Dinuclear complexes formed with the triazacyclononane derivative ENOTA4-: high-pressure 17O NMR evidence of an associative water exchange on [MnII2(ENOTA)(H2O)2].
Mn2+ has five unpaired d-electrons, a long electronic relaxation time, and labile water exchange, all of which make it an attractive candidate for contrast agent application in medical magnetic resonance imaging. In the quest for stable and nonlabile Mn2+ complexes, we explored a novel dimeric triazacyclononane-based ligand bearing carboxylate functional groups, H4ENOTA. The protonation constants of the ligand and the stability constants of the complexes formed with some endogenously important metals (Ca2+, Cu2+, Zn2+), as well as with Mn2+ and Ce3+, have been assessed by NMR methods, potentiometry, and UV-vis spectrophotometry. Overall, the thermodynamic stability of the complexes is lower as compared to that of the corresponding NOTA analogues (H3NOTA, 1,4,7-triaazacyclononane-1,4,7-triacetic acid). The crystal structure of Mn2(ENOTA)(H2O) x 5H2O contains two six-coordinated Mn2+, in addition to the three amine nitrogens and the two oxygens from the pendent monodentate carboxylate groups, and one water (Mn2) or one bridging carboxylate oxygen (Mn1) completes the coordination sphere of the metal ion. In an aqueous solution, this bridging carboxylate is replaced by a water molecule, as evidenced by the 17O chemical shifts and proton relaxivity data that point to monohydration for both metal ions in the dinuclear complex. A variable-temperature and -pressure 17O NMR study has been performed on [Mn2(ENOTA)(H2O)2] to assess the rate and, for the first time on a Mn2+ chelate, also the mechanism of the water exchange. The inner sphere water is slightly more labile in [Mn2(ENOTA)(H2O)2] (k298ex = 5.5 x 107 s-1) than in the aqua ion (2.1 x 107 s-1, Merbach, A. E.; et al. Inorg. Chem. 1980, 19, 3696). The water exchange proceeds via an almost limiting associative mechanism, as evidenced by the large negative activation volume (deltaV = -10.7 cm3 mol-1). The proton relaxivities measured on [Mn2(ENOTA)(H2O)2] show a low-field dispersion at approximately 0.1 MHz arising from a contact interaction between the MnII electron spin and the water proton nuclear spins.


[Cesarean section on demand or elective. Cesarean section: request for rethinking].
Nowadays, the mortality and morbidity of caesarean section, particularly elective caesarean section, are hardly different from those of vaginal delivery. 'Section on request' is so extremely rare that it is of no importance and that these terms should not be used at all. A change in thinking is necessary because only real misgivings make the pregnant woman wish for this procedure. In this context, the increasing importance of autonomy and the right to self-determination of the woman lead to a fundamental shift in the relationship between doctor and patient. Long-term sequelae after vaginal delivery, e.g. injury to the pelvic floor with functional impairment and disturbances of sexual function, but also considerations about the safety of the child become more and more important for the pregnant woman and have to be taken seriously by the physician. Although there are no precise bases for assessment, a global comparison of costs between vaginal delivery and elective caesarean section with regard to the long-term sequelae will hardly show any true differences, and therefore the health insurances are not entitled to refuse the reimbursement of costs.


Necropolitics in the "Compassionate" City: Care/Brutality in San Francisco.
In San Francisco in the United States, the urban precariat is governed simultaneously by two logics of intervention that are highly contradictory: compassion and brutality. In this article, I explore the contours of violence embedded in humanitarian governance for unstably housed/homeless women who use drugs as they navigate care systems for their health and well-being. I use Mbembe's concept of necropolitics to examine how women embody an anticipation of death, at the same time as they manage their risk for actual death in engagements with care in a city paradoxically known for its progressive, compassionate principles of intervention for those who are most marginalized.


Protection of Radiation-Induced DNA Damage by Functional Cosmeceutical Poly-Gamma-Glutamate.
This study compared the radioprotective effects of high-molecular-weight poly-gamma-glutamate (γ-PGA, average molecular mass 3,000 kDa) and a reduced form of glutathione (GSH, a known radioprotector) on calf thymus DNA damage. The radiation-induced DNA damage was measured on the basis of the decreased fluorescence intensity after binding the DNA with ethidium bromide. All the experiments used ⁶⁰Co gamma radiation at 1,252 Gy, representing 50% DNA damage. When increasing the concentration of γ-PGA from 0.33 to 1.65 μM, the DNA protection from radiation-induced damage also increased, with a maximum of 87% protection. Meanwhile, the maximal DNA protection when increasing the concentration of GSH was only 70%. Therefore, γ-PGA exhibited significant radioprotective effects against gamma irradiation.


Multi-resolution multi-object statistical shape models based on the locality assumption.
Statistical shape models learned from a population of previously observed training shapes are nowadays widely used in medical image analysis to aid segmentation or classification. However, providing an appropriate and representative training population of preferably manual segmentations is typically either very labor-intensive or even impossible. Therefore, statistical shape models in practice frequently suffer from the high-dimension-low-sample-size (HDLSS) problem resulting in models with insufficient expressiveness. In this paper, a novel approach for learning representative multi-resolution multi-object statistical shape models from a small number of training samples that adequately model the variability of each individual object as well as their interrelations is presented. The method is based on the assumption of locality, which means that local shape variations have limited effects in distant areas and, therefore, can be modeled independently. This locality assumption is integrated into the standard statistical shape modeling framework by manipulating the sample covariance matrix (non-zero covariances between distant landmarks are set to zero). To allow for multi-object modeling, a method for computing distances between points located on different object shapes is proposed. Furthermore, different levels of locality are introduced by deriving a multi-resolution scheme, which is equipped with a method to combine variability information modeled at different levels into a single shape model. This combined representation of global and local variability in a single shape model allows the use of the classical active shape model strategy for model-based image segmentation. An extensive evaluation based on a public data base of 247 chest radiographs is performed to show the modeling and segmentation capabilities of the proposed approach in single- and multi-object HDLSS scenarios. The new approach is not only compared to the classical shape modeling method but also to three state-of-the-art shape modeling approaches specifically designed to cope with the HDLSS problem. The results show that the new approach significantly outperforms all other approaches in terms of generalization ability and model-based segmentation accuracy.


Drooping eyelids due to aging.
Aging is a normal sequence of life. When one's eyelids start to age many changes can occur, and these changes may affect one's life activities and appearance. Nurses can help the elderly to accept some of life's changes gracefully and at the same time make them aware that some visual changes are correctable.


Thorium-230 ages of corals and duration of the last interglacial sea-level high stand on oahu, hawaii.
Thorium-230 ages of emergent marine deposits on Oahu, Hawaii, have a uniform distribution of ages from approximately 114,000 to approximately 131,000 years, indicating a duration for the last interglacial sea-level high stand of approximately 17,000 years, in contrast to a duration of approximately 8000 years inferred from the orbitally tuned marine oxygen isotope record. Sea level on Oahu rose to >/=1 to 2 meters higher than present by 131,000 years ago or approximately 6000 years earlier than inferred from the marine record. Although the latter record suggests a shift back to glacial conditions beginning at approximately 119,000 years ago, the Oahu coral ages indicate a near present sea level until approximately 114,000 years ago.


The Relationship between Social Cognition and Executive Functions in Alzheimer's Disease: A Systematic Review.
Social Cognition (SC) is a complex construct that reflects a wide variety of implicit and explicit cognitive processes. Many neurocognitive domains are associated with SC and the Executive Function (EF) is the most representative one. We conducted a systematic review aiming at clarifying whether SC impairments are associated with dysfunction on EF in people with Alzheimer Disease (AD). The search, based on the Preferred Reporting Items for Systematic Reviews and Meta- Analyses (PRISMA), was undertaken between January 2007 and December 2019 using Pubmed, SciELO, BIREME and Thomson Reuters Web of Science electronic databases. The keywords were SC, AD, EF, Neuropsychological functioning and Executive Disorder. One hundred thirty-six articles were identified and fifteen were included. These studies are not in agreement about the extent of SC deficits in AD, mainly in the mild stage of the disease. EF deficits, specifically inhibition and the ability to manipulate verbal information, are associated with the impairment in SC in AD. SC decreases with the disease progression, a relationship explained by global cognition impairment and SC specific symptoms. SC impairment is associated with disease progression, mainly because of the decline in EF. Studies on SC components are unequal, contributing to a frequent generalization of Theory of Mind results, and often hampering the investigation of other components, mainly empathy. More precise knowledge about SC functioning in AD may contribute to a better understanding of the behavioral changes and interpersonal interactions.


Mobility and Cognition in Seniors. Report from the 2008 Institute of Aging (CIHR) Mobility and Cognition Workshop.
The annual Scientific Meeting of the Canadian Association on Gerontology was held on October 24 and 25, 2008 in London, Ontario. Prior to the annual meeting, mobility and cognition experts met on October 23, 2008 to engage in a pre-conference workshop. Discussions during the workshop addressed novel areas of research and knowledge and research gaps pertaining to the interaction between mobility and cognition in seniors. Workshop presenters moved from the neuromuscular, biomechanics, and neurology of gait impairments, and falls through the role of cognition and mood on mobility regulation to the whole person in the environment. Research gaps were identified. Despite a consensus that mobility and cognition are increasingly correlated as people age, several gaps in our understanding of mechanisms and how to assess the interaction were recognized. The gaps originally identified in 2008 are still pertinent today. Common and standardized assessments for "mobility and cognition" are still not in place in current practice. Interventions that target mobility and cognitive decline as a single entity are still lacking.


New palladium complexes with N-heterocyclic carbene and morpholine ligands: Synthesis, characterization, crystal structure, molecular docking, and biological activities.
This work includes the synthesis of a new series of palladium-based complexes containing both morpholine and N-heterocyclic carbene (NHC) ligands. The new complexes were characterized using NMR (1 H and 13 C), FTIR spectroscopic, and elemental analysis techniques. The crystal structure of complex 1b was obtained by utilizing the single-crystal X-ray diffraction method. X-ray studies show that the coordination environment of palladium atom is completed by the carbene carbon atom of the NHC ligand, the nitrogen atom of the morpholine ring, and a pair of bromide ligand, resulting in the formation of slightly distorted square planar geometry. All complexes were determined for some metabolic enzyme activities. Results indicated that all the synthetic complexes exhibited powerful inhibitory actions against all aims as compared to the control molecules. Ki values of new morpholine-liganded complexes bearing 4-hydroxyphenylethyl group 1a-e for hCA I, hCA II, AChE, BChE, and α-glycosidase enzymes were obtained in the ranges 0.93-2.14, 1.01-2.03, 4.58-10.27, 7.02-13.75, and 73.86-102.65 µM, respectively. Designing of reported complexes is impacted by molecular docking study, and interaction with the current enzymes also proclaimed that compounds 1e (-12.25 kcal/mol for AChE and -11.63 kcal/mol for BChE), 1c (-10.77 kcal/mol and -9.26 kcal/mol for α-Gly and hCA II, respectively), and 1a (-8.31 kcal/mol for hCA I) are showing binding affinity and interaction from the synthesized five novel complexes.


