to +1.7‰) values in leachate collected under crop rows prohibited the reliable identification of the applied N sources on individual sampling dates. However, the mass-weighted average δN (FT: +3.2‰, MT: +7.3‰) values in leachate were significantly different and can be explained by accounting for the estimated contributions of nitrate and δN values of the various N sources, including applied fertilizer (-0.7‰) or manure (+7.9‰), nitrate-rich irrigation water (+9.0‰), and nitrate from soil N mineralization and nitrification (FT: +3.7‰, MT: +4.6‰; the seasonal timing of which is unknown). This study illustrates the importance of characterizing all major N sources and considering the seasonal variation of these sources and of N cycling processes, as they contribute to the δN values of leachate.


Using algorithms to address trade-offs inherent in predicting recidivism.
Although risk assessment has increasingly been used as a tool to help reform the criminal justice system, some stakeholders are adamantly opposed to using algorithms. The principal concern is that any benefits achieved by safely reducing rates of incarceration will be offset by costs to racial justice claimed to be inherent in the algorithms themselves. But fairness trade-offs are inherent to the task of predicting recidivism, whether the prediction is made by an algorithm or human. Based on a matched sample of 67,784 Black and White federal supervisees assessed with the Post Conviction Risk Assessment, we compared how three alternative strategies for "debiasing" algorithms affect these trade-offs, using arrest for a violent crime as the criterion . These candidate algorithms all strongly predict violent reoffending (areas under the curve = 0.71-72), but vary in their association with race (r = 0.00-0.21) and shift trade-offs between balance in positive predictive value and false-positive rates. Providing algorithms with access to race (rather than omitting race or "blinding" its effects) can maximize calibration and minimize imbalanced error rates. Implications for policymakers with value preferences for efficiency versus equity are discussed.


Coordinate expression of fimbriae in uropathogenic Escherichia coli.
Uropathogenic Escherichia coli is the most common etiological agent of urinary tract infections. Bacteria can often express multiple adhesins during infection in order to favor attachment to specific niches within the urinary tract. We have recently demonstrated that type 1 fimbria, a phase-variable virulence factor involved in adherence, was the most highly expressed adhesin during urinary tract infection. Here, we examine whether the expression of type 1 fimbriae can affect the expression of other adhesins. Type 1 fimbrial phase-locked mutants of E. coli strain CFT073, which harbors genes for numerous adhesins, were employed in this study. CFT073-specific DNA microarray analysis of these strains demonstrates that the expression of type 1 fimbriae coordinately affects the expression of P fimbriae in an inverse manner. This represents evidence for direct communication between genes relating to pathogenesis, perhaps to aid the sequential occupation of different urinary tract tissues. While the role of type 1 fimbriae during infection has been clear, the role of P fimbriae must be further defined to assert the relevance of coordinated regulation in vivo. Therefore, we examined the ability of P fimbrial isogenic mutants, constructed in a type 1 fimbrial-negative background, to compete in the murine urinary tract over a period of 168 h. No differences in the colonization of these mutants were observed. However, comparison of these results with previous studies suggests that inversely coordinated expression of adhesin gene clusters does occur in vivo. Interestingly, the mutant that was incapable of expressing either type 1 or P fimbriae compensated by synthesizing F1C fimbriae.


