Role of matrix metalloproteinase-7 in angiogenesis associated with age-related macular degeneration.
To investigate the possible role of matrix metalloproteinase-7 in choroidal neovascularization associated with age-related macular degeneration, immunoelectron microscopy using ultrathin frozen sections and conventional transmission electron microscopy were performed in subfoveal fibrovascular membranes from patients with age-related macular degeneration. immunoelectron microscopy revealed that matrix metalloproteinase-7 was expressed within basal laminar deposits and amorphous materials around the retinal pigment epithelial cells. The results support a role for matrix metalloproteinase-7 in the development of choroidal neovascularization in age-related macular degeneration.


Cytokine Profiling of Cyst Fluid and Tumor-Associated Macrophages in Cystic Vestibular Schwannoma.
The vestibular schwannoma (VS) secretome can initiate monocyte recruitment and macrophage polarization to M1 (proinflammatory) and/or M2 (protumorigenic) phenotypes, which in turn secrete additional cytokines that contribute to the tumor microenvironment. Profiling cyst fluid and cerebrospinal fluid (CSF) in cystic VS provides a unique opportunity to understand mechanisms that may contribute to tumor progression and cyst formation. Cystic VSs secrete high levels of cytokines into cyst fluid and express abundant M1 and M2 macrophages. Tumor, CSF, and cyst fluid were prospectively collected from 10 cystic VS patients. Eighty cytokines were measured in fluid samples using cytokine arrays and compared with normal CSF from normal donors. Immunofluorescence was performed for CD80 + M1 and CD163 + M2 macrophage markers. Demographic, audiometric, and radiographic information was obtained through retrospective chart review. Cyst fluid expressed more osteopontin and monocyte chemotactic protein-1 (MCP-1; p < 0.0001), when compared with normal CSF. Cyst fluid also expressed more protein ( p = 0.0020), particularly MCP-1 ( p < 0.0001), than paired CSF from the same subjects. MCP-1 expression in cyst fluid correlated with CD80 + staining in VS tissue ( r = 0.8852; p = 0.0015) but not CD163 + staining. Cyst fluid from cystic VS harbored high levels of osteopontin and MCP-1, which are cytokines important in monocyte recruitment and macrophage polarization. MCP-1 may have a significant role in molding the tumor microenvironment, by polarizing monocytes to CD80 + M1 macrophages in cystic VS. Further investigations into the role of cytokines and macrophages in VS may lead to new avenues for therapeutic intervention.


Effects of vowel coproduction on the timecourse of tone recognition.
Vowel contrasts tend to be perceived independently of pitch modulation, but it is not known whether pitch can be perceived independently of vowel quality. This issue was investigated in the context of a lexical tone language, Mandarin Chinese, using a printed word version of the visual world paradigm. Eye movements to four printed words were tracked while listeners heard target words that differed from competitors only in tone (test condition) or also in onset consonant and vowel (control condition). Results showed that the timecourse of tone recognition is influenced by vowel quality for high, low, and rising tones. For these tones, the time for the eyes to converge on the target word in the test condition (relative to control) depended on the vowel with which the tone was coarticulated with /a/ and /i/ supporting faster recognition of high, low, and rising tones than /u/. These patterns are consistent with the hypothesis that tone-conditioned variation in the articulation of /a/ and /i/ facilitates rapid recognition of tones. The one exception to this general pattern-no effect of vowel quality on falling tone perception-may be due to fortuitous amplification of the harmonics relevant for pitch perception in this context.


Differential Diagnosis of Chronic Total Occlusive and Subtotal Occlusive Disease of the Lower Extremity Arteries Using Reverse Attenuation Gradient Sign on CT Angiography.
The purpose of this study is to evaluate the diagnostic usefulness of the reverse attenuation gradient sign in occlusive lower extremity arterial disease through CT angiography (CTA). This study sample enrolled 45 men and eight women in the chronic total occlusion group and 30 men and seven women in the subtotal occlusion group. Luminal CT attenuation (in Hounsfield units) was measured at three points from the end of the occlusion site to the first collateral vessel's insertion point. We also used Hounsfield units to measure the CT attenuation of the opposite side artery at the same level in a similar manner. We compared each value using the Mann-Whitney U test. The absolute value of the mean differences in the Hounsfield units among the proximal, middle, and distal portion of chronic total occlusions were higher than those of subtotal occlusions, and this result was statistically significant (p < 0.001). The mean ratios of the Hounsfield units (Hounsfield units of the stenosed lumen divided by Hounsfield units of the opposite normal lumen) of the proximal portion of chronic total occlusions were statistically significantly lower than those of subtotal occlusions. The reverse attenuation gradient sign can be applied to the lower extremity arteries and can be helpful for differential diagnosis of chronic total occlusions from subtotal occlusions using CTA.


Autograft versus allograft with or without demineralized bone matrix in posterolateral lumbar fusion in rabbits. Laboratory investigation.
Posterolateral spinal fusions are performed to treat different spinal disorders. Autograft continues to be the gold standard; it is, however, associated with donor site morbidity and limited sources. Allograft has been used, but has been reported to result in lower fusion rates. Demineralized bone matrix (DBM) has also been used and reportedly increases the fusion rate in a variety of critical defect models. Different forms of DBM are available, not all have been independently studied. To evaluate the effect of a xenogenic DBM added to allograft on the fusion rate of posterolateral lumbar spine arthrodesis the authors designed an experimental study comparing posterolateral fusion rate using autograft, allograft, and allograft plus a xenogenic DBM in a validated animal model. A bilateral, 1-level (L4-5) intertransverse process fusion was performed in 45 male New Zealand rabbits. Iliac crest bone graft was harvested bilaterally from each rabbit. The rabbits were randomly assigned to 3 groups: Group I, Autograft, 15 rabbits; Group II, Allograft, 15 rabbits; and Group III, Allograft plus DBM in a paste form (Dynagraft). The animals were killed 8 weeks after surgery. Fusion was assessed radiographically and by manual palpation by 2 independent observers. The results were analyzed using the Fisher exact test and chi-square test. The fusion rate was 46.6% (7 of 15 rabbits) in the autograft group, 33.3% (5 of 15 rabbits) in the allograft group, and 33.3% (5 of 15 rabbits) in the allograft plus DBM group (p > 0.05). Autograft produced a higher fusion rate than allograft in this spinal fusion rabbit model, but the difference was not statistically significant. Allograft plus xenogenic DBM showed the same fusion rate as allograft alone.


Molecules relevant for T cell-target cell interaction are present in cytolytic granules of human T lymphocytes.
An ultrastructural analysis of human cytotoxic T lymphocyte-target cell (CTL-TC) interaction has been undertaken to enable a better understanding of the killing mechanism. Attention was focused on granules in the CTL, which are known to contain lethal compounds. Within the membrane-delimited cytotoxic granule an electron-dense core as well as numerous membrane vesicles were identified. In CTL-TC conjugates, specific membrane interactions take place, allowing the formation of intercellular clefts into which the granule cores and internal vesicles are released. T cell surface membrane molecules known to be involved in CTL-TC interaction (T cell receptor, CD3 and CD8) are present on the membranes of the granule cores and internal vesicles, facing outward. An explanation for this localization of the membrane may be found in the fact that the granule is connected with an endocytotic pathway. Moreover, the lumen of the granule is rich in the enzyme cathepsin D, which indicates an association with a lysosomal compartment. Exocytosed vesicles and cores are seen to adhere to the plasma membrane of the TC. Although the exact contents of the granule vesicles and core remain to be identified, we suggest that specific interaction of CTL membrane molecules on the cytolytic granule components with molecules on the plasma membrane of the TC may ensure the unidirectional delivery of the lethal hit.


Zinc and copper biochemical indices of antioxidant status in elite athletes of different modalities.
The purpose of this study was to compare zinc and copper biochemical indices of antioxidant status and their relationship in elite athletes of different modalities: aerobic with high-impact (triathletes, n = 10 and long-distance runners, n = 12), anaerobic with high-impact (short-distance runners, n = 9), and anaerobic with low-impact (short-distance swimmers, n = 13). The influence of recent dietary intake and body composition was also evaluated. A venous blood sample was drawn 16-20 hr after competition for the following measurements: packed-cell volume and hemoglobin in blood; copper and zinc in plasma and erythrocytes; ceruloplasmin in plasma; superoxide dismutase activity and metal-lothionein in erythrocytes; and erythrocyte osmotic fragility. Zinc and copper intakes were not different in the athlete groups and did not affect the biochemical indices measured. Athletes of the long-distance high-impact aerobic modalities had higher indices of antioxidant protection (erythrocyte zinc, superoxide dismutase activity, and metallothionein) than those of the short-distance low-impact modalities, suggesting that there is adaptation of the antioxidant capacity to the specific training. Significant correlations were observed in all athletes between erythrocyte zinc, superoxide dismutase activity, and metallothionein consistent with the importance of an adequate zinc status in the response of antioxidant mechanisms to intense exercise.


Transition-Metal-Doped SiP2 Monolayer for Effective CO2 Capture: A Density Functional Theory Study.
Two-dimensional materials have exhibited great potential in mitigating climate change through sensing and capturing carbon dioxide. The interaction of CO2 on orthorhombic silicon diphosphide remains unexplored in spite of its interesting properties such as high carrier mobility, piezoelectricity, and mechanical stability. Here, using density functional theory, the adsorption of CO2 on pristine and Ti-, V-, and Cr-doped monolayer SiP2 is investigated. Doped systems exhibited significantly stronger adsorption (-0.268 to -0.396 eV) than pristine SiP2 (-0.017 to -0.031 eV) and have the possibility of synthesis with low defect formation energies. Our results on adsorption energy, band structure, partial density of states, and charge transfer conclude that titanium- and vanadium-doped SiP2 monolayers would be promising materials for CO2 capture and removal.


[The role of angiotension II receptor and calpain in myocardium remodeling].
To investigate the relation among myocardial angiotension II receptor (AT1/AT2) expression, calpain and cardiac function in patients with congestive heart failure (CHF). Message RNA (mRNA) expression of AT1/AT2 receptor in myocardial tissue of 39 patients with CHF due to valvular heart disease and 8 control subjects were analyzed using reverse transcriptase-polymerase chain reaction (RT-PCR). Immunoprecipitation was used to assay the protein expression of u-calpain and m-calpain. Pathological changes of myocardial tissue in CHF due to valvular heart disease showed typical myocardial remodeling. AT1 receptor mRNA expression was slightly increased in the patients with mild CHF than in the control subjects, but decreased in the moderate and severe CHF patients. No difference was observed in AT2 receptor mRNA expression among all the groups, but the ratio of AT1/AT2 decreased. The protein expression of u-calpain and m-calpain were positively correlated to the levels of cardiac function in patient with CHD. The expression of AT1 receptor is down-regulated in moderate and severe CHF, the dominant receptor subtype is transformed to AT2. Cardiomyocyte apoptosis or death may be induced via AT2 receptor to activate calpain system, leading the deterioration of cardiac function.


