The primary health care of transgender adults.
Gender dysphoria is associated with significant health disparity. Gender services perform specialised activities such as diagnosis, endocrine management and liaison with surgical services. Although providing these specialised transition services appears to be safe and improves well-being, significant health disparity remains. Engaging primary care providers is an important part of any strategy to improve the health care of transgender people. The relationships between gender dysphoria and a range of primary care issues such as mental health, cardiovascular disease and cancer are explored.


Immune Checkpoint Inhibitor Exposure in Pregnancy: A Scoping Review.
Since their approval, immune checkpoint inhibitors (ICIs) have become the standard of care for multiple malignancies. ICIs enhance tumor destruction by blocking important immunomodulatory pathways that regulate T-cell activation. These pathways include programmed cell death protein-1 and its ligands (programmed cell death protein-1 and programmed death ligand-1, respectively) and cytotoxic T-lymphocyte-associated protein 4. While blocking these pathways can enhance tumor destruction, these pathways are critical for the development of maternal tolerance towards the fetus. Therefore, if ICIs disrupt these immunomodulatory pathways, there could be a maternal immune response against the fetus, as was found in animal studies. With few reported cases of human pregnancy exposure to ICIs, the effects of ICIs on human pregnancy remain largely unknown. Here, we review and summarize the 6 cases of maternal exposure to immunotherapy that have been published before the present study. To add to the evidence, we present a case series of 2 patients who have been exposed to immunotherapy in pregnancy.


Multicomponent Reaction: Pd/Cu-Catalyzed Coupling and Boration of Acyl Chlorides and Alkynes to β-Boryl Ketones.
An unprecedented and challenging multicomponent reaction has been developed that allows for the direct transformation of acyl chlorides with alkynes into the corresponding saturated β-boryl ketones via Pd/Cu-catalyzed coupling and boration with ethyl acetate as the hydrogen sources. Various β-boryl ketones were synthesized in good to excellent yields with broad functional group tolerance. In addition, the introduction of boron groups into the products provides substantial opportunities for further conversions.


Subclinical Hypothyroidism - Whether and When To Start Treatment?
Subclinical hypothyroidism represents a state with increased values of thyroid stimulating hormone (TSH) and normal values of thyroxine (T4) and triiodothyronine (T3). The disorder is asymptomatic, and the diagnosis is made based on the results of laboratory findings when the level of TSH reaches values above 4.0 mU/l. It is still subject to debate whether patients with subclinical hypothyroidism are at increased risk of cardiovascular disease, neuropsychiatric and neuromuscular disorders. Studies have shown that the appearance of general symptoms and complications are more common in patients whose values of TSH are above 10 mU/l. Therefore, the initiation of therapy with levothyroxine, which is the foundation of substitution therapy, is advised in patients whose TSH is >10 mU/l. As for patients whose values of TSH are from 4.0 to 10.0 mU/l and who make up 90% of the patients with subclinical hypothyroidism, further research is needed to determine the effects of the disorder and levothyroxine therapy on the health. Until then, the introduction of the substitution therapy in patients with TSH which is <10 mU/l should be considered in the case of the presence of general symptoms, anti-thyroid antibodies, increased lipids and other risk factors, goitre, pregnancy, ovarian dysfunction and infertility.


[Autoimmune thyroiditis and thyroid cancer].
Association between autoimmune thyroiditis (CLT) and thyroid cancer remains not clear. Although both diseases often occur simultaneously in histological samples, it is not yet clear whether CLT can be regarded as a risk factor for thyroid malignancy. This review focus on the known epidemiological and molecular genetics links between both diseases. Most studies have shown a significant association between thyroid cancer and positive antibodies to thyroglobulin and histological evidence of CLT, as well. Both disorders share some risk factors (greater incidence in women, in areas with adequate supply of iodine and in patients after radiotherapy of the neck) and molecular genetics linkage. For example: RET/PTC rearrangements could be more often found in carcinomas associated with CLT, but this mutation could be found in benign lesions such as CLT, as well. CLT seems to be a positive prognostic factor in patients with differentiated thyroid cancer. It is associated with less invasive forms of tumor, lower occurrence of infiltrated lymphatic nodes and a lower risk of recurrence.


Portable and Reliable Surface-Enhanced Raman Scattering Silicon Chip for Signal-On Detection of Trace Trinitrotoluene Explosive in Real Systems.
There is an increasing interest in the development of surface-enhanced Raman scattering (SERS) sensors for rapid and accurate on-site detection of hidden explosives. However, portable SERS methods for trace explosive detection in real systems remain scarce, mainly due to their relatively poor reliability and portability. Herein, we present the first demonstration of a portable silicon-based SERS analytical platform for signal-on detection of trace trinitrotoluene (TNT) explosives, which is made of silver nanoparticle (AgNP)-decorated silicon wafer chip (0.5 cm × 0.5 cm). In principle, under 514 nm excitation, the Raman signals of p-aminobenzenethiol (PABT) modified on the AgNP surface could be largely lit up due to the formation of electronic resonance-active TNT-PABT complex. In addition, the surface of AgNPs and silicon substrate-induced plasmon resonances also contribute the total SERS enhancement. For quantitative evaluation, the as-prepared chip features ultrahigh sensitivity [limit of detection is down to ∼1 pM (∼45.4 fg/cm2)] and adaptable reproducibility (relative standard deviation is less than 15%) in the detection of TNT standard solutions. More importantly, the developed chip can couple well with a hand-held Raman spectroscopic device using 785 nm excitation, suitable for qualitative analysis of trace TNT even at ∼10-8 M level from environmental samples including lake water, soil, envelope, and liquor with a short data acquisition time (∼1 min). Furthermore, TNT vapors diffusing from TNT residues (∼10-6 M) can be detected by using such a portable device, indicating its feasibility in determination of hidden samples.


Aromatic Plant-Based Functional Foods: A Natural Approach to Manage Cardiovascular Diseases.
Aromatic plants and their essential oils have shown beneficial effects on the cardiovascular system and, therefore, are potential raw materials in the development of functional foods. However, despite their undeniable potential, essential oils present several limitations that need to be addressed, such as stability, poor solubility, undesirable sensory effects, and low bioavailability. The present review provides a current state-of-the-art on the effects of volatile extracts obtained from aromatic plants on the cardiovascular system and focuses on major challenges that need to be addressed to increase their use in food products. Moreover, strategies underway to overcome these limitations are pointed out, thus anticipating a great appreciation of these extracts in the functional food industry.


Artificial intelligence and internet of things oriented sustainable precision farming: Towards modern agriculture.
Agriculture encompasses the study, practice, and discipline of plant cultivation. Agriculture has an extensive history dating back thousands of years. Depending on climate and terrain, it began independently in various locations on the planet. In comparison to what could be sustained by foraging and gathering, agriculture has the potential to significantly increase the human population. Throughout the twenty-first century, precision farming (PF) has increased the agricultural output. precision agriculture (PA) is a technology-enabled method of agriculture that assesses, monitors, and evaluates the needs of specific fields and commodities. The primary objective of this farming method, as opposed to conventional farming, is to increase crop yields and profitability through the precise application of inputs. This work describes in depth the development and function of artificial intelligence (AI) and the internet of things (IoT) in contemporary agriculture. Modern day-to-day applications rely extensively on AI and the IoT. Modern agriculture leverages AI and IoT for technological advancement. This improves the accuracy and profitability of modern agriculture. The use of AI and IoT in modern smart precision agricultural applications is highlighted in this work and the method proposed incorporates specific steps in PF and demonstrates superior performance compared to existing classification methods. It achieves a remarkable accuracy of 98.65%, precision of 98.32%, and recall rate of 97.65% while retaining competitive execution time of 0.23 s, when analysing PF using the FAOSTAT benchmark dataset. Additionally, crucial equipment and methods used in PF are described and the vital advantages and real-time tools utilised in PA are covered in detail.


Executive strategic processing during verbal fluency performance in children with phenylketonuria.
In the current study, we examined a specific aspect of executive abilities, strategic processing, in 32 children with early-treated phenylketonuria (PKU) and 41 typically-developing control children. To do so, clustering and switching were assessed during semantic (animal, food/drink) and phonemic (S, F) fluency tasks. Specifically, number of words generated, number of subcategory clusters, number of words in subcategory clusters, and number of switches between subcategories were analyzed to provide a refined analysis of strategic processing. Compared with controls, children with PKU generated significantly fewer words and made significantly fewer switches between subcategories in the food/drink trial and the phonemic fluency condition. Number of switches was associated with number of words generated in these tasks. In addition, a significant interaction between age and group in number of switches for the food/drink trial reflected a greater increase in number of switches for the control than PKU group as a function of increasing age. These results suggest impairment in frontally-mediated aspects of strategic processing in children with early-treated PKU and indicate that strategic processing should be evaluated carefully as these children age.


Assessing knowledge, attitude, and readiness to use e-health among doctors in a tertiary health care unit in Bhubaneswar city, Odisha - A cross-sectional survey.
The term ""e-health"" refers to all technological applications in the delivery of a more affordable, high-speed, and widely accessible mode of health care. It is a definite solution to managing the public's health and well-being during the coronavirus disease (COVID-19) pandemic, and doctors from all fields of expertise are required to be at par with it in terms of knowledge, attitude, and readiness to use it to their advantage under the current circumstances. A cross-sectional survey was conducted among the faculty, postgraduates, and interns of the medical and dental schools of a university, which used an expert-validated self-administered questionnaire assessing knowledge, attitude, and readiness to use e-health. Among the 400 participants, it was observed that the categories of age (P < 0.0001), gender (P = 0.018), designation (P = 0.031), and years of service (P < 0.0001) have significant differences across the groups. It was seen that the mean e-health knowledge (3.55 ± 0.52) and mean attitude (2.42 ± 0.59) to use e-health were more in dentists while participants from the medical field showed higher mean readiness (1.97 ± 0.58) to use e-health in daily practice. It was observed that male professionals had more mean knowledge (3.54 ± 0.60) than female professionals (3.43 ± 0.52) while female participants had more mean e-health readiness (1.96 ± 0.57). In a broad sense, the majority of participants responded positively to using e-health in their everyday practice. While medical doctors have a stronger outlook and preparedness, dentists showed more literacy and a supportive attitude to adopting e-health and telemedicine. Thus, it is necessary to step up comprehensive e-health workshops and training sessions for health care experts.


