Regulation of the Yeast Hxt6 Hexose Transporter by the Rod1 α-Arrestin, the Snf1 Protein Kinase, and the Bmh2 14-3-3 Protein.
Cell viability requires adaptation to changing environmental conditions. Ubiquitin-mediated endocytosis plays a crucial role in this process, because it provides a mechanism to remove transport proteins from the membrane. Arrestin-related trafficking proteins are important regulators of the endocytic pathway in yeast, facilitating selective ubiquitylation of target proteins by the E3 ubiquitin ligase, Rsp5. Specifically, Rod1 (Art4) has been reported to regulate the endocytosis of both the Hxt1, Hxt3, and Hxt6 glucose transporters and the Jen1 lactate transporter. Also, the AMP kinase homologue, Snf1, and 14-3-3 proteins have been shown to regulate Jen1 via Rod1. Here, we further characterized the role of Rod1, Snf1, and 14-3-3 in the signal transduction route involved in the endocytic regulation of the Hxt6 high affinity glucose transporter by showing that Snf1 interacts specifically with Rod1 and Rog3 (Art7), that the interaction between the Bmh2 and several arrestin-related trafficking proteins may be modulated by carbon source, and that both the 14-3-3 protein Bmh2 and the Snf1 regulatory domain interact with the arrestin-like domain containing the N-terminal half of Rod1 (amino acids 1-395). Finally, using both co-immunoprecipitation and bimolecular fluorescence complementation, we demonstrated the interaction of Rod1 with Hxt6 and showed that the localization of the Rod1-Hxt6 complex at the plasma membrane is affected by carbon source and is reduced upon overexpression of SNF1 and BMH2.


Impact of traffic-related air pollution on the expression of Platanus orientalis pollen allergens.
Air pollutants and their interaction with environmental allergens have been considered as an important reason for the recent increase in the prevalence of allergic diseases. The aim of this study was to investigate the traffic pollution effect, as a stressor, on Platanus orientalis pollen allergens messenger RNA (mRNA) and protein expression. P. orientalis pollen grains were collected along main streets of heavy traffic and from unpolluted sites in Mashhad city, in northeast Iran. The pollen samples were examined by scanning electron microscopy. To assess the abundance of pollen allergens (Pla or 1, Pla or 2, and Pla or 3) from polluted and unpolluted sites, immunoblotting was performed. Moreover, the sequences encoding P. orientalis allergens were amplified using real-time PCR. Scanning electron microscopy showed a number of particles of 150-550 nm on the surface of pollen from polluted sites. Also, protein and gene expression levels of Pla or 1 and Pla or 3 were considerably greater in pollen samples from highly polluted areas than in pollen from unpolluted areas (p < 0.05). In contrast, no statically significant difference in Pla or 2 protein and mRNA expression level was found between samples from the two areas. We found greater expression of allergens involved in plant defense mechanisms (Pla or 1 and Pla or 3) in polluted sites than in unpolluted ones. The high expression of these proteins can lead to an increase in the prevalence of allergic diseases. These findings suggest the necessity of supporting public policies aimed at controlling traffic pollution to improve air quality and prevent the subsequent clinical outcomes and new cases of asthma.


Cold atmospheric plasma: A non-negligible strategy for viral RNA inactivation to prevent SARS-CoV-2 environmental transmission.
Cold atmospheric plasma (CAP), regarded as a powerful physics technology, displays antimicrobial, antitumor, and even antiviral properties, but the underlying mechanism is rarely studied. In this study, four CAP exposure doses (30, 60, 120, and 240 s) were applied to inactivate a severe acute respiratory syndrome coronavirus 2 like pseudovirus on a stainless steel disk, which comprised spike protein on its membrane and can express a green fluorescent protein. In order to unravel the potential effects of CAP irradiation on pseudovirus, infection assay, optical emission spectra analysis, transmission electron microscopy (TEM), sodium dodecyl sulfate polyacrylamide gel electrophoresis, ELISA, and qPCR experiments were carried out. As a result, our study indicated that CAP irradiation can significantly decrease the infectivity of pseudovirus in a dose dependent manner through destroying the cell membrane and further damaging viral RNA, with the molecular weight and conformation of spike receptor binding domain protein unchanged.


Development of a Japanese version of the Psychological Ownership Scale.
The present study addresses the need for a valid instrument for measuring dimensions of psychological ownership, including that of owned and non-owned objects, for use in the language and culture of Japan. Although the theory of psychological ownership has expanded self-extension theory, the most widely used scale of psychological ownership does not measure the extent to which one feels that it (the owned object) is a part of them. Thus, the present study aimed to develop a Japanese version of the Psychological Ownership Scale (POS-J) and examine its reliability and validity. Study 1 measured the POS-J of an owned object, finding the POS-J to have a two-factor structure (possession-self link and feeling of ownership) and its internal consistency and reliability to be adequate. Moreover, POS-J scores were positively correlated with perceived control and self-extension tendency, but not monetary value, indicating that conceptual validity was generally supported. To confirm whether the POS-J could be used for a non-owned object, Study 2 rephrased the expressions of item descriptions and examined the effect of imagining touching a non-owned object on the POS-J scores, showing that doing so increased the POS-J scores for the object. Our findings suggest that the POS-J is a reliable and valid measure of the psychological ownership of owned and non-owned objects for use in Japan.


Hepatoblastoma: current understanding, recent advances, and controversies.
Introduction: Hepatoblastoma (HB) is the most common primary malignant liver neoplasm in children. Its increasing survival rate is related to the progress in modern imaging, surgical techniques, and new chemotherapy regimens. Clinical approach: One of the past achievements was the development of the pretreatment extension of disease (PRETEXT) system. Gradually, the HB therapeutic approach has become more individualized with better stratification of patients. Controversies: These include the need for preoperative chemotherapy and its optimal duration; intensity of preoperative chemotherapy required for locally advanced cases (PRETEXT 4); optimal surgical treatment for locally advanced tumors: aggressive hepatic resections versus liver transplantation; the role of postoperative chemotherapy in the post-transplant setting; the timing and role of metastasectomy in patients with disseminated disease who undergo partial liver resection; and the prognostic significance of several HB pathology variants. Hepatoblastoma biology: Beta-catenin mutations and the beta-catenin/Wnt pathway play an important role in HB development. There have been at least two molecular signatures in HB published. Unluckily, all of these findings are based on relatively small clinical series and require confirmation. Conclusion: The treatment of HB started from one and the same therapy for all patients and aimed at increased treatment individualization, but the future seems to lie in biology-driven patient-tailored therapies.


Plants exhibit significant effects on the rhizospheric microbiome across contrasting soils in tropical and subtropical China.
The rhizospheric microbiome appears to be one of the key determinants of plant health and productivity. In this study, to understand the assembly process of the rhizospheric microbiome, the effects of different sites, soils and plants on the rhizospheric microbiome were compared and examined using high-throughput sequencing. A series of comparisons of rhizospheric microbiomes were conducted using two plants (wild rice (Oryza rufipogon Griff.) and L. hexandra (Leersia hexandra Swartz)), two soils (high nutrient and low nutrient) and two sites (Guangdong and Hainan provinces in China). The results of the redundancy analysis, between-class analysis and coinertia analysis indicated that the factors shaping the rhizospheric microbiome (in decreasing order of strength), were the site, soil and plant. The effects of plants on the rhizospheric microbiome were slight and unobvious, with relatively low-explained variations and few core groups and indicator groups; however, the effects were significant across different sites and soils, especially for specific microbial groups that are closely associated with plants, such as pathogens, symbionts, and saprotrophs. Furthermore, rhizospheric fungi were more strongly influenced by plants than rhizospheric bacteria. Our results provide insights into the relationships among multiple factors that shape the rhizospheric microbiome in natural ecosystems and highlight the effects of plants across regional environmental shifts.


Stimulus-secretion coupling in exocrine pancreas; possible role of calmodulin.
Many calcium-mediated effects in mammalian cells may be activated by calcium-calmodulin stimulated enzymes. These effects are inhibited by various antidepressant drugs which bind to and inactivate calmodulin. In the current study, calmodulin was identified by affinity chromatography and gel electrophoresis in the cytoplasm of dispersed rat pancreatic acinar cells. Its role in enzyme secretion was assessed by evaluating the effects of various antidepressants drugs on the enzyme secretory process. Chlorpromazine, trifluoperazine, thioridazine, chlorprothixene and amitriptyline inhibited amylase secretion stimulated by carbachol, A-23187, and cholecystokinin-pancreozymin but not that elicited by dibutyryl cyclic AMP secretin or vasoactive intestinal peptide (VIP). Haloperidol, sulpiride, phenobarbital, and ethanol were without effect on secretagogue-stimulated enzyme release. Only those agents which blocked secretion also inhibited 45Ca release stimulated by carbachol from isotope preloaded cells. The data suggest that calmodulin may have a functional role in pancreatic enzyme secretion.


Bariatric surgery and diabetes remission: Who would have thought it?
Type 2 diabetes mellitus (T2DM) and obesity are increasingly common and major global health problems. The Edmonton obesity staging system clearly pointed towards increased mortality proportionate to the severity of obesity. Obesity itself triggers insulin resistance and thereby poses the risk of T2DM. Both obesity and T2DM have been associated with higher morbidity and mortality and this calls for institution of effective therapies to deal with the rising trend of complications arising out of this dual menace. Although lifestyle changes form the cornerstone of therapy for both the ailments, sustained results from this modalities is far from satisfactory. While Look AHEAD (action for HEAalth in diabetes) study showed significant weight loss, reduction in glycated hemoglobin and higher remission rate of T2DM at 1(st) year following intensive lifestyle measures; recurrence and relapse rate bounced back in half of subjects at 4 years, thereby indicating that weight loss and glycemic control is difficult to maintain in the long term with lifestyle interventions. Same recurrence phenomenon was also observed with pharmacotherapy with rimonabant, sibutramine and orlistat. Bariatric surgery has been seen to associate with substantial and sustained weight loss in morbidly obese patients. Interestingly, bariatric surgeries also induce higher rates of short and long-term diabetes remission. Although the exact mechanism behinds this diabetes remission are not well understood; improved insulin action, beta-cell function and complex interplay of hormones in the entero-insular axis appears to play a major role. This article reviews the effectiveness of bariatric procedures on remission or improvement in diabetes and put a perspective on its implicated mechanisms.


