[Neuropsychological deficits, obstetric complications and premorbid adjustment in patients with the first psychotic episode].
In spite of the great number of studies that have proved the existence of cognitive disturbances in schizophrenic subjects, conflicting results have not allowed to glimpse a typical pattern of neuropsychological deficits in schizophrenia. On the contrary, these results have raised important controversies regarding the nature of such cognitive impairment. Thus, questions concerning the existence of generalized versus focal cognitive impairment or in relation lo the static versus progressive nature of these deficits remain unresolved. In the middle of these debates, the need for prospective research, which focuses on the neuropsychological deficits of schizophrenia and other psychotic disorders from the beginning of the illness, has been pointed out. In these lines we present the results obtained in our study in which 59 subjects, who were admitted in our hospital for presenting a first psychotic episode, were assessed. Measures of premorbid adjustment, obstetric complications and clinical symptoms were taken and correlated to measures of cognitive performance obtained by using a minibattery of neuropsychological tests at time of dismissal. Results showed, as in previous research, that neuropsychological deficits are already present in psychotic patients at the beginning of the illness. These deficits in our sample were related lo obstetric complications especially in males, and disturbances of premorbid adjustment occurred in early stages of development. These results support the neurodevelopmental hypothesis of schizophrenia.


Multifocal leukoencephalopathy in cocaine users: a report of two cases and review of the literature.
Cocaine abuse is associated with several mechanisms of brain injury including ischemic, hemorrhagic and metabolic. Recently two case reports of leukoencephalopathy in cocaine users implicated a commonly used cocaine adulterant, levamisole. One well-documented adverse effect of levamisole, when used alone as antihelminthic or immunomodulatory drug, is multifocal inflammatory leukoencephalopathy. Therefore, immune mechanisms may also contribute to cocaine-induced brain injury. Two cocaine users with multifocal leukoencephalopathy, treated with steroids and plasmapheresis, are described. The first is a 25-year-old man who presented with unilateral motor and sensory impairment progressing to bilateral deficits, dysphagia, dysarthria and confusion over several days. Serial MRI showed increasing abnormal FLAIR signal lesions with patchy restricted diffusion and heterogenous enhancement deep in the right and left hemispheres, including periventricular white matter as well as in the pons and cerebellar peduncle. The second patient is a 41-year-old woman who presented with confusion and impaired balance. MRI showed bilateral periventricular FLAIR lesions with scattered restricted diffusion and subtle gadolinium enhancement of some of the lesions. She initially stabilized with supportive care only, but after further cocaine use was re-admitted six weeks later with marked neurological deterioration and MRI showed prominent worsening of the lesions. Both patients received steroid and plasma exchange and showed substantial improvement clinically and on imaging, which was sustained during out-patient follow-up. Multifocal leukoencephalopathy associated with cocaine use may have an inflammatory/immune basis, possibly related to levamisole contamination, at least in some patients. Three cases, including the present two, have been described wherein good neurological improvement was seen in association with steroid treatment. However, in the absence of appropriate clinical trials, it remains unknown whether immunotherapy is truly beneficial for these patients.


Cortical modulation of spatial and angular tuning maps in the rat thalamus.
The massive feedback projections from cortex to the thalamus modulate sensory information transmission in many ways. We investigated the role of corticothalamic feedback projections on the directional selectivity (angular tuning) of neurons in the rat ventral posterior medial (VPM) nucleus to stimulation of their principal whisker. The angular tuning properties of single VPM neurons were compared before and after epochs of electrical stimulation of layer VI feedback neurons in the ipsilateral cortex under urethane anesthesia. Microstimulation of layer VI in "matched" (homologous) barrel columns sharpens the angular tuning curves of single VPM neurons that are tuned to the same direction as the stimulation site in the cortex. Further, microstimulation rotates the angular preference of VPM neurons initially tuned to a different direction toward the direction that cortical neurons prefer. Stimulation in "mismatched" (nonhomologous) barrel columns suppresses responses without consistent effects on angular tuning. We conclude that the primary sensory cortex exerts a significant influence on both spatial and angular tuning maps in the relay nuclei that project to it. The results suggest that the tuning properties of VPM cells in the behaving animal are continually modified to optimize perception of the most salient incoming messages.


New drugs, new techniques, new indications in pediatric regional anesthesia.
The use of regional anesthesia in children represents one of the most effective methods for perioperative analgesia and postoperative pain control. Things have been dramatically changed in the last two decades due to the appearance of new safer drugs and new tools; moreover new techniques were introduced showing their efficacy. In this paper we briefly describe the efficacy of new local anesthetics and adjuvants; we review the use of continuous peripheral blocks and other not very diffused techniques of regional anesthesia.


Neoadjuvant chemotherapy with vinorelbine-containing regimens in elderly patients with locally advanced breast cancer.
The purpose of this study was to evaluate retrospectively the efficacy and safety of neoadjuvant chemotherapy with vinorelbine-containing regimens in elderly patient with locally advanced breast cancer (LABC). From 2002 to 2006, 14 female elderly patients with LABC underwent neoadjuvant chemotherapy with vinorelbine-containing regimens. Vinorelbine alone or in combination with pirarubicin/epirubicin was administered every 3 weeks (25 mg/m2, i.v., day 1 and day 8). All 14 patients received 2-6 cycles of chemotherapy. The median age was 68.5 years (range 65 to 78 years). Six patients had stage IIIA breast tumor, 7 stage IIIB and 1 stage IIIC. There was 1 complete response and 10 partial responses, with an overall response rate of 78.57%, and stable disease in 3 patients (21.43%); there were no patients with progressive disease before surgery. After a median follow-up of 35 months, the estimated 3-year disease-free and overall survival rates were 57% and 69%, respectively. The results of the current study showed that vinorelbine-containing neoadjuvant chemotherapy was effective and well-tolerated in elderly patients with LABC.


Multicystic dysplastic kidney: conservative management and follow-up.
This study reports our experience in the conservative management of multicystic dysplastic kidney (MCDK) disease. Between 1992 and 2003, 35 children, 18 male (51.4%) and 17 female (48.6%), were diagnosed with MCDK and prospectively followed at the Riyadh Armed Forces Hospital. Static scintigraphy with dimercaptosuccinic acid and micturating cystourethrogram were performed in all patients. Ultrasonography (US) examinations were conducted every 3 months, and then annually. Mean age at diagnosis during the postnatal period was 2.4 days. Median follow-up time was 33.75 months. Follow-up US examinations showed partial involution in 17 (48.6%), complete involution in 13 (37.1%), and 5 (14.3%) showed an unchanged size without any pathological manifestations. The mean age at complete or partial involution of the lesion was 43.7 months. No child developed complications such as hypertension or tumors, and all maintained normal growth and development. In conclusion, MCDK lesions are often benign, and the affected kidneys tend to show involution with time.


Postoperative chylous ascites: a rare complication of laparoscopic Nissen fundoplication.
The accumulation of chylous fluid in the abdominal cavity is an infrequent, yet alarming, complication in abdominal surgery. Laparoscopic fundoplication has assumed a central role in the surgical treatment of gastroesophageal reflux disease and is significantly altering the balance of therapy toward more common and earlier surgical intervention. We report the case of a 67-year-old woman with gastroesophageal reflux disease and intense esophagitis who underwent a laparoscopic Nissen fundoplication in February 2000. The procedure was performed without apparent complications. Twenty days later, the patient complained of abdominal pain and distension. Ultrasonography showed ascites, whereas endoscopic and radiological exploration of the fundoplication demonstrated no abnormalities. A paracentesis was performed, which showed a milky fluid with high concentrations of triglycerides (1024 ng/dL) and cholesterol (241 ng/dL). The patient was treated successfully with total parenteral nutrition for 3 weeks, followed by a low-fat diet. To our knowledge, this is the third reported case of chylous ascites after a Nissen fundoplication and the second case after laparoscopic fundoplication. The development of chylous ascites seems to be related to the injury of lymphatic vessels, including the thoracic duct, during the retroesophageal window dissection. The careful dissection and judicious use of diathermy is proposed to prevent this rare complication.


Mediastinitis: a life-threatening complication of acute tonsillitis.
Acute tonsillitis is a common condition and usually runs a benign course. However life-threatening complications do still occur, even in this postantibiotic era. Infection can spread downwards into the mediastinum through the anatomic cervical spaces, causing widespread cellulitis, necrosis, abscess formation and sepsis. We present a case of descending mediastinitis in an 18-year-old woman, arising from her first episode of tonsillitis and treated successfully by surgical drainage. We believe that an awareness of this complication, early diagnosis using computed tomography scanning, and prompt, adequate surgical drainage will reduce morbidity and mortality.


Machine Learning-based Characterization of Longitudinal Health Care Utilization Among Patients With Inflammatory Bowel Diseases.
Inflammatory bowel disease (IBD) is associated with increased health care utilization. Forecasting of high resource utilizers could improve resource allocation. In this study, we aimed to develop machine learning models (1) to cluster patients according to clinical utilization patterns and (2) to predict longitudinal utilization patterns based on readily available baseline clinical characteristics. We conducted a retrospective study of adults with IBD at 2 academic centers between 2015 and 2021. Outcomes included different clinical encounters, new prescriptions of corticosteroids, and initiation of biologic therapy. Machine learning models were developed to characterize health care utilization. Poisson regression compared frequencies of clinical encounters. A total of 1174 IBD patients were followed for more than 5673 12-month observational windows. The clustering method separated patients according to low, medium, and high resource utilizers. In Poisson regression models, compared with low resource utilizers, moderate and high resource utilizers had significantly higher rates of each encounter type. Comparing moderate and high resource utilizers, the latter had greater utilization of each encounter type, except for telephone encounters and biologic therapy initiation. Machine learning models predicted longitudinal health care utilization with 81% to 85% accuracy (area under the receiver operating characteristic curve 0.84-0.90); these were superior to ordinal regression and random choice methods. Machine learning models were able to cluster individuals according to relative health care resource utilization and to accurately predict longitudinal resource utilization using baseline clinical factors. Integration of such models into the electronic medical records could provide a powerful semiautomated tool to guide patient risk assessment, targeted care coordination, and more efficient resource allocation.


