Effect of histamine on aorta preparations of different species.
The effect of histamine (10(-8) to 10(-3)M) on aorta preparations of 5 different species was studied. In aortic ring segments, precontracted by norepinephrine, three types of dose-response curves were found: relaxation (rat), contraction (guinea-pig, cat, mouse) and relaxation followed by contraction at higher doses (rabbit). In relaxed preparations, histamine either had no effect (rat) or elicited a contraction (rabbit, guinea-pig). All the contraction effects proved to be H1-mediated as they were antagonized by mepyramine. These contraction effects were maintained or even increased after rubbing the endothelial surface of the vessel, which suggests a direct action on muscular structures. The differences between the species in the dose-response curves to histamine appeared to be determined by the role of the endothelial structures, which can induce an H1-mediated (rat) or an H2-mediated (rabbit) relaxation or may have no influence (guinea-pig).


Disposition and metabolism of the new oral antidiabetic drug troglitazone in rats, mice and dogs.
The pharmacokinetics of troglitazone (CAS 97322-87-7, CS-045), a new oral antidiabetic drug for the treatment of non-insulin-dependent diabetes mellitus (NIDDM), were investigated in rats, mice and dogs following oral and intravenous administration of 14C-labeled troglitazone at doses of 5 mg/kg. The absorption rates, calculated from the AUC ratios of total radioactivity after oral and intravenous administration, or from the biliary excretion rate after intraduodenal administration in rats were both as high as 75%. High uptake by the liver, one of the pharmacological target organs, was demonstrated in both rats and mice. Furthermore, in the KK mouse, an obese NIDDM model animal, the radioactivity was incorporated selectively as troglitazone itself to muscle, the peripheral target organ. Troglitazone reversibly bound to serum albumin with a high ratio (> 99%). Troglitazone was mostly metabolized to the conjugates: sulfate (M 1) and glucuronide (M 2). The oxidized metabolite, a quinone-type metabolite (M 3), was found to be further metabolized to the sulfate (U 2). The biliary excretion rates of these conjugates were high in each animal, and the occurrence of enterohepatic circulation of the conjugates was also suggested. Sex differences in pharmacokinetics were observed in rats; i.e. females showed a higher plasma concentration of troglitazone, and a lower concentration of M 1, than males, and they excreted the sex-related metabolite, a hydroxylated M 1 (U 1), in the bile.


Thrombospondin-1 stimulates platelet aggregation by blocking the antithrombotic activity of nitric oxide/cGMP signaling.
Platelet alpha-granules constitute the major rapidly releasable reservoir of thrombospondin-1 in higher animals. Although some fragments and peptides derived from thrombospondin-1 stimulate or inhibit platelet aggregation, its physiologic function in platelets has remained elusive. We now show that endogenous thrombospondin-1 is necessary for platelet aggregation in vitro in the presence of physiologic levels of nitric oxide (NO). Exogenous NO or elevation of cGMP delays thrombin-induced platelet aggregation under high shear and static conditions, and exogenous thrombospondin-1 reverses this delay. Thrombospondin-1-null murine platelets fail to aggregate in response to thrombin in the presence of exogenous NO or 8Br-cGMP. At physiologic concentrations of the NO synthase substrate arginine, thrombospondin-1-null platelets have elevated basal cGMP. Ligation of CD36 or CD47 is sufficient to block NO-induced cGMP accumulation and mimic the effect of thrombospondin-1 on aggregation. Exogenous thrombospondin-1 also reverses the suppression by NO of alphaIIb/beta3 integrin-mediated platelet adhesion on immobilized fibrinogen, mediated in part by increased GTP loading of Rap1. Thrombospondin-1 also inhibits cGMP-mediated activation of cGMP-dependent protein kinase and thereby prevents phosphorylation of VASP. Thus, release of thrombospondin-1 from alpha-granules during activation provides positive feedback to promote efficient platelet aggregation and adhesion by overcoming the antithrombotic activity of physiologic NO.


Determinants of Follow-up Care for Patients With Celiac Disease.
This study aimed to investigate follow-up patterns among celiac disease (CD) patients. Gender factors are important in CD with women diagnosed more frequently than men despite equal seropositivity in screening studies. To determine if gender influences postdiagnosis care, we performed a retrospective cohort study investigating the impact of gender and mode of presentation on follow-up patterns after diagnosis. The study included adults with biopsy-proven CD presenting to a single tertiary care center between 2005 and 2014. The primary exposure was at least 1 visit with a CD specialist. The primary outcome was ≥2 follow-up visits, including office visits and endoscopic procedures. Data extracted included whether patients had tissue transglutaminase antibodies performed by our laboratory. We analyzed 708 patients of which 70.5% were female. Follow-up was good with a majority of patients (69%) having at least 1 follow-up visit. On bivariate analysis, patients least likely to follow-up were ages 18 to 29 (P=0.03) and women with atypical presentations (P=0.003). After adjusting for potential confounders, individuals over age 65 were significantly more likely to attend at least 2 follow-up visits (odds ratio, 2.07; 95% confidence interval, 1.21-3.55; P=0.0079). Individuals with an abnormal baseline tissue transglutaminase antibody value in our laboratory were significantly more likely to follow-up (odds ratio, 1.99; 95% confidence interval, 1.39-2.85; P=0.0002). Gender had no impact on follow-up patterns despite prior studies demonstrating an impact on diagnosis rates. Future attention should focus on retaining young patients and those with atypical modes of presentation.


A chemical synthesis of 11-methoxy mitragynine pseudoindoxyl featuring the interrupted Ugi reaction.
A synthesis of 11-methoxy mitragynine pseudoindoxyl, a new member of the mitragynine class of opioid agonists, from a derivative of the Geissman-Waiss lactone is described. An internal attack of an electron-rich aromatic ring on an electrophilic nitrilium ion and a late-stage construction of the functionalized piperidine ring by the method of reductive cyclization are the pivotal transformations; both ring annulations proceed in a highly diastereoselective fashion. The construction of substituted indoxyl frameworks by the interrupted Ugi method offers an attractive alternative to the strategy of oxidatively rearranging indoles.


A composite electrodynamic mechanism to reconcile spatiotemporally resolved exciton transport in quantum dot superlattices.
Quantum dot (QD) solids are promising optoelectronic materials; further advancing their device functionality requires understanding their energy transport mechanisms. The commonly invoked near-field Förster resonance energy transfer (FRET) theory often underestimates the exciton hopping rate in QD solids, yet no consensus exists on the underlying cause. In response, we use time-resolved ultrafast stimulated emission depletion (STED) microscopy, an ultrafast transformation of STED to spatiotemporally resolve exciton diffusion in tellurium-doped cadmium selenide-core/cadmium sulfide-shell QD superlattices. We measure the concomitant time-resolved exciton energy decay due to excitons sampling a heterogeneous energetic landscape within the superlattice. The heterogeneity is quantified by single-particle emission spectroscopy. This powerful multimodal set of observables provides sufficient constraints on a kinetic Monte Carlo simulation of exciton transport to elucidate a composite transport mechanism that includes both near-field FRET and previously neglected far-field emission/reabsorption contributions. Uncovering this mechanism offers a much-needed unified framework in which to characterize transport in QD solids and additional principles for device design.


Delivery systems for agriculture: Fe-EDDHSA/CaCO3 hybrid crystals as adjuvants for prevention of iron chlorosis.
Fe-EDDHSA/CaCO3 hybrid crystals are synthesized and tested in vitro to determine their effect in treating iron chlorosis in kiwifruit plants, used as a proof of concept. Under the alkaline conditions provided by the calcareous substrate, plants release protons that dissolve the hybrids and trigger Fe uptake. These CaCO3 hybrids represent a new system for active molecule delivery in agriculture.


Host-aware modelling of a synthetic genetic oscillator.
Synthetic genetic circuits sometimes exhibit unexpected functionality or even fail entirely when implemented in vivo, due to the effects of interactions with the host cell that were not accounted for in the circuit's design. In this paper, we consider the effects that limitations in cellular resources have on the dynamics of a synthetic cellular oscillator. We show that incorporating these effects into a host-aware model of the synthetic oscillator results in significant changes in its dynamics, highlighting the need to take account of host-circuit interactions in mathematical models that are to be used as CAD tools for synthetic circuitry.


[Not Available].
In his last works, Ferenczi emphasizes the suffering of the child, who is a victim of the seductive parent, and environment. In the Clinical Diary he writes about the consequences of the trauma more dramatically. A part of the personality dies but can be alive again in psychoanalysis. The author tries to examine whether the appearance of these topics in Ferenczi's late papers is connected with sensing the illness, and imminent death. If this theory is correct, we must see a high elaboration level in Ferenczi's reaction. The heavy symptoms of the illness did not lead to narcissistic regression, but to a deepening of empathy, and of the experience of human solidarity.


High-frequency dispersion from viscous drag at the grain-grain contact in water-saturated sand.
Shear viscous drag within the thin fluid film at the contact between grains in water-saturated sand is an important loss mechanism for high-frequency sound in the Biot-Stoll plus contact squirt flow and shear viscous drag (BICSQS) model [J. Acoust. Soc. Am. 116, 2011-2022 (2004)]. Couette flow was assumed for the shear drag but it breaks down when inertial effects within the film become significant. Using Biot's method, a correction is derived for the shear drag and inserted into the BICSQS model. The result is a prediction of negative sound speed dispersion, consistent with dynamic theories of fluid-filled poroelastic bodies.


Ruptured subcapsular liver hematoma and pregnancy: a rare complication of severe preeclampsia: a report of a case discovered fortuitously at the Maternity Teaching Hospital of Cocody.
We report a case of spontaneous rupture of a subcapsular hematoma of the liver (SHL). It was discovered incidentally at the end of an emergency exploratory laparotomy performed due to unexplained hemoperitoneum with hypovolemic shock which occurred with severe preeclampsia. Diagnosis and therapeutic management are very difficult in sub-Saharan Africa due in part to the limitations and lack of medical equipment. The prognosis is usually marked by the death of the patient, as in our case. Through this clinical observation we wanted to show the interest in performing a liver ultrasound at any level of preeclampsia to detect liver abnormalities as soon as possible.


