Magnesium production by molten salt electrolysis with liquid tin cathode and multiple effect distillation.
Low-cost clean primary production of magnesium metal is important for its use in many applications, from light-weight structural components to energy technologies. This work describes new experiments and cost and emissions analysis for a magnesium metal production process. The process combines molten salt electrolysis of MgO using MgF₂-CaF₂ electrolyte and a reactive liquid tin cathode, with gravity-driven multiple effect thermal system (G-METS) distillation to separate out the magnesium product, and re-use of the tin. Electrolysis experiments with carbon anodes showed current yield above 90%, while a yttria-stabilized zirconia solid oxide membrane (SOM) anode experiment showed 84% current yield. G-METS distillation is an important component of the envisioned process. It can potentially lower costs and energy use considerably compared with conventional magnesium distillation. Techno-economic analysis including detailed mass and energy balances shows that this electrolyte composition could lower costs by utilizing CaO, which is the primary impurity in MgO, as the Hall-Héroult process uses the sodium impurity in alumina. Analysis options include: raw material types (magnesite rock vs. brine or seawater), drying and calcining using electricity vs. natural gas, and carbon vs. SOM anode type. Using SOM inert anodes results in a cost premium around 10%-15%, mostly due to higher electrical energy usage resulting from membrane resistance, and reduces GHG emissions by approximately 1 kg CO₂/kg Mg product. Capital and operating cost estimates, and cradle to gate greenhouse gas (GHG) emissions analysis under several raw material and process technology scenarios, show comparable costs and emissions to those of aluminum production.


Nucleotide excision repair disorders and the balance between cancer and aging.
Cancer incidence increases with age and is driven by accumulation of mutations in the DNA. In many so-called premature aging disorders, cancer appears earlier and at elevated rates. These diseases are predominantly caused by genome instability and present with symptoms, including cancer, resembling "segments" of aging and are thus often referred to as "segmental progerias". Two related segmental progerias, Cockayne syndrome (CS) and trichothiodystrophy (TTD), don't fit this pattern. Although caused by defects in genome maintenance via the nucleotide excision DNA repair (NER) pathway and displaying severe progeroid symptoms, CS and TTD patients appear to lack any cancer predisposition. More strikingly, genetic defects in the same NER pathway, and in some cases even within the same gene, XPD, can also give rise to disorders with greatly elevated cancer rates but without progeria (xeroderma pigmentosum). In this review, we will discuss the connection between genome maintenance, aging and cancer in light of a new mouse model of XPD disease.


Malignant transformation of rat liver cells by N-benzoyloxy-3'-methyl-4-methylaminoazobenzene and its related compound.
N-Benzoyloxy-3'-methyl-4-methylaminoazobenzene-(N-benzoyloxy-3'-Me-MAB) was highly toxic to rat liver epithelial cells (Ac2F) and induced many more chromosome aberrations and unscheduled DNA synthesis than did 3'-methyl-4-dimethylaminoazobenzene (3'-Me-DAB). N-Benzoyloxy-3'-Me-MAB and its related compound, N-acetoxy-4-methylaminoazobenzene, efficiently induced malignant transformation of the cells, but 3'-Me-DAB was not so effective. The cells transformed by N-acyloxy-4-methylaminoazobenzene (N-acyloxy-MAB) derivatives showed significant increases in plating efficiency in liquid medium and in the size of aggregates in rotation culture. Such increases were not seen in the 3'-Me-DAB-transformed cells. The results indicate that the N-acyloxy form of the 4-dimethylaminobenzene derivatives seems very likely to be the ultimate metabolite.


The antibody spectrum in individuals with defect expression of HLA class II and the LFA-1 glycoprotein family genes.
HLA class II antigens and the LFA-1 (lymphocyte function-associated type 1) glycoprotein family are cell surface structures of central importance in many lymphocyte reactions. Specific antibodies are normally restricted to particular IgG subclasses. In order to study the mechanism of isotype restriction we have analysed specific IgG1, IgG2, IgG3 and IgG4 antibodies directed against a number of different protein and polysaccharide antigens in individuals with HLA class II or LFA-1 deficiency. HLA class II deficiency resulted in decreased total IgG2, IgG4 and IgA in 4/4 patients, whereas total IgM and IgG were low in 2/4. In HLA class II deficiency the levels of specific antibodies directed against protein as well as polysaccharide antigens were frequently low. Virtually normal total as well as specific antibody levels were found in individuals with both severe and moderate forms of LFA-1 deficiency. There was no clear evidence for an abnormal subclass pattern of specific antibodies with a shift from one subclass to an isotype which is normally not used, in any of the patient groups investigated.


Primary CNS lymphoma: managing patients with spontaneous and AIDS-related disease.
Primary central nervous system lymphoma, especially that associated with AIDS, is increasing in frequency. CT scan is virtually diagnostic when it shows multiple, hyperdense, diffusely enhancing periventricular lesions. Treatment often results in a complete remission, but the overall prognosis is poor. Surgery is important diagnostically, but resection is not helpful. Corticosteroids can produce significant shrinkage, and even disappearance, of PCNSL, but cranial radiation is still the cornerstone of therapy. The addition of chemotherapy to RT is promising in non-AIDS patients but still investigational.


Toward Public Bioethics?
This issue of the Hastings Center Report (May-June 2017) features a couple of interesting takes on the governance challenges of emerging technologies. In an essay on the National Academies of Science, Engineering, and Medicine report published this February on human germ-line gene editing, Eric Juengst, a philosopher at the University of North Carolina, argues that the NASEM committee did not manage to rethink the rules. Juengst reaches what he calls an "eccentric conclusion": "The committee's 2017 consensus report has been widely interpreted as 'opening the door' to inheritable human genetic modification and holding a line against enhancement interventions. But on a close reading it does neither." In the column Policy and Politics, Sarah Chan, a chancellor's fellow at the University of Edinburgh, discusses the emerging science of "organoids," "embryoids," and "synthetic human entities with embryo-like features" and calls for a sustained effort to rethink the rules for embryo research.


Pattern of gynaecological malignancies at the University of Ilorin Teaching Hospital, Ilorin, Nigeria.
Gynaecological malignancies contribute to the global burden of diseases and are of public health interest. The objective of this study was to determine the pattern of distribution of gynaecological malignancies seen between 1 January 2002 and 31 December 2006, at the University of Ilorin Teaching Hospital, Ilorin, Nigeria. It was a retrospective descriptive study. A total of 166 cases of gynaecological malignancies were encountered, cervical cancer was the most common (59.6%). This was followed by ovarian cancer (21.1%), trophoblastic tumour (7.8%) and corpus uteri cancer (6.0%). Others included cancer of the vulva (3.6%) and cancer of the vagina (1.8%). Squamous cell carcinoma accounted for 96.0% of cervical cancers. Epithelial tumours represented 60.0% of ovarian cancers, and serous cyst adenocarcinoma was the most common histological variety. All the vulval and vaginal cancers were of squamous cell type. In conclusion, genital malignancies are common and cervical cancer remains the leading gynaecological malignancy in this centre.


Declining Acidic Deposition Begins Reversal of Forest-Soil Acidification in the Northeastern U.S. and Eastern Canada.
Decreasing trends in acidic deposition levels over the past several decades have led to partial chemical recovery of surface waters. However, depletion of soil Ca from acidic deposition has slowed surface water recovery and led to the impairment of both aquatic and terrestrial ecosystems. Nevertheless, documentation of acidic deposition effects on soils has been limited, and little is known regarding soil responses to ongoing acidic deposition decreases. In this study, resampling of soils in eastern Canada and the northeastern U.S. was done at 27 sites exposed to reductions in wet SO4(2-) deposition of 5.7-76%, over intervals of 8-24 y. Decreases of exchangeable Al in the O horizon and increases in pH in the O and B horizons were seen at most sites. Among all sites, reductions in SO4(2-) deposition were positively correlated with ratios (final sampling/initial sampling) of base saturation (P < 0.01) and negatively correlated with exchangeable Al ratios (P < 0.05) in the O horizon. However, base saturation in the B horizon decreased at one-third of the sites, with no increases. These results are unique in showing that the effects of acidic deposition on North American soils have begun to reverse.


Use of thymidine kinase gene-modified endothelial progenitor cells as a vector targeting angiogenesis in glioma gene therapy.
The poor prognosis of patients with glioma is due to infiltrative growth of glioma cells, which correlates with their ability to induce angiogenesis. Tumor angiogenesis is supported by the mobilization and functional incorporation of endothelial progenitor cells (EPCs). The aim of this study was to propose the use of gene-modified EPCs as a vector system that allowed systemic gene delivery into multiple areas of tumor angiogenesis for glioma therapy. Thymidine kinase (TK) gene-modified EPCs were mixed with glioma cells or human umbilical vein endothelial cells (HUVECs) at varying ratios for ganciclovir in vitro. Cell proliferation was evaluated by MTT assay, and apoptosis was examined by annexin-V and phosphatidylserine (propidium iodide) staining. EPCs were injected via tail vein into nude mice bearing glioma, and EPC incorporation into the tumor was determined immunohistochemically. The antitumor effects of TK gene-modified EPCs in vivo were evaluated by apoptosis assay and microvessel density analysis. TK gene-modified EPCs exerted a potent bystander effect on glioma cells and HUVECs by induction of apoptosis via caspase activation in vitro. EPCs incorporated preferentially into glioma vasculatures. Furthermore, TK gene-modified EPCs clearly augmented the antitumor effect by inhibition of angiogenesis following repeated intravenous injection in vivo. The results indicate the feasibility of EPC-based gene delivery into disseminated areas of tumor angiogenesis as a rational strategy for glioma gene therapy.


Sociocultural determinants of anticipated vaccine acceptance for acute watery diarrhea in early childhood in Katanga Province, Democratic Republic of Congo.
Rotavirus and oral cholera vaccines have the potential to reduce diarrhea-related child mortality in low-income settings and are recommended by the World Health Organization. Uptake of vaccination depends on community support, and is based on local priorities. This study investigates local perceptions of acute watery diarrhea in childhood and anticipated vaccine acceptance in two sites in the Democratic Republic of Congo. In 2010, 360 randomly selected non-affected adults were interviewed by using a semi-structured questionnaire. Witchcraft and breastfeeding were perceived as potential cause of acute watery diarrhea by 51% and 48% of respondents. Despite misperceptions, anticipated vaccine acceptance at no cost was 99%. The strongest predictor of anticipated vaccine acceptance if costs were assumed was the educational level of the respondents. Results suggest that the introduction of vaccines is a local priority and local (mis)perceptions of illness do not compromise vaccine acceptability if the vaccine is affordable.


