Study design of an interdisciplinary and participatory nature-based palliative rehabilitation intervention in a Danish nursing home for people with severe dementia.
A limited amount of research has examined how nature-based palliative rehabilitation can be implemented in nursing homes for people with dementia, even though evidence suggests that these gardens are underused. This paper will present the study protocol of an intervention study co-designed in an interdisciplinary collaboration with a nursing home for people with dementia, to develop a tailored nature-based palliative rehabilitation program to increase qualified use of garden with the purpose of promoting a range of health outcomes. The study is a single-cased quasi-experimental mixed methods study. The intervention will be developed, designed, and implemented in collaboration with the nursing home, using different co-design tools and methods. The effect of the intervention will be evaluated using the The Neuropsychiatric Inventory Nursing Home version in combination with medication use, a survey on staff burnout, and cameras in the garden to register garden use. A process evaluation with single- and focus group interviews consisting of various stakeholders in the study will be used to gain knowledge on the intervention processes and implementation. The paper presents new approaches in the field of palliative rehabilitation for people with dementia using nursing home gardens, through interdisciplinary collaboration, participatory co-design approach and mixed methods design. Using both effect and process evaluation, the study will provide unique insights in the role and importance of participatory process, interdisciplinary collaboration, and tailoring palliative rehabilitation activities in gardens at nursing homes to local needs and wishes. These results can be used to guide other nursing homes and renewal projects in the future. ISRCTN, ISRCTN14095773 . Registered 15 July 2022-Retrospectively registered.


Chronic cognitive deficits and long-term histopathological alterations following contusive brain injury in the immature rat.
Although diffuse axonal injury is the primary pathology in pediatric brain trauma, the additional presence of focal contusions may contribute to the poor prognosis in brain-injured children younger than 4 years of age. Because existing models of pediatric brain trauma focus on diffuse brain injury, a model of contusive brain trauma was developed using postnatal day (PND) 11 and 17 rats, ages that are neurologically equivalent to a human infant and toddler, respectively. Closed head injury was modeled by subjecting the intact skull over the left parietal cortex of the immature rat to an impact with a metal-tipped indenter. Brain trauma on PND11 or PND17 led to significant spatial learning deficits at 28 days post-injury, compared to age-matched control rats (p < 0.05). Although both groups of rats sustained skull fractures on impact, the histopathologic response of the brain was distinctly age-dependent. At 3 days post-injury in PND11 rats, the cortex below the impact site was contused and hemorrhagic, and contained reactive astrocytes, while the subcortical white matter and thalamus contained injured (swollen) axons. At 14 and 28 days post-injury, the cortex, white matter, and hippocampus were substantially atrophied, and the lateral ventricle was enlarged. In contrast, in PND17 rats, the contused cortex observed at 3 days post-injury matured into a pronounced cavity lined with a glia limitans at 14 days; reactive astrocytes were present in both the hippocampus and thalamus up to 28 days post-injury. No evidence of traumatic axonal injury was observed in any region of the brain-injured PND17 rat. These data suggest that contusive brain trauma in the immature rat is associated with chronic cognitive deficits, but underscore the effect of the age-at-injury on behavioral and histopathologic outcomes.


A new method of purification of proteasome substrates reveals polyubiquitination of 20 S proteasome subunits.
The 26 S proteasome is implicated in the control of many major biological functions but a reliable method for the identification of its major substrates, i.e. polyubiquitin (Ub) conjugates, is still lacking. Based on the steps present in cells, i.e. recognition and deubiquitination, we developed an affinity matrix-based purification of polyUb conjugates suitable for any biological sample. Ub-conjugates were first purified from proteasome inhibitor-treated C2C12 cells using the Ub binding domains of the S5a proteasome subunit bound to an affinity matrix and then deubiquitinated by the catalytic domain of the USP2 enzyme. This two step purification of proteasome substrates involving both protein-protein interactions and enzyme-mediated release allowed highly specific isolation of polyUb 26 S proteasome substrates, which were then resolved on two-dimensional gels post-deubiquitination. To establish our method, we focused on a gel area where spots were best resolved. Surprisingly, spot analysis by mass spectrometry identified alpha2, alpha6, alpha7, beta2, beta3, beta4, and beta5 20 S proteasome subunits as potential substrates. Western blots using an anti-beta3 proteasome subunit antibody confirmed that high molecular weight forms of beta3 were present, particularly in proteasome inhibitor-treated cells. Sucrose gradients of cell lysates suggested that the proteasome was first disassembled before subunits were polyubiquitinated. Altogether, we provide a technique that enables large scale identification of 26 S proteasome substrates that should contribute to a better understanding of this proteolytic machinery in any living cell and/or organ/tissue. Furthermore, the data suggest that proteasome homeostasis involves an autoregulatory mechanism.


A clinical database to assess action levels and tolerances for the ongoing use of Mobius3D.
In radiation therapy, calculation of dose within the patient contains inherent uncertainties, inaccuracies, limitations, and the potential for random error. Thus, point dose-independent verification of such calculations is a well-established process, with published data to support the setting of both action levels and tolerances. Mobius3D takes this process one step further with a full independent calculation of patient dose and comparisons of clinical parameters such as mean target dose and voxel-by-voxel gamma analysis. There is currently no published data to directly inform tolerance levels for such parameters, and therefore this work presents a database of 1000 Mobius3D results to fill this gap. The data are tested for normality using a normal probability plot and found to fit this distribution for three sub groups of data; Eclipse, iPlan and the treatment site Lung. The mean (μ) and standard deviation (σ) of these sub groups is used to set action levels and tolerances at μ ± 2σ and μ ± 3σ, respectively. A global (3%, 3 mm) gamma tolerance is set at 88.5%. The mean target dose tolerance for Eclipse data is the narrowest at ± 3%, whilst iPlan and Lung have a range of -5.0 to 2.2% and -1.8 to 5.0%, respectively. With these limits in place, future results failing the action level or tolerance will fall within the worst 5% and 1% of historical results and an informed decision can be made regarding remedial action prior to treatment.


Using the Freiburg Acuity and Contrast Test to measure visual performance in USAF personnel after PRK.
Photorefractive keratectomy (PRK) may be an alternative to spectacle and contact lens wear for United States Air Force (USAF) aircrew and may offer some distinct advantages in operational situations. However, any residual corneal haze or scar formation from PRK could exacerbate the disabling effects of a bright glare source on a complex visual task. The USAF recently completed a longitudinal clinical evaluation of the long-term effects of PRK on visual performance, including the experiment described herein. After baseline data were collected, 20 nonflying active duty USAF personnel underwent PRK. Visual performance was then measured at 6, 12, and 24 months after PRK. Visual acuity (VA) and contrast sensitivity (CS) data were collected by using the Freiburg Acuity and Contrast Test (FrACT), with the subject viewing half of the runs through a polycarbonate windscreen. Experimental runs were completed under 3 glare conditions: no glare source and with either a broadband or a green laser (532-nm) glare annulus (luminance approximately 6090 cd/m) surrounding the Landolt C stimulus. Systematic effects of PRK on VA relative to baseline were not identified. However, VA was almost 2 full Snellen lines worse with the laser glare source in place versus the broadband glare source. A significant drop-off was observed in CS performance after PRK under conditions of no glare and broadband glare; this was the case both with and without the windscreen. As with VA, laser glare disrupted CS performance significantly and more than broadband glare did. PRK does not appear to have affected VA, but the changes in CS might represent a true decline in visual performance. The greater disruptive effects from laser versus broadband glare may be a result of increased masking from coherent spatial noise (speckle) surrounding the laser stimulus.


Acute lymphoblastic leukemia in young adults: which treatment?
Acute lymphoblastic leukemia (ALL) is the most common and one of the most curable malignancies in children; however, it presents unique challenges in adolescents and young adults (AYAs). The purpose of this review is to discuss factors that contribute to the outcome disparities in AYAs with ALL as well as approaches that can be taken to optimize the care of this patient population. AYAs with ALL are unique and have outcomes that have lagged behind those observed in children with ALL. Contributing factors to the challenges faced by this group include distinctive disease biology, different drug pharmacology and toxicity profiles, and complex psychosocial and socioeconomic factors. Several clinical trials conducted worldwide have demonstrated that treatment with pediatric protocols significantly improves outcomes in the AYA population. Initiatives to improve outcomes for AYAs with ALL include treatment with pediatric regimens tailored to be delivered without excessive toxicity and in centers with the necessary supportive care and medical services to address the specific needs of this population. As more is understood about the unique disease biology of AYA ALL, targeted therapeutic approaches may offer promise for the future.


Plasticiser-Free 3D Printed Hydrophilic Matrices: Quantitative 3D Surface Texture, Mechanical, Swelling, Erosion, Drug Release and Pharmacokinetic Studies.
Hydroxypropyl methyl cellulose, HPMC, a hydrophilic polymer, is widely used for the development of extended release hydrophilic matrices and it is also considered as a good contender for the fabrication of 3D printing of matrix tablets. It is often combined with plasticisers to enable extrusion. The aim of the current project was to develop plasticizer-free 3D printed hydrophilic matrices using drug loaded filaments prepared via HME to achieve an in vitro (swelling, erosion and drug release) and in vivo (drug absorption) performance which is analogous to hydrophilic matrix tablets developed through conventional approaches. Additionally, the morphology of the printed tablets was studied using quantitative 3D surface texture studies and the porosity calculated. Filaments were produced successfully and used to produce matrix tablets with acceptable drug loading (95-105%), mechanical and surface texture properties regardless of the employed HPMC grade. The viscosity of HPMC had a discernible impact on the swelling, erosion, HPMC dissolution, drug release and pharmacokinetic findings. The highest viscosity grade (K100M) results in higher degree of swelling, decreased HPMC dissolution, low matrix erosion, decreased drug release and extended drug absorption profile. Overall, this study demonstrated that the drug loaded (glipizide) filaments and matrix tablets of medium to high viscosity grades of HPMC, without the aid of plasticisers, can be successfully prepared. Furthermore, the in vitro and in vivo studies have revealed the successful fabrication of extended release matrices.


