High molecular weight RNAs and small interfering RNAs induce systemic posttranscriptional gene silencing in plants.
Posttranscriptional gene silencing (PTGS) in transgenic plants is an epigenetic form of RNA degradation related to PTGS and RNA interference (RNAi) in fungi and animals. Evidence suggests that transgene loci and RNA viruses can generate double-stranded RNAs similar in sequence to the transcribed region of target genes, which then undergo endonucleolytic cleavage to generate small interfering RNAs (siRNA) that promote degradation of cognate RNAs. The silent state in transgenic plants and in Caenorhabditis elegans can spread systemically, implying that mobile silencing signals exist. Neither the chemical nature of these signals nor their exact source in the PTGS pathway is known. Here, we use a positive marker system and real-time monitoring of green fluorescent protein expression to show that large sense, antisense, and double-stranded RNAs as well as double-stranded siRNAs delivered biolistically into plant cells trigger silencing capable of spreading locally and systemically. Systemically silenced leaves show greatly reduced levels of target RNA and accumulate siRNAs, confirming that RNA can induce systemic PTGS. The induced siRNAs represent parts of the target RNA that are outside of the region of homology with the triggering siRNA. Our results imply that siRNAs themselves or intermediates induced by siRNAs could comprise silencing signals and that these signals induce self-amplifying production of siRNAs.


Tailored Nanoparticles With the Potential to Reduce Ruminant Methane Emissions.
Agricultural methane produced by archaea in the forestomach of ruminants is a key contributor to rising levels of greenhouse gases leading to climate change. Functionalized biological polyhydroxybutyrate (PHB) nanoparticles offer a new concept for the reduction of enteric methane emissions by inhibiting rumen methanogens. Nanoparticles were functionalized in vivo with an archaeal virus lytic enzyme, PeiR, active against a range of rumen Methanobrevibacter species. The impact of functionalized nanoparticles against rumen methanogens was demonstrated in pure cultures, in rumen batch and continuous flow rumen models yielding methane reduction of up to 15% over 11 days in the most complex system. We further present evidence of biological nanoparticle fermentation in a rumen environment. Elevated levels of short-chain fatty acids essential to ruminant nutrition were recorded, giving rise to a promising new strategy combining methane mitigation with a possible increase in animal productivity.


[Non-specific dye absorption studies in quantitative cytochemical reactions with alkalic fast green and heparin-alcian blue (model experiment)].
Stöchiometria of the alkalic Fast green and Heparin-alcianblue was studied in model experiment by the aid of integrating microdensitometer. The changes of the optical density in cases of Heparin-alcian-blue occurred to be proportional to the histon quantity, in cases of staining with alkalic Fast green nonspecific dye-absorption was revealed. Results of the model experiment indicate that in quantitative cytochemical studies Heparin-alcian-blue should be preferred to alkalic Fast green.


Interleukin-6 174G/C polymorphism and ischemic stroke: a systematic review.
Interleukin-6 (IL-6) is associated with atherosclerotic disease and is also a key mediator in the inflammatory response to cerebral ischemia. Although the IL-6 -174G/C promoter polymorphism has been associated with carotid artery atherosclerosis and coronary heart disease, its relation to ischemic stroke is unclear. This review summarizes the current literature and discusses methodological considerations for future studies. Electronic searches were conducted in the PubMed MEDLINE, Scopus, and ISI Web of Science databases. Two investigators independently reviewed all abstracts to identify studies examining the association between the IL-6 -174G/C polymorphism and ischemic cerebrovascular events. Twelve relevant publications were identified. Three reported on a subset of patients from a later publication, leaving 9 independent studies. Two studies found an association between ischemic stroke and the G allele or GG genotype, whereas 4 found an association with the C allele or CC genotype. One study found the CC genotype to be significantly less frequent in retinal artery occlusion patients. Two studies found no association between the -174G/C polymorphism and stroke. Studies investigating stroke and the -174G/C polymorphism report conflicting results, which may reflect the complex physiology of IL-6 and true differences between stroke subtypes and populations. However, interpretation of published results is hindered by methodological limitations, and greater rigor and consistency in future studies will help unravel the relationship between the -174G/C polymorphism and stroke.


Profilin-1 promotes the development of hypertension-induced artery remodeling.
Hypertension is associated with the structural remodeling and stiffening of arteries and is known to increase cardiovascular risk. In the present study, we investigated the effects of overexpression and knock down of profilin-1 on the vascular structural remodeling in spontaneous hypertensive rats (SHRs) using an adenovirus injection to knock down or overexpress profilin-1 mRNA. As a control, blank adenovirus was injected into age-matched SHRs and Wistar-Kyoto rats (WKYs). We quantified arterial structural remodeling through morphological methods, with thoracic aortas stained with hematoxylin-eosin and picosirius red. Western blotting was performed to measure the protein expression of inducible nitric oxide synthase (iNOS) and p38 mitogen-activated protein kinase (p38), and peroxynitrite was quantified by immunohistochemical staining. Overexpression of profilin-1 significantly promoted aortic remodeling, including an increase in vessel size, wall thickness, and collagen content, whereas the knockdown of profilin-1 could reverse these effects. In addition, the expression of phosphorylated p38, iNOS and peroxynitrite was significantly upregulated in SHRs with profilin-1 overexpression along with an increased level of interleukin- 6 (IL-6). These changes could be reversed by knockdown of profilin-1. Our results demonstrate a crucial role for profilin-1 in hypertension-induced arterial structural remodeling at least in part through the p38-iNOS-peroxynitrite pathway.


Improvements in the analytical methodology for the residue determination of the herbicide glyphosate in soils by liquid chromatography coupled to mass spectrometry.
The determination of glyphosate (GLY) in soils is of great interest due to the widespread use of this herbicide and the need of assessing its impact on the soil/water environment. However, its residue determination is very problematic especially in soils with high organic matter content, where strong interferences are normally observed, and because of the particular physico-chemical characteristics of this polar/ionic herbicide. In the present work, we have improved previous LC-MS/MS analytical methodology reported for GLY and its main metabolite AMPA in order to be applied to "difficult" soils, like those commonly found in South-America, where this herbicide is extensively used in large areas devoted to soya or maize, among other crops. The method is based on derivatization with FMOC followed by LC-MS/MS analysis, using triple quadrupole. After extraction with potassium hydroxide, a combination of extract dilution, adjustment to appropriate pH, and solid phase extraction (SPE) clean-up was applied to minimize the strong interferences observed. Despite the clean-up performed, the use of isotope labelled glyphosate as internal standard (ILIS) was necessary for the correction of matrix effects and to compensate for any error occurring during sample processing. The analytical methodology was satisfactorily validated in four soils from Colombia and Argentina fortified at 0.5 and 5mg/kg. In contrast to most LC-MS/MS methods, where the acquisition of two transitions is recommended, monitoring all available transitions was required for confirmation of positive samples, as some of them were interfered by unknown soil components. This was observed not only for GLY and AMPA but also for the ILIS. Analysis by QTOF MS was useful to confirm the presence of interferent compounds that shared the same nominal mass of analytes as well as some of their main product ions. Therefore, the selection of specific transitions was crucial to avoid interferences. The methodology developed was applied to the analysis of 26 soils from different areas of Colombia and Argentina, and the method robustness was demonstrated by analysis of quality control samples along 4 months.


[Microangiographic research on revascularization in the fracture model of the canine tibia].
Micro-angiograms were performed between eight weeks and one year following osteotomies and pressure osteosyntheses in 34 dog tibiae. Seventeen animals also underwent lumbar sympathectomy. In more than half of the cases, vascularisation of the medulla was reduced by damage to the nutrient artery. Segmental connections could be demonstrated by means of transcortical anastomoses. Following sympathectomy, revascularisation was more marked as a result of numerous trans-osseus anastomoses. This, however, did not lead to improved healing; healing was worse after sympathectomy. Transcortical revascularisation and vessel growth along drill holes are of crucial significance.


Techniques for prevention of calcification of valvular bioprostheses.
Calcification of valvular bioprostheses in children is a major problem that has stimulated extensive research in our laboratory. In previous reports, we have shown that the rate of calcification could be reduced by decreasing the phosphate content in the tissue or by blocking calcification binding sites with Mg++ and/or with a surfactant (Tween 80). Since then, we have systematically investigated incorporation of numerous other surfactants and of polyacrylamide within the tissue, and these investigations form the basis of this report. The methods of investigation included subcutaneous implantation of treated tissues in growing rabbits, stability tests, and intracardiac implantation in sheep. Results showed that surfactants differed in their efficacy in mitigating calcification, with N-lauroylsarcosine and triton X-100 being the most efficient. Polyacrylamide incorporation was also efficient in calcification mitigation, but this effect was lost after flexibility testing in vitro or implantation in vivo, a drawback that suggests further research is necessary into stabilization of this polymer. This report not only brings attention to new alternatives in calcification mitigation treatment of bioprosthetic tissues but also underlines important points of methodology.


Complications of Self-Injected Facial Fillers: A Treatment Conundrum in the UK.
There has been a rise in nonsurgical cosmetic procedures seen within the UK population in the past decade. A change in legislation has placed restrictions on the distribution and provision of such treatments. Therefore, patients may seek alternative methods to bring about a change to their appearance, such as self-injection of a filler. Complications may include oral ulceration, foreign body tissue reaction, and infection due to a lack in sterility during injection. Such presentations may mimic that of oral cancer and can lead to misdiagnoses and undue cost to the National Health Service. This case highlights the common features leading to correct identification of patients self-injecting with facial fillers and discusses the controversy surrounding the economic aspects of their care. We would like to report one such case presenting to our oral and maxillofacial surgical unit.


SEXUAL DIMORPHISM, MATING SYSTEM AND BODY SIZE IN NEW WORLD BLACKBIRDS (ICTERINAE).
Although sexual selection is widely accepted as a primary functional cause of sexual size dimorphism in birds and mammals, results from some comparative studies have cast doubt on this conclusion. Chief among these contradictory results is the widespread association between body size and size dimorphism-large species tend to be more dimorphic than small species. This correlation is not directly predicted by the normal sexual selection scenario, and many hypotheses have been advanced to explain it. This paper reviews these hypotheses and evaluates them using data for the New World blackbirds (Icterinae). In this avian subfamily, (1) body size correlates with the intensity of sexual selection (as measured by mean harem size), and (2) size does not correlate with dimorphism if the effects of mating system are removed. Similar results are obtained when controlling for the confounding influence of phylogeny. Further, body size and mating system are associated with nesting dispersion. These results strongly argue that sexual dimorphism is a product of sexual selection in this subfamily, and suggest that either: (1) large body size itself, or the ecology of large species, promotes the development of coloniality and a polygynous mating system; or (2) polygyny and/or coloniality lead to the evolution of large size in both males and females. None of the other hypotheses examined predict an association between size and mating system, and all predict that size will correlate with dimorphism after the effects of mating system are removed. Thus, none of the other hypotheses seem applicable in this case. These results are compared to those obtained for other avian and mammalian taxa. Difficulties of analysis present in previous studies are discussed. I argue that it is inappropriate to assume that associations between a trait and body size or phylogeny are evidence of nonadaptive evolutionary "constraints."