Is intact PTH a sensitive biochemical indicator of deranged calcium homeostasis in vitamin D deficiency?
Intact PTH was elevated in 38/40 Asians with reduced serum 25 hydroxyvitamin D [25(OH)D] including seven patients with normal serum calcium, phosphate and alkaline phosphatase. Changes in intact PTH were disproportionately greater than for other biochemical parameters, making it the most sensitive early indicator of deranged calcium homeostasis in vitamin D deficiency.


Assessing associations between socio-economic environment and self-reported health in Amsterdam using bespoke environments.
The study of the relationship between residential environment and health at micro area level has a long time been hampered by a lack of micro-scale data. Nowadays data is registered at a much more detailed scale. In combination with Geographic Information System (GIS)-techniques this creates opportunities to look at the relationship at different scales, including very local ones. The study illustrates the use of a 'bespoke environment' approach to assess the relationship between health and socio-economic environment. We created these environments by buffer-operations and used micro-scale data on 6-digit postcode level to describe these individually tailored areas around survey respondents in an accurate way. To capture the full extent of area effects we maximized variation in socio-economic characteristics between areas. The area effect was assessed using logistic regression analysis. Although the contribution of the socio-economic environment in the explanation of health was not strong it tended to be stronger at a very local level. A positive association was observed only when these factors were measured in buffers smaller than 200 meters. Stronger associations were observed when restricting the analysis to socioeconomically homogeneous buffers. Scale effects proved to be highly important but potential boundary effects seemed not to play an important role. Administrative areas and buffers of comparable sizes came up with comparable area effects. This study shows that socio-economic area effects reveal only on a very micro-scale. It underlines the importance of the availability of micro-scale data. Through scaling, bespoke environments add a new dimension to study environment and health.


An integrated segmentation and analysis approach for QCT of the knee to determine subchondral bone mineral density and texture.
We have developed a new integrated approach for quantitative computed tomography of the knee in order to quantify bone mineral density (BMD) and subchondral bone structure. The present framework consists of image acquisition and reconstruction, 3-D segmentation, determination of anatomic coordinate systems, and reproducible positioning of analysis volumes of interest (VOI). Novel segmentation algorithms were developed to identify growth plates of the tibia and femur and the joint space with high reproducibility. Five different VOIs with varying distance to the articular surface are defined in the epiphysis. Each VOI is further subdivided into a medial and a lateral part. In each VOI, BMD is determined. In addition, a texture analysis is performed on a high-resolution computed tomography (CT) reconstruction of the same CT scan in order to quantify subchondral bone structure. Local and global homogeneity, as well as local and global anisotropy were measured in all VOIs. Overall short-term precision of the technique was evaluated using double measurements of 20 osteoarthritic cadaveric human knees. Precision errors for volume were about 2-3% in the femur and 3-5% in the tibia. Precision errors for BMD were about 1-2% lower. Homogeneity parameters showed precision errors up to about 2% and anisotropy parameters up to about 4%.


Clinical supervision: beginning the supervisory relationship.
While much has been written on clinical supervision (CS) in the nursing literature, there appears to be minimal attention afforded to the supervisory relationship and in particular the early phases of this relationship. It is understood that the quality of the supervisory relationship has a significant contribution towards the efficacy of CS. In acknowledging the struggles in demonstrating the effectiveness of supervision it seems reasonable to turn attention towards the relationship between supervisor and supervisee. This article begins by providing an overview of the supervision literature concerned with the supervisory relationship. Following this, attention is focused on the commencement of this alliance by describing the processes and attributes needed to commence a supervisory relationship.A comprehensive template for establishing a supervision agreement is presented. However, it is suggested that this template does not have to be confined for use in this particular clinical context but may be applicable to a variety of nursing environments. It is proposed that such an agreement/contract facilitates healthy beginnings for the supervisory relationship and goes some way towards enhancing the trajectory of this alliance.


Bilateral cholesterol granuloma of the skull base: case report and review of the literature.
A unique case of bilateral cholesterol granuloma of the skull base and its treatment is presented. Cholesteatoma, a pathological entity often confused with cholesterol granuloma, is differentiated from cholesterol granuloma. Cholesterol granuloma is not rare. This tumor seems to derive from an inflammatory process at the skull base that results in bony erosion surrounding a cyst wall of inflammatory tissue. Neurological abnormalities reflect the location of the tumor in relation to the brain stem. Radiographically, the cyst wall enhances with the administration of i.v. contrast agent, and the center of the lesion is isodense with brain on computed tomography, unlike cholesteatoma. Magnetic resonance imaging characteristics are currently being defined. At operation, cholesterol granuloma consists primarily of a viscous fluid within a capsule of inflammatory tissue. Treatment requires establishing a pathway for drainage of the granuloma. The advantages of transsphenoidal, transclival drainage of such lesions are outlined.


In situ thiolated alginate hydrogel: Instant formation and its application in hemostasis.
An in situ formed hydrogel was synthesized by sodium alginate and cysteine methyl ester, which turned the sodium alginate into thiolated alginate (SA-SH). SA-SH can in situ formed into hydrogel (SA-SS-SA) with a large amount of water through covalent bond in less than 20 s. The structure characterization showed that the mechanism of SA-SH gelation was thiol-disulfide transformation. The rheology and cytotoxicity experiments of SA-SS-SA hydrogel were also investigated, which indicated that SA-SS-SA hydrogel had an appropriate mechanical strength as well as an excellent biocompatibility. The SA-SS-SA hydrogel would degrade under certain conditions after a few days and its mechanism was disulfide alkaline reduction. Finally, the hemostatic property of SA-SH was tested by rat tail amputation experiment. The time to hemostasis of rat reduced from 8.26 min to 3.24 min, which proved that SA-SH had an excellent hemostatic property.


Neoplastic angioendotheliomatosis with multifocal hemorrhagic necrosis of the liver.
We describe an autopsy case of neoplastic angioendotheliomatosis with an emphasis on hepatic pathology. The neoplastic cells were found mainly in small vessels and capillaries throughout the body, especially in the lung, liver, and spleen. These cells showed immunophenotypes of B-cells indicating differentiation toward B-cells. The liver (1350 g) showed multiple hemorrhagic areas, especially in the subcapsular region. Microscopically, neoplastic cells were found in the dilated sinusoids, portal vein branches, and central and sublobular hepatic veins, and there was hemorrhage with hepatocytic necrosis and dropout, especially in centrilobular areas. Thromboemboli admixed with neoplastic cells were often found in portal veins and sublobular hepatic veins, which might have resulted in the multifocal hemorrhagic necrosis.


An investigation of a fertilizer-tap water medium for mass algal production in outdoor plastic-enclosed systems.
The feasibility of using two fertilizers (urea plus superphosphate) in tap water as a medium for the mass culture of green algae (Scenedesmus and Ankistrodesmus) in outdoor plastic-enclosed minipond systems was investigated. Experiments in which the basic fertilizer-tap water medium was enriched with micro- and/or macronutrients revealed no nutrient deficiency symptoms in the algal biomass produced. Biomass production was found to be quantitatively related to the concentration of fertilizer added and maximal production (> 15 g/m(2) day) was achieved following the addition of 30 mg N/L (1.89 g N/m(2) day) and 4.5 mg P/L (0.28 g P/m(2)/day).


Novel Bipolar Indole-Based Solution-Processed Host Material for Efficient Green and Red Phosphorescent OLEDs.
A new bipolar host material 2-(2'-(5-(dibenzo[b,d]furan-4-yl)-1H-indol-1-yl)-1,1'-biphenyl]-4-yl)-1-phenyl-1H-benzo[d]imidazole (INDY) has been designed and synthesized for solution-processed PHOLEDs. A hole-transporting indole conjugated dibenzofuran scaffold and an electron-transporting benzimidazole unit were orthogonally connected with incorporation of a 2,4'-biphenyl bridge, which endows a balanced bipolar charge transfer distribution and appropriate triplet energy level (>2.6 eV). The twisted conformation of INDY also ensures good thermal/morphological stability with high Tg (148 °C). The solution-processed green PHOLEDs achieved great device efficiencies with 27.33 cd/A and 12.26 lm/W at 7 V. Meanwhile, the red solution-processed PHOLEDs gained excellent performance with the maximum efficiencies of 17.20 cd/A, 9.82 lm/W, and 12.61%. In addition, all of the red devices presented excellent color stability with the same CIE coordinate as (0.65, 0.35) under varying dopant contents and operating voltages.


Renal transplantation and cancer. The Scandia transplant material.
Between 1965 and 1973, 30 malignant tumours were found in patients transplanted in Scandinavia. Of these tumours, 24 were found in the 1,254 patients transplanted in Scandinavia as part of the Scandia Tranplant Programme between 1969 and 1972. Using the information recorded in the programme, 418 Danish patients who received their first and only transplant between 1969 and 1972 were selected and followed until 31/12 1973. Twelve tumours occurred in these patients. A comparison with the expected age, sex and time-specific incidence rates from the Danish Cancer Register was made and the observed tumour incidence was found to be significantly (P less than 0.001) greater than expected. Tumour incidence was found to be associated with incompatibility in the FOUR series, but was unrelated to number of rejections, the presence of HL-A antibodies and sex difference between donor and recipient. Apart from certain special forms of immunosuppression which could be oncogenic, the cause of tumour development appears to be multifactorial, both the allograft itself and immunosuppressive treatment playing a role.


Follow-up of retinoblastoma using RetCam fluorescein angiography and correlation with clinical findings.
To report RetCam fluorescein angiographic (FA) changes and correlation with clinical findings in the follow-up of retinoblastoma (RB) after frontline intravenous chemotherapy and other treatments. Patients having RB who underwent post-treatment RetCam fundus photography and FA under general anesthesia between February 2020 and February 2022 were retrospectively analyzed. 78 eyes of 70 patients with RB were included. In 55 (70.5%) eyes with type 1, 2 or 3 regression patterns, the main tumor started to show hyperfluorescence in arterial phase in 24 eyes (43.6%), in early venous phase in 24 (43.6%) eyes, and in late venous phase in 7 (12.7%) eyes. Of thirty-six (46.2%) eyes with chorioretinal scars developing after focal treatments (cryotherapy and transpupillary thermotherapy), window defects and visible choroidal vessels were found in all eyes, scleral staining in 10 (27.8%), and gliosis on scar tissue in 8 (22.2%). Vitreous seeds showed hyperfluorescence if they were calcified (6 eyes, 7.7%) and hypofluorescence if non-calcified (11 eyes, 14.1%). Retrohyaloid seeds (11 eyes, 14.1%) were hypo/isofluorescent while subretinal seeds (6 eyes, 7.7%) were hyperfluorescent. Leakage from peripheral retinal vessels was detected in 14 (17.9%) eyes and non-perfusion in 6 (7.7%) eyes. RetCam wide-angle FA is useful to evaluate the tumor and associated vascular and retinal changes after treatment in RB. Regressed tumors demonstrate later fluorescein uptake in venous phases. Fluorescein angiographic changes in chorioretinal scars include window defects, visibility of choroidal vessels, scleral staining, and leakage from vessels. Retinal vascular leakage and peripheral non-perfusion can be seen in eyes with regressed stable tumors.


