Measuring the principal Hugoniot of inertial-confinement-fusion-relevant TMPTA plastic foams.
Wetted-foam layers are of significant interest for inertial-confinement-fusion capsules, due to the control they provide over the convergence ratio of the implosion and the opportunity this affords to minimize hydrodynamic instability growth. However, the equation of state for fusion-relevant foams are not well characterized, and many simulations rely on modeling such foams as a homogeneous medium with the foam average density. To address this issue, an experiment was performed using the VULCAN Nd:glass laser at the Central Laser Facility. The aim was to measure the principal Hugoniot of TMPTA plastic foams at 260mg/cm^{3}, corresponding to the density of liquid DT-wetted-foam layers, and their "hydrodynamic equivalent" capsules. A VISAR was used to obtain the shock velocity of both the foam and an α-quartz reference layer, while streaked optical pyrometry provided the temperature of the shocked material. The measurements confirm that, for the 20-120 GPa pressure range accessed, this material can indeed be well described using the equation of state of the homogeneous medium at the foam density.


Comparison of Kang's and Littmann's methods of correction for ocular magnification in circumpapillary retinal nerve fiber layer measurement.
To assess and compare the accuracy of Kang's method for ocular magnification correction in circumpapillary retinal nerve fiber layer (cpRNFL) thickness measurement with that of the currently used Littmann's method. A total of 148 eyes of 148 healthy participants underwent cpRNFL measurement without correction and with correction by Littmann's method using spectral-domain optical coherence tomography. Correction of ocular magnification by Kang's method is based on the observed uncorrected cpRNFL thickness. The accuracy of Kang's method was compared with that of Littmann's method for magnification correction by using the Pearson product-moment correlation coefficient (r) and Bland-Altman analysis. A total of 132 eyes were assessed. The two methods used to correct the global cpRNFL thickness were strongly correlated (r = 0.940, P < 0.01), and the mean difference between the two methods was -0.4 μm, with 95% limits of agreement (LoA) of ±6 μm without systemic bias (P > 0.05). Although the cpRNFL thicknesses corrected with the two methods at quadrant and 12-o'clock sectors showed a strong correlation (r > 0.731, P < 0.01), high LoAs ranging from ±13.3 to ±27.9 and systemic biases were observed at nasal and inferior sectors. No difference was found between Kang's and Littmann's methods for correction of ocular magnification in global cpRNFL thickness measurement. However, with regard to magnification correction for sectoral cpRNFL thickness, further scrutiny of Kang's method is warranted, even in healthy participants, because of the high variability between Littmann's and Kang's methods.


Neuroestrogens rapidly shape auditory circuits to support communication learning and perception: Evidence from songbirds.
Contribution to Special Issue on Fast effects of steroids. Steroid hormones, such as estrogens, were once thought to be exclusively synthesized in the ovaries and enact transcriptional changes over the course of hours to days. However, estrogens are also locally synthesized within neural circuits, wherein they rapidly (within minutes) modulate a range of behaviors, including spatial cognition and communication. Here, we review the role of brain-derived estrogens (neuroestrogens) as modulators within sensory circuits in songbirds. We first present songbirds as an attractive model to explore how neuroestrogens in auditory cortex modulate vocal communication processing and learning. Further, we examine how estrogens may enhance vocal learning and auditory memory consolidation in sensory cortex via mechanisms similar to those found in the hippocampus of rodents and birds. Finally, we propose future directions for investigation, including: 1) the extent of developmental and hemispheric shifts in aromatase and membrane estrogen receptor expression in auditory circuits; 2) how neuroestrogens may impact inhibitory interneurons to regulate audition and critical period plasticity; and, 3) dendritic spine plasticity as a candidate mechanism mediating estrogen-dependent effects on vocal learning. Together, this perspective of estrogens as neuromodulators in the vertebrate brain has opened new avenues in understanding sensory plasticity, including how hormones can act on communication circuits to influence behaviors in other vocal learning species, such as in language acquisition and speech processing in humans.


Gateway Scholars Program - reducing barriers to STEM for undergraduate students through scholarship and supportive programs.
This report presents the Gateway Scholars Program, an NSF-S-STEM supported program that recruited academically talented undergraduate students with demonstrated financial need. The objectives of our program included establishing a mentored cohort program, implementing enhanced risk-based advising, integrating evidence-based instructional practices in the curriculum, engaging students in co-curricular experiences, and generating new knowledge about the effect of activities on retention, student success, and degree attainment. Knowledge about broadening participation and effectiveness of evidence-based practices in STEM curricular and co-curricular activities and systems developed through this program have the potential to impact all STEM departments.


Effects of excess granulocyte-macrophage colony stimulating factor (GM-CSF) in mice infected with a GM-CSF retrovirus.
To study the effects of dysregulated granulocyte-macrophage colony stimulating factor (GM-CSF) production, a retroviral vector (MPZen) containing a GM-CSF cDNA has been used to infect murine bone marrow cells prior to their transplantation into lethally-irradiated recipients. Animals transplanted with 1 x 10(6) bone marrow cells 14 to 21 days after transplantation displayed shortness of breath, trembling to the touch, and dragging of the hind limbs. These animals were shown to have increased peripheral blood neutrophil counts (x 200), decreased marrow cellularity (but with increased neutrophil and macrophage frequency) and increased spleen cellularity (with up to a 40-fold increase in neutrophil, macrophage and eosinophil frequency). Examination of sections of tissues from infected mice showed massive infiltration of neutrophils and macrophages in muscle, lungs, liver, and variable infiltration of these cells in lymphoid tissues and the eye. Haemopoietic tissues produced high levels of GM-CSF (10(5) Units/10(6) cells) and the serum contained up to 5.5 x 10(5) Units of GM-CSF per ml.


Manifestations of non-planar adsorption geometries of lead pyrenocyanine at the liquid-solid interface.
In this work, we provide evidence for multiple non-planar adsorption geometries of a novel pyrenocyanine derivative at the liquid-solid interface under ambient conditions. When adsorbed at the organic liquid-solid interface, lead pyrenocyanine forms well-ordered monolayers that exhibit peculiar non-periodic contrast variation. The different contrast of the adsorbed molecules is attributed to dissimilar adsorption geometries which arise from the non-planar conformation of the molecules. The non-planarity of the molecular backbone in turn arises due to a combination of the angularly extended pyrene subunits and the presence of the large lead ion, which is too big to fit inside the central cavity and thus is located out of the aromatic plane. The two possible locations of the lead atom, namely below and above the aromatic plane, could be identified as depression and protrusion in the central cavity, respectively. The manifestation of such multiple adsorption geometries on the structure of the resultant monolayer is discussed in detail. The packing density of these 2D arrays of molecules could be tuned by heating of the sample wherein the molecular packing changes from a low-density, pseudo six-fold symmetric to a high-density, two-fold symmetric arrangement. Finally, a well-ordered two-component system could be constructed by incorporating C60 molecules in the adlayer of lead pyrenocyanine at the liquid-solid interface.


Antimicrobial resistance to benzylpenicillin in invasive pneumococcal disease in Belgium, 2003-2010: the effect of altering clinical breakpoints.
The Belgian data (2003-2010) for the European Antimicrobial Resistance Surveillance Network (EARS-Net) showed a significant decreasing trend in the proportion of penicillin non-susceptible Streptococcus pneumoniae (9·4% to <1%) from blood and CSF isolates. We found that 75% of this decrease was explained by a change in Clinical and Laboratory Standards Institute (CLSI) breakpoints as the trend disappeared if only the new breakpoints were applied. Applying only European Committee on Antimicrobial Susceptibility Testing (EUCAST) breakpoints also resulted in a relatively stable proportion of penicillin non-susceptibility (average 5%), but this proportion was 7-13 times higher than with the new CLSI breakpoints. When the new CLSI breakpoints alone are used, fewer than 1% of bacteraemia isolates were penicillin non-susceptible during the entire period, but the proportion of non-susceptible meningitis isolates rose from 6·3% in 2003 to 15·9% between 2003 and 2010. Changing breakpoints should lead to retrospective analysis of historical data to minimize wrongly interpreting resistance trends.


New nuclear magnetic resonance data in epilepsy.
Nuclear magnetic resonance methods as a whole have contributed as much to the study and treatment of epilepsy as to any branch of medicine. The pace of the progress in this field increases as recently developed nuclear magnetic resonance techniques mature into practical tools for epilepsy research and management. Recent examples of such progress include new data on seizure-related brain water diffusion changes, brain metabolic abnormalities in epileptic patients, and pharmacologic manipulation of brain gamma-aminobutyric acid.


T lymphocyte response against pancreatic beta cell antigens in fulminant Type 1 diabetes.
Fulminant Type 1 diabetes is a novel subtype of Type 1 diabetes that involves the abrupt onset of insulin-deficient hyperglycaemia. This subtype appears to be non-autoimmune because of the absence of diabetes-related autoantibodies in the serum, and of insulitis in pancreatic biopsy specimens. The pathogenesis of the disease is still unknown. In this study, we investigated whether T cell autoimmune responses are involved in fulminant Type 1 diabetes. Cellular immune responses to beta cell autoantigens were studied by enzyme-linked immunospot (ELISPOT) assay in 13 fulminant Type 1 diabetic patients and 49 autoantibody-positive autoimmune Type 1 diabetic patients. Results were compared with those of 18 Type 2 diabetic patients, six secondary diabetic patients (diabetes due to chronic pancreatitis) and 35 healthy controls. Nine of 13 (69.2%) GAD-reactive Th1 cells, and three of 12 (25%) insulin-B9-23-reactive Th1 cells were identified in fulminant Type 1 diabetic patients by ELISPOT, as in autoantibody-positive Type 1 diabetic patients. Four fulminant Type 1 diabetic patients possessed the highly diabetes-resistant allele DR2, three of whom had GAD-reactive Th1 cells in the periphery. Peripheral immune reaction was observed in 69.2% of fulminant Type 1 diabetic patients, indicating that autoreactive T cells might contribute, at least in part, to the development of fulminant Type 1 diabetes.


