Metal Slot Color Filter Based on Thin Air Slots on Silver Block Array.
The human eye perceives the color of visible light depending on the spectrum of the incident light. Hence, the ability of color expression is very important in display devices. For practical applications, the transmitted color filter requires high transmittance and vivid colors, covering full standard default color spaces (sRGB). In this paper, we propose a color filter with a silver block array on a silica substrate structure with nanoscale air slots where strong transmission is observed through the slots between silver blocks. We investigated the transmitted color by simulating the transmission spectra as functions of various structure parameters. The proposed structure with an extremely small pixel size of less than 300 nm covers 90% of sRGB color depending on the structure and has a narrow angular distribution of transmitted light.


Behavior of Implants and Oral Tissues in Maxillary Fixed Prostheses, with a Follow-up of 1 to 12 Years: Analytical Cross-Sectional Study.
The aim of this study was to evaluate maxillary full-arch implant-supported fixed rehabilitations by identifying biologic complications, implant survival and success rates, and patient satisfaction with treatment. In addition, the study verified the influence of attendance at maintenance appointments on the occurrence of complications. Data were collected from clinical follow-up appointments. The sample consisted of 52 patients (363 implants) with follow-up of 1 to 12 years (mean: 4.69). The main biologic complication was soft tissue recession (20.8%) at the implant level. Tissue hyperplasia was observed in eight patients (15.4%), and 17 (4.7%) implants had bone loss ≥ 2 mm. The peri-implantitis rate was 3.1% (11 implants). Implant survival and success rates were 97.8% and 93.4%, respectively. Rates of patient satisfaction with treatment were as follows: 21 (40.4%) completely satisfied, 28 (53.8%) satisfied with some complaint, and 3 (5.8%) expected more from treatment. The main complaint was the difficulty of cleaning (64.5%). Patients who attended annual follow-up appointments were associated with less bone remodeling and peri-implant disease, but no significant difference was found in biofilm accumulation. This type of rehabilitation is susceptible to biologic complications, but high survival and success rates and patient satisfaction were found. Periodic maintenance was associated with reduced complications, such as bone loss or peri-implantitis.


Comparative analysis of anti-arrhythmic effect of propranolol and metoprolol in patients with supraventricular tachyarrhythmias.
Eighty-seven patients with paroxysmal tachydysrhythmias were submitted to clinical and laboratory evaluation and electrophysiologic studies were performed during the 3rd, 6th and 12th months of the therapy with propranolol or metoprolol. Metoprolol did not induce any significant change in sinoatrial correct time, in sinoatrial recovery time or in corrected sinoatrial recovery time. It decreases significantly the effective and functional AV refractory periods as well as increases the effective refractory period of the additional pathway. The mechanism of tachycardia preventing an involvement of the additional pathway in retrograde direction consists in the appearance of a block in the indicated additional pathway. The results of the humoral aspects are the following: propranolol inhibits the functions of the thyroid and sexual glands both in acute tests and in tests performed during the 3rd, 6th and 12th month of therapy; metoprolol has no significant effect on the functions of the thyroid and sexual glands; apparently, it influences the cardiac conduction system and myocardium directly.


Chromosomal "fingerprints" of prior exposure to densely ionizing radiation.
A biomarker that would distinguish radiation-induced biological damage from damage produced by other agents has long been a goal in radiation biology. We suggest that densely ionizing radiations such as alpha particles from radon daughters, or fission neutrons, leave a distinctive chromosomal marker that may be detected and measured long after radiation exposure. Specifically, they produce an anomalously low ratio (F) of interchromosomal to intrachromosomal, interarm exchange-type chromosome aberrations, in comparison with either X rays or chemical carcinogens. For densely ionizing radiations and for other agents, experimental values of this F ratio, determined both in vitro and in vivo, are quantitatively consistent with theoretical expectations based on considerations of chromosomal geometry and radiation track structure. The use of fluorescence in situ hybridization to measure F values in stable chromosomal aberrations, together with recent developments in techniques for harvesting viable human cells, makes the application of this biological marker quite feasible. For example, the use of this marker could greatly facilitate epidemiological studies of radon-exposed cohorts.


Half-metallicity in single-layered manganese dioxide nanosheets by defect engineering.
Defect engineering is considered as one of the most efficient strategies to regulate the electronic structure of materials and involves the manipulation of the types, concentrations, and spatial distributions of defects, resulting in unprecedented properties. It is shown that a single-layered MnO2 nanosheet with vacancies is a robust half-metal, which was confirmed by theoretical calculations, whereas vacancy-free single-layered MnO2 is a typical semiconductor. The half-metallicity of the single-layered MnO2 nanosheet can be observed for a wide range of vacancy concentrations and even in the co-presence of Mn and O vacancies. This work enables the development of half-metals by defect engineering of well-established low-dimensional materials, which may be used for the design of next-generation paper-like spintronics.


Feeling the conflict: the crucial role of conflict experience in adaptation.
In the study reported here, we examined the role of conflict experience in cognitive adaptation to conflict. Although the experience of conflict is generally neglected in theoretical models of cognitive control, we demonstrated that it plays a critical role in cognitive adaptation. Using a masked-priming paradigm, we showed that conflict adaptation was present only after trials on which participants experienced response conflict. Furthermore, when subjective experience did not coincide with actual conflict, adaptation effects in the error rates were observed after the experience of conflict, not after response conflict. We conclude that the experience of conflict, and not response conflict per se, is the crucial factor underlying cognitive adaptation effects. The current findings provide a new perspective on the question of why the human cognitive system exerts cognitive control, and they suggest that a crucial role of subjective experience is to allow for top-down control of behavior.


Angina Pectoris as a Manifestation of ALCAPA Syndrome in a 20-Year-Old Female: A Case Report and Review of Literature.
Anomalous left coronary artery from the pulmonary artery (ALCAPA) is considered a rare congenital heart disease where the take-off of the left coronary artery abnormally originates from the pulmonary artery instead of left aortic sinus. It is associated with a high mortality rate in the first year of life and sudden death in adults if left untreated. We report an adult form of ALCAPA syndrome in a 20-year-old female who presented with anginal pain for the previous few months. Unfortunately, the patient was hesitant to have surgery at the time. The abnormal origin of the left coronary artery from the pulmonary artery (ALCAPA) is rare and potentially fatal coronary congenital disease, accounting for 0.5% of all congenital heart diseases; it is associated with poor outcomes if left untreated.ALCAPA is classified into infantile and adult forms. The prevalence of adult individuals with ALCAPA syndrome has significantly increased as a result of recent developments in non-invasive cardiac imaging.The prevalence of sudden mortality in childhood and the early stages of adulthood makes surgery the preferred treatment, and coronary reimplantation surgery is considered the surgical procedure of choice.


AI-assisted Method for Efficiently Generating Breast Ultrasound Screening Reports.
Ultrasound is one of the preferred choices for early screening of dense breast cancer. Clinically, doctors have to manually write the screening report, which is time-consuming and laborious, and it is easy to miss and miswrite. We proposed a new pipeline to automatically generate AI breast ultrasound screening reports based on ultrasound images, aiming to assist doctors in improving the efficiency of clinical screening and reducing repetitive report writing. AI efficiently generated personalized breast ultrasound screening preliminary reports, especially for benign and normal cases, which account for the majority. Doctors then make simple adjustments or corrections based on the preliminary AI report to generate the final report quickly. The approach has been trained and tested using a database of 4809 breast tumor instances. Experimental results indicate that this pipeline improves doctors' work efficiency by up to 90%, greatly reducing repetitive work. Personalized report generation is more widely recognized by doctors in clinical practice than non-intelligent reports based on fixed templates or options to fill in the blanks.


Mechanistic study on Cu-catalyzed CO2 electroreduction into CH4 at simulated low overpotentials based on an improved electrochemical model.
An improved CO coverage-dependent electrochemical model with explicit relaxed H2O molecules used in CO2 electroreduction is presented, which is firstly applied to Cu-catalyzed CO2 electroreduction into CH4 production at low overpotentials in this paper. The results show that the present defined CH2O and CHOH pathways via common intermediates CHO and CH2 may be able to occur parallelly at the present simulated low overpotential. The potential-limiting steps may be the formation of CO and its further electroreduction into CHO, which are considered as the origin of the observed experimentally high overpotential. The present study also explains why at electrochemical interfaces, only CH4 is observed experimentally on the Cu surface rather than CH3OH. The present results are found to be in excellent agreement with the available experimental data and partial theoretical analysis, further validating the rationality of the present employed methodology.


Wet-surface-enhanced ellipsometric contrast microscopy identifies slime as a major adhesion factor during bacterial surface motility.
In biology, the extracellular matrix (ECM) promotes both cell adhesion and specific recognition, which is essential for central developmental processes in both eukaryotes and prokaryotes. However, live studies of the dynamic interactions between cells and the ECM, for example during motility, have been greatly impaired by imaging limitations: mostly the ability to observe the ECM at high resolution in absence of specific staining by live microscopy. To solve this problem, we developed a unique technique, wet-surface enhanced ellipsometry contrast (Wet-SEEC), which magnifies the contrast of transparent organic materials deposited on a substrate (called Wet-surf) with exquisite sensitivity. We show that Wet-SEEC allows both the observation of unprocessed nanofilms as low as 0.2 nm thick and their accurate 3D topographic reconstructions, directly by standard light microscopy. We next used Wet-SEEC to image slime secretion, a poorly defined property of many prokaryotic and eukaryotic organisms that move across solid surfaces in absence of obvious extracellular appendages (gliding). Using combined Wet-SEEC and fluorescent-staining experiments, we observed slime deposition by gliding Myxococcus xanthus cells at unprecedented resolution. Altogether, the results revealed that in this bacterium, slime associates preferentially with the outermost components of the motility machinery and promotes its adhesion to the substrate on the ventral side of the cell. Strikingly, analogous roles have been proposed for the extracellular proteoglycans of gliding diatoms and apicomplexa, suggesting that slime deposition is a general means for gliding organisms to adhere and move over surfaces.


