Serum hepatitis B core antibody as a biomarker of hepatic inflammation in chronic hepatitis B patients with normal alanine aminotransferase.
Our previous studies unexpectedly indicated that the level of serum hepatitis B core antibody (anti-HBc) was positively correlated with the serum alanine aminotransferase (ALT) level. The aim of this study was to determine whether anti-HBc could serve as a potential biomarker for the detection of liver inflammation in chronic hepatitis B (CHB) patients, especially in patients with normal ALT levels. Serum anti-HBc levels were quantified in 655 treatment-naïve CHB patients, including 45 patients who underwent two liver biopsies (baseline phase and the 78th weeks of antiviral-treatment). Serum anti-HBc levels increased significantly along with the increasing histology activity index (HAI) score. After antiviral-treatment, patients with HAI score reduction had significant decline in serum anti-HBc level. Multivariate analysis showed that anti-HBc was independently associated with moderate-to-severe hepatic inflammation in patients with normal ALT level. Furthermore, serum anti-HBc showed a high diagnostic accuracy for predicting moderate-to-severe inflammation in both hepatitis B e antigen (HBeAg)-positive and HBeAg-negative CHB patients with normal ALT levels (area under the curve, AUC = 0.87 and 0.75; respectively). Thus, anti-HBc may be a strong indicator for assessing the hepatic inflammatory degree and used for antiviral treatment decisions in CHB patients with normal ALT levels.


Has resistance to chlorhexidine increased among clinically-relevant bacteria? A systematic review of time course and subpopulation data.
Chlorhexidine (CHX) was introduced for use as an antimicrobial more than 70 years ago. CHX has been and continues to be used broadly for disinfecting surfaces in medical and food service facilities as well as directly on skin of humans and animals. Considering its widespread use over many decades, questions of resistance to CHX have been raised. Additionally, questions of possible coincident resistance to the biocide and resistance to clinically relevant antibiotics have also been raised. A number of important questions remain, including is there consistent evidence of resistance, what is the degree of resistance, especially among clinically isolated microbial strains, and what is the degree of resistance compared to the typical concentrations of the biocide used? Data for microbial species isolated over the last 70+ years were compiled to construct as complete a picture as practical regarding possible resistance, especially among species in which resistance to commonly used antibiotics has been noted to be increasing. This is a compilation and analysis of individual MIC values for CHX reported in the literature, not a compilation of the conclusions individual authors reached. The data were analyzed using straight-forward and robust statistical procedures to detect changes in susceptibility to CHX over time, i.e. linear regression. Linear regression was supplemented with the use of nonlinear least squares regression analysis to detect the presence of population parameters associated with subpopulations of microbial strains which exhibit increased resistance to CHX. Pseudomonas aeruginosa, Klebsiella pneumoniae, and Acinetobacter baumannii were all found to have an increased resistance to CHX over time with the most profound change detected in A. baumannii. Additionally, subpopulations with log-normal distributions were found consistent with the presence of a baseline subpopulation of susceptible strains and a subpopulation with increased resistance to CHX. However, the CHX-resistant subpopulations did not correlate exactly with antibiotic resistance, so details of the relationship remain to be addressed. Increased resistance over time was not detected for Escherichia coli, Enterobacter faecalis, Staphylococcus aureus, or Candida albicans, although a subpopulation with greater than baseline resistance to CHX was detected among strains of E. faecalis and C. albicans. A difference in susceptibility to CHX was also detected between methicillin-resistant (MRSA) and methicillin-sensitive (MSSA) S. aureus strains. The levels of resistance to CHX detected were all markedly lower than concentrations routinely used in medical and food service applications. Reaching conclusions regarding the relationship between antibiotic and CHX resistance was complicated by the limited overlap between tests of CHX and antibiotic resistance for several species. The results compiled here may serve as a foundation for monitoring changes in resistance to CHX and possible relationships between the use of CHX and resistance to antibiotics commonly used in clinical medicine.


Effect of diuretics on urinary oxalate, calcium, and sodium excretion in very low birth weight infants.
To study the effect of diuretic drugs on urinary oxalate excretion in premature infants, and to examine the relationship between urinary calcium and sodium excretion in premature infants. We measured urinary oxalate, calcium, and sodium excretion in 32 premature infants at approximately 34 weeks gestational age. Seven infants were receiving furosemide, 5 infants were receiving thiazide, 8 infants were receiving furosemide plus thiazide, and 12 infants who were not receiving diuretics served as controls. Urinary oxalate to creatinine ratios in infants receiving furosemide (0.48 +/- .26), thiazide (0.54 +/- .20), furosemide plus thiazide (0.44 +/- .19), and control infants (0.51 +/- .43) were similar by analysis of variance (ANOVA). Data expressed as oxalate concentration gave similar results. Urinary calcium to creatinine ratios in infants receiving furosemide (0.81 +/- .30), thiazide (0.54 +/- .25), furosemide plus thiazide (0.75 +/- .49), and control infants (0.37 +/- .25) were similar by ANOVA. The urinary calcium concentration in infants receiving furosemide plus thiazide (0.085 +/- 0.042 mg/mL) was different from control infants (0.044 +/- .023) by ANOVA and Student-Newman-Keuls test. Urinary calcium to creatinine ratio was correlated with sodium to creatinine ratio (r = .751). Urinary oxalate excretion in premature infants is not affected by diuretic drugs. Urinary sodium and calcium excretion are closely linked in sodium supplemented premature infants receiving diuretics. The calciuric effect of furosemide is not decreased by the addition of thiazide in premature infants receiving sodium supplements.


Predicting postoperative complications after bariatric surgery: the Bariatric Surgery Index for Complications, BASIC.
Around 20% of bariatric surgery patients develop a short- or long-term complication. Aim of this study was to develop a risk model predicting complications: the Bariatric Surgery Index for Complications (BASIC). The Obesity Center Amsterdam, located in a large teaching hospital, in Amsterdam, The Netherlands. A prospective consecutive database including patients operated between November 2007 and February 2015 was used. For the BASIC, analysis according to the TRIPOD statement was performed to identify risk factors for complications. Class I included patients with zero to one risk factor, class II patients with two risk factors, and class III patients with three or more risk factors. Of 1709 analyzed patients, mean age was 45 years (±SD 10.7), 1393 (81.5%) were female; mean body mass index was 44.5 kg/m2 (6.8). Overall, 271 (15.9%) patients developed a complication of which 197 (72.5%) occurred within 30 days. Predictors in multivariable analysis were use of anticoagulants (odd's ratio (OR) 1.5); chronic obstructive pulmonary disease (OR 2.3); dyslipidemia (OR 1.4); gender (OR 1.4); psychiatric history (OR 1.3); and revisional surgery (OR 1.5). In class I, 13.5% (181 out of 1338) experienced complications, in class II 58 (21.6%) of the 269 patients and in class III 32 (31.4%) of the 102 patients, respectively. There was a significant difference (p < 0.001) in both overall and 30 day complications. The BASIC uses six preoperative variables to classify patients in a low-, intermediate-, or high-risk group for postoperative complications after bariatric surgery.


A high-resolution G-banding idiogram of Rattus norvegicus chromosomes.
G-banded karyotypes of Rattus norvegicus fibroblast cells at the late prophase, prometaphase, early metaphase, mid and late metaphase, and diagrammatic representation of the banding patterns at the 450-band level are presented. High-resolution G-banded rat chromosomes were prepared following the actinomycin D pretreatment technique. Silver-stained nucleolus organizer regions (Ag-NORS) were found in chromosome pairs 3, 11 and 12 of the rat karyotype.


Endotracheal tube with movable blocker to prevent aspiration of intratracheal bleeding.
A newly developed endotracheal tube with a movable blocker was found to be lifesaving in patients with copious and persistent intratracheal bleeding. The cases of 4 patients are presented. In 3 patients, severe intratracheal bleeding was attributed to the extensive bronchopulmonary laceration caused by blunt chest trauma. In the remaining patient, the bleeding was due to rupture of the sutured site in the right pulmonary artery; the rupture was caused by a postoperative bronchopleural fistula. In these patients, spread of blood was completely prevented and pulmonary resection was performed safely by using the blocker in this new device.


Serum level of squamous cell carcinoma antigen and tumor size are useful to identify preoperatively patients at high risk of cervical cancer.
The benefit of postoperative adjuvant therapy for patients with cervical cancer is uncertain, and moreover, may increase morbidity. In this study, patient age, clinical stage of the cancer, tumor size, and levels of serum squamous cell carcinoma cell antigen and carcinoembryonic antigen were studied in patients with Stage Ib and IIa squamous cell carcinoma of the uterine cervix to determine if these parameters can be used, before the surgical intervention, to distinguish patients who require postoperative adjuvant therapy from those who do not. Ninety-nine patients were studied. After surgery, patients were classified either as high risk or low risk according to the results of histopathologic findings. The age of the patient was noted, and FIGO stage, squamous cell carcinoma antigen, carcinoembryonic antigen, and clinical tumor size were determined. A univariate analysis and then a stepwise logistic regression procedure were performed to select significant clinical predictors from among the five variables mentioned above. Any selected predictors were further analyzed by the receiver operator characteristic curve. Serum squamous cell carcinoma antigen and clinical tumor size measured by colposcopic examination were significant clinical predictors of the treatment strategy postoperatively. From the receiver operator characteristic curve, a sensitivity of 84.2%, a specificity of 91.8%, a positive predictive value of 84.5% were attained. Serum squamous cell carcinoma antigen assays and clinical tumor size estimated by colposcopic examination are helpful in identifying patients who require postoperative adjunctive therapy.


Effect of propionate on pyruvate metabolism in adipose tissue.
Glyceride-glycerol formation in rat adipose tissue from pyruvate-2-(14)C is increased by fasting, while fatty acid synthesis is markedly depressed. In tissues of fasted animals glyceride-glycerol formation is maximal with concentrations of pyruvate exceeding 2.5 mM. With 0.25 mM pyruvate-2-(14)C, glyceride-glycerol formation is increased severalfold by the addition of 0.25 mM propionate. No further increase in synthesis is caused by propionate when pyruvate is supplied in optimal amounts. Addition of equimolar concentrations of acetate or pyruvate does not replace propionate. The effect of propionate on glyceride-glycerol synthesis from pyruvate is also given by a series of even-chain fatty acids. However, only propionate promotes fatty acid synthesis in tissues of fasted and fed animals. Fixation of (14)CO(2) in glyceride-glycerol is dependent on the presence of propionate and is maximal in tissues of fasted rats and when pyruvate is also added. Succinate has no significant effect. Actinomycin treatment blocks glyceride-glycerol synthesis in tissues of fed and fasted animals, in the presence and absence of propionate. At the same time, fatty acid synthesis in tissues of fasted rats is markedly increased.