Down-regulation of Forkhead box protein A1 (FOXA1) leads to cancer stem cell-like properties in tamoxifen-resistant breast cancer cells through induction of interleukin-6.
The selective estrogen receptor (ER) modulator tamoxifen inhibits ER signaling in breast cancer cells, and it is used for the treatment of ER-positive breast cancer. However, this type of cancer often acquires resistance to tamoxifen, and a better understanding of the molecular mechanisms underlying tamoxifen resistance is required. In this study, we established tamoxifen-resistant (TAM-R) breast cancer cells by long-term tamoxifen treatment of ER-positive breast cancer MCF7 cells. In TAM-R cells, expression of not only ERα, a major form of ER in breast cancer, but also its transcriptional partner forkhead box protein A1 (FOXA1) was found to be reduced. In contrast, activation of the transcription factor nuclear factor-κB (NF-κB) and expression of its target IL6 were increased in these cells. Stable expression of FOXA1, but not ERα, reduced the expression of IL6 in the FOXA1- and ERα-negative breast cancer MDA-MB-231 cells and TAM-R cells, without affecting the activation of the NF-κB signaling pathways. Conversely, FOXA1 knockdown induced IL6 expression in MCF7 cells. Chromatin immunoprecipitation assays revealed that FOXA1 bound to the promoter region of IL6 and repressed recruitment of the NF-κB complex to this region. TAM-R cells were found to have high mammosphere-forming activity, characteristics of cancer stem cells, and this activity was suppressed by NF-κB and IL6 signaling inhibitors. Taken together, these results suggest that FOXA1 suppresses expression of IL6 through inhibition of NF-κB recruitment to the IL6 promoter in an ERα-independent manner and that reduction in FOXA1 expression induces IL6 expression and contributes to cancer stem cell-like properties in TAM-R cells.


Alternatives to oral estrogen replacement. Transdermal patches, percutaneous gels, vaginal creams and rings, implants, other methods of delivery.
Alternatives to oral estrogen replacement, including the transdermal patch, deliver estradiol in a constant manner, produce more physiologic estrone and estradiol levels than oral therapy, and avoid the first-pass effect on hepatic protein synthesis. Transdermal patches and estradiol implants have been demonstrated to produce favorable lipid profiles, prevent bone loss, relieve vasomotor symptoms, and improve urogenital atrophy. Vaginal estrogen is an effective treatment for vaginal atrophy. The advantages and disadvantages of each of the hormonal alternatives to oral estrogen replacement are discussed.


Second cancers in patients with neuroendocrine tumors.
Second cancers have been reported to occur in 10-20% of patients with neuroendocrine tumors (NETs). However, most published studies used data from a single institution or focused only on specific sites of NETs. In addition, most of these studies included second cancers diagnosed concurrently with NETs, making it difficult to assess the temporality and determine the exact incidence of second cancers. In this nationwide population-based study, we used data recorded by the Taiwan Cancer Registry (TCR) to analyze the incidence and distribution of second cancers after the diagnosis of NETs. NET cases diagnosed from January 1, 1996 to December 31, 2006 were identified from the TCR. The data on the occurrence of second cancers were ascertained up to December 31, 2008. Standardized incidence ratios (SIRs) of second cancers were calculated based on the cancer incidence rates of the general population. Cox-proportional hazards regression analysis was performed to estimate the hazard ratio (HR) and 95% confidence interval (CI) for the risk of second cancers associated with sex, age, and primary NET sites. A total of 1,350 newly diagnosed NET cases were identified according to the selection criteria. Among the 1,350 NET patients, 49 (3.63%) developed a second cancer >3 months after the diagnosis of NET. The risk of second cancer following NETs was increased compared to the general population (SIR = 1.48, 95% CI: 1.09-1.96), especially among those diagnosed at age 70 or older (HR = 5.08, 95% CI = 1.69-15.22). There appeared to be no preference of second cancer type according to the primary sites of NETs. Our study showed that the risk of second cancer following NETs is increased, especially among those diagnosed at age 70 or older. Close monitoring for the occurrence of second cancers after the diagnosis of NETs is warranted.


The friend number paradox.
We identify a friend number paradox, that is, a mismatch between people's preferences for the friends they might acquire in social interactions and their predictions of others' preferences. People predict that others are attracted to them if they have a relatively large number of friends. However, they personally prefer to make friends with someone who has a relatively small number of friends. People regard a large number of friends as a signal of social capital that increases their interpersonal attractiveness. However, it can actually be a signal of social liabilities that diminish their ability to reciprocate obligations to others. We conducted a series of studies, including 3 speed-friending studies in which participants either engaged or expected to engage in actual interactions for the purpose of initiating long-term friendships. These studies provide converging evidence of the hypothesized mismatch and our conceptualization of its determinants. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Biodistribution, dosimetry, and temporal signal-to-noise ratio analyses of normal and cancer uptake of [68Ga]Ga-P15-041, a gallium-68 labeled bisphosphonate, from first-in-human studies.
[68Ga]Ga-P15-041 ([68Ga]Ga-HBED-CC-BP) is a novel bone-seeking PET radiotracer that can be generator-produced. We undertook a Phase 0/I clinical trial to assess its potential for imaging bone metastases in prostate cancer including assessment of radiotracer biodistribution and dosimetry. Subjects with prostate cancer and known or suspected osseous metastatic disease were enrolled into one of two arms: dosimetry or dynamic. Dosimetry was performed with 6 whole body PET acquisitions and urine collection spanning 3 h; normal organ dosimetry was calculated using OLINDA/EXM. Dynamic imaging included a 60 min acquisition over a site of known or suspected disease followed by two whole body scans. Bootstrapping and subsampling of the acquired list-mode data were conducted to recommend image acquisition parameters for future clinical trials. Up to 233 MBq (6.3 mCi) of [68Ga]Ga-P15-041 was injected into 12 enrolled volunteers, 8 in dosimetry and 4 in dynamic cohorts. Radiotracer accumulated in known bone lesions and cleared rapidly from blood and soft tissue. The highest individual organ dose was 0.135 mSv/MBq in the urinary bladder wall. The average effective dose was 0.0173 ± 0.0036 mSv/MBq. An average injected activity of 166.5 MBq (4.5 mCi) resulted in absorbed dose estimates of 22.5 mSv to the urinary bladder wall, 8.2 mSv to the kidneys, and an effective dose of 2.9 mSv. Lesion signal to noise ratios on images generated from subsampled data were significantly higher for injected activities above 74 MBq (2 mCi) and were also significantly higher for imaging at 90 min than at 180 min post-injection. Dosimetry estimates are acceptable and [68Ga]Ga-P15-041 uptake characteristics in patients with confirmed bone metastases support its continued development. Use of [68Ga]Ga-P15-041 would not require cyclotron infrastructure for manufacturing and distribution, allowing for improved patient access to a promising PET bone imaging agent.


Multi method approach to the assessment of data quality in the Finnish Medical Birth Registry.
To assess comprehensively the validity of the data in the Finnish Medical Birth Registry (MBR) by the combined use of several controls and internal analysis of the data. The MBR data were individually linked to a medical record sample (n = 775) and to all perinatal death certificates in 1987. The data were also compared with annual hospital statistics. The distributions of birth weights and gestational ages were examined. All stillborn and liveborn babies registered in the MBR in 1987 (n = 59,370). The nationwide MBR data were compared with medical records from one third of the Finnish hospitals, with statistics for all hospitals, and with nationwide cause of death registry data. With regard to most variables, the data quality was good or satisfactory (agreement with medical records 95% or more). Allowing for minor deviations in variables with continuous scales improved the agreement rates further. Explanations could be deduced for items with poor agreement values. For most variables, the amount of missing data was less than 1%. With the exception of caesarean sections, medical procedures were registered in only 30 to 72% of the cases, and the proportion varied strongly between the hospitals. Common diagnoses (32 to 86%) and primary causes of death (59 to 78%) were also poorly recorded. Combined use of several control materials and internal analyses was successful in investigating the whole data content. The data in the MBR were generally valid but diagnoses and most data on medical procedures were not of sufficiently good quality.


Identification and purification of an irreversible presynaptic neurotoxin from the venom of the spider Hololena curta.
A search for potent toxins that inhibit neuronal calcium channels in Drosophila melanogaster has resulted in the identification of a presynaptic neurotoxin from the venom of the hunting spider Hololena curta. Using Drosophila neuromuscular junction as an assay, presynaptic inhibitory activity was purified using gel filtration and reverse-phase HPLC. Data from gel electrophoresis indicate that the toxin is composed of two different subunits of Mr 7000 and 9000. At nanomolar concentrations the toxin produced a complete and long-lasting inhibition of synaptic transmission at the Drosophila larval neuromuscular junction without affecting the amplitudes of the spontaneously occurring miniature junction potentials. The block of transmission produced by the toxin was observed even during the direct depolarization of the motor nerve terminal. These physiological results indicate that the terminal is the site of action for the toxin. Indirect evidence using abnormally excitable Drosophila mutants suggests that the toxin is inhibiting transmitter release by altering the electrical properties of the nerve terminal rather than by interfering with nonelectrical events that may occur subsequent to calcium influx. All of the actions of the Hololena toxin can be explained by a specific and direct effect on presynaptic calcium channels in Drosophila motor neurons.


Two Distinct Cardiolipin Synthases Operate in Agrobacterium tumefaciens.
Cardiolipin (CL) is a universal component of energy generating membranes. In most bacteria, it is synthesized via the condensation of two molecules phosphatidylglycerol (PG) by phospholipase D-type cardiolipin synthases (PLD-type Cls). In the plant pathogen and natural genetic engineer Agrobacterium tumefaciens CL comprises up to 15% of all phospholipids in late stationary growth phase. A. tumefaciens harbors two genes, atu1630 (cls1) and atu2486 (cls2), coding for PLD-type Cls. Heterologous expression of either cls1 or cls2 in Escherichia coli resulted in accumulation of CL supporting involvement of their products in CL synthesis. Expression of cls1 and cls2 in A. tumefaciens is constitutive and irrespective of the growth phase. Membrane lipid profiling of A. tumefaciens mutants suggested that Cls2 is required for CL synthesis at early exponential growth whereas both Cls equally contribute to CL production at later growth stages. Contrary to many bacteria, which suffer from CL depletion, A. tumefaciens tolerates large changes in CL content since the CL-deficient cls1/cls2 double mutant showed no apparent defects in growth, stress tolerance, motility, biofilm formation, UV-stress and tumor formation on plants.