[A comparison of the incidence of postoperative nausea and vomiting after propofol-fentanyl anesthesia and that after nitrous oxide-isoflurane anesthesia].
We compared the incidence of postoperative nausea and vomiting after total intravenous propofol-fentanyl anesthesia (TIVA group) and that after thiamylal-nitrous oxide-isoflurane anesthesia (GOI group) in 60 ASA physical I and II patients for elective abdominal simple total hysterectomy. When the patients returned to the ward, the incidence of nausea was lower in TIVA group than in GOI group (P < 0.05), but no difference was found in the incidence of vomiting between the two groups. There were no differences in the incidence of nausea and vomiting 6 hours after the operation and on the next morning between the two groups. Postoperative pain scores were similar between the two groups, while total postoperative evaluation scores (nausea, vomiting, pain, fever, and sleep disturbance) were lower in TIVA group (P < 0.05). We conclude that TIVA with propofol-fentanyl reduced the incidence of nausea and improved total evaluation scores in the immediate postoperative period.


7(th) HUPO World Congress of Proteomics: launching the second phase of the HUPOPlasma Proteome Project (PPP-2) 16-20 August 2008, Amsterdam, The Netherlands.
The HUPO Plasma Proteome Project new phase, PPP-2, held its initial workshop on 17 August, 2008, at the 7(th) World Congress of Proteomics in Amsterdam. Technology platforms, data repositories, informatics, and engagement of research groups for the submission of major datasets were key topics. Plasma is expected to be the common pathway for biomarker development and application through collaboration and integration with other HUPO initiatives.


Determining growth rates of focal lesions of bone from radiographs.
Rate of growth divides focal lesions of bone into two classes which are largely mutually exclusive. Not all focal lesions require biopsy, and grading is especially helpful in deciding which should be biopsied and which may be safely followed. The statistical proof and logic of grading as an expression of growth rate are presented with a set of rules establishing each of the five grades in the presence of bone destruction. The radiologic signs necessary to establish rates are described and illustrated.


Enhanced resistance to the rice blast fungus Magnaporthe grisea conferred by expression of a cecropin A gene in transgenic rice.
Cecropins are a family of antimicrobial peptides, which constitute an important key component of the immune response in insects. Here, we demonstrate that transgenic rice (Oryza sativa L.) plants expressing the cecropin A gene from the giant silk moth Hyalophora cecropia show enhanced resistance to Magnaporthe grisea, the causal agent of the rice blast disease. Two plant codon-optimized synthetic cecropin A genes, which were designed either to retain the cecropin A peptide in the endoplasmic reticulum, the ER-CecA gene, or to secrete cecropin A to the extracellular space, the Ap-CecA gene, were prepared. Both cecropin A genes were efficiently expressed in transgenic rice. The inhibitory activity of protein extracts prepared from leaves of cecropin A-expressing plants on the in vitro growth of M. grisea indicated that the cecropin A protein produced by the transgenic rice plants was biologically active. Whereas no effect on plant phenotype was observed in ER-CecA plants, most of the rice lines expressing the Ap-CecA gene were non-fertile. Cecropin A rice plants exhibited resistance to rice blast at various levels. Transgene expression of cecropin A genes was not accompanied by an induction of pathogenesis-related (PR) gene expression supporting that the transgene product itself is directly active against the pathogen. Taken together, the results presented in this study suggest that the cecropin A gene, when designed for retention of cecropin A into the endoplasmic reticulum, could be a useful candidate for protection of rice plants against the rice blast fungus M. grisea.


Implication of "Down syndrome cell adhesion molecule" in the hippocampal neurogenesis of ischemic monkeys.
Molecular signals regulating adult neurogenesis in primates are largely unknown. Here the authors used differential display to analyze gene expression changes that occur in dentate gyrus of adult monkeys after transient global cerebral ischemia. Among 14 genes upregulated, the authors focused on Down syndrome cell adhesion molecule (DSCAM) known to play crucial role during neuronal development, and characterized its expression pattern at the protein level. In contrast with approximately threefold upregulation of Dscam gene on days 5 and 7, immunoblotting and immunofluorescence analyses using specific antibodies showed a gradual decrease of DSCAM after ischemia until day 9 followed by recovery on day 15. In the control, immunofluorescence reactivity of DSCAM was detected in dentate gyrus granule cells and CA4 neurons but decreased after ischemia, being compatible with the immunoblotting data. However, in the subgranular zone, cerebral ischemia led to a marked increase of DSCAM-positive cells on days 9 and 15. DSCAM upregulation was seen in two cell types: one is immature neurons positive for polysialylated neural cell adhesion molecule or betaIII-tubulin, while another is astrocytes positive for S100beta. Young astrocytes were in intimate contact with newly generated neurons in the subgranular zone. These data suggest implication of DSCAM in the adult neurogenesis of primate hippocampus upregulated after ischemia.


Provision and utilization of low-vision rehabilitation services in Toronto.
Demographic changes expected to occur in the near future and the need for planning to address them are behind the urgent drive to assess present day provision and utilization of low-vision rehabilitation (LVR) services in the community. Current data available in Canada in this regard are mostly from Canadian National Institute for the Blind (CNIB) sources from clients accessing services, and are therefore incomplete. The purpose of this study, therefore, was to survey the provision and utilization of LVR services as reported by patients identified with low vision (LV) outside the CNIB system, specifically among those attending hospital-based ophthalmology clinics. The study design was a prospective, nonrandomized, observational case series based on interviews with LV patients. Cases with LV identified according to preset criteria were interviewed and tested for best-corrected visual acuity. The interview format included questions on multiple outcome measures of LVR, which provided answers addressing the theme of this study. A separate questionnaire was used to assess quality-of-life measures. Thirty-four subjects were recruited for the study, 21 females and 13 males, with a mean age of 74 (SD 16) years. LV had been present for a mean of 8.26 (SD 12.2) years, mostly caused by age-related macular degeneration (44%) and other maculopathies (38%). Patients classified as having LV were referred to LVR services only in 50% of cases and mostly to CNIB offices (47%). The majority of cases (59%) used magnifiers as the most common remedy for LVR. A majority of cases (59%) felt that current rehabilitation services are insufficient and that more LVR interventions were warranted in their case. Many cases with LV are not referred to LVR services. Those referred are directed mainly to the CNIB, bypassing other advanced and comprehensive suppliers of LVR services. The majority of cases express dissatisfaction with the current LVR services provided. There is a clear and urgent need to expand and reform the delivery of current LVR services.


Local transplantation, adaptation, and creation of AI models for public health policy.
This paper presents the Transplantation, Adaptation and Creation (TAC) framework, a method for assessing the localization of different elements of an AI system. This framework is applied in the public health context, notably to different types of models that were used during the COVID-19 pandemic. The framework aims to guide AI for public health developers and public health officials in conceptualizing model localization. The paper provides guidance justifying the importance of model localization, within a broader context of policy models, geopolitics and decolonization. It also suggests procedures for moving between the different elements in the framework, for example going from transplantation to adapation, and from adaptation to creation. This paper is submitted as part of a special research topic entitled: A digitally-enabled, science-based global pandemic preparedness and response scheme: how ready are we for the next pandemic?


Microspectrophotometric studies of Romanowsky stained blood cells. II. Comparison of the performance of two standardized stains.
This paper describes a comparison of the performance of two standardized Romanowsky blood stains, namely those of Marshall et al. and Wittekind et al., both containing azure B and eosin alone. Stain performance is assessed objectively by the use of three complementary techniques, all based on the visible absorbance spectra of stained cellular substrates. The first of these techniques is a simple comparison of the shapes and heights of the absorbance spectra. The second technique uses the CIE Colorimetric System, and thus permits the quantitation of colour in a manner that agrees with human observation. CIE co-ordinates (chromaticity points, luminance) are calculated directly from absorbance spectra. The third technique is that of spectral subtraction, which yields a set of factors which describe the quantities of component dyes which are bound by the object. This technique, unlike the other two, requires a priori knowledge of the dyes used in the stains, and their spectra when bound to cellular substrates. Although the differences between the two methods are subtle, and hard for the subjective observer to define, the objective methods described here do show statistically significant differences. Wittekind's stain produces less intense staining, except for lymphocyte and monocyte cytoplasms. To the human eye, the differential coloration of these two substrates is more pronounced, but the difference between all nuclei and cytoplasm is less marked. The major difference in the uptake of dye components is in the small quantities of eosin dimer that are bound in this technique.


