Comparison of weight loss, food consumption and frequency of vomiting among Roux-en-Y gastric bypass patients with or without constriction ring.
After Roux-en-Y gastric bypass to avoid rapid gastric emptying, dumping syndrome and regained weight due to possible dilation of the gastric pouch, was proposed to place a ring around the gastric pouch. To compare weight loss, consumption of macronutrients and the frequency of vomiting among patients who underwent Roux-en-Y gastric bypass with and without the placement of a constriction ring around the pouch. A retrospective study, in which an analysis of medical records was carried out, collecting data of two groups of patients: those who underwent the operation with the placement of a constriction ring (Ring Group) and those who underwent without the placement of a ring (No-Ring Group). The food intake data were analyzed using three 24-hour recalls collected randomly in postoperative nutritional accompaniment. Data on the percentage of excess weight loss and the occurrence of vomiting were collected using the weight corresponding to the most recent report at the time of data collection. Medical records of 60 patients were analyzed: 30 from the Ring Group (women: 80%) and 30 from the No-Ring Group (women: 87%). The average time since the Ring Group underwent the operation was 88 ± 17.50 months, and for the No-Ring Group 51 ± 15.3 months. The percentage of excess weight loss did not differ between the groups. The consumption of protein (g), protein/kg of weight, %protein and fiber (g) were higher in the No-Ring Group. The consumption of lipids (g) was statistically higher in the Ring Group. The percentage of patients who never reported any occurrence was statistically higher in the No-Ring Group (80%vs.46%). The percentage who frequently reported the occurrence was statistically higher in the Ring Group (25%vs.0%). The placement of a ring seems to have no advantages in weight loss, favoring a lower intake of protein and fiber and a higher incidence of vomiting, factors that have definite influence in the health of the bariatric patient.


Detection of 100 aM fluorophores using a high-sensitivity on-chip CE system and transient isotachophoresis.
We present a highly sensitive capillary electrophoresis (CE) assay that combines transient, single-interface on-chip isotachophoresis (ITP) and a laser-induced confocal fluorescence detection setup. We performed experimental parametric studies to show the effects of microscope objective specifications and intensity of excitation laser on optimization of a high-sensitivity on-chip CE detection system. Using the optimized detection system, single-molecule detection of Alexa Fluor 488 was demonstrated, and signal data were validated with autocorrelation analysis. We also demonstrated a separation and detection of 100 aM fluorophores (Alexa Fluor 488 and bodipy) in a fast assay using a high-sensitivity on-chip CE detection system and an ITP/CE protocol with no manual buffer exchange steps. This is, to the knowledge of the authors, the highest electrophoretic separation sensitivity ever reported.


Postoperative anxiety and depression in surgical gastric cancer patients: their longitudinal change, risk factors, and correlation with survival.
Anxiety and depression are important concerns negatively affecting life quality and prognosis in cancer patients. Then, this prospective cohort study aimed to explore the longitudinal change and potential risk factors for postoperative anxiety and depression in surgical gastric cancer patients.A total of 226 surgical gastric cancer patients were consecutively enrolled. The Hospital Anxiety and Depression Scale (HADS) was used to assess the anxiety and depression status at baseline (M0), 12th month (M12), 24th month (M24), and 36th month (M36) after hospital discharge, then the HADS for anxiety (HADS-A) score and HADS for depression (HADS-D) score were calculated. Diseasefree survival (DFS) and overall survival (OS) were evaluated.HADS-A and HADS-D scores were gradually increased from M0 to M36, and their occurrences and grades were also worsened piece by piece. Additionally, older age, female, unemployed before surgery, single/divorced/widowed marry status, poor education duration, diabetes, hyperlipidemia, large tumor size, high TNM stage, and adjuvant chemotherapy were independent risk factors for postoperative anxiety or depression. Regarding survival, DFS and OS appeared to be shorter in anxiety patients compared to nonanxiety patients at M0 but showed no statistical significance. However, DFS and OS were worse in depression patients compared to non-depression patients at M0.In conclusion, postoperative anxiety and depression are gradually worsened, relating to poor prognosis, and their main risk factors include female, single/divorced/widowed marry status, diabetes, hyperlipidemia, large tumor size, and high TNM stage in gastric cancer patients.


Molecular Associations and Clinical Significance of RAPs in Hepatocellular Carcinoma.
Hepatocellular carcinoma (HCC) is an aggressive gastrointestinal malignancy with a high rate of mortality. Multiple studies have individually recognized members of RAP gene family as critical regulators of tumor progression in several cancers, including hepatocellular carcinoma. These studies suffer numerous limitations including a small sample size and lack of analysis of various clinicopathological and molecular features. In the current study, we utilized authoritative multi-omics databases to determine the association of RAP gene family expression and detailed molecular and clinicopathological features in hepatocellular carcinoma (HCC). All five RAP genes were observed to harbor dysregulated expression in HCC compared to normal liver tissues. RAP2A exhibited strongest ability to differentiate tumors from the normal tissues. RAP2A expression was associated with progressive tumor grade, TP53 and CTNNB1 mutation status. Additionally, RAP2A expression was associated with the alteration of its copy numbers and DNA methylation. RAP2A also emerged as an independent marker for patient prognosis. Further, pathway analysis revealed that RAP2A expression is correlated with tumor-infiltrating immune cell composition and oncogenic molecular pathways, such as cell cycle and cellular metabolism.


[Oncogene amplification and inactivation of tumor suppressor genes in urological malignant tumors--the application of restriction fragment length polymorphism analysis].
We applied restriction fragment length polymorphism (RFLP) analysis to 24 cases of renal cell carcinomas (RCC), 18 cases of prostate adenocarcinomas (PC), and 11 cases of transitional cell carcinomas (TCC) in the renal pelvis to study the oncogene amplification and inactivation of tumor suppressor genes. All of the cases showed no amplification nor gross rearrangements of the Harvey ras, c-myc, c-fos, c-myb, EGFR and PDGFR. In contrast, RFLP analyses demonstrated allelic losses interpreted as inactivational events of TSGs among the tumor forms studied. RCC had allelic losses on the short arm of chromosome 3 (3p) (68%), the long arm of chromosome 18 (18q) (33%), Y chromosome (29%), and 17p (27%) at high frequencies. PC showed frequent allelic losses on 16q (67%), 8p (50%), 18q (43%), 10p (40%), and 10q (38%). TCC had allelic losses on 17p (73%), 11p (64%), and 9p (40%). It was likely that the cases with the more malignant grade tumor had the more allelic losses.


The decision-making experiences of women who legally aborted: A meta-ethnography.
Abortion is one of the most common gynaecological procedures. It is related to personal, social, and economic reasons under a legal term that is recognised as a common sexual and reproductive right in most of countries. However, making the decision to abort is complex, because it is politicised and is often framed in public discourse related to moral or ethical issues beyond women's experiences. Therefore, it is subject to medical criteria, religious evaluations, and sociological analysis. The aim of this synthesis of qualitative studies was to synthesise the decision-making experiences of women who legally aborted. The Noblit and Hare's interpretive meta-ethnography was conducted, and it was written in accordance with the eMERGe meta-ethnography reporting guidance. Ten studies met the research objective and inclusion criteria, after a comprehensive systematic search strategy in five databases. The metaphor "The wrestling between why and what will happen next" and three themes emerged from the data analysis: (1) Forces that incite the arm wrestling; (2) Facing social stigma; and (3) Defeated by a greater rival. The metaphor provided interpretive experiences of the moral conflict experienced by women who decided to have an abortion and emerged from the confrontation of the reasons why they decided to abort and the social repercussions that making the decision entails. The result of the struggle was loneliness and vulnerability. The lines of action impact policy makers, the media, and health professionals. Actions should focus on the de-stigmatisation and normalisation of abortion, the use of appropriate language, and the training and sensitisation of health professionals.


Psychiatric epidemiology of the elderly population in Chile.
Little attention has been given to the prevalence rate of mental illness among elderly adults in Latin America. The prevalence rates for psychiatric disorders in Chile among those 65 and older compared with younger individuals, and the prevalence rate of psychiatric disorders among those age 75 and older are presented. A stratified random sample of 2,659 individuals. Four provinces representative of the Chile's population were surveyed. Adults age 15 and older were interviewed; however, the analysis is limited to those over age 20. The Composite International Diagnostic Interview was administered to obtain Diagnostic and Statistical Manual of Mental Disorders, Third Edition-R diagnoses. Lifetime and 12-month prevalence rates were estimated. Of the 2,659 interviewed 352 were over age 64. Overall, elderly adults had lower prevalence rates of lifetime disorders than the younger population, 20% in comparison with 34%. Dysthymia, agoraphobia, simple phobia, and alcohol dependence disorders were noted to be less common among elderly subjects. Those over the age of 64 in comparison with those over the age of 74 had higher prevalence rates of disorders. A sizable proportion of the disorders among older adults began after the age of 59. One third of elderly respondents with major depression had a late onset disorder. Service utilization was similar between elderly individuals and younger respondents, except for use of specialized psychiatric services, which was lower among elderly adults. Both lifetime and 1-year prevalence of mental disorders were less common in older than in younger persons; however, among elderly adults late onset disorders were not uncommon. Additional studies of the prevalence rates of disorders among older individuals in Latin America are needed for public health planning.


Can knowledge of developmental processes illuminate the evolution of parental care?
There are two levels of investigation for elucidating the evolution of parental behavior. The macro level focuses on how parental behavior can evolve as an aspect of reproduction. The micro level focuses on how species variations in parental behavior evolve. Recently, modern evolutionary biology has turned to developmental biology as a source for information about how trait variability (the substrate upon which natural selection and other evolutionary mechanisms can operate) can emerge during development (called "evo-devo"). Application of this evo-devo approach to the phenomenon of parental behavior requires identification of those mechanisms that produce variations in developmental pathways leading to parental behavior. It is these variations that provide the phenotypes for the potential evolution of different parental behavior systems. Variations in rodent maternal behavior affect the development of the HPA and HPG axes in their offspring. These mechanisms are examined to reveal how such developmental variations could underlie the evolution of biparental behavior. Knowledge of the developmental mechanisms responsible for species variations in mammalian parental behavior systems may provide insight into those mechanisms that may have been involved in the evolution of parental behavior itself.