Lesions of right heart failure and ascites in broiler chickens.
A naturally occurring cardiomyopathy in broiler chickens from a single Ontario farm was studied in order to define the morphologic changes. Gross and histologic features of affected birds were compared with those in age-matched control penmates. Body weight and weight and volume of individual cardiac chambers were measured. Histologic sections of 18 different tissues were examined, and lesions observed were scored subjectively. Affected birds were stunted and had marked right ventricular dilation and hypertrophy, atrial hypertrophy, ascites, pulmonary congestion and edema, and hepatic capsular fibrosis. Microscopic changes in the heart of affected birds were mild and did not suggest a specific cause of heart failure. Lungs had marked hypertrophy of parabronchial smooth muscle and collapse and apparent loss of associated air capillaries. Other histologic changes observed were thought to be the result of passive congestion of viscera caused by right heart failure and chronic debility. Although the specific etiology of this condition could not be determined, it was felt that this syndrome was unlikely to have been the result of any of the commonly recognized causes of congestive heart failure and ascites in broilers.


The gambling urge scale: development, confirmatory factor validation, and psychometric properties.
The urge to gamble is a physiological, psychological, or emotional motivational state, often associated with continued gambling. The authors developed and validated the 6-item Gambling Urge Questionnaire (GUS), which was based on the 8-item Alcohol Urge Questionnaire (M. J. Bohn, D. D. Krahn, & B. A. Staehler, 1995), using 968 community-based participants. Exploratory factor analysis using half of the sample indicated a 1-factor solution that accounted for 55.18% of the total variance. This was confirmed using confirmatory factor analysis with the other half of the sample. The GUS had a Cronbach's alpha coefficient of.81. Concurrent, predictive, and criterion-related validity of the GUS were good, suggesting that the GUS is a valid and reliable instrument for assessing gambling urges among nonclinical gamblers.


Short-term effect of atorvastatin on endothelial function in healthy offspring of parents with type 2 diabetes mellitus.
Endothelial function is impaired in healthy subjects at risk of type 2 diabetes mellitus (DM). We investigated whether endothelial dysfunction can be normalized by statin therapy in this potentially predisposed population. Flow-mediated dilation (FMD) was measured in 56 first-degree relatives (FDRs) (normotensive, normal glucose tolerance) and 20 age-, sex-, and BMI-matched controls with no family history of DM. Other measurements included insulin resistance index using the homeostasis model of insulin resistance (HOMA(IR)), plasma lipids, and markers of inflammation. The FDRs were then randomized and treated with atorvastatin (80 mg) or placebo daily in a 4-week double-blind, placebo-controlled trial. The FDRs had significantly impaired FMD (4.4 +/- 8.1% vs. 13.0 +/- 4.2%; P < 0.001), higher HOMA(IR) (1.72 +/- 1.45 vs. 1.25 +/- 0.43; P = 0.002), and elevated levels of plasma markers of inflammation-highly sensitive C-reactive protein (hsCRP) (2.6 +/- 3.8 mg/L vs. 0.7 +/- 1.0 mg/L; P = 0.06), interleukin (IL)-6 (0.07 +/- 0.13 ng/mL vs. 0.03 +/- 0.01 ng/mL; P < 0.001), and soluble intercellular adhesion molecule (sICAM) (267.7 +/- 30.7 ng/mL vs. 238.2 +/- 20.4 ng/mL; P < 0.001). FMD improved in the atorvastatin-treated subjects when compared with the placebo-treated subjects (atorvastatin, from 3.7 +/- 8.5% to 9.8 +/- 7.3%; placebo, from 3.9 +/- 5.6% to 4.7 +/- 4.2%; P = 0.001). There were also reductions in the levels of IL-6 (0.08 +/- 0.02 ng/mL vs. 0.04 +/- 0.01 ng/mL; P < 0.001) and hsCRP (3.0 +/- 3.9 mg/L vs. 1.0 +/- 1.3 mg/L; P = 0.006). Our study suggests that treatment with atorvastatin may improve endothelial function and decrease levels of inflammatory markers in FDRs of type 2 DM patients.


Circular dichroism studies of relaxin and insulin peptide chains.
The circular dichroism (CD) spectra of pig relaxin and pig insulin are similar, reflecting the known structural similarities between the two hormones. However, the conformational characteristics of the separate chains of insulin and relaxin show significant differences. The S-sulfo forms of insulin A and B chains and S-sulfo relaxin A chain have CD spectra consistent with largely unordered structures whereas the S-sulfo form of relaxin B-chain has at least 90% beta--structure. This beta-structure may explain the unusual solubility and adsorptive properties of the relaxin B-chain and the poor combination yields with A-chain. The relaxin B-chain changes to a largely unordered conformation if the peptide is shortened at the carboxyl terminus by six amino acid residues. This conformational change has important implications in planning relaxin synthesis strategy. Significant interactions and conformational changes are observed between the oxidized forms of the A and B chains of both relaxin and insulin. In using CD to monitor chain recombination of native relaxin peptides it was found that the spectra obtained after depending on whether the reduced chains are separated or not separated from the reaction mixture prior to reoxidation. Although the spectra differ the biological activity was 20% in both cases. The remainder of the reoxidized but inactive material contains beta-structures which make a greater contribution to the CD spectrum when the chains have been separated and processed than when they are reoxidized in situ.


Molecular mimicry in type 1 diabetes: immune cross-reactivity between islet autoantigen and human cytomegalovirus but not Coxsackie virus.
Type 1 diabetes is caused by a T cell-mediated autoimmune destruction of the pancreatic beta cells. Molecular mimicry between viral pathogens and beta cell protein has been a popular theory to explain loss of tolerance in type 1 diabetes. However, functional data in support of this hypothesis have been lacking, presumably because the homologies were defined on the basis of linear similarities in peptide sequences, which ignores the criteria of HLA versus T cell receptor contact residues in peptide epitopes required for T cell recognition. We applied a HLA-binding dedicated peptide microarray analysis using autoreactive T cell clones specific for the autoantigen GAD65 to determine the algorithm of T cell recognition by this given T cell clone. The subsequent database search identified a 100% fit with cytomegalovirus peptide, which was subsequently shown to be recognized by these clonal T cells. However, T cell clones reactive with linear homologies previously described as putative candidates for T cell cross-reactivity between GAD65 and Coxsackie virus peptide were unable to recognize the homologous counterparts.


Increased frequency of HCV but not HBV infection in type 2 diabetic patients in Turkey.
The aim of this study was to investigate the prevalence of hepatitis B and hepatitis C virus infections in type 2 diabetic patients in Gaziantep, Turkey. Six hundred and ninety-two type 2 diabetic patients and 1014 healthy blood donors were included in the study. No significant difference was found between type 2 diabetic patients and the control group for seropositivity of HBsAg (5.3% vs 5.1%, p>0.05). In contrast, anti-HCV was significantly more frequent in type 2 diabetic patients (7.5% vs 0.1%, p>0.0001). We found no significant difference for HBsAg seropositivity between type 2 diabetic patients with a disease duration of 12 months or less, but anti-HCV seropositivity was significantly more frequent in diabetic patients with a longer disease duration (p<0.05). We suggest that HCV infection is not a trigger factor for type 2 diabetes mellitus but is frequently associated with it.


Sella turcica morphometrics in subjects with down syndrome.
Since the number of patients diagnosed with Down syndrome seeking orthodontic treatment is increasing, clinicians could contribute by applying diagnostic modalities used frequently in the orthodontic field for research purposes. Thus, The aim of the present study is to implement morphometric methods to investigate the size and shape of sella turcica in subjects with Down syndrome. In this retrospective study, archive records of 24 individuals with Down syndrome were compared to 48 healthy controls matched for age and gender. Parameters such as sella anterior, midpoint, and posterior height were measured, as well as sella width, area, and length were calculated. Independent sample t-tests were applied for the comparison of differences in sella turcica dimensions. Geometric morphometric analysis of the sella was performed with, implementing methods such as Procrustes superimposition and principal component analysis. Statistical significance was set at p<0.05. Statistically significant differences were found for sella anterior height, sella midpoint height, sella posterior height, sella maximum height, sella length, and sella area. All the aforementioned values were significantly increased in the Down syndrome subjects (p<0.05). Principal component analysis (PCA) depicted a statistically significant difference in sella shape between patients with Down syndrome and healthy controls (p<0.05). Subjects with Down syndrome presented significantly increased sella turcica dimensions as well statistically significant differences in shape compared to healthy controls.


Possible role of palliative surgery for bowel obstruction in advanced ovarian cancer patients.
Bowel obstruction is a relatively common event (30-40%) in advanced or recurrent ovarian cancer patients. No definitive data are available on the optimal management of this serious complication and treatment is generally limited to adoption of palliative measures. These modalities include both surgical and medical procedures. The aim of this study was to define selection criteria for subjects who would benefit from palliative surgery. Out of 270 epithelial ovarian cancer patients treated in the period 1984-2005, 75 (28%) developed bowel obstruction related to progression/recurrence of the disease. Palliative treatment - both medical and surgical - was applied on an individual basis. A new score developed by these authors was retrospectivelly applied to this group of patients with the aim of defining a subgroup that could benefit from surgical treatment. Fifty cases (66.7%) were medically treated whereas 25 patients (33.3%) underwent surgery. Mean and median survival rates were 34 and 28 weeks in the surgical group versus 12 and four weeks in the medical group. Distribution according to score showed 53 cases (71%) in the low score group (< 14) and 22 (29%) in the high score group (> 14). A significantly better survival was observed in the low-score group (p < 0.0001) and in the surgically treated patients (p < 0.001). According to the risk score variables patients treated surgically for obstruction with low scores had a longer survival (p < 0.005) compared to medical treatment but this difference was not found in the high-risk group (p < 0.05). The prognosis of patients with bowel obstruction in relation to advanced ovarian cancer is best determined by comprehensive assessment of all prognostic parameters to define a subgroup of patients in a low-risk group that may benefit from surgical treatment.


Post-embryonic development of chicks of the Japanese quail under conditions of the limited volume.
According to our results, chicks of the Japanese quail can survive within the first 10 days of a life under conditions of the limited volume when their mobility is completely limited. However, their development was impaired in comparison with chicks housed in the common cages. Besides, the delay in development of chick's plumage has been observed. The analysis of body mass in test groups has shown that practically all chicks were smaller than chicks from control group. It is the result of feed consumption decrease (about 30% from control group) caused by the restriction of mobility of chicks. But after their transferring to the common cages at the end of the experiment, body mass in test group rapidly reached the level of body mass in control group. Research has shown that percent of alive of quail chicks maintained in the chamber of animals of complex "Incubator-2", was higher than in first two experiments. Therefore, works on improvement of devices for the maintenance of quail chicks continue, and also new adaptations develop for the maintenance of chicks in their early post-embryonic period (till 10 days) with reference to conditions of weightlessness.


