The efficacy and safety of collagenase clostridium histolyticum in the treatment of patients with moderate Dupuytren's contracture.
The efficacy and safety of collagenase clostridium histolyticum (CCH) in patients with Dupuytren's contracture (DC) was demonstrated in a program including two pivotal phase 3 clinical trials (CORD I and II) which included patients with a broad range of disease severity. This analysis assessed the efficacy and safety of CCH in the subpopulation of DC patients with up to two joints affected and moderate disease according to British Society of Surgery of the Hand classification. This was in support of a resubmission to the Scottish Medicines Consortium. A post-hoc analysis that included data from patients with up to two joints affected and moderate disease treated with CCH during the randomized and open-label phases of CORD I and II. Of 362 patients who received CCH during the two trials, 58 had one or two joints affected and moderate disease. Sixty-seven joints were treated; 49 patients received treatment for one joint, and 9 patients received treatment for two joints. Each patient received an average of 1.62 injections of CCH per joint. Of 65 evaluable joints, 82% met the primary endpoint of clinical success (reduction in contracture to ≤5° of full extension 30 days after the last injection). This was similar if only primary joints were considered (81% achieved clinical success). Recurrence at 12 months (increase in joint contracture to ≥20° in the presence of a palpable cord in joints that had attained clinical success) was observed in 3.8% of joints. Reported adverse events were mild to moderate in intensity; none resulted in discontinuation. CORD I and II show that CCH is well tolerated and effective in the treatment of DC in a broad population. The present analysis suggests that CCH has particular value in patients with moderate severity disease and up to two joints affected. This analysis used data from both the randomized and open-label phases of CORD I and II; therefore, it is not possible to present comparative data for this subpopulation. As this was a post-hoc analysis in a relatively small patient subpopulation, statistical comparisons with the full population were not considered appropriate. Furthermore, the small sample size means that additional subgroup analyses, for example of patients by previous treatment or number of injections administered, are not appropriate. Nevertheless, the data presented demonstrate that CCH is both well tolerated and effective in this population when managed by appropriately trained individuals.


The influence of diet composition and tissue type on the stable isotope incorporation patterns of a small-bodied southern African minnow Enteromius anoplus (Cypriniformes, Cyprinidae).
In trophic ecology, the use of stable isotope data relies on the general understanding of isotope turnover rates and diet-to-tissue discrimination factors (DTDFs). Recent studies on the application of stable isotope data have shown that isotope turnover rates and DTDFs can be influenced by many factors, including diet composition and tissue type. This study investigated the influence of diet composition and tissue type on stable isotope incorporation patterns in a small-bodied African minnow, the chubbyhead barb Enteromius anoplus. The isotopic incorporation patterns of carbon (δ13 C values) and nitrogen (δ15 N values) into white muscle and caudal fin tissues of the chubbyhead barb were examined using two isotopically different diets. Controlled-diet stable isotope feeding trials using a fishmeal-based diet (diet 1) and a soya-based diet (diet 2) were conducted over a 180-day period for the chubbyhead barb. The two diets had contrasting isotopic incorporation patterns: diet 1 was associated with progressively high δ13 C and δ15 N values, whereas diet 2 was associated with progressively low δ13 C and δ15 N values over time for both muscle and fin tissues. The δ13 C turnover rates were similar for both tissues (56 and 61 days), whereas the δ15 N turnover rates differed between fin and muscle tissue in both diets (diet 1 = 4 and 130 days, and diet 2 = 72 and 300 days, respectively). The DTDFs were similar for both tissues in diet 1 (Δ13 C: -3.96 to -2.62‰, Δ15 N: 1.98 to 2.61‰) and diet 2 (Δ13 C: 4.05 to 5.24‰, Δ15 N: 8.45 to 9.69‰). These results suggest that fin tissue can potentially be used as an alternative for muscle tissue in food web studies with a reasonable level of error. The isotopic turnover rate and DTDFs estimates for E. anoplus, however, require consideration of diet composition because different diets may differ in their isotopic incorporation patterns.


The representative COVID-19 cohort Munich (KoCo19): from the beginning of the pandemic to the Delta virus variant.
Population-based serological studies allow to estimate prevalence of SARS-CoV-2 infections despite a substantial number of mild or asymptomatic disease courses. This became even more relevant for decision making after vaccination started. The KoCo19 cohort tracks the pandemic progress in the Munich general population for over two years, setting it apart in Europe. Recruitment occurred during the initial pandemic wave, including 5313 participants above 13 years from private households in Munich. Four follow-ups were held at crucial times of the pandemic, with response rates of at least 70%. Participants filled questionnaires on socio-demographics and potential risk factors of infection. From Follow-up 2, information on SARS-CoV-2 vaccination was added. SARS-CoV-2 antibody status was measured using the Roche Elecsys® Anti-SARS-CoV-2 anti-N assay (indicating previous infection) and the Roche Elecsys® Anti-SARS-CoV-2 anti-S assay (indicating previous infection and/or vaccination). This allowed us to distinguish between sources of acquired antibodies. The SARS-CoV-2 estimated cumulative sero-prevalence increased from 1.6% (1.1-2.1%) in May 2020 to 14.5% (12.7-16.2%) in November 2021. Underreporting with respect to official numbers fluctuated with testing policies and capacities, becoming a factor of more than two during the second half of 2021. Simultaneously, the vaccination campaign against the SARS-CoV-2 virus increased the percentage of the Munich population having antibodies, with 86.8% (85.5-87.9%) having developed anti-S and/or anti-N in November 2021. Incidence rates for infections after (BTI) and without previous vaccination (INS) differed (ratio INS/BTI of 2.1, 0.7-3.6). However, the prevalence of infections was higher in the non-vaccinated population than in the vaccinated one. Considering the whole follow-up time, being born outside Germany, working in a high-risk job and living area per inhabitant were identified as risk factors for infection, while other socio-demographic and health-related variables were not. Although we obtained significant within-household clustering of SARS-CoV-2 cases, no further geospatial clustering was found. Vaccination increased the coverage of the Munich population presenting SARS-CoV-2 antibodies, but breakthrough infections contribute to community spread. As underreporting stays relevant over time, infections can go undetected, so non-pharmaceutical measures are crucial, particularly for highly contagious strains like Omicron.


Increased risk of coronary heart disease death in men with low total and low-density lipoprotein cholesterol in the Russian Lipid Research Clinics Prevalence Follow-up Study.
A continuously increasing risk of coronary heart disease with increasing levels of cholesterol has been reported by many observational and experimental studies. However, this type of association has not been observed in studies in the Russian Lipid Research Clinics. Twelve-year coronary heart disease mortality among 40- to 59-year-old men was analyzed in the Moscow and St Petersburg examines in the Russian Lipid Research Clinics Program. The baseline survey examined 6431 men fasting and free of prevalent coronary heart disease. Lipids and lipoproteins, blood pressure, body mass, education level, alcohol intake, and smoking history were obtained. Mortality follow-up was based on contacts with participants or their relatives or neighbors. Coronary heart disease mortality was analyzed based on risk factor levels and was further divided into rapid and nonrapid deaths. A J-shaped cholesterol-coronary heart disease risk function was present for both total and low-density lipoprotein cholesterol. Further examination showed hypocholesterolemic men to have lower low-density and higher high-density lipoprotein cholesterol, higher alcohol consumption, leaner body mass, and less education than men with normal or high cholesterol levels. When education level was considered, the J-shaped risk function was present only among men with less than a high school education. When deaths were classified into rapid (less than 24 hours after onset of symptoms) and nonrapid, the J-shaped risk function was restricted to rapid deaths. The results of disclose a sizeable subset of hypocholesterolemics in this population at increased risk of cardiac death associated with lifestyle characteristics.


Electroconvulsive Therapy Added to Non-Clozapine Antipsychotic Medication for Treatment Resistant Schizophrenia: Meta-Analysis of Randomized Controlled Trials.
This meta-analysis of randomized controlled trials (RCTs) examined the efficacy and safety of the combination of electroconvulsive therapy (ECT) and antipsychotic medication (except for clozapine) versus the same antipsychotic monotherapy for treatment-resistant schizophrenia (TRS). Two independent investigators extracted data for a random effects meta-analysis and pre-specified subgroup and meta-regression analyses. Weighted and standard mean difference (WMD/SMD), risk ratio (RR) ±95% confidence intervals (CIs), number needed to treat (NNT), and number needed to harm (NNH) were calculated. Eleven studies (n = 818, duration = 10.2±5.5 weeks) were identified for meta-analysis. Adjunctive ECT was superior to antipsychotic monotherapy regarding (1) symptomatic improvement at last-observation endpoint with an SMD of -0.67 (p<0.00001; I2 = 62%), separating the two groups as early as weeks 1–2 with an SMD of -0.58 (p<0.00001; I2 = 0%); (2) study-defined response (RR = 1.48, p<0.0001) with an NNT of 6 (CI = 4–9) and remission rate (RR = 2.18, p = 0.0002) with an NNT of 8 (CI = 6–16); (3) PANSS positive and general symptom sub-scores at endpoint with a WMD between -3.48 to -1.32 (P = 0.01 to 0.009). Subgroup analyses were conducted comparing double blind/rater-masked vs. open RCTs, those with and without randomization details, and high quality (Jadad≥adadup analyses were Jadad<3) studies. The ECT-antipsychotic combination caused more headache (p = 0.02) with an NNH of 6 (CI = 4–11) and memory impairment (p = 0.001) with an NNH of 3 (CI = 2–5). The use of ECT to augment antipsychotic treatment (clozapine excepted) can be an effective treatment option for TRS, with increased frequency of self-reported memory impairment and headache. CRD42014006689 (PROSPERO).


