European survey on training objectives in disaster medicine.
As part of the I SEE (Interactive Simulation Exercise for Emergencies) project, financially supported by the Leonardo da Vinci Programme 2000-2006 of the European Commission, a study was planned to assess the type of disaster and to establish the tasks to be included in an emergency exercise to be developed, according to the possible target groups, physicians, nurses, ambulance personnel, dispatchers and first responders. A secondary objective was a description of the actual computer-based training situation in the training centres. A study involving different actors or target groups has not yet been conducted. A questionnaire was developed, validated and subsequently distributed to the training centres for the different target groups in the partner countries. Each partner had to contact and interview the person responsible for the training in disaster medicine in the training institution. Data entry and analysis was carried out using the SPSS software on Apple Macintosh. Apart from descriptive statistics of the variables, differences between groups were analysed using analysis of variance and the Kruskal-Wallis test. In 75 questionnaires out of a total of 206, the combination of a major road traffic accident and a chemical accident was indicated as the first choice (36.4%). These priorities were present for the different countries and all target groups. Concerning the medical procedures to be included in the training exercise, the highest priority was given to medical coordination, medical management on site, medical alert procedures, assessment of immediate needs, medical resources management, victim transport and protection and safety procedures. Only minor differences were noted between countries, different target groups and the institutions irrespective of whether they are involved in response in case of a major accident or disaster. With regard to the secondary objective, 27% of the institutions used computer-based training in disaster medicine and, of those not using computer-based training, 23% plan its use in the near future. The European centres surveyed, put the emphasis for disaster medicine training on a mass casualty scenario. In accordance with this choice, prehospital aspects of medical care and management were considered as priorities for training. The I SEE project will develop a template and pilot exercise, serving all countries and providing team training. Among the institutions involved in the survey, a limited number will be invited to participate in the formative evaluation of the pilot exercise.


Dual-energy X-ray absorptiometry derived structural geometry for stress fracture prediction in male U.S. Marine Corps recruits.
A total of 626 U.S. male Marine Corps recruits underwent anthropometric measurements and dual-energy X-ray absorptiometry (DXA) scans of the femoral midshaft and the distal third of the tibia prior to a 12 week physical training program. Conventionally obtained frontal plane DXA scan data were used to measure the bone mineral density (BMD) as well as to derive the cross-sectional area, moment of inertia, section modulus, and bone width in the femur, tibia, and fibula. During training, 23 recruits (3.7%) presented with a total of 27 radiologically confirmed stress fractures in various locations in the lower extremity. After excluding 16 cases of shin splints, periostitis, and other stress reactions that did not meet fracture definition criteria, we compared anthropometric and bone structural geometry measurements between fracture cases and the remaining 587 normals. There was no significant difference in age (p = 0.8), femur length (p = 0.2), pelvic width (p = 0.08), and knee width at the femoral condyles (p = 0.06), but fracture cases were shorter (p = 0.01), lighter (p = 0.0006), and smaller in most anthropometric girth dimensions (p < 0.04). Fracture case bone cross-sectional areas (p < 0.001), moments of inertia (p < 0.001), section moduli (p < 0.001), and widths (p < 0.001) as well as BMD (p < 0.03) were significantly smaller in the tibia and femur. After correcting for body weight differences, the tibia cross-sectional area (p = 0.03), section modulus (p = 0.05), and width (p = 0.03) remained significantly smaller in fracture subjects. We conclude that both small body weight and small diaphyseal dimensions relative to body weight are factors predisposing to the development of stress fractures in this population. These results suggest that bone structural geometry measurements derived from DXA data may provide a simple noninvasive methodology for assessing the risk of stress fracture.


A model for collaborative service delivery for students with language-learning disorders in the public schools. Committee on Language Learning Disorders American Speech-Language-Hearing Association.
Collaborative service delivery can augment traditional methods for serving students with language-learning disorders in the public schools. In collaborative service delivery, the speech-language pathologist is an integral member of a transdisciplinary team consisting of educators, parents, and the student. Team members collaborate to formulate a single educational program for each student. The team devises all treatment goals, assessment methods, intervention procedures, and documentation systems to enhance the student's academic and social functioning in the school environment. All team members are aware of the student's entire curriculum, and team members typically share responsibility for specific educational goals. Most special services, as well as regular instruction, take place within the classroom. Administrative support is crucial to the implementation of collaborative service delivery. Effective collaboration requires that team members be allotted time to meet outside of their classroom duties. In addition, cooperation among team members is essential. Potential team members must be willing to pool their expertise and abandon notions of professional "turf." The implementation of collaborative service delivery may require some adjustment in the way speech-language pathologists and other educators perceive their roles in public school settings. However, this service delivery model holds great promise for providing services to maximize the functional potential of students with language-learning disorders.


Effect of ischemic preconditioning on P-selectin expression in hepatocytes of rats with cirrhotic ischemia-reperfusion injury.
To investigate the effects and mechanisms of ischemic preconditioning (IPC) on the ischemia/reperfusion (I/R) injury of liver cirrhosis in rats and the effect of IPC on P-selectin expression in hepatocytes. Forty male SD rats with liver cirrhosis were randomly divided into sham operation group (SO group), ischemia/reperfusion group (I/R group), ischemic preconditioning group (IPC group), L-Arginine preconditioning group (APC group), L-NAME preconditioning group (NPC group), eight rats in each group. Hepatocellular viability was assessed by hepatic adenine nucleotide level and energy charge (EC) determined by HPLC, ALT, AST and LDH in serum measured by auto- biochemical analyzer and bile output. The expression of P-selectin in the liver tissue was analyzed by immunohistochemical technique. Leukocyte count in ischemic hepatic lobe was calculated. At 120 min after reperfusion, the level of ATP and EC in IPC and APC groups was higher than that in I/R group significantly. The increases in AST, ALT and LDH were prevented in IPC and APC groups. The livers produced more bile in IPC group than in I/R group during 120 min after reperfusion (0.101+/-0.027 versus 0.066+/-0.027 ml/g liver, P=0.002). There was a significant difference between APC and I/R groups, (P=0.001). The leukocyte count in liver tissues significantly increased in I/R group as compared with SO group (P<0.05). The increase in the leukocyte count was prevented in IPC group. Administration of L-arginine resulted in the same effects as in IPC group. However, inhibition of NO synthesis (NPC group) held back the beneficial effects of preconditioning. Significant promotion of P-selectin expression in hepatocytes in the I/R group was observed compared with the SO group (P<0.01). IPC or L-arginine attenuated P-selectin expression remarkably (P<0.01). However, inhibition of NO synthesis enhanced P-selectin expression (P<0.01). The degree of P-selectin expression was positively correlated with the leukocyte counts infiltrating in liver (r=0.602, P=0.000). IPC can attenuate the damage induced by I/R in cirrhotic liver and increase the ischemic tolerance of the rats with liver cirrhosis. IPC can abolish I/R induced leukocyte adhesion and infiltration by preventing post-ischemic P-selectin expression in the rats with liver cirrhosis via a NO-initiated pathway.


Characterization of a palmitoyl-acyl carrier protein thioesterase (FatB1) in cotton.
The relatively high level of palmitic acid (22 mol%) in cotton seeds may be due in part to a palmitoyl-acyl carrier protein (ACP) thioesterase (PATE), which prefers C16:0-ACP as its substrate. In embryo extracts, PATE activity was highest at the maximum rate of reserve accumulation (oil and protein), occurring about 30-35 d post anthesis. Thioesterase activity toward oleoyl-ACP was relatively similar at all developmental stages examined, but was considerably lower than the PATE activity. In developing seeds and in cotyledons and hypocotyls of seedlings, the PATE activity predominated. A cotton PATE cDNA clone isolated by screening a cDNA library with a heterologous Arabidopsis FatB1 probe has a 1.7-kb insert sequence with an open reading frame of 410 amino acids, lacking codons for the three N-terminal amino acids. The predicted amino acid sequence of the cotton PATE preprotein has a characteristic stromal-targeting domain and a 63% identity to the Arabidopsis long-chain acyl ACP-thioesterase FatB1 sequence. Alkaline blot hybridization of cotton genomic DNA with the Arabidopsis FatB1 probe suggested the presence of at least two FatB1 thioesterase genes in cotton. Relative cotton FatB1 transcript abundance was compared by RT-PCR and slot blot analysis in total RNA extracts from embryos, seedlings and leaves of mature plants. The cotton FatB1 mRNA apparently was expressed in all tissues but paralleled the profiles of PATE enzyme activity and seed oil accumulation in embryos.


Determination of sphincter of Oddi dysfunction in patients with prior normal manometry.
Assessment of sphincter of Oddi motility by manometry is limited to a finite time period, and the presence of a motor disorder that is intermittent may not be documented. This study evaluated the frequency of sphincter of Oddi dysfunction in persistently symptomatic patients with previously normal sphincter of Oddi manometry studies. A total of 177 patients underwent ERCP for suspected sphincter of Oddi dysfunction and had a normal sphincter of Oddi manometry study (both biliary and pancreatic) over a 5-year period (1996-2001). All patients referred for a second ERCP with sphincter of Oddi manometry for evaluation of persistent symptoms were included in this study. Of the 177 patients, 12 (mean age 37.6 years, range 19-59 years) met criteria for inclusion. The mean time interval between the first and second ERCP was 337 days (range 43-792 days). Sphincter of Oddi dysfunction was diagnosed at a second sphincter of Oddi manometry in 5 (42%) patients; 4 had pancreatic sphincter hypertension; one had elevation of both pancreatic and biliary sphincter pressures. All 5 patients underwent endoscopic sphincter ablation therapy; 4 were symptom-free on follow-up at, respectively, 26, 40, 48, and 72 months; one patient had persistent symptoms from pancreatic sphincter restenosis and required multiple endoscopic interventions. Five of the 12 (42%) patients with normal manometric studies were found to have pancreatographic changes of chronic pancreatitis; the two remaining patients had a normal ERCP and manometry. A single negative manometry study does not rule out sphincter of Oddi dysfunction. Repeat ERCP with manometry may be warranted for patients with persistent symptoms in whom the clinical suspicion for sphincter of Oddi dysfunction remains high.