Predicting Kinetics and Dynamics of Spin-Dependent Processes.
ConspectusPredicting mechanisms and rates of nonadiabatic spin-dependent processes including photoinduced intersystem crossings, thermally activated spin-forbidden reactions, and spin crossovers in metal centers is a very active field of research. These processes play critical roles in transition-metal-based and metalloenzymatic catalysis, molecular magnets, light-harvesting materials, organic light-emitting diodes, photosensitizers for photodynamic therapy, and many other applications. Therefore, accurate modeling of spin-dependent processes in complex systems and on different time scales is important for many problems in chemistry, biochemistry, and materials sciences.Nonadiabatic statistical theory (NAST) and nonadiabatic molecular dynamics (NAMD) are two complementary approaches to modeling the kinetics and dynamics of spin-dependent processes. NAST predicts the probabilities and rate constants of nonradiative transitions between electronic states with different spin multiplicities using molecular properties at only few critical points on the potential energy surfaces (PESs), including the reactant minimum and the minimum energy crossing point (MECP) between two spin states. This makes it possible to obtain molecular properties for NAST calculations using accurate but often computationally expensive electronic structure methods, which is critical for predicting the rate constants of spin-dependent processes. Alternatively, NAST can be used to study spin-dependent processes in very large complex molecular systems using less computationally expensive electronic structure methods. The nuclear quantum effects, such as zero-point vibrational energy, tunneling, and interference between reaction paths can be easily incorporated. However, the statistical and local nature of NAST makes it more suitable for large systems and slow kinetics. In contrast, NAMD explores entire PESs of interacting electronic states, making it ideal for modeling fast barrierless spin-dependent processes. Because the knowledge of large portions of PESs is often needed, the simulations require a very large number of electronic structure calculations, which limits the NAMD applicability to relatively small molecular systems and ultrafast kinetics.In this Account, we discuss our contribution to the development of the NAST and NAMD approaches for predicting the rates and mechanism of spin-dependent processes. First, we briefly describe our NAST and NAMD implementations. The NAST implementation is an extension of the transition state theory to the processes involving two crossing potential energy surfaces of different spin multiplicities. The NAMD approach includes the trajectory surface hopping (TSH) and ab initio multiple spawning (AIMS) methods. Second, we discuss several applications of NAST and NAMD to model spin-dependent processes in different systems. The NAST applicability to large complex systems is demonstrated by the studies of the spin-forbidden isomerization of the active sites of metal-sulfur proteins. Our implementation of the MECP search algorithm within the fully ab initio fragment molecular orbital method allows applying NAST to systems with thousands of atoms, such as the solvated protein rubredoxin. Applications of NAMD to ultrafast spin-dependent processes are represented by the generalized AIMS simulations utilizing the fast GPU-based TeraChem electronic structure program to gain insight into the complex photoexcited state relaxation in 2-cyclopentenone.


Comparative Proteomics Analysis Reveals the Reversal Effect of Cryptotanshinone on Gefitinib-Resistant Cells in Epidermal Growth Factor Receptor-Mutant Lung Cancer.
Cryptotanshinone (CTS) is a lipophilic constituent of Salvia miltiorrhiza, with a broad-spectrum anticancer activity. We have observed that CTS enhances the efficacy of gefitinib in human lung cancer H1975 cells, yet little is known about its molecular mechanism. To explore how CTS enhances H1975 cell sensitivity to gefitinib, we figured out differential proteins of H1975 cells treated by gefitinib alone or in combination with CTS using label-free liquid chromatography-tandem mass spectrometry (LC-MS/MS). Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and protein-protein interaction (PPI) bioinformatic analyses of the differential proteins were performed. CTS enhanced H1975 cell sensitivity to gefitinib in vitro and in vivo, with 115 and 128 differential proteins identified, respectively. GO enrichment, KEGG analysis, and PPI network comprehensively demonstrated that CTS mainly impacted the redox process and fatty acid metabolism in H1975 cells. Moreover, three differential proteins, namely, catalase (CAT), heme oxygenase 1 (HMOX1), and stearoyl-CoA desaturase (SCD) were validated by RT-qPCR and Western blot. In conclusion, we used a proteomic method to study the mechanism of CTS enhancing gefitinib sensitivity in H1975 cells. Our finding reveals the potential protein targets of CTS in overcoming gefitinib resistance, which may be therapeutical targets in lung cancer.


How feasible is implementation of distress screening by cancer clinicians in routine clinical care?
There is considerable uncertainty regarding the acceptability of routine distress screening. In an unfunded implementation study, the authors asked 50 clinicians (chemotherapy nurses and treatment radiographers/radiation technologists) to implement a screening program for distress as part of routine care and to record their feedback after each clinical encounter. In total, 379 patients were screened using a simple paper-and-pencil versions of distress thermometer and the emotion thermometer (ET). Across all screening applications, clinicians believed that screening was useful during 43% of assessments and was not useful during 35.9% of assessments, and they were unsure or neutral in 21.1% of assessments. The application of the screening program assisted staff in changing their clinical opinion after 41.9% of assessments, and clinicians believed that the screening program helped with communication in >50% of assessments. However, 37.5% believed that screening was impractical for routine use, and more chemotherapy nurses than radiographers rated the screening program as "not useful." On multivariate analysis, 3 variables were associated with high staff satisfaction with screening, namely, receipt of prior training, talking with the patient about psychosocial issues, and improved detection of psychological problems. A favorable perception of screening also was linked to a change in clinical opinion. Opinions of cancer clinicians regarding routine distress screening were mixed: Approximately 33% considered screening not useful/impractical, whereas >50%n believed promoted good communication and/or helped with recognition. Clinicians who were more positive about screening gained greater benefits from screening in terms of communication and recognition.


A potential peptide vaccine against two different strains of influenza virus isolated at intervals of about 10 years.
We have developed a strategy for making synthetic peptide vaccines, in which a peptide, HA127-133, derived from the hemagglutinin (HA) of A/Aichi/2/68(H3N2) influenza virus (Aichi/68) is introduced into the Ab binding component consisting of 43-46 and 54-58 residues of a pigeon cytochrome c analogue peptide, 46F50V54A. Indeed, this hybrid peptide, 46F/HA127-133/54A, induced impressive T-cell responses and antibody production neutralizing infectivity of Aichi/68 in vitro. In a subsequent study we found that 46F/HA127-133/54A(18mer) peptide antigen, which had been prepared by substitution at the central five residues of 46F50V54A with HA127-133, generated T-cell responses and neutralizing antibody responses as well. On the basis of these prior findings, in the present study we analyzed immunopotency of 46F/HA127-133/54A(18mer) in vivo administered in several ways to I-Ab mice. We show herein that this peptide vaccine loaded in multilamellar liposomes without adjuvant protects the mice against infection with Aichi/68 within 2 weeks after final immunization. Further, this peptide vaccine was shown to be effective in preventing infection with a naturally occurring antigenic variant, A/Texas/1/77(H3N2), carrying the same sequence at 127-133 of the HA as Aichi/68 virus. Since this part of the HA is relatively conserved among H3 subtype influenza viruses, our peptide vaccine may become the basis for a new strategy to prepare effective vaccines that will overcome the ineffectiveness of classical vaccines attributable to antigenic drift of influenza viruses.


Effect of prolonged fasting on heme metabolism in the rat.
It is known that fasting may provoke an acute attack in patients with latent hepatic porphyrias. We examined the influence of fasting on some aspects of heme synthesis in rats. Urinary excretion of both uroporphyrin and coproporphyrin, as well as fecal elimination of protoporphyrin and coproporphyrin, were increased on fasting. These biochemical aberrations resemble those found in subjects with latent porphyria variegata, suggesting that fasting rats may constitute an experimental model for latent variegate porphyria. The administration of phenobarbitone had a pronounced, synergistic effect on the urinary excretion of porphyrins. The activity of delta-aminolevulinic acid synthase (ALAS) and the concentration of cellular heme were determined in homogenates and subcellular fractions of the livers of fasting rats. A marked increase in the concentration of heme in the homogenate, the nuclei and the postmicrosomal supernatant fractions was observed. ALAS activity in the homogenate and the supernatant fraction increased while that in the mitochondria decreased. The possible relationship of these results to the human disease is discussed.


Apparatus for the measurement of total body nitrogen using prompt neutron activation analysis with californium-252.
Details of clinical apparatus designed for the measurement of total body nitrogen (as an indicator of body protein), suitable for the critically ill, intensive-care patient are presented. Californium-252 radio-isotopic neutron sources are used, enabling a nitrogen measurement by prompt neutron activation analysis to be made in 40 min with a precision of +/- 3.2% for a whole body dose equivalent of 0.145 mSv. The advantages of Californium-252 over alternative neutron sources are discussed. A comparison between two irradiation/detection geometries is made, leading to an explanation of the geometry adopted for the apparatus. The choice of construction and shielding materials to reduce the count rate at the detectors and consequently to reduce the pile-up contribution to the nitrogen background is discussed. Salient features of the gamma ray spectroscopy system to reduce spectral distortion from pulse pile-up are presented.


[A case of atretic cephalocele].
We report a case of atreric cephalocele. A 13-year-old boy who was developmentally normal was admitted to our hospital, complaining of scalp mass located at the midparietal region. He was noticed to have had it since his birth. Physical examination revealed 2.5 x 2.5cm, round, skin-covered midline subscalp mass with a hairless top. Bone 3D-CT showed bone defect at the base of the mass. MRI and MR venography showed the embryonic positioning of the straight sinus. He was treated with surgical excision of the mass, and fibrous tract extending intracranially at the base of the lesion was identified. Pathologic examination showed it to be meningocele.


On acquired hemophilia A. A survey of 11 cases.
Acquired hemophilia A due to antibodies of factor VIII procoagulant activity is rare. This paper reports 11 such patients followed up for long periods. The exemplify various forms of associated disorders. Four of them have died from hemorrhages, 4 have had complete remission and 3 are still alive with persistent inhibitors. The inhibitor activity was recovered in the immunoglobulin fraction in all the patients studied. Various forms of treatment were tried but remission related to therapy was seen in only one woman affected post partum. Spontaneous remissions are common and the aim of therapy must be to control acute severe hemorrhage.


