Reducing Physical Therapy Consults for Patients With High Functional Mobility in the Acute Medical Inpatient Setting: A Difference-in-Difference Analysis.
To evaluate the effectiveness of clinical decision support for reducing misallocation of physical therapy (PT) consults. A prospective quasi-experimental study. Between October 2018 and November 2021, routinely documented data on functional status and physical therapy referrals were collected from electronic medical records. Hospital Medicine and General Internal Medicine service lines at a large quaternary academic medical center. 20,810 adult patients hospitalized on any of the included treatment (hospital medicine) or control (general internal medicine) service lines. The primary outcome was "change in proportion of misallocated PT consults" measured as likelihood of PT consults for patients admitted with high functional mobility scores. Changes in the primary outcome from the pre-intervention to post-intervention period were compared in the control and treatment groups using propensity score-weighted difference-in-differences multivariable logit regression adjusting for clinically relevant covariates. The intervention period was measured for 20 months and consisted of a clinical decision support tool embedded in the daily note templates for hospital medicine providers. The tool provided education on patient mobility scores and their relation to need for PT consult. The tool was rolled out without any further announcements or education. Our cohort included 20,810 unique admissions (mean age 58.9, 55% women, 83% Black). Post-intervention, the likelihood of PT referrals for patients with high baseline mobility (AM-PAC >18) decreased by 7.3% (P<.001) for the treatment group compared with control, adjusted for age, sex, race, ethnicity, length-of-stay, and mobility change. Mobility score-based clinical decision support can decrease unneeded PT consults in the inpatient setting. This could help allocate therapy time for at-risk patients while also having a positive effect on health care systems.


[Transhepatic transportal embolization of gastroesophageal veins in profuse esophageal hemorrhage].
The article deals with the results of treatment of 27 patients with profuse esophageal hemorrhage in portal hypertension. Sixteen patients were treated by roentgen-guided endovascular surgery, namely, transhepatic transportal embolization of varicose veins of the esophagus and stomach. In view of the peculiarities of blood drainage and for the prevention of recurrent bleeding, seven patients were subjected to additional manipulations: embolization of the splenic artery (4) and the left gastric artery (3). Despite reliable arrest of bleeding, 3 patients died in the first 2-3 days from progressive hepatorenal failure. Only one patient had recurrent bleeding in the late-term period. The authors believe transhepatic transportal embolization of the gastroesophageal veins at the peak of hemorrhage to be a hardly injurious and effective method for its arrest.


New evidences on efficacy of boronic acid-based derivatization method to identify sugars in plant material by gas chromatography-mass spectrometry.
This work presents an analytical procedure based on gas chromatography-mass spectrometry which allows the determination of aldoses (glucose, mannose, galactose, arabinose, xylose, fucose, rhamnose) and chetoses (fructose) in plant material. One peak for each target carbohydrate was obtained by using an efficient derivatization employing methylboronic acid and acetic anhydride sequentially, whereas the baseline separation of the analytes was accomplished using an ionic liquid capillary column. First, the proposed method was optimized and validated. Successively, it was applied to identify the carbohydrates present in plant material. Finally, the procedure was successfully applied to samples from a XVII century painting, thus highlighting the occurrence of starch glue and fruit tree gum as polysaccharide materials.


Dietary fatty acid sources affect conjugated linoleic acid concentrations in milk from lactating dairy cows.
Conjugated linoleic acid (CLA), a naturally occurring anticarcinogen found in dairy products, is an intermediary product of ruminal biohydrogenation of polyunsaturated fatty acids. Our objective was to determine the effect of different dietary oils, which vary in fatty acid composition, on CLA concentrations in milk from lactating dairy cows. Twelve Holstein cows were randomly assigned to a 3 x 3 Latin square design. Dietary treatments were the addition (53 g/kg dietary dry matter) of peanut oil (high oleic acid), sunflower oil (high linoleic acid) and linseed oil (high linolenic acid). Each treatment period was 2 wk, and milk samples were collected on the last 4 d of each period. Milk yield (34.2 +/- 1.3 kg/d) and milk fat (2.25 +/- 0.06%) were not different among treatments. Milk protein during the sunflower oil treatment (mean, 3.44% protein) was significantly higher (P < 0.01) than during the other treatments. Milk fat concentration of CLA during the sunflower oil treatment was significantly different from other treatments (P < 0.001) and approximately 500% greater than typically observed when cows consume traditional diets. CLA concentrations (mg/g of milk fat) were 13.3, 24.4 and 16.7 during peanut oil, sunflower oil and linseed oil treatment, respectively. CLA concentration in milk fat can be enhanced by the addition of polyunsaturated fatty acids to the diet, especially oils high in linoleic acid.


Investment case for the prevention and reduction of childhood and adolescent overweight and obesity in Mexico.
Despite efforts to curb the rise in Mexico's child and adolescent overweight and obesity rates, prevalence in Mexico has grown by 120% since 1990 to 43.3% in 2022. This investment case identifies policies that will produce the largest returns for Mexico. The investment case model builds beyond a cost-of-illness analysis by predicting the health and societal economic impact of implementing child and adolescent overweight and obesity interventions in a cohort aged 0-19 from 2025 to 2090. The Markov model's impacts include healthcare expenditures, years of life lost, and reduced wages and productivity. We projected and compared costs in a status quo scenario to an intervention scenario to estimate cost savings and calculate return-on-investment (ROI). Total lifetime health and economic costs amount to USD 1.8 trillion-USD 30 billion on average per year. Implementing five interventions can reduce lifetime costs by approximately 7%. Each intervention has a low cost per disability-adjusted life year averted over 30-year, 50-year, and lifetime horizons. The findings demonstrate that a package of interventions mitigating child and adolescent overweight and obesity offers a strong ROI. The novel investment case methods should be applied to other countries, particularly low- and middle-income countries.


Characterization of alpha1(IV) collagen mutations in Caenorhabditis elegans and the effects of alpha1 and alpha2(IV) mutations on type IV collagen distribution.
Type IV collagen is a major component of basement membranes. We have characterized 11 mutations in emb-9, the alpha1(IV) collagen gene of Caenorhabditis elegans, that result in a spectrum of phenotypes. Five are substitutions of glycines in the Gly-X-Y domain and cause semidominant, temperature-sensitive lethality at the twofold stage of embryogenesis. One is a glycine substitution that causes recessive, non-temperature-sensitive larval lethality. Three putative null alleles, two nonsense mutations and a deletion, all cause recessive, non-temperature-sensitive lethality at the threefold stage of embryogenesis. The less severe null phenotype indicates that glycine substitution containing mutant chains dominantly interfere with the function of other molecules. The emb-9 null mutants do not stain with anti-EMB-9 antisera and show intracellular accumulation of the alpha2(IV) chain, LET-2, indicating that LET-2 assembly and/or secretion requires EMB-9. Glycine substitutions in either EMB-9 or LET-2 cause intracellular accumulation of both chains. The degree of intracellular accumulation differs depending on the allele and temperature and correlates with the severity of the phenotype. Temperature sensitivity appears to result from reduced assembly/secretion of type IV collagen, not defective function in the basement membrane. Because the dominant interference of glycine substitution mutations is maximal when type IV collagen secretion is totally blocked, this interference appears to occur intracellularly, rather than in the basement membrane. We suggest that the nature of dominant interference caused by mutations in type IV collagen is different than that caused by mutations in fibrillar collagens.


Essential roles of c-Rel in TLR-induced IL-23 p19 gene expression in dendritic cells.
IL-23 plays crucial roles in both immunity against pathogens and autoimmunity against self. Although it is well recognized that IL-23 expression is restricted to the myeloid lineage and is tightly regulated at the transcriptional level, the nature of transcription factors required for IL-23 expression is poorly understood. We report, in this study, that murine dendritic cells deficient in c-Rel, a member of the NF-kappaB family, are severely compromised in their ability to transcribe the p19 gene, one of the two genes that encode the IL-23 protein. The p19 gene promoter contains three putative NF-kappaB binding sites, two of which can effectively bind c-Rel as determined by chromatin immunoprecipitation and EMSA. Unexpectedly, mutation of either of these two c-Rel binding sites completely abolished the p19 promoter activity induced by five TLRs (2, 3, 4, 6, and 9) and four members of the NF-kappaB family (c-Rel, p65, p100, and p105). Based on these observations, we conclude that c-Rel controls IL-23 p19 gene expression through two kappaB sites in the p19 promoter, and propose a c-Rel-dependent enhanceosome model for p19 gene activation.


[Research progress in vasculogenic mimicry in multiple tumors].
Vasculogenic mimicry (VM) is a brand-new tumor vascular pattern with the ability to form vessel-like networks without participation of endothelial cells and independent on angiogenesis. It can provide adequate blood supply for tumor growth. The formation of VM involves multiple molecule mechanisms and signal pathways, including cancer stem cell and epithelial-mesenchymal transition. As a unique blood-supply pattern, VM is associated with cancer invasion, metastasis and poor prognosis. Because of its important role in cancer progression, VM will become a new target for therapy of cancers.


Classification of forefoot pain based on plantar pressure measurements.
Plantar pressure is widely used to evaluate foot complaints. However, most plantar pressure studies focus on the symptomatic foot with foot deformities. The purposes of this study were to investigate subjects without clear foot deformities and to identify differences in plantar pressure pattern between subjects with and without forefoot pain. The second aim was to discriminate between subjects with and without forefoot pain based on plantar pressure measurements using neural networks. In total, 297 subjects without foot deformities of whom almost 50% had forefoot pain walked barefoot over a pressure plate. Foot complaints and subject characteristics were assessed with a questionnaire and a clinical evaluation. Plantar pressure was analyzed using a recently developed method, which produced pressure images of the time integral, peak pressure, mean pressure, time of activation and deactivation, and total contact time per pixel. After pre-processing the pressure images with principal component analysis, a forward selection procedure with neural networks was used to classify forefoot pain. The pressure-time integral and mean pressure were significantly larger under the metatarsals II and III for subjects with forefoot pain. A neural network with 14 input parameters correctly classified forefoot pain in 70.4% of the test feet. The differences in plantar pressure parameters between subjects with and without forefoot pain were small. The reasonable performance of forefoot pain classification by neural networks suggests that forefoot pain is related more to the distribution of the pressure under the foot than to the absolute values of the pressure at fixed locations.


Vulvar dystrophies.
The primary symptom of the vulvar dystrophies (nonneoplastic epithelial disorders of the vulvar skin and mucosa) is vulvar pruritus. The development of malignancy is relatively uncommon (1-5%) over a prolonged period. Medical therapy is effective in alleviating symptoms in most patients.