[Effect of iron plaque on root surfaces on phosphorus uptake of two wetland plants].
In situ micro-suction cups were used to collect samples of soil solution with Arundo donax Linn and Typha latifolia from defined segments at rhizosphere in field. The experiment was conducted to elucidate the contribution of iron plaque while wetland plants were used to remove phosphorus. The reddish iron plaque was observed and measured on the surfaces of roots of Arundo donax Linn and Typha latifolia in the field, 20,170.8 mg/kg (fresh weight) for Arundo donax Linn and 7640.3 mg/kg (fresh weight) for Typha latifolia were collected. Olsen-P contents of Arundo donax Linn with iron plaque were 28.85 mg/kg, 46.2% more than that of without, 34.99 mg/kg for Typha latifolia 21.9% more than that of without. The phosphate concentrations in the in situ rhizosphere soil solution of Arundo donax Linn with iron plaque were 0.65 mg/kg, 9.2% more than that of without, 0.56 mg/kg for Typha latifolia, 33.9% more than that of without. The phosphorus contents adsorbed by iron plaque were 81.7% for Arundo donax Linn and 85.7% for Typha latifolia of the wetland plants with iron plaque. Phosphate use efficiency of Arundo donax Linn with iron plaque was 16.5% more than that of without, 31.4% for Typha latifolia. The contents of phosphorus of single plant of the two wetland plants with iron plaque are higher than that of without. Due to adsorb phosphate with iron plaque, the transfer speeds of phosphate from non-rhizosphere to rhizosphere and from soil to soil solution are increasing. The phosphorus contents with iron plaque accumulated at rhizosphere and depleted at rhizosphere without iron plaque of Arundo donax Linn and Typha latifolia.


Focus: current issues in medical ethics.
The current debates about seat belts in motor cars and the evils of smoking may only be straws in the wind if the scenario sketched in this paper were translated into a social, political programme. Then 'illness would increasingly be seen as a failure to keep healthy and thus culpable. The failures [the patients] ... must either be irresponsible and hence punishable at least by the imposition of financial penalties or insane and thus in need of corrective therapy.' If this sounds like 1984 the reader must read the whole argument set out in this paper and make his own judgment. He may not be encouraged by what he reads but he will be forewarned. There is no answer to the question, What shall I do, if this prophecy is true?


The fixed-dose combination of losartan/hydrochlorothiazide elicits potent blood pressure lowering during nighttime in obese hypertensive patients.
Hypertension is one of the most powerful predictor of the future cardiovascular events, and antihypertensive therapy adopting multiple drug regimen is often needed to obtain the appropriate blood pressure (BP) control. To clarify the blood pressure-lowering effect of the fixed-dose combination (FDC) of an angiotensin receptor blocker (ARB) and diuretic agent in poorly controlled hypertensive patients, we intended a multicenter prospective observational study (Investigation for Normalized Blood pressure control with the Appropriate medication: INBA) by means of the sequential ambulatory blood pressure monitoring (ABPM). One hundred and thirteen hypertensive patients who had not achieved the target BP control proposed in the guidelines with medication containing any ARB but without diuretic agents (54 men; mean age, 66 years old; mean office systolic/diastolic BP (SBP/DBP), 158/82 mmHg) were enrolled. Daytime and nighttime blood pressures were assessed with ABPM before and at 12 weeks after switching the ARB to the FDC of 50 mg of losartan, and 12.5 mg of hydrochlorothiazide (HCTZ). Daytime SBP/DBP (mean ± SD) decreased from 151 ± 14/88 ± 8 mmHg to 140 ± 11/82 ± 8 mmHg (P < 0.001, P < 0.001, respectively), and nocturnal SBP/DBP from 138 ± 18/78 ± 9 mmHg to 125 ± 14/72 ± 9 mmHg (P < 0.001, P < 0.001, respectively) during the 12 weeks treatment. Pulse rate did not change irrespective of the time window. Among various parameters (age, history of hypertension, body mass index (BMI), serum potassium, uric acid, estimated glomerular filtration rate, plasma B-type natriuretic peptide), BMI alone showed significant negative correlation with 12-weeks reduction in nocturnal SBP (r = -0.43, P < 0.05). No parameters correlated with reduction in daytime SBP during this period. Patients with BMI ≥ median (25.8 kg/m(2)) showed significantly greater reduction in nocturnal SBP for 12 weeks than patients with BMI < median (20.1 ± 15.6 mmHg vs 6.1 ± 10.9 mmHg, P < 0.001) although reduction in daytime SBP was comparable between the two groups (8.9 ± 13.5 mmHg vs 11.9 ± 12.7 mmHg). The administration of the FDC of losartan/HCTZ lowers BP both in day- and nighttime, and the nocturnal antihypertensive potency is remarkable in obese patients.


Rescue high frequency oscillatory ventilation for preterm infants: neurodevelopmental outcome and its prediction.
The role of rescue high-frequency oscillatory ventilation (HFO) in treating very-low-birth-weight neonates with severe respiratory failure in relation to neurodevelopmental outcome has not been evaluated. We performed a retrospective cohort study on 21 patients (out of 52 consecutively admitted preterm neonates with gestational age < or = 30 weeks and birth weight < or = 1.250 g; mortality rate 60%) rescued with HFO between October 1988 and August 1993. Neurodevelopment, including Bayley Scales in Infant Development, was assessed at 12-61 (mean 28.5) months adjusted age. Thirteen normal (scores better than 2 SD below mean, and no sensory or motor disability) (62%) and neurodevelopmentally disabled children (38%) survived more than 1 year for developmental assessment. The mental and performance developmental indices were 94 (78-117) and 89 (68-110), and 63 (49-102) and 49 for the 13 normal and 8 disabled children, respectively (both p < 0.05). The incidence of bronchopulmonary dysplasia, intraventricular hemorrhage (IVH; grade 3 or 4), growth retardation, developmental scores and disabilities of these 21 HFO survivors were not significantly different from that of a birth-weight- and gestational-age-matched comparison group. While all HFO survivors had significant improvement in oxygenation 12 and 24 h after starting HFO, FiO2 and the alveolar-arterial oxygen gradient (A-aDO2) decreased significantly 1 h after starting HFO in survivors with normal neurodevelopmental outcome. The lack of initial response to HFO (20% decrease in A-aDO2 1 h after starting HFO) and the presence of grade 3 or 4 IVH predicted neurodevelopmental disability with a sensitivity of 63%, a specificity of 100%, and positive and negative predictive values of 100 and 81%, respectively. We concluded that HFO could be used as a rescue treatment in sick preterm neonates. The lack of early improvement in oxygenation and the presence of grade 3 or 4 IVH can predict adverse early childhood neurodevelopment in such neonates.


[Effect of deferoxamine on erythropoiesis in patients hemodialyzed for chronic renal insufficiency treated with erythropoietin].
The aim of the study was to evaluate the effect of deferoxamine therapy on erythropoiesis, aluminium concentration and iron metabolism in hemodialyzed patients with chronic renal insufficiency treated with human recombinant erythropoietin (Eprex, Cilag). 8 hemodialyzed patients (2 female and 6 male) in long-term programme with aluminium serum concentration over 160 micrograms/l were treated with deferoxamine (5 mg/kg b.m.) during the last hour of hemodialysis in slowly intravenous infusion since 1 months. During this treatment aluminium and iron serum concentrations, serum iron-binding capacity, transferrin and hematocrit were determined before and after 1 months of deferoxamine therapy. The significant decrease of aluminium serum concentration (p < 0.05) and increase of hematocrit (p < 0.01), iron (p < 0.05) and serum iron-binding capacity (p < 0.001) were determined. The results of performed analysis indicate that aluminium is able to inhibit erythropoiesis induced by erythropoietin. The improvement in erythropoiesis and iron metabolism after deferoxamine therapy was observed.


Factors associated with physiotherapists' confidence during assessment of clinical cervical and lumbar spine instability.
Physiotherapists commonly encounter patients with complaints of vague, indistinguishable neck and back pain, such as clinical spine instability. Since confidence is a component of expert clinical practice, we were interested in measuring expert clinicians' confidence in diagnosing and assessing clinical spine instability. The aims of the present study were to factor out the common 'identifiers' associated with physiotherapists' objective, physical diagnosis and assessment of clinical spine instability, and to determine the association of reported diagnostic confidence to these identifiers. The study used data from a Delphi instrument for the factor analysis and a survey of APTA Board-certified orthopaedic specialists for report of confidence. Using an ologit regression analysis, the identifier themes and clinical background characteristics were associated with confidence in diagnosis of clinical spine instability. Only clinical cervical spine instability obtained significant findings. The identifier 'observable or palpable abnormalities of motion during movement assessment in clinical practice' was positively associated with reported confidence in diagnosis, as was the influence of manual therapy background models: Cyriax, Maitland, McKenzie, NAIOMPT, Osteopathic, Paris and other. Male gender yielded negative association with reported confidence. No factors were associated with reported lumbar confidence. Multiple backgrounds of physiotherapists demonstrate confidence in detecting clinical spine instability using observable or palpable methods to detect abnormal movements.


Controlling brain dynamics: Landscape and transition path for working memory.
Understanding the underlying dynamical mechanisms of the brain and controlling it is a crucial issue in brain science. The energy landscape and transition path approach provides a possible route to address these challenges. Here, taking working memory as an example, we quantified its landscape based on a large-scale macaque model. The working memory function is governed by the change of landscape and brain-wide state switching in response to the task demands. The kinetic transition path reveals that information flow follows the direction of hierarchical structure. Importantly, we propose a landscape control approach to manipulate brain state transition by modulating external stimulation or inter-areal connectivity, demonstrating the crucial roles of associative areas, especially prefrontal and parietal cortical areas in working memory performance. Our findings provide new insights into the dynamical mechanism of cognitive function, and the landscape control approach helps to develop therapeutic strategies for brain disorders.


The cell wall-modifying xyloglucan endotransglycosylase/hydrolase LeXTH1 is expressed during the defence reaction of tomato against the plant parasite Cuscuta reflexa.
A suppressive subtractive hybridization technique was used to identify genes, which were induced during the early phases of the interaction between dodder (Cuscuta reflexa), a phanerogamic parasite, and its incompatible host plant tomato. One of the identified genes encodes a tomato xyloglucan endotransglycosylase/hydrolase (XTH)--an enzyme involved in cell wall elongation and restructuring. The corresponding LeXTH1 mRNA accumulated 6 h after attachment of the parasite. In contrast, wounding did not influence the expression level. Subsequent to LeXTH1 mRNA accumulation, an increase in XTH activity at the infection sites as well as in adjacent tissues was observed. The effect of IAA on LeXTH1 expression was analyzed because the concentration of this phytohormone is known to increase in the tomato tissue during the interaction with the parasite. LeXTH1 mRNA accumulation was in fact induced by external application of auxin. However, in the auxin-insensitive tomato mutant diageotropica, Cuscuta induced LeXTH1-mRNA accumulated with a time course similar to wild type tomato. Thus, auxin appears not to be an essential signal for infection-induced LeXTH1 activation. Our data suggest a role for xyloglucan transglycosylation in defence reactions associated with the incompatible tomato- Cuscuta interaction.


