[Suicide in the elderly: collapse of value orientation?].
Suicide of the aged has often been understood as a careful deliberation of the quintessence of life. Nevertheless, it displays the breakdown or the entire lack of value orientation. Some gerontologists have come to terms with the fact that the ideal of value-free living results in the suicidality of the aged. Suicide seems to be a probable solution of their problems. But values regulate the social existence of humans. Accordingly, this paper considers suicide of the aged to be a result of this disorientation. Thus, it demands first of all that a rich set of values has to be developed, and secondly, that adequate resources of values have to be proposed. This can be achieved by four steps: 1) distance from the critical situation, 2) combination of interaction and mutual appreciation, 3) analyzing the reduced set of values, and 4) opening new priorities and preferences.


Increased levels of Wee-1 kinase in G(2) are necessary for Vpr- and gamma irradiation-induced G(2) arrest.
Human immunodeficiency virus type 1 (HIV-1) Vpr induces cell cycle arrest at the G(2)/M transition and subsequently apoptosis. Here we examined the potential involvement of Wee-1 in Vpr-induced G(2) arrest. Wee-1 is a cellular protein kinase that inhibits Cdc2 activity, thereby preventing cells from proceeding through mitosis. We previously showed that the levels of Wee-1 correlate with Vpr-mediated apoptosis. Here, we demonstrate that Vpr-induced G(2) arrest correlated with delayed degradation of Wee-1 at G(2)/M. Experimental depletion of Wee-1 by a small interfering RNA directed to wee-1 mRNA alleviated Vpr-induced G(2) arrest and allowed apparently normal progression through M into G(1). Similar results were observed when cells were arrested at G(2) following gamma irradiation. Thus, Wee-1 is integrally involved as a key cellular regulatory protein in the signal transduction pathway for HIV-1 Vpr-induced cell cycle arrest.


Anesthesia and Postoperative Respiratory Compromise Following Major Lower Extremity Surgery: Implications for Combat Casualties.
Care of military casualties requires not only assessment of patient, injury, and setting, but also the consequences of care decisions on other organ systems. In contemporary conflicts, pelviperineal and lower extremity trauma are common injuries, yet the optimal perioperative anesthetic and analgesic care remains unclear. Residual anesthesia and opioids can cause respiratory depression, specifically postoperative respiratory depression and opioid-induced respiratory depression. This observational study quantified and compared the incidences of respiratory depression following general anesthesia (GA) and spinal anesthesia (SA) for lower extremity surgery. Respiratory data were collected from 173 patients receiving either GA (n = 43) or SA (n = 130) via a bioimpedance-based respiratory volume monitor. Patients were further subdivided by postoperative opioid administration. The overall incidence of respiratory depression was significantly higher in the SA group (48/130 vs. 6/43, p = 0.004). These findings suggest that, while SA may be considered the safer alternative, it may in fact introduce confounding factors, which increase the risk of respiratory depression. Ensuring adequate respiratory status is particularly critical for the military population, as combat casualties are often monitored in understaffed environments following surgery. Using an SA strategy instead of GA may not prevent postoperative respiratory depression, and respiratory volume monitor monitoring may be useful to optimize care.


Bladder and kidney function after cure of pelvic rhabdomyosarcoma in childhood.
Eleven survivors of pelvic rhabdomyosarcoma underwent bladder function studies and upper urinary tract evaluation at a mean of 6.6 years after completion of therapy, which included a conservative, bladder-sparing surgical policy. Primary tumour sites were: bladder base/prostate, 6; bladder dome, 1; vagina, 2; and pelvic side wall, 2. Seven children (five bladder base/prostate, one vagina and one pelvic side wall tumours) had received irradiation to the pelvis with external beam alone, brachytherapy or both. All seven of these patients had markedly reduced functional bladder capacity (11-48% of mean expected value for age) and abnormal voiding patterns, though bladder compliance was not reduced and bladder emptying was almost complete in five cases. Four of these children also had upper tract dilatation and two required reconstructive bladder surgery because of severe bilateral hydronephrosis. By contrast, each of four children treated without radiotherapy had a normal functional bladder capacity and a normal voiding pattern. all survivors of pelvic rhabdomyosarcoma, especially those who have received radiotherapy, should be carefully monitored for dysfunction of both lower and upper urinary tracts. The frequency-volume voiding chart is a sensitive and easily accomplished method of assessing bladder function in these patients.


Differential regulation of c-fos, fosB, c-jun, junB, bcl-2 and bax expression in rat skin following single or chronic ultraviolet irradiation and in vivo modulation by antisense oligodeoxynucleotide superfusion.
Single ultraviolet (u.v.) irradiation of mammalian cells in culture evokes the transcriptional activation of various proto-oncogenes, among them members of the fos/jun family which are known to play an important role in cell proliferation and differentiation. u.v. exposure of mammalian skin results in growth arrest and cell death followed by hyperproliferation of epidermal cells. To obtain information in vivo about a possible relationship between u.v.-induced proto-oncogene expression and cellular alterations, we have analysed the expression of c-fos, fosB, c-jun, junB, bcl-2 and bax in rat epidermis after single and chronic u.v. irradiation. We present data demonstrating that the transcripts of these genes are constitutively expressed in the epidermis and that expression is differentially modulated by u.v. exposure. Single u.v. irradiation causes a rapid and sustained increase in c-jun, junB and c-fos mRNA and a decline in bcl-2 transcripts, whereas expression of bax remained unchanged. c-Fos and c-Jun immunoreactivity was localized throughout the epidermal cell layers 1.5 h after single irradiation, but restricted to basal cells at 48 h suggesting an involvement in both u.v.-induced apoptosis and hyperproliferation. 48 h after chronic exposure a significantly higher induction and a totally different pattern of epidermal proto-oncogene expression was detectable which may be associated with malignancy. Superfusion of rat skin with c-fos antisense oligodeoxynucleotides inhibited the increase in c-Fos immunolabeled epidermal cells 1.5 h after single u.v. irradiation demonstrating that antisense oligodeoxynucleotides are capable of penetrating mammalian skin and modulating the u.v. response in vivo. However, suppression of the early c-Fos activation did not significantly affect the formation of sunburn cells in the u.v.-exposed epidermis. Thus, c-Fos does not seem to play a major role in u.v.-induced apoptosis or other members of the fos/jun family may compensate for a loss in c-Fos.


A beryllium container for wide angle x-ray scattering characterization of radioactive glasses at synchrotron facilities.
A beryllium containment device suitable for wide angle x-ray scattering experiments with highly radioactive amorphous samples and conforming to safety regulations at synchrotron x-ray radiation sources is presented. The container is made of three concentric tubes closed at one end with threaded caps. The final device looks like Russian nesting dolls. The container was tested with a Cm-doped borosilicate glass, in transmission mode and normal conditions. The strength and weakness of the obtained results are discussed.


The in vivo effect of melatonin on cellular activation processes in human blood during strenuous physical exercise.
Melatonin has been reported to have anti- as well as pro-inflammatory properties. Because physical stress is associated with the activation of blood cells, the present study examines melatonin's role in exercise-induced cell activation processes. Eight healthy volunteers (aged 20-62 yr, mean = 31), exercised on an 'Ergometric' bike for 30 min at 80% of their calculated maximum pulse rate. Blood samples were taken just before melatonin administration, directly after exercise, and 2 hr after exercise completion. Cytokine and eicosanoid parameters were measured in plasma from blood stimulated with lipopolysaccharide (LPS) for 2 hr whereas tissue factor (TF) activity was measured in isolated monocytes. Melatonin significantly decreased LPS-induced TF activity by 48% (P < 0.01) directly after exercise, and a 44% reduction was seen 2 hr later (P < 0.02). Furthermore, melatonin significantly reduced the lymphocyte count rise produced directly after exercising by more than 30% (P < 0.01). A trend was also seen for melatonin suppressing the increase of WBC by around 10% and to strengthen the platelet increase by about 8% after physical stress. Melatonin also significantly lowered RBC and hemoglobin counts by 5 and 3-4% during exercise (P < 0.005 and <0.02 respectively). Two hours after exercise, melatonin tended to lower leukotriene B4 levels by 30%. Interleukin-8 and tumor necrosis factor-alpha levels tended to be lower in individuals who had taken melatonin following hard physical activity and a larger sample size may show significance. Thromboxane B2 production seemed unaffected by melatonin during exercise. In conclusion, in vivo intake of melatonin appears to suppress LPS-induced activation of monocytes in whole blood reactions associated with physical exercise and facilitates the down-regulation of inflammatory mediators.


Intranasal insulin suppresses endogenous glucose production in humans compared with placebo in the presence of similar venous insulin concentrations.
Intranasal insulin (INI) has been shown to modulate food intake and food-related activity in the central nervous system in humans. Because INI increases insulin concentration in the cerebrospinal fluid, these effects have been postulated to be mediated via insulin action in the brain, although peripheral effects of insulin cannot be excluded. INI has been shown to lower plasma glucose in some studies, but whether it regulates endogenous glucose production (EGP) is not known. To assess the role of INI in the regulation of EGP, eight healthy men were studied in a single-blind, crossover study with two randomized visits (one with 40 IU INI and the other with intranasal placebo [INP] administration) 4 weeks apart. EGP was assessed under conditions of an arterial pancreatic clamp, with a primed, constant infusion of deuterated glucose and infusion of 20% dextrose as required to maintain euglycemia. Between 180 and 360 min after administration, INI significantly suppressed EGP by 35.6% compared with INP, despite similar venous insulin concentrations. In conclusion, INI lowers EGP in humans compared with INP, despite similar venous insulin concentrations. INI may therefore be of value in treating excess liver glucose production in diabetes.


Service use of older people who participate in primary care health promotion: a latent class analysis.
Recruiting patients to health promotion programmes who will benefit is crucial to success. A key policy driver for health promotion in older people is to reduce health and social care use. Our aim was to describe service use among older people taking part in the Multi-dimensional Risk Appraisal for Older people primary care health promotion programme. A random sample of 1 in 3 older people (≥65 years old) was invited to participate in the Multi-dimensional Risk Appraisal for Older people project across five general practices in London and Hertfordshire. Data collected included socio-demographic characteristics, well-being and functional ability, lifestyle factors and service use. Latent class analysis (LCA) was used to identify groups based on use of the following: secondary health care, primary health care, community health care, paid care, unpaid care, leisure and local authority resources. Differences in group characteristics were assessed using univariate logistic regression, weighted by probability of class assignation and clustered by GP practice. Response rate was 34% (526/1550) with 447 participants presenting sufficient data for analysis. LCA using three groups gave the most meaningful interpretation and best model fit. About a third (active well) were fit and active with low service use. Just under a third (high NHS users) had high impairments with high primary, secondary and community health care contact, but low non-health services use. Just over a third (community service users) with high impairments used community health and other services without much hospital use. Older people taking part in the Multi-dimensional Risk Appraisal for Older people primary care health promotion can be described as three groups: active well, high NHS users, and community service users.