Sleeping energy expenditure in paediatric patients with obstructive sleep apnoea syndrome.
To investigate sleeping energy expenditure in paediatric patients with obstructive sleep apnoea syndrome. Retrospective study. Setting. University teaching hospital, Hong Kong. A retrospective analysis comparing sleeping energy expenditure in patients with confirmed obstructive sleep apnoea syndrome and control subjects matched for age, sex, and ideal weight for body height. Subjects were recruited from the Paediatric Chest Clinic and all had undergone overnight polysomnography and sleeping energy expenditure measurement by open-circuit indirect calorimetry using a metabolic cart and canopy system. The measurements were taken during slow-wave sleep. Twenty-four cases with obstructive sleep apnoea syndrome (apnoea hypopnoea index >5) and 23 control subjects were studied. Mean age and ideal weight for body height were 9.4 (standard deviation, 3.9) years and 152.5% (27.2%), respectively. Mean sleeping energy expenditure corrected for body weight for the cases and the control group were 44.83 (standard deviation, 10.49) Kcal/day and 40.71 (10.60) Kcal/day, respectively. Sleeping energy expenditure was not found to be associated with the severity of obstructive sleep apnoea syndrome (r=0.34, P=0.27). A trend towards greater sleeping energy expenditure was found in patients with obstructive sleep apnoea syndrome. Further studies on the metabolic aspects of this condition are required.


Distraction lengthening by callotasis of traumatically shortened bones of the hand.
Callotasis of the hand has several advantages: it is less invasive than other techniques as bone grafting is unnecessary, gradual distraction is possible, joint mobilization can be performed during treatment, and sensation is maintained. Disadvantages include longer period of treatment and perhaps the need for complicated and bulky instrumentation. We reported results of the lengthening of eight traumatically shortened metacarpals or phalanges (in six patients). There were two men and four women, with a mean age of 17.5 years. There were one thumb and seven fingers. There were three proximal phalanges and five metacarpals. Unilateral external fixator was applied to all cases. Osteotomy was performed at the proximal metaphysis in three cases, middle diaphysis in two cases, and the distal metaphysis in three cases. Lengthening was begun after 10 days to 14 days at a rate of 0.25 mm two times or three times daily. We modified the rate of distraction according to the development of pain, sensory disturbance, and contracture of the digit during lengthening. In former cases, the rate was 0.25 mm three times daily. The proposed length was achieved in all digits and no bone graft was required. The mean length increase was 18.9 mm (53.5% of the original length of 35.25 mm). Age was positively correlated with the healing index and consolidation time as younger patients healed faster than older patients. Conversely, the faster the distraction rate, the slower were the healing index and consolidation time. There were few complications which did not affect the final results. We preferred metacarpal lengthening in cases with very short proximal phalangeal traumatic amputation stump (<1 cm). Distraction lengthening is a valid option with minor complications rate. Therapeutic study, level V.


[Diagnosis and treatment of sarcomatoid renal cell carcinoma].
To study the clinical diagnosis and treatment of sarcomatoid renal cell carcinoma, and to analyze the connection of prognosis with therapy. 10 cases with sarcomatoid renal cell carcinoma from 1997 - 2007 in our hospital were analyzed, and the related literatures were reviewed. All patients were performed with operation, and pathologically diagnosed as sarcomatoid renal cell carcinoma. Cases with metastasis were performed with chemical therapy, biological therapy or radiotherapy after operation. Clinical stage (TNM) of 10 cases is T1N0M0 1 case, T2N0M0 3 cases, T3N0M0 1 case, T4N0M0 1 case, T2N0M1 3 cases, T4N0M1 1 case. 60% (6/10) of patients were diagnosed with metastasis or diffusion. In these 6 cases, 4 cases were diagnosed with pulmonary metastasis, 1 with brain metastasis, and 1 with osseous metastasis, and 1 with inferior vena cava tumor thrombus. The average life span of all 10 cases was 17 months, and cases with advanced stage was 8 months. Otherwise, the average survival time of cases with earlier stage was 30 months, and it was 21 months from diagnosis to metastasis. Sarcomatoid renal cell carcinoma is a special type of renal cell carcinoma with features of high malignant and rapid progress. It is clinical rare and with bad prognosis. Operation is the first choice for the therapy, the effect of radiotherapy or chemical therapy is not obviously. The lung is main position for metastasis. Early diagnosis and treatment are effective to prolong the life span of patients, and the new therapy may be more important.


Acral vesicles and bullae in a patient with severe rheumatoid arthritis.
We present the case of a 56-year-old black woman with rheumatoid arthritis who developed worsening fatigue, fever, weight loss, and a vesiculobullous skin eruption while being treated with certolizumab pegol for her arthritis. Microscopic findings confirmed the diagnosis of a neutrophilic dermatosis.


Sociodemographic risk factors for sudden infant death syndrome: associations with other risk factors. The Nordic Epidemiological SIDS Study.
The aim of this study was to investigate associations between sudden infant death syndrome (SIDS) and social factors in the Nordic countries. A case-control study was conducted in Denmark, Norway and Sweden: The Nordic Epidemiological SIDS Study. Parents of 244 SIDS infants and 869 control infants matched on gender, age at death and place of birth filled in questionnaires. The dataset was analysed by conditional logistic regression. In univariate analysis, the following sociodemographic factors were associated with an increased risk of SIDS: low maternal age [odds ratio (OR) 7.8; 2.8-21.5], high birth order (OR 4.4; 2.5-7.5), single motherhood (OR 2.9; 1.7-5.0), low maternal education (OR 4.5; 2.8-7.1), low paternal education (OR 3.0; 1.9-4.7), maternal unemployment (OR 2.4; 1.8-3.4) and paternal unemployment (OR 4.0; 2.7-5.9). In a multivariate analysis where maternal smoking was also included, only paternal unemployment, young maternal age and high birth order remained significantly associated with SIDS. Housing conditions were not associated with SIDS. However, the risk of SIDS was high if the family had lived in their present home for only a few years (OR 2.3; 1.3-4.1). Sociodemographic differences remain a major concern in SIDS in a low-incidence situation and even in an affluent population with adequate health services.


Effect of the thermodynamic factor on the intrinsic and tracer diffusivities in binary mixtures.
One of the Darken equations gives a relationship between the intrinsic and the tracer diffusion coefficients, D_{A} and D_{A}^{*}, of species A in a solid binary mixture. In its original formulation, the equation reads D_{A}=D_{A}^{*}Γ, with Γ the thermodynamic factor. The question addressed in this paper is how D_{A} and D_{A}^{*} depend separately on Γ. Using a recent result for transition probabilities in terms of the excess chemical potential [M. Di Muro and M. Hoyuelos, Phys. Rev. E 104, 044104 (2021)2470-004510.1103/PhysRevE.104.044104], it is shown that the intrinsic diffusivity does not depend on Γ. This approach simplifies a previous theoretical analysis that reaches the same result. Experimental results of diffusion in Ni-Pd and Fe-Pd alloys [M. J. H. van Dal et al., Acta Mater. 48, 385 (2000)1359-645410.1016/S1359-6454(99)00375-4] are used to check the theory. Numerical simulations of Ni-Pd were performed to show that the migration energy is the main factor responsible for the increase in diffusivity at intermediate concentrations.


Utility of Cyclin D1 in the Diagnostic Workup of Hematopoietic Neoplasms: What Can Cyclin D1 Do for Us?
Cyclin D1, encoded by CCND1, promotes cell cycle progression from G1 to S phase. Its expression is induced by MAPK/ERK pathway as well as translocations/rearrangements involving CCND1 gene. The evaluation of cyclin D1 expression by immunohistochemistry plays an important role in the diagnostic workup of various hematopoietic diseases. In this review, we aimed to discuss the value of cyclin D1 immunostain in the diagnosis and different diagnosis of hematopoietic neoplasms.


The Effect of Reducing the Fasting Time on Postoperative Pain in Orthopaedic Patients: A Randomized Controlled Trial.
Patients undergoing orthopedics surgery experience the most severe postoperative pain. The fasting time is a factor that affects this complication. The aim of this study was to investigate the impact of fasting time reduction by using oral carbohydrate on postoperative pain and analgesic consumption in orthopedic patients. This randomized control trial was conducted between November 2017 and December 2018. Sixty-four patients were randomly assigned into the intervention (which consumed 200 mL of the 12.50% carbohydrate, 2 h before the surgery) and the control group (which was fasted from midnight). Postoperative pain was measured by visual analog scale; the amount of the consumed analgesics was also recorded. The data were analyzed by using Chi-square and t-test. The mean (SD) of the pain scores in the control group immediately and 2, 4, 6, 12 and 24 h after consciousness were 7.19 (2.64), 6.69 (2.17), 6.31 (2.05), 6.16 (2.08), 6.06 (2.24), and 5.38 (1.86), respectively. These scores for the intervention group were 7.44 (1.48), 6.31 (1.25), 5.72 (1.17), 5.59 (1.43), 5.25 (1.13), and 4.97 (1.57). The mean of the pain scores between two groups was not different (p > 0.05). The amount of the consumed morphine (t 61= -2.10, p = 0.039), pethidine (t 62= -2.25, p = 0.028), and diclofenac (t 62= -2.51, p = 0.015) were significantly different between the two groups. The pain intensity in the patients with shortened fasting time was lower, but it was not statistically significant. Moreover, reducing fasting time by using carbohydrate significantly reduced the use of analgesics.


Water level response to hydropower development in the upper Mekong River.
Environmental changes and their transboundary influences on the Mekong watercourse system have been an international research focus in recent years, but the opinions and results related to the impacts of upper Mekong River dams are quite different. In this paper, based on the records of water levels from 1960 to 2003 at three mainstream sites in the upper Mekong River, a quantitative examination has been undertaken into characteristics of the mainstream water-level process at multiple timescales and its response to cascade development. The major results are: i) Annual mean, wet period mean, and the mean water levels during the period between March and April (PBMA period) exhibit a significant increasing trend at Jiuzhou and Yunjinghong sites, which are influenced by large-scale factors such as climate change and solar activity. ii) The interdecadal and interannual variations of annual mean, annual maximum, and wet period mean water levels at three sites show similar features during the dam construction period. iii) The interdecadal variations of PBMA period water level show a gradual increase at Gajiu and Yunjinghong sites but a falling trend at Jiuzhou; these trends confirm that there is some regulation on the flow in the dry season caused by the two existing dams. iv) The downstream effects of the present dams on water levels are very limited at the annual mean and wet season mean levels, not apparent at the monthly and yearly timescales, and relatively significant at daily and hourly timescales.