Effects of ethanol on structure and solubility of potato proteins and the effects of its presence during the preparation of a protein isolate.
In this study, a protein isolate with a high solubility at neutral pH was prepared from industrial potato juice by precipitation at pH 5 in the presence of ethanol. The effects of ethanol itself and the effects of its presence during precipitation on the properties of various potato protein fractions were examined. The presence of ethanol significantly reduced the denaturation temperature of potato proteins, indicating that the preparation of this potato protein isolate should be performed at low temperature in order to retain a high solubility. In the presence of ethanol, the thermal unfolding of the tertiary and the secondary structure of patatin was shown to be almost completely independent. Even at 4 degrees C, precipitation of potato proteins in the presence of ethanol induced significant conformational changes. These changes did, however, only result in minor changes in the solubility of the potato protein fractions as a function of pH and heat treatment temperature.


Age trajectories of everyday cognition in African American and White older adults under prompted and unprompted conditions.
We investigated how race and verbal prompting interacted with age to predict age trajectories on a performance-based measure of everyday cognition. African American (n = 727) and White (n = 2052) older adults from the ACTIVE clinical trial were given the Observed Tasks of Daily Living (OTDL; a performance-based measure of medication management/finances/telephone use) at baseline and 1-, 2-, 3-, 5-, and 10-year follow-ups. When participants said "I don't know" or did not respond, they received a standardised verbal prompt, which served only as a cue to initiate the first step. At each occasion, unprompted (sum of items correct without prompting) and prompted (sum of correct prompted and unprompted items) scores were derived for each participant. Mixed effects models for change were used to determine the age trajectories of OTDL performance by race. When not prompted, African Americans demonstrated more rapid decline in OTDL performance than Whites, especially after age 80. When prompted, both groups had improved performance and evinced shallower decline, although African Americans continued to demonstrate a slightly more rapid decline. Simple prompting attenuated age-related changes of African Americans and Whites on a measure of everyday cognition. Prompting may be especially helpful for older African Americans.


Progress toward the Synthesis of garsubellin A and related phloroglucins: the direct diastereoselective synthesis of the bicyclo[3.3.1]nonane core.
[reaction: see text] A highly diastereoselective single-step cyclization reaction provides access to the bicyclo[3.3.1]nonane core of the polyprenylated phloroglucin natural product garsubellin A. Further elaboration to a more functionalized analogue involves a sequential Claisen rearrangement/Grubbs olefin cross-metathesis strategy. Additionally, this strategy was extended to the preparation of the bis-quaternary carbon array found at the bridgehead positions of the phloroglucin natural products.


[Tumors of the mouth cavity. Not all fluorescent tumors are malignant].
Early diagnosis and treatment of malignant tumors of the mouth and throat can greatly improve survival rates. Diagnostic fluorescence permits the reliable detection not only of oral cancer, but also of cancer precursor lesions. A problem here is the fact that although carcinomas can be detected with a high level of sensitivity, our own studies also demonstrate a considerable false-positive rate (35%). Possible reasons for this currently being considered are non-compliance by the patient with the required fasting period, poor mouth hygiene and the state after radiation therapy to the face. Under these circumstances, patient management is of particular importance.


[Biobanking in a histocompatibility laboratory. Guidelines from the Francophone Society of Histocompatibility and Immunogenetics (SFHI)].
Histocompatibility laboratories perform the biological analyses linked related to organ transplant, hematopoietic stem cells transplant, some immune dysfunction diseases and immuno-allergy after therapeutic treatment. Most of these analyses are prospectively or retrospectively performed on sera and DNA. The Société Francophone d'Histocompatibilité et d'Immunogénétique (SFHI) has made some recommendations in order to define storage conditions and storage lifetime of the samples required in a histocompatibility laboratory. These recommendations have been drawn up by a working group of ten biologists. They have been established on literature review and data from method validation, which has been already performed within French laboratories (collected through a national questionnaire sent to participant laboratories). The recommendations made by the SFHI for the storage of samples for immunogenetics analyses facilitate the harmonization of practices among histocompatibility laboratories.


Multiparametric Atomic Force Microscopy Imaging of Biomolecular and Cellular Systems.
There is a need in biochemical research for new tools that can image and manipulate biomolecular and cellular systems at the nanoscale. During the past decades, there has been tremendous progress in developing atomic force microscopy (AFM) techniques to analyze biosystems, down to the single-molecule level. Force-distance (FD) curve-based AFM in particular has enabled researchers to map and quantify biophysical properties and biomolecular interactions on a wide variety of specimens. Despite its great potential, this AFM method has long been limited by its low spatial and temporal resolutions. Recently, novel FD-based multiparametric imaging modalities have been developed, allowing us to simultaneously image the structure, elasticity and interactions of biological samples at high spatiotemporal resolution. By oscillating the AFM tip, spatially resolved FD curves are obtained at much higher frequency than before, and as a result, samples are mapped at a speed similar to that of conventional topographic imaging. In this Account, we discuss the general principle of multiparametric AFM imaging and we provide a snapshot of recent studies showing how this new technology has been applied to biological specimens, from soluble proteins to membranes and cells. We emphasize novel methodologies that we recently developed, in which multiparametric imaging is combined with probes functionalized with chemical groups, ligands, or even live cells, in order to image and quantify receptor interaction forces and free-energy landscapes in a way not possible before. Key breakthroughs include observing the mechanical and chemical properties of single proteins in purple membranes, measuring the electrostatic potential of transmembrane pore forming proteins, structurally localizing chemical groups of water-soluble proteins, mapping and nanomechanical analysis of single sensors on yeast cells, imaging the sites of assembly and extrusion of single filamentous bacteriophages in living bacteria, unravelling the adhesive properties of biofilm-forming microbial pathogens, mapping the ligand-binding free energy landscape of human membrane receptors in proteoliposomes, and finally, the nanomechanical mapping of the first binding events of viruses to animal cells. In the coming years, it is anticipated that multiparametric AFM imaging will be increasingly used by chemists from broad horizons, enabling them to shed light into the sophisticated functions of biomolecular and cellular systems.


Otologic involvement in late syphilis.
In 38 patients with cochleovestibular dysfunction and no cause other than syphilis (congenital in 15, acquired in 23), there was no characteristic pattern to the dysfunction. Sensorineural hearing loss was present in all (bilateral in 82%, unilateral in 18%), and 42% had episodic rotatory vertigo. Only 24% had the classic triad of symptoms of endolymphatic hydrops. The impairment was less in the first 5 years of hearing loss than in subsequent intervals; the average impairments were comparable in the second through fifth decades.


Efficient tracking of non-iron-labeled mesenchymal stem cells with serial MRI in chronic stroke rats.
Although stem cell-based treatments for neurodegenerative diseases have advanced rapidly, there is currently no clinically available method to monitor the fate of transplanted cells in the brain. To use magnetic resonance imaging for tracking transplanted stem cells in the ischemic rat brain, we used the cellular labeling substance Effectene to transfect a standard contrast agent (Gd-DTPA) into immortalized human bone marrow stromal cells. The transfection efficiency of this method was up to 90%, which is substantially better than pure spontaneous endocytosis or other transfection agents. In addition, cellular uptake of Gd-DTPA in vitro was maintained for >28 days. Therefore, we could follow transplanted stem cell migration and homing into the penumbric area. Using double immunofluorescence, the transplanted cells were seen to differentiate into glial cells, neurons and vascular endothelial cells. Cortical neurochemical activity as evaluated by proton magnetic resonance spectroscopy ((1)H-MRS) also increased considerably after immortalized human bone marrow stromal cell transplantation. This method of tracking immortalized human bone marrow stromal cells is highly efficient and allows for nontoxic labeling of cells.


Longitudinal absolute metabolite quantification of white and gray matter regions in healthy controls using proton MR spectroscopic imaging.
The purpose of this study was to evaluate quality parameters, metabolite concentrations and concentration ratios, and to investigate the reproducibility of quantitative proton magnetic resonance spectroscopic imaging ((1)H-MRSI) of selected white and gray matter regions of healthy adults. 2D-quantitative short-TE (1)H-MRSI spectra were obtained at 1.5T from the healthy human brain. Subjects (n = 12) were scanned twice with an interval of six months. Absolute metabolite concentrations were obtained based on coil loading, taking into account differences in sensitivity of the phased-array head coil. Spectral quality parameters, absolute metabolite concentrations, concentration ratios, and their reproducibility were determined and compared between time-points using a repeated measures general linear model. The quality of the spectra of selected brain areas was good, as determined by a mean spectral linewidth between 4.8 and 7.3 Hz (depending on the region). No significant differences between the two time-points were observed for spectral quality, concentrations, or concentration ratios. The mean intrasubject coefficient of variation (CoV) varied between 4.0 and 8.5% for total N-acetylaspartate, 7.2 and 10.8% for total creatine, 5.9 and 9.8% for myo-inositol, and 8.0 and 13.3% for choline, and remained below 20% for glutamate. CoV was generally lower when concentration ratios were considered. The study shows that longitudinal quantitative short-TE (1)H-MRSI generates reproducible absolute metabolite concentrations in healthy human white and gray matter. This may serve as a background for longitudinal clinical studies in adult patients.


Identical genetic basis for lymphosarcoma and hemolytic anemia in the rabbit.
Tests for identity of ha (hemolytic anemia) and ls (lymphosarcoma) in the rabbit show that they are both allelic and identical by descent and that the two different conditions result from interaction of these genes with the host genotype. Hemolytic anemia is the primary cause of death in compound heterozygotes (ha/ls) with increasing lympho-proliferative disease with age. Ages at death of histologically confirmed affected rabbits range from 5 days to 22.5 monts with an average of 10.5 months. The symbol ha will now be used to represent the gene for either disorder.