Research on corn production efficiency and influencing factors of typical farms: Based on data from 12 corn-producing countries from 2012 to 2019.
Globally, corn is characterised by high production and high export concentrations, yet the world is experiencing an unprecedented, huge change in this regard. Ensuring the global supply of corn, and thereby the energy and food security of nations has become particularly important. To understand the importance of corn production as an influencing mechanism of global food supplies, the present study researched the corn production of typical farms in major corn-producing and importing countries around the world. I selected the corn input and output data of 18 typical farms in 12 countries from 2012 to 2019, used the data envelopment analysis (DEA) model to calculate the technical efficiency of corn production, and built a tobit model to explore the impact of farming methods, input elements, supporting services, and other factors on efficiency. The study established that the average comprehensive technical efficiency of corn production on a typical farm was 0.863, and the average loss was 13.7%. In addition, it concluded that intensive tillage and conservation tillage have high technical efficiency. It also demonstrated that the proportion of mechanical labour and technical efficiency is in a 'U'-shaped relationship, among others.


Development of Portable Digital Radiography System with a Device for Monitoring X-ray Source-Detector Angle and Its Application in Chest Imaging.
This study developed a device measuring the X-ray source-detector angle (SDA) and evaluated the imaging performance for diagnosing chest images. The SDA device consisted of Arduino, an accelerometer and gyro sensor, and a Bluetooth module. The SDA values were compared with the values of a digital angle meter. The performance of the portable digital radiography (PDR) was evaluated using the signal-to-noise (SNR), contrast-to-noise ratio (CNR), spatial resolution, distortion and entrance surface dose (ESD). According to different angle degrees, five anatomical landmarks were assessed using a five-point scale. The mean SNR and CNR were 182.47 and 141.43. The spatial resolution and ESD were 3.17 lp/mm (157 μm) and 0.266 mGy. The angle values of the SDA device were not significantly difference as compared to those of the digital angle meter. In chest imaging, the SNR and CNR values were not significantly different according to the different angle degrees. The visibility scores of the border of the heart, the fifth rib and the scapula showed significant differences according to different angles (p < 0.05), whereas the scores of the clavicle and first rib were not significant. It is noticeable that the increase in the SDA degree was consistent with the increases of the distortion and visibility score. The proposed PDR with a SDA device would be useful for application in the clinical radiography setting according to the standard radiography guidelines.


Mechanistic Understanding toward the Maternal Transfer of Nanoplastics in Daphnia magna.
Nanoplastics induce transgenerational toxicity to aquatic organisms, but the specific pathways for the maternal transfer of nanoplastics remain unclear. Herein, laser scanning confocal microscopy (LSCM) observations identified the specific pathways on the maternal transfer of polystyrene (PS) nanoplastics (25 nm) in Daphnia magna. In vivo and in vitro experiments showed that PS nanoplastics could enter the brood chamber through its opening and then be internalized to eggs and embryos using LSCM imaging (pathway I). In addition, PS nanoplastics were observed in the oocytes of the ovary, demonstrating gut-ovary-oocyte transfer (pathway II). Furthermore, label-free hyperspectral imaging was used to detect the distribution of nanoplastics in the embryos and ovary of Daphnia, again confirming the maternal transfer of nanoplastics through the two pathways mentioned above. The contribution from pathway I (88%) was much higher than pathway II (12%) based on nanoflow cytometry quantification. In addition, maternal transfer in Daphnia depended on the particle size of PS nanoplastics, as demonstrated by using LSCM and hyperspectral imaging. Unlike 25 nm nanoplastics, 50 nm PS nanoplastics could enter the brood chamber and the eggs/embryos (pathway I), but were not detected in the ovary (pathway II); 100 nm PS nanoplastics were difficult to be internalized by eggs/embryos and could not enter the ovary either. These findings provide insight into the maternal transfer mechanisms of nanoplastics in Daphnia, and are critical for better understanding the transgenerational toxicity of aquatic organisms.


Giardiasis as a threat to backpackers in the United States: a survey of state health departments.
Forty-eight of the 50 state health departments in the United States responded to a questionnaire about giardiasis in their jurisdictions. The agencies had reports of 34348 cases during 1991 and studied 80 outbreaks in the same period. Nineteen of these outbreaks were attributed to consumption of contaminated drinking water; only two outbreaks were reported among individuals identified as campers or backpackers. Only two departments considered water-associated giardiasis to be a problem for backpackers in their jurisdiction, and neither had any data to support this concern. The surveillance data of health departments indicate that giardiasis is a common communicable disease in the United States. They do not, however, provide any evidence that wilderness water is an important cause of the disease in this country.


Bufadienolides and other constituents of Urginea sanguinea.
Fresh bulbs of Urginea sanguinea yielded stigmasterol, phloroglucinol, phloroglucinol 1-beta-D-glucopyranoside (phlorin), scillaren A, a novel compound 5 alpha-4,5-dihydroscillaren A (1), salicylic acid, and 3-hydroxy-4-methylbenzoic acid. The latter two showed weak antibacterial activity. The compounds were identified using spectroscopic techniques such as 1D and 2D NMR, EI-MS and FAB-MS.


Optimization of fermentation conditions, purification and rheological properties of poly (γ-glutamic acid) produced by Bacillus subtilis 1006-3.
This study aimed to investigate the optimal fermentation condition, purification and rheological properties of extracellular polymers produced by Bacillus subtilis 1006-3. An optimum temperature of 30.2 °C, inoculation amount of 6.1%, and pH of 8.2 were determined via Response Surface Methodology. The result of amino acid analysis and gel electrophoresis indicated that the obtained polymer contained only glutamic acid, with a wide molecular weight range. This polymer was finally determined as γ-PGA by infrared spectroscopy. The γ-PGA solution displayed a behavior of pseudoplastic non-Newtonian fluid with shear thinning properties, which can be described by the Ostward-de Waele power law model. The apparent viscosity of γ-PGA solution increased with the increase in its concentration from 1% to 10%. The deviation in pH from neutral value, and the addition of NaCl or MgCl2 can reduce the apparent viscosity of γ-PGA solution, and it was more sensitive to Mg2+ than to Na+ addition. At the concentration of 4, 6, and 8%, γ-PGA solution showed predominantly viscous response in the range of 0.1-100 rad/s angular frequency (G″>G'). These results indicated the potential application of the γ-PGA as a thickening agent.


Distribution of horn flies on individual cows as a percentage of the total horn fly population.
Twenty-three mixed-breed herd cows were phenotyped for their ability to serve as a suitable host for Haematobia irritans, the horn fly. Based upon consistent observations within the lower quartile or upper quartile of individual fly counts, four cows were phenotyped as low carriers and five cows were phenotyped as high carriers of horn flies. The cows designated as low carriers consistently carried levels of flies below the economic threshold. However, during a period of fly population explosion, low carriers harbored flies well above the economic threshold. Although the number of flies counted on these low carrying cattle increased as the population increased, the relative percentage of the population that they carried changed very little. A hypothesis is proposed to explain this observation, and future studies are suggested.


Cardiovascular risk stratification in patients with non-valvular atrial fibrillation: the 2MACE score.
Recent findings suggest that patients with non-valvular atrial fibrillation (AF), in addition to having a high risk for ischemic stroke, are also at risk for myocardial infarction (MI). The aim of the study was to combine factors predicting Major Adverse Cardiovascular Events (MACE) in AF patients, including fatal/nonfatal MI, cardiac revascularization, and cardiovascular death, into a simple risk score. Predictors of MACE were obtained from a prospective observational cohort study, including 1019 AF patients taking vitamin K antagonists from the Atherothrombosis Center, of Sapienza University of Rome. Thus, we derived the 2MACE score [2 points for Metabolic Syndrome and Age ≥75, 1 point for MI/revascularization, Congestive heart failure (ejection fraction ≤40 %), thrombo-Embolism (stroke/transient ischemic attack)], ranging from 0 to 7 points. To evaluate the 2MACE score, we included an external validation cohort of 1089 anticoagulated AF patients from the Thrombosis Centre of Azienda Ospedaliero-Universitaria Careggi, Firenze, Italy. At follow-up, 111 AF patients in the internal and 68 in the external cohort experienced a MACE. The 2MACE score showed a good ability in discriminating AF patients experiencing MACE both in the internal derivation cohort, with a c-index of 0.79 [95 % Confidence Interval (CI) 0.71-0.90, p < 0.001] and in the external validation cohort (c-index 0.66, 95 % CI 0.60-0.73, p < 0.001). The overall Hazard Ratio (HR) was 1.61 (95 % CI 1.40-1.85, p < 0.001) for each additional point. A 2MACE score ≥3 had the best combination of specificity and sensitivity, with an HR of 3.92 (95 % CI 2.41-6.40, p < 0.001). The new simple 2MACE score may help identifying AF patients at risk for cardiovascular events.


Promoting Vaginal Distribution of E7 and MCL-1 siRNA-Silencing Nanoparticles for Cervical Cancer Treatment.
There is an urgent need to develop a less aggressive and more effective treatment against cervical lesions induced by different high-risk human papillomavirus (HR-HPV). We investigated the potential of a cocktail of small interfering RNA (siRNA) directed against the oncoprotein E6 (E6), the oncoprotein E7 (E7), or the antiapoptotic protein MCL-1 (MCL-1). The combination of siRNA anti-E7 and anti-MCL-1 demonstrated high efficacy on multiple HPV16 and HPV18 cell lines and no effects on healthy keratinocytes. This gene therapy has been considered for a vaginal administration since this route of application holds high potential for the treatment of diseases in the female reproductive tracts. Therefore, PEGylated lipoplexes have been designed and characterized to protect siRNA and to diffuse in the mucosal environment before they reach the cervico/vaginal epithelium. This new nanovector complexed to the combination of active siRNA induced an efficient mRNA knockdown since biological effects were obtained in vitro. This work also provided evidence that the PEGylated lipoplexes had appropriate physicochemical properties to diffuse into a mucin network according to size measurement experiments in artificial mucus. After demonstrating the distribution and the efficacy of siRNA into a 3D-cervical model lesion and through porcine vaginal mucosa, in vivo experiments in mouse have been performed under physiological conditions. This study revealed a complete and sustained coverage of the mucosal epithelium following an unique vaginal administration of fluorescent PEGylated lipoplexes. Overall, our results showed the potential of the PEGylated lipoplexes for the prolonged delivery of active siRNA to treat HPV-induced lesions.


