Intergenerational service-learning: an innovative teaching strategy to infuse gerontology content into foundation courses.
This article provides an overview of intergenerational service- learning, an experiential pedagogy that involves students in learning outside the traditional classroom while providing a needed service in the community. Examples of intergenerational service-learning projects are presented that have been successfully utilized by the authors. These projects demonstrate the importance of using reflective practice assignments to help students deconstruct and reconstruct images, beliefs and paradigms about older adults. In addition, problems and opportunities in developing service-learning projects in urban and rural settings and with the Hispanic community are described, as well as some of the types of learning that may result from implementing service-learning experiences in various social work foundation courses.


Minimizing the duration of laser Doppler flowmetry recordings while maintaining wavelet analysis quality: A methodological study.
Recording oscillations in cutaneous blood perfusion using laser Doppler flowmetry (LDF) is of common use in clinical research, due, mainly, to its non-invasive nature. Detailed information about the vascular tone in different frequency bands and the related physiologic compartment can be inferred from wavelet analysis (WA) of an LDF signal. However, little is known about the minimal recording duration required to generate a proper representation of the frequency content of such signals. To address this question, the three lowest frequency bands (i.e. myogenic, neurogenic and endothelial) of the LDF wavelet power spectrum were studied to define the shortest recording duration needed to perform a quality WA. Sixty-five healthy participants were included for 20 min of basal LDF recording on forearm and dorsum of the foot. Recordings were short cut every minute and compared to the 20-min reference recording that is generally used in the literature. Our results indicate that minimum 10 min recordings are required for analysis of myogenic events, whatever the anatomical site. On the forearm, LDF recordings lengths should be at least 15 min and 10 min for the neurogenic and endothelial bands, respectively. On the foot, 13 min of LDF recording is required to assess neurogenic and endothelial bands. Depending on the aim of any given study involving healthy subjects, LDF recordings need to last at least 15 min on forearm and 13 min on the foot to maintain a quality WA on low-frequency bands.


Reasons for and management of postvitrectomy vitreous hemorrhage in proliferative diabetic retinopathy.
To analyze the reasons for postvitrectomy vitreous hemorrhage in proliferative diabetic retinopathy (PDR), and to evaluate the effects of retreatment. Retrospective, nonrandomized, observational case series. Three hundred and fifteen eyes of 302 consecutive patients underwent primary standard three-port vitrectomy with 20-gauge instruments for complications of PDR from 2000 to 2006. One hundred and forty-two patients were male, and 160 were female. The age ranged from 38 to 72 years with a mean of 56 years. There were 32 eyes which developed postvitrectomy vitreous hemorrhage during follow-up. The mean follow-up was 12 months with a range from 3 to 48 months. Of 315 eyes with PDR and receiving pars plana vitrectomy, 32 eyes had postvitrectomy vitreous hemorrhage. The onset of recurrent vitreous hemorrhage ranged from 1 to 210 days with an average of 51 days. The reasons for postvitrectomy vitreous hemorrhage in PDR mainly included fibrovascular ingrowth at sclerotomy sites (9 eyes), residual or recurrent neovascular membrane on the optic nerve (6 eyes), insufficient retinal photocoagulation (7 eyes), residual and recurrent epiretinal proliferative membrane (3 eyes), retinal vein occlusion (2 eyes), postoperative low intraocular pressure (2 eyes), and ocular trauma (3 eyes). The visual acuity increased in 31 eyes (96.88%), and decreased in 1 eye (3.12%) after retreatment. The postoperative complications following the treatment of recurrent vitreous hemorrhage mainly included posterior synechia of the iris (3 eyes), nucleus sclerosis (18 eyes), and delayed healing of corneal epithelium (3 eyes). Vitrectomy is a safe and effective method for treating PDR. Appropriate and complete analysis of postvitrectomy vitreous hemorrhage can significantly improve the primary treatment effects for PDR.


Menstrual Characteristics and Related Problems in 9- to 18-Year-Old Turkish School Girls.
To determine the cross-sectional characteristics of menstruating girls, dysmenorrhea, and the frequencies of related problems. Descriptive, cross-sectional study. Randomly selected primary, junior, and high schools in the city center of Kayseri. Two thousand female adolescents of ages between 9 and 18 years. We used a questionnaire addressing the epidemiological characteristics of menstruation, such as age at menarche, duration of menstrual intervals, average days of bleeding, and any menstrual problems and their frequencies. This study consists of a sufficient number of participants from all age groups. Of the participant (n = 2000) girls, 63.7% (n = 1274) had started menstruating. The mean age at menarche was 12.74 (±1.03) years. With a prevalence of 84.8% (n = 1080), dysmenorrhea was the most prevalent menstrual problem and the average pain score was 5.87 (±2.45). Of the menstruating girls, 34% (n = 439) used painkillers, the most commonly used was acetaminophen; during their period the prevalence of nonmedical methods to relieve pain was 35.2%; the rate of seeking medical help for dysmenorrhea was 9.3% (n = 119). In menstruating participants, 90.8% discussed their menstrual problems with their mothers. The rate of school absenteeism in menstruating girls was 15.9% in general and 18% in those with dysmenorrhea. Problems related to menstruation are common in adolescents and these problems affect their social life. In adolescent girls, the most common menstrual problem is dysmenorrhea and it affects school performance and attendance. Girls with menstrual problems showed a low rate of seeking medical help.


The effect of the H2 antagonist cimetidine on the numbers of CD4+ and CD8+ cells in the nasal mucosa of patients with allergic rhinitis.
This paper reports the effects of the H2 antagonist cimetidine on the number of CD4+ and CD8+ cells in nasal mucosa and the IgE level of nasal secretions in patients with allergic rhinitis. The results showed the numbers of CD4+ cells were greater than the numbers of CD8+ cells in nasal mucosa, both in the patients with allergic rhinitis and normal subjects, but the ratio of CD4+:CD8+ cells was much higher in the patients with allergic rhinitis. After treatment with cimetidine locally for 4 weeks, the numbers of CD4+ cells fell and the numbers of CD8+ cells increased in the patients with allergic rhinitis. The high IgE level of nasal secretion of the patients with allergic rhinitis was much reduced after treatment with cimetidine. The results suggest that there are high numbers of CD4+ cells and lower numbers of CD8+ cells in the nasal mucosa and a high level of IgE in the nasal secretions of the patients with allergic rhinitis. Treatment with cimetidine locally may be of some value to relieve the clinical symptoms of allergic rhinitis.


Cardiovascular effects of quinidine and procainamide on intact dogs and isolated cross-perfused canine atria.
The effects of quinidine and procainamide were studied in isolated canine atria cross-perfused with heparinized arterial blood from donor dogs as well as in these donor dogs. When administered intravenously to donor dogs, both drugs produced dose-related hypotensive effects, but quinidine was 3-10 times more potent than procainamide. Quinidine frequently caused tachycardia in the donor dogs, while procainamide usually produced bradycardia. Quinidine-induced tachycardia was partially suppressed by vagotomy and completely inhibited or changed to bradycardia after propranolol. In isolated atria, small doses of drugs caused slight negative chronotropic and inotropic effects, frequently accompanied by small and short-lasting increases in contractile force and heart rate. Only decreases in contractile force and rate were observed with large doses. Administration of quinidine and procainamide into the sinus node artery of the isolated atrium induced negative, biphasic, or triphasic changes in chronotropism and inotropism. In isolated atria, quinidine and verapamil depressed the contractile force to a greater extent at higher stimulation frequencies. Procainamide showed less of this effect, because atrial muscle became unresponsive to high-frequency pacing with the larger doses of procainamide. These results suggest that quinidine and procainamide have both cardiac-depressant and -stimulating properties.


Intracardiac coiling of permanent atrial leads.
We have observed intracardiac movement of permanently implanted atrial pacing leads in two patients with AAI pacemakers. This resulted in looping of the lead body into the right atrium and ventricle, without displacement of the tip or changes in the pacing or sensing thresholds. At surgery only a single fixation ligature was found and allowed sliding of the lead through the suture sheath, in both cases. The position was corrected by gently pulling the lead. Multiple ligature fixation may avoid this complication.


Substrate level control of the local doping in graphene.
Graphene exfoliated onto muscovite mica is studied using ultrahigh vacuum scanning tunneling microscopy (UHV-STM) techniques. Mica provides an interesting dielectric substrate interface to measure the properties of graphene due to the ultraflat nature of a cleaved mica surface and the surface electric dipoles it possesses. Flat regions of the mica surface show some surface modulation of the graphene topography (24 pm) due to topographic modulation of the mica surface and full conformation of the graphene to that surface. In addition to these ultraflat regions, plateaus of varying size having been found. A comparison of topographic images and STS measurements show that these plateaus are of two types: one with characteristics of water monolayer formation between the graphene and mica, and the other arising from potassium ions trapped at the interfacial region. Immediately above the water induced plateaus, graphene is insulated from charge doping, while p-type doping is observed in areas adjacent to these water nucleation points. However, above and in the neighborhood of interfacial potassium ions, only n-type doping is observed. Graphene regions above the potassium ions are more strongly n-doped than regions adjacent to these alkali atom plateaus. Furthermore, a direct correlation of these Fermi level shifts with topographic features is seen without the random charge carrier density modulation observed in other dielectric substrates. This suggests a possible route to nanoscopic control of the local electron and hole doping in graphene via specific substrate architecture.


Intranasal administration of nerve growth factor promotes angiogenesis via activation of PI3K/Akt signaling following cerebral infarction in rats.
Angiogenesis plays a critical role in neural repair following ischemic stroke. Therapeutic angiogenesis contributes to neurological functional recovery after cerebral infarction. Nerve growth factor (NGF) has been reported as a neurotrophic factor. However, the angiogenic efficacy of NGF in cerebral ischemia remains unclear. In this study, we investigated the effect of NGF on angiogenesis in the ischemic penumbra and neurological outcome in a rat model of middle cerebral artery occlusion (MCAO). Our results demonstrate that the intranasal administration of NGF improves neurological outcome and reduces infarct volume on day 7 after MCAO in rats. Treatment with NGF promoted angiogenesis in the peri-infarct region, increased the serum levels of VEGF and SDF-1 protein, and elevated the number of circulating endothelial progenitor cells (EPCs) on day 4 after MCAO. In addition, NGF enhanced capillary-like tube formation of rat brain microvascular endothelial cells in vitro, further confirming its angiogenic effect. Furthermore, the neuroprotective and angiogenic effects of NGF can be significantly attenuated by the phosphatidylinositide 3-kinase (PI3K)/Akt pathway antagonist LY294002. Our results indicate that NGF-enhanced angiogenesis contributes to neurological functional recovery after ischemic stroke, which may occur partly via activation of the PI3K/Akt signaling pathway. This study provides novel experimental evidence for the angiogenic role of NGF in treating ischemic stroke.