Do financial incentives linked to ownership of specialty hospitals affect physicians' practice patterns?
Although physician-owned specialty hospitals have become increasingly prevalent in recent years, little research has examined whether the financial incentives linked to ownership influence physicians' referral rates for services performed at the specialty hospital. We compared the practice patterns of physician owners of specialty hospitals in Oklahoma, before and after ownership, to the practice patterns of physician nonowners who treated similar cases over the same time period in Oklahoma markets without physician-owned specialty hospitals. We constructed episodes of care for injured workers with a primary diagnosis of back/spine disorders. We used pre-post comparisons and difference-in-differences analysis to evaluate changes in practice patterns for physician owners and nonowners over the time period spanned by the entry of the specialty hospital. Findings suggest the introduction of financial incentives linked to ownership coincided with a significant change in the practice patterns of physician owners, whereas such changes were not evident among physician nonowners. After physicians established ownership interests in a specialty hospital, the frequency of use of surgery, diagnostic, and ancillary services used in the treatment of injured workers with back/spine disorders increased significantly. Physician ownership of specialty hospitals altered the frequency of use for an array of procedures rendered to patients treated at these hospitals. Given the growth in physician-owned specialty hospitals, these findings suggest that health care expenditures will be substantially greater for patients treated at these institutions relative to persons who obtain care from nonself-referral providers.


Optimal management of adults with ALL.
The cure rate of acute lymphoblastic leukaemia (ALL) in adults remains unsatisfactory. The remarkable progress in childhood ALL has not been replicated in adult ALL and approximately two thirds of patients younger than 60 years, and more than 90% of those over 60 years, are expected to succumb to their disease. Over 80% of adults can achieve a complete remission; however, the majority of such patients relapse. Nevertheless, significant developments have occurred over the past decade. Prognostic factors have been more clearly defined, moving cytogenetics and molecular determinants forefront, much like acute myeloid leukaemia. Studies of postremission therapy have included prospective evaluation of allogeneic transplantation in areas not previously evaluated, i.e. patients with standard risk. Most importantly, the advent of imatinib mesylate has changed the outlook for adults with Ph-positive ALL. Much work needs to be done to further improve chemotherapy treatment and reduce the toxicity of transplants.


Nanofiber Composite for Improved Water Retention and Dendrites Suppression in Flexible Zinc-Air Batteries.
Water loss of the gel polymer electrolytes (GPEs) and dendrites growth on Zn anode are overriding obstacles to applying flexible zinc-air batteries (ZABs) for wearable electronic devices. Nearly all previous efforts aim at developing novel GPEs with enhanced water retention and therefore elongate their lifespan. Herein, a facile interface engineering strategy is proposed to retard the water loss of GPE from the half-open structured air cathode. In detail, the poly(ethylene vinyl acetate)/carbon powder (PEVA-C) nanofiber composite interface layer with features of hydrophobicity, high conductivity, air permeability, and flexibility are prepared on the carbon cloth and set up between the GPE and electrode. The as-assembled ZAB with simple alkaline PVA GPE exhibits an impressive cycle life of 230 h, which outperforms ZAB without the PEVA-C nanofibers interface layer by 14 times. Additionally, the growth of Zn dendrites can be suppressed due to the tardy water loss of GPE.


Phosphate uptake in chick kidney cells: effects of 1,25(OH)2D3 and 24,25(OH)2D3.
Phosphate homeostasis is controlled in part by absorption from the intestine, and reabsorption in the kidney. While the effect of Vitamin D metabolites on enterocytes is well documented, in the current study we assess selected responses in primary cultures of kidney cells. Time course studies revealed a rapid stimulation of phosphate uptake in cells treated with 1,25(OH)(2)D(3), relative to controls. Dose-response studies indicated a biphasic curve with optimal stimulation at 300 pM 1,25(OH)(2)D(3) and inhibition at 600 pM seco-steroid. Antibody 099--against the 1,25D(3)-MARRS receptor - abolished stimulation by the steroid hormone. Moreover, phosphate uptake was mediated by the protein kinase C pathway. The metabolite 24,25(OH)(2)D(3), which was found to inhibit the rapid stimulation of phosphate uptake in intestinal cells, had a parallel effect in cultured kidney cells. Finally, the 24,25(OH)(2)D(3) binding protein, catalase, was assessed for longer term down regulation. In both intestinal epithelial cells and kidney cells incubated with 24,25(OH)(2)D(3) for 5-24h, both the specific activity of the enzyme and protein levels were decreased relative to controls, while 1,25(OH)(2)D(3) increased both parameters over the same time periods. We conclude that the Vitamin D metabolites have similar effects in both kidney and intestine, and that 24,25(OH)(2)D(3) may have effects at the level of gene expression.


Neurocognitive function and insight in schizophrenia: support for an association with impairments in executive function but not with impairments in global function.
It remains unclear how impaired insight and neurocognitive impairment are related to one another in schizophrenia. In order to examine this relationship, subjects with schizophrenia or schizoaffective disorder were classified as having 'impaired' (n=38) or 'unimpaired' (n=43) insight based on their insight rating on the Positive and Negative Syndrome Scale (PANSS). Their performance on neuropsychological tests of global function, executive function, memory and vigilance was then compared. Multivariate analyses followed by Scheffe tests indicated that subjects with impaired insight performed less well on the Wisconsin Card Sorting Test, demonstrating poorer abstract flexibility and heightened perseveration. No differences were found between the groups with regard to global cognitive function, memory or vigilance. This suggests that insight is closely linked to deficits in executive function, and that it may be associated with the compromise of frontal lobe function.


Single-dose pharmacokinetics of cefsulodin in patients with cystic fibrosis.
The single-dose pharmacokinetics of cefsulodin were evaluated in 12 patients with cystic fibrosis. Each patient received 3 g of cefsulodin intravenously over 30 min. Multiple plasma and urine samples were obtained during the 6-h study period for the determination of cefsulodin. Pharmacokinetic parameters were determined by model-independent methods. Mean values for t1/2, Vss, and CLp were 1.53 h, 0.242 liters/kg, and 117.3 ml/min per 1.73 m2, respectively. Six-hour urine recovery revealed 73.2% of the administered dose with a corresponding cefsulodin urinary clearance of 75.1 ml/min. These pharmacokinetic data in patients with cystic fibrosis appear consistent with data reported for unaffected individuals.


Assessing the application of HIV and AIDS related education and counselling on the Internet.
This study reviewed Internet technological capabilities for counselling and several appropriate counselling models and assessed the application of HIV/AIDS related counselling on the Internet. Sixteen health professionals in HIV/AIDS related face-to-face counselling positions were interviewed: their HIV/AIDS service background was limited to Texas-certified HIV pre/post test counsellors. Texas-licensed counsellors in HIV/AIDS service field and HIV/AIDS case managers and social workers. Duration of interviews ranged from 30 min to 60 min and were recorded on audio cassette for review and analysis. Responses were generated using an editing style of the long-interview process. Edited responses were then analyzed for content and themes. Four major themes evolved from interview responses: counsellor-client relationship, target population, ethics and operation. Major concerns included the lack of visual and verbal cues during interaction, problems of accessibility by the neediest, confidentiality, impersonal experience and increased client separation/isolation. Greater benefits may be attained by targeting the younger segment of the population and other health professionals. A majority of respondents indicated support for additional development of Internet-based HIV/AIDS related counselling.


[The questionnaire survey on glaucoma diagnosis and treatment in China (2016)].
Objective: To investigate the present situation of diagnosis and treatment for primary angle-closure glaucoma (PACG) and primary open-angle glaucoma (POAG) and awareness of the relevant progress among Chinese ophthalmologists. Methods: This study was a cross-sectional, non-randomized sampling survey. Participants were ophthalmologists who attended the 11st Chinese Glaucoma Society Congress during November 11 to 12, 2016. They were invited to fill out a questionnaire. The questionnaire included participants' basic information and their knowledge about glaucoma diagnosis and treatment. The data collected through questionnaire were analyzed with SAS9.4. Results: A total of 450 questionnaires were distributed and 372 valid questionnaires were retrieved, with a response rate of 82. 7%(372/450). ISGEO classification system was adopted by 58.9% (219/372) of the participants as the diagnostic criteria for PACG. Of the respondents, 48.1% (179/372) of the participants believed that "anterior chamber angle closure mechanism-based PACG classification system" was more instructive for treatment, the percentage was higher than ISGEO classification system (42.2%, 157/372). Most (72.3%, 269/372) of the participants knew the 3-minute dark room prone test, but only 27.7%(103/372) of them applied it in clinical practice. A total of 83.4%(310/372) of the participants believed that low cerebrospinal fluid pressure is a risk factor for POAG. In all, 71.8% (267/372) of the participants reported that their institutes had applied compound trabeculectomy with adjustable suture, with 76.9%(286/372) of the participants agreeing that the adjustable suture reduced the rate of complications after trabeculectomy. Conclusions: Currently, both ISGEO classification system and anterior chamber angle closure mechanism-based PACG classification system were adopted in the diagnosis and treatment of glaucoma. Low cerebrospinal fluid pressure as new risk factors for POAG has been widely acknowledged and given attentions by Chinese ophthalmologists. The 3-minute darkroom prone test and compound trabeculectomy with adjustable suture still need to be promoted. (Chin J Ophthalmol, 2017, 53: 115-120).


The effect of exercise and nutrition on intramuscular fat metabolism and insulin sensitivity.
Intramuscular triacylglycerol (IMTG) is both a dynamic fat-storage depot that can expand during periods of elevated lipid availability and a fatty acid source that can be utilized during periods of increased energy expenditure in active individuals. Although many studies have investigated the lifestyle determinants of IMTG content, the results are far from consistent, and studies attempting to unravel the mechanisms behind IMTG metabolism are in their infancy. The limited evidence available suggests that the enzymes responsible for skeletal muscle lipolysis and IMTG synthesis play an important role in determining the fate of fatty acids and therefore the concentration of lipid metabolites and insulin sensitivity of skeletal muscle. This review provides a summary of current knowledge on the effects of acute and chronic exercise as well as energy intake and macronutrient composition of the diet upon the metabolism of IMTG and the implications for metabolic health.


