Twin boundaries can be moved by step edges during film growth.
We track individual twin boundaries in Ag films on Ru(0001) using low-energy electron microscopy. The twin boundaries, which separate film regions whose close-packed planes are stacked differently, move readily during film growth but relatively little during annealing. The growth-driven motion of twin boundaries occurs as film steps advance across the surface--as a new atomic Ag layer reaches an fcc twin boundary, the advancing step edge carries along the boundary. This coupling of the microstructural defect (twin boundary) and the surface step during growth can produce film regions over 10 microm wide that are twin free.


The antioxidant potential of the Mediterranean diet.
The Mediterranean diet not only produces favourable effects on blood lipids but also protects against oxidative stress. Oxidative damage is thought to represent one of the mechanisms leading to chronic diseases such as atherosclerosis and cancer. Many studies suggest that a link exists between fruit and vegetables in the diet or the amounts of plasma antioxidant vitamins (ascorbic acid, tocopherol and carotenoids) and risk of death from cancer or coronary heart diseases. Although a large emphasis has been given to different components of the diet, attention has recently shifted to the diet as a whole. The Mediterranean diet is able to modulate oxidative stress through complex mechanisms and not just the high antioxidant compound content. The preference for fresh fruit and vegetables in the Mediterranean diet will result in a higher consumption of raw foods, a lower production of cooking-related oxidants and a consequent decreased waste of nutritional and endogenous antioxidants. The high intake of antioxidant and fibre helps to scavenge even the small amount of oxidants or oxidized compounds.


Palliative Care: Opportunities for Nursing.
Ayda G. Nambayan, PhD, RN is the Training Consultant for The Ruth Foundation for Palliative and Hospice Care. Prior to this, she held various positions as a Consultant for Advanced Education and Training at Makati Medical Center, Philippines; a curriculum and distance learning developer for www.Cure4Kids.org, the educational website of the International Outreach Program of St. Jude Children's Research Hospital in Memphis, TN. In 2002, she retired from a faculty position from the University of Alabama at Birmingham, where she taught Adult Health Nursing for 25 years. Her nursing degrees were from the University of Santo Tomas, Manila, Philippines, Teacher's College, Columbia University in New York, NY and The University of Alabama at Birmingham, Birmingham, AL. Among her many professional awards include the Oncology Nursing Society's Pearl Moore Making a Difference Award in Oncology Nursing, International Award for Contributions in Cancer Care and the End of Life Nursing Education Consortium award for Pediatric Education.


[Autosomal dominant distal myopathy with rimmed vacuoles and cytoplasmic inclusions: report of a family].
We reported four patients with distal myopathy in the same family. Muscle weakness and atrophy started in the lower extremities, especially in the calf muscle, and it extended to the upper extremities and pelvic muscles to a variable extent. Facial and bulbar muscles were slightly involved in one case. The anterior tibial muscle tended to be better preserved than the calf muscle. Cardiac abnormalities were absent in any case. Serum creatine kinase activity was normal or mildly elevated. Skeletal muscle biopsies revealed myopathic process presenting rimmed vacuoles, eosinophilic cytoplasmic inclusions and/or subsarcolemmal mass. Ultrastructurally, cytoplasmic inclusions were composed of electron dense granular material and intermediate-sized filaments. There were membranous whorls and myelin-like figures which were the characteristic findings of rimmed vacuoles. Immunohistochemistry revealed accumulation of desmin, dystrophin and vimentin in the cytoplasm of degenerating muscle fibers and in the inclusion. In present patients, cardiac function was normal and the tibialis anterior muscle was relatively spared. These features were different from the autosomal dominant rimmed-vacuolar myopathy with desmin storage described in previous reports.


Trace Water Changes Metal Ion Speciation in Deep Eutectic Solvents: Ce3+ Solvation and Nanoscale Water Clustering in Choline Chloride-Urea-Water Mixtures.
Eutectic mixtures of choline chloride, urea, and water in deep eutectic solvent (DES)/water molar hydration ratios (w) of 2, 5, and 10, with dissolved cerium salt, were measured using neutron diffraction with isotopic substitution. Structures were modeled using empirical potential structure refinement (EPSR). Ce3+ was found to form highly charged complexes with a mean coordination number between 7 and 8, with the shell containing mostly chloride, followed by water. The shell composition is strongly affected by the molar ratio of dilution, as opposed to the mass or volume fraction, due to the high affinity of Cl- and H2O ligands that displace less favorable interactions with ligands such as urea and choline. The presence of Ce3+ salt disrupted the bulk DES structure slightly, making it more electrolyte-like. The measured coordination shell of choline showed significant discrepancies from the statistical noninteracting distribution, highlighting the nonideality of the blend. Cluster analysis revealed the trace presence of percolating water clusters (25 ≥ n ≥ 2) in solvent compositions of 5 and 10w for the first time.


Treatment of Primary Shoulder Stiffness: Results of a Survey on Surgeon Practice Patterns in Italy.
Objectives Shoulder stiffness is a condition of restricted glenohumeral range of motion (ROM), which can arise spontaneously or as consequence of a known cause. Several treatment options are available and currently no consensus has been obtained on which treatment algorithm represents the best choice for the patient. The aim of this study was to investigate surgeon practice patterns in Italy regarding treatment of primary shoulder stiffness. Methods A literature review was performed to identify randomized controlled trials reporting results of shoulder stiffness treatment. The following controversial or critical points in the treatment of primary shoulder stiffness were identified: modalities of physical therapy; indication for oral corticosteroid; indication and frequency for injective corticosteroid; technique and site of injection; and indication, timing, and technique for surgery. A survey composed by 14 questions was created and administrated to the members of a national association specialized in orthopaedics and sports traumatology (SIGASCOT at the time of survey completion, recently renamed SIAGASCOT after the fusion of the societies SIGASCOT and SIA). Results A total of 204 completed questionnaires were collected. Physical therapy was recommended by 98% of the interviewed. The use of oral corticosteroids was considered by 51%, and injections of corticosteroids by 72%. The posterior injection approach was the one preferred and a number of three was considered the upper limit for repeated injections. Injective therapy with local anesthetics and hyaluronic acid was considered by more than 20% of the interviewed. Thirty percent of the interviewed did not treat shoulder stiffness surgically. Conclusion Several approaches to shoulder stiffness have been proposed and high-level evidence is available to analyze and discuss their results. Several controversial points emerged both from a literature review and from this national survey. Treatment of shoulder stiffness should be tailored to the patient's clinical situation and the stage of its pathology and should aim at pain reduction, ROM restoration, functional regain, and shortening of symptoms duration, with conservative therapy remaining the mainstay of treatment.