Histamine receptors in the brain.
In mammalian brain, neuronal histamine is likely to act as a neurotransmitter and is recognized by the two classes of histamine receptors (H1 and H2) previously characterized in peripheral organs. Cerebral H1 receptors can be selectively labeled by a tritiated antagonist mepyramine, in particulate fractions or in the living animal. Cerebral H1 receptors mediate the glycogen hydrolysis and the breakdown of inositol phospholipids elicited by the amine. They are indirectly involved in the histamine-mediated accumulation of cyclic AMP. All these biochemical responses mediated by H1 receptors are calcium-dependent. H2 receptors are coupled to an adenylate cyclase. In addition, a novel class of histamine receptors (H3) are presynaptic autoreceptors and modulate the release of neuronal histamine.


Optimized Treatment of Fibromyalgia Using System Identification and Hybrid Model Predictive Control.
The term adaptive intervention is used in behavioral health to describe individually-tailored strategies for preventing and treating chronic, relapsing disorders. This paper describes a system identification approach for developing dynamical models from clinical data, and subsequently, a hybrid model predictive control scheme for assigning dosages of naltrexone as treatment for fibromyalgia, a chronic pain condition. A simulation study that includes conditions of significant plant-model mismatch demonstrates the benefits of hybrid predictive control as a decision framework for optimized adaptive interventions. This work provides insights on the design of novel personalized interventions for chronic pain and related conditions in behavioral health.


Stress response of Caenorhabditis elegans induced by space crowding in a micro-column array chip.
Crowding stress has been reported to play an important role in affecting physiological behaviour. To study this process, a reliable analytical method under confined space is essential. In this work, we demonstrated a microfluidic approach for investigating physiological responses of C. elegans to confined spaces. The PDMS microfluidic chip consisting of arrays of micro-columns enabled us to mimic different crowding conditions by changing the intervals among micro-columns. C. elegans were transferred into this micro-column array and the subcellular distribution of DAF-16, which is a well-known transcription factor regulating different stress responses, was monitored for analysing the physiological responses to the confined spaces. We found that the worms exhibited a gradual increase in DAF-16 nuclear localization in the micro-column array with intervals from 200 μm to 40 μm. Moreover, the results showed that the absence of food and crowding stress could cooperate to promote increased DAF-16 nuclear localization. Finally, loss-of-function mutations in mec-4 and mec-10, which are amiloride-sensitive Na(+) channel genes expressed in all six gentle touch neurons, accelerated the velocity of DAF-16 nuclear localization, induced by confined space, revealing that mec-4/mec-10 were not required for this stress response. Thus, this device will provide a versatile, reliable and controllable platform for crowding stress studies.


The role of age-related T-cell differentiation in patients with renal replacement therapy.
Dialysis patients have deficiencies regarding the generation of immune responses and show an increased susceptibility for infections. Persisting uremic conditions are made responsible for the increased aging of their immune system. In this study, we analyzed whether age-related differences in the differentiation of both recent-thymic-emigrant-(RTE)-regulatory (Tregs) and RTE-responder T cells (Tresps) into CD31--memory Tregs/Tresps led to differences in the suppressive activity of naive and memory Tregs on autologous Tresps between healthy volunteers and dialysis patients. We found that regardless of age, the differentiation of RTE-Treg/Tresps into CD31--memory-Treg/Tresps was significantly increased in dialysis patients. By analyzing the age-related differences in the differentiation of Tregs/Tresps, we saw that in healthy volunteers RTE-Tregs differentiate via CD31+-memory Tregs into CD31--memory Tregs, which may strengthen the suppressive activity of the total Treg pool. In contrast RTE-Tresps of healthy volunteers differentiate via mature naive (MN)-Tresps into CD31--memory-Tresps, which may weaken the reactivity of the total Tresp pool. Our data revealed that this normal differentiation via MN-Tresps was lost in dialysis patients, suggesting that their Tresps are less sensitive to Treg-mediated immunosuppression. Functional analysis of Tregs on autologous Tresps showed an increasing suppressive activity with age in healthy individuals, who therefore may have a lower risk of developing autoimmune diseases but owing to decreased reactivity of their Tresps are more likely to suffer from infections. In contrast, dialysis patients exhibited a decreasing suppressive activity with age, owing to strengthened Tresp reactivity, which could explain the higher prevalence of chronic inflammatory conditions in these patients.


Seeking a blood pressure-independent measure of vascular properties.
Pulse wave velocity (PWV) and pulse pressure (PP) are blood pressure (BP)-dependent surrogates for vascular stiffness. Considering that there are no clinically useful markers for arterial stiffness that are BP-independent, our objective was to identify novel indices of arterial stiffness and compare them with previously described markers. PWV and PP were measured in young and old male Fisher rats and in young and old male spontaneously hypertensive rats (SHR) over a wide range of BPs. The BP dependence of these and several other indices of vascular stiffness were evaluated. An index incorporating PWV and PP was also constructed. Both PWV and PP increase in a non-linear manner with rising BP for both strains of animals (Fisher and SHRs). Age markedly changes the relationship between PWV or PP and BP. The previously described Ambulatory Arterial Stiffness Index (AASI) was able to differentiate between young and old vasculature, whereas the Cardio-Ankle Vascular Index (CAVI) did not reliably differentiate between the two. The novel Arterial Stiffness Index (ASI) differentiated stiffer from more compliant vasculature. Considering the limitations of the currently available indices of arterial stiffness, we propose a novel index of intrinsic arterial stiffness, the ASI, which is robust over a range of BPs and allows one to distinguish between compliant and stiff vasculature in both Fisher rats and SHRs. Further studies are necessary to validate this index in other settings.


An insulin-like growth factor-binding protein purified from medium conditioned by a human lung fibroblast cell line (He[39]L) has a novel N-terminal sequence.
We have identified a novel insulin-like growth factor (IGF)-binding protein secreted into the culture medium of a human lung fibroblast cell line (He[39]L). This binding protein was purified by S-Sepharose cation exchange chromatography, IGF affinity chromatography and reverse-phase high-performance liquid chromatography. Analysis of the He[39]L-binding protein on silver-stained polyacrylamide gels and by ligand blotting showed that it had a molecular weight of 32 kDa under non-reducing conditions. In charcoal competition binding assays, IGF-II competed at lower concentrations than IGF-I for binding to the He[39]L-binding protein and the more potent form of IGF-I (des-(1-3)-IGF-I) was not bound. This is a similar IGF binding pattern to that of the bovine IGF-binding protein-2 (bIGFBP-2). However, immunoblotting with an antibody to bIGFBP-2 demonstrated that the He[39]L-binding protein is not immunochemically related to bIGFBP-2. It is a glycosylated protein, having N-acetyl-glucosaminyl sugars detected by wheatgerm agglutinin affinity chromatography. Of the first 15 N-terminal amino acids of the He[39]L-binding protein, 13 are identical to the 15 amino acid sequence of a recently sequenced cerebrospinal fluid-binding protein. However, the total He[39]L-binding protein sequence (25 amino acids) showed no homology to other previously sequenced binding proteins (IGFBP-1, IGFBP-2 and IGFBP-3). We conclude that the He[39]L-binding protein is a novel binding protein.


A Cross-Cultural Study on Behaviors When Death Is Approaching in East Asian Countries: What Are the Physician-Perceived Common Beliefs and Practices?
The primary aim of this study was to explore common beliefs and practices when death is approaching in East-Asian countries. A cross-sectional survey was performed involving palliative care physicians in Japan, Korea, and Taiwan. Measurement outcomes were physician-perceived frequencies of the following when patient death was approaching: (1) reluctance to take part in end-of-life discussions, (2) role of family members, (3) home death, and (4) circumstances surrounding death. A total of 505, 211, and 207 responses were obtained from Japanese, Korea, and Taiwan physicians, respectively. While 50% of the Japanese physicians reported that they often or very often experienced families as being reluctant to discuss end-of-life issues, the corresponding figures were 59% in Korea and 70% in Taiwan. Two specific reasons to avoid end-of-life discussion, "bad things happen after you say them out loud" and "a bad life is better than a good death" were significantly more frequently observed in Taiwan. Prioritizing the oldest of the family in breaking bad news and having all family members present at the time of death were significantly more frequently observed in Korea and Taiwan. Half of Taiwanese physicians reported they often or very often experienced the patients/family wanted to go back home to die because the soul would not be able to return from the hospital. In all countries, more than 70% of the physicians reported certain family members were expected to care for the patient at home. At the time of death, while no Japanese physicians stated that they often experienced patients wanted a religious person to visit, the corresponding figure in Korean and Taiwan was about 40%. Uncovered expression of emotion was significantly frequently observed in Korean and Taiwan, and 42% of the Japanese physicians reported family members cleaned the dead body of the patient themselves. There seem to be significant intercountry differences in beliefs and practices when death is approaching in East Asian countries. Future studies on direct observations of patients and families are needed.


Seawater desalination and serum magnesium concentrations in Israel.
With increasing shortage of fresh water globally, more countries are consuming desalinated seawater (DSW). In Israel >50% of drinking water is now derived from DSW. Desalination removes magnesium, and hypomagnesaemia has been associated with increased cardiac morbidity and mortality. Presently the impact of consuming DSW on body magnesium status has not been established. We quantified changes in serum magnesium in a large population based study (n = 66,764), before and after desalination in regions consuming DSW and in regions where DSW has not been used. In the communities that switched to DSW in 2013, the mean serum magnesium was 2.065 ± 0.19 mg/dl before desalination and fell to 2.057 ± 0.19 mg/dl thereafter (p < 0.0001). In these communities 1.62% of subjects exhibited serum magnesium concentrations ≤1.6 mg/dl between 2010 and 2013. This proportion increased by 24% between 2010-2013 and 2015-2016 to 2.01% (p = 0.0019). In contrast, no such changes were recorded in the communities that did not consume DSW. Due to the emerging evidence of increased cardiac morbidity and mortality associated with hypomagnesaemia, it is vital to consider re-introduction of magnesium to DSW.