Progress towards development of a cholera subunit vaccine.
Cholera, an enteric disease that can reach pandemic proportions, remains a world-wide problem that is positioned to increase in incidence as changes in global climate or armed conflict spawn the conditions that enhance transmission to humans and, thus, precipitate epidemic cholera. An effective subunit cholera vaccine that can provide protective immunity with one parenteral immunization would be a major advantage over the existing oral vaccines that can require two doses for optimal protection. The existing vaccines are clearly effective in some settings, but are less so in others, especially with respect to specific groups such as young (2-5 years) children. In our efforts to develop a cholera subunit vaccine, we focused on two Vibrio cholerae antigens, LPS (lipopolysaccharide) and TCP (toxin co-regulated pilus), that are known to induce protective antibodies in animal models and, in the case of anti-LPS antibodies, to be associated with clinical protection of V. cholerae exposed or vaccinated individuals. This review discusses the current cholera vaccines and compares the advantages of a cholera subunit vaccine to that of the whole cell vaccines. We discuss the possible subunit antigens and prospective targeted use of a subunit cholera vaccine.


Fabrication of nanostructures on polyethylene terephthalate substrate by interference lithography and plasma etching.
We report results of an attempt to create nanostructures on polyethylene terephthalate substrate using the interference lithography and plasma etching technique. Methods to create nanogrooves, nanopillars, nanofins and nanoholes have been presented. The effects of chemical and physical etching associated with plasma etching on the synthesis of nanostructures were examined in detail. Different etch rates and anisotropy as a function of plasma power and pressure were reported and explained, offering good understanding of the physics of the etching process. Ways to improve anisotropy have been suggested and experimentally verified. We show that this method can produce nanostructured substrate with wide surface coverage and good uniformity. The flexibility of this method was demonstrated in that the period and shapes of the nanopattern can be varied easily without resorting to complicated fabrication processes and machinery. Our method brings forth an easy and cost-effective way to create uniform nanostructures on a large area in a controllable fashion.


Plant lipidomics based on hydrophilic interaction chromatography coupled to ion trap time-of-flight mass spectrometry.
Plants synthesize a wide range of hydrophobic compounds, generally known as lipids. Here, we report an application of liquid chromatography ion trap time-of-flight mass spectrometry (LC-IT-TOF-MS) for plant lipidomics. Using hydrophilic interaction chromatography (HILIC) for class separation, typical membrane lipids including glycerolipids, steryl glucosides and glucosylceramides, and hydrophobic plant secondary metabolites such as saponins were analyzed simultaneously. By this method, we annotated approximately 100 molecules from Arabidopsis thaliana. To demonstrate the application of this method to biological study, we analyzed Arabidopsis mutant trigalactosyldiacylglycerol3 (tgd3), which has a complex metabolic phenotype including the accumulation of unusual forms of galactolipids. Lipid profiling by LC-MS revealed that tgd3 accumulated an unusual form of digalactosyldiacylglycerol, annotated as Gal(β1 → 6)βGalDG. The compositional difference between normal and unusual forms of digalactosyldiacylglycerol was detected by this method. In addition, we analyzed well-known Arabidopsis mutants ats1-1, fad6-1, and fad7-2, which are also disrupted in lipid metabolic genes. Untargeted lipidome analysis coupled with multivariate analysis clearly discriminated the mutants and their distinctive metabolites. These results indicated that HILIC-MS is an efficient method for plant lipidomics.


Development of a stable reference material for prostatic acid phosphatase.
We describe the development of a stable reference material for prostatic acid phosphatase, derived from human prostatic tissue and human seminal fluid. The enzyme was purified by an L-tartramic acid affinity-chromatography technique. Two-dimensional electrophoresis revealed essentially no contaminating proteins, and specific tests revealed no contaminating enzymes. The preparations, in a matrix containing 30 g of human serum albumin and 0.1 mol of sodium acetate per liter, pH 6.0, were studied with respect to stability of both catalytic activity and immunological identity. We conclude that the preparations from either source are satisfactorily stable, and that either is acceptable for use in preparing clinical reference materials. These materials will be used in developing a reference method.


Primary Liver Carcinosarcoma and 18F-FDG PET/CT.
Primary liver carcinosarcoma is a very rare, malignant neoplasm that is concomitantly composed of a mixture of sarcomatous and carcinomatous elements. In the present study, an initial staging FDG PET/CT showed intense FDG uptake in a patient with liver carcinosarcoma composed of hepatocellular carcinoma and rhabdomyosarcoma. Two months after surgical resection, a restaging PET/CT showed rapid progression of the disease with abdominal and lung metastases, indicating aggressive feature of the disease. The case shows the importance to repeat a restaging PET/CT at early time after surgery for a patient with liver carcinosarcoma to monitor disease progression.


External validity in distributed data networks.
While much has been written about how distributed networks address internal validity, external validity is rarely discussed. We aimed to define key terms related to external validity, discuss how they relate to distributed networks, and identify how three networks (the US Food and Drug Administration's Sentinel System, the Canadian Network for Observational Drug Effect Studies [CNODES], and the National Patient Centered Clinical Research Network [PCORnet]) deal with external validity. We define external validity, target populations, target validity, generalizability, and transportability and describe how each relates to distributed networks. We then describe Sentinel, CNODES, and PCORnet and how each approaches these concepts, including a sample case study. Each network approaches external validity differently. As its target population is US citizens and it includes only US data, Sentinel primarily worries about lack of external validity by not including some segments of the population. The fact that CNODES includes Canadian, United States, and United Kingdom data forces them to seriously consider whether the United States and United Kingdom data will be transportable to Canadian citizens when they meta-analyze database-specific estimates. PCORnet, with its focus on study-specific cohorts and pragmatic trials, conducts more case-by-case explorations of external validity for each new analytic data set it generates. There is no one-size-fits-all approach to external validity within distributed networks. With these networks and comparisons between their findings becoming a key part of pharmacoepidemiology, there is a need to adapt tools for improving external validity to the distributed network setting.


National prospective cohort study of peritonsillar abscess management and outcomes: the Multicentre Audit of Quinsies study.
To investigate variations in the management and outcomes of peritonsillar abscesses, and to develop a trainee collaborative network in the UK. Data were collected prospectively on suspected peritonsillar abscess cases presenting over a 2-month period at 42 participating secondary care centres, covering a population of 16 million. The primary outcome was an adverse event at 30 days, defined as re-presentation or re-drainage. Eighteen per cent of the 325 cases experienced an adverse event. Follow-up data were valid for 90 per cent of cases. Regression analyses showed a significant reduction in adverse events in the 12 per cent of patients who were discharged within 12 hours, and there was no significant increase in adverse events for the 70 per cent receiving corticosteroids. Out-patient management of peritonsillar abscess is not commonly practised in the UK. Corticosteroid usage is common and appears safe. This study demonstrates that trainees working in collaboration can effectively deliver prospective multicentre cohort studies in the UK.


Seasonal trends in atrial fibrillation episodes and physical activity collected daily with a remote monitoring system for cardiac implantable electronic devices.
Remote monitoring (RM) of cardiac implantable electronic devices is an ideal experimental model to evaluate long-term trends of physiological and clinical data automatically collected from large patient cohorts. We studied data of atrial fibrillation (AF) and physical activity (PA) transmitted daily during 3.5years from a subgroup of patients enrolled in the HomeGuide trial, a previously conducted study on patients routinely followed with a RM system transmitting clinical and diagnostic data daily. We selected 988 patients (80% male, mean age 68±11) implanted with a pacemaker (16%) or an implantable defibrillator and provided with atrial sensing and movement sensors. Remotely transmitted data were processed in order to obtain AF incidence and time of PA in the form of collective time series daily sampled. We found that both PA and AF incidence clearly showed seasonal trends with an annual period and inverse correlation. In a first-order autoregressive model the regression coefficient of daily activity to AF incidence was -0.64 (standard error, 0.18, p<0.0001), while the cross-correlation coefficient reached its maximum values at ±180day lags. AF incidence was 14.4% higher and PA was 14.7% lower in winters than in summers (p<0.0001 for both comparisons). Power spectral analysis revealed weekly periodicity in the PA series (corresponding to festivity rest) but not in the AF incidence. RM data collected daily from a relatively large patient cohort revealed marked seasonal trends in AF incidence and PA with opposite behavior in winters and summers.


Germination, early development, and creativity in the acquisition of the Yucatec Maya deictic system.
The Yucatec Maya language has a highly complex deictic system with interesting typological differences that in addition to demonstratives and locative adverbs also includes ostensive evidentials and modal adverbs. Given that deictic words are among the first that children produce, the aim of this study is to identify the early acquisition that Yucatec Mayan children follow to map out each deictic form. Deictic words taken from spontaneous, longitudinal, transversal corpora and Gaskins's (1990) field work annotations were labeled and analyzed. The results show that children begin by uttering protoforms mapped with prototypical functions of locative and modal adverbs, but the functions of both demonstratives and ostensive evidentials are expressed mostly with the same protoform, which is similar to the deictic organizations of other languages. When children become productive, they overextend functions, which demonstrates a reanalysis of the system before acquisition is complete.


NET silencing by let-7i in postural tachycardia syndrome.
While strongly implicated in postural tachycardia syndrome (POTS), considerable controversy exists regarding norepinephrine transporter (NET) loss of function. POTS is characterized by the clinical symptoms of orthostatic intolerance, lightheadedness, tachycardia, and syncope or near syncope with upright posture. Abnormal sympathetic nervous system activity is typical, of a type which suggests dysfunction of the NET, with evidence that the gene responsible is under tight epigenetic control. Using RNA of isolated chromatin combined with massive parallel sequencing (RICh-seq) we show that let-7i miRNA suppresses NET by methyl-CpG-binding protein 2 (MeCP2). Vorinostat restores epigenetic control and NET expression in leukocytes derived from POTS participants.