Denosumab: a potential new and innovative treatment option for aneurysmal bone cysts.
Aneurysmal bone cysts (ABCs) are expansive and destructive lesions positive for osteoclast markers, resembling benign giant cell tumors (GCTs). Treatment options include surgical resection, curettage and cavity filling, embolization, injection of fibrosing agents, or radiotherapy. Particularly in children and adolescents with spinal ABCs, these options may be unsatisfactory, and innovative forms of treatment are needed. Denosumab is a human monoclonal antibody that inhibits osteoclast function by blocking the cytokine receptor activator of the nuclear factor-kappa B ligand. Satisfactory results with denosumab in treating GCTs and immunohistochemical similarities suggest that it may also have positive effects on ABCs. This report is the first description of the therapeutic use of denosumab in two patients with spinal ABCs. Two boys (aged 8 and 11) had recurrent ABCs at C5 after surgery with intralesional tumor resection. Treatment options were discussed by the interdisciplinary tumor board. Arterial embolization was attempted, but failed due to an absence of appropriate afferent arteries. After the families had received extensive information and provided written consent, denosumab therapy was initiated as an individualized treatment, despite the absence as yet of scientific evidence. After the start of denosumab therapy, both patients recovered from pain and neurologic symptoms significantly and are now in a healthy condition with no severe side effects. Magnetic resonance imaging check-ups after 2 or 4 months of denosumab treatment, respectively, showed tumor regression in both patients. Longer follow-up and clinical studies are warranted to establish the value of denosumab in the treatment of ABCs.


The effect of a progesterone releasing intravaginal device (PRID) on pregnancy risk to fixed-time insemination following diagnosis of non-pregnancy in dairy cows.
The objective was to compare the probability of pregnancy after fixed-time insemination in cows diagnosed as non-pregnant and re-inseminated following the Ovsynch protocol, with or without exogenous progesterone. Cows (n=415) used in this study originated from 25 farms. Upon diagnosis of non-pregnancy between 30 and 60 days after AI, cows were randomly assigned to receive either a progesterone releasing intravaginal device (PRID; n=208) or a placebo intravaginal device (PID; n=207). All cows received GnRH at enrollment (Day 0), PGF(2alpha) concurrent with intravaginal device removal 7 days later, GnRH on Day 9 and fixed-time insemination 16h later (Day 10). Cows observed in estrus prior to Day 7, had the device removed and were inseminated. Ovaries were examined by transrectal palpation at the time of enrollment and the prominent structures were assessed and recorded. Body condition score, lameness status, interval from previous insemination, and times bred at enrollment were recorded. At intravaginal device removal, the occurrence and intensity of vaginitis was determined according to the amount of debris on the device. Overall, the intravaginal device retention rate was 91%. A total of 5.2% of PID-treated cows and 2.9% of PRID-treated cows were detected in estrus within the 7 days treatment period. Pregnancy status was diagnosed between 30 and 56 days after insemination and all cows were followed for a minimum of 150 days after enrollment. Approximately 28% of cows had evidence of mild vaginitis in response to the intravaginal device, whereas 6% of cows had copious debris associated with the intravaginal device at removal. The probability of pregnancy after fixed-time insemination was 43.8% versus 34.9% in PRID-treated versus PID-treated animals. Exogenous progesterone provided through an intravaginal device to non-pregnant cows that had not displayed estrus improved the probability of pregnancy after fixed-time AI.


Measurement of end-expiratory pressure as an indicator of airway patentcy above tracheostomy in children.
The tracheostomy speaking valve is a one-way valve that closes during exhalation. It causes redirection of exhaled gas into the larynx, mouth and nasal cavity, thus enabling children with long-term tracheostomies to speak. Whether a child can tolerate the valve depends mainly on the patency of the upper airway around and above the tracheostomy tube. To measure end-expiratory pressure (EEP) at the tracheostomy tube when the speaking valve is being put in place may be a useful noninvasive tool to assess the patency of the exhalation pathway. The authors, therefore, measured EEP when the patients were first put on the speaking valves and tried to follow-up the patients thereafter. Twenty-two tracheostomized children (aged 3.2 months to 1 7years, male/female 16/6) were recruited for the present study and EEP was measured. It was found that 13 children having the EEP in the range of 2-6 cmH2O could breathe normally through the valves and later could use the valves without any problems, whereas 9 children with EEP in the range of 10-40 cmH2O demonstrated breathing difficulties and the valves had to be taken off immediately. Bronchoscopy revealed upper airway narrowing in all of those children with unsuccessful valve placements. It was concluded that EEP was exceedingly high in children with upper airway narrowing. The measurement of EEP via speaking valves can, thus, be used as an objective indicator to evaluate the patency of upper airway proximal to the tracheostomy tube.


Inhibition of androgen action by dehydroepiandrosterone sulfotransferase transfected in PC-3 prostate cancer cells.
Age-dependent loss of androgen sensitivity of the rat liver is associated with a marked increase in dehydroepiandrosterone/hydroxysteroid sulfotransferase (rStd) activity. Sulfonated steroid hormones are known to be ineffective in binding receptor proteins. These observations suggest that intracellular androgen sulfonation can physiologically influence androgen action. We have examined the inhibitory effect of rStd on androgen action in the human prostate cancer-derived PC-3 cells transfected with the rat androgen receptor (AR) expression plasmid and two androgen-responsive promoter reporter constructs (murine mammary tumor long-terminal repeat ligated to chloramphenicol acetyltransferase (CAT) gene and rat probasin androgen response element (ARE) ligated to firefly luciferase (LUC) gene). These transfected cells were dependent on 5alpha-dihydrotestosterone (DHT) for the activation of both reporter genes and showed about a 200- and a 800-fold increase of CAT and LUC activity, respectively, at 10(-10) M DHT over the no-hormone control. Expression of the sulfonating enzyme in this cell transfection system via the rStd expression plasmid caused a dose-dependent decline in the reporter activity with approximately 90% inhibition of androgen action at a rStd:AR plasmid ratio of 100. From these results we conclude that irrespective of a high level of AR, changes in the Std expression can markedly alter the androgen sensitivity of target cells.


Foreign scientists on the contribution of Serbian physician and scientist Dr. Lazar K. Lazarević to medical science.
Dr. Lazar K. Lazarević (1851-1890, Julian calendar/1891, Gregorian calendar) was an exceptional Serbian physician, scientist, writer and translator. During his short life and his close to 11-year-long professional career (1879-1890), Dr. Lazarević authored 78 scientific papers and presentations in various branches of medicine. His greatest contribution to the field of neurology and to medical science in general is his description of the straight leg raising test.The article titled"Ischiac postica Cotunnii--One contribution to its differential diagnosis"was published in the Serbian language (in Cyrillic alphabet) in the Serbian Archives of Medicine in 1880.The article was translated to German and republished in Vienna in 1884 in Allgemeine Wiener medizinische Zeitung. The straight leg raising test is usually called Lasegue's test/sign, after the French clinician Charles Lasègue, although he never described it. However, there are numerous authors who admit that Lasègue never published the description of the straight leg raising test, and instead give full credits for its discovery to Dr. Lazarević. Our objective in this article is to highlight the major literature written by foreign scientists who give credit to Dr. Lazarević for his contribution to medical science.


Elevated thyroxine levels in a euthyroid patient. A search for the cause of euthyroid hyperthyroxinemia.
A clinically euthyroid man with a family history of hyperthyroidism presented for evaluation of an elevated thyroxine (T4) level and an increased free T4 index with a normal thyrotropin (TSH) level. Results of thyroid hormone-binding protein tests confirmed the diagnosis of familial dysalbuminemic hyperthyroxinemia. This disorder should be considered in patients who have a normal serum TSH level, despite an elevated total T4 concentration. Accurate diagnosis is essential to avoid inappropriate treatment. Affected family members also should be identified. No treatment is required, because patients remain euthyroid and maintain a normal free T4 level.


Elevated macrophage-inducible C-type lectin expression in the synovial tissue of patients with rheumatoid arthritis.
Rheumatoid arthritis (RA), a systemic autoimmune disease, is known to cause chronic inflammation in synovial joints. A number of inflammatory conditions are associated with stimulation of Clec4e, a macrophage-inducible C-type lectin (MINCLE) and transmembrane pattern recognition receptor that functions in innate immunity. We previously reported MINCLE expression in synovial macrophages isolated from the synovium of osteoarthritis (OA) patients. However, MINCLE expression has not been examined in RA synovial tissue. To examine MINCLE expression in RA patients, synovial tissue specimens were obtained from patients with RA and OA during joint replacement surgery (n = 20 each). Total RNA was extracted from synovial tissue and used to compare MINCLE expression in OA and RA (n = 15 each). We also extracted fresh CD14+ (macrophage-rich) and CD14- cell fractions from synovial tissue and compared MINCLE expression between OA and RA patients (n = 5 each). MINCLE levels in synovial tissue were significantly elevated in RA patients compared to OA patients. MINCLE expression was significantly elevated in the CD14+ fraction compared to the CD14- fraction in both OA and RA patients. Further, while there were no differences in the CD14+ fraction between RA and OA, MINCLE expression in the CD14- fraction was elevated in RA compared to OA. Our findings indicate that MINCLE expression is elevated in the synovium of RA patients and that MINCLE expression in non-macrophage cell fractions may be a key feature of RA.


Essential Roles for RNA in Shaping Nuclear Organization.
It has long been proposed that nuclear RNAs might play an important role in organizing the structure of the nucleus. Initial experiments performed more than 30 years ago found that global disruption of RNA led to visible rearrangements of nuclear organization. Yet, this idea remained controversial for many years, in large part because it was unclear what specific RNAs might be involved, and which specific nuclear structures might be dependent on RNA. Over the past few years, the contributions of RNA to organizing nuclear structures have become clearer with the discovery that many nuclear bodies are enriched for specific noncoding RNAs (ncRNAs); in specific cases, ncRNAs have been shown to be essential for establishment and maintenance of these nuclear structures. More recently, many different ncRNAs have been shown to play critical roles in initiating the three-dimensional (3D) spatial organization of DNA, RNA, and protein molecules in the nucleus. These examples, combined with global imaging and genomic experiments, have begun to paint a picture of a broader role for RNA in nuclear organization and to uncover a unifying mechanism that may explain why RNA is a uniquely suited molecule for this role. In this review, we provide an overview of the history of RNA and nuclear structure and discuss key examples of RNA-mediated bodies, the global roles of ncRNAs in shaping nuclear structure, and emerging insights into mechanisms of RNA-mediated nuclear organization.