Treatment of Candida infections with amphotericin B lipid complex.
The efficacy and renal safety of amphotericin B lipid complex (ABLC) were assessed in >900 patients with candidiasis. Overall, a favorable clinical response (cured or improved) was observed in 61% of patients infected with Candida species only, in 62% of patients infected with C. albicans, and in 61% of patients infected with a non-albicans Candida species. Clinical responses were similar in patients infected with invasive C. albicans and non-albicans Candida species (63% and 62%, respectively). Similarly, response rates of 60% and 59% were observed in patients infected with noninvasive C. albicans and non-albicans Candida species, respectively. Compared with patients who received lower doses of ABLC, patients who required higher doses of ABLC because of more-virulent infections did not demonstrate significant renal impairment, as assessed by end-of-therapy changes in serum creatinine level from baseline (median, 0.1 mg/dL; range, -3.9 to 2.4 mg/dL), incidence of serum creatinine doubling (16%), and need for new dialysis (7%). These data indicate the safety and efficacy of ABLC in treating candidiasis.


Motivation to quit using substances among individuals with schizophrenia: implications for a motivation-based treatment model.
Although the motivation to quit using substances is an important prognostic and treatment-matching factor in substance abuse treatment, there is limited information on motivation to quit among individuals with schizophrenia. This study used the five-stages-of-change model to evaluate the motivational levels of 497 individuals with schizophrenia or schizoaffective disorder in an outpatient mental health clinic. Rates of substance abuse, motivation levels to quit each specific substance, and correlates to motivational levels were evaluated. At least one substance use disorder was diagnosed in 224 of the subjects (45%); however, there was significant variability among the caseloads of the outpatient division teams. The patients in the triage/acute services and community outreach teams had substance abuse rates of about 70 percent. Most subjects had low motivation to quit substances, and the rates varied according to substance (range of 41% for opiates to 60% for cocaine). Treatment-matching strategies are suggested in the motivation-based treatment model.


Response of alpine grassland to elevated nitrogen deposition and water supply in China.
Species composition and productivity are influenced by water and N availability in semi-arid grasslands. To assess the effects of increased N deposition and water supply on plant species composition and productivity, two field experiments with four N addition treatments, and three N and water combination treatments were conducted in alpine grassland in the mid Tianshan mountains, northwest China. When considering N addition alone, aboveground biomass (AGB) of forbs (F(AGB)) responded less to N addition than AGB of grasses (G(AGB)). G(AGB) increased as an effect of N combined with water addition but F(AGB) did not show such an effect, reflecting a stronger response of grasses to the interaction of water availability and N than forbs. Under all treatments, N allocation to the aboveground tissue did not change for either forbs or grasses. N deposition and water addition did not alter species richness in the present study. These results suggest that N addition generally promoted AGB but had little effect on species richness in wet years. Snowfall in winter combined with rainfall in the early growing season likely plays a critical role in regulating plant growth of the subsequent year in the alpine grassland.


[Advances in studies on pharmacokinetics of scutellarin and scutellarein].
Scutellarin is the major effective ingredient of breviscapine, which is widely used in the treatment of cardiovascular diseases and has a remarkable achievement. In recent years, more and more reseaches had focused on the pharmacokinetics of scutellarin and scutellarein. The article summarized the studies on pharmacokinetics of scutellarin and scutellarein have been performed by domestic and oversea scholars.


The role of multiple reproductive barriers: strong post-pollination interactions govern cytotype isolation in a tetraploid-octoploid contact zone.
Polyploidy is an important contributor to sympatric speciation and assortative mating is a key mechanism driving cytotype interactions in contact zones. While strong reproductive barriers can mediate the coexistence of different cytotypes in sympatry, positive frequency-dependent mating disadvantage ultimately drives the transition to single-ploidy populations. However, comprehensive estimates of reproductive isolation among cytotypes and across multiple barriers are rare. We quantify the strength of isolation across multiple reproductive stages in a tetraploid-octoploid contact zone to understand the potential for coexistence. Assortative mating due to flowering asynchrony, pollinator behaviour, morphological overlap, self-fertilization and gametic competition between tetraploid and octoploid Gladiolus communis in a contact zone in the Western Iberian Peninsula were assessed in natural and experimental populations to quantify reproductive isolation (RI) between cytotypes. Tetraploids and octoploids have a high degree of overlap in flowering time and similar floral morphology, and are visited by generalist insects without cytotype foraging preferences, resulting in weak pre-pollination RI (from 0.00 to 0.21). In contrast, post-pollination isolation resulting from gametic selection was a strong barrier to inter-cytotype mating, with ploidy composition in stigmatic pollen loads determining the levels of RI (from 0.54 to 1.00). Between-cytotype cross-incompatibility was relatively high (RI from 0.54 to 0.63) as was isolation acquired through self-pollination (RI of 0.59 in tetraploids and 0.39 in octoploids). Total RI was high for both tetraploids (from 0.90 to 1.00) and octoploids (from 0.78 to 0.98). Such high rates of assortative mating will enable cytotype coexistence in mixed-ploidy populations by weakening the impacts of minority cytotype exclusion. This study reveals the key role of gametic selection in cytotype siring success and highlights the importance of comprehensive estimates across multiple reproductive barriers to understand cytotype interactions at contact zones.


Lewis Basic Sulfide Catalyzed Electrophilic Bromocyclization of Cyclopropylmethyl Amide.
A Lewis basic sulfide catalyzed electrophilic bromocyclization of cyclopropylmethyl amide has been developed. The catalytic protocol is applicable to both 1,1- and 1,2-substituted cyclopropylmethyl amides, giving oxazolines and oxazines in good yields and excellent diastereoselectivity.


EUCAST breakpoints for antifungals.
Susceptibility testing of fungi and development of interpretative breakpoints has become increasingly important due to the growing incidence of invasive fungal infections, the number and classes of antifungals, and the emerging reports of acquired resistance. The subcommittee on antifungal susceptibility testing of the European Committee on Antibiotic Susceptibility Testing (EUCAST) has developed standards for susceptibility testing of fermentative yeasts and molds as well as proposing breakpoints for fluconazole and voriconazole against Candida. The aim of this work is to describe the EUCAST process of setting breakpoints for antifungals. Five aspects are evaluated during the process of developing breakpoints: 1) the most common dosage used in each European country, 2) the definition of the wild-type population for each target microorganism at the species level and the determination of epidemiological cutoffs, 3) the drug's pharmacokinetics and 4) pharmacodynamics, including Monte Carlo simulations, and 5) the correlation of MICs with clinical outcome of patients treated with the compound. When insufficient data are available (e.g., due to lack of information on the clinical outcome of infections caused by isolates with an elevated MIC), epidemiological cutoff values, rather than breakpoints, are recommended until the necessary information becomes available.


[Comparative research of moxibustion and infrared method in testing heat-sensitive state at Xiaguan (ST 7) in primary trigeminal neuralgia].
To explore the possibility of the infrared objective displaying of heat-sensitive state of acupoint. Fifty-four qualified subjects were enrolled. In the natural state, thermal tomography (TTM) was adopted to shoot the thermograms on the face. After the thermograms collection, the thermo-sensitive detection with moxibustion was applied. The suspending moxibustion with moxa stick was used at Xiaguan (ST 7, affected side) for 10 mm. The cases with heat extension and transmission at the acupoint were recorded at the end of moxibustion. In following, the second infrared radiation detection was done so as to record the changes in the infrared images on the face before and after moxibustion and compare the difference in the heat-sensitive state at Xiaguan (ST 7, affected side) in the subjects between two detection methods. Before moxibustion, the infrared radiation intensity at Xiaguan (ST 7, affected side) in the patients displayed mostly low temperature feature and its sensibility (true positive rate) was 65.6%, the specificity (true negative rate) was 68.2% and the accuracy was 66.7%. After moxibustion at Xiaguan (ST 7, affected side), there was an obvious block-diffused increment area of infrared radation along the cheek and its sensitivity (true positive rate) was 81.8%, the specificity (true negative rate) was 81.0% and the accuracy was 81.5% as compared with the moxibustion detection. (1) The heat-sensitive state at Xiaguan (ST 7, affected side) in the patients of primary trigeminal neuralgia can be objectively displayed by infrared imaging to a certain extent. (2) The acupoint heat-sensitization produced by moxibustion is not only the subjective sensation of the subjects, but also can be objectively displayed by infrared imaging to a certain extent.


[Grouped pigmentation of the retina].
A case of grouped pigmentation of the retina with unilateral localization is presented. It is an asymptomatic congenital abnormality, a rare affection, and the positive diagnosis is confirmed using retinal-photographical methods, angiofluorographic methods and electrophysiological methods (ERG, EOG, adaptometry).


Saliva-based HIV-antibody testing in Thailand.
To determine whether saliva could serve as an alternative to serum for HIV-antibody testing in an ongoing sentinel surveillance program in Thailand. Serum and saliva specimens were collected from 1955 individuals in four of the 73 sentinel sites of the national surveillance program in Thailand. Intravenous drug users, female prostitutes, and men attending sexually transmitted disease clinics were included as participants. All specimens were collected and tested anonymously. Saliva was gathered with the Omni-Sal collection device and analyzed for the presence of HIV antibodies using the immunoglobulin G antibody-capture enzyme-linked immunosorbent assay (GACELISA) laboratory test, specially designed for low concentration body fluids. Our gold standard was serum, collected and analyzed independently from the saliva specimens, using an ELISA test for screening and Western blot for confirmation. Linkage between serum and saliva was blind to the laboratory. A set of HIV-positive and HIV-negative quality assurance samples for both serum and saliva were also analyzed blind. Findings are presented as observed in the field, and as quality assurance samples after the correction of various field and laboratory errors. The sensitivity of the GACELISA with saliva was 98.0% in the field (298 HIV-positive specimens), 100% after correction of errors (300 HIV-positive specimens), and 100% among the quality assurance samples (95 HIV-positive specimens). The specificity of the GACELISA was 99.4% in the field (1653 HIV-negative specimens), 99.6% after correction of errors (1654 HIV-negative specimens), and 100% among the quality assurance samples (96 HIV-negative specimens). Our findings support other published studies that also featured the GACELISA. We conclude that saliva is comparable to serum for assessing HIV antibodies in individuals for surveillance and screening purposes.