An experimental renal acidification defect in patients with hereditary fructose intolerance. II. Its distinction from classic renal tubular acidosis; its resemblance to the renal acidification defect associated with the Fanconi syndrome of children with cystinosis.
In adult patients with hereditary fructose intolerance (HFI) fructose induces a renal acidification defect characterized by (a) a 20-30% reduction in tubular reabsorption of bicarbonate (T HCO(3) (-)) at plasma bicarbonate concentrations ranging from 21-31 mEq/liter, (b) a maximal tubular reabsorption of bicarbonate (Tm HCO(3) (-)) of approximately 1.9 mEq/100 ml of glomerular filtrate, (c) disappearance of bicarbonaturia at plasma bicarbonate concentrations less than 15 mEq/liter, and (d) during moderately severe degrees of acidosis, a sustained capacity to maintain urinary pH at normal minima and to excrete acid at normal rates. In physiologic distinction from this defect, the renal acidification defect of patients with classic renal tubular acidosis is characterized by (a) just less than complete tubular reabsorption of bicarbonate at plasma bicarbonate concentrations of 26 mEq/liter or less, (b) a normal Tm HCO(3) (-) of approximately 2.8 mEq/100 ml of glomerular filtrate, and (c) during acidosis of an even severe degree, a quantitatively trivial bicarbonaturia, as well as (d) a urinary pH of greater than 6. That the fructose-induced renal acidification defect involves a reduced H(+) secretory capacity of the proximal nephron is supported by the magnitude of the reduction in T HCO(3) (-) (20-30%) and the simultaneous occurrence and the persistence throughout administration of fructose of impaired tubular reabsorption of phosphate, alpha amino nitrogen and uric acid.A reduced H(+) secretory capacity of the proximal nephron also appears operative in two unrelated children with hyperchloremic acidosis, Fanconi's syndrome, and cystinosis. In both, T HCO(3) (-) was reduced 20-30% at plasma bicarbonate concentrations ranging from 20-30 mEq/liter. The bicarbonaturia disappeared at plasma bicarbonate concentrations ranging from 15-18 mEq/liter, and during moderate degrees of acidosis, urinary pH decreased to less than 6, and the excretion rate of acid was normal.


[Contrast study of cardiac output and oxygen metabolism in infants with congenital heart disease after cardiopulmonary bypass].
To conduct a contrast study of postoperative cardiac output and oxygen metabolism in infants with congenital heart disease undergoing cardiopulmonary bypass. Retrospective analysis was conducted for 55 case of congenital heart disease from January 2006 to January 2009 at our hospital. There were 34 males and 21 females. And they were divided into simple group (n = 30) and complex group (n = 25). In the simple group, all had pulmonary arterial hypertension and there were simple ventricular septal defect (VSD) (n = 15), atrial septal defect (ASD) + VSD (n = 9) and ASD + VSD + patent ductus arteriosus (PDA) (n = 6); in the complex group, there were tetralogy of Fallot (TOF) (n = 12), double outlet of right ventricular with pulmonary stenosis (DORV) (n = 8) and total anomalous pulmonary vein connection (TAPVC) (n = 5). All completed cardiopulmonary bypass procedures under venous injection and inhalation anesthesia. Cardiac outputs were measured by the thermodilution method with a 4 F Swan-Ganz floating catheter at operation completion and postoperative 4, 8, 12, 24, 48, 72 h. Arterial and mixed venous blood specimens were collected through radial artery and floating catheter for blood gas analysis. The parameters of cardiac index (CI), oxygen supply index (DO₂I), oxygen consumption index (VO₂I) and oxygen intake rate (O₂ER) were calculated with PHLIPS M: 8007 A. (1) At postoperative 8 h, ScVO₂ was minimal (simple group 68% ± 14%; complex group 65% ± 9%); and postoperative 12 h CI (L×min⁻¹×m⁻²) bottomed out (simple group 3.29 ± 0.65; complex group 2.88 ± 0.54); DO₂I (492 ± 153) ml×min⁻¹×m⁻² and VO₂I(138 ± 45) ml×min⁻¹×m⁻² were minimal in complex group. (2) DO₂I, VO₂I, O₂ER and ScVO₂ changed with CI and simple group was higher than complex group. (3) Postoperative CI showed a positive correlation with DO₂I, VO₂I, ScVO₂ and a negative correlation with O₂ER. The postoperative cardiac output decreases and oxygen metabolism becomes disordered in congenital heart disease. It is most obvious at postoperative 12 h. And complex CHD is more serious. Cardiac output should be actively boosted to improve tissue oxygen metabolism during an early postoperative period.


Molecular analysis of vancomycin-resistant Enterococcus faecalis from Michigan hospitals during a 10 year period.
We evaluated the molecular relatedness of 47 clinical isolates of vancomycin-resistant Enterococcus faecalis collected from 15 Michigan hospitals from 1991 to 2000. There were 17 PFGE strain types for the 47 isolates. Ten of 15 hospitals demonstrated interhospital, and three of 15 intrahospital, dissemination of some isolates. Forty-two isolates (89.4%) demonstrated vanB resistance. All vanA isolates comprised unique PFGE groups, suggesting transposon dissemination or the presence of a similar plasmid. The results of this study suggest inter- and intrahospital dissemination of strains of vancomycin-resistant E. faecalis during a 10 year period in Michigan.


Languages in space.
The activation-orienting hypothesis and possible effects of hemispace for verbal stimuli in the native (Croatian) and foreign (English) language were studied on a sample of 72 healthy female right-handers. In an experimental design involving two competing commands referring to objects in left and right hemispace presented simultaneously to the two ears it was recorded which of the two was attended to first. The activation-orienting hypothesis was confirmed for Croatian but not for English. Clear dissociation between the two languages was found with respect to preferred hemispace: for the stimuli in the native language the subjects preferred the left hemispace, whereas for the stimuli in the foreign language they preferred the right hemispace.


Accelerating the Domestication of New Crops: Feasibility and Approaches.
The domestication of new crops would promote agricultural diversity and could provide a solution to many of the problems associated with intensive agriculture. We suggest here that genome editing can be used as a new tool by breeders to accelerate the domestication of semi-domesticated or even wild plants, building a more varied foundation for the sustainable provision of food and fodder in the future. We examine the feasibility of such plants from biological, social, ethical, economic, and legal perspectives.


The strength of a loosely defined movement: eugenics and medicine in imperial Russia.
This essay examines the 'infiltration' of eugenics into Russian medical discourse during the formation of the eugenics movement in western Europe and North America in 1900-17. It describes the efforts of two Russian physicians, the bacteriologist and hygienist Nikolai Gamaleia (1859-1949) and the psychiatrist Tikhon Iudin (1879-1949), to introduce eugenics to the Russian medical community, analysing in detail what attracted these representatives of two different medical specialties to eugenic ideas, ideals, and policies advocated by their western colleagues. On the basis of a close examination of the similarities and differences in Gamaleia's and Iudin's attitudes to eugenics, the essay argues that lack of cohesiveness gave the early eugenics movement a unique strength. The loose mix of widely varying ideas, ideals, methods, policies, activities and proposals covered by the umbrella of eugenics offered to a variety of educated professionals in Russia and elsewhere the possibility of choosing, adopting and adapting particular elements to their own national, professional, institutional and disciplinary contexts, interests and agendas.