Transforming growth factor beta enhances respiratory syncytial virus replication and tumor necrosis factor alpha induction in human epithelial cells.
Asthma is characterized as a chronic inflammatory disease associated with significant tissue remodeling. Patients with asthma are more susceptible to virus-induced exacerbation, which subsequently can lead to increased rates of hospitalization and mortality. While the most common cause of asthma-related deaths is respiratory viral infections, the underlying factors in the lung environment which render asthmatic subjects more susceptible to viral exacerbation are not yet identified. Since transforming growth factor beta (TGF-beta) is a critical cytokine for lung tissue remodeling and asthma phenotype, we have focused on the effects of TGF-beta on viral replication and virus-induced inflammation. Treatment of human epithelial cells with TGF-beta increased respiratory syncytial virus (RSV) replication by approximately fourfold. Tumor necrosis factor alpha (TNF-alpha) mRNA and protein expression were also significantly increased above levels with RSV infection alone. The increase in RSV replication and TNF-alpha expression after TGF-beta treatment was concomitant with an increase in virus-induced p38 mitogen-activated protein kinase activation. Our data reveal a novel effect for TGF-beta on RSV replication and provide a potential mechanism for the exaggerated inflammatory response observed in asthmatic subjects during respiratory viral infections.


The contribution of skin camouflage volunteers in the management of vitiligo.
A 52-year-old woman with recently diagnosed vitiligo presented at the Skin Camouflage Clinic of the British Red Cross. She found these hypo-pigmented patches very distressing and wanted to be able to cover them up. She was referred to the clinic by her general practitioner. This service of the British Red Cross is run by volunteers and helps the patient find suitable creams, foundations and powders that even out the skin tone and so disguise skin conditions. This patient was taught how to apply the cream and left the clinic with an appreciably improved mood. Observational studies have highlighted an improvement in quality of life after the introduction of skin camouflage for vitiligo. This is a free service in the Red Cross and is a necessary part of its management, equipping the patient with practical ways to cope with a condition that does not usually respond well to treatment.


A CCRK-EZH2 epigenetic circuitry drives hepatocarcinogenesis and associates with tumor recurrence and poor survival of patients.
Aberrant chromatin modification is a key feature of hepatocellular carcinoma (HCC), which is characterized by strong sexual dimorphism. Both enhancer of zeste homolog 2 (EZH2) and cell cycle-related kinase (CCRK) contribute to hepatocarcinogenesis, yet whether the two oncogenic factors have functional crosstalk is unknown. Cellular proliferation and tumorigenicity upon transgenic expression and RNA interference were determined by colony formation and soft agar assays, xenograft, orthotopic and diethylnitrosamine-induced HCC models. Gene regulation was assessed by chromatin immunoprecipitation, site-directed mutagenesis, luciferase reporter, co-immunoprecipitation and expression analyses. Protein levels in clinical specimens were correlated with clinicopathological parameters and patient survival rates. Ectopic CCRK expression in immortalized human liver cells increased EZH2 and histone H3 lysine 27 trimethylation (H3K27me3) to stimulate proliferation and tumor formation. Conversely, knockdown of CCRK reduced EZH2/H3K27me3 levels and decreased HCC cell growth, which could be rescued by EZH2 over-expression. Mechanistically, GSK-3β phosphorylation by CCRK activated a β-catenin/TCF/E2F1/EZH2 transcriptional feedback loop to epigenetically enhance androgen receptor (AR) signaling. Simultaneously, the phosphorylation of AKT/EZH2 by CCRK facilitated the co-occupancy of CCRK promoter by EZH2-AR and its subsequent transcriptional activation, thus forming a self-reinforcing circuitry. Lentiviral-mediated knockdown of CCRK, which abrogated the phosphorylation-transcriptional network, prevented diethylnitrosamine-induced tumorigenicity. More importantly, the hyperactivation of the CCRK-EZH2 circuitry in human HCCs correlated with tumor recurrence and poor survival. These findings uncover an epigenetic vicious cycle in hepatocarcinogenesis that operates through reciprocal regulation of CCRK and EZH2, providing novel therapeutic strategy for HCC.


Low-Valent Metal Ions as MOF Pillars: A New Route Toward Stable and Multifunctional MOFs.
PCM-102 is a new organophosphine metal-organic framework (MOF) featuring diphosphine pockets that consist of pairs of offset trans-oriented P(III) donors. Postsynthetic addition of M(I) salts (M = Cu, Ag, Au) to PCM-102 induces single-crystal to single-crystal transformations and the formation of trans-[P2M]+ solid-state complexes (where P = framework-based triarylphosphines). While the unmetalated PCM-102 has low porosity, the addition of secondary Lewis acids to install rigid P-M-P pillars is shown to dramatically increase both stability and selective gas uptake properties, with N2 Brunauer-Emmett-Teller surface areas >1500 m2 g-1. The Ag(I) analogue can also be obtained via a simple, one-pot peri-synthetic route and is an ideal sacrificial precursor for materials with mixed bimetallic MA/MB pillars via postsynthetic, solvent-assisted metal exchange. Notably, the M-PCM-102 family of MOFs contain periodic trans-[P2M]+ sites that are free of counter anions, unlike traditional analogous molecular complexes, since the precursor PCM-102 MOF is monoanionic, enabling access to charge-neutral metal-pillared materials. Four M-PCM-102 materials were evaluated for the separation of C2 hydrocarbons. The separation performance was found to be tunable based on the metal(s) incorporated, and density functional theory was employed to elucidate the nature of the unusual observed sorption preference, C2H2 > C2H6 > C2H4.


Atrial fibrillation and embolic complications.
Clinical records of 136 cardiac patients with atrial fibrillation (AF) followed in the cardiac clinic of the Black Lion Hospital were analysed. The mean age of the patients was 41 +/- 13 years, with a male to female ratio of 1.0:1.6. Rheumatic heart disease (RHD) was found in 66.3%, hypertension in 10.3%, cardiomyopathy in 8.8% and ischaemic heart disease in 6.6%. Embolic episodes occurred in 26 (19.1%) cases with five deaths. Twenty-one patients had cerebrovascular accident while five had femoral artery occlusion. The major cause of embolisation was rheumatic valvular heart diseases (65.5%), especially mitral stenosis. In order to reduce the high risk of systemic emboli, it is recommended that patients with AF and associated recent onset of congestive heart failure, previous history of thromboembolism and hypertension should be anticoagulated if there are no contraindications.


Posture affects motion coupling patterns of the upper cervical spine.
Measurements of motions of the cervical spine are used to help diagnose the problems of clinical instability due to degenerative changes and trauma. For a better interpretation of the three-dimensional motions of the upper cervical spine, knowledge of the effects of posture on these motions is necessary. Seven fresh human cadaveric C0-C3 spinal specimens were utilized. Each specimen was put in three distinct sagittal plane postures: full flexion, neutral, and full extension. At each posture, two load types were applied: left and right axial torques, and left and right lateral bending moments up to 1.5 Nm. The resulting three-dimensional relative motions of C0-C1 and C1-C2 were measured, with use of nonconstraining stereophotogrammetry, in the form of load-displacement curves. We found that the curves were nonlinear. The most dramatic change due to modification in posture was found in coupled sagittal plane rotation, which changed from extension at extended posture to flexion at flexed posture at both levels and in response to both load types. For the axial torque, the main axial rotation and coupled lateral bending changed little with posture. For the lateral bending moment, the main lateral bending rotation and coupled axial rotation decreased; the latter changed direction at C1-C2 as the spine was put into flexed posture. The motions for the right and left load applications generally were mirror images, except for the coupled sagittal plane rotations, which did not change with the direction of the load.


Transposition of mini-Mu containing only one of the ends of bacteriophage Mu.
Transposition of mini-Mu containing only one of the ends of bacteriophage Mu was studied. Transposition was observed when plasmids containing this mini-Mu were used as the donor in a mating-out assay with the F factor POX38, which lacks all known transposable elements, as the target. Analysis of the plasmids isolated from the recipient strain showed that in most cases the mini-Mu containing plasmid and POX38 were fused and that a part of the plasmid had been duplicated, indicating the formation of co-integrates. To obtain the DNA sequences of the junctions between donor and recipient DNA, an F factor was constructed that made it possible to analyse these junctions directly. The results showed that several sequences can be used as an alternative end in transposition and that these alternative ends show homology with the consensus for a strong A binding site. Moreover, the first base pair at the junction was always a (TA) base pair. This base pair is situated at exactly the same position with respect to the sequence which has homology with the consensus for a strong A binding site as in the ends of Mu.