Preclinical efficacy of growth hormone-releasing hormone antagonists for androgen-dependent and castration-resistant human prostate cancer.
Advanced hormone-sensitive prostate cancer responds to androgen-deprivation therapy (ADT); however, therapeutic options for recurrent castration-resistant disease are limited. Because growth hormone-releasing hormone (GHRH) and GHRH receptor (GHRH-R) are regulated in an autocrine fashion in prostate cancer, inhibition of GHRH-R represents a compelling approach to treatment. We investigated the effects of the latest series of improved, highly potent GHRH antagonists--MIA-602, MIA-606, and MIA-690--on the growth of androgen-dependent as well as castration-resistant prostate cancer (CRPC) cells in vitro and in vivo. GHRH-R and its splice variant, SV1, were present in 22Rv1, LNCaP, and VCaP human prostate cancer cell lines. Androgen-dependent LNCaP and VCaP cells expressed higher levels of GHRH-R protein compared with castration-resistant 22Rv1 cells; however, 22Rv1 expressed higher levels of SV1. In vitro, MIA-602 decreased cell proliferation of 22Rv1, LNCaP, and VCaP prostate cancer cell lines by 70%, 61%, and 20%, respectively (all P < 0.05), indicating direct effects of MIA-602. In vivo, MIA-602 was more effective than MIA-606 and MIA-690 and decreased 22Rv1 xenograft tumor volumes in mice by 63% after 3 wk (P < 0.05). No noticeable untoward effects or changes in body weight occurred. In vitro, the VCaP cell line was minimally inhibited by MIA-602, but in vivo, this line showed a substantial reduction in growth of xenografts in response to MIA-602, indicating both direct and systemic inhibitory effects. MIA-602 also further inhibited VCaP xenografts when combined with ADT. This study demonstrates the preclinical efficacy of the GHRH antagonist MIA-602 for treatment of both androgen-dependent and CRPC.


Management and Case Outcome of Gastric Impaction in Four Raptors: A Case Series.
Four captive raptors, an American kestrel ( Falco sparverius ), peregrine falcon ( Falco peregrinus ), golden eagle ( Aquila chrysaetos ), and barn owl ( Tyto alba ), were diagnosed with ventricular and/or proventricular foreign material impactions consisting of artificial turf substrate, paper and plastic substrate, grass, and newspaper. Partial or total anorexia was reported in all birds and decreased casting in 2 birds. Survey radiographs confirmed presence of gastric enlargement in all 4 birds. The kestrel and eagle were treated unsuccessfully with gastroscopy and gastric lavage, respectively, followed by surgical intervention to remove the ventricular impactions. Both birds died of undetermined causes after surgery. The peregrine falcon died before medical or surgical intervention was started, and the owl was managed successfully with oral mineral oil and liquid diet to facilitate egestion of the foreign material as a pellet. Lead poisoning was suspected as the predisposing cause for foreign body ingestion in the eagle, but underlying causes for pica in the other birds were not determined. Radiographs can provide useful diagnostic information in sick raptors that exhibit vomiting or changes in appetite or casting frequency, and may help guide treatment decisions of impacted birds. Careful consideration of substrate, enrichment items, and access to potential foreign material that could be ingested may be the best pre-emptive management strategy in captive raptors.


Complete Genome Sequence of Solvent-Tolerant Clostridium beijerinckii Strain SA-1.
We report the complete genome sequence of Clostridium beijerinckii SA-1, derived by directed evolution from C. beijerinckii NCIMB 8052, selecting for enhanced solvent tolerance. This sequence allows for accurate placement of SA-1 as C. beijerinckii, permits functional analyses of mutant phenotypes, and suggests methods for distinguishing SA-1 from its parent.


Lactiplantibacillus paraplantarum BPF2 and Pediococcus acidilactici ST6, Two Bacteriocinogenic Isolated Strains from Andalusian Spontaneous Fermented Sausages.
Traditional spontaneously fermented foods are well known for their sensory and safety properties, which is mainly due to their indigenous microflora. Within this group of food, Mediterranean dry-cured sausages stand out as a significant source of lactic-acid bacterial strains (LAB) with biotechnological properties, such as their antimicrobial activity. The aim of this study was to investigate the biodiversity of antagonistic LAB strains from different Andalusian traditional sausages, such as salchichón and chorizo. First, a screening was carried out focusing on the antimicrobial activity against foodborne pathogens, such as Listeria monocytogenes, Escherichia coli, Clostridium perfringens, and Staphylococcus aureus, selecting two strains due to their higher antibiosis properties, both in agar and liquid media. These bacteria were identified as Lactiplantibacillus paraplantarum BPF2 and Pediococcus acidilactici ST6. In addition, genomic studies confirmed the presence of certain structural genes related to the production of bacteriocins. Finally, the culture supernatants of both strains were purified and analyzed by LC-MS/MS, obtaining the relative molecular mass and the amino acid sequence and identifying the peptides as the bacteriocins Pediocin-PA and Leucocin K. In conclusion, genomes and antimicrobial substances of P. acidilactici ST6, a Pediocin-PA producer, and Lpb. paraplantarum BPF2, a Leucocin K producer, isolated from Andalusian salchichón and chorizo, respectively, are presented in this work. Although further studies are required, these strains could be used alone or in combination as starters or protective cultures for the food industry.


A validated assay for measuring doxorubicin in biological fluids and tissues in an isolated lung perfusion model: matrix effect and heparin interference strongly influence doxorubicin measurements.
Doxorubicin is an antineoplasic agent active against sarcoma pulmonary metastasis, but its clinical use is hampered by its myelotoxicity and its cumulative cardiotoxicity, when administered systemically. This limitation may be circumvented using the isolated lung perfusion (ILP) approach, wherein a therapeutic agent is infused locoregionally after vascular isolation of the lung. The influence of the mode of infusion (anterograde (AG): through the pulmonary artery (PA); retrograde (RG): through the pulmonary vein (PV)) on doxorubicin pharmacokinetics and lung distribution was unknown. Therefore, a simple, rapid and sensitive high-performance liquid chromatography method has been developed to quantify doxorubicin in four different biological matrices (infusion effluent, serum, tissues with low or high levels of doxorubicin). The related compound daunorubicin was used as internal standard (I.S.). Following a single-step protein precipitation of 500 microl samples with 250 microl acetone and 50 microl zinc sulfate 70% aqueous solution, the obtained supernatant was evaporated to dryness at 60 degrees C for exactly 45 min under a stream of nitrogen and the solid residue was solubilized in 200 microl of purified water. A 100 microl-volume was subjected to HPLC analysis onto a Nucleosil 100-5 microm C18 AB column equipped with a guard column (Nucleosil 100-5 microm C(6)H(5) (phenyl) end-capped) using a gradient elution of acetonitrile and 1-heptanesulfonic acid 0.2% pH 4: 15/85 at 0 min-->50/50 at 20 min-->100/0 at 22 min-->15/85 at 24 min-->15/85 at 26 min, delivered at 1 ml/min. The analytes were detected by fluorescence detection with excitation and emission wavelength set at 480 and 550 nm, respectively. The calibration curves were linear over the range of 2-1000 ng/ml for effluent and plasma matrices, and 0.1 microg/g-750 microg/g for tissues matrices. The method is precise with inter-day and intra-day relative standard deviation within 0.5 and 6.7% and accurate with inter-day and intra-day deviations between -5.4 and +7.7%. The in vitro stability in all matrices and in processed samples has been studied at -80 degrees C for 1 month, and at 4 degrees C for 48 h, respectively. During initial studies, heparin used as anticoagulant was found to profoundly influence the measurements of doxorubicin in effluents collected from animals under ILP. Moreover, the strong matrix effect observed with tissues samples indicate that it is mandatory to prepare doxorubicin calibration standard samples in biological matrices which would reflect at best the composition of samples to be analyzed. This method was successfully applied in animal studies for the analysis of effluent, serum and tissue samples collected from pigs and rats undergoing ILP.


Insight into the sulfur metabolism of Desulfurella amilsii by differential proteomics.
Many questions regarding proteins involved in microbial sulfur metabolism remain unsolved. For sulfur respiration at low pH, the terminal electron acceptor is still unclear. Desulfurella amilsii is a sulfur-reducing bacterium that respires elemental sulfur (S0 ) or thiosulfate, and grows by S0 disproportionation. Due to its versatility, comparative studies on D. amilsii may shed light on microbial sulfur metabolism. Requirement of physical contact between cells and S0 was analyzed. Sulfide production decreased by around 50% when S0 was trapped in dialysis membranes, suggesting that contact between cells and S0 is beneficial, but not strictly needed. Proteome analysis was performed under the aforementioned conditions. A Mo-oxidoreductase suggested from genome analysis to act as sulfur reductase was not detected in any growth condition. Thiosulfate and sulfite reductases showed increased abundance in thiosulfate-reducing cultures, while rhodanese-like sulfurtransferases were highly abundant in all conditions. DsrE and DsrL were abundantly detected during thiosulfate reduction, suggesting a modified mechanism of sulfite reduction. Proteogenomics suggest a different disproportionation pathway from what has been reported. This work points to an important role of rhodaneses in sulfur processes and these proteins should be considered in searches for sulfur metabolism in broader fields like meta-omics.


Agronomic performance of lines derived from anther culture, maize pollination and single-seed descent in a spring wheat cross.
Anther culture and maize hybridization are two frequently used techniques for doubled haploid production in wheat (Triticum aestivum L.). Information on the field performance of lines derived from these techniques is limited. This study was conducted to compare the performance of F(4:6) lines obtained by single-seed descent with lines obtained by anther culture and maize (Zea mays L.) pollination from the same cross of spring wheat, 'Chris'/MN 7529. Thirty-three lines derived from each of those techniques were evaluated in six environments for grain yield, protein content, test weight, heading date, kernel weight and plant height. Mean performance of the single-seed descent lines exceeded performance of the anther culture lines for grain yield, kernel weight and plant height with no apparent differences for grain protein content, test weight and heading date. No differences between trait means for the single-seed descent and maize pollination lines were found except for plant height. The best 5 lines from each method for grain yield, protein content and test weight were similar in performance except that the protein content was higher for the maize pollination lines than for the single-seed descent lines. Acceptable levels of agronomic performance could be found among lines from each method. Wide acceptance of the doubled haploid technique for pure line production in breeding programs may, however, be limited by the often poor efficiency of doubled haploid line production, resulting in smaller population sizes for selection of desirable traits in comparison to the single-seed descent method.