Modulation of enrofloxacin binding in OmpF by Mg2+ as revealed by the analysis of fast flickering single-porin current.
One major determinant of the efficacy of antibiotics on gram-negative bacteria is the passage through the outer membrane. During transport of the fluoroquinolone enrofloxacin through the trimeric outer membrane protein OmpF of Escherichia coli, the antibiotic interacts with two binding sites within the pore, thus partially blocking the ionic current. The modulation of one affinity site by Mg(2+) reveals further details of binding sites and binding kinetics. At positive membrane potentials, the slow blocking events induced by enrofloxacin in Mg(2+)-free media are converted to flickery sojourns at the highest apparent current level (all three pores flickering). This indicates weaker binding in the presence of Mg(2+). Analysis of the resulting amplitude histograms with β distributions revealed the rate constants of blocking (k(OB)) and unblocking (k(BO)) in the range of 1,000 to 120,000 s(-1). As expected for a bimolecular reaction, k(OB) was proportional to blocker concentration and k(BO) independent of it. k(OB) was approximately three times lower for enrofloxacin coming from the cis side than from the trans side. The block was not complete, leading to a residual conductivity of the blocked state being ∼25% of that of the open state. Interpretation of the results has led to the following model: fast flickering as caused by interaction of Mg(2+) and enrofloxacin is related to the binding site at the trans side, whereas the cis site mediates slow blocking events which are also found without Mg(2+). The difference in the accessibility of the binding sites also explains the dependency of k(OB) on the side of enrofloxacin addition and yields a means of determining the most plausible orientation of OmpF in the bilayer. The voltage dependence suggests that the dipole of the antibiotic has to be adequately oriented to facilitate binding.


Phylogenetic analyses and expression studies reveal two distinct groups of calreticulin isoforms in higher plants.
Calreticulin (CRT) is a multifunctional protein mainly localized to the endoplasmic reticulum in eukaryotic cells. Here, we present the first analysis, to our knowledge, of evolutionary diversity and expression profiling among different plant CRT isoforms. Phylogenetic studies and expression analysis show that higher plants contain two distinct groups of CRTs: a CRT1/CRT2 group and a CRT3 group. To corroborate the existence of these isoform groups, we cloned a putative CRT3 ortholog from Brassica rapa. The CRT3 gene appears to be most closely related to the ancestral CRT gene in higher plants. Distinct tissue-dependent expression patterns and stress-related regulation were observed for the isoform groups. Furthermore, analysis of posttranslational modifications revealed differences in the glycosylation status among members within the CRT1/CRT2 isoform group. Based on evolutionary relationship, a new nomenclature for plant CRTs is suggested. The presence of two distinct CRT isoform groups, with distinct expression patterns and posttranslational modifications, supports functional specificity among plant CRTs and could account for the multiple functional roles assigned to CRTs.


Amphibians of Serra Bonita, southern Bahia: a new hotpoint within Brazil's Atlantic Forest hotspot.
We studied the amphibian community of the Private Reserve of Natural Heritage (RPPN) Serra Bonita, an area of 20 km(2) with steep altitudinal gradients (200-950 m a.s.l.) located in the municipalities of Camacan and Pau-Brasil, southern Bahia State, Brazil. Data were obtained at 38 sampling sites (including ponds and transects within the forest and in streams), through active and visual and acoustic searches, pitfall traps, and opportunistic encounters. We recorded 80 amphibian species distributed in 15 families: Aromobatidae (1), Brachycephalidae (3), Bufonidae (4), Centrolenidae (2), Ceratophryidae (1), Craugastoridae (7), Eleutherodactylidae (2), Hemiphractidae (2), Hylidae (42), Hylodidae (1), Leptodactylidae (7), Microhylidae (3), Siphonopidae (1), Odontophrynidae (3) and Pipidae (1). Species richness was positively correlated with monthly rainfall. Near 36% of the species were found in strictly forest environments, 15% are endemic to Bahia State and 77.2% are endemic to the Atlantic Forest biome. The large species diversity of this small area, the high degree of endemism and the taxonomic and biogeographic significance turn the Serra Bonita mountain into a hotpoint for amphibians within Brazil's Atlantic Forest hotspot.


[New coronavirus infection COVID-19 as a trigger for the development of symptoms of ankylosing spondylitis. Case report].
The novel coronavirus infection COVID-19 (SARS-CoV-2) is now known to cause a variety of extrapulmonary complications, including cardiovascular, neurological and dermatological complications, many of which occur or last several weeks after infection. We present a clinical case of a patient who first developed symptoms of ankylosing spondylitis 2 weeks after recovering from COVID-19. The patient was prescribed therapy in accordance with international and Russian recommendations for the management of patients with ankylosing spondylitis with a positive effect in the form of absence arthritis, enthesitis and reducing the inflammatory back pain.


Rapid short-term reorganization in the language network.
The adaptive potential of the language network to compensate for lesions remains elusive. We show that perturbation of a semantic region in the healthy brain induced suppression of activity in a large semantic network and upregulation of neighbouring phonological areas. After perturbation, the disrupted area increased its inhibitory influence on another semantic key node. The inhibitory influence predicted the individual delay in response speed, indicating that inhibition at remote nodes is functionally relevant. Individual disruption predicted the upregulation of semantic activity in phonological regions. In contrast, perturbation over a phonological region suppressed activity in the network and disrupted behaviour without inducing upregulation. The beneficial contribution of a neighbouring network might thus depend on the level of functional disruption and may be interpreted to reflect a differential compensatory potential of distinct language networks. These results might reveal generic mechanisms of plasticity in cognitive networks and inform models of language reorganization.


Are school and home environmental characteristics associated with oral health-related quality of life in Brazilian adolescents and young adults?
The aim of this study was to test the association of contextual school and home environmental characteristics and individual factors with oral health-related quality of life (OHRQoL) in a representative sample of Brazilian adolescents and young adults. Individual-level data from 3854 fifteen- to nineteen-year-olds who participated in the Brazilian Oral Health Survey were pooled with contextual city-level data. The dependent variable was the frequency of impacts of oral disorders on daily performances (OIDP extent), as a measure of OHRQoL. Contextual school and home environmental characteristics were categorized into three equal groups according to tertiles of the contextual variable's scores (low, moderate and high). Individual demographic, socioeconomic and oral clinical measures were the covariates. The association between contextual and individual characteristics and OIDP extent was estimated using multilevel Poisson regression models. The mean of OIDP extent was 0.9 (standard error 0.1). Adolescents and young adults living in the cities with high levels of lack of security at school (RR 1.33; 95% CI=1.02-1.74), moderate levels of bullying at school (RR 1.56; 95% CI=1.20-2.03) and moderate levels of low maternal schooling (RR 1.43; 95% CI=1.06-1.92) had a higher mean OIDP extent. Male sex, higher age, skin colour, poor individual socioeconomic status and worse oral clinical measures were also associated with higher mean of OIDP extent. Poor school and home environmental characteristics were independently associated with poor OHRQoL in individuals aged between 15 and 19 years. Our findings suggest the place where they study and the maternal level of education are meaningful aspects for their oral health.


The microRNA regulatory landscape of MSC-derived exosomes: a systems view.
Mesenchymal stem cell (MSC)-derived exosomes mediate tissue regeneration in a variety of diseases including ischemic heart injury, liver fibrosis, and cerebrovascular disease. Despite an increasing number of studies reporting the therapeutic effects of MSC exosomes, the underlying molecular mechanisms and their miRNA complement are poorly characterized. Here we microRNA (miRNA)-profiled MSC exosomes and conducted a network analysis to identify the dominant biological processes and pathways modulated by exosomal miRNAs. At a system level, miRNA-targeted genes were enriched for (cardio)vascular and angiogenesis processes in line with observed cardiovascular regenerative effects. Targeted pathways were related to Wnt signaling, pro-fibrotic signaling via TGF-β and PDGF, proliferation, and apoptosis. When tested, MSC exosomes reduced collagen production by cardiac fibroblasts, protected cardiomyocytes from apoptosis, and increased angiogenesis in HUVECs. The intrinsic beneficial effects were further improved by virus-free enrichment of MSC exosomes with network-informed regenerative miRNAs capable of promoting angiogenesis and cardiomyocyte proliferation. The data presented here help define the miRNA landscape of MSC exosomes, establish their biological functions through network analyses at a system level, and provide a platform for modulating the overall phenotypic effects of exosomes.


The effects of race/ethnicity and physician recommendation for physical activity on physical activity levels and arthritis symptoms among adults with arthritis.
Among U.S. adults with physician-diagnosed arthritis, we examined the association of 1) participant race/ethnicity with meeting physical activity guidelines and arthritis symptoms, and 2) the association of receipt of a physician exercise recommendation with physical activity levels and arthritis symptoms, and whether race/ethnicity moderates these associations. Retrospective, cross-sectional study of National Health Interview Survey pooled data from 2002, 2006, 2009, and 2014 from 27,887 U.S. adults aged ≥18 years with arthritis. Outcomes were meeting aerobic (yes/no) and strengthening guidelines (yes/no), arthritis-associated activity limitations (yes/no) and arthritis-related pain (0-10; higher score = more pain). Predictors were race/ethnicity (White, African American, Latino, and Asian) and receipt of physician recommendation for exercise (yes/no). Covariates included demographic and health characteristics. Adjusting for covariates, African Americans were more likely (AOR = 1.27; 95% CI 1.12, 1.43) and Asians were less likely (AOR = 0.75; 95% CI 0.61, 0.92) than Whites to meet muscle strengthening activity guidelines. Compared to Whites, African Americans (B = 0.48; 95% CI 0.24, 0.72) and Latinos (B = 0.44; 95% CI 0.15, 0.72) reported more severe, while Asians reported less severe (B = -0.68; 95% CI -1.22, - 0.14) joint pain. Controlling for covariates, physician exercise recommendation was associated with meeting aerobic (AOR = 1.20; 95% CI 1.11, 1.30) and strengthening (AOR = 1.21; 95% CI 1.11, 1.33) guidelines, regardless of race/ethnicity except for a weak negative association with meeting strengthening guidelines (AOR = 0.85; CI 0.74-0.99) among Latinos. Disparities in pain exist for African Americans and Latinos with arthritis. Physician exercise recommendation is critical among patients with arthritis to relieve symptom burden.


Diagnostic value of KLK6 as an ovarian cancer biomarker: A meta-analysis.
Kallikrein-related peptidase 6 (KLK6) is a new potential serum biomarker of ovarian cancer. The aim of the present study was to assess the diagnostic value of KLK6 systematically for ovarian cancer. All the selected studies regarding the changes of KLK6 in ovarian cancer were published prior to April 2015. Five studies involving 485 patients with ovarian cancer, 420 benign cysts and 245 healthy controls met the inclusion criteria. The value of sensitivity, specificity, positive-likelihood ratio (LR+), negative-likelihood ratio (LR-) and area under the receiver operating characteristic curve (ROC) were obtained. All these indices were used to evaluate the diagnostic value of KLK6 for ovarian cancer. The values of sensitivity, specificity, LR+ and LR- (95% confidence interval) of KLK6 were 0.50 (0.47-0.54), 0.91 (0.89-0.93), 7.20 (3.34-15.52) and 0.51 (0.43-0.62), respectively. The area under the summary ROC of KLK6 was 0.86. The index of Q* was 0.79. In conclusion, KLK6 showed high specificity for the diagnosis of ovarian cancer. It can improve the diagnostic accuracy of cancer antigen 125 (CA125). A combined panel of CA125 and KL K6 shows a high diagnostic efficiency for advanced ovarian cancer. Owing to the small number of studies and lack of samples, additional studies meeting the inclusion criteria are required to further analyze the diagnostic value of KLK6 for ovarian cancer.