Surface Compositions of Oxide Supported Bimetallic Catalysts: A Compared Study by High-Sensitivity Low Energy Ion Scattering Spectroscopy and X-Ray Photoemission Spectroscopy.
It is well known that there is a critical relationship between the surface composition and catalytic performance for a bimetallic catalyst. However, in most cases, the surface composition is obviously different from that of the bulk. Moreover, the surface is normally reconstructed under reaction conditions. In this personal account, our recent progresses in determining the surface compositions of oxide supported bimetal catalysts by high-sensitivity low energy ion scattering spectroscopy (HS-LEIS) and X-ray photoemission spectroscopy (XPS) are summarized. Phase diagrams of the surface compositions under various conditions as a function of the bulk composition are established and compared. It is found that oxidation induces de-alloying and enrichment of PdO, CuO, SnO2 on the surface, while H2 reduction results in re-alloying. The addition of the second component not only modifies the nature of the active site, but also varies the dispersion of the active components. The support effects are discussed. The compared studies reveal that HS-LEIS can achieve a more reliable surface composition for oxide supported catalysts.


P065 A One-Time Education for Gastroenterologists Regarding Osteoporosis Screening for IBD Patients Improves Provider Knowledge But Not Screening Rates.
Inflammatory Bowel Disease (IBD) is a chronic gastrointestinal inflammatory condition and has been increasing in prevalence in the United States, with a 30-40% increase over the past few decades. Osteoporosis can be seen in up to 40% of IBD patients. Screening for osteoporosis in IBD patients involves the use of DEXA scans and is recommended by the IBD Cornerstone Committee for select patients, including steroid use > 3 months consecutively or a total of 1 year in the past 2 years, family history of osteoporosis, malnutrition, amenorrheic or post-menopausal. Our quality improvement study looked to improve osteoporosis screening among gastroenterologists. We conducted a retrospective chart review on all IBD patients within the St. Luke's Network and extrapolated data on age (>50 in male and >65 in female), sex, chronic glucocorticoid use (3 month consecutively or cumulative), osteoporosis/osteopenia diagnosis, vitamin D (vit-D) levels, and DEXA scan between 2019 to 2021. We gave a 5-minute presentation on current DEXA screen recommendations for patients with IBD on 5/27/2021 to all the network's gastroenterologists, which totaled 12. We performed a pre and post education survey consisting of 5 questions on provider knowledge and comfortability with osteoporosis screening. We assessed provider knowledge, as well as rates of osteoporosis screening. All statistical analyses were conducted in IBM SPSS for Windows Version 26. Chi Square tests were used to compare two groups in categorical variables while Mann-Whitney tests were done to compare continuous variables like age and vit-D levels. There were a total of 5442 patients; 3927 patients before the educational intervention on 5/27/2021 and 1515 patients after the intervention. Both pre and post intervention groups were balanced in terms of age, gender, smoking status, and alcohol risk. Percent of DEXA scans were similar between both groups (13.0% vs 12.3%, p=0.5). DEXA screening rates among patients with chronic steroid use pre-intervention vs post-intervention was 44.45 vs 42.4% respectively. Vit-D levels compared between both groups was not statistically significant (30.5 vs 31.8, p=0.1). Surveys conducted before and after the intervention showed an overall increase in percentage of agreement responses about knowledge and confidence in DEXA screening (88.5% vs 97.5%). DEXA scanning can help detect premature decrease in bone mineral density and provide physicians with the opportunity to prevent further morbidity. Our study showed no difference in DEXA screening rates before and after intervention. However, there was an increase in provider knowledge based on post-intervention surveys. A similar study showed that it took three interventions, including educational presentation, flyers, and on screen EMR reminders for there to be a sustainable improvement in the rate of DEXA screening. Our project may have required additional interventions to produce an effect and thus reinforces the need for further efforts to improve osteoporosis screening in IBD patients.


Isolated anaemia as a manifestation of Rh isoimmunisation.
Rh isoimmunisation leads to haemolytic anaemia and hyperbilirubinaemia in the first h of life. Isolated early onset neonatal anaemia has rarely been reported. The authors describe the case of a term infant, born to an 'A' negative, second gravida mother. On the second day of life, pallor was noticed. His haemoglobin (Hb) was 6.8 g/dl, he had reticulocytosis and a positive direct antiglobulin test. However, he did not have a high total serum bilirubin (TSB) (87.2 μmol/l). He was transfused with red blood cells and kept under phototherapy for 3 days. Three weeks later, he received another transfusion for severe anaemia (Hb 6 5 g/dl). During this period, he was never jaundiced and the maximum level of TSB was 122 μmol/l. On follow-up, his Hb stabilised and he had no further problems. This report highlights the possibility of early onset anaemia without jaundice as the sole manifestation of Rh isoimmunisation.


Image-encoded biological and non-biological variables may be used as shortcuts in deep learning models trained on multisite neuroimaging data.
This work investigates if deep learning (DL) models can classify originating site locations directly from magnetic resonance imaging (MRI) scans with and without correction for intensity differences. A large database of 1880 T1-weighted MRI scans collected across 41 sites originally for Parkinson's disease (PD) classification was used to classify sites in this study. Forty-six percent of the datasets are from PD patients, while 54% are from healthy participants. After preprocessing the T1-weighted scans, 2 additional data types were generated: intensity-harmonized T1-weighted scans and log-Jacobian deformation maps resulting from nonlinear atlas registration. Corresponding DL models were trained to classify sites for each data type. Additionally, logistic regression models were used to investigate the contribution of biological (age, sex, disease status) and non-biological (scanner type) variables to the models' decision. A comparison of the 3 different types of data revealed that DL models trained using T1-weighted and intensity-harmonized T1-weighted scans can classify sites with an accuracy of 85%, while the model using log-Jacobian deformation maps achieved a site classification accuracy of 54%. Disease status and scanner type were found to be significant confounders. Our results demonstrate that MRI scans encode relevant site-specific information that models could use as shortcuts that cannot be removed using simple intensity harmonization methods. The ability of DL models to exploit site-specific biases as shortcuts raises concerns about their reliability, generalization, and deployability in clinical settings.


Morphology of the Canine Omentum Part 1: Arterial Landmarks that Define the Omentum.
Although the omentum remains an enigmatic organ, research during the last decades has revealed its fascinating functions including fat storage, fluid drainage, immune activity, angiogenesis and adhesion. While clinicians both in human and veterinary medicine are continuously exploring new potential omental applications, detailed anatomical data on the canine omentum are currently lacking, and information is often retrieved from human medicine. In this study, the topographic anatomy of the canine greater and lesser omentum is explored in depth. Current nomenclature is challenged, and a more detailed terminology is proposed. Consistent arteries that are contained within folds of the superficial omental wall are documented, described and named, as they can provide the anatomical landmarks that are necessary for unambiguous scientific communication on the canine omentum. In an included dissection video, the conclusions and in situ findings described in this study are demonstrated.


Diabetes increases the mortality of patients with COVID-19: a meta-analysis.
Nowadays, the ongoing pandemic of COVID-19 caused by the novel coronavirus Syndrome-Coronavirus-2 (SARS-CoV-2) is an emerging, rapidly evolving situation. Complications such as hypertension, diabetes, COPD, cardiovascular disease, and cerebrovascular disease are major risk factors for patients with COVID-19. No meta-analysis has explored if or not diabetes related to mortality of patients with COVID-19. Therefore, this meta-analysis first aims to explore the possible clinical mortality between diabetes and COVID-19, analyze if diabetes patients infected with SARS-CoV-2 are exposed to the worst clinical prognostic risk, and to evaluate the reliability of the evidence. Our results showed a close relationship between diabetes and mortality of COVID-19, with a pooled OR of 1.75 (95% CI 1.31-2.36; P = 0.0002). The pooled data were calculated with the fixed effects model (FEM) as no heterogeneity appeared in the studies. Sensitivity analysis showed that after omitting any single study or converting a random effect model to FEM, the main results still held. Our meta-analysis showed that diabetes increases the mortality of patients with COVID-19. These results indicated the disturbance of blood glucose in the COVID-19 patients. More importantly, this meta-analysis grades the reliability of evidence for further basic and clinical research into the diabetes dysfunction in COVID-19 patients.


[The indices of pressure variability by noninvasive ambulatory monitoring of the arterial pressure. A study in 2 normotensive and hypertensive populations].
Analysis of different indices of blood pressure (BP) variability using the ambulatory blood pressure monitoring (ABPM) method in two populations of hypertensive patients (HTA Group) and normotensive volunteers (NOR Group). Noninvasive prospective ambulatory study to assess the alterations of the circadian blood pressure profile through ABPM indices of blood pressure variability. Patients with the diagnosis of essential arterial hypertension referred for clinical investigation to the Cardiology Department of Egas Moniz Hospital in Lisbon. 40 hypertensive patients (HTA Group) and 30 normal subjects (NOR Group) were included in this study. We calculated the short and long term variability indices. The short term variability indices were the casual and mean immediate BP deviation, percentage of BP peaks and BP peak relative deviation and maximal range variation. Some clinical and general factors considered were namely age, gender, height, weight, body area and index, mean and casual systolic-diastolic blood pressure. Concerning systolic blood pressure in hypertension Vs normal groups respectively, the casual BP deviation was 15 +/- 4 mmHg and 7 +/- 4 mmHg (p 0.003), the mean immediate BP deviation was 18.5 +/- 4 mmHg and 7.5 +/- 3 mmHg (p 0.002), the percentage of BP peaks was 27 +/- 6% (p < 0.001), the percentage of BP peak area was 29 +/- 7% and 6 +/- 3% (p 0.001) and the percentage of relative deviation was 14 +/- 4% and 8 +/- 3% (p 0.03). For diastolic blood pressure all differences were not statistically significant between the two groups and the same happened for systolic blood pressure in relation to standard deviation and maximal range variation. Among these parameters and general and clinical characteristics, the systolic mean and casual blood pressure level showed an acceptable correlation with mean immediate deviation (R = 0.54/0.49), percentage of BP peaks (R = 0.56/0.49) and percentage of BP peak area (R = 0.60/0.53). Blood pressure variability can be adequately evaluated through the method of ambulatory blood pressure monitoring. Some variability indices can be extracted from the 24 hour curves of ambulatory blood pressure monitoring. Long-term variability indices are not related to the level of blood pressure. In the hypertension group we found a greater variability concerning short term indices, namely immediate deviation, percentage and are of peak curve.


