Comparison of Short and Mid-Term Mortality and Morbidity in Patients With Severe Aortic Stenosis (Intermediate/High Risk) Who Underwent Transcatheter Aortic Valve Replacement and Surgical Aortic Valve Replacement.
Treatment protocols for severe aortic valve stenosis include surgical aortic valve replacement (SAVR), balloon valvuloplasty, transcatheter aortic valve replacement (TAVR), and medical treatment. Because the success rates are getting higher with both SAVR and TAVR, making the right treatment decision is important. This study retrospectively shows the short- (1 month) and mid-term (6 months) mortality and morbidity rate differences between 2 groups of patients, who arrived to our hospital from January 2014 through October 2018. The first group consists of 54 patients who underwent mid-high risk SAVR operations at Istanbul University-Cerrahpasa, Institute of Cardiology, Department of Cardiovascular Surgery. The second group consists of 57 patients who underwent TAVR at the Cardiology Department. Preoperative evaluation showed that the mean age of the SAVR group (71.5 years) was higher than the TAVR group (80 years). Also, the history of previous cardiac valve replacement surgery significantly was higher in the SAVR group than the TAVR group (P = .028). There were no significant differences between the remaining preoperative tests and diagnostic procedures. Of the patients who underwent SAVR, 3.7% experienced postoperative cardiac arrhythmias, while the 17.5% of patients from the TAVR group experienced cardiac arrhythmias after the procedure. This difference between the groups were statistically significant. Mortality rate was 9.3% in the SAVR group and 5.3% in the TAVR group. The mortality rate was not statistically different between the groups. There was no significant difference between the groups in the means of neurological incidents. The TAVR group had more vascular complications (17.9% to none) and pacemaker implantations (21.4% to 1.9%). Minor or major bleeding was the most common reason for admission to the hospital after SAVR. Seven out of 10 patients experienced bleeding. Aortic regurgitation was more common in the TAVR group at the first and sixth month following the procedure. Ratios between the gradient values were higher in the SAVR group (P < .001). Peak gradient values at the sixth month following the procedure were lower than the values of the first month (P < .040). Aortic regurgitation symptoms increased with patients at the mid-term follow-up appointment. To prevent the vascular complications in the TAVR group, preoperative peripheral vascular examination thoroughly should be performed. Considering that bleeding disorders are the main reason the SAVR group arrived to the hospital, INR values should closely be monitored. There seems to be no mortality difference between the groups at the six-month follow up, but studies should continue with more patients and long-term results.


Our experience in minimized surgery for retinal detachment: first results.
This study included the first 35 patients with retinal detachment that underwent cryopexy and scleral segmental buckling by silicone sponge with nondrainage and without serclage after Lincoff. Precise localization of the retinal lesions and proper circumferential cryopexy was achieved intraoperatively under the guidance of indirect ophthalmoscope provided with +20/+30d biaspherical lens (Volk, USA). Mean age of the patients was 42 +/- 11 years. A single hole/break was visualized in 20%, two holes/breaks in 26%, and more than two holes/breaks in 40% of the patients; disinsertion of the retina of one quadrant was present in 14%. The duration of the disease was less than 3 months in 66% and more than 3 months in 34% of the patients. On the first postoperative day anatomical reattachment of the retina was achieved in 86% of the patients and in 14% of the resorption was delayed until day 7. Postoperative haemophthalmus, vitreitis, ischaemia of the anterior ocular segment, or elevated intraocular pressure were found in none of the patients. All patients were discharged with reattached retinas. Visual acuity was more than 0.5 in 60% and from 0.1 to 0.5 in 40% of the patients. At the last postoperative examination the visual acuity was 1.0 in 40%, 0.5-0.9 in 40% and 0.1-0.4 in 20% of the eyes. The retina was reattached in all patients. The method of minimized surgery for retinal detachment yields good anatomical and functional results. It helps to avoid the postoperative complications of conventional scleroplastic surgery with serclage and drainage.


Oxygen Requirement in Overweight/Obese Kidney Transplant Recipients with COVID-19: An Observational Cohort Study.
Obesity is one of the components of the cardiometabolic syndrome that contributes to COVID-19 progression and mortality. Immunosuppressed individuals are at greater risk of the COVID-19 burden. Therefore, we sought to investigate the impact of the combination of overweight/obesity and kidney transplant on oxygen (O2) requirements in the COVID-19 setting. Retrospective analysis of 284 kidney transplant recipients (KTRs) from March/2020 to August/2020 in a single center. We investigated the risk factors associated with O2 requirements in overweight/obese KTRs. Overall, 65.1% had a BMI (body mass index) ≥ 25 kg/m2, 52.4% were male, the mean age was 53.3 ± 11 years old, 78.4% had hypertension, and 41.1% had diabetes mellitus. BMI was an independent risk factor for O2 requirements (OR = 1.07, p = 0.02) alongside age, lymphopenia, and hyponatremia. When overweight/obese KTRs were older, smokers, they presented higher levels of lactate dehydrogenase (LDH), and lower levels of estimated glomerular filtration rate (eGFR), lymphocytes, and sodium at admission, and they needed O2 more often. Being overweight/obese is associated with greater O2 requirements in KTRs, in particular in older people and smokers, with worse kidney allograft functions, more inflammation, and lower sodium levels. Therefore, the early identification of factors that predict a worse outcome in overweight/obese KTRs affected by COVID-19 contributes to risk stratification and therapeutic decisions.


The Development of Cooking Videos to Encourage Calcium Intake in Young Adults.
Young adults are among the lowest consumers of calcium-rich foods. As young adults move out of home and commence university, meal skipping, food budgets and poor cooking skills may contribute to low intakes. This research aimed to develop and evaluate cooking videos to educate young adults about calcium-containing foods and provide demonstrations for culinary skills training. Fifteen short videos were designed that required minimal cooking skills, ingredients of low cost, and covered main meals and snacks. Thirty-four young adults (nine males) participated in four focus groups to assess usability and desirability of content and explore barriers to cooking. Individually completed questionnaires assessed knowledge and motivation gained post-video screening. Qualitative data were analysed with both a deductive and inductive thematic approach, and questionnaires using descriptive statistics. Video content was well accepted, most participants reported knowledge was gained and their motivation to prepare food at home and consume calcium-rich foods increased. Cooking videos appear to be a well-accepted alternative to formal classes to demonstrate calcium-rich meals that can be quickly prepared. In the future, the videos should be tested in a trial of effectiveness as social media presents a dissemination opportunity for these videos among university and college students.


The DNA mismatch repair system in sebaceous tumors: an update on the genetics and workup of Muir-Torre syndrome.
Mutations in the genes encoding the DNA mismatch repair (MMR) are identified in most sebaceous neoplasms. Sebaceous tumors are rare in the general population; however, they are common in patients with inherited or acquired mutations in the MMR system. This article describes the DNA MMR system and its implication in sebaceous tumors as well as discusses the recent recommendations for screening for Muir-Torre syndrome (MTS) in patients presenting with sebaceous tumors.


Identification of (23S)-5beta-cholestane-3alpha, 7alpha, 12alpha, 23, 25-pentol in cerebrotendinous xanthomatosis.
The synthesis of (23R)- and (23S)-5beta-cholestane-3alpha, 7alpha, 12alpha, 23, 25-pentols is described. Norcholyl aldehyde was converted into the cholestanepentols by a Reformatsky reaction with ethyl bromoacetate followed by a Grignard reaction with methylmagnesium iodide. One of the synthetic pentols, the 23S epimer was identical with a bile alcohol isolated from patients with cerebrotendinous xanthomatosis.


MG53 regulates membrane budding and exocytosis in muscle cells.
Membrane recycling and remodeling contribute to multiple cellular functions, including cell fusion events during myogenesis. We have identified a tripartite motif (TRIM72) family member protein named MG53 and defined its role in mediating the dynamic process of membrane fusion and exocytosis in striated muscle. MG53 is a muscle-specific protein that contains a TRIM motif at the amino terminus and a SPRY motif at the carboxyl terminus. Live cell imaging of green fluorescent protein-MG53 fusion construct in cultured myoblasts showed that although MG53 contains no transmembrane segment it is tightly associated with intracellular vesicles and sarcolemmal membrane. RNA interference-mediated knockdown of MG53 expression impeded myoblast differentiation, whereas overexpression of MG53 enhanced vesicle trafficking to and budding from sarcolemmal membrane. Co-expression studies indicated that MG53 activity is regulated by a functional interaction with caveolin-3. Our data reveal a new function for TRIM family proteins in regulating membrane trafficking and fusion in striated muscles.


Chitinase-3 like-protein-1 promotes glioma progression via the NF-κB signaling pathway and tumor microenvironment reprogramming.
Background: Chitinase-3-like protein 1 (CHI3L1) is overexpressed in various types of tumors, especially in glioma, and contributes to tumor progression. However, the definite role of CHI3L1 and involved pathway in glioma progression are not completely understood. Methods: CHI3L1 expression in human gliomas and its association with patient survival was determined using enzyme-linked immunosorbent assay, western blot, immunohistochemistry, and public databases. Single-cell RNA-seq was used to characterize the landscape of tumor and myeloid cells. Human proteome microarray assay was applied to identify the binding partners of CHI3L1. Protein-protein interactions were analyzed by co-immunoprecipitation and cellular co-localization. The roles of CHI3L1 in glioma proliferation and invasion were investigated in tumor cell lines by gain- and loss- of function, as well as in vivo animal experiments. Results: CHI3L1 was up-regulated in all disease stages of glioma, which was closely related with tumor survival, growth, and invasion. CHI3L1 was primarily expressed in glioma cells, followed by neutrophils. Moreover, glioma cells with high expression of CHI3L1 were significantly enriched in NF-κB pathway. Pseudo-time trajectory analysis revealed a gradual transition from CHI3L1low to CHI3L1high glioma cells, along with the NF-κB pathway gradually reversed from inhibition to activation. Intriguingly, CHI3L1 binds to actinin alpha 4 (ACTN4) and NFKB1, and enhances the NF-κB signaling pathway by promoting the NF-κB subunit nuclear translocation in glioma cells. Further, CHI3L1 were released into the tumor microenvironment (TME) and interacted with CD44 expressed on tumor-associated macrophages to activate AKT pathway, thereby contributing to M2 macrophage polarization. In addition, CHI3L1 positively correlated to the expression of immune checkpoints, such as CD274 (PD-L1) and HAVCR2 (LAG3), which then remodeled the TME to an immunosuppressive phenotype. Conclusion: Our research revealed that CHI3L1 facilitated NF-κB pathway activation within glioma cells and reprogramed the TME, thereby serving as a promising therapeutic target for glioma.