Absorption of calcium measured by intubation and perfusion of the intact hyman small intestine.
Absorption of calcium was measured by direct intubation and perfusion of the small intestine in 10 volunteer normal adult subjects, two adults with celiac-sprue, and one with a parathyroid adenoma. A total of 60 studies were completed using one of two different levels, duodenojejunum or ileum. Solutions containing stable calcium, radiocalcium(47), and a nonabsorbable dilution-concentration marker, polyethylene glycol, were infused at a uniform rate via the proximal lumen of a triple-lumen polyvinyl tube. The mixed intraluminal contents were continuously sampled by siphonage from two distal sites, 10 and 60 cm below the point of infusion. Unidirectional flux rates, lumen to blood and blood to lumen, and net absorption of calcium for the 50 cm segment of small intestine between the two collection sites were calculated from the measured changes in concentration of stable calcium, calcium-47, and polyethylene glycol.Flux of calcium from lumen to blood in the duodenojejunum of normal subjects was appreciable even when the concentration of calcium in the perfusate was below that of extracellular fluid and, as the intraluminal concentration of calcium was increased through a range of 0.5-3.5 mumoles/ml, was positively correlated, ranging from 1.9 to 7.0 mumoles/min per 50 cm. Repeated studies of individual subjects demonstrated a consistent pattern of absorptive efficiency in each, but significant variability from person to person. Flux from lumen to blood in the ileal segment occurred at a much lower rate than that found in the proximal intestine, and there was not a significant dependence upon intraluminal calcium concentration. The opposite flux, from blood to lumen, was low both in the duodenojejunum and ileum (average 0.76 mumoles/min per 50 cm) and was independent of the intraluminal calcium concentration. Unidirectional flux, lumen to blood, from the duodenojejunum was not altered by parathyroid extract administered at the time of the infusion, but was accelerated in the subject with a parathyroid adenoma and markedly reduced in the two subjects with celiac-sprue.


Temporal gradients limit the accumulation of neutrophils towards sources of chemoattractant.
Neutrophil trafficking during inflammation is a highly orchestrated process, coordinating neutrophil recruitment, sterilization of the wound, and inflammation resolution. Although the chemotactic signals guiding neutrophil recruitment to sites of inflammation are relatively well understood, mechanisms controlling cessation of neutrophil recruitment and return to normal tissue physiology remain undefined. To gain insights into these processes, we designed a microfluidic device with an array of chemoattractant reservoirs, which mimics the microenvironment in infected tissues, when multiple clusters of microbes are present. We monitored the temporal dynamics of neutrophil recruitment towards the chemoattractant reservoirs at single cell resolution, for 3 hours. We observed robust neutrophil recruitment that reached a plateau after 1.5 hours, despite the continuous presence of robust chemoattractant gradients around the reservoirs. The timing of the plateau was dependent on the geometry of the devices and was independent from the number of neutrophils. Based on these observations, we ruled out sub-population sensitivity, chemoattractant scavenging, and production of a self-limiting stop signal as potential mechanisms underpinning the plateau in neutrophil recruitment. We found a strong correlation between the temporal stabilization of concentration changes and the plateau in neutrophils recruitment. These results suggest that dynamic aspects of chemoattractant gradients are key for maximizing recruitment during the acute phase of infections and limiting the accumulation of neutrophils as soon as the infection is contained.


QTL with pleiotropic effects on serum levels of bone-specific alkaline phosphatase and osteocalcin maps to the baboon ortholog of human chromosome 6p23-21.3.
Bone ALP and OC are under partial genetic control. This study of 591 pedigreed baboons shows a QTL corresponding to human 6p23-21.3 that accounts for 25% (bone ALP) and 20% (OC) of the genetic variance. A gene affecting osteoblast activity, number, or recruitment likely resides in this area. Serum levels of bone alkaline phosphatase (ALP) and osteocalcin (OC) reflect osteoblast activity. Both of these measures are under partial genetic control. Genetic effects on bone ALP have not been previously localized to chromosomal regions in primates, nor has the degree to which genetic effects are shared (pleiotropic) between bone ALP and OC been studied. We applied variance components methods to a sample of 591 adult pedigreed baboons to detect and quantify effects of genes that influence bone ALP and that have pleiotropic effects on bone ALP and OC. A univariate linkage analysis was conducted for bone ALP. Bivariate linkage analyses were conducted in areas for which the bone ALP results presented here and a previous univariate OC linkage analysis showed evidence for linkage on the same chromosome for both bone ALP and OC. A quantitative trait locus (QTL) for serum levels of bone ALP is evident on the baboon ortholog of human chromosomal region 6p (LOD 2.93). Thirty-seven percent (genetic correlation [rho(G)] = 0.61) of the genetic variance in bone ALP and OC is caused by pleiotropic effects of the same gene(s). Bivariate linkage analysis revealed a QTL in the region corresponding to human chromosome 6p23-21.3, with the strongest evidence for bivariate linkage near D6S422 (LOD = 2.97 at 22 cM from our pter-most marker). D6S422 maps to 20.4 Mb in the human genome. The QTL-specific heritability (h2) is 0.25 and 0.20 for bone ALP and OC, respectively. This first formal test for shared genetic effects on two serum markers of osteoblast activity indicates that a significant pleiotropic effect on bone ALP and OC levels, and thus on bone formation, is detectible. The fact that this region corresponds to one on mouse chromosome 13 that has repeatedly yielded QTLs for BMD should encourage more intensive study of the effect of genes in this region on bone maintenance and turnover.


Amiodarone increases the accumulation of DEA in a human alveolar epithelium-derived cell line.
Amiodarone (AMD)-induced pulmonary toxicity (AIPT) is the most life-threatening side-effect of AMD treatment. N-Monodesethylamiodarone (DEA), an active metabolite of AMD, also exhibits cytotoxicity and tends to accumulate in the lung more intensively than AMD. In this study, we characterized the mechanism of DEA accumulation using A549 cells as a model of the alveolar epithelium. Typical ATP-depletion compounds caused an approximately 30% increase in the accumulation of DEA in A549 cells, although these effects were less than those in Caco-2 cells. Triiodothyronine (T(3)), which exhibited an inhibitory effect on DEA efflux in Caco-2 cells, did not affect the accumulation of DEA in A549 cells. On the other hand, 100 microM AMD caused an approximately 200% increase in DEA content in A549 cells, although AMD accumulation was not affected by 100 microM DEA. Since the reducing effect of AMD on cellular ATP levels and that of FCCP were similar, the mechanism by which DEA accumulation is increased by AMD might be different from the ATP-dependent DEA efflux mechanism. The decrease in cell viability by DEA in the presence of AMD (IC(50) value of DEA for A549 cell viability: 25.4+/-2.4 microM) was more pronounced than that by DEA alone (IC(50) value: 11.5+/-3.0 microM). This further DEA accumulation by AMD might be a factor responsible for the greater accumulation of DEA than that of AMD in the lung in long-term AMD-treated patients.


Linked head injury and conduct problem symptom pathways from early childhood to adolescence and their associated risks: Evidence from the millennium cohort study.
Conduct problems and head injuries increase the risk of delinquency and share a bidirectional association. However, how they link across development is unknown. The present study aimed to identify their linked developmental pathways and associated risk factors. Latent class analysis was modeled from Millennium Cohort Study data (n = 8,600) to identify linked pathways of conduct problem symptoms and head injuries. Head injuries were parent-reported from ages 3 to 14 and conduct problems from ages 3 to 17 using the Strengths and Difficulties Questionnaire (SDQ). Multinomial logistic regression then identified various risk factors associated with pathway membership. Four distinct pathways were identified. Most participants displayed low-level conduct problem symptoms and head injuries (n = 6,422; 74.7%). Three groups were characterized by clinically relevant levels of conduct problem symptoms and high-risk head injuries in childhood (n = 1,422; 16.5%), adolescence (n = 567; 6.6%), or persistent across development (n = 189; 2.2%). These clinically relevant pathways were associated with negative maternal parenting styles. These findings demonstrate how pathways of conduct problem symptoms are uniquely linked with distinct head injury pathways. Suggestions for general preventative intervention targets include early maternal negative parenting styles. Pathway-specific interventions are also required targeting cumulative risk at different ecological levels.


Relief from neuropathic pain by blocking of the platelet-activating factor-pain loop.
Neuropathic pain resulting from peripheral neuronal damage is largely resistant to treatment with currently available analgesic drugs. Recently, ATP, lysophosphatidic acid, and platelet-activating factor (PAF) have been reported to play important inductive roles in neuropathic pain. In the present study, we found that pain-like behaviors resulting from partial sciatic nerve ligation (PSL) were largely attenuated by deficiency of lysophosphatidylcholine acyltransferase (LPCAT)2, which is one of the PAF biosynthetic enzymes. By contrast, deficiency of the other PAF biosynthetic enzyme, LPCAT1, did not ameliorate neuropathic pain. With regard to the mechanism of the observed effects, LPCAT2 was detected in wild-type spinal cord microglia, and the absence of LPCAT2 expression precluded spinal PAF expression in LPCAT2-knockout mice. Furthermore, ATP-stimulated PAF biosynthesis in macrophages was decreased by pretreatment with the PAF receptor antagonist ABT-491, indicating the existence of a positive feedback loop of PAF biosynthesis, which we designated the PAF-pain loop. In conclusion, LPCAT2 is a novel therapeutic target for newly categorized analgesic drugs; in addition, our data call for the re-evaluation of the clinical utility of PAF receptor antagonists.-Shindou, H., Shiraishi, S., Tokuoka, S. M., Takahashi Y., Harayama, T., Abe, T., Bando, K., Miyano, K., Kita, Y., Uezono, Y., Shimizu, T. Relief from neuropathic pain by blocking of the platelet-activating factor-pain loop.


