Structural and mechanical characterization of nanoclay-reinforced agarose nanocomposites.
Nanoclay-reinforced agarose nanocomposite films with varying weight concentration ranging from 0 to 80% of nanoclay were prepared, and structurally and mechanically characterized. Structural characterization was carried out by transmission electron microscopy (TEM), scanning electron microscopy (SEM) and atomic force microscopy (AFM). It was found that pre-exfoliated clay platelets were re-aggregated into particles (stacked platelets) during the composite preparation process. Each particle consists of approximately 11 clay platelets stacked together. The nanoclay particles were homogeneously dispersed within an agarose matrix. The clay particles were oriented with a slight preference of the stacked platelets being parallel to the composite film's surface within the low loading composite films. Mechanical properties of the nanocomposite films were measured by tensile, three-point bending and nanoindentation tests. Mechanical testing results show that nanoclays provide a significant enhancement to the tensile modulus and strength. For the 60% clay nanocomposite, its elastic modulus increases up to 21.4 GPa, which is five times higher than that of the agarose matrix. Based upon the structural characterization, a theoretical model has been developed to simulate the mechanical behaviour of the nanoclay-reinforced polymer composites.


Update of transcatheter valve treatment.
Transcatheter valve implantation or repair has been a very promising approach for the treatment of valvular heart diseases since transcatheter aortic valve implantation (TAVI) was successfully performed in 2002. Great achievements have been made in this field (especially TAVI and transcatheter mitral valve repair--MitraClip system) in recent years. Evidence from clinical trials or registry studies has proved that transcatheter valve treatment for valvular heart diseases is safe and effective in surgical high-risk or inoperable patients. As the evidence accumulates, transcatheter valve treatment might be an alterative surgery for younger patients with surgically low or intermediate risk valvular heart diseases in the near future. In this paper, the updates on transcatheter valve treatment are reviewed.


[Percutaneous tracheotomy: personal contributions to the technique].
We developed within our service of intensive care a hybrid procedure combining the advantages of the techniques of Caglia and Fantoni. Ventilation downstream from the site of dilatation, thanks to a longer tracheal tube of small diameter, ensures an optimal spirometry and reduces to a minimum the time of apnea. It decreases the risks of per-operational subcutaneous emphysema. A system of camera video assembled on a flexible fibroscope allows a direct vision on television screen. The operator can, constantly, visualise his gesture in one glance, in real time. Such an approach increases the security and the effectiveness of the method. The procedure remains nevertheless simple and does not require a thorough experience in percutaneous dilatational tracheotomy.


Human Factors Integration in Robotic Surgery.
Using the example of robotic-assisted surgery (RAS), we explore the methodological and practical challenges of technology integration in surgery, provide examples of evidence-based improvements, and discuss the importance of systems engineering and clinical human factors research and practice. New operating room technologies offer potential benefits for patients and staff, yet also present challenges for physical, procedural, team, and organizational integration. Historically, RAS implementation has focused on establishing the technical skills of the surgeon on the console, and has not systematically addressed the new skills required for other team members, the use of the workspace, or the organizational changes. Human factors studies of robotic surgery have demonstrated not just the effects of these hidden complexities on people, teams, processes, and proximal outcomes, but also have been able to analyze and explain in detail why they happen and offer methods to address them. We review studies on workload, communication, workflow, workspace, and coordination in robotic surgery, and then discuss the potential for improvement that these studies suggest within the wider healthcare system. There is a growing need to understand and develop approaches to safety and quality improvement through human-systems integration at the frontline of care.Precis: The introduction of robotic surgery has exposed under-acknowledged complexities of introducing complex technology into operating rooms. We explore the methodological and practical challenges, provide examples of evidence-based improvements, and discuss the implications for systems engineering and clinical human factors research and practice.


A continuous enzyme-coupled assay for triphosphohydrolase activity of HIV-1 restriction factor SAMHD1.
The development of deoxynucleoside triphosphate (dNTP)-based drugs requires a quantitative understanding of any inhibition, activation, or hydrolysis by off-target cellular enzymes. SAMHD1 is a regulatory dNTP-triphosphohydrolase that inhibits HIV-1 replication in human myeloid cells. We describe here an enzyme-coupled assay for quantifying the activation, inhibition, and hydrolysis of dNTPs, nucleotide analogues, and nucleotide analogue inhibitors by triphosphohydrolase enzymes. The assay facilitates mechanistic studies of triphosphohydrolase enzymes and the quantification of off-target effects of nucleotide-based antiviral and chemotherapeutic agents.


LncRNA HOTAIRM1 promotes osteogenesis by controlling JNK/AP-1 signalling-mediated RUNX2 expression.
Mesenchymal stem cells (MSCs) have potential ability to differentiate into osteocytes in response to in vitro specific induction. However, the molecular basis underlying this biological process remains largely unclear. In this study, we identify lncRNA HOTAIRM1 as a critical regulator to promote osteogenesis of MSCs. Loss of HOTAIRM1 significantly inhibits the calcium deposition and alkaline phosphatase activity of MSCs. Mechanistically, we find that HOTAIRM1 positively modulates the activity of JNK and c-Jun, both of which are widely accepted as crucial regulators of osteogenic differentiation. More importantly, c-Jun is found to be functionally involved in the regulation of RUNX2 expression, a master transcription factor of osteogenesis. In detail, c-Jun can help recruit the acetyltransferase p300 to RUNX2 promoter, facilitating acetylation of histone 3 at K27 site, therefore epigenetically activating RUNX2 gene transcription. In summary, this study highlights the functional importance of HOTAIRM1 in regulation of osteogenesis, and we characterize HOTAIRM1 as a promising molecular target for bone tissue repair and regeneration.


Transcriptional repression by XPc1, a new Polycomb homolog in Xenopus laevis embryos, is independent of histone deacetylase.
The Polycomb group (Pc-G) genes encode proteins that assemble into complexes implicated in the epigenetic maintenance of heritable patterns of expression of developmental genes, a function largely conserved from Drosophila to mammals and plants. The Pc-G is thought to act at the chromatin level to silence expression of target genes; however, little is known about the molecular basis of this repression. In keeping with the evidence that Pc-G homologs in higher vertebrates exist in related pairs, we report here the isolation of XPc1, a second Polycomb homolog in Xenopus laevis. We show that XPc1 message is maternally deposited in a translationally masked form in Xenopus oocytes, with XPc1 protein first appearing in embryonic nuclei shortly after the blastula stage. XPc1 acts as a transcriptional repressor in vivo when tethered to a promoter in Xenopus embryos. We find that XPc1-mediated repression can be only partially alleviated by an increase in transcription factor dosage and that inhibition of deacetylase activity by trichostatin A treatment has no effect on XPc1 repression, suggesting that histone deacetylation does not form the basis for Pc-G-mediated repression in our assay.


Crystal structure of di-μ-benzato-κ(4) O:O'-bis-[aqua-(benzato-κO)(benzato-κ(2) O,O')(2,2':6',2''-terpyridine-κ(3) N,N',N'')europium(III)]-benzoic acid (1/2).
The title compound, [Eu2(C7H5O2)6(C15H11N3)2(H2O)2]·2C7H6O2, is a co-crystalline compound containing a dinuclear Eu(III) coordination complex with inversion symmetry co-crystallized with benzoic acid in a 1:2 ratio. The Eu(3+) ions within the dimer are nine-coordinate, containing one tridentate terpyridine, one water, and four benzoate ions, two of which bridge the Eu(3+) ions. Of the four benzoate ligands coordinating to each Eu(3+) position, three distinct coordination modes [monodentate, bidentate-chelating, and bidentate-bridging (twice)] are observed. Within the crystal, there are two additional uncoordinating benzoic acid mol-ecules per dinuclear complex. Within the dimer, the water bound to each Eu(3+) ion participates in intra-molecular hydrogen bonding with a coordinating benzoate. Additionally, the carb-oxy-lic acid group on the benzoic acid participates in inter-molecular hydrogen bonding with a benzoate ligand bound to the dimer complex.


Rat anterior pituitary neuropeptides following chronic prolactin manipulation: a combined radioimmunoassay and mRNA study.
Prolactin secretion is highly regulable, and the possibility exists that there are local intrapituitary factors controlling prolactin secretion. Recently, the neuropeptides vasoactive intestinal peptide (VIP), galanin and substance P (SP) have been co-localized to the lactotroph in the female rat. We investigated the effects of alterations in prolactin status in vivo on pituitary and hypothalamic expression of these peptides by specific radioimmunoassays and mRNA analysis. In the anterior pituitary, following haloperidol treatment, the contents of both VIP and galanin were suppressed to below detectable levels. Similarly, after bromocriptine treatment, the content of VIP was decreased to below the detection limit of the assay while galanin (14.2 +/- 1.3 vs control 21.0 +/- 2.1 fmol/mg, P less than 0.05) also showed a significant reduction. The levels of VIP mRNA and galanin mRNA in these groups showed the same qualitative change as their respective peptides. Concurrent treatment with high-dose oestrogen modified the VIP peptide response to bromocriptine (1368.7 +/- 149.2 vs bromocriptine 843.4 +/- 82.7 fmol/mg, P less than 0.05) but not to haloperidol. Oestrogen-induced decreases in galanin content were not influenced by either treatment. The pituitary content of SP showed a fall after oestrogen treatment (1.1 +/- 0.01 vs control 6.4 +/- 0.8 fmol/mg, P less than 0.05) which was not significantly altered by either bromocriptine or haloperidol. Likewise, SP mRNA levels in the pituitary were decreased by 90% following oestrogen treatment. Hypothalamic expression of these peptides did not change with any of the treatments.(ABSTRACT TRUNCATED AT 250 WORDS)


Inspired by Mary Jane? Mechanisms underlying enhanced creativity in cannabis users.
Previous research suggests cannabis may enhance some aspects of creativity, although the results remain somewhat equivocal. Moreover, it is unclear whether differences in cannabis users' personalities may account for any potentially beneficial effects of cannabis on creativity. This study was designed to examine whether sober cannabis users demonstrate superior self-reported and objective creativity test performance relative to non-users, and to determine whether any of the Big 5 personality domains underlie these effects. A sample of sober cannabis users (n=412) and non-users (n=309) completed measures of cannabis consumption, personality, self-reported and objective creativity. Relative to non-users, sober cannabis users self-reported higher creativity, and performed significantly better on a measure of convergent thinking. Controlling for cannabis users' higher levels of openness to experience abolished these effects. Therefore, while cannabis users appear to demonstrate enhanced creativity, these effects are an artifact of their heightened levels of openness to experience.


