Sorption and displacement of pyrene in soils and sediments.
Sorption isotherms of pyrene on soils and sediments were examined to understand its sorption behavior. All systems examined exhibited nonlinear sorption. Sorption nonlinearity was found to be a function of the polarity index of soil/sediment organic matter (SOM), suggesting that the degree of condensation of SOM, characterized by its polarity index, was correlated with the sorption behavior of pyrene. The polarity index of SOM could be a new factor for explaining the sorption nonlinearity. The sorption affinity of two soils and two sediments for pyrene increased with decreasing SOM polarity. A higher sorption affinity in the two soils was associated with a higher degree of condensation of SOM compared to that of the two sediments. A displacement test was performed after pyrene sorption using phenanthrene as a displacer. Pyrene was displaced in all systems examined, and nonlinearity became less pronounced after displacement. Such an increase in isotherm linearity implied that sorption site energies became more homogeneous after displacement. Furthermore, the site energy distribution IE*) derived from the Freundlich model parameters showed that energy reduction of high-energy sites was more significant than that of low-energy sites after displacement. In addition, a decrease in sorption capacity after displacement could be ascribed to the partial depletion of sorption sites by the displacer. The displacement data indicated that the cocontaminant can have potential effects on the fate and bioavailability of anthropogenic organic pollutants sorbed in soils and sediments, thus affecting their exposure risks.


Total synthesis of (+)-ambruticin S: probing the pharmacophoric subunit.
An enantioselective synthesis of the antifungal natural product (+)-ambruticin S has been accomplished starting with the readily available methyl alpha-d-glucopyranoside, (R)-Roche ester, and (S)-glycidol as chirons, which encompassed seven of the 10 stereogenic centers of the target molecule. The remaining three centers were set by a highly diastereoselective, asymmetric cyclopropanation employing a chiral, nonracemic phosphonamide reagent. Our strategy for the construction of the dihydropyran subunit involved a highly syn-selective Lewis acid catalyzed 6-endo-trig cyclization. Other key steps in the synthesis featured an epoxide opening with a dithiane anion, two efficient phosphonamide-anion based olefinations, and a late-stage C-glycosylation.


Bio-Zirconium Metal-Organic Framework Regenerable Bio-Beads for the Effective Removal of Organophosphates from Polluted Water.
Organophosphate-based pesticides, such as diazinon, are among the most toxic organic contaminants to human and environment. Effective removal of diazinon from contaminated water sources is critical. Zirconium Metal-organic frameworks (Zr-MOFs) are promising candidates for the removal of organic contaminants from wastewater. Herein, we report the adequacy of a bio based Zr-MOF named MIP-202 for the removal of diazinon from water. On the other hand, the use of these materials in powder form is not workable, the development of scalable and economical processes and integrative of these materials onto beads is paramount for industrial processes. Hence, it was reported a scalable, bio aqueous solution-based preparation strategy for Bio Zr-MOF beads production. The composite material exposed identical reactivity under the same ambient parameters compared to powdered material in an aqueous solution. These results signify a critical procedure to an integrated strategy for organophosphates removal using bio-based MOFs, which demonstrates high potential for manufacturing applications such as continued removal of organophosphates from wastewater supplies.


Free Nipple Graft Breast Reduction without a Vertical Incision.
A technique of a free nipple graft with an inframammary incision and no vertical incision offers promising postoperative results as a safe and aesthetic alternative. This was a retrospective chart review of patients who presented to a single surgeon for breast reduction surgery using a free nipple graft with an inframammary incision from June 1999 to March 2021. Baseline patient demographics and clinical information along with postoperative complications were recorded and compared between patients who presented for concomitant reconstruction or just reduction. A narrative literature review on surgical techniques and outcomes was also conducted. From the literature search, there have been minimal prior mentions of breast reductions using a free nipple graft with an inframammary incision and no vertical incision. Fifty-five cases were identified for breast reduction surgery in the author's 22-year study period, of which 46 had adequate clinical documentation and follow-up. An estimated 22 patients had either both or one breast reconstructed with opposite side breast reduction, and 24 patients underwent breast reduction alone with free nipple grafting. No implants were used in any of the patients. The free nipple graft technique with an inframammary incision can be performed on patients with excessively large or ptotic breasts. It is possible to reduce the volume of the breast and obtain good projection with this method. Furthermore, avoidance of the vertical incision reduces breakdown at the T-junction and is aesthetically beneficial.


Clinical and pharmacokinetic study of a single daily dose of amikacin in paediatric patients with severe gram-negative infections.
The efficacy and safety of a single 20 mg/kg daily dose of amikacin was studied in an open, uncontrolled trial in 56 infants and children. Most of the patients suffered from severe Gram-negative infection which had failed to respond to previous antibacterial therapy. Amikacin was given in combination with a beta-lactam antibiotic in 43 cases, with other antibiotics in five cases and monotherapy in eight cases. Pseudomonas aeruginosa was the most frequently isolated organism (27 cases). Clinical results were satisfactory in 98% of the infections treated. Two patients died, one from the infection and the other 8 weeks after therapy from unrelated causes. Amikacin serum concentrations were high during the first hour after iv infusion, low after 8 h and undetectable at 24 h. Nephrotoxicity and ototoxicity was not detected in any patient. Amikacin when used as a single daily dose in combination with a beta-lactam antibiotic was effective and safe in treating infants and children with severe Gram-negative infection.


ORF-C4 from the early branching eukaryote Giardia lamblia displays characteristics of alpha-crystallin small heat-shock proteins.
Giardia lamblia is a medically important protozoan parasite with a basal position in the eukaryotic lineage and is an interesting model to explain the evolution of biochemical events in eukaryotic cells. G. lamblia trophozoites undergo significant changes in order to survive outside the intestine of their host by differentiating into infective cysts. In the present study, we characterize the previously identified Orf-C4 (G. lamblia open reading frame C4) gene, which is considered to be specific to G. lamblia. It encodes a 22 kDa protein that assembles into high-molecular-mass complexes during the entire life cycle of the parasite. ORF-C4 localizes to the cytoplasm of trophozoites and cysts, and forms large spherical aggregates when overexpressed. ORF-C4 overexpression and down-regulation do not affect trophozoite viability; however, differentiation into cysts is slightly delayed when the expression of ORF-C4 is down-regulated. In addition, ORF-C4 protein expression is modified under specific stress-inducing conditions. Neither orthologous proteins nor conserved domains are found in databases by conventional sequence analysis of the predicted protein. However, ORF-C4 contains a region which is similar structurally to the alpha-crystallin domain of sHsps (small heat-shock proteins). In the present study, we show the potential role of ORF-C4 as a small chaperone which is involved in the response to stress (including encystation) in G. lamblia.


Two Distinctions That Help to Chart the Interplay Between Conscious and Unconscious Volition.
Research initiated by Benjamin Libet suggests that short-term conscious intentions are not the onsets of bodily actions. However, other research, particularly on longer-term intentions, seems to show that at least some conscious intentions are effective. This leads to the idea that volition is a complex interplay between conscious and unconscious processes. The nature and structure of this interplay is mostly uncharted territory. In this article, I will highlight two currently neglected distinctions that will help to chart the territory. The first distinction is between intentions we become conscious of (passive) and consciously formed intentions (active). The second is Fred Dretske's distinction between structuring and triggering causes. I will introduce both distinctions by discussing how they tie in with and strengthen recent criticism of free selection paradigms and support the idea that consciously self-initiated action issues from processes of conscious deliberation and/or information integration. I will argue that consciously self-initiated action typically involves consciously formed intentions that are the structuring causes of our actions. This notion of conscious intentional action allows us to identify at least four stages in which unconscious processes co-determine our actions-without undermining their self-initiated character.


Isoelectric Focusing of Plant Plasma Membrane Proteins : Further Evidence that a 55 Kilodalton Polypeptide Is Associated with beta-1,3-Glucan Synthase Activity from Pea.
Detergent-solubilized plasma membrane proteins from pea (Pisum sativum L.) stem tissue were separated by isoelectric focusing (IEF) using a Bio-Rad Rotofor cell, with the goal of identifying protein(s) involved in beta-1,3-glucan synthase (GS-II) activity. Ordinary IEF procedures result in membrane protein precipitation. Inclusion of 10% glycerol mitigates this problem in digitonin-solubilized preparations, but not in those solubilized in 3-[(-cholamidopropyl)dimethylammonio]-1-propanesulfonate. Loss of GS-II activity during IEF is minimized by improved cooling of the Rotofor cell. GS-II focuses at pH 5.1. Antiserum against a 55 kilodalton (kD) polypeptide that was recognized from other evidence as involved in GS-II activity, detects this polypeptide in exact correspondence with the GS-II activity peak. A presumptive P-type ATPase, detected using an antibody against corn root plasma membrane 97 kD ATPase, focuses at pH 5.3. In this digitonin/glycerol medium, most of the membrane proteins focus within the relatively narrow pH range of 4.5 to 6, compared to pH 5.5 to 8.5 for IEF in the presence of 9 molar urea, 2% Nonidet P-40 (NP-40), and 5% mercaptoethanol, a medium that inactivates GS-II. This latter medium increases the apparent isoelectric point (pl) values of the abovementioned 55 and 97 kD polypeptides to 5.8 and 7.3, respectively. In the digitonin/glycerol medium, membrane polypeptides apparently focus at pH values lower than their true pls, because of adhering negatively charged phospholipids, which can be at least partially removed by the detergent NP-40 in the presence of urea. These results provide independent evidence that the 55 kD polypeptide is associated with the GS-II activity and indicate that inclusion of urea and a strong nonionic detergent such as NP-40 is necessary if membrane proteins are to be focused at pH values near their true pls.


A Seismic Strengthening Technique for Reinforced Concrete Columns Using Sprayed FRP.
Conventional methods for seismic retrofitting of concrete columns include reinforcement with steel plates or steel frame braces, as well as cross-sectional increments and in-filled walls. However, these methods have some disadvantages, such as the increase in mass and the need for precise construction. Fiber-reinforced polymer (FRP) sheets for seismic strengthening of concrete columns using new light-weight composite materials, such as carbon fiber or glass fiber, have been developed, have excellent durability and performance, and are being widely applied to overcome the shortcomings of conventional seismic strengthening methods. Nonetheless, the FRP-sheet reinforcement method also has some drawbacks, such as the need for prior surface treatment, problems at joints, and relatively expensive material costs. In the current research, the structural and material properties associated with a new method for seismic strengthening of concrete columns using FRP were investigated. The new technique is a sprayed FRP system, achieved by mixing chopped glass and carbon fibers with epoxy and vinyl ester resin in the open air and randomly spraying the resulting mixture onto the uneven surface of the concrete columns. This paper reports on the seismic resistance of reinforced concrete columns controlled by shear strengthening using the sprayed FRP system. Five shear column specimens were designed, and then strengthened with sprayed FRP by using different combinations of short carbon or glass fibers and epoxy or vinyl ester resins. There was also a non-strengthened control specimen. Cyclic loading tests were carried out, and the ultimate load carrying capacity and deformation were investigated, as well as hysteresis in the lateral load-drift relationship. The results showed that shear strengths and deformation capacities of shear columns strengthened using sprayed FRP improved markedly, compared with those of the control column. The spraying FRP technique developed in this study can be practically and effectively used for the seismic strengthening of existing concrete columns.