Photoinduced Charge Separation within Metallo-supramolecular Wires Built around a [Ru(bpy)3](2+)-Bisterpyridine Linear Entity.
A [Ru(bpy)3](2+)-like complex (L1) bearing two free terpyridine groups at the 5 and 5' positions of the same bipyridine, linked by the rigid and linear 2,5-dimethyl phenylene bridges has been synthesized to open access to two classes of linear molecular wires with photosensitive properties: a bimetallic coordination polymer and an inorganic triad. In this Research Article, we report on the synthesis and characterization of the resulting [{Ru(II_)Fe(II)}n](4n+) alternated bimetallic polymer and the [Co(III_)Ru(II_)Fe(II)](7+) triad based on the building block L1. The [{Ru(II_)Fe(II)}n](4n+) polymer is fully characterized in solution. Cyclic voltammetry and emission lifetime measurements show that the bridging ligand allows interaction between the metal centers in the excited state despite the lack of interactions in the ground state. Under visible irradiation, the polymer can be fully oxidized in the presence of a sacrificial electron acceptor in solution. Thin robust films of the polymer are easily obtained on ITO by a simple electrochemical procedure based on an electroreduction adsorption process. The ITO/[{Ru(II_)Fe(II)}n](4n+)-modified electrode behaves as a photocathode under irradiation in the presence of ArN2(+). The magnitude of the photocurrent is dependent on the film thickness, probably limited by the diffusion of charge in thicker film. On the other hand L1 is also used to construct a well-ordered triad in association with Co(III) and Fe(II) metallic centers as electron acceptor and donor, respectively. The metallic triad is anchored on ITO or on a SiO2 wafer, starting from a terpyridine phosphonate modified surface. AFM images prove the presence of the triad in a linear upward orientation. Irradiation of the ITO/[Co(III_)Ru(II_)Fe(II)](7+) modified surface in the presence of triethanolamine in CH3CN induces the generation of an anodic photocurrent of around 30 μA.cm(-2). The photocurrent density generated by the ITO/[Co(III_)Ru(II_)Fe(II)](7+) electrode, appears to be more stable than in the case of ITO/[{Ru(II_)Fe(II)}n](4n+) because of the presence of the anchoring group. Moreover, this photocurrent magnitude represents an enhancement of 30% compared to our previous triad ( Dalton Trans. 2014 , 43 , 12156 - 12159 ), proving the advantage of a linear and rigid spacer for the construction of such molecular assemblies with photoinduced charge transfer abilities.


The impact of calcimimetics on mineral metabolism and secondary hyperparathyroidism in end-stage renal disease.
The impact of calcimimetics on mineral metabolism and secondary hyperparathyroidism in end-stage renal disease. Secondary hyperparathyroidism is often complicated by elevations in calcium and phosphorus either as a result of the disease per se or due to toxicity from current therapeutic options. These disturbances in mineral metabolism limit the successfulness of therapy and have been implicated as contributing to the development and progression of vascular calcification, an important and often overlooked component of cardiovascular disease in patients on dialysis. Phosphorus, active vitamin D, and calcium all play important roles in the pathogenesis of secondary hyperparathyroidism; however, serum calcium is the primary regulator of minute-to-minute parathyroid hormone secretion. Small changes in serum calcium are detected by a cell surface calcium sensing receptor that has recently been cloned. Calcimimetic agents modulate the activity of the calcium-sensing receptor and result in profound reductions in levels of circulating parathyroid hormone. Additionally, these agents result in decreases in serum calcium, phosphorus, and calcium-phosphorus product. Recently completed phase 2 clinical trials with the second-generation calcimimetic agent cinacalcet HCl confirm that this agent represents a safe and effective novel therapeutic agent which has the potential to dramatically alter the treatment and complications associated with secondary hyperparathyroidism in patients on dialysis.


Malposition of the colon in left renal agenesis and ectopia.
The anatomic splenic flexure of the colon occupies the renal fossa in patients with left renal agenesis or ectopia and presents a characteristic appearance on radiographs and contrast enema studies. If excretory urography fails to reveal the left kidney, demonstration of the normal colon will exclude renal agenesis or ectopia. The colon remains in normal position in patients with left renal dysplasia or after left nephrectomy.


Aggregation-Induced Emission Probe for Study of the Bactericidal Mechanism of Antimicrobial Peptides.
Multidrug resistant bacterial infection has become one of the most serious threats to human health. Antimicrobial peptides (AMPs) have been identified as potential alternatives to antibiotics owing to their excellent bactericidal activity. However, the complicated bactericidal mechanism of AMPs is still poorly understood. Fluorescence imaging has many advantages in terms of dynamic monitoring, easy operation, and high sensitivity. In this study, we developed an aggregation-induced emission (AIE)-active probe AMP-2HBT by decorating the antimicrobial peptide HHC36 (KRWWKWWRR) with an AIEgen of 2-(2-hydroxyphenyl)benzothiazole (HBT). This AIE-active probe exhibited an excellent light-up fluorescence after binding with bacteria, enabling a real-time monitoring of the binding process. Moreover, a similar time-dependent bactericidal kinetics was observed for the AIE-active probe and HHC36 peptide, which indicated that the bactericidal activity of the peptide was not compromised by decorating with the AIEgen. The bactericidal mechanism of HHC36 peptide was further investigated by super-resolution fluorescence microscopy, transmission electron microscopy (TEM), and scanning electron microscopy (SEM), which suggested that the probe tended to accumulate on the bacterial membrane and efficiently disrupt the membrane structure to kill both Gram-positive and -negative bacteria. This AIE-active probe thus provided a convenient tool to investigate the bactericidal mechanism of AMPs.


Leiomyosarcoma of Renal Vein - A Rare Case Report.
Leiomyosarcomas (LMS) arising from vascular channel are rare and more often arise from inferior vena cava and pulmonary arteries. Primary renal vein LMS are even rarer and occur predominantly in females with peak in fifth and sixth decade. Preoperative diagnosis is difficult because these are rare tumours and present with symptoms and radiological findings similar to Renal Cell Carcinoma (RCC). We report a case of 55-year-old female who presented with abdominal discomfort with radiology showing a renal mass with features of RCC, radical nephrectomy was done and resected tumour showed an attachment to the wall of renal vein with morphology resembling LMS.


[Rett's syndrome: clinical analysis of a case report].
Rett syndrome often remains unrecognized. The study deals with a case report with specific symptoms of Rett syndrome. Viennese criteria for the diagnosis of Rett syndrome are considered as sufficient for recognition of the nosologic unit. A theoretical model which would explain the incidence of specific locomotor stereotypies is briefly discussed. (Ref. 20.)


Cloning of the gene encoding a protochlorophyllide reductase: the physiological significance of the co-existence of light-dependent and -independent protochlorophyllide reduction systems in the cyanobacterium Plectonema boryanum.
Cyanobacteria have two protochlorophyllide (Pchlide) reductases catalyzing the conversion of Pchlide to chlorophyllide, a key step in the biosynthetic pathway of chlorophylls (Chls); a light-dependent (LPOR) and a light-independent (DPOR) reductase. We found an open reading frame (ORF322) in a 2,131-bp EcoRI fragment from the genomic DNA of the cyanobacterium Plectonema boryanum. Because the deduced amino acid sequence showed a high similarity to those of various plant LPORs and the LPOR activity was detected in the soluble fraction of Escherichia coli cells over-expressing the ORF322 protein, ORF322 was defined as the por gene encoding LPOR in P. boryanum. A por-disrupted mutant, YFP12, was isolated by targeted mutagenesis to investigate the physiological importance of LPOR. YFP12 grew as well as wild type under low light conditions (10-25 muE m-2 s-1). However, its growth was significantly retarded as a result of a significant decrease in its Chl content under higher light conditions (85-130 muE m-2 s-1). Furthermore, YFP12 stopped growing and suffered from photobleaching under the highest light intensity (170 muE m-2 s-1). In contrast, a chlL-disrupted (DPOR-less) mutant YFC2 grew as well as wild type irrespective of light intensity. From these phenotypic characteristics, we concluded that, although both LPOR and DPOR contribute to Chl synthesis in the cells growing in the light, the extent of the contribution by LPOR increases with increasing light intensity; without it, the cells are unable to grow under light intensities of more than 130 muE m-2 s-1.


Treatment for transverse patella fractures with minimally invasive techniques (Review).
The transverse fracture pattern is the most common pattern among patellar fractures. Although open reduction with internal fixation using tension band wiring is the common method for treating the majority of transverse patellar fractures with displacement, this approach has distinct disadvantages, including damage to the blood supply and general post-operative complications. Therefore, minimally invasive techniques have been introduced to overcome these problems. In the present review, the advanced surgical procedures using Kirschner wires with cerclage, cannulated screw optioning of supplementary cerclage tension banding, external fixation and combined tension-band braided polyester with a suture button, as well as post-operative rehabilitation, were described in detail. To improve any malreduction due to poor control of the patellar articular surfaces, the utility of arthroscopically assisted techniques was also presented. The advantages and disadvantages of the above-mentioned techniques were also discussed. Minimally invasive techniques were demonstrated to achieve improved knee joint mobility, shorter hospitalization and more favorable outcomes. Such techniques decrease the risk of complications compared to conventional open reduction and fixation. Although specific problems associated with each technique still require to be resolved to reduce late complications, such as the onset of patella-femoral arthritis, minimally invasive techniques remain an alternative option for treating transverse patellar fractures.


Effects of a High Protein Food Supplement on Physical Activity, Motor Performance and Health Related Quality of Life of HIV Infected Botswana Children on Anti-Retroviral Therapy (ART).
Despite existing evidence about the benefits of nutrition, physical activity (PA) and sport to the overall health and wellbeing of children, knowledge gaps remain on this relationship in children living with chronic conditions like HIV/AIDS. Such knowledge should inform context specific programs that could enhance the quality of life of children. The purpose of this study was to examine the effects of integrating a nutrition intervention (culturally tailored food supplement) into antiretroviral therapy (ART) on psychosocial outcomes and physical activity among HIV-positive children in Botswana. 201 HIV-positive children (6-15 years; M = 9.44, SD = 2.40) were recruited and randomly assigned (stratified by age and gender) to two groups. The intervention group (n = 97) received a high protein (bean-sorghum plus micronutrients) food supplement, while the control group (n = 104) received a sorghum plus micronutrients supplement. Participants were followed over 12 months. Anthropometric measures, PA, motor performance, and health related quality of life (HRQL) were collected at baseline, 6 and 12 months. Mixed repeated-measures ANOVA revealed a significant time effect of the food supplement on target variables except body fat percentage, speed, and school functioning. Time × treatment interaction was found for physical functioning, psychosocial functioning and total quality of life score. Scores on physical functioning and total of quality life in the intervention group significantly increased from baseline to 6 months compared with the control group (p = 0.015). A combination of ART and nutritional intervention had a positive effect on physical functioning and total quality of life of HIV-positive children in this study. There were also improvements to physical activity and motor performance tests over time. More research is needed on long term effects of nutrition and PA interventions on HRQL in children living with HIV.


A computational model of information retrieval with UMLS.
A high level representation of data would clarify the complex collection of medical concepts, terms and relationships derived from standard classifications that the Unified Medical Language System contains. A conceptual model is described which represents the data structure. A second objective of this conceptual model is to provide users with the capability to build queries to information databases as easily as possible on the basis of this data structure. The methods used to build this model are semantic networks and conceptual graphs. The object-oriented computational model which implements this conceptual model is detailed. It reuses part of the generic C++ classes of the National Institutes of Health library. New classes are added to this library to implement the needed functionalities.