Neurological complications of central venous cannulation.
The reports of neurological damage after central venous cannulation over the past 20 yrs have been gathered, summarized, and analyzed. We found 59 cases of nerve lesions: 32 serious or even fatal, and 27 light or transient ones. They included: Lesions of the cervical sympathetic chain: needle trauma, compression by hematoma, anesthetic blockade; brachial plexopathies: needle trauma or compression by hematoma; phrenic or recurrent nerve palsies: anesthetic blockade, needle trauma, or compression by hematoma; cerebral damage following venous air embolism, carotid artery embolism or obstruction (thrombosis, compression), or internal jugular vein obstruction (thrombosis or catheter tip); lesions of the IX, X, XI, and XII cranial nerves by hematoma compression or spilling of histotoxic solutions; and, massive lesions of the anterior rami of the cervical nerves by spillage of histotoxic solutions. We believe that the following simple and well-known measures can substantially reduce the incidence of those serious complications. 1. Avoiding the subclavian or jugular central routes in patients with marked anatomical changes, coagulopathies, and carotid artery or lung diseases. 2. Using only small amounts of dilute concentrations of short-acting local anesthetics before the puncture. 3. Using a small gauge "seeking" needle and placing a finger on the carotid artery during a jugular venipuncture to avoid accidental arterial puncture. 4. Using radiopaque catheters long enough to have their tip in midsuperior vena cava. The position of the catheter must be checked radiographically immediately after insertion and even at later periods. The catheter must be meticulously fixed to the skin to avoid its movement.(ABSTRACT TRUNCATED AT 250 WORDS)


Combined monitoring of evoked potentials during microsurgery for lesions adjacent to the brainstem and intracranial aneurysms.
Neurophysiologic monitoring during surgery is to prevent permanent neurological injury resulting from surgical manipulation. To improve the accuracy and sensitivity of intraoperative neuromonitoring, combined monitoring of transcranial electrical stimulation motor evoked potentials (TES-MEPs), somatosensory evoked potentials (SSEPs) and brainstem auditory evoked potentials (BAEPs) was attempted in microsurgery for lesions adjacent to the brainstem and intracranial aneurysms. Monitoring of combined TES-MEPs with SSEPs was attempted in 68 consecutive patients with lesions adjacent to the brainstem as well as intracranial aneurysms. Among them, 31 patients (31 operations, 28 of posterior cranial fossa tumors, 3 of posterior circulation aneurysms) were also subjected to monitoring of BAEPs. The correlation of monitoring results and clinical outcome was studied prospectively. Combined monitoring of evoked potentials (EPs) was done in 64 (94.1%) of the 68 patients. MEPs monitoring was impossible for 4 patients (5.9%). No complication was observed during the combined monitoring in all the patients. In 45 (66.2%) of the 68 patients, EPs were stable, and they were neurologically intact. Motor dysfunction was detected by MEPs in 8 patients, SSEPs in 5, and BAEPs in 4, respectively. A close relationship exists between postoperative motor function and the results of TES-MEPs monitoring. TES-MEPs are superior to SSEPs and BAEPs in detecting motor dysfunction, but combined EPs serve as a safe, effective and invasive method for intraoperative monitoring of the function of the motor nervous system. Monitoring of combined EPs during microsurgery for lesions adjacent to the brainstem and intracranial aneurysms may detect potentially hazardous maneuvers and improve the safety of subsequent procedures.


Combined analysis of acetylcholinesterase and alpha-fetoprotein improves the accuracy of antenatal diagnosis of neural-tube defects.
Acetylcholinesterase (AChE), butyrylcholinesterase (BChE) and alpha-fetoprotein (AFP) were measured in 293 amniotic fluids from the second and third trimesters of pregnancy in a prospective study of their diagnostic value in the detection of neural-tube defects (NTD). In normal samples, the mean AChE and BChE concentrations were 3.0 u/L (SEM = 9.1 u/L) and 15.2 u/L (SEM = 1.2 u/L) in the second trimester, and 1.6 u/L (SEM = 0.1 u/L) and 7.8 u/L (SEM = 0.6 u/L) in the third trimester. AFP levels fell throughout the second trimester to unmeasurable levels in the third. AChE levels were markedly elevated in samples from NTD pregnancies at all gestational ages, and a cut-off level of the mean + 3 SD optimally separated normal from abnormal samples. This cut-off correctly predicted 10 of 11 fetuses with neural lesions; there were three false positive results. A similar cut-off for AFP predicted nine of 11 cases of neural lesion with two false positive results. For BChE, a cut off of 50 u/L predicted eight of 11 neural lesions with two false positive results. The specificity, sensitivity, and predictive value positive (PVP) were calculated for each test. The assays of AFP and AChE were useful when used individually (PVP congruent to 80%), but a Bayesian combination of these two tests produced a superior PVP (98%). Because the cost of AChE assay is low, and the test is so simple, it is suggested that an AChE analysis should be performed whenever an amniocentesis is requested for the diagnosis of NTD.


[Genetic diseases in pediatric patients hospitalised in the town of Ubaté, Colombia].
Describing genetic disease frequency in a second-level hospital's in-patient paediatric service The hospital's statistical department's records for 2005 were comprehensively reviewed; the study was carried out in the town of Ubaté during 2006. Complex diseases led to nearly 25% of all hospitalisations, including multifactor diseases and congenital malformations. However, an aetiological study and/or geneticist consultation or referral took place on a few occasions. Primary care hospitals should become more relevant reference centres for detecting genetic diseases amongst the paediatric population. New mechanisms are needed for implementing this to allow patients access to a geneticist and for an aetiological diagnosis to be made and providing suitable genetic counselling.


Increased alpha-synuclein and neuroinflammation in the substantia nigra triggered by systemic inflammation are reversed by targeted inhibition of the receptor for advanced glycation end products (RAGE).
The receptor for advanced glycation end products (RAGE) is a protein of the immunoglobulin superfamily capable of regulating inflammation. Considering the role of this receptor in the initiation and establishment of neuroinflammation, and the limited understanding of the function of RAGE in the maintenance of this condition, this study describes the effects of RAGE inhibition in the brain, through an intranasal treatment with the antagonist FPS-ZM1, in an animal model of chronic neuroinflammation induced by acute intraperitoneal injection of lipopolysaccharide (LPS). Seventy days after LPS administration (2 mg/kg, i.p.), Wistar rats received, intranasally, 1.2 mg of FPS-ZM1 over 14 days. On days 88 and 89, the animals were submitted to the open-field test and were killed on day 90 after the intraperitoneal injection of LPS. Our results indicate that blockade of encephalic RAGE attenuates LPS-induced chronic neuroinflammation in different brain regions. Furthermore, we found that intranasal FPS-ZM1 administration reduced levels of gliosis markers, RAGE ligands, and α-synuclein in the substantia nigra pars compacta. Additionally, the treatment also reversed the increase in S100 calcium-binding protein B (RAGE ligand) in the cerebrospinal fluid and the cognitive-behavioral deficits promoted by LPS-less time spent in the central zone of the open-field arena (more time in the lateral zones), decreased total distance traveled, and increased number of freezing episodes. In summary, our study demonstrates the prominent role of RAGE in the maintenance of a chronic neuroinflammatory state triggered by a single episode of systemic inflammation and also points to possible future RAGE-based therapeutic approaches to treat conditions in which chronic neuroinflammation and increased α-synuclein levels could play a relevant role, such as in Parkinson's disease.


[Early exercise test in patients with myocardial infarction after nifedipine administration of prolonged duration].
In 25 patients with transmural myocardial infarction a mean of 16 days after the onset of infarction an exercise stress test was performed 2 hours after the administration of Corinfar Retard. We evaluated ECG, blood pressure, heart rate, echocardiograms and spirographic parameters before and after drug administration. In the majority of patients ST segment depressions were reduced and duration of the exercise test increased or remained unchanged. In 5 patients the magnitude of ST segment depression was markedly decreased and associated with prolonged duration of exercise and substantial patient comfort. In these patients the drug is continued, as its withdrawal resulted in decreased exercise tolerance with accompanying chess discomfort. Corinfar Retard significantly decreased weigh blood pressure, both systolic and diastolic, whereas its effect on low blood pressure was only slight or none. Heart rate was higher before exercise, during and after exercise it did not differ from that measured without the drug. Ejection fraction increased by a mean of 4%; VC and FEV1 increased or remained unchanged. Exercise testing was safe, did not produce and any side effects and seems to be useful in deciding about the choice of drug after myocardial infarction, especially in patients with counterindications to beta blockers.


S100 Proteins As an Important Regulator of Macrophage Inflammation.
The S100 proteins, a family of calcium-binding cytosolic proteins, have a broad range of intracellular and extracellular functions through regulating calcium balance, cell apoptosis, migration, proliferation, differentiation, energy metabolism, and inflammation. The intracellular functions of S100 proteins involve interaction with intracellular receptors, membrane protein recruitment/transportation, transcriptional regulation and integrating with enzymes or nucleic acids, and DNA repair. The S100 proteins could also be released from the cytoplasm, induced by tissue/cell damage and cellular stress. The extracellular S100 proteins, serving as a danger signal, are crucial in regulating immune homeostasis, post-traumatic injury, and inflammation. Extracellular S100 proteins are also considered biomarkers for some specific diseases. In this review, we will discuss the multi-functional roles of S100 proteins, especially their potential roles associated with cell migration, differentiation, tissue repair, and inflammation.


Practicing implant dentistry profitably.
The success of dental implants has opened up countless treatment possibilities for restorative dentists to offer to their patients. Just as our clinical paradigms have had to change because of this new technology, so too must our paradigms concerning the way we communicate with our patients change if we are to get them to say "yes" to treatment that we know that they need. Success in clinical treatment using implants requires a systematic approach. A systematic approach to communicating with your patients will allow you to have the same high degree of success with treatment acceptance that is possible with dental implants. The key to the systems we have discussed is Relationship Centered Care. A relationship is fostered and enhanced through a Comprehensive Examination Process, a structured Consultation Process utilizing the influencing process and Financial Arrangements that allow the patient to receive what they want while the office maintains the profitability that it needs. A system for calculating rational fees can be utilized that allows the practice to have control over an area that traditionally was controlled by anecdotal factors. The Pride Institute has developed this material and is presenting it to the profession so that restorative dentists can truly practice implant dentistry profitably.