Cholecalciferol improves glycemic control in type 2 diabetic patients: a 6-month prospective interventional study.
To investigate the effects of vitamin D supplementation on glucose homeostasis and lipid profile in type 2 diabetic patients who have vitamin D deficiency. One hundred twenty-five type 2 diabetic patients taking oral hypoglycemic agents as mono- or combination therapy were recruited from the diabetes and endocrinology clinic. Subject demographics, duration of diabetes, antidiabetic medication, body mass index (BMI), pulse, and blood pressure (BP) were assessed. Laboratory measurements of serum vitamin D3 level, hemoglobin A1c (HbA1c), fasting plasma glucose (FPG), and lipid profile were measured. Homeostatic model assessment-insulin resistance (HOMA-IR) was calculated whenever fasting insulin (FI) was available. Forty-one patients (27 males and 14 females) were started on cholecalciferol replacement-45,000 units once weekly for 8 weeks and then 22,500 units once weekly for 16 weeks. Calcium carbonate tablets 500 mg once daily were also prescribed for the initial 2 months of treatment. Measured variables were reassessed after 6 months of replacement therapy. During the trial, subjects were instructed not to change their diabetes drugs or lifestyle. No significant association was found between vitamin D3 level and any of the measured variables apart from a significant positive correlation with blood urea nitrogen. Vitamin D3 replacement was associated with a significant increase in its level (14.0±4.0 vs 31.0 vs 7.9 ng/mL, P<0.001). This was associated with a significant reduction of HbA1c (7.9±1.7 vs 7.4%±1.2%, P=0.001) and FPG (9.1±4.3 vs 7.9±2.4 mmol/L, P=0.034). Mean reduction of HbA1c was 0.54% and that of FPG was 1.22 mmol/L. FI, c-peptide and insulin resistance (IR) were reduced but this was statistically insignificant (P=0.069, 0.376, 0.058, respectively). FI decreased by 22%, HOMA-IR by 27.6%, and c-peptide by 1.83%. Total cholesterol, low-density lipoprotein cholesterol, parathyroid hormone, alkaline phosphatase, serum creatinine, and pulse rate significantly decreased (4.3±0.9 vs 4.0±0.9 mmol/L, P=0.036; 2.5±0.8 vs 2.2±0.8 mmol/L, P=0.018; 4.6±2.1 vs 3.5±1.8 pmol/L, P=0.001; 82.1±26.2 vs 66.2±19.5 U/L, P<0.001; 74.6±15.6 vs 70.7±14.7 μmol/L, P=0.047; and 81.6±11.9 vs 77.5±12.0 bpm, P=0.045, respectively). Triglycerides and high-density lipoprotein cholesterol, both systolic and diastolic BP, and BMI did not show significant change. Cholecalciferol helps improve blood glucose control and cholesterol profile in vitamin D3-deficient type 2 diabetic patients.


Synchronous occurrence of lobular breast carcinoma and granulosa cell tumor of ovary mimicking metastatic lobular breast carcinoma.
Breast cancer is one of the main sources of ovarian metastasis. Diffuse sheet of lobular carcinoma cells can strongly mimic granulosa cell tumor (GCT) which itself is a rare ovarian neoplasm constituting <5% of all the ovarian neoplasms. A 55-year-old female presented with a painful lump in the right breast associated with nipple discharge for 4 months, which on radiological and cytological findings was suspicious of an epithelial malignancy. During routine work-up, a solid-cystic lesion in the left ovarian adnexa was identified. The patient underwent right modified radical mastectomy along with left salpingo-oophorectomy. Histopathological and immunohistochemical features confirmed the diagnosis of a synchronous lobular carcinoma breast with GCT ovary. Simultaneous occurrence of Lobular carcinoma breast (LCB) and GCT ovary is extremely rare. Morphologically, these can look similar, raising a suspicion of LCB metastasis to ovary. This is important to differentiate the two for a proper patient management and prognosis.


Differential isotype recognition of two centromere associated polypeptides by immunoblotting in connective tissue disease.
On investigating the immunoblotting profile of 65 systemic sclerosis patients, a 140 kD polypeptide was recognised by sera from 16, when immunoblotted against a nuclear-enriched K562 cell sonicate. All 16 sera contained anticentromere antibodies (ACA) detected by immunofluorescence (IF) and 15 of 16 also recognized a 19 kD polypeptide on immunoblotting. Two ACA positive sera failed to recognize the 140 kD polypeptide but one of these recognized the 19 kD polypeptide. The 140 kD polypeptide identified a group with more limited skin involvement (P less than 0.05) and all 16 had Raynaud's phenomenon. The sera from three of 100 systemic lupus erythematosus (SLE) patients also recognized both polypeptides. On investigating the isotype specificity, the 140 kD polypeptide was strongly detected by an IgM autoantibody and the 19 kD polypeptide by an IgG autoantibody.


Effect of Trace Metal Ions on the Conformational Stability of the Visual Photoreceptor Rhodopsin.
Trace metals are essential elements that play key roles in a number of biochemical processes governing human visual physiology in health and disease. Several trace metals, such as zinc, have been shown to play important roles in the visual phototransduction process. In spite of this, there has been little research conducted on the direct effect of trace metal elements on the visual photoreceptor rhodopsin. In the current study, we have determined the effect of several metal ions, such as iron, copper, chromium, manganese, and nickel, on the conformational stability of rhodopsin. To this aim, we analyzed, by means of UV-visible and fluorescence spectroscopic methods, the effects of these trace elements on the thermal stability of dark rhodopsin, the stability of its active Metarhodopsin II conformation, and its chromophore regeneration. Our results show that copper prevented rhodopsin regeneration and slowed down the retinal release process after illumination. In turn, Fe3+, but not Fe2+, increased the thermal stability of the dark inactive conformation of rhodopsin, whereas copper ions markedly decreased it. These findings stress the important role of trace metals in retinal physiology at the photoreceptor level and may be useful for the development of novel therapeutic strategies to treat retinal disease.


Self-organization of honeycomb-like porous TiO2 films by means of the breath-figure method for surface modification of titanium implants.
This study describes a facile breath-figure method for the preparation of honeycomb-like porous TiO2 films with an organometallic small-molecule precursor. Multiple characterization techniques have been used to investigate the porous films and a mechanism for the formation process of porous TiO2 films through the breath-figure method is proposed. The pore size of the TiO2 films could be modulated by varying the experimental parameters, such as the concentration of titanium n-butoxide (TBT) solution, the content of cosolvent, and the air flow rate. In vitro cell-culture experiments indicate that NIH 3T3 fibroblast cells seeded on the honeycomb-like porous TiO2 films show good adhesion, spreading, and proliferation behaviors, which suggests that honeycomb-like porous TiO2 films are an attractive biomaterial for surface modification of titanium and its alloys implants in tissue engineering to enhance their biocompatibility and bioactivity.


A rare case of basilar impression.
A teenage girl presented with progressively worsening neck and occipital pain since 8 months ago that was associated with restriction of neck movements, low to moderate grade fever, anorexia and weight loss followed by gradually progressive quadriparesis since 3 months ago. Neurological examination revealed spastic quadriparesis without cranial nerve palsy. MRI of the cervical spine revealed prevertebral and paravertebral abscess from clivus to C2/C3 level, which extended into the anterior epidural space at C1-C3 level, causing atlantoaxial dislocation. There was evidence of basilar invagination. The dislocated dens caused compression over the cervicomedullary junction. On this basis, a diagnosis of craniovertebral junction Pott's disease was made. The patient was given neck immobilisation with cervical collar, and antitubercular treatment was started. She showed significant improvement in her neurological deficit during follow-up.


CMA Infobase: clinical practice guidelines.
The CMA Infobase is a free Web-based resource that contains evidence-based clinical practice guidelines. The database is maintained by the Canadian Medical Association (CMA) and is available on its Web site. The CMA Infobase currently contains 1,200-plus clinical practice guidelines either developed or endorsed by an authoritative health care organization located in Canada. It is an alternative source of free clinical practice guidelines to the National Guideline Clearinghouse. This column will cover the basics of CMA Infobase, including searching, special features, and available resources which complement the database.


[Trans-vesical incarceration of a small bowel loop after pelvic trauma].
The authors report the case of a patient presenting with small bowel obstruction after a pelvic trauma with associated bladder injury. While urinary bladder and bowel injuries are frequent following this type of trauma, their association is rare. Small bowel obstruction secondary to trans-vesical incarceration of a small bowel loop at the fracture site is exceptional. CT is invaluable for diagnosis.


Properties of hepatitis B e antigen synthesized by rat cells transfected with circular viral DNA.
Transfection of Buffalo rat liver cells with closed circular hepatitis B virus DNA resulted in the synthesis of both hepatitis B e and surface antigens. A 14000 mol. wt. peptide bearing hepatitis B e antigenic determinants was isolated from cell culture fluids. Native hepatitis B e antigen was present in multimeric forms in the cell culture fluids and was associated with protein phosphokinase activity. The multimeric forms of hepatitis B e antigen may serve both structural and enzymic functions for the hepatitis B virion with its small genome.


Collagen XIII secures pre- and postsynaptic integrity of the neuromuscular synapse.
Both transmembrane and extracellular cues, one of which is collagen XIII, regulate the formation and function of the neuromuscular synapse, and their absence results in myasthenia. We show that the phenotypical changes in collagen XIII knock-out mice are milder than symptoms in human patients, but the Col13a1-/- mice recapitulate major muscle findings of congenital myasthenic syndrome type 19 and serve as a disease model. In the lack of collagen XIII neuromuscular synapses do not reach full size, alignment, complexity and function resulting in reduced muscle strength. Collagen XIII is particularly important for the preterminal integrity, and when absent, destabilization of the motor nerves results in muscle regeneration and in atrophy especially in the case of slow muscle fibers. Collagen XIII was found to affect synaptic integrity through binding the ColQ tail of acetylcholine esterase. Although collagen XIII is a muscle-bound transmembrane molecule, it also undergoes ectodomain shedding to become a synaptic basal lamina component. We investigated the two forms' roles by novel Col13a1tm/tm mice in which ectodomain shedding is impaired. While postsynaptic maturation, terminal branching and neurotransmission was exaggerated in the Col13a1tm/tm mice, the transmembrane form's presence sufficed to prevent defects in transsynaptic adhesion, Schwann cell invagination/retraction, vesicle accumulation and acetylcholine receptor clustering and acetylcholinesterase dispersion seen in the Col13a1-/- mice, pointing to the transmembrane form as the major conductor of collagen XIII effects. Altogether, collagen XIII secures postsynaptic, synaptic and presynaptic integrity, and it is required for gaining and maintaining normal size, complexity and functional capacity of the neuromuscular synapse.


In vivo whole body and appendicular bone mineral density in rats: a dual energy X-ray absorptiometry study.
Bone mineral density (BMD) of the whole body and hind limb of young adult rats, with and without a sham-operated stifle joint was studied, using dual energy x-ray absorptiometry (DEXA) at three time points. Data from the whole body scan were used for analyses of BMD, bone mineral content (BMC), fat, lean, body weight (BW), percentage of BMC (%BMC), percentage of fat (%fat), and percentage of lean (%lean), none of which were significantly different between the groups at any time point. Significant (P < 0.05) differences in BMD, BMC, %BMC, BW, fat, %fat, and %lean were apparent at the second and third scans, compared with the initial scan, within both groups. Changes in whole body BMD, BMC, and %BMC as well as BW were highly correlated with time in both groups. In the hind limb scans, regions of interest (ROIs) were created to obtain values of BMD and BMC from the whole femur, whole tibia including the fibula, distal portion of the femur, and proximal portion of the tibia. Significant differences were not found between the groups for any ROIs. However, significant BMD and BMC increases were evident in all ROIs at the second and third scans, compared with the initial scan. Similar to those in the whole body scan, BMD and BMC obtained from ROIs were highly correlated with time. The positioning technique for the whole body and appendicular scans was analyzed by calculating percentage of the coefficient of variation (%CV) at the beginning of the study. The %CV was low and acceptable in ROIs for the hind limb and for all parameters of the whole body scan, except fat. The results suggest that in vivo DEXA scanning of the rat whole body and appendicular skeleton is highly reproducible and useful to study the whole skeleton, as well as a region of a long bone of the rat. Values for the sham-operated rats were not significantly different from those for the untreated controls, which suggests that soft tissue damage around the stifle joint did not alter BMD in the subchondral bone of the distal portion of the femur and proximal portion of the tibia.