Pathophysiological and Molecular Basis of the Side Effects of Ticagrelor: Lessons from a Case Report.
Ticagrelor is currently considered a first-line choice in dual antiplatelet therapy (DAPT) following revascularization of acute coronary syndrome (ACS). However, its use is correlated with an increased incidence of two side effects, dyspnea and bradyarrhythmias, whose molecular mechanisms have not yet been defined with certainty and, consequently, neither of the therapeutic decisions they imply. We report the case of a patient with acute myocardial infarction treated with ticagrelor and aspirin as oral antithrombotic therapy after primary percutaneous coronary intervention (PCI), manifesting in a significant bradyarrhythmic episode that required a switch of antiplatelet therapy. Starting from this case report, this article aims to gather the currently available evidence regarding the molecular mechanisms underlying these side effects and propose possible decision-making algorithms regarding their management in clinical practice.


Neuroprotective effects of linagliptin in a rotenone-induced rat model of Parkinson's disease.
The present study investigates the antiParkinsonian activity of dipeptidyl peptidase-4 (DPP-IV) inhibitor, linagliptin. The experimental Parkinson's disease (PD) was induced by administration of rotenone at a dose of 1.5 mg/kg at alternate day subcutaneously for 21 days. Standard drug (levodopa-200 mg/kg and carbidopa-50 mg/kg) and treatment drug (linagliptin-5 mg/kg, 10 mg/kg, and 20mg/kg) were administered orally daily 1 h before rotenone administration. In a rat rotenone model, linagliptin improved muscle coordination, motor performance, and corrected akinesia. Pretreatment with linagliptin showed significant higher levels of superoxide dismutase, catalase, and glutathione in brain homogenate of animals. Linagliptin significantly elevated the levels of striatal DA and active glucagon-like peptide 1 in brain homogenate of animals. Furthermore, linagliptin amended alterations induced by rotenone in the thiobarbituric acid reactive substances and inflammatory marker such as tumor necrosis factor-α level. The results of the present study indicate the neuroprotective potential of linagliptin for the management of PD might be due to remarkable improvement in motor functions, antioxidant, anti-inflammatory, anti-apoptotic, and neuroprotective mechanisms.


On the microscopic basis of Newton's law of cooling and beyond.
The microscopic basis of Newton's law of cooling and its modification when the difference in temperature between the system and the surroundings is very large is discussed. When the system of interest is interacting with a small bath, the effect of the dynamical evolution of the bath variables is important to find out its dynamical feedback on the system. As in the usual system-bath approach, however, the bath is finally considered to be in thermal equilibrium and thereby provides an effective generalization of the Born-Markov master equation. It is shown that the cooling at early time is faster than that predicted by Newton's law due to the dynamical feedback of the bath.


Pancreatitis-associated protein is related closely to neoplastic proliferative activity in patients with colorectal carcinoma.
Pancreatitis-associated protein (PAP) is a secretory protein that is not only expressed during acute pancreatitis but also in pancreatic adenocarcinoma, gastric carcinoma, hepatocellular carcinoma, and colorectal carcinoma. Expression in carcinoma might be another characteristic of PAP. The aim of our study was to assess, in 27 patients undergoing surgery for colorectal carcinoma, the expression of the PAP mRNA and to evaluate its association with DNA ploidy and proliferative activity (S-phase fraction, SPF) by reverse transcriptase-polymerase chain reaction (RT-PCR) and flow cytometric analysis (FCM). PAP mRNA was expressed in 29.6% (8 of 27) of the patients with colorectal carcinoma. DNA aneuploid and high SPF were found in 87.5% (7 of 8) of patients with PAP mRNA positive colorectal carcinoma. The serum PAP level was significantly elevated in patients with colorectal carcinoma when compared with the healthy subjects. Twelve of the 27 patients with colorectal carcinoma had high serum PAP concentrations (>25 ng/mL) and the mean SPF was 17.82% +/- 8.02%, which was significantly higher compared with the normal colorectal tissue group (7.33% +/- 3.18%, P < 0.05). The mean serum PAP concentration of DNA aneuploidy colorectal carcinomas was 46.67 +/- 17.58 ng/mL, which was significantly different when compared with the DNA diploidy group (19.18 +/- 8.89 ng/mL, P < 0.05). PAP mRNA expression and serum PAP levels are closely related to neoplastic proliferative activity in patients with colorectal carcinoma. No significant differences are observed between PAP mRNA expression and clinicopathologic parameters (P > 0.05).


Cell-cell interactions and fluctuations in the direction of motility promote directed migration of osteoblasts in direct current electrotaxis.
Under both physiological (development, regeneration) and pathological conditions (cancer metastasis), cells migrate while sensing environmental cues in the form of mechanical, chemical or electrical stimuli. In the case of bone tissue, osteoblast migration is essential in bone regeneration. Although it is known that osteoblasts respond to exogenous electric fields, the underlying mechanism of electrotactic collective movement of human osteoblasts is unclear. Here, we present a computational model that describes the osteoblast cell migration in a direct current electric field as the motion of a collection of active self-propelled particles and takes into account fluctuations in the direction of single-cell migration, finite-range cell-cell interactions, and the interaction of a cell with the external electric field. By comparing this model with in vitro experiments in which human primary osteoblasts are exposed to a direct current electric field of different field strengths, we show that cell-cell interactions and fluctuations in the migration direction promote anode-directed collective migration of osteoblasts.


Sublethal effects of contaminants on marine habitat-forming species: a review and meta-analysis.
Contaminants may affect ecosystem functioning by reducing the fitness of organisms and these impacts may cascade through ecosystems, particularly if the sensitive organisms are also habitat-forming species. Understanding how sub-lethal effects of toxicants can affect the quality and functions of biogenic habitats is critical if we are to establish effective guidelines for protecting ecosystems. We carried out a global systematic review and meta-analysis critically evaluating contaminant effects on properties of habitat-formers linked to ecosystem functioning. We reviewed a total of 95 publications. However, 40% of publications initially captured by the literature search were identified as having flaws in experimental design and ~11% did not present results in an appropriate way and thus were excluded from the quantitative meta-analysis. We quantitatively reviewed 410 studies from 46 publications, of which 313 (~76%) were on plants and seaweeds, that is macro-algae, saltmarsh plants and seagrasses, 58 (~14%) studied corals and 39 (~10%) looked at toxicant impacts on bivalves, with 70% of those on mussels and the remaining studies on oysters. Response variables analysed were photosynthetic efficiency, amount of chlorophyll a (as a proxy for primary production) and growth of plants, seaweeds and corals as well as leaf area of plants. We also analysed filtration, growth and respiration rates of bivalves. Our meta-analysis found that chemical contaminants have a significant negative impact on most of the analysed functional variables, with the exception of the amount of chlorophyll a. Metals were the most widely harmful type of contaminant, significantly decreasing photosynthetic efficiency of kelps, leaf area of saltmarsh plants, growth of fucoids, corals and saltmarsh plants and the filtration rates of bivalves. Organic contaminants decreased the photosynthetic efficiency of seagrass, but had no significant effects on bivalve filtration. We did not find significant effects of polycyclic aromatic hydrocarbons on any of the analysed functional variables or habitat-forming taxa, but this could be due to the low number of studies available. A meta-regression revealed that relationships between concentrations of metal contaminants and the magnitude of functional responses varied with the type of metal and habitat-former. Increasing concentrations of contaminants significantly increased the negative effects on the photosynthetic efficiency of habitat-formers. There was, however, no apparent relationship between ecologically relevant concentrations of metals and effect sizes of photosynthetic efficiency of corals and seaweeds. A qualitative analysis of all relevant studies found slightly different patterns when compared to our quantitative analysis, emphasising the need for studies to meet critical inclusion criteria for meta-analyses. Our study highlights links between effects of contaminants at lower levels of organisation (i.e. at the biochemical and/or physiological level of individuals) and ecological, large-scale impacts, through effects on habitat-forming species. Contaminants can clearly reduce the functioning of many habitat-forming marine species. We therefore recommend the adoption of routine measures of functional endpoints in monitoring and conservation programs to complement structural measures.


GRK2 and Beta-Arrestins in Cardiovascular Disease: Established and Emerging Possibilities for Therapeutic Targeting.
Heptahelical G protein-coupled receptors, such as the -adrenergic and the angiotensin II type 1 receptors, are the most diverse and therapeutically important family of receptors in the human genome, playing major roles in the physiology of various organs/tissues including the heart and blood vessels. Ligand binding activates heterotrimeric G proteins that transmit intracellular signals by regulating effector enzymes or ion channels. G protein signaling is terminated, in large part, by phosphorylation of the agonist-bound receptor by the family of G-protein coupled receptor kinases (GRKs), with GRK2 being its most prominent member, followed by barrestin binding, which uncouples the phosphorylated receptor and G protein and subsequently targets the receptor for internalization. As the receptor-barrestin complex enters the cell, barrestins serve as ligand-regulated scaffolds that recruit a host of intracellular proteins and signal transducers, thus promoting their own wave of signal transduction independently of G-proteins. A large number of preclinical studies in small and large animals over the past several years have pinpointed specific pathophysiologic roles played by these two families of receptor-regulating proteins in various cardiovascular diseases, directly implicating them in disease pathology and suggesting them as potential therapeutic targets. The present review gives an account of what is currently known about the benefits of cardiac and adrenal GRK2 inhibition for cardiovascular disease treatment, and also discusses the exciting new therapeutic possibilities emerging from uncovering the physiological roles of arrestin-mediated signaling in vivo in the cardiovascular system.


Effects of biliary obstruction on hepatic deoxyribonucleic acid and protein synthesis after partial hepatectomy.
Major hepatectomy for biliary malignancy associated with biliary obstruction is often complicated due to hepatic failure. To determine the effects of biliary obstruction on liver regeneration, hepatic deoxyribonucleic acid and protein synthesis after partial hepatectomy was studied in rats with pre-operative biliary obstruction. After 5 or 14 days of biliary obstruction, experimental rats underwent concurrent biliary decompression and 70% partial hepatectomy. Control rats underwent partial hepatectomy alone. Hepatic deoxyribonucleic acid synthesis was determined 24 hours after partial hepatectomy. Hepatocellular protein synthesis and secretory protein synthesis were determined at baseline and 48 hours after partial hepatectomy. Deoxyribonucleic acid synthesis was significantly depressed in rats with biliary obstruction compared with controls (p < 0.05). Baseline hepatocellular protein synthesis and secretory protein synthesis, especially secretory protein synthesis, increased in proportion to the duration of biliary obstruction (p < 0.01). After partial hepatectomy, control rats showed marked increases in hepatocellular protein synthesis and secretory protein synthesis (p < 0.01). Increased baseline hepatocellular protein synthesis and secretory protein synthesis were preserved in the regenerating liver of rats with biliary obstruction. The results suggest that biliary obstruction gives priority to secretory protein synthesis over DNA synthesis which may inhibit liver regeneration.