The Mechanisms of Resistin-Like Molecule-β-Mediated Airway Inflammation in Chronic Obstructive Pulmonary Disease via Autophagy.
The role of irreversible airway inflammatory damage in chronic obstructive pulmonary disease (COPD) progression is evident. Autophagy is an essential process in the cellular material metabolic cycle, and a family of resistant vegetative molecules may be involved in the COPD autophagic process. In this study, we investigated the mechanism of resistin-like molecule β (RELMβ) in COPD smoking-induced autophagy. Firstly, the expression differences of RELMβ and autophagy markers between COPD and control groups were analyzed in the Gene Expression Omnibus (GEO) datasets and clinical specimens. Secondly, in vitro and in vivo experiments were conducted using immunoblotting, immunofluorescence, immunohistochemistry, and other methods to investigate the mechanism by which RELMβ promotes airway inflammation through autophagy in a cigarette smoke extract-induced 16HBE cell inflammation model and a cigarette smoke-induced COPD-like mouse model. In addition, immunoprecipitation was used to analyze the binding of RELMβ to the membrane protein TLR4. The expression of RELMβ and autophagy genes p62 and LC3B in lung tissue of COPD patients was significantly increased. RELMβ can mediate the activation of autophagy in 16HBE cells, and through autophagy, it increases the expression of inflammatory cytokines in a cigarette smoke extract-induced 16HBE cell inflammation model. RELMβ promotes cigarette smoke-induced COPD-like mouse airway inflammation through autophagy, and RELMβ can mediate signal transduction through the cell membrane receptor TLR4. The RELMβ binds to TLR4 to encourage signal transduction and that RELMβ can promote inflammation in smoky COPD lungs through autophagy.


[Epithelial growth factor receptor mutation status to the effective of survival in non-small cell lung cancer after surgery].
To investigate the relationship between the epithelial growth factor receptor (EGFR) mutation status and clinicopathological factors, and to analyze the mutation on the effect in non-small cell lung cancer (NSCLC) after surgery. The NSCLC patients who were resected and detected EGFR gene from March 2009 to March 2011 were retrospectively reviewed. The relationship between EGFR mutation status and clinicopathological factors, tumor markers, prognostic was analyzed. The mutation and the wild group had 169 and 214 patients respectively. EGFR mutation in female, non-smoking, adenocarcinoma and less than 60 years old accounted for 63.91%, 61.54%, 88.76% and 62.13% with statistical significance compared with male (χ(2) = 53.490, P = 0.000), smoking (χ(2) = 48.568, P = 0.000), non-adenocarcinoma (χ(2) = 105.560, P = 0.000) and more than 60 years old (χ(2) = 6.057, P = 0.017). Disease free survival (DFS) of the wild group was better than mutation group (χ(2) = 11.329, P = 0.001). In addition, there were some relations between mutation status and excision repair cross complementing (ERCC1) protein, carcinoembryonic antigen (CEA), squamous cell carcinoma (SCC) and Cyfra21-1. ERCC1(+) (χ(2) = 6.739, P = 0.012), SCC(χ(2) = 16.839, P = 0.000) and Cyfra21-1(χ(2) = 6.638, P = 0.013) more than normal value was common in wild group. Increased CEA was common in mutation group (χ(2) = 5.436, P = 0.023). EGFR mutation is commonly found in female, non-smoking, adenocarcinoma and less than 60 years old NSCLC patients. The wild group obtains better DFS than mutation group. Tumor markers may predict the mutation status, which need further research.


Effects of flexibility and aspect ratio on the aerodynamic performance of flapping wings.
In the current study, we experimentally investigated the flexibility effects on the aerodynamic performance of flapping wings and the correlation with aspect ratio at angle of attack α = 45°. The Reynolds number based on the chord length and the wing tip velocity is maintained at Re = 5.3 × 103. Our result for compliant wings with an aspect ratio of 4 shows that wing flexibility can offer improved aerodynamic performance compared to that of a rigid wing. Flexible wings are found to offer higher lift-to-drag ratios; in particular, there is significant reduction in drag with little compromise in lift. The mechanism of the flexibility effects on the aerodynamic performance is addressed by quantifying the aerodynamic lift and drag forces, the transverse displacement on the wings and the flow field around the wings. The regime of the effective stiffness that offers improved aerodynamic performance is quantified in a range of about 0.5-10 and it matches the stiffness of insect wings with similar aspect ratios. Furthermore, we find that the aspect ratio of the wing is the predominant parameter determining the flexibility effects of compliant wings. Compliant wings with an aspect ratio of two do not demonstrate improved performance compared to their rigid counterparts throughout the entire stiffness regime investigated. The correlation between wing flexibility effects and the aspect ratio is supported by the stiffness of real insect wings.


Visual effects of concussion: A review.
A concussion occurs when a direct or indirect force is transmitted to the brain, causing a change in brain function. Given that approximately half the brain circuits are involved in vision and the control of eye movements, a concussion frequently results in visual symptoms. Ophthalmic abnormalities are helpful in the assessment of acute concussion, identified by rapid automized naming tasks and eye movement assessments. In particular, convergence, eye-tracking and the vestibular-ocular motor screening tool may be used. For patients suffering from post-concussion syndrome more than 3 months from the original injury, abnormalities may be found in convergence, accommodation and smooth pursuit. Orthoptic exercises are useful rehabilitation tools to allow patients to return to school, work and recreation. This article provides a brief overview of concussion as it relates to vision and ophthalmic practice.


Employment and hospital support among pediatric surgeons.
Employment, either by an academic entity or a hospital, is increasingly becoming a feature of surgical practice. Independent practices receive indirect subsidies to support their revenue. A survey of the extent of employment and the forms of indirect subsidies by which hospitals support independent practices, not previously done, would be of interest to all clinicians. A 2012 Internet survey of pediatric surgeons, asking practice description, hospital support, governance and management, conditions of compensation, selected contractual obligations, and arrangements for part-time coverage was conducted. Response rate was 21.8 per cent (253 of 1,163). Employed surgeons comprised 80 per cent: 60 per cent academic (152 of 253) and 20 per cent nonacademic (51). Only eight per cent (19) were in private practice. Half (47% [106 of 226]) had administrative tasks. One-fifth (20% [45 of 223]) was in a system without physician input in governance. The rest were in practices with physicians involved in management: on boards of directors (35% [78]), in management positions (31% [69]), and entirely physician-run (14% [31]). Most salaries were independent of external benchmarks. Productivity measures, when applied to compensation (54% [117 of 218]), used relative value units (71% [83 of 117]) more often than revenue production (29% [34]). Patient contact minimums (4% [nine of 217]) and penalties were less common (20% [43 of 218]) than bonus provisions (53% [116 of 218]). Most surgeons in private practice (75% [14 of 19]) received nonsalary hospital support. Pediatric surgery reflects the current trend of physician employment and hospital subsidies. Surgeon participation in governance and strategic system decisions will be necessary as healthcare systems evolve.


Resuscitation of trauma patients with type-specific uncrossmatched blood.
The present study was undertaken to determine the safety of type-specific uncrossmatched blood transfusions for severely hypovolemic trauma patients. During a 3-year period 875 units of type-specific uncrossmatched blood were given to 160 severely hypovolemic trauma patients who could not be adequately resuscitated with crystalloid solutions. No transfusion reactions resulted from the administration of type-specific uncrossmatched blood. Subsequent major crossmatch failed to identify either blood incompatibility or significant antibodies. Type-specific uncrossmatched blood is safe and is a rapidly available alternative to crossmatched blood in the severely hypovolemic trauma patient.


[Preparation of a recombinant tumor-targeting ribosome inactivating protein luffin-α-NGR and evaluation of its antitumor activity].
Loofah seeds ribosome inactivating protein luffin-α was fused with a tumor-targeting peptide NGR to create a recombinant protein, and its inhibitory activity on tumor cells and angiogenesis were assessed. luffin-α-NGR fusion gene was obtained by PCR amplification. The fusion gene was ligated with pGEX-6p-1 vector to create a recombinant plasmid pGEX-6p-1/luffin-α-NGR. The plasmid was transformed into E. coli BL21, and the target protein was isolated and purified by GST affinity chromatography. The luffin-α-NGR fusion gene with a full length of 849 bp was successfully obtained, and the optimal soluble expression of the target protein was achieved under the conditions of 16 ℃, 0.5 mmol/L IPTG after 16 h induction. SDS-PAGE and Western blotting confirmed the recombinant protein has an expected molecular weight of 56.6 kDa. Subsequently, the recombinant protein was de-tagged by precision protease digestion. The inhibitory effects of the recombinant protein on liver tumor cells HepG2 and breast cancer cells MDA-MB-231 were significantly stronger than that of luffin-α. The Transwell and CAM experiment proved that the recombinant protein luffin-α-NGR also had a significant inhibitory effect on tumor cells migration and neovascularization. The inhibitory activity on tumor cells and angiogenesis of the recombinant luffin-α-NGR protein lays a foundation for the development of subsequent recombinant tumor-targeting drugs.


Drinking the Winds: Monsoon as Atmospheric Spring.
This paper explores monsoons as a set of atmospheric-orographic dynamics productive of water resources and as a site of actionable concern for landscape practice. From study to representation to design, the term "landscape practice" is used to describe a way of positioning environments as both subject and object of concern. While monsoons are constituents of many geographies, dynamics, materials and experiences, this paper focuses on the South Asian monsoon and its relationship with the Tibetan Plateau. In this region, freshwater resources are dependent on the monsoon; however, as rising global temperatures and rapid urban development significantly impact the behavior of the monsoon and the Plateau's ability to store freshwater, the monsoon-as a kinetic body of freshwater-becomes the focal point of visual media productions and extractive technologies that require a shifting of perspective from one that privileges land to one that centers the atmosphere. The inclusion of meteorological and atmospheric material and dynamics within the space of landscape practice, constructively challenges the spatial discipline's engagement with exploitable resources; and the monsoon provides a tangible site and set of conditions that is in urgent need of this exploration.


Cytochemical evidence for a proteoglycan-associated filamentous network in ligament extracellular matrix.
The purpose of this investigation was to examine the extracellular matrix of rabbit ligament before and after digestion with glycosaminoglycan degrading enzymes. In order to preserve and enhance the visibility of negatively charged tissue components, particularly the glycosaminoglycan-containing proteoglycans, the cationic stains ruthenium red (RR) and ruthenium hexamine trichloride (RHT) were used. Cross-sections of the midsubstance of 10-month-old (mature) rabbit medial collateral ligaments fixed using conventional procedures revealed a sparse population of stellate-shaped cells that did not appear to be interconnected. Similar tissue fixed in either RR or RHT showed an extensive network of thin, electron-dense "seams" that interconnected cells and appeared to irregularly subdivide the extracellular matrix (ECM). These seams mainly consisted of a meshwork of microfilaments throughout which small granules were dispersed. Numerous 14-nm microfibrils, as well as mature elastic fibers were also present within the seams. The size and shape of the microfilaments, together with their threadlike, beaded appearance suggested that they could be Type VI collagen. The seam granules were easily removed with chondroitinase ABC, chondroitinase AC II, and mild (0.18 M) salt treatment. Only chondroitinase ABC succeeded in removing additional granules, tentatively identified as proteodermatan sulphate molecules, that were periodically located at d band sites along the Type I collagen fibrils. These results suggest that the seam granules are not dermatan sulphate containing proteoglycans, and further, that these proteoglycans may be sequestered into specific zones within the ECM through loose association with the seam microfilaments. While the functional significance of the seams remains unknown and their specific composition clearly requires further study, it is likely that they represent important functional (e.g., viscoelastic) or biological (e.g., nutritional) subdivisions of ligament substance.