[Intelligence and creativity changes induced by pathological growth of space-occupying cerebral lesion].
Creativity and intelligence changes depending on tumor localization in frontal or parietal cortex before surgical procedure in 24 patients in comparison with control group are studied. Brain damage-induced intelligence impairment and a decrease of fluency, flexibility of figural divergent thinking, and originality of verbal one without specificity of tumor localization were found. Intelligence decrease was more presented while performing of figural tasks and least of all in verbal ones. The left prefrontal brain damage induced a decrease of all components of intelligence and a trend to a decrease of verbal creativity and figural fluency. The right parietal brain lesion was more associated with a decline of divergent thinking originality.


[Pollution and Potential Ecology Risk Evaluation of Heavy Metals in River Water, Top Sediments on Bed and Soils Along Banks of Bortala River, Northwest China].
This paper focuses on the sources, pollution status and potential ecology risks of heavy metals (Cr, Cu, Hg, As, Cd, Pb, and Zn) in the surface water, top sediment of river bed and soil along banks of Bortala River, which locates in the oasis region of Xinjiang, northwest China. Results showed that: (1) As a whole, contents of 7 tested heavy metals of Bortala River were low, while the maximum values of Hg, Cd, Pb, and Cr in the river water were significantly higher than those of Secondary Category of the Surface Water Quality Standards of People's Republic of China (GB 3838-2002) and Drinking Water Guideline from WHO. Analysis showed that the heavy metals contents of top sediment on river bed and soils along river banks were significantly higher than those of the river water. (Correlation analysis and enrichment factor (EF) calculation showed that in the river water, top sediment on river bed and soils along river banks, Hg, Cd, Pb, and Cr mainly originated from industrial emissions, urban and rural anthropogenic activities, transportation and agricultural production activities; While Cu, Zn, and As mainly originated from natural geological background and soil parent materials. (3) Pollution assessment showed that in three matrices, the single factor pollution index(Pi) and the integrated pollution index (Pz) of 7 heavy metals were all lower than 1, and they all belonged to safe and clean levels. (4) Potential ecology risk evaluation showed that as a whole the single factor potential ecological risk (Eir) and the integrated potential ecology risks (RI) of 7 heavy metals were relatively low, and would not cause threats to the health of water and soil environment of river basin, while the potential ecology risks of Cd, Hg, Pb, and Cr were significantly higher than those of other heavy metals.


Auditory brainstem responses to a chirp stimulus designed from derived-band latencies in normal-hearing subjects.
In an attempt to compensate for the temporal dispersion in the human cochlea, a chirp has previously been designed from estimates of the cochlear delay based on derived-band auditory brain-stem response (ABR) latencies [Elberling et al. (2007). "Auditory steady-state responses to chirp stimuli based on cochlear traveling wave delay," J. Acoust. Soc. Am. 122, 2772-2785]. To evaluate intersubject variability and level effects of such delay estimates, a large dataset is analyzed from 81 normal-hearing adults (fixed click level) and from a subset thereof (different click levels). At a fixed click level, the latency difference between 5700 and 710 Hz ranges from about 2.0 to 5.0 ms, but over a range of 60 dB, the mean relative delay is almost constant. Modeling experiments demonstrate that the derived-band latencies depend on the cochlear filter buildup time and on the unit response waveform. Because these quantities are partly unknown, the relationship between the derived-band latencies and the basilar membrane group delay cannot be specified. A chirp based on the above delay estimates is used to record ABRs in ten normal-hearing adults (20 ears). For levels below 60 dB nHL, the gain in amplitude of chirp-ABRs to click-ABRs approaches 2, and the effectiveness of chirp-ABRs compares favorably to Stacked-ABRs obtained under similar conditions.


Synthesis of trifluoromethylated aza-BODIPYs as fluorescence-19F MRI dual imaging and photodynamic agents.
Dual-imaging agents with highly sensitive fluorescence (FL) imaging and highly selective fluorine-19 magnetic resonance imaging (19F MRI) are valuable for biomedical research. At the same time, photosensitizers with a high reactive oxygen species (ROS) generating capability are crucial for photodynamic therapy (PDT) of cancer. Herein, a series of tetra-trifluoromethylated aza-boron dipyrromethenes (aza-BODIPYs) were conveniently synthesized from readily available building blocks and their physicochemical properties, including ultraviolet-visible (UV-Vis) absorption, FL emission, photothermal efficacy, ROS generating efficacy, and 19F MRI sensitivity, were systematically investigated. An aza-BODIPY with 12 symmetrical fluorines was identified as a potent FL-19F MRI dual-imaging traceable photodynamic agent. It was found that the selective introduction of trifluoromethyl (CF3) groups into aza-BODIPYs may considerably improve their UV absorption, FL emission, photothermal efficacy, and ROS generating properties, which lays the foundation for the rational design of trifluoromethylated aza-BODIPYs in biomedical applications.


Womb transplants with live births: an update and the future.
Absolute uterine factor infertility, with a uterine absence or presence of a nonfunctional uterus, has during the last decades been the only remaining, major group of female infertility. Uterus transplantation (UTx) has now emerged as the first therapy for these women that have traditionally been regarded as unconditionally infertile. Areas covered: This review summarizes the research preparations in several experimental animal species that paved the way for the clinical introduction of UTx. The article also describes the human UTx attempts that have been reported up until today and the several live births that have occurred after the initial UTx baby was born in 2014. Future developments in human UTx and efforts to create a bioengineered uterus are also discussed. Expert opinion: UTx has already at this early phase of experimental introduction in the human setting proved to be a highly effective treatment for absolute uterine factor infertility. The UTx procedure has now been introduced at several centers worldwide within clinical research studies and with variations in techniques. The outcome and data from these studies will further optimize the UTx procedure to become a safe and highly effective infertility treatment.


Four Wave Mixing control in a photonic molecule made by silicon microring resonators.
Four Wave Mixing (FWM) is the main nonlinear interaction in integrated silicon devices, which finds diffuse use in all-optical signal processing and wavelength conversion. Despite the numerous works on coupled resonator devices, which showed record conversion efficiencies and broadband operation, the possibility to coherently control the strength of the stimulated FWM interaction on a chip has received very limited attention. Here, we demonstrate both theoretically and experimentally, the manipulation of FWM in a photonic molecule based on two side coupled silicon microring resonators. The active tuning of the inter-resonator phase and of their eigenfrequencies allows setting the molecule in a sub-radiant state, where FWM is enhanced with respect to the isolated resonators. On the other hand, we can reconfigure the state of the photonic molecule to have energy equipartition among the resonators, and suppress FWM by making the two Signal waves to interfere destructively in the side coupled waveguides. This work constitutes an experimental demonstration of the control of a nonlinear parametric interaction via coherent oscillation phenomena in an integrated optical device.


Uterine fibroid embolization can still be improved: observations on post-procedure magnetic resonance imaging.
To evaluate the efficacy and completeness of uterine fibroid embolization (UFE) measured by changes in volume and signal intensity at magnetic resonance imaging (MRI), and to compare with clinical outcome. 40 women with symptomatic uterine fibroids underwent bilateral uterine artery embolization. At MRI studies, including post-contrast sequences before and repeatedly after treatment, the uterus and dominant fibroids were evaluated for volume, location, and contrast enhancement. Prior to treatment, all myomas showed significant contrast enhancement. The mean uterine volume was 929 ml. Clinical examinations with emphasis on menorrhagia, pelvic pain, and urinary dysfunction were performed before and 6 and 12 months after treatment. UFE was bilaterally successful in 38 patients. After UFE, MRI showed no enhancement of myomas in 30 patients. In 8 patients, post-procedural MRI revealed partially remaining vascularization of fibroids despite angiographically complete embolization of the uterine arteries. On average, uterine volume decreased by 46.2% at 12 months. There was significant improvement of symptoms in the majority of patients, but slightly less improvement in patients with partially remaining vascularization of myomas. UFE causes significant volume reduction of myomas and clinical improvement. MRI can reveal remaining vascularization in myomas despite angiographically complete embolization of uterine arteries.


Reimbursement for injury-induced medical expenses in Chinese social medical insurance schemes: A systematic analysis of legislative documents.
Social medical insurance schemes are crucial for realizing universal health coverage and health equity. The aim of this study was to investigate whether and how reimbursement for injury-induced medical expenses is addressed in Chinese legislative documents relevant to social medical insurance. We retrieved legislative documents from the China National Knowledge Infrastructure and the Lawyee databases. Four types of social medical insurance schemes were included: urban employee basic medical insurance, urban resident basic medical insurance, new rural cooperative medical system, and urban and rural resident medical insurance. Text analyses were conducted on all identified legislative documents. As a result, one national law and 1,037 local legislative documents were identified. 1,012 of the 1,038 documents provided for reimbursement. Of the 1,012 documents, 828 (82%) provided reimbursement only for injuries without a legally responsible person/party or not caused by self-harm, alcohol use, drug use, or other law violations, and 162 (16%) did not include any details concerning implementation. Furthermore, 760 (92%) of the 828 did not provide an exception clause applying to injuries when a responsible person/party could not be contacted or for situations when the injured person cannot obtain reimbursement from the responsible person/party. Thus, most Chinese legislative documents related to social medical insurance do not provide reimbursement for medical expenses from injuries having a legally responsible person/party or those caused by illegal behaviors. We argue that all injury-induced medical expenses should be covered by legislative documents related to social medical insurance in China, no matter what the cause of the injury. Further research is needed to explore the acceptability and feasibility of such policy changes.