Silver nanowire-graphene hybrid transparent conductive electrodes for highly efficient inverted organic solar cells.
Silver nanowires (AgNWs) and graphene are both promising candidates as a transparent conductive electrode (TCE) to replace expensive and fragile indium tin oxide (ITO) TCE. A synergistically optimized performance is expected when the advantages of AgNWs and graphene are combined. In this paper, the AgNW-graphene hybrid electrode is constructed by depositing a graphene layer on top of the network of AgNWs. Compared with the pristine AgNWs electrode, the AgNW-graphene TCE exhibits reduced sheet resistance, lower surface roughness, excellent long-term stability, and corrosion resistance in corrosive liquids. The graphene layer covering the AgNWs provides additional conduction pathways for electron transport and collection by the electrode. Benefiting from these advantages of the hybrid electrodes, we achieve a power conversion efficiency of 8.12% of inverted organic solar cells using PTB7:PC71BM as the active layer, which is compared to that of the solar cells based on standard ITO TCE but about 10% higher than that based on AgNWs TCE.


Linking immune patterns and life history shows two distinct defense strategies in land snails (gastropoda, pulmonata).
Life history integration of the defense response was investigated at intra- and interspecific levels in land snails of the family Helicidae. Two hypotheses were tested: (i) fitness consequences of defense responses are closely related to life history traits such as size at maturity and life span; (ii) different pathways of the immune response based on "nonspecific" versus "specific" responses may reflect different defense options. Relevant immune responses to a challenge with E. coli were measured using the following variables: blood cell density, cellular or plasma antibacterial activity via reactive oxygen species (ROS) level, and bacterial growth inhibition. The results revealed that the largest snails did not exhibit the strongest immune response. Instead, body mass influenced the type of response in determining the appropriate strategy. Snails with a higher body mass at maturity had more robust plasma immune responses than snails with a lower mass, which had greater cell-mediated immune responses with a higher hemocyte density. In addition, ROS appeared also to be a stress mediator as attested by differences between sites and generations for the same species.


THERMOLUMINESCENCE SPECTRA AND DOSE RESPONSES OF SrSO4 PHOSPHORS DOPED WITH RARE EARTHS (Eu, Dy, Tm) AND PHOSPHORUS.
The thermoluminescence (TL) spectra and dose responses of strontium sulphate doped with rare earth ions show that the SrSO4:Eu2+ phosphor might reasonably be assumed a isoelectronic trap sample which has unique TL characteristics: there is only one obvious glow peak at 385 nm, 489 K in the TL 3D emission spectra and its TL dose response is linear-sublinear. However, there are several elementary glow peaks in the TL 3D emission spectra and their TL dose responses are linear-supralinear for SrSO4:RE3+ (RE = Dy, Tm). These TL peaks occurred from low to high temperature indicate that the traps are distributed in different energy levels. When a suitable amount of other impurities co-doped into these SrSO4:RE3+, such as phosphorus, the relative intensities of these elementary glow peaks are changed significantly, especially the TL peak ~500 K is enhanced while the peaks at lower temperature are suppressed. The enhanced peak of SrSO4:RE3+,P is attributed to the deep traps. Their dose responses remain in nonlinearity when co-doped phosphorus. The above results and the luminescence properties of other sulphate doped rare earths impurities illustrate that the TL characteristics depend on the structure of defect complexes which can be assumed the basic elements in the TL multi-stage processes.


The distribution and nature of colour vision among the mammals.
1. An oft-cited view, derived principally from the writings of Gordon L. Walls, is that relatively few mammalian species have a capacity for colour vision. This review has evaluated that proposition in the light of recent research on colour vision and its mechanisms in mammals. 2. To yield colour vision a retina must contain two or more spectrally discrete types of photopigment. While this is a necessary condition, it is not a sufficient one. This means, in particular, that inferences about the presence of colour vision drawn from studies of photopigments, the precursors of photopigments, or from nervous system signals must be accepted with due caution. 3. Conjoint signals from rods and cones may be exploited by mammalian nervous systems to yield behavioural discriminations consistent with the formal definition of colour vision. Many mammalian retinas are relatively cone-poor, and thus there are abundant opportunities for such rod/cone interactions. Several instances were cited in which animals having (apparently) only one type of cone photopigment succeed at colour discriminations using such a mechanism. it is suggested that the exploitation of such a mechanism may not be uncommon among mammals. 4. Based on ideas drawn from natural history, Walls (1942) proposed that the receptors and photopigments necessary to support colour vision were lost during the nocturnal phase of mammalian history and then re-acquired during the subsequent mammalian radiations. Contemporary examination of photopigment genes along with the utilization of better techniques for identifying rods and cones suggest a different view, that the earliest mammals had retinas containing some cones and two types of cone photopigment. Thus the baseline mammalian colour vision is argued to be dichromacy. 5. A consideration of the broad range of mammalian niches and activity cycles suggests that many mammals are active during photic periods that would make a colour vision capacity potentially useful. 6. A systematic survey was presented that summarized the evidence for colour vision in mammals. Indications of the presence and nature of colour vision were drawn both from direct studies of colour vision and from studies of those retinal mechanisms that are most closely associated with the possession of colour vision. Information about colour vision can be adduced for species drawn from nine mammalian orders.(ABSTRACT TRUNCATED AT 400 WORDS)


Combination of celecoxib and doxorubicin increases growth inhibition and apoptosis in acute myeloid leukemia cells.
Cyclooxygenase-2 (COX-2) inhibitors have been shown to enhance antitumor activity of therapeutic agents in a variety of solid tumor cells. However, this has not been well established in hematopoietic tumors, especially in acute myeloid leukemia (AML). This study was designed to investigate the effects of the combination of celecoxib, a specific COX-2 inhibitor, and doxorubicin on cell growth and apoptosis in human leukemia cells. Co-treatment with celecoxib and doxorubicin significantly inhibited cell growth and induced cell apoptosis in the acute leukemia cell line HL60 and primary AML cells. The growth inhibition effect was accompanied by down-regulation of the expression of cyclin E and cyclin-dependent kinase 2 (CDK2), the key regulators of cell cycle progression, which was associated with arrest of cells at G0/G1 phase. The pro-apoptotic effect was accompanied by down-regulation of the expression of survivin, an inhibitor of apoptosis protein, which mediated anti-apoptosis in AML cells. These results provide the first evidence that the growth inhibitory and pro-apoptotic effects of celecoxib and doxorubicin on AML cells are synergistic.


Pain Management of Amazon Indigenous Peoples: A Community-Based Study.
Indigenous peoples are vulnerable populations that live in remote areas of the Amazon forest with limited access to health-care services. Underreporting and undertreatment of pain is a common event in the general population but little is known about these issues in indigenous peoples. The aim of this study was to investigate the characteristics and cultural aspects of pain management in five ethnicities of the Brazilian Amazon. Cross-sectional study carried out with adult indigenous individuals from five ethnicities of the Brazilian Amazon over two scientific expeditions (June-July/2017 and February-March/2019). Pain assessment included etiology, intensity, duration, aggravating and alleviating factors, body location, impact of pain on activities of daily living, and treatment. Ninety indigenous individuals with a mean age of 41.42 ± 19.59 years (range 19‒98 years) and median age of 37 years participated in the study. Sixty-four individuals (71.1%) reported experiencing pain at the time of interview with intermittent musculoskeletal pain of strong intensity being the more prevalent (back pain: 45.3%, joint pain: 43.7%) followed by headache (26.5%). The main alleviating factors reported were traditional indigenous medicine (21.0%) and rest (30.0%), and physical exertion was the main aggravating factor (69.0%). Most study participants reported that pain affected their mood, activities of daily living, and sleep and that they used both traditional indigenous medicine (78.0%) and conventional medicine (81.0%) for pain relief. Musculoskeletal pain is prevalent among indigenous individuals, affects their quality of life, and is partly attributed to their lifestyle. Cultural aspects mediating the pain experience were observed. Traditional indigenous medicine for pain relief remains partially preserved among the ethnic groups investigated. The findings of this study can help improve the delivery care to these vulnerable populations.


Clear Cell Papillary Renal Cell Carcinoma.
Clear cell papillary renal cell carcinoma (ccpRCC) is a recently recognized entity and represents the fourth most common variant of renal cell carcinoma (RCC). It has unique morphologic and immunohistochemical features and demonstrates an indolent clinical behavior. Microscopically, it may mimic other RCCs with clear cell features, such as clear cell RCC, translocation RCC, and papillary RCC with clear cell changes. A high index of suspicion is required to keep ccpRCC in the differential diagnosis of RCCs with features of clear cell and/or papillary architecture. In equivocal cases, immunohistochemistry is generally sufficient to substantiate the diagnosis of ccpRCC. In this review, we discuss the clinical, gross, and histopathologic features, immunohistochemical and genetic profiling, and prognosis of ccpRCC.


Inhibition of hematopoietic progenitor cell growth by Tyr-MIF, an endogenous opiate modulator, and its degradation products.
There is increasing evidence that neuronal factors can affect hematopoietic cell proliferation. Endogenous opioids with specificity for several opioid receptor classes were tested for their ability to inhibit murine and human hematopoietic progenitor cell proliferation. Tyr-MIF, an opioid tetrapeptide (H-Tyr-Pro-Leu-Gly-NH2), demonstrated a dose-dependent inhibition of colony formation at concentrations < 10 uM, inhibiting M-CSF and G-CSF-responsive progenitor cells equally. Tyr-MIF did not inhibit the number of colonies responsive to recombinant interleukin 3 (rmIL-3) or recombinant murine granulocyte-macrophage colony stimulating factor (rmGM-CSF), but significantly reduced colony size of GM-CSF responsive colonies. Colony formation by human low density and CD34+ marrow cells in response to G-CSF was also inhibited by Tyr-MIF and was more sensitive to inhibition than murine progenitor cells. Colony formation by single CD34+ cells was also inhibited by Tyr-MIF, indicating an effect directly on progenitor cells. Incubation of marrow cells in liquid culture and removal of Tyr-MIF prior to quantitating progenitor cell proliferation demonstrated that opioid-induced inhibition was reversible. The inhibitory effect of Tyr-MIF was not blocked by naloxone, a mu receptor specific antagonist, or diminished in mu opioid receptor deficient mice. HPLC analysis of cell-free culture medium containing Tyr-MIF showed no presence of the parent peptide after 24 h while progenitor cell inhibitory activity was retained. Analysis of potential degradation products of Tyr-MIF indicated that only H-Gly-NH9 or H-Gly-NH2 containing peptides inhibited colony forming unit (CFU) proliferation. These results indicate that Tyr-MIF is a reversible inhibitor of mature hematopoietic progenitor cell proliferation, and that this effect is most likely mediated by the degradation product H-Gly-NH2. Potential applications including protection of myeloid cells after cytosuppresive therapy are discussed.