On the adsorption/reaction of acetone on pure and sulfate-modified zirconias.
In situ FTIR spectroscopy was employed to investigate some aspects of the ambient temperature (actually, IR-beam temperature) adsorption of acetone on various pure and sulfate-doped zirconia specimens. Acetone uptake yields, on all examined systems and to a variable extent, different types of specific molecular adsorption, depending on the kind/population of available surface sites: relatively weak H-bonding interaction(s) with surface hydroxyls, medium-strong coordinative interaction with Lewis acidic sites, and strong H-bonding interaction with Brønsted acidic centres. Moreover acetone, readily and abundantly adsorbed in molecular form, is able to undergo the aldol condensation reaction (yielding, as the main reaction product, adsorbed mesityl oxide) only if the adsorbing material possesses some specific surface features. The occurrence/non-occurrence of the acetone self-condensation reaction is discussed, and leads to conclusions concerning the sites that catalyze the condensation reaction that do not agree with either of two conflicting interpretations present in the literature of acetone uptake/reaction on, mainly, zeolitic systems. In particular, what turns out to be actually necessary for the acetone aldol condensation reaction to occur on the examined zirconia systems is the presence of coordinatively unsaturated O(2-) surface sites of basicity sufficient to lead to the extraction of a proton from one of the CH3 groups of adsorbed acetone.


Erratum: Investigation of Consensually Nonmonogamous Relationships: Theories, Methods, and New Directions.
Conley, T. D., Matsick, J. L., Moors, A. C., & Ziegler, A. (2017). Investigation of consensually nonmonogamous relationships: Theories, methods, and new directions. Perspectives in Psychological Science, 12, 205-232. doi: 10.1177/1745691616667925 The byline for this article should be as follows: Terri D. Conley1, Jes L. Matsick2, Amy C. Moors3, and Ali Ziegler1.


Diagnostic comparison of needle and wedge biopsy specimens of the liver in dogs and cats.
To compare morphologic diagnoses determined from needle biopsy specimens obtained from the livers of dogs and cats with morphologic diagnoses determined from wedge biopsy specimens. Prospective study. 124 dogs and cats. 2 needle biopsy specimens were obtained from each animal; wedge biopsy specimens were obtained from the same liver lobe during laparotomy or postmortem examination. Histologic features were scored independently by 3 individuals; a morphologic diagnosis was rendered after histologic features were scored. Cases were included only if at least 2 of the 3 examiners agreed on the morphologic diagnosis; the definitive diagnosis was considered to be the morphologic diagnosis rendered for the wedge biopsy specimen. Physical characteristics (length, width, surface area, degree of fragmentation, and number of portal triads for needle biopsy specimens and surface area for wedge biopsy specimens) were determined. Definitive diagnoses included hepatic necrosis (n = 10), cholangitis-cholangiohepatitis (13), chronic hepatitis-cirrhosis (12), canine vacuolar hepatopathy (11), portosystemic vascular anomaly-microvascular dysplasia (17), neoplasia (10), miscellaneous hepatic disorders (18), and no hepatic disease (33). For individual examiners, the morphologic diagnosis assigned to needle biopsy specimens agreed with the morphologic diagnosis assigned to wedge biopsy specimens for 56 and 67% of the specimens. All 3 examiners agreed on the morphologic diagnosis assigned to needle and wedge biopsy specimens for 44 and 65% of the specimens, respectively. Morphologic diagnoses assigned to needle biopsy specimens concurred with the definitive diagnosis for 59 of 124 (48%) animals. Results suggest that needle biopsy specimens of the liver from dogs and cats must be interpreted with caution.


Surgical unit time utilization review: resource utilization and management implications.
As health care providers seek ways to reduce the cost of health care services, hospital operating rooms (ORs) have been identified as potential areas for cost reduction efforts. Cost containment efforts which have shifted significant portions of the inpatient population to ambulatory areas have resulted in an inpatient population which is sicker and more procedure-intensive. Efficient management of operating rooms has assumed even greater importance in this environment. Inefficient or inaccurate scheduling of OR time often results in delays of surgery or cancellations of procedures, which are costly to the patient and the hospital. Approaches to efficient use of ORs include computerized scheduling, utilization monitoring, and refinement of scheduling policies and procedures. In the absence of commercially available software to meet operating room management information needs, Johns Hopkins developed its own system in 1983. This software provides detailed information for daily OR management and long-term planning. The computerized operating room scheduling and monitoring system is described in this article and an operational measure of scheduling accuracy is proposed. Suggestions are made for incorporating this measure into planning and allocation decisions.


[HIV-1 infection up-regulating expression of interferon-stimulated gene 15 in cell lines].
To investigate whether HIV-1 infection affects expression of interferon-stimulated gene 15 (ISG15) and determine the antiviral effect of ISG15 in vitro, ISG15 expression at transcription and protein level and supernatant p24 of HIV-1 was detected in various HIV-1 infected or transfected cell lines, respec tively. HIV-1 molecular clone pNL4-3 was used to transfect 293T, TZM-bl and HeLa cells while HIV-1 pseudo-typed virus was used to infect Jurkat, MT-1 and THP-1 cells. After twenty-four hours post infection or transfection, cells were harvested for extraction of total RNAs and subsequently used in real time PCR for quantification of ISG15 transcriptional expression. After forty-eight hours post infection or transfection, cells were harvested for extraction of total proteins to detect ISG15 protein expression. A significant up-regulation of ISG15 at transcription level was observed in HIV-1 infected or transfected cell lines, particulaly in THP-1 and TZM-bl cells. Up-regulation of ISG15 protein was observed only in TZM-bl cell. Cotransfection of ISG15 and HIV-1 indicated that ISG15 inhibited production of HIV-1 progeny virus in a dose and time depend manner in 293T cell but not TZM-bl cell. These results revealed upregulating ISG15 expression in transcriptional level and potential antagonistic mechanism against ISG15 by HIV-1 infection, simultanelusly.


[Experimental study of the correlation of telomerase and intramedullary scar after spinal cord injury in rats].
To detect the expression of telomerase in glial scar and its correlation with glial scar. There were 120 Sprague Dawley rats were randomly divided into non-interference group of telomerase, interference group of telomerase and control group. Non-interference group and interference group were for spinal cord injury, which adopted Allen's Weight Dropping to make molding; control group was for sham operation to open the vertebral plate and expose spinal marrow, in which spinal cord injury would not be caused. The expression of telomerase and glial fibrillary acidic profein (GFAP) was detected by PCR-ELISA and Western blot, and the formation of glial scar was observed by immunofluorescence on the 1st, 3rd, 5th, 7th, 14th, 28th, 42 th and 56th day after the spinal injury, and analyzed its relativity. The expression of telomerase in non-interference group was (0.180 ± 0.004 - 1.217 ± 0.072), which was significantly higher than those in interference group (0.028 ± 0.007 - 0.092 ± 0.004, χ(2) = 28.753 - 37.518, P < 0.05) and control group (0.072 ± 0.007 - 0.075 ± 0.004, χ(2) = 18.618 - 41.093, P < 0.05) at all the time, with statistical significance. The expression of GFAP in non-interference group was (1.98 ± 0.15 - 19.40 ± 0.55) which was significantly higher than those in interference group (1.10 ± 0.13 - 16.64 ± 1.02, χ(2) = 14.538 - 37.366, P < 0.05) and control group (0.44 ± 0.05 - 0.48 ± 0.04, χ(2) = 16.733 - 34.041, P < 0.05) at all the time, with statistical significance. The expression of GFAP showed a linear correlation with that of telomerase in non-interference group, and with statistical differences (r = 0.755, P < 0.01). The expression of telomerase in interference group and control group were always negative. Glial scar observed by immunofluorescence in non-interference group was heavier than that in interference group, and control group showed no formation of glial scar. Telomerase shows a dynamic expression in glial scar and has positive correlational linear relationship with GFAP which shows the formation of glial scar. And the telomerase may be an important factor in promoting the formation of glial scar.


Synthesis and Adsorption Property of SiO₂@Co(OH)₂ Core-Shell Nanoparticles.
Silica nanoparticles were directly coated with cobalt hydroxide by homogeneous precipitation of slowly decomposing urea in cobalt nitrate solution. The cobalt hydroxide was amorphous, and its morphology was nanoflower-like. The BET (Brunauer-Emmett-Teller) surface area of the core-shell composite was 221 m²/g. Moreover, the possible formation procedure is proposed: the electropositive cobalt ions were first adsorbed on the electronegative silica nanoparticles surface, which hydrolyzed to form cobalt hydroxide nanoparticles. Then, the cobalt hydroxide nanoparticles were aggregated to form nanoflakes. Finally, the nanoflakes self-assembled, forming cobalt hydroxide nanoflowers. Adsorption measurement showed that the core-shell composite exhibited excellent adsorption capability of Rhodamine B (RB).


Prevalence and Risk Factors of Allergic Rhinitis in Primary School Students of Isfahan, Iran.
Allergic rhinitis (AR) is one of the most common chronic diseases of childhood. Different studies have indicated an increasing prevalence of AR worldwide. The most common complaints of the patients are itching, tearing eyes, and rhinorrhea. The present study aims to assess the prevalence and risk factors of AR among 6-7-year-old children of Isfahan Province, Iran. This cross-sectional study conducted on 973 67-year-old primary school students of Isfahan Province in 2016. The study was conducted based on the International Study of Asthma and Allergies in Childhood questionnaire. This study was conducted on 322 (33.1%) 6-year-old and 651 (66.9%) 7-year-old students. A total of 563 (57.9%) and 410 (42.1%) students were male and female, respectively. AR was diagnosed in 397 (40.8%) cases that 190 (47.8%) and 130 (32.7%) showed seasonal and permanent AR, respectively. A percentage of 44.7% of 6-year-old and 38.9% of 7-year-old (P = 0.04) students, 42.1% of males and 39% of females (P = 0.336), had AR; however, the percentages were not significant (P = 0.005). Exposure to smoking, plants, and domestic association with AR was not significant (P = 0.317, P = 0.863, and P = 0.253, respectively), but infancy breastfeeding association was significant (P = 0.015). Residence in the second area of Isfahan city was accompanied by higher prevalence of AR (P = 0.006). The prevalence of AR was considerably higher in Isfahan as one of the largest cities of Iran. It was significantly associated with age, infancy milk feeding, and area of residence but not with sex, smoking, plant, and domestic exposure.