Polyphenylene sulfide fabric with enhanced oxidation resistance and hydrophobicity through polybenzoxazine surface coating for emission control in harsh environment.
Emissions from power generation and municipal waste incineration sources are primarily at high temperatures and contain corrosive gases, particulate pollutants and are enormously challenging on the performance of the filtration systems in use. Here, polyphenylene sulfide (PPS) nonwoven fabric, a primary material used commercially in such settings, is modified with a polybenzoxazine precursor as a coating to deliver improved thermal and oxidation resistance to the fibrous substrate. The polybenzoxazine precursor undergoes chain propagation and crosslinking upon the treatment process to provide a protective layer over the PPS fibers such that enhanced structural stability in a harsh environment was demonstrated. We have shown the improved overall tensile strength (+15%), Young's modulus (+26%), and more hydrophobic nature of the modified PPS fabric, while the superior environmental stability and better filtration performance could be achieved. Such methodology may lead to higher service temperature and extended service time of the PPS filtration bags in harsh fire exhaustion airstreams encountered in power plants or municipal garbage incineration facilities. The crosslinkable benzoxazine could also be the most cost-effective high temperature coating layer on fibers, enabling future high-performance air filtration materials.


Origins of the Electronic Apex Locator - Achieving Success with Strict Adherence to Business.
Current history would have you believe that the evolution and development of the electronic apex locator for use during root canal procedures emanated from the work of Suzuki in 1942, which was developed as a product by Sunada in 1962. Yes, this is partly correct, however the concept of using electrical means to locate the ends of root canals was brought to the dental profession as early as 1918 by Dr. Levitt Ellsworth Custer, which was not addressed until Suzuki revisited Custer's concepts. This contribution was only one of the many that Custer proffered as he championed the use of electricity in dentistry.


Body composition predictors of outcome in patients with COVID-19.
Obesity is a strong risk factor for adverse outcomes in patients hospitalized with COVID-19, however, the distribution of fat and the amount of muscle mass are more accurate risk factors than BMI. The objective of this study was to assess body composition measures obtained on opportunistic abdominal CTs as predictors of outcome in patients hospitalized with COVID-19. We hypothesized that elevated visceral and intermuscular adipose tissue would be associated with adverse outcome. Our retrospective study was IRB-approved and HIPAA-compliant. The study group comprised 124 patients (median age: 68 years, IQR: 56, 77; 59 weeks, 65 months) who were admitted with COVID-19 to a single hospital and who had undergone abdominal CT for clinical purposes. Visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), intermuscular adipose tissue (IMAT), and paraspinal and abdominal muscle cross-sectional areas (CSA) were assessed. Clinical information including prognostic factors, time of admission to the intensive care unit (ICU) and time of death within 28 days were obtained. Multivariate time-to-event competing risk models were fitted to estimate the hazard ratio (HR) for a composite outcome of ICU admission/mortality associated with a one standard deviation increase in each body compositional measure. Each model was adjusted for age, sex, race, BMI, and cardiometabolic comorbidities. There were 50 patients who were admitted to the ICU or deceased over a median time of 1 day [IQR 1, 6] from hospital admission. Higher VAT/SAT ratio (HR of 1.30; 95% CI 1.04-1.62, p = 0.022) and higher IMAT CSA (HR of 1.44; 95% CI 1.10-1.89, p = 0.008) were associated with a reduced time to ICU admission or death in adjusted models. VAT/SAT and IMAT are predictors of adverse outcome in patients hospitalized with COVID-19, independent of other established prognostic factors. This suggests that body composition measures may serve as novel biomarkers of outcome in patients with COVID-19.


Cutaneous and subcutaneous metastases of adenocarcinoma of the colon and rectum.
The interesting topic of cutaneous and subcutaneous metastasis from rectal carcinoma is discussed using 3 cases. The first case was a 70-year-old man with T3N2M0 rectal mucinous adenocarcinoma, who developed an inflammatory subcutaneous metastasis at the left scapula 2 years after anterior resection. The second case was a 51-year-old man with T4N2M0 splenic flexure mucinous adenocarcinoma, who developed metastatic disease including a subcutaneous secondary to the back. The third case was a 53-year-old woman who developed vulval recurrence 10 months after abdomino-perineal resection for a low T3N1M0 rectal adenocarcinoma. All underwent wide resection. This entity is rare and usually signifies disseminated disease if found remote from the resection site and warrants a thorough metastatic work up. A high index of suspicion is recommended when encountered with unresolving skin lesions in cancer patients.


Urinary Cyclophilin A as a New Marker for Diabetic Nephropathy: A Cross-Sectional Analysis of Diabetes Mellitus.
Type 2 diabetes mellitus (DM) is the most common single cause of end-stage renal disease. Albuminuria is the most commonly used marker to predict onset of diabetic nephropathy (DN) without enough sensitivity and specificity to detect early DN. This is the first study to identify urinary cyclophilin A (CypA) as a new biomarker for early DN.We recruited DM outpatients and healthy control subjects from January 2014 to December 2014. In this cross-sectional study, patients' urine samples were collected to determine the expression of urinary CypA. We also treated mesangial (MES-13) and tubular (HK-2) cells with glucose or free radicals to observe the expression of secreted CypA in Western blot analysis.A total of 100 DN patients and 20 healthy control subjects were enrolled. All variables were matched. In univariate analysis, the concentration of urinary CypA correlated well with the progression of renal function. A significant increase in urinary CypA was noted in stage 2 DN and persisted in later stages. We could diagnose stage 2 DN using urinary CypA with a sensitivity of 90.0% and specificity of 72.7%. The area under curve was up to 0.85, indicating a good discriminatory power. In cellular models, MES-13 and HK-2 cells can both release CypA.Urinary CypA is a good biomarker for early DN detection in humans and it can be released from either mesangial or tubular cells. The underlying molecular mechanisms still need further clarification in cellular and animal studies.


[Surgical aspects of breast cancer screening at our hospital].
In addition to discussing effectiveness of breast cancer screening initiated within the National Public Health Programme, the problem of how to treat non-palpable, early invasive and in situ breast cancer (DCIS) is considered. The theoretical issue of the sentinel lymph node and its impact on biopsy practice have also been dealt with. In the authors' region, screening was introduced in 1999 and after a short break has been continued since 2002. Patient data of three periods, each of two years, each with ten years' interval (1982-1983, 1992-1993, 2002-2003) have been analysed. Changes in the number of surgical operations and tumour size, incidence of in situ cancer, lymph node involvement and distribution of types of surgery have been studied. Biopsy of the sentinel lymph node has been applied since May, 2003 (with 45 biopsies performed until 31 December, 2004). The number of persons participating in the screening programme has gradually increased, the number of surgical operations because of breast cancer increased from period to period. Size of the detected tumours has decreased, the percentage of non-palpable cases has been significant (445 surgical interventions during the years 2002-2004: surgery: 19%). The proportion of DCIS has increased to nearly four times as compared to data of years immediately preceding the era of screening (1993-1998: 11 cases, 2%; 1999-2004: 62 cases, 7.5%). Specificity of sentinel lymph node biopsy was 90%, with a sensitivity of 65%. The proportion of breast saving surgery has increased above 50%. The authors regard screening as successful, in their opinion, its benefits cannot be questioned, in spite of some controversial issues. As to the treatment of non-palpable, early invasive cancer, they underline the importance of preoperative evaluation--cytology, core biopsy--and establishing dignity. The issues of localisation--wire hook marking--and histological processing--large blocks--have also been dealt with. In spite of the fact that the risk for potential malignancy of DCIS lesions has not yet been fully clarified, adequate treatment is indicated; the authors take stand on the issues of indication for surgery, postoperative radiotherapy and use of Tamoxifen. Indications and contraindications of sentinel lymph node biopsy have been summed up.


Structural changes of the gastrointestinal mucosa induced by prostaglandins.
Prostaglandins of the E series, which have been proposed as therapeutic agents for the treatment of peptic ulcers and other gastrointestinal diseases, cause hyperplasia of the gastrointestinal mucosa in experimental animals. The changes are most evident in the stomach, especially the antrum, in which the wall is thickened by hyperplasia of surface mucous cells and/or submucosal edema. In rodents, the non-glandular forestomach becomes hyperplastic and hyperkeratotic. Affected stomachs are heavier and may have a larger surface area than control stomachs. Small intestines may be heavier and have a thicker mucosa, with elongation of villi and crypts. Colonic mucosa may exhibit mild hyperplasia at very high dosages. Conflicting data exist as to whether the gastrointestinal mucosal hyperplasia is more related to increased production or decreased loss of epithelial cells.


Brain mechanism of unfamiliar and familiar voice processing: an activation likelihood estimation meta-analysis.
Interpersonal communication through vocal information is very important for human society. During verbal interactions, our vocal cord vibrations convey important information regarding voice identity, which allows us to decide how to respond to speakers (e.g., neither greeting a stranger too warmly or speaking too coldly to a friend). Numerous neural studies have shown that identifying familiar and unfamiliar voices may rely on different neural bases. However, the mechanism underlying voice identification of individuals of varying familiarity has not been determined due to vague definitions, confusion of terms, and differences in task design. To address this issue, the present study first categorized three kinds of voice identity processing (perception, recognition and identification) from speakers with different degrees of familiarity. We defined voice identity perception as passively listening to a voice or determining if the voice was human, voice identity recognition as determining if the sound heard was acoustically familiar, and voice identity identification as ascertaining whether a voice is associated with a name or face. Of these, voice identity perception involves processing unfamiliar voices, and voice identity recognition and identification involves processing familiar voices. According to these three definitions, we performed activation likelihood estimation (ALE) on 32 studies and revealed different brain mechanisms underlying processing of unfamiliar and familiar voice identities. The results were as follows: (1) familiar voice recognition/identification was supported by a network involving most regions in the temporal lobe, some regions in the frontal lobe, subcortical structures and regions around the marginal lobes; (2) the bilateral superior temporal gyrus was recruited for voice identity perception of an unfamiliar voice; (3) voice identity recognition/identification of familiar voices was more likely to activate the right frontal lobe than voice identity perception of unfamiliar voices, while voice identity perception of an unfamiliar voice was more likely to activate the bilateral temporal lobe and left frontal lobe; and (4) the bilateral superior temporal gyrus served as a shared neural basis of unfamiliar voice identity perception and familiar voice identity recognition/identification. In general, the results of the current study address gaps in the literature, provide clear definitions of concepts, and indicate brain mechanisms for subsequent investigations.