Relative vitamin D insufficiency in Hashimoto's thyroiditis.
Vitamin D insufficiency, defined as serum levels of 25-hydroxyvitamin D [25(OH)D3] lower than 30 ng/mL, has been reported to be prevalent in several autoimmune diseases such as multiple sclerosis and type 1 diabetes mellitus. The goal of the present study was to assess whether vitamin D insufficiency is also a feature of Hashimoto's thyroiditis (HT). We performed a prevalence case-control study that included 161 cases with HT and 162 healthy controls. Serum levels of 25(OH)D3, calcium, phosphorus, and parathyroid hormone were measured in all 323 subjects. The prevalence of vitamin D insufficiency in HT cases (148 of 161, 92%) was significantly higher than that observed in healthy controls (102 of 162, 63%, p < 0.0001). Among HT cases, the prevalence rate of vitamin D insufficiency showed a trend to be higher in patients with overt hypothyroidism (47 of 50, 94%) or subclinical hypothyroidism (44 of 45, 98%) than in those with euthyroidism (57 of 66, 86%), but the differences were not significant (p = 0.083). Vitamin D insufficiency is associated with HT. Further studies are needed to determine whether vitamin D insufficiency is a casual factor in the pathogenesis of HT or rather a consequence of the disease.


Lactose in human breast milk an inducer of innate immunity with implications for a role in intestinal homeostasis.
Postpartum, infants have not yet established a fully functional adaptive immune system and are at risk of acquiring infections. Hence, newborns are dependent on the innate immune system with its antimicrobial peptides (AMPs) and proteins expressed at epithelial surfaces. Several factors in breast milk are known to confer immune protection, but which the decisive factors are and through which manner they work is unknown. Here, we isolated an AMP-inducing factor from human milk and identified it by electrospray mass spectrometry and NMR to be lactose. It induces the gene (CAMP) that encodes the only human cathelicidin LL-37 in colonic epithelial cells in a dose- and time-dependent manner. The induction was suppressed by two different p38 antagonists, indicating an effect via the p38-dependent pathway. Lactose also induced CAMP in the colonic epithelial cell line T84 and in THP-1 monocytes and macrophages. It further exhibited a synergistic effect with butyrate and phenylbutyrate on CAMP induction. Together, these results suggest an additional function of lactose in innate immunity by upregulating gastrointestinal AMPs that may lead to protection of the neonatal gut against pathogens and regulation of the microbiota of the infant.


Fluoroquinolone Metalloantibiotics: A Promising Approach against Methicillin-Resistant Staphylococcus aureus.
Fluoroquinolones (FQs) are antibiotics commonly used in clinical practice, although nowadays they are becoming ineffective due to the emergence of several mechanisms of resistance in most bacteria. The complexation of FQs with divalent metal ions and phenanthroline (phen) is a possible approach to circumvent antimicrobial resistance, since it forms very stable complexes known as metalloantibiotics. This work is aimed at determining the antimicrobial activity of metalloantibiotics of Cu(II)FQphen against a panel of multidrug‑resistant (MDR) clinical isolates and to clarify their mechanism of action. Minimum inhibitory concentrations (MICs) were determined against MDR isolates of Escherichiacoli,Pseudomonasaeruginosa and methicillin-resistant Staphylococcus aureus (MRSA). Metalloantibiotics showed improved antimicrobial activity against several clinical isolates, especially MRSA. Synergistic activity was evaluated in combination with ciprofloxacin and ampicillin by the disk diffusion and checkerboard methods. Synergistic and additive effects were shown against MRSA isolates. The mechanism of action was studied though enzymatic assays and atomic force microscopy (AFM) experiments. The results indicate a similar mechanism of action for FQs and metalloantibiotics. In summary, metalloantibiotics seem to be an effective alternative to pure FQs against MRSA. The results obtained in this work open the way to the screening of metalloantibiotics against other Gram‑positive bacteria.


Giant Leiomyoma of the Oesophagus.
Leiomyomas are rare benign tumours of the oesophagus that remain silent in more than 50% of the cases. Giant leiomyomas measuring more than 5 cm are very rare. A 47-year-old female presented with chest pain, cough and dysphagia for two months. Imaging studies were indicative of a 12.1x11.9 cm mass lesion in the distal oesophagus, CT guided biopsy confirmed leiomyoma. The patient being taken up for surgery was found to have a 20x19x17 cm irregular lobulated and encapsulated mass lesion arising from distal oesophagus encapsulating submucosally. En bloc resection of the tumour along with distal oesophagus with a clearance of 4 cm above and below the oesophagogastric junction was done followed by gastro-oesophageal anastomosis. Histopathologically, leiomyoma was confirmed. The patient had a smooth postoperative recovery.


Clinical determination of the corrected retinal image size in spectacle-corrected aphakes.
For individual spectacle-corrected aphakic patients, a method of estimating the size of the corrected retinal image corresponding to distant objects smaller than Snellen 6/360 (20/1200) is developed. Our results indicate that an estimate of the corrected retinal image size corresponding to a distant Snellen 6/12 (20/40) object in an individual spectacle-corrected aphake can be obtained to within plus or minus 1.0 micron of error using a multivariate regression model based on the measurement of six patient factors: axial length, anterior corneal power, spectacle lens back vertex power, lens thickness, lens back curve, and lens vertex distance. Clinical application of these results are discussed along with comparisons to other results based on traditional spectacle magnification formulas. The size of the corrected retinal image corresponding to a Snellen 6/12 (20/40) object was found to vary between 60 and 84 micron in patients corrected with CR-39 optical plastic and for patients corrected with high-index optical glass, it was between 56 and 78 microns.


The unique role of the agent within the romantic group.
In this commentary, we apply the authors' view to small groups consisting of two people who are in a committed romantic relationship. Our focus is on the circumstances that make it more likely that people will stay within such a group and minimize the chances that they will replace their partner. In our restless society, such ongoing replacement is a pressing issue.


Effects of streptozotocin-induced diabetes and physical training on gene expression of titin-based stretch-sensing complexes in mouse striated muscle.
In striated muscle, a sarcomeric noncontractile protein, titin, is proposed to form the backbone of the stress- and strain-sensing structures. We investigated the effects of diabetes, physical training, and their combination on the gene expression of proteins of putative titin stretch-sensing complexes in skeletal and cardiac muscle. Mice were divided into control (C), training (T), streptozotocin-induced diabetic (D), and diabetic training (DT) groups. Training groups performed for 1, 3, or 5 wk of endurance training on a motor-driven treadmill. Muscle samples from T and DT groups together with respective controls were collected 24 h after the last training session. Gene expression of calf muscles (soleus, gastrocnemius, and plantaris) and cardiac muscle were analyzed using microarray and quantitative PCR. Diabetes induced changes in mRNA expression of the proteins of titin stretch-sensing complexes in Z-disc (MLP, myostatin), I-band (CARP, Ankrd2), and M-line (titin kinase signaling). Training alleviated diabetes-induced changes in most affected mRNA levels in skeletal muscle but only one change in cardiac muscle. In conclusion, we showed diabetes-induced changes in mRNA levels of several fiber-type-biased proteins (MLP, myostatin, Ankrd2) in skeletal muscle. These results are consistent with previous observations of diabetes-induced atrophy leading to slower fiber type composition. The ability of exercise to alleviate diabetes-induced changes may indicate slower transition of fiber type.


Ageing and CNS remyelination.
Remyelination of demyelinated axons in the CNS is a regenerative process that, like many others, becomes less efficient with age. This article reviews a series of studies in which toxin models of demyelination have been used to characterize this phenomenon. The delayed rate of remyelination in older animals is associated with a decrease in the rate of oligodendrocyte progenitor recruitment and in the rate at which the recruited cells differentiate into remyelinating oligodendrocytes. The differences in the behaviour of oligodendrocyte lineage cells during remyelination in young and old animals are related to the age-related changes that occur in the expression of growth factors that affect the proliferation, migration and differentiation of oligodendrocyte progenitors, and in the inflammatory process associated with toxin-induced demyelination. Based on these differences, a conceptual framework is proposed to explain the age-associated effects on remyelination, which we have called the dysregulation hypothesis, and the feasibility of reversing these effects is discussed.


Meat tastes good, legumes are healthy and meat substitutes are still strange - The practice of protein consumption among Swedish consumers.
Replacing some meat with grain legumes would benefit human health, the environment and agriculture. This study analysed legume and meat consumption practices by investigating consumer perceptions and competences relating to lightly processed grain legumes (LPL), legume-based meat substitutes (LBMS) and meat in Sweden, and how these (and demographic variables) influenced stated intention to change consumption. Major differences in consumer perceptions of LPL and LBMS compared with meat related to product attractiveness and status, with meat seen as more fun, popular, suitable in diets and for festive occasions, and tastier. Most consumers knew of the environmental impact of meat and health benefits of LPL. Country of origin, i.e. Swedish origin, was important for many consumers (especially for meat and women). Preferences relating to health and environmental impact were important for intention to decrease meat consumption. Perceived environmental impact was important for intention to change consumption of LPL, but taste, healthiness, weight control, ease of preparation and suitability in the diet were equally or more important. Leveraging stated consumer willingness and intention to eat more LPL by making LPL more accessible to consumers could increase their consumption. For LBMS, there are still important barriers in terms of taste, familiarity and overall attractiveness of these products that need to be overcome to increase their consumption in Sweden.


Cytological study of DNA content and nuclear morphometric analysis for aid in the diagnosis of high-grade dysplasia within oral leukoplakia.
To quantitatively examine the DNA content and nuclear morphometric status of oral leukoplakia (OL) and investigate its association with the degree of dysplasia in a cytologic study. Oral cytobrush biopsy was carried out to obtain exfoliative epithelial cells from lesions before scalpel biopsy at the same location in a blinded series of 70 patients with OL. Analysis of nuclear morphometry and DNA content status using image cytometry was performed with oral smears stained with the Feulgen-thionin method. Nuclear morphometric analysis revealed significant differences in DNA content amount, DNA index, nuclear area, nuclear radius, nuclear intensity, sphericity, entropy, and fractal dimension (all P < .01) between low-grade and high-grade dysplasia. DNA content analysis identified 34 patients with OL (48.6%) with DNA content abnormality. Nonhomogeneous lesion (P = .018) and high-grade dysplasia (P = .008) were significantly associated with abnormal DNA content. Importantly, the positive correlation between the degree of oral dysplasia and DNA content status was significant (P = .004, correlation coefficient = 0.342). Cytology analysis of DNA content and nuclear morphometric status using image cytometry may support their use as a screening and monitoring tool for OL progression.