[The human alpha(2A)-AR gene and the genotype of site -1296 and the susceptibility to motion sickness].
The gene sequences of alpha(2A)-adrenergic receptor(alpha(2A)-AR) in 39 Chinese and 1 Englishman showed 13 differences of g or c insertion or deletion in its regulation region, coding region and 3' untranslated region, compared with that reported in GenBank. The gene sequences from all the samples respectively were identical except for 2 single nucleotide polymorphisms, including the sequence of sense and antisense strand sequenced. It was found that: (1) the frequency of gg genotype in Chinese and Japanese, who are high susceptible to motion sickness, were 5.8 and 7.8 fold higher than that in Englishmen; (2) g allele frequencies in Chinese and Japanese were higher than latter ( P 0.01 ); (3) gg genotype frequency in population susceptible to motion sickness was 1.6 fold higher than that in population unsusceptible to motion sickness, and g allele frequency was higher than latter ( P 0.01 ). All the populations were in Hardy-Weinberg equilibrium. The results suggested that gg genotype and g allele at site -1296 in alpha(2A)-AR gene could associate with the susceptibility to motion sickness.


Three new species of Trimmatothelopsis (Acarosporales, Acarosporaceae) from southwestern North America.
The discovery and study of three new species of Trimmatothelopsis from Southwestern North America, T.californica, T.mexicana, and T.novomexicana, adds not only to the diversity of the genus and family but generated new insights into the occurrence of two ascus types in the genus and the variety of conidiogenous cells and conidia. Trimmatothelopsis now includes 15 species with a mainly Holarctic distribution (Asia, Europe, North America) and one species in Australia. A key is supplied to the genus. An overview of the genus Trimmatothelopsis is given, including differentiation from other genera of Acarosporaceae. The monotypic genus Thelocarpella is considered to be a synonym of Trimmatothelopsis. The new combination Trimmatothelopsiswirthii is proposed. The ascus type is shown to be variable in the genus with species with two types being intermixed with each other in our phylogeny.


The use of immunoblotting to detect antibodies to nuclear and cytoplasmic antigens. Clinical and serological associations in rheumatic diseases.
Using the immunoblotting technique, sera from 433 patients with rheumatic diseases were screened for the presence of antibodies against several nuclear and cytoplasmic antigens, such as RNP, Sm, Ro(SSA), La(SSB), CR-19 (centromeric antigen), Topo-1 (Scl-70), Jo-1, histone and 56 kD. At the same time clinical data from these patients were collected without prior knowledge of the immunoblotting results. Syndrome-specific autoantibodies were found for mixed connective tissue disease (antibodies against the RNP related 70 kD antigen), for CREST (anti-CR-19 antibodies), for diffuse scleroderma (anti-Topo-1 antibodies) and for polymyositis (anti-Jo-1 antibodies). Almost all specific autoantibodies were present exclusively in patients with a connective tissue disease. Controls were only in a few cases positive for antihistone and anti-56 kD antibodies. Associations of specific autoantibodies with clinical and laboratory features of the patients were mostly as expected. However, some unexpected associations were found, for example polymyositis and calcinosis with anti-Sm antibodies, sicca symptoms with anti-centromere antibodies and leucopenia with Ro(SSA) and La(SSB).


Elevating the role of medical informational officer.
Consider the reasons why a chief medical informatics officer should be part of the senior management team of a health care organization.


Lipid-dependent deposition of alpha-synuclein and Tau on neuronal Secretogranin II-positive vesicular membranes with age.
This report demonstrates insoluble alpha-synuclein (aSYN)+ aggregates in human sporadic Parkinson's disease (PD) midbrain that are linearly correlated with loss of glucocerebrosidase (GCase) activity. To identify early protein-lipid interactions that coincide with loss of lipid homeostasis, an aging study was carried out in mice with age-dependent reductions in GCase function. The analysis identified aberrant lipid-association by aSYN and hyperphosphorylated Tau (pTau) in a specific subset of neurotransmitter-containing, Secretogranin II (SgII)+ large, dense-core vesicles (LDCVs) responsible for neurotransmission of dopamine and other monoamines. The lipid vesicle-accumulation was concurrent with loss of PSD-95 suggesting synaptic destabilization. aSYN overexpression in the absence of lipid deregulation did not recapitulate the abnormal association with SgII+ vesicles. These results show lipid-dependent changes occur with age in neuronal vesicular membrane compartments that accumulate lipid-stabilized aSYN and pTau.


The effect of cholestyramine and Mevinolin on the diurnal cycle of rat hepatic 3-hydroxy-3-methylglutaryl coenzyme A reductase.
Rats were fed powdered rat chow or a rat chow diet containing 5% cholestyramine or 5% cholestyramine with Mevinolin (112 mg/100 g food, 200 mg/kg body weight per day). The specific activity of hepatic 3-hydroxy-3-methylglutaryl coenzyme A reductase was determined at different times during the diurnal cycle of the enzyme. Animals fed cholestyramine had higher specific activities of HMG-CoA reductase at all time points tested when compared to controls. The specific activity at the peak in the diurnal cycle was approximately 8-fold higher in cholestyramine-treated animals. Rats administered the cholestyramine-Mevinolin diet had higher specific activities of the enzyme than either cholestyramine-treated or control animals. In the cholestyramine-Mevinolin-treated animals the peak in the diurnal cycle was shifted to D-12 (12th hour of the dark cycle) and the specific activity at this point was approximately 133-fold greater than the basal (L-6) activity in control animals. Optimal conditions for immunotitration studies were determined such that valid conclusions could be drawn from these data. Based on immunotitration experiments, the increased hepatic HMG-CoA reductase activity in cholestyramine-treated animals resulted in part from a 3-fold activation of the enzyme, while the increased specific activity in the cholestyramine-Mevinolin-treated animals was due solely to increased enzyme mass. Hence the administration of Mevinolin blocked the activation of the enzyme induced by feeding cholestyramine alone. This was confirmed by purifying the enzyme to apparent homogeneity from cholestyramine-Mevinolin-treated animals; the specific activity of this enzyme was 4,000-7,700 nmol NADPH oxidized/min per mg protein. Cholestyramine-Mevinolin treatment affords a novel system for generating milligram quantities of rat hepatic HMG-CoA reductase.-Tanaka, R. D., P. A. Edwards, S. Lan, E. M. Knöppel, and A. M. Fogelman. The effect of cholestyramine and Mevinolin on the diurnal cycle of rat hepatic 3-hydroxy-3-methylglutaryl coenzyme A reductase.


The role of nidopallium caudolaterale in the goal-directed behavior of pigeons.
Avian nidopallium caudolaterale (NCL) is believed to be analogue to the mammalian prefrontal cortex (PFC), a key brain region for guiding goal-directed behavior. But the role of NCL during goal-directed behavior remains unclear. To investigate whether the pigeon NCL participate in the goal-directed behavior, we recorded single-units from the NCL of four pigeons as they performing goal-directed decision-making task in a plus-maze. During the decision-making process, the firing rates of NCL neurons significantly increased and they are associated with the choice of the upcoming movement. Moreover, both the firing rates and the decoding performance in the correct trials are significantly higher both of that in the error trials. These suggest that the NCL neurons indeed participate in the goal-directed behavior of pigeon and the neural activities may be induced by the rewards. However, the NCL neurons are depend on the rewards received to produce firing patterns discriminating the features of goal-directed behaviors, rather than encode the reward itself. In addition, we found that the functional components of goal-directed behavior are lateralized in the NCL, both the firing rates and the decoding performance in left NCL are significantly higher than both of that in right NCL.


A PEGylation method of fabricating bioprosthetic heart valves based on glutaraldehyde and 2-amino-4-pentenoic acid co-crosslinking with improved antithrombogenicity and cytocompatibility.
With the development of diagnostic techniques, the incidence of bioprosthetic heart valve thrombosis (BHVT) is found to be seriously underestimated. Developing bioprosthetic heart valves (BHVs) that have good hemocompatibility without sacrificing other properties such as hydrodynamics and durability will be an effective strategy to alleviate BHVT. In this study, we developed a PEGylation method by co-crosslinking and subsequent radical polymerization. 2-amino-4-pentenoic acid was used to introduce carbon-carbon double bonds for glutaraldehyde crosslinked pericardia. Then poly (ethylene glycol) diacrylate (PEGDA) was immobilized on pericardia by radical polymerization. A comprehensive evaluation of the modified pericardia was performed including structural characterization, hemocompatibility, cytocompatibility, mechanical properties, component stability, hydrodynamic performance and durability of the BHVs. The modified pericardia significantly reduced platelet adhesion by more than 75% compared with traditional glutaraldehyde crosslinked pericardia. Cell viability in the modified pericardia group was nearly 5-fold higher than that in glutaraldehyde crosslinked pericardia. The hydrodynamic performance met the requirements of ISO 5840-3 under physiological aortic valve conditions and its durability was proved after 200 million cycles of accelerated fatigue test. In conclusion, PEGDA modified pericardia exhibited improved antithrombogenicity and cytocompatibility properties compared with glutaraldehyde crosslinked pericardia. STATEMENT OF SIGNIFICANCE: Bioprosthetic valve (BHV) implantation requires BHV to be structurally stable as well as biocompatible in vivo. Traditional glutaraldehyde crosslinking method prepared BHV suffers from severe cytotoxicity, thrombosis, and calcification. BHV modification methods that have simultaneously improved structural stability and biocompatibility were rarely reported. Here, we proposed a PEGylation method for BHV based on co-crosslinking strategy that could improve its structural stability as well as hemocompatibility. We take the advantage of high efficiency of glutaraldehyde crosslinking and demonstrate the feasibility and superiority of the PEGylated strategy, offering a promising option in glutaraldehyde-based BHV fabrication in the future.