Bleeding risk stratification in an era of aggressive management of acute coronary syndromes.
Major bleeding is currently one of the most common non-cardiac complications observed in the treatment of patients with acute coronary syndrome (ACS). Hemorrhagic complications occur with a frequency of 1% to 10% during treatment for ACS. In fact, bleeding events are the most common extrinsic complication associated with ACS therapy. The identification of clinical characteristics and particularities of the antithrombin therapy associated with an increased risk of hemorrhagic complications would make it possible to adopt prevention strategies, especially among those exposed to greater risk. The international societies of cardiology renewed emphasis on bleeding risk stratification in order to decide strategy and therapy for patients with ACS. With this review, we performed an update about the ACS bleeding risk scores most frequently used in daily clinical practice.


Immune-enhancing activity of Astragalus maximus extract for inhibiting the Toxoplasma gondii infection: experimental research.
This study aimed to evaluate the in-vitro anti-Toxoplasma effects and cytotoxicity effects of Astragalus maximus chloroformic extract (AMCE) on the T. gondii Rh strain. In-vitro effects of AMCE (2-64 µg/ml) on tachyzoites were measured by MTT assay for 48 h. The effects of AMCE on infectivity rate and intracellular parasites into macrophage cells (J774-A1) were evaluated. The Griess reaction assay and quantitative real-time PCR were used to determine the nitric oxide (NO) and the mRNA expression levels of IFN-γ and iNOS in infected J774-A1 macrophage cells. The mortality rate of the parasites significantly (P<0.001) increased in a dose-dependent manner with an IC50 value of 9.85 μg/ml. The rate of infection and the mean number of intracellular tachyzoites in macrophage cells were significantly reduced (P<0.001) after exposure of the macrophage cells to AMCE. The mRNA expression levels of IFN-γ, iNOS, and NO production in macrophage cells after treatment with the AMCE were increased, especially at the concentration of ½ IC50 and IC50 (P<0.001). The findings of the current in vitro investigation revealed favorable anti-Toxoplasma effects of AMCE against tachyzoites and intracellular forms of T. gondii. Despite the fact that the accurate anti-Toxoplasma mechanisms of AMCE are not clear, our results showed that triggering NO production and cellular immunity can be considered as the main mechanisms of action of AMCE for controlling and eliminating T. gondii. However, further surveys are mandatory to assess the efficacy and safety of AMCE in an animal model and its accurate mechanisms of action.


Outcomes and Surgical Considerations for Neurosurgical Patients Hospitalized with COVID-19-A Multicenter Case Series.
Neurosurgical patients are at a higher risk of having a severe course of coronavirus disease 2019 (COVID-19). The objective of this study was to determine morbidity, hospital course, and mortality of neurosurgical patients during the coronavirus disease 2019 (COVID-19) pandemic in a multicenter health care system. A retrospective observational study was conducted to identify all hospitalized neurosurgical patients positive for COVID-19 from March 11, 2020 to November 2, 2020 at Mayo Clinic and the Mayo Clinic Health System. Eleven hospitalized neurosurgical patients (0.68%) were positive for COVID-19. Four patients (36.6%) were men and 7 (63.3%) were women. The mean age was 65.7 years (range, 35-81 years). All patients had comorbidities. The mean length of stay was 13.4 days (range, 4-30 days). Seven patients had a central nervous system malignancy (4 metastases, 1 meningioma, 1 glioblastoma, and 1 schwannoma). Three patients presented with cerebrovascular complications, comprising 2 spontaneous intraparenchymal hemorrhages and 1 ischemic large-vessel stroke. One patient presented with an unstable traumatic spinal burst fracture. Four patients underwent neurosurgical/neuroendovascular interventions. Discharge disposition was to home in 5 patients, rehabilitation facility in 3, and hospice in 3. Five patients had died at follow-up, 3 within 30 days from COVID-19 complications and 2 from progression of their metastatic cancer. COVID-19 is rare among the inpatient neurosurgical population. In all cases, patients had multiple comorbidities. All symptomatic patients from the respiratory standpoint had complications during their hospitalization. Deaths of 3 patients who died within 30 days of hospitalization were all related to COVID-19 complications. Neurosurgical procedures were performed only if deemed emergent.


Monitoring chloroquine resistance using Plasmodium falciparum parasites isolated from wild mosquitoes in Tanzania.
Monitoring antimalarial drug resistance is a useful epidemiologic tool and provides early detection of resistance foci. Using DNA extracted from the head/thorax of wild mosquitoes collected from Bagamoyo Coastal Tanzania, samples infected by Plasmodium falciparum (N = 89, in 2002 and N = 249 in 2004) were screened by nested polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP) assay for mutations at Pfcrt76 and Pfmdr1-86 associated with chloroquine (CQ) resistance. The majority of isolates were of single infection (71%), and the prevalence of mutant alleles of Pfcrt76 decreased from 64.5% in 2002 to 16% in 2004; likewise, mutant Pfmdr1-86 alleles decreased from 46.6% to 2.7%. Overall, there was a decline of mutant isolates by a factor of 17 and 4 for Pfmdr1 and Pfcrt, respectively. In contrast, isolates with wild-type alleles increased significantly from < 20% in 2002 to 67.6% for Pfcrt76 and 83.5% for Pfmdr1-86 in 2004. This observation suggest a biologic trend of decrease of CQ mutants and a subsequent increase of CQ susceptible parasites in circulation after the discontinued use of CQ in 2001 as a first-line drug in Tanzania. High prevalence of susceptible P. falciparum found in circulation not only supports other reports of a decline of mutant parasites after a reduction of drug selection pressure but suggests that the fitness cost is high in mutant parasites. Typing parasite isolates from infected mosquitoes, an alternative means of data collection, has the potential to increase the spatial and temporal coverage, and this approach is practical in highly endemic regions of Africa.


Preparation and characterization of glass hollow fiber membrane for water purification applications.
This work discusses the preparation and characterizations of glass hollow fiber membranes prepared using zeolite-5A as a starting material. Zeolite was formed into a hollow fiber configuration using the phase inversion technique. It was later sintered at high temperatures to burn off organic materials and change the zeolite into glass membrane. A preliminary study, that used thermogravimetric analysis (TGA), X-ray diffraction (XRD), and Fourier transform infrared (FTIR), confirmed that zeolite used in this study changed to glass at temperatures above 1000 °C. The glass hollow fiber membranes prepared using the phase inversion technique has three different microstructures, namely (i) sandwich-like structure that originates from inner layer, (ii) sandwich-like that originates from outer layer, and (iii) symmetric sponge like. These variations were influenced by zeolite weight loading and the flow rate of water used to form the lumen. The separation performances of the glass hollow fiber membrane were studied using the pure water permeability and the rejection test of bovine serum albumin (BSA). The glass hollow fiber membrane prepared from using 48 wt% zeolite loading and bore fluid with 9 mL min-1 flow rate has the highest BSA rejection of 85% with the water permeability of 0.7 L m-2 h-1 bar-1. The results showed that the separation performance of glass hollow fiber membranes was in the ultrafiltration range, enabled the retention of solutes with molecular sizes larger than 67 kDa such as milk proteins, endotoxin pyrogen, virus, and colloidal silica.


Evaluation of Tris-Bipyridine Chromium Complexes for Flow Battery Applications: Impact of Bipyridine Ligand Structure on Solubility and Electrochemistry.
This report describes the design, synthesis, solubility, and electrochemistry of a series of tris-bipyridine chromium complexes that exhibit up to six reversible redox couples as well as solubilities approaching 1 M in acetonitrile. We have systematically modified both the ligand structure and the oxidation state of these complexes to gain insights into the factors that impact solubility and electrochemistry. The results provide a set of structure-solubility-electrochemistry relationships to guide the future development of electrolytes for nonaqueous flow batteries. In addition, we have identified a promising candidate from the series of chromium complexes for further electrochemical and battery assessment.


[Modified molecular beacon-based dual real-time PCR for detection of SARS virus and its application].
To develop the modified molecular beacon-based dual fluorescent PCR assays for detection of SARS virus. The assay was applied to the early clinic diagnosis & animal tracking. On the basis of the obtained core sequence of open reading frame 1b of the coronavirus polymerase gene sequences, which was published in GenBank, using modified molecular beacon probe, artifical virus techinique and two different fragments amplification with different fluoresce, one set of primers and probe were designed. Then fluorescent PCR assays for specific and sensitive detection of the SARS virus was established, while the ELISA & the traditional method were used as control. 368 clinical specimens such as the throat swab, serum, feces, and urine from different cases, 52 cell cultures and 50 animal specimens were detected by the molecular beacon-based PCR. The sensitivity of real -time PCR was 10 - 100 copies/ml, there was no cross reaction to other respiratory viruses such as influenza virus etc. Of 368 specimens, 20 were positive by using molecular beacon-based fluorescence PCR. The positive rate of SARS case (10/47) were 21.27%, the positive rate of the throat swab of SARS cases (10/23) were 43.87% . Among 52 SARS cell cultures, 29 were positive. The positive rate of SARS cell cultures was 55.77% . Of 50 animal specimens, 23 were positive. The positive rate was 46%. Furthermore, SARS virus RNA was detected in feces and in serum during the acute phase. The molecular beacon-based PCR is sensitive and specific, it could be applied to the early diagnosis and animal tracking. This molecular beacon-based PCR kit is useful for the different units.


Degradation of MUC7 and MUC5B in human saliva.
Two types of mucins, MUC7 and MUC5B constitute the major salivary glycoproteins, however their metabolic turnover has not been elucidated in detail to date. This study was conducted to examine turnover of MUC7 and MUC5B in saliva, by focusing on the relationship between their deglycosylation and proteolysis. Whole saliva samples were collected from healthy individuals and incubated at 37°C in the presence of various protease inhibitors, sialidase, or a sialidase inhibitor. General degradation patterns of salivary proteins and glycoproteins were examined by SDS-polyacrylamide-gel-electrophoresis. Furthermore, changes of molecular sizes of MUC7 and MUC5B were examined by Western blot analysis. A protein band was identified as MUC7 by Western blot analysis using an antibody recognizing an N-terminal epitope. The MUC7 signal disappeared rapidly after 20-minutes of incubation. In contrast, the band of MUC7 stained for its carbohydrate components remained visible near its original position for a longer time indicating that the rapid loss of Western blot signal was due to the specific removal of the N-termimal epitope. Pretreatment of saliva with sialidase facilitated MUC7 protein degradation when compared with samples without treatment. Furthermore, addition of sialidase inhibitor to saliva prevented proteolysis of N-terminus of MUC7, suggesting that the desialylation is a prerequisite for the degradation of the N-terminal region of MUC7. The protein band corresponding to MUC5B detected in both Western blotting and glycoprotein staining showed little sign of significant degradation upon incubation in saliva up to 9 hours. MUC7 was highly susceptible to specific proteolysis in saliva, though major part of MUC5B was more resistant to degradation. The N-terminal region of MUC7, particularly sensitive to proteolytic degradation, has also been proposed to have distinct biological function such as antibacterial activities. Quick removal of this region may have biologically important implication.