[A Case of Intrathecal Infusion of Methotrexate and Ara-C for a Patient with Meningitis Due to Recurrent Gastric Cancer].
A 69-year-old woman underwent total gastrectomy for advanced gastric cancer with pyloric stenosis. She had a good postoperative course and was discharged 2 weeks after surgery. She received adjuvant chemotherapy with S-1 after discharge. One month after the initiation of the adjuvant chemotherapy, she complained of wobbling and weakness of her limbs. She stopped intake of S-1, but the symptoms did not improve. She was admitted to the hospital, but she became unconscious and had headache and blurred vision. We conducted a cerebrospinal fluid examination and made a diagnosis of meningeal carcinomatosis. After we started intrathecal infusion of methotrexate and Ara-C, referring to case reports clinical symptoms, including unconsciousness, headache, and left upper limb paralysis, improved and the CEA level in cerebrospinal fluid decreased.


CO2 laser treatment for regional cutaneous malignant melanoma metastases.
Cutaneous in-transit and satellite metastases are distressing presentations of melanoma progression. The purpose of this study was to analyze the efficacy of carbon dioxide (CO2) lasers in patients with melanoma with cutaneous in-transit and satellite metastases. Results of CO2 laser therapy were retrospectively evaluated in 22 patients between January 2004 and January 2008. The number of laser treatments, postoperative morbidity, regional control, and overall survival were analyzed. Twenty-two patients received a total of 42 CO2 laser treatments. The number of lesions treated per session varied from 3 to 329. The median duration of regional control in all patients was 14 weeks (range, 3-117). In 9 of 22 patients, only 1 treatment with CO2 laser was performed resulting in a mean regional control of 11 weeks. In 10 patients, an average of 4 laser treatments (range, 1-17) was necessary to achieve regional control. Three of the 22 patients underwent isolated limb perfusion after laser treatment for disease control. This study shows that (repeated) laser treatment can achieve adequate regional control with little morbidity. CO2 laser is recommended as a first-line treatment to patients with small but numerous cutaneous satellite or in-transit lesions in whom other surgery would induce substantial morbidity.


The morphometry of the Sudan-III-positive granules in the cytoplasm of the human amniotic epithelium.
Seventy-nine human amnions from different gestational ages were studied by new morphometric methods. The Sudan-III-positive granules in the cytoplasm of the amniotic epithelial cells were first observed in the reflected amnion from the second trimester of normal gestation. During the third trimester of normal gestation, the number of cytoplasmic granules increased remarkably with gestational age not only in the reflected amnion but also in the placental amnion. The number of granules was generally related to the increasing rates of anucleated cells and binucleated cells in the amniotic epithelium during the third trimester of normal gestation. During the third trimester of gestation, the number of granules was greater in the distant reflected amnion with its less adequate blood supply than in the placental amnion. A vast accumulation of the granules in the entire amnion was observed in cases of fetal death, in which blood supply had ceased. It is suggested, therefore, that the progressive accumulation of Sudan-III-positive cytoplasmic granules in the human amniotic epithelium during the third trimester of normal gestation is the result of cell degeneration.


DNA binding sites for putative methylation boundaries in the unmethylated region of the BRCA1 promoter.
Changes in DNA methylation patterns are frequently observed in human cancers and are associated with a decrease in tumor suppressor gene expression. Hypermethylation of the BRCA1 promoter has been reported in a portion of sporadic breast tumours that correspond to a reduction in BRCA1 transcription and expression. Questions remain concerning the maintenance of methylation free zones in promoter regions of tumor suppressor genes in normal tissues. Sodium bisulfite based analysis of the BRCA1 promoter defines a methylation free zone in normal breast tissue that starts 650 bp upstream of the transcription start site and extends for 1.4 kb through most of the BRCA1 CpG island. We provide data implicating 2 proteins, Sp1 and CTCF, in the maintenance of this methylation-free zone. Both of these proteins have been shown to function as methylation boundaries in other genes. Four Sp1 sites have been identified in the BRCA1 promoter by gel shift assays. In vivo binding of Sp1 has been confirmed at 2 of these sites in the BRCA1 promoter and at 2 CTCF sites that flank the unmethylated region. Our data suggest that these DNA binding sites for Sp1 and CTCF may act as boundary elements that are important in maintaining genomic integrity by delineating the normal methylation free BRCA1 promoter. Inactivation or disruption of these boundaries may facilitate an epigenetic "hit", in this case DNA methylation, leading to BRCA1 downregulation and contributing to tumorigenesis, particularly the genesis of sporadic breast tumours.


[Application and Integration of Qualitative and Quantitative Research Methods in Intervention Studies in Rehabilitation Research].
In order to develop and evaluate interventions in rehabilitation research a wide range of empirical research methods may be adopted. Qualitative research methods emphasize the relevance of an open research focus and a natural proximity to research objects. Accordingly, using qualitative methods special benefits may arise if researchers strive to identify and organize unknown information aspects (inductive purpose). Particularly, quantitative research methods require a high degree of standardization and transparency of the research process. Furthermore, a clear definition of efficacy and effectiveness exists (deductive purpose). These paradigmatic approaches are characterized by almost opposite key characteristics, application standards, purposes and quality criteria. Hence, specific aspects have to be regarded if researchers aim to select or combine those approaches in order to ensure an optimal gain in knowledge.


ERC-BiP Functional Protein Pathway for Assessing Endoplasmic Reticulum Stress Induced by SARS-CoV-2 Replication after Cell Invasion.
SARS-CoV-2 induces apoptosis and amplifies the immune response by continuously stressing the endoplasmic reticulum (ER) after invading cells. This study aimed to establish a protein-metabolic pathway associated with ER dysfunction based on the invasion mechanism of SARS-CoV-2. This study included 17 healthy people and 46 COVID-19 patients, including 38 mild patients and 8 severe patients. Proteomics and metabolomics were measured in the patient plasma collected at admission and one week after admission. The patients were further divided into the aggravation and remission groups based on disease progression within one week of admission. Cross-sectional comparison showed that endoplasmic reticulum molecular chaperone-binding immunoglobulin protein (ERC-BiP), angiotensinogen (AGT), ceramide acid (Cer), and C-reactive protein (CRP) levels were significantly increased in COVID-19 patients, while the sphingomyelin (SM) level was significantly decreased (P < 0.05). In addition, longitudinal comparative analysis found that the temporal fold changes of ERC-BiP, AGT, Cer, CRP, and SM were significantly different between the patients in the aggravation and remission groups (P < 0.05). ERC-BiP, AGT, and Cer levels were significantly increased in aggravation patients, while SM was significantly decreased (P < 0.05). Meanwhile, ERC-BiP was significantly correlated with AGT (r = 0.439; P < 0.001). ERC-BiP can be used as a core index to reflect the degree of ER stress in COVID-19 patients, which is of great value for evaluating the functional state of cells. A functional pathway for AGT/ERC-BiP/glycolysis can directly assess the activation of unfolded protein reactions. The ERC-BiP pathway is closer to the intracellular replication pathway of SARS-CoV-2 and may help in the development of predictive protocols for COVID-19 exacerbation.


Describing an episode of home nursing care for elderly postsurgical cancer patients.
While studies have documented the beneficial effect of home care for cancer patients, the actual interventions implemented during these studies have not been well described. Purposes of this study were to analyze interventions documented in narrative form by advanced practice nurses during a four-week episode of home care and describe intervention type, frequency, range, and variation over time in intervention emphasis and dose intensity. Chart audits were performed on records kept for 148 postsurgical cancer patients who were assigned to the experimental group in a randomized clinical trial to evaluate the effect of home care on quality of life outcomes (McCorkle et al., 2000). Interventions statements (N = 7,275) were analyzed using Grobe's (1996) Nursing Intervention Lexicon and Taxonomy. Teaching accounted for the highest percentage of interventions documented, followed by provision of psychological support and reassurance, determination of patient needs and nursing care requirements, assessment of current status, and indirect care. Physical care and actions to promote self-care independence were documented least frequently. Differences in nursing care were found by cancer site with the greatest diversity of interventions documented for breast cancer patients. Intervention emphasis and dose intensity varied over time, suggesting that these nurses altered their care in response to the changing needs of their patients. These nurses responded to complex problems and used a variety of interventions to assist patients and families in management of the illness experience. They also tailored their care to each patient's location along the illness trajectory. These findings provide beginning support for the clinical utility of Nursing Intervention Lexicon and Taxonomy as a way to quantify an episode of nursing care.


Relationship of occupational and non-occupational stress with smoking in automotive industry workers.
Tobacco use is the second cause of death and first cause of preventable mortality worldwide. Smoking in the workplace is particularly concerning. Smoking-free workplaces decrease the risk of exposure of non-smoking personnel to cigarette smoke. Recent studies have mostly focused on the effect of daily or non-occupational stressors (in comparison with occupational stress) on prevalence of smoking. Occupational stress is often evaluated in workplaces for smoking cessation or control programs, but the role of non-occupational stressors is often disregarded in this respect. This cross-sectional study was conducted in an automobile manufacturing company. The response of automotive industry workers to parts of the validated, reliable, Farsi version of Musculoskeletal Intervention Center (MUSIC)-Norrtalje questionnaire was evaluated. A total of 3,536 factory workers participated in this study. Data were analyzed using SPSS and P<0.05 was considered statistically significant. The correlation of smoking with demographic factors, occupational stressors and life events was evaluated. The results of logistic regression analysis showed that even after adjusting for the confounding factors, cigarette smoking was significantly correlated with age, sex, level of education, job control and life events (P<0.05). The results showed that of occupational and non-occupational stressors, only job control was correlated with cigarette smoking. Non-occupational stressors had greater effect on cigarette smoking. Consideration of both non-occupational and occupational stressors can enhance the success of smoking control programs. On the other hand, a combination of smoking control and stress (occupational and non-occupational) control programs can be more effective than smoking cessation interventions alone.