Occupant restraint in the rear seat: ATD responses to standard and pre-tensioning, force-limiting belt restraints.
Recent studies have shown that restrained occupants over the age of 50 in frontal crashes have a higher risk of injury in the rear seat than in the front, and have hypothesized that the incorporation of technology such as belt pre-tensioning and force limiting preferentially in the front seat is at least partially responsible for this trend. This study investigates the potential benefits and trade-offs of seat belt pretensioners and force-limiters in the rear seat using a series of frontal impact sled tests at two speeds (48 km/h and 29 km/h DeltaV) with a buck representing the interior of the reat seat occupant compartment of a contemporary mid-sized sedan. Four different dummies were tested: the Hybrid III six year old (in a booster seat, H3 6YO), the Hybrid III 5(th) percentile female (H3 AF05), the Hybrid III 50(th) percentile male (H3 AM50), and the THOR-NT. The restraints consisted of either a standard three point belt, or a 3-point belt with a retractor pretensioner and a progressive force-limiter (FL+PT). Each test condition was repeated in triplicate. The FL+PT restraints (compared to the standard restraints) resulted in a significant (p < or = 0.05) decrease in peak internal chest deflection for each of the Hybrid III dummies at both test speeds (48 km/h: 29% decrease for H3 6YO, 38% decrease for H3 AF05, 30% decrease for H3 AM50), and for the THOR-NT at a DeltaV of 29 km/h. At 48 km/h, the FL+PT restraint qualitatively decreased the average peak internal chest deflection of the THOR-NT, however this decrease was not statistically significant (p=0.06). Furthermore, the FL+PT system allowed little or no increase in forward head excursion, and improved whole-body kinematics for all dummies by restricting pelvic excursion and slightly increasing torso pitch. The results suggest that the FL+PT system studied here may provide injury-reducing benefit to rear seat occupants in moderate to high severity frontal crashes, although more study is needed to evaluate these restraints in other crash scenarios.


Role of tamoxifen in the long-term treatment and prevention of breast cancer.
The past twenty years have witnessed the introduction and development of antiestrogens as powerful new nontoxic drugs for the treatment of breast cancer. Tamoxifen is currently the agent of choice for the endocrine treatment of breast cancer. Several clinical studies now support the concept that long-term or indefinite adjuvant tamoxifen therapy is of benefit to at least some groups of Stage I/II breast cancer patients (usually those who are estrogen receptor positive). This article will consider the basic laboratory principles that led to the successful clinical testing of long-term adjuvant tamoxifen therapy; future strategies to improve the encouraging early results of long-term antiestrogen therapy will be offered and the use of antiestrogens as a possible preventive in women at high risk for breast cancer will be considered.


The right to choose treatment-without-treatment: respecting civil rights or an unprecedented manifestation of 'reverse stigma'?
Recently the Norwegian Health Minister ordered the creation of medication-free treatment wards as a result of the lobbying by patients' groups and activists. The idea behind this is that patients should have the right to choose their treatment, but for the first time, with this arrangement, the user/patient does not choose between treatment options; he literally determines by himself what efficacious treatment is. In our opinion this is another step towards a 'reverse stigma' which denies patients the right to be considered as such and eventually kicks them out of the health care system, deprives them of the right for proper treatment and care and instead puts them at the jurisdiction of the much cheaper and ineffective social services.


Carbon Monoxide (CO), Nitric Oxide, and Hydrogen Sulfide Signaling During Acute CO Poisoning.
Major toxic effects of acute carbon monoxide (CO) poisoning result from increases in reactive oxygen species (ROS) and reactive nitrogen species (RNS) producing oxidative stress. The importance of altered nitric oxide (NO) signaling in evoking increases in RNS during CO poisoning has been established. Although there is extensive literature describing NO and hydrogen sulfide (H2S) signaling in different types of cells under normal conditions, how CO poisoning-evoked deregulation of additional NO signaling pathways and H2S signaling pathways could result in cell injury has not been previously considered in detail. The goal of this article was to do this. The approach was to use published data to describe signaling pathways driven by CO bonding to different ferroproteins and then to collate data that describe NO and H2S signaling pathways that could interact with CO signaling pathways and be important during CO poisoning. Arteriolar smooth muscle cells-endothelial cells located in the coronary and some cerebral circulations-were used as a model to illustrate major signaling pathways driven by CO bonding to different ferroproteins. The results were consistent with the concept that multiple deregulated and interacting NO and H2S signaling pathways can be involved in producing cell injury evoked during acute CO poisoning and that these pathways interact with CO signaling pathways.


Solvent effect on the luminescent properties of new europium and terbium nitrate complexes with 3,3,7,7-tetra[N-methyl-N-phenyl(acetamide)-2-oxymethyl]-5-oxanonane.
The multipodal ligand 3,3,7,7-tetra[N-methyl-N-phenyl(acetamide)-2-oxymethyl]-5-oxanonane (L) and its europium and terbium nitrate complexes were synthesized. The complexes were characterized by elemental analysis, IR, fluorescence spectroscopy and conductivity. The lanthanide atoms are coordinated by O atoms from CO, COC. With the difference of the solvent, the fluorescence properties of solvent effect for the complexes were investigated. Some factors that influencing the fluorescent intensity were discussed.


Genome-wide identification, characterization and evolution of cuticular protein genes in the malaria vector Anopheles sinensis (Diptera: Culicidae).
Thirteen cuticular protein (CP) families have been recognized in arthropods. In this study, 250 Anopheles sinensis CP genes were identified and named based on genome and transcriptome sequences. They were classified into 10 families based on motifs and phylogenetic analyses. In 11 other insect species, nine had CP numbers > 150 while Apis mellifera and Tribolium castaneum had CP numbers less than 52. The CPs of eight species occupied > 1.4% of the total genomic gene number, whereas in three species the CPs occupied < 1%. The phylogenies for each CP family in An. sinensis were constructed and discussed. The 250 CPs each had 1-8 exons with 144 CPs (57.6%) having two exons. The intron length ranged from 66-3888 bp with 174 introns (54.0%) being 66-100 bp long. Except for two CPs on two contigs, 248 CPs were mapped onto 28 scaffolds with 136 genes (54.4%) restricted to five scaffolds. A total of 107 CPs were clustered and located at 27 loci. The CPR family had the conserved motif GSYSLVEPDGTVRTV. The RR-1 subfamily had an additional 21 amino acid (aa) motifs with the YVADENGF sequence that is common in insects. The RR-2 subfamily had an additional 50 aa motifs with two additional regions RDGDVVKG and G-x(3)-VV. A comparison with 115 orthologous counterparts of An. gambiae CPs suggested purifying selection for all of these genes. This study provides basic information useful for further studies on biological functions of An. sinensis CPs as well as for comparative genomics of insect CPs.


First evidence of a volatile sex pheromone in lady beetles.
To date, volatile sex pheromones have not been identified in the Coccinellidae family; yet, various studies have suggested that such semiochemicals exist. Here, we collected volatile chemicals released by virgin females of the multicolored Asian lady beetle, Harmonia axyridis (Pallas), which were either allowed or not allowed to feed on aphids. Virgin females in the presence of aphids, exhibited "calling behavior", which is commonly associated with the emission of a sex pheromone in several Coleoptera species. These calling females were found to release a blend of volatile compounds that is involved in the remote attraction (i.e., from a distance) of males. Gas Chromatography-Mass Spectrometry (GC-MS) analyses revealed that (-)-β-caryophyllene was the major constituent of the volatile blend (ranging from 80 to 86%), with four other chemical components also being present; β-elemene, methyl-eugenol, α-humulene, and α-bulnesene. In a second set of experiments, the emission of the five constituents identified from the blend was quantified daily over a 9-day period after exposure to aphids. We found that the quantity of all five chemicals significantly increased across the experimental period. Finally, we evaluated the activity of a synthetic blend of these chemicals by performing bioassays which demonstrated the same attractive effect in males only. The results confirm that female H. axyridis produce a volatile sex pheromone. These findings have potential in the development of more specific and efficient biological pest-control management methods aimed at manipulating the behavior of this invasive lady beetle.


[The long-term treatment outcomes of adult osteosarcoma].
Osteosarcoma is the most common primary bone tumor. Treatment of osteosarcoma patients is based on chemotherapy as well as surgical resection of primary tumor and distant metastases. Lung metastases are the primary cause of death in this group of patients. The aim of this study is to summarize the 20 years of osteosarcoma treatment outcomes in the Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology in Warsaw. Our analysis included clinical data of 299 osteosarcoma patients aged between 14 and 81 years (median 32) treated in Maria Sklodowska-Curie Memorial Cancer Center between 1998 and 2016. The standard therapeutic protocol included perioperative anthracycline-based chemotherapy and surgical resection of primary tumor and distant metastases. The statistical analysis was performed using Kaplan-Meier estimator, log-rank test and Cox proportional hazards model. In analyzed group 38 (13%) patients had distant metastases at the diagnosis. The tumor size was greater than 8 cm in 61% of cases. In the histopathological assessment the most prevalent subtype was the conventional one (diagnosed in 76% of cases) and histological grade 3 (79%). The 5-year survival rate for patients with localized disease reached 46%. The negative prognostic factors included: distant metastases at diagnosis, axial location of primary tumor, unresectability of the primary lesion, higher histological grade, and older age of patients. The best results of the treatment of osteosarcoma patients are achieved with multidisciplinary treatment, and when the reference center supports other healthcare providers in management of diagnostic and treatment procedures of osteosarcoma patients.


The association between caregiver child relationships and mental health of Ethiopian orphans.
The relationship between caregivers and children has importance for the development of children's mental health and wellbeing. This study examines the association between orphaned children's mental health and their relationship with their current caregivers. It used a correlational research design, appropriate to answer the research questions. The participants were 172 Ethiopian orphans aged 12-18 years, living in institutional care settings, who were selected by stratified sampling techniques, based on a proportionate number of orphans of both sexes. The findings of multivariate analysis revealed that the level of trusting relationships between children and caregivers was strongly associated, and significantly contributed to mental health measures, such as depression, social anxiety, and self-esteem. Trusting relationships with caregivers showed a significant contribution to mental health measures (depression, social anxiety, and self-esteem).