Subvoxel vascular imaging of the midbrain using USPIO-Enhanced MRI.
There is an urgent need for better detection and understanding of vascular abnormalities at the micro-level, where critical vascular nourishment and cellular metabolic changes occur. This is especially the case for structures such as the midbrain where both the feeding and draining vessels are quite small. Being able to monitor and diagnose vascular changes earlier will aid in better understanding the etiology of the disease and in the development of therapeutics. In this work, thirteen healthy volunteers were scanned with a dual echo susceptibility weighted imaging (SWI) sequence, with a resolution of 0.22 × 0.44 × 1 mm3 at 3T. Ultra-small superparamagnetic iron oxides (USPIO) were used to induce an increase in susceptibility in both arteries and veins. Although the increased vascular susceptibility enhances the visibility of small subvoxel vessels, the accompanying strong signal loss of the large vessels deteriorates the local tissue contrast. To overcome this problem, the SWI data were acquired at different time points during a gradual administration (final concentration = 4 mg/kg) of the USPIO agent, Ferumoxytol, and the data was processed to combine the SWI data dynamically, in order to see through these blooming artifacts. The major vessels and their tributaries (such as the collicular artery, peduncular artery, peduncular vein and the lateral mesencephalic vein) were identified on the combined SWI data using arterio-venous maps. Dynamically combined SWI data was then compared with previous histological work to validate that this protocol was able to detect small vessels on the order of 50 μm-100 μm. A complex division-based phase unwrapping was also employed to improve the quality of quantitative susceptibility maps by reducing the artifacts due to aliased voxels at the vessel boundaries. The smallest detectable vessel size was then evaluated by revisiting numerical simulations, using estimated true susceptibilities for the basal vein and the posterior cerebral artery in the presence of Ferumoxytol. These simulations suggest that vessels as small as 50 μm should be visible with the maximum dose of 4 mg/kg.


The clinical use of human leukocyte interferon in viral infections.
This review presents the results of the clinical use of human leukocyte interferon (HLI) in certain diseases with viral etiology. Viral infections with manifestations in the eye, skin, and/or mucous membranes and in the respiratory system were treated with HLI by local application. HLI was incorporated into ointment, oil suspension, powder, dilution for inhalation, and dilution for subcutaneous and subconjunctival injections. The treatment in some of the diseases yielded statistical results that were highly significant in favor of interferon.


[Function and Breakdown of the Neuron-Glia Dual-Layer Super-Network].
Glial cells appear to have the capacity of coding information. Neuronal and glial circuits form a loosely coupled dual-layer super network within the brain. Glial cells react with the excitatory transmitter glutamate released from synapses of neurons and, in turn, release additional glutamate. Thus, they effectively function as excitatory signal amplifiers, with the gain of amplification depending on their cytosolic pH. Activation of metabotropic glutamate receptors in neurons is largely influenced by the state of glial cells. Depending on the state of our mind, an experience can become a lasting memory or fade away. The pH of glial cells at the time of the experience could play a pivotal role in memory formation. Glial function is also susceptible to plasticity. First-time exposure to a brief period of brain hyperactivity results in an acute breakdown of the inter-cellular network of glial cells. Therefore, artificial control of the glial state and glial plasticity may provide a new preventative strategy to manage dementia and epilepsy.


[DNA polymorphism in the Mongolian population. Restriction fragment length polymorphism analysis of mitochondrial DNA].
Restriction enzyme fragment patterns in the D loop and deletion-insertion polymorphism in the V noncoding region of human mitochondrial DNA (mt DNA) were analysed in Mongolian population using the polymerase chain reaction. Polymorphisms were detected and mt DNAs classified into 40 types using seven enzymes--AvaII, BamHI, CfrI131, KpnI, EcoRV, HaeIII RsaI and Asian specific deletion and insertion. The allele frequencies of the polymorphisms and gene diversity were determined. The data obtained for Mongolian population and the literature data were comparatively studied.


Genetic Analysis for the Flag Leaf Heterosis of a Super-Hybrid Rice WFYT025 Combination Using RNA-Seq.
The photosynthetic capacity of flag leaf plays a key role in grain yield in rice. Nevertheless, there are few studies on the heterosis of the rice flag leaf. Therefore, this study focuses on investigating the genetic basis of heterosis for flag leaf in the indica super hybrid rice combination WFYT025 in China using a high-throughput next-generation RNA-seq strategy. We analyzed the gene expression of flag leaf in different environments and different time periods between WFYT025 and its female parent. After obtaining the gene expression profile of the flag leaf, we further investigated the gene regulatory network. Weighted gene expression network analysis (WGCNA) was used to identify the co-expressed gene sets, and a total of 5000 highly expressed genes were divided into 24 co-expression groups. In CHT025, we found 13 WRKY family transcription factors in SDGhps under the environment of early rice and 16 WRKY family genes in SDGhps of under the environment of middle rice. We found nine identical transcription factors in the two stages. Except for five reported TFs, the other four TFs might play an important role in heterosis for grain number and photosynthesis. Transcription factors such as WRKY3, WRKY68, and WRKY77 were found in both environments. To eliminate the influence of the environment, we examined the metabolic pathway with the same SDGhp (SSDGhp) in two environments. There were 312 SSDGhps in total. These SSDGhps mainly focused on the phosphorus metallic process, phosphorylation, plasma membrane, etc. These results provide resources for studying heterosis during super hybrid rice flag leaf development.


Abl protein-tyrosine kinase selects the Crk adapter as a substrate using SH3-binding sites.
To understand the normal and oncogenic functions of the protein-tyrosine kinase Abl, the yeast two-hybrid system has been used for identifying proteins that interact with it. One interacting protein is Crk-I, an SH3/SH2-containing adapter protein that was originally identified as the oncogenic element in the avian sarcoma virus CT10. Direct interaction between the Crk-I SH3 and Abl at novel, approximately 10 amino acid sites just carboxy-terminal to the Abl kinase domain occurs in vitro and in mammalian cells. There is a nearby site specific for binding another adapter, Nck, and these sites also bind Grb-2. When bound to Abl, Crk-I was phosphorylated on tyrosine. Thus, the SH3-binding sites on Abl serve as substrate recognition sites for the relatively nonspecific kinase of Abl. In Crk-I-transformed cells, Crk-I associates with endogenous c-Abl and is phosphorylated on tyrosine. The association of Crk and Abl suggests that Abl could play a role in v-Crk and Crk-I transformation and that normal Abl function may be partly mediated through bound adapter molecules.


Benefits of an Orthopedic Education Research Collaborative: An Innovative Approach.
Background Graduate Medical Education (GME) research in orthopedic surgery is an important but underrepresented subject in the medical literature. It was unknown if orthopedic residency leaders were interested in a surgical education research collaborative (orthopedic collaborative). The objectives of this study were to assess the potential benefit of an orthopedic collaborative from orthopedic residency leaders and investigate the factors associated with the support of a research collaborative within a surgical subspecialty. Methodology An anonymous 19-question survey-based study was distributed through REDCap (Nashville, TN, USA) to orthopedic residency leaders in the United States, from July to October 2020. The main outcome was perceived benefit. Additional aspects included program characteristics, challenges in performing resident education research, and organizational issues such as authorship, frequency of study requests, and governance. Results Almost all orthopedic faculty leadership (99%, 73/74) stated that resident education and faculty development research projects would benefit from an orthopedic education research collaborative. In comparison to unsupportive respondents, younger age (P = 0.006), 15 or fewer years in practice (P = 0.04), and having 0 to 100 peer-reviewed publications (P = 0.047) were associated with support for an orthopedic collaborative. Conclusions Challenges related to survey-based study quality and generalizability at single institutions can benefit from multi-institutional collaboration to develop high-quality studies that capture a representative sample to support orthopedic surgery program development.


[Discovery and confirmation of protein action site AK1 of ginsenosides in brain based on DARTS technology].
This study aims to explore the targets of ginsenosides in brain based on drug affinity responsive target stability(DARTS) technology. Specifically, DARTS technology was combined with label-free liquid chromatography tandem mass spectrometry(LC-MS) to screen out the proteins in the brain that might interact with ginsenosides. Based on the screening results, adenylate kinase 1(AK1) was selected for further confirmation. First, the His-AK1 fusion protein was yielded successively through the construction of recombinant prokaryotic expression vector, expression of target protein, and purification of the fusion protein. Biolayer interferometry(BLI) was employed to detect the direct interaction of Rg_1, Re, Rb_1, Rd, Rh_2, F1, Rh_1, compound K(CK), 25-OH-PPD, protopanaxa-diol(PPD), and protopanaxatriol(PPT) with AK1, thereby screening the ginsenoside monomer or sapogenin that had strong direct interaction with the suspected target protein AK1. Then, the BLI was used to further determine the kinetic parameters for the binding of PPD(strongest interaction with AK1) to His-AK1 fusion protein. Finally, molecular docking technology was applied to analyze the binding properties between the two. With DARTS and LC-MS, multiple differential proteins were screened out, and AK1 was selected based on previous research for target verification. Fusion protein His-AK1 was obtained by prokaryotic expression, and the response(nm) of Re, Rg_1, Rd, Rb_1, Rh_1, Rh_2, F1, PPT, PPD, 25-OH-PPD, and CK with His-AK1 was respectively 0.003 1, 0.001 9, 0.042 8, 0.022 2, 0.013 4, 0.037 3, 0.013 9, 0.030 7, 0.140 2, 0.016 0, and 0.040 8. The K_(on), K_(off), and K_D values of PPD and His-AK1 were determined by the BLI as 1.22×10~2 mol~(-1)·L·s~(-1), 1.04×10~(-2) s~(-1), 8.52×10~(-5) mol·L~(-1). According to the molecular docking result, PPD bound to AK1 with the absolute value of the docking score of 3.438, and hydrogen bonds mainly formed between the two. Thus, AK1 is one of the protein action sites of ginsenosides in the brain. The direct interaction between ginsenoside metabolite PPD and AK1 is the strongest.