Concentration of formocresol used by pediatric dentists in primary tooth pulpotomy.
Diluted formocresol is the most widely recommended primary tooth pulpotomy medicament, but it is not commercially available. This investigation surveyed practicing pediatric dentists about the concentration of formocresol that they use to perform pulpotomies and, if they use diluted formocresol, where they obtain it. Eight-hundred-and-six surveys were sent to a randomly selected sample of practicing pediatric dentists, and 422 were returned for a 52% response rate. Eighty-four percent of the respondents use formocresol for their primary tooth pulpotomies. Of those, 69% use full strength, 27% use diluted and 4% don't know. Sources of diluted formocresol for those who use the diluted form include: 34% who buy it that way, 58% who dilute it themselves and 8% who have the pharmacy dilute it. The majority of pediatric dentists who use formocresol for primary tooth pulpotomies use a full strength formulation.


Prothrombotic and hemorrhagic effects of aspirin.
Aspirin remains the most widely used drug for prevention of vascular events. Recent observational epidemiological evidence has raised the concern that aspirin withdrawal for treatment noncompliance, surgery, or side effects can carry an increased thrombotic risk. The delay to the thrombotic event was between 7 to 30 days in most reports and most frequently 7 to 10 days. The mechanism underlying this effect remains poorly understood. Using an in vivo model of laser-induced thrombosis, aspirin injected in 1 single dose of 100 mg/kg body weight has also shown a prothrombotic activity in the rat 8 to 10 days after injection in the normal rat. The hypothesis was made that minimal concentrations of aspirin or ultra-low dose aspirin (ULDA) could induce this effect. ULDA showed prothrombotic properties in the same model of induced thrombosis that were very similar to those described after aspirin withdrawal, but the effect was observed only 1 hour after aspirin administration. This prothrombotic effect of ULDA is very similar to the effect observed after COX 2 selective inhibition with NS 398. The administration of both the selective COX 2 inhibitor and ULDA did not produce further changes. In conclusion, the prothrombotic effects described in recent observational studies are likely produced by a direct effect of aspirin, whose putative mechanism involving COX 2 inhibition remains poorly understood.


Hypertriglyceridaemia and risk of coronary artery disease.
An elevated serum level of LDL cholesterol is a well-known risk factor for cardiovascular disease (CVD), but the role of elevated triglyceride levels is debated. Controversies regarding hypertriglyceridaemia as an independent risk factor for CVD have occurred partly because elevated triglyceride levels are often a component of atherogenic dyslipidaemia - they are associated with decreased levels of HDL cholesterol and increased levels of small dense LDL particles, which are highly atherogenic. Findings from several large studies indicate that elevated levels of triglycerides (either fasting or nonfasting) or, more specifically, triglyceride-rich lipoproteins and their remnants, are independently associated with increased risk of CVD. Possible mechanisms for this association include excessive free fatty acid release, production of proinflammatory cytokines, coagulation factors, and impairment of fibrinolysis. Therapeutic targeting of hypertriglyceridaemia could, therefore, reduce CVD and cardiovascular events, beyond the reduction achieved by LDL-cholesterol lowering. Elevated triglyceride levels are reduced with lifestyle interventions and fibrates, which can be combined with omega-3 fatty acids. Some new drugs are on the horizon, such as volanesorsen (which targets apolipoprotein C-III), pemafibrate, and others. However, CVD outcome studies with triglyceride-lowering agents have produced inconsistent results, meaning that no convincing evidence is available that lowering triglycerides by any approach can reduce mortality.


[Geometry of laparoscopy, telesurgery, training and telementoring].
Laparoscopic surgery in general is handicapped by the reduction of the range of motion from 6 to 4 degrees of freedom. This has a major impact on technically difficult procedures such as laparoscopic radical prostatectomy. Solutions for this problem include understanding the geometry of laparoscopy with sophisticated training programs, but also newly developed surgical robots, computer simulators, and telementoring. This article evaluates the value of these alternatives based on own experience and an analysis of the current literature. Our experience with robot-assisted surgery includes 244 laparoscopic radical prostatectomies using a voice-controlled camera arm (AESOP) and 6 telesurgical interventions with the da Vinci system. Additionally, experimental studies were performed focussing on the geometry of laparoscopy and new training concepts such as perfused pelvitrainers and computer simulation. Three-dimensional systems have not yet proved to be effective due to handling problems such as shutter glasses, video helmets, or reduced brightness. At present, there are only two robotic surgical systems (ZEUS, da Vinci) in clinical use for telesurgery, of which only the da Vinci provides stereovision and all 6 degrees of freedom (DOF). In the meantime, more than 100 laparoscopic radical prostatectomies have been performed with this system. However, there was no evidence of any advantages over the conventional laparoscopic approach. The ZEUS in combination with the telecommunication system SOKRATES is the only device that enables telemanipulation and telementoring over long distances (i.e., transatlantic). Robotic surgery represents a turning point in surgical research. However, broad use of robotic systems is limited mainly because of high investment and running costs. Whereas audiovisual telementoring will play a clear role in future training concepts, the need for telemanipulation or telesurgery has not yet been clarified.


Detection of Homologue and Isomer Vapors through Dynamic Reflection Spectra of Hollow Mesoporous Silica Sphere Photonic Crystals.
Vapors of homologues and isomers with very similar refractive indices can be easily distinguished by using dynamic reflection spectra (DRS) of hollow mesoporous silica sphere (HMSS) photonic crystals (PCs). Different diffusion behaviors render the HMSS PCs with a distinct response to different chemicals vapors, leading to diversity in the evolution of the reflection spectra and their DRS patterns. Therefore, by studying the geometric characteristics and color changes of color-filled contour maps, as well as the reflection peak shift speeds at different stages, even isomers such as n-butanol and iso-butanol, with a refractive index difference of only 0.001, can be recognized. The reflection peak shift speed depends on both the refractive index and the diffusion speed of chemicals. The proposed strategy provides a convenient, accurate, and low-cost method to detect vapors of homologues and isomers.


Development of Parsonage-Turner Syndrome After Interscalene Brachial Plexus Block Including 10-Year Follow-up: A Case Report.
A 22-year-old female patient demonstrated physical examination findings of Parsonage-Turner syndrome (PTS) 5 days after left shoulder arthroscopic surgery with interscalene brachial plexus block. The diagnosis was confirmed with electrodiagnostic testing 2 weeks after surgery. Symptoms resolved spontaneously within 2 years with full return-to-preinjury sport and job activity. These outcomes were maintained at the 10-year follow-up. PTS should be considered in the differential diagnoses for any postsurgical neurological variations after upper extremity surgery under regional anesthesia.