[Transcription factors in osteoclast differentiation].
Osteoclasts are specialized, multinucleated macrophages that resorb bone. Genetic experiments in mice revealed that the three families of transcription factors, nuclear factor-kappaB (NF-kappaB), activator protein-1 (AP-1), and nuclear factor of activated T-cells (NFAT) are each essential for osteoclast differentiation. Macrophage colony stimulating factor (M-CSF), receptor activator of NF-kappaB ligand(RANKL), and other osteoclastogenic ligands activate the NF-kappaB components p50 or p52, the AP-1 component c-Fos, and NFATc1 in osteoclast precursors. Consequently, diverse groups of genes are transcribed, including those encoding tartrate-resistant acid phosphatase (TRAP), calcitonin receptor, cathepsin K and interferon-beta. Surprisingly, recent studies have begun to uncover a linear relationship among these transcription factors, including the c-Fos-NFATc1 transcriptional activation cascade.


[Study on the function localization during different brain calculation tasks].
The aim of this study is to define the anatomical localization of corresponding brain function area during calculating. The activating modes in brain during continuous silent calculating subtraction and repeated silent reading multiplication table were compared and investigated. Fourteen volunteers of right-handedness were enrolled in this experiment. The quite different reaction models in brain area during the two models of calculation revealed that there are different processing pathways in brain during these two operating tasks. During continuous silent calculating, the function areas were found localized on the posterior portion of superior and middle gyrus of frontal lobe and the lobule of posterior parietal lobe (P < 0.01, T = 5.41), demonstrating that these function areas play an important role in the performance of calculation and working memory. During repeated silent reading multiplication table, the activating cluster was found only located in in the gyri occipital lateral(P < 0.01, T = 4.77).


Early Adversity, Toxic Stress, and Resilience: Pediatrics for Today.
Never before in the history of science have we had better insight into the factors that determine the health and well-being of a person from infancy to adulthood. An expanding body of knowledge is converging from numerous disciplines including neuroscience, education, behavioral science, public health, the social sciences, and medicine. Awareness of the impact of early childhood adversity and toxic stress is growing rapidly among both professionals and the lay public. This calls for a reevaluation of how and what we, as child health care providers, should deliver to maximize our impact on individual health and well-being across the lifespan. This article briefly summarizes the topic and gives examples of how child health care providers are innovatively incorporating the latest science in practice. [Pediatr Ann. 2017;46(7):e246-e249.].


Two-dimensional fluorescence spectroscopy of laser-produced plasmas.
We use a two-dimensional laser-induced fluorescence spectroscopy technique to measure the coupled absorption and emission properties of atomic species in plasmas produced via laser ablation of a solid aluminum target at atmospheric pressure. Emission spectra from the Al I 394.4 nm and Al I 396.15 nm transitions are measured while a frequency-doubled, continuous wave (cw) Ti:sapphire laser is tuned across the Al I 396.15 nm transition. The resulting two-dimensional spectra show the energy coupling between the two transitions via increased emission intensity for both transitions during resonant absorption of the cw laser at one transition. Time-delayed, gated detection of the emission spectrum is used to isolate resonantly excited fluorescence emission from thermally excited emission from the plasma. In addition, the tunable cw laser measures the absorption spectrum of the Al transition with ultrahigh resolution after the plasma has cooled, resulting in narrower spectral linewidths than observed in emission spectra. Our results highlight that fluorescence spectroscopy employing cw laser re-excitation after pulsed laser ablation combines benefits of both traditional emission and absorption spectroscopic methods.


Lipoprotein(a) levels from childhood to adulthood: Data in nearly 3,000 children who visited a pediatric lipid clinic.
Elevated lipoprotein(a) [Lp(a)] is an independent risk factor for cardiovascular disease. In clinical practice, Lp(a) is mostly measured only once assuming that it does not change with age nor vary within individuals. This is mainly based on adult data and data on Lp(a) levels during childhood is scarce. Therefore, we evaluated whether Lp(a) levels changed with age and determined the intra-individual variation of Lp(a) in a large cohort of children. We collected all Lp(a) measurements of children referred to the pediatric lipid clinic of the Amsterdam UMC between 1989 and 2017. The association between Lp(a) and age, as well as the intra-individual variation of Lp(a), was assessed using mixed models. We stratified for lipid-lowering medication use. In total, we included 2740 children. From the age of 8 years onwards, mean Lp(a) increased with 22% in children that reached adulthood without lipid-lowering medication (n = 2254). In statin-users (n = 418) and children that used ezetimibe additionally (n = 65), Lp(a) increased with 43% and 9%, respectively. The intra-individual variation of Lp(a) was 70%. Lp(a) levels increase with age and exhibit considerable variation within children referred to a lipid clinic. Measuring Lp(a) only once during childhood might therefore lead to substantial over- or underestimation and possibly result in over- or under treatment in the future. Thus, to more accurately assess the Lp(a) level, we suggest measuring Lp(a) more than once during childhood and to repeat this in adulthood if a patient only has childhood assessment of Lp(a).


Chronic constipation is negatively associated with colonic diverticula.
Constipation has been considered the key risk factor for diverticulosis occurrence, but the underlying mechanism is unclear. We investigated the factors associated with diverticulosis, focusing on the association of constipation severity with the localization and number of diverticula. We analyzed consecutive patients who underwent colonoscopy between March and December 2019. Chronic constipation was diagnosed as constipation meeting Rome IV criteria or as that requiring laxative therapy for more than 6 months. The degree of constipation was scored using the Constipation Scoring System (CSS). We assessed 1014 patients. Multivariate analysis revealed that age, alcohol consumption, and hypertension were positively associated with diverticulosis, whereas chronic constipation was negatively associated with diverticulosis (odds ratio [OR] = 0.74; 95% confidence interval [CI], 0.55-0.99). When assessed according to the location of diverticula, right-sided diverticula were significantly associated with a lower incidence of constipation (OR = 0.94; 95% CI, 0.89-0.98), whereas neither left-sided nor bilateral diverticula was associated with constipation. This negative association of diverticula with constipation was stronger in patients with a high CSS score. In stratified analysis, the number of diverticula decreased with increasing degree of constipation (p for trend <.01), and a high CSS score was associated with a decreased prevalence of ≥3 diverticula (OR = 0.64; 95% CI, 0.44-0.99). Chronic constipation was negatively associated with colonic diverticulosis. The association increased with the degree of constipation and was strong only in cases with right-sided diverticula and those with ≥3 diverticula.


Immunization status of thirty patients with sickle cell disease five years post hepatitis B vaccination. A comparison with normal controls.
In order for hepatitis B immunization programmes to be cost effective and clinically beneficial, vaccinated persons should maintain an immunity threshold titre of antibodies to hepatitis B surface antigen greater than 10 IU/l. Those who fall below this level should be boosted in order to be covered against the risk for which the vaccine was administered. Persons with sickle cell disease are included in the group for whom hepatitis B immunization is routinely prescribed. Antibody to hepatitis B surface antigen was measured in paired sera of thirty patients with sickle cell disease compared with a control group of healthy medical staff, five years post vaccination. There was no significant difference between patients with sickle cell disease and normal controls in the levels of antibody maintained or numbers that required booster vaccination. Recommendations for the maintenance of protection via revaccination should be the same for persons with sickle cell disease as for healthy persons.


Sacubitril-valsartan versus enalapril for the treatment of acute decompensated heart failure in Chinese settings: A cost-effectiveness analysis.
Background: The episode of acute decompensated heart failure (ADHF) is the main cause of hospitalization for heart failure (HF). Sacubitril-valsartan has been proven to be effective in reducing the risks of hospitalization for HF in ADHF. When to initiate sacubitril-valsartan in ADHF to make it the most cost-effective in China remains unclear. Methods: A lifetime Markov model with a 1-month cycle length was developed to evaluate the cost-effectiveness of early or late initiation of sacubitril-valsartan versus enalapril in ADHF. Early initiation of sacubitril-valsartan meant that it was initiated after stabilization from ADHF, and late initiation of sacubitril-valsartan meant that it was initiated after stabilization from HF, which includes no hospitalization for at least three consecutive months. The primary outcome was the incremental cost-effectiveness ratio (ICER), expressed as the ratio of incremental cost to incremental effectiveness. The secondary outcomes were total costs and total effectiveness. Three times of per capita GDP of China in 2021 was set as the willingness-to-pay threshold. One-way sensitivity analysis and probabilistic sensitivity analysis were employed to test the robustness of the results. Results: The early initiation of sacubitril-valsartan treatment resulted in an ICER of 3,662.4 USD per quality-adjusted life year, lower than the willingness-to-pay threshold, and the late initiation of sacubitril-valsartan treatment gained an ICER of 4,444.4 USD/QALY, still lower than the willingness-to-pay threshold. One-way sensitivity analysis showed that our results were robust, and probabilistic sensitivity analysis suggested that early initiation of sacubitril-valsartan in ADHF was cost-effective under a 97.4% circumstance. Conclusion: Early initiation of sacubitril-valsartan after stabilization of ADHF is highly cost-effective compared with the use of enalapril; late initiation of sacubitril-valsartan after stabilization of HF is still cost-effective but not as cost-effective as early initiation of sacubitril-valsartan in ADHF. For Chinese ADHF patients, the time to initiate sacubitril-valsartan should be when the patient is stabilized from ADHF rather than when stabilized from HF, from the perspective of economic evaluation.


Morphine diesters. II. Blood metabolism and analgesic activity in the rat.
The kinetics of hydrolysis of dipropanoylmorphine (DPM) and dibutanoylmorphine (DBM) in human blood fractions and for diacetylmorphine (DAM) and DBM in rat blood fractions were investigated. In each case the hydrolysis of morphine diesters terminated with the production of the corresponding 6-monoester derivative. Generally, decreases in Km and Vmax were observed for the plasma, red blood cell (RBC) cytosol, and RBC membrane esterases responsible for morphine diester hydrolysis as the alkyl chain length of the ester moiety increased. This resulted in an overall decrease in the rate of hydrolysis of morphine diesters by human or rat blood with longer chain homologs of DAM. The analgesic potency and duration of morphine, DAM, and DBM were assessed at various i.v. dosages in the rat by means of the tail-flick latency test. A comparison of equianalgesic doses of morphine, DAM, and DBM indicated that DAM and DBM were 11.5 and 6 times as potent and 0.8 and 1.2 times as long acting, respectively, as morphine.