The nitric oxide/cyclic GMP pathway in the olfactory processing system of the terrestrial slug Limax marginatus.
To examine the distribution of nitric oxide (NO)-generative cells and NO-responsive cells in the tentacles and procerebral lobes (olfactory processing center) of terrestrial slugs, we applied NADPH diaphorase (NADPH-d) histochemistry and NO-induced cyclic GMP (cGMP)-like immunohistochemistry. We found that NADPH-d reactive cells/fibers and cGMP-like immunoreactive cells/fibers were different, but they were localized adjacent to each other, in both the tentacles and the procerebral lobes. Then, we measured the concentration of NO that was generated around the procerebral lobes using an NO sensitive electrode, when the olfactory nerve was electrically stimulated as a replacement for an odorant stimulus. Stimulation of the olfactory nerve evoked an increase in NO concentration at nanomolar levels, suggesting that binding of nanomolar concentrations of NO to the prosthetic heme group activates soluble guanylyl cyclase. Taken together with previously reported physiological data, our results, therefore, showed that the NO/cGMP pathways are involved in slug olfactory processing.


[Cerebral digital tomosynthetic angiography for planning stereotactic biopsy of brain tumor].
We used cerebral digital tomosynthetic angiography for planning the probe trajectory of stereotactic biopsy of brain tumors in four patients. The probe trajectory was basically planned by MRI examinations. However, cerebral digital tomosynthetic angiography demonstrated detailed three-dimensional vascular anatomy around the brain tumors, and therefore was very helpful in revising the planned trajectory when there was a fairly large vessel likely to cross with it.


[Hypersensitivity angiitis, Henoch-Schönlein purpura].
Pathogenesis and treatment of hypersensitivity angiitis and Henoch-Schönlein purpura were summarized. Both diseases were included in the category of "leukocytoclastic vasculitis". Hypersensitivity angiitis was frequently associated with drug or infectious exposure and the involvement of venules and capillaries. Many patients with this disease have detectable autoantibodies to neutrophil cytoplasmic antigens (ANCA) typically reactive with myeloperoxidase. Henoch-Schönlein purpura was characterized by vasculitis in multiple organs such as the skin, joints, gastrointestinal tract and kidneys. Henoch-Schönlein purpura nephritis revealed marked deposition of IgA (mainly IgA1) and C3 in the glomerular mesangial areas and capillary walls by immunofluorescence. Combinations of intensive plasma exchange, steroids and cyclophosphamide were effective for patients with both diseases.


The dynamic impact of digital finance on green innovation: evidence enterprise-level empirical data in China.
The digital finance generated by technology empowerment profoundly affects the innovative behavior of micro-enterprises. To estimate how digital finance influences the quantity and quality of green technological innovation, this paper introduces digital finance into endogenous economic growth model and further conducts correlation analysis with the combination of fixed effects model (FE) and panel threshold model (PTM). Moreover, this paper investigates the action mechanism from the perspective of financial constraint and financial cost. The empirical results indicate that digital finance improves the quantity and quality of green technological innovation significantly. Compared with the coverage of digital finance and digital services, the impact of usage depth on green innovation accumulates dynamically superimposed in the long term. The digital finance contributes to correct the mismatch of financial resources and further induces inclusive green innovation in the dimension of ownership, growth cycle, and enterprise scale. Mechanism analysis shows that the relief of financial constraint, environmental information disclosure, and increase of R&D investment are the main paths for digital finance to drive green innovation. With the different thresholds, the dynamic evolution process of green innovation driven by digital finance is characterized by "first quantitative change and then qualitative change." This paper suggests that the integration of technological innovation and digital financial services needs to build an inclusive digital financial service system, cultivate diversified financial formats, and improve the market environment of digital financial services.


[Interferons in medicine].
In the last decade, recombinant DNA technology and monoclonal antibodies have allowed the production of great amounts of pure interferons that have been used in clinical trials. Presently, interferons have a defined role in the therapy of infectious and malignant disorders and are widely available both to the specialist and the general practitioner. The aim of the present review is to summarize the main biochemical properties and the molecular mechanisms underlying the broad spectrum of the biological activities of the interferons. Furthermore, on the basis of the results obtained in therapeutical trials, the infectious and neoplastic diseases responsive to therapy with interferons are outlined, along with the most frequent side or toxic effects.


Inhibition of thyroglobulin biosynthesis and degradation by excess iodide. Synergism with lithium.
Lithium and excess iodide inhibit the release of thyroid hormone from preformed stores. We thus tested the hypothesis that this was due to an inhibition of thyroglobulin breakdown. Rats were pre-treated with propyl-thiouracil (PTU) for 3 weeks in order to deplete their thyroids of thyroglobulin. While the PTU was continued, lithium chloride (0.25 mEq./100 g weight) or potassium iodide (3 mg per rat) were injected every 12 h for d days. Thereafter the thyroglobulin content in thyroid gland homogenates was measured. PTU pre-treatment lowered the thyroglobulin content from 4.21 to 0.22 mg/100 mg gland. Lithium caused a marked re-accumulation of thyroglobulin to 0.60 mg/100 mg within 3 days. While iodide alone had only a borderline effect, it markedly potentiated the action of lithium and a combination of the two drugs increased the thyroglobulin content to 1.04 mg/100 mg. Thyroxine was injected into similarly pre-treated animals to suppress secretion of thyrotrophic hormone. This markedly inhibited the proteolysis of thyroglobulin and 1.3 mg/100 mg gland accumulated after 3 days. Excess iodide, given in addition to thyroxine, decreased the amount of thyroglobulin accumulated to 0.75 mg/100 mg gland. To study whether this could be explained by an inhibitory action of iodide on thyroglobulin biosynthesis, thyroid glands from animals treated with excess iodide were incubated in vitro in the presence of 0.2 mM iodide for 3 h. Iodide decreased the incorporation of radioactive leucine into total thyroidal protein and into thyroglobulin by 25 and 35% respectively. Iodide did not inhibit protein synthesis in the kidney, liver or muscle tissue. Thus, large doses of iodide selectively inhibit thyroglobulin biosynthesis.


Environmental Factors Influencing Adoption of Canadian Guidelines on Smoking Cessation in Dental Healthcare Settings in Quebec: A Qualitative Study of Dentists' Perspectives.
Background: This study aimed to understand dentists' perspective of the environmental determinants which positively or negatively influence the implementation of Canadian smoking cessation clinical practice guidelines (5As: Ask-Advise-Assess-Assist-Arrange) in private dental clinics in Quebec. Methods: This study used a qualitative design and an integrative conceptual framework composed of three theoretical perspectives. Data collection was conducted in individual semi-directed interviews with 20 private dentists lasting between 35 and 45 min. The audio-recorded data were transcribed verbatim, followed by a directed content analysis. Results: Some of the barriers identified to counselling in smoking cessation were lack of time, patient attitude, lack of prescription of nicotine replacement therapies, lack of reimbursement, and the lack of training of the dental team. Enablers cited by participants were the style of dentist's leadership, the availability of community, human and material resources, the perception of counselling as a professional duty, and the culture of dental medicine. In addition to these variables, dentists' attitude and behaviour were affected by different organisations giving initial or continual training to dentists, governmental policies, and the compatibility of Canadian smoking cessation guidelines with the practice of dentistry. Conclusion: Our findings will inform the development of smoking cessation interventions in dental healthcare settings.


Cardiac isoform of alpha 2 macroglobulin, an early diagnostic marker for cardiac manifestations in AIDS patients.
This study investigated the possible role of the cardiac isoform of alpha 2-macroglobulin (CA2M) as an early diagnostic marker for HIV-associated cardiovascular manifestations. A total of 349 samples were analysed by Western blot and quantified by sandwich enzyme-linked immunosorbent assay. The levels of CA2M present in sera of HIV-associated cardiac diseases were significantly higher than those of HIV without cardiac involvement and healthy sera. CA2M may act as a novel diagnostic marker to identify cardiac manifestations in HIV/AIDS patients.


Amino acid sequence of the murine Mac-1 alpha chain reveals homology with the integrin family and an additional domain related to von Willebrand factor.
Clones encoding the Mac-1 alpha chain were selected from a mouse macrophage cDNA library by screening with oligonucleotide probes based on the sequence of a genomic clone encoding the N-terminus of the mature protein. The sequence of overlapping clones (4282 nt) was determined and translated into a protein of 1137 amino acids and a signal peptide of 15 amino acids. The Mac-1 sequence was found to be related to the alpha chain sequences of three other members of the integrin family of cell adhesion receptors, i.e. the fibroblast receptors for fibronectin and vitronectin and the platelet glycoprotein IIb/IIIa. All four sequences share a number of structural features, like the position of 13 cysteine residues, a transmembrane domain near the C-terminus and the location of three putative binding sites for divalent cations. Furthermore, a conserved sequence motif is repeated seven times in the N-terminal half of the molecule and three of these repeats include putative Ca/Mg-binding sites of the general structure DXDXDGXXD. On the other hand, Mac-1 contains a unique domain of 220 amino acids inserted into the N-terminal part of the integrin structure. This additional domain is homologous to a repeated domain found in von Willebrand factor, cartilage matrix protein and in the complement factors B and C2. In two of these proteins, the homologous domain is likely to be involved in binding to collagen fibrils. Therefore, Mac-1 may also bind to collagen, which could play a role in the interaction of leukocytes with the subendothelial matrix.