[A clinical analysis on fever of unknown origin in in-patients with systemic lupus erythematosus].
To investigate the etiology and differential diagnoses of patients with systemic lupus erythematosus (SLE) and fever of unknown origin (FUO). From January 2012 to December 2014, a total of 928 SLE patients were admitted to Peking Union Medical College Hospital.Only 50 patients were combined with FUO (5.4%). The most common reason of fever was caused by infections(33 cases, 66.0%), including bacterial infection in 17 cases with 5 tuberculosis, viral infection in 11 cases, and fungal infection in 5 cases.The second reason offever was due to poor disease control or recurrence in 17 patients (34.0%). No fever was caused by malignant tumor.When clinical data was compared between 17 non-infected patients versus 33 infected patients, C reactive protein and procalcitonin in the infected group were significantly higher than those in the non-infected group.In SLE patients combined with FUO, infection is the most common etiology which is necessary to be paid attention to.


Drug therapy of childhood asthma.
Drug therapy is used to prevent and control asthma, and also to reduce the frequency and severity of its exacerbations, and reverse airflow obstruction. Asthma medications are thus categorized into two general classes--bronchodilators (relievers) and anti-inflammatory drugs (preventers). Short acting beta2-agonists is the therapy of choice for relief of acute symptoms and prevention of exercise induced bronchospasm (EIB). Corticosteroids are the most potent and effective anti-inflammatory medication currently available. Inhaled form is used in the long-term control of asthma. Systemic corticosteroids are used to gain prompt control of the disease when initiating long-term therapy. Long acting bronchodilator used concomitantly with anti-inflammatory medications for long-term control of symptoms, especially nocturnal symptoms. Ipratropium bromide may provide some additive benefit to inhaled beta2-agonists in severe exacerbations. Sustained release theophylline is a mild to moderate bronchodilator used principally as adjuvant to inhaled corticosteroids for prevention of nocturnal asthma. Leukotriene modifiers may be considered as an alternative therapy to inhaled corticosteroids or cromolyn or nedocromil.


Enteral nutrition is associated with improved outcome in patients with severe sepsis. A secondary analysis of the VISEP trial.
The optimal nutritional strategy remains controversial, particularly in severely septic patients. Our aim was to analyze the effect of three nutritional strategies--enteral (EN), parenteral (PN), and combined nutrition (EN+PN)--on the outcome of patients with severe sepsis or septic shock. This secondary analysis of the prospective, randomized-controlled, multicenter "Intensive Insulin Therapy and Pentastarch Resuscitation in Severe Sepsis (VISEP)" trial only included patients with a length of stay in the intensive care unit (ICU) of more than 7 days. Besides patient characteristics, data on nutrition therapy were collected daily for up to 21 days. Morbidity as measured by the mean Sequential Organ Failure Assessment (SOFA) score, incidence of secondary infections, renal replacement therapy, ventilator-free days and severe hypoglycemia, length of ICU stay, and mortality at 90 days were compared between the three nutritional strategies. In all, 353 patients were included in the analysis with the majority (68.5 %) receiving EN+PN, 24.4 % receiving EN, and only 7.1 % receiving PN. Median caloric intake was 918 kcal/day (EN), 1,210 kcal/day (PN), and 1,343 kcal/day (EN+PN; p < 0.001). In the latter group, calories were predominantly administered via the parenteral route within the first week. The rate of death at 90 days was lower with EN than with EN+PN (26.7 % vs. 41.3 %, p = 0.048), as was the rate of secondary infections, renal replacement therapy, and duration of mechanical ventilation. In the adjusted Cox regression analysis, the effect on mortality [hazard ratio (HR)= 1.86, 95 % confidence interval (CI): 1.16-2.98, p = 0.010] and the rate of secondary infections (HR= 1.89, 95 % CI: 1.27-2.81, p = 0.002) remained different between EN and EN+PN. In patients with severe sepsis or septic shock and prolonged ICU stay, EN alone was associated with improved clinical outcome compared to EN+PN. This hypothesis-generating result has to be confirmed by a randomized-controlled trial in this specific patient population.


Artful leadership in healthcare: encouraging the possible.
A dramatic trend has developed in leadership preparation: the use of Arts Based Training (ABT). Recent literature has reported that the corporate world and graduate business degree programs have discovered the significant value that the arts can play in educating and developing management talent. The MFA (Master of Fine Arts) is the new MBA! The reasoning behind this shift is the increased need for "right brain" thinkers. This trend may very well extend to healthcare leadership. This paper provides a comprehensive literature review, a section on possibilities for ABT in healthcare organizations, a section on possibilities for ABT in Graduate Education of Healthcare Leaders, a summary rationale for using ABT for developing healthcare leaders, and conclusions and recommendations.


The Arrhenius equation revisited.
The Arrhenius equation has been widely used as a model of the temperature effect on the rate of chemical reactions and biological processes in foods. Since the model requires that the rate increase monotonically with temperature, its applicability to enzymatic reactions and microbial growth, which have optimal temperature, is obviously limited. This is also true for microbial inactivation and chemical reactions that only start at an elevated temperature, and for complex processes and reactions that do not follow fixed order kinetics, that is, where the isothermal rate constant, however defined, is a function of both temperature and time. The linearity of the Arrhenius plot, that is, Ln[k(T)] vs. 1/T where T is in °K has been traditionally considered evidence of the model's validity. Consequently, the slope of the plot has been used to calculate the reaction or processes' "energy of activation," usually without independent verification. Many experimental and simulated rate constant vs. temperature relationships that yield linear Arrhenius plots can also be described by the simpler exponential model Ln[k(T)/k(T(reference))] = c(T-T(reference)). The use of the exponential model or similar empirical alternative would eliminate the confusing temperature axis inversion, the unnecessary compression of the temperature scale, and the need for kinetic assumptions that are hard to affirm in food systems. It would also eliminate the reference to the Universal gas constant in systems where a "mole" cannot be clearly identified. Unless proven otherwise by independent experiments, one cannot dismiss the notion that the apparent linearity of the Arrhenius plot in many food systems is due to a mathematical property of the model's equation rather than to the existence of a temperature independent "energy of activation." If T+273.16°C in the Arrhenius model's equation is replaced by T+b, where the numerical value of the arbitrary constant b is substantially larger than T and T(reference), the plot of Ln k(T) vs. 1/(T+b) will always appear almost perfectly linear. Both the modified Arrhenius model version having the arbitrary constant b, Ln[k(T)/k(T(reference)) = a[1/ (T(reference)+b)-1/ (T+b)], and the exponential model can faithfully describe temperature dependencies traditionally described by the Arrhenius equation without the assumption of a temperature independent "energy of activation." This is demonstrated mathematically and with computer simulations, and with reprocessed classical kinetic data and published food results.


Auditory frequency discrimination development depends on the assessment procedure.
Developmental gains in performance on auditory discrimination tasks are often attributed to either sensory or attentional factors. Here we show that depending on the assessment procedure, auditory frequency discrimination thresholds are either adult-like by 8 years of age (when measured with an oddball procedure) or still not adult-like by 14 years of age (when measured with a 2-interval-2-alternative-forced-choice high/low identification procedure). Because the stimuli used in the two assessment procedures were similar, sensory maturation seems unlikely to account for the discrepancy between the two procedures. To determine whether inattention could account for the prolonged development of performance in the identification procedure, within-listener performance variability was analyzed. Among the 14 year-old participants, we found no evidence for an association between increased performance variability and elevated discrimination thresholds. These findings suggest that attentional factors alone were also not likely to contribute to the group differences. It therefore seems likely that cognitive functions other than sensation and attention are responsible for the development of auditory discrimination, and furthermore that these functions continue to develop during adolescence.


Effect of time of oocyte collection and site of insemination on oocyte transfer in mares.
The objective of the study was to compare embryo development rates after transfer of oocytes collected 22 or 33 h after hCG injection into recipients inseminated within the uterus or the oviduct. Oocytes were collected at approximately 22 or 33 h after hCG injections and incubated for approximately 16 or 1.5 h, respectively, before transfer. Intrauterine inseminations using 1 x 10(9) progressively motile sperm were done approximately 12 h before and 2 h after transfer. For intraoviductal inseminations (gamete intrafallopian transfer [GIFT]), semen was centrifuged through a Percoll gradient, and 200,000 progressively motile sperm were transferred with oocytes into the oviduct. Time of oocyte collection (22 or 33 h) after hCG injection did not affect embryo development rates (17/25, 68%, vs 12/23, 52%, respectively; P = 0.40). When results from oocyte collections at 22 and 33 h after hCG were combined, oocyte transfer with intraoviductal vs intrauterine insemination resulted in similar (P = 0.70) embryo development rates (12/22, 55%, and 17/26, 65%, respectively). However, the interaction between time of oocyte collection and site of insemination tended to be significant (P = 0.09), suggesting that GIFT using oocytes collected at 33 h after hCG may not be as effective as using oocytes collected at 22 h after hCG. Because intraoviductal insemination requires a low number of sperm, GIFT could be used in cases of male subfertility, frozen semen, or sexed sperm.


Long-Term Outcomes Among Participants in the WEGENT Trial of Remission-Maintenance Therapy for Granulomatosis With Polyangiitis (Wegener's) or Microscopic Polyangiitis.
Findings from the WEGENT trial and other short-term studies have suggested that azathioprine (AZA) or methotrexate (MTX) could effectively maintain remission of granulomatosis with polyangiitis (Wegener's) (GPA) or microscopic polyangiitis (MPA). This study was undertaken to examine whether differences in rates of relapse or adverse events would appear after discontinuation of these 2 maintenance regimens, when assessed over a longer followup period. Long-term outcomes in patients enrolled in the WEGENT trial were analyzed according to their randomized treatment group (AZA or MTX). Parameters at trial entry were evaluated as potential prognostic factors for death, relapse, or damage in multivariate models. Data from 10 years of followup were available for 112 (88.8%) of the 126 original trial participants. The median followup time was 11.9 years (95% confidence interval [95% CI] 11.3-12.5 years). In patients receiving AZA and those receiving MTX, the 10-year overall survival rates were 75.1% (95% CI 64.8-86.9%) and 79.9% (95% CI 70.3-90.8%) (P = 0.56), respectively, and relapse-free survival rates were 26.3% (95% CI 17.3-40.1%) and 33.5% (95% CI 23.5-47.7%) (P = 0.29), respectively. No between-treatment differences were observed with regard to rates of relapse, adverse events, damage, survival without severe side effects, and survival without relapse and severe side effects. In analyses limited to the 97 patients with GPA, no between-treatment differences in survival rates were observed. The 10-year relapse-free survival rate was lower in patients with GPA than in patients with MPA. However, in the multivariate analysis, anti-proteinase 3 antineutrophil cytoplasmic antibody (ANCA) positivity, and not GPA, was retained as being independently associated with the relapse rate. The results of this long-term analysis confirm that AZA and MTX are comparable treatment options for maintaining remission of GPA or MPA. Despite achieving good overall survival with these treatments, relapse rates, adverse events, and damage remain matters of concern and further studies are needed to reduce their frequency in these ANCA-associated vasculitides.