The Unconscious Mind.
The unconscious mind is still viewed by many psychological scientists as the shadow of a "real" conscious mind, though there now exists substantial evidence that the unconscious is not identifiably less flexible, complex, controlling, deliberative, or action-oriented than is its counterpart. This "conscious-centric" bias is due in part to the operational definition within cognitive psychology that equates unconscious with subliminal. We review the evidence challenging this restricted view of the unconscious emerging from contemporary social cognition research, which has traditionally defined the unconscious in terms of its unintentional nature; this research has demonstrated the existence of several independent unconscious behavioral guidance systems: perceptual, evaluative, and motivational. From this perspective, it is concluded that in both phylogeny and ontogeny, actions of an unconscious mind precede the arrival of a conscious mind-that action precedes reflection.


Residues of veterinary drugs and heavy metals in bovine meat from Urabá (Antioquia, Colombia), a promising step forward towards international commercialization.
Veterinary drugs are used for disease control in bovines Their presence at acceptable levels is a cause of concern for consumers and control agencies, as well as being a limitation for accessing international markets. The objective of this research was to evaluate the presence of residues of veterinary drugs and heavy metals in meat cuts from the Urabá region in Colombia. From a total of 80 samples of meat cuts from the loin and neck, we determined the presence of 29 veterinary drug residues and of cadmium and lead. The drug residues were quantified by liquid chromatography coupled to mass spectrometry. Heavy metals were measured by electrothermal atomic absorption. As a result, all evaluated samples complied with Colombian and European regulations for drug residues and heavy metals. These results demonstrate good veterinary practices used for bovines raised in this part of Colombia, and they represent an export opportunity and an opening for new markets that can be enhanced by the implementation of a meat quality seal from this region.


Dab1-deficient deep layer neurons prevent Dab1-deficient superficial layer neurons from entering the cortical plate.
The mammalian neocortex has a 6-layered cytoarchitecture, where early- and late-born neurons are positioned deeply and superficially, respectively. Inverted lamination has been observed in mice defective in the Reelin/Disabled-1 (Dab1) pathway. Considering that Dab1-deficient superficial layer neurons can migrate into the Dab1 +/+ cortical plate and that Dab1 is thought to function cell-autonomously, it is unclear why superficial layer neurons are positioned below deep layer neurons in Reelin/Dab1-deficient mice. Here, we reconfirmed that Dab1 -/- superficial layer neurons enter the cortical plate using in utero electroporation on embryonic day (E) 14.5 Dab1-floxed mice. Electroporation in E12.5 Dab1-floxed mice reconfirmed that many deep layer neurons were mispositioned below the subplate. We also found an accumulation of Dab1-deficient superficial layer neurons below the cortical plate in many of these brains, in which deep layer neurons below the subplate showed high cell density. These phenotypes were rescued by decreasing the knockout probability and by expressing Dab1 in deep layer neurons. These observations suggest that cell-dense Dab1 -/- deep layer neurons prevent Dab1 -/- superficial layer neurons from entering the cortical plate. This reflects a non-cell-autonomous function of Dab1 and may explain the preplate splitting failure and outside-in lamination observed in Reelin/Dab1-deficient mice.


Impact of northern and southern air mass transport on the temporal distribution of atmospheric (210)Po and (210)Pb in the east coast of Johor, Malaysia.
Concentration activities of (210)Pb and (210)Po in the PM10 were determined to discuss their distribution and chemical behavior in relation to meteorological parameters especially in air mass transport during monsoon events. Marine aerosol samples were collected between January 2009 and December 2010 at the coastal region of Mersing, which is located in the southern South China Sea and is about 160 km northeast of Johor Bahru, as part of the atmosphere-ocean interaction program in Malaysia. About 47 PM10 samples were collected using the Sierra-Andersen model 1200 PM10 sampler over a 2-year sampling campaign between January 2009 and December 2010. Samples were processed using acid digestion sequential extraction techniques to analyze various fractions such as Fe and Mn oxides, organic matter, and residual fractions. While, (210)Pb and (210)Po activities were measured with the Gross Alpha/Beta Counting System model XLB-5 Tennelec® Series 5 and the Alpha Spectrometry (model Alpha Analyst Spectroscopy system with a silicon-surface barrier detector), respectively. The distribution activities of (210)Pb and (210)Po in the PM10 samples were varied from 162 to 881 μBq/m(3) with mean value of 347 ± 170 μBq/m(3) and from 85 to 1009 μBq/m(3) with mean value of 318 ± 202 μBq/m(3), respectively. The analysis showed that (210)Po activity in our samples lies in a border and higher range than global distribution values due to contributions from external sources injected to the atmosphere. The speciation of (210)Pb and (210)Po in marine aerosol corresponds to transboundary haze; e.g., biomass burning especially forest fires and long-range air mass transport of terrestrial dust has enriched concentrations of particle mass in the local atmosphere. The monsoon seems to play an important role in transporting terrestrial dust from Indo-China and northern Asia especially during the northeast monsoon, as well as biogenic pollutants originating from Sumatra and the southern ASEAN region during southwest monsoon events.


Switchable semiconductive property of the polyhydroxylated metallofullerene.
The temperature-sensitive property of polyhydroxylated metallofullerene film of Gd@C82(OH)x with special hydroxyl number was studied using synchrotron radiation ultraviolet photoelectron spectroscopy (UPS) and TEM techniques. From room temperature (RT) to 4 degrees C the photoelectron onset energy of the spectra of Gd@C82(OH)12 shifted from 1.9 to 0.2 eV, indicating that Gd@C82(OH)12 automatically shifted from insulator at RT to semiconductor at 4 degrees C. However, this could not be observed for Gd@C82(OH)20. TEM experiments show that the variation of conductivity can be ascribed to formation of a microcrystal under low temperature. The dipole moment induced unique intermolecular interactions and self-assembled microcrystalline structures for Gd@C82(OH)12. This may cause reconstruction of the upper valence band formed by pi-like electrons as well as the density of states (DOS) around the Fermi level (EF) and reconstruct the deeper valence band formed by sigma-like electrons, eventually resulting in a shift to a semiconducting nature. These findings revealed a novel nature for polyhydroxylated Gd@C82(OH)x materials: Their insulating properties can be controllably tuned into semiconducting ones as a function of temperature.


Correlation between clinical fetal head station and sonographic angle of progression during the second stage of labor.
To investigate the correlation between the angle of progression and the clinical fetal head station (FHS) during the second stage of labor, and to build reference range. A prospective, observational study was conducted. Women carrying singleton term pregnancies were enrolled during the second stage of labor. FHS was assessed manually by a senior obstetrician, while the angle of progression (AOP) was assessed by transperineal ultrasound (TPU). Both examiners were blinded to each others results. The correlation between the sonographic AOP and the clinical FHS was analyzed. Seventy patients comprised the study group. Clinical FHS demonstrated an excellent correlation with the sonographic measurement of AOP (Pearson's Correlation 0.642, p < 0.001). This correlation was best described by a cubic regression according to the formula: 123.800 + 10.290 × FHS -2.889 * FHS +0.910, (r2 = 0.423, p < .001). After aggregation of the mean AOP per FHS, the relative predicted centiles values and standard deviation were calculated. The mean Z score between measured and predicted values of the AOP for a given FHS was 0.007 (range -0.13 to +0.006). Our results demonstrate a significant correlation between the clinical FHS and the TPU measured AOP. These standardized sonographic values may serve the obstetrician as a reliable, objective auxiliary tool for the evaluation of the FHS during the second stage of labor.


Rise and Fall of an Oak Gall Wasp (Hymenoptera: Cynipidae) Outbreak in Massachusetts.
The recently described oak gall wasp Zapatella davisae Buffington & Melika (Hymenoptera: Cynipidae) has caused extensive damage and mortality to black oak trees, Quercus velutina L. (Fagales: Fagaceae), in coastal parts of New England, United States. Like many newly described and/or newly introduced species, it is unclear how long populations of Z. davisae have existed in this region. However, as this species forms galls on the woody-tissue of its host, it may be possible to obtain historical information about changes in its population size by examining the presence of galls in relation to annual growth nodes. Here, we explore the utility of this approach to determine population size changes in Z. davisae densities on Nantucket, Martha's Vineyard, and Cape Cod, Massachusetts, through dissection of black oak branches. In addition, we calculated parasitism rates during the years of study and obtained morphological and molecular identifications for the parasitoids associated with Z. davisae. Our results show significant changes in population sizes, with higher levels of parasitism at sites on Martha's Vineyard and Cape Cod compared to sites on Nantucket. In addition, morphological examinations, in combination with DNA sequencing, identified the associated parasitoids as five species in the genus Sycophila Walker (Hymenoptera: Eurytomidae). We comment that considerable morphological variation within several of these recovered species was observed, present the first record of males for a species from which only females have been described, and suggest that future work is required to clarify the species boundaries for this important parasitoid group.


Effects of cardiac output on the clearance of air emboli from the superior vena cava.
The authors assessed the effect of cardiac output on the rate of clearance of air emboli from the superior vena cava (SVC) in 11 dogs placed in a supine 30 degrees head-up inclined position. Venous air emboli were produced by infusing 4 ml of air into the dorsal sagittal sinus. Air emboli appearance and clearance from the SVC were determined from the analog record produced by a transesophageal Doppler ultrasound monitor. Cardiac output was altered by changing the level of anesthesia and the administration of intravenous fluid. Eighty-eight per cent of air infusions resulted in an analog response of consistent amplitude indicating that all or a similar fraction of the infused air arrived consistently at the ensonified region of the SVC. In this group, air emboli passed from the SVC with a clearance time (CT) that was related inversely to the cardiac index (CI). CT = 24 CI-1.3 with a correlation coefficient = 0.57. Following 12% of the air infusions, there was evidence that a part of the air became detained in vascular sites cranial to the ensonified portion of the SVC. This evidence consisted of the following observations: analog responses were diminished in amplitude; subsequent air injections evoked responses that sometimes were exaggerated; and/or subsequent increases in cardiac output alone, produced spontaneous analog responses characteristic of air emboli. The authors postulate that air similarly may be detained in clinical settings and may explain such phenomenon as persistent precordial Doppler sounds of air emboli after pulmonary artery pressure has returned to normal following symptomatic air embolism and occurrence of air emboli after scalp closure.