Altered gene structure and tissue expression of islet amyloid polypeptide in the chicken.
In mammals, islet amyloid polypeptide (IAPP) is a putative pancreatic peptide hormone that is coproduced and cosecreted with insulin in the beta-cells. However IAPP is also structurally and functionally similar to calcitonin gene-related peptide (CGRP), a 37-amino acid peptide that is expressed predominantly in neurones, and it has been suggested that these peptides arose from a common ancestral gene. In the present study we have characterized an avian IAPP cDNA and gene and have analyzed their expression in various tissues. The cloned chicken IAPP cDNA encodes a 135-amino acid (aa) precursor in which the mature 37-residue IAPP is 80% identical to human IAPP. However, the N-terminal propeptide of chicken proIAPP (55 aa) is considerably longer than that found in the mammalian proIAPPs (9-12 aa) and is comparable in length to that of chicken proCGRP (52 aa). Most of this additional peptide material was found to be encoded in an exon of the cloned chicken IAPP gene that is homologous to exon 3 in the CGRP gene. This exon is absent in the human IAPP gene and thus the exon-intron organization of the chicken IAPP gene more closely resembles that of mammalian CGRP genes. Northern blot analyses demonstrated that chicken IAPP mRNA is expressed predominantly in intestine and brain but at a much lower level in pancreas. The pancreas and intestine contained a single 0.7 kilobase (kb) IAPP transcript while two transcripts, 0.7 kb and 0.9 kb, were detected in brain. Densitometric analysis indicated that IAPP transcripts were 11 times more abundant in brain and intestine than pancreas.(ABSTRACT TRUNCATED AT 250 WORDS)


UV light-induced duplex-to-duplex crosslinking of DNA molecules in aqueous ethanol solutions.
Ultraviolet light is known to generate crosslinks between the complementary strands of DNA and between DNA and proteins. Here we demonstrate that the UV light also crosslinks DNA duplexes to other DNA duplexes. However, the duplex-to-duplex crosslinks only appear in the presence of about 75% (vol/vol) ethanol plus a millimolar or submillimolar concentration of monovalent or divalent cations, e.g. 2 mM Na+. Methanol or formamide are ineffective. The present observations provide a direct means to detect physical contacts of DNA molecules or their parts, e.g. during recombination. It is remarkable that the solution conditions leading to the duplex-to-duplex UV light-induced crosslink formation are the same as those inducing the B-to-A conformational transition of DNA.


A cost-effectiveness analysis of folic acid fortification policy in the United States.
To quantify the health and economic outcomes associated with changes in folic acid consumption following the fortification of enriched grain products in the USA. Cost-effectiveness analysis. Annual burden of disease, quality-adjusted life years (QALY) and costs were projected for four steady-state strategies: no fortification, or fortifying with 140, 350 or 700 microg folic acid per 100 g enriched grain. The analysis considered four health outcomes: neural tube defects (NTD), myocardial infarctions (MI), colon cancers and B12 deficiency maskings. The US adult population subgroups defined by age, gender and race/ethnicity, with folate intake distributions from the National Health and Nutrition Examination Surveys (1988-1992 and 1999-2000), and reference sources for disease incidence, utility and economic estimates. The greatest benefits from fortification were predicted in MI prevention, with 16 862 and 88 172 cases averted per year in steady state for the 140 and 700 microg fortification levels, respectively. These projections were between 6261 and 38 805 for colon cancer and 182 and 1423 for NTD, while 15-820 additional B12 cases were predicted. Compared with no fortification, all post-fortification strategies provided QALY gains and cost savings for all subgroups, with predicted population benefits of 266 649 QALY gained and $3.6 billion saved in the long run by changing the fortification level from 140 microg/100 g enriched grain to 700 microg/100 g. The present study indicates that the health and economic gains of folic acid fortification far outweigh the losses for the US population, and that increasing the level of fortification deserves further consideration to maximise net gains.


Erratum: βKlotho is identified as a target for theranostics in non-small cell lung cancer: Erratum.
[This corrects the article DOI: 10.7150/thno.35582.].


Dose-dependent role of the cohesin complex in normal and malignant hematopoiesis.
Cohesin complex members have recently been identified as putative tumor suppressors in hematologic and epithelial malignancies. The cohesin complex guides chromosome segregation; however, cohesin mutant leukemias do not show genomic instability. We hypothesized that reduced cohesin function alters chromatin structure and disrupts cis-regulatory architecture of hematopoietic progenitors. We investigated the consequences of Smc3 deletion in normal and malignant hematopoiesis. Biallelic Smc3 loss induced bone marrow aplasia with premature sister chromatid separation and revealed an absolute requirement for cohesin in hematopoietic stem cell (HSC) function. In contrast, Smc3 haploinsufficiency increased self-renewal in vitro and in vivo, including competitive transplantation. Smc3 haploinsufficiency reduced coordinated transcriptional output, including reduced expression of transcription factors and other genes associated with lineage commitment. Smc3 haploinsufficiency cooperated with Flt3-ITD to induce acute leukemia in vivo, with potentiated Stat5 signaling and altered nucleolar topology. These data establish a dose dependency for cohesin in regulating chromatin structure and HSC function.


An Empirically Derived Pediatric Cardiac Inotrope Score Associated With Pediatric Heart Surgery.
We aimed to empirically derive an inotrope score to predict real-time outcomes using the doses of inotropes after pediatric cardiac surgery. The outcomes evaluated included in-hospital mortality, prolonged hospital length of stay, and composite poor outcome (mortality or prolonged hospital length of stay). The study population included patients <18 years of age undergoing heart operations (with or without cardiopulmonary bypass) of varying complexity. To create this novel pediatric cardiac inotrope score (PCIS), we collected the data on the highest doses of 4 commonly used inotropes (epinephrine, norepinephrine, dopamine, and milrinone) in the first 24 hours after heart operation. We employed a hierarchical framework by representing discrete probability models with continuous latent variables that depended on the dosage of drugs for a particular patient. We used Bayesian conditional probit regression to model the effects of the inotropes on the mean of the latent variables. We then used Markov chain Monte Carlo simulations for simulating posterior samples to create a score function for each of the study outcomes. The training dataset utilized 1030 patients to make the scientific model. An online calculator for the tool can be accessed at https://soipredictiontool.shinyapps.io/InotropeScoreApp. The newly proposed empiric PCIS demonstrated a high degree of discrimination for predicting study outcomes in children undergoing heart operations. The newly proposed empiric PCIS provides a novel measure to predict real-time outcomes using the doses of inotropes among children undergoing heart operations of varying complexity.


Self-handicapping strategies in educational context: construction and validation of the Brazilian Self-Handicapping Strategies Scale (EEAPREJ).
Self-handicapping strategies refer to the set of choices and attitudes adopted to minimize blame for failure and increase the value of success in achievement situations. This paper aims to describe the stages of construction and the psychometric analysis of a scale to measure the self-handicapping strategies of university students. In study 1, the major steps for the construction of the scales and initial results are reported. The internal consistency indices were acceptable and the principal component analysis revealed factors with little explanation of data variance. In study 2, data from a sample of 834 students from several undergraduate courses of different Brazilian universities were subjected to exploratory factor analysis using the minimum rank factor analysis (MRFA) method and the matrix of polychoric correlations. The parallel analysis criterion for factor retention indicated the one-factor solution as the best fit to data. The importance of having a valid and reliable measure to assess self-handicapping strategies in educational contexts and the promising use of the scale in actions to improve learning in higher education are discussed.


Rethinking cultural safety while waiting to do fieldwork: methodological implications for nursing research.
The concept of culture has been widely applied as an explanatory concept within health care, often within a framework representing culture as a fixed, reified entity, with cultural groups existing in a binary sense vis-;-vis mainstream culture. However, if our scholarship is to generate knowledge that addresses longstanding patterns of inclusion and exclusion along lines such as race, ethnicity, class, and gender, interpretive frames are needed that account for culture as embedded in fields of power relations; as mediated by social forces such as economics, politics, and historical patterns of oppression and colonization; and as being constantly renegotiated. In this article we trace a series of theoretical explorations, centered on the concept of cultural safety, with corresponding methodological implications, engaged in during preparation for an intensive period of fieldwork to study the hospitalization and help-seeking experiences of diverse ethnocultural populations.


Role of Resistin in Various Diseases with Special Emphasis on Periodontal and Periapical Inflammation - A Review.
Resistin is a small adipocyte-specific secretory hormone molecule. It has been associated with a number of cellular and metabolic processes. It has also been essentially implicated to have a vital role in the interplay between insulin resistance, obesity, and type II diabetes. Numerous clinical studies have demonstrated an association between many pathological illnesses with elevated serum resistin levels. It has also been shown to affect and modulate various molecular processes such as atherosclerosis, cancer cell metabolism, and inflammation. Periodontitis is a widespread inflammatory disease affecting human beings. Periapical periodontitis is an inflammatory disease that manifests as a sequela of untreated dental caries. Therefore, in this article, we summarize the divergent physiological roles played by resistin and its association with the mechanism of various pathologies. Moreover, current scientific studies discussing its association and role in common dental pathologies, periodontitis, and apical periodontitis are reviewed.


Enhanced efficacy of porcine lung surfactant extract by utilization of its aqueous swelling dynamics.
This study investigates the interactions between a porcine lung surfactant (PLS) extract and distilled water, saline solution or Ringer solution. The phases which coexist in equilibrium with water or electrolyte solutions were analysed by X-ray diffraction and cryo transmission electron microscopy (cryo-TEM). A lamellar phase with a structure unit consisting of double bilayers was observed in water, whereas lamellar phases with the usual bilayer structure unit were formed in saline and in Ringer solutions. At 25 degrees C the presence of a 4.2-A peak in the X-ray diffraction wide-angle region of these three maximally swollen phases showed that most of the hydrocarbon chains were organized in a crystalline packing. At 42 degrees C the chains in all three phases were melted which, in combination with the low-angle diffraction, shows that they were liquid-crystalline. Polyhedral-like vesicles and spherically shaped multilamellar vesicles were observed in cryo-TEM. The bilayer unit structures were consistent with the periodicity seen by X-ray diffraction. The dynamic swelling behaviour was followed in the polarizing microscope. A remarkable growth of birefringent networks was seen at the air interface of samples swollen in Ringer solution and saline solution. No such interfacial growth phenomena were observed during swelling in water without electrolytes. Then, these dynamics were analysed in relation to time-dependent pulmonary administration of the surfactant extract in rats. Variation in the time of administration (20 and 60 min) after mixing the extract with saline or Ringer solution showed clear differences in physiological effects. At pulmonary administration when the swelling behaviour in vitro showed a maximum in dynamics, the arterial oxygenation was superior to that of administration at a time after a steady-state had been reached. This means that the clinical performance of mammalian lung surfactant extracts can be significantly improved by taking the time-dependent aqueous swelling of the extract into account.