Intranasal administration of a single dose of a candidate live attenuated vaccine derived from an NSP16-deficient SARS-CoV-2 strain confers sterilizing immunity in animals.
Live attenuated vaccines might elicit mucosal and sterilizing immunity against SARS-CoV-2 that the existing mRNA, adenoviral vector and inactivated vaccines fail to induce. Here, we describe a candidate live attenuated vaccine strain of SARS-CoV-2 in which the NSP16 gene, which encodes 2'-O-methyltransferase, is catalytically disrupted by a point mutation. This virus, designated d16, was severely attenuated in hamsters and transgenic mice, causing only asymptomatic and nonpathogenic infection. A single dose of d16 administered intranasally resulted in sterilizing immunity in both the upper and lower respiratory tracts of hamsters, thus preventing viral spread in a contact-based transmission model. It also robustly stimulated humoral and cell-mediated immune responses, thus conferring full protection against lethal challenge with SARS-CoV-2 in a transgenic mouse model. The neutralizing antibodies elicited by d16 effectively cross-reacted with several SARS-CoV-2 variants. Secretory immunoglobulin A was detected in the blood and nasal wash of vaccinated mice. Our work provides proof-of-principle evidence for harnessing NSP16-deficient SARS-CoV-2 for the development of live attenuated vaccines and paves the way for further preclinical studies of d16 as a prototypic vaccine strain, to which new features might be introduced to improve safety, transmissibility, immunogenicity and efficacy.


Anaesthesia and analgesia: contribution to surgery, present and future.
Anaesthetists provide comprehensive perioperative medical care to patients undergoing surgical and diagnostic procedures, including postoperative intensive care when needed. They are involved in the management of perioperative acute pain as well as chronic pain. This manuscript considers some of the recent advances in modern anaesthesia and their contribution to surgery, from the basic mechanisms of action, to the delivery systems for general and regional anaesthesia, to the use of new drugs and new methods of monitoring. It assesses the resulting progress in acute and chronic pain services and looks at patient safety and risk management. It speculates on directions that may shape its future contributions to the management of the patient undergoing surgery.


Identification of a carbonic anhydrase-Rubisco complex within the alpha-carboxysome.
Carboxysomes are proteinaceous organelles that encapsulate key enzymes of CO2 fixation-Rubisco and carbonic anhydrase-and are the centerpiece of the bacterial CO2 concentrating mechanism (CCM). In the CCM, actively accumulated cytosolic bicarbonate diffuses into the carboxysome and is converted to CO2 by carbonic anhydrase, producing a high CO2 concentration near Rubisco and ensuring efficient carboxylation. Self-assembly of the α-carboxysome is orchestrated by the intrinsically disordered scaffolding protein, CsoS2, which interacts with both Rubisco and carboxysomal shell proteins, but it is unknown how the carbonic anhydrase, CsoSCA, is incorporated into the α-carboxysome. Here, we present the structural basis of carbonic anhydrase encapsulation into α-carboxysomes from Halothiobacillus neapolitanus. We find that CsoSCA interacts directly with Rubisco via an intrinsically disordered N-terminal domain. A 1.98 Å single-particle cryoelectron microscopy structure of Rubisco in complex with this peptide reveals that CsoSCA binding is predominantly mediated by a network of hydrogen bonds. CsoSCA's binding site overlaps with that of CsoS2, but the two proteins utilize substantially different motifs and modes of binding, revealing a plasticity of the Rubisco binding site. Our results advance the understanding of carboxysome biogenesis and highlight the importance of Rubisco, not only as an enzyme but also as a central hub for mediating assembly through protein interactions.


Reversal of impaired counterregulatory cortisol response following diazoxide treatment in a patient with non insulinoma pancreatogenous hypoglycemia syndrome: Case report and overview of pathogenetic mechanisms.
Non-insulinoma pancreatogenous hypoglycemia syndrome (NIPHS) is one of the rare causes of endogenous hyperinsulinism. Its diagnosis is challenging and may require selective intraarterial calcium stimulation and concomitant hepatic vein sampling (SACVS). Impaired counterregulatory hormones' production in response to hypoglycemia has been previously described in patients with diabetes, insulinoma and infancy hypoglycemia. We present a case of endogenous hyperinsulinism, secondary to NIPHS, with deficient cortisol response to hypoglycemia which resolved after diazoxide treatment. A 43-year-old woman was admitted with recurrent episodes of registered fasting and postprandial hypoglycemia. Abdominal computed tomography, magnetic resonance imaging and endoscopic ultrasonography of the pancreas failed to reveal any lesion while SACVS sampling demonstrated a 5- to 8-fold increase in insulin levels in diverse parts of the pancreas. Counterregulatory hormones' measurement revealed an attenuated cortisol response. Treatment with diazoxide resulted in disappearance of hypoglycemic episodes. Twelve months later, an insulin tolerance test was performed which revealed a normal cortisol response. This report describes the first, to our knowledge, reported case in the literature of NIPHS with deficient cortisol response to hypoglycemia which resolved after diazoxide treatment. It is important for clinicians to include NIPHS in the differential diagnosis of hypoglycemia and identify possible impairment of counterregulatory hormones' production.


Prognostic role of lymphocyte to monocyte ratio for patients with pancreatic cancer: a systematic review and meta-analysis.
Lymphocyte to monocyte ratio (LMR) was recently reported as a prognostic factor of pancreatic cancer (PC). However, the prognostic role of LMR in PC remains inconsistent and inconclusive. The aim of this study was to assess the prognostic value of LMR in patients with PC through meta-analysis. Eligible studies inquiring into the connection between LMR and survival of patients with PC were collected and extracted by searching PubMed, Embase, Cochrane Library and Web of Science up to May 9, 2017. Pooled hazard ratios (HRs) and the 95% CIs were calculated to assess the prognostic value of LMR on overall survival (OS) and disease-free survival/recurrence-free survival/time to progression (DFS/RFS/TTP). A total of 1,795 patients with PC from 8 studies were included in the meta-analysis. Pooled analysis indicated that elevated LMR predicted a favorable OS (HR =0.56, 95% CI: 0.38-0.83, P=0.004) and DFS/RFS/TTP in PC patients (HR =0.38, 95% CI: 0.15-0.95, P=0.04). Prognostic values of LMR on OS were observed in subgroups with all ethnicities, treatment with surgery, American Joint Committee on Cancer (AJCC) stage of III-IV, and LMR cut-off value ≥3. In addition, low LMR was significantly connected with gender and AJCC stage. An elevated LMR is associated with favorable survival in patients with pancreatic cancer.


Synthesis and Characterization of Iron Bispyridine Bisdicyanamide, Fe[C5H5N]2[N(CN)2]2.
Fe[C5H5N]2[N(CN)2]2 (1) was synthesized from a reaction of stoichiometric amounts of NaN(CN)2 and FeCl2·4H2O in a methanol/pyridine solution. Single-crystal and powder diffraction show that 1 crystallizes in the monoclinic space group I2/m (no. 12), different from Mn[C5H5N]2[N(CN)2]2 (P21/c, no. 14) due to tilted pyridine rings, with a = 7.453(7) Å, b = 13.167(13) Å, c = 8.522(6) Å, β = 114.98(6)° and Z = 2. ATR-IR, AAS, and CHN measurements confirm the presence of dicyanamide and pyridine. Thermogravimetric analysis shows that π-stacking interactions of the pyridine rings play an important role in structural stabilization. Based on DFT-optimized structures, a chemical bonding analysis was performed using a local-orbital framework by projection from a plane-wave basis. The resulting bond orders and atomic charges are in good agreement with the expectations based on the structure analysis. SQUID magnetic susceptibility measurements show a high-spin state FeII compound with predominantly antiferromagnetic exchange interactions at lower temperatures.


Magnetic Transitions in Iron Porphyrin Halides by Inelastic Neutron Scattering and Ab Initio Studies of Zero-Field Splittings.
Zero-field splitting (ZFS) parameters of nondeuterated metalloporphyrins [Fe(TPP)X] (X = F, Br, I; H₂TPP = tetraphenylporphyrin) have been directly determined by inelastic neutron scattering (INS). The ZFS values are D = 4.49(9) cm⁻¹ for tetragonal polycrystalline [Fe(TPP)F], and D = 8.8(2) cm⁻¹, E = 0.1(2) cm⁻¹ and D = 13.4(6) cm⁻¹, E = 0.3(6) cm⁻¹ for monoclinic polycrystalline [Fe(TPP)Br] and [Fe(TPP)I], respectively. Along with our recent report of the ZFS value of D = 6.33(8) cm⁻¹ for tetragonal polycrystalline [Fe(TPP)Cl], these data provide a rare, complete determination of ZFS parameters in a metalloporphyrin halide series. The electronic structure of [Fe(TPP)X] (X = F, Cl, Br, I) has been studied by multireference ab initio methods: the complete active space self-consistent field (CASSCF) and the N-electron valence perturbation theory (NEVPT2) with the aim of exploring the origin of the large and positive zero-field splitting D of the ⁶A₁ ground state. D was calculated from wave functions of the electronic multiplets spanned by the d⁵ configuration of Fe(III) along with spin–orbit coupling accounted for by quasi degenerate perturbation theory. Results reproduce trends of D from inelastic neutron scattering data increasing in the order from F, Cl, Br, to I. A mapping of energy eigenvalues and eigenfunctions of the S = 3/2 excited states on ligand field theory was used to characterize the σ- and π-antibonding effects decreasing from F to I. This is in agreement with similar results deduced from ab initio calculations on CrX₆³⁻ complexes and also with the spectrochemical series showing a decrease of the ligand field in the same directions. A correlation is found between the increase of D and decrease of the π- and σ-antibonding energies e(λ)(X) (λ = σ, π) in the series from X = F to I. Analysis of this correlation using second-order perturbation theory expressions in terms of angular overlap parameters rationalizes the experimentally deduced trend. D parameters from CASSCF and NEVPT2 results have been calibrated against those from the INS data, yielding a predictive power of these approaches. Methods to improve the quantitative agreement between ab initio calculated and experimental D and spectroscopic transitions for high-spin Fe(III) complexes are proposed.