The Relationship between Kinesiophobia and Return to Sport after Shoulder Surgery for Recurrent Anterior Instability.
Purpose To evaluate the relationship between kinesiophobia and patient's return to sport after shoulder stabilization surgery. The hypothesis was that kinesiophobia represents an independent factor correlated to the difference between preinjury and postoperative level of sport. Methods This study retrospectively evaluated 66 patients (mean age: 35.5, standard deviation [SD] = 9.9 years) and at a mean follow-up of 61.1 (SD = 37.5) months after arthroscopic Bankart's repair or open Bristow-Latarjet procedure. Kinesiophobia was assessed with the Tampa Scale for Kinesiophobia (TSK); return to the preinjury sport was assessed by the difference between baseline and postoperative degree of shoulder involvement in sport (D-DOSIS) scale. The Western Ontario Shoulder Instability index (WOSI) was used to evaluate participants' perceptions of shoulder function. Results TSK showed correlation with D-DOSIS ( ρ = 0.505, p < 0.001) and the WOSI score ( ρ = 0.589, p < 0.001). There was significant difference in TSK and WOSI scores between participants who had and had not returned to their previous level of sport participation ( p = 0.006, and 0.0001, respectively). Conclusion This study demonstrated that kinesiophobia is correlated to the return to sport after shoulder stabilization surgery. Level of Evidence Level IV, retrospective case series.


Chromosome-Membrane Interactions in Bacteria.
Prokaryotes, by definition, do not segregate their genetic material from the cytoplasm. Thus, there is no barrier preventing direct interactions between chromosomal DNA and the plasma membrane. The possibility of such interactions in bacteria was proposed long ago and supported by early electron microscopy and cell fractionation studies. However, the identification and characterization of chromosome-membrane interactions have been slow in coming. Recently, this subject has seen more progress, driven by advances in imaging techniques and in the exploration of diverse cellular processes. A number of loci have been identified in specific bacteria that depend on interactions with the membrane for their function. In addition, there is growing support for a general mechanism of DNA-membrane contacts based on transertion-concurrent transcription, translation, and insertion of membrane proteins. This review summarizes the history and recent results of chromosome-membrane associations and discusses the known and theorized consequences of these interactions in the bacterial cell.


Socio-economic and environmental factors and human health example of cholera El Tor in Manila.
The environmental health factors relevant to the occurrence of cholera in an urban milieu (Manila) have been studied. Cholera has been found to be a disease significantly more prevalent in the areas with lowest environmental condition. Association have been found between the disease incidence and several socioeconomic variables: population density, water and sewer connections each per 1000 population and squatter/slum dweller density. The correlation between cholera incidence and population density was found to be statistically significant at 5% level. A multiple regression analysis showed that the variations in cholera incidence were explained to the extent of 53.23% by the three variables-population density, water and sewer connections. In a check, using data for several years, positive correlations were found between incidence rates and the number of persons per sanitary facility, overcrowding, and density per square kilometer. The association between cholera and the low levels of socioeconomic conditions has been examined in a detailed study of a sample of 711 patients during the cholera season 1971-72. The socioeconomic profile of the sample places the patients in the least affluent part of the community. - The paper points out the need for priority of urban redevelopment in areas of maximum health risk.


Review of LCA studies of solid waste management systems--part II: methodological guidance for a better practice.
Life cycle assessment (LCA) is increasingly used in waste management to identify strategies that prevent or minimise negative impacts on ecosystems, human health or natural resources. However, the quality of the provided support to decision- and policy-makers is strongly dependent on a proper conduct of the LCA. How has LCA been applied until now? Are there any inconsistencies in the past practice? To answer these questions, we draw on a critical review of 222 published LCA studies of solid waste management systems. We analyse the past practice against the ISO standard requirements and the ILCD Handbook guidelines for each major step within the goal definition, scope definition, inventory analysis, impact assessment, and interpretation phases of the methodology. Results show that malpractices exist in several aspects of the LCA with large differences across studies. Examples are a frequent neglect of the goal definition, a frequent lack of transparency and precision in the definition of the scope of the study, e.g. an unclear delimitation of the system boundaries, a truncated impact coverage, difficulties in capturing influential local specificities such as representative waste compositions into the inventory, and a frequent lack of essential sensitivity and uncertainty analyses. Many of these aspects are important for the reliability of the results. For each of them, we therefore provide detailed recommendations to practitioners of waste management LCAs.


Ultrasound monitoring of alcholic liver steatosis during glutathione (GSH) treatment.
In addition to clinical and laboratory alterations, the ultrasound picture in patients with liver steatosis may be quite clearly and closely connected to the histological aspects of this disease. Moreover, these patients have been found to have a reduced hepatocytic and plasmatic glutathione (GSH) level and consequently a reduced liver detoxicating capacity. The aim of this study was to evaluate the therapeutic action of exogenous GSH and its positive modifying role, not only in hepatic function indices (transaminase - GT), but also in the ultrasound picture, in a group of alcholic subjects suffering from carying levels of hepatic steatosis.


Biohydrogenation of fatty acids and digestibility of fresh alfalfa or alfalfa hay plus sucrose in continuous culture.
The pattern of biohydrogenation of fatty acids from fresh alfalfa or alfalfa hay supplemented with 3 concentrations (0, 4, and 8%) of sucrose was studied at a constant pH of 6.2. Four continuous culture fermenters were used in a 4 x 4 Latin square design to test the hypothesis that fresh forage would increase flow of vaccenic acid (VA) from the fermenters compared with the same forage in hay form and that this difference would be diminished by adding sucrose to the hay diet by changing the bacterial community profile. Effluent was collected from each of the 4 fermenters during the last 3 d of each 10-d period. Nutrient digestibility, volatile fatty acids (VFA), and fatty acids in the effluent were measured. Flow of bacterial organic matter (OM) and neutral and acid detergent fiber and acid detergent fiber digestibilities were higher for fresh alfalfa than alfalfa hay. True OM digestibility of alfalfa hay tended to linearly decrease with sucrose supplementation. However, microbial efficiency and flow of bacterial OM (g/d) linearly increased with sucrose addition. There was no change in total VFA concentration; however, proportion of acetate linearly decreased and proportion of butyrate linearly increased with sucrose addition. Fresh alfalfa increased total biohydrogenation of fatty acids compared with than hay. Vaccenic acid flow (mg/d) was much higher for fresh alfalfa compared with alfalfa hay (216 vs. 41) and VA was the predominant 18:1 isomer, followed by trans-13 18:1; however, sucrose had no effect on VA flow. The percentage of VA (of total trans-18:1) was not different between fresh alfalfa and hay, whereas percentage of trans-10 18:1 was much lower for fresh alfalfa. Therefore, the ratio of VA to trans-10 18:1 was higher for fresh alfalfa. Flow of trans-12 18:1 linearly increased, whereas flows of cis-12 and total cis-18:1 had quadratic responses to sucrose supplementation. Total biohydrogenation and biohydrogenation of linoleic and linolenic acids linearly decreased with sucrose; however, there was no effect of sucrose on total trans fatty acid flow. Sucrose may be more detrimental to the last step of biohydrogenation of VA. The effects of sucrose on biohydrogenation and concentration of VFA may have been caused by a shift in microbial population by mechanisms that are independent of pH.


Extracellular Vesicles from Skeletal Muscle Cells Efficiently Promote Myogenesis in Induced Pluripotent Stem Cells.
The recent advances, offered by cell therapy in the regenerative medicine field, offer a revolutionary potential for the development of innovative cures to restore compromised physiological functions or organs. Adult myogenic precursors, such as myoblasts or satellite cells, possess a marked regenerative capacity, but the exploitation of this potential still encounters significant challenges in clinical application, due to low rate of proliferation in vitro, as well as a reduced self-renewal capacity. In this scenario, induced pluripotent stem cells (iPSCs) can offer not only an inexhaustible source of cells for regenerative therapeutic approaches, but also a valuable alternative for in vitro modeling of patient-specific diseases. In this study we established a reliable protocol to induce the myogenic differentiation of iPSCs, generated from pericytes and fibroblasts, exploiting skeletal muscle-derived extracellular vesicles (EVs), in combination with chemically defined factors. This genetic integration-free approach generates functional skeletal myotubes maintaining the engraftment ability in vivo. Our results demonstrate evidence that EVs can act as biological "shuttles" to deliver specific bioactive molecules for a successful transgene-free differentiation offering new opportunities for disease modeling and regenerative approaches.


Exhausted and Senescent T Cells at the Maternal-Fetal Interface in Preterm and Term Labor.
Successful pregnancy requires a tightly-regulated equilibrium of immune cell interactions at the maternal-fetal interface (i.e., the decidual tissues), which plays a central role in the inflammatory process of labor. Most of the innate immune cells in this compartment have been well characterized; however, adaptive immune cells are still under investigation. Herein, we performed immunophenotyping of the decidua basalis and decidua parietalis to determine whether exhausted and senescent T cells are present at the maternal-fetal interface and whether the presence of pathological (i.e., preterm) or physiological (i.e., term) labor and/or placental inflammation alter such adaptive immune cells. In addition, decidual exhausted T cells were sorted to test their functional status. We found that (1) exhausted and senescent T cells were present at the maternal-fetal interface and predominantly expressed an effector memory phenotype, (2) exhausted CD4+ T cells increased in the decidua parietalis as gestational age progressed, (3) exhausted CD4+ and CD8+ T cells decreased in the decidua basalis of women who underwent labor at term compared to those without labor, (4) exhausted CD4+ T cells declined with the presence of placental inflammation in the decidua basalis of women with preterm labor, (5) exhausted CD8+ T cells decreased with the presence of placental inflammation in the decidua basalis of women who underwent labor at term, (6) both senescent CD4+ and CD8+ T cells declined with the presence of placental inflammation in the decidua basalis of women who underwent preterm labor, and (7) decidual exhausted T cells produced IFNγ and TNFα upon in vitro stimulation. Collectively, these findings indicate that exhausted and senescent T cells are present at the human maternal-fetal interface and undergo alterations in a subset of women either with labor at term or preterm labor and placental inflammation. Importantly, decidual T cell function can be restored upon stimulation.