Downstaging and Resection of Initially Unresectable Hepatocellular Carcinoma with Tyrosine Kinase Inhibitor and Anti-PD-1 Antibody Combinations.
Combined therapy with tyrosine kinase inhibitors (TKIs) and anti-PD-1 antibodies has shown high tumor response rates for patients with unresectable hepatocellular carcinoma (HCC). However, using this treatment strategy to convert initially unresectable HCC to resectable HCC was not reported. Consecutive patients with unresectable HCC who received first-line therapy with combined TKI/anti-PD-1 antibodies were analyzed. Tumor response and resectability were evaluated via imaging every 2 months (±2 weeks) using RECIST v1.1. Resectability criteria were (1) R0 resection could be achieved with sufficient remnant liver volume and function; (2) intrahepatic lesions were evaluated as partial responses or stable disease for at least 2 months; (3) no severe or persistent adverse effects occurred; and (4) hepatectomy was not contraindicated. Sixty-three consecutive patients were enrolled. Of them, 10 (15.9%) underwent R0 resection in 3.2 months (range: 2.4-8.3 months) after the initiation of combination therapy. At baseline, these 10 patients had a median largest tumor diameter of 9.3 cm, 7 had Barcelona Clinic Liver Cancer stage C (vascular invasion) disease, 2 had stage B, and 1 had stage A. Before surgery, 6 patients were evaluated as a partial response, 3 stable disease, and 1 partial response in the intrahepatic lesion but a new metastatic lesion in the right adrenal gland. Six patients (60%) achieved a pathological complete response. One patient died from immune-related adverse effects 2.4 months after hepatectomy. After a median follow-up of 11.2 months (range: 7.8-15.9 months) for other 9 patients, 8 survived without disease recurrence, and 1 experienced tumor recurrence. Combination of TKI/anti-PD-1 antibodies is a feasible conversion therapy for patients with unresectable HCC to become resectable. This study represents the largest patient cohort on downstaging role of combinational systemic therapy on TKI and PD-1 antibody for HCC.


Overexpression of dimethylarginine dimethylaminohydrolase enhances tumor hypoxia: an insight into the relationship of hypoxia and angiogenesis in vivo.
The oxygenation status of tumors derived from wild-type C6 glioma cells and clone D27 cells overexpressing dimethylarginine dimethylaminohydrolase (DDAH) was assessed in vivo using a variety of direct and indirect assays of hypoxia. Clone D27 tumors exhibit a more aggressive and better-vascularized phenotype compared to wild-type C6 gliomas. Immunohistochemical analyses using the 2-nitroimidazole hypoxia marker pimonidazole, fiber optic OxyLite measurements of tumor pO2, and localized 31P magnetic resonance spectroscopy measurements of tumor bioenergetic status and pH clearly demonstrated that the D27 tumors were more hypoxic compared to C6 wild type. In the tumor extracts, only glucose concentrations were significantly lower in the D27 tumors. Elevated Glut-1 expression, a reliable functional marker for hypoxia-inducible factor-1-mediated metabolic adaptation, was observed in the D27 tumors. Together, the data show that overexpression of DDAH results in C6 gliomas that are more hypoxic compared to wild-type tumors, and point strongly to an inverse relationship of tumor oxygenation and angiogenesis in vivo--a concept now being supported by the enhanced understanding of oxygen sensing at the molecular level.


Long-term excess mortality in pediatric patients with cerebral aneurysms.
Knowledge of the long-term excess mortality in pediatric aneurysm patients is lacking. The aim of this study was to assess the long-term excess mortality of 102 pediatric patients with cerebral aneurysm treated at the department of neurosurgery at Helsinki University Central Hospital between 1937 and 2009. Patients were followed from diagnosis until death or the end of the year 2010. Relative survival ratio provided the measure of excess mortality in these patients compared with mortality of the general Finnish population matched by age, sex, and calendar time. A majority of the patients (n=89) presented with subarachnoid hemorrhage. Aneurysms (n=118) were treated operatively (n=79), endovascularly (n=1), or conservatively (n=36). The mean follow-up time was 26.8 years (range, 0-55.6 years). By the end of follow-up, 34 of the 102 patients had died; 26 of these deaths (76%) were aneurysm-related. There was overall excess mortality of 10% (cumulative relative survival ratio, 0.90; 95% CI, 0.80-0.96) and 19% (cumulative relative survival ratio, 0.81; 95% CI, 0.66-0.91) at 20 and 40 years after the diagnosis among the 1-year subarachnoid hemorrhage survivors, respectively. The excess mortality was particularly high in boys. There was no long-term excess mortality among patients with unruptured aneurysms. Aneurysm-related deaths included rebleedings from open or partially occluded aneurysms, epileptic seizures, de novo and recurrent aneurysms, or sequelae of subarachnoid hemorrhage. There is long-term excess mortality in pediatric patients with aneurysm even decades after successful treatment of a ruptured aneurysm, especially among boys. The excess mortality is mainly aneurysm-related.


Computed tomographic and radiographic characteristics of aortic lesions in 42 dogs with spirocercosis.
Spirocerca lupi is a common cause of vomiting, regurgitation, and sudden death in dogs that live in tropical or subtropical regions. Sudden death due to aortic rupture may occur with no preceding clinical signs. The purpose of this prospective study was to compare radiographic and computed tomographic (CT) characteristics of aortic lesions in a cohort of 42 dogs with endoscopically confirmed spirocercosis. Dorsoventral and right lateral recumbent thoracic radiographic findings were compared with pre- and postcontrast thoracic CT findings. Aortic mineralization was detected using CT in 18/42 dogs (43%). Three dogs had faint diffuse aortic wall mineralization. Using CT as the reference standard, radiographs had a sensitivity and specificity of 6% and 96%, respectively, for detecting aortic mineralization. A total of 20 aortic aneurysms were detected using CT in 15/42 dogs (36%). Using CT as the reference standard, radiographs had a sensitivity and specificity of 86% and 56%, respectively, for detecting aortic aneurysms. Respiratory motion, aortic displacement by esophageal masses and Spirocerca nodules adjacent to the aorta mimicked aneurysm formation on radiographs. Aortic thrombi were seen in two dogs in postcontrast CT images. Findings from this study indicated that aortic mineralization and aneurysm formation are common in dogs with spirocercosis. Findings also supported the use of pre- and postcontrast CT as effective methods for detecting and characterizing these lesions.


Study protocol: MyoFit46-the cardiac sub-study of the MRC National Survey of Health and Development.
The life course accumulation of overt and subclinical myocardial dysfunction contributes to older age mortality, frailty, disability and loss of independence. The Medical Research Council National Survey of Health and Development (NSHD) is the world's longest running continued surveillance birth cohort providing a unique opportunity to understand life course determinants of myocardial dysfunction as part of MyoFit46-the cardiac sub-study of the NSHD. We aim to recruit 550 NSHD participants of approximately 75 years+ to undertake high-density surface electrocardiographic imaging (ECGI) and stress perfusion cardiovascular magnetic resonance (CMR). Through comprehensive myocardial tissue characterization and 4-dimensional flow we hope to better understand the burden of clinical and subclinical cardiovascular disease. Supercomputers will be used to combine the multi-scale ECGI and CMR datasets per participant. Rarely available, prospectively collected whole-of-life data on exposures, traditional risk factors and multimorbidity will be studied to identify risk trajectories, critical change periods, mediators and cumulative impacts on the myocardium. By combining well curated, prospectively acquired longitudinal data of the NSHD with novel CMR-ECGI data and sharing these results and associated pipelines with the CMR community, MyoFit46 seeks to transform our understanding of how early, mid and later-life risk factor trajectories interact to determine the state of cardiovascular health in older age. Prospectively registered on ClinicalTrials.gov with trial ID: 19/LO/1774 Multimorbidity Life-Course Approach to Myocardial Health- A Cardiac Sub-Study of the MCRC National Survey of Health and Development (NSHD).


Early diagnosis of systemic scleroderma.
Systemic scleroderma (SSc) is a systemic immune-mediated connective tissue disease characterized by fibroproductive changes in connective tissue and microvascular disorders. The disease affects the skin, musculoskeletal system and internal organs. It is a disease with a significant rate of morbidity and mortality, significantly worsening the quality of life of patients. Early initiation of therapy is necessary to prevent disease progression. This review article discusses the current possibilities of early diagnosis of systemic scleroderma.


Hypotonicity-induced exocytosis of the skate anion exchanger skAE1: role of lipid raft regions.
Upon hypotonic volume expansion, skate erythrocytes lose solutes via a pathway that requires participation of anion exchangers (AEs). Three skate AE isoforms (skAEs) are expressed, and at least skAE1 has been shown to mediate this effect when expressed in oocytes. Under isoosmotic conditions, only a small fraction of skAE1 is expressed on the external plasma membrane. Under these conditions, a portion of skAE1 may be found in non-ionic detergent-insoluble regions. However, the detergent-insoluble material is found intracellularly. Cellular volume expansion by hypoosmotic volume expansion but not volume expansion by isoosmotic medium by permeant solutes (ethylene glycol, diethyl urea, or ammonium chloride) stimulates the appearance of skAE1 in the external plasma membrane, and a significant portion of this is found in detergent-insoluble regions. Upon hypoosmotic volume expansion nearly half of the skAE1 is found as oligomers. SkAE1 in these detergent-insoluble fractions is highly tyrosine phosphorylated. These data suggest that volume expansion by hypoosmotic medium stimulates movement of skAE1 from an intracellular pool contained in detergent-insoluble lipid rafts to the plasma membrane. This skAE1 associates to form oligomers that could be involved in the solute efflux that occurs upon volume expansion.