Abdominosacral approach for retrorectal tumors.
The relative rarity and anatomical position of retrorectal tumors may lead to difficulty in diagnosis and surgical treatment. The clinical features and management of 20 such tumors (chordoma 8, neurilemmoma 3, teratoma 3, hemangiopericytoma 1, chondrosarcoma 1, osteosarcoma 1, dermoid 1, lipoma 1, and undifferentiated sarcoma 1) have therefore been reviewed. Low back or sacral pain was present in 18 patients and, although all tumors were palpable on rectal examination, pain had been present for a median of 12 months before diagnosis. Mean tumor size was 9.4 cm (range: 2.5-17 cm). Sacral bone destruction was demonstrated radiographically in all chordomas and three sarcomas, but in none of the benign tumors. Three patients had undergone previous partial removal of their tumors. Surgical resection was carried out using a combined abdominal and transsacral approach in 13, a transsacral approach in the right lateral position in four and transabdominally in three. There was one operative death following secondary operation for chbrdoma. Four of 12 patients with malignant tumors are alive and well at seven months to eight years. One died of a myocardial infarct without recurrence at 11 years. For small benign tumors, the right lateral position permits maximal flexibility for resection either by the transsacral, transabdominal or a combined approach. For bulky or malignant tumors, a combined abdominal transsacral approach in the right lateral position permits vascular control and provides good exposure for protection of vital structures and wide resection.


Saline irrigation for the management of skin extravasation injury in neonates.
Extravasation injury, a complication commonly seen in the neonatal intensive care unit, can result in scarring with cosmetic and functional sequelae. A wide variety of treatments are available, including subcutaneous irrigation with saline (with or without hyaluronidase), liposuction, use of specific antidotes, topical applications, and normal wound care with dry or wet dressings. All such treatments aim to prevent or reduce the severity of complications. Primary objective To compare the efficacy and safety of saline irrigation or saline irrigation with prior hyaluronidase infiltration versus no intervention or normal wound care for tissue healing in neonates with extravasation injury. Secondary objectives To evaluate by subgroup analysis of controlled trials the influence of type of extravasate, timing of irrigation following extravasation, and postmenstrual age (PMA) of the neonate at the time of injury on outcomes and adverse effects.Specifically, we planned to perform subgroup analysis for the primary outcome, if appropriate, by examining:1. time to irrigation from identified extravasation injury (< 1 hour or ≥ 1 hour);2. type of extravasate (parenteral nutrition fluid or other fluids or medications);3. amount of saline used (< 500 mL or ≥ 500 mL); and4. PMA at injury (< 37 completed weeks or ≥ 37 completed weeks). We used the standard search strategy of the Cochrane Neonatal Review Group to search the Cochrane Central Register of Controlled Trials (CENTRAL; 2017, Issue 1), MEDLINE via PubMed (1966 to 2 February 2017), Embase (1980 to 2 February 2017), and the Cumulative Index to Nursing and Allied Health Literature (CINAHL; 1982 to 2 February 2017). We also searched clinical trial databases, conference proceedings, and reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials. We used the Google Scholar search tool for reverse citations of relevant articles. Randomised controlled trials (RCTs) and quasi-randomised controlled trials comparing saline irrigation with or without hyaluronidase infiltration versus no intervention or normal wound care for the management of extravasation injury in neonates. Three review authors independently reviewed and identified articles for possible inclusion in this review. We used the GRADE approach to assess the quality of evidence. We found no eligible studies. Our search revealed 10 case reports or case series describing successful outcomes with different interventions for this condition. To date, no RCTs have examined the effects of saline irrigation with or without prior hyaluronidase infiltration for management of extravasation injury in neonates. Saline irrigation is frequently reported in the literature as an intervention for management of extravasation injury in neonates. Research should focus first on evaluating the efficacy and safety of this intervention through RCTs. It will also be important for investigators to determine effect size by examining the timing of the intervention, the nature of the infusate, and severity of injury at the time of intervention.


Associations between air pollution, residential greenness, and glycated hemoglobin (HbA1c) in three prospective cohorts of U.S. adults.
While studies suggest impacts of individual environmental exposures on type 2 diabetes (T2D) risk, mechanisms remain poorly characterized. Glycated hemoglobin (HbA1c) is a biomarker of glycemia and diagnostic criterion for prediabetes and T2D. We explored associations between multiple environmental exposures and HbA1c in non-diabetic adults. HbA1c was assessed once in 12,315 women and men in three U.S.-based prospective cohorts: the Nurses' Health Study (NHS), Nurses' Health Study II (NHSII), and Health Professionals Follow-up Study (HPFS). Residential greenness within 270 m and 1,230 m (normalized difference vegetation index, NDVI) was obtained from Landsat. Fine particulate matter (PM2.5) and nitrogen dioxide (NO2) were estimated from nationwide spatiotemporal models. Three-month and one-year averages prior to blood draw were assigned to participants' addresses. We assessed associations between single exposure, multi-exposure, and component scores from Principal Components Analysis (PCA) and HbA1c. Fully-adjusted models built on basic models of age and year at blood draw, BMI, alcohol use, and neighborhood socioeconomic status (nSES) to include diet quality, race, family history, smoking status, postmenopausal hormone use, population density, and season. We assessed interactions between environmental exposures, and effect modification by population density, nSES, and sex. Based on HbA1c, 19% of participants had prediabetes. In single exposure fully-adjusted models, an IQR (0.14) higher 1-year 1,230 m NDVI was associated with a 0.27% (95% CI: 0.05%, 0.49%) lower HbA1c. In basic component score models, a SD increase in Component 1 (high loadings for 1-year NDVI) was associated with a 0.19% (95% CI: 0.04%, 0.34%) lower HbA1c. CI's crossed the null in multi-exposure and fully-adjusted component score models. There was little evidence of associations between air pollution and HbA1c, and no evidence of effect modification. Among non-diabetic adults, environmental exposures were not consistently associated with HbA1c. More work is needed to elucidate biological pathways between the environment and prediabetes.


Simplified Insertion of Transgenes Onto Balancer Chromosomes via Recombinase-Mediated Cassette Exchange.
Balancer chromosomes are critical tools for Drosophila genetics. Many useful transgenes are inserted onto balancers using a random and inefficient process. Here we describe balancer chromosomes that can be directly targeted with transgenes of interest via recombinase-mediated cassette exchange (RMCE).


Anaphylactic reaction to lychee in a 12-year-old girl: cross-reactivity to latex?
There are very few case reports on allergic reactions to lychee in the literature - so far only in adults. We report on a 12-year-old girl who developed swelling of lips, pruritus, generalized urticaria and dyspnea 30 min after eating a raw lychee. A second event occurred after eating a piece of cake covered with a fruit cocktail. All other foods were well tolerated. In infancy the girl had suffered from atopic dermatitis, which disappeared in childhood; for the previous 2 yr she had presented with seasonal allergic rhinoconjunctivitis. Upon oral provocation, she developed restlessness, flush, generalized urticaria and inspiratory stridor 50 min after eating half a lychee. The diagnostic work up showed a clear positive skin prick test to raw lychee and specific immunoglobulin E (IgE) in serum to latex but not to lychee. In the cellular antigen stimulation test (CAST) carried out with lychee extracts in several concentrations, the same positive results could be found confirming an allergic reaction. Cross-reactivity of lychee to latex was shown by inhibition experiments using the UniCAP 100-system. In conclusion, it seems worthwhile considering the rare allergy to lychee in the case of unclear food-allergic reactions and lychee should be added to the list of foods cross-reacting with latex.


Hypopharynx and larynx defect repair after resection for pyriform fossa cancer with a platysma skin flap.
We used a platysma skin flap to repair larynx and hypopharynx defects to improve postoperative laryngeal function in patients with pyriform fossa cancer. Larynx-sparing surgery and postoperative radiotherapy were used in 10 patients with pyriform fossa cancer. The surgical approaches of lymph node dissection of the neck, vertical partial laryngectomy, and pyriform fossa resection were adopted, and a platysma skin flap was used to repair the resulting defects. In this group, the overall 3-year survival rate was 75% according to the Kaplan-Meier analysis, and the local control rate was 90%. Additionally, all patients were able to speak fluently with mild-to-moderate hoarseness. The tracheal tube was removed in all cases. Laryngeal fistulas were observed in 1 patient during radiotherapy. In conclusion, a platysma skin flap can be used to rebuild the larynx and hypopharynx in larynx-sparing resection for pyriform fossa cancer. These patients can obtain good postoperative function in swallowing, breathing, and pronunciation.


Silver-Catalyzed C(sp3)-H Chlorination.
A silver-catalyzed chlorination of benzylic, tertiary, and secondary C(sp3)-H bonds was developed. The reaction proceeded with as low as 0.2 mol % catalyst loading at room temperature under air atmosphere with synthetically useful functional group compatibility. The regioselectivity and reactivity tendencies suggest that the chlorination proceeded through a radical pathway, but an intermediate alkylsilver species cannot be ruled out.