MMP2 and MMP9 associate with crescentic glomerulonephritis.
Background: Systemic lupus erythematosus (SLE) is a systemic autoimmune disease characterized by multiple organ involvement. Lupus nephritis (LN) is a common manifestation with a wide variety of histological appearances. Matrix metalloproteinases (MMP) 2 and 9 are gelatinases capable of degrading glomerular basement membrane type IV collagen, which have been associated with LN. We examine the expression of MMP2 and MMP9 in different classes of LN. Methods: MMP2 and MMP9 expression was detected by immunohistochemistry in sections from renal biopsy specimens with class III, class IV and class V LN (total n = 31), crescentic immunoglobulin A nephropathy (n = 6), pauci-immune glomerulonephritis (n = 7), minimal change disease (n = 2), mesangiocapillary glomerulonephritis (n = 7), diabetic nephropathy (n = 12) and histologically normal controls (n = 8). Results: MMP2 and MMP9 were not expressed in all classes of LN, but were observed in LN with cellular and fibrocellular crescents. MMP2/MMP9 was expressed in cellular and fibrocellular crescents regardless of glomerulonephritis but not observed in inactive fibrous crescents or with mesangial proliferation. This suggests that MMP2 and MMP9 are involved in the development of extracapillary proliferative lesions. Conclusions: MMP2/MMP9 is expressed with active extracapillary proliferation. Further study is necessary to define whether the expression of MMP2/MMP9 reflects a role in glomerular repair after injury, a role in organ-level immune responses or a role as a marker of epithelialization.


[Minute Pulmonary Meningothelial-like Nodule:A Case Report and Literature Review].
Minute pulmonary meningothelial-like nodule(MPMN)is a rare respiratory disease with no specific clinical manifestations and requires bronchial or percutaneous lung biopsy for diagnosis.Here we report a case of an old male patient with recurrent cough and sputum as the main manifestations,which failed to be cured by antibiotic.His chest computed tomography showed a mass-like tumorous lesion located in the posterior segment of the right upper lobe,and the pathological diagnosis by percutaneous lung biopsy confirmed MPMN with lung infection.At the same time,we reviewed 34 cases to summarize the clinical data,pathological manifestation,diagnosis,treatment,and prognosis of MPMN.


Melatonin prevents amyloid protofibrillar induced oxidative imbalance and biogenic amine catabolism.
Oxidative stress is one of the hypothesized pathogenic mechanisms for neurodegenerative diseases, including Alzheimer's disease (AD); numerous studies suggest that Abeta is toxic to neurons by free radical mediated mechanism. A constant feature in AD brain is selective neuronal loss, accompanied by dysfunction of several neurotransmitter systems, such as cholinergic, serotoninergic and noradrenergic systems. In the present study, we studied the neuroprotective role of melatonin against amyloid protofibrils and the toxicity of protofibrils on serotoninergic and noradrenergic systems. Mice were divided into four groups (n=8 each), control, Scrambles Abeta(35-25) treated, Abeta(25-35) injected, and melatonin treated. A single dose of Abeta(25-35) (25 microg) was administered to mice via intraperitoneal injection. Melatonin (50 mg/kg body weight) was administered intraperitoneally for 3 days to the Abeta(25-35) injected mice. Control mice received only physiological saline and Scrambles receives Abeta(35-25) single intraperitoneal injection of 25 microg of Abeta(35-25). Our study showed that melatonin significantly reduces reactive oxygen species (ROS) production in the astrocytes, lymphocytes and hepatocytes of Abeta injected mice by increasing the levels of scavenging enzymes, SOD, catalase and GSH when compared to the untreated group. Immunohistochemistry study reveals that melatonin prevents the activation of GFAP in neocortex and transcription factor NF-kappaB in liver and neocortex of Abeta injected mice. It also prevents the elevation of dopamine depletion and its degradation products. Thus, while melatonin may be a potential therapeutic agent in the prevention of oxidative stress associated with Abeta and AD, it can also prevent dopamine turnover induced by Abeta.


Fresh Washed Microbiota Transplantation Alters Gut Microbiota Metabolites to Ameliorate Sleeping Disorder Symptom of Autistic Children.
Accumulating studies have raised concerns about gut dysbiosis associating autism spectrum disorder (ASD) and its related symptoms. However, the effect of gut microbiota modification on the Chinese ASD population and its underlying mechanism were still elusive. Herein, we enrolled 24 ASD children to perform the first course of fresh washed microbiota transplantation (WMT), 18 patients decided to participate the second course, 13 of which stayed to participate the third course, and there were 8 patients at the fourth course. Then we evaluated the effects of fresh WMT on these patients and their related symptoms. Our results found that the sleeping disorder symptom was positively interrelated to ASD, fresh WMT significantly alleviated ASD and its sleeping disorder and constipation symptoms. In addition, WMT stably and continuously downregulated Bacteroides/Flavonifractor/Parasutterella while upregulated Prevotella_9 to decrease toxic metabolic production and improve detoxification by regulating glycolysis/myo-inositol/D-glucuronide/D-glucarate degradation, L-1,2-propanediol degradation, fatty acid β-oxidation. Thus, our results suggested that fresh WMT moderated gut microbiome to improve the behavioral and sleeping disorder symptoms of ASD via decrease toxic metabolic production and improve detoxification. Which thus provides a promising gut ecological strategy for ASD children and its related symptoms treatments.


β-secretase inhibitors for Alzheimer's disease: identification using pharmacoinformatics.
In this study we searched for potential β-site amyloid precursor protein cleaving enzyme1 (BACE1) inhibitors using pharmacoinformatics. A large dataset containing 7155 known BACE1 inhibitors was evaluated for pharmacophore model generation. The final model (R = 0.950, RMSD = 1.094, Q2 = 0.901, se = 0.332, rm2 = 0.901, Rpred2 = 0.756, sp = 0.468, rm-test2 = 0.667) was revealed with the importance of spatial arrangement of hydrogen bond acceptor and donor, hydrophobicity and aromatic ring features. The validated model was then used to search NCI and InterBioscreen databases for promising BACE1 inhibitors. The initial hits from both databases were sorted using a number of criteria and finally three molecules from each database were considered for further validation using molecular docking and molecular dynamics studies. Different protonation states of Asp32 and Asp228 dyad were analysed and best protonated form used for molecular docking study. Observation of the number of binding interactions in the molecular docking study supported the potential of these molecules being promising inhibitors. Values of RMSD, RMSF, Rg in molecular dynamics study and binding energies unquestionably explained that final screened molecules formed stable complexes inside the receptor cavity of BACE1. Hence, it can be concluded that the final screened six compounds may be potential therapeutic agents for Alzheimer's disease.


Evaluation of synergy and bacterial regrowth in photocatalytic ozonation disinfection of municipal wastewater.
The use of solar and ultraviolet titanium dioxide photocatalytic ozonation processes to inactivate waterborne pathogens (Escherichia coli, Salmonella species, Shigella species and Vibrio cholerae) in synthetic water and secondary municipal wastewater effluent is presented. The performance indicators were bacterial inactivation efficiency, post-disinfection regrowth and synergy effects (collaboration) between ozonation and photocatalysis (photocatalytic ozonation). Photocatalytic ozonation effectively inactivated the target bacteria and positive synergistic interactions were observed, leading to synergy indices (SI) of up to 1.86 indicating a performance much higher than that of ozonation and photocatalysis individually (SI≤1, no synergy; SI>1 shows synergy between the two processes). Furthermore, there was a substantial reduction in contact time required for complete bacterial inactivation by 50-75% compared to the individual unit processes of ozonation and photocatalysis. Moreover, no post-treatment bacterial regrowth after 24 and 48h in the dark was observed. Therefore, the combined processes overcame the limitations of the individual unit processes in terms of the suppression of bacterial reactivation and regrowth owing to the fact that bacterial cells were irreparably damaged. The treated wastewater satisfied the bacteriological requirements in treated wastewater for South Africa.


Recent advances in electron manipulation of nanomaterials for photoelectrochemical biosensors.
Photoelectrochemical (PEC) biosensing as a promising and largely developing technique has been widely applied in biological analysis in recent years because of its low background signal and high sensitivity. By utilizing suitable PEC active materials to establish a photoelectric (PE) conversion system, selective and sensitive measurements can be achieved with the help of specific biological recognition elements. PEC biosensors rely on the change of photocurrent that depends on the electron transfer process of nanomaterials. Therefore, the electron manipulation of PEC active nanomaterials is crucial for PEC sensing. In this review, from the perspective of the electron transfer manipulation of PEC active nanomaterials, we summarize the principle of PEC biosensors in three parts, i.e., generation of excited electrons in PEC active materials, introduction of specific materials for the formation of new electron transfer pathways, and separation of excited electrons in semiconductors. For each part, typical PEC biosensors are displayed and compared to reveal the superiority of different principles. In addition, current challenges of PEC biosensors are discussed, and some insight is given into the development of PEC biosensors in the future.


Beyond Wernicke's: a lexicon of eponyms in psychiatry.
Because no one has ever composed a glossary of psychiatry's numerous eponyms, the author collected eponymous signs and syndromes for a behavioral lexicon. Eponyms are included if they recall a real person, if they have special relevance to psychiatry, and if they describe an abnormal symptom or syndrome that we consider clinically important today, even if American physicians no longer favor the eponym. The author used MEDLINE and Campbell's Psychiatric Dictionary to locate candidates for the glossary. A brief definition and suggested reference accompany each entry.


A broadly neutralizing germline-like human monoclonal antibody against dengue virus envelope domain III.
Dengue is the most widespread vector-borne viral disease caused by dengue virus (DENV) for which there are no safe, effective drugs approved for clinical use. Here, by using sequential antigen panning of a yeast antibody library derived from healthy donors against the DENV envelop protein domain III (DIII) combined with depletion by an entry defective DIII mutant, we identified a cross-reactive human monoclonal antibody (mAb), m366.6, which bound with high affinity to DENV DIII from all four DENV serotypes. Immunogenetic analysis indicated that m366.6 is a germline-like mAb with very few somatic mutations from the closest VH and Vλ germline genes. Importantly, we demonstrated that it potently neutralized DENV both in vitro and in the mouse models of DENV infection without detectable antibody-dependent enhancement (ADE) effect. The epitope of m366.6 was mapped to the highly conserved regions on DIII, which may guide the design of effective dengue vaccine immunogens. Furthermore, as the first germline-like mAb derived from a naïve antibody library that could neutralize all four DENV serotypes, the m366.6 can be a tool for exploring mechanisms of DENV infection, and is a promising therapeutic candidate.