Permeability of oral tissues to blood-borne coxsackievirus B-1.
The ability of coxsackievirus B-1 to pass the barriers of the circulatory system into whole saliva has been shown previously. In this investigation, the major salivary glands and the oral mucosa were studied, and their role as participants in the excretion of coxsackievirus B-1 during viremia was evaluated. The effect of the salivary-gland stimulant pilocarpine nitrate on both the salivary flow rate and the recovery of virus during viremia was determined. A comparison was made between the amount of virus recovered from whole saliva during viremia in animals deficient in one or both of the major salivary-gland pairs and animals with a complete complement of salivary glands. The salivary glands in other animals were cannulated, and pure glandular secretions were collected during viremia and assayed for the presence of virus The amount of virus passing from the capillaries of the oral mucosa to the surface was also determined to evaluate this route as a possible site for the excretion of virus into saliva during viremia. The major salivary glands did not excrete appreciable quantities of virus during viremia. The submaxillary-gland secretions did not contain virus, and the parotid-gland secretions showed virus only at extremely high blood virus levels. Either removal of the major salivary glands or decreased salivary flow rates increased the concentration of virus in whole saliva. This observation suggested that the production of saliva by the major salivary glands tends to dilute the virus in the oral cavity. A 0.88-cm(2) sample of the oral mucosa excreted significantly large amounts of virus during viremia and suggested that the passage of virus through the oral mucosa was the major route for the excretion of virus into saliva during viremia.


Developmental course(s) of lifetime cigarette use and panic attack comorbidity: an equifinal phenomenon?
The present investigation examined the developmental course(s) of lifetime cigarette use and panic attack comorbidity. Participants included 4,409 adults, ages 15 to 54 years of age (M(Age) = 33.1, SD = 10.7, N (females) = 2,221) from the National Comorbidity Survey (NCS). The primary objective of the present investigation was to better understand the developmental course(s) of lifetime cigarette use and panic attacks. A second objective of the investigation was to evaluate the developmental features of smoking-panic comorbidity in relation to other comorbid psychiatric and substance outcomes. Results demonstrated two distinct and novel operative developmental patterns of smoking-panic attack co-occurrence. The theoretical and clinical implications of delineating course-related factors underlying smoking-panic attack comorbidity are discussed.


THE ULTRASTRUCTURE OF FLAGELLAR FIBRILS.
The tips of rat sperm tails were slightly frayed by mechanical agitation, thus exposing the fibrils, which were then studied by electron microscopy after negative staining. Only the fibrils survived this treatment. Each fibril proved to be a cylinder with a hollow core. The walls of the cylinders were made up of 10 longitudinally oriented filaments. The filaments had a markedly beaded appearance, with a repeating period of 88 A. The filament thickness (bead width) was approximately 35 to 40 A. Beads of neighboring filaments were in register with each other so that cross-linking bound the filaments together to complete the wall structure of each fibril. The center-to-center spacing from one filament to the next was 55 to 60 A. The periodicity and the diameters of the filaments make it unlikely that the filaments are related to either actin or myosin. From the way the fibrils kinked, it can be inferred that they possessed considerable mechanical strength. It is consistent with present knowledge that fibrils of the mitotic apparatus may have the same basic structure as the flagellar fibrils. Under some circumstances, pairs of fibrils separated from one another along their length, except at their extreme tips. It was apparent that there was special bridging material to be found there. In other preparations, however, the paired fibrils remained together, indicating a powerful coupling mechanism.


Impact of solids retention time on the biological performance of an AnMBR treating lipid-rich synthetic dairy wastewater.
In this study, the impact of applied solids retention time (SRT) on the biological performance of an anaerobic membrane bioreactor (AnMBR) treating synthetic dairy wastewater with high lipid content was assessed. Two side-stream AnMBR systems were operated at an SRT of 20 and 40 days (R20 and R40, respectively), equipped with an inside-out tubular membrane operated in cross-flow mode under full-scale operational conditions, i.e. crossflow velocity, transmembrane pressure, membrane flux. Successful operation was achieved and removal efficiencies of both reactors were up to 99% applying an organic loading rate (OLR) of 4.7 g COD L-1 d-1. No precipitation of lipids was observed throughout the operational period, keeping the lipids available for the anaerobic degradation. Long chain fatty acid (LCFA) accumulation was very modest and amounted 148 and 115 mg LCFA-COD per gram of volatile suspended solids (VSS) for R20 and R40, respectively. At an SRT of 40 days, a slightly better biological conversion was obtained. Periodically performed specific methanogenic activity (SMA) tests showed stabilization of the SMA for R40 sludge, whereas for R20 sludge the SMA continued to decrease. This study revealed a more stable reactor performance operating the AnMBR at an SRT of 40 days compared to 20 days.