A comparison of the association between glomerular filtration and L-arginine status in HIV-infected and uninfected African men: the SAfrEIC study.
Hypertension, a major risk factor for cardiovascular disease worldwide, is increasing significantly in urbanised South Africans. Impaired glomerular filtration is a potential contributor to hypertension. Although HIV infection is widespread, little is known regarding its contribution to diminished estimated glomerular filtration rate (eGFR) and, in turn, hypertension in Africans. We compared eGFRs and cardiovascular profiles of newly identified HIV infected African men (N=53) not yet undergoing anti-retroviral therapy, and uninfected African men of similar age and anthropometry. The aim of the study was to determine whether eGFR is diminished in treatment naive HIV infected individuals and whether eGFR is associated with a potential modulator of hypertension, namely serum L-arginine. Cardiovascular risk factor profiles of HIV infected and uninfected men were similar. In men with healthy eGFRs >90 ml min(-1) per 1.73 m(2), eGFR was significantly lower with HIV infection (114 (90; 147)) compared with that in uninfected men: (120 (91; 168)), P=0.043. Despite the absence of clinically-diagnosed renal dysfunction, eGFR associated significantly with serum L-arginine only in HIV infected men (R(2)=0.277, β=-0.299, P=0.034), whereas L-arginine did not stay in the model for uninfected men. This difference suggests that the fate of L-arginine as a substrate for nitric oxide generation may be altered in HIV infected individuals. Subsequently this is likely to escalate endothelial dysfunction, contributing to later hypertension and cardiovascular disease. Our findings show that while glomerular filtration rate is not associated with L-arginine in uninfected men, it is diminished and significantly negatively associated with serum L-arginine in HIV infected men.


Is stemflow a vector for the transport of small metazoans from tree surfaces down to soil?
Stemflow is an essential hydrologic process shaping the soil of forests by providing a concentrated input of rainwater and solutions. However, the transport of metazoans by stemflow has yet to be investigated. This 8-week study documented the organisms (< 2 mm) present in the stemflow of different tree species. Because the texture of the tree bark is a crucial determination of stemflow, trees with smooth bark (Carpinus betulus and Fagus sylvatica) and rough bark (Quercus robur) were examined. Up to 1170 individuals per liter of stemflow were collected. For rotifers and nematodes, a highly positive correlation between abundance and stemflow yield was determined. Both taxa were predominant (rotifers: up to 70%, nematodes: up to 13.5%) in the stemflow of smooth-barked trees whereas in that of the oak trees collembolans were the most abundant organisms (77.3%). The mean number of organisms collected per liter of stemflow from the two species of smooth-barked trees was very similar. A higher number of nematode species was found in the stemflow of these trees than in the stemflow of rough-barked oak and all were typical colonizers of soil- and bark-associated habitats. This pilot study showed for the first time that stemflow is a transport vector for numerous small metazoans. By connecting tree habitats (e.g., bark, moss, lichens or water-filled tree holes) with soil, stemflow may influence the composition of soil fauna by mediating intensive organismal dispersal.


Functional MRI in clinical practice: Assessment of language and motor for pre-surgical planning.
Functional magnetic resonance imaging (fMRI) has been widely used for pre-neurosurgical planning and may eventually become a routine pre-surgical imaging modality. The validity of fMRI for clinical application depends on various factors such as proper task selection, correct statistical analysis and threshold setting with appropriate patient cooperation. This study was performed on 40 patients with different types of brain mass lesions or hippocampal sclerosis to assess the role of appropriate patient selection for achieving a reliable fMRI result. Accurate and reproducible fMRI strongly depends on the patient's cooperation. In this study we observed that a pre-test mock fMRI session held by a radiologist may help to predict which patients are more or less suitable candidates for fMRI.


Low dose lignocaine + butorphanol vs. low dose bupivacaine for spinal anaesthesia in day care urological surgeries: a prospective randomized control trial.
A local anaesthetic with fast onset, short and reliable duration of anaesthesia may be preferable for day care urological surgeries. Low dose lignocaine is believed to act faster and to have a shorter duration of action than low dose bupivacaine. Use of lignocaine for spinal anesthesia is discouraged now a days because of rare reports of transient neurological symptoms. The purpose of this study was to compare effectiveness and safety of low dose of lignocaine + butorphanol against low dose of bupivacaine for day care urological surgeries. A prospective randomized control trial was conducted between December 2012 to November 2015. After taking ethical committe approval and patient consent, total 990 patients were randomized in two groups. Group A received 0.5 mL of 5% lignocaine (25 mg) + 0.3 mL butorphanol (0.3 mg) and group B received 1 mL of 0.5% bupivacaine (5 mg) for spinal anesthesia. Spinal anesthesia was given at the L3-L4 interspace with the patient in the sitting or lateral position. The criteria for evaluation were time till onset of sensory and motor block, duration of sensory and motor block, time till ambulation, time till fit for discharge and any complications. Both the groups were comparable in terms of age, male to female ratio, American Society of Anesthesiologists (ASA) grade and duration surgery. Group A and Group B were statistically different in terms of mean time till onset of sensory block (120±22 sec and 274±36 sec), onset of motor block (228±34 sec and 372±41 sec), duration of sensory block (100±21 min and 230±28 min), duration of motor block (60±15 min and 152±23 min), time till ambulation (138±24 min and 292±48 min), time till fit for discharge (256±35 min and 428±46 min) respectively (<0.0001). Nausea, vomitings, hypotension, bradycarida and pruritis were less in group A compared to group B (<0.01). None of patient in any group had temporary or permanent neurological defecit. Spinal anaesthesia is an effective as well as a safe modality to anaesthetize the patient for day care urological procedures. This study shows lignocaine + butorphanol is preferable over bupivacaine for spinal anesthesia for day care urological procedures. It also favours day care surgery at remote areas with lesser medical facilities. It helps to minimize requirement of medical and paramedical staff, thus further extending scope of day care urological surgeries.


Assessment of the in Vitro Antimelanoma Potential of Lippia microphylla Cham (Verbenaceae) Essential Oil.
Essential oils stand out among natural products for their complex composition, frequently described in the literature with a range of biological effects. This study evaluated the cytotoxic activity against several human cancer cell lines of essential oils extracted from the leaves of Lippia microphylla (EO-LM) Cham. (Verbenaceae). The melanoma cell line SK-MEL-28 was the most sensitive to the EO-LM, presenting an IC50 of 33.38±1.16 μg/mL. Afterward, the effects of EO-LM on the cell cycle, induction of apoptosis, and production of reactive oxygen species (ROS) were evaluated. We stated a significant increase in the sub-G1 population, indicating apoptosis, later confirmed by an increase of SK-MEL-28 cells labeled with Annexin V-FITC and by the formation of apoptotic bodies and membrane blebs, observed by confocal microscopy. Additionally, EO-LM reduced the production of ROS, indicating antioxidant activity. Therefore, EO-LM exhibits anti-melanoma activity in vitro, suggesting its potential as an anticancer agent.


Recovery education: a tool for psychiatric nurses.
Patient teaching is vital for nursing care of psychiatric patients. This paper describes the process of developing Recovery Education as a tool for nurses who lead daily patient education groups. Gundersen Lutheran's Recovery Model developed for the Inpatient Psychiatric Unit includes seven Elements of Recovery--Hope, Security, Support/Managing Symptoms, Empowerment, Relationships, Coping and Finding Meaning. Concepts of cognitive behavioural therapy, mindfulness and case-based education were woven through recovery lessons in ready-to-use folders. Statistics on patient satisfaction and patient outcome data were positive. Education for self-management can move patients forward to improve health and healing on their recovery journey.


Nocturnal penile tumescence in the evaluation of erectile disorders: a critical review.
This article provides a critical review of the extensive literature on the nocturnal penile tumescence (NPT) method for the differential diagnosis of erectile disorders. It discusses the validity of the method and several theoretical and practical issues of importance for the adequate interpretation of results. NPT data have been considered primarily as providing a diagnostic tool for potency problems. NPT studies may contribute, in addition, significant information on central neurobiological processes that mediate male sexual function.


The Nature of Social Positive Illusory Bias: Reflection of Social Impairment, Self-Protective Motivation, or Poor Executive Functioning?
The present study examined if a social positive illusory bias (PIB) is: a) simply a reflection of low adult-rated social acceptance, b) evident when children's perceived social acceptance is measured implicitly, and c) directly relates to impaired executive functioning (EF). Participants were 8 to 12 year-old children (N = 120; 55 boys and 65 girls) with and without clinical symptoms of attention-deficit/hyperactivity disorder (ADHD). Ratings of the child's social acceptance were obtained from an adult and the child using the Self-Perception Profile for Children (Harter 2012); social bias was calculated as the discrepancy between standardized adult- and child-ratings. Children also completed a reaction time measure to assess implicit perceptions of social acceptance and a battery of EF measures. Depression symptoms were assessed based on parent report. Group comparisons were focused on the presence or absence of social PIB rather than on ADHD diagnostic status. Relative to non-PIB children, those with a social PIB were significantly higher in self-reported social acceptance, but significantly lower on adult reports and implicit perceived social acceptance; these children also were significantly higher in depression symptoms. EF impairments were indirectly related to social PIB as a function of adult-rated social impairment. Results suggest that social PIB is not merely a reflection of low adult-ratings of social acceptance. However, the high explicit self-reports of social acceptance in children with a social PIB are not fully consistent with their implicit self-perceptions of social acceptance. Results are discussed in light of the self-protective and cognitive deficits hypotheses regarding the nature of social PIB.


Symposium on allergic lung disease. II. The late asthmatic responses.
Immediate asthmatic responses have been regarded as the characteristic type of asthmatic response to follow exposure to inhaled allergens in patients with extrinsic asthma. They begin within minutes, clear within one to three hours and are inhibited by disodium cromoglycate but not by corticosteroids. They involve the reaction of antigen with antibodies usually of the IgE class. In recent years allergen inhalation tests have demonstrated the frequent occurrence of late asthmatic responses, either following immediate responses (dual responses) or occurring in isolation. The late asthmatic responses begin two to six hours after the allergen challenge, are prolonged and often severe, and are inhibited by both disodium cromoglycate and corticosteroids. The mechanisms involved in their provocation are not clearly understood but from the allergic viewpoint they may involve the participation of IgG +/- IgM antibodies and/or IgE antibodies. Late asthmatic responses explain the frequent occurrence of allergen-induced prolonged asthma. Their features suggest that they are more important than immediate responses in the pathophysiology of asthma.


Improved Performance of Printable Perovskite Solar Cells with Bifunctional Conjugated Organic Molecule.
A bifunctional conjugated organic molecule 4-(aminomethyl) benzoic acid hydroiodide (AB) is designed and employed as an organic cation in organic-inorganic halide perovskite materials. Compared with the monofunctional cation benzylamine hydroiodide (BA) and the nonconjugated bifunctional organic molecule 5-ammonium valeric acid, devices based on AB-MAPbI3 show a good stability and a superior power conversion efficiency of 15.6% with a short-circuit current of 23.4 mA cm-2 , an open-circuit voltage of 0.94 V, and a fill factor of 0.71. The bifunctional conjugated cation not only benefits the growth of perovskite crystals in the mesoporous network, but also facilitates the charge transport. This investigation helps explore new approaches to rational design of novel organic cations for perovskite materials.