Exploring Representations for Singular and Multi-Concept Relations for Biomedical Named Entity Normalization.
Since the rise of the COVID-19 pandemic, peer-reviewed biomedical repositories have experienced a surge in chemical and disease related queries. These queries have a wide variety of naming conventions and nomenclatures from trademark and generic, to chemical composition mentions. Normalizing or disambiguating these mentions within texts provides researchers and data-curators with more relevant articles returned by their search query. Named entity normalization aims to automate this disambiguation process by linking entity mentions onto their appropriate candidate concepts within a biomedical knowledge base or ontology. We explore several term embedding aggregation techniques in addition to how the term's context affects evaluation performance. We also evaluate our embedding approaches for normalizing term instances containing one or many relations within unstructured texts.


Classification of Soft Tissue Sarcoma Specimens with Raman Spectroscopy as Smart Sensing Technology.
Intraoperative confirmation of negative resection margins is an essential component of soft tissue sarcoma surgery. Frozen section examination of samples from the resection bed after excision of sarcomas is the gold standard for intraoperative assessment of margin status. However, it takes time to complete histologic examination of these samples, and the technique does not provide real-time diagnosis in the operating room (OR), which delays completion of the operation. This paper presents a study and development of sensing technology using Raman spectroscopy that could be used for detection and classification of the tumor after resection with negative sarcoma margins in real time. We acquired Raman spectra from samples of sarcoma and surrounding benign muscle, fat, and dermis during surgery and developed (i) a quantitative method (QM) and (ii) a machine learning method (MLM) to assess the spectral patterns and determine if they could accurately identify these tissue types when compared to findings in adjacent H&E-stained frozen sections. High classification accuracy (>85%) was achieved with both methods, indicating that these four types of tissue can be identified using the analytical methodology. A hand-held Raman probe could be employed to further develop the methodology to obtain spectra in the OR to provide real-time in vivo capability for the assessment of sarcoma resection margin status.


Development and field evaluation of PCR assays based on minimum length Bm86 cDNA fragments required for Rhipicephalus and Hyalomma tick species delineation.
Hyalomma and Rhipicephalus ticks are important genera that can transmit diseases to both animals and humans, including Crimean-Congo hemorrhagic fever, tick-borne encephalitis, and several types of spotted fever. The accurate identification of tick species is essential for the effective control and prevention of tick-borne diseases. However, traditional identification methods based on morphology can be challenging and subjective, leading to errors. The development of DNA markers has provided more precise and efficient methods for tick species identification, but the currently available markers have limitations in their discriminatory power and sensitivity. To address this need for more sensitive and specific markers, this study aimed to identify two minimum sequence fragments required for tick Hyalomma and Rhipicephalus species identification using the Bm86 cDNA marker, which has previously been shown to be in perfect agreement with the current taxonomy of hard ticks based on its complete sequence. Based on our in silico determination that a minimum sequence of 398 bp for Rhipicephalus spp. (from 1487 to 1884) and 559 bp for Hyalomma species (from 539 to 1097) was necessary for species delineation, two distinct PCR assays were developed to apply these sequences in practice. Discrimination between species within each genus was achieved through sequence homology and phylogenetic analysis following the sequencing of the two PCR products. Subsequently, their performance was evaluated by testing them on the field-collected ticks of the Hyalomma and Rhipicephalus genera obtained from various host animals in different geographic regions of Tunisia. The use of shorter partial sequences specific to the tick genera Rhipicephalus and Hyalomma, which target the tick's RNA banks, could represent a significant advance in the field of tick species identification, providing a sensitive and discriminatory tool for interspecific and intraspecific diversity analysis.


Regulation of adrenergic receptor function by phosphorylation. II. Effects of agonist occupancy on phosphorylation of alpha 1- and beta 2-adrenergic receptors by protein kinase C and the cyclic AMP-dependent protein kinase.
The present study was undertaken to determine the ability of protein kinase C and protein kinase A to directly phosphorylate the purified alpha 1- and beta 2-adrenergic receptors (AR). Both the catalytic subunit of protein kinase A and the protein kinase C, purified from bovine heart and pig brain, respectively, are able to phosphorylate the purified alpha 1-AR from DDT1 MF-2 smooth muscle cells. Occupancy of the receptor by an alpha 1 agonist, norepinephrine (100 microM), increases the rate of phosphorylation by protein kinase C but not by protein kinase A. The maximum stoichiometry of phosphorylation obtained is not affected by the agonist and reached 3 mol of PO4/mol of receptor for protein kinase C and 1 mol of PO4/mol of receptor for protein kinase A. The phosphopeptide maps of the trypsinized alpha 1-AR phosphorylated by each kinase differ drastically. The beta 2-AR purified from hamster lungs can also be phosphorylated by the two kinases. In contrast to the alpha 1-AR, the occupancy of the beta 2-AR by the agonist isoproterenol (20 microM) increases the rate of phosphorylation of the beta 2-AR by protein kinase A but not by protein kinase C. The maximum amount of phosphate incorporated into the receptor is not affected in either case by the agonist and reaches 1 mol of PO4/mol of receptor with protein kinase A and 0.4 mol of PO4/mol of receptor with protein kinase C. The phosphopeptide maps of the trypsinized receptor phosphorylated by either kinase reveal similar profiles. Thus, both alpha 1-AR and beta 2-AR are substrates for protein kinase A and protein kinase C. Agonist occupancy of the two receptors facilitates their phosphorylation only by the protein kinase coupled to their own signal transduction pathway. These observations suggest that "feedback" and "cross-system" phosphorylation may represent distinct and differently regulated mechanisms of modulation of receptor function.


The human horizontal vestibulo-ocular reflex during combined linear and angular acceleration.
We employed binocular magnetic search coils to study the vestibulo-ocular reflex (VOR) and visually enhanced vestibulo-ocular reflex (VVOR) of 15 human subjects undergoing passive, whole-body rotations about a vertical (yaw) axis delivered as a series of pseudorandom transients and sinusoidal oscillations at frequencies from 0.8 to 2.0 Hz. Rotations were about a series of five axes ranging from 20 cm posterior to the eyes to 10 cm anterior to the eyes. Subjects were asked to regard visible or remembered targets 10 cm, 25 cm, and 600 cm distant from the right eye. During sinusoidal rotations, the gain and phase of the VOR and VVOR were found to be highly dependent on target distance and eccentricity of the rotational axis. For axes midway between or anterior to the eyes, sinusoidal gain decreased progressively with increasing target proximity, while, for axes posterior to the otolith organs, gain increased progressively with target proximity. These effects were large and highly significant. When targets were remote, rotational axis eccentricity nevertheless had a small but significant effect on sinusoidal gain. For sinusoidal rotational axes midway between or anterior to the eyes, a phase lead was present that increased with rotational frequency, while for axes posterior to the otolith organs phase lag increased with rotational frequency. Transient trials were analyzed during the first 25 ms and from 25 to 80 ms after the onset of the head rotation. During the initial 25 ms of transient head rotations, VOR and VVOR gains were not significantly influenced by rotational eccentricity or target distance. Later in the transient responses, 25-80 ms from movement onset, both target distance and eccentricity significantly influenced gain in a manner similar to the behavior during sinusoidal rotation. Vergence angle generally remained near the theoretically ideal value during illuminated test conditions (VVOR), while in darkness vergence often varied modestly from the ideal value. Regression analysis of instantaneous VOR gain as a function of vergence demonstrated only a weak correlation, indicating that instantaneous gain is not likely to be directly dependent on vergence. A model was proposed in which linear acceleration as sensed by the otoliths is scaled by target distance and summed with angular acceleration as sensed by the semicircular canals to control eye movements. The model was fit to the sinusoidal VOR data collected in darkness and was found to describe the major trends observed in the data. The results of the model suggest that a linear interaction exists between the canal and otolithic inputs to the VOR.


Exploring Overlaps Between the Genomic and Environmental Determinants of LVH and Stroke: A Multicenter Study in West Africa.
Whether left ventricular hypertrophy (LVH) is determined by similar genomic and environmental risk factors with stroke, or is simply an intermediate stroke marker, is unknown. We present a research plan and preliminary findings to explore the overlap in the genomic and environmental determinants of LVH and stroke among Africans participating in the SIREN (Stroke Investigative Research and Education Network) study. SIREN is a transnational, multicenter study involving acute stroke patients and age-, ethnicity-, and sex-matched control subjects recruited from 9 sites in Ghana and Nigeria. Genomic and environmental risk factors and other relevant phenotypes for stroke and LVH are being collected and compared using standard techniques. This preliminary analysis included only 725 stroke patients (mean age 59.1 ± 13.2 years; 54.3% male). Fifty-five percent of the stroke subjects had LVH with greater proportion among women (51.6% vs. 48.4%; p < 0.001). Those with LVH were younger (57.9 ± 12.8 vs. 60.6 ± 13.4; p = 0.006) and had higher mean systolic and diastolic blood pressure (167.1/99.5 mm Hg vs 151.7/90.6 mm Hg; p < 0.001). Uncontrolled blood pressure at presentation was prevalent in subjects with LVH (76.2% vs. 57.7%; p < 0.001). Significant independent predictors of LVH were age <45 years (adjusted odds ratio [AOR]: 1.91; 95% confidence interval [CI]: 1.14 to 3.19), female sex (AOR: 2.01; 95% CI: 1.44 to 2.81), and diastolic blood pressure > 90 mm Hg (AOR: 2.10; 95% CI: 1.39 to 3.19; p < 0.001). The prevalence of LVH was high among stroke patients especially the younger ones, suggesting a genetic component to LVH. Hypertension was a major modifiable risk factor for stroke as well as LVH. It is envisaged that the SIREN project will elucidate polygenic overlap (if present) between LVH and stroke among Africans, thereby defining the role of LVH as a putative intermediate cardiovascular phenotype and therapeutic target to inform interventions to reduce stroke risk in populations of African ancestry.


Amyotrophic lateral sclerosis: A guide to collaborative care.
With the incidence of amyotrophic lateral sclerosis (ALS) increasing over recent decades, wide variability in disease presentation, and a median survival of only 2 to 4 years from disease onset, timely referral is key for patients with suspected ALS. This article discusses primary care providers' roles in recognizing ALS and managing symptoms in patients whose travel to specialists can become restricted in the later stages of the disease.