Ras p21 immunostaining in early stage squamous cervical carcinoma: relationship with lymph nodal involvement and 72 kDa-metalloproteinase index.
Ras p21 expression seems to be associated with aggressiveness of neoplastic growth and metastatic potentially in human solid tumors. In our series of early-stage squamous cervical carcinoma, we evaluated ras p21 expression with respect to lymph nodal involvement; the aim was to analyse the ras p21 immunostaining as potential marker of lymphatic spread, and investigate the relationship between ras p21 expression and 72 kDa-metalloproteinase immunostaining. 46 patients with FIGO stage I squamous cell cervical carcinoma, who had undergone primary radical surgery with systematic pelvic and paraaortic lymphadenectomy (Piver's type III) at the Institute of Gynecologic and Obstetrics, Ancona University, were recruited from our series of 59 consecutive cases, and included the study. Any characteristic that could be relevant for prognosis was recorded such as: histologic grade of differentiation, tumor size, lymphatic spread, or adjuvant radiotherapy. Immunohistochemical staining was performed using the avidin-biotin peroxidase complex method (LSAB, Dako, Copenhagen, Denmark). Monoclonal antibody anti-pan ras (Ab-1) (Oncogene Science) and affinity purified rabbit anti-72 kDa-metalloproteinase antibody were used. Positivity for ras p21 was evaluated by semiquantitative analysis, while 72 kDa-metalloproteinase staining was expressed as the percentage of positive cells per 10(3) counted neoplastic cells (index). The expression of ras p21 was observed in 31 patients (67%) with FIGO stage I squamous cervical carcinoma. No connection was found between ras p21 expression and tumor size (P = 0.2), or histologic grade (P = 0.9), while a significant relationship was observed with respect to lymph nodal status (p = 0.048). By analysing 72 kDa-metalloproteinase immunostaining, ras p21 positive carcinomas showed significantly higher 72 kDa-metalloproteinase index than the negative ones (mean + standard deviation, 23.3% + 7.7% and 13.8% + 5.1% respectively, and P < 0.001). Though the relatively small size of our series does not allow any definitive conclusion, a significant relationship between ras p21 expression and risk of lymphatic spread was detected in early-stage cervical carcinoma. ras p21 positivity seems to be an indicator of neoplastic aggressiveness and lymphatic spread, and is associated with significantly higher expression of 72 kDa-metalloproteinase.


Ultrasound-guided gadolinium joint injections for magnetic resonance arthrography.
To determine the feasibility and accuracy of ultrasound (US) -guided gadolinium injection for MR arthrography of shoulders, wrists, hips, and knee joints as an alternate technique to fluoroscopy. One hundred patients referred to our center for an MR arthrogram of shoulders, wrists, hips, and knees were included in the study. There were 53 males and 47 females and ages ranged from 17 to 63 years (mean age, 37). US was used to guide the needle tip into the joint. The intra-articular location of the needle tip was confirmed by fluoroscopic visualization of injected iodinated contrast medium, prior to gadolinium injection. The patients then proceeded for the MRI examination. Ninety-nine of the 100 patients were successfully injected with gadolinium under US guidance. One patient had a vasovagal reaction after local anesthetic injection and the procedure was aborted. US is an effective alternate guidance technique for the injection of gadolinium into shoulder, hip, knee, and wrist joints for MR arthrography. Its advantages are cost effectiveness, ease of performance, and lack of radiation.


Pancreas: optimal scan delay for contrast-enhanced multi-detector row CT.
To prospectively determine optimal scan delays for multiphasic contrast medium-enhanced imaging of the pancreas with multi-detector row computed tomography (CT). This study was approved by an institutional review committee, and patients gave written informed consent. One hundred ninety-one patients underwent three-phase CT of the pancreas after receiving intravenous contrast medium with a fixed duration injection of 30 seconds. Patients were prospectively assigned among four groups with scan delays of 25, 45, and 65 seconds (group 1); 30, 50, and 70 seconds (group 2); 35, 55, and 75 seconds (group 3); and 40, 60, and 80 seconds (group 4). Mean CT numbers of abdominal aorta, spleen, pancreatic parenchyma, superior mesenteric artery and vein, splenic vein, and hepatic parenchyma were measured, and increases in contrast enhancement on enhanced images were assessed. Qualitative analysis was performed with a four-point scale. Abdominal aorta and superior mesenteric artery enhanced at a mean of 35 seconds from the start of injection (both P < .001). Pancreatic parenchyma enhanced most intensely at 35-45 seconds (P < .001) with a peak enhancement at the mean of 40 seconds. Liver parenchyma enhanced most intensely at 55-65 seconds with a peak at 60 seconds (P < .001). The mean time to peak enhancement was 45 seconds for the splenic vein and 55 seconds for the superior mesenteric vein. Qualitative results were in good agreement with quantitative results (both P < .001). With the injection protocol used in this study, optimal scan delays for imaging the pancreas were 30-35 seconds for the abdominal aorta and the superior mesenteric artery, 35-45 seconds for the pancreas, 45 seconds for the splenic vein, and 55 seconds or later for the liver.


[BBX transcriptional factors family in plants-a review].
Transcriptional factors play important roles in plant growth, development and responses to stresses. BBX transcriptional factors are characterized with one or two B-box domains in the protein sequence. They are comprehensively involved in photomorphogenesis, flowering, shade avoidance, signal transduction of phytohormones, biotic and abiotic stress responses in plants by regulating gene transcription and interacting with other transcription factors. The classification, structure and functions of BBX of plants are reviewed in this paper.


Synthesis and mass spectrometric behavior of some new nucleosides as potential anti-HIV agents.
The electron-impact (EI) mass spectrometric behaviour of a series of 8-aza-purines derivatized with hydroxymethylcyclopentane and exhibiting cis-trans isomerization in the cyclopentane ring has been studied in detail with the aid of metastable-ion data. Specific fragmentation processes, present in both EI and mass analysed ion kinetic energy spectra of molecular species, allow characterization of the different pairs of stereoisomers. Contrary to what is observed in the case of purine analogs, the presence of a nitrogen atom in position 8 strongly inhibits fragmentation processes related to the heterocycle.


Effect of isopod parasite, Cymothoa indica on gobiid fish, Oxyurichthys microlepis from Parangipettai coastal waters (South-east coast of India).
The present study reported for the first time on the effect of isopod parasite, Cymothoa indica infestation on Oxyurichthys microlepis an ecologically important gobiid fish from Parangipettai coastal environment (South-east coast of India). The loss of weight in host fishes (male 20.47 and female 32.84%) were observed due to parasitism. The weight of uninfested female fish was found to be higher than that of infested one. The calus like thickening developed on the gill arch and gill filaments of host fish due to the persistent irritation caused by the appendages of the parasite. The reduction of gill surface area was observed due to the attachment of the parasites. The maximum reduction noticed in the first gill arch is mainly due to the heavy pressure exerted by the parasite. Details of gross lesions observed in the branchial chamber, buccal cavity and body surface was enumerated. Heavy infestations of parasitic juveniles have the potential to kill small fingerlings. The swimming capacity of the fish was also found to be affected.


Release and permeation profiles of spray-dried chitosan microparticles containing caffeic acid.
Caffeic acid (CA), a phenolic compound found in plants with antioxidant and antimicrobial activity, induces collagen production and prevents premature aging of the skin. The objective of this study was to develop two types of chitosan microparticles (MP) containing CA and to relate the morphology with the release and permeation profiles. One type of MP was prepared from a hydroalcoholic solution (MPI) and the other from an aqueous solution (MPII). Their morphology and size was evaluated by high-resolution scanning electron microscopy. The release profile of CA was evaluated using the cellulose membrane from the two MPs in Franz diffusion cells and the permeation profile was evaluated using human abdominal skin samples; the epidermal membranes were prepared by the heat-separation technique. MPII was spherical with a smooth surface, suitable for the controlled release of substances, whereas MPI was porous with non-internalized residual material. This result was consistent with their release and permeation profiles because MPII exhibited a slower and more controlled release than MPI. Thus, the method of preparation of MP and their composition influence the release profile of CA. Therefore, the production conditions must be closely controlled.


Simultaneous removal of SO2 and NOx from flue gas by wet scrubbing using a urea solution.
Nitrogen oxides (NOx) and sulfur dioxide (SO2) are major air pollutants, so simultaneously removing them from gases emitted during fossil fuel combustion in stationary systems is important. Wet denitrification using urea is used for a wide range of systems. Additives have strong effects on wet denitrification using urea, and different mechanisms are involved and different effects found using different additives. In this study, the effects of different additives, initial urea concentrations, reaction temperatures, initial pH values, gas flow rates, and reaction times on the simultaneous desulfurization and denitrification efficiencies achieved using wet denitrification using urea were studied in single factor experiment. The optimum reaction conditions for desulfurization and denitrification were found. Desulfurization and denitrification efficiencies of 97.5% and 96.3%, respectively, were achieved at a KMnO4 concentration 5 mmol/L, a reaction temperature of 70°C, initial urea solution pH 8, a urea concentration of 9%, and a gas flow rate of 40 L/h. The concentrations of the desulfurization and denitrification reaction products in the solution were determined. NOx was mainly transformed into N2, and the NO3- and NO2- concentrations in the solution became very low. The reactions involved in SO2 and NOx removal using urea were analyzed from the thermodynamic viewpoint. Increasing the temperature was not conducive to the reactions but increased the rate constant, so an optimum temperature was determined. The simultaneous desulfurization and denitrification kinetics were calculated. The urea consumption and NO2- , NO3- , and SO42- generation reactions were all zero order. The NO3- generation rate was greater than the NO2- generation rate. The simultaneous desulfurization and denitrification process and mechanism were studied. The results provide reference data for performing flue gas desulfurization and denitrification in factories.


Identifying novel modulators of G protein-coupled receptors via interaction at allosteric sites.
Allosteric intervention at G protein-coupled receptors is considered an alternative approach to developing new drugs for both classical and novel biological targets. Allosteric compounds, which by definition bind at sites spatially separated from those of the endogenous ligands, may offer benefits over orthosteric ligands in terms of providing therapeutic benefits with reduced side effects due to increased selectivity and the temporal nature of their duration of action. The aim of this review is to assess, with reference to recent data and concepts, the potential benefits and pitfalls in the discovery and development of small-molecule allosteric compounds as novel therapeutics.