Dissecting the Biological Heterogeneity within Hormone Receptor Positive HER2 Negative Breast Cancer by Gene Expression Markers Identifies Indolent Tumors within Late Stage Disease.
Hormone receptor positive (HR+) breast cancers are a heterogeneous class with differential prognosis. Although more than half of Indian women present with advanced disease, many such patients do well. We have attempted identification of biologically indolent tumors within HR+HER2- tumors based on gene expression using histological grade as a guide to tumor aggression. 144 HR+HER2- tumors were divided into subclasses based on scores derived by using transcript levels of multiple genes representing survival, proliferation, and apoptotic pathways and compared to classification by Ki-67 labeling index (LI). Clinical characters and disease free survival were compared between the subclasses. The findings were independently validated in the METABRIC data set. Using the previously established estrogen receptor (ER) down stream activity equation, 20% of the tumors with greater than 10% HR positivity by immunohistochemistry (IHC) were still found to have inadequate ER function. A tumor aggression probability score was used to segregate the remainder of tumors into indolent (22%) and aggressive (58%) classes. Significant difference in disease specific survival was seen between the groups (P = .02). Aggression probability based subclassification had a higher hazard ratio and also independent prognostic value (P<.05). Independent validation of the gene panel in the METABRIC data set showed all 3 classes; indolent (24%), aggressive (68%), and insufficient ER signaling (7%) with differential survival (P = .01). In agreement with other recent reports, biologically indolent tumors can be identified with small sets of gene panels and these tumors exist in a population with predominantly late stage disease.


Livedoid vasculopathy: A review with focus on terminology and pathogenesis.
Livedoid vasculopathy (LV) is a rare thrombotic vasculopathy of the dermis characterized by painful, relapsing ulcers over the lower extremities. Diagnosis is challenging due to the overlap in clinical appearance and nomenclature with other skin disorders. Treatment selection is complicated by poor understanding of the pathogenesis of LV and lack of robust clinical trials evaluating therapy efficacy. The terminology and pathophysiology of LV are reviewed here, along with its epidemiology, clinical and histologic features, and treatment options. A diagnostic pathway is suggested to guide providers in evaluating for comorbidities, referring to appropriate specialists, and choosing from the available classes of therapy.


Dreamlike events are correlated with the length of sleep mentation reports.
We investigated the relationship between length and dreamlike quality in sleep mentation reports. Reports were obtained by waking subjects at sleep onset (SO) and at 5 and 10 minutes into the second (REMP2) and fourth REM periods (REMP4). Reports were recorded, transcribed, and scored blindly for total word count (TWC) and dreamlike quality as measured by a composite dream scale score (CDS). Dreamlike quality was strongly correlated with TWC; both CDS and TWC scores increased across successively later awakenings. Significant differences were found in both TWC and CDS between SO and REMP4 and also between REMP2 and REMP4; however, differences were not significant between SO and REMP2 or between the 5 and 10 minute awakenings in REMPs 2 and 4. These findings provide further evidence that the amount of dreamlike mentation is related to the within-sleep arousal level rather than to REMP duration and that the dreamlike quality of reports increases as they become longer.


[Effect of the body mass index on outcomes of ureterorenoscopy for renal stones].
Purpose of this work is to compare the outcome of ureterorenoscopy (URS) with regard to stone-free rates (SFR) and complication rates (CR) in patients with different body mass index (BMI) scores for the treatment of kidney stones. A retrospective chart review of all patients with known BMI, who underwent URS for kidney stones between 2006 and 2012 at our institution, was performed (n = 556 patients). The SFR and CR of obese patients were compared to overweight and normal weight patients. Mean age was 52.51 years and the average BMI 27.74 kg/m2. Of the patients, 34.2 % had normal weight (22.59 ± 1.91 kg/m2), 39.6 % were overweight (27.30 ± 1.42 kg/m2), and 26.3 % were obese (35.09 ± 5.93 kg/m2). The mean ASA score differed significantly between normal weight (1.99 ± 0.57), overweight (2.03 ± 0.62), and obese (2.22 ± 0.63) patients (p ≤ 0.036). The mean stone size was 8.51 ± 6.84 mm and the mean number of stones per patient 1.9 ± 2.41, whereby the differences between groups was not significant. There were no differences between the groups regarding the use of preoperative (94.8 %) and postoperative ureteral stents (60.3 %), the Ho:YAG laser (33.6 %), the use of flexible (16.2 %) or semirigid/flexible URS (59.4 %), and the mean operative time (52.04 ± 34.55 min). There were no differences in the SFR for the upper (90 %), mid (94.7 %), and lower pole (90.2 %), multiple location (68.6 %) or the total SFR (86.3 %). Total SFR of 95.7, 88.4, and 73.7 % for urinary calculi < 5 mm, 5-9 mm, and ≥ 10 mm, respectively, were found and the differences between the patient groups was not significant. The CR was 10.4 % (differences between the patient groups not significant). URS is an appropriate treatment for renal stones with high SFR and low CR regardless of patient's BMI.


Effects of san qi on gastric secretion and protective factors of gastric mucosa in the rat with precancerous lesion of stomach.
In the model rat with precancerous lesion of stomach induced by the combined method of insertion of a spring into the pylorus and high salt hot paste, effects of San Qi ([symbol: see text] Radix Notoginseng) on gastric secretion and protective factors of stomach were investigated. The results indicated that gastric secretion, gastric mucosal blood flow (GMBF) and aminohexose content lowered significantly, and malondialdehyde (MDA) increased significantly (P < 0.01) in the model group as compared with the normal group; after treatment with San Qi Powder for 12 weeks, both gastric secresion and GMBF increased, and MDA content decreased as compared with the negative control group (P < 0.01), with no significant increase of aminohexose content. It is suggested that San Qi ([symbol: see text] Radix Notoginseng) may improve gastric secretion, and that increase of GMBF and antagonism against the lesion of oxygen free radicals are possibly one of its mechanisms.


Development of an Instrument for Assessing the Maturity of Citizens for Consumer Health Informatics in Developing Countries: The Case of Chile, Ghana, and Kosovo.
We aimed to develop a survey instrument to assess the maturity level of consumer health informatics (ConsHI) in low-middle income countries (LMIC). We deduced items from unified theory of acceptance and use of technology (UTAUT), UTAUT2, patient activation measure (PAM), and ConsHI levels to constitute a pilot instrument. We proposed a total of 78 questions consisting of 14 demographic and 64 related maturity variables using an iterative process. We used a multistage convenient sampling approach to select 351 respondents from all three countries. Our results supported the earlier assertion that mobile devices and technology are standard today than ever, thus confirming that mobile devices have become an essential part of human activities. We used the Wilcoxon Signed-Rank Test (WSRT) and item response theory (IRT) to reduce the ConsHI-related items from 64 to 43. The questionnaire consisted of 10 demographic questions and 43 ConsHI relevant questions on the maturity of citizens for ConsHI in LMIC. Also, the results supported some moderators such as age and gender. Additionally, more demographic items such as marital status, educational level, and location of respondents were validated using IRT and WSRT. We contend that this is the first composite instrument for assessing the maturity of citizens for ConsHI in LMIC. Specifically, it aggregates multiple theoretical models from information systems (UTAUT and UTAUT2) and health (PAM) and the ConsHI level.


Exploring the dynamic effect of economic growth on carbon dioxide emissions in Africa: evidence from panel PMG estimator.
The relationship between economic growth and environmental pollution continues to attract significant research interest for researchers, practitioners, and policymakers all over the globe. Theoretically, the environmental benefit of economic growth should be greater than its negative externality with higher level of development. However, from the African perspective, countries with higher economic performances often face several environmental challenges, which raises the doubt whether economic growth helps or constrains environmental quality improvement. Under the environmental Kuznets curve (EKC) hypothesis, this study re-examined the effect of economic growth on CO2 emissions conditional on the dynamics of urbanization, renewable energy, and good governance across 47 African countries using panel data from 1996 to 2019. We employ panel cointegration tests to establish whether there is a long-run equilibrium relationship among our variables. We also apply pooled mean group ARDL (PMG-ARDL) techniques and the Dumitrescu-Hurlin causality test to determine the long- and short-run effects of economic growth, urbanization, renewable energy consumption, and good governance on CO2 emissions. The results from the PMG estimator validate the EKC hypothesis since a 1% surge in GDP per capita increases emissions by 0.61% in the long run, while a 1% increase in its square decreases emissions by 0.03%. In the short-run, economic growth does not exercise any significant effect on emissions. Furthermore, results indicate a significantly negative and positive long-run effect of renewable energy and governance, respectively. Finally, our causality test shows bidirectional relationship between CO2 emissions and all the explanatory variables. Henceforth, we provided policy implications based on the study's results.


Educational intervention to improve the knowledge of hand hygiene in pediatric residents and nurses.
To assess the improvement in the knowledge of hand hygiene in Pediatric residents and nurses after theoretical and hands-on educational intervention. This study was a questionnaire-based cross-sectional survey carried out in the department of Pediatrics, King Edward Medical University/ Mayo hospital Lahore in two weeks period. Total 41 Pediatrics residents and nurses, participated in the study. Initially a pretest questionnaire was given to each participant, followed by an educational intervention: a day's worth of didactic lectures and practical training of practices for infection control. After two weeks, an identical post-test questionnaire was sent to the participants via email. Data were statistically analyzed through SPSS 22. Z test was applied to see the normality of data while paired t test was applied to compare the pretest score with posttest score. Of 41 participants who attended the workshop, 34 participants responded to post-test giving an overall response rate of 83%. Out of 34, there were 27(80%) doctors and 7(20%) nurses, who participated in workshop. Each item of the questionnaire was analyzed, showing that pretest score for questions related to indication for hand washing, minimum timings required for hand rub, and spread of infection from unclean hands was quite low, as compared to post-test score, indicating statistically significant increment (p value 0.000, 0.001and 0.046 respectively). Mean pre-test score for doctors was 3.22 while for nurses, it was 3.14, whereas post-test score was 4.51 and 4.00 for doctors and nurses respectively. Overall, there was statistically significant increase in knowledge after educational intervention. There is statistically significant impact of educational intervention on improving the knowledge of Pediatric residents and nurses with respect to hand hygiene practices.