Graphene mediated self-assembly of fullerene nanorods.
A simple procedure for solution-based self-assembly of C60 fullerene nanorods on graphene substrates is presented. Using a combination of electron microscopy, X-ray diffraction and Raman spectroscopy, it is shown that the size, shape and morphology of the nanorods can be suitably modified by controlling the kinetics of self-assembly.


Liberating the Oppressed: Research Knowledge Differentials and Ethical Investigation in Special Operations Forces Clinical Science.
Special Operations Forces (SOF) medics do not have preparation in research knowledge that enables them to independently initiate or generate their own studies. Thus, medics rely on evidence generated by others, who are removed from medics' practice environment. Here, salient literature on research self-efficacy and the genesis of institutional review boards (IRBs) are reviewed and interpreted for contextual applications to medics' practice and initiation of studies. More publications delving into research methods are warranted to promote medics' participation and initiation of selfdirected scientific investigation, in collaboration with research scientists.


Introduction of a carbon paste electrode based on nickel carbide for investigation of interaction between warfarin and vitamin K1.
In this paper a novel electrochemical sensor based on nickel carbide (Ni3C) nanoparticles as a new modifier was constructed. Ni3C nanoparticle was synthesized and characterized by scanning electron microscopy, X-ray diffraction and first-principles study. Electrochemical impedance spectroscopy (EIS) and cyclic voltammetry (CV) studies confirmed the electrode modification. Afterwards, the new electrode for the first time was used for interaction study between vitamin K1 and warfarin as an anticoagulant drug by differential pulse voltammetry. The adduct formation between the drug and vitamin K1 was improved by decreasing in anodic peak current of warfarin in the presence of different amounts of vitamin K1. The binding constant between warfarin and vitamin K1 was obtained by voltammetric and UV-vis and fluorescence spectroscopic methods. The molecular modeling method was also performed to explore the structural features and binding mechanism of warfarin to vitamin K1. The different aspects of modeling of vitamin K1 and warfarin and their adduct structures confirmed the adduct formation by hydrogen bonding.


Tuning Aromaticity of para-Substituted Benzene Derivatives with an External Electric Field.
Substituent effects are phenomena which play an important role in organic chemistry, especially when aromatic species are considered. For this class of systems, the question of the interrelation between substituent effect and aromaticity arises. The relationship between aromaticity and substituent effects appears to be of a competitive nature. This work examines changes in aromaticity in para-substituted benzene derivatives exposed to external electric fields of various intensities. Three systems with different substituent electron-accepting/donating properties are studied, namely p-aminophenol, p-nitrobenzonitrile and p-nitrophenol. In these cases, the competitive character between substituent effects and aromaticity is emphasised. It is also shown that aromaticity (and the substituent effect) can be tuned using an external electric field applied to the system.


Brain abscess caused by Gemella morbillorum: case report and review of the literature.
We describe a rare case of cerebral abscess in an immunocompetent 67-year-old male with Gemella morbillorum as the causative agent. Gemella morbillorum is an aerobic gram positive coccus and is deemed to be a normal inhabitant of the oral cavity. The aim of this report is to introduce Gemella morbillorum as the emerging pathogen involved in brain abscesses. To the best of our knowledge only eight cases of Gemella morbillorum brain abscess have been reported in the literature. An exhaustive review of the literature is included with emphasis on the primary source of infection, clinical presentation, radiological diagnosis, and treatment modalities.


Fostering Children and Adolescents' Creative Thinking in Education. Theoretical Model of Drama Pedagogy Training.
Drama Pedagogy Training (DPT), as other drama-based pedagogies, has been related to several outcomes, including creativity enhancement. This enhancement is commonly proven through the measurement of different creative processes. In our review we systematize characteristics, activities and techniques of DPT that are assumed to be related to creativity in order to have a more comprehensive framework to identify the specific DPT elements that are involved in the enhancement of some of the creative processes of children and adolescents. To this end, we identified five creative processes in experimental studies using DPT: divergent thinking, fantasy and imagination, associative thinking, symbolization, and problem solving. These processes were cross referenced with DPT characteristics, activities, and techniques that were argued to be related to creativity enhancement. Our review will propose a model with two main categories and six elements as follows: (1) technical drama phases which emphasizes the role of narrative and embodiment through (a) corporal and vocal training and (b) main drama techniques (e.g., storytelling and improvisation and role-play), and (2) psycho-pedagogical framework which emphasizes the role of a dialogic space through (c) playfulness and a (d) collaborative, safe space. We also identified (e) feedback as an important element of DPT which belongs to both drama technical phases and psycho-pedagogical framework categories. Along with the model, we explain the creative outcomes associated to each of these elements as a means to attire the attention to drama-based pedagogies for the development of creativity in the educational setting.


Mass spectrometric gene diagnosis of one-base substitution from polymerase chain reaction amplified human DNA.
One-base substitution has been detected on the polymerase chain reaction (PCR) products amplified from human mutated DNA for the first time by using mass spectrometry. PCR fragments of 52 base pairs were produced on a collagen gene of an osteogenesis imperfecta patient's heterozygous DNAs. The products were digested with EcoRI restriction enzyme to liberate 3'-end adducts and purified by phenol + chloroform extraction, ammonium acetate addition and ethanol precipitation to remove sodium ions from the phosphoric acid backbone of the DNAs. Purified products were examined using an electrospray ionization mass spectrometer. Mass spectra showed four groups of fragment peaks with the expected molecular masses, which originate from the sense and antisense strands of the heterozygous DNAs.