Real-Time High-Resolution MRI Endoscopy at up to 10 Frames per Second.
Objective. Atherosclerosis is a leading cause of mortality and morbidity. Optical endoscopy, ultrasound, and X-ray offer minimally invasive imaging assessments but have limited sensitivity for characterizing disease and therapeutic response. Magnetic resonance imaging (MRI) endoscopy is a newer idea employing tiny catheter-mounted detectors connected to the MRI scanner. It can see through vessel walls and provide soft-tissue sensitivity, but its slow imaging speed limits practical applications. Our goal is high-resolution MRI endoscopy with real-time imaging speeds comparable to existing modalities. Methods. Intravascular (3 mm) transmit-receive MRI endoscopes were fabricated for highly undersampled radial-projection MRI in a clinical 3-tesla MRI scanner. Iterative nonlinear reconstruction was accelerated using graphics processor units connected via a single ethernet cable to achieve true real-time endoscopy visualization at the scanner. MRI endoscopy was performed at 6-10 frames/sec and 200-300 μm resolution in human arterial specimens and porcine vessels ex vivo and in vivo and compared with fully sampled 0.3 frames/sec and three-dimensional reference scans using mutual information (MI) and structural similarity (3-SSIM) indices. Results. High-speed MRI endoscopy at 6-10 frames/sec was consistent with fully sampled MRI endoscopy and histology, with feasibility demonstrated in vivo in a large animal model. A 20-30-fold speed-up vs. 0.3 frames/sec reference scans came at a cost of ~7% in MI and ~45% in 3-SSIM, with reduced motion sensitivity. Conclusion. High-resolution MRI endoscopy can now be performed at frame rates comparable to those of X-ray and optical endoscopy and could provide an alternative to existing modalities, with MRI's advantages of soft-tissue sensitivity and lack of ionizing radiation.


Ciprofloxacin-resistant ST198 Salmonella Kentucky in a hospitalized American black bear (Ursus americanus), with evidence of subsequent nosocomial transmission.
Global emergence of ciprofloxacin-resistant ST198 Salmonella Kentucky poses an important public health threat. While conducting Salmonella surveillance among wildlife patients admitted to our veterinary medical teaching hospital in central New York, we isolated multidrug-resistant (MDR) ST198 Salmonella Kentucky from an American black bear (Ursus americanus) in September 2020. The isolate was phenotypically resistant to numerous antimicrobial agents, including ceftriaxone and ciprofloxacin, and several antimicrobial resistance genes and mutational resistance determinants were detected. Between April and July 2021, the same strain of MDR ST198 Salmonella Kentucky was also isolated from seven other wildlife patients and multiple hospital environmental locations, suggesting nosocomial transmission. Ciprofloxacin resistance is conferred by triple point mutations in the quinolone resistance-determining regions (QRDRs), a genotypic profile indicative of Clade ST198.2. To our knowledge, this is the first report of this ciprofloxacin-resistant clade being identified in animals or animal products in the United States. Timely resolution of the outbreak was achieved following efforts to further enhance environmental disinfection protocols and biosecurity measures at the hospital, with no known cases or positive environmental samples after July 2021.


Interface for the documentation and compilation of a library of computer models in physiology.
A software interface for the documentation and compilation of a library of computer models in physiology was developed. The interface is an interactive program built within a word processing template in order to provide ease and flexibility of documentation. A model editor within the interface directs the model builder as to standardized requirements for incorporating models into the library and provides the user with an index to the levels of documentation. The interface and accompanying library are intended to facilitate model development, preservation and distribution and will be available for public use.


Listening with text.
Asynchronous, text-based patient-physician encounters are highly effective as a first touch point to the health system as they allow experienced physicians to make the first decision on next steps. Results are beginning to come in with patients in Colorado and Texas along five key measures: utilization, re-engagement, compliance, response time, and overall savings.


Legislative developments in patients' rights in Belgium.
The legislative developments regarding the rights of patients in Belgium are described, analysed and discussed. Legislative developments in this field are rather recent and scarce. Up to now overall interest of the legislator has been disappointing. This may be explained by an exaggerated and out-dated confidence in medical professional ethics as an alternative source of regulation.


Comparison of the three-dimensional structures of mandibular condyles between adults with and without facial asymmetry: A retrospective study.
This retrospective study compared the three-dimensional (3D) structure of mandibular condyles between adults with and without facial asymmetry, and whether it influences menton deviation. Sixty adult patients were classified into symmetry and asymmetry groups based on the menton deviation on postero-anterior radiographs. The right/left differences of 3D measurements were compared between the two groups, and measurements were compared separately on the right and left sides. The correlations between menton deviation and the right/left differences were analyzed. The mediolateral dimension, neck length, condylar angles to the anteroposterior reference (PO) and midsagittal reference planes, and neck and head volumes showed significantly larger right/left differences in the asymmetry group compared to the symmetry group. Separate comparisons of the right and left sides between the two groups showed that the neck was significantly shorter and neck and head volumes were significantly smaller on the left side, which was deviated side in the asymmetry group. Pearson's correlation analysis showed significant positive correlations of menton deviation with right/left differences in neck length, condylar angle to the PO plane, and neck and head volumes in the asymmetry group. In individuals with facial asymmetry, menton deviation is associated with the right/left differences caused by a smaller condyle on the deviated side, particularly in neck length and neck and head volumes.


Corrosion Passivation in Simulated Body Fluid of Ti-Zr-Ta-xSn Alloys as Biomedical Materials.
The powder metallurgy method was used to manufacture three Ti-based alloys: Ti-15%Zr-2%Ta-4%Sn (Ti-Zr-Ta-4Sn), Ti-15%Zr-2%Ta-6%Sn (Ti-Zr-Ta-6Sn), and Ti-15%Zr-2%Ta-8%Sn (Ti-Zr-Ta-8Sn). Electrochemical measurements and surface analyses were used to determine the effect of Sn concentration on the corrosion of these alloys after exposure to a simulated body fluid (SBF) solution for 1 h and 72 h. It was found that the passivation of the alloy surface significantly increased when the Sn content increased from 4% to 6% and then to 8%, which led to a significant reduction in corrosion. The impedance spectra derived from the Nyquist graphs also explained how the addition of Sn significantly improved the alloys' polarization resistances. According to the change in the chronoamperometric current at an applied anodic potential over time, the increase in Sn content within the alloy significantly reduced the currents over time, indicating that the uniform and pitting corrosion were greatly decreased. The formation of an oxide layer (TiO2), which was demonstrated by the surface morphology of the alloys after exposure to SBF solution for 72 h and corrosion at 400 mV (Ag/AgCl) for 60 min, was supported by the profile analysis obtained by an X-ray spectroscopy analyzer. It was clear from all of the findings that the tested alloys have a remarkable improvement in resistance to corrosivity when the Sn content was increased to 8%.


Effects of Spectral Overlays on Reading Performance of Brazilian Elementary School Children.
To investigate the effects of spectral overlays on reading performance of Brazilian elementary school children. Sixty-eight children (aged 9-12 years) enrolled in the 5th and 6th grade were included in the study. The Rate of Reading Test (RRT - Brazilian Portuguese version) was used to evaluate reading speed and the Irlen Reading Perceptual Scale was used to allocate the sample according to reading difficulty/discomfort symptoms and to define the optimal spectral overlays. A total of 13% of the children presented an improvement of at least 15% in reading speed with the use of spectral overlays. Pupils with severe reading difficulties tended to have more improvement in RRT with spectral overlays. Children with severe reading discomfort obtained the highest gains in RRT, with an average of 9.6% improvement with intervention, compared to a decrease of -8.2% in the control group. Participants with severe discomfort had an odds ratio of 3.36 to improve reading speed with intervention compared to the control group. The use of spectral overlays can improve reading performance, particularly in those children with severe visual discomfort.


Socioeconomic Disparities in Colorectal Cancer Screening in Korea: A Nationwide Cross-Sectional Study.
Colorectal cancer (CRC) is a common cancer worldwide. The incidence and mortality rates of CRC are higher among lower socioeconomic status (SES) populations. We investigated the association between different indicators of SES and CRC screening rates in Korea. The eligible study population included males and females aged 50 to 74 years who participated in a nationwide cross-sectional survey (2010-2012). The "compliance with recommendation" category was applicable to participants who had undergone a fecal occult blood test (FOBT), double-contrast barium enema, or colonoscopy within 1, 5, or 10 years, respectively. In total, 6221 subjects (51.4% female, 55.6% aged 50 years) were included in the final analysis. Lower household income was significantly negatively related to compliance with screening recommendations (P for trend < 0.01) and marginally significantly related to noncompliance with recommendations (P for trend = 0.07). Older age and poor self-reported health were associated with the screening rate using the FOBT; male sex, older age, higher household income, having supplemental insurance, family history of cancer, and poor self-reported health were associated with a higher screening rate using colonoscopy. Lower household income was associated with a higher screening rate using the FOBT and with a lower screening rate using colonoscopy. To increase the rate of CRC screening using colonoscopy, efforts should be made toward improving the education and promotion of screening to the low household income target population.


Rifampicin loaded mannosylated cationic nanostructured lipid carriers for alveolar macrophage-specific delivery.
In this study, cationic mannosylated nanostructured lipid carriers (Man-NLCs) were developed for the targeted delivery of rifampicin to alveolar macrophages. Rifampicin loaded Man-NLCs (RFP-Man-NLCs) and rifampicin loaded unmodified nanostructured lipid carriers (REP-NLCs) were prepared using thin film homogenization method and characterized by particle size, polydispersity index, zeta potential, transmission electron microscopy, encapsulation efficiency, pharmacokinetics, biodistribution, cell specific targeting, cytotoxicity and inflammatory response. RFP-Man-NLCs and REP-NLCs obtained displayed a size distribution around 160 nm (PDI <0.30) with positive charges of approximately 30 mV. The encapsulation efficiency of RFP was above 90%. In the biodistribution study, both RFP-Man-NLCs and RFP-NLCs, compared with the commercially available rifampicin solution, displayed superior lung-targeting ability. Compared to REP-NLCs, RFP-Man-NLCs exhibited significantly higher uptake efficiency in NR8383 cells and alveolar macrophages, which achieved cell-specific targeting. In addition, RFP-Man-NLCs were demonstrated to be a safe formulation with minimum toxicity and no inflammatory response. RFP-Man-NLCs provided an alternative strategy for selectively delivering rifampicin to alveolar macrophages.


[Association of peroxisome proliferator-activated-receptors-gamma C161-->T gene polymorphism with metabolic syndrome and dietary predisposition].
To study the genotype frequencies of peroxisome proliferators-activated -receptors-gamma C161-->T gene and its possible association with the metabolic syndrome and dietary intakes. The PCR-PFLP method was used to detect the polymorphism of PPARgammaC161-->T gene of 224 adults with metabolic syndrome and 224 normal adults in Shanghai. Their physical examinations, dietary investigation and the serum biochemistry were analyzed. (1) The genotype frequencies of PPARgamma C161-->T CC, CT and TT were 32.4%, 49.6% and 18.0% respectively, which were in agreement with Hardy-Weinberg equilibrium. There was no significant difference in the distribution of genotypes or allele between the metabolic syndrome group and the control group, and the result was the same between male and female subjects. (2) The levels of body mass index,waist width and hip width were significantly different among three genotypes groups. Subjects of the CT genotype had the highest levels. (3) There was significant difference in the negative correlation with the intake of protein and serum TG levels in the metabolic syndrome group. The results suggested PPARgamma gene C161-->T should be associated with body mass index, waist width and hip width. It might contribute to the heterogeneity in diet response to TG.