Novel wearable and contactless monitoring devices to identify deteriorating patients in the clinical setting: a systematic review protocol.
With technological advances, there has been increasing interest in developing contactless and/or non-invasive wearable technologies that continuously monitor vital signs in the clinical setting, and in particular in the deteriorating patient. These devices as of yet have not been well validated in the clinical setting in the clinical ranges observed in a critically unwell patient. We will perform a systematic review of all novel wearable and contactless devices in the clinical setting with focus on degree of novelty and the range of vital signs captured. Ovid MEDLINE including Epub Ahead of Print and In-Process & Other Non-Indexed Citations, Ovid Embase, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials (CENTRAL) Health Technology Assessment (HTA) database (Ovid), CINAHL with Full Text, searches of the grey literature, cited references of eligible studies through Web of Science, and reference lists of eligible studies will be searched. Outcomes of interest will include the quality of studies in relation to reporting guidelines, limitations of non-invasive technology, and application in different clinical populations. We will perform a qualitative assessment of the novelty of the device and discuss its validation in deteriorating patients. While novel monitoring devices are often proposed as a solution to problems with infection, discomfort, and frequency of monitoring in the clinical setting it has not yet been established which devices have been validated in clinical settings in the pathological ranges of vital signs that reflect patient deterioration. It is equally unclear what additional value these devices might provide. This systematic review will synthesize published data regarding devices that have been tested and validated in patients AND in a clinical setting AND in reference ranges that reflect severe illness. PROSPERO CRD42019130091.


[Studies on airway hyperresponsiveness by the Astograph(r) method in asthmatics and young adult non-asthmatic asymptomatics].
We investigated airway hyperresponsiveness (AHR) by the continuous inhalation method using an Astograph(R) in 105 asthmatics and 141 non-asthmatic asymptomatics. The range of Dmin (1 U=one minute inhalation of 1 mg/ml of methacholine) of asthmatics was 0.001 to 28.70 U, and that of adjusted Dmin of non-asthmatic asymptomatics was 0.28 to 190 U; thus, an apparent overlap was recognized in the distributions of Dmin. Ninety-five percent of asthmatics had a Dmin lower than 7 U, and 95% of non-asthmatic asymptomatics had a Dmin higher than 0.9 U. Presuming that almost all asthmatics had AHR, it was inferred that nearly half of non-asthmatic asymptomatics had AHR, too. Comparison with previous reports suggests that AHR in healthy people may be increasing generally. When Dmin is determined to be>7 U by the Astograph(R) method, it is likely that the patient does not have asthma. When a patient has a Dmin<0.9 U, it is highly probable that the patient has asthma.


HLA mismatching within or outside of cross-reactive groups (CREGs) is associated with similar outcomes after unrelated hematopoietic stem cell transplantation.
The National Marrow Donor Program maintains a registry of volunteer donors for patients in need of a hematopoietic stem cell transplantation. Strategies for selecting a partially HLA-mismatched donor vary when a full match cannot be identified. Some transplantation centers limit the selection of mismatched donors to those sharing mismatched antigens within HLA-A and HLA-B cross-reactive groups (CREGs). To assess whether an HLA mismatch within a CREG group ("minor") may result in better outcome than a mismatch outside CREG groups ("major"), we analyzed validated outcomes data from 2709 bone marrow and peripheral blood stem cell transplantations. Three-hundred and ninety-six pairs (15%) were HLA-DRB1 allele matched but had an antigen-level mismatch at HLA-A or HLA-B. Univariate and multivariate analyses of engraftment, graft-versus-host disease, and survival showed that outcome is not significantly different between minor and major mismatches (P = .47, from the log-rank test for Kaplan-Meier survival). However, HLA-A, HLA-B, and HLA-DRB1 allele-matched cases had significantly better outcome than mismatched cases (P < .001). For patients without an HLA match, the selection of a CREG-compatible donor as tested does not improve outcome.


Evaluating the Impact of Year-Long, Augmented Diabetes Self-Management Support.
This was a randomized controlled study to test a scalable intervention model addressing the need for ongoing diabetes support. The study included individuals receiving care in a Federally Qualified Health Center (FQHC) with HbA1c >8. The aim of this project was to determine whether augmenting diabetes self-management education (DSME) with support for an economically vulnerable population might better meet patient needs and reduce morbidity and premature mortality. The intervention utilized pre and post comparisons and was designed to test the efficacy of a telephonic diabetes support intervention to increase patient engagement in self-care and with the health care system as a means to improve clinical outcomes. There were significant improvements in HbA1c, body mass index, low-density lipoprotein cholesterol, triglycerides, and depression screening scores in the year following DSME. However, there was no statistically significant difference between the 2 groups. This randomized controlled study demonstrated that comprehensive face-to-face care with consistent assessment and documentation over time in FQHCs produce clinically significant and predictable improvement for people with diabetes. The addition of structured provision of telephonic support overlapping in time with the comprehensive face-to-face process of care in this environment did not produce statistically significant clinical or behavioral care improvement.


Nutrition and growth in infants with established bronchopulmonary dysplasia.
Bronchopulmonary dysplasia (BPD) remains the most common late morbidity of preterm birth. Ongoing clinical care and research have largely focused on the pathogenesis and prevention of BPD in preterm infants. However, preterm infants who develop BPD have significant medical needs that persist throughout their neonatal intensive care unit course and continue post-discharge, including those associated with growth and nutrition. The objective of this manuscript was to provide a review on nutrition and growth in infants with established BPD after discharge from the hospital and to identify the knowledge and research gaps to provide direction for future studies.


Host liver changes in leukemic mice: effect of alpha-difluoromethyl ornithine, an inhibitor of polyamine synthesis.
Elevated levels of polyamines and gamma-Glutamyl Transpeptidase were seen in the liver of P388 leukemia bearing mice. There was also increase in specific activity of beta-Hexosaminidase and the B/A isoenzyme ratio. Administration of a 2% solution of alpha-Difluoromethylornithine (DFMO) immediately after inoculation of tumor cells prevented increases in polyamines in liver, but did not have any effect on gamma-Glutamyl Transpeptidase. Almost normal ratio of beta-Hexosaminidase B to A was maintained during treatment. Endogenous ornithine level was not altered both in treated and untreated mice. However, proline level was elevated in liver of untreated mice and DFMO prevented this increase. Glutathione levels were altered both by leukemia and DFMO in the host liver. The effect of drug was more prominent in the early stages rather than during terminal stages of leukemic growth.


Insulin, Insulin Everywhere: A Rare Case Report of Rabson-Mendenhall Syndrome.
Rabson-Mendenhall syndrome (RMS) is a rare autosomal recessive disorder characterized by severe insulin resistance, a condition in which the body's tissues and organs do not respond appropriately to the hormone insulin. Insulin resistance impairs blood sugar regulation and ultimately leads to diabetes mellitus. A 19-year-old male presented with joint pain, blurring of vision, and generalized weakness. Investigations revealed hyperglycemia (random blood sugar (RBS) > 625 mg/dL, glycosylated hemoglobin (HbA1c) 18%), as well as sugars, protein, and ketone bodies in urine routine examination. An ultrasound of the abdomen was normal. Cardiac status was normal. Based on the clinical features, particularly the head to toe examination, skin changes, and the onset of type 2 diabetes mellitus, RMS syndrome was considered. The joint pain was alleviated with intravenous tramadol. Actrapid®, a fast-acting insulin, was given to control sugar levels, along with metformin. Vitamin B12 and pregabalin were also supplemented. A dermatological cream containing ammonium chloride, calcium lactate, glycerin, potassium chloride, sodium dihydrogen phosphate, and urea was given for skincare. It is an extremely rare disease with a frequency of fewer than one million people worldwide. Most patients survive only up to 15 years of age, although some can live into their third decade of life. Hepatic gluconeogenesis and fatty acid oxidation are affected, leading to ketoacidosis. The progression is much faster in RMS. In RMS, the genetic defect affects the insulin receptor (INSR) gene transcription with non-sense mutations and causes splicing defects. This results in premature chain termination and eventually to lower amounts of the insulin receptor messenger ribonucleic acid (mRNA). Ultimately, the number and density of insulin receptors in the plasma membrane are smaller, making the cells resistant to insulin. Herein, we report the case of a 19-year-old patient with RMS who was treated in our hospital, leading to a successful improvement in symptoms and discharge of the patient.


Cultural diversity in adolescent health care.
In Australia, where about 16% of young people are born overseas and 24% are from a non-English-speaking background, adolescent health care is a multicultural challenge. "Cultural competency" involves challenging one's own cultural assumptions and beliefs, developing empathy for people from other cultures, and applying specific communication and interaction skills in clinical encounters. For health professionals, sensitivity to the cultural, ethnic, linguistic and social diversity among young people helps to avert problems and misunderstandings, improves satisfaction for all concerned and leads to better outcomes. Engaging the family and gaining the trust of parents is critical in treating young people from cultural backgrounds in which participation in health care is a family concern rather than an individual responsibility.


Characteristics of indoor aerosols in residential homes in urban locations: a case study in Singapore.
As part of a major study to investigate the indoor air quality in residential houses in Singapore, intensive aerosol measurements were made in an apartment in a multistory building for several consecutive days in 2004. The purpose of this work was to identify the major indoor sources of fine airborne particles and to assess their impact on indoor air quality for a typical residential home in an urban area in a densely populated country. Particle number and mass concentrations were measured in three rooms of the home using a real-time particle counter and a low-volume particulate sampler, respectively. Particle number concentrations were found to be elevated on several occasions during the measurements. All of the events of elevated particle concentrations were linked to indoor activities based on house occupant log entries. This enabled identification of the indoor sources that contributed to indoor particle concentrations. Activities such as cooking elevated particle number concentrations < or =2.05 x 10(5) particles/cm3. The fine particles collected on Teflon filter substrates were analyzed for selected ions, trace elements, and metals, as well as elemental and organic carbon (OC) contents. To compare the quality of air between the indoors of the home and the outdoors, measurements were also made outside the home to obtain outdoor samples. The chemical composition of both outdoor and indoor particles was determined. Indoor/outdoor (I/O) ratios suggest that certain chemical constituents of indoor particles, such as chloride, sodium, aluminum, cobalt, copper, iron, manganese, titanium, vanadium, zinc, and elemental carbon, were derived through migration of outdoor particles (I/O <1 or - 1), whereas the levels of others, such as nitrite, nitrate, sulfate, ammonium, cadmium, chromium, nickel, lead, and OC, were largely influenced by the presence of indoor sources (I/O >1).


Plasmon-enhanced fluorescence from single fluorophores end-linked to gold nanorods.
We reported a method to fabricate fluorescent probes preferentially end-linked to Au nanorods. In comparison with organic dyes, the single nanocomplexes provide significant improvement in signal brightness. The bioconjugated nanoantenna structure implicates an approach that is more convenient and amenable to integration for photonic, optoelectronic, and biotechnological applications.