Reliable individual-level neural markers of high-level language processing: A necessary precursor for relating neural variability to behavioral and genetic variability.
The majority of functional neuroimaging investigations aim to characterize an average human brain. However, another important goal of cognitive neuroscience is to understand the ways in which individuals differ from one another and the significance of these differences. This latter goal is given special weight by the recent reconceptualization of neurological disorders where sharp boundaries are no longer drawn either between health and neuropsychiatric and neurodevelopmental disorders, or among different disorders (e.g., Insel et al., 2010). Consequently, even the variability in the healthy population can inform our understanding of brain disorders. However, because the use of functional neural markers is still in its infancy, no consensus presently exists about which measures (e.g., effect size?, extent of activation?, degree of lateralization?) are the best ones to use. We here attempt to address this question with respect to one large-scale neural system: the set of brain regions in the frontal and temporal cortices that jointly support high-level linguistic processing (e.g., Binder et al., 1997; Fedorenko, Hsieh, Nieto-Castanon, Whitfield-Gabrieli, & Kanwisher, 2010). In particular, using data from 150 individuals all of whom had performed a language "localizer" task contrasting sentences and nonword sequences (Fedorenko et al., 2010), we: a) characterize the distributions of the values for four key neural measures of language activity (region effect sizes, region volumes, lateralization based on effect sizes, and lateralization based on volumes); b) test the reliability of these measures in a subset of 32 individuals who were scanned across two sessions; c) evaluate the relationship among the different regions of the language system; and d) evaluate the relationship among the different neural measures. Based on our results, we provide some recommendations for future studies of brain-behavior and brain-genes relationships. Although some of our conclusions are specific to the language system, others (e.g., the fact that effect-size-based measures tend to be more reliable than volume-based measures) are likely to generalize to the rest of the brain.


An experimental study on the significance of muscle tissue interposition on fracture healing.
Ten ulnae of mongrel dogs were osteotomized and a 3 to 5 mm cylindrical segment of bone removed from each shaft. In 10 ulnae of the opposite forelimb, living muscle tissue was placed in the resection site. The control ulnae (Set 1, Set 2) revealed 60 per cent unions, while the experimental ulnae revealed 100 per cent non-unions as determined by radiological and histological examination. Although necrotic muscle will be invaded by primitive bone, healing is certainly delayed or does not occur. A large muscle mass contributes a barrier too large to be successfully incorporated into the healing process of a fracture of the shaft of a long bone. On the basis of this experiment fractures should be opened and obstructing tissue removed whenever conservative measures fail to remove muscle interposition.


Computational approach to nuclear magnetic resonance in 1-Alkyl-3-methylimidazolium ionic liquids.
A quantum-chemical computational approach to accurately predict the nuclear magnetic resonance (NMR) properties of 1-alkyl-3-methylimidazolium ionic liquids has been performed by the gauge-including atomic orbitals method at the B3LYP/6-31++G** level using different simulated ionic liquid environments. The first molecular model chosen to describe the ionic liquid system includes the gas-phase optimized structures of ion pairs and separated ions of a series of imidazolium salts containing methyl, butyl, and octyl substituents and PF6-, BF4-, and Br- anions. In addition, a continuum polarizable model of solvation has been applied to predict the effects of the medium polarity on the molecular properties of 1,3-dimethylimidazolium hexafluorophosphate (MmimPF6). Furthermore, the specific acidic and basic solute-solvent interactions have been simulated by a discrete solvation model based on molecular clusters formed by MmimPF6 species and a discrete number of water molecules. The computational prediction of the NMR spectra allows a consistent interpretation of the dispersed experimental evidence in the literature. The following are main contributions of this work: (a) Theoretical results state the presence of a chemical equilibrium between ion-pair aggregates and solvent-separated counterions of 1-alkyl-3-methylimidazolium salts which is tuned by the solvent environment; thus, strong specific (acidic and basic) and nonspecific (polarity and polarizability) solvent interactions are predicted favoring the dissociated ionic species. (b) The calculated 1H and 13C NMR properties of these ionic liquids are revealed as highly dependent on the nature of solute-solvent interactions. Thus, the chemical shift of the hydrogen atom in position two of the imidazolium ring is deviated to high values by the specific interactions with water molecules, whereas nonspecific interaction with water (as a solvent) affects, in the opposite direction, this 1H NMR parameter. (c) Last, current calculations support the presence of hydrogen bonding between counterions, suggesting the importance of this interaction in the properties of the solvent in the 1-alkyl-3-methylimidazolium ionic liquids.


Histone deacetylase 1 and 3 regulate the mesodermal lineage commitment of mouse embryonic stem cells.
The important role of histone acetylation alteration has become increasingly recognized in mesodermal lineage differentiation and development. However, the contribution of individual histone deacetylases (HDACs) to mesoderm specification remains poorly understood. In this report, we found that trichostatin A (TSA), an inhibitor of histone deacetylase (HDACi), could induce early differentiation of embryonic stem cells (ESCs) and promote mesodermal lineage differentiation. Further analysis showed that the expression levels of HDAC1 and 3 are decreased gradually during ESCs differentiation. Ectopic expression of HDAC1 or 3 significantly inhibited differentiation into the mesodermal lineage. By contrast, loss of either HDAC1 or 3 enhanced the mesodermal differentiation of ESCs. Additionally, we demonstrated that the activity of HDAC1 and 3 is indeed required for the regulation of mesoderm gene expression. Furthermore, HDAC1 and 3 were found to interact physically with the T-box transcription factor T/Bry, which is critical for mesodermal lineage commitment. These findings indicate a key mechanism for the specific role of HDAC1 and 3 in mammalian mesoderm specification.


[Bottoming out in augmentation mammaplasty--correction and prevention].
Displacement of a breast implant beneath the original submammary fold is known as a rare but, in most cases, difficult to correct complication after augmentation mammaplasty. Suggestions for re-centering the mammary implant range from simple percutaneous sutures to the additional application of expensive alloplastic dermal grafts. Based on the latest findings concerning plastination histology of the fascial system of the breast and in the light of our own clinical experience regarding correction of implant ptosis we have developed a special treatment concept. When placing the implant, the vertical fibers of the submammary fold are saved as a precautionary measure. In cases where there is a risk of possible inferior displacement of the mammary implant, an individually manufactured belt-like bandage is applied for approximately eight weeks postoperatively. In cases requiring the correction of a severe "bottoming out" deformity, we either lift the capsular shell of the implant or, if the fibrous capsule is thin and vulnerable, we use a special capsular flap technique resulting in a hammock that catches the implant at the height of the new submammary fold. Postoperative application of our belt-like bandage is again indispensable.


Synthetic and systems biology for microbial production of commodity chemicals.
The combination of synthetic and systems biology is a powerful framework to study fundamental questions in biology and produce chemicals of immediate practical application such as biofuels, polymers, or therapeutics. However, we cannot yet engineer biological systems as easily and precisely as we engineer physical systems. In this review, we describe the path from the choice of target molecule to scaling production up to commercial volumes. We present and explain some of the current challenges and gaps in our knowledge that must be overcome in order to bring our bioengineering capabilities to the level of other engineering disciplines. Challenges start at molecule selection, where a difficult balance between economic potential and biological feasibility must be struck. Pathway design and construction have recently been revolutionized by next-generation sequencing and exponentially improving DNA synthesis capabilities. Although pathway optimization can be significantly aided by enzyme expression characterization through proteomics, choosing optimal relative protein expression levels for maximum production is still the subject of heuristic, non-systematic approaches. Toxic metabolic intermediates and proteins can significantly affect production, and dynamic pathway regulation emerges as a powerful but yet immature tool to prevent it. Host engineering arises as a much needed complement to pathway engineering for high bioproduct yields; and systems biology approaches such as stoichiometric modeling or growth coupling strategies are required. A final, and often underestimated, challenge is the successful scale up of processes to commercial volumes. Sustained efforts in improving reproducibility and predictability are needed for further development of bioengineering.


An update on psoriasis and metabolic syndrome: A meta-analysis of observational studies.
The relationship between psoriasis and metabolic syndrome is not well understood. Though multiple epidemiologic studies have suggested a link between psoriasis and metabolic syndrome, there is a lack of a comprehensive meta-analysis synthesizing the results of all available observational studies to date. In this meta-analysis, we examined global data on the relationship between psoriasis and odds of metabolic syndrome by searching for studies published between 1946-2016. Specifically, we analyzed the results from 35 observational studies from 20 countries with 1,450,188 total participants, of which 46,714 were psoriasis patients. The pooled odds ratio based on random effects analysis was 2.14 (95% CI 1.84-2.48). Publication bias was present, as evidenced by an Egger test and graphical visualization through a funnel plot (p = 0.001). Based on this comprehensive meta-analysis, psoriasis patients have higher odds of having metabolic syndrome when compared with the general population.


'Better than nothing' is not good enough: challenges to introducing evidence-based approaches for traumatized populations.
Focus group data were generated by a larger, mixed-methods investigation on treatment practices among therapists working with significantly traumatized populations in a primarily rural, underdeveloped region of the USA. This paper explores reasons behind low utilization of evidence-based practices (EBPs) that putatively would benefit poor communities where these behavioural health care providers serve. Eight focus groups of 45 licensed and certified behavioural health professionals were conducted over a 6-month period of time in 2006. Sites were selected based on Beale code designations with representation from urban, rural, and rural with urban influence providers. Potential respondents were selected from licensing board membership rosters and invited to participate in the study. Focus groups were facilitated by trained interviewers using a semi-structured interview schedule that focused on how participants defined, assessed, and understood trauma, as well as the information therapists utilized to determine interventions for clients with trauma histories. Focus group transcripts were analysed using qualitative data reduction methods and six major themes emerged regarding the limited use of EBPs: complexity of trauma identification, issues with manualized assessment, role of treatment settings, conditions for innovation success and failure, untangling cultural effects, and defining successful treatment outcomes. These findings shed light on the endurance of insufficient behavioural health infrastructures despite therapists' access to scientifically validated treatments for trauma spectrum and co-morbid mental disorders suffered by children and adults. Such insights have implications for the success of global dissemination of validated behavioural health interventions.