[Imaging of the Calcaneus applied to the internal fixation of fractures by a sinus tarsi approach].
The mini-invasive technique, through a sinus tarsi approach (STA), has become an increasingly popular choice for the treatment of calcaneal fractures. However, despite the good results reported, the complications related with internal fixation have not yet been analyzed. Using 3D reconstruction CT scans, we proposed doing biometric description of the calcaneus with the purpose of performing osteosynthesis as treatment for calcaneal fractures. A total of 24 CT scans were retrospectively obtained from 22 consecutive patients with healthy calcanei and no history of surgery or fracture. They included 18 males and 4 females; 14 right and 10 left calcanei. Mean age was 45.8 (range 19-79). The width and length of the screws needed to fix a calcaneal fracture with a predefined montage were measured. The results focus on biometric measurements obtained from CT scans that may help surgeons achieve proper positioning, angulation and length of the screws needed for the internal fixation of calcaneal fractures. This study describes a series of biometric calcaneal measurements that are useful for the internal fixation of calcaneal fractures using a sinus tarsi approach. The purpose is to minimize the complications resulting from osteosynthesis to treat these fractures.


Possible functional immunotoxicity of acrylonitrile (VCN).
Acrylonitrile (vinyl cyanide, VCN), an environmental pollutant, has been shown to be an animal and human carcinogen particularly for the GIT. In a previous work done in our laboratory, VCN induced immunosuppressive effects as indicated by a decrease in plaque forming cell (PFC) response to SRBCs (sheep red blood cell) immunization, a marked depletion of spleen lymphocyte subsets by flow cytometric analysis as well as bacterial translocation of the normal flora leading to brachial lymph node abscess. This work was carried out to evaluate the systemic and/or local immunotoxic potential of VCN. Acrylonitrile (2.7 mg kg-1 day-1) was given to CD-1 mice once daily for 5, 10 and 15 days. Immunohistochemical assessment of the number of cells capable of producing IgA in different intestinal compartments (duodenum, jejunum and ileum) revealed a significant decrease following VCN treatment. On the contrary, Bromodeoxyuridine (BrdU) incorporation in gut epithelial cells (duodenum and ileum) showed a significant increase in the same VCN-treated groups of animals. On the other hand, [3H]thymidine uptake was significantly decreased in splenocytes stimulated with phytohemaglutinin (PHA), Concanavalin-A (Con-A) and Lipopolysaccharide (LPS) and derived from animals treated with VCN. The effects of VCN were started after 5 days and increased up to 15 days of daily treatment in most of the investigated parameters. The results suggested that VCN has a profound immunosuppressive effect either systemically or locally which could be a contributing factor in its GIT carcinogenicity.


A comparison of the effectiveness of MMPI indices in the discrimination of brain-damaged and schizophrenic patients.
Assessed the effectiveness of 22 published MMPI procedures to differentiate organic brain syndrome (OBS) from schizophrenic (Sc) patients. Generally, each procedure previously has been suggested to have some effectiveness in making this differentiation. When assessed across studies, however, the S groups have differed on so many relevant variables (age, sex, clinical setting, etc.) that direct comparisons of their relative effectiveness cannot be made. In the current study the accuracy rates are presented for each of the 22 discrimination procedures with a sample matched on age, education, and IQ and also with an unmatched sample, all selected from the patient population at a neuropsychiatric setting. With the matched sample the Hs-Pt Index (Watson, Plemel , & Jacobs, 1978) and the Sc-O Scale, Unweighted Long form (Watson, 1971) reached statistical significance (p less than .10). With the unmatched sample both of the above procedures plus the OBS Signs procedure ( Markowitz , 1973) and P-O Scale (Watson & Plemel , 1978) reached statistical significance (p less than .10). Overall accuracy rates of those procedures found to be statistically significant ranged from 61.5 to 70.0%. These accuracy rates compare favorably to those obtained with more complex and time-consuming neuropsychiatric batteries.


A stranger in a strange land: the utility and interpretation of heterologous expression.
One of the major goals of the modern study of evodevo is to understand the evolution of gene function across a range of contexts, including sub/neofunctionalization, co-option of genetic modules, and the evolution of morphological novelty. To these ends, comparative studies of gene expression can be useful for constructing hypotheses, but cannot provide direct evidence of functional evolution. Unfortunately, determining endogenous gene function in non-model species is often not an option. Faced with this dilemma, a common approach is to use heterologous expression (HE) in genetically tractable model species as a proxy for functional analyses. Such experiments have important limitations, however, and require caution in the interpretation of their results. How do we dissociate biochemical function from its original genomic context? In the end, what does HE actually tell us? Here, I argue that HE only sheds light on specific types of biochemical conservation, but can be useful when experiments are carefully interpreted.


Gender and class tensions between psychiatric nurses and the general nursing profession in mid-twentieth century New Zealand.
Abstract Histories of twentieth century nursing usually present 'general nursing' as the norm and make the assumption that nursing was a female-dominated profession in which men were a marginalised minority. In this article, we argue that in New Zealand, psychiatric nursing had developed a distinct culture from general nursing, was more an occupation than a profession, and was one in which men held a central and powerful position. We explore the tensions that developed between male psychiatric nurses (attendants) and professional nursing leaders when general nursing began to gain authority over mental hospital nursing in the period 1939 to 1959. We argue that rather than being marginalised, the male nurses used their strength as unionised, working-class men to resist the incremental control by general nursing, a profession underpinned by middle-class values. Some battles were lost, but overall the men retained a powerful position in the mental health system during this period.


High-protein goat's milk diet identified through newborn screening: clinical warning of a potentially dangerous dietetic practice.
Breast-feeding is an unequalled way of providing optimal food for infants' healthy growth and development and the WHO recommends that infants should be exclusively breast-fed for the first 6 months of life. For mothers who are unable to breast-feed or who decide not to, infant formulas are the safest alternative. Despite recommendations, it is possible that parents make potentially harmful nutritional choices for their children because of cultural beliefs or misinformation on infant nutrition. We describe a possible health risk of not breast-feeding, highlighting a potentially dangerous dietetic practice. Design/Setting/Subjects We report the case of a newborn who was fed with undiluted goat's milk because her mother could not breast-feed and was not aware of infant formulas. The dietary mistake was detected because of a positive expanded newborn screening result, characterized by severe hypertyrosinaemia with high methionine and phenylalanine levels, a pattern suggestive of severe liver impairment. The pattern of plasma amino acids was related to a goat's milk diet, because of its very different composition compared with human milk and infant formula. Our experience demonstrates that, when breast-feeding is not possible or is not exclusive, infants may be at risk of dangerous nutritional practices, including diets with very high protein content, such as a goat's milk diet. Families of not breast-fed infants may need appropriate advice on safe alternatives for infant nutrition to avoid the risks of inappropriate diets.


Endodontic patency. How to get it. How to keep it. Why it is so important.
Complete elimination of the root canal contents is imperative for predictable endodontic success. Establishing and maintaining apical patency of the root canal system is critical for proper cleaning, shaping and obturating objectives, despite timidity about this region in the past. Contemporary concepts are discussed.


Chiral recognition of functionalized cyclodextrins in capillary electrophoresis.
The chiral recognition of hydroxypropylated, dimethylated, and sulfated cyclodextrins was evaluated by utilizing them as chiral additives in capillary electrophoresis. Although each selector yielded enantiomeric separations of most of the target analytes, differences were observed in the electrophoretic results for the different derivatized cyclodextrins and for additives having varying degrees of substitution. The results for the sulfated cyclodextrins also highlighted the importance of knowing the degree of substitution as well as the location of the substituents when comparing chiral selectors.


Efficient in vitro inhibition of HIV-1 gag reverse transcription by peptide nucleic acid (PNA) at minimal ratios of PNA/RNA.
We have tested the inhibitory potential of peptide nucleic acid (PNA) on in vitro reverse transcription of the HIV-1 gag gene. PNA was designed to target different regions of the HIV-1 gag gene and the effect on reverse transcription by HIV-1, MMLV and AMV reverse transcriptases (RTs) was investigated. We found that a bis-PNA (parallel antisense 10mer linked to antiparallel antisense 10mer) was superior to both the parallel antisense 10mer and antiparallel antisense 10mer in inhibiting reverse transcription of the gene, thus indicating triplex formation at the target sequence. A complete arrest of reverse transcription was obtained at approximately 6-fold molar excess of the bis-PNA with respect to the gag RNA. At this molar ratio we found no effect on in vitro translation of gag RNA. A 15mer duplex-forming PNA was also found to inhibit reverse transcription at very low molar ratios of PNA/ gag RNA. Specificity of the inhibition of reverse transcription by PNA was confirmed by RNA sequencing, which revealed that all tested RTs were stopped by the PNA/RNA complex at the predicted site. We propose that the effect of PNA is exclusively due to steric hindrance, as we found no signs of RNA degradation that would indicate PNA-mediated RNase H activation of the tested RTs. In conclusion, PNA appears to have a potential to become a specific and efficient inhibitor of reverse transcription in vivo , provided sufficient intracellular levels are achievable.


[Dorsal onlay urethroplasty with foreskin mucosa free graft (Barbagli's technique): preliminary results of our case series].
We evaluate the indication and results in the treatment of complex urethral stenosis by the Barbagli's technique. We retrospectively review 8 patients undergoing dorsal onlay urethroplasty with foreskin mucosa free graft. We analyze their preoperative characteristics. Mean stenosis length was 6.25 cm and the site was bulbar urethra in seven cases and penile in one. Mean preoperative flow was 8.78 ml/sec. We describe the technique and present our results. There are 87.5% of goods results (cure of the stenosis) with 22 months of mean follow-up. Only one patient required a second operation (end to end anastomosis) with good outcome. The dorsal onlay urethroplasty with foreskin mucosa free graft is an effective technique in long and complex urethral stenosis, and we consider it the technique of first choice in view of our results.


Aerosol sampling methods in workplace and ambient environments.
Aerosols are emitted into the workplace atmosphere and the ambient environment through a variety of processes. Aerosol particles are known to have significant effects on both human health and the ambient environment. For this reason, monitoring aerosol concentrations in the atmosphere by aerosol sampling is undertaken in workplace and ambient environments. A wide range of aerosol sampling methods using different collection mechanisms has been used for collecting representative aerosol samples using either a collecting or sensing medium. This paper shows the existing and commonly used aerosol sampling methods based on aerosol collection and real-time measurements. The method of choice for aerosol sampling will ultimately depend on a variety of factors, such as purpose of sampling, type of aerosol, analysis requirements, and available budget.