Apparent diffusion coefficient values in differential diagnosis and prognostic prediction of solitary of fibrous tumor/hemangiopericytoma (WHOII) and atypical meningioma.
It is difficult to distinguish solitary of fibrous tumor/hemangiopericytoma (SFT/HPC) from atypical meningioma (AM) by conventional imaging.As far as we know,diffusion weighting imaging may identify them effectively. The purpose of this study was to determine the role of apparent diffusion coefficient (ADC) values to distinguish and predict prognosis of solitary of fibrous tumor/hemangiopericytoma (SFT/HPC) (WHOII) and atypical meningioma (AM). Preoperative diffusion-weighted imaging (DWI) of 30 cases with histopathologic and immunhistochemical testified SFT/HPC WHOII (n= 11) and AM (n= 19) were performed retrospectively. The ADC values of lesion, peritumoral edema, normal white matter and lesion NADC ratio (lesion ADC values/ADC values of normal white matter (NWN ADC)) were compared. The immunhistochemical markers (Ki-67, CD34, Vim, EMA, GFAP, S-100, PR, CD56) were compared. The correlation between the ADC values and Ki-67 index was evaluated. The mean lesion ADC values of SFT/HPC (1.15 ± 0.04 × 10-3 mm2/s) was significantly higher than that of AM (0.80 ± 0.04 × 10-3 mm2/s) (t= 23.824, p< 0.05). The mean NADC ratio was lower for AM (1.03 ± 0.06) compared with SFT/HPC (1.51 ± 0.05) (t= 23.105, p< 0.05). The mean edema ADC for SFT/HPC (1.47 ± 0.06 × 10-3 mm2/s) was lower compared with AM (1.68 ± 0.05 × 10-3 mm2/s) (t=-9.926, p< 0.05 ). There was no statistical difference between the two groups of NWM ADC (t=-1.475, p> 0.05) . The mean Ki-67 of SFT/HPC (7.18 ± 2.60%) was lower than the mean Ki-67 of AM (13.58 ± 4.50%) (t=-4.934, p< 0.05). The CD34 showed statistically differences between two groups (X2= 13.659, p< 0.05). The EMA also showed statistically differences between two groups (X2= 4.474, p< 0.05). Vim,GFAP, S-100, PR, CD56 showed no statistical difference in the two group (p> 0.05). The pearson analysis indicated that there was a negative correlation between lesion ADC and Ki-67 in SFT/HPC group (r=-0.770, p< 0.05) and AM group (r=-0.727, p< 0.05). There was also a negative correlation between lesion NADC ratio and Ki-67 in SFT/HPC group (r=-0.673, p< 0.05) and AM group (r=-0.707, p< 0.05). There was a positive correlation between edema ADC and Ki-67 in SFT/HPC group (r= 0.819, p< 0.05) and AM group (r= 0.942, p< 0.05). Furthermore,there was no correlation between NWM A DC and Ki-67 in SFT/HPC group (r=-0.403, p> 0.05) and AM group (r= 0.202, p> 0.05). The lesion ADC, lesion NADC ratio and edema ADC can distinguish the SFT/HPC WHO II from AM and be helpful to predict prognosis of the two tumors before operation. Further more, histopathologic and immunhistochemical can make a definite diagnosis of the two tumors.


Walking in sacred spaces in the therapeutic bond: therapists' experiences of compassion satisfaction coupled with the potential for vicarious traumatization.
The therapeutic bond is at the heart of effective therapy, yet few studies have examined therapists' experience of this bond. Using a qualitative study design, this exploratory study examines the experiences of couple and family therapists in relation to their perceptions of the satisfactions and risks involved in the therapeutic bond. The research was conducted using grounded theory methodology and eight in-depth interviews were conducted with therapists working in five counseling agencies in Sydney, Australia. Therapists described the importance of the 3 component parts of the therapeutic bond: the empathic connection between therapist and client; the role investment of the client; and the mutual affirmation experienced by both therapist and client in the therapeutic process. Walking in sacred spaces with the client was seen as both enriching and challenging for the therapist. The therapeutic bond gave therapists intense satisfaction and posed risks for them, especially when working with traumatic client experiences. However, the findings suggest that the experience of compassion satisfaction and the development of vicarious resilience counter-balanced the intense difficulty of bearing witness to clients' traumatic experiences and the potential for vicarious traumatization. The implications for sustaining couple and family therapists in their work are discussed.


Molecular and Morphological Characterization of Colletotrichum Species in the Colletotrichum gloeosporioides Complex Associated with Persimmon Anthracnose in South Korea.
Anthracnose is a major disease of persimmon in the pre- and postharvest phase. Several species of Colletotrichum (Colletotrichum gloeosporioides, C. acutatum, and C. horii) have been reported as causal agents of persimmon anthracnose in South Korea. In this study, a collection of 50 isolates associated with persimmon anthracnose were collected from Sangju (n = 25) and Cheongdo-gun (n = 25), South Korea. The morphological characteristics of all 50 Colletotrichum isolates were similar, and it was difficult to identify the isolates to the species level. A subsample of eight isolates was characterized phylogenetically to ascertain species. BLAST search and phylogenetic analysis of the internal transcribed spacer (ITS), glyceraldehyde-3-phosphate dehydrogenase (GAPDH), and actin (ACT) genes revealed two species: C. horii as well as a previously unreported persimmon anthracnose causal agent C. siamense. C. siamense isolates were confirmed again by phylogenetic analysis of the ITS, ACT, GAPDH, calmodulin, and Apn2-Mat1-2 intergenic spacer partial mating type genes. Koch's postulates for C. horii and C. siamense were fulfilled, confirming the pathogenicity of the two species in persimmon fruit. Morphological characteristics (colony morphology and size and shape of conidia and appressoria) from two representative isolates support results of the phylogenetic analysis and match those of previous descriptions of C. horii and C. siamense.


Ion-exchange properties of imidazolium-grafted SBA-15 toward AuCl4(-) anions and their conversion into supported gold nanoparticles.
Imidazolium groups were successfully prepared and grafted on the surface of SBA-15 mesoporous silica. The ion-exchange properties of the functionalized porous solid (SBA-15/R(+)Cl(-)) toward AuCl(4)(-) anions were evaluated through an ion-exchange isotherm. The calculated values of the equilibrium constant (log β = 4.47) and the effective ion-exchange capacity (t(Q) = 0.79 mmol g(-1)) indicate that the AuCl(4)(-) species can be loaded and strongly retained on the functionalized surface as counterions of the imidazolium groups. Subsequently, solids containing different amounts of AuCl(4)(-) ions were submitted to a chemical reduction process with NaBH(4), converting the anionic gold species into supported gold nanoparticles. The plasmon resonance bands, the X-ray diffraction patterns, and transmission electron microscopy images of the supported gold nanoparticles before and after thermal treatment at 973 K indicate that the metal nanostructures are highly dispersed and stabilized by the host environment.


Effect of temperature on ergosterol biosynthesis in yeast.
Anaerobically grown Saccharomyces cerevisiae was aerated for 7 hr at 20 degrees, 30 degrees, or 40 degrees, in a phosphate buffer containing 2% glucose. At elevated temperature (40 degrees), de novo synthesis of squalene and sterois in the aerated yeast was only 32-35% of that at lower temperature (20 degrees or 30 degrees), and this decrease was attributed to the repression of the enzymes involved in the synthesis of mevalonate from acetyl-COA. In addition, at elevated temperature, the metabolic flux from squalene to ergosterol was blocked at squalene epoxidation, lanosterol demethylation, and ergosta-5, 7, 22, 24(28)-tetraene-3beta-ol reduction.


Update on fetal hemoglobin gene regulation in hemoglobinopathies.
The developmental switch from fetal to adult hemoglobin has long fascinated biologists and attracted hematologists given its importance for patients with hemoglobin disorders. New discoveries have reinvigorated the field of globin gene regulation. These results hold promise for improved treatment of the major hemoglobinopathies. Both genome-wide association studies and traditional linkage studies have identified several genetic loci involved in silencing fetal hemoglobin. BCL11A is a potent silencer of fetal hemoglobin in both mouse and humans. It controls the beta-globin gene cluster in concert with other factors. KLF1, a vital erythroid transcription factor, activates BCL11A and assists in coordinating the switch from fetal to adult hemoglobin. A regulatory network of cell-intrinsic and cell-extrinsic factors maintains the epigenetic homeostasis of the beta-globin cluster and accounts for the precise lineage-specific and developmental stage-specific regulation of the globin genes. With an improved understanding of pathways involved in the switch from fetal to adult hemoglobin, new targets have emerged for the treatment of the common hemoglobin disorders, sickle cell anemia and beta-thalassemia.


Unassisted assessment of stroke severity using telemedicine.
Quantification of stroke severity through telemedicine consultation is challenging and relies on professional support at the patient's bedside. We aimed to develop a novel scale for assessing stroke severity through telemedicine without assistance from a third party (Unassisted TeleStroke Scale [UTSS]). Stroke severity was assessed in 45 patients with suspicion of acute stroke by bedside examination using the National Institutes of Health Stroke Scale (NIHSS) and by teleconsultation using the UTSS. Scale reliability was evaluated by intrarater and interrater variability, internal consistency, and rater agreement. Concurrent and predictive validity were tested by relating the UTSS with the NIHSS and long-term outcome (modified Rankin Scale and mortality at 6 months). Clinimetric analysis of the UTSS was obtained via the Rasch model. The mean examination time for the UTSS was 3.1 minutes (SD, 1.1) versus 8.5 minutes for the NIHSS (SD, 2.6; P<0.001). Both UTSS and NIHSS showed excellent intrarater variability (r=0.97 and 0.98; P<0.001) and interrater variability (r=0.96 and 0.98; P<0.001), as well as excellent internal consistency and rater agreement. The UTSS correlated strongly with the NIHSS and was identified as an independent predictor of stroke outcome in logistic regression analysis. Rasch analysis indicated that the UTSS represents a unidimensional scale of stroke severity. The UTSS is a rapid, reliable, and valid tool for unassisted assessment of stroke severity through telemedicine.


Using LiF:Mg,Cu,P TLDs to estimate the absorbed dose to water in liquid water around an 192Ir brachytherapy source.
The absorbed dose to water is the fundamental reference quantity for brachytherapy treatment planning systems and thermoluminescence dosimeters (TLDs) have been recognized as the most validated detectors for measurement of such a dosimetric descriptor. The detector response in a wide energy spectrum as that of an (192)Ir brachytherapy source as well as the specific measurement medium which surrounds the TLD need to be accounted for when estimating the absorbed dose. This paper develops a methodology based on highly sensitive LiF:Mg,Cu,P TLDs to directly estimate the absorbed dose to water in liquid water around a high dose rate (192)Ir brachytherapy source. Different experimental designs in liquid water and air were constructed to study the response of LiF:Mg,Cu,P TLDs when irradiated in several standard photon beams of the LNE-LNHB (French national metrology laboratory for ionizing radiation). Measurement strategies and Monte Carlo techniques were developed to calibrate the LiF:Mg,Cu,P detectors in the energy interval characteristic of that found when TLDs are immersed in water around an (192)Ir source. Finally, an experimental system was designed to irradiate TLDs at different angles between 1 and 11 cm away from an (192)Ir source in liquid water. Monte Carlo simulations were performed to correct measured results to provide estimates of the absorbed dose to water in water around the (192)Ir source. The dose response dependence of LiF:Mg,Cu,P TLDs with the linear energy transfer of secondary electrons followed the same variations as those of published results. The calibration strategy which used TLDs in air exposed to a standard N-250 ISO x-ray beam and TLDs in water irradiated with a standard (137)Cs beam provided an estimated mean uncertainty of 2.8% (k = 1) in the TLD calibration coefficient for irradiations by the (192)Ir source in water. The 3D TLD measurements performed in liquid water were obtained with a maximum uncertainty of 11% (k = 1) found at 1 cm from the source. Radial dose values in water were compared against published results of the American Association of Physicists in Medicine and the European Society for Radiotherapy and Oncology and no significant differences (maximum value of 3.1%) were found within uncertainties except for one position at 9 cm (5.8%). At this location the background contribution relative to the TLD signal is relatively small and an unexpected experimental fluctuation in the background estimate may have caused such a large discrepancy. This paper shows that reliable measurements with TLDs in complex energy spectra require a study of the detector dose response with the radiation quality and specific calibration methodologies which model accurately the experimental conditions where the detectors will be used. The authors have developed and studied a method with highly sensitive TLDs and contributed to its validation by comparison with results from the literature. This methodology can be used to provide direct estimates of the absorbed dose rate in water for irradiations with HDR (192)Ir brachytherapy sources.