[Spectrophotometric determination of scandium,gallium and vanadium in white cabbage leaves].
Scandium, gallium and vanadium contents in plants is on the ppm level, although plants from industrial areas can show higher concentrations of these elements. In Department of Analytical Chemistry of Silesian University there have been elaborated new, sensitive, spectrophotometric methods of determination of scandium, gallium and vanadium using Chrome Azurol S (CAS) and Sterinol (ST). The aim of this study was the application of these methods in analysis of cultivated plants from polluted regions. White cabbage from Upper Silesia was chosen. Because the spectrophotometric methods are not selective, scandium, gallium and vanadium should be preliminary separated from interfering elements. The solvent reaction was applied for the isolation from main and trace components of investigated material. Tienoiltrifluoracetone solution in xylene was used for the extraction of scandium, mesithyloxide for vanadium and n-butyl acetate--for gallium. Interfering and not separated Fe(III) was isolated using the extraction with acetylacetone solution in CHCl3 in the case of scandium and the reduction to Fe(II) by ascorbic acid in the case of gallium and vanadium. Due to influence of Fe(II) on the vanadium determination, KCN was used as a masking agent directly after the reduction. Scandium, gallium and vanadium were determined in 6 independent samples of white cabbage after dry or wet mineralization and contents of these leemnets were found from calibration graphs. Obtain results were checked by the internal standard addition method and Atomic Emission Spectrometry Method (ICP AES). The amounts of gallium and vanadium in white cabbage from Upper Silesia District determined by elaborated methods are in good correlation with a literature data, although the contents of vanadium are on the toxic level. The scandium concentration is higher than in plants from not industrial areas. The standard recovery is satisfactory. The Atomic Emission Spectrometry Method gave comparable results. The proposed the spectrophotometric methods are sensitive, precise and economical too, because they require only small amounts of reagents and simple not expensive apparatus. The methods can be recommended for many laboratories to the analytical control of white cabbage and after adaptation to the other plant material analysis.


High-frequency repetitive transcranial magnetic stimulation for treating moderate traumatic brain injury in rats: A pilot study.
Transcranial magnetic stimulation (TMS) is a method of noninvasive brain stimulation that causes neuromodulation by activating neurons or changing excitability in a certain brain area. Considering the known effects of TMS and the pathophysiology of traumatic brain injury (TBI), TMS was proposed to have potential for treating this condition. Moderate TBI was induced in adult male Sprague Dawley rats using Feeney's weight-dropping method. Injured rats were divided into a TMS group and a control group. Repetitive TMS (rTMS) was administered to rats in the TMS group from post-TBI day 2. At post-TBI days 7, 14 and 28, three or four of the rats were sacrificed, and harvested brains were embedded in paraffin and sectioned. Sections were then treated with hematoxylin and eosin and immunohistochemical staining. Three rats from each group underwent fludeoxyglucose F 18 micro-positron emission tomography scanning on post-TBI day 2 and 13. The unexpected mortality rate after injury was lower in the TMS group than in the control group. The modified neurological severity score of the TMS group was lower compared with the control group at post-TBI day 14. According to the results of hematoxylin eosin staining, relative cerebral parenchyma loss was lower at post-TBI day 28 in the TMS group compared with the control group. However, the aforementioned differences were not found to be statistically significant. There was also no significant difference in glucose metabolism between the two groups. According to immunohistochemical staining, the TMS group showed a significantly higher level of proliferation (indicated by bromodeoxyuridine) in the subventricular zone, as compared with the control group (P<0.05). A significantly higher rate of neuron survival at day 28 (P<0.05; indicated by NeuN) and a significantly reduced rate of apoptosis at days 7 and 14 (P<0.05; indicated by caspase-3) were observed in the perilesional zone of the TMS group, as compared with the control group. The current findings suggest that high-frequency rTMS may promote neurogenesis and provide a basis for further studies in this area.


Prescription medication misuse among adolescents with severe mental health problems in Ontario, Canada.
The purpose of this study was to examine the prevalence of prescription medication misuse among adolescents with severe mental health problems in Ontario, Canada, and to explore some of the factors that influence the misuse of prescription medication. Data were obtained from the Resident Assessment Instrument for Mental Health. A total of 2,677 adolescents between the ages of 12 and 18 years who were admitted into adult mental health beds were analyzed. Logistic regression was used in estimating the likelihood of misusing prescription medication. Overall, 17% of adolescent inpatients misused prescription medication. In the multivariate model, the following were found to be associated with misuse: being female, having multiple psychiatric admissions, education, threat or danger to self, problem with addiction, history of emotional abuse, use of alcohol, past year use of opiates and cannabis, as well as symptoms of depression. Misuse of prescription medication was less likely to occur among adolescents with a diagnosis of schizophrenia and adolescents who were admitted as a result of posing a threat or danger to others. Implications of the findings are discussed with suggestions for future research.


[Multiple autoimmune syndromes].
The possibility of three or more autoimmune diseases occurring in the same patient cannot be fortuitous and suggests a pathogenic relationship between each of them. In the light of 4 personal cases, the authors have recorded 87 reports of such associations in the literature, an analysis of which leads them to propose a classification of three types of multiple autoimmune syndrome. The grouping of these syndromes under a single heading should make the research and analysis of these morbid associations easier. Moreover, the classification adopted by the authors allows a more precise definition of patients with at least two autoimmune diseases and so helps to recognize the onset of a third autoimmune disease at a later date. Multiple autoimmune syndromes can be classified in 3 groups according to the prevalence of their associations one with another. Type I comprises myasthenia, thymoma, polymyositis and giant cell myocarditis, this association having a single pathogenic mechanism. Type II includes the Sjögren's syndrome, rhumatoid arthritis, primary biliary cirrhosis, scleroderma and autoimmune thyroid disorders. Type III groups together 10 autoimmune diseases (autoimmune thyroid disease, myasthenia and/or thymoma, Sjögren's syndrome, pernicious anaemia, idiopathic thrombocytopaenic purpura, Addison's disease, insulin-dependent diabetes, vitiligo, autoimmune haemolytic anaemia, systemic lupus erythematosus) for which a genetic predisposition (phenotype HLA B8 and/or DR3 or DR5) seems to be an important factor.


Differential effects of cannabis extracts and pure plant cannabinoids on hippocampal neurones and glia.
We have shown previously that the plant cannabinoid cannabidiol (CBD) elevates intracellular calcium levels in both cultured hippocampal neurones and glia. Here, we investigated whether the main psychotropic constituent of cannabis, Delta(9)-tetrahydrocannabinol (THC) alone or in combination with other cannabis constituents can cause similar responses, and whether THC affects the responses induced by CBD. Our experiments were performed with 1 microM pure THC (pTHC), with 1 microM pure CBD (pCBD), with a high-THC, low CBD cannabis extract (eTHC), with a high-CBD, low THC cannabis extract (eCBD), with a mixture of eTHC and eCBD (THC:CBD=1:1) or with corresponding 'mock extracts' that contained only pTHC and pCBD mixed in the same proportion as in eTHC, eCBD or the 1:1 mixture of eTHC and eCBD. We detected significant differences in neurones both between the effects of pTHC and eTHC and between the effects of pCBD and eCBD. There were also differences between the Ca(2+) responses evoked in both neurones and glia by eTHC and mock eTHC, but not between eCBD and mock eCBD. A particularly striking observation was the much increased response size and maximal responder rates induced by the mixture of eTHC and eCBD than by the corresponding 1:1 mixture of pTHC and pCBD. Our data suggest that THC shares the ability of CBD to elevate Ca(2+) levels in neurones and glia, that THC and CBD interact synergistically and that the cannabis extracts have other constituents yet to be identified that can significantly modulate the ability of THC and CBD to raise Ca(2+) levels.


Dietary energy level, feeder space, and group size on growth performance and carcass characteristics of growing-finishing barrows and gilts.
To benefit from feeding low net energy (NE) diets, growing-finishing pigs must be able to increase feed intake to compensate for lower caloric density, but this might be difficult in pens with a high stocking density. Access to the feeder, trough space, and(or) floor area may limit voluntary feed intake. The objective of this study was to clarify the relationships among dietary NE level, feeder space, group size, sex, and interactions in growing-finishing pigs. In a 2 × 2 × 2 × 2 factorial design, 1,920 pigs (33 kg) housed in 96 fully slatted floor pens (6.1 × 2.4 m) with 2 or 3 feeder spaces, and 18 or 22 barrows or gilts per pen, were fed either low (9.2 MJ/kg) or high (9.85 MJ/kg) NE diets over 5 growth phases (Grower 1: day [d] 0 to 20, Grower 2: d 21 to 41, Grower 3: d 42 to 62, Finisher 1: d 63 to 80, Finisher 2: d 81 to slaughter). Pen body weight (BW) and average daily feed disappearance (ADFD) were measured for each growth phase, biweekly from the start of shipping and at slaughter. Warm carcasses were weighed and graded (Destron). For the entire trial, pigs fed low versus (vs.) high NE diets had 0.119 kg/d greater (P < 0.001) ADFD, but 0.556 MJ/d lower (P < 0.050) average daily caloric disappearance (ADCD), and 0.017 kg/kg lower (P < 0.001) gain-to-feed (G:F). Pens with 18 vs. 22 pigs had 0.062 kg/d greater (P < 0.001) ADFD, 0.730 MJ/d greater (P < 0.010) ADCD, and 0.029 kg/d greater (P < 0.001) average daily weight gain (ADWG). Pigs in pens with 3 vs. 2 feeding spaces had 0.051 kg/d greater (P < 0.010) ADFD, 0.511 MJ/d greater (P = 0.050) ADCD but 0.004 kg/kg lower (P < 0.050) G:F. Pigs fed low vs. high NE diets had 0.6 kg lower (P < 0.050) carcass weight and 0.9 mm lower (P < 0.050) loin depth. Pens with 18 vs. 22 pigs took 2.8 days less (P < 0.001) to reach 130 kg slaughter BW. Pens with 18 vs. 22 pigs had a 0.4 %-point decrease (P < 0.050) in dressing percentage. Feeding low vs. high NE diets reduced (P < 0.001) feed cost by Can$21.87/tonne, $3.34/pig, $0.03/kg gain, and increased (P < 0.05) gross income subtracting feed cost by $1.82/pig. Housing 18 vs. 22 pigs per pen increased (P < 0.010) ISFC by $1.98 per pig. Lack of interactions between NE level, feeder space, and group size for ADFD indicate that low NE diets can be fed to pigs even if they have lower than recommended floor area allowance during part of the finishing phase.