Designing a leadership development program for nurse managers: an evidence-driven approach.
The authors describe an evidence-driven approach used in designing a leadership development program targeted for nurses in middle management positions in an academically affiliated integrated healthcare system. A qualitative study was conducted to investigate leadership development needs and experiences of nurse managers across the health system. Study findings were used to inform educational programs and organizational initiatives responsive to needs of both novice and expert nurse managers across diverse clinical settings.


Stress Processes Linking Parent-Child Disconnection to Disease Risk in Young Adulthood: Amplification by Genotype.
Previous studies have documented that early stressful family relationships influence subsequent stressful life circumstances and health outcomes over the life course. Less is known, however, about whether stressful parent-child relationships increase the influence of proximal stressors on youth health operating as a stress-sensitizing life context, and individual genetic variations have effects on these developmental processes. Informed by life course stress process theory, which focuses on the proliferation, accumulation, and interactions of stressors over the life course as health risks, we examined whether (a) parent-child disconnection influences the occurrence of stressful life events in young adulthood, (b) parent-child disconnection potentiates the impact of stressful life events on young adults' health, or (c) potential health impact is intensified further by individual genotype. Using longitudinal data from a nationally representative sample of 11,290 adolescents (Mean age 15.5 years, 53% female) over a period of 13 years, we found parent-child disconnection influenced young adults' stressful life events and amplified the impact of stressful life events on cardio-metabolic disease risk. We also found the association between stressful life events and cardio-metabolic disease risk was further intensified by the 5-HTTLPR polymorphism. Our findings demonstrate that stressful family relationships not only initiate stress processes over the early life course, but also sensitize youth to stressors, and that 5-HTTLPR polymorphism interacts with stressful life experiences to predict heightened disease risk.


Subject recruitment, retention, and compliance in clinical trials in periodontics.
Recruitment of subjects in randomized controlled trials is the process of screening and enrolling a predetermined number of subjects within a planned time. Differences between projected and actual recruitment rates are common and, when large, form a serious threat to the successful completion of the trial. Recruitment can be enhanced by 1) use of different, concurrent recruitment methods; 2) avoiding underestimations of the costs and time intensity of subject recruitment; and 3) regular monitoring of the efficiency of the recruitment effort. The recruitment process can be complicated by legal requirements of proper representation of sex and race characteristics or by stringent entry criteria. Complex designs (e.g., trials with a pre-randomization placebo run-in, split-mouth designs) have not yet shown to be cost-effective and may endanger recruitment success. Enhancing both subject retention and protocol compliance requires careful planning, attention to product design and staff training. The impact on trial findings is discussed.


Optimized Methods to Explore the Mechanistic and Biomarker Potential of Hepatocyte-Derived Exosomes in Drug-Induced Liver Injury.
Recent evidence supports that alterations in hepatocyte-derived exosomes (HDE) may play a role in the pathogenesis of drug-induced liver injury (DILI). HDE-based biomarkers also hold promise to improve the sensitivity of existing in vitro assays for predicting DILI liability. Primary human hepatocytes (PHH) provide a physiologically relevant in vitro model to explore the mechanistic and biomarker potential of HDE in DILI. However, optimal methods to study exosomes in this culture system have not been defined. Here we use HepG2 and HepaRG cells along with PHH to optimize methods for in vitro HDE research. We compared the quantity and purity of HDE enriched from HepG2 cell culture medium by 3 widely used methods: ultracentrifugation (UC), OptiPrep density gradient ultracentrifugation (ODG), and ExoQuick (EQ)-a commercially available exosome precipitation reagent. Although EQ resulted in the highest number of particles, UC resulted in more exosomes as indicated by the relative abundance of exosomal CD63 to cellular prohibitin-1 as well as the comparative absence of contaminating extravesicular material. To determine culture conditions that best supported exosome release, we also assessed the effect of Matrigel matrix overlay at concentrations ranging from 0 to 0.25 mg/ml in HepaRG cells and compared exosome release from fresh and cryopreserved PHH from same donor. Sandwich culture did not impair exosome release, and freshly prepared PHH yielded a higher number of HDE overall. Taken together, our data support the use of UC-based enrichment from fresh preparations of sandwich-cultured PHH for future studies of HDE in DILI.


Human immunodeficiency virus infection does not alter serum transaminases and hepatitis B virus (HBV) DNA in homosexual patients with chronic HBV infection.
The influence of human immunodeficiency virus (HIV) infection on the clinical course of chronic hepatitis B virus (HBV) infection is controversial. We followed a cohort of 64 homosexual men with persistent HBs antigenemia for a median of 24 months in the hepatitis clinic of a large urban public hospital. We divided the patients into three groups according to their immune status. Group 1 (n = 13) consisted of HIV-seropositive men with evidence of immunosuppression; group 2 (n = 17), HIV-positive patients without evidence of immunosuppression; and group 3 (n = 34), HIV-negative patients. We followed serum ALT and HBV DNA determinations. There was no difference in the demographic characteristics of the three groups. Group 1 had significantly lower levels of circulating T4 lymphocytes. We found no differences in the number and severity of episodes of HBV reactivation, serum ALT levels, or HBV DNA scores among the three groups. In each group, the percentage of patients with circulating HBV DNA was the same. We conclude that HIV infection apparently does not influence the markers of liver inflammation or HBV replication in homosexual men.


Interaction of spatial perception, vestibular function, and exercise in young school age boys with learning disabilities.
Form rotation, figure directionality, and figure-ground discrimination were evaluated before and after 10 days of vestibular or aerobic exercises for 30 boys (7 to 12 yr.) who showed problems in learning, reading, and inattention. Eight subjects had normal vestibulo-ocular reflex (VOR) responses as determined by caloric and rotational testing. They were assigned to a vestibular program (Control Group I). The 22 subjects with abnormal VOR test responses were randomly assigned to either aerobic exercises (Experimental Group II) or a vestibular program (Experimental Group III). Spatial perceptual test scores varied widely, with the majority performing below age-expected norms but no significant differences on vestibular status appeared. Postexercise, only subjects completing the vestibular program made significant gains: Experimental Group III (abnormal VOR) made significant gains in accuracy and normal test responses compared to the other groups, and Control Group I made significantly greater gains in speed of spatial perceptual processing. For boys with problems in learning, reading, inattention, and vestibular function, a vestibular exercise program complementing a traditional or special educational program may enhance the spatial perceptual skills needed for reading.


Escape of U251 glioma cells from temozolomide-induced senescence was modulated by CDK1/survivin signaling.
Temozolomide (TMZ) has been widely used in conjunction with radiotherapy for treating various types of cancers. However, tumor cells arrested in senescence due to TMZ administration can sometimes escape and become drug resistant. In the current study, the possible role of survivin in the senescence escape of TMZ-treated glioma cells was comprehensively studied. The levels of survivin and CDK1 expression in a human glioma cell line (U251) were monitored, and cell apoptosis, cell cycle distribution, anchorage-independent growth, and senescence were studied in U251 cells in different degrees of senescence. To further investigate how survivin affects the TMZ-resistance of gliomas, we modulated the levels of survivin and CKD1 expression in TMZ-treated cells and then examined how the treated cells responded. The results showed that knockdown of the survivin gene increased the sensitivity of glioma cells to TMZ treatment by inducing senescent cells to become apoptotic. Moreover, after senescence was induced, expression of the survivin gene became suppressed, but survivin levels returned to normal after the cells had escaped from senescence. While down-regulation of the survivin gene in senescent and senescence-escaping U251 cells had no effect on cell apoptosis, cell cycle distribution, or senescence status, it dramatically reduced the anchorage-independent growth ability of the cells. Additionally, CDK1 was able to not only enhance the anchorage-independent growth ability of the cells, but also contribute to their further senescence escape by modulating the survivin and other pathways. In conclusion, the survivin gene was necessary for glioma cells to escape from and enter into senescence during treatment with TMZ.


Carbonic anhydrase inhibitors: an editorial.
This issue of Expert Opinion on Therapeutic Patents is dedicated to carbonic anhydrase (CA, EC 18.104.22.168) inhibitors (CAIs), a highly dynamic research topic in the last years. Several review articles and patent analyses on diuretics and antiglaucoma, antiepileptic, anti-obesity and anticancer agents belonging to the pharmacological class of the CAIs are presented, together with a review on bacterial, fungal and protozoan CAs and their inhibition as a novel means of designing anti-infectives.


Therapeutic efficacy of a new anhydrous theophylline dosage form.
A clinical study was performed on 41 asthmatic patients. After complete physical and spirometric examinations, they received capsules containing 200 mg anhydrous theophylline per capsule t.i.d. for three weeks. All other antiasthmatic medications were omitted during this study. The results showed that these capsules (Elixophyllin Capsules) produced statistically significant improvement in wheezing, dyspnea, global clinical assessment, vital capacity, and forced expiratory volume at 1 second. Side effects, which were generally mild and transient, were those usually reported for theophylline and were observed in 11 of the 41 patients. One patient dropped out of the study because of extreme nausea. It was concluded that theophylline as a single entity can provide significant improvement in asthmatic patients at a total daily dose of 600 mg.


Neutral dynamics and cell renewal of colonic crypts in homeostatic regime.
The self renewal process in colonic crypts is the object of several studies. We present here a new compartment model with the following characteristics: (a) we distinguish different classes of cells: stem cells, six generations of transit amplifying cells and the differentiated cells; (b) in order to take into account the monoclonal character of crypts in homeostatic regimes we include symmetric divisions of the stem cells. We first consider the dynamic differential equations that describe the evolution of the mean values of the populations, but the small observed value of the total number of cells involved plus the huge dispersion of experimental data found in the literature leads us to study the stochastic discrete process. This analysis allows us to study fluctuations, the neutral drift that leads to monoclonality, and the effects of the fixation of mutant clones.


Effect of some polyvalent cations on plaque formation in vivo.
The purpose of the present study was to investigate the effect of polyvalent cations on plaque formation in a test panel of students. Heavy plaque formers were selected and plaque formation was enhanced by frequent sucrose rinses. Mouthrinses were performed twice daily with 20 mmol/l SnF2, SnCl2, AlCl3, ZnCl2 and MgCl2, and 40 mmol/l NaF and NaCl. It was found that SnF2 AND SnCl2 exhibited a marked plaque-inhibiting capacity compared with NaF or NaCl. The aluminum, zinc and magnesium salts also reduced plaque formation, although not to the same degree. Polyvalent cations may prevent plque formattion by interaction with negatively charged plaque components essential in the adsorption mechanism, or by inhibiting some enzyme activity essential in plaque formation.