Comparative mechanisms of PAH toxicity by benzo[a]pyrene and dibenzo[def,p]chrysene in primary human bronchial epithelial cells cultured at air-liquid interface.
Current assumption for assessing carcinogenic risk of polycyclic aromatic hydrocarbons (PAHs) is that they function through a common mechanism of action; however, recent studies demonstrate that PAHs can act through unique mechanisms potentially contributing to cancer outcomes in a non-additive manner. Using a primary human 3D bronchial epithelial culture (HBEC) model, we assessed potential differences in mechanism of toxicity for two PAHs, benzo[a]pyrene (BAP) and dibenzo[def,p]chrysene (DBC), compared to a complex PAH mixture based on short-term biosignatures identified from transcriptional profiling. Differentiated bronchial epithelial cells were treated with BAP (100-500 μg/ml), DBC (10 μg/ml), and coal tar extract (CTE 500-1500 μg/ml, SRM1597a) for 48 h and gene expression was measured by RNA sequencing or quantitative PCR. Comparison of BAP and DBC gene signatures showed that the majority of genes (~60%) were uniquely regulated by treatment, including signaling pathways for inflammation and DNA damage by DBC and processes for cell cycle, hypoxia and oxidative stress by BAP. Specifically, BAP upregulated targets of AhR, NRF2, and KLF4, while DBC downregulated these same targets, suggesting a chemical-specific pattern in transcriptional regulation involved in antioxidant response, potentially contributing to differences in PAH potency. Other processes were regulated in common by all PAH treatments, BAP, DBC and CTE, including downregulation of genes involved in cell adhesion and reduced functional measurements of barrier integrity. This work supports prior in vivo studies and demonstrates the utility of profiling short-term biosignatures in an organotypic 3D model to identify mechanisms linked to carcinogenic risk of PAHs in humans.


The benefits and challenges of virtual SMART recovery mutual-help groups: Participant and facilitator perspectives.
COVID-19 prompted widespread transition of face-to-face mutual-help groups to virtual delivery. Current understanding of the experience of virtual mutual-help groups is limited to 12-step approaches or asynchronous groups (e.g., forums). This paper explores participant and facilitator perspectives regarding the benefits and challenges of accessing SMART Recovery mutual-help groups virtually via videoconference. A self-selected convenience sample of participants (n = 29) and facilitators (n = 15) from SMART Recovery mutual-help groups in Australia were enrolled. Participants and facilitators were sampled to reflect experience of virtual groups delivered via videoconference ('online'), face-to-face groups ('face-to-face') or both types of groups ('both'). Telephone qualitative interviews were conducted using a semi-structured interview guide. Interviews were audio-recorded, transcribed, and analysed using iterative categorisation. Participant and facilitators discussed their experience across eight interconnected themes benefits were typically discussed with regard to the (1) availability, (2) ease of access and (3) value add of the chat feature in online groups. Challenges largely pertained to (1) in-group engagement, (2) group size, (3) non-verbal cues, (4) social interaction and (5) technology problems. The impact of these challenges on participant and facilitator experience varied, and neither modality was consistently identified as superior. SMART Recovery mutual-help groups provided participants with another option for accessing mutual-help and appealed to different people under different circumstances. Depending on the needs and preferences of the individual, online SMART Recovery mutual-help groups may help to mitigate a range of barriers to help seeking and may also engage people otherwise unable or reluctant to engage in treatment. To inform training, practice and policy, improved understanding of the individual and contextual factors that enhance participant engagement, experience and outcomes is needed.


Fluorescence Probe Based on Hybrid Mesoporous Silica/Quantum Dot/Molecularly Imprinted Polymer for Detection of Tetracycline.
A newly designed fluorescence probe made from a hybrid quantum dot/mesoporous silica/molecularly imprinted polymer (QD/MS/MIP) was successfully created, and the probe was used for the detection of tetracycline (TC) in serum sample. QD/MS/MIP was characterized by transmission electron microscope, Fourier transform infrared spectroscopy, UV spectroscopy, X-ray powder diffraction, nitrogen adsorption-desorption experiment and fluorescence spectroscopy. Tetracycline, which is a type of broad-spectrum antibiotic, was selected as the template. The monomer and the template were combined by covalent bonds. After the template was removed to form a binding site, a hydrogen bonding interaction formed between the hole and the target molecule. Moreover, when rebinding TC, a new complex was produced between the amino group of QD/MS/MIP and the hydroxyl group of TC. After that, the energy of the QDs could transfer to the complex, which explains the fluorescence quenching phenomenon. The fluorescent intensity of QD/MS/MIP decreased in 10 min, and an excellent linearity from 50 to 1000 ng mL(-1) was correspondingly obtained. This composite material has a high selectivity with an imprinting factor of 6.71. In addition, the confirmed probe strategy was successfully applied to serum sample analyses, and the recoveries were 90.2%-97.2% with relative standard deviations of 2.2%-5.7%. This current work offers a novel and suitable method to synthesize QD/MS/MIP with a highly selective recognition ability. This composite material will be valuable for use in fluorescence probe applications.


Serum cardiac troponin T as a prognostic marker in early sepsis.
Sepsis is the leading cause of death in the noncardiologic ICU. Maldistributed nutritive blood flow and altered convective and diffusive oxygen transport during sepsis can lead to organ dysfunction and multiple organ failure. One of the causes of myocardial dysfunction is thought to be myocardial ischemia in sepsis; however, conventional biochemical parameters to detect myocardial ischemia lack sensitivity and specificity. Serum cardiac troponin T (S-TnT) was reported to have higher sensitivity and specificity in diagnosing minor myocardial injury. The aim of this study was to investigate if and how often S-TnT is pathologically elevated in patients with sepsis and to evaluate whether S-TnT might be a prognostic marker in early sepsis. Prospective study. Surgical ICU. Twenty-six patients with sepsis were included in this study within 24 h of the onset of sepsis. The patients were allocated a priori to a high S-TnT group (S-TnT > or = 0.2 microg/L) and a low S-TnT group (S-TnT<0.2 microg/L). Blood samples for the determination of S-TnT and conventional myocardial ischemia markers as well as for adhesion molecules were drawn. Hemodynamic measurements were performed every 4 h during the first 24 h and then once per day over 7 days. S-TnT was determined by enzyme-linked immunosorbent sandwich assay. Eighteen patients had pathologically high S-TnT values. High S-TnT values were associated with an increased mortality rate (15/18 in the high S-TnT group vs 3/8 in the low S-TnT group; p=0.02). Significant differences between the two groups were found in the norepinephrine dosages at maximum values of S-TnT. Soluble intercellular adhesion molecule-1 was significantly elevated in the high S-TnT group. As high S-TnT values were associated with an increased mortality rate, it seems reasonable to further evaluate S-TnT as a prognostic marker of myocardial ischemia in patients with sepsis under different therapeutic regimens.


Autoantibodies to beta2-glycoprotein I in systemic lupus erythematosus and primary antiphospholipid antibody syndrome: clinical correlations in comparison with other antiphospholipid antibody tests.
To examine relationships between anti-beta2-glycoprotein (beta2-GPI) antibodies and other antiphospholipid antibody (aPL) tests (aPL ELISA and the lupus anticoagulant or LAC) and the associations of each of these aPL tests with individual clinical manifestations of the antiphospholipid antibody syndrome (APS). IgG and IgM anti-beta2-GPI antibodies were determined by ELISA in 281 patients with SLE, primary APS, or other connective tissue diseases. Frequencies, sensitivities, specificities, and predictive values and correlations of anti-beta2-GPI were compared to the aPL ELISA (IgG and IgM) and LAC for individual (and combined) features of APS. Among 139 patients with positive aPL ELISA and/or LAC tests, 57 (41%) had anti-beta2-GPI antibodies (IgG and/or IgM) compared to 11% of patients with SLE negative for these tests (p = 0.00001). In 130 patients with APS, anti-beta2-GPI occurred in 42% and tended to be more specific but less sensitive than the aPL ELISA or LAC. When all 3 aPL tests were combined, the best sensitivities and negative predictive values were achieved; however, specificity and positive predictive values remained low. Anti-beta2-GPI antibodies occurred more frequently in primary APS (58%) vs secondary antiphospholipid syndromes (33%) (p = 0.008, OR = 2.9). Among 79 patients with SLE negative by both aPL ELISA and LAC, 9 (11 %) were positive for anti-beta2-GPI, 7 of whom had clinical features consistent with APS (representing 5% of all with APS). Stepwise multiple logistic regression analysis revealed beta2-GPI to be most strongly associated with neurological syndromes other than stroke, deep venous thrombosis, and recurrent fetal loss, while LAC was most strongly correlated with stroke and thrombocytopenia. IgM aPL antibodies also were independently associated with neurological syndromes and recurrent fetal loss. Testing for beta2-GPI antibodies may be clinically useful in the diagnosis of APS but cannot supplant other aPL ELISA or LAC. Multivariate analyses suggest that anti-beta2-GPI antibodies may play a more central role in certain clinical manifestations of APS than antibodies detected by the aPL ELISA or LAC.


Labeling and unlabeling: perceptions of diagnostic terms among mothers and professionals.
Perceptions of diagnostic terms were investigated in a study of 30 mothers of developmentally deviant preschoolers, 24 psychiatrists, 24 pediatricians, and 15 therapeutic nursery school educators. Statistical analysis of ranking by severity revealed little concordance between mothers and professionals and among the three groups of professionals. Results indicated that the mothers tended to discard or reinterpret diagnostic terms to permit themselves to maintain hope. Professional awareness of the potential for miscommunication with parents is urged.


New Insights into the Deposition of Zearalenone in Minipigs: A Suitable Bioindicator for Internal Exposure.
The detrimental footprint of mycotoxins in agriculture and on animal production has been widely recognized, especially in swine. Despite an increased number of research evaluating the toxicokinetics of mycotoxins in animal organisms, the absorption, distribution, metabolization, and excretion (ADME) patterns of zearalenone (ZEN) need further understanding. Furthermore, in vivo bioindicator for ZEN exposure in individual pigs has yet to be characterized. This study explored the ADME of ZEN in Bama Aroma pigs, a Chinese miniature pig breed, that has been used herein as a swine model. The findings revealed that ZEN was mainly metabolized into α-zearalenol (α-ZOL), and both ZEN and α-ZOL were mostly found in conjugated forms in the plasma, urine, and bile. The concentration and composition patterns of ZEN and its metabolites were tissue-specific, implying that the small intestine, liver, kidney, and lung play different roles in ZEN metabolism. The plasma concentrations of ZEN + α-ZOL highly correlated (R2 = 0.993) with the ZEN dietary exposure and may be utilized as a bioindicator to investigate animal exposure and mitigation efficacy of mycotoxin detoxifiers. This research would provide both fundamental information and a useful animal model for ZEN toxicity and detoxification studies.