Clinical features and long-term outcomes of interstitial lung disease with anti-neutrophil cytoplasmic antibody.
Patients with interstitial lung disease (ILD) are occasionally positive for anti-neutrophil cytoplasmic antibodies (ANCAs). Differences between ILDs secondary to microscopic polyangiitis (MPA) and isolated ANCA-positive idiopathic interstitial pneumonia (IIP) remain unclear. The aim of this study was to explore the differences in clinical features and outcomes between MPA-associated ILDs and isolated ANCA-positive IIPs. We reviewed 1338 ILDs patients with available ANCA results and retrospectively analysed 80 patients who were ANCA-positive. MPA-associated ILDs (MPA-ILDs group) and isolated ANCA-positive IIPs (ANCA-IIPs group) were compared. Among 80 patients with ANCA-positive ILDs, 31 (38.75%) had MPA-ILDs, and 49 (61.25%) had isolated ANCA-positive IIPs. Compared with ANCA-IIPs group, patients in MPA-ILDs group had a higher proportion of fever (p = 0.006) and higher neutrophil count (p = 0.011), erythrocyte sedimentation rate (ESR) (p < 0.001) and C-reactive protein (CRP) (p = 0.005). Multivariable analysis showed that ESR level was an independent risk factor for mortality in all 80 ANCA-positive ILDs patients (HR 1.028, p = 0.001). Survival in MPA-ILDs group was lower than that in ANCA-IIPs group, and further stratified analysis revealed that ANCA-IIPs patients with elevated ESR or CRP had a worse prognosis than those with normal inflammation markers, with 5-year cumulative survival rates of 60.00%, 86.90% and 100.00% in MPA-ILDs and ANCA-IIPs with and without elevated inflammation markers, respectively. Among patients with ANCA-positive ILDs, the prognoses of ANCA-IIPs with normal inflammation markers, ANCA-IIPs with elevated inflammation markers and MPA-ILDs were sequentially poorer. Therefore, stratified treatment should be considered in the management of ILDs patients positive for ANCAs.


Immunomodulatory effects and clinical benefits of intravenous immunoglobulin in myasthenia gravis.
Myasthenia gravis (MG) is an antibody-mediated disease that develops in the majority of patients mainly as a result of acetylcholine receptor (AChR) autoantibodies. This process is mediated by a series of immunoregulatory events. Therapeutic targets for MG include suppression of circulating antibodies or antibody production, suppression of complement activation, and immunomodulation of cytokines or T cells. Intravenous immunoglobulin (IVIg) has an effect on all of these mechanisms. This narrative review explores the broad immunomodulatory effects of IVIg in MG and provides an update on IVIg treatment for MG. IVIg has a range of immunomodulatory effects on therapeutic targets relevant to the immunopathogenesis of MG. An emerging area of research is the pharmacogenomics of IVIg in MG related to FcRn and IgG catabolism. New data suggest that the FcRn VNTR3 genotype can affect the efficacy of IVIg in certain MG patients and may have an impact on IgG kinetics and selected dosing. Immune globulin 10% caprylate/chromatography purified (IVIg-C) has been shown to reverse the symptoms of severe acute exacerbation in patients with MG supporting its use for this severely ill subgroup of patients during a relapse.


Health hazards of bivalve-mollusk ingestion.
Bivalve mollusks (oysters, clans, and mussels) filter large quantities of water unselectively and thereby may concentrate a variety of aquatic contaminants pathogenic for man within edible shellfish viscera. The recognized bacterial disease associated with ingestion of contaminated bivalves include typhoid fever (not presently a public health problem), Vibrio parahemolyticus gastroenteritis, and Vibrio chloerae infection. The major known shellfish-associated viral diseases are viral hepatitis and possibly viral gastroenteritis. The ingestion of bivalves that have fed on the toxic species of dinoflagellates that produce red tides may be responsible for an uncommon and very rarely fatal illness, paralytic shellfish poisoning. Outbreaks of airborne respiratory irritation in populations exposed to red tides may be the most common public health problem associated with red tides. The health hazards resulting from industrial, agricultural, and oil pollution of bivalves in coastal waters and the hazard from improper handling of bacterially contaminated mollusks remain to be defined.


Effects of Whole-Body Vibration on Motor Impairments in Patients With Neurological Disorders: A Systematic Review.
This systematic review was conducted to examine the effects of whole-body vibration training on motor impairments among patients with neurological disorders and to investigate which the whole-body vibration training parameters induced improvement in motor impairments. PubMed, SCOPUS, PEDro, REHABDATA, and Web of Science were searched for randomized controlled trials and pseudo-randomized controlled trials investigated the effect of whole-body vibration on motor impairments in patients with neurological disorders. The methodological quality was rated using the Cochrane Collaboration's tool. Twenty studies were included in this systematic review. Four studies included patients with multiple sclerosis, cerebral palsy (n = 2), stroke (n = 9), Parkinson disease (n = 3), spinal cord injuries (n = 1), and spinocerebellar ataxia (n = 1). The results showed different evidence of benefits and nonbenefits for whole-body vibration training in motor impairments outcomes. There is weak evidence for a positive effect of short-term whole-body vibration training on spasticity of lower limbs, mobility, balance, and postural control. Besides, positive effect of the long-term effect of whole-body vibration training on mobility in patients with neurological disorders. The optimal whole-body vibration training parameters in treating patients with neurological disorders remain unclear.


Light-Tunable Surface State and Hybridization Gap in Magnetic Topological Insulator MnBi8Te13.
MnBi8Te13 is an intrinsic ferromagnetic (FM) topological insulator with different complex surface terminations. Resolving the electronic structures of different termination surfaces and manipulation of the electronic state are important. Here, by using micrometer spot time- and angle-resolved photoemission spectroscopy (μ-TrARPES), we resolve the electronic structures and reveal the ultrafast dynamics upon photoexcitation. Photoinduced filling of the surface state hybridization gap is observed for the Bi2Te3 quintuple layer directly above MnBi2Te4 accompanied by a nontrivial shift of the surface state, suggesting light-tunable interlayer interaction. Relaxation of photoexcited electrons and holes is observed within 1-2 ps. Our work reveals photoexcitation as a potential control knob for tailoring the interlayer interaction and surface state of MnBi8Te13.


Development and validation of a yoga module for Parkinson disease.
Background Parkinson's disease (PD), a progressive neurodegenerative disease, affects motor and nonmotor functions, leading to severe debility and poor quality of life. Studies have reported the beneficial role of yoga in alleviating the symptoms of PD; however, a validated yoga module for PD is unavailable. This study developed and validated an integrated yoga module(IYM) for PD. Methods The IYM was prepared after a thorough review of classical yoga texts and previous findings. Twenty experienced yoga experts, who fulfilled the inclusion criteria, were selected validating the content of the IYM. A total of 28 practices were included in the IYM, and each practice was discussed and rated as (i) not essential, (ii) useful but not essential, and (iii) essential; the content validity ratio (CVR) was calculated using Lawshe's formula. Results Data analysis revealed that of the 28 IYM practices, 21 exhibited significant content validity (cut-off value: 0.42, as calculated by applying Lawshe's formula for the CVR). Conclusions The IYM is valid for PD, with good content validity. However, future studies must determine the feasibility and efficacy of the developed module.


Reductive Degradation of Tetrabromobisphenol Using Iron-Silver and Iron-Nickel Bimetallic Nanoparticles with Microwave Energy.
In this work, a novel combined system by Fe-Ag or Fe-Ni nanoparticles and microwave (MW) radiation were used for the debromination of tetrabromobisphenol A (TBBPA) in aqueous solutions. Core-shell structure bimetallic nanoparticles were prepared by replacement reaction in liquid phase and then characterized by X-ray diffraction, transmission electron microscopy, and X-ray photoelectron spectroscopy techniques. MW radiation can enhance the degradation of TBBPA by Fe-Ag or Fe-Ni observably. The rate of reduction reactions for bimetallic nanoparticles under MW were first compared with those under conventional heating conditions. Compared with nano-iron, the deposition of Ag or Ni also accelerated the debromination, and Fe-Ag was more reactive than Fe-Ni toward TBBPA reduction. Removal efficiencies increased with increasing Fe-Ag dosage and MW energy level. Major reduction products of TBBPA identified by liquid chromatography-mass spectrometry/mass spectrometry (LC-MS/MS) were tri-BBPA, di-BBPA, mono-BBPA, and BPA, which indicated a stepwise debromination process. It provides an effective technology for TBBPA laden wastewater treatment.


Does Helicobacter pylori infection influence response rate or speed of symptom control in patients with gastroesophageal reflux disease treated with rabeprazole?
The findings of several studies suggest that proton-pump inhibitors (PPIs) suppress gastric acid more effectively in Helicobacter pylori-infected (Hp +) than in non-infected (Hp -) patients, but there has been no evaluation of the short-term clinical response. Results of the first week of treatment with rabeprazole in Hp+ and Hp- patients with gastroesophageal reflux disease (GERD) were compared in a large prospective open-label, multicenter, cohort study in general and specialized practices. GERD patients were recruited on the basis of either typical symptoms alone or endoscopic results, assessed for H. pylori infection and treated with rabeprazole (20 mg). Heartburn and regurgitation symptoms were assessed daily during the first 7 days. Outcome parameters were calculated for both symptoms and compared between Hp+ and Hp- patients. Data on 1548 patients (74.5% Hp-, 25.5% Hp + ) were available. Mean heartburn and regurgitation scores decreased during the first week. For both symptoms, more than 70% of the patients had "adequate" symptom relief at day 5, and more than 80% at day 7. "Complete" symptom relief was reached in more than 70% of patients. Mean onset of adequate symptom control was about 4 days. In Hp+ and Hp- patients there was no difference in response for any of the parameters. Among patients treated with rabeprazole in clinical practice, H. pylori infection or its absence has no effect on the speed or degree of GERD symptom relief. Infected patients and non-infected patients can therefore be treated with a similar dose. When treating heartburn with rabeprazole, physicians do not need to consider the patient's H. pylori status and most patients (>80%) have adequate symptom relief after just a few days of treatment.