Evaluation of the antioxidant capacity and preventive effects of a topical emulsion and its vehicle control on the skin response to UV exposure.
Supplying topical exogenous antioxidants to the skin may prevent or minimize free radical-induced damaging. This study determines antioxidative capacity of a topical skin care emulsion (an oil-in-water vitamin E-containing formulation) versus its vehicle on human skin that was exposed to ultraviolet radiation (UVR) by utilizing a photochemiluminescence device and biophysical methods. Ten healthy Caucasians (3 male and 7 female; mean age 47 +/- 10 years) were enrolled. In a randomized and double-blind manner, a pH-balanced vitamin E emulsion or its vehicle control was applied onto predesignated forearm prior to UVR exposure. Thirty minutes after application, these test sites were exposed to a UV light to induce the minimal erythema dose. One untreated site served as a blank control. Visual scoring and instrumental measurements were recorded at baseline and at 24 h and 48 h thereafter. At day 3, after completing instrumental measurements, each test site was stripped three times in a consecutive manner with a proprietary adhesive tape disc. These tapes were quantified for antioxidant capacity using a photochemiluminescence device. Vitamin E emulsion and vehicle control significantly (p < 0.05) suppressed visual scores when compared with blank control at day 2 and day 3 after UV exposure. However, vitamin E emulsion showed significantly (p < 0.05) lower visual scores when compared with vehicle control at day 2 and day 3 after UV exposure.Also,vitamin E emulsion and its vehicle control significantly (p < 0.05) diminished skin color measurement (a*) values when compared with blank control at day 2 and day 3 after UV exposure. At day 2 after UV exposure, only vitamin E emulsion significantly (p < 0.05) reduced skin blood flow volume when compared with blank control. Vitamin E emulsion and its vehicle control showed significant (p < 0.05) reduction of blood flow volume when compared with blank control at day 3 after UV exposure. Vitamin E emulsion and its vehicle control proved effective in preventing induction of erythema and reducing inflammatory damage caused by UV exposure. The effect of vitamin E emulsion exceeded that of an 'active control'.


[Effects of H2 relaxin on the expression of Epac in a murine model of chronic asthma].
To explore the effects of H(2) relaxin on the expression of exchange protein directly activated by cyclic adenosine monophosphate (Epac) in a murine model of chronic asthma and the roles in the management of airway remodelling. Thirty-two BALB/c mice were randomly divided into 4 groups of normal control, asthma, vehicle control and relaxin treatment (n = 8 each). They were sensitized and challenged with ovalbumin to establish a chronic asthmatic model. The vehicle control and relaxin treatment groups were subcutaneously injected with saline and relaxin (0.25 mg×kg(-1)×d(-1)) respectively. Alteration of airway inflammation was observed by hematoxylin-eosin (HE) staining. The airway expressions of proliferating cell nuclear antigen (PCNA) and α-smooth muscle actin (α-SMA) were evaluated by immunohistochemistry. The protein expression of Epac and phosphorylated extracellular signal regulated kinases1/2 (p-ERK1/2) were detected by Western blot. Compared to those in the normal control group, massive infiltration of inflammatory cells, airway stenosis, bronchial smooth muscle hypertrophy were present in the asthmatic and vehicle control groups. The above-mentioned changes were significantly ameliorated in the relaxin treatment group. The percentage of PCNA positive cells (34.8% ± 6.1%, 33.5% ± 6.6%) and the expression of α-SMA ((1.70 ± 0.25), (1.54 ± 0.24) µm(2)/µm) in the asthmatic and vehicle control groups were significantly higher than those in the normal control group (9.9% ± 2.6%, (0.51 ± 0.16) µm(2)/µm) (all P < 0.05) while administration of relaxin decreased the airway expression levels of PCNA and α-SMA (22.9% ± 5.2%, (1.06 ± 0.25) µm(2)/µm) (all P < 0.05). The results of Western blot showed that the expression levels of Epac in the asthmatic and vehicle groups (0.62 ± 0.12, 0.68 ± 0.11) were lower than those in the control group (1.50 ± 0.17) (all P < 0.05) while it significantly increased in the relaxin group (1.08 ± 0.15) (all P < 0.05). The levels of phosphorylation of ERK1/2 in the asthmatic and vehicle groups (1.45 ± 0.13, 1.36 ± 0.09) were higher than those in the control group (0.38 ± 0.17) (all P < 0.05) while it decreased in the relaxin treatment group (0.72 ± 0.06) (all P < 0.05). No differences existed in all parameters between the asthmatic and vehicle groups (P > 0.05). Relaxin alleviates the airway inflammation and airway smooth muscle cell proliferation in a murine model of chronic asthma probably through activating Epac and inhibiting the phosphorylation of ERK1/2.


Draft Genome Sequence of Clostridium sp. Strain FP1, with Similarity to Clostridium tagluense, Isolated from Spoiled Lamb.
Clostridium sp. strain FP1 was isolated from vacuum-packaged refrigerated spoiled lamb, and this article describes its 5.4-Mb draft genome sequence. The FP1 genome was sequenced to facilitate source tracking and attribution studies, adding to our understanding of the role of Clostridium species in premature spoilage of red meats.


Collection method for Mycobacterium leprae from infected armadillo liver.
Leprosy bacilli were separated from infected armadillo liver almost free from tissue contaminants by a Percoll gradient centrifugation. The yield of bacilli was 46.7%. This is a very simple and effective method without enzyme treatment.


A genetic marker of risk in HIV-infected individuals with a history of hazardous drinking.
Impulsivity and sensation seeking have been linked to hazardous drinking, increased sexual risk behaviors, and lower treatment adherence among persons living with HIV (PLH). The dopamine active transporter1 (DAT1or SLC6A3) gene has been linked to impulsivity and sensation seeking in several populations but has not been investigated among populations of PLH. This study used data from 201 PLH who report a recent history of heavy episodic drinking. Results indicate that DAT1*10R vs DAT1*9R genotype was related to higher propensity for risk taking (standardized difference score (d) = 0.30 [95% CI: 0.02;0.59]), more hazardous drinking (d = 0.35 [0.05;0.64]), and more condomless sex (rate ratio (RR)= 2.35[1.94; 2.85]), but were counter-intuitively associated with fewer sexual partners (RR = 0.65[0.43;0.91]) and possibly better treatment adherence (d = 0.32 [-0.01;0.65]). Results are consistent with the suggested associations between DAT1 and risk-taking behavior. The counter-intuitive finding for partner selection and treatment adherence may be evidence of additional factors that place PLH at risk for engaging in hazardous drinking as well as relationship difficulties and problems with treatment adherence (e.g., depressive symptoms, avoidant coping, trauma history). Caution is required when using a single gene variant as a marker of complex behaviors and these findings need to be replicated using larger samples and additional variants.


Hydrogen/deuterium exchange mass spectrometry with improved electrochemical reduction enables comprehensive epitope mapping of a therapeutic antibody to the cysteine-knot containing vascular endothelial growth factor.
Hydrogen/deuterium exchange mass spectrometry (HDX-MS) has become a popular method for analysis of the conformational dynamics and interactions of proteins. Disulfide-bonded proteins, however, present a challenge to HDX-MS as they require efficient disulfide bond reduction prior to enzymatic proteolysis. Electrochemical reduction (ER) provides an attractive solution to tackle disulfide-bonded proteins that are resistant to conventional chemical reduction during HDX-MS. However, ER-enabled HDX-MS has been limited by technical challenges including partial unwanted protein oxidation side-reactions, incompatibility with certain buffer components and most importantly, a lack of overall method robustness. In this study, we have sought to address these challenges. We perform a systematic screening of the compatibility of ER to buffers commonly used in HDX-MS samples by using a reliable and simple system suitability test (SST). Furthermore, we demonstrate the benefits of a new design of the electrochemical cell (EC) for ER-enabled HDX-MS, which include a) high repeatability and robustness over large sample batches without the need for electrode polishing and b) high reduction efficiency of disulfide-bonded proteins without unwanted oxidation side-reactions. We show the real-world applicability of the optimized ER-enabled HDX-MS workflow by performing an epitope mapping of a Fab fragment of a therapeutic monoclonal antibody (mAb) to the cysteine knot-containing vascular endothelial growth factor (VEGF). The results allow us to comprehensively map sites in VEGF involved in mAb binding. Overall, our findings show how ER and HDX-MS can be combined to enable analysis of the conformation and interactions of challenging disulfide-rich proteins.


Chemical and Biological Properties of S-1-Propenyl-l-Cysteine in Aged Garlic Extract.
S-1-Propenyl-l-cysteine (S1PC) is a stereoisomer of S-1-Propenyl-l-cysteine (SAC), an important sulfur-containing amino acid that plays a role for the beneficial pharmacological effects of aged garlic extract (AGE). The existence of S1PC in garlic preparations has been known since the 1960's. However, there was no report regarding the biological and/or pharmacological activity of S1PC until 2016. Recently, we performed a series of studies to examine the chemical, biological, pharmacological and pharmacokinetic properties of S1PC, and obtained some interesting results. S1PC existed only in trace amounts in raw garlic, but its concentration increased almost up to the level similar of SAC through aging process of AGE. S1PC showed immunomodulatory effects in vitro and in vivo, and reduced blood pressure in a hypertensive animal model. A pharmacokinetic study revealed that S1PC was readily absorbed after oral administration in rats and dogs with bioavailability of 88-100%. Additionally, S1PC had little inhibitory influence on human cytochrome P450 activities, even at a concentration of 1 mM. Based on these findings, S1PC was suggested to be another important, pharmacologically active and safe component of AGE similar to SAC. In this review, we highlight some results from recent studies on S1PC and discuss the potential medicinal value of S1PC.


[An outline of experimental studies on the factors effecting electroacupuncture analgesia].
In the present paper, an outline of experimental studies on the factors effecting electroacupuncture analgesia is reviewed. Most of the results indicate that electroacupuncture stimulation at different intensities, frequencies, acupoints and hours produces different analgesic effects; electroacupuncture at different parameters induces different analgesia by different neurophydiologic and neurobiochemical mechanism.