Differential impacts of copper oxide nanoparticles and Copper(II) ions on the uptake and accumulation of arsenic in rice (Oryza sativa).
Arsenic (As) in rice grains is a serious food safety concern. Some coexisting engineered nanoparticles (ENPs) were shown to alter the accumulation and speciation of As in rice grains. However, investigation on the effects of copper oxide nanoparticles (CuO NPs), a popular ingredient in pesticides, on the uptake and accumulation of As is rare. We explored the potentially different impact of CuO NPs and corresponding Cu(II) ions on the accumulation of two As species in rice seedlings in a hydroponic system. Rice seedlings were treated with a combinations of 1 mg/L of arsenite (As(III)) or arsenate (As(V)) and 100 mg/L of CuO NPs or Cu(II) for 6 days. Both forms of Cu significantly reduced the accumulation of total As in rice tissues, with Cu(II) exhibiting significantly greater effect than CuO NPs. As speciation in rice roots was markedly affected by both forms of Cu, and the impacts were Cu-form dependent. For example, the co-existence of As(V) with CuO NPs led to a 45% decrease of As(V) in rice roots, while the co-existence of As(V) with Cu(II) caused a 47% increase in As(V) in rice roots. As speciation in rice shoots was less affected by co-present Cu than in rice roots. Co-occurring As(III) or As(V) lowered Cu concentration in rice roots by 40% and 50% in treatments with CuO NPs, but did not affect Cu content in rice roots co-exposed to Cu(II). The study confirmed the reciprocal effect of co-occurring CuO NPs or Cu(II) and As in rice paddies and highlighted the unique "nano-effect" of CuO NPs. The results alsos showed that the initial oxidation state of As plays an important role in the interactions between As and Cu. The results shed light on the current debate on the safe applications of nano-enabled agrichemicals vs. conventional metal salts in agriculture.


The central control of fetal breathing and movements.
In fetal lambs after 115 days gestation breathing movements become episodic in association with electrocortical differentiation into predominantly high voltage slow or low voltage rapid activity, the latter characteristic of rapid eye movement sleep. Section of the brainstem at or above the colliculi dissociates fetal breathing from electrocortical activity. It is included that breathing is inhibited, towards the end of gestation, by a supracollicular mechanism during high voltage activity. After brainstem transection at the colliculi hypoxia no longer causes an arrest of fetal breathing, which often becomes more vigorous. The arrest of breathing in normal fetuses subjected to mild hypoxia is also attributed to a supracollicular mechanism. The pattern of fetal skeletal movements and of the spinal segmental reflexes is related to electrocortical activity near term; both are suppressed by hypoxia. The hypothesis is discussed of a central control centre, excited directly or indirectly by hypoxia, which inhibits fetal movements including breathing. Its possible location is considered.


Designing molecular bistability in ruthenium dimethyl sulfoxide complexes.
Compounds of the type [Ru(tpy)(L2)(dmso)](z+) (tpy is 2,2':6',2' '-terpyridine; L2 can be 2,2'-bipyridine (bpy), N,N,N',N'-tetramethylethylenediamine (tmen), 2-pyridine carboxylate (pic), acetylacetonate (acac), malonate (mal), or oxalate (ox)) have been studied by X-ray crystallography, electrochemistry, NMR, IR, and UV-vis spectroscopy. When L2 is bpy, tmen, or pic, the dmso ligand can be intramolecularly isomerized either electrochemically or photochemically. Isomerization is not observed when L2 is acac, mal, or ox. Isomerization results in a drastic change in the absorption spectrum, as well as in the voltammetry. Absorption maxima shift by 3470 (419-490 nm), 4775 (421-527 nm), and 4440 cm(-)(1) (429-530 nm) for the bpy, pic, and tmen complexes, respectively. Reduction potentials for S-bonded and O-bonded complexes differ by 0.57, 0.75, and 0.62 V for the bpy, pic, and tmen complexes, respectively. Quantum yields of isomerization (phi(S)(-->)(O)) were determined for the bpy (0.024 +/- 1), pic (0.25 +/- 1), and tmen (0.007 +/- 1) complexes. In comparison of these data to photosubstitution quantum yields, it appears that the isomerization mechanism does not involve the ligand field states. This result is surprising given the importance of these states in the photochemistry of ruthenium and osmium polypyridine complexes. These results and details of the mechanism are discussed.


DWI prediction of symptomatic hemorrhagic transformation in acute MCA infarct.
Symptomatic hemorrhagic transformation is a severe complication of acute ischemic stroke which occurs at a higher frequency after thrombolysis. The present study was designed to analyze whether early DWI can be used for predicting the risk of hemorrhagic transformation with clinical worsening in MCA stroke patients. Of 28 patients with a middle cerebral artery (MCA) infarct and proven MCA or carotid T occlusion on DWI and MR angiography performed within 14 hours after onset (mean 6.5 +/- 3.5 hours, median 5.2 hours), 4 developed hemorrhagic transformation with clinical worsening, while 24 did not. For the 2 groups, we compared admission NIHSS score, site of arterial occlusion, volume of DWI abnormalities, and several apparent diffusion coefficient (ADC) measurements: ADC(infarct) (mean ADC value of the whole infarct), ADC(core) (peak ADC decrease as calculated in a 57 mm(2) circular ROI, manually centered on the ischemic area with the lowest ADC value on the ADC maps), ADC(superficial) and ADC(deep). Discriminant function analysis was used to determine the most accurate predictors of symptomatic hemorrhagic transformation. The best predictor was the ADC(core) (F=5.34, p=2.9%, cut-off value=300 x 10(-6) mm(2)/s). This monovariate model allowed to correctly classify all 4 patients (ADC(core) 300 x 10(-6) mm(2)/s) with subsequent symptomatic hemorrhage, and 17 of the 24 patients without symptomatic hemmorrhage (ADC(core)>300 x 10(-6) mm(2)/s) (100% sensitivity, 71% specificity). Although preliminary, these results suggest that a simple measurement of minimum ADC values within an acute MCA stroke could be useful in targeting those patients with a high risk of severe hemorrhagic transformation.


Immunotoxic Effect of Low-Dose Methylmercury Is Negligible in Mouse Models of Ovalbumin or Mite-Induced Th2 Allergy.
Methylmercury (MeHg) is one of the most toxic environmental pollutants and presents a serious hazard to health worldwide. Although the adverse effects of MeHg, including neurotoxicity, have been studied, its effects on immune function, in particular the immune response, remain unclear. This study examined the effects of low-dose MeHg on immune responses in mice. Mice were orally immunized with ovalbumin (OVA) or subcutaneously injected with mite extract to induce a T-helper 2 (Th2) allergic response. They were then exposed to MeHg (0, 0.02, 1.0, or 5.0 mg·kg(-1)·d(-1)). Immunization with oral OVA or subcutaneous mite extract increased serum levels of OVA-specific immunoglobulin (Ig) E (OVA-IgE), OVA-IgG1, interleukin (IL)-4, and IL-13, and total IgE, total IgG, and IL-13 when compared with levels in non-immunized mice. However, no interferon (IFN)-γ was detected. By contrast, serum levels of OVA-IgE, OVA-IgG1, IL-4, and IL-13, or total IgE, total IgG, and IL-13 in Th2 allergy model mice subsequently treated with MeHg were no higher than those in MeHg-untreated mice. These results suggest that MeHg exposure has no adverse effects on Th2 immune responses in antigen-immunized mice.


Polarization Effects in Graded AlGaN Nanolayers Revealed by Current-Sensing and Kelvin Probe Microscopy.
We experimentally demonstrate that the conductivity of graded AlxGa1-xN increases as a function of the magnitude of the Al concentration gradient (%Al/nm) due to polarization doping effects, without the use of impurity dopants. Using three up/down-graded AlxGa1-xN nanolayers with Al gradients ranging from ∼0.16 to ∼0.28%Al/nm combined in one structure, the effects of polarization engineering for localized electric fields and current transport were investigated. Cross-sectional Kelvin probe force microscopy and conductive atomic force microscopy were used to directly probe the electrical properties of the films with spatial resolution along the thickness of the growth. The experimental profiles of the built-in electric fields and the spreading current found in the graded layers are shown to be consistent with simulations of the field distribution as well as of the electron and hole densities. Finally, it was directly observed that for gradients less than 0.28%Al/nm the native n-type donors still limit polarization-induced hole doping, making p-type conductivity still a challenge due to background impurities and defects.


Persistence of antibodies 20 y after vaccination with a combined hepatitis A and B vaccine.
Vaccination is the most effective and well-tolerated method of conferring long-term protection against hepatitis A and B viruses (HAV; HBV). Long-term studies are required to characterize the duration of protection and need for boosters. Following primary immunization of 150 and 157 healthy adults with 3-doses of combined hepatitis A/hepatitis B vaccine (HAB; Twinrix™, GSK Vaccines, Belgium) at 0-1-6 months in 2 separate studies, we measured vaccine-induced antibody persistence against HAV and HBV annually for 20 y (Study A: NCT01000324; Study B: NCT01037114). Subjects with circulating anti-HAV antibodies < 15 mIU/mL or with anti-hepatitis B surface antigen < 10 mIU/mL were offered an additional monovalent hepatitis A and/or B vaccine dose (Havrix™/Engerix™-B, GSK Vaccines, Belgium). Applying the immunogenicity results from these studies, mathematical modeling predicted long-term persistence. After 20 y, 18 and 25 subjects in studies A and B, respectively, comprised the long-term according-to-protocol cohort for immunogenicity; 100% and 96.0% retained anti-HAV antibodies ≥ 15 mIU/mL, respectively; 94.4% and 92.0% had anti-HBs antibodies ≥ 10 mIU/mL, respectively. Between Years 16-20, 4 subjects who received a challenge dose of monovalent hepatitis A vaccine (N = 2) or hepatitis B vaccine (N = 2), all mounted a strong anamnestic response suggestive of immune memory despite low antibody levels. Mathematical modeling predicts that 40 y after vaccination ≥ 97% vaccinees will maintain anti-HAV ≥ 15 mIU/mL and ≥ 50% vaccinees will retain anti-HBs ≥ 10 mIU/mL. Immunogenicity data confirm that primary immunization with 3-doses of HAB induces persisting anti-HAV and anti-HBs specific antibodies in most adults for up to 20 y; mathematical modeling predicts even longer-term protection.