Conditional nuclear localization of hMLH3 suggests a minor activity in mismatch repair and supports its role as a low-risk gene in HNPCC.
DNA mismatch repair (MMR) mechanism contributes to the maintenance of genomic stability. Loss of MMR function predisposes to a mutator cell phenotype, microsatellite instability (MSI) and cancer, especially hereditary non-polyposis colorectal cancer (HNPCC). To date, five MMR genes, hMSH2, hMSH6, hMLH1, hPMS2, and hMLH3 are associated with HNPCC. Although, hMLH3 is suggested to be causative in HNPCC, its relevance to MMR needs to be confirmed to reliably assess significance of the inherited sequence variations in it. Recently, a human heterodimer hMLH1/hMLH3 (hMutLgamma) was shown to be able to assist hMLH1/hPMS2 (hMutLalpha) in the repair of mismatches in vitro. To repair mismatches in vivo, hMLH3 ought to localize in the nucleus. Our immunofluorescence analyses indicated that when all the three MutL homologues are natively expressed in human cells, endogenous hMLH1 and hPMS2 localize in the nucleus, whereas hMLH3 stays in the cytoplasm. Absence of hPMS2 and co-expression of hMLH3 with hMLH1 results in its partial nuclear localization. Our results are clinically relevant since they show that in the nuclear localization hMLH3 is dependent on hMLH1 and competitive with hPMS2. The continuous nuclear localization of hMLH1 and hPMS2 suggests that in vivo, hPMS2 (hMutLalpha) has a major activity in MMR. In absence of hPMS2, hMLH3 (hMutLgamma) is located in the nucleus, suggesting a conditional activity in MMR and supporting its role as a low-risk gene in HNPCC.


[Role of the markers PAP-PSA in the diagnosis of cancer of the prostate].
The Authors report their personal experience relating to diagnostic screening for prostatic carcinoma using serum assays for specific markers of this tumour: prostatic acid phosphatase (PAP) and prostatic specific antigen (PSA). They underline the importance of high serum values of these substances, especially in tumors in an advanced state, and point out that these markers can play a role both in the diagnosis and in the follow-up of prostatic carcinoma.


Relapsed Wilms' tumor in pediatric patients: challenges in low- to middle-income countries-a single-center experience.
Wilms' tumor (WT) affects one in 10,000 children and accounts for 5% of all childhood cancers. Although the overall relapse rate for children with WT has decreased to less than 15 %, the overall survival for patients with recurrent disease remains poor at approximately 50 %. The aim of the study to evaluate the outcome of relapsed Wilms' tumor pediatric patients treated at the National Cancer Institute (NCI), Egypt, between January 2008 and December 2015. One hundred thirty (130) patients diagnosed with WT during the study period, thirty (23%) patients had relapsed. The median follow up period was 22.3 months (range 3.6-140 months). The Overall Survival (OS) was 30.9% while the event-free survival (EFS) was 29.8% at a 5-year follow up period. Median time from diagnosis to relapse was 14.4 months. A second complete remission was attained in 18/30 patients (60%). The outcome of the 30 patients; 11 are alive and 19 had died. Three factors in our univariate analysis were prognostically significant for survival after relapse. The first was radiotherapy given after relapse (p = 0.012). The 5-year EFS and OS for the group that received radiotherapy were 41.9% versus 16.7% and 11.1% respectively for those that did not. The second was the state of lymph nodes among patients with local stage III (p = 0.004). Lastly, when risk stratification has been applied retrospectively on our study group, it proved to be statistically significant (p = 0.029). Among relapsed pediatric WT, radiotherapy improved survival at the time of relapse and local stage III with positive lymph nodes had the worst survival among other stage III patients.


Induction of neuronal death by microglial AGE-albumin: implications for Alzheimer's disease.
Advanced glycation end products (AGEs) have long been considered as potent molecules promoting neuronal cell death and contributing to neurodegenerative disorders such as Alzheimer's disease (AD). In this study, we demonstrate that AGE-albumin, the most abundant AGE product in human AD brains, is synthesized in activated microglial cells and secreted into the extracellular space. The rate of AGE-albumin synthesis in human microglial cells is markedly increased by amyloid-β exposure and oxidative stress. Exogenous AGE-albumin upregulates the receptor protein for AGE (RAGE) and augments calcium influx, leading to apoptosis of human primary neurons. In animal experiments, soluble RAGE (sRAGE), pyridoxamine or ALT-711 prevented Aβ-induced neuronal death in rat brains. Collectively, these results provide evidence for a new mechanism by which microglial cells promote death of neuronal cells through synthesis and secretion of AGE-albumin, thereby likely contributing to neurodegenerative diseases such as AD.


Midwifery and nursing students' communication skills and life orientation: correlation with stress coping approaches.
Methods learnt by nursing and midwifery students' such as communication skills, optimisim and coping with stress would be used in their profeesional life. It is very important to promote their positive thinking and communication skills to raise coping with stress. This cross sectional study was performed to examine the nursing and midwifery students' communication skills and optimistic life orientation and its correlation with coping strategies with stress. The study population included 2572 students who were studying in departments of nursing and midwifery in Istanbul. The sample was included 1419 students. Three questionnaires including Communication Skills Test, Life Orientation Test and Ways of Coping Inventory were used for data collection. The data were evaluated by calculating frequency, percentage, arithmetic mean, standard deviation and Pearson correlation coefficient. Students' total mean score from the Communication Skills Scale was 165.27 ± 15.39 and for the Life Orientation Test was 18.51 ± 4.54. There was a positive correlation between their Life Orientation scores and the scores for self confidence (r = 0.34, P < 0.001), optimistic approach (r = 0.42, P < 0.001), and seeking social help (r = 0.17, P < 0.001). Also there was a significant positive correlation between Communication skill scores and self confidence (r = 0.46, P < 0.001), optimistic (r = 0.37, P < 0.001) and seeking social help approaches (r = 0.29, P < 0.001), but there was a significant negative correlation between communication skill scores and scores for helpless (r = -0.29, P < 0.001) and submissive approaches (r = -0.36, P < 0.001). As scores of students in optimistic life orientation and communication skills increased self confidence approach, optimistic, and social support seeking scores increased, whereas helpless, and submissive scores decreased.


Overexpression of mitochondrial uncoupling protein 1 (UCP1) induces a hypoxic response in Nicotiana tabacum leaves.
Mitochondrial uncoupling protein 1 (UCP1) decreases reactive oxygen species production under stress conditions by uncoupling the electrochemical gradient from ATP synthesis. This study combined transcriptome profiling with experimentally induced hypoxia to mechanistically dissect the impact of Arabidopsis thaliana UCP1 (AtUCP1) overexpression in tobacco. Transcriptomic analysis of AtUCP1-overexpressing (P07) and wild-type (WT) plants was carried out using RNA sequencing. Metabolite and carbohydrate profiling of hypoxia-treated plants was performed using (1)H-nuclear magnetic resonance spectroscopy and high-performance anion-exchange chromatography with pulsed amperometric detection. The transcriptome of P07 plants revealed a broad induction of stress-responsive genes that were not strictly related to the mitochondrial antioxidant machinery, suggesting that overexpression of AtUCP1 imposes a strong stress response within the cell. In addition, transcripts that mapped into carbon fixation and energy expenditure pathways were broadly altered. It was found that metabolite markers of hypoxic adaptation, such as alanine and tricarboxylic acid intermediates, accumulated in P07 plants under control conditions at similar rates to WT plants under hypoxia. These findings indicate that constitutive overexpression of AtUCP1 induces a hypoxic response. The metabolites that accumulated in P07 plants are believed to be important in signalling for an improvement in carbon assimilation and induction of a hypoxic response. Under these conditions, mitochondrial ATP production is less necessary and fermentative glycolysis becomes critical to meet cell energy demands. In this scenario, the more flexible energy metabolism along with an intrinsically activated hypoxic response make these plants better adapted to face several biotic and abiotic stresses.


Long-term stability of a cyanmethemoglobin reference standard.
A comparative analysis performed in late 1974 revealed that a cyanmethemoglobin secondary standard prepared by the laboratory at the Michigan Department of Public Health in 1966 was still suitable for use in hemoglobin assays. These results would suggest that the current one-year expiration time used for commercial standards could be extended considerably.


[Prediction formulas for estimating body fat percent of obesity from bioelectrical impedance].
The bioelectrical impedance method has become a popular and widely used method to determine body composition. In this study, body fat was measured by densitometry in a group of 66 males and 130 females obesity Chinese, aged 18 to 67 years. Body weight, body height were measured as well as total body bioelectrical impedance at 50 kHz. BMI and BF% was (27.7 +/- 3.1) kg/m2 and (38.81 +/- 6.27)% respectively (mean +/- SD). The prediction formulas for body fat from bioelectrical impedance developed in western societies, are significant underestimate body fat of Chinese obesity from body density. The prediction formulas for body fat with our subjects is; BF = 0.846 * Wt - 0.185 * Ht2/Z - 2.361 * Sex - 24.977. (r = 0.923, SEE = 3.43, F = 365.7, P < 0.001). Wt: body weight; Ht: body height; Sex; male = 1, female = 0; Z: bioelectrical impedance.


ADHD symptoms and school impairment history in parents of ADHD children are a fundamental diagnostic and therapeutic clue.
Attention Deficit and Hyperactivity Disorder (ADHD) is a multi-factorial condition, with inheritance playing a major role. Recognizing parents' ADHD represents a clue not only for an earlier diagnosis of the disease in their children, but also to optimize psycho-educational therapy outcomes, by addressing the impairment of parenting related to untreated ADHD. This study aimed to assess the frequency of features suggestive of ADHD during childhood among parents of affected children, and the presence of school and emotional impairment. We administered the Wender Utah Rating Scale-25, a self-assessment tool for the retrospective identification of symptoms consistent with ADHD during childhood, to a cohort of 120 parents of 60 children with ADHD, and to a consistent number of "controls". The WURS-25 proved positive in 49.1% of fathers and 30.0% of mothers of ADHD patients, compared to 1.7% of fathers and 1.7% of mothers of non-ADHD patients (p < 0.0001). The questions addressing learning and emotional impairment provided significantly higher scores in parents with an overall positive test compared to those with negative test (p < 0.0001). This study demonstrates a remarkably high rate of symptoms consistent with ADHD during childhood in parents of affected children. Physicians should be aware that this is a relevant anamnestic clue and, given the relevance of parents' role in the management of children with ADHD, an important issue to address in order to optimize patients' treatment.


Next generation agricultural system data, models and knowledge products: Introduction.
Agricultural system models have become important tools to provide predictive and assessment capability to a growing array of decision-makers in the private and public sectors. Despite ongoing research and model improvements, many of the agricultural models today are direct descendants of research investments initially made 30-40 years ago, and many of the major advances in data, information and communication technology (ICT) of the past decade have not been fully exploited. The purpose of this Special Issue of Agricultural Systems is to lay the foundation for the next generation of agricultural systems data, models and knowledge products. The Special Issue is based on a "NextGen" study led by the Agricultural Model Intercomparison and Improvement Project (AgMIP) with support from the Bill and Melinda Gates Foundation.