Interfacial N-Cu-S coordination mode of CuSCN/C3N4 with enhanced electrocatalytic activity for hydrogen evolution.
Nitrogen/carbon layer coordinated transition metal complexes are the most important alternatives to improve the catalytic performance of catalysts for energy storage and conversion systems, which require systematic investigation and improvement. The coordination mode of transition metal ions can directly affect the catalytic performance of catalysts. Herein, this paper reports that two kinds of Cu-based composites (CuSCN and CuSCN/C3N4) are prepared by in situ controllable crystallization of copper foam (CF) through electropolymerization and calcination. As a comparison, it is clarified that the different coordination modes of Cu1+ ions determine the different catalytic properties. The samples can be switched freely by tuning the electropolymerization period, which leads to different coordination modes of Cu1+ ions dramatically, thus affecting the electrocatalytic performance of composite materials for the hydrogen evolution reaction (HER) in turn. Thorough characterization using techniques, including X-ray photoelectron spectroscopy (XPS) and synchrotron-based near edge X-ray absorption fine structure (EXAFS) spectroscopy, reveals that strong interactions between CuSCN and C3N4 of CuSCN/C3N4 facilitate the formation of subtle coordinated N-Cu-S species, of which electronic structures are changed. Density Functional Theory (DFT) calculations indicate that the electrons can penetrate from CuSCN to N atoms present in C3N4. As a result, CuSCN/C3N4 demonstrates a better catalytic performance than the conventional transition-metal-based electrocatalysts. Besides, CuSCN/C3N4 reflects almost identical hydrogen evolution reaction (HER) activity and stability in an acid electrolyte with Pt/C.


Low-dose computed tomography in assessment of pulmonary abnormalities in children with febrile neutropenia suffering from malignant diseases.
Management of febrile neutropenia in pediatric patients is challenging. Chest X-ray and CT scan help to identify infective foci; however, exposure to radiation is a risk factor for development of secondary cancer. For this reason, attention is paid to reducing radiation exposure. The aim of the study was to define the role of LDCT examination in the early detection of pulmonary lesions in children during oncology or autoimmune treatment complicated by neutropenia-related fever. Additionally, we focused on the possibility to optimize image quality in low-dose protocols. The study included 138 pediatric patients (mean age 8.08 years) with fever of 38.2°C or higher with an absolute neutrophil count of 10 mm with or without surrounding GGO or cavitations was sensitive at 77% and specific at 65% for fungal infection insert after neutrophil count: < 500/pL who underwent chest X-ray and LDCT in the maximal interval of 24 h. CT findings were compared with initial and final diagnosis as well as with clinical information. LDCT detected pulmonary abnormalities in 116 patients (84.06%) showing ground-glass opacities (GGO) (n = 79), nodules (n = 60) and air-space consolidations (n = 58). Radiologists correctly diagnosed infective lesions in 94 out of 116 patients (81.03%). The presence of random or pleural-based nodules. Diagnosis of pyogenic infection based on the presence of air-space consolidation, pleural effusion, GGO or centrilobular nodules showed a sensitivity of 78% and specificity of 67%, whereas patchy or diffuse GGO, interstitial thickening and/or air-space consolidation showed a high sensitivity of 81% and specificity of 68% for Pneumocystis jirovecii pneumonia. LDCT is an excellent modality in the diagnostic algorithm in patients with febrile neutropenia. It allows early detection and detailed characterization of pulmonary abnormalities. Using contrast, unenhanced CT examinations can further reduce radiation dose and diminish the number of complications without a negative influence on the diagnostic process.


Defective CD2 pathway T cell activation in systemic lupus erythematosus.
CD2 (T11; sheep erythrocyte receptor) is the surface component of an alternative, antigen-independent pathway of human T cell activation. The response to certain anti-CD2 antibodies is relatively independent of accessory cell signals and therefore provides a direct measurement of T cell function. The CD2 pathway may be important in the differentiation of thymocytes, on which the expression of CD2 precedes the appearance of the CD3-T cell receptor complex. In view of the impaired T cell regulation of immune responses in patients with systemic lupus erythematosus (SLE), we examined the activation of peripheral blood lymphocytes by anti-CD2 antibodies in 57 SLE patients and 32 normal control subjects. The CD2 pathway response was lower in the SLE patients (P less than 0.0001); 18 of the 57 SLE patients had a lower response than any of the control subjects. The SLE low-responder patients did not differ from the normal-responder patients in terms of disease activity or use of antiinflammatory and immunosuppressive medications. Low responses to anti-CD2 were corrected to normal by the coaddition of a submitogenic amount of phorbol myristate acetate (1 ng/ml). In some low-responder patients, the responses were normalized by the removal of non-T cells. The data indicate that some SLE patients have impaired responses to CD2 pathway activation and that this may reflect intrinsic T cell defects and/or regulatory influences of non-T cells.


Rectosigmoidoscopy complicated by bilateral pneumothoraces, pneumomediastinum, pneumoperitoneum, pneumoretroperitoneum, and pneumoderma.
Rectosigmoidoscopy is a common procedure for diagnosis and follow-up of diseases of the lower gastrointestinal system. Although the procedure is proven to be safe in experienced hands, there is always risk of complications. We report a case of bilateral pneumothoraces, pneumoperitonium, pneumoretroperitoneum, pneumomediastinum, and pneumoderma due to perforation during a rectosigmoidoscopy. Co-occurrence of all these in 1 patient is a very rare clinical condition. This report underlines the possibility of even the rarest and unexpected complications related to rectosigmoidoscopy. Endoscopist should be careful to avoid perforation, be aware of the potential complications, and be able to manage them.


Nutrient-induced gastrointestinal hyperemia and specific dynamic action in rainbow trout (Oncorhynchus mykiss)--importance of proteins and lipids.
Mechanical gastric distension induces a dorsal aortic pressor response in rainbow trout (Oncorhynchus mykiss) with no change in gastrointestinal blood flow. To elucidate what role chemical stimuli from the digested food has on the postprandial cardiovascular response, a new method was developed to investigate the contribution of individual nutrient components. Three predigested experimental diets were injected directly into the proximal intestine of rainbow trout and cardiac output (CO), gut blood flow (Qcma), heart rate (HR), and stroke volume (SV) were recorded. Specific dynamic action (SDA) was estimated by measuring oxygen consumption. When a balanced diet (50% protein, 25% fat, 15% carbohydrate) was injected, Qcma and CO increased within 1 h by 45 and 27%, respectively. The response to a high-protein diet (70% protein, 5% fat, 15% carbohydrate) was quantitatively similar but delayed, with a maximal blood flow response after 2 h. With a high-lipid diet (60% fat, 15% protein, 15% carbohydrate), the peak increase in Qcma by 22% occurred after 30 min and thereafter declined rapidly. The SDA response (19%) to the balanced diet was temporally matched with the hyperemia. With a high-protein diet, the response is delayed and enlarged (34%) compared with the balanced diet. The high-lipid diet gave no significant SDA response. We conclude that the chemical composition of the food influences the postprandial hyperemia and the SDA, such that the components appear to work in a synergistic fashion. The present results also demonstrate that both redistribution of blood flow and an overall increase in CO contribute to the postprandial increase in gut blood flow in this species.


Low-dose-rate radiation sensitivity of a human hepatoma cell line.
A human hepatoma cell line, HepG2, is being used in a study of the radiobiologic factors that determine the effectiveness of radiolabeled immunoglobulin therapy of primary hepatoma. Growth inhibition by continuous low-dose-rate radiation occurs at lower dose rates for HepG2 than for most other cell lines studied. Based on survival curves following acute radiation, HepG2 appears to have less sublethal damage repair than most human tumors. Prior treatment with acute radiation did not sensitize HepG2 to either growth inhibition or cell killing by low-dose-rate radiation.


Improving children's nutritional status in Cambodia: Multidimensional poverty and early integrated interventions.
One in three Cambodian children under 5 years of age are stunted. This study adopted a multidimensional approach to understand the influence of a series of contextual factors on the nutritional status of Cambodian children. In this study, we use a multidimensional poverty framework to identify a combination of interventions likely to achieve reductions in child stunting, in Cambodia. We used the UNICEF Multiple Overlapping Deprivation Analysis tool and data from the Cambodia Demographic and Health Survey 2014 to assess children's multidimensional poverty across nutrition, health, early childhood development, water, sanitation, and housing dimensions. We found that 80% of children under age five were deprived in at least two poverty dimensions. Multivariate logistic regression analysis revealed that reducing the likelihood of being deprived in three or more poverty dimensions was associated with a significant reduction of the probability of being stunted, after controlling for potential confounders. The combined probability of nondeprivation in nutrition, sanitation, and health dimensions had the largest effect on reducing the probability of stunting. The results of this study highlight the multiple, intersecting needs of children and their associated explanatory factors. Targeted and integrated cross-sectoral policies that reinforce comprehensive early childhood interventions are needed for improving nutritional status as part of a wider set of child poverty reduction measures in Cambodia.


A Bayesian supervised dual-dimensionality reduction model for simultaneous decoding of LFP and spike train signals.
Neuroscientists are increasingly collecting multimodal data during experiments and observational studies. Different data modalities-such as EEG, fMRI, LFP, and spike trains-offer different views of the complex systems contributing to neural phenomena. Here, we focus on joint modeling of LFP and spike train data, and present a novel Bayesian method for neural decoding to infer behavioral and experimental conditions. This model performs supervised dual-dimensionality reduction: it learns low-dimensional representations of two different sources of information that not only explain variation in the input data itself, but also predict extra-neuronal outcomes. Despite being one probabilistic unit, the model consists of multiple modules: exponential PCA and wavelet PCA are used for dimensionality reduction in the spike train and LFP modules, respectively; these modules simultaneously interface with a Bayesian binary regression module. We demonstrate how this model may be used for prediction, parametric inference, and identification of influential predictors. In prediction, the hierarchical model outperforms other models trained on LFP alone, spike train alone, and combined LFP and spike train data. We compare two methods for modeling the loading matrix and find them to perform similarly. Finally, model parameters and their posterior distributions yield scientific insights.