Effects of high-dose creatine supplementation on kidney and liver responses in sedentary and exercised rats.
This study evaluated the effects of high-dose of short-term creatine supplementation (5g.kg(-1).day(-1) to 1 week) and long-term creatine supplementation (1g.kg(-1). day(-1) to 4-8 weeks) on kidney and liver structure and function of sedentary and exercised Wistar rats (Exercise sessions consisted of swimming at 80% of maximal work load supported during 5 days per week with daily sessions of 60 minutes throughout the duration of the supplementation). Seventy- two animals (245 ± 5g) were divided into four groups (n = 18): control diet Sedentary (SED), Creatine diet Sedentary (CRE), control diet Exercised (EXE), and Creatine diet Exercised (EXECRE). Histological and blood biochemical studies were performed after one, four, and eight weeks of creatine supplementation and exercise (n = 6). No differences were found when comparing SED, EXE and EXECRE groups for kidney and liver structure and function at one, four and eight weeks. However, the CRE group showed higher levels of creatinine (1.1 ± 0.2 vs. 0.4 ± 0.1 mg.dl(-1); p < 0.05), and urea (37 ± 3 vs. 19 ± 1 mg.dl(-1); p < 0.05) when compared with all others groups at four and eight weeks. At eight weeks, the CRE group presented increased levels of ALT (41 ± 7 vs. 23 ± 7 U.L(-1); p < 0.05), AST (89 ± 6 vs. 62 ± 5 U.L(-1); p < 0.05), GGT (8.0 ± 0.9 vs. 3.9 ± 1.0 U.L(-1); p < 0.05), and AP (125 ± 10 vs. 69 ± 9 U.L(-1); p < 0.05) also when compared with all others groups. Moreover, the CRE group demonstrated some structural alterations indicating renal and hepatic damage at four and eight weeks, respectively. These results suggest that long-term creatine supplementation (up to 4-8 weeks) may adversely affect kidney and liver structure and function of sedentary but not of exercised rats. Key pointsCreatine supplementation is an established ergogenic aid in sports and is now claimed to have therapeutical applications in a variety of diseases.Although acknowledged, this nutritional supplement is rarely monitored precisely about their possible side effects.Previous studies indicated that short-term creatine supplementation associate with the physical exercise may be safe, but the effect of long-term creatine supplementation is still unknown.There is a need for further research to elucidate the controversial points refers to renal and hepatic function after creatine supplementation.The results of the current study indicate that supraphysiological long-term creatine supplementation (up to 4-8 weeks) may adversely affect kidney and liver structure and function of sedentary but not of exercised rats.


Pressure-energy correlations in liquids. IV. "Isomorphs" in liquid phase diagrams.
This paper is the fourth in a series devoted to identifying and explaining the properties of strongly correlating liquids, i.e., liquids where virial and potential energy correlate better than 90% in their thermal equilibrium fluctuations in the NVT ensemble. For such liquids we here introduce the concept of "isomorphic" curves in the phase diagram. A number of thermodynamic, static, and dynamic isomorph invariants are identified. These include the excess entropy, the isochoric specific heat, reduced-unit static and dynamic correlation functions, as well as reduced-unit transport coefficients. The dynamic invariants apply for both Newtonian and Brownian dynamics. It is shown that after a jump between isomorphic state points the system is instantaneously in thermal equilibrium; consequences of this for generic aging experiments are discussed. Selected isomorph predictions are validated by computer simulations of the Kob-Andersen binary Lennard-Jones mixture, which is a strongly correlating liquid. The final section of the paper relates the isomorph concept to phenomenological melting rules, Rosenfeld's excess entropy scaling, Young and Andersen's approximate scaling principle, and the two-order parameter maps of Debenedetti and co-workers. This section also shows how the existence of isomorphs implies an "isomorph filter" for theories for the non-Arrhenius temperature dependence of viscous liquids' relaxation time, and it explains isochronal superposition for strongly correlating viscous liquids.


Ethical Reasoning During a Pandemic: Results of a Five Country European Study.
Introduction: There has been no work that identifies the hidden or implicit normative assumptions on which participants base their views during the COVID-19 pandemic, and their reasoning and how they reach moral or ethical judgements. Our analysis focused on participants' moral values, ethical reasoning and normative positions around the transmission of SARS-CoV-2.Methods: We analyzed data from 177 semi-structured interviews across five European countries (Germany, Ireland, Italy, Switzerland and the United Kingdom) conducted in April 2020.Results: Findings are structured in four themes: ethical contention in the context of normative uncertainty; patterns of ethical deliberation when contemplating restrictions and measures to reduce viral transmission; moral judgements regarding "good" and "bad" people; using existing structures of meaning for moral reasoning and ethical judgement.Discussion: Moral tools are an integral part of people's reaction to and experience of a pandemic. 'Moral preparedness' for the next phases of this pandemic and for future pandemics will require an understanding of the moral values and normative concepts citizens use in their own decision-making. Three important elements of this preparedness are: conceptual clarity over what responsibility or respect mean in practice; better understanding of collective mindsets and how to encourage them; and a situated, rather than universalist, approach to the development of normative standards.


New potential stable structures of XMg n (X = Ge, C, Sn; n = 2-12) clusters: XMg8 with high stability.
Several potential stable structures of X-doped magnesium (X = Ge, C, Sn) clusters have been fully investigated by using CALYPSO structure searching software together with density functional theory calculations. XMg n (X = Ge, C, Sn; n = 3-7) clusters have similar geometric structure grows in tetrahedron, while the structures of XMg n (X = Ge, C, Sn; n = 8-12) are based on a kind of tower-like geometry. Interestingly, the relative stability computations indicate that XMg8 (X = Ge, C, Sn) are more stable than other clusters, and thus can be identified as magic clusters. In addition, XMg8's (X = Ge, C, Sn) high stability and atomic interactions contained in structures are studied through their electronic localization function and molecular orbitals. It is shown that the covalent σ bond interaction of X-Mg and Mg-Mg are mainly responsible for their robust stability. Finally, the theoretical calculations of IR and Raman spectra of XMg8 (X = Ge, C, Sn) clusters were implemented for guiding further experimental observation.


Development of reactive artificial liner using recycled materials. 2. Chemical transport properties.
Volatile organic compounds (VOCs) have so far been found to permeate through geomembranes within days and potentially pollute the surrounding groundwater if no sufficient depth of underlain soil barrier existed In order to cope with the fast breakthrough of VOCs through high-density polyethylene (HDPE) geomembrane in the composite liner system, a composite material made of recycled materials was proposed and its mechanical properties were analyzed in a previous study. This artificial liner was composed of crumb rubber, organo-clay, silica fume and epoxy binder together with an environmentally-friendly solvent recycled from paper pulping, and dimethyl sulfoxide as a plasticizer. In this study, the new artificial liner and a typical HDPE geomembrane were tested to compare their abilities to mitigate the movement of VOCs, specifically partition coefficient, diffusion coefficient and mass fluxes. It was found that this new artificial liner had 2-3 orders of magnitude less VOC mass flux than the HDPE geomembrane. The new artificial liner is thought to have a great potential for containing VOCs, even with a thickness of 2.5 cm, and as a substitute for the clay liner. The cost of installing the artificial liner was estimated to be $13.78/m(2). This is lower than the current geomembrane-related price of $19.70-26.91/m(2). The new liner might give a new perspective in future liner design and alleviate the concerning issue of groundwater pollution caused by landfill leachate, which might contain highly mobile VOCs.


Prenatal and early life exposures to ambient air pollution and development.
Residential proximity to major roadways, and prenatal exposures to particulate matter <2.5 μm (PM2.5) and ozone (O3) are linked to poor fetal outcomes but their relationship with childhood development is unclear. We investigated whether proximity to major roadways, or prenatal and early-life exposures to PM2.5 and O3 increase the risk of early developmental delays. Prospective cohort. New York State excluding New York City. 4089 singletons and 1016 twins born between 2008 and 2010. Proximity to major roadway was calculated using road network data from the NY Department of Transportation. Concentrations of PM2.5 and O3 estimated by the Environmental Protection Agency Downscaler models were spatiotemporally linked to each child's prenatal and early-life addresses incorporating residential history, and locations of maternal work and day-care. Parents reported their children's development at ages 8, 12, 18, 24, 30 and 36 months in five domains using the Ages and Stages Questionnaire. Generalized mixed models estimated the relative risk (RR) and 95% CI for failing any developmental domain per 10 units increase in PM2.5 and O3, and for those living <1000 m away from a major roadway compared to those living further. Models adjusted for potential confounders. Compared to those >1000 m away from a major roadway, those resided 50-100 m [RR: 2.12 (1.00-4.52)] and 100-500 m [RR: 2.07 (1.02-4.22)] away had twice the risk of failing the communication domain. Prenatal exposures to both PM2.5 and ozone during various pregnancy windows had weak but significant associations with failing any developmental domain with effects ranging from 1.6% to 2.7% for a 10 μg/m3 increase in PM2.5 and 0.7%-1.7% for a 10 ppb increase in ozone. Average daily postnatal ozone exposure was positively associated with failing the overall screening by 8 months [3.3% (1.1%-5.5%)], 12 months [17.7% (10.4%-25.5%)], and 30 months [7.6%, (1.3%-14.3%)]. Findings were mixed for postnatal PM2.5 exposures. In this prospective cohort study, proximity to major roadway and prenatal/early-life exposures to PM2.5 and O3 were associated with developmental delays. While awaiting larger studies with personal air pollution assessment, efforts to minimize air pollution exposures during critical developmental windows may be warranted.