The oncogenic role of the spliced somatostatin receptor sst5TMD4 variant in prostate cancer.
sst5TMD4, a splice variant of the sst5 gene, is overexpressed and associated with aggressiveness in various endocrine-related tumors, but its presence, functional role, and mechanisms of actions in prostate cancer (PCa)-the most common cancer type in males-is completely unexplored. In this study, formalin-fixed, paraffin-embedded prostate pieces from patients with localized PCa, which included tumoral and nontumoral adjacent regions (n = 45), fresh biopsies from patients with high-risk PCa (n = 52), and healthy fresh prostates from cystoprostatectomies (n = 14) were examined. In addition, PCa cell lines and xenograft models were used to determine the presence and functional role of sst5TMD4. Results demonstrated that sst5TMD4 is overexpressed (mRNA/protein) in PCa samples, and this is especially drastic in metastatic and/or high Gleason score tumor samples. Remarkably, sst5TMD4 expression was associated with an altered frequency of 2 single-nucleotide polymorphisms: rs197055 and rs12599155. In addition, PCa cell lines and xenograft models were used to demonstrate that sst5TMD4 overexpression increases cell proliferation and migration in PCa cells and induces larger tumors in nude mice, whereas its silencing decreased proliferation and migration. Remarkably, sst5TMD4 overexpression activated multiple intracellular pathways (ERK/JNK, MYC/MAX, WNT, retinoblastoma), altered oncogenes and tumor suppressor gene expression, and disrupted the normal response to somatostatin analogs in PCa cells. Altogether, we demonstrate that sst5TMD4 is overexpressed in PCa, especially in those patients with a worse prognosis, and plays an important pathophysiologic role in PCa, which suggesting its potential as a biomarker and/or therapeutic target.-Hormaechea-Agulla, D., Jiménez-Vacas, J. M., Gómez-Gómez, E., L.-López, F., Carrasco-Valiente, J., Valero-Rosa, J., Moreno, M. M., Sánchez-Sánchez, R., Ortega-Salas, R., Gracia-Navarro, F., Culler, M. D., Ibáñez-Costa, A., Gahete, M. D., Requena, M. J., Castaño, J. P., Luque, R. M. The oncogenic role of the spliced somatostatin receptor sst5TMD4 variant in prostate cancer.


New windows into retroviral RNA structures.
The multiple roles of both viral and cellular RNAs have become increasingly apparent in recent years, and techniques to model them have become significantly more powerful, enabling faster and more accurate visualization of RNA structures. Techniques such as SHAPE (selective 2'OH acylation analysed by primer extension) have revolutionized the field, and have been used to examine RNAs belonging to many and diverse retroviruses. Secondary structure probing reagents such as these have been aided by the development of faster methods of analysis either via capillary or next-generation sequencing, allowing the analysis of entire genomes, and of retroviral RNA structures within virions. Techniques to model the three-dimensional structures of these large RNAs have also recently developed. The flexibility of retroviral RNAs, both structural and functional, is clear from the results of these new experimental techniques. Retroviral RNA structures and structural changes control many stages of the lifecycle, and both the RNA structures themselves and their interactions with ligands are potential new drug targets. In addition, our growing understanding of retroviral RNA structures is aiding our knowledge of cellular RNA form and function.


Separation and partial characterization of surface-active fractions from mouse and rat lung homogenates. Identification of a possible marker system for pulmonary surfactant.
The purpose of this study was to identify a "marker system" for pulmonary surfactant. A density gradient centrifugation procedure was developed to concentrate the surface-active material in mouse and rat lung homogenates. These fractions contained morphologic variants of surfactant such as lamellar bodies and tubular myelin. Lipid and protein analyses were consistent with other techniques indicating that these preparations were surface active. A comparison of the nonspecific esterases in these and other surfact-active preparations (i.e., pulmonary lavage fluid and isolated type II cells) allowed the identification of certain surfactant-associated esterases which are distinguishable electrophoretically and cytochemically from the other pulmonary esterases and which, therefore, may be used as "markers" for surfactant. Possible uses for these enzyme markers in studies of (a) the sites of synthesis and routes of clearance of surfactant and (b) the assessment of variations in surface activity due to either diseases such as the respiratory distress syndrome or to experimental manipulation are discussed.


A model for 3-methyladenine recognition by 3-methyladenine DNA glycosylase I (TAG) from Staphylococcus aureus.
The removal of chemically damaged DNA bases such as 3-methyladenine (3-MeA) is an essential process in all living organisms and is catalyzed by the enzyme 3-MeA DNA glycosylase I. A key question is how the enzyme selectively recognizes the alkylated 3-MeA over the much more abundant adenine. The crystal structures of native and Y16F-mutant 3-MeA DNA glycosylase I from Staphylococcus aureus in complex with 3-MeA are reported to 1.8 and 2.2 Å resolution, respectively. Isothermal titration calorimetry shows that protonation of 3-MeA decreases its binding affinity, confirming previous fluorescence studies that show that charge-charge recognition is not critical for the selection of 3-MeA over adenine. It is hypothesized that the hydrogen-bonding pattern of Glu38 and Tyr16 of 3-MeA DNA glycosylase I with a particular tautomer unique to 3-MeA contributes to recognition and selection.


Project connect online: user and visitor experiences of an Internet-based intervention for women with breast cancer.
This study's purpose was to characterize the experience of patients with breast cancer randomly assigned to the intervention arm of Project Connect Online (PCO), a randomized controlled trial of an Internet-based intervention, and to examine relationships between website use variables and psychosocial outcomes. In the larger PCO trial, patients with breast cancer (n = 88) were randomly assigned to an intervention or a waiting-list control. This report pertains to the 46 women in the intervention arm, a 3-h workshop for creation of personal websites with a blog function to communicate with their interpersonal network and chronicle their breast cancer experience. Participants completed assessments at 1 and 6 months. Visitors to the websites (n = 66) completed an online questionnaire. Reactions to website use were positive, although lack of time was a barrier for some. Women with advanced cancer were more likely to use their websites. Women found the websites useful for telling the story of their experience and expressing emotions. Positive word use was associated with heightened positive mood at 6 months; negative word use was associated with improved depressive symptoms. Visitors were most commonly female friends of participants who valued the websites as a way to connect emotionally with participants and receive information about their health. Specific aspects of patients' blogs predicted improvements in psychosocial functioning. Personal websites can help women with breast cancer construct a narrative of their experience, express emotions, and receive the social support they need, particularly from friends and extended family.


Thermostatistic properties of a q-generalized Bose system trapped in an n-dimensional harmonic oscillator potential.
The thermostatistic properties of a q-generalized boson system trapped in an n-dimensional harmonic oscillator potential are studied, based on the generalized statistic distribution derived from Tsallis' entropy. The density of states, total number of particles, critical temperature at which Bose-Einstein condensation occurs, internal energy, and heat capacity at constant volume are derived. The characteristics of Bose-Einstein condensation of the system are discussed in detail. It is found from the results obtained here that the thermostatistic properties of such a system depend closely on parameter q, dimensional number of the space, and frequency of the harmonic oscillator; and the external potential has a great influence on the thermostatistic properties of the system.


Psychological factors and weight loss in bariatric surgery.
Morbid obesity is associated with a high prevalence of psychopathological conditions that might have an impact on postsurgery outcomes. This review summarizes recent data about psychological disorders in obese patients before and after bariatric surgery as well as the assessment and impact of these factors on postsurgery outcomes. Psychological health and quality of life were found to improve after bariatric surgery. Weight loss could not be clearly related to any specific psychological condition prior to surgery, but the presence of more than one psychiatric condition might play a role. A multi-intervention treatment, including approaches for lifestyle changes after bariatric surgery showed positive long-term results in term of weight loss and weight loss maintenance. Recent studies focused on eating behavior changes following bariatric surgery providing important information on the topic of eating disorders after bariatric surgery. Psychological assessment before bariatric surgery and systematic follow-up are necessary to guarantee optimal weight loss and weight loss maintenance. The field of psychological factors in bariatric surgery is still in need of controlled randomized prospective trials to better understand relation between psychological presurgery conditions and surgical outcomes. Self-monitoring and cognitive behavioral programs could prevent weight regain.