The approach of fused fissures with fissureless technique decreases the incidence of persistent air leak after lobectomy.
To evaluate two different approaches used to perform fused fissures in lobectomies in terms of persistent air leak (PAL) and their impact on length of hospital stay. One hundred and nineteen patients underwent lobectomy or bilobectomy in our unit. We focused on patients with fused fissures (63 patients), all of whom were selected intraoperatively based on predefined criteria. These patients with incomplete fissures were randomly assigned to two groups: Group A patients who underwent a 'traditional technique' to approach fused fissures and Group B patients who underwent a 'fissureless technique'. The latter technique avoids dissecting the lung parenchyma over the pulmonary artery, reducing the chances of air leak. Patients in both groups had shown no significant difference in preoperative variables (p>0.05). The incidence of PAL was significantly higher among patients with incomplete or fused fissures (0 case vs 8 cases (Groups A and B), p<0.005). Furthermore, the incidence of PAL was significantly higher in the Group A (traditional technique) (7 vs 1) (p<0.05, OR=3.1, CI 0.22-0.51). The probability for air leak cessation was significantly higher in patients of Group B (fissureless technique) (log rank p<0.0001). The length of hospital stay was higher in Group A (5.76+/-3.1) compared with Group B (4.9+/-1.7) (p<0.05). No other variables were identified as risk factors for PAL in this series. The fissureless technique appears to be a superior approach for fused fissures in terms of both preventing persistent air leak and reducing the length of hospitalisation. This technique can be performed safely at no additional cost and without adverse consequences.


Extraction of absorption and scattering contribution of metallic nanoparticles toward rational synthesis and application.
Noble metal nanoparticles have unique localized surface plasmon resonance (LSPR), leading to their strong absorption and scattering in the visible light range. Up to date, the common practice in the selection of nanoparticles for a specific application is still based on the measured extinction spectra. This practice may be erroneous, because the extinction spectra contain both absorption and scattering contribution that may play different roles in different applications. It would be highly desirable to develop an efficient way to obtain the absorption and scattering spectra simultaneously. Herein, we develop a method to use the experimentally measured extinction and scattering signals to extract the absorption and scattering spectra that is in excellent agreement with that simulated by discrete dipole approximation (DDA). The heating curve measurement on the three types of gold nanorods, with almost the same extinction spectra but different absorption and scattering contribution, convincingly reveals an excellent correlation between the heating effect and the absorption strength rather than the extinction strength. The result demonstrates the importance to obtain the scattering and absorption spectra to predict the potential application for different types of nanoparticles, which in turn will screen efficiently nanoparticles for a specific application.


Chelation of postsynaptic Ca2+ facilitates long-term potentiation of hippocampal IPSPs.
In guinea pig hippocampal slices, a tetanic stimulation of the stratum radiatum caused long-term potentiation (LTP) of the excitatory postsynaptic potential (EPSP) but not of the GABAB receptor-mediated slow inhibitory postsynaptic potential (IPSP) in the CA1 neurons. In neurons in which Ca2+ was chelated with 1,2-bis(2-aminophenoxy) ethane N,N,N',N'-tetra-acetic acid (BAPTA) or ethylene-bis(oxyethylenenitrilo)tetra-acetic acid (EGTA), tetanic stimulation of the stratum radiatum caused LTP of the slow IPSP but not of the EPSP. These results indicate that a reciprocal relationship exists between LTP of the EPSP and LTP of the slow IPSP as far as the involvement of the postsynaptic Ca2+ is concerned.


Increased heat sensitivity of photosynthesis in tobacco plants with reduced Rubisco activase.
High temperature inhibits photosynthesis by several mechanisms including deactivation of Rubisco. The inhibition of photosynthesis by high temperature and its relationship to Rubisco deactivation was studied using tobacco (Nicotiana tabaccum L. cv W38) transformed with a Rubisco activase gene inserted in the antisense orientation and untransformed controls. High temperature (42 degrees C) reduced photosynthesis in both lines of plants. However, photosynthesis recovered nearly completely in wild-type plants and very little in plants lacking Rubisco activase. The F(0)' level of chlorophyll fluorescence decreased and q(N) increased in the control plants during heating. In the antisense plants, q(N) was always high and F(0)' increased slightly during heat stress. NADP-malate dehydrogenase activation was unaffected by heat stress in control plants but was increased in the transgenic plants, consistent with a high redox status in the chloroplast. In wild-type plants, the inhibition of photosynthesis could be explained by a reversible decarbamylation of Rubisco and an acceptor-side limitation imposed on photosynthetic electron transport. However, in the anti-activase plants, carbamylation was low and constant and could not explain how photosynthesis was reduced at high temperature. Because ribulose bisphosphate was saturating at high temperature, the reduction in photosynthesis must have been caused by some impairment of Rubisco function not reflected in measurements of activation state or carbamylation status. This in vivo Rubisco impairment was not relieved upon return to lower temperature. We speculate that the reversible decarbamylation of Rubisco at moderately high temperature may be a protective mechanism by which the plant avoids more serious effects on Rubisco and the rest of the photosynthetic apparatus.


The molecular basis of vulnerable plaque: potential therapeutic role for immunomodulation.
Atherosclerosis is a chronic inflammatory/immune disease involving multiple cell types including monocytes-macrophages, T-lymphocytes, mast cells, and endothelial cells. Through recent studies the role of the immune system on development of atherosclerosis and approaches to modulate this response are being elucidated. The use of statins, PPARgamma agonists or lipoprotein-associated phospholipase A2 (Lp-PLA2) inhibitors may play a role in reducing progression of atherosclerosis through immunomodulatory pathways. Oxidized LDL biases development toward the pro-inflammatory T-cell Th1 subset and recruits macrophages into the vascular wall. IFNgamma, produced by Th1 cells, inhibits PPARgamma effects. Lp-PLA2 levels correlate with an increased risk of recurrent ischemic events in patients presenting with acute coronary syndromes or myocardial infarction. Recent research has shown that immune pathways play a major role in the development and progression of atherosclerosis. Commonly used medications, specifically statins and some PPARgamma agonists, have demonstrated anti-inflammatory/immune effects unrelated to their primary mode of action. Treatment of infectious agents has proven elusive in the clinical arena. Novel agents targeting immune and inflammatory pathways may prove beneficial in reducing progression and instability of the atherosclerotic plaque.


Challenges of Treating Childhood Medulloblastoma in a Country With Limited Resources: 20 Years of Experience at a Single Tertiary Center in Malaysia.
Pediatric medulloblastoma (MB) treatment has evolved over the past few decades; however, treating children in countries with limited resources remains challenging. Until now, the literature regarding childhood MB in Malaysia has been nonexistent. Our objectives were to review the demographics and outcome of pediatric MB treated at the University Malaya Medical Center between January 1994 and December 2013 and describe the challenges encountered. Fifty-one patients with childhood MB were seen at University Malaya Medical Center. Data from 43 patients were analyzed; eight patients were excluded because their families refused treatment after surgery. Headache and vomiting were the most common presenting symptoms, and the mean interval between symptom onset and diagnosis was 4 weeks. Fourteen patients presented with metastatic disease. Five-year progression-free survival (± SE) for patients ≥ 3 years old was 41.7% ± 14.2% (95% CI, 21.3% to 81.4%) in the high-risk group and 68.6% ± 18.6% (95% CI, 40.3% to 100%) in the average-risk group, and 5-year overall survival (± SE) in these two groups was 41.7% ± 14.2% (95% CI, 21.3% to 81.4%) and 58.3% ± 18.6% (95% CI, 31.3% to 100%), respectively. Children younger than 3 years old had 5-year progression-free and overall survival rates (± SE) of 47.6% ± 12.1% (95% CI, 28.9% to 78.4%) and 45.6% ± 11.7% (95% CI, 27.6% to 75.5%), respectively. Time to relapse ranged from 4 to 132 months. Most patients who experienced relapse died within 1 year. Febrile neutropenia, hearing loss, and endocrinopathy were the most common treatment-related complications. The survival rate of childhood MB in Malaysia is inferior to that usually reported in the literature. We postulate that the following factors contribute to this difference: lack of a multidisciplinary neuro-oncology team, limited health care facilities, inconsistent risk assessment, insufficient data in the National Cancer Registry and pathology reports, inadequate long-term follow-up, and cultural beliefs leading to treatment abandonment.


Globalization and its challenges for water management in the developing world.
Water management in developing countries is significantly affected by the processes of globalization: primarily the rapidly acting market-oriented changes that aim to improve economic efficiency through competition and trade. The various impacts of market forces enable 3 categories of developing country to be differentiated: those rapidly integrating into the global economy; those that are not attractive to international investment and become increasingly marginalized; and those countries where both tendencies are powerful, leading to internal divisions and instabilities. Broad framework national development plans are needed that are sensitive to the different circumstances in these countries and that enable the possible actors to collaborate optimally. Often the business sector can take a leading role, but its role is severely limited in other countries. In all cases however the long-term commitment of local communities is essential even when it is hard to secure.


The Proteome and Lipidome of Extracellular Vesicles from Haemonchus contortus to Underpin Explorations of Host-Parasite Cross-Talk.
Many parasitic worms have a major adverse impact on human and animal populations worldwide due to the chronicity of their infections. There is a growing body of evidence indicating that extracellular vesicles (EVs) are intimately involved in modulating (suppressing) inflammatory/immune host responses and parasitism. As one of the most pathogenic nematodes of livestock animals, Haemonchus contortus is an ideal model system for EV exploration. Here, employing a multi-step enrichment process (in vitro culture, followed by ultracentrifugation, size exclusion and filtration), we enriched EVs from H. contortus and undertook the first comprehensive (qualitative and quantitative) multi-omic investigation of EV proteins and lipids using advanced liquid chromatography-mass spectrometry and informatics methods. We identified and quantified 561 proteins and 446 lipids in EVs and compared these molecules with those of adult worms. We identified unique molecules in EVs, such as proteins linked to lipid transportation and lipid species (i.e., sphingolipids) associated with signalling, indicating the involvement of these molecules in parasite-host cross-talk. This work provides a solid starting point to explore the functional roles of EV-specific proteins and lipids in modulating parasite-host cross-talk, and the prospect of finding ways of disrupting or interrupting this relationship to suppress or eliminate parasite infection.