Aberrant expression of circulating Th17, Th1 and Tc1 cells in patients with active and inactive ulcerative colitis.
Ulcerative colitis (UC) is a chronic relapsing inflammatory bowel disease, yet its etiology and pathogenesis remain poorly understood. The aberrant expression of T lymphocytes plays an essential role in the progression of UC. This study aimed to evaluate the expression profile of circulating Th17, Th1 and Tc1 cells in patients with active and inactive UC. Our results revealed that the percentage of circulating Th17 cells (CD3+CD8-IL-17+) was significantly increased in patients with active UC when compared with the percentage in patients with inactive UC, Crohn's disease (CD) and healthy controls. The percentages of circulating Th1 (CD3+CD8-IFN-γ+) and Tc1 (CD3+CD8+IFN-γ+) cells were also higher in patients with active UC when compared with the percentages in patients with inactive UC and normal controls, although levels were lower than that in CD. Further analysis showed that Th17 cells were positively correlated with Th1 cells, but not with Tc1 cells. Notably, the three cells had a positive correlation with disease activity, extent of disease, detection of erythrocyte sedimentation rate and c-reactive protein in active UC. Moreover, plasma IL-17 was higher in patients with active UC, and a similar trend applied to the mRNA levels of RORγt and T-bet in peripheral blood mononuclear cells (PBMCs). The levels of p-STAT3 and p-STAT5 in PBMCs, as well as the ratio of p-STAT3/p-STAT5, were also elevated in active UC patients. Taken together, our findings revealed that elevated circulating Th17, Th1 and Tc1 cells and the aberrant activation of the STAT pathway may be implicated in the progression of UC. These findings may provide preliminary experimental clues for the development of new therapies for UC.


Wilson's disease: indications for liver transplants.
The clinical course of certain patients with Wilson's disease resembles that of patients with viral or drug-induced fulminant hepatitis lasting only few weeks from recognition of symptoms to severe hepatic insufficiency and death. The disease is complicated by hemolysis and is characterized by hypercupremia. Routine laboratory findings may underestimate the severity of the disease. These patients, as well as patients with decompensated Wilsonian cirrhosis who are not responding to therapy, should be considered as candidates for liver transplants.


Antimicrobial Properties of Selected Copper Alloys on Staphylococcus aureus and Escherichia coli in Different Simulations of Environmental Conditions: With vs. without Organic Contamination.
Background: Hospital equipment made from copper alloys can play an important role in complementing traditional methods of disinfection. Aims of the study: The aim of this study was to assess the dynamics of the antimicrobial properties of selected copper alloys in different simulations of environmental conditions (with organic contamination vs. without organic contamination), and to test alternatives to the currently used testing methods. Materials and Methods: A modification of Japanese standard JIS Z 2801 as well as Staphylococcus aureus (SA) and Escherichia coli (EC) suspended in NaCl vs. tryptic soy broth (TSB) were used in tests performed on seven commonly used copper alloys, copper, and stainless steel. Results: A much faster reduction of the bacterial suspension was observed for the inoculum prepared in NaCl than in TSB. A faster reduction for EC than for SA was observed in the inoculum prepared in NaCl. The opposite results were found for the inoculum based on TSB. A significant correlation between the copper concentration in the copper alloys and the time and degree of bacterial suspension reduction was only observed in the case of EC. Conclusions: This study confirmed the antimicrobial properties of copper alloys, and additionally showed that Staphylococcus aureus was more resistant than Escherichia coli in the variant of the experiment without organic contamination. However, even for SA, a total reduction of the bacterial inoculum's density took no longer than 2 h. Under conditions simulating organic contamination, all of the tested alloys were shown to have bactericidal or bacteriostatic properties, which was contrary to the results from stainless steel.


How INNs are created. Making drug names safer by contributing to INN selection.
The international nonproprietary names (INNs) of drugs proposed by the World Health Organization (WHO) are released for public consultation. These consultations provide an opportunity to identify any risks associated with INNs that could lead to confusion. Prescrire has submitted numerous comments since it began participating in the WHO's public consultations on proposed INNs in 2007. The WHO INN programme has occasionally taken our objections into account. It is easier to replace a proposed INN when a risk of confusion is identified early, before the drug is introduced to the market and the INN enters into use. Regular analysis of the INNs proposed by the WHO reveals some of the challenges of naming drugs and the influence exerted by pharmaceutical companies and the US drug nomenclature committee (USANC) in particular. The lack of an identifiable common stem in certain INNs, sometimes perceived as an obstacle to INN comprehensibility, is a consequence of the procedure for assigning INNs, because the INN programme wants to ensure that new common stems are not created prematurely. Critical analysis of proposed INNs during WHO public consultations offers an insight into the challenges involved in devising common stems. This analysis is useful for improving the quality and safety of INNs.


Pesticide assessment: Protecting public health on the home turf.
Pesticide regulation is examined in the context of Health Canada's Pest Management Regulatory Agency's assessment of the chlorophenoxy herbicide 2,4-dichlorophenoxyacetic acid (2,4-D) for turf. 2,4-D is the most common herbicide used to kill weeds in grass.The medical literature does not uniformly indicate harms from herbicides. However, the balance of epidemiological research suggests that 2,4-D can be persuasively linked to cancers, neurological impairment and reproductive problems. These may arise from 2,4-D itself, from breakdown products or dioxin contamination, or from a combination of chemicals.Regulators rely largely on toxicology, but experiments may not replicate exposures from 2,4-D application to lawns because environmental breakdown products (eg, 2,4-dichlorophenol) may not accumulate and selected herbicides are possibly less contaminated. Dioxins are bioaccumulative chemicals that may cause cancer, harm neurological development, impair reproduction, disrupt the endocrine system and alter immune function. No dioxin analyses were submitted to the Pest Management Regulatory Agency, and the principal contaminants of 2,4-D are not among the 17 congeners covered in pesticide regulation. Independent assessment of all dioxins is needed, in tissues and in the environment.The 2,4-D assessment does not approach standards for ethics, rigour or transparency in medical research. Canada needs a stronger regulator for pesticides. Potentially toxic chemicals should not be registered when more benign solutions exist, risks are not clearly quantifiable or potential risks outweigh benefits. Until landscaping pesticides are curtailed nationally, local bylaws and Quebec's Pesticide Code are prudent measures to protect public health. Physicians have a role in public education regarding pesticides.


Carbon Footprints for Food of Animal Origin: What are the Most Preferable Criteria to Measure Animal Yields?
There are increasing efforts to determine the origin of greenhouse gas emissions caused by human activities (including food consumption) and to identify, apply and exploit reduction potentials. Low emissions are generally the result of increased efficiency in resource utilization. Considering climate related factors, the emissions of carbon dioxide, methane and laughing gas are summarized to so-called carbon footprints (CF). The CF for food of animal origin such as milk, eggs, meat and fish depend on a number of influencing factors such as animal species, type of production, feeding of animals, animal performance, system boundaries and outputs of production. Milk and egg yields are more clearly defined animal yields or outcomes of production than food from the carcasses of animals. Possible endpoints of growing/slaughter animals are body weight gain, carcass weight gain (warm or cold), meat, edible fractions or edible protein. The production of edible protein of animal origin may be considered as one of the main objectives of animal husbandry in many countries. On the other hand, the efficiency of various lines of production and the CF per product can also be easily compared on the basis of edible protein. The pros and contras of various outputs of animal production under special consideration of edible protein are discussed in the paper.


Crossing effect for improving egg production traits in chickens involving local and commercial strains.
This study aimed to contribute to the productivity improvement of the local chickens by enhancing their egg production traits using a crossbreeding program between Alexandria (local strain) and Lohmann White (commercial strain). One thousand two-hundred and eighty-five 4-week-old chicks from two strains: Alexandria local strain (AA) and Lohmann White commercial strain (LL) and their reciprocal crosses obtained from 16 males and 160 females, were used to produce four genetic groups (AA, LL, AL, and LA). Differences among genotypes, direct additive, heterosis, and reciprocal effects were investigated regarding the following traits: Body weight at 4 and 8 weeks and at the age of sexual maturity, age at sexual maturity, egg production, average egg weight, and egg mass during the first 90 days of laying. Statistically significant effects of the genotypes were observed on traits studied. Analysis of direct additive effects showed that AA was superior as a sire strain for improving body weight at early age. For egg traits (age at sexual maturity, egg production, average egg weight, and egg mass), LL was better as a sire strain to improve these traits. Significant positive heterosis percentages were observed for body weight. The crosses (AL and reciprocal) were significantly superior in egg traits (egg production, average egg weight, and egg mass) compared to the local strain. The cross (LA) laid significantly earlier than the local strain. Analysis of reciprocal effects cleared that the local strain could be used as a strain of dam to improve body weight and egg traits. Crossing improved egg production, egg weight, and egg mass in hybrids compared to the local strain.


A new therapy for highly effective tumor eradication using HVJ-E combined with chemotherapy.
Inactivated HVJ (hemagglutinating virus of Japan; Sendai virus) particles (HVJ envelope vector; HVJ-E can incorporate and deliver plasmid DNA, siRNA, antibody and peptide and anti-cancer drugs to cells both in vitro and in vivo. We attempted to eradicate tumors derived from mouse colon cancer cells, CT26, by combining bleomycin (BLM)-incorporated HVJ-E (HVJ-E/BLM) with cisplatin (CDDP) administration. CT-26 tumor mass was intradermally established in Balb/c mice. HVJ-E/BLM was directly injected into the tumor mass with or without intraperitoneal administration of CDDP. The anti-tumor effect was evaluated by measuring tumor size and cytotoxic T cell activity against CT26. Re-challenge of tumor cells to treated mice was performed 10 days or 8 months after the initial tumor inoculation. We found that three intratumoral injections of HVJ-E/BLM along with a single intraperitoneal administration of CDDP eradicated CT26 tumors with more than 75% efficiency. When tumor cells were intradermally re-injected on day 10 after the initial tumor inoculation, tumors on both sides disappeared in most of the mice that received the combination therapy of HVJ-E/BLM and CDDP. Eight months after the initial tumor eradication, surviving mice were re-challenged with CT26 cells. The re-challenged tumors were rejected in all of the surviving mice treated with the combination therapy. Cytotoxic T lymphocytes specific for CT26 were generated in these surviving mice. Combination therapy consisting of HVJ-E and chemotherapy completely eradicated the tumor, and generated anti-tumor immunity. The combination therapy could therefore be a promising new strategy for cancer therapy.


Residue Specific Interaction of an Unfolded Protein with Solvents in Mixed Water-Ethanol Solutions: A Combined Molecular Dynamics and ONIOM Study.
The molecular mechanism of ethanol governed unfolding of an enzymatic protein, chymotrypsin inhibitor 2 (CI2), in water-ethanol mixed solutions has been studied by using combined molecular dynamics simulations and ONIOM study. The residue specific solvation of the unfolded protein and the interactions between the individual amino acid residues of the protein with ethanol as well as water have been investigated. The results are compared with that obtained from the folded state of the protein. Further, emphasis has been given to explore the residue's preferential site of attraction toward the nature of the solvents. The heterogeneous structuring of water and ethanol around the hydrophobic and hydrophilic surfaces of the protein is found to correlate well with their available surface areas to the solvents. Both hydrophobic and hydrophilic interactions are found to have important contributions in rupturing protein's secondary structural segments. Further, residue-water as well as residue-ethanol binding energies show significant involvement of the hydrogen bonding environment in the unfolding process; particularly, residue-water hydrogen bonds are found to play an indispensable role.