Mark-recapture estimates of injecting drug users in Sydney.
The number of injecting drug users in the Central and Eastern Sydney Area Health Services (CSAHS and ESAHS) in 1989-1990 was estimated by applying the Petersen mark-recapture method to data obtained from the Australian National AIDS and Injecting Drug Use Surveys conducted in 1989 and in 1990. The population estimates for injecting drug users were 8368 (95 per cent confidence interval (CI) 6099 to 11,829) for ESAHS and 1466 (CI 742 to 2841) for CSHS. An estimate was also obtained for the number of injecting opioid users residing within the ESAHS; our figure of 3597 (CI 2731 to 5737) was consistent with previously reported estimates obtained using mark-recapture but based on different data sets.


An effective internet-based system for surveillance and elimination of triatomine insects: AlertaChirimacha.
Vector-borne diseases remain a significant public health threat in many regions of the world. Traditional vector surveillance and control methods have relied on active and passive surveillance programs, which are often costly and time-consuming. New internet-based vector surveillance systems have shown promise in removing some of the cost and labor burden from health authorities. We developed and evaluated the effectiveness of a new internet-based surveillance system, "AlertaChirimacha", for detecting Triatoma infestans (known locally by its Quechua name, Chirimacha), the Chagas disease vector, in the city of Arequipa, Peru. In the first 26 months post-implementation, AlertaChirimacha received 206 reports of residents suspecting or fearing triatomines in their homes or neighborhoods, of which we confirmed, through pictures or inspections, 11 (5.3%) to be Triatoma infestans. After microscopic examination, none of the specimens collected were infected with Trypanosoma cruzi. AlertaChirimacha received 57% more confirmed reports than the traditional surveillance system and detected 10% more infested houses than active and passive surveillance approaches combined. Through in-depth interviews we evaluate the reach, bilateral engagement, and response promptness and efficiency of AlertaChirimacha. Our study highlights the potential of internet-based vector surveillance systems, such as AlertaChirimacha, to improve vector surveillance and control efforts in resource-limited settings. This approach could decrease the cost and time horizon for the elimination of vector-mediated Chagas disease in the region.


The need for routine bleomycin test dosing in the 21st century.
To review the clinical evidence for routine use of bleomycin test dosing. English-language review articles, references from retrieved articles, case reports, and clinical trials were identified from a MEDLINE literature search (1966-July 2005). Key search terms included bleomycin, test dose, anaphylactic reactions, and hypersensitivity. Information from an unpublished E-mail survey, the manufacturer, and the Internet was also used. Early clinical trials and isolated case reports suggest that bleomycin-induced acute hypersensitivity reactions occur in 1% of patients with lymphoma and <0.5% of those with solid tumors. The reactions are mainly characterized by high-grade fever, chills, hypotension, and in a few cases, cardiovascular collapse, which can lead to death. The exact mechanism of these reactions is unclear, but is thought to be related to the release of endogenous pyrogens from the host cells. Evidence does not suggest any correlation between doses and the onset or severity of the reactions. Supportive care, including hydration, steroids, antipyretics, and antihistamines, may resolve the symptoms. However, it may not completely prevent recurrences. The incidence of acute hypersensitivity or hyperpyrexic reactions associated with bleomycin is very low, but the reaction is potentially fatal. Clinicians should monitor their patients for any signs and symptoms of acute hyperpyrexic reactions during bleomycin administration. Since the onset of the reactions can occur with any dose of bleomycin and at any time, routine test dosing does not seem to predict when drug reactions may occur.


Role of Vascular Endothelial Cells in Disseminated Intravascular Coagulation Induced by Seawater Immersion in a Rat Trauma Model.
Trauma complicated by seawater immersion is a complex pathophysiological process with higher mortality than trauma occurring on land. This study investigated the role of vascular endothelial cells (VECs) in trauma development in a seawater environment. An open abdominal injury rat model was used. The rat core temperatures in the seawater (SW, 22°C) group and normal sodium (NS, 22°C) group declined equivalently. No rats died within 12 hours in the control and NS groups. However, the median lethal time of the rats in the SW group was only 260 minutes. Among the 84 genes involved in rat VEC biology, the genes exhibiting the high expression changes (84.62%, 11/13) on a qPCR array were associated with thrombin activity. The plasma activated partial thromboplastin time and fibrinogen and vWF levels decreased, whereas the prothrombin time and TFPI levels increased, indicating intrinsic and extrinsic coagulation pathway activation and inhibition, respectively. The plasma plasminogen, FDP, and D-dimer levels were elevated after 2 hours, and those of uPA, tPA, and PAI-1 exhibited marked changes, indicating disseminated intravascular coagulation (DIC). Additionally, multiorgan haemorrhagia was observed. It indicated that seawater immersion during trauma may increase DIC, elevating mortality. VECs injury might play an essential role in this process.


Surgical malpractice in the United States, 1990-2006.
Information about national trends and predictors of malpractice payments can constructively add to the hotly debated topic of medical malpractice. We sought to evaluate predictors of surgical malpractice payments and to explore national trends. Retrospective analysis of surgery-related malpractice payments using the National Practitioner Data Bank from 1990 to 2006. Payments were adjusted to 2006 dollars. We evaluated predictors of payment size and large payments (defined as those >$1 million). Statutory law in the states demonstrating significant predictive values was analyzed. In total, 58,518 surgical malpractice payments met inclusion criteria. Patients were predominantly female (62%) and inpatient (63%), with a mean age of 42 years. The number of payments decreased and payment sums increased during the study period. Median payment was $132,915 (95th percentile $983,263). Claims most frequently cited improper performance (42%). Patient outcomes were the strongest predictor of both payment size and likelihood of a large payment. Children younger than 10 years old were 70% more likely to receive a large payment (p = 0.005); and patients older than 70 years were 80% less likely (p < 0.0005). Large variations across states were seen for both payment size and likelihood of large payment. The likelihood of reaching out-of-court settlement did not appear to be correlated with known factors. Nationwide, surgical malpractice claims show rising payment amounts. Patient outcomes are the strongest predictor of payment size. Considerable variation in payment size between states suggests a profound impact from local legal environments.


Supporting validity: steps to contextualise applications for technology and assessment, for learning.
In the paper, the authors offer perspectives on the uses of technology and assessment, that support learning. The perspectives are viewed through validity (from the field of assessment) as a framework and they discuss four aspects of an interconnected technology, learning and assessment space that represent theory informed, authentic practice. The four are: 1) integrated coherence for learning, assessment and technology; 2) responsibilities for equity, diversity, inclusion and wellbeing; 3) sustainability; and 4) balancing resources in global contexts. The authors propose steps and considerations for medical and health professions educators who need to contextualise applications for technology, learning and assessment, for positive impact for learners, faculty, institutions and patient care.


Fish gall bladder consumption presenting as acute renal failure.
A forty two year old male was admitted with history of anuria and breathlessness following consumption of raw rohu fish gall bladder. He had azotemia and required hemodialysis. His renal failure improved over a period of about four weeks. Incidences have been reported from South East Asian countries associating consumption of raw rohu fish gall bladder with acute renal failure.


Inverted Internal Limiting Membrane Flap Technique: Is It the Best Option for Macular Holes?
Surgical treatment is generally necessary to repair full-thickness macular holes (FTMH). Although vitrectomy with or without internal limiting membrane (ILM) peeling remains the standard surgical technique, the inverted ILM flap procedure has increasingly assumed a role in the primary surgical repair of FTMHs. Some vitreoretinal surgeons reserve this technique to treat large or myopic holes, whereas others use it routinely in all cases. This paper is a comprehensive review of the current scientific evidence on the anatomical and functional outcomes of the inverted ILM flap technique in the repair of macular holes, following the International Vitreomacular Traction Study (IVTS) group classification.


Analysis of the prevalence and causes of ultrafiltration failure during long-term peritoneal dialysis: a cross-sectional study.
Ultrafiltration failure (UFF) is a major complication of peritoneal dialysis (PD). It can occur at any stage of PD, but develops in time and is, therefore, especially important in long-term treatment. To investigate its prevalence and to identify possible causes, we performed a multicenter study in The Netherlands, where patients treated with PD for more than 4 years were studied using a peritoneal function test (standard peritoneal permeability analysis) with 3.86% glucose. UFF was defined as net UF < 400 mL after a 4-hour dwell. 55 patients unselected for the presence or absence of UFF were analyzed. Mean age was 48 years (range 18 - 74 years); duration of PD ranged from 48 to 144 months (median 61 months); UFF was present in 20 patients (36%). Patients with and without UFF did not differ in age or duration of PD. Median values for patients with normal UF compared to patients with UFF were, for net UF 659 mL versus 120 mL (p < 0.01), transcapillary UF rate 3.8 versus 2.1 mL/ minute (p < 0.01), effective lymphatic absorption 1.0 versus 1.6 mL/min (p < 0.05), mass transfer area coefficient (MTAC) for creatinine 9.0 versus 12.9 mL/min (p< 0.01), dialysate-to-plasma ratio (D/P) for creatinine 0.71 versus 0.86 (p < 0.01), glucose absorption 60% versus 73% (p < 0.01), maximum dip in D/P sodium (as a measure of free water transport) 0.109 versus 0.032 (p < 0.01), and osmotic conductance to glucose 3.0 versus 2.1 microL/min/mmHg (p < 0.05). As causes for UFF, high MTAC creatinine, defined as > 12.5 mL/min, or a glucose absorption > 72%, both reflecting a large vascular surface, a lymphatic absorption rate (LAR) of > 2.14 mL/min, and a decreased dip in D/P sodium of < 0.046 were identified. Most patients had a combination of causes (12 patients), whereas there was only a decreased dip in D/P sodium in 3 patients, only high MTAC creatinine in 1 patient, and only high LAR in 2 patients. We could not identify a cause in 2 patients. Both groups had similar clearances of serum proteins and peritoneal restriction coefficients. However, dialysate cancer antigen 125 concentrations, reflecting mesothelial cell mass, were lower in the UFF patients (2.79 vs 5.38 U/L). The prevalence of UFF is high in long-term PD. It is caused mainly by a large vascular surface area and by impaired channel-mediated water transport. In addition, these patients also had signs of a reduced mesothelial cell mass, indicating damage of the peritoneum on both vascular and mesothelial sites.