Measuring temperature.
Temperature measurement is an essential clinical skill and is recognised as being an important indicator in assessing the course of an illness. This article identifies temperature ranges and describes the procedures for taking temperature orally and via the tympanic canal in adult and paediatric patients.


Pseudoaneurysms complicating organ transplantation: roles of CT, duplex sonography, and angiography.
In a retrospective study of proved pseudoaneurysms (PAs) in 15 patients with transplanted organs (11 liver, three kidney, one pancreas), the results of computed tomography (CT), duplex sonography, and angiography were reviewed. Of the 15 cases of PA, eight occurred at the arterial anastomosis and seven were nonanastomotic. Three of the eight anastomotic PAs were caused by infection. Of the seven nonanastomotic PAs, four were caused by percutaneous biopsy, two were caused by infection, and one was of undetermined cause. In nine (60%) of the 15 patients the PAs were incidentally detected at imaging studies performed for other reasons. Diagnosis requires a high degree of suspicion. CT was performed in nine cases and duplex sonography in ten. The diagnosis of PA was made with CT in six (67%) patients and with duplex sonography in five (50%). CT and duplex sonography could not enable diagnosis when the PA was small, when the arterial anastomosis was not included in the field of study, or when enhancement with intravenously administered contract material was suboptimal. Angiography depicted the PAs in all 15 patients. In three liver transplant recipients with gastrointestinal tract bleeding, the causative PAs were detected only with angiography.


Carcinoma of the urachus demonstrated by CT.
Carcinoma of the urachus is a rare tumor with a poor prognosis. Only a few cases explored by CT have been reported until now. This report illustrates the value of CT in establishing the diagnosis and the tumor extension. Furthermore this patient has a probable biological tracer with positive dosage of carcino-embryogenic antigen (CEA).


Autonomized flaps in secondary head and neck reconstructions.
Free flaps, with their very high rates of success and low donor site morbidity, are considered the gold standard in head and neck reconstruction, allowing the transfer of ideal tissues for head and neck reconstruction. Nonetheless, under certain circumstances they may be contraindicated or cannot be utilized. We describe four subjects in which delayed locoregional flaps were used to reconstruct head and neck defects after a previous flap failure. Due to adverse anatomic and systemic conditions these patients were not suitable for a free flap, and thus one delayed prelaminated temporalis fasciocutaneous flap placement and three delayed supraclavicular flap (one of which was prelaminated) placements to reconstruct large defects of the cheek and commissural region needed to be performed. All flaps and grafts were viable. All patients in this case series had acceptable functional and aesthetic outcomes. Donor-site morbidity was negligible. Delayed locoregional flap placement required a total of three surgical sessions. Although limited, our experience suggests that in cases in which a free flap is contraindicated or not ideal, locoregional flaps may be a valid and safe alternative. Limitations of these procedures include increased duration of hospitalization and, foremost, the need for three-step surgery.


Hydroxyl-directed ruthenium-catalyzed C-H bond functionalization: versatile access to fluorescent pyrans.
Hydroxyl-assisted oxidative annulations of alkynes were accomplished with an inexpensive ruthenium(II) complex, delivering fluorescent pyrans via highly site selective as well as chemo- and regioselective C-H/O-H bond functionalizations.


A comparison of the effects of automated percutaneous diskectomy and conventional diskectomy on intradiscal pressure, disk geometry, and stiffness.
Diskectomy, chemonucleolysis, percutaneous diskectomy, and laser ablation are used to treat patients with sciatica. The effects of percutaneous diskectomy on the intradiscal pressure of the human disk are not known. Our aims were to determine (a) whether removal of nucleus through automated percutaneous diskectomy significantly reduces intradiscal pressure without altering the disk geometry and stiffness, and if so, how much nucleus removal is required to achieve these goals; and (b) whether the effects of conventional diskectomy on these same parameters are equivalent to removal of nucleus through automated percutaneous diskectomy. Cyclic compressive loads of 20-900 N were applied to lumbar disks. Conventional diskectomy or automated percutaneous diskectomy (performed for 40 min with biomechanical measurements made four times at 10-min intervals) was then performed under zero load and the specimens retested under the same cyclic compressive loading. There were significant (p < 0.01) decreases in intradiscal pressure (by 7% under 900 N) after 10 min of automated percutaneous lumbar diskectomy. There were no further significant decreases in pressure during the next 30 min of percutaneous diskectomy. There were also significant decreases in pressure due to a puncture hole made with the Nucleotome trephine alone, without removal of disk material, and there was no difference in pressure after trephining alone and after percutaneous diskectomy. Decreases in disk height were significant, ranging from 5% at 10 min to 7% at 40 min of treatment. There were equivalent decreases in intradiscal pressure and disk height due to removal of similar amounts of nucleus during conventional diskectomy and during 40 min of percutaneous diskectomy.(ABSTRACT TRUNCATED AT 250 WORDS)


Marketing orientation in hospitals: findings from a multi-phased research study.
It is clear from numerous studies conducted over a wide variety of industries that marketing-oriented organizations perform better than those that do not adopt this business philosophy. Recent studies have confirmed this finding in healthcare organizations as well. What is now coming to light is the way in which a marketing orientation does contribute to better performance in hospitals, and the difficulties marketers face in getting recognition of that fact by non-marketers in their organization. This article reports on a multi-phased research study of the implementation of marketing-oriented behaviors in a hospital setting.


Is the DEA's new "prescription series" regulation balanced?
To address the dual public health imperatives of enhanced pain management and decreased abuse and diversion of prescription medications, the U.S. Drug Enforcement Administration (DEA) recently adopted regulations to allow practitioners to issue multiple prescriptions for a Schedule II controlled substance on the same day, to be dispensed sequentially. Public feedback suggested there was concern that practitioners could interpret the initially proposed language as limiting the quantity of prescribed medication and establishing an ambiguous practice standard. The DEA later explicitly confirmed that they did not intend to impose undue limits on practice. Rather, if implemented appropriately, the new regulation can be considered an important mechanism to control medication diversion while maintaining access for legitimate medical purposes and patient care.


Biowaiver monographs for immediate release solid oral dosage forms based on biopharmaceutics classification system (BCS) literature data: verapamil hydrochloride, propranolol hydrochloride, and atenolol.
Literature data related to the Biopharmaceutics Classification System (BCS) are presented on verapamil hydrochloride, propranolol hydrochloride, and atenolol in the form of BCS-monographs. Data on the qualitative composition of immediate release (IR) tablets containing these active substances with a Marketing Authorization (MA) in the Netherlands (NL) are also provided; in view of these MA's the assumption was made that these tablets were bioequivalent to the innovator product. The development of a database with BCS-related data is announced by the International Pharmaceutical Federation (FIP).


Absorption analysis of boLA sera.
BoLA specificities w1 w2 w5 w8 w9 w10 and w11 have been re-examined by absorption. All of the clusters except w9 showed evidence of sub-group specificities, but only in some cases (w1, w5, w8 and w11) is it suggested that the definition should be revised. The results show a very high degree of reproducibility between sera from different laboratories with clusters of narrow and wide sera for most specificities. These behave in all the cases reported here as linear sub groups or inclusion groups.


Critical illness survivors' experiences of attending an intensive care unit follow-up service: a systematic review protocol.
The objective of this review is to explore critical illness survivors' experiences of attending an intensive care unit (ICU) follow-up service. A significant proportion of critical illness survivors will require ICU follow-up care to support adverse symptoms in health domains, including cognition, mental health, and physical and social function. While there is consensus on the need for ICU follow-up services, systematic reviews to date have not identified any significant impact of ICU follow-up services on clinical health outcomes. An understanding of survivors' experiences of attending an ICU follow-up service may improve the effectiveness and design of such services. This review will include studies that explore the experiences of adult ( 18 years of age) critical illness survivors who attended an ICU follow-up service following discharge from an ICU, regardless of the admitting diagnosis or ICU length of stay. This review will be conducted in line with the JBI methodological framework for qualitative systematic reviews. Electronic databases, including MEDLINE, CINAHL, PsycINFO, Embase, and Web of Science Core Collection, will be searched to identify relevant studies for inclusion in the review. Studies will be screened by 2 independent reviewers. Critical appraisal, data extraction, and data synthesis will be completed by 2 independent reviewers using a meta-aggregation method for data synthesis. Confidence in the research findings will be assessed and assigned a ConQual score. PROSPERO CRD42023404585.


Real-world treatment patterns and healthcare costs among biologic-naive patients initiating apremilast or biologics for the treatment of psoriasis.
This study compared real-world treatment patterns and healthcare costs among biologic-naive psoriasis patients initiating apremilast or biologics. A retrospective cohort study was conducted using the Optum Clinformatics™ claims database. Patients with psoriasis were selected if they had initiated apremilast or biologics between January 1, 2014, and December 31, 2015; had 12 months of pre-index and post-index continuous enrollment in the database; and were biologic-naive. The index date was defined as the date of the first claim for apremilast or biologic, and occurred between January 1, 2014, and December 31, 2015. Treatment persistence was defined as continuous treatment without a > 60-day gap in therapy (discontinuation) or a switch to a different psoriasis treatment during the 12-month post-index period. Adherence was defined as a medication possession ratio (MPR) of ≥ 80% while persistent on the index treatment. Persistence-based MPR was defined as the number of days with the medication on hand measured during the patients' period of treatment persistence divided by the duration of the period of treatment persistence. Because patients were not randomized, apremilast patients were propensity score matched up to 1:2 to biologic patients to adjust for possible selection bias. Treatment persistence/adherence and all-cause healthcare costs were evaluated. Cost differences were determined using Wilcoxon rank-sum tests. In all, 343 biologic-naive patients initiating apremilast were matched to 680 biologic-naive patients initiating biologics. After matching, patient characteristics were similar between cohorts. Twelve-month treatment persistence was similar for biologic-naive patients initiating apremilast vs biologics (32.1% vs 33.2%; p = 0.7079). While persistent on therapy up to 12 months, per-patient per-month (PPPM) total healthcare costs were significantly lower among biologic-naive cohorts initiating apremilast vs biologics ($2,214 vs $5,184; p < 0.0001). Likewise, PPPM costs while persistent on therapy were significantly lower among patients initiating apremilast vs biologics, whether they switched treatments ($2,475 vs $4,422; p < 0.0001), remained persistent ($2,279 vs $3,883; p < 0.0001), or discontinued but did not switch treatments ($2,104 vs $6,294; p < 0.0001). Data were limited to individuals with United Healthcare commercial and Medicare Advantage insurance plans, and may not be generalizable to psoriasis patients with other insurance or without health insurance coverage. Biologic-naive patients with similar patient characteristics receiving apremilast vs biologics had significantly lower PPPM costs, even when they switched to biologics during the 12-month post-index period. These results may be useful to payers and providers seeking to optimize psoriasis care while reducing healthcare costs.