GSK-3 Inhibitors and Tooth Repair: An Ethical Analysis.
Tideglusib®, a GSK-3 inhibitor, was initially tested for the treatment of Alzheimer's disease. However, a recent report has suggested its potential off-label use for the treatment of dental cavities. Even if this effect is not yet confirmed, this off-label use can have significant public/dental health consequences, mainly because of the large number of patients with cavities. The purpose of this mini-review is to perform an ethical analysis of the use of Tideglusib in dentistry. The ethical analysis identified three main areas in which ethical breaches could be significant: 1) respect for the autonomy of the patient, 2) issues raised by horizontal shifts in the translational research process, and 3) the conflict between dental beneficence and general non-maleficence. In conclusion, the use of Tideglusib in dentistry should respect the same strict ethical and regulatory criteria from clinical medicine. A translation of the potential risks should be done only after large-scale, phase-III/IV clinical trials, explicitly designed to test the usefulness of this drug in dental medicine.


Identity of the tree-spider crab, Parasesarma leptosoma (Hilgendorf, 1869 (Decapoda: Brachyura: Sesarmidae), with descriptions of seven new species from the Western Pacific.
The identity of the tree-spider crab, Parasesarma leptosoma (Hilgendorf, 1869) (family Sesarmidae), which is believed to be widely distributed in the Indo-West Pacific, is reassessed and shown to be a species-complex with nine species, seven of which are here described as new. Parasesarma leptosoma sensu stricto is now restricted to South and East Africa; and P. limbense (Rathbun, 1914) from Sulawesi, which had been regarded as a junior synonym, is here recognized as a valid species. The following species are described as new: P. gecko n. sp. from Vanuatu, Fiji, Guam and Japan; P. macaco n. sp. from Taiwan and the Philippines; P. kui n. sp. from Taiwan; P. parvulum n. sp. from the Philippines; P. gracilipes n. sp. from Indonesian Papua; P. purpureum n. sp. from Malaysia; and P. tarantula n. sp. from Sulawesi, Indonesia. The nine species of the Parasesarma leptosoma species-complex can be separated by the different shapes of their carapaces, the form of the dactylar tubercles on the male chelipeds, proportions of their ambulatory legs and the structure of the male first gonopod.


Gonadotropin-releasing hormone (GnRH)-binding sites in human breast cancer cell lines and inhibitory effects of GnRH antagonists.
GnRH-binding sites have previously been described in human breast tumors, and a GnRH agonist has been shown to inhibit growth of the MCF-7 human breast cancer cell line. We have investigated the presence of GnRH-binding sites in ZR-75-1, MDA-MB-231, Sk Br 3, MDA-MB-157, and MCF-7 human breast cancer cell lines and the effect of GnRH analogs on the incorporation of [3H]thymidine and 14C-labeled amino acids into DNA and protein. Specific GnRH-binding sites were present in membrane preparations of all five human breast carcinoma cell lines. Studies in three cell lines indicated low affinity (Kd, 1.6-3.0 X 10(-6) M) GnRH binding similar to that reported in human placenta and corpus luteum. In contrast, human pituitary GnRH receptors were of high affinity (Kd, 4.8 X 10(-9) M). Breast carcinoma cell GnRH-binding sites also differed from the pituitary receptor in their inability to discriminate between GnRH and superactive analogs. Binding of a [125I]GnRH analog to ZR-75-1 breast cancer cells and pituitary membranes was affected similarly by various cations. GnRH antagonists rapidly inhibited [3H]thymidine incorporation into DNA (within 3 hr), and this effect was reversible. GnRH antagonists also inhibited cell growth, but only after 6 days. GnRH agonists did not alter either thymidine incorporation or growth. The present observations of low affinity GnRH-binding sites in breast cancer cell lines and inhibitory effects of GnRH antagonists point to the possibility of an autocrine regulatory role of GnRH-like peptides in mammary cells.


Angiotensin II interacts with prostaglandin F2alpha and endothelin-1 as a local luteolytic factor in the bovine corpus luteum in vitro.
Recent findings suggest that the ovarian renin-angiotensin system may regulate ovarian function through the paracrine/autocrine actions of angiotensin II (Ang II). In this study, we have examined and characterized the local effects of Ang II as a luteolytic factor and its interaction with prostaglandin F2alpha (PGF2alpha) and endothelin-1 (ET-1) in the bovine corpus luteum (CL) of the mid-luteal phase, by using an in vitro microdialysis system (MDS). Ang II was detected in the MDS perfusate (4 pg/ml), and infusion of PGF2alpha (10(-6) M) for 2 h increased the Ang II release by 50-100% during the following experimental period, in addition to its stimulation of ET-1 release. Two 2-h infusions of Ang II (10(-7)-10(-5) M) separated by a 2-h interval induced a dose- and time-dependent decrease of progesterone (P4) release by 41-66%. When the luteal explants were pre-perfused with PGF2alpha (10(-6) M) for 2 h, two consecutive perfusions of Ang II (10(-6) M) at a 2-h interval rapidly reduced the P4 release (by 50%). This reduction occurred 6 h earlier than those of infusions of PGF2alpha or Ang II alone. The simultaneous infusion of either 1) Ang II (10(-6) M) with PGF2alpha (10(-6) M), 2) ET-1 (10(-7) M) with PGF2alpha, or 3) Ang II + ET-1 with PGF2alpha (10(-6) M) for 2 h also induced a rapid and pronounced (60%) decrease in P4 release. Perfusion with the Ang II antagonist blocked the P4-suppressing activity of Ang II alone or PGF2alpha + Ang II infusion. Ang II stimulated the release of ET-1 and oxytocin during infusion but inhibited them after infusion. These results show that Ang II is released in the bovine midcycle CL in vitro, and this peptide, either alone or together with PGF2alpha, can suppress the release of P4. As PGF2alpha directly stimulated Ang II release, Ang II may influence the critical period for starting the cascade of functional luteolysis in vivo and might lead to structural luteolysis with ET-1 as a major vasoconstrictor. The overall results suggest that Ang II may have an important role at luteolysis in the bovine CL.


An expanded view of infertility: The challenge of the changing profiling of major birth defects in China.
Over the past two decades, China has experienced a significant decline in birth rates, accompanied by a decrease in fertility and changes in major congenital defects. The development of assisted reproductive technology (ART) has brought hope to individuals facing infertility. However, some issues related to reproductive health and congenital defects have arisen. The reasons for the changing profiling of birth defects and the relationship between the decline in fertility and ART need to be further investigated. Lifestyle factors such as nutritional supplementation need to be altered to protect reproductive capacity. Birth defects, such as congenital heart defects and hypospadias, may serve as a signal for understanding the decline in fertility. To improve fertility, the factors contributing to it need to be identified, vital genetic and medical technologies need to be introduced, and environmental interventions, such as nutritional changes, need to be implemented.


Uptake of COVID-19 vaccines and associated factors among adults in Uganda: a cross-sectional survey.
COVID-19 pandemic remains one of the most significant public health challenges ever faced globally. Vaccines are key to ending the pandemic as well as minimise its consequences. This study determined the uptake of COVID-19 vaccines and associated factors among adults in Uganda. We conducted a cross-sectional mobile phone survey among adults in Uganda. Participants reported their uptake of COVID-19 vaccines. Of the participants contacted, 94% (1173) completed the survey. Overall, 49.7% had received COVID-19 vaccines with 19.2% having obtained a full dose and 30.5% an incomplete dose. Among the unvaccinated, 91.0% indicated intention to vaccinate. Major reasons for vaccine uptake were protection of self from COVID-19 (86.8%) and a high perceived risk of getting the virus (19.6%). On the other hand, non-uptake was related to vaccine unavailability (42.4%), lack of time (24.1%) and perceived safety (12.5%) and effectiveness concerns (6.9%). The factors associated with receiving COVID-19 vaccines were older age (≥65 years) (Adjusted Prevalence Ratio (APR)=1.32 (95% CI: 1.08 to 1.61)), secondary (APR=1.36 (95% CI: 1.12 to 1.65)) or tertiary education (APR=1.62 (95% CI: 1.31 to 2.00)) and health workers as a source of information on COVID-19 (APR=1.26 (95% CI: 1.10 to 1.45)). Also, reporting a medium-income (APR=1.24 (95% CI: 1.02 to 1.52)) and residence in Northern (APR=1.55, 95% CI: 1.18 to 2.02) and Central regions (APR=1.48, 95% CI: 1.16 to 1.89) were associated with vaccine uptake. Uptake of COVID-19 vaccines was moderate in this sample and was associated with older age, secondary and tertiary education, medium-income, region of residence and health workers as a source of COVID-19 information. Efforts are needed to increase access to vaccines and should use health workers as champions to enhance uptake.


Influence of Physical Education Teachers on Motivation, Embarrassment and the Intention of Being Physically Active During Adolescence.
According to a WHO report (2018), more than 80% of adolescents do not do enough physical activity. Physical Education (PE) classes should be aimed at solving this problem. The present study aims to analyze the influence teachers have on motivation, embarrassment and intention to be physically active among their students. A total of 604 secondary school students participated in the study. Various statistical analyses were carried out to explain the causal relationships between the variables. The results revealed a positive relation between the autonomy support and the satisfaction of basic psychological needs (BPN), and a negative relation with the frustration of BPN. In contrast, perceived control revealed a positive relation with frustration of BPN, and a negative relation with the satisfaction of BPN. Satisfaction of BPN was negatively related to embarrassment and positively related to self-determined motivation. On the other hand, frustration of BPN was positively related to embarrassment and negatively with self-determined motivation. Embarrassment was negatively related to self-determined motivation, and the latter was positively related to intention to be physically active. Indeed, the study demonstrates the influence and the importance of PE teachers and of the motivational and emotional processes of adolescents during PE classes and the role they play in acquiring the habits of an active lifestyle.


Manned space flight--some scientific results.
The paper presents the data of medical monitoring and physiological research carried out during the flights of V.F. Bykovsky, V.V. Tereshkhova and partially of G. Cooper. The results of measurements of hygienic parameters and microclimate testify to good reliability of life-support systems employed aboard the spacecraft. The analysis of the information of medical monitoring and physiological investigations allows the conclusion to be made that 5-day manned space flight causes no pathological changes. No essential peculiarities related to tolerance of flight factors by woman as compared to man have been revealed either. In conclusion the authors formulate basic tasks confronting physicians in performing physiological and hygienic investigations to promote further development of manned space flight.