Control of differentiation of a mammary cell line by lipids.
A rat mammary cell line (LA7) undergoes spontaneous differentiation into domes due to production of specific inducers by the cells. Some of these inducers may be lipids, and we show that lipids regulate this differentiation as both inducers and inhibitors. One inhibitor is the tumor promoter tetradecanoyl-13 phorbol 12-acetate. The inducers are saturated fatty acids of two groups: butyric acid and acids with chain lengths from C13 to C16, especially myristic acid (C14). Other inducers are myristoyl and palmitoyl lysolecithins, myristic acid methyl ester, and two cationic detergents with a tetradecenyl chain. We propose that the lipids with a C14-C16 alkyl chain affect differentiation by recognition specific receptors through their alkyl chains and that the effects obtained depend on the head groups. These lipids may be physiological regulators in the mammary gland.


[Outbreak of food poisoning caused by Salmonella typhimurium].
In this paper, a food poisoning outbreak of 42 people who ate the sucuk (Turkish sausage flavored with garlic) which was made of the same meat has been described. Salmonella typhimurium was isolated from the stool of 20 patients and from the sucuk. Efficacy rate of Ofloxacin was 75 percent in these 20 patients treated Ofloxacin.


POU5F1 enhances the invasiveness of cancer stem-like cells in lung adenocarcinoma by upregulation of MMP-2 expression.
Lung cancer is the leading cause of cancer-related human deaths. Exploration of the mechanisms underlying the metastasis of cancer stem-like cells (CSLCs) will open new avenues in lung cancer diagnosis and therapy. Here, we demonstrated that CSLCs-derived from lung adenocarcinoma (LAC) cells displayed highly invasive and migratory capabilities via expressing high levels of POU5F1 and MMP-2. We found that POU5F1 directly regulated MMP-2 transcription via interaction with the promoter of MMP-2. POU5F1 knockdown in LACSLCs reduced MMP-2 protein abundance, leading to inhibition of the cell invasion, migration and tumorigenesis potentials of LAC cells. Clinically, aberrantly high expressions of POU5F1 and MMP-2 were inversely correlated with the survival of LAC patients, and the double-positive POU5F1 and MMP-2 showed the worst prediction for the patient's poor survival. These results indicate that POU5F1 can bind to the MMP-2 promoter for the degradation of surrounding extracellular matrix, and therefore promote invasive and migratory capabilities of LACSLCs. Moreover, our data implicate that the pathological detection of the double-positive expressions for POU5F1 and MMP-2 will be useful as diagnostic and prognostic biomarkers in LAC to advance anti-metastasis therapy.


Electronic cigarette solutions and resultant aerosol profiles.
Electronic cigarettes (e-cigarettes) are growing in popularity exponentially. Despite their ever-growing acceptance, their aerosol has not been fully characterized. The current study focused on evaluating e-cigarette solutions and their resultant aerosol for potential differences. A simple sampling device was developed to draw e-cigarette aerosol into a multi-sorbent thermal desorption (TD) tube, which was then thermally extracted and analyzed via a gas chromatography (GC) mass spectrometry (GC-MS) method. This novel application provided detectable levels of over one hundred fifteen volatile organic compounds (VOCs) and semivolatile organic compounds (SVOCs) from a single 40mL puff. The aerosol profiles from four commercially available e-cigarettes were compared to their respective solution profiles with the same GC-MS method. Solution profiles produced upwards of sixty four unidentified and identified (some only tentatively) constituents and aerosol profiles produced upwards of eighty two compounds. Results demonstrated distinct analyte profiles between liquid and aerosol samples. Most notably, formaldehyde, acetaldehyde, acrolein, and siloxanes were found in the aerosol profiles; however, these compounds were never present in the solutions. These results implicate the aerosolization process in the formation of compounds not found in solutions; have potential implications for human health; and stress the need for an emphasis on electronic cigarette aerosol testing.


Associations of Adenovirus Genotypes in Korean Acute Gastroenteritis Patients with Respiratory Symptoms and Intussusception.
Human adenoviruses (HAdVs) cause a wide range of diseases, including respiratory infections and gastroenteritis, and have more than 65 genotypes. To investigate the current genotypes of circulating HAdV strains, we performed molecular genotyping of HAdVs in the stool from patients with acute gastroenteritis and tried to determine their associations with clinical symptoms. From June 2014 to May 2016, 3,901 fecal samples were tested for an AdV antigen, and 254 samples (6.5%) yielded positive results. Genotyping using PCR and sequencing of the capsid hexon gene was performed for 236 AdV antigen-positive fecal specimens. HAdV-41, of species F, was the most prevalent genotype (60.6%), followed by HAdV-2 of species C (13.8%). Other genotypes, including HAdV-3, HAdV-1, HAdV-5, HAdV-6, HAdV-31, HAdV-40, HAdV-12, and HAdV-55, were also detected. Overall, 119 patients (50.4%) showed concomitant respiratory symptoms, and 32 patients (13.6%) were diagnosed with intussusception. HAdV-1 and HAdV-31 were significantly associated with intussusception (P < 0.05). Our results demonstrate the recent changes in trends of circulating AdV genotypes associated with gastroenteritis in Korea, which should be of value for improving the diagnosis and developing new detection, treatment, and prevention strategies for broad application in clinical laboratories.


An initiative to increase opioid overdose education and naloxone distribution for homeless veterans residing in contracted housing facilities.
Up to 35% of veterans with opioid use disorder (OUD) are homeless, and veterans with OUD are nearly 29 times higher risk for homelessness; however, few are prescribed naloxone, an evidence-based intervention to reverse life-threatening opioid overdose. Many housing facilities for homeless veterans contracted with the San Francisco Veterans Affairs Health Care System are located in neighborhoods with high rates of opioid overdose. No systematic interventions have been implemented to provide opioid overdose education and naloxone kits to veterans and staff at these facilities. This quality improvement (QI) initiative aimed to increase provision of opioid overdose education and naloxone for veterans and staff at contracted housing facilities. This was a prospective single-arm cohort QI intervention. All contracted veteran housing programs were included. Descriptive statistics evaluated results. A total of 18 contracted veteran housing programs were contacted from July 2019 through January 2020 to schedule training. Of those, 13 programs responded to outreach and 10 visits were completed at 8 housing facilities. Training was provided by pharmacist and nurse practitioner trainers to 26 staff members and 59 veterans. Naloxone was prescribed to 37 veterans. A pharmacist-led and nurse practitioner-led initiative was effective in increasing veteran and staff access to opioid overdose education and naloxone at >44% contracted veteran housing facilities. Challenges included lack of response from housing programs, low veteran turn out, and inability to provide naloxone to veterans not enrolled/ineligible for health care. Future initiatives should examine strategies to standardize access in homeless veterans' programs.


The measurement properties of modified Rivermead mobility index and modified functional ambulation classification as outcome measures for Chinese stroke patients.
Valid, reliable, responsive and practical outcome measures are essential for treatment planning and outcome assessment. This study aimed to examine the measurement properties of Modified Rivermead Mobility Index (MRMI) and Modified Functional Ambulation Classification (MFAC) in Chinese stroke patients. The content validity, responsiveness, predictive validity, test-retest reliability, internal consistency and factor structure of the MRMI were examined. The content validity, discriminative power and inter-rater agreement of the MFAC were investigated. A total of 456 Chinese stroke patients were recruited. Evidence of good content validity, high responsiveness, adequate predictive validity, excellent test-retest reliability with 1.3-point as minimum detectable change in 95% confidence interval, high internal consistency and unidimensionality was obtained for the MRMI. Good content validity, sufficient discriminative power and excellent inter-rater agreement were demonstrated for the MFAC. Both the MRMI and MFAC have good to excellent measurement properties and are recommended as routine outcome measures for Chinese stroke patients.


Predictors of Longitudinal Growth in Inhibitory Control in Early Childhood.
In the current study, we examined latent growth in 731 young children's inhibitory control from ages 2 to 4, and whether demographic characteristics or parenting behaviors were related to initial levels and growth in inhibitory control. As part of an ongoing longitudinal evaluation of the Family Check-Up (FCU), children's inhibitory control was assessed yearly at ages 2, 3, and 4. Inhibitory control was initially low and increased linearly to age 4. High levels of harsh parenting and male gender were associated with low initial status in inhibitory control. High levels of supportive parenting were associated with faster growth. Extreme family poverty and African American ethnicity were also associated with slower growth. The results highlight parenting as a target for early interventions in contexts of high socioeconomic risk.


Domain and interdomain energetics underlying gating in Shaker-type Kv channels.
To understand gating events with a time-base many orders-of-magnitude slower than that of atomic motion in voltage-gated ion channels such as the Shaker-type KV channels, a multiscale physical model is constructed from the experimentally well-characterized voltage-sensor (VS) domains coupled to a hydrophobic gate. The four VS domains are described by a continuum electrostatic model under voltage-clamp conditions, the control of ion flow by the gate domain is described by a vapor-lock mechanism, and the simple coupling principle is informed by known experimental results and trial-and-error. The configurational energy computed for each element is used to produce a total Hamiltonian that is a function of applied voltage, VS positions, and gate radius. We compute statistical-mechanical expectation values of macroscopic laboratory observables. This approach stands in contrast with molecular-dynamic models which are challenged by increasing scale, and kinetic models which assume a probability distribution rather than derive it from the underlying physics. This generic model predicts well the Shaker charge/voltage and conductance/voltage relations; the tight constraints underlying these results allow us to quantitatively assess the underlying physical mechanisms. The total electrical work picked up by the VS domains is an order-of-magnitude larger than the work required to actuate the gate itself, suggesting an energetic basis for the evolutionary flexibility of the voltage-gating mechanism. The cooperative slide-and-interlock behavior of the VS domains described by the VS-gate coupling relation leads to the experimentally observed bistable gating. This engineering approach should prove useful in the investigation of various elements underlying gating characteristics and degraded behavior due to mutation.