The impact on selection of non-alcoholic vs alcoholic drink availability: an online experiment.
Increasing the availability of healthier food increases its selection and consumption. However, there is an absence of evidence related to alcohol. This study aimed to estimate the impact of increasing the absolute and relative availability of non-alcoholic compared to alcoholic drinks on selection. We also assessed whether effects were modified by cognitive resource. UK adult weekly alcohol consumers (n = 808) were recruited to an online experiment with a hypothetical drink selection task. Participants were randomly assigned to one of eight conditions, in a 4 (availability) × 2 (cognitive resource) factorial design. The four availability conditions were: i. Reference 1 (two non-alcoholic, two alcoholic drinks); ii. Reference 2 (four non-alcoholic, four alcoholic drinks); iii. Increased non-alcoholic drinks (six non-alcoholic, two alcoholic drinks); iv. Increased alcoholic drinks (two non-alcoholic, six alcoholic drinks). The two cognitive resource conditions were: a. Low (high time pressure); b. High (low time pressure). Logistic regression was used to assess selection of a non-alcoholic drink. 49% of participants selected a non-alcoholic drink in the Increased non-alcoholic drinks condition, compared to 36% in Reference 1, 39% in Reference 2, and 26% in the Increased alcoholic drinks condition. Non-alcoholic drink selection was similar between Reference 1 and 2 when the total number of drinks increased (absolute availability) but the proportion of non-alcoholic compared to alcoholic drinks (relative availability) was unchanged (OR = 1.15, 95% CI 0.77, 1.73). In contrast, the odds of selecting a non-alcoholic drink were 71% higher when both absolute and relative availability of non-alcoholic compared to alcoholic drinks was increased from Reference 1 to the Increased non-alcoholic drinks condition (OR: 1.71, 95% CI 1.15, 2.54), and 48% higher when increased from Reference 2 to the Increased non-alcoholic drinks condition (OR: 1.48, 95% CI 0.99, 2.19). There was no evidence of an effect of cognitive resource. Greater availability of non-alcoholic drinks, compared to alcoholic drinks, increased their online selection, an effect that may be larger when changing their relative availability, i.e., increasing the proportion of non-alcoholic drinks. Naturalistic studies are needed to determine the impact of availability interventions on reducing alcohol purchasing and consumption.


Development of a rapid matrix digestion technique for ultrastructural analysis of elastic fibers in the intervertebral disc.
Collagen and elastic fibers are two major fibrous constituents of the annulus fibrosus (AF) in the disc that contribute to its mechanical and viscoelastic properties. It was thought that elastic fibers play no substantial role in the function and properties of the disc as these fibers were irregularly distributed. Studies that have revealed highly organized elastic fibers with different regional orientation and distribution, while being strongly crosslinked with matrix, suggesting their contribution to disc structure-function properties. These studies that were performed by light microscopic analysis of histologically prepared samples, have not been able to reveal the fine-scale architectural details of the elastic fiber network. Since elastic fibers are intermingled with other fibrous components of the disc and mostly obscured by the extracellular matrix, it is difficult to demonstrate their ultra-structural organization using scanning electron microscopy (SEM). Therefore the aim of this study was to develop a rapid matrix digestion technique for ultrastructural analysis of the disc elastic fibers. This study provides a new method for fundamental visualization of elastic fibers and their architecture in the disc. Through the ultra-structural analysis, the relationship between structure and function, as well as the role of elastic fibers on AF mechanical properties can be studied. This method may be used to develop a three-dimensional map of elastic fibers distribution within the disc, which would provide valuable information for designing tissue engineered scaffolds for AF repair and replacement.


Psychotropic drugs in breast milk: no evidence for adverse effects on prepulse modulation of startle reflex or on cognitive level in infants.
Reversals in modulation of the startle reflex probably reflect maturational processes in the central nervous system. This study has investigated the longitudinal changes in prepulse modulation of the blink reflex in three groups of individual infants: (a) breast-fed infants of mentally ill mothers who were prescribed selected psychotropic drugs, (b) bottle-fed infants of similarly ill and medicated mothers, and (c) breast-fed infants of healthy control mothers. The acoustic stimulation paradigm and neurophysiological methods were similar to those used in previous studies and, in addition, the infants' development was simultaneously assessed using the Bayley Scales of Infant Development. All the infants were found to be developing normally and across all three groups we observed a clear transition in prepulse modulation of the eye-blink reflex from small inhibition or facilitation in early infancy (1-4 months) to a robust facilitation in middle infancy (5-8 months). This reversal probably reflects the changing balance of developing neural function in normal infants. There were, therefore, no discernible effects in breast-fed infants of exposure to small doses of antidepressant or neuroleptic drugs.


Decision Making in Interventional Oncology: Intra-arterial Therapies for Metastatic Colorectal Cancer-Y90 and Chemoembolization.
Colorectal cancer is the third most common cancer in the United States and the liver is the most common site of metastatic disease. The presence and extent of hepatic metastases are a major prognostic indicator. Although surgical resection is the accepted first-line therapy for colorectal liver metastasis, only 20 to 25% of patients are eligible for resection due to the extent and location of disease. This article discusses the current role of transarterial therapies in the treatment of colorectal liver metastases.


[Therapeutic effect of antithymocyte/antilymphocyte globulin on severe aplastic anemia and therapy-related complications].
Immunsuppressive therapy is a major therapy for severe aplastic anemia, and antithymocyte /antilymphocyte globulin (ATG/ALG) is usually used. This study investigated the therapeutic effect of ATG/ALG on severe aplastic anemia and explored the management of therapy-related complications. Clinical data of 28 children with severe aplastic anemia who received ATG/ALG treatment from December, 1994 through to September, 2005 were analyzed retrospectively. Of the 28 patients, 2 were nearly cured (7.1%), 4 were relieved (14.3%) and 12 were improved (42.9%) based on a hemoglobin/white blood cell/platelet count. These results represented an overall effective rate of 64.3%. Clinical evidence of serum sickness developed in 19 patients, manifesting as fever (n = 9), cutaneous eruptions (n = 12), arthralgias (n = 7), myalgia (n = 7) and arthrocele (n = 3). Serum sickness occurred 5-17 days after ATG/ALG administration and lasted for 1-15 days (mean 4.4 days). Three children with mild serum sickness symptoms recovered without any treatment. The symptoms of the other 16 patients disappeared after 3-5 days of methylprednisolone treatment (10 mg/kg daily). However, 3 patients had relapses at 2-4 days after termination of methylprednisolone therapy. Another course of methylprednisolone therapy was administered to the 3 patients until the symptoms disappeared. The patients with no serum sickness or with mild serum sickness had a better response to ATG/ALG therapy than those who had severe serum sickness (100% vs 60%; P < 0.05). ATG/ALG therapy for severe aplastic anemia is effective. Serum sickness is a common complication in children with severe aplastic anemia following ATG/ALG therapy, but can be improved by methylprednisolone application.


Weak evidence for the management of medication-related osteonecrosis of the jaw: An overview of systematic reviews and meta-analyses.
Although several therapies are proposed for medication-related osteonecrosis of the jaw (MRONJ), to date there is no consensus or treatment protocol for MRONJ. This overview aims to summarize the available evidence on the management and outcomes of MRONJ. An electronic search without language or date restrictions occurred in five databases and gray literature for articles published until March 2020. This overview was performed according to the PICO format. The eligibility criteria comprised systematic reviews (RS) with or without meta-analyses that analyzed treatments outcomes for MRONJ. The methodological quality of each SR was evaluated using AMSTAR 2. Fifteen studies published between 2014 and 2020 were included in this overview. The summary of the evidence showed that conservative treatment and low level laser therapy can yield favorable results for early stages of MRONJ whereas surgical treatment seems to be better for advanced stages. However, qualitative assessment of the SRs highlighted a global low level of quality. There is weak evidence to support treatment protocols for MRONJ. Because of the low quality of the SRs, highlighted by this overview, no insightful therapeutic recommendations can be issued for any intervention for MRONJ.