Description of a computer model of forest onchocerciasis transmission and its application to field scenarios of vector control and chemotherapy.
This paper describes a computer simulation model for onchocerciasis (SIMON). Using epidemiological and entomological data from a specific hyperendemic village in the forest area of Sierra Leone, the model is used to examine the effect of vector and chemotherapeutic control strategies, both separately and in combination, as well as the risk to an uninfected population caused by immigrant, infected Simulium damnosum and humans. The model suggests that, in this village, the human population of about 420 requires an average annual input of about 200 mature fecund, female Onchocerca volvulus per year to maintain a skin-snip prevalence of just under 70%. SIMON also predicts that 99% effective vector control would lead to eradication of all adult worms in 18 years, and that abandoning control before 14 years could lead to recrudescence. Chemotherapy with ivermectin at six-month intervals reaching 90% of eligible persons (effective 66%) might take 29 years to achieve eradication because of continuing transmission, particularly in the early years, but it would probably be possible to abandon treatments after 18 years because the residual worm population would no longer be self-sustaining. Combined ivermectin and vector control, both at reduced levels, could be as effective as 99% vector control. Immigrant infected flies are likely to pose a greater threat to an uninfected human population than small numbers of infected persons. The model suggests that, at levels of infection undetectable by skin-snip, the parasite could linger in the human population for 30 or more years sustained by sporadic transmission.(ABSTRACT TRUNCATED AT 250 WORDS)


Bayesian Assessment of the Accuracy of a PCR-Based Rapid Diagnostic Test for Bovine Tuberculosis in Swine.
Infection with the Mycobacterium bovis (M. bovis) causes a disease referred to as bovine tuberculosis (bTB), which affects a wide range of mammal hosts. Many countries have implemented control and eradication plans that have resulted in variable levels of efficacy and success. Although bTB is a notifiable disease in Argentina, and a control plan that targets cattle herds has been in place for decades, M. bovis is still prevalent in cattle, swine, and certain wild species. The aim of the paper here was to assess the sensitivity (Se), specificity (Sp), and positive and negative predictive values (PPV and NPV) of PCR from tissue, which is a test for rapid M. bovis detection in swine. Bacteriological culture was also performed for comparison purposes. A Bayesian approach was applied to estimate the accuracy of the diagnostic tests, PCR and bacteriological culture, in 266 swine samples with bTB-like lesions recovered during routine official inspections at slaughterhouses. A one-population model, assuming conditional dependence between test results, and incorporating prior information on the performance of the tests obtained from the literature, was used to estimate the tests Se and Sp. The accuracy of the combined (in parallel) application of both tests was also estimated. The Se of the PCR (82.9%) was higher than the Se of the bacteriological culture (79.9%), whereas the Sp of both tests was similar (88.5 and 89.0%, respectively). Furthermore, when both techniques were assessed in parallel, the Se of the diagnostic system increased substantially (Se = 96.6%) with a moderate Sp loss (Sp = 78.8%; PPV = 92.8%; NPV = 89%). Results suggest that the PCR, or the combined application of bacteriological culture and PCR, may serve as an accurate diagnostic tool to confirm bTB in swine samples. Results here will help the design and implementation of effective surveillance strategies for the disease in swine of Argentina and other settings in which the disease is prevalent.


Evaluation of Left Ventricular Systolic Function in Patients with Coronary Microvascular Dysfunction by Three-Dimensional Speckle-Tracking Imaging.
The objective of this study is to evaluate the left ventricular systolic function of patients with coronary microvascular dysfunction (CMD) using the three-dimensional speckle-tracking imaging (3D-STI) technique. From June 2018 to June 2019,72 subjects from Huzhou Central Hospital were enrolled, including 42 CMD in-patients with typical chest pain or chest tightness and positive treadmill exercise stress test, but without coronary stenosis on coronary angiography, (the CMD group) and another 30 healthy individuals who were undergoing physical examinations in an outpatient clinic (the control group). Using 3D-STI technique, the global longitudinal strain (GLS), global radial strain (GRS), global circumferential strain (GCS), global area strain (GAS), and left ventricle were measured. Compared with the control group, GLS and GAS were significantly reduced in the CMD group (P<0.05), while GRS and GCS were similar in both groups (P>0.05). Univariate logistic regression analysis showed that GLS and GAS were the influencing factors of CMD. For the diagnosis of CMD, the area under the receiver operating characteristic (ROC) curve of GLS was 0.883, and the area under the ROC curve of GAS was 0.875. GAS of -29.3% (log-rank test chi-square=34.245, P<0.001) was a strong predictor of major adverse cardiac events. 3D-STI technique has obvious advantages in the evaluation of the left ventricular systolic function for CMD patients. Moreover, 3D-STI parameters, especially GLS and GAS, can detect the early abnormal changes in the ischaemic myocardium. Being timelier and more sensitive than echocardiography, 3D-STI should be recommended for clinical application.


Reaching Up, Down, In, and Around: Couple and Family Coping During the Coronavirus Pandemic.
The worldwide coronavirus (COVID-19) has had profound effects on all aspects of life: physical health, the ability to travel locally or to more distant destinations, material and financial resources, and psychosocial wellbeing. Couples, families, and communities and individual persons in those relationships have struggled to cope with emerging depression, anxiety, and trauma, and the rise of relational conflict. In this article, we suggest that the existential nature of the pandemic's challenges requires more than just the usual psychosocial interventions. We propose a taxonomy of responses to foster coping and resilience-"Reaching Up, Down, In, and Around." "Reaching Up" includes accessing spiritual, religious, and ethical values. "Reaching Down" includes ideas and practices that foster a revised relationship with the Earth and its resources, and that engage families to participate in activities that aid the Earth's recovery from decades of human-caused damage. "Reaching In" represents a turn towards experiences available in the mind and in shared minds in relationships that provide pleasure, excitement, joy, and peace, given that external sources of these emotions are of limited availability due to quarantine. "Reaching Around" involves reframing the mandate for "social distancing" as fostering social connection and support while maintaining physical distancing. The challenges for family therapists, whose practices are confined largely to online therapy, and who are struggling with the same fears and constraints as those persons they are attempting to help, are also discussed.


[Alteration of coronary blood flow after injection of a contrast medium (author's transl)].
The injection of with different, energetic separable radioactive isotope labelled particles in the same coronary artery before and short after the injection of a contrast medium reveals in many cases variable scintigraphic pictures. The temporary vasodilatation caused by the contrast medium produces in presence of a coronary stenosis a disturbance of the regional blood flow. Thereby we find in the poststenotic myocardial area a transient ischemia, bringing about a decrease of the activity at the scintigram. As this transient ischemia is only demonstrable with a hemodynamic effective stenosis, in such cases a good effect of coronary surgery can be expected. On the other hand, in the presence of effective stenoses in all three coronary branches, in the double-scintigram alterations of the perfusion can be missed, showing the same scintigraphic picture as with normal coronary arteries.


An aerobic oxidation/homolytic substitution-cascade for stereoselective methylsulfanyl-cyclization of 4-pentenols.
4-Pentenols (dihomoallylic alcohols) are oxidized by cobalt(II)-activated dioxygen in solutions of dimethyl disulfide and cyclohexa-1,4-diene to afford methylsulfanyl (CH3S)-functionalized tetrahydrofurans in up to 74% yield. The reaction is a cascade, composed of oxidative alkenol cyclization providing tetrahydrofuryl-2-methyl radicals, which are trapped in dimethyl disulfide. Homolytic methylsulfanyl substitution by carbon radicals is a slow reaction, as exemplified by the rate constant of k(SCH(3)) = 3 × 10(4) M(-1) s(-1) (70 °C) derived from competition kinetics for the reaction between dimethyl disulfide and the trans-2-phenyltetrahydrofuryl-5-methyl radical. Methylsulfanyl-cyclizations therefore are experimentally performed in neat dimethyl disulfide, containing the minimum amount of cyclohexa-1,4-diene necessary for attaining almost quantitative alkenol conversion. The oxidative tetrahydrofuran synthesis occurs with noteworthy (>99%) 2,5-trans-stereoselectivity, as shown by the synthesis of diastereomerically pure 2,3- and 2,3,3-substituted 5-(methylsulfanyl)methyltetrahydrofurans from stereodefined 1,2-di- and 1,2,2-trisubstituted 4-pentenols. Changing the chemical nature of the disulfide reagent or the alkenol extends the scope of alkylsulfanyl-cyclization to ethylsulfanyl-cyclization, allylsulfanyl-transfer, or tetrahydropyran synthesis.


Successful experience utilizing dexrazoxane treatment for an anthracycline extravasation.
To describe a successful case of dexrazoxane treatment after an extravasation of doxorubicin and share a creative solution for formulary cost management. A 42-year-old female diagnosed with breast cancer was receiving doxorubicin as adjuvant treatment. The patient recently underwent a right mastectomy for a 3-centimeter grade 3 invasive ductal carcinoma. Three of 20 lymph nodes were positive, and the patient was stage 2B at presentation, with an estrogen receptor/progesterone receptor-positive and HER-2/neu-negative tumor. At an outside hospital, the patient was receiving doxorubicin through an infusion port when extravasation was noted after approximately 15 mL had been infused. She was transferred to Riverside Methodist Hospital and dexrazoxane treatment was initiated within 6 hours after extravasation. She received a full 3-day course of dexrazoxane treatment without complication and was discharged home. Significant delays in chemotherapy administration were avoided, and the patient successfully completed her planned chemotherapy course. Dexrazoxane has the potential to minimize tissue damage and treatment delays after an anthracycline extravasation. Although dexrazoxane is commercially marketed for 2 separate treatment indications, Totect is the Food and Drug Administration-approved product for anthracycline extravasations. Facilities administering anthracyclines should proactively resolve how to obtain, process, prepare, and administer this antidote to a patient within 6 hours of an extravasation event. Developing a preprinted chemotherapy extravasation order may facilitate the incorporation of the most recent Oncology Nursing Society guidelines to utilize dexrazoxane for an anthracycline extravasation. Cost sharing with other institutions may offer a creative solution to lessen the financial impact of stocking dexrazoxane therapy. Ensuring expedient treatment and accessibility to dexrazoxane therapy after an anthracycline extravasation is critical to the success of the treatment. All facilities utilizing anthracycline chemotherapy should purchase dexrazoxane or secure agreements with other facilities to guarantee the administration of this medication should extravasation occur.


Physical and genetic characterization of Rhizobium meliloti symbiotic mutants.
A set of 19 symbiotic mutants of Rhizobium meliloti obtained by a Tn5 "suicide plasmid" mutagenesis procedure was characterized genetically and physically. As part of this characterization, we showed that R. meliloti strain 1021, like other R. meliloti strains, contains a very large indigenous plasmid (greater than 300 Md) that carries the structural genes for nitrogenase (nifHDK genes). Among the 19 symbiotic mutations studied, at least six were shown to reside on the megaplasmid. By a "walking procedure" we obtained from a cosmid clone bank a set of overlapping cosmids that contained megaplasmid sequences contiguous to nifHDK. A 90 kb region of contiguous DNA from these cosmids was used to probe the mutant strains for rearrangements within this region. The same six mutations that were located on the megaplasmid mapped within the 90 kb region examined, which included the structural genes for nitrogenase (nifHDK). A majority of the mutations characterized in this study could not be correlated with a bona fide Tn5 insertion into a symbiotic gene.