Skin temperature changes during a footbath in patients who had had a stroke with consequent sensory impairment.
The objectives of this study were to examine skin temperature changes on the unaffected and affected sides as well as changes in perceived temperature and comfort during a footbath in patients who had had a stroke with consequent sensory impairment. The study used a quasi-experimental design in which the results of intervention for patients who had had a stroke and healthy adults were compared. The subjects were 20 patients who had had a stroke with consequent sensory impairment and 20 healthy adults. Before the footbath, the skin temperature of the dorsum of the foot on the affected side of the patient who had had a stroke was lower than that of the foot on the unaffected side. Five minutes after the start of the footbath, however, the relationship reversed, with the skin temperature on the affected side increasing in parallel with the water temperature. After the footbath, the dorsum skin temperature on the affected side was again lower than that on the unaffected side. In healthy adults, a difference was found in dorsum skin temperature between the left and right feet. In contrast with patients who had had a stroke, no reversal of the sides was found with the lower and higher temperature. Unlike in the healthy adults, the skin temperature of the patients who had had a stroke with consequent sensory impairment was susceptible to changes in the external environment. However, no significant changes in the physiological indices were seen, while perceived temperature and comfort remained at high levels after the footbath.


The Mediating Role of Depression in the Association Between Hearing Impairment and Functional Disability Among Middle-Aged and Older Adults in China.
This study aims to explore the association between hearing impairment (HI) and functional disability and to examine whether depression mediates this association. In the study, 11 335 individuals aged 45 years and older were analyzed from the China Health and Retirement Longitudinal Study. The study used logistic regression and Karlson/Holm/Breen's method to examine the correlation between HI, depression, and functional disability. Functional disability was assessed using activities of daily living and instrumental activities of daily living. HI was significantly associated with activities of daily living disability (odds ratio [OR] = 1.34, 95% confidence interval [CI] = 1.21-1.49) and instrumental activities of daily living disability (OR = 1.57, 95% CI = 1.46-1.68). The mediated effect of depression accounted for 22.80% and 15.17% of the total effect of HI on activities of daily living and instrumental activities of daily living disability, respectively. Additionally, depression partially mediated the effects of HI on specific activities of daily living and instrumental activities of daily living tasks, including bathing (33.23%), toileting (27.50%), doing chores (37.36%), preparing meals (28.04%), shopping (25.81%), taking care of finances (11.82%), and taking medicine (12.71%). HI increased the likelihood of functional disability partially through depression in middle-aged and older adults, suggesting that emphasizing the mental wellness of these people with HI is necessary to prevent impairments in physical function.


Weight gain on antipsychotic medication is associated with sustained use among veterans with schizophrenia.
Continuous antipsychotic treatment is important in schizophrenia, and studies have shown that rates of discontinuation are high. Some studies suggest that weight gain may lead schizophrenic patients to discontinue treatment, whereas other studies show smaller effects of weight gain on medication discontinuation, and some find weight gain associated with symptom improvement. Our retrospective cohort study investigated the effect of weight change on the continued use for 1 year (persistence) of all antipsychotics, then among users of first-generation antipsychotics and second-generation antipsychotics (SGAs), and lastly subgroups of SGAs. We identified 2130 patients with schizophrenia starting an antipsychotic that had not used 1 in the prior year. Using multivariable logistic regression adjusted for demographic and clinical variables, we determined the odds of remaining persistent on medication among patients who either gained weight or did not gain weight in the following year. For all antipsychotics combined, weight change was not associated with persistence. Among SGAs, weight gain was associated with a 23% increase in the adjusted odds ratio (OR) for persistence (OR, 1.23; 95% confidence interval [CI], 1.00-1.51), whereas there was a nonsignificant decrease in the adjusted odds of persistence among first-generation antipsychotic users (OR, 0.74; 95% CI, 0.43-1.28). When SGAs were divided into subgroups (clozapine/olanzapine, risperidone/quetiapine), both had increases in the likelihood of persistence, but only the association for clozapine/olanzapine was significant at a trend level (adjusted OR, 1.46; 95% CI, 0.99-2.16). These findings are supportive of other research that shows weight gain does not invariably lead to medication discontinuation and may be associated with clinical improvement.


Microflora of soil as viewed by freeze-etching.
The indigenous microflora of soil were released from the soil materials and concentrated without the occurrence of growth by use of a blending-simple centrifugation procedure. The cell concentrate was then frozen-etched and viewed by transmission electron microscopy. Criteria were established for detecting microbial cells among the residual soil debris. The freeze-etching of the soil cell concentrate provided results on cell size distributions in agreement with those obtained by thin sectioning. However, the blending-simple centrifugation procedure for cell release and concentration from soil allowed the observation of large cells (>/=1.0 mum in diameter) which apparently are missed by the "exhaustive centrifugal washing" cell separation-concentration procedure. The procedure of blending-simple centrifugation combined with the viewing of frozenetched preparations allowed evaluations of the soil microflora for cellular diameters, length-width ratios, shapes, and structure.


Moving alcohol prevention research forward-Part I: introducing a complex systems paradigm.
The drinking environment is a complex system consisting of a number of heterogeneous, evolving and interacting components, which exhibit circular causality and emergent properties. These characteristics reduce the efficacy of commonly used research approaches, which typically do not account for the underlying dynamic complexity of alcohol consumption and the interdependent nature of diverse factors influencing misuse over time. We use alcohol misuse among college students in the United States as an example for framing our argument for a complex systems paradigm. A complex systems paradigm, grounded in socio-ecological and complex systems theories and computational modeling and simulation, is introduced. Theoretical, conceptual, methodological and analytical underpinnings of this paradigm are described in the context of college drinking prevention research. The proposed complex systems paradigm can transcend limitations of traditional approaches, thereby fostering new directions in alcohol prevention research. By conceptualizing student alcohol misuse as a complex adaptive system, computational modeling and simulation methodologies and analytical techniques can be used. Moreover, use of participatory model-building approaches to generate simulation models can further increase stakeholder buy-in, understanding and policymaking. A complex systems paradigm for research into alcohol misuse can provide a holistic understanding of the underlying drinking environment and its long-term trajectory, which can elucidate high-leverage preventive interventions.


Use of type V group B streptococcal conjugate vaccine in adults 65-85 years old.
One-third of the cases of invasive group B streptococcal (GBS) disease now occur in adults >or=65 years old. Serotype V is most frequent among these invasive isolates. The safety and immunogenicity of type V GBS capsular polysaccharide (CPS)-tetanus toxoid (V-TT) conjugate vaccine (CV) were assessed in 32 healthy adults 65-85 years old who were randomized to receive a single intramuscular dose of V-TT CV (n=22) or licensed tetanus-diphtheria toxoid vaccine (Td) (n=10; double-masked design). V-TT CV elicited significant increases in type V CPS-specific immunoglobulin (Ig) G, IgM, and IgA serum concentrations 4, 8, 26, and 52 weeks after immunization. V-TT-induced type V CPS-specific antibodies promoted the opsonophagocytic killing of type V GBS in vitro. Both vaccines elicited similar concentrations of TT-specific IgG in 4-week postimmunization serum samples. These results suggest the potential for prevention of invasive type V GBS infections in healthy elderly adults through immunization.


[Relationship between ethanol intake and sexual function in rats].
To investigate the relationship between the intake of ethanol and sexual function of rats. Sixty adult male Wistar rats were randomly divided into five groups: the control, 10% , 20% , 30% and 40 ethanol groups, which received. . 9% sodium chloride, 10% , 20% , 30% and 40% ethanol solutions respectively at a dose of 2 ml through gastric tubes once a day. Three months later, we observed the effects of ethanol on the sexual function of the rats by their sexual behaviors, the number of apomorphine-induced penile erections, and the content of testosterone in the serum and nitric oxide synthase ( NOS) in the penis. Compared with the control group, the number of apomorphine-induced penile erections in the 10% and 20% ethanol groups was not inhibited significantly (P > 0.05), but the latent period of mounting and intromission in the 10% ethanol group was prolonged and the sexual behaviors in the 20% ethanol group were inhibited except the latent period of ejaculation. The sexual behaviors and the number of apomorphine-induced penile erections of the 30% and 40% ethanol groups were inhibited significantly (P < 0.05). Testosterone in the serum and NOS activity in the penis of the experimental groups were reduced (Pat < 0.05). An adequate volume of ethanol does not induce sexual dysfunction in rats, but long term and excessive intake of ethanol may cause penile erectile dysfunction.


[Use of pharmacogenetic testing to prevent adverse drug reactions during statin therapy].
The number of patients receiving statins increases every year and due to the fact that they should take statins during their lives, the problem of their safety use comes to the forefront. The paper analyzes the safety of using the medications of this group and discusses the diagnosis of myopathies induced by statins and the occurrence of immune-mediated statin myopathies. It considers a personalized approach to prescribing statins, analyzes Russian and foreign experience in using pharmacogenetics to reduce the risk of myopathies, publishes the results of the authors' experience in clinically introducing pharmacogenetic testing at hospitals, and analyzes the long-term results of determining the polymorphism of the SLCO1B1 gene for the prediction of the risk of adverse events when using statins and estimating patient compliance to prescribed treatment.


Fully reversible lithium storage of tin oxide enabled by self-doping and partial amorphization.
SnO2 has a high theoretical capacity of 1493 mA h g-1 as an anode material for Li-ion batteries, but its full reversibility is difficult to achieve upon cycling due to the sluggish kinetics. We for the first time demonstrate a fully reversible SnO2 anode for Li-ion batteries enabled by self-doping and partial amorphization by anchoring its nanoparticles on a graphene/single walled carbon nanotube hybrid framework. The uniquely structured nanocomposite containing 74% SnO2 exhibits high reversible capacities together with good rate and cycling capabilities. For instance, the composite anode retains an overall capacity of 1215 mA h g-1 (1425 mA h g-1 for SnO2) after 200 cycles at 0.1 A g-1, which is very close to its theoretical capacity. Moreover, an overall capacity of 947 mA h g-1 (1062 mA h g-1 for SnO2) can be delivered at a higher rate (1 A g-1) with 98% capacity retention over 350 cycles. This exceptional performance can be attributed to the formation of highly dispersed metallic Sn in the Li2O matrix during cycling, which is caused by the unique two-step lithiation mechanism of the self-doped and partially amorphous SnO2 nanoparticles. A similar strategy can also be applied to develop other high-performance electrodes with conversion reactions.