Eco-audit of conventional heart surgery procedures.
Healthcare systems have a significant environmental impact and, thus, indirectly affect public health. In order to improve current practices, a better understanding of the actual environmental impact generated by surgical procedures is necessary. An eco-audit methodology was carried out to assess the greenhouse gas emissions arising from conventional isolated cardiac surgery procedures. This inquiry took into account 3 workstations (the surgical, the anaesthesia and the cardiopulmonary bypass workstations). All wastes were analysed including the disposable medical products, pharmaceuticals and energy consumption during such surgeries. Twenty-eight cardiac surgeries were analysed out of a 4-week study period. The mean emissions during a single cardiac surgery was 124.3 kg of carbon dioxide equivalent (CO2-e). Eighty-nine per cent of the total emissions was related to the use of disposable medical products. The environmental impact of pharmaceuticals used at anaesthesia workstations was 12.4 kg of CO2-e (10% of total greenhouse gas emission), with 11.1 kg of CO2-e resulting from the use of halogenated gas. Direct electrical consumption resulted in 4.0 kg of CO2-e per surgery (3% of all emission), including lighting and air conditioning. Conventional isolated cardiac procedures yield the global warming equivalent of a 1080 km plane ride for a single passenger. The environmental impact of such life-saving interventions, therefore, must be put in perspective alongside pollution induced by 'non-indispensable' human activities. However, numerous initiatives at the local and individual level as well as at a larger systemic and countrywide scale appear to provide accessible pathways to meaningfully reduce greenhouse gas emissions during cardiac surgery.


[Metabolic risk factors in calcium urolithiasis according to gender and age of the patients].
Little information is available on the metabolic changes found in relation to gender and aging in patients with urolithiasis. In this study a comparison has been made of the metabolic profiles in men and women, in different groups of aging, with calcium-containing urinary stones in order to identify possibly significant differences. In the past five years, a total of 500 patients with calcium-containing urinary stones, 226 male (45.2%) and 274 female (54.8%), have undergone comprehensive metabolic evaluation. The mean age was 47.4 years, with a range of 20 to 75 years. The patients was included in 3 groups: 151 patients aged 20-39 years, 255 patients aged 40-59 years and 94 patients aged 60-75 years. A comparison has been made of the frequency of metabolic changes, the urinary biochemical parameters and the supersaturation index (AP(CaOx)) between a group of men and a group of women and the different groups of aging. All patients carried out in an identical manner to metabolic diagnosis. The patients with morphologic and functional abnormalities were excluded. Hyperoxaluria, hyperuricosuria and hypocitraturia were more common in men than in women, whilst in women, hypercalciuria and a low urinary volume were more frequent with respect to men, though the differences in hypercalciuria were not statistically significant. Men excrete higher levels of calcium, phosphate, oxalate, uric acid and magnesium than women. On the other hand, women excrete higher levels of citrate than men. The AP(CaOx) index is significantly higher in men than in women. Hypercalciuria were more common in patients aged < 60 years, and low urinary volume were more frequent in patients aged < 40 years. Patients aged < 60 years excrete higher levels of calcium, phosphate and uric acid. The AP(CaOx) index is significantly higher in patients aged < 60 years. Differences were observed between the metabolic profiles of men and women, and in different groups of aging. Men and younger patients afford a metabolic profile of upper lithogenic risk compared with women and older patients; this is consistent with the upper reported prevalence of lithiasis and the upper tendency to recurrence in men and middle-age patients.


Ell3 stimulates 5-FU resistance in a breast cancer cell line.
Ell3 is an RNA polymerase II transcription elongation factor that acts as a negative regulator of p53 expression, and regulates cell proliferation and survival. Recent studies by our group have demonstrated that ectopic expression of Ell3 in breast cancer cell lines enhances cell proliferation, potentiates cancer stem cell properties, and promotes 5-Fluorouracil (5-FU) resistance. In the present study, the underlying mechanism for the induction of 5-FU resistance was investigated in Ell3 over-expressing MCF-7 cells (Ell3 OE cells). By comparing the gene expression profiles of Ell3 OE cells with control cells, the present data revealed that Lipocalin2 (LCN2) and Wnt signaling activity are associated with 5-FU resistance of Ell3 OE. siRNA-mediated suppression of LCN2 reversed 5-FU resistance in Ell3 OE cells. Chemical inhibition of Wnt signaling also reversed 5-FU resistance in Ell3 OE cells. Furthermore, the expression levels of survivin, which is a direct transcriptional target of Wnt/β-catenin and an inhibitor of apoptosis, were markedly elevated when Ell3 OE cells were treated with 5-FU, as detected by western blot analysis. These findings suggest that enhanced expression of LCN2 and activation of the Wnt signaling pathway may induce 5-FU resistance in Ell3 OE cells as a means of evading apoptosis.


Adherence to a fixed-dose combination of rosiglitazone/glimepiride in subjects switching from monotherapy or dual therapy with a thiazolidinedione and/or a sulfonylurea.
In 2005, a fixed-dose combination therapy (FDCT) of rosiglitazone maleate and glimepiride became available for treatment of type 2 diabetes mellitus. It is hypothesized that FDCTs increase adherence by decreasing the number of required tablets. To assess changes in medication adherence and hemoglobin A(1c) (A1C) values in subjects switching from monotherapy with either a sulfonylurea or rosiglitazone or dual therapy with both to rosiglitazone/glimepiride FDCT. This retrospective database analysis included subjects with 1 or more prescription fills for rosiglitazone, a sulfonylurea, or rosiglitazone/glimepiride FDCT during the identification period of January 1, 2006, to September 30, 2006. Subjects were grouped according to baseline and follow-up period treatment regimens: sulfonylurea or rosiglitazone monotherapy switched to sulfonylurea and rosiglitazone dual therapy (Mono/Dual), monotherapy to rosiglitazone/glimepiride FDCT (Mono/FDCT), sulfonylurea and rosiglitazone dual therapy in both periods (Dual/Dual), and dual therapy to rosiglitazone/glimepiride FDCT (Dual/FDCT). The medication possession ratio (MPR) was calculated as a measure of adherence. The change in A1C from the baseline period to the follow-up period was assessed for each cohort. The study included 16,490 subjects. From baseline to follow-up, MPR decreased for both the Mono/FDCT cohort and the Mono/Dual cohort, but the magnitude of this decrease was less for the Mono/FDCT cohort (-0.02 vs -0.10; p < 0.001). Mean MPR significantly improved for the Dual/FDCT cohort compared with the Dual/Dual cohort (+0.10 vs +0.05; p < 0.001). The mean absolute A1C reduction did not differ significantly between the Mono/FDCT cohort (-1.08%) and the Mono/Dual cohort (-0.77%). Compared with the Dual/Dual cohort, the Dual/FDCT cohort experienced a greater absolute reduction in A1C (-0.06% vs -0.51%; p = 0.004). The results remained statistically significant in the multivariate model. Switching to rosiglitazone/glimepiride FDCT, in comparison with switching to dual therapy, was associated with improvements in medication adherence and glycemic control.


Optimal aerobic exercise intensity and its influence on the effectiveness of exercise therapy in patients with pulmonary arterial hypertension: a systematic review.
Exercise intensity in exercise training programs is an important determinant of program efficacy, such as improvement in exercise capacity and quality of life (QOL). It is not well known whether differently applied exercise intensities are efficacious when used in exercise-based cardiac rehabilitation programs for patients with pulmonary arterial hypertension (PAH). Three databases (PubMed, EMBASE, and CINAHL) were searched with the following inclusion criteria: comparative study of exercise interventions for patients with pulmonary arterial hypertension. Three clinical specialists (a physician, nurse, and exercise physiologist) selected the included articles using the process of systematic review. Included articles were grouped according to aerobic exercise intensity: low, moderate-to-vigorous, and vigorous. The level of evidence for each study was rated using Sackett's levels of evidence. Of 1,452 studies reviewed, 8 were included according to the inclusion criteria (3 randomized controlled trials (RCTs), 3 prospective studies, and 2 case series). Exercise capacity for a six-minute walk distance (mean: 57.7 m) and QOL improved in the above moderate intensity group, while the low intensity group did not show improvement after intervention. For termination criteria, data obtained from the reviewed articles were not sufficient to suggest any exercise intensity recommendations for patients with pulmonary arterial hypertension. The findings in this study suggest that at least moderate aerobic exercise intensity is needed to significantly improve six-minute walk distance and QOL in individuals diagnosed with World Health Organization Group 1 of pulmonary arterial hypertension. There is a need for prospective RCTs comparing different exercise intensities in this patient population.


Psychometric properties of the self-efficacy for clinical evaluation scale in Turkish nursing students.
To examine psychometric properties of the Self-Efficacy for Clinical Evaluation Scale (SECS) in a nursing student sample. Self-efficacy is a good choice to be used in order to make a prediction of nursing students' performance in clinical practice. The SECS, consisting of perceived self-efficacy and importance subscales, seems to be suitable to evaluate self-efficacy regarding care skills for patients with chronic diseases. However, there is not a valid tool to evaluate the perception of self-efficacy for Turkish nursing students. Cross-sectional methodological design. The sample included 400 Turkish nursing students who attended practicum at a hospital. Content of the SECS was evaluated by content validity index (CVI). Reliability was evaluated with internal consistency, item-total correlation and test-retest reliability. Confirmatory factor analysis (CFA) and convergent and divergent validity were used to test the validity. The CVI results were satisfactory. We found satisfactory evidence for internal consistency and item-total correlations. Intraclass correlation coefficients showed stability of subscales. The CFA replicated two-factor structure for the SECS. This was reflected in all fit indices. All factor loadings were positive and were above the perfect level. The convergent validity was supported by the correlation between SECS and General Self-Efficacy Scale. The divergent validity findings demonstrated that SECS differentiated between students with various levels of general point average, which is an indicator of academic success. In conclusion, SECS is a reliable and valid tool used in clinical nursing education settings. Measuring students' self-efficacy in a clinical environment can provide an insight for students into what they have learned. Nurse educators can also use the SECS to spot nursing students with weaknesses in care activities and create educational strategies to help them to enhance their academic performance. Using the SECS can yield an insight both for students and for nursing educators.