Practices of Japanese nurses for the preparation of N95 respirators.
A delay in the diagnosis of tuberculosis (TB) is a public health problem in Japan. This delay may increase the chance of a TB patient visiting in a medical institution without a TB ward. We evaluated the practices of nurses for fit testing and seal checking their N95 respirator masks at hospitals without tuberculosis wards in Kanagawa, Japan. Of 36 nurses who participated in a medical course on infection control and medical safety in June 2010, 33 (91.7%) answered a questionnaire. Seven (22.6%) and 8 (26.7%) nurses had practical experience of fit testing and seal checking N95 masks, respectively. Nurses affiliated with hospitals having sanatorium wards were more likely to be acquainted with fit testing and seal checking than nurses from hospitals with only general wards [6 (39.9%) vs. 0 (0%) and 7 (46.7%) vs. 0 (0%), respectively]. Fewer than 30% of nurses exposed to TB patients had no experience with fit testing and scale checking N95 masks. Only one nurse had practical experience fitting testing at the hospital where she worked. Although the sample size in this study was small, these results showed inadequate experience in handling N95 respirator marks among Japanese nurses at hospitals without tuberculosis wards, which suggests the need to educate nurses practically in fit testing and seal checking N95 respirator masks.


Elastic modulus in the selection of interbody implants.
The modulus of elasticity of an assortment of materials used in spinal surgery, as well as cortical and cancellous bones, is determined by direct measurements and plotting of the appropriate curves. When utilized in spine surgery, the stiffness of a surgical implant can affect its material characteristics. The modulus of elasticity, or Young's modulus, measures the stiffness of a material by calculating the slope of the material's stress-strain curve. While many papers and presentations refer to the modulus of elasticity as a reason for the choice of a particular spinal implant, no peer-reviewed surgical journal article has previously been published where the Young's modulus values of interbody implants have been measured. Materials were tested under pure compression at the rate of 2 mm/min. A maximum of 45 kilonewtons (kN) compressive force was applied. Stress-strain characteristics under compressive force were plotted and this plot was used to calculate the elastic modulus. The elastic modulus calculated for metals was more than 50 Gigapascals (GPa) and had significantly higher modulus values compared to poly-ether-ether-ketone (PEEK) materials and allograft bone. The data generated in this paper may facilitate surgeons to make informed decisions on their choices of interbody implants with specific attention to the stiffness of the implant chosen.


Diseases Led to Refer Iranian Pilgrims From Hajj in 2012.
Some Iranian pilgrims are referred to Iran because of catching a new disease or exacerbation of their disease during the Hajj ceremony. These diseases need prolonged and specialized treatments. Investigation of the reasons led to their return to Iran is useful and effective in policy-making and planning of preventive health services. This study aimed to investigate the causes of referring Iranian patients to Iran during Hajj in 2010. In this cross-sectional study, all Iranian pilgrim cases in Hajj (2012) who referred to Iran were studied, and data analysis was performed. Demographic data and the causes of return to Iran during and after Hajj rituals were analyzed. A total of 106 cases were referred Iran during Hajj 2012. Psychiatric problems, with 26.4% allocated the highest rate of return to Iran during Hajj days, and significant difference was observed in the reasons before and after performing Hajj rituals (P = 0.001). Psychiatric, neurological, gastrointestinal, and respiratory diseases are the most frequent reasons of referring patients to Iran. More accuracy in screening and care of patients are recommended before Hajj in order to prevent references to Iran and its complications.


A comparison of the expected and actual pain experienced by women during insertion of an intrauterine contraceptive device.
To compare the expected and actual pain experienced with the insertion of intrauterine contraception in women, and to determine whether either of these are related to their personal circumstances, or affected their satisfaction with the procedure. A convenience sample of 89 women aged 15-50 years attending a sexual health clinic for same day intrauterine contraception insertion were given a questionnaire that they completed following the procedure. The women were asked to rate their expectation of pain prior to insertion and to rate the actual pain they experienced immediately after insertion, on a scale of 1-10, with 10 being severe pain. Information on the women's circumstances and their level of satisfaction with the procedure was also obtained. Overall, the median actual pain experienced by women during insertion (4) was significantly lower than the expected pain median (6) (P<0.001). For those women who had not had a previous vaginal delivery, actual pain was significantly higher compared with women who had had a previous vaginal delivery (median [interquartile range]: 6 [3.5-7.5] and 3 [1-5], P<0.001, respectively), but there was no significant difference between expected and actual pain experiences. In women who had a previous vaginal delivery, actual pain was much lower than expected (P<0.001). Neither actual nor expected pain experiences were linked to any other sociodemographic reproductive health or service use factors. All women had a high expectation of pain prior to IUD insertion, but for those who had had a previous vaginal delivery, this was significantly greater than that actually experienced. Satisfaction levels overall were high. Counseling of women should take into account their expected pain prior to IUD insertion and consideration should be given to alternative and additional methods of pain relief in women who have not had a previous vaginal delivery.


Engagement of Neurotropic Viruses in Fast Axonal Transport: Mechanisms, Potential Role of Host Kinases and Implications for Neuronal Dysfunction.
Much remains unknown about mechanisms sustaining the various stages in the life cycle of neurotropic viruses. An understanding of those mechanisms operating before their replication and propagation could advance the development of effective anti-viral strategies. Here, we review our current knowledge of strategies used by neurotropic viruses to undergo bidirectional movement along axons. We discuss how the invasion strategies used by specific viruses might influence their mode of interaction with selected components of the host's fast axonal transport (FAT) machinery, including specialized membrane-bounded organelles and microtubule-based motor proteins. As part of this discussion, we provide a critical evaluation of various reported interactions among viral and motor proteins and highlight limitations of some in vitro approaches that led to their identification. Based on a large body of evidence documenting activation of host kinases by neurotropic viruses, and on recent work revealing regulation of FAT through phosphorylation-based mechanisms, we posit a potential role of host kinases on the engagement of viruses in retrograde FAT. Finally, we briefly describe recent evidence linking aberrant activation of kinase pathways to deficits in FAT and neuronal degeneration in the context of human neurodegenerative diseases. Based on these findings, we speculate that neurotoxicity elicited by viral infection may involve deregulation of host kinases involved in the regulation of FAT and other cellular processes sustaining neuronal function and survival.


European cardiac resynchronization therapy survey II: rationale and design.
The Cardiac Resynchronization Therapy (CRT) Survey II is a 6 months snapshot survey initiated by two ESC Associations, the European Heart Rhythm Association and the Heart Failure Association, which is designed to describe clinical practice regarding implantation of CRT devices in a broad sample of hospitals in 47 ESC member countries. The large volume of clinical and demographic data collected should reflect current patient selection, implantation, and follow-up practice and provide information relevant for assessing healthcare resource utilization in connection with CRT. The findings of this survey should permit representative benchmarking both nationally and internationally across Europe.


Molecular characteristics of extended-spectrum β-lactamase-producing Escherichia coli in Riyadh: emergence of CTX-M-15-producing E. coli ST131.
The prevalence of extended-spectrum β-lactamase-producing Escherichia coli (ESBL-EC) has increased recently. The aim of this study was to further characterise and to assess the occurrence of ESBL-EC in Riyadh, to use pulsed field gel electrophoresis (PFGE) typing to investigate the epidemiology of ESBL-EC and to determine the prevalence of ST131 in ESBL-EC. A total of 152 E. coli isolates were collected at a tertiary hospital in Riyadh from September 2010 to June 2011. Genotypic and phenotypic methods were used to characterise ESBLs. PFGE was used to determine genetic relatedness. Detection of ST131 and CTX-M-like ESBLs was performed using real-time PCR. Of 152 strains, 31 were positive for ESBLs by phenotypic methods. The blaCTX-M-15 gene was highly prevalent (30/31 strains, 96.77%) among the 31 ESBL-positive E. coli strains. The blaCTX-M-27 gene was detected in one strain. Twenty (64.5%) out of 31 of ESBL-EC were ST131. PFGE revealed 29 different pulsotypes. Our study documented the high prevalence of ESBLs in E. coli isolates, with CTX-M-15 as the predominant ESBL gene. ST131 clone producing CTX-M-15 has a major presence in our hospital. The high prevalence of CTX-M producers was not due to the spread of a single clone. To the best of our knowledge, this study represents the first report of CTX-M-15 and CTX-M-27 β-lactamases and the detection of the ST131 clone in Saudi E. coli isolates.


Fighting the waterborne menace.
Although only around 400 cases are reported annually to the U.K.'s Health Protection Agency (HPA), climate change, and thus warmer cold water supplies entering hospitals, the bacterium's apparent ability to mutate, and the considerable challenge of properly monitoring, and successfully identifying and addressing, all potential infection sources on a large hospital estate mean an increasing risk of hospital patients acquiring the potentially deadly waterborne infection, Legionnaires' disease. This was the warning from a top U.K. microbiologist at a recent "waterborne infection masterclass" organised by specialist water filtration product supplier Pall Medical in Antwerp. Jonathan Baillie reports.


Genetic parameters for body weight, hip height, and the ratio of weight to hip height from random regression analyses of Brahman feedlot cattle.
The objective of this research was to assess the genetic control of BW, hip height, and the ratio of BW to hip height (n = 5,055) in Brahman cattle through 170 d on feed using covariance function-random regression models. A progeny test of Brahman sires (n = 27) generated records of Brahman steers and heifers (n = 724) over 7 yr. Each year after weaning, calves were assigned to feedlot pens, where they were fed a high-concentrate grain diet. Body weights and hip heights were recorded every 28 d until cattle reached a targeted fatness level. All calves had records through 170 d on feed; subsequent records were excluded. Models included contemporary group (sex-pen-year combinations, n = 63) and age at the beginning of the feeding period as a covariate. The residual error structure was modeled as a random effect, with 2 levels corresponding to two 85-d periods on feed. Information criterion values indicated that linear, random regression coefficients on Legendre polynomials of days on feed were most appropriate to model additive genetic effects for all 3 traits. Cubic (hip height and BW:hip height ratio) or quartic (BW) polynomials best modeled permanent environmental effects. Estimates of heritability across the 170-d feeding period ranged from 0.31 to 0.53 for BW, from 0.37 to 0.53 for hip height, and from 0.23 to 0.6 for BW:hip height ratio. Estimates of the permanent environmental proportion of phenotypic variance ranged from 0.44 to 0.58 for BW, 0.07 to 0.26 for hip height, and 0.30 to 0.48 for BW:hip height ratio. Within-trait estimates of genetic correlation on pairs of days on feed (at 28-d intervals) indicated lower associations of BW:hip height ratio EBV early and late in the feeding period but large positive associations for BW or hip height EBV throughout. Estimates of genetic correlations among the 3 traits indicated almost no association of BW:hip height ratio and hip height EBV. The ratio of BW to hip height in cattle has previously been used as an objective measure of BCS in cows or calves; it may offer a unique assessment of body dimension. Results indicated that there is substantial additive genetic variation for this trait, and it may be possible to use EBV to increase BW without increasing frame score in Brahman cattle.