Defibillator electrogram T wave alternans as a predictor of spontaneous ventricular tachyarrhythmias in defibrillator recipients.
Although T wave alternans (TWA) and the T wave peak-to-end (Tpte) interval are associated with vulnerability to ventricular tachyarrhythmia (VT), no previous reports have demonstrated that TWA immediately precedes spontaneous VT in the human ambulatory setting. Stored electrograms from the implantable cardioverter defibrillators (ICD) of 74 patients (59 males, 55.3+/-12.2 years) were analyzed. TWA (DeltaT amplitude), Tpte interval, QT interval, and RR intervals were measured from magnified digital images immediately before spontaneous VT (VT(Clinical); n=73), or immediately after ICD shocks during artificially-induced VT (VT(Induced); n=74) or inappropriate shocks (Shock(Inapp); n=6). (1) TWA was significantly greater in VT(Clinical) than VT(Induced) (P<0.01) or Shock(Inapp) (P<0.001), but Tpte was not (P=NS). (2) In the VT(Clinical) group, TWA was significantly greater in patients with ischemic VT than in those with non-ischemic cardiomyopathy or idiopathic VF (P<0.05). (3) In the same patient, the TWA for VT(Clinical) was significantly greater than that for VT(Induced) (P<0.01). TWA measured from ICD electrograms is significantly greater immediately before spontaneous VT than immediately after inappropriate shocks or shocks during induced VT. These findings indicate that repolarization alternans plays an important role in the induction of VT in humans.


The Temporal Relationship Between Local School Closure and Increased Incidence of Pediatric Diabetic Ketoacidosis.
The incidence of pediatric diabetic ketoacidosis (DKA) increased early in the COVID-19 pandemic, but the relative contribution of behavioral changes and viral-related pathophysiology are unknown. To evaluate the relationship between school closure date and onset of increased DKA to help clarify the etiology of the increased incidence. A multi-center, quality-controlled Pediatric Intensive Care Unit (PICU) database was used to identify the number of admissions to a participating PICU with DKA on each calendar day from 60 days before local school closure to 90 days after, and compared to baseline data from the same periods in 2018-2019. Interrupted time series and multiple linear regression analyses were used to identify admission rates that differed significantly between 2020 and baseline. Eighty-one PICUs in the United StatesParticipants: Children ages 29 days to 17 years admitted to a PICU with DKAExposures: Statewide school closureMain outcome/measure: Rate of admission to the PICU for DKA. There were 1936 admissions for children with DKA in 2020 and 1795 admissions/year to those same PICUs in 2018-2019. Demographics and clinical outcomes did not differ before school closure, but pandemic-era patients were less often white and had longer hospital length of stay in the post-school closure period. The difference between 2020 admissions and 2018-2019 admissions was not different than zero before school closure, and significantly higher than zero after school closure, but was significantly increased in 2020 at >30 days after school closure (p = 0.039). An increase in pediatric DKA admissions began one month after school closures. Given that behavioral changes started near school closure dates and viral activity peaked weeks after, this suggests that behavioral factors may not be the primary etiology and it is possible that SARS-CoV-2 infection may have direct effects on pediatric DKA.


The stereoselective interaction of warfarin and metronidazole in man.
Because of the known interaction of warfarin and disulfiram and the "disulfiram effect" of metronidazole, the interaction with metronidazole of commercial racemic warfarin and its separated enantiomorphs was evaluated in eight normal subjects. Single oral doses of racemate, S(-)-warfarin, and R (+)-warfarin, were administered in the amounts of 1.5, 0.75 and 1.5 mg per kilogram of body weight, respectively, with and without metronidazole, 750 mg by mouth, beginning seven days before the warfarin dose and continuing seven days before the warfarin dose and continuing daily throughout the hypoprothrombinemia. Daily plasma samples were analyzed for warfarin in content and one-stage prothrombin time. A highly significant (P less than 0.01) augmentation of the mean warfarin level and hypoprothrombinemia with metronidazole occurred for racemic and S (-)-warfarin; none occurred with R (+)-warfarin. Thus, the interaction of racemic warfarin and metronidazole is stereoselective and can be lessened or even avoided by use of R (+)-warfarin alone for long-term therapy.


Characterization of Peptacetobacter hominis gen. nov., sp. nov., isolated from human faeces, and proposal for the reclassification of Clostridium hiranonis within the genus Peptacetobacter.
A novel, Gram-stain-positive, rod-shaped, non-motile, non-spore-forming, obligately anaerobic bacterium, designated strain ZHW00191T, was isolated from human faeces and characterized by using a polyphasic taxonomic approach. Growth occurred at 25-45 °C (optimum, 37-42 °C), at pH 5.5-10.0 (optimum, pH 6.5-7.0) and with 0-2 % (w/v) NaCl (optimum, 0 %). The end products of glucose fermentation were acetic acid, isobutyric acid and isovaleric acid and a small amount of propionic acid. The dominant cellular fatty acids (>10 %) of strain ZHW00191T were C16 : 0, C18 : 1 ω9с and C18 : 2ω6,9с. Its polar lipid profile comprised diphosphatidylglycerol, phosphatidylglycerol, three unidentified phospholipids and ten unidentified glycolipids. Respiratory quinones were not detected. The cell-wall peptidoglycan contained meso-2,6-diaminopimelic acid, and the whole-cell sugars were ribose and glucose. The genomic DNA G+C content was 32.8 mol%. Analysis of the 16S rRNA gene sequence indicated that ZHW00191T was most closely related to Clostridium hiranonis TO-931T (95.3 % similarity). Average nucleotide identity (ANI) and digital DNA-DNA hybridization (dDDH) analyses with closely related reference strains indicated that reassociation values were both well below the thresholds of 95-96% and 70 % for species delineation, respectively. Based on phenotypic, chemotaxonomic and genetic studies, a novel genus, Peptacetobacter gen. nov., is proposed. The novel isolate ZHW00191T (=JCM 33482T=GDMCC 1.1530T) is proposed as the type strain of the type species Peptacetobacter hominis gen. nov., sp. nov. of the proposed new genus. Furthermore, it is proposed that Clostridium hiranonis be transferred to this novel genus, as Peptacetobacter hiranonis comb. nov.


mRNA stability and cancer: an emerging link?
Many oncogenes, growth factor, cytokine and cell-cycle genes are regulated post-transcriptionally. The major mechanism is by controlling the rate of mRNA turnover for transcripts bearing destabilizing cis-elements. To date, only a handful of regulatory factors have been identified that appear to control a large pool of target mRNAs, suggesting that a slight perturbation in the control mechanism may generate wide-ranging effects that could contribute to the development of a complex disorder such as cancer. In support of this view, mRNA turnover responds to signalling pathways that are often overactive in cancer, suggesting a post-transcriptional component in addition to the well-recognised transcriptional aspect of oncogenesis. Here the authors review examples of deregulated post-transcriptional control in oncogenesis, discuss post-transcriptionally regulated transcripts of oncologic significance, and consider the key role of signalling pathways in linking both processes and as an enticing therapeutic prospect.


Managing Written Directives: A Software Solution to Streamline Workflow.
A written directive is required by the U.S. Nuclear Regulatory Commission for any use of 131I above 1.11 MBq (30 μCi) and for patients receiving radiopharmaceutical therapy. This requirement has also been adopted and must be enforced by the agreement states. As the introduction of new radiopharmaceuticals increases therapeutic options in nuclear medicine, time spent on regulatory paperwork also increases. The pressure of managing these time-consuming regulatory requirements may heighten the potential for inaccurate or incomplete directive data and subsequent regulatory violations. To improve on the paper-trail method of directive management, we created a software tool using a Health Insurance Portability and Accountability Act (HIPAA)-compliant database. This software allows for secure data-sharing among physicians, technologists, and managers while saving time, reducing errors, and eliminating the possibility of loss and duplication. Methods: The software tool was developed using Visual Basic, which is part of the Visual Studio development environment for the Windows platform. Patient data are deposited in an Access database on a local HIPAA-compliant secure server or hard disk. Once a working version had been developed, it was installed at our institution and used to manage directives. Updates and modifications of the software were released regularly until no more significant problems were found with its operation. Results: The software has been used at our institution for over 2 y and has reliably kept track of all directives. All physicians and technologists use the software daily and find it superior to paper directives. They can retrieve active directives at any stage of completion, as well as completed directives. Conclusion: We have developed a software solution for the management of written directives that streamlines and structures the departmental workflow. This solution saves time, centralizes the information for all staff to share, and decreases confusion about the creation, completion, filing, and retrieval of directives.


The screening of a microRNA expression during development of human macrophages and mouse dendritic cells.
There is increasing evidence showing specific roles of microRNA in cell differentiation and cancer progression. Here we examine miRNA profiles during maturation of monocytes and bone marrow-derived dendritic cells (BMDCs) in human and mouse, respectively. We have identified significant changes of various miRNA expression during monocyte and BMDC monocyte development via miRNA microarrays, confirmed by quantitative PCR. Increases in miR155 expression positively correlated with increasing maturity of monocyte and BMDC in both mouse and human microarrays, indicating its importance in development. We describe a requirement of miR155 for MHCII expression during GM-CSF-induced development and LPS-induced maturation of DCs, suggesting reduced immune function of DC when miR155 is absent. Our study suggests that miRNAs might have an important role in differentiation of myeloid cell such as dendritic cells and macrophages.


Circular noncoding RNAs as potential therapies and circulating biomarkers for cardiovascular diseases.
Recent advancements in genome-wide analyses and RNA-sequencing technologies led to the discovery of small noncoding RNAs, such as microRNAs (miRs), as well as both linear long noncoding RNAs (lncRNAs) and circular long noncoding RNAs (circRNAs). The importance of miRs and lncRNAs in the treatment, prognosis and diagnosis of cardiovascular diseases (CVDs) has been extensively reported. We also previously reviewed their implications in therapies and as biomarkers for CVDs. More recently, circRNAs have also emerged as important regulators in CVDs. CircRNAs are circular genome products that are generated by back splicing of specific regions of pre-messenger RNAs (pre-mRNAs). Growing interest in circRNAs led to the discovery of a wide array of their pathophysiological functions. CircRNAs have been shown to be key regulators of CVDs such as myocardial infarction, atherosclerosis, cardiomyopathy and cardiac fibrosis. Accordingly, circRNAs have been recently proposed as potential therapeutic targets and biomarkers for CVDs. In this review, we summarize the current state of the literature on circRNAs, starting with their biogenesis and global mechanisms of actions. We then provide a synopsis of their involvement in various CVDs. Lastly, we emphasize the great potential of circRNAs as biomarkers for the early detection of CVDs, and discuss several patents and recent papers that highlight the utilization of circRNAs as promising biomarkers.