Cholesteatoma of the ear.
Cholesteatoma is a hazardous condition because of the erosion and tissue destruction, which result in deafness, and the complications which threaten life. Early diagnosis and treatment provide the best opportunity for eradication of the disease and preservation of hearing. The patient usually complains of intermittent or persistent ear drainage and of diminished hearing acuity. Close examination of the tympanic membrane reveals a perforation, which at times may be quite small, with epithelial extension into the middle ear space. In most instances surgical intervention is necessary for eradication of the disease.


Measurement of fibronectin concentration in benign and malignant ascites.
Fifty-eight consecutive patients who were admitted to two departments of general surgery with ascites of unknown origin were investigated by measurement of ascitic fluid fibronectin concentration in a prospective study. A fibronectin concentration of 100 ml/l or more was chosen as indicative of malignant disease. In 40 patients with malignant disease, the median fibronectin concentration was 160 mg/l (interquartile range 120-270, range 20-560). In 18 patients with ascites from benign disease the corresponding figures were 40 mg/l (30-70, 20-90) (p less than 0.01). The diagnostic specificity (predictive value of a positive test) was 1.00 (34/34) (95% confidence interval 0.90 to 1.00), while the diagnostic sensitivity (predictive value of a negative test) was 0.75 (18/24) (95% CI 0.53 to 0.90). In this series an ascitic fluid fibronectin concentration of 100 mg/l or more indicated malignant disease, but a lower value did not exclude it. The test should be investigated in combination with another test with high diagnostic sensitivity to optimise its diagnostic value.


Development of high-throughput flexible multichannel electron detectors at Daresbury Laboratory.
Continuing demands from Synchrotron Radiation Source (SRS) end-users for higher throughput and improved reliability in photoelectron spectroscopy experiments have driven an intensive development programme for new multichannel electron detectors. The development philosophy focuses on high throughput to match present and future source intensity, flexible structures to allow increased mobility of designs and modular design for easy maintenance and repair. Developments include parallel readout electronics and innovative detector heads for the hemispherical deflection analysers currently in use on the SRS. Novel anode arrays have been implemented in the detector heads and extensive microchannel plate (MCP) characterization has been undertaken to source the MCPs most suited to this application. The present multichannel detection systems provide a significant enhancement to single-channel detection systems. They have also surpassed previous multichannel detection systems due to their high throughput, flexible structure and modular design. Information on these developments and experimental results obtained at Daresbury Laboratory are presented.


A mixed-method approach to generate and deliver rapid-cycle evaluation feedback: lessons learned from a multicenter implementation trial in pediatric surgery.
Rapid-cycle feedback loops provide timely information and actionable feedback to healthcare organizations to accelerate implementation of interventions. We aimed to (1) describe a mixed-method approach for generating and delivering rapid-cycle feedback and (2) explore key lessons learned while implementing an enhanced recovery protocol (ERP) across 18 pediatric surgery centers. All centers are members of the Pediatric Surgery Research Collaborative (PedSRC, www.pedsrc.org ), participating in the ENhanced Recovery In CHildren Undergoing Surgery (ENRICH-US) trial. To assess implementation efforts, we conducted a mixed-method sequential explanatory study, administering surveys and follow-up interviews with each center's implementation team 6 and 12 months following implementation. Along with detailed notetaking and iterative discussion within our team, we used these data to generate and deliver a center-specific implementation report card to each center. Report cards used a traffic light approach to quickly visualize implementation status (green = excellent; yellow = needs improvement; red = needs significant improvement) and summarized strengths and opportunities at each timepoint. We identified several benefits, challenges, and practical considerations for assessing implementation and using rapid-cycle feedback among pediatric surgery centers. Regarding potential benefits, this approach enabled us to quickly understand variation in implementation and corresponding needs across centers. It allowed us to efficiently provide actionable feedback to centers about implementation. Engaging consistently with center-specific implementation teams also helped facilitate partnerships between centers and the research team. Regarding potential challenges, research teams must still allocate substantial resources to provide feedback rapidly. Additionally, discussions and consensus are needed across team members about the content of center-specific feedback. Practical considerations include carefully balancing timeliness and comprehensiveness when delivering rapid-cycle feedback. In pediatric surgery, moreover, it is essential to actively engage all key stakeholders (including physicians, nurses, patients, caregivers, etc.) and adopt an iterative, reflexive approach in providing feedback. From a methodological perspective, we identified three key lessons: (1) using a rapid, mixed method evaluation approach is feasible in pediatric surgery and (2) can be beneficial, particularly in quickly understanding variation in implementation across centers; however, (3) there is a need to address several methodological challenges and considerations, particularly in balancing the timeliness and comprehensiveness of feedback. NIH National Library of Medicine Clinical Trials. gov Identifier: NCT04060303. Registered August 7, 2019, https://clinicaltrials.gov/ct2/show/NCT04060303.


Haemopoietic growth factors: their relevance in osteoclast formation and function.
The major recent advance in our knowledge of the haemopoietic system has been the purification and characterization of a family of haemopoietic growth factors, and their availability in recombinant form. In the bone marrow the sequences of differentiation and proliferation leading to the production of mature cells that these factors regulate may be determined by the relative availability of the factors in microenvironmental domains. The observation that growth factor-producing cells and haemopoietic progenitor cells are not evenly distributed in the bone marrow leads us to expect that the overall effect of growth factors (and other regulatory molecules) on the production and function of macrophages and osteoclasts may differ when in vivo or in vitro assays are used as end-points and, in the latter case, when whole marrow or purified cell populations are tested. The availability of an in vitro assay in which osteoclast-like cells are generated will allow these concepts to be tested.


[Euconol in the treatment of patients with ischemic heart disease].
The clinical efficacy of the foodstuff euconol was studied in 72 patients with coronary heart diseases, stable angina of effort, postinfarct cardiosclerosis, or silent myocardial ischemia. A good antianginal effect was achieved in 51.4% of patients treated with euconol. At month 4 of treatment, the patients with coronary heart disease displayed a significant decrease in the number of anginal episodes and nitroglycerin tablets; this was followed by a reduction in the number and duration of silent myocardial ischemic episodes. It is concluded that a prolonged euconol intake causes positive changes in the blood lipid composition and natural history of coronary heart disease.


Building a Flexible and Highly Ionic Conductive Solid Electrolyte Interphase on the Surface of Si@C Anodes by Binary Electrolyte Additives.
Si@C as a high specific capacity anode material for lithium batteries (LIBs) has attracted a lot of attention. However, the severe volume change during lithium de-embedding causes repeated rupture/reconstruction of the solid electrolyte interphase (SEI), resulting in poor cycling stability of the Si-based battery system and thus hindering its application in commercial batteries. Using electrolyte additives to form an excellent SEI is considered to be a cost-effective method to meet this challenge. Here, the classical film-forming additive vinyl carbonate (VC), and the newly emerging lithium salt additive lithium difluorophosphate (LiDFP), are chosen as synergistic additives to improve the electrode-electrolyte interface properties. Final results show that the VC additive generates flexible polycarbonate components at the electrode/electrolyte interface, preventing the fragmentation of Si particles. However, the organic components show high impedance, inhibiting the fast transport of Li+. This defect can be supplemented from the decomposition substances of the LiDFP additive. The derived inorganic products, such as LiF and Li3PO4, can strengthen the reaction kinetics of the electrode, reduce the interfacial impedance, and promote the Li+ transport. Thus, the synergistic effect of VC and LiDFP additives builds an effective SEI with good flexibility and high ionic conductivity and then significantly improves the cycling and rate stability of Si@C anodes. The experimental results show that the utilization of LiDFP and VC additives to modify the Si@C anode interface enhances the capacity retention of the Si@C/Li half-cell after 100 cycles from 68.2% to 85.1%. Besides, the possible mechanism of action between VC and LiDFP is proposed by using the spectral characterization technique and density functional theory (DFT) calculations. This research opens up a new possibility for improvement of SEI, and provides a simple way to achieve high-performance Si-based LIBs.


One-dimensional bright discrete solitons in media with saturable nonlinearity.
A problem of pulse propagation in a homogeneous nonlinear waveguide array with saturable nonlinearity is studied. The corresponding model equation is the discretized Vinetskii-Kukhtarev equation with neglected influence of diffusion of charge carriers. For periodic boundary conditions, exact homogeneous and oscillating stationary solutions are found. A wide instability region of the homogeneous, array-independent solution is identified. An approximate analytical solution for the bright one-dimensional discrete soliton where the energy is concentrated mainly in a few waveguides is obtained. The soliton stability is investigated both analytically and numerically and a cascade nature of the saturation mechanism is revealed.


Unnatural Base Pairs for Synthetic Biology.
In this review, we have summarized the research effort into the development of unnatural base pairs beyond standard Watson-Crick (WC) base pairs for synthetic biology. Prior to introducing our research results, we present investigations by four outstanding groups in the field. Their research results demonstrate the importance of shape complementarity and stacking ability as well as hydrogen-bonding (H-bonding) patterns for unnatural base pairs. On the basis of this research background, we developed unnatural base pairs consisting of imidazo[5',4':4.5]pyrido[2,3-d]pyrimidines and 1,8-naphthyridines, i.e., Im : Na pairs. Since Im bases are recognized as ring-expanded purines and Na bases are recognized as ring-expanded pyrimidines, Im : Na pairs are expected to satisfy the criteria of shape complementarity and enhanced stacking ability. In addition, these pairs have four non-canonical H-bonds. Because of these preferable properties, ImNN : NaOO, one of the Im : Na pairs, is recognized as a complementary base pair in not only single nucleotide insertion, but also the PCR.