Cluster randomised trial of an active, multifaceted educational intervention based on the WHO Reproductive Health Library to improve obstetric practices.
We conducted a trial to evaluate the effect of an active, multifaceted educational strategy to promote the use of the WHO Reproductive Health Library (RHL) on obstetric practices. Cluster randomised trial. The trial was assigned the International Standardised Randomised Controlled Trial Number ISRCTN14055385. Twenty-two hospitals in Mexico City and 18 in the Northeast region of Thailand. The intervention consisted primarily of three interactive workshops using RHL over a period of 6 months. The focus of the workshops was to provide access to knowledge and enable its use. A computer and support for using both the computer and RHL were provided at each hospital. The control hospitals did not receive any intervention. The main outcome measures were changes in ten selected clinical practices as recommended in RHL starting approximately four to six months after the third workshop. Clinical practice data were collected at each hospital from 1000 consecutively delivered women or for a 6-month period whichever was reached sooner. The active, multifaceted educational intervention we employed did not affect the ten targeted practices in a consistent and substantive way. Iron/folate supplementation, uterotonic use after birth and breastfeeding on demand were already frequently practiced, and we were unable to measure external cephalic version. Of the remaining six practices, selective, as opposed to routine episiotomy policy increased in the intervention group (difference in adjusted mean rate = 5.3%; 95% CI -0.1 to 10.7%) in Thailand, and there was a trend towards an increased use of antibiotics at caesarean section in Mexico (difference in adjusted mean rate = 19.0%; 95% CI: -8.0 to 46.0%). There were no differences in the use of labour companionship, magnesium sulphate use for eclampsia, corticosteroids for women delivering before 34 weeks and vacuum extraction. RHL awareness (24.8-65.5% in Mexico and 33.9-83.3% in Thailand) and use (4.8-34.9% in Mexico and 15.5-76.4% in Thailand) increased substantially after the intervention in both countries. The multifaceted, active strategy to provide health workers with the knowledge and skills to use RHL to improve their practice led to increased access to and use of RHL, however, no consistent or substantive changes in clinical practices were detected within 4-6 months after the third workshop.


Should we keep hemoglobin levels as a viable outcome measure?
In conclusion, the most important priority is to shift thinking to ESA dose exposure and away from focusing on the target Hb level. More attention needs to be spent on developing strategies to minimize exposure to high doses of ESAs. Possible strategies might include the subcutaneous administration of ESAs, treating a patient with an elevated ferritin, identifying sources of blood losses, treating infections and/or an inflammatory focus, and the use of computerized protocols. An equally important goal should be to change the CMS QIP anemia measure to a target Hb >9 g/dL. This modification in the QIP anemia measure is supported by the evidence from both the Normal Hematocrit trials and TREAT. If one models the effect of this QIP on the dialysis patient population as a whole, the majority of achieved Hb concentrations will likely be <11 g/dL (similar to the reported findings in the Normal Hematocrit study--see Figure 1). Lastly, translational studies and clinical trials are necessary to test whether exposure to high doses of ESAs explains the higher risk observed in CHOIR, TREAT, and the Normal Hematocrit study.


Effects of age and platelet-rich plasma on ACL cell viability and collagen gene expression.
Platelet-rich plasma (PRP) has shown in vivo potential to stimulate anterior cruciate ligament (ACL) healing at early time points in large animal models. However, in animal models, the healing potential of the ACL is dependent on animal age. In this study, we hypothesized that there are age-dependent differences in ACL cell metabolism, collagen gene expression, and the ability of the cells to respond to growth factors in PRP. To test this hypothesis, ACL cells were obtained from skeletally immature, adolescent and adult pigs, and cultured in a collagen type I hydrogel with or without PRP for 14 days. When cultured in collagen-only hydrogel, ACL cells from adult pigs had a 19% lower apoptotic rate as compared to immature pigs (p = 0.001) and a 25% higher cellular metabolic activity as compared to adolescent pigs (p = 0.006). The addition of PRP to the collagen hydrogel resulted in a significantly increased cellular metabolic activity, reduced apoptotic rate, and stimulation of collagen production in the cells from the immature and adolescent animals (p < 0.05 for all comparisons) but had less effect on adult cells. These findings suggest that skeletal maturity may influence ACL cells' metabolic activity, apoptosis, collagen production, and response to PRP.