Shaker K+ channel T1 domain self-tetramerizes to a stable structure.
The potassium channel T1 domain plays an important role in the regulated assembly of subunit proteins. We have examined the assembly properties of the Shaker channel T1 domain to determine if the domain can self-assemble, the number of subunits in a multimer, Ns and the mechanism of assembly. High pressure liquid chromatography (HPLC) size exclusion chromotography (SEC) separates T1 domain proteins into two peaks. By co-assembly assays, these peaks are identified to be a high molecular weight assembled form and a low molecular weight monomeric form. To determine the Ns of the assembled protein peak on HPLC SEC, we first cross-linked the T1 domain proteins and then separated them on HPLC. Four evenly spaced bands co-migrate with the assembled protein peak; thus, the T1 domain assembles to form a tetramer. The absence of separate dimeric and trimeric peaks of assembled T1 domain protein suggests that the tetramer is the stable assembled state, most probably a closed ring structure.


Pack-year cigarette smoking affects the course of palmoplantar pustulosis.
Palmoplantar pustulosis (PPP) is a chronic inflammatory disease with poorly understood pathogenesis. The disease has a chronic course with improvements and exacerbations. Due to palmoplantar location, PPP has a severely negative impact on patients' quality of life. To identify demographic and environmental factors, concomitant diseases, medications, and bacterial factors which may affect the course of PPP. A total of 51 patients suffering from PPP took part in the study. They were classified according to the Palmoplantar Pustulosis Psoriasis Area and Severity Index (ppPASI) into 3 groups due to the severity of the disease. Pack-year of smoking score was established as a quotient of packets smoked every 24 h and the years of being addicted. Diagnosis of metabolic syndrome was based on the IDF criteria from 2009. Chlamydia trachomatis was detected using enzyme-linked immunosorbent assay (ELISA) technique, Staphylococcus aureus by the culture swabs. Contact hypersensitivity was examined with the T.R.U.E. test. Significantly high severity of PPP was observed in patients addicted to smoking with a high pack-year score (p = 0.03). Significantly lower intensity of PPP lesions was observed in patients treated with ibuprofen (p < 0.01). There was no correlation between severity of PPP skin lesions and comorbidities. Addiction to cigarette smoking and a high pack-year score aggravates the course of PPP. Treatment with ibuprofen can improve the course of the disease.


Atomically Dispersed Pt on Three-Dimensional Ordered Macroporous SnO2 for Highly Sensitive and Highly Selective Detection of Triethylamine at a Low Working Temperature.
Triethylamine (TEA) is a widely used volatile organic chemical, which is harmful and can cause headache, dizziness, and respiratory discomfort. Developing an efficient sensor to detect trace amounts of TEA is significant for industrial and healthcare monitoring. In this work, SnO2 with a three-dimensional ordered macroporous structure (3DOM) was prepared through a polymethylmethacrylate sphere template route. The TEA sensing performance of the 3DOM SnO2 was enhanced through Pt loading. Aberration-corrected high-angle annular dark-field scanning transmission electron microscopy images and X-ray absorption fine-structure analysis indicate that Pt on the 3DOM 0.20% Pt/SnO2 surface mainly exists in the state of atomic dispersion, which results in more active sites, higher Hall mobility and active oxygen contents, and lower response energy barriers. The 0.20% Pt/SnO2 sensor has a low operating temperature of 80 °C and a low limit of detection (0.32 ppb). Because of the uniform adsorption of TEA on the atomically dispersed Pt, the 3DOM Pt/SnO2 sensor exhibits high selectivity.


Changes in apical base sagittal relationship in Class II malocclusion treatment with and without premolar extractions: A systematic review and meta-analysis.
To evaluate the changes in apical base sagittal relationship in Class II treatment with and without premolar extractions. Controlled studies evaluating ANB angle changes after Class II Division 1 malocclusion treatment with or without premolar extractions were considered. Electronic databases (PubMed, Embase, Web of Science, Scopus, The Cochrane Library, Lilacs, and Google Scholar) without limitations regarding publication year or language were searched. Risk of bias was assessed with Risk Of Bias in Non-randomized Studies-of Interventions tool of the Cochrane Collaboration. Mean difference (MD) and 95% confidence interval (CI) were calculated from the random-effects meta-analysis. Subgroup and sensitivity analyses were also performed. Twenty-five studies satisfied the inclusion criteria and were included in the qualitative synthesis. Eleven nonextraction and only one extraction Class II treatment studies presented untreated Class II control group. Therefore, meta-analysis was performed only for the nonextraction protocol. In treated Class II nonextraction patients, the average of the various effects was a reduction in the ANB angle of 1.56° (95% CI: 1.03, 2.09, P < .001) compared with untreated Class II subjects. Class II malocclusions treated with two maxillary-premolar extractions and four-premolar extractions produced estimated mean reductions in ANB of -1.88° and -2.55°, respectively. However, there is a lack of low-risk-of-bias studies. According to the existing low quality evidence, the apical base sagittal relationship in nonextraction, two-maxillary and four-premolar extractions Class II treatments decreases -1.56°, 1.88° and 2.55°, respectively. Further studies are necessary to obtain more robust information.


Assessment of the performance of long-range-corrected density functionals for calculating the absorption spectra of silver clusters.
We assess the accuracy of several long-range-corrected (LC-) density functionals for the prediction of absorption spectra of silver clusters by time-dependent density functional theory. Several types of LC-functionals, with the exact Hartree-Fock exchange at long-range, are used: those applying the long-range correction to a standard GGA-type functional (LC-BP86, LC-ωPBE) or to a local meta-GGA functional (LC-M06L) and two global hybrid functionals (CAM-B3LYP and ωB97x). The spectra calculated with those density functionals are in good agreement with the recent accurate experimental measurements. We show that CAM-B3LYP and ωB97x are some of the most accurate functionals for evaluating the electronic excitation energies, while LC-M06L is more effective in reducing the occurrence of spurious states. The long-range correction appears to be essential in describing the absorption spectra of large clusters. The description of the plasmon-like band with LC functionals as transitions associated with excitations from s orbitals to s + p orbitals is in fairly good agreement with the classical interpretation as a collective excitation of valence s electrons.


Newer variants of progressive familial intrahepatic cholestasis.
Progressive familial intrahepatic cholestasis (PFIC) is a heterogeneous group of disorders characterized by defects in bile secretion and presentation with intrahepatic cholestasis in infancy or childhood. The most common types include PFIC 1 (deficiency of FIC1 protein, ATP8B1 gene mutation), PFIC 2 (bile salt export pump deficiency, ABCB11 gene mutation), and PFIC 3 (multidrug resistance protein-3 deficiency, ABCB4 gene mutation). Mutational analysis of subjects with normal gamma-glutamyl transferase cholestasis of unknown etiology has led to the identification of newer variants of PFIC, known as PFIC 4, 5, and MYO5B related (sometimes known as PFIC 6). PFIC 4 is caused by the loss of function of tight junction protein 2 (TJP2) and PFIC 5 is due to NR1H4 mutation causing Farnesoid X receptor deficiency. MYO5B gene mutation causes microvillous inclusion disease (MVID) and is also associated with isolated cholestasis. Children with TJP2 related cholestasis (PFIC-4) have a variable spectrum of presentation. Some have a self-limiting disease, while others have progressive liver disease with an increased risk of hepatocellular carcinoma. Hence, frequent surveillance for hepatocellular carcinoma is recommended from infancy. PFIC-5 patients usually have rapidly progressive liver disease with early onset coagulopathy, high alpha-fetoprotein and ultimately require a liver transplant. Subjects with MYO5 B-related disease can present with isolated cholestasis or cholestasis with intractable diarrhea (MVID). These children are at risk of worsening cholestasis post intestinal transplant (IT) for MVID, hence combined intestinal and liver transplant or IT with biliary diversion is preferred. Immunohistochemistry can differentiate most of the variants of PFIC but confirmation requires genetic analysis.


Carboxy-functionalized pH responsive capsule polymer particles fabricated by particulate interfacial photocrosslinking.
pH-responsive capsule particles show promise for various applications, such as self-healing materials, micro/nanoreactors, and drug delivery systems. Herein, carboxy-functionalized capsule polymer particles possessing neutral-alkaline pH responsive controlled release capability were newly fabricated by interfacial photocrosslinking of spherical photoreactive polymer [poly(2-carboxyethyl acrylate-co-2-cinnamoylethyl methacrylate): P(CEA-CEMA)] particles and a subsequent encapsulation process. Using P(CEA-CEMA) particles, the shell-crosslinked hollow polymer particles were fabricated by the particulate interfacial photocrosslinking procedure. Furthermore, the encapsulation of sulforhodamine B as a model dye into the hollow particles was also performed. Under acidic pH conditions, encapsulated molecules were stably retained in the P(CEA-CEMA) capsules with negligible release of sulforhodamine B. However, the encapsulated sulforhodamine B was gradually or drastically released from the capsule particles under neutral or basic conditions, respectively, indicating that the neutral-alkaline pH responsive controlled release from the capsules was successfully achieved by regulating the release kinetics. These results demonstrate that the fabrication routes of hollow and capsule particles based on particulate interfacial photocrosslinking can be successfully applied to carboxy-functionalized photoreactive polymer particles, and the capsule polymer particles possessing pH-responsive release properties under neutral-basic conditions were successfully fabricated.


Analytic energy gradients for the spin-free exact two-component theory using an exact block diagonalization for the one-electron Dirac Hamiltonian.
We report the implementation of analytic energy gradients for the evaluation of first-order electrical properties and nuclear forces within the framework of the spin-free (SF) exact two-component (X2c) theory. In the scheme presented here, referred to in the following as SFX2c-1e, the decoupling of electronic and positronic solutions is performed for the one-electron Dirac Hamiltonian in its matrix representation using a single unitary transformation. The resulting two-component one-electron matrix Hamiltonian is combined with untransformed two-electron interactions for subsequent self-consistent-field and electron-correlated calculations. The "picture-change" effect in the calculation of properties is taken into account by considering the full derivative of the two-component Hamiltonian matrix with respect to the external perturbation. The applicability of the analytic-gradient scheme presented here is demonstrated in benchmark calculations. SFX2c-1e results for the dipole moments and electric-field gradients of the hydrogen halides are compared with those obtained from nonrelativistic, SF high-order Douglas-Kroll-Hess, and SF Dirac-Coulomb calculations. It is shown that the use of untransformed two-electron interactions introduces rather small errors for these properties. As a first application of the analytic geometrical gradient, we report the equilibrium geometry of methylcopper (CuCH(3)) determined at various levels of theory.