70-kilodalton heat shock protein induction in cerebellar astrocytes and cerebellar granule cells in vitro: comparison with immunocytochemical localization after hyperthermia in vivo.
Induction of the 70-kDa heat shock protein, hsp70, was evaluated in cultured cerebellar astrocytes and granule cell neurons subjected to a hyperthermic stress, using a monoclonal antibody and an oligonucleotide probe that selectively recognize stress-inducible species of hsp70-related proteins and RNAs, respectively. Immunoblots of cultures enriched in either granule cells or astrocytes, and immunocytochemical localization studies in cocultures of these cell types, demonstrated that hsp70 induction was restricted to the astrocyte population. Amino acid incorporation experiments showed little difference in the loss and recovery of overall protein synthesis activity in these two cell types following transient hyperthermic stress. RNA blot hybridizations confirmed the preferential glial induction of hsp70. In vivo immunocytochemical studies in brains of adult rats following hyperthermia were consistent with earlier observations that suggested a primarily glial and vascular localization of the heat shock response in most brain regions, although the intense immunoreactivity in the cerebellar granule cell layer suggests that there is induction of hsp70 in these neurons under in vivo conditions. These results suggest the potential value of such defined cell cultures in identifying mechanisms responsible for differences in the heat shock response of various cell types in vitro, and in revealing factors that may account for the apparent absence of the stress response in cultured cerebellar granule cell neurons.


Malignization of a vestibular schwannoma 13 years after radiation therapy.
This article presents a case of malignant transformation of vestibular schwannoma 13 years after stereotactic radiation therapy, which lead to an acute life-threatening condition. Although the observation is currently only based on case reports, an increasing number of these support the hypothesis that there is a relevant risk of malignant transformation in the long-term course of previously irradiated vestibular schwannomas. Therefore, long-term MRI follow-up should be considered.


Transcatheter ablation through the cardiac veins in a patient with a biventricular device and left ventricular epicardial arrhythmias.
Left ventricular outflow tract (LVOT) may be a source of repeated premature ventricular complexes (PVCs). In symptomatic patients, radiofrequency catheter ablation (RFCA) can be effective, either from endocardial or from epicardial sites. A 50-year-old patient, with dilated cardiomyopathy (DCM) and severe left ventricular (LV) dysfunction, left bundle branch block (LBBB), New York Heart Association (NYHA) class IV, received a biventricular implantable cardioverter/defibrillator (ICD) in 2002. Despite drug therapy, PVCs were frequent (21.019/24 h) including prolonged runs, prompting ICD intervention. Premature ventricular complexes showed an inferior axis morphology, with an R/S ratio in V3>1, suggesting an LVOT origin. Despite the cardiac resynchronization therapy (CRT) device, successful RFCA was performed through the anterior venous branch, with a favourable clinical outcome. To our knowledge, this is the first case describing epicardial RFCA of a PVC focus from cardiac veins in the presence of a CRT device.


Supramolecular Assembly of Photosystem II and Adenosine Triphosphate Synthase in Artificially Designed Honeycomb Multilayers for Photophosphorylation.
Plant thylakoids have a typical stacking structure, which is the site of photosynthesis, including light-harvesting, water-splitting, and adenosine triphosphate (ATP) production. This stacking structure plays a key role in exchange of substances with extremely high efficiency and minimum energy consumption through photosynthesis. Herein we report an artificially designed honeycomb multilayer for photophosphorylation. To mimic the natural thylakoid stacking structure, the multilayered photosystem II (PSII)-ATP synthase-liposome system is fabricated via layer-by-layer (LbL) assembly, allowing the three-dimensional distributions of PSII and ATP synthase. Under light illumination, PSII splits water into protons and generates a proton gradient for ATP synthase to produce ATP. Moreover, it is found that the ATP production is extremely associated with the numbers of PSII layers. With such a multilayer structure assembled via LbL, one can better understand the mechanism of PSII and ATP synthase integrated in one system, mimicking the photosynthetic grana structure. On the other hand, such an assembled system can be considered to improve the photophosphorylation.


Ring-Opening Alternating Copolymerization of O-Carboxyanhydrides of Lactic Acid and Malic Acid Using Hafnium Alkoxide Initiators with Different Stereo Selectivities and Activities.
Monomer sequence controllable syntheses of copolymers, including copolyesters, remain a challenge in polymer science. Although alternating sequence-controlled copolymerization of O-carboxyanhydrides (OCAs) can be achieved via using syndioselective initiators, the alternating copolymerization of lactic acid-derived O-carboxyanhydride (LacOCA) with other monomers still suffers from a lack of highly syndioselective initiators. In this work, a highly syndioselective system for the ring-opening polymerization (ROP) of LacOCA was achieved using a bulky amine tris(phenolate) hafnium alkoxide initiator with a high Pr value of 0.91. However, the stereoselectivities of amine tris(phenolate) hafnium alkoxide initiators for the ROP of malic acid O-carboxyanhydride (MalOCA) change to be modestly or lowly isoselective. Interestingly, despite the different stereoselectivities of this system for the two different monomers, the high syndioselectivity of the initiator for the ROP of LacOCA and the low activity of MalOCA in the ROP allow comparatively high rates of cross-propagation; consequently, the ring-opening alternating copolymerization (ROAP) of LacOCA and MalOCA was achieved successfully.


Presentations to an urban emergency department in Bern, Switzerland associated with acute recreational drug toxicity.
Although the recreational use of psychoactive substances is common there is only limited systematic collection of data on acute drug toxicity or hospital presentations. Currently, data from Switzerland are only available from the University Hospital of Basel. The present study aimed to describe the presentations due to recreational drug use at an emergency department in Bern, Switzerland during a 4 year period. Retrospective analysis of cases presenting from May 2012 to April 2016 at the emergency department of the University Hospital of Bern, Switzerland, with symptoms/signs consistent with acute toxicity of recreational drug use. The cases were retrieved using a comprehensive full-text search algorithm of the electronic health records. Isolated ethanol intoxications were excluded. During the study period, 503 of the 157,328 emergency department attendances were directly related to acute toxicity of substances used recreationally. The mean patient age was 33 years (range 16-74), 68% were male. Alcohol co-ingestion was reported in 54% of the cases, and use of more than one recreational drug in 37% of the cases. Most presentations were related to cocaine (29%), cannabis (26%), heroin (20%) and benzodiazepines/sedatives (18%). Urine drug screening immunoassay was available in 277 cases (55%). The most frequently detected substances were cannabis (29%), cocaine (22%), benzodiazepines (21%) and opioids excluding methadone (20%). There were only two intoxications with novel psychoactive substances (NPSs): One with methylone and one with 2,5-dimethoxy-4(n)-propylphenethylamine (2C-P). The majority of patients (58%) displayed impaired consciousness (Glasgow Coma Scale (GCS) <15) upon presentation and/or pre-hospital; 21% were unconscious (GCS <8). Other frequent symptoms were agitation (36%), tachycardia (29%), and anxiety (24%). Severe complications included two fatalities, three acute myocardial infarctions, two intracranial haemorrhages, as well as psychosis and seizures in 71 and 26 cases, respectively. Most medical problems related to recreational drug use were associated with cocaine and cannabis use and were mainly characterised by central nervous system depression, sympathomimetic toxicity and/or psychiatric disorders. Presentations related to acute toxicities of NPSs appear to be uncommon, while prescription drugs were after classical recreational drugs the substances most commonly reported.


Clinical and Imaging Follow-up Practices after Transarterial Therapy for Primary and Secondary Hepatic Malignancies: Results of an Online Survey.
To characterize practices and quantify variation in longitudinal follow-up approaches among interventional radiologists (IRs) after liver transarterial locoregional therapy (LRT) in contemporary Interventional Oncology practice. In November/December 2014, Society of Interventional Radiology members were invited to participate in a survey regarding clinical and imaging follow-up of liver cancer patients treated with transarterial LRT. On survey closure, responses were compiled and analyzed. The 30-item survey response rate was 11% (361 of 3290). Respondents were predominantly American IRs (311 of 355, 88%) who perform 1-5 LRTs monthly (196 of 354, 55%). Most (305 of 336, 91%) IRs reported longitudinal follow-up, with patient encounters within 1-month (73%, 211 of 290) postprocedure and every 3 months (68%, 196 of 287) thereafter and involvement in imaging (up to 80%, 235 of 290) ordering and evaluation. Preferred timing of first follow-up imaging (1 month vs. 3 months) and response criteria used (mRECIST favored) varied. Although IRs are actively involved in clinical and imaging follow-up of patients with liver malignancies treated with transarterial LRTs, there are differences in imaging frequency and response assessment. These data may serve as a starting point for standardization of LRT follow-up.


Supported Zeolite Beta Layers via an Organic Template-Free Preparation Route.
Layers of high silica zeolites, synthesized with an organic structure directing agent (OSDA) and grown onto porous support structures, frequently suffer from the thermal stress during the removal of OSDA via the calcination process. The different thermal expansion coefficients of the zeolite and the support material, especially when stainless steel is used as a support, causes enormous tension resulting in defect formation in the zeolite layer. However, the calcination is an easy procedure to decompose the OSDA in the pore system of the zeolite. Recently, methods to synthesize zeolite beta without the use of an organic structure directing agent have been described. In the present study, a seed-directed synthesis is used to prepare OSDA-free zeolite beta layers on stainless steel supports via an in situ preparation route. For the application as membrane, a porous stainless steel support has been chosen. The beta/stainless steel composites are characterized by X-ray diffraction (XRD) and scanning electron microscopy (SEM). To prove its possible application as a membrane, the beta/stainless steel composites were also tested by single gas permeances of H₂, He, CO₂, N₂, and CH₄.


Adaptive-weighted high order TV algorithm for sparse-view CT reconstruction.
With the development of low-dose computed tomography (CT), incomplete data reconstruction has been widely concerned. The total variation (TV) minimization algorithm can accurately reconstruct images from sparse or noisy data. However, the traditional TV algorithm ignores the direction of structures in images, leading to the loss of edge information and block artifacts when the object is not piecewise constant. Since the anisotropic information can facilitate preserving the edge and detail information in images, we aim to improve the TV algorithm in terms of reconstruction accuracy via this approach. In this paper, we propose an adaptive-weighted high order total variation (awHOTV) algorithm. We construct the second order TV-norm using the second order gradient, adapt the anisotropic edge property between neighboring image pixels, adjust the local image-intensity gradient to keep edge information, and design the corresponding Chambolle-Pock (CP) solving algorithm. Implementing the proposed algorithm, comprehensive studies are conducted in the ideal projection data experiment where the Structural similarity (SSIM), Root Mean Square Error (RMSE), Contrast to noise ratio (CNR), and modulation transform function (MTF) curves are utilized to evaluate the quality of reconstructed images in statism, structure, spatial resolution, and contrast, respectively. In the noisy data experiment, we further use the noise power spectrum (NPS) curve to evaluate the reconstructed images and compare it with other three algorithms. We use the 2D slice in the XCAT phantom, 2D slice in TCIA Challenge data and FORBILD phantom as simulation phantoms and use real bird data for real verification. The results show that, compared with the traditional TV and FBP algorithms, the awHOTV has better performance in terms of RMSE, SSIM, and Pearson correlation coefficient (PCC) under the projected data with different sparsity. In addition, the awHOTV algorithm is robust against the noise of different intensities. The proposed awHOTV method can reconstruct the images with high accuracy under sparse or noisy data. The awHOTV solves the strip artifacts caused by sparse data in the FBP method. Compared with the TV method, the awHOTV can effectively suppress block artifacts and has good detail protection ability.