The improved dynamic slicing for spectrum-based fault localization.
Spectrum-based Fault localization have proven to be useful in the process of software testing and debugging. However, how to improve the effectiveness of software fault localization has always been a research hot spot in the field of software engineering. Dynamic slicing can extract program dependencies under certain conditions. Thus, this technology is expected to benefit for locating fault. We propose an improved dynamic slicing for spectrum-based fault localization under a general framework. We first obtain the dynamic slice of program execution. Secondly, we construct a mixed slice spectrum matrix from the dynamic slice of each test case and the corresponding test results. Finally, we compute the suspiciousness value of each statement in the mixed-slice spectram matrix. To verify the performance of our method, we conduct an empirical study on 15 widely used open-source programs. Experimental results show that our approach achieves significant improvement than the compared techniques. Our approach can reduce approximately 1% to 17.79% of the average cost of code examined significantly.


Revising the generic characters of Lobogonodes Bastelberger, 1909, with description of a new species from Taiwan (Lepidoptera: Geometridae: Larentiinae).
The present study re-assesses the characters of the Oriental genus Lobogonodes Bastelberger, 1909 based on all 8 species, including the newly described L. shiushioui sp. nov. and the distinct species L. dactylotypa Prout, 1940 stat. rev.. Three synapomorphic characters based on the male genitalia are proposed: the presence of a sclerotized subscaphium, the U-shaped connection between the juxta and anellus lobe and the saccus process pointed anteriorly. A new key to the species in this genus is provided.


[A clinical observation on therapeutic effect of colon purification on hepatic encephalopathy].
To observe therapeutic effect of colon purification on hepatic encephalopathy. 117 patients with hepatic encephalopathy treated in our hospital were randomly divided into the treatment group (59 cases) and the control group (58 cases). Routine anti-coma hepaticum treatments were carried out in both treatment and control groups, and colon purification treatment was performed in the treatment group on basis of routine anti-coma hepaticum. The changes in symptoms and signs were observed, the grading scores of hepatic encephalopathy were evaluated, liver function was tested and blood ammonia level was determined before and after treatment in the two groups. Time for regaining consciousness was recorded after treatment in the two groups. The symptoms and signs were obviously improved, time for regaining consciousness was shortened, the grading scores decreased, and serum aminotransferase activity and bilirubin level and blood ammonia level significantly decreased in the treatment group as compared with those of the control group. Total effective rate in the treatment was significantly higher than that in the control group and death rate in the treatment group was significantly lower than that in the control group. Colon purification treatment is effective for hepatic encephalopathy due to cirrhosis.


Immune responses and clinical outcomes after COVID-19 vaccination in patients with liver disease and liver transplant recipients.
Comparative assessments of immunogenicity following different COVID-19 vaccines in patients with distinct liver diseases are lacking. SARS-CoV-2-specific T-cell and antibody responses were evaluated longitudinally after one to three vaccine doses, with long-term follow-up for COVID-19-related clinical outcomes. A total of 849 participants (355 with cirrhosis, 74 with autoimmune hepatitis [AIH], 36 with vascular liver disease [VLD], 257 liver transplant recipients [LTRs] and 127 healthy controls [HCs]) were recruited from four countries. Standardised immune assays were performed pre and post three vaccine doses (V1-3). In the total cohort, there were incremental increases in antibody titres after each vaccine dose (p <0.0001). Factors associated with reduced antibody responses were age and LT, whereas heterologous vaccination, prior COVID-19 and mRNA platforms were associated with greater responses. Although antibody titres decreased between post-V2 and pre-V3 (p = 0.012), patients with AIH, VLD, and cirrhosis had equivalent antibody responses to HCs post-V3. LTRs had lower and more heterogenous antibody titres than other groups, including post-V3 where 9% had no detectable antibodies; this was heavily influenced by intensity of immunosuppression. Vaccination increased T-cell IFNγ responses in all groups except LTRs. Patients with liver disease had lower functional antibody responses against nine Omicron subvariants and reduced T-cell responses to Omicron BA.1-specific peptides compared to wild-type. 122 cases of breakthrough COVID-19 were reported of which 5/122 (4%) were severe. Of the severe cases, 4/5 (80%) occurred in LTRs and 2/5 (40%) had no serological response post-V2. After three COVID-19 vaccines, patients with liver disease generally develop robust antibody and T-cell responses to vaccination and have mild COVID-19. However, LTRs have sustained no/low antibody titres and appear most vulnerable to severe disease. Standardised assessments of the immune response to different COVID-19 vaccines in patients with liver disease are lacking. We performed antibody and T-cell assays at multiple timepoints following up to three vaccine doses in a large cohort of patients with a range of liver conditions. Overall, the three most widely available vaccine platforms were immunogenic and appeared to protect against severe breakthrough COVID-19. This will provide reassurance to patients with chronic liver disease who were deemed at high risk of severe COVID-19 during the pre-vaccination era, however, liver transplant recipients had the lowest antibody titres and remained vulnerable to severe breakthrough infection. We also characterise the immune response to multiple SARS-CoV-2 variants and describe the interaction between disease type, severity, and vaccine platform. These insights may prove useful in the event of future viral infections which also require rapid vaccine development and delivery to patients with liver disease.


[The role of some cell regeneration markers of epithelial cells in genesis of gastric tumors associated with H. pylori].
It is established, that chronic atrophic gastritis adenomatous polyps and gastric cancer are consecutive stages of gastric mucous tunic cell renovation disturbance, manifests itself in progressive delay its apoptosis activity from proliferation, which reflects increase in expression Ki-67 and Bcl-2. Eradication of Helicobacter pylori shorts activity and reduces intensity of inflammatory process in gastric mucous tunic and improves indices of cell renovation.


Pregnant adolescents' preferences for labor pain management.
The purpose of this study was to examine the obstetric anesthesia method used, based on the patient's age. Confounding variables analyzed were the effect on labor pain management choices of parity, race, prenatal care participation, insurance status, and length of labor. This was a case control study from the Medical University of South Carolina (MUSC). The primary outcome measured was regional anesthesia (RA) use in labor. The exposure groups were based on the patient's age. All women aged 11 years and older who delivered vaginally from 1996 to 2001 were included; 7,583 patients met inclusion criteria. Results were analyzed using chi2 statistic, univariate analysis, ANOVA, and logistic regression. We found that primiparous adolescents used RA less than primiparous women over age 20. This association is not found in multiparous teens. Patients with shorter labors, black women, those without prenatal care, and older patients lacking private insurance declined RA more often. RA is the most utilized form of obstetric pain management in the last decade. In primiparous adolescents, declining RA cannot be explained by length of labor, race, insurance status, or prenatal care participation.


Positive blood cultures for coagulase-negative staphylococci in neonates: does highly selective vancomycin usage affect outcome?
The implication of highly-selective vancomycin usage on the outcome for infants with positive blood cultures for coagulase-negative staphylococci (CONS) was assessed retrospectively. The analysis was performed on partly prospective collected data from infants under 3 months of age with a least one CONS-positive blood culture in the neonatal intensive care unit at the Soroka University Medical Center between 1990 and 1996. During the study period, 239 episodes of CONS-positive blood cultures were identified from among 64,226 live births (3.7 per 1,000). Vancomycin was administered in 22 (9%) episodes, in all cases only after identification of the bacteria. The remaining 217 episodes were managed either without antibiotics or with continuation or initiation of empiric antibiotic therapy (usually ceftazidime +/- ampicillin) for suspected sepsis. Severity of the initial illness, subsequent morbidity and mortality were low regardless of the treatment administered. Only a single case of a blood-borne vancomycin resistant gram-positive organism was observed during the study period. The approach to CONS-positive blood cultures in neonates used here was associated with low morbidity and mortality. These findings support a policy of highly selective vancomycin usage in an era of emerging vancomycin resistance.


Trends in stroke prevalence between 1973 and 1991 in the US population 25 to 74 years of age.
Stroke mortality in the United States has declined since 1900. Primary prevention of stroke incidence did not decline and may have increased during the 1980s, whereas survival after stroke improved substantially during the 1970s and 1980s. The effect of these trends on the prevalence and number of stroke survivors in the United States has not been determined. The prevalence and number of noninstitutionalized stroke survivors in the United States was estimated through self-report for 3 time periods: 1971-1975, 1976-1980, and 1988-1994, using data from the National Health and Nutrition Examination Surveys (NHANES) I, II, and III, respectively. Prevalence and number of stroke survivors were analyzed by age (25 to 59 and 60 to 74 years), race (non-Hispanic whites/Mexican-Americans and non-Hispanic blacks), and sex. Estimates were limited to the US population ages 25 to 74 years because NHANES I and II did not include persons older than 75 years. The age-, race-, and sex-adjusted prevalence of stroke increased from 1.41% to 1.87% from 1971-1975 to 1988-1994, an average increase of 7.5% (95% confidence interval: -2%, +18%) for each 5-year period during this time. Additionally, during this period, the estimated number of noninstitutionalized stroke survivors increased by 930 000 (95% CI: 300 000 to 1.6 million) from 1.5 million to 2.4 million. Additionally, the average "health in general" among stroke survivors was similar in all 3 periods. These data point to the increasing importance of the care and rehabilitation of stroke survivors.


Dynamic Transitions Between Brain States Predict Auditory Attentional Fluctuations.
Achievement of task performance is required to maintain a constant level of attention. Attentional level fluctuates over the course of daily activities. However, brain dynamics leading to attentional fluctuation are still unknown. We investigated the underlying mechanisms of sustained attention using functional magnetic resonance imaging (fMRI). Participants were scanned with fMRI while performing an auditory, gradual-onset, continuous performance task (gradCPT). In this task, narrations gradually changed from one to the next. Participants pressed a button for frequent Go trials (i.e., male voices) as quickly as possible and withheld responses to infrequent No-go trials (i.e., female voices). Event-related analysis revealed that frontal and temporal areas, including the auditory cortex, were activated during successful and unsuccessful inhibition of predominant responses. Reaction-time (RT) variability throughout the auditory gradCPT was positively correlated with signal changes in regions of the dorsal attention network: superior frontal gyrus and superior parietal lobule. Energy landscape analysis showed that task-related activations could be clustered into different attractors: regions of the dorsal attention network and default mode network. The number of alternations between RT-stable and erratic periods increased with an increase in transitions between attractors in the brain. Therefore, we conclude that dynamic transitions between brain states are closely linked to auditory attentional fluctuations.