Microbial community structural and functional differentiation in capped thickened oil sands tailings planted with native boreal species.
The oil sands mining operations in Alberta have produced billions of m3 of tailings which must be reclaimed and integrated into various mine closure landforms, including terrestrial landforms. Microorganisms play a central role in nutrient cycling during the reclamation of disturbed landscapes, contributing to successful vegetation restoration and long-term sustainability. However, microbial community succession and response in reconstructed and revegetated tailings remain largely unexplored. This study aimed to monitor the structural and functional responses of microbial communities in tailings subjected to different capping and vegetation strategies over two growing seasons (GS). To achieve this, a column-based greenhouse experiment was conducted to investigate microbial communities in tailings that were capped with a layer (10 or 30 cm) of peat-mineral mix (PMM) and planted with either upland or wetland communities. DNA metabarcoding analysis of the bacterial 16S rRNA gene and fungal ITS2 region as well as shotgun metagenomics were used to asses the impact of treatments on microbial taxonomy and functions, respectively. Results showed that tailings microbial diversity and community composition changed considerably after two GS compared to baseline samples, while communities in the PMM capping layer were much more stable. Likewise, several microbial functions were significantly enriched in tailings after two GS. Interestingly, the impact of capping on bacterial communities in tailings varied depending on the plant community, leading to a higher number of differentially abundant taxa and to a decrease in Shannon diversity and evenness in the upland treatment but not in the wetland treatment. Moreover, while capping in the presence of wetland vegetation increased the energy-related metabolic functions (carbon, nitrogen, and sulfur), these functions were depleted by capping in the upland treatment. Fungi represented a small proportion of the microbial community in tailings, but the relative abundance of several taxa changed over time, while the capping treatments favored the growth of some beneficial taxa, notably the root endophyte Serendipita, in both upland and wetland columns. The results suggest that selecting the right combination of capping material and vegetation type may contribute to improve below-ground microbial processes and sustain plant growth in harsh environments such as oil sands tailings.


Portal Cavernoma during Pregnancy.
Portal vein thrombosis (PVT) is characterized by the obstruction of the portal venous system. The venous obstruction can be partial or complete and it is caused by thrombogenic conditions (acquired or hereditary) or nonthrombotic factors. The acquired conditions include abdominal inflammation, infections, surgery, myeloproliferative disorders, obesity, oral contraceptive intake, pregnancy, and postpartum period. Occasionally, it is not possible to recognize any overt cause of PVT. During pregnancy there is an increased venous thromboembolism risk mainly in the systemic venous system and the PVT can occur, but there are no data about its exact prevalence, etiology, and outcome. The portal cavernoma is the cavernomatous transformation of the portal vein. It is a consequence of chronic PVT and occurs when myriads of collateral channels develop to bypass the occlusion. The clinical presentation includes hematemesis due to variceal bleeding, ascites or anaemia, and splenomegaly. The cavernous transformation of the portal vein is easily diagnosed by sonography. We report our case of a 32-year-old, gravida 3 para 2, pregnant woman admitted to our hospital at 13 weeks and 1 day of gestation, clinically asymptomatic. Laboratory test, ultrasound, and endoscopic evaluation were negative. After a detailed counseling, the patient decided on termination of pregnancy at 15 weeks and 1 day of gestation.


Immune Checkpoint Inhibitor-Mediated Diarrhea and Colitis: A Clinical Review.
Immune-mediated diarrhea and colitis (IMDC) is among the most common immune-related adverse events in patients with cancer treated with immune checkpoint inhibitors (ICIs). Many factors will affect the risk of IMDC, including the type of ICI used, the type of underlying cancer, and patient characteristics. A recent study showed that preexisting inflammatory bowel disease significantly increases the risk of diarrhea and colitis with ICI treatment. In terms of management, early endoscopic evaluation improves clinical outcome by identifying high-risk patients who will benefit from early add-on immunosuppressants. Inflammatory markers, including fecal lactoferrin and calprotectin, are good screening tools to predict which patients are at risk for colitis. Calprotectin especially is associated with colitis outcome and can be used as a surrogate marker to follow treatment response. Corticosteroids remain the first-line medical treatment of IMDC management, and add-on therapy with vedolizumab or infliximab should be considered in selected patients. Fecal microbiota transplantation may be considered in refractory cases. The decision to resume ICI should be decided by balancing the risk of recurrent IMDC and the likelihood of benefiting from further ICI treatment. There is no clear evidence about whether the use of immunosuppressants will result in a worse cancer outcome. With emerging evidence, our understanding and management strategies are likely to evolve in the future.


Noradrenaline modifies arterial reflection phenomena and left ventricular efficiency in septic shock patients: A prospective observational study.
To determine whether noradrenaline alters the arterial pressure reflection phenomena in septic shock patients and the effects on left ventricular (LV) efficiency. Thirty-seven septic shock patients with a planned change in noradrenaline dose. Timing and magnitude (Reflection Magnitude and Augmentation Index) of arterial reflections were evaluated. Total, steady, and oscillatory LV power (also expressed as fraction of the total power), subendocardial viability ratio (SEVR), energy efficiency and transmission ratios were used as a marker of LV efficiency. An incremental change in noradrenaline increased Reflection Magnitude [0.28(0.09) to 0.31(0.1], Augmentation Index [-6.4(23.6) to 4.8(20.7)%], and LV total power [0.79(IQR:0.47-1) to 0.98(IQR:0.57-1.27)W], all p < 0.001; whereas decreased arrival time of reflected waves [from 95(87 to 121) to 83(79 to 101)ms; p < 0.001]. Variables of LV performance showed a decreased efficiency: oscillatory fraction and energy efficiency ratio increased [20.9(5.7) to 22.8(4.9)%, and 8.2(1.7) to 10.1(2) mW.min.litre-1; p < 0.001, respectively]; and energy transmission ratio and SEVR decreased [73.8(9.9) to 72(9.8)% and 146(IQR:113-188) to 143(IQR:109-172)%, p = 0.003 and p = 0.041, respectively]. Noradrenaline increased reflection phenomena, increasing LV workload and worsening LV performance in septic shock patients. These conditions could explain the detrimental effects during long-term use of noradrenaline.


Vacuum-assisted closure (VAC) therapy in the management of wound infection following renal transplantation.
Wound infection in the setting of immunosuppressed state such as renal transplantation (RT) causes significant morbidity from sepsis, prolongs hospital stay and is expensive. Vacuum-assisted closure (VAC) therapy is a new technique of management of wound based on the principle of application of controlled negative pressure. The aim of this study was to assess the efficacy of VAC therapy in the management of wound infection following RT. This is a prospective study of a cohort of 180 consecutive RTs performed over a period of 4 years, where the data were retrieved from a prospectively maintained computerised database and case-notes. 9 of 180 (5%) patients developed wound infection following RT which led to cavitations and dehiscence with copious discharge, and refused to heal with conventional treatment. All 9 cases were treated with VAC therapy. The VAC system was removed after a median of 9 (range 3-30) days when discharge from the wound ceased. Four patients were discharged home with portable VAC device and managed on an outpatient basis, where the system was removed after a median 5.5 (range 3-7) days. The median hospital stay after initiation of VAC therapy was significantly shorter (5, range 2-12 days) than on conventional treatment prior to VAC therapy (11, range, 5-20 days) (p=0.003). Complete healing was achieved in all cases. The use of VAC therapy is an effective and safe adjunct to conventional and established treatment modalities for the management of wound infection and dehiscence following RT. Key words: Renal transplantation, wound infection, vacuum-assisted closure therapy.


The role of alpha-difluoromethyl ornithine as an adjuvant to immunotherapy in mice bearing transplantable tumors.
alpha-Difluoromethyl ornithine (DFMO), an inhibitor of ornithine decarboxylase (ODC), depletes cellular polyamine levels which is significantly correlated to neoplastic transformation. DFMO was used to modulate the growth rate of Ehrlich ascites carcinoma in mice and attempts were made to use DFMO as an adjuvant to immunotherapy. The therapeutic efficacy was estimated by measurement of polyamine levels of blood and ODC activity. Significant changes were also observed in the survival of the treated groups of animals, the implications of which have been discussed.


Algorithm of the finite-lattice method for high-temperature expansion of the Ising model in three dimensions.
We propose an algorithm of the finite-lattice method to generate the high-temperature series for the Ising model in three dimensions. It enables us to extend the series for the free energy of the simple-cubic lattice from the previous series of 26th order to 46th order in the inverse temperature. The obtained series give the estimate of the critical exponent for the specific heat in high precision.


Reperfusion injury of postischemic tissues.
Reperfusion injury, occurring when blood circulation is restored to previously ischemic tissues, is now demonstrable as a pathophysiologic entity distinct from the primary ischemic injury that develops during ischemia per se. The primary pathogens that cause reperfusion injury are thought to be partially reduced oxygen species, including superoxide radicals, hydrogen peroxide, and hydroxyl radicals, which initiate lipid peroxidation and other deleterious oxidation reactions during the reperfusion period. Antioxidant drugs, given at the end of ischemia or at the very onset of reperfusion, can improve the postischemic function of isolated organs and the survival of intact animals subject to a cycle of circulatory arrest and reperfusion, suggesting that reperfusion injury is both a real and a preventable pathophysiologic entity.


Factors affecting treatment motivation among Turkish patients receiving inpatient treatment due to alcohol/substance use disorder.
Motivation is a significant factor in the treatment of addiction and has been proven to be a predictor of treatment outcomes. The present study investigated the effects of clinical variables, perceived social support, temperament, and personality traits on treatment motivation. This study included 100 patients whose detoxification treatment was completed following hospitalization in Alcohol and Drug Research, Treatment, and Training Center (AMATEM). Treatment motivations were assessed through Motivation for Treatment scale (MfT). Addiction Profile Index (API) was used to evaluate drug use characteristics, craving, and the effects of drug use on life. Temperament and character traits and perceived social support were evaluated by Temperament and Character Inventory (TCI) and Multidimensional Scale of Perceived Social Support (MSPSS), respectively. The number of treatment admissions, presence of a history of previous inpatient treatment, completed inpatient treatment, social support from the family, harm avoidance, substance use characteristics, craving, and the effect of substance on life showed differences while motivations of the patients were compared. Presence of a history of previously completed inpatient treatment, presence of high social support from the family, and significant recognition of the effects of substance on own life were evaluated as the factors predicting high motivation. The present study demonstrated that social support from family, previously completed inpatient treatment, and effect of substance in life had significant impact on motivation. Therefore, the assessment of these factors will aid in better understanding this population and in the design of long-term treatment plans.