Familial Mediterranean Fever: an unusual cause of liver disease.
Familial Mediterranean Fever is an autoinflammatory disease typically expressed with recurrent attacks of fever, serositis, aphthous stomatitis, rash. Only a few reports describe the association with hepatic involvement. We describe the clinical case of a child affected, since the age of 1 year, by recurrent fever, aphthous stomatitis, rash, arthralgia, associated with abdominal pain, vomiting, lymphadenopathy. The diagnosis of Familial Mediterranean Fever was confirmed by the genetic study of MEFV gene; the homozygous mutation M694 V in exon was documented. A partial control of attacks was obtained with colchicine. The child continued to manifest only recurrent episodes of abdominal pain without fever, however serum amyloid A persisted high, in association with enhanced levels of CRP, AST and ALT (1.5 x n.v.). The dosage of colchicine was increased step by step and the patient achieved a better control of symptoms and biochemical parameters. However, the patient frequently needed an increase in the dose of colchicine, suggesting the possible usefulness of anti-interleukin-1 beta treatment. The unusual presentation of Familial Mediterranean Fever with liver disease suggests the role of inflammasome in hepatic inflammation. Colchicine controls systemic inflammation in most of the patients; however, subclinical inflammation can persist in some of them and can manifest with increased levels of CRP, ESR, serum amyloid A also in attack-free intervals.


Contemporary management of neurofibromatosis.
The neurofibromatoses are two distinct entities with different genetic origins. The phenotypic expressions and required treatments are different. The devastating nature of neurofibromatosis-2 may be more effectively controlled through the application of advanced imaging techniques and contemporary neurotologic procedures. The most common manifestation of neurofibromatosis-2 is that of bilateral acoustic neuromas. The eventual total bilateral sensorineural deafness associated with this condition can be obviated in selected cases if the diagnosis is established early. Follow-up data are reported for three patients in whom hearing was preserved in at least one ear. When removal with hearing preservation is not possible, subtotal tumor removal with decompression of the internal auditory canals may delay progression of hearing loss. A new approach to tumors of the pterygomaxillary fossa that have extended to the middle cranial fossa has been successfully applied and is described.


Amifostine-antioxidant drug in anticancer therapy.
Antineoplastic drugs and/or their metabolites are very reactive chemically and easily react with cell components, both those neoplastic and healthy, which leads to uncontrolled cell damage. Research is being carried out to discover new drugs preventing those destructive changes in healthy cells. Amifostine is one of the few drugs with protective abilities in regard to healthy tissues during antineoplastic therapy. Amifostine alone is inactive chemically, but active metabolite amifostine WR-1065 has been assumed to protect the healthy tissues during antineoplastic therapy by bounding of anticancer drug, causing their detoxification and/or eliminating the free radicals generated during radiation and cytostatic therapy. WR-1065 also protects the healthy tissues by inhibition of apoptosis caused by irradiation and/or alkylating compounds. However, the protective mechanism of amifostine influence on healthy cells has not been fully comprehended, and the research is still being carried out.


Elevated plasma adiponectin levels in patients with chronic obstructive pulmonary disease.
Adiponectin is an anti-inflammatory adipokine that may play a role in chronic obstructive pulmonary disease (COPD) pathogenesis. To investigate the relationship between adiponectin, interleukin (IL) 6, IL-8 and C-reactive protein (CRP) and COPD by evaluating these biomarkers in ever-smokers with or without the disease. Plasma levels of adiponectin, IL-6, IL-8 and CRP were measured using commercially available kits in COPD patients (n = 71), healthy ever-smokers (n = 62) and non-smokers (n = 51). There were significant increases in plasma adiponectin, IL-6 and CRP in COPD patients (median [IQR] 4.39 microg/ml [2.68-6.98], 4.19 pg/ml [<2.40-6.40], 8.75 mg/l [4.26-40.63], respectively) compared to healthy ever-smokers (1.90 microg/ml [0.86-2.86], <2.40 pg/ml [<2.40-2.77], 3.71 mg/l [1.97-10.37 mg/l], respectively, P < 0.001) and non-smokers (1.76 microg/ml [1.34-2.52], <2.40 pg/ml [<2.40-2.78], 3.12 mg/l [2.11-5.71], respectively, P < 0.001). COPD patients had lower plasma IL-8 levels than healthy ever-smokers. Among ever-smokers with or without COPD, plasma adiponectin, IL-6 and CRP levels were inversely correlated with forced expiratory volume in 1 second (% predicted) after adjustment for age, body mass index, smoking status and pack-years. Our findings suggest that in COPD patients, adiponectin might be associated with COPD pathogenesis.


Gene expression of angiotensin II receptor in blood cells of Cushing's syndrome.
The relation between serum cortisol, plasma renin activity, angiotensin II (Ang II), or aldosterone levels and peripheral blood cell (mononuclear leukocytes and platelets) angiotensin II type 1A (AT1A) and 1B (AT1B) receptor mRNA levels was examined in both patients with Cushing's syndrome (seven patients with Cushing's syndrome due to unilateral adrenal cortical adenoma) and control subjects (seven normotensive patients with renal cell carcinoma). Blood was collected from each participant for estimation of plasma renin activity and plasma angiotensin II, aldosterone, and cortisol concentrations and for isolation of mononuclear leukocytes and platelets, which were then used to measure AT1A and AT1B receptor mRNA levels before and after adrenalectomy with the use of reverse transcription-polymerase chain reaction. In patients with Cushing's syndrome, both mononuclear leukocyte and platelet AT1A mRNA levels, which were elevated, were reduced after removal of the adrenal tumors, whereas AT1B receptor mRNA levels of both types of blood cells did not significantly change after adrenalectomy. In contrast, in control subjects, both AT1A and AT1B receptor mRNA levels did not significantly change after unilateral adrenalectomy and nephrectomy. In the adrenal tumors of patients with Cushing's syndrome, gene expression of AT1A receptor was decreased compared with that from adrenals of control subjects. AT1A receptors of the platelets were shown to be upregulated in a manner similar to those of mononuclear leukocytes in patients with Cushing's syndrome. These results suggest that cortisol excess is an important factor upregulating AT1A receptor mRNA levels in human blood cells.


Associations between chronic pain, analgesic use and physical therapy among adults living with HIV in Atlanta, Georgia: a retrospective cohort study.
Chronic pain - widely classified as pain lasting longer than 3 months - has emerged as a treatment priority among people living with HIV (PLHIV), and has been associated with decreased patient retention in HIV primary care. This retrospective cohort study evaluated the changes in self-reported pain scores and analgesic usage for HIV-positive adults with chronic pain enrolled at a large, urban HIV clinic in Atlanta, Georgia, USA who received a physical therapy (PT) intervention compared with a demographically matched cohort who did not receive PT. Retrospective data was collected from patients' charts who received PT, and from patients' charts who did not receive PT during the time period. Patients who had received PT were referred by their primary HIV providers at the clinic, but were not recruited specifically for study purposes. Results revealed that among patients who received PT interventions, the majority (93.5%) reported a decrease or total elimination of pain. In addition, all of the patients who received PT reported decreased analgesic use, with the exception of opioids, which remained unchanged. Among patients who did not receive PT intervention, there was an overall increase in analgesic usage in all medication categories including opioids. The majority of the non-PT group (74%) reported increased or unchanged pain over the study period. In a non-randomized sample of HIV-positive adults at one HIV clinic, PT intervention appears to be an effective, non-pharmacological method to decrease chronic pain and analgesic use in selected persons living with HIV.


Role of Porphyromonas gingivalis in oral squamous cell carcinoma development: A systematic review.
The target of the current systematic review is to gather and synthesize the most recent scientific information about the role of Porphyromonas gingivalis in the molecular pathways of oral squamous cell carcinoma (OSCC). Oral squamous cell carcinoma is the most common malignancy of the oral cavity, with a poor prognosis and a low survival rate. Etiology is multifactorial but consumption of tobacco and alcohol is the most important risk factors. P gingivalis is a Gram-negative anaerobic bacterium commonly found in oral microbiota that has been linked to periodontal disease (PD), and recently to OSCC. However, its association with OSCC development is not well defined. A bibliographic research was carried out selecting articles published until 2019, on PubMed, Web of Science, and Scopus databases, with the keywords "Porphyromonas gingivalis," "oral cancer," "oral squamous cell carcinoma," and "periodontal pathogen." Seventeen articles, 14 in vitro and three in animal models, were selected. Models mimicking OSCC were OSCC pre-established cell lines (11 studies), OSCC/ healthy human biopsies (three studies), and animals with OSCC (three studies). P gingivalis strains used to cause infection in these studies were ATCC 33277, 381, and W83. Porphyromonas gingivalis could play an important role in OSCC development and could be involved in three different stages: epithelial-mesenchymal transition of malignant cells, neoplastic proliferation, and tumor invasion. Current findings emphasize the convenience of treatment and control approaches of PD as part of the primary prevention of OSCC.


Remifentanil versus fentanyl for esophagogastroduodenoscopy in children.
We compared sedation by propofol combined with either fentanyl or remifentanil in pediatric outpatients undergoing diagnostic esophagogastroduodenoscopy. Forty-two children scheduled for esophagogastroduodenoscopy in our institution were randomly assigned to receive 2 mg/kg propofol plus either 1 μg/kg bolus of fentanyl (group F; n = 20) or 0.5 μg/kg bolus of remifentanil (group R; n = 22). Cardiorespiratory parameters, sedation level, adverse effects related to the drugs and/or to the procedure, ease of performance for the endoscopist, and time to awakening were analyzed. There were no clinically significant changes in hemodynamics. Apnea periods >20 seconds and decreases in SaO2 <90% occurred more frequently in group R (31.8% vs 0%, P < 0.01, and 27.3% vs 5.0%, P > 0.05, respectively). Children in group R had significantly shorter average time to awakening: 9.5 ± 5.6 vs 16.5 ± 10.5 minutes (P = 0.01), and received a significantly lower total dose of propofol (P = 0.034). Adverse effects within the first 24 hours postprocedure occurred less frequently in group R (P = 0.03). Remifentanil in combination with propofol provides good analgesic and sedative effects, which were shorter lasting compared with fentanyl-based sedation, and caused fewer delayed adverse effects. The use of remifentanil was associated with respiratory depression, emphasizing the need for experienced anesthesiologists.