Interaction of chitosan with nanoplastic in water: The effect of environmental conditions, particle properties, and potential for in situ remediation.
Micro- and nanoplastic (MNP) pollution in aquatic ecosystems requires investigation on its source, transport, and extent to assess and mitigate its risks. Chitosan is a potential biomolecule for water treatment, but its interaction with MNP is undefined. In this work, chitosan-nanoplastic interaction was explored in the laboratory under environmentally relevant conditions using polystyrene (PS) nanoplastic (NP) as model particle to identify conditions at which PS-chitosan interaction resulted in aggregation. Aggregation limits NP transport and allows separation of NP for targeted remediation. The effect of environmental conditions (pH, salinity, dissolved organic matter (DOM) content), chitosan particle size and NP surface modification on chitosan-NP interaction was studied at various chitosan doses. PS aggregated at chitosan doses as low as 0.2 % w/w, while higher doses of chitosan resulted in re-stabilization of NP in solution, restoring the particle size to its initial value. Increasing pH, DOM, or carboxyl modification of the NP surface also improved NP stability in solution. Increased salinity of the solution caused aggregation of unmodified PS independent of chitosan, but carboxyl-modified PS remained stable and aggregated at the same chitosan doses across all salinity levels. Chitosan with low molecular weight promoted PS aggregation at lower doses. Notably, zeta potential (ZP) alone did not indicate chitosan-induced PS aggregation, which occurred independently of changes in ZP. DLVO calculations based on ZP, however, still indicated attractive interaction due to charge differences, albeit with less contrast at high pH, salinity, and DOM content. Additional insights gained in the work recommend caution when using spectrophotometric methods to assess NP removal. Overall, this study demonstrates that chitosan impacts NP transport and holds potential for water remediation of NP.


Analysis of transmembrane segment 7 of the dipeptide transporter hPepT1 by cysteine-scanning mutagenesis.
To investigate the involvement of transmembrane segment 7 (TMS7) of hPepT1 in forming the putative central aqueous channel through which the substrate traverses, we individually mutated each of the 21 amino acids in TMS7 to a cysteine and analyzed the mutated transporters using the scanning cysteine accessibility method. Y287C- and M292C-hPepT1 did not express at the plasma membrane. Out of the remaining 19 transporters, three (F293C-, L296C-, and F297C-hPepT1) showed negligible glycyl-sarcosine (gly-sar) uptake activity and may play an important role in defining the overall hPepT1 structure. K278C-hPepT1 showed approximately 40% activity and the 15 other transporters exhibited more than 50% gly-sar uptake when compared with wild type (WT)-hPepT1. Gly-sar uptake for the 16 active transporters containing cysteine mutations was then measured in the presence of 2.5 mM 2-aminoethyl methanethiosulfonate hydrobromide (MTSEA) or 1 mM [2-(trimethylammonium) ethyl] methanethiosulfonate bromide (MTSET). Gly-sar uptake was significantly inhibited for each of the 16 single cysteine mutants in the presence of 2.5 mM MTSEA. In contrast, significant inhibition of uptake was only observed for K278C-, M279C-, V280C-, T281C-, M284C-, L286C-, P291C-, and D298C-hPepT1 in the presence of 1 mM MTSET. MTSET modification of R282C-hPepT1 resulted in a significant increase in gly-sar uptake. To investigate this further, we mutated WT-hPepT1 to R282A-, R282E-, and R282K-hPepT1. R282E-hPepT1 showed a 43% reduction in uptake activity, whereas R282A- and R282K-hPepT1 had activities comparable with WT-hPepT1, suggesting a role for the Arg-282 positive charge in substrate translocation. Most of the amino acids that were MTSET-sensitive upon cysteine mutation, including R282C, are located toward the intracellular end of TMS7. Hence, our results suggest that TMS7 of hPepT1 is relatively solvent-accessible along most of its length but that the intracellular end of the transmembrane domain is particularly so. From a structure-function perspective, we speculate that the extracellular end of TMS7 may shift following substrate binding, providing the basis for channel opening and substrate translocation.


CVD-assisted fabrication of hierarchical microparticulate Li2TiSiO5-carbon nanospheres for ultrafast lithium storage.
Particular recent interest has been given to the Li2TiSiO5 (LTSO) anode material owing to its low lithiation potential (0.28 V vs. Li/Li+) and decent theoretical capacity (308 mA h g-1). However, its poor electronic conductivity (∼10-7 S m-1) fundamentally limits the utilization of this material, and current strategies fail to tackle such issues in practical ways. Herein, a hierarchical microparticulate LTSO-carbon composite (LTSO/C) is fabricated by chemical vapor deposition (CVD), where microsized LTSO/C particles assembled from nanospheres guarantee a practical tap density of ∼1.3 g mL-1. Meanwhile, significantly elevated conductivity of LTSO/C (∼103 S m-1) is achieved by a thin layer (15 nm) of graphitic carbon growth on LTSO, which is theoretically catalyzed by the surface functional groups on the parent LTSO. The electrochemical characterization of LTSO/C reveals a superior graphite-like volumetric capacity of 441.1 mA h cm-3 and Li4Ti5O12-like rate capability (120.1 mA h cm-3 at 4.5 A g-1), providing inspiring guidance for designing analogous Ti or Si-based compounds for ultrafast lithium storage materials.


Sarcoidosis occuring during anti-TNF-alpha treatment for inflammatory rheumatic diseases: report of two cases.
Anti-TNF-alpha agents have been tried in cases of refractory sarcoidosis, giving favourable results. Thus, the occurrence of a granulomatous disease in a patient receiving such drug seems paradoxical. We describe 2 patients with inflammatory rheumatic disease, the first with ankylosing spondylitis, the second with rheumatoid arthritis, under anti-TNF-alpha treatment (infliximab and etanercept respectively) who developed non-caseating granulomas of the lungs and lymph nodes consistent with the diagnosis of sarcoidosis. Limited and various similar cases have been reported. It is generally considered that these granulomatous diseases are related to the anti-TNF-alpha agent.


Radiomics combined with clinical features in distinguishing non-calcifying tuberculosis granuloma and lung adenocarcinoma in small pulmonary nodules.
To evaluate the performance of radiomics models with the combination of clinical features in distinguishing non-calcified tuberculosis granuloma (TBG) and lung adenocarcinoma (LAC) in small pulmonary nodules. We conducted a retrospective analysis of 280 patients with pulmonary nodules confirmed by surgical biopsy from January 2017 to December 2020. Samples were divided into LAC group (n = 143) and TBG group (n = 137). We assigned them to a training dataset (n = 196) and a testing dataset (n = 84). Clinical features including gender, age, smoking, CT appearance (size, location, spiculated sign, lobulated shape, vessel convergence, and pleural indentation) were extracted and included in the radiomics models. 3D slicer and FAE software were used to delineate the Region of Interest (ROI) and extract clinical features. The performance of the model was evaluated by the Area Under the Receiver Operating Characteristic (ROC) Curve (AUC). Based on the model selection, clinical features gender, and age in the LAC group and TBG group showed a significant difference in both datasets (P < 0.05). CT appearance lobulated shape was also significantly different in the LAC group and TBG group (Training dataset, P = 0.034; Testing dataset, P = 0.030). AUC were 0.8344 (95% CI [0.7712-0.8872]) and 0.751 (95% CI [0.6382-0.8531]) in training and testing dataset, respectively. With the capacity to detect differences between TBG and LAC based on their clinical features, radiomics models with a combined of clinical features may function as the potential non-invasive tool for distinguishing TBG and LAC in small pulmonary nodules.


Invention of the Guide Catheter Irrigation Monitoring Device for Neuroendovascular Therapy.
The thromboembolic events during neuroendovascular therapy (NET) are the major complications of concern that can be occasionally fatal. The thrombotic occlusion of the guide catheter for NET is thought to be the risk of the thromboembolic events. We have developed an idea for inventing the monitoring system of the continuous irrigation through the guide catheter. We herein present a unique invention of the guide catheter irrigation monitoring device. We have developed ideas for preventing the thrombotic occlusion of the guide catheter. In order to design a convenient device working in the practical use, we have consulted and shared the ideas with the electrical engineers about putting the invention. The guide catheter irrigation monitoring device (GCIMD) consisted of three parts of optical sensor, main body and electric adapter. In brief, the basic principles of working of the GCIMD are as follows. The optical sensor is attached to the dripping chamber of the line to irrigation solution. The main body had the small light and speaker to make an alarm sounds. The sensor monitors the dripping of flush solution. If the dripping stops more than three seconds, a warning alarm has been activated. So, the operating physicians can concentrate and check the guide catheter irrigation. After the use of the GCIMD, there was no major thromboembolic complication in conjunction with the thrombotic occlusion of the guide catheter in our institute. We have developed a brilliant invention of the GCIMD for NET.


Light-responsive polymer surfaces via postpolymerization modification of grafted polymer-brush structures.
Light-induced, spatially well-defined, reversible switching of surface properties enables the creation of remote-controlled smart surfaces. We have taken advantage of the unique high-resolution structuring capabilities of extreme ultraviolet (EUV) interference lithography to produce nanostructured photoresponsive polymer brushes. Patterns of poly(glycidyl methacrylate) (PGMA) and poly(methacrylic acid) (PMAA) were grafted from two different 100 μm thick fluoropolymer substrates by means of a radiation-initiated, grafting-from approach based on free-radical polymerization (FRP). Photochromic properties were introduced via novel one- or two-step postpolymerization modifications with spiropyran (SP) derivatives, which allowed us to control the number of photochromic groups on the polymer brushes. Depending on the degree of functionalization and the local chemical environment, the SP moieties can open upon UV-light exposure to form zwitterionic, deeply colored, and fluorescent merocyanines (MCs) and reclose to the colorless SP configuration via thermal or visible light-induced relaxation. Switching kinetics were studied by means of time-resolved fluorescence microscopy and compared with kinetic measurements of the SP moiety in solution. The results indicated the importance, for the intensity of the switching, of the local chemical environment provided by both the polymer brush and added solvents, and showed the predominant influence on the ring-closing kinetics of polar solvents, which stabilize the MC form. To allow further characterization of the polymer-brush arrangements on a macroscopic scale, similar, but unstructured brush systems were grafted from fluoropolymers after large-area activation using EUV radiation or argon plasma. All steps of the postpolymerization modification were characterized in detail using attenuated total reflection infrared (ATR-IR) spectroscopy. Furthermore, a light-induced reversible static-contact-angle switch with a range of up to 15° for PGMA-SP brushes and up to 30° for PMA-SP brushes was demonstrated upon alternating UV- and visible-light irradiation.