Development of healthy and sustainable food-based dietary guidelines for the Netherlands.
To derive healthy and sustainable food-based dietary guidelines (FBDG) for different target groups in the Netherlands and describe the process. Optimised dietary patterns for children, adolescents, adults and the elderly were calculated using an optimisation model. Foods high in saturated and trans-fatty acids, salt and sugar, and low in dietary fibre, were excluded. The dietary patterns resembled the current food consumption as closely as possible, while simultaneously meeting recommendations for food groups, nutrients, maximum limits for foods with a high environmental impact, and within 85 % of the energy requirement. Recommended daily amounts of food groups were based on the optimised dietary patterns and expert judgement. The Netherlands. FBDG were derived for Dutch people with different ages, genders, activity levels and food preferences. For most target groups the optimisation model provided dietary patterns that complied with all requirements. For some food groups, the optimised amounts varied largely between target groups. For consistent messages to consumers, the optimised dietary patterns were adjusted to uniform recommendations per target group. Recommendations were visualised in the Wheel of Five. The advice is to eat the recommended amounts of foods according to the Wheel of Five and limit consumption of other foods. Based on an optimisation model, scientific evidence, information on dietary patterns and expert knowledge, we derived FBDG for different target groups. The Wheel of Five is a key food-counselling model that can help Dutch consumers to make their diets healthier and more environmentally sustainable.


Investigation of safety and efficacy of a pneumatic finger tourniquet.
Finger tourniquets are widely used in hand surgery. However, they do not provide an estimate of the amount of pressure exerted and can potentially be left in situ with grave consequences. We assessed the pneumatic finger tourniquet in 57 adult patients in operations under local anaesthesia distal to the proximal interphalangeal joint. The average tourniquet time was 12 minutes. The tourniquet maintained its pressure for the length of the operation in 96.5% of cases. This airtight flat tubing is made of synthetic polymer, designed and manufactured by Barloworld Scientific Ltd (Staffordshire, UK). The tourniquet was easy to use and easily located after the operation. No complications were reported. This study supports the use of a pneumatic tourniquet in finger injuries requiring use of a finger tourniquet.


Retrospectively self-reported age of childhood abuse onset in a United States nationally representative sample.
Child abuse is common and several studies have linked it to health outcomes throughout the lifecourse. Recent information about timing of abuse reported retrospectively is underrepresented in the literature, despite its importance to informing target populations for primary prevention of child abuse and studying effects of child abuse. This study uses data from Wave IV (2008-2009) of The National Longitudinal Study of Adolescent Health to Adult Health (N = 14,776) to describe distributions of retrospectively self-reported age of onset of childhood emotional, physical, and sexual abuse perpetrated by parents/adult caregivers and sexual abuse perpetrated by other individuals. Information on childhood abuse history was collected when participants were between 24 and 32 years old. Parental/adult caregiver perpetrated abuse frequently started in early childhood, particularly sexual abuse. Non-parental/adult caregiver sexual abuse motivated by physical force also started early in boys (median age = 7.21 years (95% CI: 5.92, 9.05)). Earlier onset of some types of abuse was associated with male sex, not being raised by both biological parents, and low childhood household income. Future studies should further examine timing of childhood abuse onset and include diverse measures of abuse, including those derived from longitudinal studies and validated reports. If these results are replicated, they suggest that abuse, particularly sexual abuse perpetrated by parents/adult caregivers, often starts in early childhood, and preventive interventions should be designed to protect younger children.


InGaAs/InP Avalanche Photodiode for Single Photon Detection with Zinc Diffusion Process Using Metal Organic Chemical Vapor Deposition.
In this paper, we describe a design, simulation, and fabrication of an InGaAs/InP single photon avalanche photodiode (SPAD), which requires a much higher gain, compared to APD's for conventional optical communications. To achieve a higher gain, an efficient multiplication width control is essential because it significantly affects the overall performance including not only gain but also noise characteristics. Normally, the multiplication layer width is controlled by the Zinc diffusion process. For the reliable and controllable diffusion process, we used metal organic chemical vapor deposition (MOCVD). The controllability of the proposed diffusion process is proved by the diffusion depth measurement of the fabricated devices which show the proportional dependence on the square root of the diffusion time. As a result, we successfully implemented the SPAD that exhibits a high gain enough to detect single photons and a very low dark current level of about 0.1 nA with 0.95 breakdown voltage. The single photon detection efficiency of 15% was measured at the 100 kHz gate pulse rate and the temperature of 230 K.


Fusarium graminearum species complex occurrence on soybean and F. graminearum sensu stricto inoculum maintenance on residues in soybean-wheat rotation under field conditions.
The aims of this study were to determine the occurrence of Fusarium graminearum species complex (FGSC) on soybean pods, seeds and roots, including rhizoplane, during the period of soybean crop in rotation with wheat and to evaluate the FGSC dynamics on wheat and soybean residues during two soybean growing seasons in rotation with wheat, particularly F. graminearum sensu stricto (FGss). Soybean roots, pods and seeds were analysed during 2012/13 and 2013/14 seasons. The morphological identification of FGSC and mycotoxin analysis was done. Crop residues were taken in both soybean season in wheat rotation and FGss were quantificated by real-time PCR. The results showed that Fusarium species, mainly FGSC, survive in a soybean crop in rotation with wheat. Isolation frequency of these species was higher on soybean pods than on seeds at R6 stage. Deoxynivalenol contamination on soybean seeds was higher in the 2013/14 season in comparison with the 2012/13 season. Low isolation levels of Fusarium species and species that did not belong to FGSC were observed in soybean root, whereas in rhizoplane a higher level was observed. Fusarium species inoculum on residues remained stable during crop succession and the FGSC were recovered from both wheat and soybean residues. Real time PCR data showed a higher DNA concentration of FGss in wheat residues in the first developmental stages of soybean plants, being the levels more significant during 2012/13 season. With regard to soybean residues collected during the wheat growing stages, an increase in DNA from anthesis until wheat harvest was observed. In a no-till production system, the populations of FGSC can colonize wheat and soybean residues to become an inoculum source. This study provides new data on the occurrence of FGSC populations in soybean plant and FGss on residues in soybean-wheat rotation, a cultural practice commonly used in in Argentina.


Intricate phase diagram of a prevalent visual circuit reveals universal dynamics, phase transitions, and resonances.
Neural feedback-triads consisting of two feedback loops with a nonreciprocal lateral connection from one loop to the other are ubiquitous in the brain. We show analytically that the dynamics of this network topology are determined by algebraic combinations of its five synaptic weights. Exploration of network activity over the parameter space demonstrates the importance of the nonreciprocal lateral connection and reveals intricate behavior involving continuous transitions between qualitatively different activity states. In addition, we show that the response to periodic inputs is narrowly tuned around a center frequency determined by the effective synaptic parameters.


Pilot study evaluating a clinical decision tool on suspected scaphoid fractures.
In an earlier study we have proposed a scaphoid decision-protocol in order to improve diagnostic accuracy in case of suspected scaphoid fractures. This pilot study evaluated this protocol. In this pilot study (n = 31) most cases with clinical suspicion of scaphoid fractures reached a positive test result on the combined 7 clinical tests (93.5%). Using this test combination, no scaphoid fractures were missed (no false-negatives; sensitivity 100%), but it also included many patients with no scaphoid fracture. Many of these, however, were found to have another fracture. In total, 48% had a scaphoid fracture, 19% another fracture and 32% no fracture. In the pilot study the proposed protocol seems to be a safe protocol, without missing scaphoid fractures. It leads to a reduction of unnecessary plaster casting of sprained wrists and produces a marked reduction in plain radiographic examinations.


Smad7 sensitizes tumor necrosis factor induced apoptosis through the inhibition of antiapoptotic gene expression by suppressing activation of the nuclear factor-kappaB pathway.
Although tumor necrosis factor (TNF) induces apoptosis and cell death in many tumor cells, some cancer cells are still resistant to the TNF-induced death signal. In this report, we showed that Smad7, an inhibitory Smad of transforming growth factor-beta (TGF-beta) signaling, can overcome the TNF resistance in human breast and gastric cancer cells. Overexpression of Smad7 induces the degradation of poly(ADP-ribose) polymerase and the activation of caspase cascade. Although c-Jun NH2-terminal kinase (JNK) signaling is involved in TNF-induced cell death, the expression of Smad7 does not synergize the activation of JNK. However, the activation of nuclear factor-kappaB (NF-kappaB), the cell survival factor, is markedly decreased in Smad7-stable cells. Furthermore, the expression of antiapoptotic target genes of NF-kappaB is significantly reduced in accordance with the level of Smad7. In addition, Smad7 mediates the inhibitory activity of TGF-beta on TNF-induced NF-kappaB activation and the synergistic activity of TGF-beta on TNF-induced apoptosis. These findings suggest that Smad7 sensitizes the tumor cells to TNF-induced apoptosis through the inhibition of expression of antiapoptotic NF-kappaB target genes.


Does the psychological profile of a patient with frozen shoulder predict future outcome? A systematic review.
Frozen shoulder (FS) is defined as a condition characterised by functional restriction and daily and nightly pain. As in other shoulder pathologies, the manifestation of psychological factors is recognised in FS; however, from a psychological point of view, only few studies have reported its prognostic value. The aim of this systematic review is to investigate, in patients with FS, the prognostic value of psychological factors on pain, function, disability, health-related quality of life, return to work and time to recovery. This systematic review was reported following the Preferred Reporting Items for Systematic reviews and Meta-Analysis-PRISMA 2020 guideline. The authors followed the Cochrane Handbook for Systematic review of Intervention as methodological guidance. The Quality in Prognostic Studies-QUIPS tool was used to assess the risk of bias. Pain-related fear and depression could be prognostic regarding patient-reported outcome measures assessing shoulder function, disability, and pain; instead, pain catastrophizing could have a prognostic value assessed by the disability of the arm shoulder and hand -DASH scale. Anxiety would appear to impact on disability and pain. As widely reported in numerous musculoskeletal conditions, also in FS psychological factors influence the physical dimension such as pain, disability and function. Therefore, clinicians should be encouraged to identify these factors through a comprehensive assessment of the bio-psychological profile of each individual with FS. Perhaps, patients with FS that show such psychological prognostic factors could benefit from a comprehensive and shared approach with other dedicated professionals.