Children's perceptions about falls and their prevention: a qualitative study from a rural setting in Bangladesh.
Childhood falls is a major public health problem in Bangladesh. In-depth understanding of the situation by the target groups and their families is necessary for successful development, implementation and evaluation of any intervention. The study aimed at knowing the views of Bangladeshi rural children about childhood falls and their suggestions for prevention. Children of 10-17 were selected purposely from 4 villages of Sherpur Sadar upazila (sub-district), Sherpur district of Bangladesh. Six focus group discussions and ten in-depth interviews were conducted during July-August 2010 for this study. Gender and education of the participants were considered. Major themes were identified, coded and categorized from content analysis. Participants stated that young children (<5 years of age) and boys appeared to be the main victims of falls and majority of these injuries occurred in and around the households. Boys commonly fall from the tree around their premises and high places. Girls usually fall when they remain busy in household chores and playing with friends around their premises. Participants also mentioned that children mostly sustained injury when they are unsupervised. Supervision, public awareness and putting barriers (e.g. door barrier, putting pillow and use net around the bed etc.) were suggested as the preventive measures. Findings of this study could be considered as part of knowledge-base in designing interventions to address childhood falls.


Response of GNSS-R on Dynamic Vegetated Terrain Conditions.
Global navigation satellite system reflectometry (GNSS-R) has the potential to offer a cost-effective solution for global land observations. In this study, we aim to understand GNSS-R sensitivity to changing land geophysical parameters. For this objective, we performed simulations of a ground-based receiver using a recently developed coherent bistatic vegetation scattering model (SCoBi-Veg) to detect GNSS-R signatures under varying soil moisture (SM), vegetation water content (VWC), and surface roughness during a full corn growing season. We modeled different corn growth stages by using in situ measurement data. We analyzed the simulated reflectivity and received power values based on the aforementioned variable input parameters. This study demonstrates that specular reflections dominate the diffusely scattered contribution in case of moderate roughness, regardless of the corn field row structure or the polarization. Significant correlations between VWC and cross-polarized reflectivity values are also shown. Furthermore, the study quantifies the effects of SM and surface roughness on GNSS-R deliverables.


MRS findings in electrical status epilepticus in sleep: Report of two cases.
To evaluate the changes in brain metabolites by H1 magnetic resonance spectroscopy in two patients with electrical status epilepticus. Two boys (aged 6 and 7 years) with electrical status epilepticus in sleep have been evaluated. N-acetyl aspartate levels were slightly elevated, and showed no decline in the postictal period. Creatine and choline levels were similar to that in controls. No evidence of neuronal cell damage was seen. Electrical status epilepticus is a balanced condition of hypermetabolism, when not accompanied with seizure.


A timesaving BERA technique for frequency-specific assessment of the auditory threshold through tone-pulse series stimulation (TOPSTIM) with simultaneous gliding high-pass noise masking (GHINOMA).
A new stimulation paradigm is described for eliciting frequency-specific auditory brainstem responses (ABR) by stimulation with a series of seven Gaussian-shaped tone pulses with carrier frequencies descending, in half-octave steps, from 4,000 to 500 Hz, and an interstimulus interval between consecutive pulses of 18 ms. The pause between two consecutive series is 54 ms so that the interval between two tone pulses of the same frequency is 162 ms (stimulus repetition rate approximately 6/s). Simultaneously a high-pass noise masker is presented whose lower cut-off frequency is continuously diminished in such a way that, when a tone pulse is presented, the cut-off frequency of the masker is exactly one octave above the carrier frequency of the pulse. Forward masking effects of preceding tone pulses as well as forward and simultaneous masking effects of the high-pass noise suppress activity originating from those regions of the cochlea which are located basalwards to the region to be stimulated by the respective pulse, thus enhancing the frequency specificity, especially for low-frequency stimuli of higher intensity. The new stimulation paradigm was tested in 12 normal hearing subjects and turned out to be suitable to elicit frequency-specific ABR with frequencies as low as 500 Hz and intensities as low as 10 dB nHL. The main advantage of the described technique is that the time required for a complete assessment of the auditory threshold at seven test frequencies (covering the relevant speech frequency range) is substantially shorter as compared to conventional techniques so that it can routinely be employed in pedaudiology, where infants usually have to be investigated in sedation.


Suxamethonium and critical illness polyneuropathy.
Administration of suxamethonium to patients with critical illness polyneuropathy may produce life-threatening hyperkalaemia. A questionnaire to assess the awareness of this problem was sent to all UK intensive care units. A clinical scenario suggestive of critical illness polyneuropathy was accompanied by a list of possible drugs used to facilitate endotracheal intubation. Most respondents (68.7%) chose suxamethonium while 20.4% avoided any muscle relaxant. This result suggests a worrying lack of appreciation of the dangers of suxamethonium use in critical illness polyneuropathy.


[Relative Energy Deficiency in Sports].
Relative Energy Deficiency in Sports, RED-S, caused by reduced energy availability can lead to a variety of symptoms. Both male and female athletes on all performance levels and ages are at risk of developing RED-S.Case 1 describes a patient with a low energy availability due to a disturbed energy balance with increased training intensity. She presented herself with an amenorrhea, one of the possible symptoms in women. Case 2 describes a patient with fatigue due to low energy availability, caused by an underlying eating disorder. Distincting RED-S from an eating disorder is difficult due to overlapping symptoms, but important given the difference in treatment. Altogether, RED-S can disrupt various body functions, therefore early recognition is desirable. Early recognition may prevent short- and long-term effects and reduce recovery time. Increasing awareness and knowledge on this topic is of great importance.


Spontaneously Ordered Hierarchical Two-Dimensional Wrinkle Patterns in Two-Dimensional Materials.
Achieving two-dimensionally (2D) ordered surface wrinkle patterns is still challenging not only for the atomic-thick 2D materials but also in general for all soft surfaces. Normally disordered 2D wrinkle patterns on isotropic surfaces can be rendered via biaxial straining. Here, we report that the 1D and 2D ordered wrinkle patterns in 2D materials can be produced by sequential wrinkling controlled by thermal straining and vertical spatial confinement. The various hierarchical patterns in 2D materials generated by our method are highly periodic, and the hexagonal crystal symmetry is obeyed. More interestingly, these patterns can be maintained in suspended monolayers after delamination from the underlying surfaces which shows the great application potentials. Our new approach can simplify the patterning processes on 2D layered materials and reduce the risk of damage compared to conventional lithography methods, and numerous engineering applications that require nanoscale ordered surface texturing could be empowered.


Iron requirements in hemodialysis.
The correction of anemia in dialysis patients with erythropoietin (EPO) can be frustrated by insufficient iron. To address this effect, we preloaded candidate EPO patients with intravenous iron in the early 1990s. Preloading with 900-1,525 mg of iron yielded the following results: 70% of patients had increasing hematocrits (HCTs) without EPO, and 40% of patients had HCTs greater than 30%. Apparent lack of iron led to blood loss studies. Routes evaluated were blood sampling, dialyzer clotting, blood in the dialyzer circuit and postdialysis bleeding. Projected annual losses were between 2,516 and 5,126 ml, depending on circuit and posttreatment losses. In terms of red cell loss, the results are comparable to those in the early days of dialysis before the introduction of current technology. Extension of these studies to daily dialysis predicts possible losses with this 6 times a week therapy of between 4,663 and 9,884 ml per year.


Hepatic lipidosis in llamas and alpacas: 31 cases (1991-1997).
To identify factors associated with hepatic lipidosis (HL) in llamas and alpacas. Retrospective case series. 30 llamas and 1 alpaca. Medical records were searched to identify llamas or alpacas in which a histologic diagnosis of HL was made. Information was retrieved on signalment, history, clinical and laboratory findings, and results of necropsy or examination of biopsy specimens. Data were analyzed using descriptive statistics and chi 2 analyses. Females were affected more often than males; however, the sex distribution was not different from that of the camelid population in the diagnostic laboratory's database. Fifty-four percent of the females were pregnant, and 46% were lactating. Most affected camelids were 6 to 10 years old. Anorexia and recent weight loss were common (51.6% of camelids). An infective agent was found in only one ilama, and toxins and mineral deficiencies were not identified. The most common abnormalities on serum biochemical analysis were a high concentration of bile acids, high activities of gamma-glutamyltransferase (GGT) and aspartate aminotransferase (AST), and hypoproteinemia. Concentrations of nonesterified fatty acids (NEFA) and beta-hydroxybutyrate (beta-HB) were high in those camelids in which these compounds were assayed. Twenty-nine camelids did not survive. Sick camelids should be considered at risk for developing HL, especially those with anorexia or the metabolic demands of pregnancy and lactation. Other stresses also appear to contribute. High concentrations of NEFA, beta-HB, and bile acids; high activities of GGT and AST; and hypoproteinemia may indicate that HL has developed.


Using Heart Rate Variability for Comparing the Effectiveness of Virtual vs Real Training Environments for Firefighters.
The use of Virtual Reality (VR) technology to train professionals has increased over the years due to its advantages over traditional training. This paper presents a study comparing the effectiveness of a Virtual Environment (VE) and a Real Environment (RE) designed to train firefighters. To measure the effectiveness of the environments, a new method based on participants' Heart Rate Variability (HRV) was used. This method was complemented with self-reports, in the form of questionnaires, of fatigue, stress, sense of presence, and cybersickness. An additional questionnaire was used to measure and compare knowledge transfer enabled by the environments. The results from HRV analysis indicated that participants were under physiological stress in both environments, albeit with less intensity on the VE. Regarding reported fatigue and stress, the results showed that none of the environments increased such variables. The results of knowledge transfer showed that the VE obtained a significant increase while the RE obtained a positive but non-significant increase (median values, VE: before - 4 after - 7, p = .003; RE: before - 4 after - 5, p = .375). Lastly, the results of presence and cybersickness suggested that participants experienced high overall presence and no cybersickness. Considering all results, the authors conclude that the VE provided effective training but that its effectiveness was lower than that of the RE.