Anti-tumor activity of the beta-adrenergic receptor antagonist propranolol in neuroblastoma.
Neuroblastoma (NB) is a pediatric tumor of the sympathetic nervous system, which is often associated with elevated catecholamines. More than half of patients with metastatic NB relapse and survival is extremely poor with current therapies. In a high-throughput screen of FDA-approved drugs we identified anti-NB activity for the nonselective β-adrenergic receptor antagonist propranolol hydrochloride. Propranolol inhibited growth of a panel of fifteen NB cell lines irrespective of MYCN status, and treatment induced apoptosis and decreased proliferation. Activity was dependent on inhibition of the β2, and not β1, adrenergic receptor, and treatment resulted in activation of p53 and p73 signaling in vitro. The majority of NB cell lines and primary tumors express β2 adrenergic receptor and higher mRNA levels correlate with improved patient survival, but expression levels did not correlate with in vitro sensitivity to propranolol. Furthermore, propranolol is synergistic with the topoisomerase I inhibitor SN-38 and propranolol inhibits growth of NB xenografts in vivo at doses similar to those used to treat infants with hemangiomas and hypertension. Taken together, our results suggest that propranolol has activity against NB and thus should be considered in combination treatments for patients with relapsed and refractory NB.


Assessment of Microbial Reduction by Cage Washing and Thermal Disinfection using Quantitative Biologic Indicators for Spores, Viruses and Vegetative Bacteria.
Cage washing is a key process of the biosecurity program in rodent facilities. For the current study, we developed systems (i. e., magnet attachments, quantitative biologic indicators (Q-BI), and measurement of thermal disinfection at equipment level) to assess the microbial decontamination achieved by a rodent equipment washer with and without thermal disinfection. 99% of the magnets remained in position to hold Q-BI and temperature probes inside cages, water bottles or at equipment level across a cabinet washer chamber with loads dedicated to either housing or drinking devices. Various types of Q-BI for Bacillus atrophaeus, Enterococcus hirae and minute virus of mice were tested. To simulate potential interference from biologic material and animal waste during cage processing, Q-BI contained test soil: bovine serum albumin with or without feces. As a quantitative indicator of microbial decontamination, the reduction factor was calculated by comparing microbial load of processed Q-BI with unprocessed controls. We detected variation between Q-BI types and assessed the washer's ability to reduce microbial load on equipment. Reduction factor results were consistent with the Q-BI type and showed that the washing and thermal disinfection cycle could reduce loads of vegetative bacteria, virus and spore by 5 log10 CFU/TCID50 and beyond. Thermal disinfection was monitored with temperature probes linked to data loggers recording live. We measured the period of exposure to temperatures above 82.2 °C, to calculate A0, the theoretical indicator for microbial lethality by thermal disinfection, and to assess whether the cabinet washer could pass the minimum quality standard of A0 = 600. Temperature curves showed an A0 > 1000 consistently across all processed equipment during thermal disinfection. These data suggest that, when sterilization is not required, a cabinet washer with thermal disinfection could replace an autoclave and reduce environmental and financial waste.


Microbial Keratitis at an Urban Public Hospital: A 10-Year Update.
To review the epidemiology, risk factors, microbiologic spectrum, and treatment of microbial keratitis during a five-year period at an urban public hospital with comparison to similar findings a decade earlier at the same hospital. Retrospective chart review in the 5-year interval 2009 through 2014 compared to previously reported cases 2000 through 2004 [Eye & Contact Lens 33(1): 45-49, 2007]. Comparative primary outcome measures included best-corrected visual acuity (BCVA), risk factors, culture and sensitivities, treatment, and complication rates. 318 eyes with microbial keratitis were identified. Contact lens wear, ocular trauma, and ocular surface diseases were the most common risk factors. The culture and recovery rates were 73% and 66% respectively. Gram-positive organisms represented 46%, gram-negative organisms 39%, fungal organisms 15%, and Acanthamoeba <1% of corneal isolates. No common corneal pathogens were resistant to aminoglycosides or vancomycin. 48% of cases were initially treated with fortified antibiotics, 43% with fluoroquinolone monotherapy, and 6% with antifungals. 40% of cases received inpatient treatment. At resolution, average BCVA was 20/82 [logMAR 0.61] with 8% of cases resulting in light perception or worse vision. The perforation rate was 8%. 6% of cases underwent urgent penetrating keratoplasty and 4% of cases underwent urgent enucleation or evisceration. Compared to the prior study, significant differences were: (1) lower culture but higher recovery rates, (2) lower admission rate, (3) more contact lens-related cases of Pseudomonas ulcers, (4) lower resistance of coagulase-negative Staphylococcus to aminoglycoside antibiotics, (5) improved BCVA at resolution, and (6) lower associated complication rates. Microbial keratitis remains a clinical challenge in the urban public hospital setting. In the past ten years, epidemiology has shifted towards greater contact lens wear with more Pseudomonal infections. Visual outcomes have not worsened despite a shift away from routine culture and inpatient care to fluoroquinolone monotherapy and outpatient management.


COVID-19 mRNA vaccination is associated with IgA nephropathy: an analysis of the Japanese adverse drug event report database.
Purpose: Coronavirus disease 2019 (COVID-19) mRNA vaccines are used worldwide to prevent severe symptoms of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. IgA nephropathy (IgAN) is the most common form of glomerular injury after COVID-19 vaccination; however, because of the low frequency of such events, only a few reports have been published. A large pharmacovigilance database of real-world spontaneous adverse event (AE) reports is essential for evaluating the drug-associated safety signals regarding rare AEs. Herein, we aimed to investigate the frequency of IgAN after the COVID-19 vaccination, using the Japanese Adverse Drug Event Report (JADER) database. Methods: Data on drug-associated AEs reported between April 2004 and May 2022 were obtained from the JADER database on the Pharmaceuticals and Medical Devices Agency website. To evaluate the safety signals for the targeted AEs, reporting odds ratios (RORs), information components (ICs), and their 95% confidence intervals (CIs) were calculated using two-by-two contingency tables. Results: A total of 697,885 cases were included in the analysis. Safety signals were detected for IgAN (ROR: 6.49, 95% CI: 4.38-9.61; IC: 2.27, 95% CI: 1.70-2.83). Of 30 cases for IgAN associated with COVID-19 mRNA vaccines, 16 had information available on time to onset. Of the 16 cases, 11 occurred ≤2 days after vaccination, and two occurred >28 days after vaccination. Conclusion: These results suggest that, compared with other drugs, COVID-19 vaccination is associated with a higher frequency of IgAN. Monitoring of gross hematuria following COVID-19 vaccination should be needed.


Increased Trunk Kinetics Observed During Dose-Specific Trunk Lean Gait Modification.
Trunk modification is associated with knee abduction moment reduction in both healthy groups and individuals with knee osteoarthritis. Ambulatory-related changes in trunk kinematics have been implicated in increased trunk moment. The purpose of this study was to investigate the effect of dose-specific lateral trunk lean on trunk kinetics during ipsilateral and contralateral stance phases. Nineteen healthy participants completed 10 baseline walking trials, followed by 10 trials employing lateral trunk lean. Trunk modification magnitudes were determined based on the average baseline trunk angle. Five trials of both small and large trunk modification magnitudes were completed. Visual real-time biofeedback was projected as a line graph displaying the trunk angle during stance, and a highlighted bandwidth was designated the target range. A 1-factor repeated-measures analysis of variance or Friedman test was used to assess differences between the conditions (P < .05) in trunk dependent measures. Trunk kinetics displayed significant increases, even during modest modifications to the trunk angle. The participants experienced increased peak frontal plane trunk moment and angular impulse during ipsilateral stance. The observed increase in the peak lateral joint reaction force is suggestive of a compromised loading environment at the spine. Implementing trunk modification might result in unintended secondary changes along the kinetic chain, but further investigation is required.


Holistically sustainable continence care: A working definition, the case of single-used absorbent hygiene products (AHPs) and the need for ecosystems thinking.
Incontinence is a common health issue that affects hundreds of millions of people across the world. The solution is often to manage the condition with different kinds of single-use continence technologies, such as incontinence pads and other absorbent hygiene products (AHPs). Throughout their life cycle, these fossil-based products form a remarkable yet inadequately addressed ecological burden in society, contributing to global warming and other environmental degradation. The products are a necessity for their users' wellbeing. When looking for sustainability transitions in this field, focus on individual consumer-choice is thus inadequate - and unfair to the users. The industry is already seeking to decrease its carbon footprint. Yet, to tackle the environmental impact of single-use continence products, also societies and health systems at large must start taking continence seriously. Arguing that continence-aware societies are more sustainable societies, we devise in this article a society-wide working definition for holistically sustainable continence care. Involving dimensions of social, ecological and economic sustainability, the concept draws attention to the wide range of technologies, infrastructures and care practices that emerge around populations' continence needs. Holistically sustainable continence care is thus not only about AHPs. However, in this article, we examine holistically sustainable continence care through the case of AHPs. We review what is known about the environmental impact AHPs, discuss the impact of care practices on aggregate material usage, the future of biobased and degradable incontinence pads, as well as questions of waste management and circular economy. The case of AHPs shows how holistically sustainable continence care is a wider question than technological product development. In the end of the article, we envision an ecosystem where technologies, infrastructures and practices of holistically sustainable continence care can flourish, beyond the focus on singular technologies.


Surface treatment protocols in the cementation process of ceramic and laboratory-processed composite restorations: a literature review.
The clinical longevity of indirect restorations made of ceramics or indirect composite resins depends on their successful treatment and cementation. The cementation technique is determined by the type of restorative material-ceramics or indirect composite resins; thus, their intaglio surface treatment should be performed according to their particular compositions. The aim of this literature review was to define surface treatment protocols of different esthetic indirect restorative materials. A PubMed database search was conducted for in vitro studies pertaining to the most common treatment protocols of tooth-colored materials. Articles that described at least the surface treatment procedure, its effects on adhesion, its relationship with the material's composition, clinical aspects, and expected longevity were selected. The search was limited to peer-reviewed articles published in English between 1965 and 2004 in dental journals. Sandblasting, etching techniques, and silane coupling agents are the most common procedures with improved results. Tooth-colored restorative materials vary considerably in composition and require different protocols for adhesive cementation.