Physical Activity Interventions During the School Day: Reviewing Policies, Practices, and Benefits.
There are many ways to increase physical activity (PA) during the school day as part of a Comprehensive School Physical Activity Plan. This article reviews policies and practices that can be used during the school day to increase PA for students. We searched systematic reviews for articles that met criteria (2010-2018, phase 1), followed by a search for individual articles addressing topics for which we did not identify a sufficiently relevant or recent review or to update an earlier review that concluded insufficient evidence (2010-2020, phase 2). We included 45 articles (45 studies, 54 interventions). We grouped studies by intervention type: school-wide PA approaches to reach all students within the school setting (17), physical education (PE) interventions (13), and interventions related to recess (15). Few studies involved secondary schools or rural settings. Among 45 studies reporting PA behavior or fitness outcomes, 37 reported at least 1 improvement. PA policies, PE, and recess can help improve school health by increasing the PA levels of students.


A study on sludge minimization during the treatment of pickling effluent.
In pickling industries, a lot of sludge is generated during the treatment of pickling effluent and there is severe problem of its disposal. Disposal of this sludge as per the Hazardous Waste (Management & Handling) Rules, 1989 is not easy. Its transportation and construction of lined disposal sites pose very severe problems. In the normal practice, the sludge is being disposed of at the sides of roads and railway tracks to fill low lying areas. This may cause serious health hazards. Considering these problems, a study has been undertaken to minimize the sludge generation during the treatment of pickling effluent by neutralizing it with lime, sodium hydroxide and combination of both. An attempt has been made to do an economic evaluation of the above process.


Does hospitalization prevent preterm delivery in the patient with a short cervix?
This study considers whether admission to the hospital of a patient diagnosed with a short cervix delayed delivery, prevented preterm delivery, and/or decreased the rate of change in the cervical length (CL) on follow-up measurements. The design was a retrospective cohort study of women carrying singleton pregnancies with cervical lengths <or= 25 mm at gestational ages 16 to 28 weeks managed expectantly from July 2002 through July 2005. Eighty-two patients met criteria for inclusion, 26 (32%) of whom were hospitalized. On univariate analysis, hospitalization correlated with delivery < 34 weeks ( p=0.027), an earlier gestational age (GA) at delivery ( p=0.046), and a shorter time from diagnosis to delivery ( p< .001). Multivariate regression analysis of significant factors (age, prior preterm births, initial CL, GA at diagnosis, and hospitalization) showed a correlation between hospitalization and increased rate of cervical shortening ( p=0.005), and a trend toward hospitalization as an independent risk factor for delivery less than 34 weeks ( p=0.066), an earlier GA at delivery ( p=0.058), and a shorter time from diagnosis to delivery ( p=0.078). There also was no benefit seen from hospitalization when the initial CL was < 15 mm, although we were underpowered for this analysis. Admission to the hospital was not associated with a decreased rate of preterm delivery and there was a trend toward hospitalization as an independent risk factor for delivery at < 34 weeks, an earlier GA at delivery, and a shorter time from diagnosis to delivery. Hospitalization was independently associated with an increased rate of cervical shortening.


Absence of the discontinuous transition in the one-dimensional triplet creation model.
Although Hinrichsen in his unpublished work theoretically rebutted the possibility of the discontinuous transition in one-dimensional nonequilibrium systems unless there are additional conservation laws, long-range interactions, macroscopic currents, or special boundary conditions, we have recently observed the resurrection of the claim that the triplet creation (TC) model introduced by Dickman and Tomé [Phys. Rev. A 44, 4833 (1991)] would show the discontinuous transition. By extensive simulations, however, we find that the one-dimensional TC does belong to the directed percolation universality class even for larger diffusion constant than the suggested tricritical point in the literature. Furthermore, we find that the phase boundary is well described by the crossover from the mean field to the directed percolation, which supports the claim that the one-dimensional TC does not exhibit a discontinuous transition.


Synthetic biology meets tissue engineering.
Classical tissue engineering is aimed mainly at producing anatomically and physiologically realistic replacements for normal human tissues. It is done either by encouraging cellular colonization of manufactured matrices or cellular recolonization of decellularized natural extracellular matrices from donor organs, or by allowing cells to self-organize into organs as they do during fetal life. For repair of normal bodies, this will be adequate but there are reasons for making unusual, non-evolved tissues (repair of unusual bodies, interface to electromechanical prostheses, incorporating living cells into life-support machines). Synthetic biology is aimed mainly at engineering cells so that they can perform custom functions: applying synthetic biological approaches to tissue engineering may be one way of engineering custom structures. In this article, we outline the 'embryological cycle' of patterning, differentiation and morphogenesis and review progress that has been made in constructing synthetic biological systems to reproduce these processes in new ways. The state-of-the-art remains a long way from making truly synthetic tissues, but there are now at least foundations for future work.


Nanomaterials for energy conversion and storage.
Nanostructured materials are advantageous in offering huge surface to volume ratios, favorable transport properties, altered physical properties, and confinement effects resulting from the nanoscale dimensions, and have been extensively studied for energy-related applications such as solar cells, catalysts, thermoelectrics, lithium ion batteries, supercapacitors, and hydrogen storage systems. This review focuses on a few select aspects regarding these topics, demonstrating that nanostructured materials benefit these applications by (1) providing a large surface area to boost the electrochemical reaction or molecular adsorption occurring at the solid-liquid or solid-gas interface, (2) generating optical effects to improve optical absorption in solar cells, and (3) giving rise to high crystallinity and/or porous structure to facilitate the electron or ion transport and electrolyte diffusion, so as to ensure the electrochemical process occurs with high efficiency. It is emphasized that, to further enhance the capability of nanostructured materials for energy conversion and storage, new mechanisms and structures are anticipated. In addition to highlighting the obvious advantages of nanostructured materials, the limitations and challenges of nanostructured materials while being used for solar cells, lithium ion batteries, supercapacitors, and hydrogen storage systems have also been addressed in this review.


Different Paths to Different Strategies? Unique Associations Among Facets of the Dark Triad, Empathy, and Trait Emotional Intelligence.
Emotional deficits, such as limited empathy, are considered a fundamental aspect of the Dark Triad traits (narcissism, Machiavellianism, and psychopathy). However, the nature and extent of such deficiencies seem to vary among dark personalities. By applying multidimensional measures of empathy, emotional intelligence, and the Dark Triad, we aimed to investigate in more detail how individuals high in various dark traits understand and evaluate emotions. Results indicated that each trait, and, moreover, each facet thereof entailed unique emotional deficiencies. Narcissism was positively associated with trait emotional intelligence, whereas the secondary factor of psychopathy was associated negatively. With respect to empathy, only primary psychopathy was linked to an overall deficit, while a positive relationship was found between Machiavellianism and the perspective-taking facet of cognitive empathy. We argue that the specific emotional limitations of the Dark Triad traits might contribute to the successful deployment of different socially aversive strategies.


The regional genetic and newborn screening service collaboratives: the first two years.
Newborn screening and genetic technologies are expanding and changing rapidly, increasing the demand for genetic specialty services. Because of the scarcity and geographic maldistribution of genetic specialty services, access to these services is a critical issue. This article discusses some of the efforts initiated by the Maternal and Child Health Bureau of the Health Resources and Services Administration, particularly the establishment of regional genetic and newborn screening collaboratives to improve access to these services and expertise.


Importance of extracellular vesicle secretion at the blood-cerebrospinal fluid interface in the pathogenesis of Alzheimer's disease.
Increasing evidence indicates that extracellular vesicles (EVs) play an important role in the pathogenesis of Alzheimer's disease (AD). We previously reported that the blood-cerebrospinal fluid (CSF) interface, formed by the choroid plexus epithelial (CPE) cells, releases an increased amount of EVs into the CSF in response to peripheral inflammation. Here, we studied the importance of CP-mediated EV release in AD pathogenesis. We observed increased EV levels in the CSF of young transgenic APP/PS1 mice which correlated with high amyloid beta (Aβ) CSF levels at this age. The intracerebroventricular (icv) injection of Aβ oligomers (AβO) in wild-type mice revealed a significant increase of EVs in the CSF, signifying that the presence of CSF-AβO is sufficient to induce increased EV secretion. Using in vivo, in vitro and ex vivo approaches, we identified the CP as a major source of the CSF-EVs. Interestingly, AβO-induced, CP-derived EVs induced pro-inflammatory effects in mixed cortical cultures. Proteome analysis of these EVs revealed the presence of several pro-inflammatory proteins, including the complement protein C3. Strikingly, inhibition of EV production using GW4869 resulted in protection against acute AβO-induced cognitive decline. Further research into the underlying mechanisms of this EV secretion might open up novel therapeutic strategies to impact the pathogenesis and progression of AD.


A mutant Tat protein inhibits infection of human cells by strains from diverse HIV-1 subtypes.
Nullbasic is a mutant HIV-1 Tat protein that inhibits HIV-1 replication via three independent mechanisms that disrupts 1) reverse transcription of the viral RNA genome into a DNA copy, 2) HIV-1 Rev protein function required for viral mRNA transport from the nucleus to the cytoplasm and 3) HIV-1 mRNA transcription by RNA Polymerase II. The Nullbasic protein is derived from the subtype B strain HIV-1BH10 and has only been tested against other HIV-1 subtype B strains. However, subtype B strains only account for ~10% of HIV-1 infections globally and HIV-1 Tat sequences vary between subtypes especially for subtype C, which is responsible for ~50% HIV-1 infection worldwide. These differences could influence the ability of Tat to interact with RNA and cellular proteins and thus could affect the antiviral activity of Nullbasic. Therefore, Nullbasic was tested against representative HIV-1 strains from subtypes C, D and A/D recombinant to determine if it can inhibit their replication. Nullbasic was delivered to human cells using a self-inactivating (SIN) γ-retroviral system. We evaluated Nullbasic-mCherry (NB-mCh) fusion protein activity against the HIV-1 strains in TZM-bl cell lines for inhibition of transactivation and virus replication. We also examined antiviral activity of Nullbasic-ZsGreen1 (NB-ZSG1) fusion protein against the same strains in primary CD4+ T cells. The Nullbasic expression was monitored by western blot and flow cytometry. The effects of Nullbasic on primary CD4+ T cells cytotoxicity, proliferation and apoptosis were also examined. The results show that Nullbasic inhibits Tat-mediated transactivation and virus replication of all the HIV-1 strains tested in TZM-bl cells. Importantly, Nullbasic inhibits replication of the HIV-1 strains in primary CD4+ T cells without affecting cell proliferation, cytotoxicity or level of apoptotic cells. A SIN-based γ-retroviral vector used to express Nullbasic fusion proteins improved protein expression particularly in primary CD4+ T cells. Nullbasic has antiviral activity against all strains from the subtypes tested although small differences in viral inhibition were observed. Further improvement of in γ-retroviral vector stable expression of Nullbasic expression may have utility in a future gene therapy approach applicable to genetically diverse HIV-1 strains.