Immunotherapy for Prostate Cancer: Where Do We Go From Here?-PART 1: Prostate Cancer Vaccines.
Immunotherapies have emerged as a revolutionary modality for cancer treatment, and a variety of immune-based approaches are currently being investigated in the field of prostate cancer. Despite the 2010 approval of sipuleucel-T, subsequent progress in prostate cancer immunotherapy development has been limited by disappointing results with novel vaccination approaches and by prostate cancer's general resistance to immune checkpoint blockade. Nevertheless, there remains strong preclinical and clinical evidence to suggest that prostate cancer is a susceptible target for immune therapies. Innovative strategies for vaccine development, adoptive cell transfer, alleviation of immunosuppression in the tumor microenvironment, and combinatorial approaches using existing drugs and novel immune agents hold great promise for improving the treatment of prostate cancer. The first article in this two-part series will provide an overview of both past and present therapeutic vaccination strategies for the promotion of antitumor immunity against prostate cancer. Later, in Part 2, we will discuss novel areas of clinical development and identify the trends that may define the future of prostate cancer immunotherapy.


Radiographic assessment of nocturnal gastric juice secretion after administration of roxatidine acetate hydrochloride.
Adult patients with symptoms of gastric disease were randomly assigned to a treatment group (n = 103) or untreated control group (n = 89). The treatment group received 75 mg of roxatidine acetate hydrochloride at 9 PM and 12 to 13 hours later gastric juice secretion was measured with gastric x-ray films in both groups. Mean gastric juice secretion was significantly lower in the treated group (16.1 ml/12 hrs) than in the untreated controls (49.8 ml/12 hrs). Gastric juice suppression by roxatidine was 90% in patients with gastric ulcer, 74% in patients with duodenal ulcer, 63% in patients with gastritis, and 70% in patients with no evidence of disease. It is concluded that 150 mg of roxatidine daily would be adequate to treat patients with gastric diseases.


Salivary Duct Carcinoma of the Parotid Gland: Report of Two Cases in Females.
Salivary duct carcinoma is a rare tumor, commonly involving parotid gland. It typically affects middle aged to elderly males. The tumor has an aggressive behaviour and is notorious for early metastasis, high rate of local recurrence, and high mortality. Treatment is mainly surgical but other modalities are also used. We are reporting 2 cases in females who had different presentation, course of disease, treatment, and prognosis.


Modeling the Evolution of Beliefs Using an Attentional Focus Mechanism.
For making decisions in everyday life we often have first to infer the set of environmental features that are relevant for the current task. Here we investigated the computational mechanisms underlying the evolution of beliefs about the relevance of environmental features in a dynamical and noisy environment. For this purpose we designed a probabilistic Wisconsin card sorting task (WCST) with belief solicitation, in which subjects were presented with stimuli composed of multiple visual features. At each moment in time a particular feature was relevant for obtaining reward, and participants had to infer which feature was relevant and report their beliefs accordingly. To test the hypothesis that attentional focus modulates the belief update process, we derived and fitted several probabilistic and non-probabilistic behavioral models, which either incorporate a dynamical model of attentional focus, in the form of a hierarchical winner-take-all neuronal network, or a diffusive model, without attention-like features. We used Bayesian model selection to identify the most likely generative model of subjects' behavior and found that attention-like features in the behavioral model are essential for explaining subjects' responses. Furthermore, we demonstrate a method for integrating both connectionist and Bayesian models of decision making within a single framework that allowed us to infer hidden belief processes of human subjects.


The occurrence of vancomycin-resistant enterococci in hematological patients in relation to antibiotic use.
Very important bacterial pathogens found in hematological patients at present are vancomycin-resistant enterococci (VRE). The main goal of this retrospective study was to assess their occurrence in relation to antibiotic use. We isolated 1918 Enterococcus strains, in toto, 138 (7.2%) of which proved to be VRE. The VRE most frequently identified were Enterococcus faecium VanA (77%) and Enterococcusfaecalis VanB (12%), mostly isolated from stools (57%). Comparing the development of the selection pressure of antibiotics and percentage of VRE in each period of observation, an effect of the administration of each antibiotic group on the occurrence of VRE can be presumed. A reduction in the administration of third generation cephalosporins, glycopeptides and fluoroquinolones and its replacement by penicillin antibiotics combined with inhibitors of bacterial beta-lactamases, contributed to the cessation of VRE incidence and succeeding reduced occurrence from 15.1% in the second half of 1998 to 6.1% in the first half of 2000.


Cutting edge: IL-1α is a crucial danger signal triggering acute myocardial inflammation during myocardial infarction.
Myocardial infarction (MI) induces a sterile inflammatory response that contributes to adverse cardiac remodeling. The initiating mechanisms of this response remain incompletely defined. We found that necrotic cardiomyocytes released a heat-labile proinflammatory signal activating MAPKs and NF-κB in cardiac fibroblasts, with secondary production of cytokines. This response was abolished in Myd88(-/-) fibroblasts but was unaffected in nlrp3-deficient fibroblasts. Despite MyD88 dependency, the response was TLR independent, as explored in TLR reporter cells, pointing to a contribution of the IL-1 pathway. Indeed, necrotic cardiomyocytes released IL-1α, but not IL-1β, and the immune activation of cardiac fibroblasts was abrogated by an IL-1R antagonist and an IL-1α-blocking Ab. Moreover, immune responses triggered by necrotic Il1a(-/-) cardiomyocytes were markedly reduced. In vivo, mice exposed to MI released IL-1α in the plasma, and postischemic inflammation was attenuated in Il1a(-/-) mice. Thus, our findings identify IL-1α as a crucial early danger signal triggering post-MI inflammation.


[Hyperthermia in spina bifida patients treated with oxybutynin].
Paraplegic spina bifida patients often suffer from disturbed sweat secretion in the paretic regions. A diminished sweat production of caudal parts of the body is compensated by an increased secretion of sweat in parts cranial to the lesion to maintain temperature homoeostais. If the sweat secretion is blocked by anticholinergic effects of urotherapeutic drugs (for instance oxybutynin) hyperthermia can result as a side effect as these casuistic examples show.An 8-year-old girl with a lumbar meningomyelocele and a neurogenic bladder reported a dry skin and hyperthermia up to 38,5°C during oral therapy with oxybutynin (0.4 mg per kg body weight) during hot summer days. Similar symptoms were shown by a 7-year-old male patient with a sacral meningomyelocele and neurogenic bladder on oral therapy of 0.35 mg oxybutynin per kg body weight. A 4-year-old female patient with lumbar spina bifida and neurogenic bladder reacted to intravesical administration of 0.4 and 0.3 mg per kg body weight during early summertime with hyperthermia up to 38°C. In this case the medication had been started in wintertime and was primarily well tolerated.Hyperthermia under treatment with anticholinergic drugs has mainly been published for geriatric patients with sometimes fatal outcome. In the pediatric literature there is only one warning regarding the use of oxybutynin in children with spina bifida living in high temperature regions. It is remarkable that hyperthermia can also happen after intravesical administration of oxybutynin in usual dosage.


The Impact of Total Body Prehabilitation on Post-Operative Outcomes After Major Abdominal Surgery: A Systematic Review.
Despite advances in perioperative care, post-operative clinical and functional outcomes after major abdominal surgery can be suboptimal. Prehabilitation programmes attempt to optimise a patient's preoperative condition to improve outcomes. Total body prehabilitation includes structured exercise, nutritional optimisation, psychological support and cessation of negative health behaviours. This systematic review aims to report on the current literature regarding the impact of total body prehabilitation prior to major abdominal surgery. Relevant studies published between January 2000 and July 2017 were identified using MEDLINE, EMBASE, AMED, CINAHL, PsychINFO, PubMed, and the Cochrane Database. All studies published in a peer-reviewed journal, assessing post-operative clinical and functional outcomes, following a prehabilitation programme prior to major abdominal surgery were included. Studies with less than ten patients, or a prehabilitation programme lasting less than 7 days were excluded. Sixteen studies were included, incorporating 2591 patients, with 1255 undergoing a prehabilitation programme. The studies were very heterogeneous, with multiple surgical sub-specialties, prehabilitation techniques, and outcomes assessed. Post-operative complication rate was reduced in six gastrointestinal studies utilising either preoperative exercise, nutritional supplementation in malnourished patients or smoking cessation. Improved functional outcomes were observed following a multimodal prehabilitation programme. Compliance was variably measured across the studies (range 16-100%). There is substantial heterogeneity in the prehabilitation programmes used prior to major abdominal surgery. A multimodal approach is likely to have better impact on functional outcomes compared to single modality; however, there is insufficient data either to identify the optimum programme, or to recommend routine clinical implementation.


PfRON3 is an erythrocyte-binding protein and a potential blood-stage vaccine candidate antigen.
Erythrocyte invasion by merozoites is an essential step in Plasmodium falciparum infection and leads to subsequent disease pathology. Proteins both on the merozoite surface and secreted from the apical organelles (micronemes, rhoptries and dense granules) mediate the invasion of erythrocytes; some of the molecules have been regarded as targets in the development of an anti-malaria vaccine. Recently, a subgroup of rhoptry neck proteins (PfRON2, PfRON4 and PfRON5) associated with the microneme protein apical membrane antigen AMA1 has been described as components of the moving junction complex that assists merozoite invasion into erythrocytes. However, unlike PfRON2, PfRON4 and PfRON5, the latest study suggested that PfRON3 might be located in the rhoptry bulb and participates in a novel PfRON complex (PfRON2, 3 and 4), but does not form a complex with AMA1. Additionally, the full-length PfRON3 protein possesses three transmembrane regions at the N-terminus, which is highly conserved among RON3 orthologues in the genus Plasmodium, Toxoplasma gondii and Eimeria tenella. Overall, these findings suggest that PfRON3 may play an important role in merozoite invasion into erythrocytes. PfRON3 was primarily expressed during the late trophozoite stage, with a peak in transcription levels at 40 hours post-invasion. The subcellular localization of PfRON3 was confirmed that it is a merozoite rhoptry bulb protein. Additionally, the recombinant form of PfRON3 protein bound to the erythrocyte and was recognized by sera collected from malaria endemic areas in Africa, and anti-PfRON3 antibodies significantly inhibited merozoite invasion into erythrocytes. The expression of PfRON3 was analysed via real-time quantitative PCR, and the recombinant PfRON3 proteins were generated with an Escherichia coli expression system. The subcellular localization of PfRON3 was assessed with immunoelectron microscopy and immunofluorescence assay (IFA). The recognition PfRON3 by malaria immune sera was analysed with an enzyme-linked immunosorbent assay (ELISA). Erythrocyte-binding assays were performed using recombinant PfRON3 proteins and invasion inhibition assays were carried out with PfRON3-specific antibodies. This study confirmed that PfRON3 is a rhoptry protein with an erythrocyte-binding property, which is likely associated red blood cell invasion. PfRON3 is a potential vaccine candidate.