Community participation in the prevention and control of dengue: the patio limpio strategy in Mexico.
Community participation is vital to prevent and control the spread of dengue in Latin America. Initiatives such as the integrated management strategy for dengue prevention and control (IMS-Dengue) and integrated vector management (IVM) incorporate social mobilisation and behavioural change at the community level as part of a wider strategy to control dengue. These strategies aim to improve the efficacy, cost-effectiveness, environmental impact and sustainability of vector control strategies. Community empowerment is a key aspect of the strategy as it allows the local population to drive eradication of the disease in their environment. Through the patio limpio campaign, the concept of community participation has been employed in Mexico to raise awareness of the consequences of dengue. patio limpio consists of training local people to identify, eliminate, monitor and evaluate vector breeding sites systematically in households under their supervision. A community participation programme in Guerrero State found that approximately 54% were clean and free of breeding sites. Households that were not visited and assessed had a 2·4-times higher risk of developing dengue than those that were. However, after a year, only 30% of trained households had a clean backyard. This emphasises the need for a sustainable process to encourage individuals to maintain efforts in keeping their environment free of dengue.


Sagittal profile of cervical and whole spine before and after surgery of subaxial cervical spine.
Until recently, there was a lack of information on sagittal axis parameters of the cervical spine, its relationship to the global sagittal axis of the spine, and their possible implications for long-term clinical outcomes in patients following subaxial cervical spine surgery. The aim of the authors is to provide an overview of the issue from available literature. The authors present a complete overview of local radiological parameters of the sagittal axis of the cervical spine, an overview of radiological parameters of the total sagittal axis of the spine, and also spinopelvic parameters. Normative values of the majority of individual parameters are summarized. The authors discuss several topics such as: The possible effects of sagittal axis parameters on the clinical condition of an individual before surgery; furthermore, whether a change in sagittal parameters of the cervical and whole spine after subaxial cervical spine surgery can affect the clinical condition and postoperative patient satisfaction. Finally, the methodology of specific operations is discussed, including their ability to change the parameters of the sagittal axis of the spine. Short patient monitoring times and the predominant use of retrospective methodology are common drawbacks of most studies. Also, there are no clearly determined procedures and specifications for surgical correction of the sagittal axis of the cervical spine. As it turns out, multi-stage procedures are more appropriate to achieve changes of the cervical sagittal axis. It is also gradually becoming apparent that any local change of the cervical spine may affect the sagittal axis of the entire spine.


Courtship in Spiders without Prior Sperm Induction.
Experiments with a lycosid spider demonstrated that courtship behavior is displayed by males independently of whether sperm induction had occurred following the final molt. Contrary to earlier suggestions, proprioceptive feedback from sperm-filled palps is not essential for the onset of reproductive display.


Rapid screening for humoral immune deficiency.
A preliminary report on a fast, easy and inexpensive screen-test for the detection of humoral immune deficiency is presented. The method is based on the presence of heterophilic antibodies in normal human serum. Multitested normal individuals and immunodeficient patients showed a clearcut dichotomy in this screening procedure.


ARNTL2 knockdown suppressed the invasion and migration of colon carcinoma: decreased SMOC2-EMT expression through inactivation of PI3K/AKT pathway.
ARNTL2 is a transcriptional activator implicated in the molecular clock feedback system and is overexpressed in some malignant tumors. This study aimed to detect the effects of ARNTL2 knockdown by siRNA on the proliferation and invasion of colon carcinoma and clarify the molecular mechanisms of ARNTL2 in the development of colon carcinoma (CC). The CC microarray dataset GSE50760 was downloaded from the Gene Expression Omnibus (GEO) database. The expression levels of ARNTL2 in CC tissues and cancer cells were analyzed by immunohistochemistry and western blot, respectively. The knockdown of ARNTL2 expression was induced by RNA interference in colon cancer cells. The proliferation was detected by Cell Counting Kit-8 and clonal formation assays. The invasion and migration in vitro were detected by wound healing and transwell assays. Besides, a tumorigenicity test in the nude mice was performed to confirm whether ARNTL2 expression promoted the proliferation and invasion of CC cells. Furthermore, the expression of epithelial-mesenchymal transition (EMT) and PI3K/AKT signaling pathway-related factors were analyzed by western blot. Results showed that bioinformatics analysis found that ARNTL2 was upregulated in CC tissues. ARNTL2 was highly expressed in tissues and CC cells. Knockdown of ARNTL2 inhibited CC cells viability, colony formation, migration activity and reduced the size of tumors in the nude mice. Moreover, knockdown of ARNTL2 suppressed the expression of SMOC2, which may be the target gene of ARNTL2, and simultaneously inhibited the expression of EMT and PI3K/AKT signaling pathway-related factors. Taken together, downregulation of ARNTL2 could suppress CC cell proliferation and migration via SMOC2-EMT through inactivation of PI3K/AKT signaling pathway.


The interplay of externalizing problems and physical and inductive discipline during childhood.
Children who are physically disciplined are at elevated risk for externalizing problems. Conversely, maternal reasoning and reminding of rules, or inductive discipline, is associated with fewer child externalizing problems. Few studies have simultaneously examined bidirectional associations between these forms of discipline and child adjustment using cross-informant, multimethod data. We hypothesized that less inductive and more physical discipline would predict more externalizing problems, children would have evocative effects on parenting, and high levels of either form of discipline would predict low levels of the other. In a study of 241 children-spanning ages 3, 5.5, and 10-structural equation modeling indicated that 3-year-olds with higher teacher ratings of externalizing problems received higher mother ratings of physical discipline at age 5.5. Mothers endorsing more inductive discipline at child age 3 reported less physical discipline and had children with fewer externalizing problems at age 5.5. Negative bidirectional associations emerged between physical and inductive discipline from ages 5.5 to 10. Findings suggested children's externalizing problems elicited physical discipline, and maternal inductive discipline might help prevent externalizing problems and physical discipline.


Comparison of MR Imaging and Dual-Energy CT for the Evaluation of Cartilage Invasion by Laryngeal and Hypopharyngeal Squamous Cell Carcinoma.
Dual-energy CT can distinguish iodine-enhanced tumors from nonossified cartilage and has been investigated for evaluating cartilage invasion in patients with laryngeal and hypopharyngeal squamous cell carcinomas. In this study, we compared the diagnostic accuracy of MR imaging and of a combination of weighted-average and iodine overlay dual-energy CT images in detecting cartilage invasion by laryngeal and hypopharyngeal squamous cell carcinomas, in particular thyroid cartilage invasion. Fifty-five consecutive patients who underwent 3T MR imaging and 128-slice dual-energy CT for preoperative initial staging of laryngeal or hypopharyngeal squamous cell carcinomas were included. Two blinded observers evaluated laryngeal cartilage invasion on MR imaging and dual-energy CT using a combination of weighted-average and iodine-overlay images. Pathologic findings of surgically resected specimens were used as the reference standard for evaluating sensitivity, specificity, and the areas under the receiver operating characteristic curve of both modalities for cartilage invasion by each type of cartilage and for all cartilages together. Sensitivity and specificity were compared using the McNemar test and generalized linear mixed models. Dual-energy CT showed higher specificity than MR imaging for diagnosing all cartilage together (84% for MR imaging versus 98% for dual-energy CT, P < .004) and for thyroid cartilage (64% versus 100%, P < .001), with a similar average area under the curve (0.94 versus 0.95, P = .70). The sensitivity did not differ significantly for all cartilages together (97% versus 81%, P = .16) and for thyroid cartilage (100% versus 89%, P = .50), though there was a trend toward increased sensitivity with MR imaging. Dual-energy CT showed higher specificity and acceptable sensitivity in diagnosing laryngeal cartilage invasion compared with MR imaging.


[Determination of plasma endothelin-1 in aged patients with chronic obstructive pulmonary disease in its clinical significance].
The levels of plasma endothelin-1 (ET-1) were determined by radioimmunoassay in 25 aged healty men and 88 aged patients with chronic obstructive pulmonary disease (COPD) at different stages. The results showed that plasma ET-1 levels of stable patients with COPD did not significantly change, but it were significantly higher during attacks than that in healthy subjects; The levels of plasma ET-1 in the patients with cor pulmonale were significantly higher than those in the healthy and COPD patients. Plasma ET-1 levels of patients with cor pulmonale at acute exacerbation stage were the highest in all groups. It was demonstrated that ET-1 correlated negatively to PaO2 and PH and correlated positively to PaCO2 and blood creatinine. This study suggested that the elevation of ET-1 level may contribute to the pathophysiological changes in patients with COPD and cor pulmonale.


Dietary conjugated linoleic acid (CLA) intake assessment and possible biomarkers of CLA intake in young women.
The habitual intake of the conjugated linoleic acid (CLA) isomer C18:2 c9t11 (rumenic acid, RA) was assessed and compared with plasma biomarkers. The newly developed food-frequency questionnaire (FFQ) comprised 46 food items and was validated by means of a 7-day estimated record (7-d ER). Additionally, the dietary intake results of the FFQ, 7-d ER, the last day (1-d ER) and the last two days (2-d ER) before blood sampling of the 7-d ER were compared to the content of C18:2 c9t11 in plasma phospholipids (PL) and triglycerides (TG) as possible biomarkers. Metabolic unit of a university institute. Fifty-seven students completed both dietary instruments. From all participants fasting blood samples were taken. Mean daily intake of rumenic acid was 246 mg day(-1) and 323 mg day(-1) as measured by the FFQ and the 7-d-ER, respectively. The degree of correspondence between both assessment methods was acceptable; this is indicated by a total kappa value of kappa = 0.31 (P < 0.01) and a Pearson correlation coefficient of r = 0.46 (P < 0.01). Rumenic acid content in plasma triglycerides was twice as high as found in phospholipids. The correlation between the intake results gained with the 7-d ER and the plasma PL contents of C18:2 c9t11 was statistically significant; this was also true for the C18:2 c9tl 1 values in plasma TG compared with the intake results of one or two days before blood sampling. Regarding RA intake, the FFQ data revealed an acceptable degree of correspondence with the 7-d ER data but failed to show significant correlations to the potential biomarkers. However, with respect to the results of the 7-d ER, the RA content in plasma PL and TG are possible biomarkers of short-term and medium-term intake, respectively.