Progression of left ventricular functional abnormalities in hypertensive patients with heart failure: an ultrasonic two-dimensional speckle tracking study.
Two-dimensional (2-D) strain imaging is a novel echocardiographic technique for myocardial function evaluation. We sought to investigate left ventricular (LV) systolic function in patients with heart failure caused by hypertension using a 2-D strain approach and to validate this method against Doppler strain measurements. The study population comprised 81 patients (66.4 +/- 7.4 years) with hypertension in New York Heart Association (NYHA) class I to IV and 20 healthy controls. Decreased longitudinal strain was demonstrated in the basal septal segment in NYHA I, in the basal and mid septal and basal lateral segments in NYHA II, and in all segments in NYHA III and IV. Radial and circumferential strain were reduced in patients with NYHA III and IV. Independent predictors of strain were duration of HT, LV mass index, LV end-diastolic volume index, and systolic blood pressure. The agreement between 2-D and Doppler strain remained within acceptable ranges (mean difference +/- 1 standard deviation: 0.61%-1.92% +/- 2.38%-2.92% for longitudinal strain in particular segments and 4.98% +/- 5.26% for radial strain). In hypertensive patients, (1) LV longitudinal systolic function progressively deteriorates from NYHA I to IV and abnormalities commence in the basal septum, (2) LV radial and circumferential systolic impairment appears in NYHA III and IV, and (3) 2-D strain measurement provides a feasible tool for the quantitation of LV systolic performance.


Evaluating Perceived Fatigue within an Adult Spinal Muscular Atrophy Population.
Spinal muscular atrophy (SMA) is an autosomal recessive neuromuscular disease characterized by progressive muscle weakness and atrophy. While chronic fatigue is a common manifestation of SMA, the field lacks comprehensive data to assess the extent of its impact. Cure SMA, an SMA patient advocacy organization, conducted an online survey of its adults with SMA community members to measure the impact of fatigue. All survey respondents were asked to complete questions on demographics, use of SMA treatment, and quality of life, but respondents were randomized to receive three of the following fatigue instruments: the Modified Fatigue Impact Scale (MFIS), Multidimensional Fatigue Inventory (MFI), Fatigue Severity Scale (FSS), PedsQL™ Multidimensional Fatigue (PedsQL MF) Scale, and Spinal Muscular Atrophy Health Index (SMA-HI) fatigue modules. Scales were evaluated for reliability and overall fatigue scores were evaluated by multivariate regression models to determine which variables were related to the final scores of each instrument. A total of 253 adults completed the online survey. When measured against the general population, statistically significant differences were found among adults with SMA for certain variables within each measurement instrument. However, there did not appear to be differences in fatigue levels among key subgroups within the SMA population. This was the first use of more than two fatigue questionnaires simultaneously in SMA. The lack of a consistent relationship between SMA severity and fatigue levels was surprising. This may be related to the lack of specificity of the instruments for this population. An SMA-specific scale is needed to evaluate differences in fatigue impact across the SMA population.


Type D personality and self-esteem in patients with fibromyalgia: a cross-sectional case-control study.
Fibromyalgia (FM) is a complex disease related to several factors. Psychosocial elements, such as type D personality and low level of self-esteem, might increase disease burden. The current study aimed to investigate type D personality and self-esteem in patients with FM. Female patients with FM and age-matched, healthy controls were enrolled in this cross-sectional study. Type D personality was evaluated using the type D scale (DS-14). The Rosenberg self-esteem scale (RSES) was used to assess self-esteem and psychosomatic symptoms. Type D personality was observed in 58.6% of the patients (n = 70) and in 21.7% of the controls (n = 60) (p < 0.001). When compared to patients with non-type D personality, those with type D personality revealed lower self-esteem and poorer health status (p < 0.05 for both), and higher anxiety and depression scores (p < 0.001 for both). In binary logistic regression analysis, the odds of FM were 3.6 times higher (OR = 3.653, 95% CI 1.547-8.625) for patients with type D personality, after adjusting for age and education level. In addition, depression (OR= 1.178, Cl 95% 1.055 - 1.316) and lower education level (OR= 0.818, Cl 95% 0.682 - 0.982) were significantly related to type D personality in FM. Type D personality is closely associated with FM. Type D personality is more common in female patients with FM when compared to healthy women. Depression and lower education level are potential confounders of type D personality in FM.


Genotypic sex shapes maternal care in the African pygmy mouse, Mus minutoides.
Sexually dimorphic behaviours, such as parental care, have long been thought to be mainly driven by gonadal hormones. In the past two decades, a few studies have challenged this view, highlighting the direct influence of the sex chromosome complement (XX versus XY or ZZ versus ZW). The African pygmy mouse, Mus minutoides, is a wild mouse species with naturally occurring XY sex reversal induced by a third, feminizing X* chromosome, leading to three female genotypes: XX, XX* and X*Y. Here, we show that sex reversal in X*Y females shapes a divergent maternal care strategy (maternal aggression, pup retrieval and nesting behaviours) from both XX and XX* females. Although neuroanatomical investigations were inconclusive, we show that the dopaminergic system in the anteroventral periventricular nucleus of the hypothalamus is worth investigating further as it may support differences in pup retrieval behaviour between females. Combining behaviours and neurobiology in a rodent subject to natural selection, we evaluate potential candidates for the neural basis of maternal behaviours and strengthen the underestimated role of the sex chromosomes in shaping sex differences in brain and behaviours. All things considered, we further highlight the emergence of a third sexual phenotype, challenging the binary view of phenotypic sexes.


Collaborative and Multilevel Feature Selection Network for Action Recognition.
The feature pyramid has been widely used in many visual tasks, such as fine-grained image classification, instance segmentation, and object detection, and had been achieving promising performance. Although many algorithms exploit different-level features to construct the feature pyramid, they usually treat them equally and do not make an in-depth investigation on the inherent complementary advantages of different-level features. In this article, to learn a pyramid feature with the robust representational ability for action recognition, we propose a novel collaborative and multilevel feature selection network (FSNet) that applies feature selection and aggregation on multilevel features according to action context. Unlike previous works that learn the pattern of frame appearance by enhancing spatial encoding, the proposed network consists of the position selection module and channel selection module that can adaptively aggregate multilevel features into a new informative feature from both position and channel dimensions. The position selection module integrates the vectors at the same spatial location across multilevel features with positionwise attention. Similarly, the channel selection module selectively aggregates the channel maps at the same channel location across multilevel features with channelwise attention. Positionwise features with different receptive fields and channelwise features with different pattern-specific responses are emphasized respectively depending on their correlations to actions, which are fused as a new informative feature for action recognition. The proposed FSNet can be inserted into different backbone networks flexibly, and extensive experiments are conducted on three benchmark action datasets, Kinetics, UCF101, and HMDB51. Experimental results show that FSNet is practical and can be collaboratively trained to boost the representational ability of existing networks. FSNet achieves superior performance against most top-tier models on Kinetics and all models on UCF101 and HMDB51.


Altered brain response for semantic knowledge in Alzheimer's disease.
Word retrieval deficits are common in Alzheimer's disease (AD) and are thought to reflect a degradation of semantic memory. Yet, the nature of semantic deterioration in AD and the underlying neural correlates of these semantic memory changes remain largely unknown. We examined the semantic memory impairment in AD by investigating the neural correlates of category knowledge (e.g., living vs. nonliving) and featural processing (global vs. local visual information). During event-related fMRI, 10 adults diagnosed with mild AD and 22 cognitively normal (CN) older adults named aloud items from three categories for which processing of specific visual features has previously been dissociated from categorical features. Results showed widespread group differences in the categorical representation of semantic knowledge in several language-related brain areas. For example, the right inferior frontal gyrus showed selective brain response for nonliving items in the CN group but living items in the AD group. Additionally, the AD group showed increased brain response for word retrieval irrespective of category in Broca's homologue in the right hemisphere and rostral cingulate cortex bilaterally, which suggests greater recruitment of frontally mediated neural compensatory mechanisms in the face of semantic alteration.


Primary palliative care in the delivery room: patients' and medical personnel's perspectives.
To investigate circumstances of primary palliative care (PPC) in the delivery room (DR), medical personnel's experience with neonates who died under PPC in the DR and perceived sources of care-related distress in DR staff. Retrospective chart review of all neonates who were cared for under PPC in the DR during the years 2000-2010 at Charité University Medical Center Berlin, and structured face-to-face interviews with DR nursing staff and physicians. Neonates undergoing PPC could be grouped as preterm infants at the limits of viability with a gestational age between 22 (0)/7 and 23 (6)/7 weeks (n=86, 76%) and newborn infants with complex chronic conditions (n=27, 24%). The median age of neonates at death was 59 min (interquartile range [IQR] 28-105 min). Most of DR staff did not report relevant signs of distress in dying neonates, and providing palliative care was not named as a relevant care-related source of distress by medical personnel. However, half of the participants reported on high degrees of caregiver's emotional distress in PPC situations, identifying insecurity of how to communicate with parents and to provide emotional support as the most common source of distress. Caregiver's emotional distress primarily originates from providing support to parents and not from providing medical care to the dying newborn. Implications for future practice include the need for structured education to improve DR staff's communication and counselling skills related to parents in PPC situations.


THE BASE COMPOSITION OF RIBONUCLEIC ACID IN LAMPBRUSH CHROMOSOMES, NUCLEOLI, NUCLEAR SAP, AND CYTOPLASM OF TRITURUS OOCYTES.
The base composition of RNA's extracted from chromosomes, nucleoli, nuclear sap, and cytoplasm of Triturus oocytes has been determined by microelectrophoresis. The chromosomal RNA has a content of guanine+cytosine equal to that of DNA, but there is no complementarity in the composition as for DNA. Nuclear sap contains a highly variable RNA with a tendency towards high uracil values. Nucleolar and cytoplasmic RNA's are similar in composition and both are of the guanine-cytosine rich type. The chromosomes and nucleoli contain roughly equivalent amounts of RNA, somewhat less than is present in the nuclear sap. The RNA/DNA ratio of the whole chromosomes is about 10. However, the ratio in the synthetically active regions, the loops, is much higher, since the loops contain all the chromosomal RNA but only a small fraction of the DNA.