Postural control after vestibular schwannoma resection measured with visual feedback posturography.
Vestibular symptoms after surgery diminish rapidly, but the simultaneous progress in active postural control has not been fully addressed. The aim was to evaluate the progress in postural control in operated vestibular schwannoma (VS) patients with visual feedback posturography (VFP). 36 consecutive patients with unilateral VS were studied with the VFP pre-operatively, 1 month and 3 months after the surgery. The accuracy and velocity of active postural control movements to distant targets in VFP was measured and compared to that of healthy controls. The hold percentage within the targets was significantly reduced in the VS patients compared to the controls (pre-operatively p = 0.005; postoperatively at 1 month p = 0.002 and at 3 months p = 0.017). The sway velocity (SV) within the targets among patients with VS was significantly increased pre-operatively (p = 0.009), at the 1-month (p = 0.004) and at the 3-month follow-up visits (p = 0.016). All the postural control parameters except SV tended to improve slightly postoperatively. The consecutive VFP measurements in individual VS patients correlated statistically significantly (p < 0.001 for all parameters). The abnormality in the pre-operative VFP results correlated statistically significantly with that of postoperative VFP (p = 0.001). The VFP is an objective and repeatable method, which can be used to assess and follow up the active postural control in individual patients with VS. Persisting abnormality in the VFP seems to be an indication for more aggressive vestibular rehabilitation to normalize the disturbed postural control.


Antioxidants and Manganese Deficiency in Needles of Norway Spruce (Picea abies L.) Trees.
Chlorotic and green needles from Norway spruce (Picea abies L.) trees were sampled in the Calcareous Bavarian Alps in winter. The needles were used for analysis of the mineral and pigment contents, the levels of antioxidants (ascorbate, glutathione), and the activities of protective enzymes (superoxide dismutase, catalase, ascorbate peroxidase, monodehydroascorbate radical reductase, dehydroascorbate reductase, glutathione reductase). In addition, the activities of two respiratory enzymes (glucose-6-phosphate dehydrogenase, NAD-malate dehydrogenase), which might provide the NADPH necessary for functioning of the antioxidative system, were determined. We found that chlorotic needles were severely manganese deficient (3 to 6 micrograms Mn per gram dry weight as compared with up to 190 micrograms Mn per gram dry weight in green needles) but had a similar dry weight to fresh weight ratio, had a similar protein content, and showed no evidence for enhanced lipid peroxidation as compared with green needles. In chlorotic needles, the level of total ascorbate and the activities of superoxide dismutase, monodehydroascorbate radical reductase, NAD-malate dehydrogenase, and glucose-6-phosphate dehydrogenase were significantly increased, whereas the levels of ascorbate peroxidase, dehydroascorbate reductase, glutathione reductase, and glutathione were not affected. The ratio of ascorbate to dehydroascorbate was similar in both green and chlorotic needles. These results suggest that in spruce needles monodehydroascorbate radical reductase is the key enzyme involved in maintaining ascorbate in its reduced state. The reductant necessary for this process may have been supplied at the expense of photosynthate.


Measures of everyday competence in older adults with cognitive impairment: a systematic review.
The issue of safety of the cognitively impaired elderly people living alone has been continuously raised. Traditional psychometric measures of cognitive abilities may not adequately reflect older adults' functioning in a real everyday context. To conduct a systematic review on instruments available for evaluating the everyday problem-solving or everyday competence of the elderly with cognitive impairment and to critically review the measurement properties of the identified instruments. We searched the databases such as Cinahl, Medline, PsycINFO, AARP Ageline, ProQuest and the Cochrane Library for the time period between January 1995 and December 2010. Reference lists of the included papers were also manually searched. Five instruments were included. All the instruments focused their framework on Instrumental Activities of Daily Living (IADL) domains which meet well with suggestions from other studies on the importance of IADL in determining an elderly individual's capability to live independently in the community. No available instruments for the moderate to severe impairment group were identified under this review. Few existing instruments to assess the ability of everyday problem-solving of the elderly with cognitive impairment can be identified in the literature. Further research validating them against functional, real-world outcomes is needed.


C-terminal mutations that alter the turnover number for 3-O-methylglucose transport by GLUT1 and GLUT4.
Turnover numbers for 3-O-methylglucose transport by the homologous glucose transporters GLUT1 and GLUT4 were compared to those for truncated and chimeric transporters expressed in Xenopus oocytes to assess potential regulatory properties of the C-terminal domain. The ability of high intracellular sugar concentrations to increase the turnover number for sugar entry ("accelerated exchange") by GLUT1 and not by GLUT4 was maintained in oocytes. Replacing the GLUT1 C terminus with that of GLUT4 stimulated turnover 1.6-fold, but abolished accelerated exchange. Thus, the GLUT1 C terminus permits accelerated exchange by GLUT1, but in doing so must interact with other GLUT1 specific sequences since the GLUT4ctrm1 chimera did not exhibit this kinetic property. Removal of 38 C-terminal amino acids from GLUT4 reduced its turnover number by 40%, whereas removing only 20 residues or replacing its C terminus with that of GLUT1 increased its turnover number 3.5-3.9 fold. Therefore, using mechanisms independent of those which alter transporter targeting to the plasma membrane, C-terminal mutations in either GLUT1 or GLUT4 can activate transport normally restricted by the native C-terminal domain. These results implicate the C termini as targets of physiological factors, which through covalent modification or direct binding might alter C-terminal interactions to regulate intrinsic GLUT1 and GLUT4 transporter activity.


Oxidation of DOPAC by nitric oxide: effect of superoxide dismutase.
This study aimed to characterize the redox interaction between 3,4-dihydroxyphenylacetic acid (DOPAC) and nitric oxide (.NO), and to assess the reductive and oxidative decay pathways of the DOPAC semiquinone originating from this interaction. The reaction between DOPAC and.NO led to the formation of the DOPAC semiquinone radical, detected by electron paramagnetic resonance (EPR) and stabilized by Mg(2+), and the nitrosyl anion detected as nitrosylmyoglobin. The EPR signal corresponding to the DOPAC semiquinone was modulated as follows: (i) it was suppressed by glutathione and ascorbic acid with the formation of new EPR spectra corresponding to the glutathionyl and ascorbyl radical, respectively; (ii) it was enhanced by Cu,Zn-superoxide dismutase; the enzyme also accelerated the decay of the semiquinone species to DOPAC quinone. These results are interpreted as a one-electron oxidation of DOPAC by.NO; the reductive decay of the semiquinone back to DOPAC was facilitated by reducing agents, such as glutathione and ascorbate, whereas the oxidative decay to DOPAC quinone was facilitated by superoxide dismutase. The latter effect is understood in terms of a reversible conversion of nitrosyl anion to.NO by the enzyme. The biological relevance of these reactions is also discussed in terms of the reactivity of peroxynitrite towards DOPAC as a model with implications for aerobic conditions.


Act No. 23.592 adopting measures against those who arbitrarily impede the full exercise of fundamental rights and guarantees recognized in the National Constitution, 23 August 1988.
This Act provides that whoever arbitrarily impedes, obstructs, restricts, or in any other way limits the full exercise on an equal basis of fundamental rights and guarantees recognized by the National Constitution of Argentina will be obligated, at the request of the injured person, to render the discriminatory act without effect or cease in its realization and repair the moral and material damage that has resulted. To be particularly scrutinized are discriminatory acts or omissions undertaken for sexual reasons, among others.


A general scale to rate symptoms and feelings related to problems of ergonomic and organizational importance.
Advantages and drawbacks with different methods for scaling magnitudes of experiences are described. An advantage with "ratio scaling" (according to Stevens) is that it gives possibilities for rough assessments of S-R-functions, but a drawback that it does not function to determine direct ("absolute") levels of intensity. Simple "category rating scales" have instead the advantage to enable rough determinations of intensity levels but not S-R-functions. Basic principles in scale construction are presented, such as the need of a rather big subjective dynamic range from rest to maximum, the importance of good linguistic anchors, the value of using one and the same scale for most kinds of experiences, and the importance of a congruence in meaning between the numbers on a scale and the verbal anchors (or symbols). Theoretical and empirical reasons give strong support for the use of Borg's general category (C)-ratio (R) scale, the CR10 scale, for diagnostic purposes and for treatments of both sick and healthy people and work situations.


Negative regulation of Hedgehog signaling by the cholesterogenic enzyme 7-dehydrocholesterol reductase.
Cholesterol regulates Hedgehog (Hh) signaling during early vertebrate development. Smith-Lemli-Opitz syndrome (SLOS) is caused by defects in 7-dehydrocholesterol reductase (DHCR7), an enzyme catalyzing the final step of cholesterol biosynthesis. Many developmental malformations attributed to SLOS occur in tissues and organs where Hh signaling is required for development, but the precise role of DHCR7 deficiency in this disease remains murky. We report that DHCR7 and Sonic Hedgehog (Shh) are co-expressed during midline development in Xenopus embryos. DHCR7 has previously been implicated to function as a positive regulator of Hh signaling that acts to regulate the cholesterol adduction of Hh ligand or to affect Hh signaling in the responding cell. We present gain- and loss-of-function analyses suggesting that DHCR7 functions as a negative regulator of Hh signaling at the level or downstream of Smoothened (Smo) and affects intracellular Hh signaling. Our analysis also raises the possibility that the human condition SLOS is caused not only by disruption of the enzymatic role of DHCR7 as a reductase in cholesterol biosynthesis, but may also involve defects in DHCR7 resulting in derepression of Shh signaling.


Crown dimensions of deciduous and permanent teeth of Jats from Haryana (India).
Tooth crown dimensions of deciduous and permanent dentition have been measured in 356 male and 292 female Jats from Haryana, an important agriculturally-based community in North India. While the second molar is the biggest tooth of the deciduous dentition, the first molar showed greater mesiodistal and buccolingual diameters in the permanent dentition. Sex differences in the two dentitions were significant, the differences being more marked in the permanent teeth.


Difference in the integrated effects of sympathetic vasoconstriction and local vasodilation in human skeletal muscle and skin microvasculature.
We investigated the integration of sympathetic vasoconstriction and local vasodilation in the skeletal muscle and skin microvasculature of humans. In 39 healthy volunteers, we simultaneously measured the blood flow index in the flexor carpi radialis muscle using diffuse correlation spectroscopy and the skin using laser-Doppler flowmetry. We examined the effects of acute sympathoexcitation induced by forehead cooling on relatively weak and robust vasodilatory responses during postocclusive reactive hyperemia (PORH) induced by 70-sec and 10-min arterial occlusion in the upper arm. To increase sympathetic tone during PORH, forehead cooling was begun 60 sec before the occlusion release and ended 60 sec after the release. In the 70-sec occlusion trials, acute sympathoexcitation reduced the peak and duration of vasodilation in both skeletal muscle and skin. The inhibition of vasodilation by sympathoexcitation was blunted in both tissues by the robust vasodilatory stimulation produced by the 10-min occlusion, and the degree of blunting was greater in skeletal muscle than in skin, especially the initial and peak responses. Sympathoexcitation reduced the peak vasodilation only in skin, while it accelerated the initial vasodilation only in skeletal muscle. However, the decline in vasodilation after the peak was significantly hastened in skeletal muscle, shortening the duration of the vasodilation. We conclude that, in humans, the integration of sympathetic vasoconstriction and local vasodilation has different effects in skeletal muscle and skin and is likely an important contributor to the selective control of perfusion in the microcirculations of different tissues.