Biogeography and evolution of body size and life history of African frogs: phylogeny of squeakers (Arthroleptis) and long-fingered frogs (Cardioglossa) estimated from mitochondrial data.
The evolutionary history of living African amphibians remains poorly understood. This study estimates the phylogeny within the frog genera Arthroleptis and Cardioglossa using approximately 2400 bases of mtDNA sequence data (12S, tRNA-Valine, and 16S genes) from half of the described species. Analyses are conducted using parsimony, maximum likelihood, and Bayesian methods. The effect of alignment on phylogeny estimation is explored by separately analyzing alignments generated with different gap costs and a consensus alignment. The consensus alignment results in species paraphyly, low nodal support, and incongruence with the results based on other alignments, which produced largely similar results. Most nodes in the phylogeny are highly supported, yet several topologies are inconsistent with previous hypotheses. The monophyly of Cardioglossa and of miniature species previously assigned to Schoutedenella was further examined using Templeton and Shimodaira-Hasegawa tests. Cardioglossa monophyly is rejected and C. aureoli is transferred to Arthroleptis. These tests do not reject Schoutedenella monophyly, but this hypothesis receives no support from non-parametric bootstrapping or Bayesian posterior probabilities. This phylogeny provides a framework for reconstructing historical biogeography and analyzing the evolution of body size and life history. Direct development and miniaturization appear at the base of Arthroleptis phylogeny concomitant with a range expansion from Central Africa to throughout most of sub-Saharan Africa.


Retrospective analysis of high flow nasal therapy in COVID-19-related moderate-to-severe hypoxaemic respiratory failure.
Invasive mechanical has been associated with high mortality in COVID-19. Alternative therapy of high flow nasal therapy (HFNT) has been greatly debated around the world for use in COVID-19 pandemic due to concern for increased healthcare worker transmission.This was a retrospective analysis of consecutive patients admitted to Temple University Hospital in Philadelphia, Pennsylvania, from 10 March 2020 to 24 April 2020 with moderate-to-severe respiratory failure treated with HFNT. Primary outcome was prevention of intubation. Of the 445 patients with COVID-19, 104 met our inclusion criteria. The average age was 60.66 (+13.50) years, 49 (47.12 %) were female, 53 (50.96%) were African-American, 23 (22.12%) Hispanic. Forty-three patients (43.43%) were smokers. Saturation to fraction ratio and chest X-ray scores had a statistically significant improvement from day 1 to day 7. 67 of 104 (64.42%) were able to avoid invasive mechanical ventilation in our cohort. Incidence of hospital-associated/ventilator-associated pneumonia was 2.9%. Overall, mortality was 14.44% (n=15) in our cohort with 13 (34.4%) in the progressed to intubation group and 2 (2.9%) in the non-intubation group. Mortality and incidence of pneumonia was statistically higher in the progressed to intubation group. CONCLUSION: HFNT use is associated with a reduction in the rate of invasive mechanical ventilation and overall mortality in patients with COVID-19 infection.


Secondary organic aerosol formation by glyoxal hydration and oligomer formation: humidity effects and equilibrium shifts during analysis.
Glyoxal is a significant atmospheric aldehyde formed from both anthropogenic aromatic compounds and biogenic isoprene emissions. The chemical behavior of glyoxal relevant to secondary organic aerosol (SOA) formation and analysis is examined in GC-MS, electrospray ionization (ESI)-MS, and particle chamber experiments. Glyoxal oligomers are shown to rapidly decompose to glyoxal in GC injection ports at temperatures > or = 120 degrees C. Glyoxal dihydrate monomer is dehydrated at temperatures > or = 140 degrees C during GC analysis but shows only oligomers (n < or = 7) upon ESI-MS analysis. Thus both of these analytical techniques will cause artifacts in speciation of glyoxal in SOA. In particle chamber experiments, glyoxal (at -0.1 Torr) condensed via particle-phase reactions when relative humidity levels exceeded a threshold of -26%. Both the threshold humidity and particle growth rates (-0.1 nm/min) are consistent with a recent study performed at glyoxal concentrations 4 orders of magnitude below those used here. This consistency suggests a mechanism where the surface water layer of solid-phase aerosol becomes saturated with glyoxal dihydrate monomer, triggering polymerization and the establishment of an organic phase.


Smokeless tobacco mortality risks: an analysis of two contemporary nationally representative longitudinal mortality studies.
Assessments supporting smokeless tobacco (SLT) disease risk are generally decades old. Newer epidemiological data may more accurately represent the health risks associated with contemporary US-based SLT products, many of which contain lower levels of hazardous and potentially hazardous chemicals compared to previously available SLT products. Data from two longitudinal datasets (National Longitudinal Mortality Study-NLMS, and the National Health Interview Survey-NHIS) were analyzed to determine potential associations between SLT use and/or cigarette smoking and all-cause and disease-specific mortality. Mortality hazard ratios (HR) were estimated using a Cox proportional hazards regression model applied to various groups, including never users of any tobacco or SLT product, and current and former SLT users and/or cigarette smokers. The two datasets yielded consistent findings with similar patterns evident for the specific causes of death measured. All-cause mortality risk for exclusive SLT users was significantly lower than that observed for exclusive cigarette smokers and dual SLT/cigarette users. Similar trends were found for mortality from diseases of the heart, chronic lower respiratory diseases, and malignant neoplasms. Mortality risk for lung cancer in exclusive cigarette smokers was increased by about 12-fold over never-tobacco users but was rarely present in exclusive SLT users in either survey (NHIS, < 5 cases/1,563 observations; NLMS, 3 cases/1,863 observations). While the data in the surveys are limited, SLT use by former cigarette smokers was not associated with an increase in the lung cancer risk HR compared to that by former cigarette smokers who never used SLT. Emerging epidemiological data provides a new perspective on the health risks of SLT use compared to risks associated with cigarette smoking. HR estimates derived from two current US datasets, which include data on contemporary tobacco products, demonstrate a clear mortality risk differential between modern SLT products and cigarettes. Cigarette smokers had an increased overall mortality risk and risk for several disease-specific causes of death, while SLT users consistently had lower mortality risks.


A simple route to complex materials: the synthesis of alkaline earth - transition metal sulfides.
A simple, low-temperature synthesis of a family of alkaline earth metal chalcogenide thin films is reported. These materials have previously only been produced from demanding, high temperature, high pressure reactions. The decomposition of calcium, barium and copper xanthates leads to the clean formation of CaS, BaS, CaCu2S2, β-BaCu2S2 and β-BaCu4S3.


Long-term measurements of NO(3) radical at a semiarid urban site: 1. Extreme concentration events and their oxidation capacity.
Nitrate radical (NO(3)), an important nighttime tropospheric oxidant, was measured continuously for two years (July 2005 to September 2007) in Jerusalem, a semiarid urban site, by long-path differential optical absorption spectroscopy (LP-DOAS). From this period, 21 days with the highest concentrations of nitrate radical (above 220 pptv) were selected for analysis. Joint measurements with the University of Heidelberg's LP-DOAS showed good agreement (r = 0.94). For all daytime measurements, NO(3) remained below the detection limit (8.5 pptv). The highest value recorded was more than 800 pptv (July 27, 2007), twice the maximum level reported previously. For this subset of measurements, mean maximum values for the extreme events were 345 pptv (SD = 135 pptv). Concentrations rose above detection limits at sunset, peaked between midnight and early morning, and returned to zero at sunrise. These elevated concentrations of NO(3) were a consequence of several factors, including an increase in ozone concentrations parallel to a substantial decrease in relative humidity during the night; Mean nighttime NO(2) levels above 10 ppbv, which prevented a deficiency in NO(3) precursors; Negligible NO levels during the night; and a substantial decrease in the loss processes, which led to a lower degradation frequency and allowed NO(3) lifetimes to build up to a maximum mean of 25 min. The results indicate that the major sink pathway for NO(3) was direct homogeneous gas phase reactions with VOC, and a smaller indirect pathway via hydrolysis of N(2)O(5). The Jerusalem measurements were used to estimate the oxidation potential of extreme NO(3) levels at an urban location. The 24 h average potential of NO(3), OH, and O(3) to oxidize hydrocarbons was evaluated for 30 separate VOCs. NO(3) was found to be responsible for approximately 70% of the oxidation of total VOCs and nearly 75% of the olefinic VOCs; which was more than twice the VOC oxidation potential of the OH radical. These results establish the NO(3) radical as an important atmospheric oxidant in Jerusalem.


Norwegian general practitioners' knowledge and beliefs about breastfeeding, and their self-rated ability as breastfeeding counsellor.
Breastfeeding is considered the best infant-feeding method. Norway is one of the leading countries in terms of breastfeeding initiation and duration. To maintain this high breastfeeding rate, it is important to understand the factors that influence breastfeeding. A doctor s advice can improve the rates of breastfeeding initiation and duration, but not all doctors are competent in breastfeeding counselling. The aim of this study was to identify the knowledge and beliefs of general practitioners (GPs) about breastfeeding in Norway and to investigate how important they considered guidance about breastfeeding initiation and duration before and after birth. A questionnaire study about knowledge and beliefs according to predefined correct responses and about self-perceived competence as an advisor. 122 GPs engaged in apprenticeship for medical students. The response rate was 57%, 69 GPs participated. The questions were answered correctly according to national consensus for 49 % for the knowledge items and 64 % of the belief items. The GPs believed that their guidance was more important after than before birth. Female GPs had more confidence in their guidance ability than male GPs. Confidence in the GPs own guidance after birth was associated with knowledge about contraindications to breastfeeding. Although the GPs expressed beliefs favouring breastfeeding they partly lacked basic knowledge. The GPs confidence in own guidance was better after than before birth and was higher among those with more knowledge. Improved knowledge and emphasis on guidance before birth should be promoted among GPs. Key points Breastfeeding is the best infant-feeding method. Doctors' advice improves the rates of breastfeeding, but not all doctors have sufficient knowledge. This study mapped the knowledge and beliefs among Norwegian GPs. The study revealed that: GPs partly lacked basic knowledge to effectively promote breastfeeding. GPs had less confidence as advisers during pregnancy than after delivery. Most GPs agreed that knowledge about breastfeeding is basic and should be taught as an integral part of medical school programmes.