Developmentally-regulated excision of the SPβ prophage reconstitutes a gene required for spore envelope maturation in Bacillus subtilis.
Temperate phages infect bacteria by injecting their DNA into bacterial cells, where it becomes incorporated into the host genome as a prophage. In the genome of Bacillus subtilis 168, an active prophage, SPβ, is inserted into a polysaccharide synthesis gene, spsM. Here, we show that a rearrangement occurs during sporulation to reconstitute a functional composite spsM gene by precise excision of SPβ from the chromosome. SPβ excision requires a putative site-specific recombinase, SprA, and an accessory protein, SprB. A minimized SPβ, where all the SPβ genes were deleted, except sprA and sprB, retained the SPβ excision activity during sporulation, demonstrating that sprA and sprB are necessary and sufficient for the excision. While expression of sprA was observed during vegetative growth, sprB was induced during sporulation and upon mitomycin C treatment, which triggers the phage lytic cycle. We also demonstrated that overexpression of sprB (but not of sprA) resulted in SPβ prophage excision without triggering the lytic cycle. These results suggest that sprB is the factor that controls the timing of phage excision. Furthermore, we provide evidence that spsM is essential for the addition of polysaccharides to the spore envelope. The presence of polysaccharides on the spore surface renders the spore hydrophilic in water. This property may be beneficial in allowing spores to disperse in natural environments via water flow. A similar rearrangement occurs in Bacillus amyloliquefaciens FZB42, where a SPβ-like element is excised during sporulation to reconstitute a polysaccharide synthesis gene, suggesting that this type of gene rearrangement is common in spore-forming bacteria because it can be spread by phage infection.


Activation of Dinitrogen by Polynuclear Metal Complexes.
Activation of dinitrogen plays an important role in daily anthropogenic life, and the processes by which this fixation occurs have been a longstanding and significant research focus within the community. One of the major fields of dinitrogen activation research is the use of multimetallic compounds to reduce and/or activate N2 into a more useful nitrogen-atom source, such as ammonia. Here we report a comprehensive review of multimetallic-dinitrogen complexes and their utility toward N2 activation, beginning with the d-block metals from Group 4 to Group 11, then extending to Group 13 (which is exclusively populated by B complexes), and finally the rare-earth and actinide species. The review considers all polynuclear metal aggregates containing two or more metal centers in which dinitrogen is coordinated or activated (i.e., partial or complete cleavage of the N2 triple bond in the observed product). Our survey includes complexes in which mononuclear N2 complexes are used as building blocks to generate homo- or heteromultimetallic dinitrogen species, which allow one to evaluate the potential of heterometallic species for dinitrogen activation. We highlight some of the common trends throughout the periodic table, such as the differences between coordination modes as it relates to N2 activation and potential functionalization and the effect of polarizing the bridging N2 ligand by employing different metal ions of differing Lewis acidities. By providing this comprehensive treatment of polynuclear metal dinitrogen species, this Review aims to outline the past and provide potential future directions for continued research in this area.


Practice of end-of-life care for patients with advanced dementia by hospital physicians and nurses: Comparison between medical and surgical wards.
Patients with advanced dementia are commonly hospitalized in acute care wards, yet there is limited data regarding the end-of-life (EOL) care delivered to this population. The aim of the study was to examine EOL care delivered to patients with advanced dementia hospitalized on acute wards as reported by physicians and nurses. Participants were physicians and nurses from medical and surgical wards of two tertiary hospitals in Israel. Participants completed a self-report questionnaire evaluating EOL care experiences, knowledge, performance, assessment, communication, and perceived futile care regarding patients with dementia. The questionnaire was completed by 315 providers. There were 190 medical ward respondents and 125 from general surgical wards. Of them, 48.6% recognized dementia as a terminal disease, while 26.0% of the participants reported that they knew the end-of-life preferences for less than 10% of their patients. Among the providers, 53.3% reported that end-of-life ward discussions took place only when there was a life-threatening situation and 11.1%-16.5% never engaged in end-of-life communication regarding EOL patient's preferences, appointing an attorney for the patient, disease trajectory or the essence of palliative care, with patients or their representatives. Only 17.1% reported "never" performing care they considered to be futile for patients with advanced dementia. Controlling for gender, age, role, position (senior/junior), and exposure to patients with advanced dementia, surgical ward respondents reported performing less EOL care than medical ward respondents in almost all aspects of palliative care. Despite growing attention, a significant portion of staff in acute care wards do not report applying EOL care to patients with advanced dementia in clinical practice, especially surgical ward staff.


Sympathetic blockade and amitriptyline in the treatment of reflex sympathetic dystrophy.
We prospectively investigated the outcome of a combination therapy of oral amitriptyline and sympathetic ganglion blockade on 10 patients suffering from reflex sympathetic dystrophy of the upper extremity for at least three months. The efficacy of the treatment was evaluated by clinical examination, pain ratings on the visual analogue scale (VAS) and grip strength measurements using the Jamar dynamometer. The results were statistically analysed with Wilcoxon signed-ranks test for comparison of the before and after treatment grip strength measurements and with paired t-test for comparison of the mean of initial and consecutive pain ratings on the VAS. Values of p < 0.01 were considered to be statistically significant. Combination therapy proved beneficial in this particular patient population, which, as far as previously documented studies are concerned, would otherwise respond less favourably to a treatment consisting solely of sympathetic blockade.


Quercetin and Ferulic Acid Elicit Estrogenic Activities In Vivo and In Silico.
In this study, we examined the sub-acute toxicity of quercetin and ferulic acid and evaluated their effects on protein, cholesterol, and estrogen levels in vivo. Six groups of female Wistar rats were fed by gavage. The first and second groups represent the positive (Clomiphene citrate 10 mg/kg) and negative (NaCl 0.9%) control groups, while the other groups received quercetin and ferulic acid at doses of 5 and 10 mg/kg/day for 28 days. The sub-acute toxicity was monitored by examining the weights, biochemical parameters (AST, ALT, ALP, urea, and CREA), and histological changes in the kidneys and liver of the treated animals. Furthermore, the in vivo estrogenic effects were studied in terms of the serum and ovarian cholesterol levels, serum estradiol, and uterine proteins. Finally, Docking studies were conducted to evaluate the binding affinity of quercetin and ferulic acid for alpha and beta estrogen receptors. Results showed that both compounds were devoid of any signs of nephrotoxicity or hepatotoxicity. Additionally, quercetin and ferulic acid caused significant estrogenic effects evidenced by an increase of 8.7 to 22.48% in serum estradiol, though to a lesser amount than in the reference drug-treated group (64.21%). Moreover, the two compounds decreased the serum cholesterol levels (12.26-32.75%) as well as the ovarian cholesterol level (11.9% to 41.50%) compared to the negative control. The molecular docking in estrogen alpha and estrogen beta active sites showed high affinity of quercetin (-10.444 kcal/mol for estrogen alpha and -10.662 kcal/mol for estrogen beta) and ferulic acid (-6.377 kcal/mol for estrogen alpha and -6.3 kcal/mol for estrogen beta) to these receptors. This study provides promising insights into the potential use of quercetin as a therapeutic agent for the management of female fertility issues.


Case Report: Tumor-to-tumor metastasis with prostate cancer metastatic to lung cancer: the first reported case.
Tumor-to-tumor metastasis (TTM) occurs rarely in tumor progression, but this event has significant clinical implications. Although the impact of TTM on patient prognosis and survival has been increasingly recognized, understanding of TTM biology and treatment is limited. Prostate cancer is among the most common malignancies threatening male health. Prostate cancer can potentially metastasize to primary lung Cancer; however, this is an exceedingly rare event. We here report for the first time a case of TTM from a prostate cancer to a coexisting primary lung cancer.


Diabetes Resolution and Work Absenteeism After Gastric Bypass: a 6-Year Study.
Obesity-related diseases cause costs to society. We studied the cost of work absenteeism before and after gastric bypass and the effects of postoperative diabetes resolution. Data were obtained from the Scandinavian Obesity Surgery Registry (SOReg) (national coverage >98%) and cross-matched with data from the Social insurance Agency (coverage 100%) for the period ±3 years from operation. In 2010, a total of 7454 bariatric surgeries were performed; the study group is 4971 unique individuals with an annual income of >10,750 Euros and complete data sets. A sex-, age-, and income-matched reference population was identified for comparison. Patients with obesity had preoperatively a 3.5-fold higher absenteeism. During follow-up (FU), the ratio relative to the reference population remained constant. An increase of 12-14 net absenteeism days was observed in the first 3 months after surgery. Female sex (OR 1.5, CI 1.13-1.8), preoperative anti-depressant use (OR 1.5, CI 1.3-1.9), low income (OR 1.4, CI 1.2-1.8), and a history of sick leave (OR 1.004, CI 1.003-1.004) were associated with increased absenteeism during FU. Diabetes resolution did not decrease absenteeism from preoperative values. Patients with obesity have higher preoperative absenteeism than the reference population. Operation caused an increase the first 90 days after surgery of 12-13 days. There were no relative increases in absenteeism in the next 3 years; patients did not deviate from preoperative patterns but followed the trend of the reference population. Preoperative diabetes did not elevate that level during FU; diabetes resolution did not lower absenteeism.


Rapid inhalation induction with high concentration of sevoflurane using a new vaporizer.
Sevoflurane allows a moderately rapid induction with only slight problems of induction. However, it has not been possible to conduct tests with more than 2.6 minimum alveolar concentration (MAC) of sevoflurane (4.5%) because of the limitations in the performance of the currently available vaporizer. We tested the performance of a new vaporizer and tried it with single breath induction. The new vaporizer could deliver a 4.3 MAC (7.5%) sevoflurane through oxygen of 8 liter/min. Twenty-one unpremedicated volunteers breathed 7.5% sevoflurane in oxygen. The mean time for induction of anesthesia was 48 +/- 16 seconds, reflecting its high concentration and low blood/gas solubility. Although coughing was observed in two subjects, laryngospasm, breath holding, and secretions did not occur during induction by this method. All subjects except one would be willing to undergo similar induction again. This study demonstrate that the new vaporizer can be used to administer 7.5% concentration of sevoflurane and to adequately perform smooth and rapid inhalation induction of anesthesia in young volunteers without premedication.


Positive and protective: effects of early theory of mind on problem behaviors in at-risk preschoolers.
Exposure to harsh parenting and children's skills in 'Theory of Mind' (ToM) show independent and interacting associations with problem behaviors at age 2 (Hughes & Ensor, 2006). This study examined whether these age-2 measures also predict age-4 problem behaviors. In a socially diverse sample (N = 120), multi-informant, multi-measure, multi-setting ratings indexed problem behaviors at ages 2, 3 and 4; children completed both ToM and verbal-ability tasks at age 2, while video-based ratings of maternal negative affect and control within dyadic mother-child play indexed harsh parenting. Age-2 harsh parenting and ToM were independent and interacting predictors of age-4 problem behaviors, even with age-2 problem behaviors, verbal ability and social disadvantage all controlled. The interaction between harsh parenting and ToM distinguished persistent vs. diminishing problem behaviors. Both child and family characteristics predict increases in problem behaviors from 2 to 4; adverse effects of harsh parenting are attenuated for children with good ToM skills.