B-Raf(V600E) cooperates with alternative spliced Rac1b to sustain colorectal cancer cell survival.
In colorectal tumors, activating BRAF mutations occur alternative to KRAS oncogenic mutations, but in cell culture possess a much lower transforming capacity. Rac1b, a hyperactive Rac1 spliced variant, is over expressed in some colorectal tumors and activates the transcription factor nuclear factor-kappaB, which initiates a transcriptional response that promotes cell cycle progression and inhibits apoptosis. The aim of this study was to determine whether Rac1b overexpression is associated with B-Raf(V600E) in primary colorectal tumors and whether a functional cooperation between these 2 proteins exists in colorectal cells with a wild-type KRAS genotype. Screening of BRAF and KRAS mutations by direct sequencing and Rac1b mRNA expression analysis by quantitative real-time polymerase chain reaction were conducted in 74 samples (13 normal colonic mucosa, 45 primary colorectal tumors, and 16 colorectal cancer [CRC] cell lines). RNA interference and focus formation assays were used to assess the cooperation between Rac1b and B-Raf(V600E) in cancer cell viability. Rac1b overexpression and B-Raf(V600E) are significantly associated in primary colorectal tumors (P = .008) and colorectal cell lines. The simultaneous suppression of both proteins dramatically decreased CRC cell viability through impaired cell-cycle progression and increased apoptosis. Our data demonstrate that Rac1b and B-Raf(V600E) functionally cooperate to sustain colorectal cell viability and suggest they constitute an alternative survival pathway to oncogenic K-Ras. These results reveal a novel molecular characteristic of colon tumors containing B-Raf mutations and should help in defining novel targets for cancer therapy.


Redox Cascades and Making of a C-C Bond: 1,2-Benzodiazinyl Radicals and a Copper Complex of a Benzodiazine.
Two 1,2-benzodiazinyl radicals, cinnolinyl radicals by name, were successfully isolated by cascade routes using 1,4-naphthoquinone as a precursor. Reaction of 1,4-naphthoquinone with hydrazine hydrate promotes a (5e + 5H+) redox cascade affording benzo[ g]naphtho[1,2- c]cinnolinyl-7,12,14-trione (Cn•) in 69% yields, while the similar reaction with 2-hydrazinopyridine is a (7e + 7H+) oxidative cascade and furnishes N-pyridinecinnolinyl radical (PyCn•). The cascades are composed of C-N and C-C bond making reactions. The neutral even alternate arenes are always diamagnetic; thus, the isolation of Cn• and PyCn• is a breakthrough. The Cn•/Cn- and PyCn•/PyCn- redox couples are reversible, and the reaction of Cn• with [CuI(PPh3)3Cl] in the presence of hydrazine hydrate and Et3N affords a Cn- complex of copper(I), [(Cn-)CuI(PPh3)2] (1). Similar to phenalenyl radical, PyCn• exists in three redox states, PyCn+, PyCn•, and PyCn-, in a smaller potential range (-0.30 V to -0.60 V vs Fc+/Fc couple) and can be used as an oxidant as well as a reductant. PyCn• acts as a catalyst for the oxidative cleavages of benzil to benzoic and 2,2'-pyridil to picolinic acids in methanol in the presence of air. The molecular and electronic structures of Cn•, PyCn•, and 1·1/2MeOH were confirmed by single crystal X-ray crystallography, EPR spectroscopy, and DFT calculations.


The intricate link between iron, mitochondria and azoles in Candida species.
Invasive fungal infections are rapidly increasing, and the opportunistic pathogenic Candida species are the fourth most common cause of nosocomial systemic infections. The current antifungal classes, of which azoles are the most widely used, all have shortcomings. Azoles are generally considered fungistatic rather than fungicidal, they do not actively kill fungal cells and therefore resistance against azoles can be rapidly acquired. Combination therapies with azoles provide an interesting therapeutic outlook and agents limiting iron are excellent candidates. We summarize how iron is acquired by the host and transported towards both storage and iron-utilizing organelles. We indicate whether these pathways alter azole susceptibility and/or tolerance, to finally link these transport mechanisms to mitochondrial iron availability. In this review, we highlight putative novel intracellular iron shuffling mechanisms and indicate that mitochondrial iron dynamics in relation to azole treatment and iron limitation is a significant knowledge gap.


Enhanced pregenomic RNA levels and lowered precore mRNA transcription efficiency in a genotype A hepatitis B virus genome with C1766T and T1768A mutations obtained from a fulminant hepatitis patient.
The viral factors associated with the development of fulminant hepatitis B are not fully understood. We recently found four unique mutations [G to A at nucleotide 1742 (G1742A), C1766T, T1768A and T1809C] in the basal core promoter (BCP) region of a genotype A hepatitis B virus (HBV) strain (FH) obtained from a 53-year-old man with fatal fulminant hepatitis. To elucidate the association of the mutations of the FH genome with the disease, we constructed a 1.3-fold FH genome and its five variants by replacing one or two mutated nucleotides with wild-type nucleotide(s) via site-directed mutagenesis, and transfected human hepatoma cells (HepG2/C3A) with the constructs. There were no discernible differences between FH and two variants (FH_A1742G and FH_C1809T) with regard to viral replication and protein expression. However, in comparison to three other variants (FH_T1766C, FH_A1768T and FH_T1766C/A1768T) with wild-type nucleotide(s) at 1766 and/or 1768, the FH genome exhibited a 2.5-5-fold enhancement of viral replication by heightened pregenomic RNA synthesis and a 1.5-2.5-fold reduction in the hepatitis B e antigen (HBeAg) synthesis by the downregulation of the precore mRNA level. An immunofluorescence analysis revealed the increased and predominant cytoplasmic localization of the core protein in the FH genome. The present study demonstrates that the C1766T/T1768A mutations in the BCP region of genotype A HBV enhance viral replication, downregulate HBeAg expression and are responsible for the predominant localization of the core protein in the cytoplasm, which are likely associated with the development of fulminant hepatitis.


Efficacy of acupuncture on menstrual frequency in women with polycystic ovary syndrome: Protocol for a randomized, controlled trial.
Acupuncture may improve the menstrual frequency of women with polycystic ovary syndrome (PCOS). However, more sufficient data are needed to improve the efficacy of acupuncture. A total of 172 participants diagnosed with PCOS would be randomly assigned to either the acupuncture group or sham-acupuncture group, at a ratio of 1:1. Participants in both groups will receive treatment for 12 weeks, 3 times a week. The primary outcome will be the proportion of participants with at least a 50% increase from baseline in the monthly menstrual frequency from baseline after 12 weeks intervention, while secondary outcomes will be the difference in anthropometrics, serum hormone level, ovarian morphology, anxiety and depression, and quality of life from baseline to after 12 weeks intervention and to 12 weeks postintervention follow-up between groups. The aim of this study is to evaluate the efficacy and safety of acupuncture for improving menstrual frequency and other symptoms of patients with PCOS. The limitation of this trial is that it would be difficult to blind the acupuncturists. In addition, these findings may not be suitable for women with PCOS who are seeking pregnancy.


Size of recurrent symptomatic common bile duct stones and factors related to recurrence.
Some common bile duct (CBD) stones recur after endoscopic stone extraction. Little information is available on the size and recurrence interval of recurrent symptomatic CBD stones or on ways to prevent recurrence. Between January 2007 and December 2011, consecutive 481 patients undergoing endoscopic extraction of CBD stones at a single institute were enrolled. We selected 34 patients with recurrent symptomatic CBD stones and 63 patients who were followed up more than five years without recurrence. The sizes of the CBD stones increased during the recurrences: 10.1±5.2 mm, 13.5±7.3 mm, and 16.8±7.8 mm at the initial presentation, the first recurrence, and the second recurrence, respectively (p=0.016). Among CBD stone recurrences, 50% occurred within 2.3 years, and 80% occurred within 5.3 years. The recurrence group had a smaller proportion of patients under 50 years of age, larger CBD diameters, less histories of more than 10 mm endoscopic papillary large-balloon dilation (EPLBD), and more type I periampullary diverticula, compared with the non-recurrence group (p<0.05). Multivariate analysis revealed that EPLBD more than 10 mm and smaller CBD diameter were independently related to less recurrence of CBD stones (p=0.001 and 0.012, respectively). The sizes of CBD stones increased during recurrences. EPLBD more than 10 mm and smaller CBD diameter were related to less recurrence of CBD stones.


Self-reported long-term cardiac morbidity in breast cancer patients: a retrospective cohort study in Germany (PASSOS Heart Study).
Improved survival after locoregional breast cancer has increased the concern about late adverse effects after therapy. In particular, radiotherapy was identified as a risk factor for major cardiac events in women treated until the 1990s. While modern radiotherapy with computerized planning based on 3D-imaging can help spare organs at risk, heart exposure may remain substantial. In a retrospective cohort study of women treated for locoregional breast cancer, we investigated whether current radiotherapy is associated with an elevated long-term cardiac morbidity risk. The study included 11,982 women diagnosed with breast cancer in Germany in 1998-2008. After an individual mortality follow-up, 9338 questionnaires on cardiac events before or after therapy and on associated risk factors were sent out in 2014. Based on 4434 questionnaires from women with radiotherapy, we used Cox regression to analyze the association between self-reported cardiac morbidity and breast cancer laterality as a surrogate measure of radiation exposure. After a median follow-up of 8.3 years, there was no significant association of tumor laterality with cardiac morbidity in irradiated patients (458 events, hazard ratio for left-sided vs. right-sided tumors 1.07, 95% CI 0.89-1.29). Significant risk factors for any cardiac event included age at diagnosis, chemotherapy, hypertension, hypercholesteremia, and chronic kidney disease. For contemporary radiotherapy, we found no evidence for a significantly elevated cardiac morbidity risk in left-sided versus right-sided breast cancer. Possible reasons for failing to confirm earlier reports on increased risk include shorter follow-up, application of newer radiotherapy techniques, and improved health monitoring.