Genetic and oceanographic tools reveal high population connectivity and diversity in the endangered pen shell Pinna nobilis.
For marine meta-populations with source-sink dynamics knowledge about genetic connectivity is important to conserve biodiversity and design marine protected areas (MPAs). We evaluate connectivity of a Mediterranean sessile species, Pinna nobilis. To address a large geographical scale, partial sequences of cytochrome oxidase I (COI, 590 bp) were used to evaluate phylogeographical patterns in the Western Mediterranean, and in the whole basin using overlapping sequences from the literature (243 bp). Additionally, we combined (1) larval trajectories based on oceanographic currents and early life-history traits and (2) 10 highly polymorphic microsatellite loci collected in the Western Mediterranean. COI results provided evidence for high diversity and low inter-population differentiation. Microsatellite genotypes showed increasing genetic differentiation with oceanographic transport time (isolation by oceanographic distance (IBD) set by marine currents). Genetic differentiation was detected between Banyuls and Murcia and between Murcia and Mallorca. However, no genetic break was detected between the Balearic populations and the mainland. Migration rates together with numerical Lagrangian simulations showed that (i) the Ebro Delta is a larval source for the Balearic populations (ii) Alicante is a sink population, accumulating allelic diversity from nearby populations. The inferred connectivity can be applied in the development of MPA networks in the Western Mediterranean.


Tick paralysis.
Tick paralysis results from inoculation of a toxin from tick salivary glands during a blood meal. It is a relatively uncommon neuromuscular disease with a higher prevalence among young girls, although older men who get exposed to ticks may also be affected. It typically presents as an acute ascending paralysis occurring a few days after tick attachment and may result in respiratory failure and death. Patients may report minor sensory symptoms but constitutional signs are usually absent. Deep tendon reflexes are usually hypoactive or absent and ophthalmoplegia and bulbar palsy can occur. Children may be ataxic. Electromyographic studies usually show a variable reduction in the amplitude of compound muscle action potentials but no abnormalities of repetitive nerve stimulation studies. These appear to result from a failure of acetylcholine release at the motor nerve terminal level. There may be subtle abnormalities of motor nerve conduction velocity and sensory action potentials. Removal of the tick results in the very rapid reversal of clinical and physiologic deficits, quicker with North American ticks than with the Ixodes species seen in Australia.


Comparative Evaluation of Using NOTA and DOTA Derivatives as Bifunctional Chelating Agents in the Preparation of 68Ga-Labeled Porphyrin: Impact on Pharmacokinetics and Tumor Uptake in a Mouse Model.
Both NOTA (1,4,7-triazacyclononane-1,4,7-triacetic acid) and DOTA (1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid) derivatives have been used as bifunctional chelating agents (BFCAs) for the preparation of 68Ga-labeled target-specific agents having potential for positron emission tomography (PET) imaging of cancerous lesions. In the present work, the authors have attempted a comparative pharmacokinetic evaluation between 68Ga-labeled porphyrins prepared using NOTA and DOTA derivatives as the BFCAs. A symmetrical porphyrin derivative, 5,10,15,20-tetrakis(p-carboxymethyleneoxyphenyl)porphyrin, was synthesized and coupled with two different BFCAs viz. p-NH2-benzyl-NOTA and p-NH2-benzyl-DOTA. Both the porphyrin-BFCA conjugates were radiolabeled with 68Ga. A comparative bioevaluation involving pharmacokinetics and tumor affinity was performed in a tumor-bearing small animal model. Gallium-68-labeled porphyrin-amido-benzyl-NOTA and porphyrin-amido-benzyl-DOTA complexes were prepared with high radiochemical purity. Both radiolabeled complexes exhibited almost similar stability in human serum and near-identical tumor affinity and pharmacokinetic behavior in animal studies. The present study demonstrates that the pharmacokinetic behavior of 68Ga-labeled porphyrin derivatives, prepared using either NOTA or DOTA derivatives as BFCAs, remains almost identical and hence both NOTA and DOTA derivatives could be considered equivalent for developing 68Ga-based PET agents for imaging of tumorous lesions.


Post-prandial decrease in plasma growth hormone levels is not related to the increase in plasma insulin levels in goats.
In the present study, we examined whether the post-prandial reduction in plasma growth hormone (GH) levels is related to the increase in plasma insulin levels in ruminants. We performed two experiments: intravenous bolus injection of insulin (0.2 IU/kg body weight) or glucose (1.0 mmol/kg body weight) was administered to increase the plasma insulin levels in male Shiba goats. In the insulin injection experiment, significant (p<0.05) increase in GH concentrations was observed, 15 to 20 min after the injection; it was accompanied with a significant (p<0.01) increase in cortisol concentrations at 45 to 90 min, when compared to the concentrations in the saline-injected controls. The glucose injection significantly (p<0.05) increased the plasma GH concentration at 20 to 45 min; this was not accompanied by significantly higher cortisol concentrations than were observed for the saline-injected control. Hypoglycemia induced by the insulin injection, which causes the excitation of the adrenal cortex, might be involved in the increase in insulin levels. Based on these results, we conclude that post-prandial increases in plasma insulin or glucose levels do not induce a decrease in GH concentration after feeding in the ruminants.


sCD163 levels as a biomarker of disease severity in leprosy and visceral leishmaniasis.
CD163, receptor for the haptoglobin-hemoglobin complex, is expressed on monocytes/macrophages and neutrophils. A soluble form of CD163 (sCD163) has been associated with the M2 macrophage phenotype, and M2 macrophages have been shown to down-modulate inflammatory responses. In particular, previous studies have shown that M2 is closely associated with the most severe clinical presentation of leprosy (i.e. lepromatous leprosy (LL)), as well as tuberculosis. We hypothesized that sCD163 correlates with severity of diseases caused by intracellular pathogens. To assess this hypothesis, sCD163 levels were measured in the serum of leprosy and visceral leishmaniasis (VL) patients stratified by severity of the clinical presentation. sCD163 levels were significantly higher in patients with these diseases than those observed in healthy control individuals. Further analyses on infection and disease status of leprosy and VL patients revealed a clear association of sCD163 levels with clinical parameters of disease severity. In vitro culture assays revealed that Leishmania infection induced CD163 expression on the surface of both monocyte/macrophages and neutrophils, suggesting these cells as possible sources of sCD163. FACS analyses shows that the cells expressing CD163 produces both TNF-α and IL-4. Taken together, our results reveal sCD163 as a potential biomarker of severity of diseases caused by intracellular pathogens M. leprae and Leishmania spp. and have a modulatory role, with a mix of an inflammatory property induced by TNF-α release, but that potentially induces an anti-inflammatory T cell response, related to IL-4 release.


Lissajous MEMS laser beam scanner with uniform and high fill-factor projection for augmented reality display.
MEMS Laser beam scanning (LBS) has been identified as a key advancement for augmented reality (AR) displays due to its ability to create compact optical systems that generate bright, high-contrast images with minimal heat dissipation. This innovation can be attributed to the focus-free, efficient light-on-demand pixel projection mechanisms integral to LBS. The LBS, specifically in Lissajous-mode, outperforms the raster-mode in terms of larger scan angles and stability to external vibrations, by leveraging a MEMS mirror operating at bi-axial resonance. However, it tends to be hampered by small mirror aperture, low fill-factor, and inconsistent uniformity of image projection. In this research, a unique gimbal-less Lissajous MEMS scanner was proposed. It employs a bi-axial high frequency of 12,255 Hz and 7,182 Hz to achieve a resolution of 640 × 360 pixels and a video refresh rate of 57 Hz, all while maintaining a high image fill factor of 85.11%. The robust structure of the mirror is proven to sustain stable scanning under broad spectrum of external vibration disturbance up to 2,000 Hz. Furthermore, the large mirror diameter of 2 mm improves refined pixel projection and increased optical etendue for exit pupil. Mathematic model of Lissajous pixel-cells and image reconstruction simulation were established to validate the LBS's ability to generate a uniform and densely pixelated visual effect that fits for typical AR head-up display (AR-HUD). In a pioneering move, performance metric of figure-of-merit was defined to evaluate AR light-engines using varied picture-generation techniques, laying a foundation for guiding future AR system development.


Dimensions of nurse work time: Progress in instrumentation.
Because the work of health care is embedded in time, understanding nursing time-allocation practices is essential for identifying nurse staffing and workflow patterns that optimize healthcare cost and quality outcomes. The interdependent nature of nursing care requires that nurses share time with other members of their work group. Shared time, also known as social or organizational time, requires careful negotiation of workflows within healthcare teams. Evaluation of negotiated workflows is contingent upon valid and reliable measures of sociological nursing time. In this study, we evaluated the psychometric properties of a newly adapted instrument for measuring sociological nursing time and describe the experience of sociological time among hospital-employed nurses. Using a cross-sectional survey design with a convenience sample of nurses (n = 359), we identified nine reliable components of sociological nursing time: insufficient time allocation; strict adherence to schedules; increased time awareness; value of quality over speed; fast and unpredictable pace changes; predictable job duties punctuated with unpredictable job demands; expectations for a fast work pace; inconsistent work-hour expectations across departments; and high expectations for punctuality.


Myeloid Neoplasm With Germline Predisposition: A 2016 Update for Pathologists.
Myeloid neoplasms with familial occurrence have been rarely reported in the past. With the advance of molecular technology and better understanding of the molecular pathogenesis of myeloid neoplasms, investigating the genetic causes of familial acute myeloid leukemia or myelodysplastic syndrome has become feasible in the clinical setting. Recent studies have identified a rapidly expanding list of germline mutations associated with increased risks of developing myeloid neoplasm in the affected families. It is important to recognize these entities, as such a diagnosis may dictate a unique approach in clinical management and surveillance for the patients and carriers. To raise the awareness of myeloid neoplasms arising in the setting of familial inheritance among practicing pathologists. Based on recent literature and the 2016 revision of the World Health Organization classification of hematopoietic neoplasms, we provide an up-to-date review of myeloid neoplasm with germline predisposition. This short review focuses on the clinical, pathologic, and molecular characterization of myeloid neoplasm with germline predisposition. We emphasize the important features that will help practicing pathologists to recognize these newly described entities.