Are we losing awareness of other infections due to the fear of coronavirus disease-2019 and MIS-C?
Multisystem inflammatory syndrome in children (MIS-C) is a rarely seen severe complication of coronavirus disease-2019 (COVID-19). Although fever is one of the indispensable symptoms, other infections should be considered in the differential diagnosis during the pandemic. An 8-year-old and a 16-year-old female patient were admitted with fever, vomiting, headache. Both had fulfilled the criteria and were diagnosed with MIS-C. However, they both had remarkable persistent costovertebral angle tenderness, which was unexpected in MIS-C. In Case-1, urine analysis showed microscopic hematuria without pyuria, and urine culture showed no bacterial growth. Case-2 had microscopic hematuria and pyuria with Escherichia coli growth in urine culture. Contrast-enhanced computed tomography showed wedge-shaped hypodense multiple lesions in bilateral kidneys for Case-1, in the right kidney for Case-2. They diagnosed acute focal bacterial nephritis (AFBN). The diagnostic criteria of MIS-C can overlap with the symptoms of other severe septic infections such as AFBN, which is a rare urinary tract infection, diagnosed by imaging of localized renal inflammatory mass-like or wedge-shaped lesion. A detailed anamnesis and careful physical examination may help differential diagnosis.


Differentiation of murine embryonic stem cells toward renal lineages by conditioned medium from ureteric bud cells in vitro.
The kidney is formed from two tissue populations derived from the intermediate mesoderm, the ureteric bud, and the metanephric mesenchyme. Metanephric mesenchyme is a pluripotent renal stem population, and conversion of renal mesenchyme into epithelia depends on the ureteric bud in vivo and in vitro. Embryonic stem (ES) cells have been induced to differentiate into a broad spectrum of specialized cell types in vitro, including hematopoietic, pancreatic, and neuronal cells. Such ES-derived cells can provide a valuable source of progenitor cells. However, whether ES cells can be stimulated by factors secreted from the fetal renal cells to differentiate into renal precursor cells in vitro has not been reported. In this study, we showed that murine ES cells can give rise to embryoid bodies in the absence of leukemia inhibitory factor. Culture conditions were optimized [6 days, 10 ng/ml activin and 10(-7) M retinoic acid (RA)] to generate maximal mesoderm populations specifically expressing Pax2 and brachyury. Results showed that 72% of the cells were brachyury positive by fluorescent activated cell sorter on Day 6 of EB cell differentiation. Conditioned medium collected from cultures of ureteric bud cells from renal cells of a 13-day-old fetus was added to the culture medium. Mesoderm cells were cultured for up to 10 days before showing expression of renal markers, initiation of nephrogenesis (WT-1 and Pax2), and terminally differentiated renal cell types (POD-1 and E-cadherin). This study suggests that ES cells pre-treated by RA and activin can interact with secreted molecules of the fetal renal cells to specifically differentiate into renal precursor cells. Our results provide an experimental basis for the development of in vitro assays to steer differentiation of ES cells toward renal lineages.


Functional analysis of the preproendothelin-1 gene promoter in pulmonary epithelial cells and monocytes.
At least two human preproendothelin-1 mRNAs are produced by a single gene through the use of different promoters, and the mechanisms controlling the production of these alternative transcripts might be cell-specific. In human lung, endothelin-1 is produced by vascular endothelial cells, bronchial epithelial cells, and pulmonary monocytes/macrophages. Given the important role of endothelin-1 in the pathogenesis of some pulmonary diseases, we carried out a functional analysis of the preproendothelin-1 gene promoter(s) in bronchial epithelial cells and lung monocytes. Two distinct preproendothelin-1 mRNAs were expressed in the two cell populations. Using deletion mutants and enhancer trap transfection experiments, we also identified different regions of the preproendothelin-1 gene necessary for endothelin-1 expression in bronchial epithelial cells and pulmonary monocytes.


Epidemiology of intentional self-poisoning in rural Sri Lanka.
We investigated the epidemiology of intentional self-poisoning in rural Sri Lanka by prospectively recording 2189 admissions to two secondary hospitals. Many patients were young (median age 25 years), male (57%) and used pesticides (49%). Of the 198 who died,156 were men (case fatality 12.4%) and 42 were women (4.5%). Over half of female deaths were in those under 25 years old; male deaths were spread more evenly across age groups. Oleander and paraquat caused 74% of deaths in people under 25 years old; thereafter organophosphorous pesticides caused many deaths. Although the age pattern of self-poisoning was similar to that of industrialised countries, case fatality was more than 15 times higher and the pattern of fatal self-poisoning different.


Radionuclide imaging and treatment of thyroid cancer.
Over the past decades, the diagnostic methods and therapeutic tools for thyroid cancer (TC) have been greatly improved. In addition to the classical method of ingestion of radioactive iodine-131 (I131) and subsequent I123 and I124 positron emission tomography (PET) in therapy and examination, I124 PET-based 3-dimensional imaging, Ga68-labeled [1, 4, 7, 10-tetraazacyclododecane-1, 4, 7, 10-tetraacetic acid]-1-NaI(3)-octreotide (DOTANOC) PET/computed tomography (CT), Tc99m tetrofosmin, pre-targeted radioimmunotherapy, and peptide receptor radionuclide therapy have all been used clinically. These novel methods are useful in diagnosis and therapy of TC, but also have unavoidable adverse effects. In this review, we will discuss the development of nuclear medicine in TC examination and treatment.


[Topical therapy in pregnancy].
Any instance of drug administration during pregnancy can pose problems and will always take place after careful consideration and specific benefit risk evaluation. Even in the case of local therapy, which is rightly considered particularly safe, several active substances are applied whose embryotoxic potential is either relevant when given systemically in animals or humans, or unknown. With this in mind, several active substances designed for topical application are discussed that should not be applied at all during pregnancy or only within defined periods, even under various conditions of local therapy. The borderlines are unclear, and are indicated with particular reference to areas for which no reliable data are available.


Simultaneous Bistability of a Qubit and Resonator in Circuit Quantum Electrodynamics.
We explore the joint activated dynamics exhibited by two quantum degrees of freedom: a cavity mode oscillator which is strongly coupled to a superconducting qubit in the strongly coherently driven dispersive regime. Dynamical simulations and complementary measurements show a range of parameters where both the cavity and the qubit exhibit sudden simultaneous switching between two metastable states. This manifests in ensemble averaged amplitudes of both the cavity and qubit exhibiting a partial coherent cancellation. Transmission measurements of driven microwave cavities coupled to transmon qubits show detailed features which agree with the theory in the regime of simultaneous switching.


New Target for Minoxidil in the Treatment of Androgenetic Alopecia.
To investigate the mechanism of minoxidil in treating androgenetic alopecia (AGA). The mechanism of action of minoxidil on AGA was first systematically investigated from the viewpoint of network pharmacology, including minoxidil-AGA target prediction, protein-protein interaction (PPI) network analysis, molecular docking and enrichment analysis of targets related to minoxidil and AGA, and dermal papilla cell assays to confirm the viability of prediction. The combined analysis revealed that minoxidil treatment of AGA not only acts on androgenic receptors (AR) but also on 2 new targets, steroid 17-alpha-hydroxylase/17,20 lyase (CYP17A1) and aromatase (CYP19A1). The biological processes linked to these targets were concentrated on several pathways, including enzymes and hormones. Further experiments have revealed that minoxidil suppresses the expression of AR and CYP17A1, boosts the activity of CYP19A1, decreases the formation and binding of dihydrotestosterone, and enhances the production of estradiol. Through these changes, minoxidil acts as a treatment for AGA. Minoxidil may act by altering hormonal and enzymatic pathways. Our study finds two new targets (CYP17A1, CYP19A1) of minoxidil and demonstrates that minoxidil inhibits AR. These targets may provide new ideas for drug research.


Comparison of serum antibodies to pneumolysin with those to pneumococcal capsular polysaccharides in children with acute otitis media.
Streptococcus pneumoniae is a major bacterial pathogens in acute otitis media. Pneumolysin is a species-specific protein toxin produced intracellularly by all clinically relevant pneumococcal strains, and antibodies to pneumolysin should therefore represent pneumococcal involvement in the disease, regardless of the serotype. Antibodies to pneumococcal pneumolysin and capsular polysaccharides were measured by enzyme immunoassay in acute and convalescent sera of 121 children with acute otitis media. A pneumococcal otitis episode was defined by a positive middle ear fluid culture and/or pneumolysin PCR. Median age of the 10 children who developed a seroconversion response to pneumolysin was 1 year 8 months, and of the 21 children responding to polysaccharides it was 2 years 9 months. Eight of the 10 seroconversion responses to pneumolysin were of IgA class alone, whereas 17 of the 21 polysaccharide responses were of IgG class alone or IgG together with IgM and/or IgA. Of the 41 children with a pneumococcal otitis episode, 13 (39%) showed a seroconversion response, 3 (7%) to pneumolysin and 11 (27%) to capsular polysaccharides. The children with a pneumococcal otitis episode had lower titers of acute phase IgG to the capsular polysaccharide pool of S. pneumoniae (containing types 6B, 14, 19F and 23F), as compared with the titers in children with otitis caused by other pathogens and pneumococci only in the nasopharynx or not found at all (P = 0.04). Serum antibodies to pneumolysin can be detected at an earlier age than those to the capsular polysaccharides. However, a seroconversion is rare and therefore of no diagnostic value. The presence of serum IgG to the pneumococcal capsular polysaccharides seems beneficial in the prevention of pneumococcal otitis.