Epigenetic suppression of human telomerase (hTERT) is mediated by the metastasis suppressor NME2 in a G-quadruplex-dependent fashion.
Transcriptional activation of the human telomerase reverse transcriptase (hTERT) gene, which remains repressed in adult somatic cells, is critical during tumorigenesis. Several transcription factors and the epigenetic state of the hTERT promoter are known to be important for tight control of hTERT in normal tissues, but the molecular mechanisms leading to hTERT reactivation in cancer are not well-understood. Surprisingly, here we found occupancy of the metastasis suppressor non-metastatic 2 (NME2) within the hTERT core promoter in HT1080 fibrosarcoma cells and HCT116 colon cancer cells and NME2-mediated transcriptional repression of hTERT in these cells. We also report that loss of NME2 results in up-regulated hTERT expression. Mechanistically, additional results indicated that the RE1-silencing transcription factor (REST)-lysine-specific histone demethylase 1 (LSD1) co-repressor complex associates with the hTERT promoter in an NME2-dependent way and that this assembly is required for maintaining repressive chromatin at the hTERT promoter. Interestingly, a G-quadruplex motif at the hTERT promoter was essential for occupancy of NME2 and the REST repressor complex on the hTERT promoter. In light of this mechanistic insight, we studied the effects of G-quadruplex-binding ligands on hTERT expression and observed that several of these ligands repressed hTERT expression. Together, our results support a mechanism of hTERT epigenetic control involving a G-quadruplex promoter motif, which potentially can be targeted by tailored small molecules.


Understanding concerns after severe COVID-19: A self-imposed lockdown guarded by anxiety?
Many people are struggling to get back to their lives after severe COVID-19. To facilitate their reintegration into everyday life, we need to understand how the process is experienced. We aimed to gain deeper knowledge about this process by interviewing persons one year after hospitalisation due to COVID-19. The study is based on a qualitative design, with eleven in-depth interviews conducted one year after discharge for COVID-19. Participants were recruited to form a heterogeneous sample with respect to age, gender and socioeconomic background. All interviews were analysed utilising inductive thematic analysis. From the participants' narratives four themes were identified: 'Concerns and worries in everyday life', 'Supportive and concerned relatives', 'A new way of life-sorrows and advantages' and 'Seize the day-a greater awareness of one´s mortality'. Participants described how they tried to create a functioning everyday life. They were generally afraid of getting COVID-19 again and concerned about future life, where their lack of energy played a major role. Narratives were diverse regarding to what extent the struggle to cope was experienced as emotionally challenging or not. Participants described an unpredictable recovery after COVID-19, characterised by ups and downs, which created worries concerning their future. In some cases, the worry of getting COVID-19 again was strong enough to keep participants in their homes, as a self-imposed lockdown guarded by anxiety. However, the narratives also revealed gratitude towards being alive and having coped so well. This led to a more positive outlook on life with a greater focus on intrinsic values, close social relations and the deeper meaning of life.


The influence of prolonged instrument manipulation on gas leakage through trocars.
During laparoscopic surgery, CO2 insufflation gas could leak from the intra-abdominal cavity into the operating theater. Medical staff could therefore be exposed to hazardous substances present in leaked gas. Although previous studies have shown that leakage through trocars is a contributing factor, trocar performance over longer periods remains unclear. This study investigates the influence of prolonged instrument manipulation on gas leakage through trocars. Twenty-five trocars with diameters ranging from 10 to 15 mm were included in the study. An experimental model was developed to facilitate instrument manipulation in a trocar under loading. The trocar was mounted to a custom airtight container insufflated with CO2 to a pressure of 15 mmHg, similar to clinical practice. A linear stage was used for prolonged instrument manipulation. At the same time, a fixed load was applied radially to the trocar cannula to mimic the reaction force of the abdominal wall. Gas leakage was measured before, after, and during instrument manipulation. After instrument manipulation, leakage rates per trocar varied between 0.0 and 5.58 L/min. No large differences were found between leakage rates before and after prolonged manipulation in static and dynamic measurements. However, the prolonged instrument manipulation did cause visible damage to two trocars and revealed unintended leakage pathways in others that can be related to production flaws. Prolonged instrument manipulation did not increase gas leakage rates through trocars, despite damage to some individual trocars. Nevertheless, gas leakage through trocars occurs and is caused by different trocar-specific mechanisms and design issues.


Clinical Implication of Optical Coherence Tomography-Based Neoatherosclerosis.
Recent research has indicated neoatherosclerosis (NA), the de novo development of atherosclerosis within the neointimal region of the stented segment after coronary stent implantation, as a mechanism of late/very late stent thrombosis (VLST) and restenosis. This research is based on histologic and intravascular imaging studies. Optical coherence tomography (OCT) is an imaging tool that is superior with regard to resolution capacity, and can be used to visualize detailed information about distinct morphological characteristics of the restenotic tissue. Thus, OCT is a valuable imaging tool for examining NA, such as macrophage infiltration, lipid accumulation, in-stent calcification, or neointimal rupture. This article discusses the prevalence, predictors, and clinical implications of NA that can be observed by OCT.


No influence of prejunctional alpha 2-adrenoceptors on the effects of nicotine and tyramine in guinea-pig atria.
1. Guinea-pig left atria were stimulated at a rate of 0.5 Hz and preloaded with 10 microCi 7-[3H]noradrenaline. In the presence of cocaine, 3 x 10(-6) mol l-1, and atropine, 10(-7) mol l-1, noradrenaline release was stimulated twice in each atrium, either by electrical field stimulation (one pulse, 0.2 ms 30 V, during each refractory period for 5 min) or by addition of either nicotine, 3 x 10(-5) mol l-1, or tyramine 10(-5) mol l-1. 2. The release of radioactivity caused by field stimulation and the associated positive inotropic effect were almost abolished by 3 x 10(-8) mol l-1 tetrodotoxin. Pretreatment with 3 x 10(-7) mol l-1 idazoxan increased the effects of field stimulation, while they were attenuated in the presence of clonidine, 3 x 10(-7) mol l-1. 3. The inotropic effect and the release of radioactivity caused by nicotine were greatly attenuated by tetrodotoxin, but were not significantly influenced by idazoxan or clonidine. 4. The release of radioactivity caused by tyramine and the inotropic effect of this drug were resistant to tetrodotoxin pretreatment and were not modified by idazoxan or clonidine. 5. It is concluded that nicotine releases noradrenaline by initiating a propagated action potential. But activation of prejunctional alpha 2-adrenoceptors does not seem to attenuate the transmitter release by limiting the spread of the action potential in the prejunctional sympathetic neuronal network.


[Neurological diseases and nutrition -- what can we do?].
Neurological diseases and nutrition are in complex relationship. In the first part of this review the nutritional consequences of acute neurological diseases is presented, with special emphasis on traumatic injuries of the nervous system and stroke. Nutritional therapy of these patients is described in detail. In addition, chronic, degenerative neurological pathological conditions are also discussed, including nutritional consequences and possibilities of therapy. Some ethical and legal issues are also considered. The second part of this review article describes neurological consequences of nutritional problems, both deficits of macro- and micronutrients and toxic effects.


Calcium Hydroxide versus Mineral Trioxide Aggregate for Direct Pulp Capping: A Cost-effectiveness Analysis.
Recent evidence finds mineral trioxide aggregate (MTA) more effective than calcium hydroxide (CH) for direct pulp capping (DPC). The present study assessed the cost-effectiveness of MTA versus CH for DPC using a model-based simulation approach. A mixed public/private payer perspective in the context of German health care was adopted. We modeled a permanent molar with a vital asymptomatic, exposed pulp treated via DPC with either MTA or CH. The tooth was followed over the lifetime of a 20-year-old patient using Markov models. Transition probabilities were obtained from systematically and nonsystematically collected data. The primary health outcome was tooth retention time. Costs for DPC were estimated via microcosting. Required personnel time for application was estimated using a survey among German specialized and general dentists. Material expenses were calculated based on market prices in 2015. All other costs were derived from public and private item fee catalogues. Uncertainty was introduced via probabilistic and univariate sensitivity analyses. DPC using MTA was both more effective and less costly (52 years retention, lifetime costs = 1368 Euro) than CH (49 years, 1527 Euro). Regardless of a payer's willingness to pay, DPC with MTA had the higher probability of being cost-effective. The identified ranking was not affected by parameter or structural uncertainty or heterogeneity. MTA was more cost-effective than CH for DPC despite higher initial treatment costs because expensive retreatments were avoided. Our estimates apply only on the basis of current evidence and within the chosen health care setting. From a payer's perspective, MTA should be used for DPC.


Heat loss responses at rest and during exercise in pregnancy: A scoping review.
The teratogenic risk associated with maternal hyperthermia (i.e., core temperature ≥39.0 °C) has been a crucial motive in understanding thermoregulatory responses in pregnancy. To date, a substantial number of studies have focused on core temperature responses in a wide range of exercise intensities, duration, and ambient temperatures. Fortunately, none have reported core temperatures exceeding 39.0 °C. Nonetheless, there are limited studies that have provided substantial insight into both dry and evaporative heat loss mechanisms involved in facilitating the maintenance of core temperature (≥39.0 °C) during heat stress in pregnant women. The purpose of this scoping review was to summarize the available literature that has assessed heat loss responses in studies of human pregnancy. A search strategy was developed combining the terms pregnancy, thermoregulation, and adaptation. A systematic search was performed in the following databases: PubMed, Embase, Scopus, and ProQuest. Studies eligible for inclusion included pregnant women between the ages of 18-40 years old, and at least one measurement of the following: sweating, blood flow, skin temperature, and behavioural responses. Retrieved data were categorized as evaporative (sweating), dry or behavioural heat loss responses and summarized narratively. Thirty-three studies were included in this review (twenty-nine measured physiological responses and four measured behavioural responses). Studies suggest that during exercise, evaporative (sweating) and dry (skin blood flow and temperature) heat loss responses increase from early to late pregnancy in addition to greater cardiac output, blood volume and reduced vascular resistance. Behavioural practices related to heat loss responses are also influenced by cultural/religious expectations, personal preferences and sociodemographics. The findings from this review suggest that pregnancy modifies evaporative (sweating), dry and behavioural heat loss. However, future studies have an opportunity to compare heat loss measurements accounting for gestational weight gain and thermal sensation/comfort scale to associate physiological responses with perceptual responses across pregnancy.