An unusual active site architecture in cytochrome c nitrite reductase NrfA-1 from Geobacter metallireducens.
Dissimilatory nitrate reduction to ammonia (DNRA) is a central pathway in the biogeochemical nitrogen cycle, allowing for the utilization of nitrate or nitrite as terminal electron acceptors. In contrast to the competing denitrification to N2, a major part of the essential nutrient nitrogen in DNRA is retained within the ecosystem and made available as ammonium to serve as a nitrogen source for other organisms. The second step of DNRA is mediated by the pentahaem cytochrome c nitrite reductase NrfA that catalyzes the six-electron reduction of nitrite to ammonium and is widely distributed among bacteria. A recent crystal structure of an NrfA ortholog from Geobacter lovleyi was the first characterized representative of a novel subclass of NrfA enzymes that lacked the canonical Ca2+ ion close to the active site haem 1. Here, we report the structural and functional characterization of NrfA from the closely related G. metallireducens. We established the recombinant production of catalytically active NrfA with its unique, lysine-coordinated active site haem heterologously in Escherichia coli and determined its three-dimensional structure by X-ray crystallography to 1.9 Å resolution. The structure confirmed GmNrfA as a further calcium-independent NrfA protein, and it also shows an altered active site that contained an unprecedented aspartate residue, D80, close to the substrate-binding site. This residue formed part of a loop that also caused a changed arrangement of the conserved substrate/product channel relative to other NrfA proteins and rendered the protein insensitive to the inhibitor sulphate. To elucidate the relevance of D80, we produced and studied the variants D80A and D80N that showed significantly reduced catalytic activity.


Phosphorus retention capacity in red ferralitic soil.
In this study the main physical-chemical characteristics of red ferralitic soil to use as substrate in subsurface wetlands was determined. The P-removal was evaluated in a short-term isotherm batch experiment and in a column percolation experiment. The acid characteristic and high content of iron minerals in the red ferralitic soil facilitated the phosphorus removal. Also the sorption isotherms at two different temperatures were obtained. The results showed that the sorption capacity increases with an increase in solution temperature from 25 to 35 °C. The experimental data were fitted to Langmuir and Freundlich models, having a better fit to the Freundlich isotherms. The maximum P-sorption capacities estimated using the Langmuir isotherm were 0.96 and 1.13 g/kg at 25 and 35 °C respectively. Moreover a column experiment was carried out at two different flows. Sequential extractions of the phosphorus-saturated soil indicated that phosphorus is mainly bound with iron or aluminum minerals. The results have demonstrated a good potential for red ferralitic soil for phosphorus removal from urban wastewater.


Separation of time-resolved phenomena in surface-enhanced Raman scattering of the photocatalytic reduction of p-nitrothiophenol.
Straightforward analysis of chemical processes on the nanoscale is difficult, as the measurement volume is linked to a discrete number of molecules, ruling out any ensemble averaging over rotation and diffusion processes. Raman spectroscopy is sufficiently selective for monitoring chemical changes, but is not sufficiently sensitive to be applied directly. Surface-enhanced Raman spectroscopy (SERS) can be applied for studying reaction kinetics, but adds additional variability in the signal as the enhancement factor is not the same for every location. A novel chemometric method described here separates reaction kinetics from short-term variability, based on the lack of fit in a principal-component analysis. We show that it is possible to study effects that occur on different time scales independently without data reduction using the photocatalytic reduction of p-nitrothiophenol as a showcase system. Using this approach a better description of the nanoscale reaction kinetics becomes available, while the short-term variations can be examined separately to examine reorientation and/or diffusion effects. It may even be possible to identify reaction intermediates through this approach. With only a limited number of reactive molecules in the studied volume, an intermediate on a SERS hot spot may temporarily dominate the spectrum. Now such events can be easily separated from the bulk conversion process by making use of this chemometric method.


Proteolytic Nanoparticles Replace a Surgical Blade by Controllably Remodeling the Oral Connective Tissue.
Surgical blades are common medical tools. However, blades cannot distinguish between healthy and diseased tissue, thereby creating unnecessary damage, lengthening recovery, and increasing pain. We propose that surgical procedures can rely on natural tissue remodeling tools-enzymes, which are the same tools our body uses to repair itself. Through a combination of nanotechnology and a controllably activated proteolytic enzyme, we performed a targeted surgical task in the oral cavity. More specifically, we engineered nanoparticles that contain collagenase in a deactivated form. Once placed at the surgical site, collagenase was released at a therapeutic concentration and activated by calcium, its biological cofactor that is naturally present in the tissue. Enhanced periodontal remodeling was recorded due to enzymatic cleavage of the supracrestal collagen fibers that connect the teeth to the underlying bone. When positioned in their new orientation, natural tissue repair mechanisms supported soft and hard tissue recovery and reduced tooth relapse. Through the combination of nanotechnology and proteolytic enzymes, localized surgical procedures can now be less invasive.


A probable link between the DedA protein and resistance to selenite.
To understand the molecular events involved in the reduction of selenite to non-toxic elemental selenium, 4000 clones of Ralstonia metallidurans CH34 were produced by random Tn5 transposon integration mutagenesis. Eight mutants were able to resist up to 15 mM selenite while the MIC for the wild-type strain was estimated as 4-6 mM selenite. The identification of the disrupted genes was carried out by Southern blot analysis and inverse PCR. The three resistant mutants containing only one insertion were further characterized. Tn5 disrupted a gene that encoded a protein which was closely related to proteins of the DedA family. This family represents a group of integral membrane proteins with completely unknown functions. Phenotypic characterization of the dedA mutants and selenite consumption experiments strongly suggest that DedA is involved in the uptake of selenite.


Catalytically grown carbon nanotubes of small diameter have a high Young's modulus.
Experimental studies of carbon nanotubes (CNTs) obtained through different synthesis routes show considerable variability in their mechanical properties. The strongest CNTs obtained so far had a high Young's modulus of 1 TPa but could only be produced in gram scale quantities. The synthesis by catalytic chemical vapor deposition, a method that holds the greatest potential for large-scale production, gives CNTs with a high defect density. This leads to low Young's modulus values below 100 GPa for multiwall CNTs. Here we performed direct measurements of the mechanical properties of catalytically grown CNTs with only a few walls and find a Young's modulus of 1 TPa. This high value is confirmed for CNTs grown under two different growth conditions where the synthesis parameters such as the hydrocarbon source, catalyst material, and the synthesis temperature were varied. The results indicate that the observed difference in the Young's modulus for the catalytically grown CNTs with high and low numbers of walls is probably related to the growth mechanism of CNT.


Phantom study to determine radiation exposure to medical personnel involved in ERCP fluoroscopy and its reduction through equipment and behavior modifications.
The aim of this work is to evaluate the potential radiation exposure to medical personnel by comparing results from phantom studies of two different fluoroscopic units used for ERCP, and to determine which equipment or behavior modification can reduce radiation exposure. Radiation exposures using an opaque tissue equivalent chest phantom with an abdominal insert were performed on a stationary dedicated fluoroscopy unit and a mobile C-arm unit, comparing varying equipment manipulations. Scatter radiation was recorded at 1) the patients' head, 2) where the endoscopist stands, and 3) where the equipment personnel stands. Radiation exposures were significantly higher for the mobile C-arm unit, revealing a 4160-times greater dosage increase for head and neck and a 8660-times increase for body than the fixed unit. Tower position and vertically stationed lead shields facilitated exposure reduction by means of equipment manipulation. The positioning of the endoscopist away from the right corner of the units also decreased exposure. Dedicated stationary fluoroscopy units provide significantly less radiation exposure. Equipment and behavior modification including tower positioning down and vertical shielding are essential for reduction in radiation exposure to medical personnel.


Reliability of preoperative ultrasonography evaluation for vitreoretinal surgery.
To evaluate the present level of reliability of common ultrasonography prior to vitreoretinal surgery, we carried out a prospective study to compare preoperative ultrasonography data with direct intraoperative findings. A total of 228 eyes with different vitreoretinal disorders and opaque or clear media were studied. In the group of 187 eyes with tractional retinal detachment (group I), the percentage of agreement between the ultrasonography data and the surgical findings ranged from 77.1% to 92.2%, depending on the pathology. In the group of 41 eyes without retinal detachment (group II), agreement ranged from 90.4% to 100%. The most frequent causes of failure of preoperative ultrasonography were incorrect prediction of macular detachment, partial posterior vitreous detachment, posterior vitreoschisis and vitreoretinal adhesions. The main cause of failure was the presence of multiple complicated echoes in group I, particularly in tractional diabetic retinal detachment. To achieve maximum benefits from ordinary preoperative ultrasonography, the vitreoretinal surgeon must be fully aware of its present level of reliability and general limitations.


Mental rotation task of hands: differential influence number of rotational axes.
Various studies on the hand laterality judgment task, using complex sets of stimuli, have shown that the judgments during this task are dependent on bodily constraints. More specific, these studies showed that reaction times are dependent on the participant's posture or differ for hand pictures rotated away or toward the mid-sagittal plane (i.e., lateral or medial rotation, respectively). These findings point to the use of a cognitive embodied process referred to as motor imagery. We hypothesize that the number of axes of rotation of the displayed stimuli during the task is a critical factor for showing engagement in a mental rotation task, with an increased number of rotational axes leading to a facilitation of motor imagery. To test this hypothesis, we used a hand laterality judgment paradigm in which we manipulated the difficulty of the task via the manipulation of the number of rotational axes of the shown stimuli. Our results showed increased influence of bodily constraints for increasing number of axes of rotation. More specifically, for the stimulus set containing stimuli rotated over a single axis, no influence of biomechanical constraints was present. The stimulus sets containing stimuli rotated over more than one axes of rotation did induce the use of motor imagery, as a clear influence of bodily constraints on the reaction times was found. These findings extend and refine previous findings on motor imagery as our results show that engagement in motor imagery critically depends on the used number of axes of rotation of the stimulus set.


Case report: biallelic DNMT3A mutations in acute myeloid leukemia.
DNMT3A gene mutations, detected in 20-25% of de novo acute myeloid leukemia (AML) patients, are typically heterozygous. Biallelic variants are uncommon, affecting ~3% of cases and identifying a worse prognosis. Indeed, two concomitant DNMT3A mutations were recently associated with shorter event-free survival and overall survival in AML. We present an AML case bearing an unusual DNMT3A molecular status, strongly affecting its function and strangely impacting the global genomic methylation profile. A 56-year-old Caucasian male with a diagnosis of AML not otherwise specified (NOS) presented a complex DNMT3A molecular profile consisting of four different somatic variants mapping on different alleles (in trans). 3D modelling analysis predicted the effect of the DNMT3A mutational status, showing that all the investigated mutations decreased or abolished DNMT3A activity. Although unexpected, DNMT3A's severe loss of function resulted in a global genomic hypermethylation in genes generally involved in cell differentiation. The mechanisms through which DNMT3A contributes to AML remain elusive. We present a unique AML case bearing multiple biallelic DNMT3A variants abolishing its activity and resulting in an unexpected global hypermethylation. The unusual DNMT3A behavior described requires a reflection on its role in AML development and persistence, highlighting the heterogeneity of its deregulation.