NIF-scale re-emission sphere measurements of early-time Tr = 100 eV hohlraum symmetry (invited).
The indirect-drive National Ignition Campaign (NIC) proposes to set the first 2 ns of hohlraum radiation symmetry by observing the instantaneous soft x-ray re-emission pattern from a high-Z sphere in place of the ignition capsule. To assess this technique under NIC conditions, we used the Omega Laser Facility to image the re-emission of Bi coated spheres with 200 ps temporal, 50-100 microm spatial, and 30% spectral resolution. The sphere is driven by 70% NIC-scale vacuum Au hohlraums heated to Tr=100 eV using two cones per side laser beam illumination. The experiments have demonstrated the required accuracies of <3%P(2)/P(0) and <3%P(4)/P(0) Legendre mode flux asymmetry at both 900 and 1200 eV re-emission photon energies. The re-emission patterns at 900 and 1200 eV are also consistent with each other and their relative dependence on radiation temperature. We measured the P(2)/P(0) and P(4)/P(0) dependence to laser cone power ratio. View factor calculations are in agreement with the experimentally measured radiation flux and re-emit images when assuming 55% inner beam and 100 % outer beam coupling into x rays at the hohlraum wall.


Inhibition of membrane Na(+)-K+ Atpase of the brain, liver and RBC in rats administered di(2-ethyl hexyl) phthalate (DEHP) a plasticizer used in polyvinyl chloride (PVC) blood storage bags.
Significant amounts of di(2-ethylhexyl) phthalate (DEHP) leach out into blood stored in DEHP plasticized polyvinyl chloride (PVC) bags resulting in the exposure of recipients of blood transfusion to this compound. The aim of this study was to find out whether DEHP at these low levels has any effect on the activity of membrane Na(+)-K+ ATPase, since a decrease in this enzyme activity has been reported to take place in a number of disorders like neurodegenerative and psychiatric disorders, coronary artery disease and stroke, syndrome-X, tumours etc. DEHP was administered (ip) at a low dose of 750 microg/100 g body weight to rats and the activity of membrane Na(+)-K+ ATPase in liver, brain and RBC was estimated. Histopathology of brain, activity of HMG CoA reductase (a major rate limiting enzyme in the isoprenoid pathway of which digoxin, the physiological inhibitor of Na(+)-K+ ATPase is a product), intracellular concentration of Ca2+ and Mg2+ in RBC (which is altered as a result of inhibition of Na(+)-K+ ATPase) were also studied. (In the light of the observation of increase of intracellular Ca2+ load and intracellular depletion of Mg2+ when Na(+)-K+ ATPase is inhibited). Histopathology of brain revealed areas of degeneration in the rats administered DEHP. There was significant inhibition of membrane Na(+)-K+ ATPase in brain, liver and RBC. Intracellular Ca2+ increased in the RBC while intracellular Mg2+ decreased. However activity of hepatic HMG CoA reductase decreased. Activity of Na(+)-K+ ATPase and HMG CoA reductase, however returned to normal levels within 7 days of stopping administration of DEHP. The inhibition of membrane Na(+)-K+ ATPase activity by DEHP may indicate the possibility of predisposing recipients of transfusion of blood or hemodialysis to the various disorders mentioned above. However since this effect is reversed when DEHP administration is stopped, it may not be a serious problem in the case of a few transfusion; but in patients receiving repeated blood transfusion as in thalassemia patients or patients undergoing hemodialysis, possibility of this risk has to be considered. This inhibition is a direct effect of DEHP or its metabolites, since activity of HMG CoA reductase, (an enzyme which catalyses a major rate limiting step in the isoprenoid pathway by which digoxin, the physiological inhibitor of Na(+)-K+ ATPase is synthesized) showed a decrease.


Prediction of the secondary structure and functional sites of major histocompatibility complex molecules.
A method for the theoretical prediction of the antigenic determinants and the antigen-interactive receptor sites of immunological proteins from their primary structure would constitute a useful tool for their study. Such a method developed in this laboratory uses hydrophilicity, accessibility, flexibility, and recognition profiles, together with the predicted secondary structure (alpha-helices, beta-sheets, and turns). The secondary structure is determined by a modification of the method of Lim (1974), as described below. A study of human and mouse class I and class II major histocompatibility complex (MHC) antigens, central to the regulation of immune responses and to the phenomenon of graft rejection, was carried out using the above method. Comparison of the predictions with some of the available experimental and theoretical information supports the validity and usefulness of the approach.


Structuring Communication Relationships for Interprofessional Teamwork (SCRIPT): a cluster randomized controlled trial.
Despite a burgeoning interest in using interprofessional approaches to promote effective collaboration in health care, systematic reviews find scant evidence of benefit. This protocol describes the first cluster randomized controlled trial (RCT) to design and evaluate an intervention intended to improve interprofessional collaborative communication and patient-centred care. The objective is to evaluate the effects of a four-component, hospital-based staff communication protocol designed to promote collaborative communication between healthcare professionals and enhance patient-centred care. The study is a multi-centre mixed-methods cluster randomized controlled trial involving twenty clinical teaching teams (CTTs) in general internal medicine (GIM) divisions of five Toronto tertiary-care hospitals. CTTs will be randomly assigned either to receive an intervention designed to improve interprofessional collaborative communication, or to continue usual communication practices. Non-participant naturalistic observation, shadowing, and semi-structured, qualitative interviews were conducted to explore existing patterns of interprofessional collaboration in the CTTs, and to support intervention development. Interviews and shadowing will continue during intervention delivery in order to document interactions between the intervention settings and adopters, and changes in interprofessional communication. The primary outcome is the rate of unplanned hospital readmission. Secondary outcomes are length of stay (LOS); adherence to evidence-based prescription drug therapy; patients' satisfaction with care; self-report surveys of CTT staff perceptions of interprofessional collaboration; and frequency of calls to paging devices. Outcomes will be compared on an intention-to-treat basis using adjustment methods appropriate for data from a cluster randomized design. Pre-intervention qualitative analysis revealed that a substantial amount of interprofessional interaction lacks key core elements of collaborative communication such as self-introduction, description of professional role, and solicitation of other professional perspectives. Incorporating these findings, a four-component intervention was designed with a goal of creating a culture of communication in which the fundamentals of collaboration become a routine part of interprofessional interactions during unstructured work periods on GIM wards. Registered with National Institutes of Health as NCT00466297.


Proprotein convertase subtilisin/kexin type 9 gene E670G polymorphism interacts with alcohol consumption to modulate serum lipid levels.
Both alcohol consumption and the proprotein convertase subtilisin/kexin type 9 (PCSK9) gene polymorphism modulate serum lipid levels, but their interactions on serum lipid profiles are still unknown. The present study was undertaken to detect the interactions of PCSK9 E670G polymorphism and alcohol consumption on serum lipid levels. Genotypes of the PCSK9 E670G in 1352 unrelated subjects (785 non-drinkers and 567 drinkers) were determined by polymerase chain reaction and restriction fragment length polymorphism combined with gel electrophoresis, and then confirmed by direct sequencing. The interactions between PCSK9 E670G genotypes and alcohol consumption on serum lipid parameters were detected by using a factorial design covariance analysis after controlling for potential confounders. The levels of serum triglyceride, high-density lipoprotein cholesterol, apolipoprotein (Apo) A1, and the ratio of ApoA1 to ApoB were higher in drinkers than in non-drinkers (P < 0.01 for all), whereas the levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and ApoB were lower in drinkers than in non-drinkers (P < 0.001 for all). The genotypic and allelic frequencies of PCSK9 E670G were not different between non-drinkers and drinkers (P > 0.05 for each). The subjects with AA genotype in non-drinkers had higher serum LDL-C levels than the subjects with AG genotype, whereas the subjects with AG genotype in drinkers had higher serum TC levels than the subjects with AA genotypes (P < 0.05 for each). The effects of alcohol consumption on TC and LDL-C levels depended upon genotypes, the subjects with AA genotype had lower serum TC and LDL-C levels in drinkers than in non-drinkers. Alcohol consumption can modify the effects of the PCSK9 E670G polymorphism on serum TC and LDL-C levels. The subjects with AA genotype of the PCSK9 E670G benefit more from alcohol consumption than the subjects with AG genotype in decreasing serum TC and LDL-C levels.


Antioxidant and DNA methylation-related nutrients and risk of distal colorectal cancer.
To investigate the relationship between antioxidant nutrients (vitamins C and E, beta-carotene, selenium) and DNA methylation-related nutrients (folate, vitamins B6 and B12) and distal colorectal cancer risk in whites and African Americans and to examine intakes from food only versus total (food plus dietary supplements) intakes. Data are from the North Carolina Colon Cancer Study-Phase II, a case-control study of 945 distal colorectal cancer (including sigmoid, rectosigmoid, and rectum) cases and 959 controls. In-person interviews captured usual dietary intake and various covariates. Multivariate logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (95% CI). High intakes of each antioxidant and DNA methylation-related nutrient were significantly associated with lower risk in whites. In African Americans, the highest category of selenium from food only had a marginally significant inverse association with distal colorectal cancer risk (Q4 vs. Q1 OR: 0.55, 95% CI 0.29-1.02). Supplements did not provide additional risk reduction beyond intakes from food. Our findings provide evidence that antioxidant and DNA methylation-related nutrients may lower the risk of distal colorectal cancer in whites, and selenium may lower risk in African Americans. Optimal micronutrient intakes from food alone may be more beneficial than supplementation.


North Carolina's Health Care Transformation to Value: Progress to Date and Further Steps Needed.
North Carolina has received national attention for its approach to health care payment and delivery reform. Importantly, payment reform alone is not enough to drive systematic changes in care delivery. We highlight the importance of progress in four complementary areas to achieve system-wide payment and care reform.