Balanced Translocations Disrupting SMARCB1 Are Hallmark Recurrent Genetic Alterations in Renal Medullary Carcinomas.
Renal medullary carcinoma (RMC) is a rare and highly aggressive neoplasm that most often occurs in the setting of sickle cell trait or sickle cell disease (SCD). Most patients present with metastatic disease resistant to conventional chemotherapy, and therefore there is an urgent need for molecular insight to propose new therapies. To determine the molecular alterations and oncogenic pathways that drive RMC development. A series of five frozen samples of patients with RMC was investigated by means of gene expression profiling, array comparative genomic hybridization, and RNA and whole exome sequencing (WES). RNA and DNA sequencing read data were analyzed to detect gene fusions and somatic mutations. Gene fusions mutations were validated by real-time polymerase chain reaction and fluorescence in situ hybridization. Gene expression profiling was analyzed by unsupervised hierarchical clustering and Gene Set Enrichment Analysis (Broad Institute, Cambridge, MA, USA). We observed inactivation of the tumor suppressor gene SMARCB1 in all tumors. In all four cases developed in patients with SCD, we identified an original mechanism of interchromosomal balanced translocations that disrupt the SMARCB1 sequence and thus contribute to its inactivation. Gene expression profiling revealed that RMC shares common oncogenic pathways with pediatric malignant rhabdoid tumors, another tumor subtype characterized by SMARCB1 deficiency. RMCs are characterized by an original mechanism of interchromosomal balanced translocations that disrupt the SMARCB1 sequence. WES reveals that RMCs show no other recurrent genetic alteration and an overall stable genome, underscoring the oncogenic potency of SMARCB1 inactivation. Our comprehensive molecular study supports a pivotal role of the tumor suppressor gene SMARCB1 in the development of renal medullary carcinoma. The use of therapeutic strategies based on the biologic effects of its inactivation should now open new perspectives for this typically lethal malignancy.


Attitudes towards people with dementia: a cross-sectional study comparing dental hygiene students with registered dental hygienists.
In order to adequately care for patients with dementia, it is necessary for dental hygienists to develop unprejudiced attitudes towards and obtain sufficient knowledge of dementia. The aim of this study was to assess attitudes towards and knowledge of dementia among Japanese dental hygiene students and identify related factors to the attitude and the knowledge. We compared the attitude and the knowledge between dental hygiene students and practising dental hygienists. Dental hygienists are required to care for patients with dementia by developing appropriate attitudes towards dementia and gaining knowledge of dementia. Between May 2016 and July 2016, 191 third-grade dental hygiene students and 64 registered dental hygienists were surveyed. We modified questionnaires to assess attitudes towards and knowledge of dementia. Ageism was assessed using the Fraboni Ageism scale. To determine potential dementia awareness factors, information regarding participants' experiences with dementia was collected. Factor analysis revealed four factors in the attitude scale (Cronbach's α, 0.652-0.820). All item-total correlation coefficients for the knowledge scale were above 0.3, and Cronbach's α was 0.827. All awareness factors for dementia were significantly different between students and registered dental hygienists. Total scores of attitude and knowledge were higher among registered dental hygienists, indicating better attitude and knowledge, but total scores of ageism were lower among registered dental hygienists, indicating worse ageism. Multiple regression analysis revealed that the attitudes towards dementia correlated with years of experience, ageism, interest in dementia and desire to work with patients with dementia. Registered dental hygienists had more positive and more knowledge compared to dental hygiene students. Attitudes towards dementia, but not knowledge of dementia, were significantly positively correlated with ageism.


[In-vitro testing of the sensitivity of mammary carcinoma cells to cytostatic drugs (author's transl)].
In-vitro sensitivity to cystostatic agents was tested in 137 cases of breast carcinoma, with 125 tests being analysable. Inhibition of in-vitro incorporation of 3H-uridine or 3H-thymidine into RNA or DNA of the original tumour cells after incubation with antineoplastic substances was used as the index for the in-vivo sensitivity of the tumour. 30% of the carcinoma cells were sensitive in-vitro, 70% resistant. About 75% of sensitive cancers were sensitive against several agents. Cyclophosphamide proved to be most effective in-vitro: it was tested via 4-hydroxycyclophosphamide or 4-hydroperoxycyclophosphamide. There was a correlation between histological type and in-vitro sensitivity of the cancer, as well as between proliferative activity and in-vitro sensitivity in that proliferation-active tumours were more frequently sensitive in-vitro than proliferation-poor ones. Primary tumours and metastases of the same patient frequently showed different sensitivity. In some cases the development of resistance against cytostatic drugs was demonstrated during treatment. Testing tumours against combinations of cytostatic drugs demonstrated an additive effect of the antineoplastic substances in-vitro.


Responses of a forest-dwelling terrestrial turtle, Terrapene Carolina, to prescribed fire in a Longleaf Pine ecosystem.
Prescribed fire is commonly used as a tool to meet a range of forest management goals. Owing to their limited movement abilities, terrestrial turtles are likely to be at high risk of injury and mortality, and to experience other fitness consequences with population-level implications from fire. Using radiotelemetry, we studied the responses of Eastern Box Turtles, Terrapene carolina carolina, to prescribed fire management in a sandhills Longleaf Pine forest system over a five-year period and compared our results to a nearby population in an unburned coastal plain location. Individual variation in turtle survival was strongly dependent on how frequently and extensively the areas were burned, with annual survival rates of 94.5% in unburned areas decreasing to 45.9 % in the most extensively burned areas. Turtles at the fire-maintained sandhills site had annual survival rates 4.9 % less than at the unburned coastal plain site, and females had annual survival rates 6.8 % less than males. Survival varied seasonally, with greatest mortality rates in winter and spring, especially among females. Growth rates and body condition did not differ between sites, nor did they vary according to fire extent and frequency at the fire-maintained site. Although mortality was greater and spatially variable at the fire-maintained site, annual survival rates across the site (86 - 90 % for females and males, respectively) were comparable to other stable populations of T. carolina. The lesser than expected mortality rate at the fire-maintained site was likely the result of turtles' strong selection of mesic hardwood forests near bottomlands and streams - habitats that may serve as refugia from fire. In areas where T. carolina conservation is a priority, land managers should integrate maintenance of fire refuge habitats into burn planning to minimize unintended negative impacts to this imperiled species.