Job satisfaction of nurses and identifying factors of job satisfaction in Slovenian Hospitals.
To determine the level of job satisfaction of nursing professionals in Slovenian hospitals and factors influencing job satisfaction in nursing. The study included 4 hospitals selected from the hospital list comprising 26 hospitals in Slovenia. The employees of these hospitals represent 29.8% and 509 employees included in the study represent 6% of all employees in nursing in Slovenian hospitals. One structured survey questionnaire was administered to the leaders and the other to employees, both consisting 154 items evaluated on a 5 point Likert-type scale. We examined the correlation between independent variables (age, number of years of employment, behavior of leaders, personal characteristics of leaders, and managerial competencies of leaders) and the dependent variable (job satisfaction - satisfaction with the work, coworkers, management, pay, etc) by applying correlation analysis and multivariate regression analysis. In addition, factor analysis was used to establish characteristic components of the variables measured. We found a medium level of job satisfaction in both leaders (3.49±0.5) and employees (3.19±0.6), however, there was a significant difference between their estimates (t=3.237; P=lt;0.001). Job satisfaction was explained by age (Plt;0.05; β=0.091), years of employment (Plt;0.05; β=0.193), personal characteristics of leaders (Plt;0.001; β=0.158), and managerial competencies of leaders (Plt;0.000; β=0.634) in 46% of cases. The factor analysis yielded four factors explaining 64% of the total job satisfaction variance. Satisfied employees play a crucial role in an organization's success, so health care organizations must be aware of the importance of employees' job satisfaction. It is recommended to monitor employees' job satisfaction levels on an annual basis.


Care of the transgender patient: a survey of gynecologists' current knowledge and practice.
Medical school and residency curricula are lacking in content on the care of the transgender patient. As a result, many providers do not have enough experience and knowledge to adequately care for this patient population. The aim of this study was to assess gynecologists' preferences and knowledge base with regard to transgender healthcare. This was a cross-sectional survey of obstetrics and gynecology (OBGYN) providers. An anonymous survey was sent via electronic mail to nine academic OBGYN departments across the United States. Survey questions were designed to assess provider experience and practice environment, education about transgender health practices, personal experience with transgender patients, and knowledge base regarding current recommendations for the care of gender minority patients. Of the 352 providers who received the survey, 141 responded, for a 40.1% response rate. Of the respondents, 61.7% (87 of 141) were generalist OBGYNs, and 86% (117 of 136) practiced in an academic institution; 80% (113 of 141) did not receive training in residency on the care of transgender patients. Time in practice was not associated with having learned about transgender care. Only 35.3% and 29% were comfortable caring for male-to-female and female-to-male transsexual patients, respectively; and, 88.7% and 80.4% were willing to perform screening Pap smears on female-to-male transsexual patients and routine breast examinations on male-to-female patients, respectively. Eighty-two of 138 providers (59.4%) did not know the recommendations for breast cancer screening in male-to-female patients. Efforts should be made to educate trainees on the important aspects of transgender care, and comprehensive guidelines should be published for practicing providers.


The Effect of a Psychomotor Education Program on the Static Balance of Children With Intellectual Disability.
Children with intellectual disability (ID) demonstrate lower balance ability which results in substantial delays in motor growth and limits their function level. Psychomotor education comprises a holistic movement approach, with the aim to improve all aspects of each child personality. The aim of this study was to assess the effect of a psychomotor education program on static balance of school-aged children with ID. Twenty children with ID who were 8-12 years old participated in the study. They were assigned to 2 groups, 1 experiment and 1 control. The experiment group attended a 16-week psychomotor education program at a frequency of 2 lessons per week, for 45 minutes. All the children who participated in the above measurements had (a) recording of anthropometric characteristics, (b) assessment of motor developmental index, and (c) measurement of static balance. The static balance ability was measured by means of an electronic pressure platform. Each child was requested to keep a quiet stance posture under 4 different conditions: double-leg stance with eyes opened or closed while they observed a visual or visual-auditory target. Participants of the intervention group reduced the values of static balance variables for all the positions. In conclusion, findings of this study clearly indicate that psychomotor education program has an important contribution to make for the most benefit of children with ID in terms of static balance.


Prognostic factors in a transplantation center with good results.
In a homogeneous group of 299 first cadaver kidney allograft recipients transplanted within one single center between 1973 and 1983, we analyzed the influence of several factors on graft survival. All recipients received at least one blood transfusion before transplantation. Criteria of donor-recipient selection as well as immunosuppressive treatment policy have never changed significantly within the studied period. In contrast to matching for HLA-A and B antigens, DR-matching has a significant influence on early graft survival. Kidneys with zero DR-mismatches have a one year graft survival of 96.2% versus 75.6% for kidneys with 2 DR-mismatches (P less than 0.05). The presence or absence of DRW6 in the recipient as well as in the donor has no effect on graft survival. A preservation time less than 12 hours is accompanied by a decreased early graft survival. The long-term survival of kidneys from donors older than 30 years is significantly reduced. At 5 years graft survival of kidneys from donors younger than 30 years is 75% versus 53% for kidneys from donors older than 30 years.


Antiviral action of murine interferons on heterologous cells.
Five murine interferon preparations wer compared for their antiviral action on 10 heterologous cell types. Immune interferon preparations induced by either BCG/ old tuberculin in vivo or concanavalin A in vitro exhibited some protection on porcine, monkey and rat cells. This was also noted with interferon induced by polyriboinosinic acid: polyribocytidylic acid (poly I:C) in spleen cells. Interferons induced by poly I:C in vivo or in L-929 cells did not protect these three cell types. All three preparations induced by poly I:C showed some activity on guinea pig cells, but this was not the case with either immune interferon preparation. None of the five preparations exhibited any measurable activity on human, bovine, chick, or rabbit cells.


Digital sucking and tongue thrusting in children.
A conservative approach to the management of the child and parent and to the treatment by the dentist for both digital sucking and tongue thrusting is advocated. Because the prevalence of both activities continues to decrease with age, various age ranges are selected as guidelines for the dentist in selecting an approach for the management and treatment of either activity. Successful closure of an anterior open bite after the cessation of digital sucking and tongue thrusting is directly related to the ability of the dentist to assess the growth pattern and especially to determine whether there is a skeletal component contributing to an increase in the certical dimension.


The Impact of SST and PV Interneurons on Nonlinear Synaptic Integration in the Neocortex.
Excitatory synaptic inputs arriving at the dendrites of a neuron can engage active mechanisms that nonlinearly amplify the depolarizing currents. This supralinear synaptic integration is subject to modulation by inhibition. However, the specific rules by which different subtypes of interneurons affect the modulation have remained largely elusive. To examine how inhibition influences active synaptic integration, we optogenetically manipulated the activity of the following two subtypes of interneurons: dendrite-targeting somatostatin-expressing (SST) interneurons; and perisomatic-targeting parvalbumin-expressing (PV) interneurons. In acute slices of mouse primary visual cortex, electrical stimulation evoked nonlinear synaptic integration that depended on NMDA receptors. Optogenetic activation of SST interneurons in conjunction with electrical stimulation resulted in predominantly divisive inhibitory gain control, reducing the magnitude of the supralinear response without affecting its threshold. PV interneuron activation, on the other hand, had a minimal effect on the supralinear response. Together, these results delineate the roles for SST and PV neurons in active synaptic integration. Differential effects of inhibition by SST and PV interneurons likely increase the computational capacity of the pyramidal neurons in modulating the nonlinear integration of synaptic output.


Gluten induces rapid reprogramming of natural memory αβ and γδ intraepithelial T cells to induce cytotoxicity in celiac disease.
Celiac disease (CD) is an autoimmune disease in which intestinal inflammation is induced by dietary gluten. The means through which gluten-specific CD4+ T cell activation culminates in intraepithelial T cell (T-IEL)-mediated intestinal damage remain unclear. Here, we performed multiplexed single-cell analysis of intestinal and gluten-induced peripheral blood T cells from patients in different CD states and healthy controls. Untreated, active, and potential CD were associated with an enrichment of activated intestinal T cell populations, including CD4+ follicular T helper (TFH) cells, regulatory T cells (Tregs), and natural CD8+ αβ and γδ T-IELs. Natural CD8+ αβ and γδ T-IELs expressing activating natural killer cell receptors (NKRs) exhibited a distinct TCR repertoire in CD and persisted in patients on a gluten-free diet without intestinal inflammation. Our data further show that NKR-expressing cytotoxic cells, which appear to mediate intestinal damage in CD, arise from a distinct NKR-expressing memory population of T-IELs. After gluten ingestion, both αβ and γδ T cell clones from this memory population of T-IELs circulated systemically along with gluten-specific CD4+ T cells and assumed a cytotoxic and activating NKR-expressing phenotype. Collectively, these findings suggest that cytotoxic T cells in CD are rapidly mobilized in parallel with gluten-specific CD4+ T cells after gluten ingestion.


Determinants Of Impoverishment Due To Out Of Pocket Payments In Nigeria.
Poverty is an extreme consequence of out of pocket payments in countries with health systems that do not provide financial risk protection through mandatory health insurance coverage for people in both the formal and informal sectors. The study assessed the determinants of impoverishment due to out of pocket payments in Nigeria. Secondary data from the Harmonized Nigeria Living Standard Survey (HNLSS) of 2009/10 was utilized to assess factors associated with impoverishment in Nigeria. Household and individual characteristics associated with impoverishment were determined using binary logistic regression. A significance level of p<0.05 was used. Results show that lack of health insurance, having a member above 65 years, large household size, household socio-economic status, type of illness suffered, type of health facility visited, geo-political zones, education of household heads and location were major determinants of impoverishment due to out of pocket health expenditure. Findings from the study show that most households and individuals are vulnerable to financial risk due to this regressive source of payments for health care services. This explains why the level of poverty keeps increasing in spite of the numerous poverty alleviation programs across the country. Policy makers and political actors need to design a new health system financing policy that will increase financial risk protection for people in both the formal and informal sectors. Governments and decision makers have to focus on health as a determinant of economic well-being.


Alexithymia is not related to tolerance for cold pressor pain.
To test the hypothesis that higher scores on alexithymia are associated with reduced tolerance for cold pressor pain, 116 college undergraduates completed the Toronto Alexithymia Scale-20 of Bagby, Parker and Taylor and engaged in the cold pressor test. Their alexithymia scores were not associated with tolerance for cold pressor pain, suggesting that individuals scoring high on alexithymia do not show a general hypersensitivity to a cold stimulus.