Solid oxide fuel cell with corrugated thin film electrolyte.
A low temperature micro solid oxide fuel cell with corrugated electrolyte membrane was developed and tested. To increase the electrochemically active surface area, yttria-stabilized zirconia membranes with thickness of 70 nm were deposited onto prepatterned silicon substrates. Fuel cell performance of the corrugated electrolyte membranes released from silicon substrate showed an increase of power density relative to membranes with planar electrolytes. Maximum power densities of the corrugated fuel cells of 677 mW/cm2 and 861 mW/cm2 were obtained at 400 and 450 degrees C, respectively.


A mixed-methods approach to understanding trajectories of mentoring relationship growth.
The proposed study integrates quantitative and qualitative approaches to examine mentors with different relationship trajectories reflect on their relationships. Using quantitative and qualitative methods, mentor reports of relationship quality are plotted over time and different growth patterns identified: (1) progressive, (2) stable-high, (3) dip and recovery, (4) stable-low, and (5) regressive. Qualitative coding was used to identify patterns in mentors' descriptions of their relationship experiences-including both what mentors wrote about and how they wrote about it.


Validation of Malnutrition Screening Tools in Liver Cirrhosis.
Malnutrition in liver cirrhosis is frequently underestimated. To determine if a patient is at risk of malnutrition, several screening tools have been established. However, most of them are not validated for patients with liver cirrhosis. Therefore, we compared the RFH-NPT (Royal Free Hospital Nutritional Prioritizing Tool) as the validated gold standard for malnutrition screening in cirrhosis patients with GMS (Graz Malnutrition Screening), NRS-2002 (Nutritional Risk Screening) and MNA-SF (Mini Nutritional Assessment-Short Form). Based on common validity criteria for screening tools, only the MNA-SF showed fair correlation (12/15 points) with the RFH-NPT, whereas NRS-2002 and GMS performed worse (6/15 points). Taken together, our results suggest that NRS-2002 and GMS are not suitable for screening of malnutrition in cirrhosis patients. A cirrhosis-specific screening tool like RFH-NPT should be used to assess malnutrition and to identify those at risk of malnutrition.


Failure to comply with CMS' new enrollment procedures could impact physicians' cash flow.
The Centers for Medicare and Medicaid Services (CMS) has instituted big changes in its enrollment procedures that could have a major impact on physician groups that fail to comply with CMS' new requirements. First, tick ... tick ... tick ... time is quickly running out on the chance to obtain, and implement into the flow of your practice, a National Provider Identification number (NPI). The bad news is that the requirement to get an NPI is statutory, meaning it's not going to go away. Second, CMS revamped its Medicare provider enrollment processes in an attempt to reduce enrollment application processing delays. Unfortunately, rather than expedite the enrollment process, CMS' new regulations had the over-all effect of causing even more delays and backlogs in the enrollment process. Providers who do not have an NPI by the required deadline risk potential compliance penalties and payment delays. Therefore, not having an NPI or a Medicare Provider Number can have serious consequences on providers' ability to provide care as well as their bottom line (think cash flow!).