Sustained Postoperative Fever Without Evident Cause After Spine Instrumentation as an Indicator of Surgical Site Infection.
Surgical site infection after spinal instrumentation increases morbidity and mortality as well as medical costs and is a burden to both patients and surgeons. Late-onset or sustained fever increases the suspicion for comorbid conditions. This retrospective, exploratory cohort study was conducted to identify the rate of and risk factors for sustained or late-onset postoperative fever after spinal instrumentation operations and to determine its relationship with surgical site infection. Five hundred and ninety-eight patients who underwent lumbar or thoracic spinal instrumentation were retrospectively reviewed. The patients were divided according to (1) whether or not they had had a sustained fever (SF[+] or SF[-]) and (2) whether or not they had had a surgical site infection (SSI[+] or SSI[-]). Clinical characteristics, surgical factors, prophylactic antibiotic usage, fever pattern, and laboratory/imaging findings were recorded for all patients by electronic medical chart review. In total, 68 patients (11.4%) had a sustained fever. The rate of surgical site infection was significantly higher when the patient had sustained fever (13.2% [9 of 68] compared with 0.9% [5 of 530]; p < 0.001). Comparison of the patients who had a sustained fever but no surgical site infection (SF[+], SSI[-]) and those with both a sustained fever and surgical site infection (SF[+], SSI[+]) showed that continuous fever, an increasing or stationary pattern of inflammatory markers, and a C-reactive protein (CRP) level of >4 mg/dL on postoperative days 7 to 10 were diagnostic clues for surgical site infection. The sensitivity and specificity of postoperative magnetic resonance imaging (MRI) for the detection of surgical site infection were 40.0% and 90.9%, respectively, when MRI was performed within 1 month after surgery. Although most patients with sustained fever did not have surgical site infection, fever was significantly related to surgical site infection. Continuous fever, increasing patterns of inflammatory markers, and high CRP on postoperative days 7 to 10 were diagnostic clues for surgical site infection. This study demonstrated provisional results for factors that can discriminate febrile patients with surgical site infection from febrile patients without infection. Further investigation with a larger sample size is warranted for clarification. Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.


Confirmatory assay increases specificity of the chlamydiazyme test for Chlamydia trachomatis infection of the cervix.
Enzyme immunoassays for the detection of chlamydial antigens are commonly used to diagnose Chlamydia trachomatis infection. As is true for all nonculture methods, the specificities of these tests are a concern. A confirmatory blocking assay (Abbott Laboratories, North Chicago, Ill.) was evaluated at four sexually transmitted disease test sites. This assay is designed to confirm true-positive Chlamydiazyme (CZ) specimens and to identify false-positive CZ reactions caused by cross-reacting bacteria. Cervical specimens were collected from 2,891 women. Chlamydia prevalence by tissue culture (TC) was 9.2% (266 of 2,891 specimens). Compared with TC, the sensitivity and specificity of CZ were 78.9% (210 of 266 specimens) and 98.2% (2,577 of 2,625 specimens), respectively. There were 48 CZ false-positive reactions. The direct fluorescent-antibody test (DFA) was positive for 31 of 48 false-positive reactions, indicating culture misses. Thus, when the standard was both TC and DFA, CZ sensitivity was 81.1% and CZ specificity was 99.3%. Of the 17 CZ-positive patients who were negative by both TC and DFA, 3 were negative on repeat CZ and 11 of 14 were identified as false positive by the confirmatory assay. The confirmatory test was positive for CZ-positive women who were positive by TC or DFA. Use of the confirmatory test, which increased the specificity to 99.9%, would increase confidence in positive CZ results and make the test more useful for screening populations with a low prevalence of C. trachomatis infection.


Evaluation of Preference and Purpose of Utilisation of Cone Beam Computed Tomography (CBCT) Compared to Orthopantomogram (OPG) by Dental Practitioners - A Cross-Sectional Study.
Cone beam computed tomography (CBCT) has become a reliable adjunctive tool for both diagnosis and treatment planning in the field of dentistry. There are numerous advantages of CBCT over 2D imaging techniques (OPG). There is a need to evaluate the changing trend of preference and purpose of utilisation of these imaging modalities by dental practitioners. This study was carried out to evaluate and compare the purpose and preference of utilisation of CBCT and OPG by various dental practitioners in their clinical practice. A retrospective, cross-sectional study was carried out on CBCT and OPG data of 620 different cases treated by different dental practitioners from imaging centres in the twin cities of Telangana (Hyderabad & Secunderabad). For comparisons, we used the Mann-Whitney U test (Z test). The analysis of data showed that among the dental practitioners OPG was more commonly ordered by general dentists (31%) followed by prosthodontists (30%), whereas CBCT was more advocated by general dental practitioners (25%) followed by OMFS (23%). OPG preference was greater for fixed partial denture planning (FPD) 59%, whereas CBCT was highly preferred for implant planning 61%. The present study showed that general dentists preferred OPG and CBCT compared to other dental practitioners, and OPG was advocated for FPD planning, whereas CBCT was advocated for implant planning. Moreover, and it was found that there had been a drastic increase in the preference of CBCT over OPG in recent times.


[The role of pathomorphologic diagnosis in differentiating intestinal inflammatory diseases].
The principles of collaboration between a gastrologist and a pathomorphologist in diagnosis of the intestinal diseases were presented. The optimal criteria of drawing and fixing cytological and tissue samples were presented. The importance of extensive clinical information for pathomorphological diagnosis was proved. It was indicated that an early collaboration between a gastrologist and a pathomorphologist in the process of clinical diagnostic planning is necessary.


Inhibition of endoplasmic reticulum stress in high-fat-diet-induced obese C57BL/6 mice: Efficacy of a novel extract from mulberry (Morus alba) leaves fermented with Cordyceps militaris.
A few clues about correlation between endoplasmic reticulum (ER) stress and mulberry (Morus alba) leaves were investigated in only the experimental autoimmune myocarditis and streptozotocin-induced diabetes. To investigate whether a novel extract of mulberry leaves fermented with Cordyceps militaris (EMfC) could suppress ER in fatty liver, alterations in the key parameters for ER stress response were measured in high fat diet (HFD)-induced obese C57L/6 mice treated with EMfC for 12 weeks. The area of adipocytes in the liver section were significantly decreased in the HFD+EMfC treated group as compared to the HFD+Vehicle treated group, while their level was higher in HFD+Vehicle treated group than No treated group. The level of the eukaryotic initiation factor 2 alpha (eIF2α) and inositol-requiring enzyme 1 beta (IRE1α) phosphorylation and CCAAT-enhancer-binding protein homologous protein (CHOP) expression were remarkably enhanced in the HFD+Vehicle treated group. However, their levels were restored in the HFD+EMfC treated group, although some differences were detected in the decrease rate. Similar recovery was observed on the ER stress-induced apoptosis. The level of Caspase-3, Bcl-2 and Bax were decreased in the HFD+EMfC and HFD+orlistat (OT) treated group compared to the HFD+Vehicle treated group. The results of the present study therefore provide first evidence that EMfC with the anti-obesity effects can be suppressed ER stress and ER stress-induced apoptosis in the hepatic steatosis of HFD-induced obesity model.


Causes of hyperhomocysteinemia and its pathological significance.
In the last 10 years, homocysteine has been regarded as a marker of cardiovascular disease and a definite risk factor for many other diseases. Homocysteine is biosynthesized from methionine through multiple steps and then goes through one of two major metabolic pathways: remethylation and transsulfuration. Hyperhomocysteinemia is a state in which too much homocysteine is present in the body. The main cause of hyperhomocysteinemia is a dysfunction of enzymes and cofactors associated with the process of homocysteine biosynthesis. Other causes include excessive methionine intake, certain diseases and side effects of some drugs. Hyperhomocysteinemia is a trigger for many diseases, such as atherosclerosis, congestive heart failure, age-related macular degeneration, Alzheimer's disease and hearing loss. There are many studies showing a positive relationship between homocysteine level and various symptoms. We speculate that a high level of homocysteine can be the sole reason or an aggravating factor in numerous diseases for which causal links are not fully understood.


Numbers and heterogeneity of mast cells in the male genital tract of the rat.
Normal adult rats were used to quantitate and characterize mast cells in the male genital tract. The tissues were either fixed in a fixative containing formalin (Schaffer solution) or with basic lead acetate (BLA) to identify 'connective-tissue mast cells' and 'mucosal mast cells', respectively. In the epididymis and seminal vesicle small numbers of mast cells were identified without any obvious heterogeneity. In the prostate, however, a mean of 45.1 +/- 9.3 and 23.0 +/- 4.0 mast cells/mm2 was found after BLA and Schaffer fixation, respectively. This difference might be of functional and clinical significance.


Quality improvement in public health emergency preparedness.
Quality improvement (QI) methods have been used in many industries to improve performance and outcomes. This chapter reviews key QI concepts and their application to public health emergency preparedness (PHEP). We conclude that for QI to flourish and become standard practice, changes to the status quo are necessary. In particular, public health should build its capabilities in QI, enhance implementation, and align incentives to facilitate use of QI.


Sectioning and imaging hard mineral fibres in biological tissues.
A technique is described which overcomes the problems associated with sectioning biological tissue containing hard mineral fibres. 0.2--0.5 micrometer thick sections were cut with a diamond knife, placed in a folding grid, conventionally stained with uranyl acetate and lead citrate and viewed at an accelerating voltage of 200 kV in the scanning transmission mode.


Complex structure of human bronchial mucus glycoprotein.
Human bronchial mucus glycoproteins or mucins were isolated from the sputum of two patients by a method avoiding reducing agents and involving water extraction and gel filtration on Sepharose CL-2B in 6 M guanidinium chloride. The chemical analysis indicated approximately 25-40% lipid. The amino acid and carbohydrate analysis differ quantitatively from that of mucins purified after prior reduction of mucus. These fractions also have a higher proportion of aspartic and glutamic acids than that of the mucins from reduced sputum. These mucins are still contaminated by small amounts of peptides but do not seem to contain disulfide-attached cross-linking protein. Human bronchial mucins have a strong tendency to form aggregates except in 6 M guanidinium chloride. Electron microscopy performed with various procedures indicates the presence of both micelles and flexible threads measuring 200-1000 nm. Delipidation removes most of the micellar forms. Thereafter mucins appear mainly as polydisperse flexible extended threads and also as aggregates. These features of bronchial mucins do not fit with the generally accepted idea of mucin subunits linked by disulfide bridges (unless they are linked end to end) and alternatively favour a model where mucin molecules behave like filaments that could easily aggregate according to the solvent system (mucin concentration, absence of dissociating conditions).