Validation of the Intelligibility in Context Scale for Jamaican Creole-Speaking Preschoolers.
To describe validation of the Intelligibility in Context Scale (ICS; McLeod, Harrison, & McCormack, 2012a) and ICS-Jamaican Creole (ICS-JC; McLeod, Harrison, & McCormack, 2012b) in a sample of typically developing 3- to 6-year-old Jamaicans. One-hundred and forty-five preschooler-parent dyads participated in the study. Parents completed the 7-item ICS (n = 145) and ICS-JC (n = 98) to rate children's speech intelligibility (5-point scale) across communication partners (parents, immediate family, extended family, friends, acquaintances, strangers). Preschoolers completed the Diagnostic Evaluation of Articulation and Phonology (DEAP; Dodd, Hua, Crosbie, Holm, & Ozanne, 2006) in English and Jamaican Creole to establish speech-sound competency. For this sample, we examined validity and reliability (interrater, test-rest, internal consistency) evidence using measures of speech-sound production: (a) percentage of consonants correct, (b) percentage of vowels correct, and (c) percentage of phonemes correct. ICS and ICS-JC ratings showed preschoolers were always (5) to usually (4) understood across communication partners (ICS, M = 4.43; ICS-JC, M = 4.50). Both tools demonstrated excellent internal consistency (α = .91), high interrater, and test-retest reliability. Significant correlations between the two tools and between each measure and language-specific percentage of consonants correct, percentage of vowels correct, and percentage of phonemes correct provided criterion-validity evidence. A positive correlation between the ICS and age further strengthened validity evidence for that measure. Both tools show promising evidence of reliability and validity in describing functional speech intelligibility for this group of typically developing Jamaican preschoolers.


Effect of Different Laser Wavelengths on Periodontopathogens in Peri-Implantitis: A Review of In Vivo Studies.
Nowadays, many studies are examining the effectiveness of dental lasers in the treatment of peri-implantitis; however, most of them only report periodontal parameter changes. The authors of this review tried to address the question: "What is the effect of different laser wavelengths on oral bacteria that cause peri-implantitis?" An electronic search of PubMed and Cochrane Central Register of Controlled Trials was performed. The following search terms were used: (peri-implantitis OR periimplantitis) OR/AND (microbial OR microbiologic) AND (laser OR Er:YAG OR erbium OR diode OR Nd:YAG OR neodymium-doped OR Er,Cr:YSGG OR chromium-doped). Initially, 212 studies were identified. After screening the titles and abstracts and excluding studies according to predefined inclusion criteria, seven publications were included in the review. Three studies about the effect of aPDT (antimicrobial photodynamic therapy) reported a decrease in the different bacterial strains associated with peri-implantitis, e.g., A. actinomycetemcomitans, P. gingivalis, P. intermedia, T. denticola, T. forsythia, F. nucleatum, and C. rectus. Two studies showed that the high-power diode laser may have some effect on peri-implant pathogens. Two articles about the Er:YAG laser reported a lowering in the count of oral pathogens; however, it was hard to determine if this was due to the use of the laser. aPDT has the ability to decrease the count of peri-implant pathogens, whereas Er:YAG laser application shows no significant effect on oral bacteria in the long term.


Analysis of responses to individual items on the tinnitus handicap inventory according to severity of tinnitus handicap.
To investigate whether certain aspects of tinnitus tend to trouble people even when they are not severely affected by tinnitus in many ways. A total of 274 patients who had requested a tinnitus clinic appointment were divided into 4 categories depending on their Tinnitus Handicap Inventory scores: no handicap (0-16), mild handicap (18-36), moderate handicap (38-56), or severe handicap (58-100). Mean scores for each of the 25 items on the questionnaire were calculated and compared within each group and between the 4 groups. Two items concerning lack of control over tinnitus and inability to escape it had the highest mean score overall and in each category, and elicited positive responses from the majority of patients in all but the "no handicap" group. One item concerning the belief that tinnitus indicates a terrible disease was found to have the lowest mean score overall and in each category and elicited negative responses from the majority of patients in all but the "severe handicap" group. These findings indicate that only those who are severely handicapped by tinnitus tend to regard it as a terrible disease, and that lack of control and inability to escape are common feelings among many people with tinnitus, from the most to the least severely handicapped.


Effects of sex and gender on adaptation to space: neurosensory systems.
Sex and gender differences have long been a research topic of interest, yet few studies have explored the specific differences in neurological responses between men and women during and after spaceflight. Knowledge in this field is limited due to the significant disproportion of sexes enrolled in the astronaut corps. Research indicates that general neurological and sensory differences exist between the sexes, such as those in laterality of amygdala activity, sensitivity and discrimination in vision processing, and neuronal cell death (apoptosis) pathways. In spaceflight, sex differences may include a higher incidence of entry and space motion sickness and of post-flight vestibular instability in female as opposed to male astronauts who flew on both short- and long-duration missions. Hearing and auditory function in crewmembers shows the expected hearing threshold differences between men and women, in which female astronauts exhibit better hearing thresholds. Longitudinal observations of hearing thresholds for crewmembers yield normal age-related decrements; however, no evidence of sex-related differences from spaceflight has been observed. The impact of sex and gender differences should be studied by making spaceflight accessible and flying more women into space. Only in this way will we know if increasingly longer-duration missions cause significantly different neurophysiological responses in men and women.


Impact of Metal Contacts on the Performance of Multilayer HfS2 Field-Effect Transistors.
HfS2 is one of the emerging transition metal dichalcogenides and is very promising for low-power nanoelectronics and high-sensitivity optoelectronic device applications. We studied the band structures of 1T-HfS2 with different thicknesses by first principles simulation, and the impact of different metal contacts to the HfS2 device performance has been experimentally studied. Back-gate and top-gate HfS2 field-effect transistors (FETs) were fabricated, and better electrical characteristics have been achieved with the FETs with the Ti/Au contact as compared with the Pt-contacted FETs. Thin layers of Pt and Ti/Au films were deposited on HfS2 flakes to investigate the metal/HfS2 interface by using scanning electron microscopy, atomic force microscopy, and Raman spectroscopy. A smoother Ti/Au film was formed on HfS2, resulting in higher carrier injection and transport efficiency. The phonon behavior being dominated by the interface chemical bonding at the Ti/Au contact region has been confirmed with the more sensitive A1g phonon mode from the bilayer HfS2.


Early and Mid-Term Outcomes of Primary Repair After Atrioventricular Canal Defect: A Single-Center Eight-Year Experience.
Surgical repair techniques and management of patients with atrioventricular septal defect (AVSD) have progressed over the last few decades. Early and definitive interventions have become the choice of treatment for these patients. Based on this background, we aimed to review the early and mid-term outcomes of primary AVSD repair. A total of 53 patients with a mean age of 3.45 ± 5.67 years underwent definitive repair for AVSD between January 2014 and June 2021. The clinical data including age, type of defect, associated co-anomalies, symptoms, pulmonary hypertension, etc. were collected and assessed retrospectively. Mitral regurgitation (MR) as a clinical outcome was assessed at 0, 1, 2, and 5 years. Among the recruited patients, 35 (66.1%) were male and 18 (33.9%) were female. Of 53 patients, repair for the complete defect was done in 38 (71.69%) patients, repair for intermediate/partial defect was done in 15 (23.1%) patients, and one patient underwent repair for incomplete type. Other associated co-anomalies were anterior mitral leaflet (12 (22.6%)), atrial and ventricular septal defect (VSD) (30 (56.6%)), and patent ductus arteriosus (PDA) (11 (20.8%)). Different procedures for surgical repair included patch closure, cleft repair, and polytetrafluoroethylene (PTFE) VSD closure. After repair, the mean follow-up period was 46.73 ± 27.37 months. Overall mortality was 3.78% (2/53), and two patients underwent reintervention due to symptomatic severe MR. A definitive and timely correction of AVSD shows satisfactory early and mid-term results.


Complete Response of Recurrent Small Cell Carcinoma of the Uterine Cervix to Paclitaxel, Carboplatin, and Bevacizumab Combination Therapy.
We report a case of recurrent small cell carcinoma of the uterine cervix that showed a complete response to paclitaxel, carboplatin, and bevacizumab (TC + Bev) combination therapy. Small cell carcinoma of the uterine cervix is extremely rare, with an incidence of only 1.3% in Japan, and a poor outcome. The patient was a 62-year-old woman with a chief complaint of irregular vaginal bleeding. Magnetic resonance imaging showed a 10-cm irregular mass from the uterine corpus's posterior wall to the cervix. Abdominal total hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymph node sampling were performed for suspected uterine sarcoma. Histopathological findings revealed small cell carcinoma with lymph node metastasis. Although 6 cycles of etoposide + cisplatin were performed, para-aortic lymph node recurrence was found 3 months after chemotherapy. Subsequently, the patient received 8 cycles of TC + Bev, which eliminated the metastases. The patient is currently alive at 24 months.


The age of developing diabetes and FTO polymorphisms (rs9939609, rs1421085, and rs9930506).
Type 2 diabetes (T2DM) is a common complex metabolic disorder that has a strong genetic predisposition. Fat mass and obesity-associated protein (FTO) is one of the genes of interest to us. Hypomethylation of a CpG site in the FTO gene was significantly associated with the risk of T2DM. The aim of the study was to find the answer to the question of whether the polymorphism changes of the FTO gene in the pathogenesis of type 2 diabetes are comparable in young, middle aged, and elderly people. The study involved 282 consecutive patients with type 2 diabetes, who attended a primary healthcare clinic in Southern Poland. The study subjects were divided into three groups according to the age at which type 2 diabetes mellitus was diagnosed (> 40 years old, 40-60 years old, and > 60 years old). The genotyping of rs9939609, rs1421085, and rs9930506 FTO polymorphisms was conducted using TaqManPre-designed SNP Genotyping Assay. No statistically significant difference was shown between the examined FTO polymorphism (rs9939609, rs1421085, and rs9930506) distribution between the subjects diagnosed with diabetes < 40 years , 40-60 years, and > 60 years old. There were no statistically significant relationships between the different analysed anthropometric and other parameters and distribution of examined FTO polymorphisms (rs9939609 , rs1421085, and rs9930506). The age of diabetes was not affect by the tested FTO polymorphisms (rs9939609 , rs1421085, and rs9930506).