Neighborhood Characteristics and the Burden of E-Cigarette, or Vaping, Product Use-Associated Lung Injury: An Ecological Comparison Study.
Purpose: E-cigarette, or vaping, product use-associated lung injury (EVALI) is a severe consequence of vaping first described in 2019. Investigating associations between neighborhood-level characteristics and EVALI cases is an important step in identifying at-risk communities to implement future targeted prevention programs. Methods: We retrospectively identified 41 adolescents <19 years hospitalized for treatment for EVALI at Children's Medical Center Dallas from December 2018 to June 2021. Patient ZIP codes were extracted from the electronic medical record and were compared with Dallas area ZIP codes containing no EVALI cases. Socioeconomic status (SES) characteristics were obtained from the 2019 American Community Survey, and they were mapped for ZIP codes using ESRI ArcMap geospatial processing software. A parallel analysis was conducted utilizing data of adolescents hospitalized with appendicitis. Results: Ninety-five percent of our cohort used tetrahydrocannabinol-containing products, and 66% obtained their vaping products from informal sources. EVALI cases were less likely to reside in higher SES ZIP codes as measured by the proportion of the population with at least a high school education (odds ratio [OR]: 0.95, 95% confidence interval [CI]: 0.92-0.99), access to broadband access (OR: 0.95, 95% CI: 0.91-0.99), and private health insurance (OR: 0.97, 95% CI: 0.95-0.99). Alternatively, they were more likely to reside in lower SES ZIP codes as measured by proportion of the population without any health insurance (OR: 1.07, 95% CI: 1.01-1.12). No neighborhood level low SES characteristics were associated with appendicitis hospitalizations. Conclusions: Although small in magnitude, EVALI cases were associated with lower SES ZIP codes but not with vape shop density.


A Pilot Split-Neck Case Study to Compare the Efficacy of the Long-Pulsed 755 nm Laser and the 532 nm Picosecond Laser for Acrochordon Removal.
Cutaneous papillomas or acrochorda usually appear after the 4th decade of life in areas with skin folds. Conventional methods of removal are associated with bleeding problems, pain and prolonged sequelae. Thus, acrochorda removal with lasers has gained attention. In this study, we compared the efficacy of two popular laser types with different wavelengths and pulse widths for removal of skin tags. A 60-year-old Korean male noticed skin tags on his neck bilaterally. All tags were treated in a single session, on one side with a picosecond (ps)-domain 532 nm Nd:YAG laser and on the contralateral side with a long-pulsed (LP) 755 nm alexandrite laser. The endpoint for the ps-532 laser was immediate whitening, while that for the LP and quasi-LP (QLP) 755 lasers were visible changes on the surface of the lesion. Antibiotic ointment was applied, dressing was done and clinical photographs were taken. Both lasers effectively removed the skin tags at all settings in a single session without bleeding and with minimal discomfort. Crust formation occurred on both sides with natural shedding within 1 to 2 weeks. Transient erythema lasted longer in the tags treated with the ps-532 laser. At the 5th month of follow-up, residual lesions were detected on the field treated with the ps-532 laser. No persistent side effects such as scarring or postinflammatory hyperpigmentation (PIH) were observed. In conclusion, both the ps-532 nm Nd:YAG and the 755 nm alexandrite lasers ensured safe and effective removal of skin tags in a single session without adverse sequelae.


Successful treatment of thoracic actinomycosis with ceftriaxone.
We report the case of a 38-year-old woman who had pulmonary actinomycosis that involved the pleura and the pectoral muscles. The patient was initially treated with intravenous ceftriaxone once a day on an outpatient basis. After 3 weeks of treatment, a computed tomogram showed resolution of the initial findings. This result suggests that ceftriaxone may be an effective and convenient therapeutic agent for the initial parenteral treatment of actinomycosis.


Mortality of older persons living alone: Singapore Longitudinal Ageing Studies.
We investigated the association of living alone with mortality among older persons, independently of marital, health and other factors, and explored its effect modification by age group, sex, marital status and physical functional disability. Using data from 8 years of mortality follow up (1 September 2003 to 31 December 2011) of 2553 participants in the Singapore Longitudinal Ageing Studies (SLAS) cohort, we estimated hazard ratio (HR) of mortality associated with living alone using Cox proportional hazard models. At baseline, 7.4 % (N = 189) of the participants were living alone, and 227 (8.9 %) died during the follow up period. Living alone was significantly associated with mortality 1.66 (95 % CI, 1.05-2.63), controlling for health status (hypertension, diabetes, chronic lung disease, stroke, heart disease, kidney failure, IADL-ADL disability and depressive symptoms), marital status and other variables (age, sex, housing type). Possible substantive effect modification by sex (p for interaction = 0.106) and marital status (p for interaction <0.115) were observed: higher among men (HR = 2.36, 95 % CI, 1.24-4.49) than women (HR = 1.14, 95 % CI, 0.58-2.22), and among single, divorce or widowed (HR = 2.26, 95 % CI, 1.24-4.10) than married individuals (HR = 0.83, 95 % CI, 0.30-2.31). Living alone was associated with increased mortality, independently of marital, health and other variables. The impact of living alone on mortality appeared to be stronger among men and those who were single, divorced or married.


Transcriptomic Characterization of Inhalation Phosphine Toxicity in Adult Male Sprague-Dawley Rats.
Phosphine (PH3) is a highly toxic, corrosive, flammable, heavier-than-air gas that is a commonly used fumigant. When used as a fumigant, PH3 can be released from compressed gas tanks or produced from commercially available metal phosphide tablets. Although the mechanism of toxicity is unclear, PH3 is thought to be a metabolic poison. PH3 exposure induces multiorgan toxicity, and no effective antidotes or therapeutics have been identified. Current medical treatment consists largely of supportive care and maintenance of cardiovascular function. To better characterize the mechanism(s) driving PH3-induced toxicity, we have performed transcriptomic analysis on conscious adult male Sprague-Dawley rats following whole-body inhalation exposure to phosphine gas at various concentration-time products. PH3 exposure induced concentration- and time-dependent changes in gene expression across multiple tissues. These gene expression changes were mapped to pathophysiological responses using molecular pathway analysis. Toxicity pathways indicative of cardiac dysfunction, cardiac arteriopathy, and cardiac enlargement were identified. These cardiotoxic responses were linked to apelin-mediated cardiomyocyte and cardiac fibroblast signaling pathways. Evaluation of gene expression changes in blood revealed alterations in pathways associated with the uptake, transport, and utilization of iron. Altered erythropoietin signaling was also observed in the blood. Upstream regulator analysis identified several therapeutics predicted to counteract PH3-induced gene expression changes. These include antihypertensive drugs (losartan, candesartan, and prazosin) and therapeutics to reduce pathological cardiac remodeling (curcumin and TIMP3). This transcriptomics study has characterized molecular pathways involved in PH3-induced cardiotoxicity. These data will aid in elucidating a precise mechanism of toxicity for PH3 and guide the development of effective medical countermeasures for PH3-induced toxicity.


Amyloid-β Peptide Targeting Peptidomimetics for Prevention of Neurotoxicity.
A new generation of ligands designed to interact with the α-helix/β-strand discordant region of the amyloid-β peptide (Aβ) and to counteract its oligomerization is presented. These ligands are designed to interact with and stabilize the Aβ central helix (residues 13-26) in an α-helical conformation with increased interaction by combining properties of several first-generation ligands. The new peptide-like ligands aim at extended hydrophobic and polar contacts across the central part of the Aβ, that is, "clamping" the target. Molecular dynamics (MD) simulations of the stability of the Aβ central helix in the presence of a set of second-generation ligands were performed and revealed further stabilization of the Aβ α-helical conformation, with larger number of polar and nonpolar contacts between ligand and Aβ, compared to first-generation ligands. The synthesis of selected novel Aβ-targeting ligands was performed in solution via an active ester coupling approach or on solid-phase using an Fmoc chemistry protocol. This included incorporation of aliphatic hydrocarbon moieties, a branched triamino acid with an aliphatic hydrocarbon tail, and an amino acid with a 4'- N, N-dimethylamino-1,8-naphthalimido group in the side chain. The ability of the ligands to reduce Aβ1-42 neurotoxicity was evaluated by gamma oscillation experiments in hippocampal slice preparations. The "clamping" second-generation ligands were found to be effective antineurotoxicity agents and strongly prevented the degradation of gamma oscillations by physiological concentration of monomeric Aβ1-42 at a stoichiometric ratio.


Post-stroke Movement Disorders: Clinical Manifestations and Pharmacological Management.
Involuntary abnormal movements have been reported after ischaemic and haemorrhagic stroke. Post stroke movement disorders can appear as acute or delayed sequel. At the moment, for many of these disorders the knowledge of pharmacological treatment is still inadequate. Dopaminergic and GABAergic systems may be mainly involved in post-stroke movement disorders. This article provides a review on drugs commonly used in post-stroke movement disorders, given that some post-stroke movement disorders have shown a partial benefit with pharmacological approach.


Optimization of Routine Monitoring of Workers Exposed to Plutonium Aerosols.
In case of incidental confinement failure, mixed oxide (MOX) fuel preparation may expose workers to plutonium aerosols. Due to its potential toxicity, occupational exposure to plutonium compounds should be kept as low as reasonably achievable. To ensure the absence of significant intake of radionuclides, workers at risk of internal contamination are monitored by periodic bioassay planned in a routine monitoring programme. From bioassay results, internal dose may be estimated. However, accurate dose calculation relies on known exposure conditions, which are rarely available when the exposure is demonstrated by routine monitoring only. Therefore, internal dose calculation is subject to uncertainty from unknown exposure conditions and from activity measurement variability. The present study calculates the minimum detectable dose (MDD) for a routine monitoring programme by considering all plausible conditions of exposure and measurement uncertainty. The MDD evaluates the monitoring quality and can be used for optimization. Here, MDDs were calculated for the monitoring of workers preparing MOX fuel. Uncertain parameters were modelled by probability distributions defined according to information provided by experts of routine monitoring, of workplace radiological protection and of bioassay analysis. Results show that the current monitoring is well adapted to potential exposure. A sensitivity study of MDD highlights high dependence on exposure condition modelling. Integrating all expert knowledge is therefore crucial to obtain reliable MDD estimates, stressing the value of a holistic approach to worker monitoring.


Cation regulation in the smooth muscle of frog stomach.
Cation composition of frog smooth muscle cells was investigated. Fresh stomach muscle rings resembled skeletal muscle, but marked Na gain and K loss followed immersion. Mean Na (49.8-79.7 mM/kg tissue) and K (61.8-80.1 mM/kg tissue) varied between batches, but were stable for long periods in vitro. Exchange of 6-30 mM Na/kg tissue with (22)Na was extremely slow and distinct. Extracellular water was estimated from sucrose-(14)C uptake. Calculated exchangeable intracellular Na was 9 mM/kg cell water, and varied little. Thus steady-state transmembrane cation gradients appeared to be steep. K-free solution had only slight effects. Ouabain (10(-4)M) caused marked Na gain and reciprocal K loss; at 30 degrees C, Na and K varied linearly with time over a wide range of contents, indicating constant net fluxes. Net fluxes decreased with temperature decrease. (22)Na exchange in ouabain-treated tissue at 20-30 degrees C was rapid and difficult to analyze. The best minimum estimates of unidirectional Na fluxes at 30 degrees C were 10-12 times the constant net flux; constant pump efflux may explain these findings. The rapidity of Na exchange may not reflect very high permeability, but it does require a high rate of transport work.