High-dose 90Y Mx-diethylenetriaminepentaacetic acid (DTPA)-BrE-3 and autologous hematopoietic stem cell support (AHSCS) for the treatment of advanced breast cancer: a phase I trial.
This Phase I trial explores the use of high-dose 90Y conjugated to the antibreast cancer monoclonal antibody BrE-3 and autologous hematologic cell support in the treatment of women with stage four breast cancer. Nine women with heavily pretreated disease were enrolled. All of the patients had BrE-3-positive tumors by immunostaining and were treated with increasing doses of 90Y (15 mCi/m2, 3 patients), 20 mCi/M2 (six patients), and a fixed (50 mg) dose of BrE-3. 111In-labeled BrE-3 (5 mCi) was given simultaneously for scanning purposes. The only toxicity noted was hematological. Grade 4 platelet toxicity requiring transfusion support occurred in four patients. Grade 4 WBC toxicity was seen in two patients that resolved in 3-9 days. All hematological nadirs occurred approximately 25 days after treatment. Objective partial responses were noted in 4 of 8 (50%) patients with measurable tumors. Dose escalation is ongoing.


Rare case of isolated splenic metastases from gastric cancer detected with fluorine-18 fluorodeoxyglucose-positron emission tomography/computed tomography.
We report a rare case of isolated splenic metastasis from gastric cancer detected with fluorine-18 fluorodeoxyglucose-positron emission tomography/computed tomography (PET/CT). A 55-year-old man with gastric cancer 1 year post surgery, evaluated with PET/CT showed focal, intense uptake in the spleen, with no other abnormal findings. On splenectomy, the lesion was confirmed as metastasis from gastric cancer pathologically.


Dynamic parameters of the stapedius muscle reflex in response to stimuli of varying duration but with the same energy content.
An evaluation was made of the behaviour of the dynamic parameters of the stapedius contraction reflex (latency, amplitude, recruitment time, duration, and efficiency) in response to stimuli with the same energy content but of different duration. A comparison was made with the results of a similar experiment in which stimuli with different energy contents were used. As adumbrated in earlier studies, it was found that these parameters are more subject to the influence of the temporal characteristics of the stimulus than to its energy content.


[Progress of microRNA in diagnosis and prognosis of diffuse large B cell lymphoma-review].
MicroRNA (miRNA) is a class of naturally occurring short non-coding small molecular RNA with 19-25 nucleotide. MiRNA can regulate gene expression through incompletely binding to complementary sequences in the 3'UTR of target mRNA. MiRNA plays key regulatory role in a diverse rang of pathways, including cell proliferation, differentiation, apoptosis, stem cell development. Many studies have shown that many miRNA have a special role of gene regulation in cancer development and have been used as therapeutic targets and diagnostic markers of cancer. This review focuses on recent advances of studies on miRNA involved in tumorigenesis, and in classification, diagnosis, therapy and prognosis of DLBCL.


Expression during Salt Stress and Nucleotide Sequence of cDNA for Ferredoxin-NADP Reductase from Mesembryanthemum crystallinum.
In the facultative halophyte Mesembryanthemum crystallinum (common ice plant) the enzyme ferredoxin-NADP(+)-reductase (FNR) is coded for by a small family of 2 to 3 genes. We have determined the expression characteristics as the plants adapt to high salt and the nucleotide sequence of a full-length cDNA coding for the precursor of this chloroplast-located enzyme. On a developmental scale amounts of FNR transcripts and protein are highest in young emerging leaves. The FNR cDNA is a member of a class of genes whose expression is only slightly affected by salt stress. Even less pronounced than mRNA fluctuations, the amount of FNR protein is unaffected by salt stress. The longest FNR cDNA found was 1,419 nucleotides in size. It consisted of 74 nucleotides 5'-leader sequence, 1,095 nucleotides of protein coding sequence encoding 365 amino acids, and 247 nucleotides 3-region excluding a short poly(A(+)) tail. As expected for a nucleus-coded chloroplast protein an amino terminal transit peptide (52 amino acids in length) was found. The mature FNR protein is predicted to contain 313 amino acids corresponding to a protein of M(r) 35,713. The deduced amino acid sequence of the mature FNR protein is 93.2 and 85.9% identical to those of spinach and pea. The transit peptide of pea and spinach have 55.8 and 69.2% identity with that from ice plant.


Dual mechanisms for change in myocardial signal intensity by means of a single MR contrast medium: dependence on concentration and pulse sequence.
To determine whether gadodiamide injection can provide sufficient enhancement on both T1- and T2-weighted spin-echo magnetic resonance (MR) images of the heart and skeletal muscles, anesthetized rats were divided into five groups. Groups 1-3 received 0.1 (n = 9), 0.3 (n = 8), or 0.5 (n = 8) mmol/kg gadodiamide injection, respectively, and T1-weighted images were obtained. Groups 4 and 5 received 0.3 or 0.5 mmol/kg gadodiamide injection, respectively, and T2-weighted images were obtained. Gadolinium concentration was measured in myocardium by means of inductively coupled plasma-atomic emission spectroscopy. On T1-weighted images, the 0.1 and 0.3 mmol/kg doses produced a dose-dependent increase in myocardial signal intensity proportional to gadolinium concentration. A dose of 0.5 mmol/kg, which correlated with higher gadolinium concentration and did not further increase myocardial signal intensity, prolonged the imaging window. On T2-weighted images, the 0.3 mmol/kg dose caused a transient decrease in myocardial signal intensity; the 0.5 mmol/kg dose produced greater and persistent loss of signal intensity. In conclusion, the changes in signal intensity induced by gadodiamide injection depend on the dose, pulse sequence, and type of tissue.


Total Analytical Error and Measurement Uncertainty for Analytical Performance Evaluation and Determination of Gray Zones of Glucose Critical Value Limits.
Total analytical error (TAE) and measurement uncertainty (MU) are important approaches to evaluating and improving the quality of measurement procedures. This study evaluates glucose analytical performance (AP) according to TAE and MU and calculates gray zones of glucose critical value limits. Using TAE and MU values, AP was evaluated according to 5 different analytical performance specifications (APS) and the gray zones of critical value limits were calculated. The number of patients in these zones was compared. TAE was higher than MU at all 3 levels. The AP for the low glucose level was poor. The number of patients in the gray zones was statistically higher in the TAE groups than in the MU groups (P < .05). TAE and MU values can be used to evaluate the AP of glucose measurement as well as to evaluate the compliance of patient results with decision limits by creating gray zones.


Ethical Maxims for a Marginally Inhabitable Planet.
Bioethics has largely neglected the Anthropocene and its ethical challenges. This essay asks which ethical norms will serve us well in the face of the coming climate catastrophe. It sketches the climate changes likely for the year 2031 and offers six adaptive maxims, drawn from bioethics work in ICUs and hospices, to guide us through the devastation and transition following environmental and social collapse. These six maxims are: work hard to grasp the immensity of the change; cultivate radical hope; have a line in the sand; appreciate the astonishing opportunity of life at this time; train your body and mind; and act for the future generations of all species. Because we are already in an environmental collapse and the beginnings of social collapse, these maxims are relevant today as well as for the future.


Experimental and Numerical Investigation of an Axial Rotary Blood Pump.
Left ventricular assist devices (LVADs) have become a standard therapy for patients with severe heart failure. As low blood trauma in LVADs is important for a good clinical outcome, the assessment of the fluid loads inside the pump is critical. More specifically, the flow features on the surfaces where the interaction between blood and artificial material happens is of great importance. Therefore, experimental data for the near-wall flows in an axial rotary blood pump were collected and directly compared to computational fluid dynamic results. For this, the flow fields based on unsteady Reynolds-averaged Navier-Stokes simulations-computational fluid dynamics (URANS-CFD) of an axial rotary blood pump were calculated and compared with experimental flow data at one typical state of operation in an enlarged model of the pump. The focus was set on the assessment of wall shear stresses (WSS) at the housing wall and rotor gap region by means of the wall-particle image velocimetry technique, and the visualization of near-wall flow structures on the inner pump surfaces by a paint erosion method. Additionally, maximum WSS and tip leakage volume flows were measured for 13 different states of operation. Good agreement between CFD and experimental data was found, which includes the location, magnitude, and direction of the maximum and minimum WSS and the presence of recirculation zones on the pump stators. The maximum WSS increased linearly with pressure head. They occurred at the upstream third of the impeller blades and exceeded the critical values with respect to hemolysis. Regions of very high shear stresses and recirculation zones could be identified and were in good agreement with simulations. URANS-CFD, which is often used for pump performance and blood damage prediction, seems to be, therefore, a valid tool for the assessment of flow fields in axial rotary blood pumps. The magnitude of maximum WSS could be confirmed and were in the order of several hundred Pascal.


Special focus. Pain.
This Part has explored some of the epidemiological factors that affect pain. The differences between acute and chronic pain have been discussed in terms of disease process, anatomy and physiology and associated signs and symptoms.


Mutations in the extracellular protein secretion pathway genes (eps) interfere with rugose polysaccharide production in and motility of Vibrio cholerae.
Vibrio cholerae is the causal organism of the diarrheal disease cholera. The rugose variant of V. cholerae is associated with the secretion of an exopolysaccharide. The rugose polysaccharide has been shown to confer increased resistance to a variety of agents, such as chlorine, bioacids, and oxidative and osmotic stresses. It also promotes biofilm formation, thereby increasing the survival of the bacteria in the aquatic environments. Here we show that the extracellular protein secretion system (gene designated eps) is involved directly or indirectly in the production of rugose polysaccharide. A TnphoA insertion in epsD gene of the eps operon abolished the production of rugose polysaccharide, reduced the secretion of cholera toxin and hemolysin, and resulted in a nonmotile phenotype. We have constructed defined mutations of the epsD and epsE genes that affected these phenotypes and complemented these defects by plasmid clones of the respective wild-type genes. These results suggest a major role for the eps system in pathogenesis and environmental survival of V. cholerae.


Trends in national family planning programs, 1999, 2004 and 2009.
National family planning programs in the developing world vary greatly in strength and coverage, and in the nature of their outreach. Periodic measures of their types and levels of effort have been conducted since 1972. In 2009, expert observers in 81 developing countries completed a questionnaire that assessed 31 features of family planning program effort, as well as other program measures. Data were compared with those from similar surveys fielded in 1999 and 2004 to examine trends over the decade. On average, national family planning programs improved their effort levels slightly from 1999 to 2004, and again from 2004 to 2009. The average effort in 2009, however, was only about half of maximum; component scores for service measures and for measures of access to contraception did not reach 50% of maximum in 2009. Differences by region and by effort quartile emerged in subgroup analyses. Overall, improvement of women's health and avoidance of unwanted births were the most important program justifications, ranking higher than fertility reduction, economic development or reduction of childbearing among unmarried adolescents. The subgroups given the most emphasis were poor and rural populations, while unmarried youth and postabortion women received the least. Among external influences, changes in donor and domestic funding were seen as more unfavorable than the merging of family planning programs into broader health services. Average program effort levels have been sustained, although deficiencies remain. Countries have not yet ensured universal access to a variety of contraceptive choices, through various channels, for both short- and long-term methods.