Comparison of MACT and 5Fu+ACT-D chemotherapy regimens in the treatment of low-risk gestational trophoblastic neoplasia.
The study aimed to compare the efficacy of methotrexate (MTX) cervical injections + actinomycin-D (ACT-D)(MACT) and 5-fluorouracil (5-Fu) + actinomycin-D (5-Fu plus ACT-D) chemotherapy regimens for low-risk gestational trophoblastic neoplasia (LR-GTN). Clinical data from 66 LR-GTN patients, admitted to the Beijing Obstetrics and Gynecology Hospital from January 2010 to April 2012, were analysed retrospectively. In total, 32 patients were treated with a MACT therapeutic regimen and the remaining 34 with a 5Fu + ACT-D therapeutic regimen. Complete remission rates (CR), duration of treatment, hospital stay and toxicity effects were compared. There was no statistical difference in CR for the MACT (90.63%) or the 5-Fu plus ACT-D (100%) therapeutic regimens (p = 0.0676) or in the duration of treatment [MACT (3.50) or 5-Fu plus ACT-D (3.71; p = 0.2021)]. Moreover, the hospital stay in the 5-Fu plus ACT-D group (32.88 days) was significantly longer than for the MACT group (22.09 days; p < 0.001). Furthermore, the degree of myelosuppression, nausea and vomiting, diarrhoea, stomatitis and alopecia was more severe in the 5Fu + ACT-D group (p < 0.01). However, there was no statistical difference in the severity of liver function damage between the two groups. A shorter hospital stay, lower hospitalization cost and slightly more toxic effects were observed in LR-GTN patients treated with the MACT therapeutic regimen. We suggest that the MACT regimen should be used as first-line chemotherapy for LR-GTN.


The effect of gender and fatigue on the biomechanics of bilateral landings from a jump: peak values.
Female athletes are substantially more susceptible than males to suffer acute non-contact anterior cruciate ligament injury. A limited number of studies have identified possible biomechanical risk factors that differ between genders. The effect of fatigue on the biomechanics of landing has also been inadequately investigated. The objective of the study was to examine the effect of gender and fatigue on peak values of biomechanical variables during landing from a jump. Thirty-two recreational athletes performed bilateral drop jump landings from a 40 cm platform. Kinetic, kinematic and electromyographic data were collected before and after a functional fatigue protocol. Females landed with 9° greater peak knee valgus (p = 0.001) and 140% greater maximum vertical ground reaction forces (p = 0.003) normalized to body weight compared to males. Fatigue increased peak foot abduction by 1.7° (p = 0.042), peak rectus femoris activity by 27% (p = 0.018), and peak vertical ground reaction force (p = 0.038) by 20%. The results of the study suggest that landing with increased peak knee valgus and vertical ground reaction force may contribute to increased risk for knee injury in females. Fatigue caused significant but small changes on some biomechanical variables. Anterior cruciate ligament injury prevention programs should focus on implementing strategies to effectively teach females to control knee valgus and ground reaction force. Key pointsFemale athletes landed with increased knee valgus and VGRF which may predispose them to ACL injury.Fatigue elicited a similar response in male and female athletes.The effectiveness of sports injury prevention programs may improve by focusing on teaching females to land softer and with less knee valgus.


[Reference values for quantitative image analysis of indocyanine green video-fluorescence angiography].
Indocyanine green video-fluorescence angiography was performed in 46 healthy normal subjects between the ages of 20 and 81 years using a 30 degrees Zeiss fundus camera, an external light supply and a high resolution CCD camera. Pictures were directly stored in a picture analysis system based on a PC with a temporal resolution of 25 pictures per second. Using statistical picture analysis, choroidal blood-flow parameters were obtained in a round area of interest with a diameter of 8 degrees with the center in the fovea. The parameters include: the mean arterial filling time (AFT) and the mean capillary density (MCD) in the choroid. There was no correlation for one of these parameters with arterial blood pressure or intraocular pressure. All values for the AFT were on an equal level for normal subjects younger than 65 years. Older normal subjects in some cases had clearly increased arterial filling times. The density of the capillary network in the choroid was significantly reduced with increasing age, and there was reduced density of the capillary network in normals with myopia.


All set! Evidence of simultaneous attentional control settings for multiple target colors.
Although models of visual search have often assumed that attention can only be set for a single feature or property at a time, recent studies have suggested that it may be possible to maintain more than one attentional control setting. The aim of the present study was to investigate whether spatial attention could be guided by multiple attentional control settings for color. In a standard spatial cueing task, participants searched for either of two colored targets accompanied by an irrelevantly colored distractor. Across five experiments, results consistently showed that nonpredictive cues matching either target color produced a significant spatial cueing effect, while irrelevantly colored cues did not. This was the case even when the target colors could not be linearly separated from irrelevantly cue colors in color space, suggesting that participants were not simply adopting one general color set that included both target colors. The results could not be explained by intertrial priming by previous targets, nor could they be explained by a single inhibitory set for the distractor color. Overall, the results are most consistent with the maintenance of multiple attentional control settings.


Disturbance of predictive response initiation of eye and head movements in cerebellar patients.
The predictability of target occurrence has influence upon the latency of motor initiation. Higher frequencies (>0.5 Hz) of periodically paced target presentation lead to decreased latencies of movement initiation. In this study we investigated the initiation of head movements and saccades during predictable and random target presentation in cerebellar patients. During the predictive condition, in particular during higher temporal frequencies and greater amplitudes, patients showed increased latencies compared to healthy subjects. The latencies between the onset of the agonistic and antagonistic muscle pulses were correlated with the severity of cerebellar impairment. We conclude that the cerebellum is involved in predictive response initiation of eye and head movements which is emphasized at higher temporal frequencies.


Crosslinking assay to study a specific cargo-coat interaction through a transmembrane receptor in the secretory pathway.
Intracellular trafficking through the secretory organelles depends on transient interactions between cargo proteins and transport machinery. Cytosolic coat protein complexes capture specific luminal cargo proteins for incorporation into transport vesicles by interacting with them indirectly through a transmembrane adaptor or cargo receptor. Due to their transient nature, it is difficult to study these specific ternary protein interactions just using conventional native co-immunoprecipitation. To overcome this technical challenge, we have applied a crosslinking assay to stabilize the transient and/or weak protein interactions. Here, we describe a protocol of protein crosslinking and co-immunoprecipitation, which was employed to prove the indirect interaction in the endoplasmic reticulum of a luminal secretory protein with a selective subunit of the cytosolic COPII coat through a specific transmembrane cargo receptor. This method can be extended to address other transient ternary interactions between cytosolic proteins and luminal or extracellular proteins through a transmembrane receptor within the endomembrane system.


[Radiation sterilization of pancreatin preparation].
The enzymatic activities (in detail, amylase-, lipase- and protease-activity) of gamma-irradiated pancreatin powder preparation decrease to 50-95% at doses range of 50 kR-8 MR. The dose-inactivation relation-ships vary depending on every different production lot. In the case of higher moisture content preparation as irradiation sample, amylase activities are more stable, the other side, protease activities are less stable. On the variation of these activities by gamma-irradiation, there are no difference between room temperature and lower temperature (-70 degrees C) as irradiation condition. The D10 values of contaminating bacteria and fungus (contamination number: about 1 X 10(3) cells/g and 9 X 10(2) spores/g) of a pancreatin preparation are 74 C/kg (280 kR) and 60 C/kg(230 kR). Then, these values are corresponded to 645 C/kg (2.5 MR) and 540 C/kg (2.1 MR) as perfect sterilization.


A family of ferro- and antiferromagnetically coupled decametallic chromium(III) wheels.
The synthesis and crystal structures of a family of decametallic Cr(III) "molecular wheels" are reported, namely [Cr10(OR)20(O2CR')10] [R' = Me, R = Me (1), Et (2); R' = Et, R = Me (3), Et (4); R' = CMe3, R = Me (5), Et (6)]. Magnetic studies on 1-6 reveal a remarkable dependence of the magnetic behaviour on the nature of R. In each pair of complexes with a common carboxylate (R') the nearest neighbour CrCr magnetic exchange coupling is more antiferromagnetic for the ethoxide-bridged (R = Et) cluster than for the methoxide analogue. In complexes 2, 4 and 6 the overall coupling is weakly antiferromagnetic resulting in diamagnetic (S = 0) ground states for the cluster, whilst in 1 and 5 it is weakly ferromagnetic thus resulting in very high-spin ground states. This ground state has been probed directly in the perdeuterated version of 1 ([D]1) by inelastic neutron scattering experiments, and these support the S = 15 ground state expected for ferromagnetic coupling of ten Cr(III) ions, and they also indicate that a single J-value model is inadequate. The ground state of 5 is large but not well defined. The trends in J on changing R are further supported by density functional calculations on 1-6, which are in excellent agreement with experiment. The very large changes in the nature of the ground state between 1 and 2, and 5 and 6 are the result of relatively small changes in J that happen to cross J = 0, hence changing the sign of J.


The most used questionnaires for evaluating satisfaction, usability, acceptance, and quality outcomes of mobile health.
Various questionnaires are used for evaluating satisfaction, usability, acceptance, and quality outcomes of mobile health (mHealth) services. Using the best one to meet the needs of an mHealth study is a challenge for researchers. Therefore, this study aimed to review and determine the frequently used questionnaires for evaluating the mentioned outcomes of mHealth services. The PubMed database was searched for conducting this review in April 2021. Papers that used a referenced questionnaire to evaluate the satisfaction, usability, acceptance, or quality outcomes of mHealth were included. The first author's name, year of publication, evaluation outcome, and evaluation questionnaire were extracted from relevant papers. Data were analyzed using descriptive statistics. In total, 247 papers were included in the study. Questionnaires were used for usability (40%), quality (34.5%), acceptance (8.5%), and satisfaction (4%) outcomes, respectively. System usability scale (36.5%), mobile application rating scale (35.5%), post study system usability questionnaire (6%), user mobile application rating scale (5%), technology acceptance model (4.5%), computer system usability questionnaire (2.5%), net promoter score (2%), health information technology usability evaluation scale (2%), the usefulness, satisfaction, and ease of use (1.5%), client satisfaction questionnaire (1.5%), unified theory of acceptance and use of technology (1.5%), questionnaire for user interaction satisfaction (1%), user experience questionnaire (1%), and after-scenario questionnaire (1%) were the most used questionnaires, respectively. Despite the existence of special questionnaires for evaluating several outcomes of mHealth, general questionnaires with fewer items and higher reliability have been used more frequently. Researchers should pay more attention to questionnaires with a goal-based design.