Whole-genome sequencing of chronic lymphocytic leukaemia reveals distinct differences in the mutational landscape between IgHVmut and IgHVunmut subgroups.
Chronic lymphocytic leukaemia (CLL) consists of two biologically and clinically distinct subtypes defined by the abundance of somatic hypermutation (SHM) affecting the Ig variable heavy-chain locus (IgHV). The molecular mechanisms underlying these subtypes are incompletely understood. Here, we present a comprehensive whole-genome sequencing analysis of somatically acquired genetic events from 46 CLL patients, including a systematic comparison of coding and non-coding single-nucleotide variants, copy number variants and structural variants, regions of kataegis and mutation signatures between IgHVmut and IgHVunmut subtypes. We demonstrate that one-quarter of non-coding mutations in regions of kataegis outside the Ig loci are located in genes relevant to CLL. We show that non-coding mutations in ATM may negatively impact on ATM expression and find non-coding and regulatory region mutations in TCL1A, and in IgHVunmut CLL in IKZF3, SAMHD1,PAX5 and BIRC3. Finally, we show that IgHVunmut CLL is dominated by coding mutations in driver genes and an aging signature, whereas IgHVmut CLL has a high incidence of promoter and enhancer mutations caused by aberrant activation-induced cytidine deaminase activity. Taken together, our data support the hypothesis that differences in clinical outcome and biological characteristics between the two subgroups might reflect differences in mutation distribution, incidence and distinct underlying mutagenic mechanisms.


Online emotional support delivered by trained volunteers: users' satisfaction and their perception of the service compared to psychotherapy.
Technology could answer the substantial need in human resources available for supporting those who suffer from mental illness, by providing scalable methods to train and engage non-professionals to those who need their support. 7 Cups of Tea (7COT) platform was chosen for this study, because it provides a good case study for examining this kind of solution. The aim of this paper was to provide empirical findings regarding users' satisfaction with online emotional support provided by trained volunteers and how it is perceived in comparison to psychotherapy. An online survey was conducted among a convenience sample of 7COT users. The findings showed high user satisfaction with the support provided by 7COT listeners and, on average, users who indicated to receive psychotherapy in their past marked the listeners' support to be as helpful as psychotherapy. Relating to psychotherapy and online emotional support advantages, different advantages were found. The findings suggest that receiving support from volunteers makes users feel that the support is more genuine. The paper provides preliminary evidence that people in emotional distress may find non-professionals support delivered through the use of technology to be helpful. Limitations and implications are discussed.


The prevalence of orodental trauma during epileptic seizures in terms of dental treatment - Survey study.
Epilepsy is one of the most common neurological disorders. Seizures that occur during attacks may lead to head injuries. It is crucial to establish proper prophylactic management against trauma occurrence, as nowadays prevention is not sufficient. Assessment of the frequency of head and intraoral trauma during epileptic seizures and to evaluate factors that may predispose to injuries. The questionnaire was carried out among 106 patients with epilepsy. Survey conducted questions regarding development of the disease and occurrence of orodental and head trauma. Results were statistically analyzed with the chi-square test (p<0.05). 52.4% of subjects admitted the occurrence of oral trauma during epileptic seizures. The most common were lips, tongue or cheeks injuries. 18% patients suffered from tooth crack and 17% from tooth fracture. 50% of respondents suffered from head trauma during seizures: 41% patients reported bruises, 39% burns, 37% wounds, 10% nose fractures, 7% eye socket trauma and 3% skull crack. 14.1% of respondents experienced dentist refusal to undertake treatment, while 4% of patients had epileptic attack during dental procedures. Dental trauma is common result of epileptic seizures. It is necessary to implement prophylactic management to prevent hard and soft tissues injuries, for example by using custom-made mouthguards. Moreover, specially designed dental programs for this group of patients should be provided.


Managing Postoperative Infection following Breast Reconstruction with the Sientra AlloX2 Tissue Expander.
Implant-based breast reconstruction is the most common reconstructive modality in the United States. Significant advances in surgical technique and technology have resulted in improvement of clinical outcomes. A recent innovation has been the introduction of a tissue expander with an integral drain that permits access to the periprosthetic space. A new use for this drain port is presented in patients with postoperative surgical-site infection. Patients who underwent staged implant-based breast reconstruction with the Sientra AlloX2 tissue expander and experienced postoperative infection that warranted inpatient management with intravenous antibiotics were included in the study. The integral drain port was used in these patients to perform washout of the periprosthetic space at the bedside. The ability to salvage the tissue expander in the setting of infection without the need for surgical revision in the operating room was determined. Of 31 patients who underwent a total of 52 staged breast reconstructions with the Sientra AlloX2 tissue expander, 3 patients (8.7%) with a mean age of 50.3 years (range, 34-76 years) and mean body mass index of 23.3 kg/m2 (range, 22.3-24.1 kg/m2) met inclusion criteria. Salvage of the device with successful progression through expansion and eventual expander-implant exchange was achieved in 2 patients. One patient failed the salvage attempt and required removal of the device. Using the integral drain port of the AlloX2 tissue expander has the potential for device salvage in a subset of patients with surgical-site infection without the need for surgical revision.


Caffeine attenuates waking and sleep electroencephalographic markers of sleep homeostasis in humans.
Prolonged wakefulness increases electroencephalogram (EEG) low-frequency activity (< 10 Hz) in waking and sleep, and reduces spindle frequency activity (approximately 12-16 Hz) in non-rapid-eye-movement (nonREM) sleep. These physiologic markers of enhanced sleep propensity reflect a sleep-wake-dependent process referred to as sleep homeostasis. We hypothesized that caffeine, an adenosine receptor antagonist, reduces the increase of sleep propensity during waking. To test this hypothesis, we compared the effects of caffeine and placebo on EEG power spectra during and after 40 h of wakefulness. A total of 12 young men underwent two periods of sleep deprivation. According to a randomized, double-blind, crossover design, they received two doses of caffeine (200 mg) or placebo after 11 and 23 h of wakefulness. Sleep propensity was estimated at 3-h intervals by measuring subjective sleepiness and EEG theta (5-8 Hz) activity, and polysomnographic recordings of baseline and recovery nights. Saliva caffeine concentration decreased from 15.7 micromol/l 16 h before the recovery night, to 1.8 micromol/l 1 h before the recovery night. Compared with placebo, caffeine reduced sleepiness and theta activity during wakefulness. Compared with sleep under baseline conditions, sleep deprivation increased 0.75-8.0 Hz activity and reduced spindle frequency activity in nonREM sleep of the recovery nights. Although caffeine approached undetectable saliva concentrations before recovery sleep, it significantly reduced EEG power in the 0.75-2.0 Hz band and enhanced power in the 11.25-20.0 Hz range relative to placebo. These findings suggest that caffeine attenuated the build-up of sleep propensity associated with wakefulness, and support an important role of adenosine and adenosine receptors in the homeostatic regulation of sleep.