A novel antisense long noncoding RNA regulates the expression of MDC1 in bladder cancer.
Antisense long noncoding RNAs (lncRNAs) play important roles in regulating the expression of coding genes in post-transcriptional level. However, detailed expression profile of lncRNAs and functions of antisense lncRNAs in bladder cancer remains unclear. To investigate regulation of lncRNAs in bladder cancer and demonstrate their functions, we performed lncRNAs microarray analysis in 3 paired bladder cancer tissues. Further molecular assays were conducted to determine the potential role of identified antisense lncRNA MDC1-AS. As a result, a series of lncRNAs were differentially expressed in bladder cancer tissues in microarray screen. In a larger size of samples validation, we found that the expression levels of MDC1-AS and MDC1 was down-regulated in bladder cancer. After over-expression of MDC1-AS, increased levels of MDC1 were observed in bladder cancer cells. We also found a remarkably inhibitory role of antisense lncRNA MDC1-AS on malignant cell behaviors in bladder cancer cells EJ and T24. Subsequently, knockdown of MDC1 revealed that suppressing role of MDC1-AS was attributed to up-regulation of MDC1. In summary, we have identified a novel antisense lncRNA MDC1-AS, which may participate in bladder cancer through up-regulation of its antisense tumor-suppressing gene MDC1. Further studies should be conducted to demonstrate detailed mechanism of our findings.


[Nursing care in systemic arterial hypertension].
The analysis shown below was made in order to bring out the importance of the nursery professional behavior on its three levels related to the Systemic Arterial Hypertension, which is considered as the main factor for cardiovascular, brain vascular and renal sufferings because it's an unknown affectation for most of the people who suffers from, it. This is why is for the professional nurse to have all the knowledge that would let him develop correctly a diagnostic which may help to improve the service they provide, in order to promote the public weal, the timely disease detection, the cares needed and the supervision of treatments. The professional nurse will have to be able to create specific conditions in every patient, so they can change their life styles habits appropriately. This is how society will be involved on issues just as prevention, control and eradication of this particular disease and also these actions will help to minimize the mortality index, the families welfare and particularly the people's quality life styles.


Magnetic resonance-guided focused ultrasound surgery (MRgFUS) of uterine fibroids in Singapore.
Uterine fibroids are the most common type of gynaecologic benign tumours, occurring in 25% to 50% of women during their reproductive lives. About half of the affected women have clinically significant symptoms, including abnormal bleeding, menstrual pain, frequent urination, constipation and abdominal distension. Magnetic resonance-guided focused ultrasound surgery (MRgFUS) has been used to treat patients with benign lesions and a variety of malignancies. The objective of this study is to evaluate symptom relief before and after MR-guided ultrasound ablation of fibroids. A total of 37 patients with symptomatic uterine fibroids were treated in this study. MRgFUS treatment led to a significant, time-dependent decrease in not only Symptom Severity Scores (SSS), but also the mean fibroid volume. The average reductions in volume were 41.6% and 52.6% at 6 months and 12 months respectively (P <0.05). The mean SSS of the 37 patients was 41.7 ± 2.8 before treatment whereas the average SSS was 26.9 ± 3.6, 20.7 ± 3.4, 18.5 ± 3.6, 16.5 ± 7.1, 9.8 ± 3.6 at 3 months, 6 months, 1 year, 2 years, and 3 to 4 years respectively. The decrease in scores was significant at all time points up to 3 to 4 years (P <0.05 and P <0.001). MRgFUS is a safe and effective non-invasive treatment for patients with symptomatic fibroids.


Homonegativity in Britain: Changing Attitudes Towards Same-Sex Relationships.
Over recent decades, British attitudes towards same-sex relationships have become more accepting. However, results from the National Survey of Sexual Attitudes and Lifestyles show that, in 2010, around a fifth of 16-59-year-olds still viewed sex between two men or two women as 'always wrong'. Using data from each edition of this survey (1990, 2000, 2010), we investigated which individuals are more likely to regard same-sex relationships as wrong and how this has changed over time. Using various measures of individual characteristics, the results showed sex, religiosity, ethnicity, education and whether someone has ever experienced same-sex attraction were most strongly associated with homonegative attitudes. We show that religiosity and ethnicity became more strongly associated with homonegativity between 1990 and 2010, with religiosity replacing education as the characteristic most associated with homonegativity by 2010; explanations for these changes are offered. Further results show that attitudes towards one night stands are also associated with attitudes towards same-sex relationships. This suggests that falling rates of homonegativity might (in part) be explained by a general liberalization in attitudes towards non-traditional sexual relationships.


Early experience with a new technique and technology designed for the study of pulsatile cardiopulmonary bypass in the rat.
The benefits of pulsatile flow during the period of cardiopulmonary bypass (CPB) applied during open-heart surgery remains controversial. We have developed a rodent (rat) model of CBP that has been designed to functionally mimic the clinical setting, principally, but not solely, for the study of pulsatile CPB. The successful development of this model centres on the design of the bypass circuitry and the surgical approach employed. The entire circuit is similar to clinical equipment in terms of its construction, configuration, performance, material surface area to blood volume ratio, and priming volume to blood volume ratio. The overall priming volume of the perfusion circuitry is less than 12 ml. Early studies confirm that the pumping technology functions well, gas exchange was adequate at all times, and blood pressure exhibited a normal CPB profile and haemodynanmic response to pulsatile blood flow. We conclude that this is an effective tool for investigating the pathophysiology of pulsatile blood flow during CPB.


[Soil enzyme activities in a Pleioblastus amurus plantation in Rainy Area of West China under simulated nitrogen deposition].
From November 2007 to May 2009, a simulation test was conducted in a Pleioblastus amarus plantation in Rainy Area of West China to study the effects of nitrogen deposition on the activities of soil enzymes. Four treatments were installed, i.e., control (0 g N x m(-2) x a(-1)), low nitrogen (5 g N x m(-2) x a(-1)), medium nitrogen (15 g N x m(-2) x a(-1)), and high nitrogen (30 g N x m(-2) x a(-1)). Half year after N deposition, 0-20 cm soil samples were collected monthly, and the activities of peroxidase, polyphenol oxidase, cellulase, sucrase, urease, and acid phosphatase were determined. All test enzyme activities had apparent, seasonal variation, with the peak of cellulase, suerase, and acid phosphatase activities in spring, of urease activity in autumn, and of peroxidase and polyphenol oxidase activities in winter. Nitrogen deposition stimulated the activities of polyphenol oxidase, sucrase, urease, and acid phosphatase, inhibited cellulase activity, but had no significant effects on peroxidase activity. The test P. amurus plantation ecosystem was N-limited, and nitrogen deposition stimulated the decomposition of soil organic matter by microbe-enzyme system.


Influence of systolic blood pressure and cigarette smoking on endothelial function in young healthy people.
Flow-mediated dilatation (FMD) of the brachial artery represents systemic endothelial function, so the relationship between FMD and blood pressure (BP) profile, in relation to the effects of cigarette smoking, was investigated in young healthy subjects. The 62 healthy subjects (14 females, 48 males; mean 29.7+/-5.5 years old), were divided into a smoking group (n=30) and non-smoking group (n=32). FMD was induced by reactive hyperemia. It was lower in the smoking group than in the non-smoking group (P<0.05). In the non-smoking group, there was an inverse correlation (r=-0.59, P<0.0005) between FMD and systolic BP (SBP), which was not recognized in the smoking group. Multiple stepwise regression analysis revealed that FMD was predicted by either the SBP or the brachial artery diameter in the non-smoking group, whereas it was predicted by the brachial artery diameter in the smoking group. Subdivision by cut-off value of SBP =120 mmHg demonstrated that although FMD with SBP <120 mmHg was preserved in subjects in the non-smoking group, it was depressed to a level comparable with SBP >or=120 mmHg in the smoking group. Highly-preserved FMD in subjects with SBP <120 mmHg appears to be impaired by cigarette smoking, resulting in a loss of association between FMD and SBP.


The role of caspase-8 in resistance to cancer chemotherapy.
Toxicity of chemotherapeutic agents against cancer cells is mediated through the initiation of programmed cell death. Apoptosis is an evolutionarily conserved cascade of intracellular proteolytic events propagated by a family of cysteine proteases called caspases. Many receptor- and non-receptor-mediated death signals induce apoptosis via activation of caspase-8 (FLICE/MACH). Mechanisms of tumor resistance to cytotoxic drugs through decreased apoptosis may occur by altered expression of caspase-8, upregulation of caspase-8 inhibitors like FLIP (FLICE-like Inhibitory Protein), or sequestration of caspase-8 by Bcl-2. Modulation of caspase-8 and apoptosis may be a therapeutic strategy for sensitization of drug-resistant malignancies to radiation or combination chemotherapy.


[Statins in chronic heart failure--new indication?].
Chronic heart failure (CHF) is connected with very high risk of death. Discovery of neurohormonal mechanisms which contribute to pathogenesis of CHF changed therapeutic management of CHF. It was indicated that statins may exert beneficial effects in patients with CHF through preventing acute coronary syndromes, reducing myocardial hypertrophy, decreasing activation of renin-angiotensin-aldosterone system and sympathetic system, inhibitory effects on inflammatory cytokines and metalloproteinases, improving endothelial function. Usefulness of statins in CHF is however controversial. There is some evidence that lower serum cholesterol concentrations relate to impaired survival in patients with CHF. Before data from large scale trials (CORONA, GISSI-HF, UNIVERSE) will be published, statin therapy in CHF must be recommended carefully.


Quantitative Profiling of Ester Compounds Using HS-SPME-GC-MS and Chemometrics for Assessing Volatile Markers of the Second Fermentation in Bottle.
A quantitative approach using HS-SPME-GC-MS was performed to investigate the ester changes related to the second fermentation in bottle. The contribution of the type of base wine to the final wine style is detailed. Furthermore, a discriminant model was developed based on ester changes according to the second fermentation (with 100% sensitivity and specificity values). The application of a double-check criteria according to univariate and multivariate analyses allowed the identification of potential volatile markers related to the second fermentation. Some of them presented a synthesis-ratio around 3-fold higher after this period and they are known to play a key role in wine aroma. Up to date, this is the first study reporting the role of esters as markers of the second fermentation. The methodology described in this study confirmed its suitability for the wine aroma field. The results contribute to enhance our understanding of this fermentative step.