Do corporate governance mechanisms and internal control systems matter in reducing mortality rates?
Internal controls are critical to guarding an institution against fraud, error, and devastation. They are effective tools for preventing losses and achieving organizational goals. However, internal control mechanisms need to be relevant, because the organization cannot comprehend the effectiveness of the system if they are out-of-touch with the operation. Health care control practices are not exceptionally different from what pertains in other industries. The health care organizations require effective corporate governance mechanisms to uphold their operations and performances. These practices assist health care organizations to exhume cynical practices that generate unproductive results and also factors militating against the hospital's goals or objectives. This study revealed that practices such as enhanced Board diligence, Health Professionals on board, financial prudence, and effective communication have the tendency of reducing mortality, if well executed.


Structural empowerment, workplace incivility, nurses' intentions to leave their organisation and profession: A path analysis.
The aim of this study is to test the theoretical model involving the relationships between nurses' perceptions of structural empowerment, supervisor and coworker incivility, and their intention to leave both the organisations and the nursing profession. Studies investigating the relationships between structural empowerment, workplace incivility and nurses' intentions to leave their organisation are increasing. However, the results of studies indicating the effects of structural empowerment on these variables are inadequate. We used a cross-sectional, correlational study to investigate relations among the variables with a sample of 574 nurses. Structural empowerment had significantly direct negative effects on supervisor incivility, coworker incivility and nurses' intentions to leave their organisation, as well as indirect negative effects on intention to leave the profession through its negative influence on intention to leave the organisation. Strong evidence points out the importance of making plans to reduce nurses' intentions to leave their organisation and profession, to increase the structural empowerment in organisations and to reduce workplace incivility is presented. The results of this study can provide guidance for managers attempting to improve working conditions for nurses by drawing attention to the various factors affecting nurses' intentions to leave.


[Surgical tactic in the injury of neck vessels].
Retrospective analysis of the surgical treatment results in 50 injured persons with the damage of the neck vessels in 1998-2003 yrs period was presented. Restorational-reconstructive operations were performed in 19 (38%) injured persons with the arteries damage, in 10 (20%)--with the veins damage, the ligature operations were done, accordingly, in 6 (12%) and in 20 (40%). Satisfactory result was noted in 41 (82%) injured persons. Neurological complications had occurred in 4 (8%) of patients. Mortality had constituted 10% (5 patients died). The principles of surgical treatment of the neck vessels damage were stated.


Roles of the vagina and the vaginal microbiota in urinary tract infection: evidence from clinical correlations and experimental models.
Mounting evidence indicates that the vagina can harbor uropathogenic bacteria. Here, we consider three roles played by the vagina and its bacterial inhabitants in urinary tract infection (UTI) and urinary health. First, the vagina can serve as a reservoir for Escherichia coli, the most common cause of UTI, and other recognized uropathogens. Second, several vaginal bacterial species are frequently detected upon urine culture but are underappreciated as uropathogens, and other vaginal species are likely under-reported because of their fastidious nature. Third, some vaginal bacteria that are not widely viewed as uropathogens can transit briefly in the urinary tract, cause injury or immunomodulation, and shift the balance of host-pathogen interactions to influence the outcomes of uropathogenesis. This chapter describes the current literature in these three areas and summarizes the impact of the vaginal microbiota on susceptibility to UTI and other urologic conditions.


Assessment of the health risks and odor concentration of volatile compounds from a municipal solid waste landfill in China.
Municipal solid waste (MSW) landfills are a source of odorous and toxic compounds. In this work, we present an integrated assessment of the odor concentration and human health risks of volatile compounds to evaluate the environmental quality at a MSW landfill. Air samples were collected seasonally from six areas of the landfill with different functions. The total concentrations of the compounds ranged from 204.0 to 7426.7 μg m-3, and the concentrations in temporarily and permanently capped areas were 50.3 and 83.4% lower than those in the tipping area, respectively. The odor concentration was greatest at the leachate collection tank (1732-6254 ouE m-3) and tipping area (1573-4113 ouE m-3) and was mainly caused by hydrogen sulfide (57.9 and 49.1%, respectively). Moreover, the odor concentration was positively correlated with the temperature (r = 0.500, p < 0.05, n = 24). Although the non-carcinogenic (HI) and carcinogenic (R) risks of most compounds were largely below the acceptable levels (HI = 1, R = 1.0E-6), HI values of hydrogen sulfide (2.3), trichloropropane (2.0), and naphthalene (1.2) as well as R values of naphthalene (1.3E-4) and trimethylbenzene (1.2E-4) in the waste areas exceeded acceptable levels. Moreover, the cumulative HI (2.5-5.7) and R (1.0E-04 to 3.4E-04) in the waste areas should receive special attention since they were above acceptable levels during all of the seasons. Aromatic and halogenated compounds dominated the cumulative R, accounting for 79 and 21% of the total, on average, while for the cumulative HI, sulfur compounds contributed the most (67%).


Lower limb joint replacement in rheumatoid arthritis.
There is limited literature regarding the peri-operative and surgical management of patients with rheumatoid disease undergoing lower limb arthroplasty. This review article summarises factors involved in the peri-operative management of major lower limb arthroplasty surgery for patients with rheumatoid arthritis. We performed a search of the medical literature, using the PubMed search engine (http://www.pubmed.gov). We used the following terms: 'rheumatoid' 'replacement' 'arthroplasty' and 'outcome'. The patient should be optimised pre-operatively using a multidisciplinary approach. The continued use of methotrexate does not increase infection risk, and aids recovery. Biologic agents should be stopped pre-operatively due the increased infection rate. Patients should be made aware of the increased risk of infection and periprosthetic fracture rates associated with their disease. The surgical sequence is commonly hip, knee and then ankle. Cemented total hip replacement (THR) and total knee replacement (TKR) have superior survival rates over uncemented components. The evidence is not clear regarding a cruciate sacrificing versus retaining in TKR, but a cruciate sacrificing component limits the risk early instability and potential revision. Patella resurfacing as part of a TKR is associated with improved outcomes. The results of total ankle replacement remain inferior to THR and TKR. RA patients achieve equivalent pain relief, but their rehabilitation is slower and their functional outcome is not as good. However, the key to managing these complicated patients is to work as part of a multidisciplinary team to optimise their outcome.


Rejection of ileal versus jejunal allografts.
Small-bowel allografts are replete with lymphocytes, which may be the main stimulus for the recipient's immune system, thereby inducing rejection. Since most of the lymphoid tissue is located in the ileum, one would expect ileal grafts to be rejected more rapidly than are jejunal grafts. To test this theory, we transplanted a jejunal (n = 13) or an ileal segment (n = 9) or the entire small bowel (n = 6) orthotopically in the BN----LEW rat strain combination. Jejunal grafts included a short segment of the mesentery, whereas ileal and whole small-bowel grafts included the entire mesentery with its lymph nodes. Segmental as well as entire-bowel grafts induced peak anti-BN titers on the 6th to 7th postoperative day. In rats with entire-bowel grafts, rejection culminated in the recipient's death after an average of 9.5 +/- 1 days from graft necrosis and peritonitis; the rejection of jejunal (13.1 +/- 2.1 days) and ileal grafts (12.9 +/- 1.3 days) was less rapid. Segmental grafts were often encapsulated, and the causes of death were inanition and intestinal obstruction. Thus, despite their high lymphocyte content, ileal grafts were not rejected more quickly than were jejunal grafts; they should, therefore, be preferred because of their greater specialized absorptive capacity. Histologically, entire-bowel grafts were found to be rejected as rapidly as were segmental grafts; however, the toxic effects of the larger grafts that are undergoing rejection lead to earlier death of the recipient.


Polyethylene glycol-polylactic acid nanoparticles modified with cysteine-arginine-glutamic acid-lysine-alanine fibrin-homing peptide for glioblastoma therapy by enhanced retention effect.
For a nanoparticulate drug-delivery system, crucial challenges in brain-glioblastoma therapy are its poor penetration and retention in the glioblastoma parenchyma. As a prevailing component in the extracellular matrix of many solid tumors, fibrin plays a critical role in the maintenance of glioblastoma morphology and glioblastoma cell differentiation and proliferation. We developed a new drug-delivery system by conjugating polyethylene glycol-polylactic acid nanoparticles (NPs) with cysteine-arginine-glutamic acid-lysine-alanine (CREKA; TNPs), a peptide with special affinity for fibrin, to mediate glioblastoma-homing and prolong NP retention at the tumor site. In vitro binding tests indicated that CREKA significantly enhanced specific binding of NPs with fibrin. In vivo fluorescence imaging of glioblastoma-bearing nude mice, ex vivo brain imaging, and glioblastoma distribution demonstrated that TNPs had higher accumulation and longer retention in the glioblastoma site over unmodified NPs. Furthermore, pharmacodynamic results showed that paclitaxel-loaded TNPs significantly prolonged the median survival time of intracranial U87 glioblastoma-bearing nude mice compared with controls, Taxol, and NPs. These findings suggested that TNPs were able to target the glioblastoma and enhance retention, which is a valuable strategy for tumor therapy.