Neuropeptide Y inhibits cholinergic transmission in the isolated guinea pig colon: mediation through alpha-adrenergic receptors.
Neuropeptide Y, a member of the pancreatic polypeptide family, caused dose-dependent relaxation of guinea pig colon longitudinal muscle. This inhibitory effect was unaffected by hexamethonium but was abolished by atropine and tetrodotoxin, suggesting that neuropeptide Y is acting via postganglionic cholinergic neurons. Studies utilizing alpha-adrenergic and dopamine receptor antagonists revealed that neuropeptide Y-mediated relaxation was blocked only by the alpha 2 antagonist yohimbine. Neuropeptide Y also antagonized muscle response to electric field stimulation that was reversed by yohimbine. Additional studies with muscle slices incubated with [3H]norepinephrine or [3H]choline showed that neuropeptide Y stimulated norepinephrine release from sympathetic nerves, which, in turn, inhibited the release of acetylcholine via alpha 2 receptors located on postganglionic nerves. This pathway provides a mechanism for neuropeptide modulation of classical neurotransmitter function.


Histometry of lymphoid infiltrate in the thyroid of primary thyrotoxicosis patients. Relation of extent of thyroiditis to preoperative drug treatment and postoperative hypothyroidism.
The thyroids of primary thyrotoxicosis patients prepared for partial thyroidectomy with propranolol contained much more lymphoid infiltrate than those prepared with carbimazole. No relation was found between the extent of lymphoid infiltrate in the thyroid and the development of postoperative hypothyroidism either between or within the two drug treatment groups. This study has shown that the extent of thyroid infiltrate should not be used as the major factor in predicting hypothyroidism after subtotal thyroidectomy for primary thyrotoxicosis.


The effect of implementation intentions on use of dental chewing gum.
This study examined the effect of implementation intentions on use of dental chewing gum. A total of 80 participants reported intentions to chew gum, read information about the benefits of dental gum, reported intentions again, and formed implementation intentions relating to gum use (experimental group) or solved word puzzles (control group). Seven days later, they reported the amount chewed. Results showed that among those motivated to chew gum, implementation intentions significantly increased the total amount chewed. Time 1 intentions were more highly correlated with behaviour than time 2 intentions. Further research is needed to establish the effectiveness of implementation intentions in dental settings.


Epidemiology of connective tissue disorders.
The reported prevalence and incidence of connective tissue disorders are quite variable, depending on differences in study methodology. Most important differences are the study duration, the classification criteria used for diagnosis and the country in which the study was undertaken. Sjögren's syndrome has the highest prevalence ranging between 0.5 and 3% of a given population. The prevalence of systemic lupus erythematosus (SLE) is estimated between 15 and 50 per 100 000 individuals, with a female:male ratio of 6-10:1 in the age group between 15 and 40 yrs. The prevalence of systemic sclerosis is lower, however, varying significantly between different studies and countries. The prevalence of overlap syndromes, especially mixed connective tissue disease, is unknown, and polymyositis and dermatomyositis are regarded as very rare rheumatic diseases. Though the classification criteria for the connective tissue disorders have not been developed for the purpose of diagnosing an individual patient, these criteria still are the most valuable tool for the identification of patients with systemic rheumatic diseases such as connective tissue disorders.


Evaluation for Ion Heating of H2A-H2B Dimer in Ion Mobility Spectrometry-Mass Spectrometry.
Ion mobility spectrometry-mass spectrometry (IMS-MS) provides m/z values and collision cross sections (CCSs) of gas-phase ions. In our previous study, an intrinsically disordered protein, the H2A-H2B dimer, was analyzed using IMS-MS, resulting in two conformational populations of CCS. Based on experimental and theoretical approaches, this resulted from a structural diversity of intrinsically disordered regions. We predicted that this phenomenon is related to ion heating in the IMS-MS instrument. In this study, to reveal the effect of ion heating from parameters in the IMS-MS instrument on the conformational population of the H2A-H2B dimer, we investigated the arrival time distributions of the H2A-H2B dimer by changing values of three instrumental parameters, namely, cone voltage located in the first vacuum chamber, trap collision energy (trap CE) for tandem mass spectrometry, and trap bias voltage for the entrance of IMS. These results revealed that the two populations observed for the H2A-H2B dimer were due to the trap bias voltage. Furthermore, to evaluate the internal energies of the analyte ions with respect to each parameter, benzylpyridinium derivatives were used as temperature-sensitive probes. The results showed that the trap CE voltage imparts greater internal energy to the ions than the trap bias voltage. In addition, this slight change in the internal energy caused by the trap bias voltage resulted in the structural diversity of the H2A-H2B dimer. Therefore, the trap bias voltage should be set with attention to the properties of the analytes, even if the effect of the trap bias voltage on the internal energy is negligible.


A new surface characterization technique: RIMAPS (Rotated Image with Maximum Average Power Spectrum).
This work introduces a new imaging technique, Rotated Image with Maximum Average Power Spectrum (RIMAPS), for use in determining orientation and characteristics of surface topography. It consists of computing the maximum value of the averaged power spectrum, given by one step of the two-dimensional Fourier transform, for each angle of rotation of a digitized image. The basic measurement science of this technique is described and different cases are studied. The characterization of simple geometrical figures explains the meaning of peaks and their angular positions given by RIMAPS analysis. A known surface pattern made on a sample of pure copper, mechanically ground, is used to study reproducibility, dependence on image quality and topography scale relative to pixel size and magnification. Samples of pure zinc, mechanically ground and chemically etched, were used to show the main features of RIMAPS analysis when characterizing a more complicated pattern on a real surface. All the studies performed under different conditions for observation and acquisition of images give strong evidence of the stability and robustness of RIMAPS as a technique for the characterization of topography.


Lack of β2-AR Increases Anxiety-Like Behaviors and Rewarding Properties of Cocaine.
It is well known that β-adrenoceptors (β-ARs) play a critical role in emotional arousal and stressful events, but the specific contributions of the β2-AR subtype to the psychological disorders are largely unknown. To investigate whether β2-AR are involved in anxiety-like behavior and reward to addictive drugs, we conducted a series of behavioral tests on β2-AR knock-out (KO) mice. β2-AR KO mice exhibited increased preference for the dark compartment and closed arm in tests of Light/Dark box and elevated plus maze, indicating that β2-AR deletion elevates level of anxiety or innate fear. β2-AR KO mice also showed decreased immobility in tail suspension test (TST), suggesting that β2-AR deletion inhibits depression-like behavior. Interestingly, β2-AR ablation did not change basal locomotion but significantly increased locomotor activity induced by acute cocaine administration. β2-AR KO mice showed enhanced place preference for cocaine, which could be attenuated by β1-selective AR antagonist betaxolol. Consistently, β2-AR agonist suppressed cocaine-conditioned place preference (CPP). These data indicate that β2-AR deletion enhances acute response and reward to cocaine. Our results suggest that β2-AR regulates anxiety level, depression-like behavior and hedonic properties of cocaine, implicating that β2-AR are the potential targets for the treatment of emotional disorders and cocaine addiction.


[Sanitary risks related to importation of workers to Reunion Island during the XIXth century].
The XIXth century is the period of the sugar industrialization in Réunion. In spite of the abolition of the slaves trade in 1817 and the English abolition of the slavery of 1833, the sugar industry imported large numbers of African and Asian workers which exceeded in number the white population and that of the slaves. As the public health and the health controls came under the governor, the prevention was insufficient in the XIXth century. There were several establishments of "decontamination", sanitary observation in Saint-Denis under the authority of the colonial doctor. However, in the absence of a lazaret, the ship which transported imported workers had to be suspected to be contaminated not to be granted access. The lazaret of La grande chaloupe opened lately around 1850. Under the pressure of the industry, traders and captains, not all immigrants passed by the lazaret before entering the island. Therefore, the public health relative to the massive immigration in Réunion depended more on the private domain than on the public domain because the immigration was linked with major economic interests.


Potentiation of azidothymidine cytotoxicity in cisplatin-resistant human ovarian carcinoma cells.
The combination of cisplatin and AZT was synergistic in a subline (A2780DDP) of human ovarian carcinoma cells resistant to cisplatin, in contrast to the parental carcinoma cell line, A2780S. A2780DDP cells have elevated levels of enzymes necessary for DNA synthesis and repair. If A2780DDP cells respond to cisplatin with an increase in thymidine kinase activity, then AZT may chain terminate newly synthesized DNA. To test this hypothesis, a dual label [( 14C]-thymidine/[3H]-AZT) experiment was designed. A2780 cells were first incubated with [14C]-thymidine to label DNA and measure DNA degradation in response to cisplatin. These [14C]-thymidine labeled A2780 cells were then incubated for short intervals with [3H]-AZT to measure chain termination after cisplatin addition. A2780S cells responded to cisplatin with a modest increase in thymidine turnover and an increase in AZT incorporation. In contrast, A2780DDP cells initially responded to cisplatin treatment with a significant increase in thymidine turnover and a corresponding increase in [3H]-AZT incorporation. This was concomitantly associated with an increase in thymidine kinase mRNA within 2 hr after cisplatin treatment. Thus, the A2780DDP cells had the ability to rapidly turnover DNA, a property effectively exploited by the deoxythymidine analogue, AZT, utilizing the enhanced enzymes of the DNA synthesis and repair complex in A2780DDP cells.