[Analysis of DSPP gene mutation in a Chinese pedigree affected with hereditary dentinogenesis imperfecta].
To analyze the clinical phenotype of a Chinese pedigree affected with hereditary dentinogenesis imperfecta and mutation of dentin sialophosphoprotein (DSPP) gene. Affected members underwent intraoral photography, dental film and panoramic radiography. Genomic DNA was extracted from peripheral venous blood samples. Coding regions of the DSPP gene were subjected to PCR amplification and Sanger sequencing. Functional effect of the mutation was predicted with SIFT and PolyPhen-2. The tertiary structure of wild type and mutant proteins were predicted by Swiss-Port. A heterozygous c.50C to T (p.P17L) mutation was identified in exon 2 of the DSPP gene in the proband and her father. The same mutation was not found among 200 unrelated healthy controls. The Pro-17 residues and its surrounding positions in DSPP are highly conserved across various species. The mutation was predicted to be damaging to the structure of DSPP protein. The c.50C to T (p.P17L) mutation of the DSPP gene probably underlies the disease in this pedigree. Above finding has expanded the spectrum of DSPP gene mutations and provided a basis for genetic counseling and prenatal diagnosis for this family.


Simian virus 40-transformed adherent cells from human long-term marrow cultures: cloned cell lines produce cells with stromal and hematopoietic characteristics.
Adherent cells from long-term marrow cultures from 23 individuals were transformed with wild-type simian virus 40 (SV40). After transformation, cloned cell lines were developed that even after rigorous subcloning invariably produced both stromal cells and round cells. The stromal cells expressed cytoskeletal filaments similar to those of long-term marrow culture adherent cells and produced interstitial and basal lamina collagen types. The round cells had the electron microscopic appearance of primitive hematopoietic cells and when examined with cytochemical stains and monoclonal antibodies to hematopoietic differentiation antigens had reaction patterns suggestive of cells from several lineages. Most round cells expressed the pan-hematopoietic T-200 determinant, and lesser percentages expressed the early T cell antigens CD-1 and CD-3, HLA-DR determinants, the monocytic antigen recognized by Leu M3, and the myeloid antigens detected by monoclonal antibodies 1G10 and 12.8. In addition, when plated in semisolid medium in the presence of a source of colony-stimulating activity, up to 11% of the cells formed colonies consisting of blastlike cells that also expressed hematopoietic cell surface determinants. The data suggest that adherent cells in long-term marrow cultures contain a cell that after transformation by SV40 obligately produces cells with hematopoietic as well as stromalike features.


Narratives of focal brain injured individuals: A macro-level analysis.
Focal brain injury can have detrimental effects on the pragmatics of communication. This study examined narrative production by unilateral brain damaged people (n=36) and healthy controls and focused on the complexity (content and coherence) and the evaluative aspect of their narratives to test the general hypothesis that the left hemisphere is biased to process microlinguistic information and the right hemisphere is biased to process macrolinguistic information. We found that people with left hemisphere damage's (LHD) narratives were less likely to maintain the overall theme of the story and produced fewer evaluative comments in their narratives. These deficits correlated with their performances on microlinguistic linguistic tasks. People with the right hemisphere damage (RHD) seemed to be preserved in expressing narrative complexity and evaluations as a group. Yet, single case analyses revealed that particular regions in the right hemisphere such as damage to the dorsolateral prefrontal cortex (DLPFC), the anterior and superior temporal gyrus, the middle temporal gyrus, and the supramarginal gyrus lead to problems in creating narratives. Our findings demonstrate that both hemispheres are necessary to produce competent narrative production. LHD people's poor production is related to their microlinguistic language problems whereas RHD people's impaired abilities can be associated with planning and working memory abilities required to relate events in a narrative.


Hemoglobin oxygen dissociation (P50) in bronchopulmonary dysplasia.
A study was devised to determine the P50 in infants with bronchopulmonary dysplasia (BPD). Other factors such as red blood cell 2,3-diphosphoglycerate (2,3-DPG) level proportions of adult (HbA) to fetal (HbF) hemoglobins which could affect P50 were also measured. Fourteen infants with clinical and radiological signs of BPD with a mean post-conceptional age of 42.2 +/- 4.7 weeks born at a mean gestational age of 29.3 +/- 2.0 weeks were evaluated. The percentage of HbF determined in 8 infants was 40.1 +/- 20.3% and the mean 2,3-DPG concentrations was 13.1 +/- 2.2 mumol/g Hb. The P50 was 25.1 +/- 2.7 mm Hg (range 18-29.5 mm Hg). When a HbO2 curve was established based on a large volume of blood consisting of adult blood and newborn cord blood mixed to attain a P50 of 25.1 mm Hg, the PaO2 at 90% O2 saturation was 52 mm Hg. Since there can be a wide range in HbO2 in infants with chronic BPD, pulse oximetry remains the most prudent method of monitoring oxygen therapy in BPD infants.


Function of human α3β4α5 nicotinic acetylcholine receptors is reduced by the α5(D398N) variant.
Genome-wide studies have strongly associated a non-synonymous polymorphism (rs16969968) that changes the 398th amino acid in the nAChR α5 subunit from aspartic acid to asparagine (D398N), with greater risk for increased nicotine consumption. We have used a pentameric concatemer approach to express defined and consistent populations of α3β4α5 nAChR in Xenopus oocytes. α5(Asn-398; risk) variant incorporation reduces ACh-evoked function compared with inclusion of the common α5(Asp-398) variant without altering agonist or antagonist potencies. Unlinked α3, β4, and α5 subunits assemble to form a uniform nAChR population with pharmacological properties matching those of concatemeric α3β4* nAChRs. α5 subunit incorporation reduces α3β4* nAChR function after coinjection with unlinked α3 and β4 subunits but increases that of α3β4α5 versus α3β4-only concatemers. α5 subunit incorporation into α3β4* nAChR also alters the relative efficacies of competitive agonists and changes the potency of the non-competitive antagonist mecamylamine. Additional observations indicated that in the absence of α5 subunits, free α3 and β4 subunits form at least two further subtypes. The pharmacological profiles of these free subunit α3β4-only subtypes are dissimilar both to each other and to those of α3β4α5 nAChR. The α5 variant-induced change in α3β4α5 nAChR function may underlie some of the phenotypic changes associated with this polymorphism.


[The surgical correction of vascular tracheal rings in children].
The aortic arch and its branches anomalia compound 1-3.8% of all vessel inborn diseases. The treatment of such anomalia as tracheal vessel ring aims the liquidation of esophageal and tracheal compression. The authors introduce their experience of thoracoscopic tracheal vessel rings resection in 6 children. The time of the operation was 145±15min. There were no conversions to the traditional open surgery. The result was excellent in 4 of 6 children, who were completely releaed of tracheal obstruction symptoms. The rest 2 children demonstrated mild respiratory symptoms, cuased by the tracheomalation.


[The functional state of the neuromuscular apparatus in patients with Urov (Kashin-Bek) disease].
In order to clarify the state of bioelectrical muscular activity in relation to the severity of the disease and the localization of the pathological process in Urowsche disease, the author examined 107 patients and 27 normals. The achieved data point to quantitative and qualitative differences of the bioelectrical muscular activity in patients and normals. In Urowsche disease in all stages of rest, in deep inhalation and synergia, electrical activity was not present. In a voluntary muscular contraction in 45.5% of the muscles there was type I in the EMG, 33.4% -- type II and 21.1% -- type IV. In all stages of the disease there was a drop in the potential amplitude fasciculation and a decrease in the frequency of acter-action fluctuations. With the development of the disease the frequency of pathological forms in the EMG was statistically higher. These data testify to lesions of the motoneurons and suprasegmental structures.


Solid Lipid Nanoparticle assemblies (SLNas) for an anti-TB inhalation treatment-A Design of Experiments approach to investigate the influence of pre-freezing conditions on the powder respirability.
For direct intramacrophagic antitubercular therapy, pulmonary administration through Dry Powder Inhaler (DPI) devices is a reasonable option. For the achievement of efficacious aerosolisation, rifampicin-loaded Solid Lipid Nanoparticle assemblies (SLNas) were developed using the melt emulsifying technique followed by freeze-drying. Indeed, this drying method can cause freezing or drying stresses compromising powder respirability. It is the aim of this research to offer novel information regarding pre-freezing variables. These included type and concentration of cryoprotectants, pre-freezing temperature, and nanoparticle concentration in the suspension. In particular, the effects of such variables were observed at two main levels. First of all, on SLNas characteristics - i.e., size, polydispersity index, zeta-potential, circularity, density, and drug loading. Secondly, on powder respirability, taking into account aerodynamic diameter, emitted dose, and respirable fraction. Considering the complexity of the factors involved in a successful respirable powder, a Design of Experiments (DoE) approach was adopted as a statistical tool for evaluating the effect of pre-freezing conditions. Interestingly, the most favourable impact on powder respirability was exerted by quick-freezing combined with a certain grade of sample dilution before the pre-freezing step without the use of cryoprotectants. In such conditions, a very high SLNas respirable fraction (>50%) was achieved, along with acceptable yields in the final dry powder as well as a reduction of powder mass to be introduced into DPI capsules with benefits in terms of administered drug dose feasibility.


The effect of estrogen receptor agonists on pancreaticobiliary duct ligation induced experimental acute pancreatitis.
The 17β-estradiol plays a role in physiology of pancreas and may protect it from inflammation. To examine the possible anti-inflammatory effects of 17β-estadiol in pancreaticobiliary duct ligated (PBDL) acute pancreatitis (AP) model, and the underlying mechanism that 17β-estradiol acts on, via evaluating the direct and the receptor related effects by using 17β-estradiol, ER-α and -β agonists. In the study both sexes of rats (n = 88) were used. Animals were divided into two groups as PBDL and PBDL + ovariectomized. ER-α agonist propyl-pyrazole-triol (PPT; 1 mg/kg/day), ER-β agonist diarylpropionitrile (DPN; 1 mg/kg/day) and 17β-estradiol (10 mg/kg/day) were administered to the groups for 3 days following AP induction. On the 3rd day, lung and pancreas tissues and serum samples were taken for malondialdehyde (MDA), glutathione (GSH), myeloperoxidase (MPO), superoxide dismutase (SOD) and interleukin (IL) assays, and histological analyses. In both tissues of male and female AP groups MPO, MDA, SOD levels were increased (P < 0.05 - 0.01) and GSH levels were decreased (P < 0.05). Pancreas and lung MDA and SOD levels were improved with all treatments in female, except lung MDA levels of PPT-treated ones, while lung MDA and SOD levels were improved by PPT and 17β-estradiol in females and via PPT in males (P < 0.05 - 0.001). The increased MPO levels were inhibited with PPT in male pancreas and female lung and with 17β-estradiol in female pancreas (P < 0.05). The increased pro-inflammatory ILs were declined by treatments (P < 0.05 - 0.001). 17β-estradiol and ER-α and -β agonists reduced oxidative pancreatic and pulmonary damage. Estrogen and agonists might have protective role in AP.