Acoustical pulling force of a limited-diffracting annular beam centered on a sphere.
A rigorous method is developed to investigate the generation of a negative (attracting) force acting in the opposite direction of wave propagation using a limited-diffracting single annular piezo-ring transducer. Based on the Rayleigh- Sommerfeld diffraction integral and the addition theorems for the Legendre and spherical wave functions, the expression for the incident velocity potential field (which is an exact solution of the Helmholtz equation) is derived analytically, and exact closed-form partial-wave series expansions for the incident and scattered fields are obtained without any approximations. The total (incident + scattered) field expression is used to evaluate the time-averaged acoustic radiation force (ARF) on a sphere centered on the beam's axis in a nonviscous fluid. Numerical predictions for the scattering and ARF performed with particular emphasis on the annular-ring's radial thickness, the distance separating the sphere from the acoustic source, the size of the transducer, as well as the sphere's elastic properties, reveal some conditions where a pulling axial ARF directed toward the annular ring-source surface arises. The simplicity and reliability of the annular-ring geometry demonstrated here provides a substantial solution with widespread applications in the experimental design of acoustical limited-diffracting beams operating over an extended axial depth-of-field for contactless and dexterous particle manipulation.


Experimental conditions affecting ribonucleic acid polymerase in isolated rat liver nuclei. Effect of nucleoside triphosphate concentration, temperature, ammonium sulphate and heparin.
1. The conditions affecting the activity of RNA polymerase in isolated rat liver nuclei were studied with Mg(2+) or Mn(2+) as activating ions. 2. The enzyme assayed with Mg(2+) and at low ionic strength is saturated by a lower concentration of nucleotide substrates than if assayed with Mn(2+) at low ionic strength or with either ion at high ionic strength. 3. At low and at high ionic strength the incorporation of AMP is affected in a similar way by variations in the temperature of incubation. Preincubation at 37 degrees impairs the AMP incorporation. 4. Heparin stimulates the RNA polymerase activity in the presence of Mn(2+). 5. Both ammonium sulphate and heparin ;restart' the reaction if added after 15min., the effect being more marked with ammonium sulphate than with heparin, and also more marked in the presence of Mn(2+) than of Mg(2+). 6. alpha-Amanitin abolishes the effect of ammonium sulphate and of heparin.


Factors affecting the acceptance of expert advice.
This paper expands research on the judge advisor system (JAS) by examining advice utilization and trust. Experiment 1 examined five factors that could increase utilization of expert advice: judge's trust in the advisor, advisor confidence, advisor accuracy, judge's prior relationship with the advisor, and judge's power to set payment to the advisor. While judge's trust and advisor confidence correlated with the judge matching the advisor's advice, a stepwise regression found that of the five variables, advisor confidence was the only significant predictor of the judge matching the advisor. Experiment 2 examined trust without the role assignment to judge or advisor. While trust expressed in partner was not higher for the judge than the advisor in Experiment 1, in Experiment 2 trust in partner expressed by the low-expertise dyad member was higher than trust expressed by the high-expertise dyad member. Results from the two experiments are discussed in the context of Sniezek and Van Swol (2001).


Ossification of the Posterior Longitudinal Ligament: Imaging Findings in the Era of Cross-Sectional Imaging.
Imaging appearance and classification systems of ossification of the posterior longitudinal ligament (OPLL) on computed tomography and magnetic resonance imaging will be reviewed. Computed tomography evaluation most accurately demonstrates OPLL length and thickness, whereas magnetic resonance imaging has the advantage of demonstrating abnormal signal in the cord. Neurologic symptoms are most common in the cervical spine and are related to the degree of spinal stenosis and presence of cord edema. Surgical treatment usually involves cases of cervical OPLL and includes anterior or posterior decompression.


Thyroid V50 Highly Predictive of Hypothyroidism in Head-and-Neck Cancer Patients Treated With Intensity-modulated Radiotherapy (IMRT).
Radiation-induced hypothyroidism affects a significant number of patients with head-and-neck squamous cell cancer (HNSCC). We examined detailed dosimetric and clinical parameters to better determine the risk of hypothyroidism in euthyroid HNSCC patients treated with intensity-modulated radiation therapy (IMRT). From 2006 to 2010, 75 clinically euthyroid patients with HNSCC were treated with sequential IMRT. The cohort included 59 men and 16 females with a median age of 55 years (range, 30 to 89 y) who were treated to a median dose of 70 Gy (range, 60 to 75 Gy) with concurrent chemotherapy in nearly all (95%) cases. Detailed thyroid dosimetric parameters including maximum dose, mean dose, and other parameters (eg, V50-percent volume receiving at least 50 Gy) were obtained. Freedom from hypothyroidism was evaluated using the Kaplan-Meier method. Univariate and multivariate analyses were conducted using Cox regression. After a median follow-up period of 50 months, 25 patients (33%) became hypothyroid. On univariate analysis, thyroid V50 was highly correlated with developing hypothyroidism (P=0.035). Other dosimetric paramaters including mean thyroid dose (P=0.11) and maximum thyroid dose (P=0.39) did not reach statistical significance. On multivariate analysis incorporating patient, tumor, and treatment variables, V50 remained highly statistically significant (P=0.037). Regardless of other factors, for V50>60%, the odds ratio of developing hypothyroidism was 6.76 (P=0.002). In HNSCC patients treated with IMRT, thyroid V50 highly predicts the risk of developing hypothyroidism. V50>60% puts patients at a significantly higher risk of becoming hypothyroid. This can be a useful dose constraint to consider during treatment planning.


Activation of human NK cells by staphylococci and lactobacilli requires cell contact-dependent costimulation by autologous monocytes.
NK cells are instrumental in innate immune responses, in particular for the early production of gamma interferon (IFN-gamma) and other cytokines necessary to control certain bacterial, parasitic, and viral infections. NK cell-mediated effector functions are controlled by a fine balance between distinct receptors mediating activating and inhibitory signals; however, little is known about activating receptors on NK cells and their corresponding ligands. Several studies have shown that commensal lactobacilli isolated from the human gastrointestinal tract activate human mononuclear cells and are potent inducers of IFN-gamma and monocyte-derived interleukin 12 (IL-12). NK cell activation was shown for Lactobacillus johnsonii La1. In this study the cellular mechanisms of in vitro NK cell activation by gram-positive bacteria were analyzed. Staphylococcus aureus- and L. johnsonii La1-mediated activation of CD3(-) CD16(+) CD56(+) human peripheral blood NK cells, including expression of the activation antigen CD69 and secretion of IFN-gamma, required cell contact-dependent costimulation by autologous monocytes. S. aureus- and L. johnsonii-preactivated monocytes retained their capacity to induce NK cell activation. In contrast, cytokine-primed monocytes completely failed to induce NK cell activation unless bacteria were present. This suggests that phagocytosis of bacteria provided additional coactivation signals on accessory cells that may differ from those induced by tumor necrosis factor and IFN-gamma. Blocking of costimulatory molecules by B7.1, B7.2, and IL-12 but not CD14 monoclonal antibodies inhibited S. aureus- and L. johnsonii-induced effector function of NK cells. Our data suggest an important role for accessory cell-derived signals in the process of NK cell activation by gram-positive bacteria.


Release of VA Records Relating to HIV. Final rule.
The Department of Veterans Affairs (VA) is amending its medical regulations governing the release of VA medical records. Specifically, VA is eliminating the restriction on sharing a negative test result for the human immunodeficiency virus (HIV) with veterans' outside providers. HIV testing is a common practice today in healthcare and the stigma of testing that may have been seen in the 1980s when HIV was first discovered is no longer prevalent. Continuing to protect negative HIV tests causes delays and an unnecessary burden on veterans when VA tries to share electronic medical information with the veterans' outside providers through electronic health information exchanges. For this same reason, VA will also eliminate restrictions on negative test results of sickle cell anemia. This final rule eliminates the current barriers to electronic medical information exchange.


Impact of dental fluorosis on the oral health related quality of life among 11- to 14-year-old school children in endemic fluoride areas of Haryana (India).
This study investigates the impact of dental fluorosis on the oral health-related quality of life (OHRQoL) among 11- to 14-year-old school children in endemic fluoride areas of Haryana (India). A cross-sectional survey was conducted among 2,200 school children in endemic fluoride areas of Haryana. Using cluster random sampling, three districts out of 14 endemic fluoride districts were selected, and children 11-14 years of age were examined. A child perception questionnaire (CPQ11-14 ) (Hindi version) evaluated the impact of dental fluorosis on OHRQoL. The Thylstrup-Fejerskov index (TFI) was used for assessing dental fluorosis. The data were analysed using SPSS version 18, and non-parametric tests were used to assess the significance. The regression analysis was used to determine the effect of change in CPQ scores with dental fluorosis at P < 0.05. The study participants included 45.3% males and 54.7% females among which mild to moderate level of dental fluorosis was identified with mean mean TFI Scores being 3.19 ± 1.55. Children without dental fluorosis had 1.17 times more odd of percieving their oral health as excellent/good when compared to children with dental fluorosis (P < 0.05). Study subjects with dental fluorosis did not have higher mean CPQ11-14 domain and total scores when compared with subjects without dental fluorosis. It can be concluded that mild dental fluorosis did not affect the OHRQoL of the children in the endemic fluoride areas of Haryana in India.


Characterization of genes for a pollen allergen, Cry j 2, of Cryptomeria japonica.
Cry j 2 is one of the major pollen allergens of Cryptomeria japonica. The polymorphism of Cry j 2 isoforms and the conservation of the structure of Cry j 2 in coniferous species remain to be analyzed. A cDNA library derived from the pollen of C. japonica was screened using a fragment of Cry j 2 cDNA. Restriction fragment length polymorphism analysis was performed to examine the diversity of Cry j 2 genes. The promoters of Cry j 2 genes were isolated with a commercially available cloning kit. Clonal variations in the expression of Cry j 2 in pollen were examined by RNA gel blot analysis, and the conservation of the structure of the Cry j 2 gene in coniferous species was evaluated by DNA gel blot analysis. We isolated three cDNA clones encoding novel isoforms of Cry j 2. We also sequenced a total of 16 promoter regions from 10 specimens. The sequences of promoter regions of Cry j 2 genes were highly divergent. The amount of Cry j 2 mRNA also varied considerably. The Cry j 2 gene was found to be conserved among species belonging to Taxodiaceae and Cupressaceae but to vary between Taxodiaceae and Pinaceae. The coding and promoter regions of Cry j 2 genes contain large numbers of polymorphisms. Our analysis revealed large variations in the expression of Cry j 2 at the transcriptional level, and we suggest that conserved homologs of Cry j 2 confer cross-allergenicity among Taxodiaceae and Cupressaceae.