The Molecular Basis of the Anti-Inflammatory Property of Astragaloside IV for the Treatment of Diabetes and Its Complications.
Astragali Radix is a significant traditional Chinese medication, and has a long history of clinical application in the treatment of diabetes mellitus (DM) and its complications. AS-IV is an active saponin isolated from it. Modern pharmacological study shows that AS-IV has anti-inflammatory, anti-oxidant and immunomodulatory activities. The popular inflammatory etiology of diabetes suggests that DM is a natural immune and low-grade inflammatory disease. Pharmacological intervention of the inflammatory response may provide promising and alternative approaches for the prevention and treatment of DM and its complications. Therefore, this article focuses on the potential of AS-IV in the treatment of DM from the perspective of an anti-inflammatory molecular basis. AS-IV plays a role by regulating a variety of anti-inflammatory pathways in multiple organs, tissues and target cells throughout the body. The blockade of the NF-κB inflammatory signaling pathway may be the central link of AS-IV's anti-inflammatory effect, resulting in a reduction in the tissue structure and function damage stimulated by inflammatory factors. In addition, AS-IV can delay the onset of DM and its complications by inhibiting inflammation-related oxidative stress, fibrosis and apoptosis signals. In conclusion, AS-IV has therapeutic prospects from the perspective of reducing the inflammation of DM and its complications. An in-depth study on the anti-inflammatory mechanism of AS-IV is of great significance for the effective use of Chinese herbal medicine and the promotion of its status and influence on the world.


Analysis of influential factors associated with the smoking behavior of aboriginal schoolchildren in remote Taiwanese mountainous areas.
A disparity in smoking behavior exists between the general and minority populations residing in Taiwan's mountainous areas. This study analyzed individual and environmental factors associated with children's smoking behavior in these areas of Taiwan. In this school-based study, data on smoking behavior and related factors for mountain-dwelling students were obtained from the 2008 and 2009 Control of School-aged Children Smoking Study surveys. A representative sample (N = 1239) from 26 primary schools was included. The association among 3 groups (never-, former-, and current-smokers) and the potential variables were simultaneously examined using unordered polytomous logistic regression analysis. Between 13% and 34% of ever-smokers reported that their first smoking experience was in third grade. More than 70% were found to have bought cigarettes and 87% reported that the tobacco retailers had sold them cigarettes. The significant factors for current-smokers were predisposing factors, ie, attitude toward smoking (adjusted odds ratio [AOR] = 1.21); reinforcing factors, ie, family smoked in front of me (AOR = 2.44), friends smoked in front of me (AOR = 16.24), and school staff smoked in front of me (AOR = 2.98); and enabling factors, ie, cigarette availability and accessibility (AOR = 2.16 and 2.42, respectively). A student's perceived punishment for smoking at school had a positive significant effect on the risk of being former-smokers (AOR = 1.57). The findings provide a basis for school and community to design and implement effective anti-smoking programs for remote mountain-based students to further reduce youth smoking.


Prevalence of undiagnosed HIV infection among persons aged ≥13 years--National HIV Surveillance System, United States, 2005-2008.
In the United States, approximately 1.1 million adults and adolescents are living with human immunodeficiency virus (HIV) infection and, each year, another 50,000 become infected. At the end of 2008, approximately 20% of the persons living with HIV had an undiagnosed infection. Of those living with HIV at the end of 2008, nearly two thirds were racial/ethnic minorities and half were men who have sex with men (MSM). In 2007, HIV ranked fifth as a leading cause of death among persons aged 35-44 years in the United States but third among blacks or African Americans in this age group. In 40 states with longstanding confidential name-based HIV surveillance systems, 33% of the estimated 41,768 adults and adolescents diagnosed with HIV infection in 2008 developed acquired immunodeficiency syndrome (AIDS) within 1 year and, of these, 44% received their initial diagnosis in an acute care setting, suggesting that they received HIV testing late in the course of the infection. HIV-infected persons who are unaware of their infection or who receive a late diagnosis cannot benefit fully from timely initiation of therapy and are more likely to experience HIV-related morbidity and premature mortality. In addition, persons unaware of their infection are more likely to transmit HIV to others because of a higher prevalence of high-risk sexual behaviors and higher levels of viral RNA that continue to replicate without appropriate antiretroviral treatment.


Biochemical and physiological parameters on the healthy skin surface of patients with common warts.
Biochemical and physiological examinations were carried out on the healthy surface of the skin of 24 test persons who had had contracted common warts during the 2 years prior to examination and on a control group of 46 healthy persons of the same age and sex. The following significant results were obtained: (1) There was a significant reduction in the percentage amount of squalene in the lipids of the skin surface in the patients with common warts as compared with the healthy control persons. (2) The alkali neutralization time in the patients with common warts was significantly shortened as compared with the healthy control group. (3) The degree of moistening of the skin with water was significantly less in the patients with common warts than in the control persons. These results indicate important predisposing factors for common warts.


Application of a bioassay with CHO cells for the routine detection of stimulating and blocking autoantibodies to the TSH-receptor.
The importance of bioassays measuring stimulating and blocking autoantibodies to the TSH-receptor (TSH-R) by their effect on cAMP production in CHO cells transfected with the recombinant TSH-R is increasingly recognized. The standard technique for this bioassay is cumbersome, as it involves purification of serum IgG with polyethylene glycol (PEG) and resuspension in hypotonic buffer. We have therefore established a simpler approach for the detection of stimulating and blocking autoantibodies using JP09 CHO cells and unfractionated human serum. The cAMP concentration was measured by a highly sensitive commercial radioimmuno assay. Thyroid stimulating autoantibodies (TSAb) were present in 107 out of 126 patients with Graves' disease (85%) and in 4 out of 40 patients with Hashimoto's thyroiditis (10%). Specificity was confirmed by the fact that only 1 patient with insulin dependent diabetes mellitus (IDDM) out of 64 patients with different non-thyroid autoimmune disorders (46 with IDDM, 10 with stiff man syndrome and 8 with rheumatoid arthritis) and 2 out of 100 healthy controls (2%) were positive in this assay. In the subgroup of hyperthyroid Graves' disease patients 76 out of 83 (92%) had TSAb and the same number had TSH binding inhibiting immunoglobulin (TBII), as assessed by the commercial TRAK assay. Although both antibody types showed only a weak correlation (r = 0.30), a combination of TSAb and TBII detected 98% of all Graves' patients and 99% of the hyperthyroid subgroup. Thyroid blocking autoantibodies (TBAb) were measured in 4 out of 24 TSAb negative patients with Graves' disease (17%), who were hypothyroid and positive for TBII. A comparison of our bioassay with the standard bioassay using PEG precipitation showed a good correlation (r = 0.76,p < 0.001), demonstrating the feasibility of the simplified assay for the routine detection of TSAb and TBAb in Graves' disease.


Women and women of color in leadership: complexity, identity, and intersectionality.
This article describes the challenges that women and women of color face in their quest to achieve and perform in leadership roles in work settings. We discuss the barriers that women encounter and specifically address the dimensions of gender and race and their impact on leadership. We identify the factors associated with gender evaluations of leaders and the stereotypes and other challenges faced by White women and women of color. We use ideas concerning identity and the intersection of multiple identities to understand the way in which gender mediates and shapes the experience of women in the workplace. We conclude with suggestions for research and theory development that may more fully capture the complex experience of women who serve as leaders.


Depletion of blood plasma cytidine due to increased hepatocellular salvage in D-galactosamine-treated rats.
Pyrimidine nucleosides in blood plasma of rats were identified by different procedures, including chemical peak shift methods, before their quantification by reversed-phase high-performance liquid chromatography. The concentrations of uridine, cytidine, and deoxycytidine were 1.0 +/- 0.2, 10.6 +/- 1.9, and 33.4 +/- 5.4 mumol/l, respectively. Six hours after the administration of D-galactosamine, the level of circulating cytidine was severely depressed to 25% of control values; uridine decreased to 54% while deoxycytidine remained unchanged. 24 h after the dose of the amino sugar, the levels of cytidine and uridine returned to control values in blood plasma. Total acid-soluble uridine, cytidine, guanosine, and adenosine was determined by reversed-phase HPLC after treatment of the neutralized acid-soluble supernatant of freeze-clamped rat livers with phosphodiesterase and alkaline phosphatase. Six hours after its administration, D-galactosamine induced a 2.2-fold and a 1.6-fold rise in total acid-soluble uridine and cytidine, respectively. Co-administration of N-(phosphonoacetyl)-L-aspartate, an inhibitor of de novo pyrimidine synthesis, suppressed the increase in total acid-soluble uridine observed after D-galactosamine alone, but was without effect on the enhancement of total cytidine. Three hours after D-galactosamine and 15 min after [2-14C] cytidine, there was a rapid fall of the labeled nucleoside in blood plasma to 49% of control animals accompanied by a 2.8-fold rise in the total radioactivity of rat liver homogenates. From these results it can be concluded that the hepatocellular rise in total acid-soluble cytidine after D-galactosamine, in contrast to the increase in total acid-soluble uridine, originates from the phosphorylation of blood plasma cytidine via the salvage pathway. The depletion of circulating cytidine in the presence of hepatocellular UTP deficiency points to the importance of the liver and the hepatic UTP level for the clearance of blood plasma cytidine.


Evolution of the low contact stress (LCS) complete knee system.
The low contact stress knee design was one of the first designs to become widely available and popular for total knee arthroplasty. The low contact stress knee was initially designed to address wear due to high contact stresses seen in fixed-bearing designs. Today, nearly 30 years after its introduction, the technology behind the knee remains just as relevant. Many of the original innovations in early low contact stress knee systems are still in use today. New innovations, like a new instrument set and the advent of computer-assisted surgery, have added to the success of the technology. The history of this innovative design is discussed with special consideration given to the specific design principals that have improved the basic design over the past three decades.