Delivery of Bone Marrow-Derived Mesenchymal Stem Cells Improves Tear Production in a Mouse Model of Sjögren's Syndrome.
The purpose of the present study was to test the potential of mouse bone marrow-derived mesenchymal stem cells (BD-MSCs) in improving tear production in a mouse model of Sjögren's syndrome dry eye and to investigate the underlying mechanisms involved. NOD mice (n = 20) were randomized to receive i.p. injection of sterile phosphate buffered saline (PBS, control) or murine BD-MSCs (1 × 106 cells). Tears production was measured at baseline and once a week after treatment using phenol red impregnated threads. Cathepsin S activity in the tears was measured at the end of treatment. After 4 weeks, animals were sacrificed and the lacrimal glands were excised and processed for histopathology, immunohistochemistry, and RNA analysis. Following BD-MSC injection, tears production increased over time when compared to both baseline and PBS injected mice. Although the number of lymphocytic foci in the lacrimal glands of treated animals did not change, the size of the foci decreased by 40.5% when compared to control animals. The mRNA level of the water channel aquaporin 5 was significantly increased following delivery of BD-MSCs. We conclude that treatment with BD-MSCs increases tear production in the NOD mouse model of Sjögren's syndrome. This is likely due to decreased inflammation and increased expression of aquaporin 5.


Α-glucosidase inhibitor isolated from coffee.
The potent α-glucosidase inhibitor (compound I) was isolated from coffee brews by the activity-based fractionation and identified as a β-carboline alkaloid norharman (9H-pyrido[ 3.4-b]indole) on the basis of mass spectroscopy and nuclear magnetic resonance spectra ((1)H NMR, (13)C NMR, and COSY). The norharman showed a potent inhibition against α-glucosidase enzyme in a concentration dependent manner with an IC50 value of 0.27 mM for maltase and 0.41 mM for sucrase, respectively. A Lineweaver-Burk plot revealed that norharman inhibited α-glucosidase enzyme uncompetitively, with a Ki value of 0.13 mM.


Enhanced Measurement of Sugar-Sweetened Beverage Marketing to Young Immigrant Children in Grocery Store Environments.
The marketing of Sugar-Sweetened Beverages (SSBs) within grocers is an obesogenic factor that negatively impacts children's nutritional behavior, specifically for people from racial and ethnic minority groups, such as immigrants. We aimed to develop and employ a methodology that more precisely assesses the availability, price, and promotion of SSBs to young immigrant children within independently owned grocery stores. A case comparison design was used to explore the differences in the grocery store landscape of SSB marketing by conducting an enhanced Nutrition Environment Measures Survey-SSB (NEMS-SSB) within 30 grocery stores in the Hispanic and Latino enclaves in Southwest Detroit, in the Arab and Chaldean enclaves in North-central Detroit, and in Warren, Hamtramck, and Dearborn, in comparison with 48 grocers in Metro Detroit. Unsweetened, plant-based, and organic toddler and infant beverages, as well as questions about marketing, were added to the original NEMS to capture the promotion tactics used in marketing SSBs. NEMS-SSB scores revealed that, in the immigrant enclaves, there was a significantly higher availability of SSBs in grocery stores (-2.38), and they had lower prices than those in the comparison group (-0.052). Unsweetened, plant-based, and organic beverages were unavailable in 97% of all participating grocery stores across both groups. Signage featuring cartoon characters was the most frequent in-store SSB marketing tactic across both groups. Widespread SSB marketing toward toddlers within the grocery stores in immigrant enclaves could be linked with the higher early childhood obesity prevalence among the immigrant population. Our findings can assist local and national organizations in developing and implementing healthy eating interventions. This study must be repeated in other immigrant enclaves across states to provide comparable results.


Impact of Ramadan Fasting on Dietary Intakes Among Healthy Adults: A Year-Round Comparative Study.
Religious rituals are considered among the principle factors that impact dietary behaviors and food selections. The main objective of this study is to characterize food intake among Lebanese adults observant of the fasting month of Ramadan and compare it to their intake of the rest of the year. During a year-round study, including the month of Ramadan, Lebanese adults (n = 62), completed multiple (9 to 13) 24-h dietary recalls. Information about sociodemographic and lifestyle characteristics was also obtained. Dietary intake was examined using food groups as well as energy, macro, and micronutrient consumption. Significant differences in dietary intakes were observed for 12 of the 19 food groups (expressed as a percent of total energy) during Ramadan as compared to the rest of the year. More specifically, the intakes of cereals, cereal-based products, pasta, eggs, nuts and seeds, milk and dairy, and fats and oils were lower, while vegetables, dried fruit, Arabic sweets, cakes and pastries, and sugar-sweetened-beverages intakes were higher during Ramadan as compared to the remainder of the year (p < 0.05). Such differences in food groups' intakes were reflected in nutrients intakes, including carbohydrates, cholesterol, calcium, beta-carotene, vitamin C, folate, and magnesium. The findings of this study highlighted major differences in dietary intakes between the fasting month as compared to the rest of the year. With the large number of adults who observe fasting during Ramadan, the particularities of dietary intake during Ramadan ought to be considered in the development of context and culture-specific dietary recommendations.


Health and Nutritional Status of Vegetarian Candidates for Bariatric Surgery and Practical Recommendations.
Data on vegetarianism and bariatric surgery (BS) are scarce. We herein describe the health and nutritional status of vegetarian patients who plan to undergo BS and propose combined recommendations for vegetarian patients who undergo BS, based on our clinical experience and current scientific literature in both nutrition fields. Cross-sectional analysis of a prospectively maintained database of all primary laparoscopic sleeve gastrectomies (LSG) performed at a bariatric center of excellence between January 2014 and November 2016 was carried out querying patients who declared a vegetarian or vegan lifestyle before surgery. Preoperative data collected included demographics, anthropometrics, dietary patterns, supplementation use, physical activity, smoking habits, co-morbidities, and blood tests. Each vegetarian was matched to five different omnivores based on age, gender, and BMI. During the study period, 1470 patients underwent primary LSG surgery (63.7% females). Twenty-one declared a vegetarian or vegan lifestyle (1.4%) pre-surgery. Most were classified as lacto-ovo (57.1%) and were driven from ethical reasons (85.7%). No differences were found between vegetarian and omnivore LSG candidates regarding co-morbidities and nutritional deficiencies, except for lower prevalence of impaired fasting glucose (14.3 vs. 47.1%;P = 0.007), lower ferritin levels (54.3 ± 50.5 vs. 96.8 ± 121.8 ng/ml; P = 0.052) and higher transferrin levels (313.9 ± 42.7 vs. 278.4 ± 40.4 mg/dl; P = 0.009) among the vegetarian cohort. Preoperative use of vitamin B12 and iron supplementation was higher among vegetarian LSG candidates than their omnivore counterparts (57.1 vs. 6.7%;P < 0.001 and 23.8 vs. 6.7%; P = 0.015, respectively). Vegetarians have comparable health status and nutritional deficiencies, lower iron stores, and higher supplementation use before surgery compared to omnivore LSG candidates.


Cyclic GMP-AMP displays mucosal adjuvant activity in mice.
The recently discovered mammalian enzyme cyclic GMP-AMP synthase produces cyclic GMP-AMP (cGAMP) after being activated by pathogen-derived cytosolic double stranded DNA. The product can stimulate STING-dependent interferon type I signaling. Here, we explore the efficacy of cGAMP as a mucosal adjuvant in mice. We show that cGAMP can enhance the adaptive immune response to the model antigen ovalbumin. It promotes antigen specific IgG and a balanced Th1/Th2 lymphocyte response in immunized mice. A characteristic of the cGAMP-induced immune response is the slightly reduced induction of interleukin-17 as a hallmark of Th17 activity--a distinct feature that is not observed with other cyclic di-nucleotide adjuvants. We further characterize the innate immune stimulation activity in vitro on murine bone marrow-derived dendritic cells and human dendritic cells. The observed results suggest the consideration of cGAMP as a candidate mucosal adjuvant for human vaccines.


A preliminary investigation of dispositional affect, the P300, and sentence processing.
We examined whether dispositional affect modulated the relation between sentence processing and the P300 Event Related Potential (ERP) component. We used sentence stimuli from our previous study, where sentences started with subject nouns that were quantified e.g., Every kid… or not, as in The kid…, and continued with a direct object which was either singular, as in a tree, or plural the trees. In this Stroop-like task, participants read sentences presented in 1- and 2-word chunks, and were asked to identify the number of words on the screen at the target word tree(s), which was always presented alone (and never sentence-final). We replicated previous findings of a P300 effect, at the target tree(s), however, actual by-condition effects differed from previous work. Of interest, clear individual differences were apparent. Participants with relatively lower Positive Affect scores (as measured by the Positive and Negative Affect Schedule; PANAS), showed differential P300 responses to the control condition, Every/The kid climbed the tree. Thus, the present ERP findings demonstrate that dispositional affect modulated P300 effects. These findings suggest that, rather than relying on global heuristic cues for sentence meaning interpretation, these participants may be differentially sensitive to local (grammatical) cues which signify task relevance. We discuss our results in terms of theories of positive affect, where less positive individuals are differentially sensitive to local (grammatical) information.


A discussion of apraxia, aphasia, and gestural language.
It is understood that damage to the left cerebral hemisphere in adulthood may result in syndromes of language disturbances called the aphasias. The study of these syndromes sheds light on normal language processes, the relationship between language behavior and the brain, and how best to treat aphasic individuals. Aphasia, for some, is a central communication disorder affecting all symbolic behavior in all modalities (i.e., speech, writing, and gesture). Difficulty producing symbolic gestures on command is called apraxia. Others view aphasia as a manifestation of a motor-sequencing disorder affecting all gestural systems including those required for speech movements. These divergent theories of the underlying nature of aphasia can be tested through examination of deaf individuals who use sign language before onset of aphasia. Poizner et al. [Am. J. Physiol. 246 (Regulatory Integrative Comp. Physiol. 15): R868-R883, 1984] studied three such patients with different aphasia syndromes: one patient had a nonsymbolic, motor-sequencing disorder; one had a gestural apraxia; and one had neither. These findings force the conclusion that neither the symbolic nor motor-sequencing theory of aphasia can account for the many varieties of that disorder.