Particulate matter exposure exacerbates cellular damage by increasing stress granule formation in respiratory syncytial virus-infected human lung organoids.
Exposure to atmospheric particulate matter (PM) increases morbidity and mortality in respiratory diseases by causing various adverse health effects; however, the effects of PM exposure on cellular stress under virus-infected conditions remain unclear. The effects of PM under 10 μm (PM10) and diesel PM (DPM) on respiratory syncytial virus (RSV) infection were investigated in human two-dimensional lung epithelial cells and human three-dimensional lung organoids mimicking the lung tissue. We evaluated the formation of stress granules, which are important in cellular adaptation to various stress conditions. Furthermore, we investigated the effects of repeated exposure to PM10 and DPM on DNA damage and cell death during viral infection. PM10 and DPM did not cause stress granule formation in the absence of RSV infection but drastically increased stress granule formation and signal transduction during RSV infection in human lung epithelial cells and human lung organoids. Further, repeated exposure to PM10 and DPM caused cell death by severely damaging DNA under RSV infection conditions. Thus, PM10 and DPM induce severe lung toxicity under stress conditions, such as viral infection, suggesting that the effects of PMs under various stressful conditions should be examined to accurately predict the lung toxicity of PM.


The osteopath-parent-child triad in osteopathic care in the first 2 years of life: a qualitative study.
Enactivism and active inference are two important concepts in the field of osteopathy. While enactivism emphasizes the role of the body and the environment in shaping our experiences and understanding of the world, active inference emphasizes the role of action and perception in shaping our experiences and understanding of the world. Together, these frameworks provide a unique perspective on the practice of osteopathy, and how it can be used to facilitate positive change in patients. Since the neonatal period is a crucial time for development, osteopaths should aim to create a therapeutic relationship. Arguably, through participatory sense-making, osteopaths can help the baby build a generative model (with positive priors) to deal with stress and needs throughout their life. Since the literature considers that interactions with the environment, which enact the patients' experiences, depending on contextual factors and communication between patient and caregiver, this research explored whether there is a correspondence between the indications in the literature and clinical practice in the management of the mother/parent-child dyad during osteopathic care on children aged 0 to 2 years old. Semi-structured interviews were conducted with a purposive sample of nine osteopaths with experience in the field of pediatrics. Interviews were transcribed verbatim, and constructivist grounded theory was used to conceptualize, collect and analyze data. Codes and categories were actively constructed through an interpretive/constructionist paradigm. The core category was the idea of the pediatric osteopath as a support for the family, not only for the child. Four additional categories were identified: (1) Preparing a safe environment for both children and parents, (2) Communication, (3) Attachment and synchrony, and (4) Synchronization. Through participatory sense-making, osteopaths manage contextual factors to establish an effective therapeutic alliance through the osteopath-parent-child triad to facilitate the construction of the child's internal generative model to promote healthy development. The therapeutic encounter is considered an encounter between embodied subjects, occurring within a field of affordances (ecological niche) that allows the interlocutors to actively participate in creating new meanings through interpersonal synchronization. Participatory sense-making and the establishment of a therapeutic alliance through the osteopath-parent-child triad are crucial to promote healthy development in the child.


Towards Safer Rocket Fuels: Hypergolic Imidazolylidene-Borane Compounds as Replacements for Hydrazine Derivatives.
Currently, toxic and volatile hydrazine derivatives are still the main fuel choices for liquid bipropellants, especially in some traditional rocket propulsion systems. Therefore, the search for safer hypergolic fuels as replacements for hydrazine derivatives has been one of the most challenging tasks. In this study, six imidazolylidene-borane compounds with zwitterionic structure have been synthesized and characterized, and their hypergolic reactivity has been studied. As expected, these compounds exhibited fast spontaneous combustion upon contact with white fuming nitric acid (WFNA). Among them, compound 5 showed excellent integrated properties including wide liquid operating range (-70-160 °C), superior loading density (0.99 g cm(-3) ), ultrafast ignition delay times with WFNA (15 ms), and high specific impulse (303.5 s), suggesting promising application potential as safer hypergolic fuels in liquid bipropellant formulations.


Dynamic-clamp analysis of the effects of convergence on spike timing. I. Many synaptic inputs.
Precise action potential timing is crucial in sensory acuity and motor control. Convergence of many synaptic inputs is thought to provide a means of decreasing spike-timing variability ("jitter"), but its effectiveness has never been tested in real neurons. We used the dynamic-clamp technique in mouse auditory brain stem slices to examine how convergence controls spike timing. We tested the roles of several synaptic properties that are influenced by ongoing activity in vivo: the number of active inputs (N), their total synaptic conductance (G(tot)), and their timing, which can resemble an alpha or a Gaussian distribution. Jitter was reduced most with large N, up to a factor of over 20. Variability in N is likely to occur in vivo, but this added little jitter. Jitter reduction also depended on the timing of inputs: alpha-distributed inputs were more effective than Gaussian-distributed inputs. Furthermore, the two distributions differed in their sensitivity to synaptic conductance: for Gaussian-distributed inputs, jitter was most reduced when G(tot) was 2-3 times threshold, whereas alpha-distributed inputs showed continued jitter reduction with higher G(tot). However, very high G(tot) caused the postsynaptic cell to fire multiple times, particularly when the input jitter outlasted the cell's refractory period, which interfered with jitter reduction. G(tot) also greatly affected the response latency, which could influence downstream computations. Changes in G(tot) are likely to arise in vivo through activity-dependent changes in synaptic strength. High rates of postsynaptic activity increased the number of synaptic inputs required to evoke a postsynaptic response. Despite this, jitter was still effectively reduced, particularly in cases when this increased threshold eliminated secondary spikes. Thus these studies provide insight into how specific features of converging inputs control spike timing.


Acute Pancreatitis Has a Long-term Deleterious Effect on Physical Health Related Quality of Life.
It is not clear how acute pancreatitis (AP) affects health related quality of life (HRQOL). We aimed to determine the long-term independent effect of AP on physical and mental HRQOL. We analyzed data from 91 patients (mean 52 years of age, 54% women) admitted with AP to the University of Pittsburgh Medical Center from 2011 to 2015 who responded to telephone surveys at a median of 14 months after hospital discharge (interquartile range, 12-16 months). Individuals who did not answer the telephone survey were sent a questionnaire by regular mail. Patients answered questions from the 12-Item Short-Form Survey, and answers were used to calculate mental component summary (MCS) and physical component summary (PCS) scores with norm-based scoring (normal ≥50). HRQOL for these subjects was compared with that of age- and sex-matched individuals without pancreatitis (1:2) identified from the North American Pancreatitis Study. We controlled for other covariates using multivariable regression analysis. At follow-up, individuals with AP had a significantly lower PCS score (46.2 ± 11.8) than did control subjects (51.1 ± 9.5; P < .01), but a similar MCS score. A 4-point reduction of the PCS was attributed to AP after controlling for sociodemographic factors and medical comorbidities. The only pancreatitis-related factor associated with low PCS score was multisystem organ failure. Presence of abdominal pain, analgesic use, disability, and current smoking at the time of follow-up were also associated with lower PCS scores. Etiology of AP, disease severity (by Revised Atlanta classification), use of nutritional support, and performance of pancreatic interventions did not affect HRQOL at follow-up. In a 14-month follow-up of patients hospitalized with AP, we found a meaningful, independent, and deleterious effect of AP in the physical HRQOL of these patients, compared to individuals without AP. Further research is needed to determine the duration of this impairment and to evaluate the effects of modifying risk factors.


Towards gene therapy for IPEX syndrome.
Immune dysregulation polyendocrinopathy enteropathy X linked (IPEX) syndrome is an uncurable disease of the immune system, with immune dysregulation that is caused by mutations in FOXP3. Current treatment options, such as pharmacological immune suppression and allogeneic hematopoietic stem cell transplantation, have been beneficial but present limitations, and their life-long consequences are ill-defined. Other similar blood monogenic diseases have been successfully treated using gene transfer in autologous patient cells, thus providing an effective and less invasive therapeutic. Development of gene therapy for patients with IPEX is particularly challenging because successful strategies must restore the complex expression profile of the transcription factor FOXP3, ensuring it is tightly regulated and its cell subset-specific roles are maintained. This review summarizes current efforts toward achieving gene therapy to treat immune dysregulation in IPEX patients.


Pfannenstiel wound dehiscence complicated by cecal bascule.
A 43-year-old female with a Pfannenstiel wound dehiscence complicated by cecal bascule is reported. The etiology of both cecal bascule and dehiscence is discussed. Contributing factors in this case include increased intra-abdominal pressure from the cecal bascule, and a running catgut closure of the anterior rectus sheath. When the diagnosis of cecal bascule is made, cecostomy with cecopexy is the treatment of choice. For prevention of wound disruption, the optimal closure of a Pfannenstiel incision utilizes interrupted nonabsorbable suture material.