Rapid and sensitive detection of Avibacterium paragallinarum in the presence of other bacteria using a 5' Taq nuclease assay: a new tool for diagnosing infectious coryza.
A 5' Taq nuclease assay specific for Avibacterium paragallinarum was designed and optimized for use in diagnosing infectious coryza. The region chosen for assay design was one of known specificity for Av. paragallinarum. The assay detected Av. paragallinarum reference strains representing the three Page and the eight Kume serovars, and field isolates from diverse geographical locations. No cross-reactions were observed with other Avibacterium species, with other bacteria taxonomically related to Av. paragallinarum nor with bacteria and viruses likely to be present in swabs collected from suspected infectious coryza cases. The detection limit for the assay was 6 to 60 colony-forming units per reaction. Twenty-two out of 53 swabs collected from sick birds reacted in the 5' Taq nuclease assay, whereas Av. paragallinarum was not isolated from any of the swabs. All of the 22 swabs yielded other bacteria in culture. The presence of Av. paragallinarum in the swabs was also demonstrated by sequencing, thereby confirming the ability of the assay to detect Av. paragallinarum in the presence of other bacteria. The ability to quantify bacterial load in the swabs using the 5' Taq nuclease assay was demonstrated.


A Review of Magnetic Particle Imaging and Perspectives on Neuroimaging.
Magnetic particle imaging is an emerging tomographic technique with the potential for simultaneous high-resolution, high-sensitivity, and real-time imaging. Magnetic particle imaging is based on the unique behavior of superparamagnetic iron oxide nanoparticles modeled by the Langevin theory, with the ability to track and quantify nanoparticle concentrations without tissue background noise. It is a promising new imaging technique for multiple applications, including vascular and perfusion imaging, oncology imaging, cell tracking, inflammation imaging, and trauma imaging. In particular, many neuroimaging applications may be enabled and enhanced with magnetic particle imaging. In this review, we will provide an overview of magnetic particle imaging principles and implementation, current applications, promising neuroimaging applications, and practical considerations.


Assay performance and tracer properties for two analog-based assays of free triiodothyronine.
We determined binding characteristics of the triiodothyronine (T3) analog tracer used in the Amerlex and Amerlex-M FT3 radioimmunoassay for the three endogenous binding proteins in serum: thyroxin-binding globulin (TBG), thyroxin binding prealbumin (PA), and albumin. Both T3 and its analog bind to the same sites on TBG and PA. However, the analog has significantly lower association constants (1.0% and 3.8%, respectively, of T3 binding affinity) and it binds to different sites on albumin. Analog binding is characterized by two (weak) specific binding sites [K = 0.46 (SD 0.03) X 10(5) L/mol]; T3 is bound at about 28 very weak, nonspecific sites [K = 0.41 (SD 0.03) X 10(4) L/mol]. Sera from healthy subjects with a wide range of concentrations of binding proteins showed no interference from analog binding in the FT3 assay. In contrast, in vitro studies of albumin binding revealed a weak dependence of both assays on albumin concentration (0.05 pmol of FT3 per gram of albumin per liter), an interference probably unimportant for most laboratory samples. Nonesterified fatty acids (NEFA) and the T3 analog apparently bind to different sites on albumin; thus the Amerlex FT3 assay is insensitive to moderately increased concentrations of NEFA in serum.


Boys who became offenders. A follow-up study of 2203 boys tested with projective methods.
Future offenders have more ratings than controls on variables indicating psychopathology. The characteristics which most consistently and significantly discriminate between preoffenders and controls, and which also turned out to be the best predictors of future criminality, are those which previously have been observed in subjects with serious mental disorders. The results indicate that the high degree of psychopathology in subsequent offenders is associated with distortion of body image and with poor reality orientation, i.e. that the most prominent characteristics of future offenders are related to a weakness of the ego. Future offenders seem to have a sufficiently developed ego to handle common tasks. However, their ego fails when they are confronted with unfamiliar and frustrating situations. The inability of subsequent offenders to complete a task properly, with failure on difficult and provocative tasks, shows that they have not developed adequate defence mechanisms and that they have a low tolerance for frustration. They are emotionally immature, instable and impulsive. In short, they are dominated by id impulses. There is no indication of gender confusion (homosexuality) in subsequent offenders. However, there are marked differences between the drawings by cases and by controls regarding characteristics related to sexuality. These findings are interpreted as an exaggeration of masculinity and an abnormal preoccupation with sexuality combined with anxiety for the opposite sex. It is possible that severe criminality, contrary to milder forms of lawbreaking, is associated with elevated self-esteem and extroversion. There are indications that ultimate offenders experience human beings (others or themselves) as deviant, monstrous and inhuman, features which indicate that distorted self-concept and distorted self-perception are characteristics of preoffenders. The findings regarding aggression are inconsistent, just as they were in prior projects. The Draw-A-Person Test (DAP) and Colour Slide Test (CST) findings indicate that preoffenders are more aggressive and destructive than controls, whereas the Hand Test (HT) shows neither more aggression nor more acting-out tendencies in future offenders than in controls. The literature offers conflicting findings regarding depression. The CST results indicate that depression is more common in preoffenders than in controls.(ABSTRACT TRUNCATED AT 400 WORDS)


Hepatitis B Screening, Vaccination, and Linkage to Care: Lessons Learned from a Mississippi Vietnamese Community.
Asian-Americans and Pacific Islanders are disproportionately impacted by chronic hepatitis B infection (CHBI). The long-term effects of untreated CHBI include cirrhosis of the liver, hepatocellular carcinoma, and liver failure. Approximately two-thirds of those living with CHBI are unaware of their HBV status. Plan, implement, and evaluate a culturally and linguistically appropriate screening, vaccination, and linkage-to-care initiative that used Vietnamese-speaking community health workers for care navigation among Vietnamese-Americans residing in the Mississippi coastal counties of Hancock, Harrison, and Jackson. The initiative employed a community-based participatory framework to plan and implement the program. An active community advisory board was established and was representative of all the partners that worked together to make the initiative a success.Results and Lessons Learned: Before program implantation, results from focus groups indicated that the Vietnamese community had low knowledge about the risk of CHBI. Additionally, there were no Vietnamese-speaking health care providers, nor primary care providers treating CHBI in the prioritized counties. A total of 505 Vietnamese individuals were screened. One-half were immune by infection (n = 235 [46.5%]), 83 (16.4%) were immune by vaccination, 46 (9.1%) had CHBI, 130 (25.7%) were vaccine naïve, and 40 (7.9%) were undetermined, (n = 130), 101 (77.7%) received the complete three-injection vaccine series. Five new primary care providers now provide treatment for those with CHBI. Cultural competency and community/medical interpreter training were also provided to reduce language barriers during medical encounters. To ensure success, it is paramount that community input is not only solicited but that partnerships provide a space where the input informs all aspects of the program.


Lysozyme gene treatment in testosterone induced benign prostate hyperplasia rat model and comparasion of its' effectiveness with botulinum toxin injection.
To compare the effects and histopathological changes of botulinum neurotoxin type A and lysozyme gene injections into prostate tissue within a testosterone induced benign prostate hyperplasia rat model. 40 male Wistar rats were randomized into four Groups. Group-1: Control, Group-2: Testosterone replacement, Group-3: Testosterone+botulinum neurotoxin type A, Group-4: Testosterone+plazmid DNA/liposome complex. Estimated prostate volume of the testosterone injected Groups were higher than the control (p <0.05). Actual prostate weight of the testosterone injected Groups was higher than the control Group (p <0.05). Testosterone undecanoate increased the prostate weight by 39%. Botulinum neurotoxin type A treatment led to an estimated prostate volume and actual prostate weights decreased up to 32.5% in rats leading to prostate apoptosis. Lysozyme gene treatment led to an estimated prostate volume and actual prostate weights decrease up to 38.7%. Lysozyme gene and botulinum neurotoxin type A treatments for prostate volume decreasing effect have been verified in the present study that could be anew modality of treatment in prostatic benign hyperplasia that needs to be verified in large randomized human experimental studies.


[From gene to disease; JAK2 and polycythaemia vera].
The identification of a point mutation in the JAK2 gene in most patients with polycythaemia vera (PV) has led to increased insight into the pathogenesis of the disease. The mutation causes cytokine-independent growth and proliferation of haematopoietic precursor cells, leading to erythrocytosis. The JAK2-V617F mutation is present in 65-97% of PV-patients and, when found, is indicative for the disease. Future research will have to show if the mutated gene can serve as a target for specific, antiproliferative therapy.


Atrial cardiopathy: a mechanism of cryptogenic stroke.
Cryptogenic stroke accounts for approximately 30% of all ischemic strokes. Recently, atrial cardiopathy diagnosed by the presence of one of its serum, imaging, or electrocardiogram biomarkers has been shown to be associated with ischemic stroke, particularly of embolic subtypes. Areas covered: This paper aims to summarize data on occult atrial fibrillation and stroke, provide an overview on mechanisms, such as inflammation and fibrosis, of stroke in atrial cardiopathy, critically review data on biomarkers of atrial cardiopathy and their association with stroke, and suggest therapeutic implications, including directions for future research. Expert commentary: Atrial cardiopathy may constitute one of the mechanisms in cryptogenic stroke, and patients with evidence of atrial cardiopathy constitute a group of patients in whom clinical trials are warranted to test anticoagulation versus antiplatelet therapy to reduce stroke recurrence risk. In addition, more studies are needed to determine the degree of overlap between these atrial cardiopathy biomarkers and which one is more useful in predicting the risk of stroke and response to anticoagulation therapy.


Fractal analysis of EEG upon auditory stimulation during waking and hypnosis in healthy volunteers.
The authors tested fluctuation analyses (DFA) of EEGs upon auditory stimulation in waking and hypnotic states as related to topography and hypnotizability. They administered the Hypnotic Induction Profile (HIP), Dissociation Experience Scale, and Tellegen Absorption Scale to 10 healthy volunteers and measured subjects' EEGs while the subjects listened to sounds, either selecting or ignoring tones of different decibels, in waking and hypnotic states. DFA scaling exponents were closest to 0.5 when subjects reported the tones in the hypnotic state. Different DFA values at C3 showed significant positive correlations with the HIP eye-roll sign. Adding to the literature supporting the state theory of hypnosis, the DFA values at F3 and C3 showed significant differences between waking and hypnotic states. Application of auditory stimuli is useful for understanding neurophysiological characteristics of hypnosis using DFA.