Ameloblastoma cell lines derived from different subtypes demonstrate distinct developmental patterns in a novel animal experimental model.
Objective Ameloblastoma is a representative odontogenic tumor comprising several characteristic invasive forms, and its pathophysiology has not been sufficiently elucidated. A stable animal experimental model using immortalized cell lines is crucial to explain the factors causing differences among the subtypes of ameloblastoma, but this model has not yet been disclosed. In this study, a novel animal experimental model has been established, using immortalized human ameloblastoma-derived cell lines. Methodology Ameloblastoma cells suspended in Matrigel were subcutaneously transplanted into the heads of immunodeficient mice. Two immortalized human ameloblastoma cell lines were used: AM-1 cells derived from the plexiform type and AM-3 cells derived from the follicular type. The tissues were evaluated histologically 30, 60, and 90 days after transplantation. Results Tumor masses formed in all transplanted mice. In addition, the tumors formed in each group transplanted with different ameloblastoma cells were histologically distinct: the tumors in the group transplanted with AM-1 cells were similar to the plexiform type, and those in the group transplanted with AM-3-cells were similar to the follicular type. Conclusions A novel, stable animal experimental model of ameloblastoma was established using two cell lines derived from different subtypes of the tumor. This model can help clarify its pathophysiology and hasten the development of new ameloblastoma treatment strategies.


Numerical approach to speciation and estimation of parameters used in modeling trace metal bioavailability.
Speciation affects trace metal bioavailability. One model used to describe the importance of speciation is the biotic ligand model (BLM), wherein the competition of inorganic and organic ligands with a biotic ligand for free-ion trace metal determines the ultimate metal availability to biota. This and similar models require natural ligand concentrations and conditional stability constants as input parameters. In concept, the BLM is itself an analogue of some analytical approaches to the determination of trace metal speciation. A notable example is competitive ligand equilibration/cathodic stripping voltammetry, which employs an artificial ligand for comparative assessment of natural ligand concentrations and discrete conditional stability constants (i.e., BLM parameters) in a natural sample. Here, we report a new numerical approach to voltammetric speciation and parameter estimation that employs multiple analytical windows and a two-step optimization process, simultaneously generating both parameters and a complete suite of corresponding species concentrations. This approach is more powerful, systematic, and flexible than those previously reported.


Calcium-dependent and -independent tumoricidal activities of polymorphonuclear leukocytes induced by a linear beta-1,3-D-glucan and phorbol myristate acetate in mice.
Some antitumor immunomodulators, such as a linear beta-1,3-D-glucan from Alcaligenes faecalis var. myxogenes IFO 13140 (TAK), induce potent tumoricidal activity of polymorphonuclear leukocytes (PMNs). In the present study we investigated the role of calcium on the tumoricidal activity of PMNs induced by immunomodulators, especially TAK. The calcium chelator ethylene glycol bis(beta-aminoethyl ether)-N,N,N',N'-tetraacetic acid (EGTA) almost completely inhibited TAK-induced PMN cytotoxicity and this inhibition was restored by Ca2+ but not by Mg2+. In Ca2+- and Mg2+-free medium, PMN cytotoxicity induced by TAK was recovered by the addition of Ca2+ provided that Mg2+ was also present. By scopoletin assay, hydrogen peroxide released from PMNs by TAK was also observed in the presence of Ca2+ but not in its absence. The PMN cytotoxicities induced by the other immunomodulators, Propionibacterium acnes, Bacillus Calmette-Guérin, zymosan A, and Nocardia cell wall skeletons were also Ca2+ dependent, judging from studies with EGTA and measurement of hydrogen peroxide release in the presence and absence of Ca2+. The Ca2+ dependency of these PMN cytotoxicities suggests that Ca2+ influx is involved in the cytolytic process, but PMN cytotoxicity was not induced by simple addition of the calcium ionophore A23187. Like TAK, phorbol myristate acetate induced PMN cytotoxicity but this cytotoxicity was not Ca2+ dependent. The present report demonstrates the difference in Ca2+ dependency of these PMN cytotoxicities; i.e., extracellular calcium was required for immunomodulator-induced PMN cytotoxicity, but not for phorbol myristate acetate-induced PMN cytotoxicity. This suggests that the processes of induction of PMN cytotoxicity by the two types of activators are not identical.


A case report of an iatrogenic coronary cameral fistula treated by retrograde percutaneous coronary intervention.
Acquired coronary cameral fistula is an extremely rare condition that involves an abnormal communication between a coronary artery and a cardiac chamber. It usually occurs after chest trauma or cardiovascular interventions, such as percutaneous coronary intervention (PCI) and is associated with various outcomes, ranging from a stable status to haemodynamic instability. Acquired coronary cameral fistula frequently arises from the right coronary artery and drains generally into the right ventricle. We report the unusual case of a 56-year-old male patient referred to an invasive cardiology centre for a suspected left anterior descending (LAD) coronary-left ventricular (LV) fistula resulting from a primary PCI for an anterior ST-elevation myocardial infarction. Here, the confirmed LAD-LV fistula was successfully treated by retrograde PCI with covered stent implantation. Clinical and angiographic outcomes were favourable at 1-month follow-up. Coronary cameral fistula can be a severe complication of primary PCI. Various treatment strategies can be considered based on haemodynamic status and anatomical features. In the case described herein, the use of a retrograde approach led to permanent fistula closure and complete revascularization.


A case of factitious disorder involving menstrual blood smeared on the face.
This article presents a case of factitious disorder in which a female smeared menstrual blood on her face. The patient was admitted to our otolaryngology clinic complaining of bleeding from the mouth, nose, ears and eyes. This event reportedly occurred three to four times on a daily basis. She acknowledged nine prior admissions to different specialists over the last two years. Following psychiatric consultation, we diagnosed factitious disorder with predominantly physical signs and symptoms. She was started on Fluoxetine 20 mg/day and supportive interviews were organized. After diagnosis, we observed that her symptoms decreased over two months. The symptoms did not reoccur three to nine months after treatment. This case report outlines two important features. The first is that a case of this type has not been reported before, and the second feature is that this case demonstrates the effect of cultural factors greatly different from those seen in classical factitious disorder.


Effects of timing of weaning on energy utilization in primiparous beef cows and post-weaning performance of their progeny1.
Early weaning is used to minimize cow nutrient requirements in situations where feed inputs are scarce or expensive. For many years, maintenance energy requirements have been assumed to be 20% greater in lactating compared with non-lactating beef cows. While not well established, maintenance energy requirements are thought to be greatest in primiparous cows and to decline with age. Consequently, early weaning primiparous cow-calf pairs should improve overall efficiency, particularly in situations where mid-to-late lactation forage or feed nutritive value is low. The objective of this study was to determine the biological efficiency of early weaning and maintenance energy requirements of lactating versus non-lactating primiparous cows. Experiments were conducted in two consecutive years using 90 primiparous cows and their calves (48 in yr 1, 42 in yr 2). Pairs were randomly assigned to one of the six pens (8 pairs/pen yr 1, 7 pairs/pen yr 2) and pens were randomly assigned to 1 of 2 treatments; (1) early weaning (130 d ± 15.4; EW, n = 6) and (2) traditional weaning (226 d ± 13.1; TW, n = 6). Late lactation cow and calf performance and feed consumption were measured for 92 d (yr 1) and 100 d (yr 2). Cows were limit-fed to meet maintenance requirements, while calves were offered ad libitum access to the same diet in a creep-feeding area. Calves were not allowed access to the cows' feed. Cow feed intake, body condition score, body weight (BW), milk yield and composition, and calf body weight gain and creep feed intake were recorded. After accounting for lactation and retained energy, there was a trend for greater maintenance energy requirements of lactating primiparous cows (P = 0.07). From the early weaning date to traditional weaning date, calf average daily gain (ADG) was greater (P < 0.01) for TW calves. Feed and energy efficiency of the pair was improved for the TW system (P < 0.01). Greater ADG were reported for EW calves during the stocker period (P = 0.03), but there were no differences during the finishing period (P > 0.40). At harvest, BW was greater (P = 0.02) and gain to feed ratio tended (P = 0.06) to be improved for TW calves. The increased TW calf performance offset the additional maintenance costs of their lactating dams, resulting in the TW system converting total feed energy to kilograms of calf BW gain more efficiently.


Travel health information at commercial travel websites.
Internet travel purchases accounted for 10% of the travel industry revenue generated in 2001. To ensure that travelers remain healthy during excursions to developing countries, travel health information needs to be available at commercial travel websites. We evaluated the current availability of travel health information at these websites. The existence, adequacy and ease of access of the travel health information provided on commercial travel websites was assessed through a review of the top 25 airline and 20 discount travel websites. Each site was examined to determine whether it provided general information, such as jet lag, or international travel health information, such as malaria prophylaxis. We also assessed hyperlinks to external travel health information websites, such as the CDC, when provided. Travel health information was not available at 20 (44%) commercial travel websites, including 36% of airline and 55% of the discount travel websites. Twenty-eight percent of airline websites contained general information only, 8% links only, and 28% general and international information. Travel health information available at discount travel websites included 10% general only, 30% link only, and 5% general and international information. On average, it took three clicks to access travel health information. Keywords clicked to access travel health information frequently did not obviously refer to health. Each of the six travel health website links provided accurate vaccine and travel health information. However, several links lacked disease-specific maps and details of disease risk (i.e. seasonal and regional variations of malaria risk). Travel health information on commercial travel websites may be the only data available to travelers purchasing online. The information currently provided is generally inadequate. Ideally, commercial travel websites would provide uniform information that is accurate and easily accessible. Internationally recognized organizations should consider establishing guidelines for the information provided on commercial travel websites.


Phospho-ERK and sex steroids in the mPOA: involvement in male mouse sexual behaviour.
This paper aimed to investigate the mechanisms triggering ERK phosphorylation and its functional role in male sexual behaviour. ERK1/2-phosphorylated form was detected in the medial preoptic area of the hypothalamus (mPOA) during the sexual stimulation of naive and sexually experienced males who were killed 5 min after the first intromission. This mating-induced ERK phosphorylation was increased in sexually experienced males compared to that in naive mice. The functional role of the ERK1/2 pathway activation during sexual behaviour was explored with the administration of a MEK inhibitor, SL-327 (30 mg/kg, i.p.), 45 min before the contact with a receptive female. Inhibition of ERK phosphorylation was found to decrease sexual motivation in both naive and experienced males without altering their copulatory ability. The mechanisms potentially involved in this rapid ERK1/2 pathway activation were specified ex vivo on hypothalamic slices. A thirty-minute incubation with 100 nM of testosterone (T), dihydrotestosterone (DHT) or oestradiol (E2) led to ERK phosphorylation. No changes were observed after incubation with testosterone 3-(O-carboxymethyl)oxime-BSA (T-BSA), an impermeable to the plasma membrane form of testosterone. All these results indicate that ERK phosphorylation within the mPOA could be a key player in the motivational signalling pathway and considered as an index of sexual motivation. They also demonstrate the involvement of oestrogen receptor (ER) and androgen receptor (AR) transduction pathways in steroid-dependent ERK activation.