Immunohistochemical localization of desmosomal and cytoskeletal proteins in the epidermis of healthy individuals and patients with Hailey-Hailey's disease.
We have studied the immunohistochemical localization of desmosomal and cytoskeletal proteins in the epidermis of healthy individuals and patients with Hailey-Hailey's disease. It was found that the localization of desmosomal proteins (desmoplakin, desmoglein) and keratin filaments in the involved epidermis of patients with Hailey-Hailey's disease was almost same as that in the normal epidermis of healthy individuals. In contrast, the localization of actin filaments in the involved epidermis of patients with Hailey-Hailey's disease differed from that in the normal epidermis of healthy individuals.


T1 lung cancers: sensitivity of diagnosis with fluorodeoxyglucose PET.
To determine the sensitivity of fluorodeoxyglucose (FDG) positron emission tomography (PET) in patients with T1 (< or =3 cm) lung cancers. One hundred eighty-five patients with 192 histopathologically proved T1 lung cancers underwent FDG PET imaging at the time of diagnosis. PET results were correlated with tumor size, histopathologic findings, and patient outcome by using the two-sample t test, exact chi(2) test, and log rank test, respectively. Of the 192 lesions, 183 (95%) that ranged in size from 0.5 to 3.0 cm in diameter (mean, 2.0 cm) were positive at PET (ie, demonstrated increased FDG uptake). Of the 192 lesions, nine (5%) that ranged in size from 0.3 to 2.5 cm in diameter (mean, 1.3 cm) were negative at PET (ie, demonstrated low FDG uptake). Patients with small tumors, as well as those with carcinoid tumors and bronchioloalveolar cell carcinoma, were more likely to have a negative PET scan (P =.004, P =.003, respectively). In addition, patients with a negative PET scan who subsequently proved to have cancer had significantly longer survival than did patients with a positive scan and cancer (P =.043). Most T1 lung cancers show increased FDG uptake on PET scans.


Inflammasomes: Mechanisms of Action and Involvement in Human Diseases.
Inflammasome complexes and their integral receptor proteins have essential roles in regulating the innate immune response and inflammation at the post-translational level. Yet despite their protective role, aberrant activation of inflammasome proteins and gain of function mutations in inflammasome component genes seem to contribute to the development and progression of human autoimmune and autoinflammatory diseases. In the past decade, our understanding of inflammasome biology and activation mechanisms has greatly progressed. We therefore provide an up-to-date overview of the various inflammasomes and their known mechanisms of action. In addition, we highlight the involvement of various inflammasomes and their pathogenic mechanisms in common autoinflammatory, autoimmune and neurodegenerative diseases, including atherosclerosis, rheumatoid arthritis, systemic lupus erythematosus, inflammatory bowel disease, Alzheimer's disease, Parkinson's disease, and multiple sclerosis. We conclude by speculating on the future avenues of research needed to better understand the roles of inflammasomes in health and disease.


Experiences with and expectations of maternity waiting homes in Luapula Province, Zambia: a mixed-methods, cross-sectional study with women, community groups and stakeholders.
Luapula Province has the highest maternal mortality and one of the lowest facility-based births in Zambia. The distance to facilities limits facility-based births for women in rural areas. In 2013, the government incorporated maternity homes into the health system at the community level to increase facility-based births and reduce maternal mortality. To examine the experiences with maternity homes, formative research was undertaken in four districts of Luapula Province to assess women's and community's needs, use patterns, collaboration between maternity homes, facilities and communities, and promising practices and models in Central and Lusaka Provinces. A cross-sectional, mixed-methods design was used. In Luapula Province, qualitative data were collected through 21 focus group discussions with 210 pregnant women, mothers, elderly women, and Safe Motherhood Action Groups (SMAGs) and 79 interviews with health workers, traditional leaders, couples and partner agency staff. Health facility assessment tools, service abstraction forms and registers from 17 facilities supplied quantitative data. Additional qualitative data were collected from 26 SMAGs and 10 health workers in Central and Lusaka Provinces to contextualise findings. Qualitative transcripts were analysed thematically using Atlas-ti. Quantitative data were analysed descriptively using Stata. Women who used maternity homes recognized the advantages of facility-based births. However, women and community groups requested better infrastructure, services, food, security, privacy, and transportation. SMAGs led the construction of maternity homes and advocated the benefits to women and communities in collaboration with health workers, but management responsibilities of the homes remained unassigned to SMAGs or staff. Community norms often influenced women's decisions to use maternity homes. Successful maternity homes in Central Province also relied on SMAGs for financial support, but the sustainability of these models was not certain. Women and communities in the selected facilities accept and value maternity homes. However, interventions are needed to address women's needs for better infrastructure, services, food, security, privacy and transportation. Strengthening relationships between the managers of the homes and their communities can serve as the foundation to meet the needs and expectations of pregnant women. Particular attention should be paid to ensuring that maternity homes meet quality standards and remain sustainable.


[Late complications and functional results at least 5 years following pars plana lentectomy for congenital cataract].
Pars plana or pars plicata lentectomy was introduced for congenital cataract at the University Eye Clinic of Freiburg 12 years ago. Records of 32 patients (48 eyes) who were operated on during a period of 7 years were retrospectively analyzed to determine the anatomical and functional results in comparison to previous methods of treatment for congenital cataract. The documented follow-up was at least 5 years long (maximum 11 years, mean 7.3 years). Seventeen patients had bilateral, 15 patients monolateral cataract operations. Thirteen eyes were operated on during the first 2 months of life, and 31 of the 48 eyes during the first year. Sixteen of the 48 eyes had additional malformations, like microphthalmus, different stages of persistent hyperplastic primary vitreous, or anterior chamber malformation. Visual acuity was at least 20/50 at the last visit in 3 of 15 eyes after monolateral lentectomy and in 19/33 eyes after bilateral lentectomy. Twenty-four children are now able to attend a regular school; only one child is attending a school for the visual handicapped; another child attends a school for deaf children. Postoperatively, secondary cataract or a retropupillary membrane was found in two eyes. Glaucoma developed in two eyes, requiring additional surgery. Postoperative retinal detachment caused by a giant tear complicated the postoperative course in one case. The anatomic results turned out to be better than after discission and aspiration with fewer postoperative complications like secondary cataract, glaucoma, or retinal detachment. The functional outcome is mainly dependent on good postoperative orthoptic and pleoptic management of the children.


Alcoholic housewives and role satisfaction.
Three groups of housewives adhering to strict inclusion criteria were compared along several variables. The groups were patients with non-alcoholic liver disease (N = 19), alcoholic liver disease (N = 15) and alcoholics attending a community treatment centre (N = 13). The study confirms the differences between alcoholics who develop liver disease from those who do not. There was a strong relationship between dissatisfaction with the role of housewife and severity of alcoholism.


Novel factors interfering with human immunodeficiency virus-type 1 replication in vivo and in vitro.
The strategy of all retroviral infections is based on establishing an equilibrium between virus replication and proviral latency in the infected host. The human immunodeficiency virus-type 1 (HIV-1), belonging to the subfamily of lentiviridae, adds an additional level of sophistication to this general rule by encoding two regulatory genes (tat and rev) and four accessory genes (nef, vif, vpr and vpu); HIV-2, structurally similar to HIV-1 but characterized by lower pathogenicity in vivo, encodes another accessory gene, vpx. The function of these accessory genes has become clear in recent years: they serve as countermeasures to host-cell restriction factors that prevent or curtail the capacity of HIV to productively infect its target cells (typically, CD4+ T lymphocytes, macrophages and dendritic cells). Some of the best characterized restriction factors for HIV-1 are Tripartite Motif-5α (TRIM5α), preventing infection of nonhuman primates, although not being effective in humans, and apolipoprotein B mRNA-editing, enzyme-catalytic, polypeptide-like 3G (APOBEC 3G), counteracted by the viral accessory protein Vif. In addition, several other molecules are under scrutiny for their mechanism of action and potential exploitation as novel anti-HIV agents. This review will summarize the recently emerging knowledge on these novel factors and their potential relevance for the discovery of new anti-HIV agents targeting not only the replicative, but also the latent state of HIV infection.


[Distribution of cholineacetyltransferase histochemistry in isthmus and medulla of Onchorynchus masu. Tract-tracing observation on the ascending meso-pontine cholinergic system].
The distribution of cholinergic neurons was studies in the brain steam, medulla and rostral spinal cord of the salmon Onchorynchus masu using histochemical choline acetyltransferase (ChAT) detection. Cholinergic neurons were observed in the isthmus, cranial nerve motor nuclei and spinal cord. In order to characterize several cholinergic nuclei observed in the isthmus of O. masu, their projections were studied by application of 1,1'-dioctadecyl-3,3,3',3,'-tetramethylindocarbocyanine perchlorate (DiI) to selected structures of the brain. The secondary gustatory nucleus projected mainly to the lateral hypothalamic lobes, whereas the nucleus isthmi projected to the optic tectum and parvocellular superficial pretectal nucleus, as it was earlier described for the other teleost group. In addition, the other isthmic cholinergic nuclei in O. masu may be homologous to the meso-pontine system of mammals. We conclude that the cholinergic systems of teleosts show many primitive features that have been presented during evolution, together with exclusive to the group characteristics.


Introduction of Structured Oral Examination as A Novel Assessment tool to First Year Medical Students in Physiology.
The traditional viva examination which is still predominantly used in most of the medical institutions as one of the assessment methods has some demerits like lack of standardization, objectivity & reliability. The process involves many faculty members from respective departments. Hence there can be variations in the time allotted to each student, number of questions asked, and difficulty level of the questions. These can be resolved by structuring the oral examination to make it a better assessment tool. The present study was conducted to introduce structured oral examination (SOE) as a novel assessment tool to first year M.B.B.S. students in Physiology and evaluating the process by taking feedback from the students and faculty. All the subjects [first year M.B.B.S. students (n=100)] were initially assessed by traditional viva. Feedback in the form of a questionnaire was collected from the students. Questionnaire included various questions based on Likert scale and numerical value for each response was decided. Topic for the structured oral examination was decided by the faculty members. Students were intimated about the viva process well in advance. A checklist of questions to be asked in the structured viva was prepared and their probable/most correct answers were discussed with the faculty in advance. Feedback was again collected from the students after the viva session. Statistical analysis of the questionnaire was done using 'paired t-test'. Questionnaire analysis depicted that students were overall satisfied with the structured viva and felt it better than the traditional viva. Statistically significant differences (p=0.0001) were observed in terms of uniformity of questions asked, syllabus coverage, reduction in the anxiety levels etc. between these two assessment methods. Faculty members also expressed that structured oral examinations are better in terms of reducing bias, minimising luck factor and uniformity of questions makes SOE a fair assessment tool. Structured oral examination can be a better assessment tool and with some modifications in blueprinting it will be acceptable to the students as well as faculty.