Simple and Scalable Chemical Surface Patterning via Direct Deposition from Immobilized Plasma Filaments in a Dielectric Barrier Discharge.
In this work, immobilization of the often unwanted filaments in dielectric barrier discharges (DBD) is achieved and used for one-step deposition of patterned coatings. By texturing one of the dielectric surfaces, a discharge containing stationary plasma filaments is ignited in a mix of argon and propargyl methacrylate (PMA) in a reactor operating at atmospheric pressure. From PMA, hydrophobic and hydrophilic chemical and topographical contrasts at sub-millimeter scale are obtained on silicon and glass substrates. Chemical and physical characterizations of the samples are performed by micrometer-scale X-ray photoelectron spectroscopy and infrared imaging and by water contact angle and profilometry, respectively. From the latter and additional information from high-speed imaging of the plasma phase and electrical measurements, it is suggested that filaments, denser in energetic species, lead to higher deposition rate with higher fragmentation of the precursor, while surface discharges igniting outwards the filaments are leading to smoother and slower deposition. This work opens a new route for a one-step large-area chemical and morphological patterning of surfaces at sub-millimeter scales. Moreover, the possibility to separately deposit coatings from filaments and the surrounding plasma phase can be helpful to better understand the processes occurring during plasma polymerization in filamentary DBD.


Catalytic enantioselective allylboration of ketones.
The first example of catalytic enantioselective allylboration and crotylboration of simple ketones is described. High enantioselectivity (up to 93% ee) was obtained using 3 mol % CuF-iPr-DuPHOS as a chiral catalyst and 4.5 mol % La(OiPr)3 as a cocatalyst. Mechanistic studies strongly suggested that the active nucleophile of the present reaction is an allylcopper, and that La(OiPr)3 facilitates the generation of an active allylcopper from the allylboronate, without affecting the transition-state structure of the ketone allylation step.


Signal-averaged electrocardiographic parameter progression as a marker of increased electrical instability in two cases with an overt form of arrhythmogenic right ventricular cardiomyopathy.
In arrhythmogenic right ventricular cardiomyopathy (ARVC) the fibrofatty substitution of the RV myocardium constitutes the substrate for reentrant circuits, leading to the onset of ventricular arrhythmias. This pathological process also accounts for "delayed ventricular potentials" that could be recorded as late potentials using the signal-averaged ECG technique (SAECG). This study examined two patients affected by overt forms of ARVC who showed a worsening of the electrical instability associated with a fast progression of SAECG parameters, while all the other clinical findings remained unchanged. This suggests a possible role of SAECG parameter progression as a marker of increased electrical instability.


Optimising recruitment and informed consent in randomised controlled trials: the development and implementation of the Quintet Recruitment Intervention (QRI).
Pragmatic randomised controlled trials (RCTs) are considered essential to determine effective interventions for routine clinical practice, but many fail to recruit participants efficiently, and some really important RCTs are not undertaken because recruitment is thought to be too difficult. The 'QuinteT Recruitment Intervention' (QRI) aims to facilitate informed decision making by patients about RCT participation and to increase recruitment. This paper presents the development and implementation of the QRI. The QRI developed iteratively as a complex intervention. It emerged from the National Institute for Health Research (NIHR) ProtecT trial and has been developed further in 13 RCTs. The final version of the QRI uses a combination of standard and innovative qualitative research methods with some simple quantification to understand recruitment and identify sources of difficulties. The QRI has two major phases: understanding recruitment as it happens and then developing a plan of action to address identified difficulties and optimise informed consent in collaboration with the RCT chief investigator (CI) and the Clinical Trials Unit (CTU). The plan of action usually includes RCT-specific, as well as generic, aspects. The QRI can be used in two ways: it can be integrated into the feasibility/pilot or main phase of an RCT to prevent difficulties developing and optimise recruitment from the start, or it can be applied to an ongoing RCT experiencing recruitment shortfalls, with a view to rapidly improving recruitment and informed consent or gathering evidence to justify RCT closure. The QRI provides a flexible way of understanding recruitment difficulties and producing a plan to address them while ensuring engaged and well-informed decision making by patients. It can facilitate recruitment to the most controversial and important RCTs. QRIs are likely to be of interest to the CIs and CTUs developing proposals for 'difficult' RCTs or for RCTs with lower than expected recruitment and to the funding bodies wishing to promote efficient recruitment in pragmatic RCTs.


Training bicultural leaders.
Increasing numbers of hospitals now employ bicultural training programs to ease the school-to-work transition for new graduates. Nurses who conduct these programs must be specially trained to guide the new graduate in the process of becoming bicultural. Describing how one hospital sponsored a program that trained 24 nurses as bicultural leaders, the authors provide guidelines and insight to other potential sponsors. They offer specific information on planning, implementation (including direct and indirect costs), and evaluation. A follow-up article will focus on evaluation of the bicultural training program's effect on turnover and performance.


Exploring the concept of alexithymia in the lives of people with learning disabilities.
Alexithymia is a construct that has attracted considerable research for people without learning disabilities. People with alexithymia have difficulties recognizing and describing emotions and have an externally oriented cognitive style. Alexithymia has been closely associated with a variety of mental health and somatic problems. However, the construct of alexithymia has not been considered in respect to people with learning disabilities. This article identifies parallels between the concept of alexithymia and the emotion recognition difficulties and external cognitive styles that have been identified in people with learning disabilities. The article further identifies that many developmental factors considered important in the aetiology of alexithymia are significantly present in the lives of people with learning disabilities and that the association between alexithymia and mental health identified in other populations may also be important for people with learning disabilities. We conclude that there is a strong argument that alexithymia should be a focus of further research for people with learning disabilities.


Prostate cancer active surveillance outcomes in a cohort composed primarily of African American and Hispanic American Men.
Active surveillance outcomes in minority patients are poorly characterized, as most surveillance series are comprised primarily of Caucasian men. We aimed to characterize outcomes of African American and Hispanic men undergoing surveillance and to identify factors associated with transition to definitive treatment. We performed a retrospective analysis of men undergoing active surveillance at our institution. Reasons for transition to definitive treatment were determined. Cessation of active surveillance was recommended for Gleason upgrading on surveillance biopsy. We characterized treatment-free survival for men on surveillance and compared this by race/ethnicity (as self reported by patients). Demographic and clinical variables associated with active surveillance cessation were identified using Cox proportional hazards regression. A total of 141 men were on active surveillance: 84 non-Hispanic Black/African American (59.6%), 32 Hispanic (22.7%), and 25 non-Hispanic White/Caucasian (17.7%). Two-year treatment-free survival for Caucasian, Black and Hispanic patients was 81.2%, 54.4%, and 75.0%, respectively. Pairwise Cox proportional hazards analysis showed significantly decreased treatment-free survival in Black compared to Caucasian men (HR 2.42, 95% CI 1.03-5.68). In African American men, cessation of active surveillance occurred most commonly due to grade reclassification at the time of confirmatory biopsy. Among our active surveillance cohort composed primarily of racial and ethnic minorities, we identified relatively high rates of progression to definitive treatment. African American race was associated with surveillance cessation on univariate analysis. These findings stress the importance of confirmatory biopsy and strict compliance with surveillance protocols in AA men to ensure timely detection of disease reclassification.


High light-induced switch from C(3)-photosynthesis to Crassulacean acid metabolism is mediated by UV-A/blue light.
The high light-induced switch in Clusia minor from C(3)-photosynthesis to Crassulacean acid metabolism (CAM) is fast (within a few days) and reversible. Although this C(3)/CAM transition has been studied intensively, the nature of the photoreceptor at the beginning of the CAM-induction signal chain is still unknown. Using optical filters that only transmit selected wavelengths, the CAM light induction of single leaves was tested. As controls the opposite leaf of the same leaf pair was studied in which CAM was induced by high unfiltered radiation (c. 2100 micromol m(-2) s(-1)). To evaluate the C(3)-photosynthesis/CAM transition, nocturnal CO(2) uptake, daytime stomatal closure and organic acid levels were monitored. Light at wavelengths longer than 530 nm was not effective for the induction of the C(3)/CAM switch in C. minor. In this case CAM was present in the control leaf while the opposite leaf continued performing C(3)-photosynthesis, indicating that CAM induction triggered by high light conditions is wavelength-dependent and a leaf internal process. Leaves subjected to wavelengths in the range of 345-530 nm performed nocturnal CO(2) uptake, (partial) stomatal closure during the day (CAM-phase III), and decarboxylation of citric acid within the first 2 d after the switch to high light conditions. Based on these experiments and evidence from the literature, it is suggested that a UV-A/blue light receptor mediates the light-induced C(3)-photosynthesis/CAM switch in C. minor.


The opposite effects of short- and long-term salt loading on pituitary adrenal axis activity in rats.
Osmotic stimulation has been shown to modify corticotropin responsiveness. We compared the effects of short- and long-term salt loading on pituitary-adrenal activity in control rats receiving tap water and rats submitted to salt loading for 1 day (S1) or 8 days (S8). Corticosterone (B) and adrenocorticotropic hormone (ACTH) plasma levels were determined at 8 a. m. under basal conditions or after immobilization stress for 15 min or corticotropin-releasing hormone (CRH) stimulation. S1 rats showed a similar ACTH response to immobilization, but an increased CRH response. In contrast, S8 rats showed blunted responses after immobilization or CRH stimulation. To evaluate the circadian variation of this inhibitory effect on the stress in the S8 group, immobilization was also performed at 8 p. m. Plasma ACTH and B levels under resting conditions were higher at 8 p. m. than 8 a. m. (p < 0.05) in control and S8 rats. The ACTH response to immobilization in the S8 group was lower than control at both 8 a. m. and 8 p. m. (p < 0.05); however, this reduction was more evident the morning, resulting in an inversion of the diurnal pattern with a higher ACTH response at 8 p. m. In conclusion, short osmotic stimulation results in an increased pituitary response to CRH, whereas prolonged stimulation decreases the pituitary response to CRH and immobilization, showing an interaction between osmoregulation and hypothalamus-pituitary-adrenocortical activity.