The development of atrophic gastritis in antrum and body in relatives of gastric carcinoma patients and in controls.
The development of atrophic gastritis (AG) in antrum and body was studied in a series consisting of 301 first-degree relatives of 73 gastric carcinoma patients, and in 431 controls, that is, 73 control probands and their 358 first-degree relatives. An analysis was performed in terms of four population pools: subjects with normal mucosa and/or superficial gastritis in antrum and body; AG occurring in the antrum only; AG in the body only; AG present in antrum and body. Antral AG commenced in the patients' teens and progressed at a constant rate up to 55 years, being retarded thereafter with decreasing age-specific prevalence of AG limited to the antral mucosa. The process started later in the body, but its constant-rate progression continued up to old age. In the pool of those subjects who had both antral and body AG the development approximated that seen in the pool with body AG only. The process was qualitatively similar in the Series and in the Controls, but marked differences were observed after the age of 55 years in the transition to the different AG pools.


Religious Service Attendance and Deaths Related to Drugs, Alcohol, and Suicide Among US Health Care Professionals.
The increase in deaths related to drugs, alcohol, and suicide (referred to as deaths from despair) has been identified as a public health crisis. The antecedents associated with these deaths have, however, seldom been investigated empirically. To prospectively examine the association between religious service attendance and deaths from despair. This population-based cohort study used data extracted from self-reported questionnaires and medical records of 66 492 female registered nurses who participated in the Nurses' Health Study II (NHSII) from 2001 through 2017 and 43 141 male health care professionals (eg, dentist, pharmacist, optometrist, osteopath, podiatrist, and veterinarian) who participated in the Health Professionals Follow-up Study (HPFS) from 1988 through 2014. Data on causes of death were obtained from death certificates and medical records. Data analysis was conducted from September 2, 2018, to July 14, 2019. Religious service attendance was self-reported at study baseline in response to the question, "How often do you go to religious meetings or services?" Deaths from despair, defined specifically as deaths from suicide, unintentional poisoning by alcohol or drug overdose, and chronic liver diseases and cirrhosis. Cox proportional hazards regression models were used to estimate the hazard ratio (HR) of deaths from despair by religious service attendance at study baseline, with adjustment for baseline sociodemographic characteristics, lifestyle factors, psychological distress, medical history, and other aspects of social integration. Among the 66 492 female participants in NHSII (mean [SD] age, 46.33 [4.66] years), 75 incident deaths from despair were identified (during 1 039 465 person-years of follow-up). Among the 43 141 male participants in HPFS (mean [SD] age, 55.12 [9.53] years), there were 306 incident deaths from despair (during 973 736 person-years of follow-up). In the fully adjusted models, compared with those who never attended religious services, participants who attended services at least once per week had a 68% lower hazard (HR, 0.32; 95% CI, 0.16-0.62) of death from despair in NHSII and a 33% lower hazard (HR, 0.67; 95% CI, 0.48-0.94) of death from despair in HPFS. The findings suggest that religious service attendance is associated with a lower risk of death from despair among health care professionals. These results may be important in understanding trends in deaths from despair in the general population.


Application of Interactive and Intelligent Packaging for Fresh Fish Shelf-Life Monitoring.
Smart packaging, also known as intelligent packaging, is responsive to external stimuli, moisture, light, oxygen, heat, pH, and bacterial growth. It has evolved from extensive applications in food safety, bacterial response, and medical packaging. Interactive packaging has a scientific basis for additional information about food products because these codes give all required data. This work deals with a combination of frontline food sciences, smart and interactive packaging that are applicable for future production of nutrition packages through smart detection of food spooling. Additionally, it verifies the best degree of food safety and population demands as the third generation of packaging technology. High qualified duplex laminated package with a nano-encapsulated pH monitoring label for fresh fish was printed. The interactive Quick Response code icon was combined in a designed package with important information about cooking, smart packaging, and fish quality. Therefore, particle size, zeta potential, and surface area are measured for a nanoencapsulated indicator which exhibits 74.4 nm, 23.6 mV, and 88.9 m2/g, respectively: overall migration, water vapor, and oxygen permeability. The properties of printing for 11 color spots are evaluated by x-rite before and after the cold storage period without any detectable changes in the rate of color change (ΔE). The bacterial count of the tested sample is examined by counting the microbial colonies in the agar plate media. There is good agreement between microbial count and smart indicator color change as an effective direct detection tool for sustainable food quality and safety.


Critical thermal maximum in mice.
The critical thermal maximum (the colonic temperature of heat-induced convulsion and righting reflex loss) and thermoregulatory response of male mice were examined following I, exposure to colonic temperature (Tco) 42 degrees C; II, a single exposure to the critical thermal maximum (Tco 44 degrees C); AND III, acclimation at ambient temperatures of 15 or 30 degrees C for 14 days. The critical thermal maximum (CTM) was greater in 30 degrees C acclimated mice than 15 degrees C acclimated mice but was unchanged in mice surviving exposure to Tco 42 degrees C or the CTM. The heating time to apparent breakdown of thermoregulation coincident with an explosive rise in the Tco during exposure to ambient temperature 40.8 degrees C was increased (100%) during the 48-h period following exposure to Tco 42 degrees. It appeared that mice exposed to severe, short-term heat stress (Tco 42 degrees) undergo a compensatory increase in their thermoregulatory cooling capacity with little or no change in the upper temperature tolerated. The animals did, however, exhibit the capability for adaptive adjustments of the upper thermal limit during extended exposure to the more prolonged and less severe environmental heat stress of acclimation at 30 degrees C.


Sequence dependence of the hyperthermic potentiation of carboplatin-induced cytotoxicity and intracellular platinum accumulation in HeLa cells.
We have examined the enhancement of cytotoxic effects of cis-diammine-1,1-cyclobutane dicarboxylate platinum(II) (carboplatin) by hyperthermia in HeLa cells using different regimes of timing and sequence. The results were compared with those obtained with cis-diamminedichloroplatinum(II) (cisplatin). We found that cisplatin simultaneously combined with heat was the most cytotoxic toward HeLa cells of the various timing and sequencing conditions studied. On the other hand, for carboplatin, drug treatment immediately following or during heat exposure showed the greatest effect. Intracellular platinum concentration in HeLa cells treated with heat before carboplatin showed a 2.75-fold increase over that in cells treated with the drug alone. The ratios for carboplatin given before, or during heating, were 0.67 and 1.42 respectively. Simultaneous exposure of cells to cisplatin and heat led to a 1.64-fold enhancement in cisplatin accumulation, compared to 0.92- and 1.24-fold increase for cells treated with cisplatin before and after heat respectively. Although each drug exposure prior to heat was less cytotoxic toward HeLa cells than any other heat/drug combination sequences, the platinum concentration was less than seen with each drug alone. Even though heat exposure prior to and during carboplatin showed a similar toxicity, platinum concentration in cells treated with heat prior to carboplatin was higher than that in cells treated with heat and carboplatin simultaneously. Thus, increased cytotoxicity cannot always be explained on the basis of intracellular platinum concentration. It is clear however that, differing from cisplatin, exposure of cells to heat prior to or during carboplatin administration results in the greatest cell kill.


Madelung's disease: comorbidities, fatty mass distribution, and response to treatment of 22 patients.
Madelung's disease (MD) is an uncommon pathology characterized by the presence of multiple masses of unencapsulated adipose tissue that is symmetrically distributed. The aim of this study was to investigate clinical and epidemiological features of patients diagnosed with MD in our department. Associated diseases and evolution after treatment were also investigated. We reviewed the clinical histories of 22 patients diagnosed with MD from 1990 to 2010 and obtained their epidemiological and clinical characteristics. We found 21 patients with MD type 1 and one patient with MD type 2 according to Enzi's classification. All patients were male, 95.5% with high alcohol intake, and 59.1% with some hepatic disease. No family antecedents were significant; 40.9% had dyslipidemia, 22.7% arterial hypertension, 22.7% chronic obstructive pulmonary disease (COPD), 13.6% hyperuricemia, 9.1% hypothyroidism, 4.5% diabetes mellitus type 2, and 4.5% carbohydrate intolerance; 40.9% had a body mass index>30, and 27.3% presented gynecomastia/lipomastia. The region most frequently affected by fatty deposits was the neck. Madelung's disease affects mainly alcoholic males in their fourth decade of life. Hepatic diseases appear in most patients. Also associated with MD are high lipid blood levels, arterial hypertension, COPD, hyperuricemia, and obesity. MD type 1 is the most frequent phenotype and the neck the most common location for fatty masses. Recurrence after surgery, in the same location or different locations, is a frequent event, even in patients who later abstain from alcohol intake. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors at www.springer.com/00266 .


[The use of paramedical treatment methods by cancer patients. A inquiry on 101 ambulatory patients].
In an anonymous inquiry 101 consecutive tumour patients and their doctors were questioned on the use of treatment methods and preparations without proven efficacy. 32 patients stated they were using such preparations and methods. Three-quarters of the patients had adopted the following dietetic measures, in descending order of frequency: beetroot juice (34%), vitamins (22%), lactic acid or herbal products (9% each). Iscador (mistletoe extract) was used by 21%, and homoeopathic preparations by 6%. Patients' estimate of the total cost, in 69% of cases, was below 300 Swiss francs, but in one case it exceeded 1200. There was no difference in the use or non-use of the products in regard to the doctor's assessment of the prognosis, age, the therapeutic success according to established medical criteria, or the diagnosis and its correct appreciation by the patient. Male patients employed these methods or preparations significantly more often (43%) than female patients (22%); such patients also showed a higher incidence of severe suffering from side effects of chemotherapy (19% vs. 7%), especially nausea. The use of Iscador was known to the doctor in 71% of the cases, whereas the use of the other methods and preparations was known in only 25%.


Dermatitis in the mining industry: incidence, sources, and time loss.
Occupational skin diseases and disorders are the most commonly reported nontrauma-related category of occupational illness in the United States, and mining has one of the highest incidence rates among all industries. The authors' objective in this study was to describe mining industry dermatitis incidence, sources of exposure, and resultant time lost from work. The authors reviewed Mine Accident, Injury and Illness Reports. From 1983 to 2002, the Mine Safety and Health Administration reported 975 cases of dermatitis in mines across the United States and its territories. Average annual incidence was 14.4 cases per 100 000 employees. Upper extremities and multiple body regions were most commonly involved. Twenty-five percent of miners with dermatitis lost at least 1 day of work. Exposure to plants, trees, and vegetation accounted for 24% of all cases. A greater understanding of this condition will assist health professionals in focusing on appropriate intervention strategies to reduce the occurrence of dermatitis and its associated morbidity in mine workers.