The diurnal variation in renal iodide excretion rate in rabbits.
The diurnal variation in renal iodide excretion rate was determined in unrestrained female rabbits by means of either a conventional clearance technique or a continuous monitoring of the whole body disappearance of iv injected 125I-iodide using an implanted Geiger-Muller detector. A distinct diurnal rhythm was detected in the disappearance rate of 125I-iodide. A slow disappearance rate occurred from 12 p.m. to 6 a.m. (darkness from 5 p.m. to 5 a.m.). The values of iodide excretion rate obtained by both methods were consistent like in humans with an excretion fraction of 0.3 for iodide in rabbits. In rabbits weighing 3-4 kg the renal iodide excretion rates were 5-7 ml/min during the rapid phase and 3-4 ml/min during the slow phase.


Production and characterization of fully selenomethionine-labeled Saccharomyces cerevisiae.
This paper reports, for the first time, a quantitative replacement of methionine (Met) by selenomethionine (SeMet) at >98% substitution, with up to 4940 microg of SeMet/g of yeast obtained for the entire protein pool of a wild-type yeast grown on a SeMet-containing medium. The incorporation of selenium in yeast proteins, in the form of selenomethionine, and the influence of various organic and inorganic Se and S sources present in the media were monitored during the growth of a wild-type Saccharomyces cerevisiae , which allowed the optimization of the composition of a fully defined synthetic growth medium that ensured maximum SeMet incorporation. Quantitation of SeMet and Met was performed by species-specific isotope dilution GC-MS. The use of ascorbic acid and a minimum concentration of cysteine (5 microg/L) was found to be beneficial to achieve incorporation by limiting the oxidative stress due to the presence of selenium. Except for small amounts of cysteine, no other sources of sulfur were necessary to achieve yeast growth. In a medium containing Se(VI), the maximum replacement of Met with SeMet was 50%, which is considerably higher than that obtained with the current commercial Se yeast formulations. For yeast grown in a Met-free defined medium, which was supplemented with SeMet, nearly total replacement of Met with SeMet could be achieved. The fully Se-labeled yeast could be an important tool for the study of eukaryotic protein structures both by mass spectrometry and by X-ray crystallography through selenomethionine single- and multiple-wavelength anomalous dispersion (SAD and MAD) phasing. In addition, a particular yeast strain, BY4741, that cannot synthesize Met using inorganic sulfur (met15Delta0) was shown to produce SeMet in the presence of inorganic selenium. This might indicate that the incorporation of inorganic selenium salts [Se(VI) and Se(IV)] is obviously not occurring exclusively through the same biological pathways as for sulfur. The reduction of inorganic Se to hydrogen selenide (H(2)Se), its reactions with organic compounds present in the yeast or in the media, and the possible metabolization through unspecific enzymatic pathways (such as transsulfuration) could also be of considerable importance in the production of selenoamino acids during yeast growth.


Synthesis of [26-2H(3)]brassinosteroids.
A number of [26-2H(3)]brassinosteroids were prepared for biochemical studies. The parent, nondeuterated compounds were considered to be biosynthetic intermediates in brassinosteroid biosynthesis. Claisen rearrangement was used to construct the steroidal side chain. Deuterium was introduced by reducing the corresponding intermediates with lithium aluminium deuteride.


Imaging Artifacts in Continuous Scanning 2D LA-ICPMS Imaging Due to Nonsynchronization Issues.
Pulsed laser ablation (LA) devices in laser ablation inductively coupled plasma mass spectrometry (LA-ICPMS) imaging have become very advanced, delivering laser pulses with high temporal accuracy and stable energy density. However, unintentional imaging artifacts may be generated in 2D element maps when the LA repetition rate and the data acquisition parameters of ICPMS instruments with a sequential mass spectrometer (i.e., quadrupole filter or sector-field mass spectrometer) are desynchronized. This may potentially lead to interference patterns, visible as ripples in elemental images, and thus, compromised image quality. This paper describes the background of aliasing in continuous scanning mode through simulation experiments and ways to modulate the effect. The existence of this image degradation source is demonstrated experimentally via real-life imaging of a homogeneous glass standard.


Fatal cytomegalovirus infection and coronary arterial thromboses after heart transplantation: a case report.
A 36-year-old woman died because of disseminated cytomegalovirus infection after a heart allograft transplantation was performed. Autopsy revealed that widespread coronary arterial thromboses were associated with cytomegalovirus infection of endothelial cells. Its possible pathogenetic mechanism and significance were discussed.


Engineering the Ultrasensitive Visual Whole-Cell Biosensors by Evolved MerR and 5' UTR for Detection of Ultratrace Mercury.
The existing mercury whole-cell biosensors (WCBs, parts per billion range) are not able to meet the real-world requirements due to their lack of sensitivity for the detection of ultratrace mercury in the environment. Ultratrace mercury is a potential threat to human health via the food chain. Here, we developed an ultrasensitive mercury WCB by directed evolution of the mercury-responsive transcriptional activator (MerR) sensing module to detect ultratrace mercury. Subsequently, the mutant WCB (m4-1) responding to mercury in the parts per trillion range after 1 h of induction was obtained. Its detection limit (LOD) was 0.313 ng/L, comparable to those of some analytical instruments. Surprisingly, the m4-1 WCB also responded to methylmercury (LOD = 98 ng/L), which is far more toxic than inorganic mercury. For more convenient detection, we have increased another green fluorescent protein reporter module with an optimized 5' untranslated region (5' UTR) sequence. This yields two visual WCBs with an enhanced fluorescence output. At a concentration of 2.5 ng/L, the fluorescence signals can be directly observed by the naked eye. With the combination of mobile phone imaging and image processing software, the 2GC WCB provided simple, rapid, and reliable quantitative and qualitative analysis of real samples (LOD = 0.307 ng/L). Taken together, these results indicate that the ultrasensitive visual whole-cell biosensors for ultratrace mercury detection are successfully designed using a combination of directed evolution and synthetic biotechnology.


Observation of relativistic effects in collective Thomson scattering.
We observe relativistic modifications to the Thomson scattering spectrum in a traditionally classical regime: v(osc)/c = eE(0)/cmomega(0) << 1 and T(e) < 1 keV. The modifications result from scattering off electron-plasma fluctuations with relativistic phase velocities. Normalized phase velocities v/c between 0.03 and 0.12 have been achieved in a N(2) gas-jet plasma by varying the plasma density from 3 x 10(18) cm(-3) to 7 x 10(19) cm(-3) and electron temperature between 85 and 700 eV. For these conditions, the complete temporally resolved Thomson scattering spectrum including the electron and ion features has been measured. A relativistic treatment of the Thomson scattering form factor shows excellent agreement with the experimental data.


Selective inhibition of thromboxane synthetase reduces group-B-beta-hemolytic-streptococci-induced pulmonary hypertension in piglets.
13 newborn piglets with group-B-beta-hemolytic-streptococci (GBS)-induced pulmonary hypertension were assigned to receive either placebo (group 1) or Dazmegrel, a thromboxane synthetase inhibitor (group 2). All piglets with pulmonary hypertension had increased thromboxane B2 (TxB2) and 6-keto PGF1 alpha levels. With continued GBS infusion, the placebo group demonstrated a continued elevation of pulmonary artery pressure (PAP) and of TxB2. The Dazmegrel piglets, however, despite continued GBS infusion, demonstrated a selective decrease in PAP associated with a significant decrease in TxB2 levels and stability of systemic pressure and cardiac output. These data demonstrate that thromboxane synthetase inhibition is effective therapeutically in selectively reducing PAP.


Semiclassical perturbation theory for diffraction in heavy atom surface scattering.
The semiclassical perturbation theory formalism of Hubbard and Miller [J. Chem. Phys. 78, 1801 (1983)] for atom surface scattering is used to explore the possibility of observation of heavy atom diffractive scattering. In the limit of vanishing ℏ the semiclassical theory is shown to reduce to the classical perturbation theory. The quantum diffraction pattern is sensitive to the characteristics of the beam of incoming particles. Necessary conditions for observation of quantum diffraction are derived for the angular width of the incoming beam. An analytic expression for the angular distribution as a function of the angular and momentum variance of the incoming beam is obtained. We show both analytically and through some numerical results that increasing the angular width of the incident beam leads to decoherence of the quantum diffraction peaks and one approaches the classical limit. However, the incoherence of the beam in the parallel direction does not destroy the diffraction pattern. We consider the specific example of Ar atoms scattered from a rigid LiF(100) surface.


COMPLEMENT AS A MEDIATOR OF INFLAMMATION. ENHANCEMENT OF VASCULAR PERMEABILITY BY PURIFIED HUMAN C'1 ESTERASE.
Purified preparations of the esterase derived from the first component of complement (C'1 esterase) increased vascular permeability in guinea pig skin, an effect inhibited by triprolidine, an antihistaminic agent, but not by soy bean trypsin inhibitor. The permeability-increasing and esterolytic properties of C'1 esterase were inhibited in parallel by the serum inhibitor of C'1 esterase, diisopropylphosphofluoridate and extremes of temperature and pH. Moreover, the permeability-increasing and esterolytic properties evolved in parallel when C'1 esterase was generated from its subcomponents. How C'1 esterase induces changes in vascular permeability remains unexplained, although the possibility that its action is mediated through a histamine-like agent is attractive.