Experimental murine leprosy: a biochemical study emphasizing lysosomal enzyme changes in vivo and enzyme secretion by macrophages in vitro.
This study was undertaken to identify biochemical alterations in serum, lymphoid organs, and peritoneal macrophages (PM) which reflect the histopathology of experimental Mycobacterium lepraemurium (MLM) infection in mice. A significant increase of acid phosphatase, beta-glucuronidase, N-acetyl-beta-D-glucosaminidase, and lysozyme was found in serum, spleen, and liver homogenates of mice infected intraperitoneally (ip) with MLM. PM from infected mice showed a substantially greater rate of secretion of beta-glucuronidase, N-acetyl-beta-D-glucosaminidase, and acid phosphatase than PM from normal mice. There was, however, no significant difference in the ability of PM from BALB/c and C57BL/6 mice to secrete such enzymes in vitro. There was also a significant increase in all these enzymes in PM in the early stage of infection but they dropped to values lower than normal in the advanced stage of infection despite the fact that such cells increased in size and protein content as the infection progressed. Infected mice were also found to have progressively elevated levels of serum lactic dehydrogenase, glutamic oxaloacetic, and glutamic pyruvic transaminases which indicated damages of hepatocytes and other tissues. Values of other blood components were also reported. Both BALB/c and C57BL/6 strain of mice, which are susceptible to the ip route of MLM infection, showed an indistinguishable pattern of biochemical alterations as reflected by their similar histopathological changes in various organs. BALB/c mice, which are still susceptible to subcutaneous (sc) route of infection showed similar characteristic changes in various serum components as before. In contrast, C57BL/6 mice, which are resistant to MLM infection sc, showed insignificant alterations in most of these biochemical parameters.


[AZOOR. After whiplash injury].
To present a case of a 30 years old woman that suffered a car accident one year ago, diagnosed of cervical sprain. One month after the accident, the patient saw a black stein in the outer side of the visual field on the left eye. Brain CAT, evocate visual potentials, color test and MRI were within of the normality. According with the ophthalmic examination, visual field test and OCT (optical coherence tomography), the diagnosis was acute zonal occult outer retinopathy (AZOOR).


Iso 19011:2002--a combined auditing standard for quality and environmental management systems.
In a precedent-setting decision in 1998, the International Organization for Standardization (ISO) directed ISO Technical Committee (TC) 176 on Quality Management and ISO TC 207 on Environmental Management to develop jointly a single guideline standard for auditing quality and environmental management systems. When approved, this standard would replace ISO 10011-1, ISO 10011-2, and ISO 10011-3 on quality auditing and ISO 14010, ISO 14011, and ISO 14012 on environmental auditing. A Joint Working Group (JWG) was established comprising experts from both TC 176 and TC 207 to develop the new standard, ISO 19011, Guidelines on Quality and/or Environmental Management Systems Auditing, and to incorporate lessons learned from efforts to improve compatibility between ISO 9001/9004 and ISO 14001/14004, the standards for quality and environmental management systems, respectively. Work is proceeding on the development of ISO 19011 with an expected completion in early 2002.


Nimodipine in migraine prophylaxis.
Nimodipine is a compound that is thought to block the influx of calcium through channels in vascular smooth muscle. This paper describes a double-blind parallel-group comparison of 40 mg nimodipine three times a day and placebo. Sixty-eight patients received treatment after a run-in period of 2 months, and of these, 57 completed 8 weeks or more of the trial. All but five of these completed the full 6-month trial. The nimodipine and placebo groups showed no significant differences in the frequency of attacks, severity or duration of headache, or gastrointestinal or other symptoms.


Development of aptamers against unpurified proteins.
SELEX (Systematic Evolution of Ligands by EXponential enrichment) has been widely used for the generation of aptamers against target proteins. However, its requirement for pure target proteins remains a major problem in aptamer selection, as procedures for protein purification from crude bio-samples are not only complicated but also time and labor consuming. This is because native proteins can be found in a large number of diverse forms because of posttranslational modifications and their complicated molecular conformations. Moreover, several proteins are difficult to purify owing to their chemical fragility and/or rarity in native samples. An alternative route is the use of recombinant proteins for aptamer selection, because they are homogenous and easily purified. However, aptamers generated against recombinant proteins produced in prokaryotic cells may not interact with the same proteins expressed in eukaryotic cells because of posttranslational modifications. Moreover, to date recombinant proteins have been constructed for only a fraction of proteins expressed in the human body. Therefore, the demand for advanced SELEX methods not relying on complicated purification processes from native samples or recombinant proteins is growing. This review article describes several such techniques that allow researchers to directly develop an aptamer from various unpurified samples, such as whole cells, tissues, serum, and cell lysates. The key advantages of advanced SELEX are that it does not require a purification process from a crude bio-sample, maintains the functional states of target proteins, and facilitates the development of aptamers against unidentified and uncharacterized proteins in unpurified biological samples.


Lung Ultrasonography in the Diagnosis of Pneumonia in Children-A Metaanalysis and a Review of Pediatric Lung Imaging.
Pneumonia is one of the most frequent widespread and severe infectious diseases in pediatric patients worldwide. Pneumonia is characterized by high incidence and possibility of complications in the course of the disease in pediatric patients. For this reason, there is a need to have a rapid and safe diagnostic method to recognize it. Imaging diagnostic tools, such as x-ray examinations, necessitate caution while using these methods. To date, there have been lots of studies with the aim to determine the role of lung ultrasonography (LUS) in the diagnosis of inflammatory lesions in children. Our aim was to assess the accuracy of the LUS as diagnostic method of pneumonia in children by making a systematic research of literature. This work is a review of available literature and studies on LUS in pneumonia in children and summary of necessary information about the usefulness of LUS and sonographic findings to diagnose pneumonia in the pediatric population. We searched the following databases: PubMed, Scopus, MEDLINE, and Ovid. The following key words were used: pediatrics, pneumonia, ultrasound, chest x-ray, and LUS. The total search results amounted to 1987. From 1987 potentially eligible studies, 19 were included, and 3 were meta-analysis. We studied and performed the statistical analysis of the results publication. As a result of the analysis, a significant advantage of the ultrasound examination in comparison with the x-ray study was demonstrated. Lung ultrasound could be a safe diagnostic method for this reason.


Comparison of soft tissue response in rabbits following laryngeal implantation with hydroxylapatite, silicone rubber, and Teflon.
This study evaluates the soft tissue response in rabbits following laryngeal implantation for medialization using hydroxylapatite prostheses, carved silicone rubber prostheses, and injectable Teflon. Sixteen rabbits underwent left recurrent laryngeal nerve section for denervation and laryngeal implantation with hydroxylapatite. At 1, 3, 6, and 12 months, 4 animals were painlessly sacrificed and processed for histology. Similarly, animals were implanted with carved silicone rubber prostheses or with Teflon injected through a flap in the thyroid lamina for comparison at 1, 3, and 6 months. In animals implanted with hydroxylapatite, histologic findings include limited acute inflammatory response, thin fibrous encapsulation, and osteogenesis in the region of the fenestra, with lamellar bone bridging the space between the implant and thyroid lamina. With silicone rubber prostheses, there is a limited inflammatory response and fibrous encapsulation of the implant without evidence of osteogenesis. Animals implanted with Teflon demonstrated a classic foreign body reaction with multinucleated giant cells, granuloma formation, and migration of Teflon into surrounding muscle. With respect to soft tissue response, both hydroxylapatite and silicone rubber are less reactive than Teflon. The osteogenesis observed in the presence of hydroxylapatite increases implant stability and minimizes the risk of migration. Conversely, the presence of bone growth may limit the reversibility of medialization procedures performed with hydroxylapatite.


[Characteristics of A-type intracytoplasmic particles produced by human cells].
Radioimmunoprecipitation was used to analyse comparatively proteins in cytoplasmic A-type particles (CAP) and structural proteins of D-type virions in Hep-2 system of cultivated human cells. Proteins of CAP were iodinated and studied by electrophoresis in SDS-PAAG. In the preparations obtained, 60 000 (p60), 45 000, 42 000 and 20 000 dalton proteins wee detected. p60 was the main protein in CAP. It was precipitated by purified CAP antiserum rather than by antisera against structural proteins of D-type virions. It was thus demonstrated that the main structural protein of CAP Hep-2 cells contains no antigenic determinants of structural proteins of D-type oncoviruses.


Beat cues facilitate time estimation at longer intervals.
Time perception in humans can be relative (beat-based) or absolute (duration-based). Although the classic view in the field points to different neural substrates underlying beat-based vs. duration-based mechanisms, recent neuroimaging evidence provided support to a unified model wherein these two systems overlap. In line with this, previous research demonstrated that internalized beat cues benefit motor reproduction of longer intervals (> 5.5 s) by reducing underestimation, but little is known about this effect on pure perceptual tasks. The present study was designed to investigate whether and how interval estimation is modulated by available beat cues. To that end, we asked 155 participants to estimate auditory intervals ranging from 500 ms to 10 s, while manipulating the presence of cues before the interval, as well as the reinforcement of these cues by beat-related interference within the interval (vs. beat-unrelated and no interference). Beat cues aided time estimation depending on interval duration: for intervals longer than 5 s, estimation was better in the cue than in the no-cue condition. Specifically, the levels of underestimation decreased in the presence of cues, indicating that beat cues had a facilitating effect on time perception very similar to the one observed previously for time production. Interference had no effects, suggesting that this manipulation was not effective. Our findings are consistent with the idea of cooperation between beat- and duration-based systems and suggest that this cooperation is quite similar across production and perception.


Aerobic and Ligand-Free Manganese-Catalyzed Homocoupling of Arenes or Aryl Halides via in Situ Formation of Aryllithiums.
Ligand-free manganese-catalyzed homocoupling of arenes or aryl halides can be carried out under aerobic conditions via the in situ formation of the corresponding aryllithiums. A wide range of biaryls and derivatives has been obtained, and a mechanism involving monomeric manganese-oxo complexes has been proposed on the basis of DFT calculations.


Asymmetric, organocatalytic, three-step synthesis of alpha-hydroxy-(E)-beta,gamma-unsaturated esters.
An efficient and enantiocontrolled three-step synthesis of alpha-hydroxy-(E)-beta,gamma-unsaturated esters is reported. Enantioenriched alpha-selenyl aldehydes, prepared in one step by asymmetric, organocatalytic alpha-selenylation of aldehydes, were directly subjected to a Wittig reaction followed by allylic selenide to selenoxide oxidation and final spontaneous [2,3]-sigmatropic rearrangement to yield the target compounds in 43-65% overall yield and in 94-97% ee.