Intraocular pharmacokinetics of ranibizumab in vitrectomized versus nonvitrectomized eyes.
To analyze the intraocular pharmacokinetic properties of intravitreally injected ranibizumab in vitrectomized and nonvitrectomized rabbit eyes. A procedure consisting of 25-gauge pars plana vitrectomy without lensectomy and posterior vitreous detachment was performed in 18 rabbit eyes, and 18 nonvitrectomized rabbit eyes served as controls. Ranibizumab (0.25 mg/0.025 mL) was intravitreally injected in all the vitrectomized and nonvitrectomized eyes. The eyes were enucleated at 1 hour or 1, 2, 5, 14, or 30 days after the intravitreal injections and frozen at -80°C. Ranibizumab concentrations in the vitreous, aqueous humor, and retina were determined using indirect enzyme-linked immunosorbent assay. Vitreous clearance of ranibizumab showed a 2-phase elimination. The vitrectomized and nonvitrectomized eyes showed comparable rates of vitreous clearance of ranibizumab. The vitreous half-life of ranibizumab for up to 14 days was 2.51 and 2.75 days in vitrectomized and nonvitrectomized eyes, respectively. Throughout the 30-day period after intravitreal injection, there were no statistically significant differences between the concentrations of ranibizumab in the vitreous, aqueous humor, and retina of vitrectomized eyes and those in nonvitrectomized eyes. Concentrations of ranibizumab in the vitreous peaked 1 hour after injection, with a mean concentration of 118.01 and 91.61 μg/mL in vitrectomized and nonvitrectomized eyes, respectively. The elimination rate constant of intravitreal ranibizumab in 1-phase analyses showed only a 9% increase in vitrectomized eyes compared to nonvitrectomized eyes. Overall intraocular pharmacokinetic properties of ranibizumab in vitrectomized eyes were similar to those in nonvitrectomized eyes. Our data do not support the use of different dosing regimens of ranibizumab in vitrectomized eyes.


Current management of psoriasis in the United Kingdom: patterns of prescribing and resource use in primary care.
The current management of psoriasis and its associated resource use in the United Kingdom (UK) was investigated in this retrospective analysis of 789,300 primary care patient records. Most patients with psoriasis (94%) were managed on topical psoriasis agents only, 4% were prescribed systemic psoriasis agents and 2% had no recorded psoriasis treatment at all during the 12-month study period. Co-medications to treat physical or psychological comorbidities were required by 22% of patients. Referral rates into secondary care were low, 5% of patients prescribed systemic psoriasis agents and 0.7% of patients prescribed topical psoriasis agents had secondary care appointments documented in their medical records. This study demonstrates that most patients with psoriasis in UK primary care are managed on topical agents even though there are surrogate markers, such as resource use and co-medication prescriptions, which indicate that their psoriasis is not optimally controlled.


A prospective study of predictors of disability at 3 months after non-central nervous system trauma.
To delineate which injury-related, demographic, and psychosocial variables were predictive of severe disability (limitations in the performance of socially defined roles and tasks) at 3 months after discharge from acute hospitalization for non-central nervous system traumatic injury. The study design was prospective, longitudinal, and correlational. The sample consisted of 109 injured patients at three urban trauma centers. Data were obtained from patient interview using the Sickness Impact Profile, the Impact of Event Scale, and the Social Support Questionnaire; injury-related data were obtained from the medical record and computerized trauma registries. The sample had a mean age of 37.4 +/- 16.8 years, a mean number of injuries per person of 4.4 +/- 2.8, and a mean Injury Severity Score of 15.5 +/- 9.9. Motor vehicle crashes (34.9%) and violent injuries (33%) were the predominant causes of injuries. Patients experienced severe levels of disability (Sickness Impact Profile, mean = 26.1) and moderate levels of psychological distress (Impact of Event Scale, mean = 30.6; intrusion mean = 14.6 and avoidance mean = 16.0). Three variables were predictive of severe disability at 3 months: high levels of intrusive thoughts (odds ratio, 2.9; 95% confidence interval, 1.1-7.7); injury with a maximal Abbreviated Injury Scale score in an extremity (odds ratio, 2.9; 95% confidence interval, 1.2-6.9); and having not graduated from high school (odds ratio, 3.4; 95% confidence interval, 1.2-10). Extremity injuries, lack of high school graduation, and high level of posttraumatic psychological distress with intrusive thoughts are risk factors for severe disability at 3 months after discharge from the hospital.


Biochemical bone markers are useful to monitor fracture repair.
Biochemical bone markers reflect bone metabolism but little is known regarding their usefulness during fracture repair. Reduced bone mineral density may influence fracture healing. We hypothesized that low bone mineral density results in decreased levels of bone markers during the acute phase of fracture healing, especially in women who are postmenopausal. We also addressed the question of different fracture types and locations resulting in different levels of bone markers. Urinary levels of N-terminal cross-linked telopeptide, deoxypyridinoline, and pyridinoline were measured preoperatively and postoperatively in patients with hip fractures, distal forearm fractures, and in 25 control subjects. Bone mineral density was determined using quantitative computed tomography of the spine. Patients with low bone mineral density, especially women who were postmenopausal, had greater concentrations of N-terminal cross-linked telopeptide when compared with patients with normal bone mineral density or men. Patients with pertrochanteric fractures had greater concentrations than patients with femoral neck fractures, as did patients with hip fractures compared with patients with fractures of the distal forearm. These results suggest that levels of bone markers increase during fracture healing despite low bone mineral density and that different fracture types and locations result in different levels of bone markers. Prognostic study, Level I (high quality prospective study-all patients were enrolled at the same time with > or = 80% of followup of enrolled patients). See the Guidelines for Authors for a complete description of levels of evidence.


Complementary DNA and deduced amino acid sequences of procine alpha 1-microglobulin and bikunin.
Analysis of complementary DNA for porcine alpha 1-microglobulin and bikunin indicates that both proteins result from proteolytic processing of a common precursor similar to that found in man. Complete primary structures of these proteins are deduced from the nucleic acid sequence and partially confirmed by peptide sequencing.


[Study of DNA extraction methods for testing for genetically modified organisms in soyproducts].
In order to evaluate three different methods for DNA extraction (CTAB, DNeasy Plant Mini Kit and Wizard DNA Clean-up Resin system), the yields of DNA extracted from soyproducts and the copy numbers of lectin genes amplified by quantitative PCR were compared. Fermented foods, such as miso and nattou, gave poor yields of DNA and low copy numbers with any method. However atsu-age and kinugoshi-tofu gave high-quality results with all methods. Kinako gave a high yield of DNA, but poor amplification. Boiled soybeans and soymilk showed in poor amplification. It is important to choose the appropriate DNA extraction method for each product.


Interaction of alpha-chymotrypsin with dimyristoyl phosphatidylcholine vesicles.
The amidolytic activity of chymotrypsin for Suc-Ala2-Pro-Phe-MCA was somewhat enhanced by dimyristoyl PC at low ionic strength, but not at high ionic strength. The activity was strongly inhibited by pure egg yolk PA. The inhibition by 200 ng PA was neutralized by addition of 1 microgram dimyristoyl PC or pure egg yolk PC, which formed vesicles with the PA. The Km and kcat (s-1) values of chymotrypsin for hydrolysis of Suc-Ala2-Pro-Phe-MCA changed from 15 microM to 42 microM, 0.1 mM and 0.5 mM, and from 1.5 to 2.7, 3.7, and 1.0 in the presence of 1 microgram dimyristoyl PC, 0.5 micrograms pure egg yolk PE and 0.2 microgram egg yolk PA, respectively. Gel-filtration chromatography showed that dimyristoyl PC formed a complex with chymotrypsin, but did not interact with the substrate, indicating that the basic globular protein, chymotrypsin, interacted with net-neutral PL.


Comparison of efficacy and safety of exchange transfusion through different catheterizations: Femoral vein versus umbilical vein versus umbilical artery/vein.
To compare the efficacy and safety of exchange transfusion (ET) via three different catheterization methods: femoral vein (FV); umbilical vein (UV); and umbilical artery/vein (UA/V). A retrospective cohort of neonates who underwent ET for hyperbilirubinemia between 1996 and 2007 was surveyed. Subjects with gestational age < 33 wks were excluded. Neonatal intensive care units in a tertiary referral hospital. A total of 109 neonates with 128 ET procedures (33 via FV, 35 via UV, and 60 via UA/V routes) were analyzed. There was no significant difference in the decline of total serum bilirubin between each group. When compared with the UA/V group, the transfusion rate was slower in the FV and UV groups (p < .001). Adverse events with clinical significance were more common in ET via the UA/V route than ET via the FV and UV routes (p < .05; odds ratio, 2.4; 95% confidence interval, 1.2-5.0). Neonates with ET via the UA/V route tended to have more asymptomatic laboratory aberrances (p < .01; odds ratio, 2.5; 95% confidence interval, 1.3-4.6). There were no significant differences in the transfusion rate (p = .498) and adverse events (p = .822) between the FV and UV groups. ET through the FV route is an effective and secure method for the treatment of neonatal hyperbilirubinemia when the UV route is unavailable. Physicians should be cautious when using UA/V catheterization for ET.


Impact of home blood pressure monitors on self-monitoring and control of blood pressure in vulnerable adults.
To evaluate associations between home blood pressure monitoring (HBPM) and blood pressure (BP) in vulnerable adults during the COVID-19 pandemic, when access to in-person care was restricted. A retrospective cohort study was conducted in adults with hypertension or elevated BP given a home BP monitor vs. usual care. Change in BP from baseline to follow-up was compared between groups, controlling for potential confounders. Subgroup analyses of BP outcomes were also assessed in patients age >50 years. There was no difference in SBP reduction between n = 82 HBPM patients (-11.7/-2.9 mmHg) and n = 280 usual care patients (-12.5/-5.8 mmHg; P> 0.05). Results were similar in multivariable analysis controlling for potential confounders [coefficient 0.44, 95% confidence interval (CI) -3.98 to 4.87]. However, in the subgroup of patients aged>50 years, there was a significant association between SBP reduction and HBPM in the multivariable analyses (coefficient -7.2, 95% CI -13.8 to -0.62, P= 0.032). HBPM use was not associated with BP reduction in vulnerable adults overall during high telehealth use. An association between SBP reduction and HBPM was observed in those aged>50 years. Targeting limited HBPM resources to those aged >50 years old may have the most impact on BP.