Tissue-specific methylation profile in obese patients with type 2 diabetes before and after Roux-en-Y gastric bypass.
Eating habits, lifestyles, and exposure to specific environmental factors can greatly impact the risk of developing type 2 diabetes (T2D), influence the genome epigenetically, and affect the expression of genes, including genes related to glycemic control, at any stage of life. The epigenetic mechanism underlying obesity and T2D pathogenesis remains poorly understood. Conventional strategies for the treatment of obesity and its comorbidities often have poor long-term adherence, and pharmacological interventions are limited. Bariatric surgery is the most effective current option to treat severe obesity, and Roux-en-Y gastric bypass (RYGB) is the most applied technique worldwide. Epigenetic changes differ depending on the approach used to treat obesity and its associated comorbidities (clinical or surgical). Compared to primary clinical care, bariatric surgery leads to much greater loss of body weight and higher remission rates of T2D and metabolic syndrome, with methylation profiles in promoter regions of genes in obese individuals becoming similar to those of normal-weight individuals. Bariatric surgery can influence DNA methylation in parallel with changes in gene expression pattern. Changes in clinical biomarkers that reflect improvements in glucose and lipid metabolism after RYGB often occur before major weight loss and are coordinated by surgery-induced changes in intestinal hormones. Therefore, the intestine methylation profile would assist in understanding the mechanisms involved in improved glycemic control after bariatric surgery. The main objectives in this area for the future are to identify epigenetic marks that could be used as early indicators of metabolic risk, and to develop treatments able to delay or even reverse these epigenetic changes. Studies that provide the "human epigenetic profile" will be of considerable value to identify tissue-specific epigenetic signatures and their role in the development of chronic diseases. Further studies should apply methods based on global analysis of the genome to identify methylated sites associated with disease and epigenetic marks associated with the remodeling response to bariatric surgery. This review describes the main epigenetic alterations associated with obesity and T2D and the potential role of RYGB in remodeling these changes.


Ibuprofen is superior to paracetamol for pain relief following third molar removal.
The Cochrane Oral Health Group's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Embase and the metaRegister of Controlled Trials were searched with no language restrictions. Randomised controlled double-blinded clinical trials using the third molar model were included. Two review authors independently and in duplicate extracted data. The proportion of patients with at least 50% pain relief (based on total pain relief (TOTPAR) and summed pain intensity difference (SPID) data) was calculated for all three drugs at both two and six hours post-dosing and meta-analysed for comparison. Seven studies involving 2241 patients were included. Two studies were considered to be at low risk of bias, three at high risk and two unclear risk of bias. Ibuprofen was found to be a superior analgesic to paracetamol at several doses, with high quality evidence suggesting that ibuprofen 400 mg is superior to 1000 mg paracetamol based on pain relief (estimated from TOTPAR data) and the use of rescue medication meta-analyses. Risk ratio (RR) for at least 50% pain relief (based on TOTPAR) at six hours was 1.47 (95% confidence interval (CI) 1.28 to 1.69; five trials) favouring 400 mg ibuprofen over 1000 mg paracetamol, RR for not using rescue medication (also favouring ibuprofen) was 1.50 (95% CI 1.25 to 1.79; four trials). For combined drug RR for at least 50% of the maximum pain relief over six hours of 1.77 (95% CI 1.32 to 2.39) (paracetamol 1000 mg and ibuprofen 400 mg) (one trial; moderate quality evidence). RR not using rescue medication 1.60 (95% CI 1.36 to 1.88) (two trials; moderate quality evidence). Adverse events were comparable between the treatment groups, but no formal analysis could be undertaken. There is high quality evidence that ibuprofen is superior to paracetamol at doses of 200 mg to 512 mg and 600 mg to 1000 mg respectively based on pain relief and use of rescue medication data collected at six hours postoperatively. The majority of this evidence (five out of six trials) compared ibuprofen 400 mg with paracetamol 1000 mg, these are the most frequently prescribed doses in clinical practice. The novel combination drug is showing encouraging results based on the outcomes from two trials when compared to the single drugs.


Functional connectivity in single and multislice echoplanar imaging using resting-state fluctuations.
A previous report of correlations in low-frequency resting-state fluctuations between right and left hemisphere motor cortices in rapidly sampled single-slice echoplanar data is confirmed using a whole-body echoplanar MRI scanner at 1.5 T. These correlations are extended to lower sampling rate multislice echoplanar acquisitions and other right/left hemisphere-symmetric functional cortices. The specificity of the correlations in the lower sampling-rate acquisitions is lower due to cardiac and respiratory-cycle effects which are aliased into the pass-band of the low-pass filter. Data are combined for three normal right-handed male subjects. Correlations to left hemisphere motor cortex, visual cortex, and amygdala are measured in long resting-state scans.


Genomic cloning and characterization of glutathione reductase gene from Brassica campestris var. Pekinensis.
We have isolated and characterized a gene encoding cytosolic glutathione reductase from Brassica campestris (B. campestris). The gene (BcgGR1) is presented as a single copy in the B. campestris genome and is composed of 17 exons and 16 introns in the trancribed region with coding sequence beginning in the 2nd exon and ending in the 17th exon. BcgGR1 is expressed strongly in roots and calli, and moderately in stems and leaves. The transcription is strongly induced by various stress treatments including ozone, paraquat, salt, hydrogen peroxide, chilling or ABA but depressed by heat treatment. The transcript level of BcgGR1 is increased significantly at 2 h after the onset of ozone (300 ppb), paraquat (10 microM) or salt (250 mM NaCI) treatments and reached a maximum level by 10-24 h. However, the maximum induction of BcgGR1 is reached at 2-4 h after the onset of hydrogen peroxide (10 mM), chilling (10 degrees C) or ABA (1 mM) treatments. The rapid reduction of BcgGR1 transcripts after 4 h in ABA treatment is distinguished from hydrogen peroxide and chilling treatments.


The Distribution Trend and Antimicrobial Susceptibility of Uropathogens in Taiwan: Retrospective Analysis of a 10-Year Study.
Background: The prevalence and antimicrobial susceptibility of uropathogens can vary with time and geographical location. Empirical antibiotic treatment is frequently started before the urine culture reports are received; thus, the correct selection of antibiotics is imperative, as inappropriate use could increase resistance rates. This study evaluates the distribution trends and antimicrobial susceptibility of common uropathogens in Taiwan to help predict causative pathogens, prevent overly broad antibiotic use, and guide the optimal prescription of empirical antibiotic therapy to improve prognosis. Methods: This retrospective study extracted 5,672,246 urine culture sample data, including outpatient, emergency, and inpatient departments, during 2007-2017 from the Chang Gung Research Database. We examined the trend and susceptibility of uropathogens. Results: The three leading microorganisms were Escherichia coli (E. coli), Klebsiella pneumoniae (K. pneumoniae), and Pseudomonas aeruginosa (P. aeruginosa). E. coli. was more common among females (42.7%) than males (24.7%), while P. aeruginosa was more common among males (10.2%) than females (4.42%). E. coli and K. pneumoniae were highly susceptible to carbapenems, followed by aminoglycosides. Nevertheless, an increased antimicrobial resistance trend was observed in cephalosporins and quinolones. Conclusions: This study establishes E. coli and K. pneumoniae as the predominant uropathogens. Age and gender of patients result in distribution variations of uropathogens, but geographical location does not. In addition, P. aeruginosa occurs more in the sample of elderly and that too among males. Overall, this study could help clinicians choose appropriate antibiotics to treat urinary tract infections per the prevalent uropathogens and local antimicrobial susceptibility patterns.


The influence of lithium and/or selenium on plasma amino acids profile in rats.
Selenium belongs to essential microelements and is used in agriculture. Lithium is used in medicine and the possibility of its exposure by environmental pollution has been reported. Both elements have been found to be connected with amino acids metabolism. The aim of the study was to compare the effect of lithium and selenium on plasma amino acids in rats, and to evaluate the influence of selenium in organisms exposed to lithium. The effect of selenium (0.5 mg/kg b.w., orally as Na2SeO3) and/or lithium (2.7 mg/kg b.w., orally as Li2CO3) given for 6 weeks on the plasma profile of selected amino acids in rats was studied. The concentrations of amino acids were determined using ion exchange chromatography with the aid of an amino acids analyzer AAA400. A significant effect of lithium on plasma amino acids profile was found in rats, much greater than for selenium. Selenium treatment slightly increased Tau, Phe, Tyr, Ala, Trp, Ser and Gln, while Lys and Orn were enhanced in a significant way. In contrast, Li-treatment caused a well-marked increase in Phe, Orn, Ala, His, Trp, Asp and Gln, whereas all the others were only slightly increased. Co-treatment resulted in a significant increase in Orn and Trp, a slight enhancement of Phe, Lys and His, while the rest remained unchanged. A significant effect of lithium alone on plasma amino acids profile in animals was demonstrated, with a much less influence of selenium alone. Co-treatment generally resulted in a slight or no effect. The slight selenium influence seems important regarding its agricultural application and the growing interest in its supplementation. Results concerning lithium could contribute to the research regarding the mechanism of Li action.


Quantitative description of short-range order and its influence on the electronic structure in Ag-Pd alloys.
We investigate the effect of short-range order (SRO) on the electronic structure in alloys from the theoretical point of view using density of states (DOS) data. In particular, the interaction between the atoms at different lattice sites is affected by chemical disorder, which in turn is reflected in the fine structure of the DOS and, hence, in the outcome of spectroscopic measurements. We aim at quantifying the degree of potential SRO with a proper parameter. The theoretical modeling is done with the Korringa-Kohn-Rostoker Green's function method. Therein, the extended multi-sublattice non-local coherent potential approximation is used to include SRO. As a model system, we use the binary solid solution Ag c Pd1-c at three representative concentrations c = 0.25, 0.5 and 0.75. The degree of SRO is varied from local ordering to local segregation through an intermediate completely uncorrelated state. We observe some pronounced features, which change over the whole energy range of the valence bands as a function of SRO in the alloy. These spectral variations should be traceable in modern photoemission experiments.


Physical and mental health impacts of the COVID-19 pandemic among college students who are undocumented or have undocumented parents.
The COVID-19 pandemic may have disproportionately affected the mental and physical health of undocumented students and students with undocumented parents. We analyzed primary data from 2111 California college students collected March-June 2020. We estimated the odds of mental or physical health being affected "a great deal" by COVID by immigration group and then examined whether this was moderated by campus belonging or resource use. Students with undocumented parents were least likely to report COVID-related mental and physical health effects. Undocumented students and students whose parents have lawful immigration status did not differ in their COVID-related physical and mental health. For all students, more campus resource use and higher campus belonging were associated with negative mental and physical health effects. Negative COVID-related mental and physical health was widespread. Separation from campus-based resources was detrimental during the early stages of the pandemic.