Curve fitting of the corporate recovery rates: the comparison of Beta distribution estimation and kernel density estimation.
Recovery rate is essential to the estimation of the portfolio's loss and economic capital. Neglecting the randomness of the distribution of recovery rate may underestimate the risk. The study introduces two kinds of models of distribution, Beta distribution estimation and kernel density distribution estimation, to simulate the distribution of recovery rates of corporate loans and bonds. As is known, models based on Beta distribution are common in daily usage, such as CreditMetrics by J.P. Morgan, Portfolio Manager by KMV and Losscalc by Moody's. However, it has a fatal defect that it can't fit the bimodal or multimodal distributions such as recovery rates of corporate loans and bonds as Moody's new data show. In order to overcome this flaw, the kernel density estimation is introduced and we compare the simulation results by histogram, Beta distribution estimation and kernel density estimation to reach the conclusion that the Gaussian kernel density distribution really better imitates the distribution of the bimodal or multimodal data samples of corporate loans and bonds. Finally, a Chi-square test of the Gaussian kernel density estimation proves that it can fit the curve of recovery rates of loans and bonds. So using the kernel density distribution to precisely delineate the bimodal recovery rates of bonds is optimal in credit risk management.


Visualization of the operational space of edge-localized modes through low-dimensional embedding of probability distributions.
Information visualization aimed at facilitating human perception is an important tool for the interpretation of experiments on the basis of complex multidimensional data characterizing the operational space of fusion devices. This work describes a method for visualizing the operational space on a two-dimensional map and applies it to the discrimination of type I and type III edge-localized modes (ELMs) from a series of carbon-wall ELMy discharges at JET. The approach accounts for stochastic uncertainties that play an important role in fusion data sets, by modeling measurements with probability distributions in a metric space. The method is aimed at contributing to physical understanding of ELMs as well as their control. Furthermore, it is a general method that can be applied to the modeling of various other plasma phenomena as well.


Histidinibacterium lentulum gen. nov., sp. nov., a marine bacterium from the culture broth of marine microalga Picochlorum sp. 122.
A Gram-stain-negative, non-spore-forming, aerobic, motile, ovoid or short rod shaped bacterium, designed strain B17T, was isolated from the culture broth of Picochlorum sp. 122. Phylogenetic analyses based on 16S rRNA gene sequences indicated that strain B17T forms a stable cluster with Oceanicolagranulosus MCCC 1A10589T (with the highest 16S rRNA gene similarity of 95.8 %) and Roseisalinusantarcticus DSM 11466T in the family Rhodobacteraceae. The only detected respiratory quinone was Q-10. The major cellular fatty acids were C18 : 1 ω7c/ω6c, C17 : 1iso I/anteiso B and C16 : 0. The major polar lipids were phosphatidylglycerol, diphosphatidylglycerol, an unidentified phospholipid and two unidentified lipids. The genome G+C content was 69 mol%. Characteristics, such as a long lag phase, being motile with single polar flagellum, no aminolipid content, and little or no C18 : 1ω7c11-methyl and C19 : 0cyclo ω8c content could significantly distinguish strain B17T from its closely related type strains. Therefore strain B17T is suggested to represent a new species in a new genus, for which Histidinibacterium lentulum gen. nov., sp. nov. is proposed. The type strain B17T (=MCCC 1K03225T=KCTC 52553T).


Effects of intravenous fentanyl administration on end-tidal sevoflurane concentrations in thoroughbred racehorses undergoing orthopedic surgery.
To evaluate the effects of IV fentanyl administration on the end-tidal sevoflurane concentration (ET(SEVO)) in thoroughbred racehorses, the ET(SEVO) required for internal fixation of longitudinal fractures was compared between horses anesthetized with sevoflurane-fentanyl (Group SF; n=9) and those anesthetized with sevoflurane alone (Group S; n=9). The loading dose of fentanyl (5.0 µg/kg) was administered over 15 min followed by a maintenance dose of fentanyl (0.1 µg/kg/min) throughout the operation in Group SF. The mean ET(SEVO) during the operation in Group SF (2.6 ± 0.2%) was significantly lower than in Group S (3.0 ± 0.3%). The plasma fentanyl concentrations (6.12 ± 0.88 to 7.78 ± 1.12 ng/ml) in 7 out of 9 horses in Group SF were stable and did not change significantly throughout the operation. The mean dobutamine infusion rate required for maintaining a mean arterial blood pressure between 60 and 80 mmHg during the operation in Group SF (0.56 ± 0.30 µg/kg/min) was significantly lower than in Group S (0.90 ± 0.16 µg/kg/min). The qualities of the recoveries were clinically acceptable, and serious complications were not observed in either group. In conclusion, continuous IV fentanyl administration reduced the sevoflurane requirement by 13% in thoroughbred racehorses undergoing orthopedic surgery; however, fentanyl was considered to be less effective in horses compared with other species.


Actin cytoskeletal dynamics in smooth muscle: a new paradigm for the regulation of smooth muscle contraction.
A growing body of data supports a view of the actin cytoskeleton of smooth muscle cells as a dynamic structure that plays an integral role in regulating the development of mechanical tension and the material properties of smooth muscle tissues. The increase in the proportion of filamentous actin that occurs in response to the stimulation of smooth muscle cells and the essential role of stimulus-induced actin polymerization and cytoskeletal dynamics in the generation of mechanical tension has been convincingly documented in many smooth muscle tissues and cells using a wide variety of experimental approaches. Most of the evidence suggests that the functional role of actin polymerization during contraction is distinct and separately regulated from the actomyosin cross-bridge cycling process. The molecular basis for the regulation of actin polymerization and its physiological roles may vary in diverse types of smooth muscle cells and tissues. However, current evidence supports a model for smooth muscle contraction in which contractile stimulation initiates the assembly of cytoskeletal/extracellular matrix adhesion complex proteins at the membrane, and proteins within this complex orchestrate the polymerization and organization of a submembranous network of actin filaments. This cytoskeletal network may serve to strengthen the membrane for the transmission of force generated by the contractile apparatus to the extracellular matrix, and to enable the adaptation of smooth muscle cells to mechanical stresses. Better understanding of the physiological function of these dynamic cytoskeletal processes in smooth muscle may provide important insights into the physiological regulation of smooth muscle tissues.


'Stressors' and difficulties in dealing with the terminal patient.
This study investigated by means of questionnaires and semi-structured interviews some of the major sources of stress for palliative care nurses and how they deal with these. The nurses' replies were related to a general measure of health. Irrespective of their shifts, duties, and training, the nurses in two units specializing in palliative care shared very similar views. The most potent influence on the nurses' attitude to death was their own experience with dying patients. The nurses found it particularly stressful to deal with patients who suffer intractable pain, with those patients who have young children, and with those patients who are afraid to die. In addition, dealing with psychiatric symptoms and with relatives are major sources of stress. Generally, it was found that those symptoms and situations which left nurses feeling helpless and useless were the most stressful. The implications of these findings for nurse training and education are discussed.


Corticosterone analgesia is mediated by the spinal production of neuroactive metabolites that enhance GABAergic inhibitory transmission on dorsal horn rat neurons.
Corticosterone (CORT) is a glucocorticoid produced by adrenal glands under the control of the hypothalamic-pituitary-adrenal axis. Circulating CORT can enter the central nervous system and be reduced to neuroactive 3α5α-reduced steroids, which modulate GABAA receptors. In the dorsal spinal cord, GABAergic transmission modulates integration of nociceptive information. It has been shown that enhancing spinal inhibitory transmission alleviates hyperalgesia and allodynia. Therefore, the spinal neuronal network is a pivotal target to counteract pain symptoms. Thus, any increase in spinal 3α5α-reduced steroid production enhancing GABAergic inhibition should reduce nociceptive message integration and the pain response. Previously, it has been shown that high levels of plasma glucocorticoids give rise to analgesia. However, to our knowledge, nothing has been reported regarding direct non-genomic modulation of neuronal spinal activity by peripheral CORT. In the present study, we used combined in vivo and in vitro electrophysiology approaches, associated with measurement of nociceptive mechanical sensitivity and plasma CORT level measurement, to assess the impact of circulating CORT on rat nociception. We showed that CORT plasma level elevation produced analgesia via a reduction in C-fiber-mediated spinal responses. In the spine, CORT is reduced to the neuroactive metabolite allotetrahydrodeoxycorticosterone, which specifically enhances lamina II GABAergic synaptic transmission. The main consequence is a reduction in lamina II network excitability, reflecting a selective decrease in the processing of nociceptive inputs. The depressed neuronal activity at the spinal level then, in turn, leads to weaker nociceptive message transmission to supraspinal structures and hence to alleviation of pain.


Traumatic brain injury in young rats leads to progressive behavioral deficits coincident with altered tissue properties in adulthood.
Traumatic brain injury (TBI) affects many infants and children, and results in enduring motor and cognitive impairments with accompanying changes in white matter tracts, yet few experimental studies in rodent juvenile models of TBI (jTBI) have examined the timeline and nature of these deficits, histologically and functionally. We used a single controlled cortical impact (CCI) injury to the parietal cortex of rats at post-natal day (P) 17 to evaluate behavioral alterations, injury volume, and morphological and molecular changes in gray and white matter, with accompanying measures of electrophysiological function. At 60 days post-injury (dpi), we found that jTBI animals displayed behavioral deficits in foot-fault and rotarod tests, along with a left turn bias throughout their early developmental stages and into adulthood. In addition, anxiety-like behaviors on the zero maze emerged in jTBI animals at 60 dpi. The final lesion constituted only ∼3% of brain volume, and morphological tissue changes were evaluated using MRI, as well as immunohistochemistry for neuronal nuclei (NeuN), myelin basic protein (MBP), neurofilament-200 (NF200), and oligodendrocytes (CNPase). White matter morphological changes were associated with a global increase in MBP immunostaining and reduced compound action potential amplitudes at 60 dpi. These results suggest that brain injury early in life can induce long-term white matter dysfunction, occurring in parallel with the delayed development and persistence of behavioral deficits, thus modeling clinical and longitudinal TBI observations.


The process of suicide: the sequence of disruptive events in the lives of suicide victims.
Certain disruptions in social relations or loss of social roles tend to precede the act of suicide. In general, this study has attempted to demonstrate the sequential ordering of these social losses and otherdisruptive events. It has been shown that loss of roles irn childhood and early adolescence, parents, home, sibilings, close relatives, and student role tends to be followed by chaotic marriages, loss of occupation role(s), and loss of one's own health either physical or mentalor, in some cases, both. Also parental roles tend to be lost through the death of a child. Take away one's social roles and you take away his humanity (See Palmer, 1970). An individual with nowhere to turn and having lost all, tends to be highly vulnerable to suicide.