Study of Galfenol direct cytotoxicity and remote microactuation in cells.
Remote microactuators are of great interest in biology and medicine as minimally-invasive tools for cellular stimulation. Remote actuation can be achieved by active magnetostrictive transducers which are capable of changing shape in response to external magnetic fields thereby creating controlled displacements. Among the magnetostrictive materials, Galfenol, the multifaceted iron-based smart material, offers high magnetostriction with robust mechanical properties. In order to explore these capabilities for biomedical applications, it is necessary to study the feasibility of material miniaturization in standard fabrication processes as well as evaluate the biocompatibility. Here we develop a technology to fabricate, release, and suspend Galfenol-based microparticles, without affecting the integrity of the material. The morphology, composition and magnetic properties of the material itself are characterized. The direct cytotoxicity of Galfenol is evaluated in vitro using human macrophages, osteoblast and osteosarcoma cells. In addition, cytotoxicity and actuation of Galfenol microparticles in suspension are evaluated using human macrophages. The biological parameters analyzed indicate that Galfenol is not cytotoxic, even after internalization of some of the particles by macrophages. The microparticles were remotely actuated forming intra- and extracellular chains that did not impact the integrity of the cells. The results propose Galfenol as a suitable material to develop remote microactuators for cell biology studies and intracellular applications.


Correlation of the National Institutes of Health patient reported outcomes measurement information system scales and standard pain and functional outcomes in spine augmentation.
The recently developed National Institutes of Health PROMIS initiative provides reliable and valid measures across many health domains. We correlated changes in pain-related PROMIS measures and changes in both an NRS and the RMDI in patients undergoing spine augmentation. Fifty patients, composed of 26 women (40-91 years of age; mean, 72.6 years) and 24 men (42-78 years of age, mean, 67.5 years) were enrolled in the study. They were asked at initial presentation and at 30 days to rate the intensity of their pain in the past 24 hours by using a 0-10 pain NRS as well at the 23-item RMDI. Study subjects also completed 3 different PROMIS short forms, including physical function, pain behavior, and pain interference. The Spearman correlation was used to assess the correlation between the scales. The RCI × 1.96 was calculated for each measurement tool as an indicator of change. All instruments were responsive to detection of change during 1 month (all, P < .0001). Correlations between changes in physical function, pain interference, and pain behavior PROMIS scores and changes in RMDI scores were 0.37, 0.44, and 0.42, respectively. Direction of changes (declines versus improvements) in RMDI and other scales were the same in approximately 60% of patients. All measures evaluated had adequate and comparable psychometric properties. The choice of which measure to use depends on the clinical intent of the intervention.


Defining new guidelines for screening the 22q11.2 deletion based on a clinical and dysmorphologic evaluation of 194 individuals and review of the literature.
The 22q11.2 deletion is the most frequent interstitial deletion in humans and presents a wide phenotypic spectrum, with over 180 clinical manifestations described. Distinct studies have detected frequencies of the deletion ranging from 0 % to 75 %, depending on the studied population and selection criteria adopted. Due to the lack of consensus in this matter, several studies have been conducted aiming to define which patients would be eligible for screening; however, the issue is still up for debate. In order to contribute to the delineation of possible clinical and dysmorphologic guidelines to optimize decision making in the clinical setting, 194 individuals with variable features of the 22q11.2 deletion syndromes (22q11.2DS) were evaluated. Group I, clinical suspicion of 22q11.2DS with palatal anomalies; Group II, clinical suspicion without palatal anomalies; Group III, cardiac malformations associated with the 22q11.2DS; and Group IV, juvenile-onset schizophrenia. Multiplex ligation-dependent probe amplification was used for screening the 22q11.2 deletion, which was detected in 45 patients (23.2 %), distributed as such: Group I, 35/101 (34.7 %); Group II, 4/18 (22.2 %); Group III, 6/52 (11.5 %); and Group IV, 0/23 (0 %). Clinical data were analyzed by frequency distribution and statistically. Based on the present results and on the review of the literature, we propose a set of guidelines for screening patients with distinct manifestations of the 22q11.2DS in order to maximize resources. In addition, we report the dysmorphic features which we found to be statistically correlated with the presence of the 22q11.2DS.