Written language skills in children with auditory brainstem implants.
This study aimed to assess the written language skills of children with auditory brainstem implants (ABI). In this study, 15 children (from second to eighth grades) with ABI were evaluated for their written language abilities using a written expression skill assessment form. Five different features of written expression points were scored and analyzed, yielding a composite score for written expression skills. This study showed that all children with ABI needed more verbal cues than spontaneously written samples. Moreover, these children used short and simple sentences with limited vocabulary and repeated words and sentences. Furthermore, these children were deficient in writing an introduction, the body, and the conclusion paragraphs and could not write events in a logical sequence. The written language skills of children with ABI depend on age at implantation, duration of implant use, and additional handicaps. Written expression skills in children with ABI are highly complex skills. The findings highlight the importance of ABI during the critical language development period and the enhancement of training programs for written language skills in children who underwent ABI.


The impact of demineralized bone matrix characteristics on pseudarthrosis and surgical outcomes after posterolateral lumbar decompression and fusion.
The objectives of our study were to compare the fusion rates and surgical outcomes of lumbar fusion surgery based on the (1) type of demineralized bone matrix (DBM) carrier allograft, (2) the presence/absence of a carrier, and (3) the presence of bone fibers in DBM. Patients >18 years of age who underwent single-level posterolateral decompression and fusion (PLDF) between L3 and L5 between 2014 and 2021 were retrospectively identified. We assessed bone grafts based on carrier type (no carrier, sodium hyaluronate carrier, and glycerol carrier) and the presence of bone fibers. Fusion status was determined based on a radiographic assessment of bony bridging, screw loosening, or change in segmental lordosis >5°. Analyses were performed to assess fusion rates and surgical outcomes. Fifty-four patients were given DBM with a hyaluronate carrier, 75 had a glycerol carrier, and 94 patients were given DBM without a carrier. DBM carrier type, bone fibers, and carrier presence had no impact on 90-day readmission rates (P = 0.195, P = 0.099, and P = 1.000, respectively) or surgical readmissions (P = 0.562, P = 0.248, and P = 0.640, respectively). Multivariable logistic regression analysis found that type of carrier, presence of fibers (odds ratio [OR] = 1.106 [0.524-2.456], P = 0.797), and presence of a carrier (OR = 0.701 [0.370-1.327], P = 0.274) were also not significantly associated with successful fusion likelihood. Our study found no significant differences between DBM containing glycerol, sodium hyaluronate, or no carrier regarding fusion rates or surgical outcomes after single-level PLDF. Bone particulates versus bone fibers also had no significant differences regarding the likelihood of bony fusion.


Elevated IL-1α and CXCL10 serum levels occur in patients with homozygous sickle cell disease and a history of acute splenic sequestration.
Acute splenic sequestration (ASS) and chronic hypersplenism are common features of homozygous sickle cell (SS) disease in the first 5 years of life affecting one-third of subjects in the Jamaican Cohort Study. The risk factors are largely unknown and the current study explores a possible role of genetic factors. We have explored these in subjects who received splenectomy in the management of ASS (n=8) or chronic hypersplenism (n=9) along with age, gender, and genotype matched controls using Luminex Technology to assess 42 human cytokines/chemokines, including IL-1α and CXCL10 (IP-10). Levels of IL-1α (p=0.008) and CXCL10 (p=0.009) were significantly elevated in patients treated by splenectomy compared with the control group. Levels of IL-1α were significantly higher in those with a history of ASS compared with matched normal controls (p=0.028) but not in those treated for hypersplenism (p=0.093). Furthermore, several significant differences were found in the median ratios of some cytokine biomarkers between the splenectomized group and the normal controls. These observations are consistent with acute splenic sequestration having a distinct phenotype which may be helpful in predicting those at risk of this complication and suggest that the mechanism of these differences merit further study.


Hierarchical multifractal representation of symbolic sequences and application to human chromosomes.
The two-dimensional density correlation matrix is constructed for symbolic sequences using contiguous segments of arbitrary size. The multifractal spectrum obtained from this matrix motif is shown to characterize the correlations in the symbolic sequences. This method is applied to entire human chromosomes, shuffled human chromosomes, reconstructed human genomic sequences and to artificial random sequences. It is shown that all human chromosomes have common characteristics in their multifractal spectrum and deviate substantially from random and uncorrelated sequences of the same size. Small deviations are observed between the longer and the shorter chromosomes, especially for the higher (in absolute values) statistical moments. The correlations are crucial for the form of the multifractal spectrum; surrogate shuffled chromosomes present randomlike spectrum, distinctly different from the actual chromosomes. Analytical approaches based on hierarchical superposition of tensor products show that retaining pair correlations in the sequences leads to a closer representation of the genomic multifractal spectra, especially in the region of negative exponents, due to the underrepresentation of various functional units (such as the cytosine-guanine CG combination and its complementary GC complex). Retaining higher-order correlations in the construction of the tensor products is a way to approach closer the structure of the multifractal spectra of the actual genomic sequences. This hierarchical approach is generic and is applicable to other correlated symbolic sequences.


Schizophrenia and multiple sclerosis.
Similarities in clinical course, age of onset, geographical distribution, and immunological responses of patients with schizophrenia and multiple sclerosis (MS) suggest that these two common illnesses of young adults may belong to a similar class of disorders. This review examines some of the similarities and differences between these two disorders and suggests that epidemiological, immunological, and viral studies considered useful in the investigation of causal factors in multiple sclerosis may also be pertinent to the search for causes of schizophrenia.


The Effect of Pneumatic Tube Systems on the Hemolysis of Biochemistry Blood Samples.
Pneumatic tube systems (PTSs) are widely used in many hospitals because they lead to reduced turnaround times and cost efficiency. However, PTSs may affect the quality of the blood samples transported to the laboratory. The aim of this study was to investigate the effect of the PTS used in our hospital on the hemolysis of the biochemical blood samples transported to the laboratory. A total of 148 samples were manually transported to the laboratory by hospital staff, 148 samples were transported with the PTS, and 113 were transported with the PTS without use of sponge-rubber inserts (PTSws). Hemolysis rates and the levels of biochemical analytes for the different transportation methods were compared. No significant difference was found between the samples transported manually and with the PTS with regard to hemolysis rate and the levels of biochemical analytes. However, the samples transported with the PTSws showed a significant difference compared with the samples transported manually and with the PTS with regard to hemolysis rate and potassium and lactate dehydrogenase levels. The percentages of the samples that exceeded the permissible threshold for the hemolysis among the samples transported manually, with the PTS, and with the PTSws were 10%, 8%, and 47%, respectively. A PTS can be used safely for transporting biochemistry blood samples to the laboratory. However, a sponge-rubber insert that holds sample tubes must be used with the PTS to prevent the hemolysis of blood samples.


Study on the Fractal Characteristics and Seepage Properties of Channels Filled by Coal Particles.
Studying the seepage process in fracture channels (where coal particles are deposited) is of great significance for improving the performance of both on-site coal seam water injection and dust reduction technology. Through a self-developed simulation experiment of water-borne coal particle migration and accumulation and computer graphics, we investigated the influencing factors of particle accumulation in water injection and their influence law on seepage, discussed the interaction relationship between the fractal structure of coal and the characteristics of accumulated coal particles, and established a new fractal model of fracture permeability based on different particle accumulation states. The results show that the seepage velocity and the particle size jointly affect the migration and accumulation process of water-borne coal particles. When the coal particle size is constant and the seepage velocity increases, then the output of the coal powder increases, the deposition decreases, and the structure fractal dimension D3 of fractures decreases. At the same seepage velocity, with the increase of the coal particle size, the output of coal powder decreases, the deposition increases, and the structure fractal dimension D3 of fractures increases. In addition, the amount of coal powder produced in the intermittent water injection process is smaller than that produced in the continuous water injection process, more easily leading to accumulation. The variation law of the theoretical permeability with porosity remains consistent for different particle accumulation states: with the increase of porosity, the structure fractal dimension D3 of fractures decreases, while the theoretical permeability increases. The above research results can provide a theoretical basis for reducing the seepage damage of coal under the particle blocking effect.


Cardiac tissue Doppler imaging in sports medicine.
The differentiation of training-induced cardiac adaptations from pathological conditions is a key issue in sports cardiology. As morphological features do not allow for a clear delineation of early stages of relevant pathologies, the echocardiographic evaluation of left ventricular function is the technique of first choice in this regard. Tissue Doppler imaging (TDI) is a relatively recent method for the assessment of cardiac function that provides direct, local measurements of myocardial velocities throughout the cardiac cycle. Although it has shown a superior sensitivity in the detection of ventricular dysfunction in clinical and experimental studies, its application in sports medicine is still rare. Besides technical factors, this may be due to a lack in consensus on the characteristics of ventricular function in relevant conditions. For more than two decades there has been an ongoing debate on the existence of a supernormal left ventricular function in athlete's heart. While results from traditional echocardiography are conflicting, TDI studies established an improved diastolic function in endurance-trained athletes with athlete's heart compared with controls.The influence of anabolic steroids on cardiac function also has been investigated by standard echocardiographic techniques with inconsistent results. The only TDI study dealing with this topic demonstrated a significantly impaired diastolic function in bodybuilders with long-term abuse of anabolic steroids compared with strength-trained athletes without abuse of anabolic steroids and controls, respectively.Hypertrophic cardiomyopathy is the most frequent cause of sudden death in young athletes. However, in its early stages, it is difficult to distinguish from athlete's heart. By means of TDI, ventricular dysfunction in hypertrophic cardiomyopathy can be disclosed even before the development of left ventricular hypertrophy. Also, a differentiation of left ventricular hypertrophy due to hypertrophic cardiomyopathy or systemic hypertension is possible by TDI. Besides the evaluation of different forms of left ventricular hypertrophy, the diagnosis of myocarditis is also of particular importance in athletes. Today, it still requires myocardial biopsy. The analysis of focal disturbances in myocardial velocities might be a promising non-invasive method; however, systematic validation studies are lacking. An important future issue for the implementation of TDI into routine examination will be the standardisation of procedures and the establishment of significant reference values for the above-mentioned conditions. Innovative TDI parameters also merit further investigation.