Validity of Neuropsychological Testing in Young African Children Affected by HIV.
Western-constructed neuropsychological tests have been used in low and middle income countries to assess the impact of HIV/AIDS and other chronic illnesses. We explore using such instruments cross-culturally in a sub-Saharan Africa setting. IMPAACT P1104S was a two-year observational study carried out at six clinical sites (South Africa- 3 sites, Malawi, Uganda and Zimbabwe) to assess and compare neuropsychological outcomes in three cohorts of children 5-11 years of age: HIV-infected (HIV), HIV-exposed but uninfected (HEU) and HIV unexposed and uninfected (HU). Descriptive statistics compared socio-demographic characteristics among children at sites. Instruments included the KABC-II cognitive ability, TOVA attention/impulsivity, BOT-2 motor proficiency tests, and BRIEF executive function problems. Test characteristics were assessed using intraclass and Spearman non-parametric correlations, linear regression and principal factor analyses. Of the 611 participants, 50% were male and mean age ranged from 6.6 to 8 years. In Malawi, Uganda and Zimbabwe, substantial proportions of families lived in rural settings in contrast to the South African sites. Intraclass correlation coefficients between weeks 0 and 48 were highest for the KABC scores, ranging between 0.42 to 0.71.Correlations among similar test domains were low to moderate but significant, with positive correlation between KABC Sequential and TOVA scores and negative correlation between BRIEF and KABC scores. TOVA response time scores correlated negatively with the BOT-2 Total points score. Strong and significant associations between individual measures of growth, disability and development with all test scores were observed. Performance-based measures were markedly lower for HIV compared to HEU and HU participants, even after controlling for age, sex and site. Factor analyses confirmed the underlying theoretical structure of the KABC scaled item scores. The KABC, TOVA, BRIEF and BOT-2 were valid and reliable tools for assessing the neuropsychological impact of HIV in four sub-Saharan African countries.


Age differences in the oxidation of and neural response to ethanol in mice.
Male mice (C57BL/6J) from three age groups, 4, 14, and 26 months, were tested to determine their oxidation rate of intragastrically infused ethanol and the response of the centrally mediated jaw-jerk reflex to ethanol challenge. There were no age-related differences in the rate of oxidation of ethanol. However, age differences in ethanol-induced decrement of the jaw-jerk amplitude were significant. The 26 month animals were the most affected, followed by the 4 month group. The middle aged mice (14 month) showed the greatest resistance to the depression induced by ethanol. The results were evaluated with regard to the current hypotheses.


Controlled Palatal Harvest Technique for Harvesting a Palatal Subepithelial Connective Tissue Graft.
Subepithelial connective tissue grafts (SCTGs) have been extensively used to augment soft-tissue volume on dental implants and natural teeth. The authors present a technique called the controlled palatal harvest (CPH) to obtain SCTGs. CPH provides an alternative to the trap-door and single-incision techniques currently utilized. The objective of this article is to describe this harvesting technique for SCTGs. A case report is presented in which the CPH technique was successfully used to obtain a SCTG. Contrary to current techniques where the SCTG is usually taken from the palatal (bone) side, this technique involves the dissection of a thick split-thickness flap in which the graft is harvested from the raised flap. Further, an L-shaped incision (with an anterior release) improves visibility and dexterity during dissection of the connective tissue graft. This technique enables the operator to maintain a certain minimum overlying flap thickness, and excellent control is ensured over the thickness of the harvested SCTG. The thickness of theremaining connective tissue overlying the palatal can also be controlled by the operator. Thus, the chances of leaving behind a thin tissue covering the palatal bone are reduced, minimizing necrosis and flap sloughing, which further improves grafting success. While the CPH can be used as an alternative to currently employed conventional harvest techniques, it may require greater operator skill. To the best of the authors' knowledge, this is the first report that documents such a technique.


The impact of prior intra-abdominal surgery on laparoscopic cholecystectomy.
The presence of abdominal wall scarring and intra-abdominal adhesions following prior abdominal surgery has been proposed as a relative contraindication to the performance of laparoscopic cholecystectomy. The impact of prior abdominal surgery on the management of symptomatic gall bladder disease was retrospectively reviewed. Three groups were evaluated: open, laparoscopic, and laparoscopic converted to open cholecystectomy. Clinical factors analyzed included lengths of operative time, postoperative hospitalization stay, medical risk (ASA Classification), and postoperative complications. In addition, factors contributing to the conversion from a laparoscopic to open procedure were evaluated to determine the impact of prior surgery on conversion. The records of 504 consecutive patients undergoing open and laparoscopic cholecystectomy were reviewed. Individuals having additional intra-abdominal procedures were excluded. A total of 175 patients were identified who had prior abdominal surgery and underwent a cholecystectomy. In patients requiring cholecystectomy who have had prior abdominal surgery, the following observations can be made regarding laparoscopic cholecystectomy: 1) The operative time is less compared to open cholecystectomy. 2) The advantage of a shorter postoperative stay is realized. 3) The conversion rate (7/158) is low. Five of the seven conversions were due to the dense adhesion that prevented safe needle/trocar placement. 4) The complication rate is not increased. 5) The successful completion rate of laparoscopic cholecystectomy following prior intra-abdominal surgery (95.6%) is high.


Does Education Affect Rural Women's Trust? Evidence From China.
Trust is of great significance to the economic and social development of a country. In the case of China, the trust of rural women has undergone tremendous changes along with the development of rural areas. It is seen that the trust of rural women has changed from localized to generalized trust, and it is stated that the major factor leading to this transformation is education. To explore the phenomenon empirically, the current study uses the survey data of rural women sourced from China Family Panel Studies (CFPS) over the year 2018. Through the ordered probit model, the study reveals that education plays a significant role in influencing rural women's generalized trust and localized trust. Through mediation analysis, the study further reveals that reliance on Internet information, access to public resources, and income are the factors mediating the relationship between education and generalized trust. Besides, the outcomes further unveil that the impact of education on localized trust is stronger when the level of mobility is low. For robustness check, the current study additionally employs a regression discontinuity model. The overall findings elucidate that education is the major factor triggering the trust of rural women in China. The findings propose that policymakers in China should imply education-oriented strategies as individuals with higher levels of education are more inclined to trust others.


Biological complexity and drug discovery: a practical systems biology approach.
Drugs fail in clinical studies most often from lack of efficacy or unexpected toxicities. These failures result from an inadequate understanding of drug action and follow, in part, from our dependence on drug discovery technologies that do not take into account the complexity of human disease biology. Biological systems exhibit many features of complex engineering systems, including modularity, redundancy, robustness, and emergent properties. Addressing these features has contributed to the successful design of an improved biological assay technology for inflammation drug discovery. This approach, termed Biologically Multiplexed Activity Profiling (BioMAP), involves the statistical analysis of protein datasets generated from novel complex primary human cell-based assay systems. Compound profiling in these systems has revealed that a surprisingly large number of biological mechanisms can be detected and distinguished. Features of these assays relevant to the behaviour of complex systems are described.


ImmunoPET and Near-Infrared Fluorescence Imaging of Pancreatic Cancer with a Dual-Labeled Bispecific Antibody Fragment.
Dual-targeted imaging agents have shown improved targeting efficiencies in comparison to single-targeted entities. The purpose of this study was to quantitatively assess the tumor accumulation of a dual-labeled heterobifunctional imaging agent, targeting two overexpressed biomarkers in pancreatic cancer, using positron emission tomography (PET) and near-infrared fluorescence (NIRF) imaging modalities. A bispecific immunoconjugate (heterodimer) of CD105 and tissue factor (TF) Fab' antibody fragments was developed using click chemistry. The heterodimer was dual-labeled with a radionuclide (64Cu) and fluorescent dye. PET/NIRF imaging and biodistribution studies were performed in four-to-five week old nude athymic mice bearing BxPC-3 (CD105/TF+/+) or PANC-1 (CD105/TF-/-) tumor xenografts. A blocking study was conducted to investigate the specificity of the tracer. Ex vivo tissue staining was performed to compare TF/CD105 expression in tissues with PET tracer uptake to validate in vivo results. PET imaging of 64Cu-NOTA-heterodimer-ZW800 in BxPC-3 tumor xenografts revealed enhanced tumor uptake (21.0 ± 3.4%ID/g; n = 4) compared to the homodimer of TRC-105 (9.6 ± 2.0%ID/g; n = 4; p < 0.01) and ALT-836 (7.6 ± 3.7%ID/g; n = 4; p < 0.01) at 24 h postinjection. Blocking studies revealed that tracer uptake in BxPC-3 tumors could be decreased by 4-fold with TF blocking and 2-fold with CD105 blocking. In the negative model (PANC-1), heterodimer uptake was significantly lower than that found in the BxPC-3 model (3.5 ± 1.1%ID/g; n = 4; p < 0.01). The specificity was confirmed by the successful blocking of CD105 or TF, which demonstrated that the dual targeting with 64Cu-NOTA-heterodimer-ZW800 provided an improvement in overall tumor accumulation. Also, fluorescence imaging validated the PET imaging, allowing for clear delineation of the xenograft tumors. Dual-labeled heterodimeric imaging agents, like 64Cu-NOTA-heterodimer-ZW800, may increase the overall tumor accumulation in comparison to single-targeted homodimers, leading to improved imaging of cancer and other related diseases.