N7-methylguanosine methylation of tRNAs regulates survival to stress in cancer.
Tumour progression and therapy tolerance are highly regulated and complex processes largely dependent on the plasticity of cancer cells and their capacity to respond to stress. The higher plasticity of cancer cells highlights the need for identifying targetable molecular pathways that challenge cancer cell survival. Here, we show that N7-guanosine methylation (m7G) of tRNAs, mediated by METTL1, regulates survival to stress conditions in cancer cells. Mechanistically, we find that m7G in tRNAs protects them from stress-induced cleavage and processing into 5' tRNA fragments. Our analyses reveal that the loss of tRNA m7G methylation activates stress response pathways, sensitising cancer cells to stress. Furthermore, we find that the loss of METTL1 reduces tumour growth and increases cytotoxic stress in vivo. Our study uncovers the role of m7G methylation of tRNAs in stress responses and highlights the potential of targeting METTL1 to sensitise cancer cells to chemotherapy.


Intracisternal neurinoma of the C1 posterior root.
We report a rare intracisternal C1 posterior root neurinoma in a 35-year-old man without neurofibromatosis who presented with headache, nuchal pain, bilateral motor weakness of the upper extremities, and numbness in the right distal upper extremity. CT and MRI study showed a 20-mm intracisternal lesion at the foramen magnum. At surgery, there was an anastomosis between the C1 posterior root and a spinal accessory nerve at the site of the tumor; the root from the collateral sulcus of this C1 root was absent. Postoperatively, the patient remains free of symptoms. Foramen magnum neurinomas have been described as accessory nerve tumors. We present new anatomical consideration regarding this lesion.


16s rRNA gene sequencing and radioisotopic analysis reveal the composition of ammonia acclimatized methanogenic consortia.
Different mesophilic and thermophilic methanogenic consortia were acclimatised and enriched to extreme total ammonia (9.0 and 5.0 g NH4+-N L-1, respectively) and free ammonia (1.0 and 1.4 g NH3-N L-1, respectively) levels in this study. [2-14C] acetate radioisotopic analyses showed the dominance of aceticlastic methanogenesis in all enriched consortia. According to 16S rRNA gene sequencing result, in mesophilic consortia, methylotrophic Methanomassiliicoccus luminyensis was predominant, followed by aceticlastic Methanosarcina soligelidi. A possible scenario explaining the dominance of M. luminyensis includes the use of methylamine produced by Tissierella spp. and biomass build-up by metabolizing acetate. Nevertheless, further studies are needed to pinpoint the exact metabolic pathway of M. luminyensis. In thermophilic consortia, aceticlastic Methanosarcina thermophila was the sole dominant methanogen. Overall, results derived from this study demonstrated the efficient biomethanation ability of these ammonia-tolerant methanogenic consortia, indicating a potential application of these consortia to solve ammonia toxicity problems in future full-scale reactors.


Extreme fluctuations and the finite lifetime of the turbulent state.
We argue that the transition to turbulence is controlled by large amplitude events that follow extreme distribution theory. The theory suggests an explanation for recent observations of the turbulent state lifetime which exhibit superexponential scaling behavior with Reynolds number.


[Prescription of strong analgesics in the out-of-hours general practice in the county of Aarhus].
The article describes the ordination of opioid analgesics in the out-of-hours general practice service to patients with pain due to an illness lasting for more than two days. The physicians working out-of-hours duty and the patient's GP answered a questionnaire. The research includes 227 contacts. The results showed that the main diagnoses were: migraine/headache (33%), angina pectoris (19%) and back-pain (11%). The physicians estimated 33% of the contacts to be "less necessary" or "unnecessary". In 78% of the cases the GPs "agreed" or "almost agreed" with the deputizing doctors' use of opioids. In most of the cases the patients' usual GPs agreed with the treatment prescribed by the deputizing doctors. There seems to be a disagreement between the GPs and the Danish National Board of Health about the principles concerning the use of opioids.


Pregnancy after transfer of embryos which were generated from in-vitro matured oocytes.
In-vitro maturation of human oocytes is an important technique in assisted reproduction due to its potential for reducing the use of fertility drugs. We offered this technique as an alternative to cancelling the cycle to a patient who was at risk of ovarian hyperstimulation syndrome (OHSS) after treatment with gonadotrophin-releasing hormone analogue (GnRHa) and human menopausal gonadotrophin (HMG). The patient had 40 visible antral follicles with a maximum diameter of 13 mm and an oestradiol concentration of 14,000 pmol/l on cycle day 12. Immature oocytes were aspirated transvaginally under ultrasound guidance. Ten cumulus-enclosed oocytes were harvested and nine of them completed nuclear maturation to metaphase II after 48 h in culture. By 18 h after an intracytoplasmic sperm injection (ICSI) procedure, seven of these metaphase II stage oocytes displayed two distinct pronuclei and two polar bodies. All fertilized oocytes but one underwent cleaveage; four of these were transferred 2 days later. Endometrial priming was initiated with 8 mg oestradiol valerate daily from the day of oocyte retrieval and 50 mg progesterone was injected i.m. daily starting 2 days after that. A single intrauterine sac was seen containing one fetus with positive fetal heart beat on ultrasound at 7 weeks of gestation. Unfortunately, the pregnancy ended at 24 weeks shortly after premature rupture of membranes; a live healthy-looking girl was delivered who died 18 days later.


Stimulus duration and frequency discrimination for normal-hearing and hearing-impaired subjects.
Frequency discrimination for 500- and 2000-Hz pure tones at durations of 5, 10, 20, 50, and 200 ms was determined for 10 normal-hearing and 10 cochlear-impaired listeners. Listeners from both groups demonstrated monotonic increases in frequency difference limens as stimulus duration decreased. The functions of the hearing-impaired listeners were parallel to those of the normal-hearing listeners for stimulus durations between 10 and 200 ms, but the overall performance of the hearing-impaired group was poorer than that of the normal-hearing group. The functions of many of the cochlear-impaired subjects were less steep than normal for the shortest durations tested (between 5 and 10 ms). There appeared to be no relation between temporal integration for frequency discrimination and temporal integration for detection threshold. The results are discussed in terms of processes of temporal integration and frequency selectivity.


Asthma management in school: parents' and school personnel perspectives.
Objective: Effective asthma management at school can help students with asthma stay healthy, learn better and participate fully during their school day. This study sought to understand school-based asthma care from the perspective of parents and school personnel to improve asthma care at school. Methods: A cross-sectional study was conducted in Hartford, CT. School personnel from 59 schools and 322 parents/guardians were invited to participate. Four cross-sectional surveys using Likert-type scales assessed parental and school personnel satisfaction, confidence in managing asthma, policy awareness, management of asthma during physical activity, and perceived gaps surrounding school-based asthma care. Results: 263/322 (82%) eligible parents of children with asthma (mean age 8.5 ± 4.3, 56% Hispanic, 30% African American) completed surveys. Thirty six school nurses (62%), 131 teachers (8%), 14 coaches (14%), and 17 school principals (29%) participated. 90% of parents were satisfied with asthma management in school. School nurses were more aware of asthma policies than teachers (74% vs. 24%, p < 0.001). 34% of school nurses, 30% of teachers and 36% of coaches were unaware of asthma-related absences. 14% of physical education teachers/coaches reported no asthma training. Conclusion: In this convenience sample of parents and school personnel, parents reported overall satisfaction regarding the asthma care their children receive at school, yet a number of gaps pertaining to school-based asthma care were identified. Increased asthma training and enhanced communication among school personnel is needed to address these gaps. National guidelines and resources are readily available to improve asthma care at school.


Red blood cell glutathione levels before and during treatment with neoadjuvant chemotherapy cisplatin/5-fluorouracil in patients with head and neck squamous cell carcinoma.
The purpose of this study was to find out whether the glutathione (GSH), in red blood cells could predict the response to neoadjuvant chemotherapy cisplatin/5-fluorouracil (CDDP/5-FU) in patients with head and neck squamous cell carcinoma (HNSCC). Three courses of induction chemotherapy with CDDP/5-FU were administered and followed by surgery and radiotherapy or radiotherapy alone, in 51 patients with HNSCC. GSH was measured by spectrophotometry in red blood cell before any treatment (Sample 1: S1), after each course of chemotherapy (S2, S3, S4). Our results showed that GSH was the same at diagnosis in patients with complete or partial response (OR) compared to those with stable or progressive disease (NR). With regard to evolution of the GSH during the 3 courses of CT a significant difference was found between courses (S2: 5.06 +/- 0.35 vs S4 = 3.61 +/- 0.4 mumol/g haemoglobin, p < 0.05). When we separated our patients into OR and NR, a significant difference was found over the 3 courses of chemotherapy for GSH content. Non responder patients showed decreased GSH content at the end of the treatment, (S2: 5 +/- 0.5 vs S4: 2.2 +/- 0.4 mumol/g haemoglobin, p < 0.05) while OR were stable. In conclusion, red blood cell GSH seems to have no early predictive value for chemoresponse to neoadjuvant chemotherapy CDDP/5-FU in HNSCC.


Completeness and reliability of mortality data in Viet Nam: Implications for the national routine health management information system.
Mortality statistics form a crucial component of national Health Management Information Systems (HMIS). However, there are limitations in the availability and quality of mortality data at national level in Viet Nam. This study assessed the completeness of recorded deaths and the reliability of recorded causes of death (COD) in the A6 death registers in the national routine HMIS in Viet Nam. 1477 identified deaths in 2014 were reviewed in two provinces. A capture-recapture method was applied to assess the completeness of the A6 death registers. 1365 household verbal autopsy (VA) interviews were successfully conducted, and these were reviewed by physicians who assigned multiple and underlying cause of death (UCOD). These UCODs from VA were then compared with the CODs recorded in the A6 death registers, using kappa scores to assess the reliability of the A6 death register diagnoses. The overall completeness of the A6 death registers in the two provinces was 89.3% (95%CI: 87.8-90.8). No COD recorded in the A6 death registers demonstrated good reliability. There is very low reliability in recording of cardiovascular deaths (kappa for stroke = 0.47 and kappa for ischaemic heart diseases = 0.42) and diabetes (kappa = 0.33). The reporting of deaths due to road traffic accidents, HIV and some cancers are at a moderate level of reliability with kappa scores ranging between 0.57-0.69 (p<0.01). VA methods identify more specific COD than the A6 death registers, and also allow identification of multiple CODs. The study results suggest that data completeness in HMIS A6 death registers in the study sample of communes was relatively high (nearly 90%), but triangulation with death records from other sources would improve the completeness of this system. Further, there is an urgent need to enhance the reliability of COD recorded in the A6 death registers, for which VA methods could be effective. Focussed consultation among stakeholders is needed to develop a suitable mechanism and process for integrating VA methods into the national routine HMIS A6 death registers in Viet Nam.