The effect of cognitive-motor dual task training with the biorescue force platform on cognition, balance and dual task performance in institutionalized older adults: a randomized controlled trial.
[Purpose] This study investigates whether cognition, balance and dual task performance in institutionalized older adults improves by a virtual reality dual task training. [Subjects and Methods] Randomized controlled trial; Twenty institutionalized older adults with mild cognitive impairment (13 female, 7 male; average age, 87.2 ± 5.96 years) were randomized to the intervention (i.e. Virtual reality dual-task training using the BioRescue) or control group (no additional training). The intervention group took part in a 6-week training program while the elderly in the control group maintained their daily activities. Balance was measured with the Instrumented Timed Up-and-Go Test with and without a cognitive task. The Observed Emotion Rating Scale and Intrinsic Motivation Inventory were administered to evaluate the emotions and motivation regarding the exergaming program. [Results] The intervention group improved significantly on the total Timed Up-and-Go duration and the turn-to-sit duration during single-task walking in comparison to the control group who received no additional training. Participants found the virtual reality dual task training pleasant and useful for their concentration, memory and balance. Pleasure and alertness were the two emotions which were mostly seen during the intervention. [Conclusion] The BioRescue is a pleasant and interesting treatment method, well suited for institutionalized older adults in need of lifelong physical therapy.


Rotating with the brakes on and other unresolved features of the vacuolar ATPase.
The rotary ATPase family comprises the ATP synthase (F-ATPase), vacuolar ATPase (V-ATPase) and archaeal ATPase (A-ATPase). These either predominantly utilize a proton gradient for ATP synthesis or use ATP to produce a proton gradient, driving secondary transport and acidifying organelles. With advances in EM has come a significant increase in our understanding of the rotary ATPase family. Following the sub nm resolution reconstructions of both the F- and V-ATPases, the secondary structure organization of the elusive subunit a has now been resolved, revealing a novel helical arrangement. Despite these significant developments in our understanding of the rotary ATPases, there are still a number of unresolved questions about the mechanism, regulation and overall architecture, which this mini-review aims to highlight and discuss.


Comparing GFR Estimating Equations Using Cystatin C and Creatinine in Elderly Individuals.
Current guidelines recommend reporting eGFR using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations unless other equations are more accurate, and recommend the combination of creatinine and cystatin C (eGFRcr-cys) as more accurate than either eGFRcr or eGFRcys alone. However, preferred equations and filtration markers in elderly individuals are debated. In 805 adults enrolled in the community-based Age, Gene/Environment Susceptibility (AGES)-Reykjavik Study, we measured GFR (mGFR) using plasma clearance of iohexol, standardized creatinine and cystatin C, and eGFR using the CKD-EPI, Japanese, Berlin Initiative Study (BIS), and Caucasian and Asian pediatric and adult subjects (CAPA) equations. We evaluated equation performance using bias, precision, and two measures of accuracy. We first compared the Japanese, BIS, and CAPA equations with the CKD-EPI equations to determine the preferred equations, and then compared eGFRcr and eGFRcys with eGFRcr-cys using the preferred equations. Mean (SD) age was 80.3 (4.0) years. Median (25th, 75th) mGFR was 64 (52, 73) ml/min per 1.73 m(2), and the prevalence of decreased GFR was 39% (95% confidence interval, 35.8 to 42.5). Among 24 comparisons with the other equations, CKD-EPI equations performed better in 9, similar in 13, and worse in 2. Using the CKD-EPI equations, eGFRcr-cys performed better than eGFRcr in four metrics, better than eGFRcys in two metrics, and similar to eGFRcys in two metrics. In conclusion, neither the Japanese, BIS, nor CAPA equations were superior to the CKD-EPI equations in this cohort of community-dwelling elderly individuals. Using the CKD-EPI equations, eGFRcr-cys performed better than eGFRcr or eGFRcys.


[Study on chemosensitivity test (in vitro) of cultured human urogenital carcinoma cell lines by MTT assay].
MTT assay was performed simultaneously with a clonogenic assay to assess its validity on chemosensitivity test by using the cultured human urogenital carcinoma cell lines PC3, 19PC93, DU145 and T24. The drugs used were carboquone (CQ), adriamycin (ADM), cisplatin (CDDP) and pepleomycin (PLM). Dose response curves were drawn and 50% inhibition doses (ID50) were calculated and examined by t-test. The correlations between the results obtained from both assays were observed. For comparing antitumor intensity of drugs with each other, predicted antitumor activity (PAA) was calculated from the peak plasma concentration of the clinically used dose. High cytotoxicity of drug was considered if PAA greater than or equal to 1 was observed. The optical density (OD) was almost directly proportional to the number of cells. Good correlations between OD and colony number, or between ID50 from both assays were noted although the clonogenic assay is more sensitive than the MTT assay. Relative resistances between cell lines to a drug observed by the clonogenic assay were also maintained by the MTT assay. The chemosensitive intensity was CQ greater than ADM greater than CDDP greater than PLM, and the sequence was similar in both assays. PC3, DU145 and T24 were sensitive to CQ but 19PC93 was to CQ and ADM. Therefore, MTT assay was concluded as a useful method for chemosensitivity test, although the problem of normal cell contamination was left to be solved for clinical use.


[Effect of different nutritional support on pancreatic secretion in acute pancreatitis].
To develop and justify optimal nutritional support in early phase of acute pancreatitis (AP). 140 AP patients were enrolled. They were divided into groups depending on nutritional support: group I (n=70) - early enteral tube feeding (ETF) with balanced mixtures, group II (n=30) - early ETF with oligopeptide mixture, group III (n=40) - total parenteral nutrition (TPN). The subgroups were also isolated depending on medication: A - Octreotide, B - Quamatel, C - Octreotide + Quamatel. Pancreatic secretion was evaluated by using of course of disease, instrumental methods, APUD-system hormone levels (secretin, cholecystokinin, somatostatin, vasointestinal peptide). ETF was followed by pancreas enlargement despite ongoing therapy, while TPN led to gradual reduction of pancreatic size up to normal values. α-amylase level progressively decreased in all groups, however in patients who underwent ETF (I and II) mean values of the enzyme were significantly higher compared with TPN (group III). Secretin, cholecystokinin and vasointestinal peptide were increasing in most cases, while the level of somatostatin was below normal in all groups. Enteral tube feeding (balanced and oligopeptide mixtures) contributes to pancreatic secretion compared with TPN, but this negative impact is eliminated by antisecretory therapy. Dual medication (Octreotide + Quamatel) is more preferable than monotherapy (Octreotide or Quamatel).


[Lymphocyte apoptosis associated to infections].
During infections, the presence of lymphocyte apoptosis both in peripheral blood and in lymphatic organs has been described. This kind of programmed cell death can be either induced by host control mechanisms aimed at eliminating infected lymphocytes and/or retaining immune system homeostasis, or by the pathogen in order to complete its life cycle, spreading the infection and/or suppressing the immune response. Thus, apoptosis has advantages and disadvantages for the host depending on the pathogen life cycle and/or the specificity of the lymphocyte population affected. Identification of the mechanisms involved in autoreactive or pathogen-specific lymphocyte apoptosis could lead to strategies designed to interfere immunologically or pharmacologically in favor of the host.


Gaze during speaking as related to shyness.
32 shy and 32 nonshy women were selected from a population of Japanese junior college students on the basis of their responses to the Trait Shyness Scale. This study manipulated shyness (shy and nonshy), interviewers' gaze (high amount of gaze and low amount of gaze), and interviewers' sex in a 2 x 2 x 2 factorial design. Subjects were randomly assigned to eight groups and interviewed by one of two male or two female confederates. Two trained judges recorded duration of gaze and speech through a one-way mirror and watching videotaped records. Analysis showed that for the interviewer in the high gaze condition the self-reported shy women gazed less while speaking than the nonshy women.


A case report of Andersen-Tawil syndrome misdiagnosed with myodystrophy.
Andersen-Tawil syndrome (ATS) is a rare periodic paralysis caused by the KCNJ2 gene mutation. Here, we report on an ATS patient misdiagnosed with myodystrophy. A 66-year-old man presented with a 60-year history of episodic weakness in the proximal muscles of the upper and lower limbs. The man has been diagnosed with muscle pathology and has undergone genetic examinations in many hospitals since childhood. We conducted a correct diagnosis in combination with the patient's history, electrical physiology, and genetic analysis and identified a heterozygous KCNJ2 gene variant (c.220A > G; p.T74A). Patients with ATS can develop permanent myasthenia characterized by chronic progressive myopathy. ATS patients should also pay special attention to the risks of anesthesia in surgery, including malignant hyperthermia (MH), muscle spasms affecting tracheal intubation or ventilation, and ventilator weakness. Early diagnosis and therapy could help delay the onset of myasthenia and prevent risks associated with anesthesia accidents.


Submicroscopic structure of glycosaminoglycans in osteocyte capsule of human embryonic bone as revealed by polarization microscopy.
Using qualitative and quantitative polarization microscopical techniques, an axiparallel orientation of chondroitin sulfate molecules and collagen fibrils could be detected in the osteocyte capsule of human embryonic and fetal bones. It is suggested that this spatially oriented microstructure plays a role in ana- and catabolic transport processes of the bone tissue.


Effects of short-acting bronchodilators added to maintenance tiotropium therapy.
Combining bronchodilators has been shown to be beneficial in patients with COPD. The additive effects of short-acting bronchodilators added to maintenance tiotropium therapy, however, are unknown. Following 3 weeks of tiotropium pretreatment, 60 patients with COPD (FEV1 40% of predicted) participated in a randomized, placebo-controlled study to assess add-on bronchodilator effects of ipratropium bromide (40 microg) or fenoterol (200 microg). Short-acting bronchodilators were added as a single dose 2 h and 8 h after tiotropium dosing. Serial lung function tests were performed over 9 h. The peak FEV1 add-on response within 6 h with fenoterol was significantly greater than with placebo (137 mL) or ipratropium (84 mL); the response with ipratropium was slightly but significantly larger than with placebo (52 mL). One hour after the second dose of the test drugs, a similar order of treatment responses was found. The peak FVC add-on response was significant for fenoterol (249 mL) but not for ipratropium (42 mL). In conclusion, both short-acting bronchodilator classes were effective when added to maintenance treatment with tiotropium. The addition of the beta2-adrenergic fenoterol provided greater additional bronchodilatation than the short-acting anticholinergic ipratropium. This is consistent with the expected effects of combining bronchodilators with different pharmacologic mechanisms. This randomized controlled trial was registered at www.clinicaltrials.gov (NCT00274066).