LLIN Evaluation in Uganda Project (LLINEUP2)-Factors associated with coverage and use of long‑lasting insecticidal nets following the 2020-21 national mass distribution campaign: a cross-sectional survey of 12 districts.
In 2020-2021, long-lasting insecticidal nets (LLINs) were distributed nationwide in Uganda during the COVID-19 pandemic. A cross-sectional survey was conducted in 12 districts to evaluate the impact of the campaign 1-5 months after LLIN distribution. During April-May 2021, households were randomly selected from target areas (1-7 villages) surrounding 12 government-run health facilities established as Malaria Reference Centres; at least 50 households were enrolled per cluster. Outcomes included household ownership of LLINs distributed through the universal coverage campaign (UCC) (at least one UCC LLIN), adequate coverage of UCC LLINs (at least one UCC LLIN per 2 residents), and use of LLINs (resident slept under a LLIN the previous night). Multivariate logistic regression models were used to identify household- and individual-level factors associated with outcomes, controlling for clustering around health facilities. In total, 634 households, with 3342 residents and 1631 bed-nets, were included. Most households (93.4%) owned at least 1 UCC LLIN, but only 56.8% were adequately covered by UCC LLINs. In an adjusted analysis, the factor most strongly associated with adequate coverage by UCC LLINs was fewer household residents (1-4 vs 7-14; adjusted odds ratio [aOR] 12.96, 95% CI 4.76-35.26, p < 0.001; 5-6 vs 7-14 residents; aOR 2.99, 95% CI 1.21-7.42, p = 0.018). Of the 3166 residents of households that owned at least one UCC LLIN, only 1684 (53.2%) lived in adequately covered households; 89.9% of these used an LLIN the previous night, compared to 1034 (69.8%) of 1482 residents living in inadequately covered households. In an adjusted analysis, restricted to residents of inadequately covered households, LLIN use was higher in children under-five than those aged 5-15 years (aOR 3.04, 95% CI 2.08-4.46, p < 0.001), and higher in household heads than distantly-related residents (aOR 3.94, 95% CI 2.38-6.51, p < 0.001). Uganda's 2021-21 campaign was successful, despite the COVID-19 pandemic. In future campaigns, strategies should be adopted to ensure high LLIN coverage, particularly for larger households. A better understanding of the drivers of LLIN use within households is needed to guide future interventions, educational messages, and behaviour change communication strategies; school-aged children and distantly-related residents appear vulnerable and could be targeted.


[The value of instrumented gait analysis in infantile cerebral palsy].
The technique of instrumented gait analysis enables the physician to exactly document spastic gait disorders. Time-distance parameters, joint kinematics and kinetics, dynamic EMG recordings and the measurement of energy consumption provide an extensive insight into gait problems. This method is used not only for diagnostic purposes but also to monitor the effects of therapeutic interventions. A significant limitation is the specialist knowledge necessary to interpret the data. For an adequate assessment, the gait data must be supplemented by clinical and radiological findings. When interpreting gait analysis reports, technical errors must always be born in mind. The subjectivity of individual interpretation is the major reason for the considerable variability in the treatment recommendations for similar patients.


Ni-Catalyzed Redox-Neutral Ring-Opening/Radical Addition/Ring-Closing Cascade of Cycloketone Oxime Esters and Vinyl Azides.
A nickel-catalyzed iminyl radical-triggered C-C bond cleavage/radical addition/cyclization cascade of oxime esters and vinyl azides is described. This protocol enables rapid access to the cyanoalkylated 3,4-dihydro-2 H-pyrroles and phenanthridines in good yields via adjustment of the substrate's properties. Moreover, these reactions proceed under mild and redox-neutral conditions with a board substrate scope and excellent functional group tolerance.


The effects of the physical cluster formation on pair-correlation functions for an ionic fluid.
A system of two integral equations, which is equivalent to the Ornstein-Zernike equation, results in two kinds of correlation functions which describe the apparent effects of the physical cluster formation on pair-correlation functions. Each pair-correlation function is equivalent to the sum of the two kinds of correlation functions, and the development of physical clusters, which are formed in an ionic fluid owing to the attractive Coulomb force between positive and negative charged particles, allows the dependence of the sum on the distance r between particular pair particles to develop the deviation from the behavior characterized as r-1. Then, their development makes the dependence of the sum on r have a tendency to approach the behavior characterized as r-3/2, and the two kinds of correlation functions aid in describing fractal structures of nonuniform particle distributions in ionic fluids.


[Clinical pantographic studies on "immediate side shift"].
The immediate side shift was pantographically recorded, photographed and measured in 32 volunteers with mostly complete dentures. 28 showed initial Bennett movement up to 0.4 mm under tooth contact. Values of between 0.4 and 1.5 mm were demonstrable in only 4 cases. Comparing these investigations in 10 volunteers with and without central supporting peg a clear decrease in measurements could usually be demonstrated.


Serum Concentrations of Angiopoietin-2 and Soluble fms-Like Tyrosine Kinase 1 (sFlt-1) Are Associated with Coagulopathy among Patients with Acute Pancreatitis.
In severe acute pancreatitis (SAP), systemic inflammation leads to endothelial dysfunction and activation of coagulation. Thrombotic disorders in acute pancreatitis (AP) include disseminated intravascular coagulation (DIC). Recently, angiopoietin-2 and soluble fms-like tyrosine kinase 1 (sFlt-1) were proposed as markers of endothelial dysfunction in acute states. Our aim was to assess the frequency of coagulation abnormalities in the early phase of AP and evaluate the relationships between serum angiopoietin-2 and sFlt-1 and severity of coagulopathy. Sixty-nine adult patients with AP were recruited: five with SAP, 15 with moderately severe AP (MSAP) and 49 with mild AP. Six patients were diagnosed with DIC according to International Society on Thrombosis and Haemostasis (ISTH) score. All patients had at least one abnormal result of routine tests of hemostasis (low platelet count, prolonged clotting times, decreased fibrinogen, and increased D-dimer). The severity of coagulopathy correlated with AP severity according to 2012 Atlanta criteria, bedside index of severity in AP and duration of hospital stay. D-dimers correlated independently with C-reactive protein and studied markers of endothelial dysfunction. Angiopoietin-2, D-dimer, and ISTH score were best predictors of SAP, while sFlt-1 was good predictor of MSAP plus SAP. In clinical practice, routine tests of hemostasis may assist prognosis of AP.


Molecular pathology of thyroid cancer: diagnostic and clinical implications.
There is now a reasonably good understanding of the key oncogenic events involved in the initiation and progression of thyroid cancer. Many of these are characteristic of certain tumor types, and their presence conveys diagnostic and prognostic information. It is not yet clear how this information will be applied to clinical practice. Based on preclinical evidence, mutations of genes encoding certain kinases may also predict response to specific tyrosine kinase inhibitors, although this has not yet been explored systematically in clinical trials.


Identification and Use of Frailty Indicators from Text to Examine Associations with Clinical Outcomes Among Patients with Heart Failure.
Frailty is an important health outcomes indicator and valuable for guiding healthcare decisions in older adults, but is rarely collected in a quantitative, systematic fashion in routine healthcare. Using a cohort of 12,000 Veterans with heart failure, we investigated the feasibility of topic modeling to identify frailty topics in clinical notes. Topics were generated through unsupervised learning and then manually reviewed by an expert. A total of 53 frailty topics were identified from 100,000 notes. We further examined associations of frailty with age-, sex-, and Charlson Comorbidity Index-adjusted 1-year hospitalizations and mortality (composite outcome) using logistic regression. Frailty (≤ 4 topics versus <4) was associated with twice the risk of the composite outcome, Odds Ratio: 2.2, 95% Confidence Interval: (2.0-2.4). This study demonstrates the feasibility of identifying frailty indicators from clinical notes and linking these to clinically relevant outcomes. Future work includes integrating frailty indicators into validated predictive tools.


Validation study of a total body electrical conductive (TOBEC) instrument that measures fat-free body mass.
Validation of the model SA-2's (EM-SCAN, Inc.) ability to measure fat-free body mass (FFM) and indirectly predict body fat mass using total body electrical conductivity (TOBEC) methodology was investigated. To simulate changes in FFM (6.8 to 27.2 g) and fat mass (5 to 20 g), saline and oil, respectively, were injected into multiple sites of male Sprague-Dawley rats in separate trials. Two identical experiments were conducted; only the body weights differed. In Experiment 1 the rats' starting body weight averaged 171.8 +/- 3.4 g, while it averaged 214.0 +/- 2.8 g in Experiment 2. In Experiments 1 and 2, model SA-2 was used, and theoretical changes in FFM had correlations of r = 0.88 and r = 0.82, respectively. There was a tendency of the machine to consistently overpredict FFM as greater amounts of saline were injected. In Experiment 1, when oil was injected, FFM remained extremely stable, whereas in Experiment 2, it consistently overpredicted the amount of fat added in these heavier rats. Because the overpredictions in both the cases were consistent, an adjustment to the prediction equation can possibly correct these problems. Until this is done, caution must be used in interpreting data gather from the model SA-2.


Quality of Life of Palestinian Patients on Hemodialysis: Cross-Sectional Observational Study.
Hemodialysis is life-saving and life-altering, affecting patients' quality of life. The management of dialysis patients often focuses on renal replacement therapy to improve clinical outcomes and remove excess fluid; however, the patient's quality of life is often not factored in. This study aimed to explore the factors affecting the quality of life of patients on dialysis in Palestine using the Kidney Disease Quality of Life (KDQOL-SFTM) questionnaire. A multicenter cross-sectional observational study was conducted at multiple dialysis centers in Palestine, including 271 participants receiving renal replacement therapy. Demographics, socioeconomic, and disease status data were collected. The Arabic version of KDQOL-SFTM was used to assess dialysis patient quality of life. Statistical analysis was performed using SPSS to find correlations among patient factors and the questionnaire's three main domains, the kidney disease component summaries (KDCS), mental component summaries (MCS), and physical component summaries (PCS). Mean KDCS, MCS, and PCS scores were 59.86, 47.10, and 41.15, respectively. KDC scores were lower among participants aged 40 years or older, with lower incomes, and with diabetes. PCS and MCS scores were lower among patients aged >40, less educated, and lower-income participants. There was a positive correlation between MCS and KDCS (r = 0.634, P-value <0.001), PCS and KDCS (r = 0.569, P-value <0.001), as well as MCS and PCS (r = 0.680, P-value <0.001). In this study, the KDQOL-SFTM questionnaire revealed lower PCS scores among hemodialysis patients in Palestine. Furthermore, the three domains of the questionnaire were adversely affected by patient income and education status. In addition, physical role, work status, and emotional role showed the lowest scores among the three main domains. Therefore, continuous assessment of patients' quality of life during their journey of hemodialysis using the KDQOL-SFTM along with the clinical assessment will allow the healthcare professionals to provide interventions to optimize their care.