Effect of Fentanyl as an Adjuvant to Brachial Plexus Block for Upper Extremity Surgeries: A Systematic Review and Meta-Analysis of RCTs.
To assess if the addition of fentanyl to brachial plexus block has an impact on anesthetic outcomes and complication rates in patients undergoing upper extremity surgeries. We explore the PubMed, Embase, ScienceDirect, CENTRAL, and Google Scholar databases for all randomized controlled trials (RCTs) comparing adjuvant fentanyl with placebo/no drug for patients undergoing upper extremity surgery under brachial plexus block. Outcomes assessed were onset, duration of sensory and motor anesthesia, complications, and postoperative analgesia scores. Meta-analysis was conducted utilizing a random-effects model. The risk of bias was assessed using the Cochrane Collaboration's risk of bias assessment tool 2. Certainty of evidence was assessed using GRADE. Subgroup analysis was conducted depending upon the approach of brachial plexus block and type of local anesthetic. Twelve RCTs with 660 patients were included. Addition of fentanyl had no effect on onset of sensory anesthesia (11 studies; MD: 0.48; 95% CI: -1.81, 0.85; I 2 = 96%; p=0.48) but significantly shortened onset of motor anesthesia (8 studies; MD: -2.36; 95% CI: -3.99, -0.74; I 2 = 96%; p=0.48). Duration of sensory anesthesia (9 studies; MD: 82.81; 95% CI: 41.81, 123.81; I 2 = 99%; p < 0.0001) and motor anesthesia (7 studies; MD: 93.41; 95% CI: 42.35, 144.46; I 2 = 99%; p=0.0003) was significantly increased with addition of fentanyl. The certainty of evidence-based on GRADE was deemed to be moderate for both onset and duration of anesthesia. The incidence of overall complications (nausea/vomiting and pruritis) was significantly higher in the fentanyl group (7 studies; OR: 2.14; 95% CI: 1.04, 4.40; I 2 = 8%; p=0.04) but with low certainty of evidence. Adjuvant fentanyl with brachial plexus block improves the onset of motor anesthesia but not sensory anesthesia. The duration of both sensory and motor anesthesia is significantly prolonged with fentanyl by around 83-93 minutes. However, clinicians should be aware that complications such as nausea/vomiting and pruritis are increased twofold with the addition of the drug. Current evidence is limited risk of bias in the RCTs and high heterogeneity in the meta-analyses.


Altered Oculomotor and Vestibulo-ocular Function in Children and Adolescents Postconcussion.
To document (1) oculomotor (OM) and vestibulo-ocular (VO) function in children with concussion who were symptomatic at the time of assessment and to compare it with that in children with concussion who were clinically recovered (asymptomatic) and in children with no concussive injury, and (2) the extent to which OM and VO function relates to postconcussion symptom severity in injured children. Participants were recruited from a concussion clinic or the community. A total of 108 youth with concussion (72 symptomatic; 36 recovered) and 79 healthy youth (aged 9-18 years). Youth with concussion were included if aged 9 to 18 years, had no previous concussion within the last 12 months, less than 90 days since injury, and no known existing visual disorders or learning disabilities. A prospective cross-sectional study. All participants were tested for OM and VO function with a commercial virtual reality (VR) eye-tracking system (Neuroflex®, Montreal,Québec, Canada). Participants in the concussion group who completed the postconcussion symptoms were scored with the Post-Concussion Symptom Inventory. There was a significant group effect for vergence during smooth pursuit (F2,176 = 10.90; P < .05), mean latency during saccades (F2,171 = 5.99; P = .003), and mean response delay during antisaccades (F2,177 = 9.07; P < .05), where children with symptomatic concussion showed poorer performance than clinically recovered and healthy children. Similar results were found in VO for average vestibular ocular reflex gain in the horizontal leftward (F2,168 = 7; P = .001) and rightward directions (F2,163 = 13.08; P < .05) and vertical upward (F2,147 = 7.60; P = .001) and downward directions (F2,144 = 13.70; P < .05). Mean saccade error was positively correlated to total Post-Concussion Symptom Inventory scores in younger clinically recovered children. VR eye tracking may be an effective tool for identifying OM and VO deficits in the subacute phase (<90 days) postconcussion.


Quantification of upper limb position sense using an exoskeleton and a virtual reality display.
Proprioceptive sense plays a significant role in the generation and correction of skilled movements and, consequently, in most activities of daily living. We developed a new proprioception assessment protocol that enables the quantification of elbow position sense without using the opposite arm, involving active movement of the evaluated limb or relying on working memory. The aims of this descriptive study were to validate this assessment protocol by quantifying the elbow position sense of healthy adults, before using it in individuals who sustained a stroke, and to investigate its test-retest reliability. Elbow joint position sense was quantified using a robotic device and a virtual reality system. Two assessments were performed, by the same evaluator, with a one-week interval. While the participant's arms and hands were occluded from vision, the exoskeleton passively moved the dominant arm from an initial to a target position. Then, a virtual arm representation was projected on a screen placed over the participant's arm. This virtual representation and the real arm were not perfectly superimposed, however. Participants had to indicate verbally the relative position of their arm (more flexed or more extended; two-alternative forced choice paradigm) compared to the virtual representation. Each participant completed a total of 136 trials, distributed in three phases. The angular differences between the participant's arm and the virtual representation ranged from 1° to 27° and changed pseudo-randomly across trials. No feedback about results was provided to the participants during the task. A discrimination threshold was statistically extracted from a sigmoid curve fit representing the relationship between the angular difference and the percentage of successful trials. Test-retest reliability was evaluated with 3 different complementary approaches, i.e. a Bland-Altman analysis, an intraclass correlation coefficient (ICC) and a standard error of measurement (SEm). Thirty participants (24.6 years old; 17 males, 25 right-handed) completed both assessments. The mean discrimination thresholds were 7.0 ± 2.4 (mean ± standard deviation) and 5.9 ± 2.1 degrees for the first and the second assessment session, respectively. This small difference between assessments was significant (- 1.1 ± 2.2 degrees), however. The assessment protocol was characterized by a fair to good test-retest reliability (ICC = 0.47). This study demonstrated the potential of this assessment protocol to objectively quantify elbow position sense in healthy individuals. Futures studies will validate this protocol in older adults and in individuals who sustained a stroke.


Morbidities in patients with hypoplastic left heart syndrome.
We sought to document morbidities and growth for patients with hypoplastic left heart syndrome (HLHS) to inform the initial surgical decision and understand healthcare needs. Data were obtained on 137 patients with HLHS, born between 1989 and 1994, who survived staged surgery ( n = 62) or transplantation ( n = 75) and had follow-up information available from four pediatric cardiac surgical centers. In patients with HLHS older than 1 year of age at follow-up, 93% experienced at least one major postsurgical morbidity. Morbidities depended on the surgery received. Hypertension, renal compromise, and abnormal infections were more common in transplanted patients than staged surgery patients. Staged surgery patients used more anticongestive medications and experienced more morbidities requiring interventional catheterization than did transplanted patients. Rejection was common for transplanted patients. On average these children spent 23 days per year in the hospital. Patients with HLHS were small for their age; 43% of staged surgery patients weighed below the third percentile at last information, compared to 19% of transplanted patients ( p = 0.003). The median height percentile was the 10th in both groups. Normal activity level was reported in more transplanted patients (90%) than staged surgery patients (49%; p < 0.001). Trade-offs between mortality and morbidity outcomes can help inform the initial surgical decision.


Extended spectrum beta lactamase--mediated resistance among isolates of family Enterobacteriaceae.
The emergence and spread of extended spectrum beta lactamase (ESBL) producing strains have led to questions regarding optimal therapy for infections especially empirical treatment of suspected gram negative infection. A total of400 isolates belonging to family enterobacteriaceae were isolated from various clinical samples and were studied for ESBL production by NCCLS (National Committee for Clinical Laboratory Standards) confirmatory test (using disc diffusion technique) and MIC brott dilution test. ESBL production was found in 61.72% of hospital isolates and 30.90% of outdoor isolates. The susceptibility of ESBL producers to imipenem and amikacin was found to be 100% and 63.38% respectively. A high degree of associated resistance to other antimicrobial was found in ESBL producers. Tests for detection of ESBLs and continuous monitoring of antimicrobial sensitivity pattern in individual setting is emphasized to minimise the emergence of drug resistant bacteria.


Synthesis and characterization of poly(DL-lactide)-grafted gelatins as bioabsorbable amphiphilic polymers.
A series of poly(DL-lactide) grafted gelatins, as new bioabsorbable amphiphilic polymers useful in parenteral drug delivery systems and in tissue engineering, were synthesized by the ring opening polymerization of DL-lactide onto a fractionated gelatin with the molecular weight of 1.02 x 10(5). Using tin(II) bis(2-ethylhexanoate) as catalyst, the bulk copolymerization at 140 degrees C and solution copolymerization in dimethylsulfoxide (DMSO) at 80 degrees C were firstly performed in the presence of gelatin. The results showed that the solution copolymerization in DMSO could afford the expected copolymers but the bulk copolymerization would result in an insoluble crosslinked product. The number of grafting sites on gelatin chain could be adjusted by the partial trimethylsilylation of side hydroxy, amino and carboxylic groups in gelatin. The solution copolymerization of DL-lactide on the partially protected gelatin in DMSO was also successful in providing copolymers with different molecular weights. The synthesized copolymers were characterized on the basis of elemental analysis, IR, 1H-NMR and thermal analysis. The IR and 1H-NMR data of these produced copolymers suggested that polylactide branches could be grafted onto gelatin via the side groups such as hydroxyl and amino groups in the solution copolymerization as well as carboxylic groups in bulk copolymerization. The molecular weights of the copolymers could be calculated from the difference of nitrogen contents between a copolymer and free gelatin. The results indicated that molecular weight of the copolymers and those of polylactide branches were increased with the feeding ratio of DL-lactide to gelatin in the copolymerization. However, because of the steric hindrance of some grafting sites on gelatin and the transesterifications of the propagating polylactide branches on gelatin with possibly formed homo-polymeric polylactide chains, the finally formed polylactide branches on gelatin were not very large and the highest average molecular weight of a polylactide branch was not over 4500 in any solution copolymerizations. The results from the thermal analysis of some copolymers, including thermogravimetry and differential scanning calorimetry, showed that the absorbed water in the samples could be lost at a temperature range below 150 degrees C and melting point decreased with increase of polylactide branches in the poly(DL-lactide)-grafted gelatins.