Higher risk perception of HIV than of chlamydia and HPV among secondary school students in two German cities.
Chlamydia and genital human papillomavirus (HPV) are the two most common sexually transmitted infections (STIs) among teens and young adults in industrialised countries. The majority of adolescents, however, have limited or no knowledge of these infections. Within the context of a cross-sectional survey on awareness and knowledge of sexually transmitted infections, secondary school students attending the 8th grade and above in Bremen and Bremerhaven, two cities in northern Germany, were asked to rate the risk of peers to get infected with HIV, HPV or chlamydia. Between October and December 2011, students aged 12-20 years completed an anonymous, self-administered questionnaire at their school. In addition to answering questions on awareness and knowledge of sexually transmitted infections, all students were also asked to rate the risk of peers to get infected with HIV, HPV or chlamydia. Furthermore, those reporting ever having sexual intercourse were asked to rate their own risk of getting infected with each of the three infections. 1,148 students, 55% female, completed the questionnaire. 27% of the students reported having had sexual intercourse. 68% of all students rated the risk of same-aged students to get infected with HIV/AIDS as high/medium. The corresponding proportions for HPV and chlamydia were 19 and 25% respectively. Those reporting ever having sexual intercourse generally perceived their own risk of getting infected with HIV, chlamydia or HPV as lower than that of their peers. Generally, the risk of getting infected with HIV was perceived as being higher than that of getting infected with HPV or chlamydia, most likely due to the fact that the students were more aware of HIV than of the other two infections. Efforts should be made to improve awareness and knowledge of HPV and chlamydia among school going adolescents, and to make them realize that these are common infections that are preventable.


IL-13 Genetic Susceptibility to Bullous Pemphigoid: A Potential Target for Treatment and a Prognostic Marker.
Bullous pemphigoid (BP) is a senile chronic autoimmune bullous skin disease with a high relapse rate, which significantly impairs patients' quality of life and contributes to disease mortality. This observational case-control study explores the gene polymorphisms of cytokines and their clinical significance in Chinese patients with BP. IL-1α (rs1800587), IL-1β (rs16944, rs1143627, rs1143634), IL-4 (rs2243250), IL-6 (rs1800795), IL-10 (rs1800896, rs1800871, rs1800872), IL-13 (rs1800925, rs20541), TNF-α (rs1799964, rs1800630, rs1799724, rs361525), IFN-γ (rs1799964, rs1800630, rs361525, rs1800629, rs4248160, rs1800750), and TGF-β1 (rs2317130, rs1800469, rs4803457) genes were genotyped in the healthy controls and BP patients, respectively. Expression of these cytokines in serum was measured. Medical profiles of patients, including baseline characteristics and prognosis, were statistically analyzed. We found that IL-1 β and IL-13 concentrations were higher in the BP patients' sera compared to those in the controls. For IL-13, significant differences were found in the nucleotide ratio/genotype/haploid frequency/haplotype, respectively. IL-13 (rs20541, rs1800925) is related to gender, and the IL-13 genotype was significantly associated with recurrence. BP is associated with IL-13 gene polymorphism and IL-13 concentration is elevated in blood circulation in patients with BP. Our results support that IL-13 is relevant in the pathogenesis of BP, suggesting that IL-13 could potentially represent a promising target for BP therapy and a prognostic marker.


A structure refinement method based on molecular dynamics in four spatial dimensions.
We have developed a method for structure refinement based on molecular dynamics in four spatial dimensions (4D-MD). The method was applied with success to the structure refinement of Cyclosporin A (CPA) and the lac-repressor headpiece (LAC) using atom-atom distance restraints derived from NMR data, two cases where conventional MD refinement methods failed. In the case of CPA we were able to refine seven out of nine substantially different structures, while conventional MD only refines three structures. Previously, it had appeared to be impossible to refine a given LAC structure with conventional MD methods, manual modifications were necessary in order to fulfil all the distance restraints. In this study we show that LAC can be refined without manual interference and using only 5000 steps (10 ps) of 4D-MD. The latter result is particularly interesting because it indicates that this method may be a very useful tool when modelling loops in proteins.


Diagnostic agreement between clinicians and the Diagnostic Interview for Children and Adolescents--DICA-R--in an outpatient sample.
The paper examines the diagnostic agreement between clinicians and the Diagnostic Interview for Children and Adolescents. One hundred and thirty-seven outpatients-children and adolescents, and their parents-were diagnosed independently following DSM-III-R criteria by clinicians and by the DICA-R. The diagnostic concordance between clinicians and DICA-R ranged from low to moderate in the majority of the categories. The only exception was Conduct Disorder. Differences depending on the informant and the quality of the information (cognitive vs. observable) were observed. Combining the information from the child/adolescent and their parents ameliorates the concordance. The reasons for the scanty agreement found could be due to the fact that clinicians and structured interviews differ in what they evaluate (conditions on which they focus), how they evaluate (strictness in the criteria application, use of different informants and different information etc.), and when they evaluate (present condition vs. lifespan). After analysing the pros and cons of both, the use of structured interviews is advisable for research purposes. There is a clear need for a variety of informants, and the combination of information from different sources is recommended, depending on the age of the children and the type of disorder.


Alpha particle mutagenesis of human lymphoblastoid cell lines.
Despite being derived from the same donor, the human lymphoblastoid cell lines WTK1 and TK6 have markedly different responses to low LET radiation. We originally observed that WTK1 was more resistant to the cytotoxic effects of X-irradiation, but significantly more sensitive to mutation induction at both the TK and HPRT loci. In an effort to better understand these properties, we have examined the effects of alpha-particles on these cells. Relative to TK6, WTK1 has enhanced survival and mutation after both X-ray and alpha-particle exposure. While the HPRT locus was significantly more mutable in WTK1 as a function of alpha-particle versus X-ray dose, the TK locus was only slightly more sensitive to alpha-particle mutagenesis. In addition, the slowly growing TK mutants that constitute the majority of X-ray-induced TK mutants of TK6 were recovered in lower proportions following alpha-particle exposures. This is consistent with the further finding that in both cell lines, loss of heterozygosity occurred in a smaller fraction of alpha-induced TK mutants than X-ray-induced mutants. These results are consistent with our previous model suggesting that WTK1 has an error-prone repair pathway that is either missing or deficient in TK6, and further suggest that this pathway may be involved in the processing of alpha-particle-induced damage.


Is Hypertension Associated with Worse Renal Functional Outcomes after Minimally Invasive Partial Nephrectomy? Results from a Multi-Institutional Cohort.
Hypertension (HTN) is a global public health issue. There are limited data regarding the effects of HTN in patients undergoing partial nephrectomy (PN) for renal tumors. To address this void, we tested the association between HTN and renal function after minimally invasive PN (MIPN). Using a multi-institutional database (2007-2017), we identified patients aged ≥ 18 years with a diagnosis of cT1 renal tumors treated with MIPN. Kaplan-Meier plots and Cox regression models addressed newly-onset CKD stage ≥ 3b or higher (sCKD). All analyses were repeated after 1:1 propensity score matching (PSM). Overall, 2144 patients were identified. Of those, 35% (n = 759) were yes-HTN. Yes-HTN patients were older, more frequently male and more often presented with diabetes. Yes-HTN patients harbored higher RENAL nephrometry scores and higher cT stages than no-HTN patients. Conversely, yes-HTN patients exhibited lower preoperative eGFRs. In the overall cohort, five-year sCKD-free survival was 86% vs. 94% for yes-HTN vs. no-HTN, which translated into a multivariable HR of 1.67 (95% CI: 1.06-2.63, p = 0.026). After 1:1 PSM, virtually the same results were observed (HR 1.86, 95% CI: 1.07-3.23, p = 0.027). Yes-HTN patients exhibited worse renal function after MIPN when compared to their no-HTN counterparts. However, these observations need to be further tested in a prospective cohort study.


[Recurrent autoimmune hemolytic anemia induced by XELOX chemotherapy for colon cancer].
We describe a 54-year old woman with oxaliplatin-induced autoimmune hemolytic anemia and review the clinical features of similar published cases. The present patient had metastatic colon cancer and was admitted to our hospital with a floating sensation and general malaise on day 4 after undergoing the last of 4 cycles of a 7th round of chemotherapy with XELOX. Laboratory data revealed 4.6g/dl hemoglobin and 8.77 mg/dl creatinine. Direct and indirect Coombs tests of a blood sample for blood transfusion were both positive. We diagnosed immune hemolysis with acute renal failure based on the clinical course and blood samples showing haptoglobin <10mg/dl. We treated her with hemodialysis, plasmapheresis and immune suppression with prednisolone, which improved the anemia and renal failure.


Effect of radiation on interstitial fluid pressure and oxygenation in a human tumor xenograft.
Elevated interstitial fluid pressure (IFP) is a pathophysiological characteristic of most human and experimental tumors and may be responsible, in part, for the poor distribution of blood-borne therapeutic agents and low blood flow rate in tumors. Recent data in cervical carcinomas in patients suggest that fractionated radiation can lower tumor IFP and increase oxygen partial pressure (pO (2)) in some patients. The goals of this study were to find the minimum dose of radiation required to modulate IFP and pO(2) and to determine the time course of IFP changes due to radiation in a preclinical model. Xenografts of the LS174T human colon adenocarcinoma were grown in the right flank of nude (BALB/c) mice. IFP and pO(2) were measured before and 24 h after graded doses of irradiation. The mean +/- SD initial IFP in untreated tumors was 12.9 +/- 0.5 mm Hg (n=109), and the range was 3.0 to 40.3 mm Hg. The mean +/- SD and median initial pO(2) were 20.2 +/- 2.4 and 11.9 mm Hg, respectively (n=37). IFP and pO(2) were independent of tumor size. Fractionated radiation lowered IFP by 2.5 mm Hg when the total dose was 10 or 15 Gy (P<0.05), but IFP did not change in the controls or the 5-Gy radiation group (P>0.05). Irradiation increased the proportion of tumors at higher oxygen tensions when compared to control tumors. The IFP and tumor volumes were followed for up to 10 days after a single dose of 10, 20, or 30 Gy of irradiation. IFP decreased for all treatment groups. The decrease was most significant for the group receiving 30 Gy. On day five following irradiation, the IFP had decreased by 35%. The changes in IFP and pO(2) occurred before any macroscopic changes in tumor volume could be observed. The radiation-induced decrease in IFP could be, in part, responsible for the increased uptake of monoclonal antibodies following single or fractionated radiation that has been reported in the literature.


Stereoselective synthesis of chiral 4-(1-chloroalkyl)-beta-lactams starting from amino acids and their transformation into functionalized chiral azetidines and pyrrolidines.
Chiral short-chain alpha-chloroaldehydes were prepared starting from enantiomerically pure amino acids in a three-step approach, thus providing a practical synthetic alternative for known organocatalytic alpha-chlorination procedures. The latter aldehydes proved to be useful starting materials for the stereoselective Staudinger synthesis of (3S,4S)-4-[(1S)-1-chloroalkyl]azetidin-2-ones in high diastereomeric ratios and good overall yields, which were used as chiral building blocks for the preparation of a number of azetidines and pyrrolidines.