Construction and characterization of a cheA mutant of Treponema denticola.
The Treponema denticola cheA gene, encoding the central kinase of the general chemotaxis pathway, was analyzed for its role in chemotaxis and tissue penetration. The cheA gene was interrupted by insertion of an ermF-ermAM gene cassette. Reverse transcription-PCR confirmed that the other downstream chemotaxis genes within the same operon (cheW, cheX, and cheY) were still expressed in the cheA mutant strain. Lack of cheA resulted in decreased swarming on soft-agar swarm plates and failure to respond chemotactically to a mixture of nutrients. Behavioral analyses using video microscopy revealed that the cheA mutant exhibited coordinated cell movement. The cellular reversal frequency, however, was severely reduced, indicating that CheA in T. denticola mainly controls cellular reversal and that active chemotaxis signaling input is not required for coordination of flagellar rotation at both cell poles.


Adjusting Reported COVID-19 Deaths for the Prevailing Routine Death Surveillance in India.
In India, the "low mortality" narrative based on the reported COVID-19 deaths may be causing more harm than benefit. The extent to which COVID-19 deaths get reported depends on the coverage of routine death surveillance [death registration along with medical certification of cause of death (MCCD)] and the errors in MCCD. In India, the coverage of routine death surveillance is 18.1%. This is compounded by the fact that COVID-19 death reporting is focused among reported cases and the case detection ratio is low. To adjust for the coverage of routine death surveillance and errors in MCCD, we calculated a correction (multiplication) factor at national and state level to produce an estimated number of COVID-19 deaths. As on July 31, 2020, we calculated the infection fatality ratio (IFR) for India (0.58:100-1.16:100) using these estimated COVID-19 deaths; this is comparable with the IFR range in countries with near perfect routine death surveillance. We recommend the release of excess deaths data during COVID-19 (at least in states with high death registration) and post-mortem COVID-19 testing as a surveillance activity for a better understanding of under-reporting. In its absence, we should adjust reported COVID-19 deaths for the coverage of routine death surveillance and errors in MCCD. This way we will have a clear idea of the true burden of deaths and our public health response will never be inadequate. We recommend that "reported" or "estimated" is added before the COVID-19 death data and related indicators for better clarity and interpretation.


Ergothioneine products derived by superoxide oxidation in endothelial cells exposed to high-glucose.
Ergothioneine (Egt), 2-mercapto-L-histidine betaine (ESH), is a dietary component acting as antioxidant and cytoprotectant. In vitro studies demonstrated that Egt, a powerful scavenger of hydroxyl radicals, superoxide anion, hypochlorous acid and peroxynitrite, protects vascular function against oxidative damages, thus preventing endothelial dysfunction. In order to delve the peculiar oxidative behavior of Egt, firstly identified in cell free-systems, experiments were designed to identify the Egt oxidation products when endothelial cells (EC) benefit of its protection against high-glucose (hGluc). HPLC-ESI-MS/MS analyses revealed a decrease in the intracellular GSH levels and an increase in the ophthalmic acid (OPH) levels during hGluc treatment. Interestingly, in the presence of Egt, the decrease of the GSH levels was lower than in cells treated with hGluc alone, and this effect was paralleled by lower OPH levels. Egt was also effective in reducing the cytotoxicity of H2O2 and paraquat (PQT), an inducer of superoxide anion production, showing a similar time-dependent pattern of GSH and OPH levels, although with peaks occurring at different times. Importantly, Egt oxidation generated not only hercynine (EH) but also the sulfonic acid derivative (ESO3H) whose amounts were dependent on the oxidative stress employed. Furthermore, cell-free experiments confirmed the formation of both EH and ESO3H when Egt was reacted with superoxide anion. In summary, these data, by identifying the EH and ESO3H formation in EC exposed to hGluc, highlight the cellular antioxidant properties of Egt, whose peculiar redox behavior makes it an attractive candidate for the prevention of oxidative stress-associated endothelial dysfunction during hyperglycemia.


Benefits of swimming in asthma: effect of a session of swimming lessons on symptoms and PFTs with review of the literature.
A study involving eight children with moderate persistent asthma was undertaken to determine whether standard swimming lessons improved symptoms and pulmonary function tests (PFTs) in asthmatic children. Five children ages 7-12 years old with moderate persistent asthma were randomized to a swimming lesson group (5- to 6-week session) and three to a control group. Both groups completed pre- and poststudy period PFTs and symptom questionnaires. Swimming lessons did not produce a significant change in asthma symptoms or PFTs. Review of previous literature found that swimming has been shown to have definite benefits in improving cardiorespiratory fitness in asthmatic children. Swimming has been shown to be less asthmogenic than other forms of exercise. Some studies have also shown improvement in asthma symptoms in children participating in exercise programs.


Pain outcomes in children who received intrathecal vs intravenous opioids for pain control following major urologic surgery: a retrospective review.
Intrathecal (IT) opioid administration has been associated with postoperative benefits including reduced pain and opioid use in children. However, the postoperative benefits and risks of IT opioid administration during major urologic surgery in children remain unclear. The aim of this study was to compare postoperative pain and adverse event outcomes among children who received IT vs intravenous (IV) opioids during major urologic surgery. We reviewed the medical records of children 3-17 years of age who underwent ureteroneocystostomy or pyeloplasty between 2006 and 2012. Electronically captured anesthetic and surgical data, postanesthesia care recovery unit (PACU) and nursing flowsheets, and daily progress notes through hospital discharge were reviewed. Analgesic techniques (i.e., IT or IV patient/nurse controlled opioids), all analgesic drugs and doses were recorded. Outcome measures included pain scores, need for rescue analgesics, opioid-related adverse events, and their treatments. Seventy-seven children received IT opioids and 51 received IV opioids. More children in the IV group required rescue analgesics and had higher pain scores at PACU discharge. Children in the IV group required rescue opioids more frequently than the IT group from 0 to 8 h and 8 to 16 h after PACU discharge, but rates were similar by 16-24 h 70% of children in IT group transitioned directly to oral opioids. Seven IT placements were considered as failed due to early need for rescue opioids. Four (8%) of the IV group and seven (9%) of the IT group experienced oxygen desaturation. Two of these, both in IT group required naloxone and one was admitted to ICU for observation. The IT group experienced a higher incidence of pruritus, constipation and hypotension. We observed better postoperative pain control in children who received IT vs IV opioids for the first 16 h with no discernible difference thereafter. The intrathecal group experienced higher incidences of pruritus, constipation, and hypotension.


POLYMORPHIC POSTTRANSLATIONAL MODIFICATION OF ALKALINE PHOSPHATASE IN ESCHERICHIA COLI.
Natural isolates of Escherichia coli have been examined by polyacrylamide gel electrophoresis for variant isozyme patterns of alkaline phosphatase. The polypeptide chains of this enzyme normally exist in two forms-an unmodified polypeptide product of the phoA gene and a posttranslationally modified version of the same polypeptide that has had its N-terminal arginine removed through the action of the iap gene product. These two forms of the polypeptide aggregate as dimers and thus normally form three electrophoretically distinguishable alkaline phosphatase isozymes. Among 104 strains screened, three had variant isozyme patterns. Two of these were deficient in the posttranslationally modified polypeptide, and cotransduction with cysI indicates that they carry mutant iap genes. The third variant is deficient in the unmodified form of the polypeptide. These results provide an unambiguous case of polymorphic posttranslational modification in E. coli.


Image Restoration by Combined Order Regularization with Optimal Spatial Adaptation.
Total Variation (TV) and related extensions have been popular in image restoration due to their robust performance and wide applicability. While the original formulation is still relevant after two decades of extensive research, its extensions that combine derivatives of first and second orders are now being explored for better performance, with examples being Combined Order TV (COTV) and Total Generalized Variation (TGV). As an improvement over such multi-order convex formulations, we propose a novel non-convex regularization functional which adaptively combines Hessian-Schatten (HS) norm and first order TV (TV1) functionals with spatially varying weight. This adaptive weight itself is controlled by another regularization term; the total cost becomes the sum of this adaptively weighted HS-TV1 term, the regularization term for the adaptive weight, and the data-fitting term. The reconstruction is obtained by jointly minimizing w.r.t. the required image and the adaptive weight. We construct a block coordinate descent method for this minimization with proof of convergence, which alternates between minimization w.r.t. the required image and the adaptive weights. We derive exact computational formula for minimization w.r.t. the adaptive weight, and construct an ADMM algorithm for minimization w.r.t. to the required image. We compare the proposed method with existing regularization methods, and a recently proposed Deep GAN method using image recovery examples including MRI reconstruction and microscopy deconvolution.


COX-2 inhibition, H. pylori infection and the risk of gastrointestinal complications.
Current data on the gastric safety of cyclooxygenase-2 (COX-2) inhibitors in the presence of H. pylori infection are largely derived from animal experiments and indirect clinical evidence. In animal models of H. pylori gastritis, COX-2 inhibitors suppressed prostaglandin synthesis and aggravated mucosal damage. In the human stomach, COX-1 appears to be the predominant source of prostaglandins despite the fact that COX-2 is upregulated in H. pylori gastritis. There are conflicting data on whether H. pylori alters the risk of ulcer in patients receiving COX-2 inhibitors. Among patients with H. pylori infection, rofecoxib reduced the risk of complicated gastric but not duodenal ulcers as compared to naproxen. The advantage of rofecoxib over naproxen also disappeared in patients with H. pylori infection and prior upper gastrointestinal events. In contrast, pooled data suggested that H. pylori increases the risk of ulcer in patients receiving nonselective nonsteroidal anti-inflammatory drugs but not in patients receiving celecoxib. In rodent gastric ulcers, COX-2 was upregulated in the granulation tissue and ulcer margin. Inhibition of COX-2 delayed healing of experimental gastric ulcer. Limited data showed that COX-2 expression was also increased in human gastric ulcer regardless of the H. pylori status. The functional significance of COX-2 in human gastric ulcer is unknown.