Spotted fever group rickettsiae in Dermacentor reticulatus and Haemaphysalis punctata ticks in the UK.
Spotted fever group (SFG) rickettsiae have recently been identified for the first time in UK ticks. This included the findings of Rickettsia helvetica in Ixodes ricinus and Rickettsia raoultii in Dermacentor reticulatus. This paper further investigates the occurrence of SFG rickettsiae in additional geographically distinct populations of D. reticulatus, and for the first time, investigates the occurrence of SFG rickettsiae in UK populations of Haemaphysalis punctata ticks. Questing D. reticulatus and H. punctata were collected at a number of sites in England and Wales. DNA from questing ticks was extracted by alkaline lysis and detection of rickettsiae DNA was performed, in addition to detection of A. phagocytophilum, N. mikurensis, C. burnetii and B. burgdorferi sensu lato. This paper builds on previous findings to include the detection of spotted fever Rickettsia which showed the highest homology to Rickettsia massiliae in Haemaphysalis punctata, as well as R. helvetica in D. reticulatus. The occurrence of SFG rickettsiae in D. reticulatus in the UK appears to be confined only to Welsh and Essex populations, with no evidence so far from Devon. Similarly, the occurrence of SFG rickettsiae in H. punctata appears confined to one of two farms known to be infested with this tick in North Kent, with no evidence so far from the Sussex populations. Anaplasma phagocytophilum, Neoehrlichia mikurensis, Coxiella burnetii and Borrelia burgdorferi sensu lato DNA was not detected in any of the ticks. These two tick species are highly restricted in their distribution in England and Wales, but where they do occur they can be abundant. Following detection of these SFG rickettsiae in additional UK tick species, as well as I. ricinus, research should now be directed towards clarifying firstly the geographic distribution of SFG rickettsiae in UK ticks, and secondly to assess the prevalence rates in ticks, wild and domesticated animals and humans to identify the drivers for disease transmission and their public health significance.


Differences between the different conditioning regimens for allogeneic stem cell transplantation.
The aim of this article is to compare the differences in efficacy and toxicity between the various conditioning regimens for allogeneic stem cell transplantation. Several studies, all retrospective, that compare the impact of various different conditioning regimens amongst each other are presented. Reduced intensity conditioning apparently lowered transplant-related mortality in patients with minimal residual disease who were at high risk for treatment-related mortality. In contrast, patients with active disease could only be salvaged when a myeloablative conditioning regimen was used. By consequence, it was concluded that patients without contraindications for a myeloablative conditioning regimen should not receive reduced regimens outside a prospective randomized trial. Despite high expectations, non-myeloablative conditioning regimens and regimens that have been reduced in intensity did not prove to be superior in survival when the outcomes were compared with those obtained with conventional myeloablative conditioning. Randomized prospective studies are needed to explore the appropriate niche for the various different regimens.


Fanconi's syndrome associated with carburetor fluid intoxication.
A patient who ingested carburetor fluid developed methanol intoxication followed by hypouricemia, hypophosphatemia, glycosuria, and hyperchloremic metabolic acidosis. Renal clearances of phosphate, uric acid, glucose, and bicarbonate were found to be elevated indicating the presence of Fanconi's syndrome. The authors postulate that the Fanconi's syndrome observed in our patient was the result of the organic solvents present in the mixture.


On inference of control-based imputation for analysis of repeated binary outcomes with missing data.
Missing data are common in longitudinal clinical trials. How to handle missing data is critical for both sponsors and regulatory agencies to assess treatment effect from the trials. Recently, a control-based imputation has been proposed, where the missing data are imputed based on the assumption that patients who discontinued the test drug will have a similar response profile to the patients in the control group. Under control-based imputation, the variance estimation may be biased using Rubin's formula which could produce biased statistical inferences. We evaluate several statistical methods for obtaining appropriate variances under control-based imputation for analysis of repeated binary outcomes with monotone missing data and show that both the analytical method developed by Robins & Wang and the nonparametric bootstrap method provide more appropriate variance estimates under various simulation settings. We use the methods in an application of an antidepressant Phase III clinical trial and give discussion and recommendations on method performance and preference.


Vaccination against hepatitis B in low endemic countries.
A mathematical model that takes transmission by sexual contact and vertical transmission into account was employed to describe the transmission dynamics of hepatitis B virus (HBV) and vaccination against it. The model is an extension of a model by Williams et al. (Epidemiol Infect 1996: 116; 71-89) in that it takes immigration of hepatitis B carriers from countries with higher prevalence into account. Model parameters were estimated from data from The Netherlands where available. The main results were that, given the estimates for the parameters describing sexual behaviour in The Netherlands, the basic reproduction number R0 is smaller than 1 in the heterosexual population. As a consequence, the immigration of carriers into the population largely determines the prevalence of HBV carriage and therefore limits the possible success of universal vaccination. Taking into account the prevalence of hepatitis B carriage among immigrants and an age-dependent probability of becoming a carrier after infection, we estimate that a fraction of between 5 and 10% of carrier states could be prevented by universal vaccination.


ROLES OF CITRATE AND ACETOIN IN THE METABOLISM OF STREPTOCOCCUS DIACETILACTIS.
Harvey, R. J. (University of California, Davis), and E. B. Collins. Roles of citrate and acetoin in the metabolism of Streptococcus diacetilactis. J. Bacteriol. 86:1301-1307. 1963.-Streptococcus diacetilactis was unable to use citrate as a source of energy for growth, but the addition of citrate to a lactose-containing medium increased the specific growth rate 35%. Besides serving as the precursor of acetoin, some of the pyruvate formed from citrate was incorporated into cell material, primarily into lipids. A constant fraction of the weight of new cells was synthesized from the pyruvate formed from citrate. The rate of entry of citrate into cells was independent of the growth rate, and the usual result was that more pyruvate was formed from citrate than was required for cell synthesis. All excess pyruvate was converted to acetoin. Thus, acetoin formation acts as a detoxification mechanism, a means of removing intracellular pyruvate not required for synthesis of cell material.


Age-Dependent Changes of Thinking about Verbs.
We investigated the knowledge of emotional and motor verbs in children and adolescents from three age ranges (8-11, 12-15, 16-19 years). Participants estimated the verbs familiarity, age of acquisition, valence, arousal, imageability, and motor- and emotion-relatedness. Participants were familiar with the verbs in our dataset. The younger (8-11) attributed an emotional character to the verbs less frequently than the middle (12-15) and the older (16-19) groups. In the 8-11 group males rated the verbs as emotion-related less frequently than females. Results indicate that processing verbal concepts as emotion-related develops gradually, and after 12-15 is rather stable. The age of acquisition (AoA) develops late: the older (16-19) had a higher awareness in reporting that they learnt the verbs earlier as compared to the estimations made by the younger (8-11 and 12-15). AoA positively correlated with attribution of emotion relatedness meaning that emotion-related verbs were learned later. Arousal was comparable across ages. Also it increased when attributing motor relatedness to verbs and decreased when attributing emotion relatedness. Reporting the verbs' affective valence (happy vs. unhappy) changes with age: younger (8-11) judged the verbs generally more "happy" than both the older groups. Instead the middle and the older group did not show differences. Happiness increased when processing the verbs as motor related and decreased when processing the verbs as emotion related. Age affected imageability: the younger (8-11) considered the verbs easier to be imagined than the two older groups, suggesting that at this age vividness estimation is still rough, while after 12-15 is stable as the 12-15 and 15-19 group did not differ. Imageability predicted arousal, AoA, emotion- and motor-relatedness indicating that this index influences the way verbs are processed. Imageability was positively correlated to emotion relatedness, indicating that such verbs were harder to be imagined, and negatively to motor relatedness. Imageablity positively correlated with valence meaning that verbs receiving positive valence were also those that were hard to be imagined, and negatively correlated with arousal, meaning that verbs that were harder to be imagined elicited low physiological activation. Our results give an insight in the development of emotional and motor-related verbs representations.


Protection of GaInP2 Photocathodes by Direct Photoelectrodeposition of MoSx Thin Films.
Catalytic MoSx thin films have been directly photoelectrodeposited on GaInP2 photocathodes for stable photoelectrochemical hydrogen generation. Specifically, the MoSx deposition conditions were controlled to obtain 8-10 nm films directly on p-GaInP2 substrates without ancillary protective layers. The films were nominally composed of MoS2, with additional MoOxSy and MoO3 species detected and showed no long-range crystalline order. The as-deposited material showed excellent catalytic activity toward the hydrogen evolution reaction relative to bare p-GaInP2. Notably, no appreciable photocurrent reduction was incurred by the addition of the photoelectrodeposited MoSx catalyst to the GaInP2 photocathode under light-limited operating conditions, highlighting the advantageous optical properties of the film. The MoSx catalyst also imparted enhanced durability toward photoelectrochemical hydrogen evolution in acidic conditions, maintaining nearly 85% of the initial photocurrent after 50 h of electrolysis. In total, this work demonstrates a simple method for producing dual-function catalyst/protective layers directly on high-performance, planar III-V photoelectrodes for photoelectrochemical energy conversion.


Examining decentering as a moderator in the relation between non-suicidal self-injury and suicide ideation via cognitive-affective factors.
Given the high prevalence of self-injury but low treatment-seeking among young adults, brief, accessible interventions might help reduce risk of self-injurious thoughts and behavior in this population. This cross-sectional study examined the moderating effects of decentering-a cognitive-affective regulation strategy-in the relation between non-suicidal self-injury (NSSI) and suicide ideation via cognitive-affective factors that increase risk for both NSSI and suicide ideation. College students (N = 125, 79% women), ages 18-27, pre-screened for moderate levels of depression and anxiety, completed self-report measures of NSSI, decentering, rumination, hopelessness, depressive symptoms, and suicide ideation. Young adults with past-year non-suicidal self-injury scored lower on decentering than their peers without NSSI. Decentering was associated with lower levels of all cognitive-affective risk factors and moderated the relation between NSSI and rumination, but not the relation between NSSI and hopelessness and depressive symptoms. Decentering moderated the indirect effect of past-year non-suicidal self-injury on past-week suicide ideation via rumination, but not via hopelessness or depressive symptoms. Decentering is a potential cognitive-affective regulation strategy for targeting factors that increase risk of self-injurious thoughts and behaviors. Future studies should examine decentering as a buffer against risk using designs that allow for conclusions about temporal order of effects.


Ultra rapid spontaneous resolution of acute posttraumatic subdural hematomas in patient with temporal linear fracture.
We report a case of 57 year-old man with documented posttraumatic acute subdural hematoma and a linear temporal bone fracture. He suffered from a blunt head injury and presented with sudden loss of consciousness. Within 2 hours he became alert and oriented. Follow-up CT scan of brain 2 hours after the initial one showed resolution and redistribution of the subdural hematoma. To our knowledge, this is the first case in the literature about spontaneous resolution of an acute subdural hematoma in a patient with a linear fracture and the fastest resolution period. In this article, the authors discuss the underlying pathophysiology of this uncommon phenomenon.