Effects of epidermal growth factor on serum zinc and plasma prostaglandin E2 levels of mice with pressure sores.
This work was undertaken to study the effects of systemic application of EGF on the plasma PGE2 and serum zinc levels of mice with pressure sores. The pressure sores were made on the hind limb of the mice by bilateral sciatic nerve neurotomy. Mice were injected IP, 1 microgram EGF daily for ten days, beginning on the 21st day after operation. EGF administration increased the serum zinc and plasma PGE2 levels compared with controls. These results indicate that EGF can be effective on wound healing by elevating the serum zinc and plasma PGE2 concentrations together with other physiological roles in cellular events.


Aroyl-pyrrolyl hydroxyamides: influence of pyrrole C4-phenylacetyl substitution on histone deacetylase inhibition.
The novel aroyl-pyrrolyl hydroxyamides 4 a-a' are analogues of the lead compound 3-(1-methyl-4-phenylacetyl-1H-pyrrol-2-yl)-N-hydroxy-2-propenamide (2) and are active as HDAC inhibitors. The benzene ring of 2 was substituted with a wide range of electron-donating and electron-withdrawing groups, and the effect was evaluated on three HDACs from maize, namely HD2, HD1-B (a class I HDAC), and HD1-A (a class II HDAC). Inhibition studies show that the benzene 3' and, to a lesser extent, 4' positions of 2 were the most suitable for the introduction of substituents, with the 3'-chloro (in 4 b) and the 3'-methyl (in 4 k) derivatives being the most potent compounds, reaching the same activity as SAHA. Inhibition data for 4 b,k against mouse HDAC1 were consistent with those observed in the maize enzyme. The substituent insertion on the benzene ring of 2 (compounds 4 a-a') abated the slight (3-fold) selectivity for class II HDACs displayed by 2. Compound 4 b showed interesting, dose-dependent antiproliferative and cytodifferentiation properties against human acute promyelocytic leukemia HL-60 cells.


An overview of bioinformatics, genomics, and transcriptomics resources for bryophytes.
Bryophytes are useful models for the study of plant evolution, development, plant-fungal symbiosis, stress responses, and gametogenesis. Additionally, their dominant haploid gametophytic phase makes them great models for functional genomics research, allowing straightforward genome editing and gene knockout via CRISPR or homologous recombination. Until 2016, however, the only bryophyte genome sequence published was that of Physcomitrium patens. Throughout recent years, several other bryophyte genomes and transcriptome datasets became available, enabling better comparative genomics in evolutionary studies. The increase in the number of bryophyte genome and transcriptome resources available has yielded a plethora of annotations, databases, and bioinformatics tools to access the new data, which covers the large diversity of this clade and whose biology comprises features such as association with arbuscular mycorrhiza fungi, sex chromosomes, low gene redundancy, or loss of RNA editing genes for organellar transcripts. Here we provide a guide to resources available for bryophytes with regards to genome and transcriptome databases and bioinformatics tools.


Pulse Oximeter App Privacy Policies During COVID-19: Scoping Assessment.
Pulse oximeter apps became of interest to consumers during the COVID-19 pandemic, particularly when traditional over-the-counter pulse oximeter devices were in short supply. Yet, no study to date has examined or scoped the state of privacy policies and notices for the top-rated and most downloaded pulse oximeter apps during COVID-19. The aim of this study was to examine, through a high-level qualitative assessment, the state and nature of privacy policies for the downloaded and top-rated pulse oximeter apps during the COVID-19 pandemic to (1) compare findings against comparable research involving other mobile health (mHealth) apps and (2) begin discussions on opportunities for future research or investigation. During August-October 2020, privacy policies were reviewed for pulse oximeter apps that had either at least 500 downloads (Google Play Store apps only) or a three out of five-star rating (Apple Store apps only). In addition to determining if the apps had an accessible privacy policy, other key privacy policy-related details that were extracted included, but were not limited to, app developer location (country); whether the app was free or required paid use/subscription; whether an ads disclosure was provided on the app's site; the scope of personal data collected; proportionality, fundamental rights, and data protection and privacy issues; and privacy safeguards. Six pulse oximeter apps met the inclusion criteria and only 33% (n=2) of the six apps had an accessible privacy policy that was specific to the pulse oximeter app feature (vs the app developer's website or at all). Variation was found in both the regulatory nature and data privacy protections offered by pulse oximeter apps, with notable privacy protection limitations and gaps, although each app provided at least some information about the scope of personal data collected upon installing the app. Pulse oximeter app developers should invest in offering stronger privacy protections for their app users, and should provide more accessible and transparent privacy policies. This is a necessary first step to ensure that the data privacy of mHealth consumers is not exploited during public health emergency situations such as the COVID-19 pandemic, where over-the-counter personal health monitoring devices could be in short supply and patients and consumers may, as a result, turn to mHealth apps to fill such supply gaps. Future research considerations and recommendations are also suggested for mHealth technology and privacy researchers who are interested in examining privacy implications associated with the use of pulse oximeter apps during and after the COVID-19 pandemic.


Intensity of symptoms from alcohol withdrawal in alcohol-dependent patients: comparison between smokers and non-smokers.
In patients with a dual dependence on alcohol and tobacco, the spontaneous discourse among doctors is not to encourage them to consider preparing to give up both substances. The argument put forward is that withdrawal would be more difficult. We wanted to compare the intensity of withdrawal symptoms in patients hospitalised for alcohol detoxification between smokers and non-smokers. We compared patients hospitalised for alcohol detoxification who smoke versus non-smokers who received replacement therapy through benzodiazepines and not nicotine replacement. The blood pressure and the cardiac frequency measure on the first day of hospitalisation, the doses of Diazepam dispensed on the first day, and the Clinical Institute Withdrawal Assessment of Alcohol Scale Revised (CIWA-Ar) score on the second day were compared. A trend emerged whereby smoking patients undergoing alcohol detoxification showed higher blood pressure, higher cardiac frequency and required higher doses of benzodiazepines on the first day of hospitalisation. Patients who smoke also had higher CIWA-Ar scores on the second day of hospitalisation. From a physiological point of view, the intensity of the symptoms of alcoholic withdrawal seems to be greater in hospitalised patients who smoke vs. non-smokers in the first two days. Does giving up both substances at the same time result in fewer withdrawal symptoms? And in this case, should a double replacement be recommended: benzodiazepines and nicotine replacement therapy? To be able to refine the recommendations on alcohol-tobacco dual withdrawal programmes, other studies are needed to compare giving up both substances with or without nicotine replacement.


Promoting Hearing Health Collaboration Through an Interprofessional Education Experience.
To enhance audiology and physician assistant (PA) student appreciation for collaboration/team-based care through an interprofessional educational activity focused on hearing assessments. A total of 18 students from Louisiana State University Health-New Orleans's audiology and PA programs participated in an optional interprofessional education learning opportunity, which included a demonstration of hearing assessments. To assess student perspectives regarding interprofessional learning, the students completed pre- and post-surveys. Eighteen students completed a survey, including 5 questions using a Likert scale and 1 open-ended question. Both audiology and PA students demonstrated significant statistical improvement in 2 interprofessional competencies: roles/responsibilities and interprofessional communication. Students also reported increased awareness and knowledge in the skills of the opposite professions as related to hearing assessments. Integrating interprofessional education experiences within an audiology program promotes collaborative practice patterns and supports new educational accreditation standards. https://doi.org/10.23641/asha.5491669.


Investigation of anaerobic zone short-circuiting using computational fluid dynamics.
Flow characteristics of anaerobic zone was investigated using the computational fluid dynamics technique. The tank is an inlet/outlet baffle tank with two impellers to provide additional energy to prevent solid settlement. The turbulent flow was modelled using the standard k-e model and the rotation of the impellers was modelled using the multiple rotating frame of reference technique. The model simulated tracer results and was in reasonable agreement with measurement. Solid settlement was tracked using the Lagrangean disperse phase tehnique. Flow in anaerobic zone exhibited completely mixed behaviour with short-circuiting. A number of options were investigated. All exhibited the general completely mixed system, which resulted from the flow circulation around the central baffle. Some options, however, led to major short circuiting and were avoided. The function of the impellers was to maintain the flow circulation and to prevent solid settlement.


Epidemiology of absence epilepsy. II. Typical absences in children with encephalopathies.
A population-based study of absence epilepsy in Swedish children, aged 0-15 years, comprised cases selected on the basis of EEG criteria. Absence epilepsy was found in 119 of the 134 children with 3 Hz spike-and-wave discharges, and 12 of these 119 (10.1%) had typical absences in addition to other generalized seizures and slow irregular spike-and-wave activity on the EEG. The mean annual incidence of this type of absence epilepsy was 0.7/100,000. The median age at onset of absences was 6 years. Eight of the 12 patients had neurological abnormalities and/or severe mental retardation. The patients constitute a heterogeneous group of encephalopathies. They may have a genetic predisposition for absence epilepsy, causing it to appear during the course of a more severe, encephalopathy related, type of epilepsy.


Trends in tobacco use among Estonian and Russian youth in Tallinn.
Smoking behaviour and exposure to environmental tobacco smoke (ETS) were examined in three cross-sectional surveys from 1991/92, 1993/94, and 1995/96. The study population comprised 3,185 Estonian and Russian adolescents from 17 schools in Tallinn, Estonia. Prevalence of ever-smoking girls increased by 13 percentage points versus 2% among boys during the study period. Mean ages of the first experimentation with tobacco and exposure to ETS did not change significantly. Regular smoking increased significantly from 1991/92 to 1995/96. Detailed analyses for the 1995/96 survey showed that among ethnic Estonians, compared with ethnic Russians, the prevalence of ever-smokers and regular smoking were higher, mean age for the first experimentation was younger, and on average, Estonians smoked more cigarettes per week. The smoking trend among adolescents in Estonia is worsening; especially among Estonian youth. This study identifies a compelling need for national and community-wide efforts to deter adolescents from smoking and to reduce the exposure to ETS.


[The thesis of Reininger (1722) in the history of pituitary sinuses].
The thesis written by Sebastian Reininger in 1722 was conserved by Albert de Haller, the renowned scholar who collected interesting medical publications in the 18th century. He included Reininger's work on the pituitary sinuses in his Disputationes anatomicae. This thesis is probably the first published work dealing exclusively with the sinuses and their anatomy, function and pathology. There are also some comments on therapy. It was thus written before thesis by Ludolph Heinrich Runge (1750) often cited as the earliest work in this field. The Reininger dissertation is based on a personal series of cranial dissections and is completed with references to other authors of the same period. It is an interesting synopsis of the knowledge of pituitary sinuses at the beginning of the 18th century.