Stability of blocked replication forks in vivo.
Replication of chromosomal DNA must be carried out to completion in order for a cell to proliferate. However, replication forks can stall during this process for a variety of reasons, including nucleoprotein 'roadblocks' and DNA lesions. In these circumstances the replisome copying the DNA may disengage from the chromosome to allow various repair processes to restore DNA integrity and enable replication to continue. Here, we report the in vivo stability of the replication fork when it encounters a nucleoprotein blockage in Escherichia coli. Using a site-specific and reversible protein block system in conjunction with the temperature sensitive DnaC helicase loader and DnaB replicative helicase, we monitored the disappearance of the Y-shaped DNA replication fork structures using neutral-neutral 2D agarose gels. We show the replication fork collapses within 5 min of encountering the roadblock. Therefore, the stalled replication fork does not pause at a block in a stable confirmation for an extended period of time as previously postulated.


Cystic schwannoma--a case report.
Cystic change in Schwannoma is uncommon with very few cases reported in literature till date. We present a case clinically mimicking a soft tissue sarcoma but diagnosed on histopathology as cystic schwannoma.


Relationships between above- and below-ground carbon stocks in mangrove forests facilitate better estimation of total mangrove blue carbon.
Although great efforts have been made to quantify mangrove carbon stocks, accurate estimations of below-ground carbon stocks remain unreliable. In this study, we examined the distribution patterns of mangrove carbon stocks in China and other countries using our own field survey data and datasets from published literature. Based on these data, we investigated the possible relationships between above-ground carbon stock (AGC) and below-ground carbon stock (BGC) for mangrove forests, aiming to provide a scientific basis for estimation of total mangrove carbon stocks. The average above-ground carbon stock in each region was sizeable (ranging from 12.0 to 150.2 Mg/ha), but average below-ground carbon stock was dominant (ranging from 46.6 to 388.6 Mg/ha), accounting for 69-91% of total carbon stock at the sites studied in China. Significant positive relationships were found between above-ground and below-ground mangrove carbon stocks, with the best fitting equation as BGC = 1.58 * AGC + 81.06 (Mg/ha, R2 = 0.62, p < 0.01, n = 122) for China. Such linear relationships vary for mangrove forests of different types and locations, from different geographical regions in China to other countries worldwide. The positive relationship we found between above- and below-ground carbon stocks of mangrove forests in China and worldwide can facilitate more accurate assessments of mangrove blue carbon stocks at regional or global scales using modern techniques including remote sensing.


Validation of an MR-based multimodal method for molecular composition and proton stopping power ratio determination using ex vivo animal tissues and tissue-mimicking phantoms.
Objective. Range uncertainty in proton therapy is an important factor limiting clinical effectiveness. Magnetic resonance imaging (MRI) can measure voxel-wise molecular composition and, when combined with kilovoltage CT (kVCT), accurately determine mean ionization potential (Im), electron density, and stopping power ratio (SPR). We aimed to develop a novel MR-based multimodal method to accurately determine SPR and molecular compositions. This method was evaluated in tissue-mimicking andex vivoporcine phantoms, and in a brain radiotherapy patient.Approach. Four tissue-mimicking phantoms with known compositions, two porcine tissue phantoms, and a brain cancer patient were imaged with kVCT and MRI. Three imaging-based values were determined: SPRCM(CT-based Multimodal), SPRMM(MR-based Multimodal), and SPRstoich(stoichiometric calibration). MRI was used to determine two tissue-specific quantities of the Bethe Bloch equation (Im, electron density) to compute SPRCMand SPRMM. Imaging-based SPRs were compared to measurements for phantoms in a proton beam using a multilayer ionization chamber (SPRMLIC).Main results. Root mean square errors relative to SPRMLICwere 0.0104(0.86%), 0.0046(0.45%), and 0.0142(1.31%) for SPRCM, SPRMM, and SPRstoich, respectively. The largest errors were in bony phantoms, while soft tissue and porcine tissue phantoms had <1% errors across all SPR values. Relative to known physical molecular compositions, imaging-determined compositions differed by approximately ≤10%. In the brain case, the largest differences between SPRstoichand SPRMMwere in bone and high lipids/fat tissue. The magnitudes and trends of these differences matched phantom results.Significance. Our MR-based multimodal method determined molecular compositions and SPR in various tissue-mimicking phantoms with high accuracy, as confirmed with proton beam measurements. This method also revealed significant SPR differences compared to stoichiometric kVCT-only calculation in a clinical case, with the largest differences in bone. These findings support that including MRI in proton therapy treatment planning can improve the accuracy of calculated SPR values and reduce range uncertainties.


Recovery of lutein from microalgae biomass: development of a process for Scenedesmus almeriensis biomass.
In this work an optimized method for the extraction of lutein from microalgae biomass is presented. It has been developed using dry biomass of the lutein-rich microalga Scenedesmus almeriensis. The method comprises three steps, cell disruption, alkaline treatment, and solvent extraction, and renders a carotenoid extract rich in lutein. The results demonstrate that cell disruption is necessary and that the best option among the treatments tested with regard to industrial applications is the use of a bead mill with alumina in a 1:1 w/w proportion as disintegrating agent for 5 min. With regard to the alkaline treatment, the optimal conditions were obtained using 4% w/v KOH with a biomass concentration of 100 g/L for 5 min. Longer alkaline treatments or the use of higher KOH concentrations reduced the yield of the process. Finally, extraction with hexane is optimized. Using a 1:1 ratio hexane to sample volume, a total of eight extraction steps are necessary to recover 99% of lutein contained in the processed biomass. However, the optimal number of extraction steps is six, 95% of the lutein being recovered. In summary, the developed method allows the efficient recovery of lutein from microalgae biomass, it being a scaleable and industrially applicable method.


Correlation between serum cytokeratin-18 and the progression or regression of non-alcoholic fatty liver disease.
Diagnosis of non-alcoholic fatty liver disease (NAFLD) is limited by the need for liver biopsies. Serum cytokeratin 18 (CK-18) levels have been investigated as potential biomarkers for the presence of NAFLD and non-alcoholic steatohepatitis (NASH). Herein, we assessed the correlation between CK-18 levels and NAFLD progression. Serum CK-18 levels were estimated using the M30 antibody enzyme-linked immunosorbent assay in 147 patients diagnosed with NAFLD. In 72 patients, disease progression was evaluated by repeated liver biopsy, which was conducted after 4.3 ± 2.6 years. The relationship between the CK-18 levels and liver histological findings was assessed. The CK-18 levels were useful for identifying NAFLD patients with NAFLD activity scores (NAS) ≥ 5 (NAS ≥ 5 vs. ≤ 4: 675.1 U/L vs. 348.7 U/L; p < 0.0001). A cut-off value of 375 U/L was calculated using the receiver operating characteristic curve approach, with a specificity and sensitivity of 81.5 and 65%, respectively, for the diagnosis of NASH. Among the 72 patients who underwent repeated liver biopsy, 11 patients with a progressed NAS also had significantly increased serum CK-18 levels (p < 0.01); in 30 patients with an improved NAS, there was a significant improvement in the mean CK-18 levels (p < 0.0001). The 31 patients with static NAS had static CK-18 levels. In conclusion, serum CK-18 levels can predict NAS ≥ 5 in NAFLD patients. In NAFLD patients, serum CK-18 levels reflect NAS values and correlate with histological changes, and they appear to be useful indicators of progression and improvement.


Total synthesis of (-)-himgaline.
The first total synthesis of (-)-himgaline and a highly enantioselective synthesis of its congener (-)-GB 13 are described. Decarboxylative aza-Michael reaction of the hexacyclic lactone precursor under acidic conditions, followed by basic workup, yielded (-)-GB 13 in 80% yield. Cyclization of (-)-GB 13 to oxohimgaline under acidic conditions, followed by internally coordinated sodium triacetoxyborohydride reduction, gave (-)-himgaline as the exclusive product.


Cholesterol facilitates the native mechanism of Ca2+-triggered membrane fusion.
The process of regulated exocytosis is defined by the Ca2+-triggered fusion of two apposed membranes, enabling the release of vesicular contents. This fusion step involves a number of energetically complex steps and requires both protein and lipid membrane components. The role of cholesterol has been investigated using isolated release-ready native cortical secretory vesicles to analyze the Ca2+-triggered fusion step of exocytosis. Cholesterol is a major component of vesicle membranes and we show here that selective removal from membranes, selective sequestering within membranes, or enzymatic modification causes a significant inhibition of the extent, Ca2+ sensitivity and kinetics of fusion. Depending upon the amount incorporated, addition of exogenous cholesterol to cholesterol-depleted membranes consistently recovers the extent, but not the Ca2+ sensitivity or kinetics of fusion. Membrane components of comparable negative curvature selectively recover the ability to fuse, but are unable to recover the kinetics and Ca2+ sensitivity of vesicle fusion. This indicates at least two specific positive roles for cholesterol in the process of membrane fusion: as a local membrane organizer contributing to the efficiency of fusion, and, by virtue of its intrinsic negative curvature, as a specific molecule working in concert with protein factors to facilitate the minimal molecular machinery for fast Ca2+-triggered fusion.


Effectiveness of Islamic spiritual care: foundations and practices of Muslim spiritual care givers.
The paper discusses the effectiveness of Islamic spiritual and religious care based on the ethnographic research with 15 Muslim spiritual caregivers. Six themes emerged from the interviews with fifteen Muslim spiritual caregivers. These six themes describe what the spiritual care providers see as effective Muslim spiritual care: (1) The most effective Muslim spiritual care is rooted in the Qur'an and the Hadith; (2) Effective Muslim spiritual care also means creating a caring relationship with the patient; (3) Muslim scholars are one of the important sources of effective Islamic spiritual care; (4) The insights of psychology and the social sciences are a necessary part of effective Islamic spiritual care; (5) There is a need for continuing education; (6). Styles of effective Muslim spiritual care are varied.


Lidocaine suppositories for prostate biopsy.
To evaluate, in a randomized prospective study, the efficiency of transrectal lidocaine suppositories to reduce pain during transrectal prostate biopsy, as suppositories allow longer for the agent to be effective. In all, 100 patients were randomized to receive either a placebo suppository or 10 mL of 2% (200 mg) lidocaine gel rectally 10 min before biopsy, or a suppository containing 60 mg lidocaine 1 or 2 h before biopsy. Costs (in euros) per application were 0.82 for gel and 0.63 for suppositories. In all patients the same 10-core biopsy technique was used. Pain was evaluated using a visual linear pain scale ranging from 0 to 100 points; the patient's side of the scale did not show the number of points. The mean pain scores in the placebo, lidocaine gel, and lidocaine suppositories applied 1 h and 2 h before biopsy were 36.2, 40.9, 29.2 and 21.2, respectively. Thus patients with no anaesthesia reported 25% more pain than those receiving lidocaine suppositories 1 h before and 71% more pain than those receiving lidocaine suppositories 2 h before biopsy (P = 0.002). Lidocaine suppositories at a lower dose and with longer to take effect can be used to reduce pain significantly more effectively than the commonly used gel. As suppositories are easy to use and cheap, they are recommended in daily routine prostate biopsy.