Association Between Guillain-Barré Syndrome and COVID-19 Infection and Vaccination: A Population-Based Nested Case-Control Study.
Existing data regarding occurrence of Guillain-Barré syndrome (GBS) after coronavirus disease 2019 (COVID-19) infection and vaccination are inconclusive. We aimed to assess the association between GBS and both severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and COVID-19 vaccine. We conducted a nested case-control study in a cohort of 3,193,951 patients aged 16 years or older, without a diagnosis of prior GBS, from the largest health care provider in Israel. Participants were followed from January 1, 2021, until June 30, 2022, for the occurrence of GBS. Ten randomly selected controls were matched to each case of GBS on age and sex. We assessed both SARS-CoV-2 infection and COVID-19 vaccine administration in the prior 6 weeks in cases and controls. Overall, 76 patients were diagnosed with GBS during follow-up and were matched to 760 controls. A positive test for SARS-CoV-2 was detected in 9 (11.8%) cases and 18 (2.4%) controls. An administration of COVID-19 vaccine was detected in 8 (10.5%) cases (all Pfizer-BioNTech [BNT162b2] vaccine) and 136 (17.9%) controls (134 Pfizer-BioNTech vaccine). Multivariable conditional logistic regression models showed that the odds ratio for GBS associated with SARS-CoV-2 infection and COVID-19 vaccine administration was 6.30 (95% CI 2.55-15.56) and 0.41 (95% CI 0.17-0.96), respectively. The results were similar when exposure to SARS-CoV-2 infection or COVID-19 vaccine administration was ascertained in the prior 4 and 8 weeks, although did not reach statistical significance for COVID-19 vaccine at 4 weeks. Our study suggests that SARS-CoV-2 infection is associated with increased risk of GBS, whereas Pfizer-BioNTech COVID-19 vaccine is associated with decreased risk of GBS.


[Purulent pleurisy in a specialized hospital environment in Bamako].
We report the results of a retrospective study of 108 cases of pleural empyema collected in the Pneumo-Phthisiology Department of the National Hospital of "Point G" from September 1984 to August 1990. The sex-ratio is 3/1 in favour of males with a mean age of 35.5 years. The pleural empyema represent 2.2% of all patients admitted in the Hospital and 20.2% of liquid effusions of the Pleura observed during the study period. The causal common germ has been placed in a proeminent position in 18 cases (16.7%) including 14 cases of gram-positive germs. Tuberculous aetiology has been proven in 16 cases (27.6%) against 67 cases of bacterial pleuresies (62%). The initial treatment has consisted in an empirical antibiotherapy of a large spectrum associated with repeated washing punctions. A short-term antituberculous chemotherapy (8 months, 2RHZS(6TH)) has been administrated each time the tuberculous aetiology has been proven or strongly presumed. The therapeutic results have been favourable in 85 cases (78.7%) and unfavourable in 23 cases (21%) including 10 deaths (9.2%).


Enhanced charge transport in polymer thin-film transistors prepared by contact film transfer method.
The charge-carrier transport in the structures formed at the surface of various conjugated polymer films is investigated by constructing organic thin-film transistors using a novel and simple contact film transfer method. Thin-film transistors prepared by this transfer process have higher field-effect mobility values compared with conventional spin-coated devices for all the studied polymers. In contrast to previous reports, the hole mobility in regioregular poly(3-alkylthiophene)s does not depend on the length of the alkyl chain when the contact film transfer method is used. These results suggest that the thiophene rings adopt a highly ordered edge-on orientation and strong interchain pi-pi interactions spontaneously form at the polymer/air interface during the spin coating.


VAC14 nucleates a protein complex essential for the acute interconversion of PI3P and PI(3,5)P(2) in yeast and mouse.
The signalling lipid PI(3,5)P(2) is generated on endosomes and regulates retrograde traffic to the trans-Golgi network. Physiological signals regulate rapid, transient changes in PI(3,5)P(2) levels. Mutations that lower PI(3,5)P(2) cause neurodegeneration in human patients and mice. The function of Vac14 in the regulation of PI(3,5)P(2) was uncharacterized previously. Here, we predict that yeast and mammalian Vac14 are composed entirely of HEAT repeats and demonstrate that Vac14 exerts an effect as a scaffold for the PI(3,5)P(2) regulatory complex by direct contact with the known regulators of PI(3,5)P(2): Fig4, Fab1, Vac7 and Atg18. We also report that the mouse mutant ingls (infantile gliosis) results from a missense mutation in Vac14 that prevents the association of Vac14 with Fab1, generating a partial complex. Analysis of ingls and two additional mutants provides insight into the organization of the PI(3,5)P(2) regulatory complex and indicates that Vac14 mediates three distinct mechanisms for the rapid interconversion of PI3P and PI(3,5)P(2). Moreover, these studies show that the association of Fab1 with the complex is essential for viability in the mouse.


Pediatric Undifferentiated Pleomorphic Sarcoma of the Cecum.
Background: Undifferentiated pleomorphic sarcoma (UPS) is a high-grade neoplasm typically diagnosed in older adults and localized to the extremities or retroperitoneum. Because of poor response to therapy and high rates of recurrence, this neoplasm is associated with a poor prognosis. Case Report: A 12-year-old female presented with weight loss, abdominal pain, fatigue, and diarrhea. She was profoundly anemic with occult blood-positive stools. On endoscopy, a fungating cecal mass was biopsied and diagnosed as malignant sarcomatoid neoplasm. The neoplasm was resected with clear margins during subsequent surgery, and on final pathology was diagnosed as UPS. A suspicious lung nodule was also removed via video-assisted thoracoscopic surgery and found to be a granuloma positive for Histoplasma capsulatum for which the patient received antifungal therapy. The patient did not receive additional chemotherapy or radiotherapy and was doing well without signs of recurrence at 12 months postresection. Conclusion: This report of cecal UPS in a 12-year-old is rare because of the patient's age and tumor location. We have identified only 2 other case reports of pediatric gastrointestinal UPS. This case illustrates the need for a broad differential and prompt workup in pediatric patients presenting with weight loss and abdominal complaints. More information regarding the management and outcomes in cases of gastrointestinal UPS is needed to assist providers in determining the best treatment course and to allow for better prognostication.


Mitochondrial complex I activity and oxidative damage to mitochondrial proteins in the prefrontal cortex of patients with bipolar disorder.
Accumulating evidence suggests that mitochondrial dysfunction and oxidative stress contribute to the pathogenesis of bipolar disorder and schizophrenia. It remains unclear whether mitochondrial dysfunction, specifically complex I impairment, is associated with increased oxidative damage and, if so, whether this relationship is specific to bipolar disorder. To evaluate whether decreased levels of the electron transport chain complex I subunit NDUFS7 are associated with complex I activity and increased oxidative damage to mitochondrial proteins in the prefrontal cortex of patients with bipolar disorder, schizophrenia, or major depressive disorder. Postmortem prefrontal cortex from patients and controls were assessed using immunoblotting, spectrophotometric, competitive enzyme immunoassay to identify group differences in expression and activity of complex I, and in oxidative damage in mitochondria. University of British Columbia, Vancouver, Canada. Patients Forty-five patients with a psychiatric disorder (15 each with bipolar disorder, schizophrenia, and major depressive disorder) and 15 nonpsychiatric control subjects were studied. Oxidative damage to proteins and mitochondrial complex I activity. Levels of NDUFS7 and complex I activity were decreased significantly in patients with bipolar disorder but were unchanged in those with depression and schizophrenia compared with controls. Protein oxidation, as measured by protein carbonylation, was increased significantly in the bipolar group but not in the depressed or schizophrenic groups compared with controls. We observed increased levels of 3-nitrotyrosine in the bipolar disorder and schizophrenia groups. Impairment of complex I may be associated with increased protein oxidation and nitration in the prefrontal cortex of patients with bipolar disorder. Therefore, complex I activity and mitochondrial dysfunction may be potential therapeutic targets for bipolar disorder.


Catalytic Asymmetric Electrophilic Cyanation of 3-Substituted Oxindoles.
The first example of catalytic asymmetric electrophilic cyanation of 3-substituted oxindoles has been achieved using readily accessible 4-acetylphenyl cyanate as the cyano source. Thus, a series of all-carbon quaternary center 3-aryl-3-cyano oxindoles were prepared using a zinc complex of a chiral pincer ligand as the catalyst in high yields (up to 95%) and excellent enantioselectivities (up to >99% ee) in the presence of 4 Å MS and 2,6-lutidine in THF at 0 °C.


Controllable side-by-side and end-to-end assembly of Au nanorods by lyotropic chromonic materials.
We present a simple and universal technique for assembling gold nanorods (NRs) using self-assembled stacks of lyotropic chromonic materials, without covalent bonding between NRs and the linking agent. The anisotropic electrostatic interaction between the chromonic stacks and NRs allows one to achieve either side-by-side or end-to-end assembly, depending on the surface charge of NRs. The assembled superstructures are stable within an extended temperature range; the degree of NR aggregation can be controlled by a number of factors influencing the self-assembly of chromonic materials, such as the concentration and pH of the solution.


Lanthanide Organophosphate Spiro Polymers: Synthesis, Structure, and Magnetocaloric Effect in the Gadolinium Polymer.
Spirocyclic lanthanide organophosphate polymers, {[Ln(dipp)(dippH)(CH3OH)(H2O)2](CH3OH)2}n [Ln = La (1), Ce (2), Pr (3), Nd (4), Sm (5), Eu (6), Gd (7), Tb (8), Dy (9), Ho (10), Er (11)], have been prepared from the reaction of Ln(NO3)3·xH2O with sterically hindered 2,6-diisopropylphenyl phosphate (dippH2) using aqueous NaOH as the base. The one-dimensional chainlike lanthanide (III) organophosphate coordination polymers have been characterized with the aid of analytical and spectroscopic methods. The single crystal structure determination of polymers (2-5 and 7-11) reveals that in these compounds the hydrophobic organic groups of the phosphate provide a protective coating for the inorganic lanthanide phosphate polymeric chain. The encapsulation of inorganic lanthanide phosphate core, which has very low solubility product, within the organic groups assists in the facile crystallization of the polymers. The di- and monoanionic organophosphate ligands dipp2- and dippH- display [2.111] and [2.110] binding modes, respectively, in 2-5 and 7. However, they exhibit only [2.110] binding mode in the case of 8-11. This results in the formation of two different types of polymers. While the lighter rare-earth metal ions in 2-5 and 7 display eight coordinate biaugmented trigonal prismatic geometry, the heavier rare-earth metal ions in 9-11 exhibit a seven coordinate capped trigonal prismatic environment. The Tb(III) ion in 8 displays distorted pentagonal bipyramidal geometry. Magnetic studies reveal the presence of weak antiferromagnetic interactions between the Ln(III) ions through the organophosphate ligand. The isotropic Gd(III) polymer 7 exhibits a maximum entropy change of 17.83 J kg-1 K-1 for a field change of 7.0 T at 2.5 K, which is significant considering the high molecular weight of the organophosphate ligand. These polymers represent the first family of any structurally characterized rare-earth organophosphate polymers derived from monoesters of phosphoric acid.