[Importance of drug selection and the use of sensitivity tests for the eradication therapy for Helicobacter pylori].
Drug selection for eradication therapy of H. pylori, considering their drug resistance was evaluated. The measurement of resistant colonies was performed in blood agar plates using the MIC method and the criteria for resistance was as follows: MIC > 1 mg/l with AMPC, MIC > 2 mg/l with CAM and MIC > 8 mg/l with MNZ. Primary resistant colonies were found in 0% with AMPC, 8.9% with CAM and 5.9% with MNZ. Secondary resistant colonies were found in 0% with AMPC, 50.0% with CAM and 54.5% with MNZ. CAM and MNZ showed high resistance rate and among them, colonies resistant to CAM were also highly resistant to MNZ. But colonies resistant to MNZ (acquired after CAM) were all sensitive to AMPC. Considering this issue and the absence of resistance to AMPC, we considered the triple therapy with AMPC, MNZ and a PPI as the best option for the eradication of H. pylori.


Effect of water on hydrolytic cleavage of non-terminal α-glycosidic bonds in cyclodextrins to generate monosaccharides and their derivatives in a dimethyl sulfoxide-water mixture.
Hydrolytic cleavage of the non-terminal α-1,4-glycosidic bonds in α-, β-, and γ-cyclodextrins and the anomeric-terminal one in d-maltose was investigated to examine how the cleavage rate for α-, β-, and γ-cyclodextrins is slower than that for d-maltose. Effects of water and temperature were studied by applying in situ (13)C NMR spectroscopy and using a dimethyl sulfoxide (DMSO)-water mixture over a wide range of water mole fraction, xw = 0.004-1, at temperatures of 120-180 °C. The cleavage rate constant for the non-anomeric glycosidic bond was smaller by a factor of 6-10 than that of the anomeric-terminal one. The glycosidic-bond cleavage is significantly accelerated through the keto-enol tautomerization of the anomeric-terminal d-glucose unit into the d-fructose one. The smaller the size of the cyclodextrin, the easier the bond cleavage due to the ring strain. The remarkable enhancement in the cleavage rate with decreasing water content was observed for the cyclodextrins and d-maltose as well as d-cellobiose. This shows the important effect of the solitary water whose hydrogen bonding to other water molecules is prohibited by the presence of the organic dipolar aprotic solvent, DMSO, and which has more naked partial charges and higher reactivity. A high 5-hydroxymethyl-2-furaldehyde (5-HMF) yield of 64% was attained in a non-catalytic conversion by tuning the water content to xw = 0.30, at which the undesired polymerization by-paths can be most effectively suppressed. This study provides a step toward designing a new optimal, earth-benign generation process of 5-HMF starting from biomass.


[Effect of Mild Moxibustion with Different Terms at Different Acupoints on Renal Functions and Renal Pathological Changes in Focal Segmental Glomerulosclerosis Rats].
To observe changes of urinary microprotein, and serum creatinine, urea nitrogen and uric acid levels in focal segmental glomerulosclerosis (FSGS) rats treated by mild moxibustion, so as to explore the mechanism of moxibustion underlying improvement of FSGS. SD rats were randomized into normal control (normal), sham operation (sham), model, medication (Losartan), moxibustion-Shenshu (BL 23) and moxibustion-Geshu (BL 17) groups. The latter two moxibustion groups were further divided into 10 min, 20 min and 30 min subgroups (n=6 in each group/subgroups). The FSGS model was established by unilateral nephrectomy combined with injection of Losartan into the tail vein twice. Mild moxibustion was applied to bilateral BL 17 and BL 23 for 10, 20 and 30 min, respectively, once every other day, for 12 weeks. The contents of urinary microglobulin α 1, micro-albumin, transferring and IgG were assayed using enzyme linked immunosorbent assay (ELISA), and serum creatinine, urea nitrogen and uric acid contents (indexes of renal function) determined using an automatic biochemical analyzer. The pathological changes of the kidney tissue was observed by using a microscope after periodic acid schiff (PAS) staining. No significant differences were found between the normal control and sham groups in the levels of all the urinary and serum indexes (P>0.05) and pathological changes of the renal tissues. Compared with the normal control group, the contents of urinary microglobulin α 1, micro-albumin, transferrin and IgG, and serum creatinine, urea nitrogen and uric acid were significantly increased in the model group (P<0.01). Following medication and moxibustion, the contents of the aforementioned 7 indexes in the Losartan group, and urinary microglobulin α 1, micro-albumin, transferrin and IgG, and serum creatinine levels in the moxibustion BL 23-20 min and 30 min groups, and the micro-albumin and transferrin contents in the BL-17 10 min group and IgG level in the BL-23 10 min group, the serum creatinine and urea nitrogen levels at the 3 time-points of both moxibustion BL 23 and BL 17 groups, and serum uric acid in the moxibustion BL 23 30 min, and BL17 20 and 30 min groups were all considerably down-regulated (P<0.05, P<0.01). The therapeutic effects of moxibustion 30 min were notably better than moxibustion 10 min in reducing urinary microglobulin α 1, micro-albumin, transferring and IgG levels (P<0.05, P<0.01). Results of PAS staining showed that the injury of the renal tissue as the endothelial and mesangial cellular proliferation, collagen proteinosis, interstitial fibrosis, etc were relatively milder in the Losartan and moxibustion 20 and 30 min groups. Mild moxibustion may reduce proteinuria, and improve the kidney function and pathological changes in FSGS rats, and longer duration of moxibustion is better in achieving therapeutic effect.


Effects of ibrutinib on T-cell immunity in patients with chronic lymphocytic leukemia.
Chronic lymphocytic leukemia (CLL), a highly heterogeneous B-cell malignancy, is characterized by tumor microenvironment disorder and T-cell immune dysfunction, which play a major role in the proliferation and survival of CLL cells. Ibrutinib is the first irreversible inhibitor of Bruton's tyrosine kinase (BTK). In addition to targeting B-cell receptor (BCR) signaling to kill tumor cells, increasing evidence has suggested that ibrutinib regulates the tumor microenvironment and T-cell immunity in a direct and indirect manner. For example, ibrutinib not only reverses the tumor microenvironment by blocking cytokine networks and toll-like receptor signaling but also regulates T cells in number, subset distribution, T-cell receptor (TCR) repertoire and immune function by inhibiting interleukin-2 inducible T-cell kinase (ITK) and reducing the expression of inhibitory receptors, and so on. In this review, we summarize the current evidence for the effects of ibrutinib on the tumor microenvironment and cellular immunity of patients with CLL, particularly for the behavior and function of T cells, explore its potential mechanisms, and provide a basis for the clinical benefits of long-term ibrutinib treatment and combined therapy based on T-cell-based immunotherapies.


Heat shock protein 60 mRNA is not increased in Graves' disease thyroid tissue.
Heat shock proteins (hsps) are highly conserved proteins which carry vital functions by assisting intracellular protein transport and degregation. Hsps of the 60-kD family have been shown to be strongly immunogenic and to be overexpressed in many autoimmune diseases. Hsp60 reactive T cells from thyroids from patients with Graveś disease have been isolated, but hsp60 expression in Graveś disease has not been investigated. We therefore investigated the expression of hsp60 mRNA in thyroids from patients with Graveś disease and from non autoimmune controls. Expression of hsp60 mRNA could be detected in all Graveś disease thyroids. This expression was not influenced by preoperative treatment with antithyroid drugs. Hsp60 mRNA was expressed in non autoimmune controls, too. There was no quantitative difference between autoimmune thyroids and controls, revealed by computer scanning of Northern blots. Our results demonstrate, that in contrast to some other autoimmune diseases hsp60 mRNA is not overexpressed in thyroids from patients with Graveś disease.


Craniofacial brown tumor as a result of secondary hyperparathyroidism in chronic renal disease patient: A rare entity.
Brown tumors are erosive bony lesions caused by rapid osteoclastic activity and peritrabecular fibrosis due to primary or secondary hyperparathyroidism resulting in a local destructive phenomenon. The differential diagnosis based on histological examination is only presumptive. Clinical, radiological and laboratory data are necessary for definitive diagnosis. Here, we report a very rare case of brown tumor involving maxilla and mandible, which is the result of secondary hyperparathyroidism in 30-year-old female patient with chronic renal disease.


Accidental Ingestion of Nasal Packing Gauze during Endonasal Endoscopic Dacryocystorhinostomy under Local Anesthesia: A Case Report.
To report a case of accidental ingestion of a nasal packing gauze during endonasal endoscopic dacryocystorhinostomy (en-DCR) under local anesthesia. A 66-year-old female patient underwent an en-DCR for a right acquired nasolacrimal duct obstruction. The surgery was performed in a supine position under local anesthesia. An X-ray detectable ribbon gauze soaked in 0.02% epinephrine was placed in the middle meatus to prevent blood and liquid from flowing into the pharynx. The same packing gauze was also used for hemostasis during the surgery. At the end of the surgery, 1 piece of gauze was missing and could not be detected by the endonasal endoscopic exploration. An abdominal X-ray image performed on the same day demonstrated the presence of the gauze in the stomach although the patient did not notice swallowing the gauze. The gauze was not there on the X-ray 1 week later. Surgeons need to be aware of accidental ingestion of a nasal packing gauze in en-DCR under local anesthesia. Keeping the gauze end out of the nostril is likely preventive for this complication. The use of X-ray detectable gauze was helpful to detect its location.


A study of Helmholtz resonators to stabilize thermoacoustically driven pressure oscillations.
This paper studies passive control of thermoacoustic instabilities from an unconventional mathematical perspective. These instabilities are notoriously known to result from the complex dynamic exchange between the unsteady heat release and the acoustic waves within a finite volume such as a combustor. One possible passive control strategy is to utilize Helmholtz resonators. Under certain simplifications, the ensemble combustion dynamics including the resonators reduces to a linear-time invariant-multiple time-delayed system (LTI-MTDS). As the main contribution of the paper, an exact analytical procedure is proposed to determine the placement of the resonators to avoid instabilities. A unique mathematical paradigm, called the cluster treatment of characteristic roots, is used to accomplish this task. It declares exactly the necessary and sufficient stability conditions for an LTI-MTDS in the space of the system parameters. This concept paper is written with the mindset that this analytical tool can invite yet unexplored design capabilities for similar noise control applications where acoustic dampers are used.