Epidemiological designs for vaccine safety assessment: methods and pitfalls.
Three commonly used designs for vaccine safety assessment post licensure are cohort, case-control and self-controlled case series. These methods are often used with routine health databases and immunisation registries. This paper considers the issues that may arise when designing an epidemiological study, such as understanding the vaccine safety question, case definition and finding, limitations of data sources, uncontrolled confounding, and pitfalls that apply to the individual designs. The example of MMR and autism, where all three designs have been used, is presented to help consider these issues.


[Diagnosis and treatment of erectile dysfunctions].
Erectile dysfunction (ED) is the most frequent form of male sexual dysfunctions. The incidence is not known. Approximately 10% of men suffer from ED. Aging is concomitted by an exponential increase in the occurrence of erectile dysfunctions. Some groups of men (suffering from diabetes, alcoholism, ICHS, renal diseases) yield several times higher values of their occurrence. In general, ED (formerly impotentio coeundi) can be defined as an inability to achieve erection and maintain it for an appropriately long period enabling sexual intercourse. ETIOPATHOGENESIS: The etiology includes psychological, neurological, arterial, sinusoidal, venous and hormonal factors which participate in erectile function. ED arises predominantly in consequence of impaired haemodynamics of the penis. It develops either due to insufficient blood inflow into the erectile bodies or due to their excessive drainage. The traumatic lesions of penile vessels are less frequent. Drugs and medicaments play a significant role among etiologic factors causing erectile dysfunctions. No regulations and principles are generally valid in coincidence with examination of patients with erectile dysfunction. The signs of neurologic, hormonal and vascular defects are detected. An objective method of examination of erectile capacity of the penis resides in the monitoring of penile nocturnal tumescensions. The examination of arterial system of the penis provides information on the perfusion pressure and blood flow in the cavernous arteries. The vascular structures of the penis and their functions can be evaluated by means of duplex ultrasonography and flowmetry. The quality to arterial supply to erectile bodies is evaluated by dynamic examination of arteries prior to and after intracavernous application of vasoactive substances. The functional state and size of venous leak from the cavernous bodies are evaluated by dynamic cavernosometry. The application of vasoactive substances meant a significant contribution to the diagnosis establishment and therapy of erectile dysfunctions. They have a common feature which resides in their myorelaxation effect and thus in their ability to induce erection by means of relaxation of the smooth muscles of cavernous bodies. Intracavernous application of vasoactive substances is the mostly spread means of therapy of erectile dysfunction as a whole, frequently with no regard to the etiology. Surgical therapy of vasculogenous impotence is based on knowledge concerning the impact of vascular lesions on the haemodynamics of erectile function of the penis. the revascularisation operations are aimed at the regeneration of normal haemodynamic conditions in the penis. Sexual life is currently considered as a proportion of life of individuals. The physicians therefore have to seek ways of how to help the patients who due to acquired erectile dysfunctions are handicapped in the establishment of family harmony and sexual life. (Ref. 31).


Sucrose Phosphate Is Not Transported into Vacuoles or Tonoplast Vesicles from Red Beet (Beta vulgaris) Hypocotyl.
Tonoplast vesicles and vacuoles isolated from red beet (Beta vulgaris L.) hypocotyl accumulated externally supplied [(14)C]sucrose but not [(14)C]sucrose phosphate despite the occurrence of sucrose phosphate phosphohydrolytic activity in the vacuole. The activities of sucrose synthase and sucrose phosphate synthase in whole cell extracts were 960 and 30 nanomoles per milligram protein per minute, respectively; whereas, no sucrose synthesizing activity was measured in tonoplast preparations. The results obtained in this investigation are incompatible with the involvement of sucrose phosphate synthase in the process of sucrose synthesis and accumulation in the storage cells of red beet.


Antioxidant Activity with Increased Endogenous Levels of Vitamin C, E and A Following Dietary Supplementation with a Combination of Glutathione and Resveratrol Precursors.
The effects of two different dietary supplements on the redox status of healthy human participants were evaluated. The first supplement (GluS, Glutathione Synthesis) contains the precursors for the endogenous synthesis of glutathione and the second (GluReS, Glutathione and Resveratrol Synthesis) contains in addition polydatin, a precursor of resveratrol. To assess the influence of GluS and GluReS on the redox status, ten thiol species and three vitamins were measured before (t0) and after 8 weeks (t1) of dietary supplementation. An inflammatory marker, neopterin, was also assessed at the same time points. Both supplements were highly effective in improving the redox status by significantly increasing the reduced-glutathione (GSH) content and other reduced thiol species while significantly decreasing the oxidized species. The positive outcome of the redox status was most significant in the GluRes treatment group which also experienced a significant reduction in neopterin levels. Of note, the endogenous levels of vitamins C, E and A were significantly increased in both treatment groups, with best results in the GluReS group. While both dietary supplements significantly contributed to recognized antioxidant and anti-inflammatory outcomes, the effects of GluReS, the combination of glutathione and resveratrol precursors, were more pronounced. Thus, dietary supplementation with GluReS may represent a valuable strategy for maintaining a competent immune status and a healthy lifespan.


Social and Biological Transgenerational Underpinnings of Adolescent Pregnancy.
Adolescent pregnancy (occurring < age 20) is considered a public health problem that creates and perpetuates inequities, affecting not only women, but societies as a whole globally. The efficacy of current approaches to reduce its prevalence is limited. Most existing interventions focus on outcomes without identifying or addressing upstream social and biological causes. Current rhetoric revolves around the need to change girls' individual behaviours during adolescence and puberty. Yet, emerging evidence suggests risk for adolescent pregnancy may be influenced by exposures taking place much earlier during development, starting as early as gametogenesis. Furthermore, pregnancy risks are determined by complex interactions between socio-structural and ecological factors including housing and food security, family structure, and gender-based power dynamics. To explore these interactions, we merge three complimentary theoretical frameworks: "Eco-Social", "Life History" and "Developmental Origins of Health and Disease". We use our new lens to discuss social and biological determinants of two key developmental milestones associated with age at first birth: age at girls' first menstrual bleed (menarche) and age at first sexual intercourse (coitarche). Our review of the literature suggests that promoting stable and safe environments starting at conception (including improving economic and social equity, in addition to gender-based power dynamics) is paramount to effectively curbing adolescent pregnancy rates. Adolescent pregnancy exacerbates and perpetuates social inequities within and across generations. As such, reducing it should be considered a key priority for public health and social change agenda.


The 17-kDa sheath protein in enamel proteins induces cementum regeneration in experimental cavities created in a buccal dehiscence model of dogs.
Commercially available enamel proteins, such as Emdogain, are clinically used for periodontal regeneration. However, the real mechanisms behind the bioactivities of enamel proteins is still unclear, as enamel proteins have multicomponents. The purpose of this in vivo study was to identify the cementum regeneration-promoting factor in enamel proteins that is clinically used for periodontal regeneration to induce cementum-promotive and osteopromotive activities. Cementum regeneration, which is an important part of periodontal regeneration, was examined in experimental cavities prepared on a buccal dehiscence model of dogs. The purification of enamel protein with cementum regeneration activity was carried out by gel filtration and ion exchange chromatographies of newly formed secretory enamel. Cementum regeneration activity was found in the aggregate comprising 13-17-kDa sheath proteins along with a small amount of amelogenins, found in the newly formed secretory enamel. In these proteins, cementum regeneration activity was detected upon application of the 17-kDa sheath protein, but not by other lower molecular-weight sheath proteins and amelogenins. However, the purified 17-kDa sheath protein induced cementum regeneration activity only in a small area, although the regenerated cementum was thick. The activity of the 17-kDa sheath protein was believed not to have been a result of contamination by growth factors such as transforming growth factor-beta1 (TGF-beta1) found in the enamel protein, as the application of TGF-beta1 induced weak cementum regeneration activity. It is concluded that the 17-kDa sheath protein itself exhibits cementum regeneration activity, although other factors may be needed to demonstrate its full ability.


2-O-Methylmagnolol, a Magnolol Derivative, Suppresses Hepatocellular Carcinoma Progression via Inhibiting Class I Histone Deacetylase Expression.
Magnolia officinalis is widely used in Southeast Asian countries for the treatment of fever, headache, diarrhea, and stroke. Magnolol is a phenolic compound extracted from M. officinalis, with proven antibacterial, antioxidant, anti-inflammatory, and anticancer activities. In this study, we modified magnolol to synthesize a methoxylated derivative, 2-O-methylmagnolol (MM1), and investigated the use of MM1, and magnolol in the treatment of liver cancer. We found that both magnolol and MM1 exhibited inhibitory effects on the growth, migration, and invasion of hepatocellular carcinoma (HCC) cell lines and halted the cell cycle at the G1 phase. MM1 also demonstrated a substantially better tumor-suppressive effect than magnolol. Further analysis suggested that by inhibiting class I histone deacetylase expression in HCC cell lines, magnolol and MM1 induced p21 expression and p53 activation, thereby causing cell cycle arrest and inhibiting HCC cell growth, migration, and invasion. Subsequently, we verified the significant tumor-suppressive effects of magnolol and MM1 in an animal model. Collectively, these findings demonstrate the anti-HCC activities of magnolol and MM1 and their potential for clinical use.


[Ultrasound-guided costoclavicular block as an alternative for upper limb anesthesia in obese patients].
Costoclavicular brachial plexus block is an anesthesia performed through the infraclavicular route described in the literature as a safe and effective route for upper limb anesthesia distal to the elbow. The following report describes the case of a patient whose traditional plexus blocking techniques presented ultrasound visualization difficulty, but the costoclavicular approach was easy to visualize for anesthetic blockade. A grade 3 obese patient scheduled for repair of left elbow fracture and dislocation. Ultrasound examination revealed a distorted anatomy of the supraclavicular region and the axillary region with skin lesions, which made it impossible to perform the blockade in these regions. It was decided to perform an infraclavicular plexus block at the costoclavicular space, where the brachial plexus structures are more superficial and closer together, supported by a muscular structure, lateral to all adjacent vascular structures and with full view of the pleura. The anesthetic block was effective to perform the procedure with a single injection and uneventfully. Costoclavicular brachial plexus block is a good alternative for upper limb anesthesia distal to the elbow, being a safe and effective option for patients who are obese or have other limitations to the use of other upper limb blocking techniques.