Practical Integration-Free Episomal Methods for Generating Human Induced Pluripotent Stem Cells.
The advent of induced pluripotent stem (iPS) cell technology has revolutionized biomedicine and basic research by yielding cells with embryonic stem (ES) cell-like properties. The use of iPS-derived cells for cell-based therapies and modeling of human disease holds great potential. While the initial description of iPS cells involved overexpression of four transcription factors via viral vectors that integrated within genomic DNA, advances in recent years by our group and others have led to safer and higher quality iPS cells with greater efficiency. Here, we describe commonly practiced methods for non-integrating induced pluripotent stem cell generation using nucleofection of episomal reprogramming plasmids. These methods are adapted from recent studies that demonstrate increased hiPS cell reprogramming efficacy with the application of three powerful episomal hiPS cell reprogramming factor vectors and the inclusion of an accessory vector expressing EBNA1.


Ethical perspectives of the Australian live export trade.
To examine the ethical perspectives of the Australian live export trade. The perspectives of farmers and other industry personnel, overseas consumers, the Australian public, veterinarians and the assumed interests of transported animals are compared in relation to the ethical consequences. Animal welfare, societal, personal and professional ethics are identified and the ratification of different perspectives considered. There are positive and negative aspects of the trade for each stakeholder group, and the overall position adopted by any individual reflects their perspective of the balance of these components. The debate as to whether Australia should continue with the trade will be best served by consideration of the interests of all parties in the trade, including the consumers and animals, which are among the most affected by the trade. There is a need for further research to address the major welfare problems for the animals, an openness to inspection on the part of the trade and balance in media reporting.


Individual and sex distinctiveness in bark calls of domestic chinchillas elicited in a distress context.
Animals obtain information about their social environment by means of communication signals, which provide relevant subtle cues for individual recognition. An important requisite for this process is the existence of larger between- than within-emitter signal variation. Acoustic signals are complex traits susceptible of variation in their spectral and temporal components, implying that signal distinctiveness can result from differences in single or various acoustic components. In this study, domestic chinchillas were induced to vocalize in a distress context to describe the acoustic characteristics of the bark calls, and to determine features that denote the potential value of this vocalization for individual and/or sexual recognition. The results demonstrate that the variation in spectral and temporal components of the bark calls of chinchillas elicited under a distress context is larger between than within individuals, suggesting the potential of these signals for distinctiveness between individual signalers, although the potential of this call type for sex distinctiveness is quite limited. These results combined with previous studies on auditory capabilities of chinchillas contribute to position this rodent as a valuable model species for studying auditory-vocal interactions.


Lipidomics Profiling of Human Adipose Tissue Identifies a Pattern of Lipids Associated with Fish Oil Supplementation.
To understand the interaction between diet and health, biomarkers that accurately reflect consumption of foods of perceived health relevance are needed. The aim of this investigation was to use direct infusion-mass spectrometry (DI-MS) lipidomics to determine the effects of fish oil supplementation on lipid profiles of human adipose tissue. Adipose tissue samples from an n-3 polyunsaturated fatty acid (PUFA) supplementation study (n = 66) were analyzed to compare the pattern following supplementation equivalent to zero or four portions of oily fish per week. Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) were incorporated into highly unsaturated (≥5 double bonds) triglycerides (TGs), phosphocholines, and phosphoethanolamines as well as being detected directly as the nonesterified fatty acid forms. Multivariate statistics demonstrated that phospholipids were the most accurate and sensitive lipids for the assessing EPA and DHA incorporation into adipose tissue. Potential confounding factors (adiposity, age, and sex of the subject) were also considered in the analysis, and adiposity was also associated with an increase in highly unsaturated TGs as a result of incorporation of the n-6 PUFA arachidonic acid. DI-MS provides a high-throughput analysis of fatty acid status that can monitor oily fish consumption, suitable for use in cohort studies.


A case of conjunctival melanoma in a cat.
Since 1985, 5 cases of feline conjunctival melanoma have been reported in the literature. Information on feline conjunctival melanoma epidemiological features, localizations, macroscopic features and histological features is limited. We are describing the clinical, histopathologic features and outcomes in a cat that presented clinically with a slow developing dark brown mass located under the upper eyelid of the left eye. Pertinent literature is reviewed; and the recognizable clinical features and treatment are discussed. The mass was surgically resected. Despite its size, the lesion was easily separated from underlying tissues, making possible a macroscopic complete resection that left intact the adjacent conjunctiva. The tumour histological examination has showed a pigmented melanoma lacking encapsulation, but presenting a clear zone delimiting the lesion. It was exclusively composed of epithelioid cells, and presented mild cellular anaplasia and weak mitotic activity. These features allowed it to be classified as a quite differentiated melanoma with few signs of potential malignancy. In accordance with these histologic features, no recurrence has been registered 34 months after surgery. Thus, a favorable outcome is now reported for two out of six cases of conjunctival melanoma in the cat. This report also confirms the predilection for this neoplasm to arise from the bulbar conjunctiva.


A linear Fe-O-Fe unit in bis(dibenzyldimethylammonium) mu-oxo-bis[tribromoferrate(III)].
The title compound, (C16H20N)2[Fe2Br6O], crystallizes with one dibenzyldimethylammonium cation and one half of a mu-oxo-bis[tribromoferrate(III)] anion in the asymmetric unit. The bridging oxo group is situated on an inversion centre, resulting in a linear conformation for the Fe-O-Fe unit. The iron(III) cations have tetrahedral geometry, with bond angles in the range 106.8 (1)-112.2 (1) degrees . The ion pairs are held together by Coulombic forces and C-H...Br hydrogen bonds. Each Br- anion forms one hydrogen bond. No C-H...O hydrogen bonds are found between the O atom in the Fe-O-Fe unit and surrounding counter-cations, consistent with the linear configuration of the Fe-O-Fe unit.


Assessment of Clinical Outcome of Root Coverage Following Coronally Advanced Flap with or without Amniotic Membrane.
The present study aimed to assess the clinical outcome of root coverage following coronally advanced flap with or without amniotic membrane in Miller's class I or class II localized gingival recession in relation to anteriors. Five patients with bilaterally symmetrical Miller's class I or class II localized gingival recession were included in the study. Each patient was divided into control (without amniotic membrane) and test sites (with amniotic membrane) arbitrarily. Clinical parameters including plaque index, probing pocket depth (PPD), clinical attachment level (CAL), and depth and width of the gingival recession were recorded in a pro forma at baseline and in the 2nd, 4th, 12th week. The results were tabulated and subjected to statistical analysis using analysis of variance (ANOVA). A 0.600-mm, 0.400-mm, 2.630-mm, and 2.616-mm reduction in PPD and gain in CAL were observed at control and test sites in the 12th week postoperatively and was found to be statistically insignificant (P = 0.580 and P = 0.871, respectively). Changes in depth and width of the gingival recession were observed and found to be maximum between base line (2.28 mm, 3.01 mm, 2.71, and 3.09 mm) and 2nd week (0.00, 0.00 mm, 0.23, and 0.20 mm) but without statistical significance. From the above results of the study, it could be concluded that the use of amniotic membrane as a barrier along with coronally advanced flap did not influence the clinical outcome of root coverage procedure.


Cognitive and emotional predictors of female sexual dysfunctions: preliminary findings.
The influence of cognitive and emotional variables on specific female sexual dysfunctions was investigated. A total of 207 women (160 without sexual problems and 47 with a Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) diagnosis of sexual dysfunction) answered a set of questionnaires assessing cognitive and emotional variables (cognitive schemas activated in sexual context - Questionnaire of Cognitive Schema Activation in Sexual Context (QCSASC); sexual beliefs - Sexual Dysfunctional Beliefs Questionnaire (SDBQ); automatic thoughts and emotions presented during sexual activity - Sexual Modes Questionnaire (SMQ)); and sexual functioning (Female Sexual Function Index (FSFI)). Results indicated that most women with sexual dysfunction activate incompetence schemas when facing unsuccessful sexual situations. Additionally, lack of erotic thoughts and increased attentional focus on failure and disengagement thoughts during sexual activity were also common in the clinical sample. Besides these common factors, results showed that some specific cognitive and emotional factors are associated with different clinical presentations. Sexual conservative beliefs seem to be closely related to hypoactive sexual desire and to a certain extent to arousal difficulties in women. Body image beliefs and automatic thoughts focusing on self-body appearance seem to be strongly associated with orgasmic disorder. Regarding emotions, fear was one of the best predictors of vaginismus, whereas sadness, disillusion, guilt, and lack of pleasure and satisfaction were closely associated to hypoactive sexual desire. Overall, these findings may contribute to the discussion regarding the treatment strategies used for the different female sexual dysfunctions.


Medicare spending on HMOs and stand-alone drug plans: what is it worth to beneficiaries?
(1) Medicare beneficiaries value the expansion of stand-alone prescription drug plans more than they value the expansion of HMOs. (2) The addition of subsidized stand-alone prescription drug plans generates nine times as much value per government dollar as the increase in payments to HMOs.


Stabilizing Turing patterns with subdiffusion in systems with low particle numbers.
The role of subdiffusion in the formation of spatial Turing patterns with particle number fluctuations is studied. It is demonstrated for a generic activator-inhibitor system that for normal diffusion the particle number fluctuations stabilize the homogenous steady state in a regime where the mean-field analysis already predicts stable spatial patterns. In contrast, pattern formation is stabilized considerably even for very low particle numbers when the activator moves subdiffusively while the inhibitor diffuses normally. In particular, this also holds true when the subdiffusive activator spreads faster than the inhibitor on small time scales. Possible applications to pattern formation in cell biology are discussed.


Update your "sore throat" differential list: A case report and discussion of oral chlamydia.
There has been an exponential increase in sexually transmitted infections (STIs) in the United States, causing the Centers for Disease Control and Prevention to declare an epidemic. Current evidence demonstrates that extragenital STIs of the oropharynx and rectum are often asymptomatic and may not be associated with concurrent positive urogenital infections. As a result, these infections are often missed in primary care. Furthermore, guidelines only recommend extragenital site testing in men who have sex with men, excluding oropharyngeal chlamydia, despite evidence that extragenital STIs are occurring in other high-risk populations as well. A case report is provided to enhance primary health care providers' knowledge of extragenital STIs and promote early recognition and testing to improve patient outcomes.