Cationic Mn4 single-molecule magnet with a sterically isolated core.
The synthesis, structure, and magnetic properties of a ligand-modified Mn(4) dicubane single-molecule magnet (SMM), [Mn(4)(Bet)(4)(mdea)(2)(mdeaH)(2)](BPh(4))(4), are presented, where the cationic SMM units are significantly separated from neighboring molecules in the crystal lattice. There are no cocrystallized solvate molecules, making it an ideal candidate for single-crystal magnetization hysteresis and high-frequency electron paramagnetic resonance studies. Increased control over intermolecular interactions in such materials is a crucial factor in the future application of SMMs.


Elimination of Plasmodium falciparum malaria in Tajikistan.
Malaria was eliminated in Tajikistan by the beginning of the 1960s. However, sporadic introduced cases of malaria occurred subsequently probably as a result of transmission from infected mosquito Anopheles flying over river the Punj from the border areas of Afghanistan. During the 1970s and 1980s local outbreaks of malaria were reported in the southern districts bordering Afghanistan. The malaria situation dramatically changed during the 1990s following armed conflict and civil unrest in the newly independent Tajikistan, which paralyzed health services including the malaria control activities and a large-scale malaria epidemic occurred with more than 400,000 malaria cases. The malaria epidemic was contained by 1999 as a result of considerable financial input from the Government and the international community. Although Plasmodium falciparum constituted only about 5% of total malaria cases, reduction of its incidence was slower than that of Plasmodium vivax. To prevent increase in P. falciparum malaria both in terms of incidence and territory, a P. falciparum elimination programme in the Republic was launched in 200, jointly supported by the Government and the Global Fund for control of AIDS, tuberculosis and malaria. The main activities included the use of pyrethroids for the IRS with determined periodicity, deployment of mosquito nets, impregnated with insecticides, use of larvivorous fishes as a biological larvicide, implementation of small-scale environmental management, and use of personal protection methods by population under malaria risk. The malaria surveillance system was strengthened by the use of ACD, PCD, RCD and selective use of mass blood surveys. All detected cases were timely epidemiologically investigated and treated based on the results of laboratory diagnosis. As a result, by 2009, P. falciparum malaria was eliminated from all of Tajikistan, one year ahead of the originally targeted date. Elimination of P. falciparum also contributed towards speedy reduction of P. vivax incidence in Tajikistan.


Control of the expression of the bithorax complex genes abdominal-A and abdominal-B by cis-regulatory regions in Drosophila embryos.
The abdominal-A (abd-A) and Abdominal-B (Abd-B) genes of the bithorax complex (BX-C) specify the identity of most of the Drosophila abdomen. Six different classes of infraabdominal (iab) mutations within the BX-C transform a subset of the parasegments affected by the lack of these two genes. It is thought that these mutations define parasegmental cis-regulatory regions that control the expression of abd-A and Abd-B. By staining embryos mutant for different iab mutations with anti-abd-A and anti-Abd-B antibodies I show here that the expression of Abd-B (and probably also abd-A) exhibit a parasegmental regulation. I have also studied the significance of the chromosomal order of parasegmental iab regulatory sequences, and the possible presence of chromosomal 'boundaries' between them, by looking at the expression of abd-A and Abd-B in embryos carrying the Uab and Mcp mutations. These data are discussed in the light of models of parasegmental-specific regulatory regions within the BX-C.


Trends of conscious sedation in the Department of Pediatric Dentistry at the Dankook University Dental Hospital for 11 Years.
Anxiety and fear in children's dental care are major impediments to successful dental care. High-quality dental treatment can be achieved using various behavioral control methods; however, conscious sedation using drugs can be used if behavioral control is difficult, owing to excessive fear and anxiety. This study aimed to examine the trends in conscious sedation implemented in pediatric dentistry at the Dankook University Dental Hospital over the past 11 years. This study included 6,438 cases of dental treatment under conscious sedation conducted over 11 years between January 2011 and December 2021 in the Department of Pediatric Dentistry at Dankook University Dental Hospital. Over the past 11 years, the number of dental treatments under sedation has increased. In the case of inhalation sedation using nitrous oxide, the rate of increase was approximately twice every year, and the use of midazolam gradually decreased. The average age of children who underwent sedation was 5.11 years, and the rate of sedation treatment in children aged <4 years tended to decrease, while that of children aged >5 years tended to increase. This is related to the trend of changes in drugs used. In a sex-based survey, sedation treatment rate was higher in males than that in females. Appropriate selection of sedatives can reduce the frequency of general anesthesia and minimize complications through efficient and safe dental treatments. Trend analysis of sedation by year will help provide guidelines for the appropriate selection of sedation for dental treatment of children and patients with disability.


Evaluation of virtual source beam configurations for rapid tomographic reconstruction of gas and vapor concentrations in workplaces.
Beam path average data from an Open Path Fourier Transform Infrared (OP-FTIR) spectrometer can be used to reconstruct two-dimensional concentration maps of the gas and vapor contaminants in workplaces and the environment using computed tomographic (CT) techniques. However, a practical limitation arises because in the past, multiple-source and detector units were required to produce a sufficient number of intersecting beam paths in order to reconstruct concentration maps. Such a system can be applied to actual field monitoring situations only with great expense and difficulty. A single monostatic OP-FTIR system capable of rapid beam movement can eliminate this deficiency. Instead of many source and detector units, a virtual source arrangement has been proposed using a number of flat mirrors and retroreflectors to obtain intersecting folded beam paths. Three virtual source beam configurations generated for a single-beam steerable FTIR system were tested using 54 flat mirrors and four retroreflectors or 54 flat mirrors and 56 retroreflectors mounted along the perimeter walls of a typical 24- x 21-ft test room. The virtual source CT configurations were numerically evaluated using concentration maps created from tracer gas concentration distributions measured experimentally in a test chamber. Synthetic beam path integral data were calculated from the test maps and beam configurations. Computer simulations of different beam configurations were used to determine the effects of beam geometry. The effects of noise and peak reducing artifacts were evaluated. The performance of the tomographic reconstruction strategy was tested as a function of concentration and concentration gradients.


Influencing factors of place of death among home care patients with cancer in Taiwan.
Multiple factors, including personal and cultural values, physical and medical factors, and various healthcare systems' forces, influence the place of death of patients with cancer. The purpose of this retrospective chart audit study was to examine the influence of sociodemographic factors, family support, patient functioning, and care needs on the place of death for patients with cancer served by a home care program in Taiwan. Among the 264 study patients, 182 (69%) died at home and 82 (31%) died in the hospital. Significant differences were found between patients dying at home or in a hospital predominantly in the categories of patient functioning and care needs. From the multivariate logistic regression model, home care patients with cancer who were never rehospitalized, who received more home care visits, and who were referred to home care services at the greatest functionally dependent status and with pain were more likely to die at home. Overall, this model could accurately classify 78% of the place of death, which is higher than other published studies. Understanding factors that influence place of death of terminally ill patients with cancer allow healthcare professionals to modify healthcare systems and tailor effective interventions to help patients die at the place they prefer.


[Finite element analysis of screw in percutaneous axial lumbosacral interbody fusion].
To establish a 3D finite element model of L5/S1 motion segment with percutaneous axial lumbosacral interbody fusion (AxiaLIF) screw and conduct a preliminary analysis of biomechanical stress. The titanium screw was implanted in L5 and S1 vertebral body. Solid model was established by CAD software according to the actual dimensions of screw. Then computer graphics were obtained from iges format and imported into the finite element analysis software to establish the finite element model. With the aid of Mechanical Virtual Human of China, a 3D finite element model of L5/S1 motion segment with AxiaLIF screw was established. Vertical compression, torque moment and bending moment were loaded respectively on the upper surface of L5 vertebrae to simulate the load stress in human body. Stress distribution of screw was obtained. Generally stress values were relatively low. Peak stresses of screw under three loading conditions were 175.334 Mpa, 183.765 Mpa and 146.237 Mpa respectively. Stress value was relatively high at the central part of interbody fusion. And all the highest values were localized at the first thread below the central part. Result of comparison between three conditions: torque load was the highest, followed by vertical load and lateral bending. Percutaneous axial lumbosacral screw can meet the normal loading conditions. Further clinical applications are recommended.


Protective Role of Rho Guanosine Diphosphate Dissociation Inhibitor, Ly-GDI, in Pulmonary Alveolitis.
Growing evidences indicate that Ly-GDI, an inhibitory protein of Rho GTPases, plays an essential role in regulating actin cytoskeletal alteration which is indispensible for the process such as phagocytosis. However, the role of Ly-GDI in inflammation remains largely unknown. In the current study, we found that Ly-GDI expression was significantly decreased in the IgG immune complex-injured lungs. To determine if Ly-GDI might regulate the lung inflammatory response, we constructed adenovirus vectors that could mediate ectopic expression of Ly-GDI (Adeno-Ly-GDI). In vivo mouse lung expression of Ly-GDI resulted in a significant attenuation of IgG immune complex-induced lung injury, which was due to the decreased pulmonary permeability and lung inflammatory cells, especially neutrophil accumulation. Upon IgG immune complex deposition, mice with Ly-GDI over-expression in the lungs produced significant less inflammatory mediators (TNF-α, IL-6, MCP-1, and MIP-1α) in bronchoalveolar lavage fluid when compared control mice receiving airway injection of Adeno-GFP. Mechanically, IgG immune complex-induced NF-κB activity was markedly suppressed by Ly-GDI in both alveolar macrophages and lungs as measured by luciferase assay and electrophoretic mobility shift assay. These findings suggest that Ly-GDI is a critical regulator of inflammatory injury after deposition of IgG immune complexes and that it negatively regulates the lung NF-κB activity.