Sensitivity theory and mental retardation: why functional analysis is not enough.
Sensitivity theory holds that aberrant behavior is a function of aberrant contingencies (direct reinforcement of maladaptive behavior), aberrant motivation (a desire for an excessive amount of reinforcement), and aberrant environments (situations in which most people cannot satiate their fundamental desires by behaving appropriately). Applied behavior analysts are almost exclusively concerned with aberrant contingencies and, to a lesser extent, aberrant environments. Because they do not treat people for aberrant motivation, behaviorists tend to treat the same people repeatedly. When a person craves an excessive amount of attention, this desire must be reduced for a durable and generalized treatment outcome, but behaviorists do not even try to do this. Implications for communication theory, assessment, and treatment strategies were discussed.


Is the pentagon-copying task more than a cognitive feature? Associations with handgrip strength, gait speed and frailty in older adults.
The pentagon copy is a sensitive item to the prediction of cognitive decline and dementia. Cognitive and physical/motor decline are able to accelerate the evolution of each other, by representing a common pathway towards frailty. To investigate the association of the pentagon-copying task with physical and motor performances and with frailty, in a sample of older adults. This observational, cross-sectional and single-center study was conducted in a Geriatric Outpatients Clinic. Subjects aged ≥ 65 years were consecutively recruited, on a voluntary basis. Subjects with positive psychiatric history, with a severe neurocognitive disorder, with severe limitations on the upper limbs and/or reporting sensory deficits were excluded. The pentagon-copying task was scored from the Mini Mental State Examination; the Qualitative Scoring Pentagon Test (QSPT) was also used. Handgrip strength was measured; a 46-item Frailty Index was calculated; in subjects with autonomous walking, a 4-meter gait speed was also measured. The study included 253 subjects (mean age 80.59 ± 6.89 years). Subjects making a wrong pentagon copy showed greater odds of exhibiting a strength deficit (OR = 3.57; p=0.001) and of being frail (OR= 4.80; p<0.001), and exhibited a slower gait. The QSTP score was significantly correlated with handgrip strength (r= 0.388) and gait speed (r= 0.188), and inversely correlated with frailty (r= -0.428); the QSTP score was significantly different between the quartiles of handgrip strength and frailty. The pentagon copying-task might also be confirmed as a quick screening tool of aging trajectories towards frailty, by jointly evaluating cognitive and physical performances.


Nonadditive interactions in ns2 and spin-polarized ns metal atom trimers.
The origins of nonadditivity in the following groups of metal trimers are examined: alkali earth metals of the IIA group (Be, Mg, and Ca), Zn as a transition metal analog of this group, spin-polarized alkali metals from IA group (Li, Na, K), and the spin-polarized Cu as its transition metal analog. The nonadditive interactions in these trimers are analyzed using the following hierarchy of approximations: the Heitler-London, self-consistent field (SCF), and correlated levels of theory. The exchange nonadditivity, which is included at the Heitler-London level, constitutes a bulk of nonadditive interactions in these systems in their equilibrium structures. The SCF treatment reveals some unphysical characteristics. At the post-SCF levels of theory the multireference character of the wave function increases from atom to dimer to trimer. The role of configurations involving excitations ns-np increases in this sequence and it is the genuine nonadditive effect. There is also a dramatic change in the characteristics of the excited states upon formation of clusters. We use the parameters of these excited states to predict which complexes are bound by the unusually strong nonadditive interactions and which are not.


Residential crisis services: a review.
Crisis assistance for persons with long-term mental illnesses is a critical part of comprehensive community support systems. Residential crisis services, while still not widely used, have been established in some communities and appear to have growing appeal as alternatives to acute psychiatric hospitalization for some clients. The services provide acute treatment in supportive, homelike settings, usually either private homes or small group facilities, and intensive discharge planning to link clients with community sources of long-term care. This review describes typical models and goals of residential crisis services and some of the factors that have impeded their development.


[Experience of carinal resection and reconstruction in the treatment of carinal tumor and bronchogenic carcinoma].
Carinal resection and reconstruction is an emphasis in surgical treatment of carinal tumor and bronchogenic carcinoma involving carina. The aim of this study is to discuss the clinical value of carinoplasty in lung cancer surgery. From 1982 to 2004, 41 cases of central bronchogenic carcinoma that invaded the carina accepted carinal resection and reconstruction in this hospital. Of the 41 patients, 25 patients underwent simutaneously additional cardiovascular plasty operation besides carinoplasty. There were 12 different types of carinal resection and reconstruction in this series. There was 1 perioperative death (because of anastomotic leakage) in this group. Arrhythmia occured in 12 patients, atelectasis in 6 patient and pneumonia in 5 patients. Five patients were assisted ventilation through breathing machine because of pulmonary function failure. The 1-, 3-, and 5-year survival rates were 76.21%, 47.23% and 26.83% respectively. The carinoplasty is a good method to treat central bronchogenic carcinoma which invaded the carina. With this method lung cancer tissue can be resected maximally, meanwhile, it can save pulmonary function of patient maximally. Postoperative multi-modality therapy is helpful to increase postoperative survival rate and improve quality of life.


Three-dimensional stress field around a membrane protein: atomistic and coarse-grained simulation analysis of gramicidin A.
Using both atomistic and coarse-grained (CG) models, we compute the three-dimensional stress field around a gramicidin A (gA) dimer in lipid bilayers that feature different degrees of negative hydrophobic mismatch. The general trends in the computed stress field are similar at the atomistic and CG levels, supporting the use of the CG model for analyzing the mechanical features of protein/lipid/water interfaces. The calculations reveal that the stress field near the protein-lipid interface exhibits a layered structure with both significant repulsive and attractive regions, with the magnitude of the stress reaching 1000 bar in certain regions. Analysis of density profiles and stress field distributions helps highlight the Trp residues at the protein/membrane/water interface as mechanical anchors, suggesting that similar analysis is useful for identifying tension sensors in other membrane proteins, especially membrane proteins involved in mechanosensation. This work fosters a connection between microscopic and continuum mechanics models for proteins in complex environments and makes it possible to test the validity of assumptions commonly made in continuum mechanics models for membrane mediated processes. For example, using the calculated stress field, we estimate the free energy of membrane deformation induced by the hydrophobic mismatch, and the results for regions beyond the annular lipids are in general consistent with relevant experimental data and previous theoretical estimates using elasticity theory. On the other hand, the assumptions of homogeneous material properties for the membrane and a bilayer thickness at the protein/lipid interface being independent of lipid type (e.g., tail length) appear to be oversimplified, highlighting the importance of annular lipids of membrane proteins. Finally, the stress field analysis makes it clear that the effect of even rather severe hydrophobic mismatch propagates to only about two to three lipid layers, thus putting a limit on the range of cooperativity between membrane proteins in crowded cellular membranes.


Slit-shaped artificial pupil and very dense nuclear cataract after early iridoplasty: May consultation #1.
A now-17-year-old girl was reportedly born with no pupil formed in her right eye. In her first week of life, she underwent attempted pupilloplasty at a foreign institution. Surgery was reported to have been complicated and followed by vitreous hemorrhage. Nine months later, the eye was reevaluated at another institution and the presence of primary persistent hyperplastic vitreous noted. Secondary widening of the artificial pupil was performed. She now presents with a slit-shaped pupil and a very dense nuclear cataract (). She now desires removal of the cataract to regain the temporal visual field and at least some residual vision as well as reformation of the pupil for cosmetic reasons.(Figure is included in full-text article.)Slitlamp examination shows superficial corneal scarring around a corneal incision and corneal sutures superiorly with iridocorneal synechiae between 10 and 12 o'clock confirmed on gonioscopy. It appears that a primary inferiorly displaced pupil was enlarged, and the iris shanks pulled up and incarcerated in the corneal incision, resulting in a slit-shaped cat's eye pupil. Intraocular pressure was 10 mm Hg. Light perception is uncertain but definitely positive on transillumination, and ultrasound reveals the retina to be fully attached ().(Figure is included in full-text article.)How would you counsel this girl, and what would be your surgical approach? Which specific techniques would you consider for removal of the cataract and reformation of the pupil?


[Improvising, innovating and experimenting in surgery. A serious problem without ethical regulation in current surgical practices].
This article analyses three terms that are often cited in the current surgical literature: improvisation, innovation and surgical research. Each one has a totally different definition yet in our daily practice terms are often confused and even used as synonyms. A wide variety of novel technical procedures are developed and sometimes published without being first subjected to rigorous peer review. These results sometimes are a by-product of improvisation. Often, these new techniques have undoubtedly contributed to the progress of surgery but in other cases, measured in the immediate or long terms, side effects have become unpredictable and have caused serious harm. In this article, I carried out a review of the literature with the aim of proposing a more rigorous approach for the publication of research results in the changing field of surgery


[Horizontal measurements of buccal vestibules].
In order to establish the horizontal measurements of the buccal vestibules- an important index for the aesthetic quality of prostheses, a total of 250 subjects, 119 males and 131 females, were measured. The size of the buccal vestibule is calculated as the half of the difference between the size of a smiling mouth and the width of the visible dentition. It has been established that the mean linear measure of the buccal vestibule is 6.5 mm and varies from 5 and 8.5 mm. Its value is directly proportional to the size of the smile and inversely proportional--to the width of the visible dentition; no discrepanciens have established depending on sex and age of the subject.


Molecular genetics of sexual development in the mushroom Coprinus cinereus.
Sexual development in the mushroom Coprinus cinereus is under the control of two mating type loci, A and B. When two haploid homokaryons with compatible alleles at both A and B loci are mated, the coordinated activities of A- and B-regulated pathways lead to formation of a mycelium termed the dikaryon, in which the two nuclei from the mating partners pair in each cell without fusing. The dikaryon is a prolonged mycelial stage that can be induced to develop a multicellular structure, the mushroom, under proper environmental conditions. The two nuclei fuse in specialized cells on the mushroom and immediately undergo meiosis to complete the sexual life cycle. It has been established recently that the A genes encode two classes of homeodomain proteins while the B genes encode pheromones and their receptors. More recently, molecular genetics has been used to reveal genes that work downstream of the mating type genes to regulate dikaryon formation, mushroom morphogenesis, and meiosis.