Elevated complement C3 is associated with early restenosis after eversion carotid endarterectomy.
Early restenosis following carotid endarterectomy (CEA) is an inflammatory process leading to myointimal hyperplasia of smooth muscle cells. The risk for restenosis is increased in homozygous carriers of the normal (A) allele of mannose-binding lectin (MBL2) gene. Our objective was to study the associations of C3 and as control three non-complement acute-phase reactants (APRs) (C-reactive protein, haptoglobin and alpha2HSglycoprotein) with early restenosis following CEA. We also considered, whether MBL2 genotype relates to C3 levels and to the risk of restenosis. Concentrations of the APRs were determined by radial immunodiffusion or immunoturbidimetric methods in 64 patients who underwent eversion CEA and were followed up with carotid duplex scan (CDS) examinations for at least one year. MBL2 genotypes were determined by a PCR-SSP method. C3 levels increased during the follow-up and correlated with the percentage of restenosis detected by CDS at 14 months postsurgery, in MBL2 A/A allele carriers. Patients with high C3 levels had nearly five-fold higher odds for the presence of significant restenosis (>50% reduction in diameter) even after adjusting for MBL2 genotype, age and gender. By contrast, no such associations were detected between the non-complement APRs and early restenosis. C3 is associated with and might have a direct role in the development of an early restenosis following CEA, which is partially related to an intact MBL lectin pathway, thus determining C3 levels might have clinical importance. On the other hand, our results indicate that the regulation of C3 differs from non-complement APRs.


Health trends in a geriatric and special needs clinic patient population.
To quantify differences and recent changes in health status among patients attending the Geriatric and Special Needs Dentistry (GSND) and Family Dentistry (FAMD) clinics at the University of Iowa College of Dentistry. A total of 388 randomly selected records from patients attending the GSND or FAMD clinics from 1996-2000 or from 2006-2010 were reviewed. Univariate and bivariate analyses were conducted, followed by multivariable logistic regression analyses to compare characteristics of patients across clinics. Between the two GSND cohorts, the mean number of medications reported increased from 4.0 to 6.5 (p < 0.001). Within both cohorts, mental health conditions were significantly more prevalent among patients attending the GSND than FAMD clinic (p < 0.001). Within cohorts, patients seen in the GSND clinic tended to have more medical problems than patients attending the FAMD clinic, particularly mental health conditions; and medication use was more common in the recent cohort in both GSND and FAMD clinics.


Adsorption of arsenic on polyaluminum granulate.
The kinetics and efficiencies of arsenite and arsenate removal from water were evaluated using polyaluminum granulates (PAG) with high content of aluminum nanoclusters. PAG was characterized to be meso- and macroporous, with a specific surface area of 35 ± 1 m(2) g(-1). Adsorption experiments were conducted at pH 7.5 in deionized water and synthetic water with composition of As-contaminated groundwater in the Pannonian Basin. As(III) and As(V) sorption was best described by the Freundlich and Langmuir isotherm, respectively, with a maximum As(V) uptake capacity of ~200 μmol g(-1) in synthetic water. While As(III) removal reached equilibrium within 40 h, As(V) was removed almost entirely within 20 h. Micro X-ray fluorescence and electron microscopy revealed that As(III) was distributed uniformly within the grain, whereas As(V) diffused up to 81 μm into PAG. The results imply that As(V) is adsorbed 3 times faster while being transported 10(5) times slower than As(III) in Al hydroxide materials.


Combining Pre-operative Diffusion Tensor Images and Intraoperative Magnetic Resonance Images in the Navigation Is Useful for Detecting White Matter Tracts During Glioma Surgery.
We developed a navigation system that superimposes the fractional anisotropy (FA) color map of pre-operative diffusion tensor imaging (DTI) and intraoperative magnetic resonance imaging (MRI). The current study aimed to investigate the usefulness of this system for neurophysiological monitoring and examination under awake craniotomy during tumor removal. A total of 10 glioma patients (4 patients with right-side tumors; 5 men and 5 women; average age, 34 years) were evaluated. Among them, the tumor was localized to the frontal lobe, insular cortex, and parietal lobe in 8, 1, and 1 patient, respectively. There were 3 patients who underwent surgery on general anesthesia, while 7 patients underwent awake craniotomy. The index of DTI anisotropy taken pre-operatively (magnetic field: 3 tesla, 6 motion probing gradient directions) was analyzed as a color map (FA color map) and concurrently co-registered in the intraoperative MRI within the navigation. In addition to localization of the bipolar coagulator and the cortical stimulator for brain mapping on intraoperative MRI, the pre-operative FA color map was also concurrently integrated and displayed on the navigation monitor. This white matter nerve functional information was confirmed directly by using neurological examination and referring to the electrophysiological monitoring. Intraoperative MRI, integrated pre-operative FA color map, and microscopic surgical view were displayed on one screen in all 10 patients, and white matter fibers including the pyramidal tract were displayed as a reference in blue. Regarding motor function, motor-evoked potential was monitored as appropriate in all cases, and removal was possible while directly confirming motor symptoms under awake craniotomy. Furthermore, the white matter fibers including the superior longitudinal fasciculus were displayed in green. Importantly, it was useful not only to localize the resection site, but to identify language-related, eye movement-related, and motor fibers at the electrical stimulation site. All motor and/or language white matter tracts were identified and visualized with the co-registration and then with an acceptable post-operative neurological outcome. Co-registering an intraoperative MR images and a pre-operative FA color map is a practical and useful method to predict the localization of critical white matter nerve functions intraoperatively in glioma surgery.


Quantification of circulating DNA in the plasma and serum of cancer patients.
A variety of tumor-genetic alterations have been identified circulating free-form in the plasma and serum of cancer patients that may have diagnostic and prognostic implications. Currently, no consensus exists as to whether plasma or serum is preferable for circulating nucleic acid analysis, and the impact of collection and processing on yield is unknown. We prospectively assessed DNA content in paired plasma and serum obtained from 10 patients with AJCC stage IV advanced metastatic melanoma. Blood (30 mL) was collected from each patient as follows: 10 mL each was processed immediately for serum and plasma and an additional 10 mL was incubated overnight at 37 degrees C and processed for serum. In addition, blood was collected from 25 normal healthy donor volunteers to determine the concentration of free DNA circulating in paired plasma and serum. DNA was isolated from 800 microl of plasma or serum and quantified. Median-free DNA concentrations were fourfold greater in serum than in the corresponding plasma sample. Serum isolated from blood allowed to clot overnight yielded four times more DNA than serum processed immediately. Among normal healthy volunteers, only serum contained detectable free DNA. These findings provide conclusive evidence that elevated levels of circulating DNA could be identified consistently in patients with cancer than in normal healthy donors. Furthermore, the method of blood processing may significantly affect the levels of circulating nucleic acids and impact the investigator's results. Significant consideration must be given to the methods by which circulating nucleic acids are obtained for clinical analysis.


The meaning of the music: the role of music in palliative care music therapy as perceived by bereaved caregivers of advanced cancer patients.
In an earlier qualitative research study exploring the meaning of preloss music therapy to bereaved caregivers who participated in sessions through a home-based hospice program, various narrative accounts revealed the significance of music in music therapy sessions. In this study, the role of music in palliative care music therapy is examined and representatively summarized, followed by a review of strategies provided by this author to home hospice patients and their caregivers. The reported perceptions of the meaning of music to 7 bereaved caregivers are presented, including a review of themes and associated narrations that illustrated its significance. The caregivers described these aspects of music in sessions to have memorable and lasting effects as follows: "music is a conduit,'' "music gets inside us,'' "live music makes a difference,'' and "music is love.'' Findings support the benefits of preloss music therapy for bereaved caregivers.


Is Hartmann's the solution?
As Hartmann's solution is commonly used by anaesthetists, we surveyed a group of Part III FRCA candidates to establish their knowledge of its constituents and the purpose and metabolism of the lactate in solution. Of the 82 candidates surveyed only three (4%) accurately recorded the electrolytes and their concentrations in Hartmann's solution. Lactate was stated to be a source of bicarbonate by 52 (63%) and a source of glucose by 17 (21%). The descriptions of lactate metabolism were largely imprecise, none was complete and 24 (29%) of candidates offered no explanation. The constituents of Hartmann's solution and their concentrations are designed to match those of plasma, reducing ion and fluid shifts postinfusion. The lactate in Hartmann's solution is metabolised by both oxidation and gluconeogenesis, predominantly in the liver, and bicarbonate is generated by both processes over 1-2 h.


Community Pharmacists' Perceptions of Care Following the Implementation of a Transitions-of-Care Program.
Pharmacist-led collaborative interventions can support improved medication use and adherence during transitions of care (TOC). Community pharmacists are not always actively connected with other health-care team professionals, however, and their confidence in having necessary information may vary. To assess community pharmacists' perceptions of information, care provided, and communication, before and after a postdischarge intervention designed to increase communication between inpatient and community pharmacists. A survey assessing 4 domains related to pharmacists' perceptions of information and care of hospital discharge patients was developed and distributed to 106 community pharmacists before and after a TOC interventional study. Based on 151 responses (77 baseline, 74 followup) from 84 participants, community pharmacists have high confidence in their ability to counsel and feel that they are an important part of the healthcare team. They are less confident that they have adequate information about patients and report gaps in having adequate support and resources to provide care. When a TOC intervention was implemented, there was significant improvement in community pharmacists' feeling of having adequate information about the patients. Not having adequate information regarding patients discharged from the hospital is an area of concern for community pharmacists and a modifiable opportunity to improve TOCs.


Endomesoderm specification in Caenorhabditis elegans and other nematodes.
The endomesoderm gene regulatory network (GRN) of C. elegans is a rich resource for studying the properties of cell-fate-specification pathways. This GRN contains both cell-autonomous and cell non-autonomous mechanisms, includes network motifs found in other GRNs, and ties maternal factors to terminal differentiation genes through a regulatory cascade. In most cases, upstream regulators and their direct downstream targets are known. With the availability of resources to study close and distant relatives of C. elegans, the molecular evolution of this network can now be examined. Within Caenorhabditis, components of the endomesoderm GRN are well conserved. A cursory examination of the preliminary genome sequences of two parasitic nematodes, Haemonchus contortus and Brugia malayi, suggests that evolution in this GRN is occurring most rapidly for the zygotic genes that specify blastomere identity.