COX2 Enhances Neovascularization of Inflammatory Tenocytes Through the HIF-1α/VEGFA/PDGFB Pathway.
Tendon injuries are among the most challenging in orthopedics. During the early tendon repair, new blood vessel formation is necessary. However, excessive angiogenesis also exacerbates scar formation, leading to pain and dysfunction. A significantly worse outcome was associated with higher expression levels of hypoxia-inducible factor-1 alpha (HIF-1α), and its transcriptional targets vascular endothelial growth factor A (VEGFA) and platelet-derived growth factor B (PDGFB), but the underlying molecular mechanisms remain unclear. In this study, lipopolysaccharide (LPS) was used to induce an inflammatory response in tenocytes. LPS increased the tenocytes' inflammatory factor COX2 expression and activated the HIF-1α/VEGFA/PDGFB pathway. Moreover, the conditioned medium from the tenocytes boosted rat aortic vascular endothelial cell (RAOEC) angiogenesis. Furthermore, Trichostatin A (TSA), an inhibitor of histone deacetylase, was used to treat inflammatory tenocytes. The expression levels of HIF-1α and its transcriptional targets VEGFA and PDGFB decreased, resulting in RAOEC angiogenesis inhibition. Finally, the dual-luciferase reporter gene assay and chromatin immunoprecipitation (ChIP) assay proved that the HIF-1α/PDGFB pathway played a more critical role in tenocyte angiogenesis than the HIF-1α/VEGFA pathway. TSA could alleviate angiogenesis mainly through epigenetic regulation of the HIF-1α/PDGFB pathway. Taken together, TSA might be a promising anti-angiogenesis drug for abnormal angiogenesis, which is induced by tendon injuries.


Impact of school peanut-free policies on epinephrine administration.
Children with food allergies spend a large proportion of time in school but characteristics of allergic reactions in schools are not well studied. Some schools self-designate as peanut-free or have peanut-free areas, but the impact of policies on clinical outcomes has not been evaluated. We sought to determine the effect of peanut-free policies on rates of epinephrine administration for allergic reactions in Massachusetts public schools. In this retrospective study, we analyzed (1) rates of epinephrine administration in all Massachusetts public schools and (2) Massachusetts public school nurse survey reports of school peanut-free policies from 2006 to 2011 and whether schools self-designated as "peanut-free" based on policies. Rates of epinephrine administration were compared for schools with or without peanut-restrictive policies. The percentage of schools with peanut-restrictive policies did not change significantly in the study time frame. There was variability in policies used by schools self-designated as peanut-free. No policy was associated with complete absence of allergic reactions. Both self-designated peanut-free schools and schools banning peanuts from being served in school or brought from home reported allergic reactions to nuts. Policies restricting peanuts from home, served in schools, or having peanut-free classrooms did not affect epinephrine administration rates. Schools with peanut-free tables, compared to without, had lower rates of epinephrine administration (incidence rate per 10,000 students 0.2 and 0.6, respectively, P = .009). These data provide a basis for evidence-based school policies for children with food allergies. Further studies are required before decisions can be made regarding peanut-free policies in schools.


Ultraviolet-induced surface grafting of octafluoropentyl methacrylate on polyether ether ketone for inducing antibiofilm properties.
Since octafluoropentyl methacrylate is an antifouling polymer, surface modification of polyether ether ketone with octafluoropentyl methacrylate is a practical approach to obtaining anti-biofilm biocompatible devices. In the current study, the surface treatment of polyether ether ketone by the use of ultraviolet irradiation, so as to graft (octafluoropentyl methacrylate) polymer chains, was initially implemented and then investigated. The Fourier-transform infrared and nuclear magnetic resonance spectra corroborated the appearance of new signals associated with the fluoroacrylate group. Thermogravimetric curves indicated enhanced asymmetry in the polymer structure due to the introduction of the said new groups. Measuring the peak area in differential scanning calorimetry experiments also showed additional bond formation. Static water contact angle measurements indicated a change in wettability to the more hydrophobic surface. The polyether ether ketone-octafluoropentyl methacrylate surface greatly reduced the protein adsorption. This efficient method can modulate and tune the surface properties of polyether ether ketone according to specific applications.


[Effect of serum from patients with kerion celsi on organ culture of chick embryo skin].
In the present work the Authors have studied the differentiation and the cellular multiplication of chick embryo skin incubated in vitro with normal human sera or with pathological human sera from patients affected by Kerion Celsi. In the following research the Authors have studied the skin structure by an optical and electron microscope and the thymidine 3H incorporation. The result demonstrates that the pathological human serum does not interfere with the multiplication and the differentiation of the skin in vitro, but displays a cytoaggressive action that induces a noticeable cytoplasmic vacuolation.


Structural elements necessary for oligomerization, trafficking, and cell sorting function of paraxial protocadherin.
Protocadherins have been shown to regulate cell adhesion, cell migration, cell survival, and tissue morphogenesis in the embryo and the central nervous system, but little is known about the mechanism of protocadherin function. We previously showed that Xenopus paraxial protocadherin (PAPC) mediates cell sorting and morphogenesis by down-regulating the adhesion activity of a classical cadherin, C-cadherin. Classical cadherins function by forming lateral dimers that are necessary for their adhesive function. However, it is not known whether oligomerization also plays a role in protocadherin function. We show here that PAPC forms oligomers that are stabilized by disulfide bonds formed between conserved Cys residues in the extracellular domain. Disruption of these disulfide bonds by dithiothreitol or mutation of the conserved cysteines results in defects in oligomerization, post-translational modification, trafficking to the cell surface and cell sorting function of PAPC. Furthermore, none of the residues in the cytoplasmic domain of PAPC is required for its cell sorting activity, whereas both the transmembrane domain and the extracellular domain are necessary. Therefore, protein oligomerization and/or protein interactions via the extracellular and transmembrane domains of PAPC are required for its cell sorting function.


In vitro comparison of the load-bearing capacity of ceramic and metal-ceramic resin-bonded fixed dental prostheses in the posterior region.
The clinical use of ceramic resin-bonded fixed dental prostheses (RBFDPs) in the posterior region is desirable for esthetic and biological reasons but has been associated with many technical problems, including fractures or chipping of the veneer. Although these problems may be overcome by using monolithic zirconia, information is lacking about the load-bearing capacity of resin-bonded monolithic zirconia restorations for replacing a molar. The purpose of this in vitro study was to compare the load-bearing capacity (Fu), the load at initial damage (F1d), and the failure pattern of posterior RBFDPs fabricated from monolithic zirconia (MZr), veneered zirconia (VZr), and veneered cobalt-chromium (VCo). For the replacement of a maxillary first molar, 4 groups (n=8) of RBFDPs differing in prosthesis material and retainer design (MZr-IR-RBFDPs, VZr-IR-RBFDPs, MZr-WR-RBFDPs, and VCo-WR-RBFDPs; IR, inlay-retained; WR, adhesive wing-retained) were fabricated with anatomic congruence of the FDP-abutment complex. The RBFDPs were subjected to thermocycling (10000×6.5°C/60°C) and mastication simulation (30-degree oblique loading on the pontic; 1200000×108 N) and then loaded until failure in a universal testing machine (0.5 mm/minute). Test forces correlating with Fu and F1d were recorded. Statistical analysis was performed by using 2-way analysis of variance (ANOVA), 2-way repeated measures ANOVA, and the Tukey honest significant differences post hoc test (2-sided α=.05). Fu was significantly affected by retainer design (P<.001) and F1d by both retainer design (P<.001) and prosthesis material (P<.001). Fu was more than 2000 N for WR-RBFDPs and more than 1000 N for IR-RBFDPs (Tukey test ranking: MZr-WR-RBFDPs = VCo-WR-RBFDPs > MZr-IR-RBFDPs = VZr-IR-RBFDPs). Ceramic RBFDPs failed by complete fracture in the connector region, whereas failure of VCo-WR-RBFDPs was limited to the ceramic veneer. F1d was significantly lower (P≤.004) than Fu for veneered specimens only; F1d started at test forces below 500 N and coincided with veneer cracking. Load-bearing capacity suitable for the definitive restoration of a molar was observed for all groups. Veneered resin-bonded fixed dental prostheses, however, were susceptible to cracking of the veneer.


The psychometric properties of the Trauma Symptom Checklist For Children (TSCC) in a sample of Swedish children.
To evaluate the psychometric properties of the Swedish version of the Trauma Symptom Checklist for Children (TSCC) and to study traumatic symptoms in a normative group of Swedish children and adolescents. A normative group of 728 children and adolescents age 10-17 and a clinical group of 91 children and adolescents known to have experienced sexual abuse participated in the study. A test-retest procedure was conducted with 79 participants from the normative group. Good reliability such as internal consistency (Cronbach's alpha) for the total scale .94 (ranging in the clinical scales .78-.83) and test-retest for the total scale r=.81 (ranging in the clinical scales .67-.81) were found. The confirmatory 6-factor analysis explained 50.7% of the variance. Other validity measures such as concurrent validity and criterion related validity were also shown to be satisfactory. The normative sample of Swedish children and adolescents showed lower means on the subscales than has been reported in previous studies from a number of other countries. The Swedish version of TSCC has been shown to be a screening instrument with satisfactory psychometric qualities that is capable to identify trauma symptoms among children and adolescents who have themselves self-reported experiencing trauma or for whom clinicians have identified traumatic experiences.


[Reconstructive operations in surgical treatment of vasorenal hypertension].
The experience of 313 reconstructive operations performed in 289 patients with renovascular hypertension is analysed. The importance of choosing the surgical procedure with due regard of the etiology and extent of the pathological process is emphasized. The most effective and frequently employed reconstructive procedures consisted in the author's original technique of transaortic endarterectomy (232 operations), resection of the renal artery with reimplantation of the ostium into the aorta (19 operations), renal artery resection with an end-to-end anastomosis (23 operations). In cases of bilateral lesions of the renal arteries two-stage procedures are recommended, spaced 3-4 months apart. Reconstructive interventions on the single renal artery are described.


Mismatched training and test distributions can outperform matched ones.
In learning theory, the training and test sets are assumed to be drawn from the same probability distribution. This assumption is also followed in practical situations, where matching the training and test distributions is considered desirable. Contrary to conventional wisdom, we show that mismatched training and test distributions in supervised learning can in fact outperform matched distributions in terms of the bottom line, the out-of-sample performance, independent of the target function in question. This surprising result has theoretical and algorithmic ramifications that we discuss.