Erratum: Using a Chemical Biopsy for Graft Quality Assessment.
An erratum was issued for: Using a Chemical Biopsy for Graft Quality Assessment. One of the affiliations was updated. The third affiliation was updated from: Department of Transplantation and General Surgery, University Hospital, University of Nicolaus Copernicus Torun" to: Department of Transplantology and General Surgery, Collegium Medicum in Bydgoszcz, Antoni Jurasz University Hospital No. 1 in Bydgoszcz, Nicolaus Copernicus University in Torun, Bydgoszcz, Poland.


In vitro activation of human suppressor cells: relative quantitation and specificity of suppressor cells generated in primary and secondary mixed lymphocyte cultures.
Human suppressor cells activated in primary and secondary mixed lymphocyte cultures (MLC) were quantitatively assessed for their ability to suppress the proliferative response of fresh responding lymphocytes to the original sensitizing (specific suppression) and third party, unrelated (non-specific suppression) alloantigens. Maximal levels of both specific and non-specific suppressor cell activities generated in primary MLC were found in the population of cells harvested on day 7 which corresponded to the peak of proliferation in bulk culture and decayed upon further culture reaching a nadir concomitant with the end of proliferation in primary bulk MLC. Maximal reactivation of the suppressor cells was accomplished by restimulation in secondary MLC with the original sensitizing alloantigens. Assessment of suppressor cell activity revealed that specific rechallenge with the original stimulating alloantigens in secondary MLC resulted in significant increases in both the levels of suppressor cell activity and in the specificity of action of the suppressor cell population as compared to suppressor cells harvested from primary MLC on day 7. Both primary and secondary MLC activated suppressor cells were capable of suppressing the induction of cytolytic lymphocytes in primary MLC. Suppression was not simply the result of altered kinetics of the fresh micro MLC response.


Role of Metal Vacancies in the Mechanism of Thermal Degradation of InGaN Quantum Wells.
In this work, we study the thermal degradation of In-rich InxGa1-xN quantum wells (QWs) and propose explanation of its origin based on the diffusion of metal vacancies. The structural transformation of the InxGa1-xN QWs is initiated by the formation of small initial voids created due to agglomeration of metal vacancies diffusing from the layers beneath the QW. The presence of voids in the QW relaxes the mismatch stress in the vicinity of the void and drives In atoms to diffuse to the relaxed void surroundings. The void walls enriched in In atoms are prone for thermal decomposition, what leads to a subsequent disintegration of the surrounding lattice. The phases observed in the degraded areas of QWs contain voids partly filled with crystalline In and amorphous material, surrounded by the rim of high In-content InxGa1-xN or pure InN; the remaining QW between the voids contains residual amount of In. In the case of the InxGa1-xN QWs deposited on the GaN layer doped to n-type or on unintentionally doped GaN, we observe a preferential degradation of the first grown QW, while doping of the underlying GaN layer with Mg prevents the degradation of the closest InxGa1-xN QW. The reduction in the metal vacancy concentration in the InxGa1-xN QWs and their surroundings is crucial for making them more resistant to thermal degradation.


A simplified observation tool for residents in the outpatient clinic.
The Accreditation Council for Graduate Medical Education promotes direct observation of residents as a key assessment tool for competency in patient care, professionalism, and communication skills. Although tools exist, validity and reliability have not been demonstrated for most, and many tools may have limited feasibility because of time constraints and other reasons. We conducted a study to measure feasibility of a simplified observation tool to evaluate these competencies and provide timely feedback. In the pediatric resident continuity clinic of a large children's hospital, we used a direct observation form with a 3-point scale for 16 items in the domains of patient care, professionalism, and communication skills. The form was divided by portion of visit, with specific items mapped to 1 or more of the competencies, and was used to provide direct oral feedback to the resident. Faculty and residents completed surveys rating the process (ease of use, satisfaction, and self-assessed usefulness) on a 5-point Likert scale. The study encompassed 89 surveys completed by attending physicians; 98% (87 of 89) of the time the form was easy to use, 99% (88) of the time its use did not interfere with patient flow, and 93% (83) of the observations provided useful information for resident feedback. Residents completed 70 surveys, with the majority (69%, 48) reporting they were comfortable about being observed by an attending physician; 87% (61) thought that direct observation did not significantly affect their efficiency. Ninety-seven percent of the time (68) residents reported that direct observation provided useful feedback. The data suggest the form was well-received by both faculty and residents, and enabled attending physicians to provide useful feedback.


Temperature Dependence of Photosynthesis in Agropyron smithii Rydb. : III. Responses of Protoplasts and Intact Chloroplasts.
Protoplasts and intact chloroplasts isolated from Agropyron smithii Rybd. were utilized in an effort to determine the limiting factor(s) for photosynthesis at supraoptimal temperatures. Saturated CO(2)-dependent O(2) evolution had a temperature optimum of 35 degrees C for both protoplasts and intact chloroplasts. A sharp decline in activity was observed as assay temperature was increased above 35 degrees C, and at 45 degrees C only 20% of the maximal rate remained. The temperature optimum for 3-phosphoglycerate reduction by intact chloroplasts was 35 degrees C. Above this temperature, 3-phosphoglycerate reduction was more stable than CO(2)-dependent O(2) evolution. Reduction of nitrite in coupled intact chloroplasts had a temperature optimum of 40 degrees C with only slight variation in activity between 35 degrees C and 45 degrees C. Reduction of nitrite in uncoupled chloroplasts had a temperature optimum of 40 degrees C, but increasing the assay temperature to 45 degrees C resulted in a complete loss of activity. Reduction of p-benzoquinone by protoplasts and intact chloroplasts had a temperature optimum of 32 degrees C when measured in the presence of dibromothymoquinone. This photosystem II activity exhibited a strong inhibition of O(2) evolution as assay temperature increased above the optimum. It is concluded that, below the temperature optimum, ATP and reductant were not limiting photosynthesis in these systems or intact leaves. Above the temperature optimum, photosynthesis in these systems is limited in part by the phosphorylation potential of the stromal compartment and not by the available reductant.


Lower lip pits in a patient with van der Woude syndrome.
van der Woude syndrome (VWS) is a congenital malformation characterized by lower lip pits with or without cleft lip or cleft palate. It is an autosomal-dominant inherited disorder with variable expression in clinical manifestation. Microdeletion in chromosome bands 1q32-q41 and recently identified mutation in interferon regulatory factor 6 gene (IRF6) have been reported to cause VWS. We report a case of VWS with lower lip pits as its main clinical manifestation without associated cleft in lip or palate. No mutation or deletion was found in the IRF6 gene or promoter site, indicating the heterogeneity of this defect.


Continuous Renal Replacement Therapy in Preterm Infants.
Despite the increasing use of continuous renal replacement therapy (CRRT) in the neonatal intensive care unit (NICU), few studies have investigated its use in preterm infants. This study evaluated the prognosis of preterm infants after CRRT and identified risk factors of mortality after CRRT. A retrospective review was performed in 33 preterm infants who underwent CRRT at the NICU of Samsung Medical Center between 2008 and 2017. Data of the demographic characteristics, predisposing morbidity, cardiopulmonary function, and CRRT were collected and compared between surviving and non-surviving preterm infants treated with CRRT. Univariable and multivariable analyses were performed to identify factors affecting mortality. Compared with the survivors, the non-survivors showed younger gestational age (29.3 vs. 33.6 weeks), lower birth weight (1359 vs. 2174 g), and lower Apgar scores at 1 minute (4.4 vs. 6.6) and 5 minutes (6.5 vs. 8.6). At the initiation of CRRT, the non-survivors showed a higher incidence of inotropic use (93% vs. 40%, p=0.017) and fluid overload (16.8% vs. 4.0%, p=0.031). Multivariable analysis revealed that fluid overload >10% at CRRT initiation was the primary determinant of mortality after CRRT in premature infants, with an adjusted odds ratio of 14.6 and a 95% confidence interval of 1.10-211.29. Our data suggest that the degree of immaturity, cardiopulmonary instability, and fluid overload affect the prognosis of preterm infants after CRRT. Preventing fluid overload and earlier initiation of CRRT may improve treatment outcomes.


Evaluation of the Norwegian version of the Adolescent Stress Questionnaire (ASQ-N): factorial validity across samples.
In spite of the potential significance of stressors, the past decades have yielded only limited and incremental progress in the field of the development of valid and reliable stress inventories for adolescents. The Adolescent Stress Questionnaire (ASQ-N) was developed to address the domain of stressors specific to adolescent experience. The present study reports an evaluation of factorial validity, as well as the construct validity of the Norwegian version of the Adolescent Stress Questionnaire (ASQ-N) across two samples, with the use of confirmatory factor analysis (CFA). Gender and age differences on the ASQ-N sub-dimensions are also evaluated. The CFA supported a seven-factor structure, where all sub-dimensions showed adequate internal consistency. The sub-dimensions were correlated positively with measures of depression and anxiety, and were correlated negatively with self-esteem, supporting the construct validity of the ASQ-N. Significant gender differences in self-reported adolescent stress were found in five of the seven scales, where girls had higher mean scores than boys. The correlation between each stress scale and age was weak, with significant correlations found in four of the seven scales. It is suggested that the ASQ-N is a measure of adolescent stress that is adequate for the research context, as well as for clinical investigation.


Expression of testis angiotensin-converting enzyme is mediated by a cyclic AMP responsive element.
Testis angiotensin-converting enzyme (testis ACE), an ACE isozyme that plays an important role in male fertility, is transcribed from a unique promotor active only in developing spermatids. In vitro analysis suggests the importance of a cyclic AMP response element (CRE)-like region within the testis ACE promoter, and similar DNA motifs are important in the expression of a variety of testis-specific genes. In the present study, we examined the effects of mutations in the CRE-like element on testis ACE promoter activity in vivo using transgenic mice. Disruption of this element reduced reporter gene expression to near background levels. In contrast, conversion of the CRE-like element to a consensus CRE-binding site resulted in high level expression of the reporter gene specifically in the testis. These experiments prove that the CRE-like element is essential for testis ACE promoter activity, although it does not appear to be responsible for its tissue specificity. These data provide insight into how a phenotypically differentiated tissue, ie, male gem cells, regulate tissue-specific gene expression.


Strong location dependent surface enhanced Raman scattering on individual gold semishell and nanobowl particles.
We demonstrate strong spatial localization of SERS on single symmetry-reduced gold semishell and nanobowl particles. A ∼30 nm carbon nanoparticle acts as a Raman reporter and is placed on different locations on a single semishell or nanobowl by e-beam induced deposition method, and remarkably different SERS intensities are observed.