Comparison of outcomes after typical and atypical eclampsia: a retrospective study.
To evaluate the characteristics, clinical features and maternal-perinatal outcomes after atypical eclampsia. In a retrospective study, we compared demographics, clinical characteristics and outcomes between typical and atypical eclampsia. Of 90 eclamptic patients, 56 had typical eclamptic features and 34 had atypical features. Compared to typical eclampsia, atypical eclampsia had higher gestational age (37.6 ± 3.3 vs. 34.6 ± 4.2 weeks, p = 0.001), a higher incidence of no antenatal risk factors [25 (73.5%) vs. 12 (21.4%), p < 0.001], less antepartum seizures [11 (32.4%) vs. 45 (80.4%), p < 0.001], a lower incidence of prodromal symptoms [20 (58.5%) vs. 49 (87.5%), p = 0.002], and a higher incidence of no lesion in brain imaging [16 (47.1%) vs. 12 (21.4%), p = 0.010). Although atypical eclampsia was associated with a lower odd ratio (OR) in composite perinatal complications (OR = 0.22, 95% CI = 0.08-0.60, p = 0.003), composite maternal complications did not differ between the two groups (OR = 0.52, 95% CI = 0.08-0.60, p =0.191). Maternal outcomes did not differ between the two groups. Therefore, more attention should be focused on atypical eclampsia.


Partial reduction and two-step modification of proteins for identification of disulfide bonds.
An experimental protocol was established to combine partial reduction, cyanylation, and a second modification step for the assignment of disulfide bonds in proteins that are resistant to proteolysis under native conditions. After proteolysis, disulfide bonds were assigned via MALDI mass spectrometry with subsequent semiautomatic interpretation using the program SearchXLinks, which enumerates all possible combinations of proteolytic fragments for all observed monoisotopic masses. The putative assignment of disulfide bonds was confirmed by ISD and PSD fragmentation of the corresponding protonated molecules.


Proposition of a Classification of Adult Patients with Hemiparesis in Chronic Phase.
Patients who have developed hemiparesis as a result of a central nervous system lesion, often experience reduced walking capacity and worse gait quality. Although clinically, similar gait patterns have been observed, presently, no clinically driven classification has been validated to group these patients' gait abnormalities at the level of the hip, knee and ankle joints. This study has thus intended to put forward a new gait classification for adult patients with hemiparesis in chronic phase, and to validate its discriminatory capacity. Twenty-six patients with hemiparesis were included in this observational study. Following a clinical examination, a clinical gait analysis, complemented by a video analysis, was performed whereby participants were requested to walk spontaneously on a 10m walkway. A patient's classification was established from clinical examination data and video analysis. This classification was made up of three groups, including two sub-groups, defined with key abnormalities observed whilst walking. Statistical analysis was achieved on the basis of 25 parameters resulting from the clinical gait analysis in order to assess the discriminatory characteristic of the classification as displayed by the walking speed and kinematic parameters. Results revealed that the parameters related to the discriminant criteria of the proposed classification were all significantly different between groups and subgroups. More generally, nearly two thirds of the 25 parameters showed significant differences (p<0.05) between the groups and sub-groups. However, prior to being fully validated, this classification must still be tested on a larger number of patients, and the repeatability of inter-operator measures must be assessed. This classification enables patients to be grouped on the basis of key abnormalities observed whilst walking and has the advantage of being able to be used in clinical routines without necessitating complex apparatus. In the midterm, this classification may allow a decision-tree of therapies to be developed on the basis of the group in which the patient has been categorised.


β-amyloid expression in age-related cataract lens epithelia and the effect of β-amyloid on oxidative damage in human lens epithelial cells.
To evaluate the changes in β-amyloid (Aβ) expression in age-related cataract (ARC) lens epithelia and the effect of Aβ on oxidative damage in human lens epithelial cells (HLECs). Specimens of lens epithelia and aqueous humor were obtained from 255 cataract surgery patients and 48 healthy donor eyes. The ARC samples were divided into four groups according to the Lens Opacities Classification System III, with increasing severity from Group I to Group IV. The HLECs were cultured under healthy or oxidative conditions with or without Aβ pretreatment. Western blot, immunofluorescence, real-time PCR, and enzyme-linked immunosorbent assay were performed to detect Aβ and β-amyloid precursor protein (APP) expression. β-secretase activity was analyzed in lens epithelia and HLECs. The effect of Aβ on the viability of HLECs under oxidative conditions was investigated using a cell viability assay. Compared with the healthy group, the Aβ 1-42 expression levels in lens epithelia and Aβ 1-40 expression levels in aqueous humor decreased in Groups I, II, and III (p<0.05) but were unchanged in Group IV. In contrast, APP expression levels increased in Groups I, II, and III (p<0.05) compared with those in the healthy group but were unchanged in Group IV. H2O2-treated HLECs exhibited decreased amounts of Aβ 1-42 and increased amounts of APP. β-secretase activity decreased in the lens epithelia of all four subgroups of ARCs compared with that in the lens epithelia of healthy subjects and decreased in H2O2-treated HLECs. Furthermore, treatment with nanomolar concentrations (0.2 nM to 10 nM) of Aβ could protect cell viability from oxidative damage. Aβ and APP expression levels exhibited differential changes during the development of ARC, indicating active feedback of this protein processing. Decreased expression of physiologically generated Aβ in the early and mid-stages of ARC development might be one of the potential mechanisms accelerating oxidative stress in HLECs during cataractogenesis.


Nanoclusters and nanoalloys of group 13 elements (B, Al, and Ga): benchmarking of methods and analysis of their structures and energies.
We investigated the structural and energetic properties of nanoclusters and nanoalloys composed of group 13 elements (B, Al, and Ga) up to a cluster size of 12. We conducted a comprehensive benchmark analysis of density functional and post-Hartree-Fock methods to identify efficient and accurate approaches for studying these systems using our benchmark dataset (BAlGa16) consisting of sixteen dimers and trimers. We compared different density functionals and post-Hartree-Fock methods using bond length and binding energy as parameters. B2PLYP closely follows CCSD(T) for geometry optimization, while REVPBE, BPBE, and PBE show cost-accuracy balanced performances. MRACPF was used as the reference for benchmarking energies, with NEVPT2 being the most accurate method, followed by CCSD(T) and DLPNO-CCSD(T). M06 and range-separated hybrid functionals perform well. Based on a cost-accuracy analysis, we recommend M06/def2-SVP as the preferred method. Additionally, we explored the structural evolution of pure, binary, and ternary clusters of group 13 elements up to 12 atoms, uncovering global and local minima. Ga clusters exhibited more rectangular faces compared to the predominantly trigonal faces of B and Al clusters. Binary clusters showed B in center positions, while Ga preferred outer positions, confirming the higher cohesion of B. The most favorable size of binary clusters (12) exhibited similar compositions of Al and Ga atoms. Compositions with 16.67-40% B, 16.67-60% Al, and 20-50% Ga were estimated to have negative mixing energies, indicating their relative stability.


Influence of processing on total, monoglutamate and polyglutamate folate contents of leeks, cauliflower, and green beans.
Bioavailability of dietary folate might be impaired by the polyglutamate chain to which approximately 70% of dietary folates are bound. This chain must be removed enzymatically in the intestine before folate is absorbed as a monoglutamate. To increase formation of monoglutamate folate in vegetables, the vegetables were subjected to various processing treatments. Treatments included freezing (-18 degrees C, 16 h) and thawing (4 degrees C, 24 h) and hydrostatic high-pressure treatment (200 MPa, 5 min). Both freezing/thawing and high-pressure treatment increased the proportion of folate in the monoglutamate form in leeks, cauliflower, and green beans 2-3-fold. However, loss of total folate after these treatments was >55%. It is concluded that conversion of folate polyglutamate to the monoglutamate form in vegetables is possible by certain processing treatments. Potentially this could lead to vegetables with higher folate bioavailability. However, to prevent folate loss into processing water, processing in a closed system should be applied.


Photodynamic therapy and associated targeting methods for treatment of brain cancer.
Brain tumors, including glioblastoma multiforme, are currently a cause of suffering and death of tens of thousands of people worldwide. Despite advances in clinical treatment, the average patient survival time from the moment of diagnosis of glioblastoma multiforme and application of standard treatment methods such as surgical resection, radio- and chemotherapy, is less than 4 years. The continuing development of new therapeutic methods for targeting and treating brain tumors may extend life and provide greater comfort to patients. One such developing therapeutic method is photodynamic therapy. Photodynamic therapy is a progressive method of therapy used in dermatology, dentistry, ophthalmology, and has found use as an antimicrobial agent. It has also found wide application in photodiagnosis. Photodynamic therapy requires the presence of three necessary components: a clinically approved photosensitizer, oxygen and light. This paper is a review of selected literature from Pubmed and Scopus scientific databases in the field of photodynamic therapy in brain tumors with an emphasis on glioblastoma treatment.


Changes in rectus abdominis and multifidus muscle activity during various leg-raising exercises in the supine position.
[Purpose] The purpose of this study is to compare the rectus abdominis and multifidus muscle activity and rectus abdominis/multifidus ratio ratios during various leg-raising exercises. [Subject and Methods] This study was conducted on 10 healthy males. Leg-raising exercises were performed in four different positions. [Results] The activity of the rectus abdominis was greatest for raising the legs while flexing the trunk. The rectus abdominis/multifidus ratio value of co-contraction of the rectus abdominis and multifidus was lowest for raising the legs while flexing the knees. [Conclusion] Raising the legs while flexing the knees, which provides the significant co-contraction of the rectus abdominis and multifidus, is recommended for treating vertebral instability in patients with back pain.


Medication counseling behaviors and attitudes of rural community pharmacists.
There is a continued emphasis on developing the pharmacist's medication counseling role to better serve the public. To understand this role, the present study utilized a shopper methodology to describe the extent to which 40 rural community pharmacists engage in five dimensions of counseling for each of two drug products. The study demonstrates a significant relationship between the attitudes toward counseling held by these practitioners and their actual counseling behaviors.


Short bowel syndrome: current medical and surgical trends.
Short bowel syndrome is a chronic malabsorptive state usually resulting from extensive small bowel resections. A combination of diarrhea, nutrient malabsorption, dysmotility, and bowel dilatation may constitute the clinical symptomatology of this syndrome. The remaining bowel undergoes a process called adaptation, which may replace lost intestinal function. Chronic complications include nutrient, electrolyte, and vitamin deficiencies. Therapy depends largely on the administration of various factors stimulating intestinal adaptation of the remaining bowel. If the patient despite medical therapy fails to return to oral diet alone, then long-term parenteral nutrition is required. However, long-term parenteral nutrition may gradually induce cholestatic liver disease. Surgical methods may be required for treatment including intestinal transplantation, as a last resort for the treatment of end-stage intestinal failure. The goal of this review is to analyze the clinical spectrum and pathophysiologic aspects of the syndrome, the process of intestinal adaptation, and to outline the medical and surgical methods currently used to treat this complicated group of patients.