Improvement of human melanoma colony formation in soft agar using boiled instead of autoclaved agar.
The effect of agar sterilized by either boiling or autoclaving on human melanoma colony formation in soft agar was compared using cells from 17 biopsies of metastatic malignant melanoma. The frequency of colony formation was significantly increased for cells grown in boiled agar in 8 samples (47%), unchanged in 8 samples (47%), and decreased in only one sample (6%). There were increases in both cluster and colony formation for the melanomas which had augmented colony formation when grown in boiled agar. There was also qualitative morphological improvement, including rounder, smoother cells and less extracellular debris surrounding the colonies. These data suggest that melanoma colony formation is enhanced when cells are grown in agar which has been sterilized by boiling rather than autoclaving.


Identification of sentinel health events as indicators of environmental contamination.
The consensus process was applied to addressing a public health topic; this was a novel endeavor. The following question was addressed: What role, if any, should sentinel health events play in the decision-making process for identifying the effects of environmental exposure? The panel developed three levels of sentinel health events lists: those that are clearly identifiable, those that are potential signs, and those that are indicators of body burdens. Additionally, the panel developed several salient statements regarding the principles of environmental health surveillance and, especially, recommendations for future research.


Wavelet treatment of radial distribution functions of solutes.
Discrete wavelets are applied to parametrize the radial distribution functions of hydrated ions and hydrophobic solutes. The data on radial distribution functions are derived from the integral equation theory and neutron scattering experiment. The Coifman and the discrete Meyer basis sets are used for the wavelet approximation. The quality of the approximation is verified by calculations of the solvation energy, the coordination number, and the change in chemical potential of solutes.


A novel small-molecule compound disrupts influenza A virus PB2 cap-binding and inhibits viral replication.
The conserved residues 318-483 in the PB2 subunit of influenza A polymerase is an independently folded cap-binding domain (PB2cap) that exhibits a distinct binding mode from other host cap-binding proteins, which suggests that PB2cap might be an ideal drug target. This study aimed to identify a new class of anti-influenza inhibitors that specifically disrupts the interaction between PB2cap and host cap structures. An innovative fluorescence polarization assay was established for primary screening, followed by cap-binding inhibitory activity, antiviral efficacy and cytotoxicity evaluations of the selected compounds. The best compound was characterized by multi-cycle virus growth assay, cross-protection test, synergism evaluation, mini-replicon assay, binding affinity analysis, docking simulation and mouse study. Several PB2 cap-binding inhibitors were discovered. The compound 7-(4-hydroxy-2-oxo-2H-chromen-3-yl)-6H,7H,8H-chromeno[3',4':5,6]pyrano[3,2-c]chromene-6,8-dione, designated PB2-39, was identified as a potent inhibitor of replication of multiple subtypes of influenza A virus, including H1N1, H3N2, H5N1, H7N7, H7N9 and H9N2 in vitro and H1N1, H5N1 and H7N9 in vivo. Combinational treatment with the influenza virus release inhibitor zanamivir and PB2-39 exerted a synergistic anti-influenza effect. Mechanistic experiments supported that PB2-39 suppressed viral polymerase activity. Docking and binding affinity analyses demonstrated that PB2-39 interacted with the PB2 cap-binding pocket, suggesting its role as a cap-binding competitor. Our study provides new insights for the strategic development of novel cap-binding inhibitors of influenza A viruses.


Esthetic noncarious Class V restorations: a case report.
When restoring anterior and posterior teeth affected by noncarious cervical lesions, many clinicians overlook the etiologic factors responsible for the lesions' development, resulting in frequent restorative failures. The treatment approach for noncarious cervical lesions must not be based only on restorative procedures since a variety of causative and aggravating factors are related to their formation. This article discusses a treatment protocol and techniques for the restoration of noncarious Class V lesions and presents a clinical case in which esthetic restorations are achieved. Treatment options for noncarious Class V lesions can range from simply eliminating the causative factors of the lesions and regularly monitoring their progression to specific restorative procedures. Resin composites are the best materials for restoring cervical defects owing to their bonding ability, physical properties, and esthetic potential. A straightforward technique for the successful restoration of noncarious Class V lesions is presented.


Serum antibodies against membranous labyrinth in patients with "idiopathic" bilateral vestibulopathy.
To investigate the possibility of an autoimmune mechanism in idiopathic bilateral vestibulopathy (IBV), we screened patients' sera for antibodies against inner ear structures. IgG antibodies against membranous labyrinth (ampulla, semicircular canals, saccule and utricle) were detected in 8 of 12 patients by immunofluorescence on rat inner ear cryosections. All but one serum of 22 healthy controls and the sera of 6 patients with known autoimmune disorders showed only background staining. Low-titre anti-nuclear IgM antibodies were present in three control sera and one IBV serum. High-titre anti-nuclear IgM was found in a patient with lupus erythematosus and in one with scleroderma. Anti-nuclear IgM was not organ-specific. No human serum used contained detectable anti-vascular preformed antibodies. Cross-reactivity to sections of liver, kidney, cornea, brain and skeletal muscle was absent. Double-staining for IgG and F-actin, the primary constituent of hair cell cilia, did not show predominant Ig-coating of sensory hair cells. Immunosuppressive therapy in 3 IBV patients did not improve the disorder, probably owing to irreversible loss of sensory and neural structures. These data suggest that the bulk of anti-labyrinthine autoantibodies may be an epiphenomenon, yet a small subgroup of organ-specific autoantibodies may synergize with a cellular response in the development of vestibular lesions.


Growth factor-mediated mechanisms of nicotine-dependent carcinogenesis.
The direct effect of nicotine on the expression of receptors for the tumor necrosis factor alpha (TNF alpha) and transforming growth factor beta (TGF beta) and the internalization, intracellular distribution and stability of these growth factors in cervical cancer cell line SiHa was studied. Nicotine at concentrations in the range 0.05-0.25% inhibited cell growth and it exerted strong apoptotic and cytolytic effects at concentrations above 0.5%. Nicotine at 0.1% stabilized and protected from degradation [125I]TNF alpha and [125I]TGF beta internalized by cervical cancer SiHa cell line. In the absence of nicotine, [125I]TNF alpha and [125I]TGF beta were internalized during the first hour of incubation and localized mainly in the cytoplasm and in smaller amounts in the nucleus. After 1 day of cell exposure to growth factors, only traces of radioactivity were detected inside the cells, which indicated that both growth factors were rapidly degraded. In the presence of nicotine, both [125I]TNF alpha and [125I]TGF beta were detected in high quantities and in a non-degraded form in the cytoplasm and chromatin during 5 days of incubation. In addition to the lack of growth factor degradation, the presence of nicotine induced a nuclear accumulation of growth factors, with up to 37% of the internalized [125I]TGF beta being in the chromatin. An increased intracellular accumulation of [125I]TNF alpha and [125I]TGF beta in cells exposed to nicotine occurred without changes in expression of the cell surface receptors. Nuclear accumulation of TGF beta was followed by increased RNA synthesis and a switch from the growth-promoting action of TGF beta to the strong growth inhibitory effect. Inhibition of the lysosomal degradation of growth factors by nicotine is discussed as a potential mechanism of tobacco-induced carcinogenesis.


Invited Commentary: A Landmark Study Launched in a Public Health Maelstrom.
The acquired immune deficiency syndrome (AIDS) epidemic was first recognized in 1981, and it quickly became a public health emergency. In a 1987 paper in the American Journal of Epidemiology (Am J Epidemiol. 1987;126(2): 310-318), Richard Kaslow et al. described the launch of the Multicenter AIDS Cohort Study (MACS), a cohort study of homosexual men in 4 US cities, the purpose of which was to better understand the natural history of AIDS and its determinants. The MACS enrolled participants through a range of community contacts. These efforts facilitated rapid recruitment, but given the targeted approaches, participants tended to comprise high-risk social networks. At baseline, 4%-26% of participants at the 4 sites reported having a sexual partner who had developed AIDS. Kaslow et al. also described baseline testing for the causative agent of AIDS, the human immunodeficiency virus (HIV). HIV seroprevalence was remarkably high, ranging from 11%-26% across age groups in Pittsburgh to 38%-53% in Los Angeles. The major turning point in the epidemic occurred in 1995-1996 when combination antiretroviral therapy was introduced, effectively blocking HIV replication and markedly reducing AIDS morbidity and mortality. The MACS cohort continues to be followed actively 3 decades after its launch and has proven to be an important resource for information on HIV infection and AIDS.


Surgical dilemmas in the management of colorectal liver metastases: The role of timing.
Colorectal cancer (CRC) is an emerging health problem in the Western World both for its raising tendency as well as for its metastatic potential. Almost half of the patients with CRC will develop liver metastases during the course of their disease. The liver surgeon dealing with colorectal liver metastases faces several surgical dilemmas especially in the setting of the timing of operation. Synchronous resectable metastases should be treated prior or after induction chemotherapy? Furthermore in the case of synchronous colorectal liver metastases which organ should we first deal with, the liver or the colon? All these questions are set in the editorial and impulse for further investigation is put focusing on multidisciplinary approach and individualization of treatment modalities.


Hybrid resolution molecular dynamics simulations of amyloid proteins interacting with membranes.
A broad range of human diseases, including Alzheimer's and Parkinson's diseases, arise from or have as key players intrinsically disordered proteins. The aggregation of these amyloid proteins into fibrillar aggregates are the key events of such diseases. Characterizing the conformation dynamics of the proteins involved is crucial for understanding the molecular mechanisms of aggregation, which in turn is important for drug development efforts against these diseases. Computational approaches have provided extensive detail about some steps of the aggregation process, however the biologically relevant elements responsible for the aggregation and or aggregation propagation have not been fully characterized. Here we describe a hybrid resolution molecular dynamics simulation method that can be employed to investigate the interaction of amyloid proteins with lipid membranes, shown to dramatically accelerate the aggregation propensity of amyloid proteins. The hybrid resolution method enables routine and accurate simulation of multi-protein and complex membrane systems, mimicking biologically relevant lipid membranes, on microsecond time scales. The hybrid resolution method was applied to computer modeling of the interactions of α -synuclein protein with a mixed lipid bilayer.