Fiber-delivered heterodyne spectroscopy with a mid-infrared frequency comb.
By exploiting the excellent short-term phase stability between consecutive pulses from a free-running optical parametric oscillator frequency comb, we report the first example of hollow-core fiber-delivered heterodyne spectroscopy in the 3.1-3.8 µm wavelength range. The technique provides a means of spectroscopically interrogating a sample situated at the distal end of a fiber, with all electronics and light sources situated at the proximal end and with an inherent capability to suppress spectroscopically interfering features present in the free-space and in-fiber delivery path. Using a silica anti-resonant, hollow-core delivery fiber, we demonstrate high quality transmission and attenuated total reflectance spectroscopy of a plastic sample for fiber lengths of up to 40 m, significantly exceeding the few-meter lengths typically possible using solid-core fibers. The technique opens a route to implementing multi-species spectroscopic monitoring in remote and / or hostile industrial environments and medical applications.


Weight loss maintenance after bariatric surgery.
Metabolic and bariatric surgery (MBS) is an effective treatment for patients with morbid obesity and its comorbidities. However, many patients experience weight regain (WR) after achieving their nadir weight. Establishing the definition of WR is challenging as postoperative WR has various definitions. Risk factors for WR after MBS include anatomical, racial, hormonal, metabolic, behavioral, and psychological factors, and evaluating such factors preoperatively is necessary. Long-term regular follow-up and timely treatment by a multidisciplinary team are important because WR after surgery is multi-factorial. Although lifestyle interventions that focus on appropriate dietary education, physical activity education or interventions, and behavioral psychological interventions are suggested, more well-designed studies are needed because studies evaluating intervention methods and the effectiveness of WR prevention are lacking. Anti-obesity drugs can be used to prevent and manage patients with WR after MBS; however, more research is needed to determine the timing, duration, and type of anti-obesity drugs used to prevent WR.


Does self-concept depend on body image? A gender analysis.
The purpose of this study was twofold, to estimate positive correlations between scores on the Tennessee Self-concept Scale for body image and self-concept within each gender and to assess differences between genders on measures of these two concepts, thereby testing the hypothesis that women have a more diminished body image than men. The study included 36 subjects, 18 male and 18 female. Within each gender were significant and positive correlations between measures of body image and self-concept. Between the genders, there was no significant difference in scores on self-concept but there was a difference in ratings of body image, with women being significantly less satisfied.


Increased Frailty in Individuals With Osteoarthritis and Rheumatoid Arthritis and the Influence of Comorbidity: An Analysis of the UK Biobank Cohort.
To determine the association between osteoarthritis (OA), rheumatoid arthritis (RA), and frailty and to determine whether comorbidities interact with OA and RA to further increase the likelihood of frailty. Participants of the UK Biobank age 40-69 years at baseline were included. Demographic, lifestyle, and clinical data were collected at baseline and follow-up in a subset. Frailty was assessed using a frailty index (FI) (continuous) and a modified frailty phenotype (robust, pre-frail, frail). The association between RA and OA and frailty at baseline and follow-up was assessed using multiple regression models. We looked at whether comorbidities, including cardiovascular disease, diabetes mellitus, chronic obstructive pulmonary disease, and depression interacted additively with OA and RA to increase the likelihood of frailty. In total, 457,561 participants contributed data. Those with (versus without) RA (n = 4,894) and OA (n = 35,884), respectively, were more likely to be frail (adjusted relative risk ratio 10.7 [95% confidence interval (95% CI) 9.7, 11.7] and 3.4 [95% CI 3.3, 3.6]) and were more likely to have a higher FI at baseline. There was evidence of additive interaction between RA, OA, and common comorbidities increasing the occurrence of prevalent frailty. Among 25,163 participants included in longitudinal analysis, patients with RA (n = 202) and OA (n = 1,811) at baseline had an increased adjusted frailty incidence rate ratio (2.8 [95% CI 1.7, 4.6] and 1.7 [95% CI 1.3, 2.1], respectively) and also a higher FI during follow-up. Individuals with RA and OA are more likely to have, or develop, frailty. Common comorbidities interact with OA and RA to further increase the likelihood of frailty.


Measuring self-care in the general adult population: development and psychometric testing of the Self-Care Inventory.
Self-care is important at all stages of life and health status to promote well-being, prevent disease, and improve health outcomes. Currently, there is a need to better conceptualize self-care in the general adult population and provide an instrument to measure self-care in this group. Therefore, the aim of this study was to develop and evaluate the Self-Care Inventory (SCI), a theory-based instrument to measure self-care in the general adult population. Based on the Middle Range Theory of Self-Care, the 20-item SCI was developed with three scales: Self-Care Maintenance (8 items), Self-Care Monitoring (6 items), and Self-Care Management (6 items). A cross sectional study with a US-based sample (n = 294) was conducted to test the SCI. Internal validity was assessed with Confirmatory Factor Analysis. Internal consistency reliability was assessed with Cronbach alpha for unidimensional scales or composite reliability and the global reliability index for multidimensional scales. Construct validity was investigated with Pearson correlation to test the relationship between general self-efficacy, positivity, stress, and self-care scores. The Self-Care Maintenance and Management scales were multidimensional and the Self-Care Monitoring scale was unidimensional. The global reliability index for multidimensional scales was 0.85 (self-care maintenance) and 0.88 (self-care management). Cronbach alpha coefficient of the self-care monitoring scale was 0.88. Test-retest reliability was 0.81 (self-care maintenance), 0.91 (self-care monitoring), and 0.76 (self-care management). The General Self-Efficacy Scale was positively related to all three self-care scale scores: self-care maintenance r = 0.46, p < 0. 001, self-care monitoring r = 0.31, p < 0. 001, and self-care management r = 0.32, p < 0. 001. The positivity score was positively related to self-care maintenance (r = 0.42, p < 0. 001), self-care monitoring (r = 0.29, p < 0. 001), and self-care management (r = 0.34, p < 0. 001) scores. The perceived stress was positively related to the self-care management (r = 0.20, p < 0. 001) score. The SCI is a theoretically based instrument designed to measure self-care in the general adult population. Preliminary evidence of validity and reliability supports its use in the general adult population.


On the type species of Geophilus Gistel, 1834 (Coleoptera: Scarabaeidae: Aphodiinae).
Geophilus Gistel, 1834 (Insecta: Coleoptera: Scarabaeidae: Aphodiinae) is invalid being a junior homonym of Geophilus Leach, 1814 (Myriapoda: Chilopoda: Geophilomorpha: Geophilidae) and of Geophilus Schönherr, 1823 (Insecta: Coleoptera: Curculionidae). Scarabaeus asper Fabricius, 1775 was recently designated as type species of Geophilus Gistel, 1834, making Geophilus a junior synonym of Psammodius Fallén, 1807 (Insecta: Coleoptera: Scarabaeidae: Aphodiinae: Psammodiini: Psammodiina). However, there is clear evidence that Scarabaeus asper Fabricius, 1775 sensu Gistel, 1834 is Ptinus germanus Linnaeus, 1767, currently Rhyssemus germanus (Linnaeus, 1767) (Insecta: Coleoptera: Scarabaeidae: Aphodiinae: Psammodiini: Rhyssemina). To resolve this issue, the type species of Geophilus Gistel, 1834 is here fixed (under Article 70.3.2 of the International Code of Zoological Nomenclature) as Ptinus germanus Linnaeus, 1767, misidentified as Scarabaeus asper Fabricius, 1775 in the original paper. Scarabaeus asper Fabricius, 1775 sensu Mulsant, 1842 (= Ptinus germanus Linnaeus, 1767) is the type species of Rhyssemus Mulsant, 1842, therefore Rhyssemus Mulsant, 1842 is a junior synonym of Geophilus Gistel, 1834 (new synonymy). Although it has priority, Geophilus Gistel, 1834 is a junior homonym and therefore invalid, so Rhyssemus Mulsant, 1842 remains the valid name of this taxon.


Phylogenetic relationships of Salmonella based on DNA sequence comparison of atpD encoding the beta subunit of ATP synthase.
DNA sequences covering 57% of atpD encoding the beta subunit of ATP synthase were determined for 16 strains of Salmonella enterica, two strains of S. bongori, and one strain each of Citrobacter freundii and Yersinia enterocolitica, and comparison was made with the published Escherichia coli and Enterobacter aerogenes sequences. The phylogenetic tree based on maximum-likelihood analysis showed separation of the subspecies of S. enterica except for two serotypes of subspecies II which were unsupported by a common node. The two serotypes of S. bongori were separated from S. enterica and related to the serotypes of subspecies II. A tight relationship was found between S. enterica subspecies IIIa consisting of monophasic serotypes and subspecies IIIb consisting of diphasic serotypes. This is in conflict with results obtained for most other housekeeping genes and the 23S rRNA gene separating mono- from diphasic subspecies.


The dual origin of vaginal epithelium.
The absence of the cranial three-fifths of the vaginae of male mice carrying the gene, Testicular Feminization, provides strong support for the view that vaginal epithelium is of dual origin, the cranial three-fifths being of Mullerian in origin and the caudal two-fifths being derived from the urogenital sinus.


Objective space division-based hybrid evolutionary algorithm for handing overlapping solutions in combinatorial problems.
Overlapping solutions occur when more than one solution in the space of decisions maps to the same solution in the space of objectives. This situation threatens the exploration capacity of Multi-Objective Evolutionary Algorithms (MOEAs), preventing them from having a good diversity in their population. The influence of overlapping solutions is intensified on multi-objective combinatorial problems with a low number of objectives. This paper presents a hybrid MOEA for handling overlapping solutions that combines the classic NSGA-II with a strategy based on Objective Space Division (OSD). Basically, in each generation of the algorithm, the objective space is divided into several regions using the nadir solution calculated from the current generation solutions. Furthermore, the solutions in each region are classified into non-dominated fronts using different optimization strategies in each of them. This significantly enhances the achieved diversity of the approximate front of non-dominated solutions. The proposed algorithm (called NSGA-II/OSD) is tested on a classic Operations Research problem: the Multi-Objective Knapsack Problem (0-1 MOKP) with two objectives. Classic NSGA-II, MOEA/D and Global WASF-GA are used to compare the performance of NSGA-II/OSD. In the case of MOEA/D two different versions are implemented, each of them with a different strategy for specifying the reference point. These MOEA/D reference point strategies are thoroughly studied and new insights are provided. This paper analyses in depth the impact of overlapping solutions on MOEAs, studying the number of overlapping solutions, the number of solution repairs, the hypervolume metric, the attainment surfaces and the approximation to the real Pareto front, for different sizes of 0-1 MOKPs with two objectives. The proposed method offers very good performance when compared to the classic NSGA-II, MOEA/D and Global WASF-GA algorithms, all of them well-known in the literature.