Mesoporous Silica-Based Supports for the Controlled and Targeted Release of Bioactive Molecules in the Gastrointestinal Tract.
Mesoporous silica particles (MSPs) have attracted increasing interest as supports in the design of controlled delivery materials. Besides their excellent properties as loading supports (that is, large surface area and pore volume), the modification of their external surface with molecular/supramolecular ensembles allows the design of gated MSPs. Delivery systems based on gated MSPs show "zero delivery" until an adequate stimulus is present and triggers gate opening and the cargo is released. Encapsulation of bioactive molecules in gated MSPs may improve biological stability, facilitate component handling, mask unpleasant sensorial properties, and modulate the bioaccessibility of target molecules along the gastrointestinal tract. These properties make gated MSPs excellent candidates for encapsulating bioactive molecules and their subsequent utilization in the formulation of functional foods. This text highlights the most significant endogenous triggering stimuli that might be applied to design these site-specific delivery systems, as well as the strategies to develop them. Given the novelty of using MSPs in the food sector, the benefits and current potential limitations of employing MSPs in human food have been identified and discussed.


Evaluation of the stability and efficacy of rhGM-CSF as a topical agent in a gel formulation.
It has been reported that recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF), applied as a solution or an emulsion, improves wound healing. In order to confirm these data, the wound-healing efficacy of this growth factor was studied in a murine model. In this double-blind randomised study, murine excisional wounds were treated with either sterilised rhGM-CSF gel (10 micrograms/cm2) or a sterilised placebo gel (control group). rhGM-CSF was applied at dosages of 10 micrograms/cm2/day to wounds until complete closure occurred. rhGM-CSF stability in gel formulation was excellent during the first week but decreased thereafter. Full wound healing occurred within 9.7 days (mean time) in the intervention group compared with 10 days in the control group. This difference was not statistically significant. Histological evaluation of the healed wounds indicated that there was a similar percentage of neutrophils in the cellular infiltrate in both groups. rhGM-CSF sterile gel had an excellent safety profile and was easy to use, but did not significantly accelerate the healing rate in this model.


Barriers to Sexual Expression and Safe Sex Among Mexican Gay Men: A Qualitative Approach.
Same-sex sexual practices among men in Mexico City are stigmatized. This article analyzes sexual practices and experiences of gay men in Mexico City and its implications on emotional and sexual health. The concept of sexual practices is used from a public health perspective, and the concept of sexual experiences from a psychological one, intending to understand both physical and emotional discomfort and pleasure in sexual contexts. The aim of this article is to analyze sexual practices and experiences of gay men in Mexico City and its implications on health, particularly emotions that can lead to depression, anxiety, substance abuse, and unsafe sex. Fifteen in-depth interviews were carried out with gay men of three generations who live in Mexico City. The data were analyzed using techniques from grounded theory to identify categories, and critical discourse analysis as an analytical approach to understand how social discourses affect subjectivity, emotions, and practices. Sexual practices and experiences are the result of homoerotic desire, which gender and heteronormative culture encourage to be kept hidden and clandestine. This leads men into risk contexts where practices are hardly negotiated, thus exposing themselves to sexually transmitted infections and abuse. These practices also produce a series of emotions such as guilt, shame, fear, and sadness that may develop into mental health issues such as depression and anxiety. Interventions at all levels must consider homophobic discrimination as part of gay men's daily lives and should be oriented toward decreasing it, to diminish discomforting emotions and reduce the probability of unsafe sex practices.


Validation of the Scale of Functioning in Older Outpatients With Schizophrenia.
The authors investigated the reliability and validity of the Scale of Functioning (SOF), a 15-item scale, in 78 middle-aged and elderly outpatients with schizophrenia. The SOF score had both high internal consistency and high interrater reliability and significantly discriminated between these patients and 45 normal comparison subjects. SOF scores correlated significantly with scores on several psychopathology rating scales as well as a number of existing instruments assessing cognitive or functional ability. Principal-components analysis using different scales of functional ability, psychopathology, and global cognitive performance and treated by orthogonal rotation revealed two domains of functioning, one of which was defined by the SOF along with scales for activities of daily living, negative symptoms, and cognitive impairment. The other domain was defined by scales for quality of well-being, social adjustment, and positive and depressive symptoms. Results support the construct validity of the SOF in late-life schizophrenia.


Modulation of select immune responses by dietary capsaicin.
Capsaicin (CAP) is the spicy principle of hot peppers that has been used as a food additive, preservative, and medicine. In this study, we investigated the effect of dietary CAP on immune status and selected immune responses. BALB/c mice were divided into 5 groups and fed diets with either 0, 5, 20, 50 or 100 ppm CAP for 3 weeks. The parameters measured with lymphocytes included mitogen-induced proliferation, plaque-forming cell number, and total serum immunoglobulin levels. In spleen cells of mice fed 20 ppm CAP there was a greater T-cell mitogen induced, lymphocyte proliferative response. In addition, the number of antibody-producing B cells and serum IgG and IgM levels increased in mice fed 20 ppm CAP as compared to the control with no CAP. The effect of dietary CAP on macrophage activity was assessed by phagocytosis and tumor necrosis factor-alpha (TNF alpha) production. Dietary CAP had no effect on phagocytic activity by peritoneal macrophages, but the levels of secreted TNF alpha increased in the groups fed 20 ppm CAP compared to the control. These results suggest that dietary CAP may differentially enhance immune status as well as select immune functions. That is in contrast with previous studies that show immunosuppression observed after CAP injection.


[INVESTIGATION ON ANTIFUNGAL SUSCEPTIBILITY OF CANDIDA YEASTS IN PREGNANT PATIENTS WITH CONFIRMED VULVOVAGINAL CANDIDIASIS AND THEIR NEWBORNS.]
Background Vulvovaginal candidiasis (VVU) is considered as a special risk factor during pregnancy, with important influence on the reproductive function of the patients and on the morbidity in the newborns from mothers with VVC. Maternal VVC is a major risk factor for the development of candida-colonization of the infant, which in turn is the first step towards the development of mucocutaneous or systemic candidiasis and Candida-septicemia in the newborn. In pregnant patients, the possible applicable local and systemic medications are limited, while the therapeutic resistance in chronic recurrent forms of VVC increases, facts that require precision of the diagnosic approach to optimize the therapeutic recommendations in pregnant patients, considered as a high risk group. The aim of this study was to investigate in vitro antifungal susceptibility of Candida yeasts to current antifungal agents in pregnant patients with confirmed VVC before the act of birth. Material and Methods Vaginal secretions of 23 healthy pregnant women with proven Candida vaginitis were taken within 48 hours before birth and the presence of yeasls of Candida was confirmed by culture examination. Between 47-72 hours after birth, samples were taken for Candida colonization of the oralmucosa and feces of their newborns. Samples were plated on Sabouraud agar and cultured in an incubator for 2 to 3 days at a temperature of 25° C. Species identification of the isolated yeasts were performed by commercial API Candida test - API 20C AUX (BioMerieux, Marcy-l'Etoile, France). Part of the isolates was identified by commercial whale AUXACOLOR (BioRad, Mames la Coquette, France). Antifungal sensitivity of isolated strains was examined by applying commercial solicitation ready kit and methods of disc diffusion and E-test, as the aim of the authors was to assess their potential for use in the diagnosis, and the correlation between them. Results Candida albicans was the prevalent etiological agent in pregnant patients with VVC immediately before birth (n = 22, 91.67 +/- 0.06%). Positive Candida colonization was detected in 14 (58.33%) of their newborns (n = 24), as no statistically significant difference was established, depending on the mode of delivery. The investigated antifungal susceptibility with test Fungifast (ELITech Microbiology Reagents), found 100% sensitivity of Candida albicans to Amphotericin B, Flucytosin and Voriconazole. Intermediate susceptibility to Itraconazole was found in 6 of 23 (26%) maternal isolates, and 5 of 23 (22%) isolates were moderately sensitive to Fluconazole. Candida krusei showed complete resistance to Fluconazole and Itraconazole. Within the group of antifungals for topical application (Econazole, Ketoconazole, Miconazole, Nystatin), the results established that 100% of the studied fungi were sensitive to Nystatin, while within the groups of azoles for vaginal and topical use - C.krusei was 100% resistant, as the sensitivity of C. albicans varied between 60-80%. Conclusion Our recommendation, based on the esablished results is that in pregnant with uncomplicated VVC as a first-line therapy should be considered the group of vaginal azoles and Nystatin, while the systemic therapy should be considered carefully and only after the firSt trimester. In cases of oral and intestinal candidiasis in neonatology, we recommend a therapy with minimal absorbable antifungals as Nystatin and miconazole (amphotericin B is available in our country), while systemic antifungal should be initiated only as a second choice. The exact etiological diagnosis is especially important because in our country there is a tendency for increased incidence of non-albicans fungus resistant to therapy, and that changes the therapeutic behavior.


Erbium: YAG laser ablation versus 70% trichloroacetıc acid application in the treatment of xanthelasma palpebrarum.
Xanthelasma palpebrarum (XP) is characterized by soft, yellow plaques on the upper or lower eyelids that create aesthetic problems for patients. There are several methods in the treatment of XP, such as surgical excision, blepharoplasty, cryotherapy, electrocauterization, chemical cauterization using trichloroacetic acid (TCA) or bichloroacetic acid and laser ablation. To evaluate the efficiency and complications of 70% TCA application versus erbium: YAG laser ablation in different XP lesions on the same patient. A total of 21 patients were taken into the study-1 male and 20 females, from ages 22 to 70 years. Erbium: YAG laser ablation and 70% TCA application were performed in different XP lesions of the same patient. All patients were photographed before initiating treatment and after 4 weeks using the same digital camera. Evaluation was performed 4 weeks after the first treatment session by comparing pre-treatment and post-treatment photographs by two independent dermatologists. No significant difference of the improvement scores between the erbium laser and TCA was found (p = 0.248). No significant difference between the complication scores using erbium laser and TCA was found (p = 0.739). Both 70% TCA application and erbium: YAG laser ablation methods have similar effectiveness and complication rates.