Comparative methylprednisolone pharmacokinetics in renal transplant patients receiving double- or triple-drug immunosuppression.
To assess the pharmacokinetics of chronic methylprednisolone therapy in renal transplant patients receiving double-drug (methylprednisolone and azathioprine) and triple-drug (methylprednisolone, azathioprine, and cyclosporine) immunosuppression. Parallel, randomized trial. Fourteen renal transplant recipients (aged 29-65 y) evaluated in a public, university-affiliated hospital clinic. All patients received their chronic oral dose of methylprednisolone via a 10-20-minute intravenous infusion. Serum methylprednisolone concentrations were determined by HPLC and were used to generate pharmacokinetic parameters for this drug. The mean daily methylprednisolone dosage was 19 +/- 19 mg in the double-drug group and 9 +/- 2 mg in the triple-drug group. Mean serum creatinine concentrations were 124 +/- 44 and 124 +/- 27 mumol/L, respectively. Mean methylprednisolone clearances were similar in both groups: 405 +/- 205 (double-drug) and 373 +/- 365 mL/h/kg (triple-drug) (p > 0.05). Mean steady-state volume of distribution was 1.5 +/- 0.8 L/kg in the double-drug group and 1.3 +/- 0.8 L/kg in the triple-drug group (p > 0.05). Plasma half-life ranged from 1.7 to 4.3 h (mean 2.7) in the double-drug group versus 1.4 to 3.4 h (mean 2.6) in the triple-drug group (p > 0.05). These data indicate that cyclosporine had no definitive influence on methylprednisolone disposition. The results reveal a wide variation in methylprednisolone metabolism in renal transplant recipients receiving either a double- or triple-drug immunosuppressive regimen. Typically, methylprednisolone is prescribed according to a standardized dosing protocol that assumes minimal interpatient variation. Therefore, the pharmacokinetic variability noted in this study may have important clinical implications regarding the development of chronic toxicity (e.g., osteoporosis, hypothalamic-pituitary-adrenal suppression) and the attainment of successful immunosuppression.


[Progress in the treatment of stained teeth].
The treatment of stained teeth has been one of the striking aspects of stomatology and esthetic dentistry. Based on detailed data and references, this article introduces the types of stained teeth and the main treatment methods including strong point, weakness, limitation of the usage, result, and the relevant mechanisms. It addresses the researches on problems in the treatment of stained teeth. Also in this paper is envisaged what will be done to treat the stained teeth in future.


[End of life and termination of life: opinions of elderly persons with health problems].
To determine the views of elderly persons with physical limitations about a number of aspects of the end stage of life and termination of life. Enquiry. University of Groningen, the Netherlands. An enquiry was conducted in 1995 among 575 elderly (429 females, 146 males; age 57-99 years; 281 living alone) with physical restrictions (mostly heart disease, hypertension, rheumatism or other articular diseases). The group had been selected from the 'Groningen longitudinal aging study'. The respondents were asked (a) what they thought about euthanasia, (b) whether they worried about the end stage of life, (c) whether they were afraid of death and how much they were 'preoccupied with death'. For the last-mentioned two questions a visual analogue scale was used. Almost one-third of the elderly were not preoccupied with death and over half were not afraid of death. Very few scored high on these scales. Respondents' views about the acceptability of active termination of life varied greatly: almost half were of the opinion that their life had to be terminated once they themselves had developed complete dementia. Regarding the end stage of life, respondents mostly worried about being a burden to others, being completely dependent on others, having to say goodbye to their loved ones and having to suffer greatly. Elderly persons with poorer health were more preoccupied with death and worried more about the problems of the end stage of life. Most of those interviewed were not greatly preoccupied with or afraid of death. They did worry, however, about the problems that might be associated with the end stage of life.


[Microbiological synthesis of [2H]-inosine with a high degree of isotopic enrichment by the gram-positive chemoheterotrophic bacterium Bacillus subtilis].
A 2H-labeled purine ribonucleoside inosine was microbiologically synthesized (yield, 3.9 g/L of culture liquid) using a deuterium-adapted strain ofthe gram-positive chemoheterotrophic bacterium Bacillus subtilis, cultivated in a heavy water medium with a high degree of deuteration (99.8 at % 2H) containing 2% hydrolysate of deuterated biomass of the methylotrophic bacterium Brevibacterium methylicum as a source of 2H-labeled growth substrate produced in an M9 minimal medium with 98% 2H20 and 2% [2H]-methanol. The inosine extracted from the culture liquid of the producer strain was fractionated by adsorption (desorption) on an activated carbon surface, extraction with 0.3 M ammonium-formate buffer (pH 8.9), subsequent crystallization in 80% ethanol, and ion exchange chromatography on a column with AG50WX 4 cation exchange resin equilibrated with 0.3 M ammonium-formate buffer containing 0.045 M NH4Cl. Fast atom bombardment (FAB) mass spectrometry demonstrated incorporation of five deuterium atoms in the inosine molecule (62.5% 2H), three of which were contained in the ribose moiety and two in the hypoxanthine moiety.


Predictors of renal function recovery among patients undergoing renal replacement therapy following orthotopic liver transplantation.
Renal dysfunction frequently occurs during the periods preceding and following orthotopic liver transplantation (OLT), and in many cases, renal replacement therapy (RRT) is required. Information regarding the duration of RRT and the rate of kidney function recovery after OLT is crucial for transplant program management. We evaluated a sample of 155 stable patients undergoing post-intensive care hemodialysis (HD) from a patient population of 908 adults who underwent OLT. We investigated the average time to renal function recovery (duration of RRT required) and determined the risk factors for remaining on dialysis > 90 days after OLT. Log-rank tests were used for univariate analysis, and Cox proportional hazards models were used to identify factors associated with the risk of remaining on HD. The results of our analysis showed that of the 155 patients, 28% had pre-OLT diabetes mellitus, 21% had pre-OLT hypertension, and 40% had viral hepatitis. Among the patients, the median MELD (Model for End-Stage Liver Disease) score was 27 (interquartile range [IQR] 22-35). When they were listed for liver transplantation, 32% of the patients had serum creatinine (Scr) levels > 1.5 mg/dL or were on HD, and 50% had serum creatinine (Scr) levels > 1.5 mg/dL or were on HD at the time of OLT. Of the transplanted patients, 25% underwent pre-OLT intermittent HD, and 14% and 41% underwent continuous renal replacement therapy (CRRT) pre-OLT and post-OLT, respectively. At 90 days post-OLT, 118 (76%) patients had been taken off dialysis, and 16 (10%) patients had died while undergoing HD. The median recovery time of these post-OLT patients was 33 (IQR 27-39) days. In the multivariate analysis, fulminant hepatic failure as the cause of liver disease (p<0.001), the absence of pre-OLT hypertension (p = 0.016), a lower intraoperative fresh-frozen plasma (FFP) transfusion volume (p = 0.019) and not undergoing pre-OLT intermittent HD (p = 0.032) were associated with performing RRT for less than 90 days. Therefore, a high proportion of OLT patients showed improved renal function after OLT, and those who were diagnosed with fulminant hepatic failure, had no pre-OLT hypertension, received a lower transfused volume of intraoperative FFP and did not undergo pre-OLT intermittent HD had a higher probability of recovery.


Polymorphic mutation frequencies in clinical isolates of Staphylococcus aureus: the role of weak mutators in the development of fluoroquinolone resistance.
The polymorphic mutation frequencies for 154 Staphylococcus aureus isolates from Chinese bovine clinical mastitis cases were investigated. We found that nearly 29% of the isolates presented as weak mutators, while only two (1.3%) strong mutators were detected. Of the 15 weak mutators that exhibited ciprofloxacin resistance phenotypes, only one isolate was found to be mutS deficient. All of the ciprofloxacin-resistant isolates had the classic ciprofloxacin resistance mutations at codon 80 within the ParC subunit of topoisomerase IV and codon 84/88 within the GyrA subunit of DNA gyrase. The proportion of ciprofloxacin-resistant isolates among the weak mutators (34.1%) was significantly higher than that found in the normomutators (11.4%) and hypomutators (0%) (P < 0.001, Fisher's exact test), suggesting a positive correlation between weak mutators and ciprofloxacin resistance.


Dissolved oxygen content prediction in crab culture using a hybrid intelligent method.
A precise predictive model is needed to obtain a clear understanding of the changing dissolved oxygen content in outdoor crab ponds, to assess how to reduce risk and to optimize water quality management. The uncertainties in the data from multiple sensors are a significant factor when building a dissolved oxygen content prediction model. To increase prediction accuracy, a new hybrid dissolved oxygen content forecasting model based on the radial basis function neural networks (RBFNN) data fusion method and a least squares support vector machine (LSSVM) with an optimal improved particle swarm optimization(IPSO) is developed. In the modelling process, the RBFNN data fusion method is used to improve information accuracy and provide more trustworthy training samples for the IPSO-LSSVM prediction model. The LSSVM is a powerful tool for achieving nonlinear dissolved oxygen content forecasting. In addition, an improved particle swarm optimization algorithm is developed to determine the optimal parameters for the LSSVM with high accuracy and generalizability. In this study, the comparison of the prediction results of different traditional models validates the effectiveness and accuracy of the proposed hybrid RBFNN-IPSO-LSSVM model for dissolved oxygen content prediction in outdoor crab ponds.


Waterborne, semicrystalline, pressure-sensitive adhesives with temperature-responsiveness and optimum properties.
The synthesis and resulting temperature-responsive properties of semicrystalline waterborne pressure-sensitive adhesives (PSAs) were investigated. A crystalline polymer fraction was produced in situ within waterborne particles by miniemulsion polymerization of non-branched long chain acrylates. The degree of crystallinity was controlled by copolymerization with a short chain acrylate. The polymerization strategy determined the polymer architecture and film structure, which then influenced the adhesion properties. The high sensitivity of the adhesion strength of these PSAs to temperature, in the range around the crystal melting point, opens up the possibility of designing temperature-responsive adhesives. With the right distribution and concentration of crystalline polymers, a simultaneous increase in both the peel strength and the shear resistance was obtained, which is a combination that is often not found when optimizing adhesive properties.