Persistence of neoangiogenesis and cardiomyocyte divisions in right ventricular myocardium of rats born and raised in hypoxic conditions.
Effects of chronic hypoxia on capillary and myocyte growth were examined in rats born and raised in a low pressure chamber (equivalent of 3500 m a.s.l.). The animals were sacrificed at the age of 3 months and their hearts were used to study right ventricular growth and vascularization. The results of our cytological and morphometric analysis suggest the persistence of capillary neogenesis in this particular model of cardiac hypertrophy. Under the optical microscope, we observed significant changes in capillary spatial patterns such as the presence of sinusoids and irregular capillary sprouts. This resulted in a significant shortening of the effective diffusion distance and in a slight decrease in the calculated diameter of the Krogh cylinder. Concomitant to the remodeling of the terminal capillary network, the right ventricular myocardium of hypoxic rats exhibited peculiar changes in myocyte cytology. The principal alteration consisted in the ectopic subsarcolemmal location of some of muscle cell nuclei which appeared enlarged and rounded, sometimes irregularly folded. At the E. M. level, they presented chromatine condensation, nucleolemmal folding and, occasionally, nuclear splitting. Irregular chromatin densifications at the equatorial position were also encountered but we never observed nucleolemmal dissolution or typical metaphase plaques which excludes the presence of mitotic division. Some of the marginalized nuclei were progressively excluded from original binucleate cells into small cytoplasmic processes that invaded the adjacent neo-formed pericapillar spaces and gave rise to small well-organized cardiomyocytes. This apparent fragmentation of cardiomyocytes may evoke the description of the apoptotic process which is believed to be stimulated in hypoxic tissues. However, we could not confirm that myocyte fragmentation that we describe is followed by shrinkage necrosis or by any mobilization of adjacent resident cells. Nuclear exclusions into pericapillary myocyte sprouts may, therefore, reflect amitotic divisions of polyploid cardiomyocytes which contribute to the persistence of hyperplasic growth in right ventricular myocardium in hearts of rats exposed to chronic hypoxia during their early postnatal life. Par analogie with our data, it can be expected that an appropriate stimulation of angiogenesis in hearts of adult animals attenuates some of cytological and functional drawbacks that accompany hypertrophic cardiomyopathies of other etiologies.


A temporary home to nurture health: lived experiences of older nursing home residents in Taiwan.
This study explored the lived experiences of older nursing home residents in Taiwan. With more long-term care institutions in Taiwan, older people are more often placed in nursing homes than in the past. Increased understanding of their lived experience is essential to assess residents' needs and determine the effectiveness of nursing interventions. A qualitative design was used to gain a deeper understanding of the lived experiences of older nursing home residents in Taiwan. Focus groups, followed by in-depth interviews, were used to gather information from 33 older residents at eight nursing homes in northern Taiwan. Participants were asked to describe what was important to them and what impressed them most in their daily lives in the nursing home. Participants (24 females and nine males) were on an average 75.3 years old. Verbatim transcripts of audiotaped focus groups and interviews were analysed by thematic analysis via ATLAS.ti software. The core theme of older residents' nursing home experience was 'a temporary home to nurture health'. This core theme was reflected in participants' descriptions of their overall life in the nursing home as a temporary experience to nurture their health. Their everyday experience was characterised by four subthemes: highly structured lifestyle, restricted activities, safety concerns and social interactions. Our findings may enhance policy makers' and healthcare providers' understanding of the lived experience of older nursing home residents, thus guiding the evaluation and development of nursing home services to improve residents' lives. For example, residents with the same characteristics could be placed in the same room or same floor, thus increasing their interactions with other residents. Residents' interactions with family members could also be developed using the Internet or mobile telephones.


Diagnostic test accuracy of serum procalcitonin compared with C-reactive protein for bone and joint infection in children and adolescents: a systematic review and meta-analysis.
The objective of this review was to synthesize the best available evidence for the diagnostic test accuracy of serum procalcitonin compared with serum C-reactive protein for suspected osteomyelitis and septic arthritis in hospitalized children and adolescents. Measurement of serum C-reactive protein remains a routine investigation for the diagnosis of osteoarticular infection in children and adolescents. Measurement of serum procalcitonin has been shown to outperform C-reactive protein in adults with osteomyelitis and septic arthritis. Before procalcitonin can be considered as a potential replacement or add-on test in children and adolescents, a systematic review and meta-analysis targeting this population should be conducted. Original studies reporting the diagnostic accuracy of procalcitonin and/or C-reactive protein in children and adolescents between one month and 18 years of age admitted to hospital with suspected osteoarticular infection were included. Studies must have compared the index test to at least one reference test. Reference test was defined as positive culture or polymerase chain reaction confirmation of a pathogen from blood, bone biopsy, or joint fluid aspirate in combination with at least two of the following: i) purulent material from sterile site, ii) positive radiological findings consistent with osteoarticular infection, and ii) symptoms and signs consistent with osteomyelitis and/or septic arthritis. The JBI methodology for systematic reviews of diagnostic test accuracy was followed. Information was sourced from four databases (MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Web of Science) and four gray literature sources (MedNar, OpenGrey, Google Scholar, and ProQuest Dissertations and Theses). Only studies published in English were considered. The methodological quality of selected studies was formally evaluated, sensitivity and specificity data were extracted, and 95% confidence intervals determined. Meta-analysis was performed to estimate summary points using a bivariate model and to generate a hierarchical summary receiver operating characteristic (HSROC) curve with global measures of test accuracy performance, such as likelihood ratio and diagnostic odds ratio. A narrative was provided where meta-analysis was not appropriate. Eight studies were included in the review. Four of these studies used a common C-reactive protein test threshold of 20 mg/L. At this threshold, the estimated pooled sensitivity of C-reactive protein was 0.86 (0.68-0.96) and the pooled specificity was 0.9 (0.83-0.94). Using a hierarchical summary receiver operating characteristic model from six studies, the diagnostic odds ratio for C-reactive protein was estimated to be 39.4 (14.8-104.9) with a positive likelihood ratio 5.3 (2.3-11.9) and a negative likelihood ratio 0.1 (0.07-0.2). There were insufficient studies from this review to statistically evaluate the diagnostic accuracy of procalcitonin. Clinicians should continue to measure serum C-reactive protein as the preferred inflammatory marker in hospitalized children and adolescents with suspected osteomyelitis or septic arthritis. More evidence is needed before incorporating procalcitonin routinely into clinicians' diagnostic test strategy. Improvements with the design, quality, and reporting of procalcitonin diagnostic test assays in children and adolescents with osteoarticular infection is needed. PROSPERO CRD42019140276.


Value of computed tomography and lymphography in staging carcinoma of the uterine cervix.
CT scanning was performed on 68 consecutive patients with newly diagnosed, untreated carcinoma of the uterine cervix (FIGO stage IB-IVA). Lymphography was performed in 61 cases. Surgical pathological correlation was obtained in 16 patients. CT and clinical stage accorded only in 68%, mainly because of CT errors in the determination of parametrial involvement. CT detected enlarged lymph nodes in 60.5%, compared to 39.5% of cases with lymphographically demonstrated nodal metastases; this discrepancy resulted mainly from the inability of CT to discriminate benign nodal changes. Our data suggest lymphography as radiological staging procedure in early stage (IB, IIA) carcinoma and the routine use of CT in advanced stage (IIB-IV) disease.


VEGF treatment promotes bone marrow-derived CXCR4+ mesenchymal stromal stem cell differentiation into vessel endothelial cells.
Stem/progenitor cells serve an important role in the process of blood vessel repair. However, the mechanism of vascular repair mediated by C-X-C chemokine receptor type 4-positive (CXCR4+) bone marrow-derived mesenchymal stem cells (BMSCs) following myocardial infarction remains unclear. The aim of the present study was to investigate the effects of vascular endothelial growth factor (VEGF) on vessel endothelial differentiation from BMSCs. CXCR4+ BMSCs were isolated from the femoral bone marrow of 2-month-old mice and the cells were treated with VEGF. Expression of endothelial cell markers and the functional properties were assessed by reverse transcription-quantitative polymerase chain reaction, flow cytometry and vascular formation analyses. The results indicated that the CXCR4+ BMSCs from femoral bone marrow cells expressed putative cell surface markers of mesenchymal stem cells. Treatment with VEGF induced platelet/endothelial cell adhesion molecule-1 (PECAM-1) and von Willebrand factor (vWF) expression at the transcriptional and translational levels, compared with untreated controls. Moreover, VEGF treatment induced CXCR4+ BMSCs to form hollow tube-like structures on Matrigel, suggesting that the differentiated endothelial cells had the functional properties of blood vessels. The results demonstrate that the CXCR4+ BMSCs were able to differentiate into vessel endothelial cells following VEGF treatment. For cell transplantation in vascular disease, it may be concluded that CXCR4+ BMSCs are a novel source of endothelial progenitor cells with high potential for application in vascular repair.


Participation of vasoactive intestinal polypeptide (VIP) as a humoral mediator in the erectile response of canine corpus cavernosum penis.
The ability of anti-vasoactive intestinal peptide (anti-VIP) serum to suppress the electrically induced relaxation of the corpus cavernosum was evaluated in vitro to define the role of VIP in penile erection. Strips of canine corpora cavernosa were placed in 5-ml organ chambers containing oxygenated Krebs-Ringer solution. They were stretched and fixed in place at both ends and pretreated with 2 x 10(-7)M noradrenaline (NA). NA was given to produce an optimal state of isometric smooth muscle contraction so that subsequent electrical field stimulation (EFS) could induce a good range of measurable relaxation response. This response was deemed to be an in vitro representation of penile erection. After NA treatment the cavernous tension rose markedly by 2-2.5 g; it then declined by up to 1-1.2 g upon EFS. Anti-VIP serum (1:16) or atropine sulfate (10(-6)M) was added at various time points between NA administration and EFS. When anti-VIP serum was administered, subsequent EFS-induced relaxation was attenuated by 20%-55% compared to the control EFS treatments. The degree of attenuation depended upon the frequency of EFS applied, being 20.6% +/- 4.0% at 20 Hz and 54.7% +/- 6.3% at 2 Hz. Atropine administered additionally following anti-VIP serum produced no further attenuation. However, atropine alone was capable of producing up to 23.7% +/- 3.5% attenuation. When anti-VIP serum was administered following atropine, the degree of attenuation that ensured was the sum of the attenuations produced by each of the two substances independently.(ABSTRACT TRUNCATED AT 250 WORDS)