Comparing Argus sling and artificial urinary sphincter in patients with moderate post-prostatectomy incontinence.
Post-prostatectomy incontinence (PPI) is a main complication of radical prostatectomy. The purpose of this study was to compare the efficacy and safety of the Argus male sling (Argus) with that of artificial urinary sphincters (AUS) in patients with moderate PPI. A total of 33 moderate PPI patients underwent AUS or Argus implantation from January 2009 to June 2013 (13 AUS, 20 Argus). We defined moderate PPI as the use of 2-4 pads per day. To compare efficacy, we assessed the success rate between the two groups. Success was defined as the daily need for no pads or one small safety pad that remained dry most of the day. The mean patient age was 73.5±6.3 yr in the AUS group and 70.9±5.1 yr in the Argus group, and the mean follow-up period was 29.8±14.9 months in the AUS group and 24.7±11.8 months in the Argus group. The success rate was 72.7% in the AUS group and 85.0% in the Argus group (P=0.557). Abnormal postoperative pain persisted in more patients in the Argus group (6/20, 30%) than in the AUS group (1/13, 7.7%) (P=0.126). However, the rate of other complications was not different between the two groups (7.7% and 15.0% for AUS and Argus, respectively, P=0.822). Argus surgery showed similar success and complication rates to those of AUS in moderate PPI patients, indicating that it could be an alternative surgical option for the treatment of moderate PPI.


Rapid carbon accumulation following managed realignment on the Bay of Fundy.
Salt marshes are highly effective carbon (C) sinks and have higher rates of soil C burial (per square meter) than terrestrial ecosystems. Marsh reclamation and anthropogenic impacts, however, have resulted in extensive losses of salt marshes. Restoration of marshes drained and "reclaimed" for agriculture (referred to in Canada as dykelands) and degraded marshes can generate C credits, but only if C burial is reliably quantified. To date, studies reporting on C burial rates have been limited primarily to restored marshes which are more than 10 years old. Here we report on a study which assessed C burial six years after the return of tidal flooding to a section of dykeland in Aulac, New Brunswick on Canada's Bay of Fundy. The C burial rate in the restored marsh averaged 1 329 g C m-2 yr-1, more than five times the rate reported for a nearby mature marsh. Carbon density in the recovering marsh was relatively consistent with depth and although salt marsh cordgrass (Spartina alterniflora) became established in 2012, the bulk of the C in the new marsh deposit is assumed to be allochthonous. Financial constraints are a barrier to marsh restoration projects and C markets could provide a considerable source of funding for restoration work in the future. For marsh restoration projects to be recognized in C crediting systems, however, it must also be demonstrated that the allochthonous C would not otherwise have been sequestered; the potential for this is discussed.


Ordered PdCu-Based Nanoparticles as Bifunctional Oxygen-Reduction and Ethanol-Oxidation Electrocatalysts.
The development of superior non-platinum electrocatalysts for enhancing the electrocatalytic activity and stability for the oxygen-reduction reaction (ORR) and liquid fuel oxidation reaction is very important for the commercialization of fuel cells, but still a great challenge. Herein, we demonstrate a new colloidal chemistry technique for making structurally ordered PdCu-based nanoparticles (NPs) with composition control from PdCu to PdCuNi and PtCuCo. Under the dual tuning on the composition and intermetallic phase, the ordered PdCuCo NPs exhibit better activity and much enhanced stability for ORR and ethanol-oxidation reaction (EOR) than those of disordered PdCuM NPs, the commercial Pt/C and Pd/C catalysts. The density functional theory (DFT) calculations reveal that the improved ORR activity on the PdCuM NPs stems from the catalytically active hollow sites arising from the ligand effect and the compressive strain on the Pd surface owing to the smaller atomic size of Cu, Co, and Ni.


Bundling and diameter selectivity in HiPco SWNTs poly(p-phenylene vinylene-co-2,5-dioctyloxy-m-phenylene vinylene) composites.
Temperature-dependent (TD) Raman measurements at laser excitation 514.5 nm were performed at different concentrations. The spectral profile of the radial breathing modes were investigated up to a polymer concentration of 1 g/L and were found to be dominated by approximately 1.2-1.4 nm diameter tubes at room temperature. Upon heating above the glass transition of the polymer (60 degrees C) the smaller tubes around approximately 0.9 nm increased significantly in relative intensity. This suggests that below the glass transition of the polymer (60 degrees C) RBMs within the composite are damped and spectral changes cannot be interpreted as diameter selective solubilization. The observed RBM damping at room temperature only occurred up to a concentration of approximately 1.2 x 10(-4) g/L and below this no damping was observed. Photoluminescence intensity (PL) measurements were taken for a range of PmPV concentrations, in which HiPco single walled carbon nanotubes (SWNTs) at 100%, 10%, 1%, 0.1%, 0.01%, and 0% mass fractions were added. Fitting of the concentration dependence to a dynamic absorption/desorption model indicates that the polymer interacts with nanotube bundles until a critical concentration of approximately 1.2 x 10(-4) g/L is reached, below which the nanotubes are isolated. The polymer and or solvent has a significant effect on the debundling and aggregation within these systems. Aggregation and/or interaction with the polymer at higher concentrations can effect the RBM profile in the composite at ambient temperatures, providing an incomplete representation of the selection of diameters present within composites at a particular wavelength.


Deciduous tooth biomarkers reveal atypical fetal inflammatory regulation in autism spectrum disorder.
Atypical regulation of inflammation has been proposed in the etiology of autism spectrum disorder (ASD); however, measuring the temporal profile of fetal inflammation associated with future ASD diagnosis has not been possible. Here, we present a method to generate approximately daily profiles of prenatal and early childhood inflammation as measured by developmentally archived C-reactive protein (CRP) in incremental layers of deciduous tooth dentin. In our discovery population, a group of Swedish twins, we found heightened inflammation in the third trimester in children with future ASD diagnosis relative to controls (n = 66; 14 ASD cases; critical window: -90 to -50 days before birth). In our replication study, in the US, we observed a similar increase in CRP in ASD cases during the third trimester (n = 47; 23 ASD cases; -128 to -21 days before birth). Our results indicate that the third trimester is a critical period of atypical fetal inflammatory regulation in ASD.


Vitamin D deficiency and myocardial diseases.
Vitamin D deficiency is common among patients with myocardial diseases because sun-induced vitamin D production in the skin and dietary intake of vitamin D is often insufficient. Knockout mice for the vitamin D receptor develop myocardial hypertrophy and dysfunction. It has also been shown that children with rickets who suffered from severe heart failure could be successfully treated with supplementation of vitamin D plus calcium. In adults, almost all patients with heart failure exhibit reduced 25-hydroxyvitamin D levels, which are used to classify the vitamin D status. In prospective studies, vitamin D deficiency was an independent risk factor for mortality, deaths due to heart failure and sudden cardiac death. Several vitamin D effects on the electrophysiology, contractility, and structure of the heart suggest that vitamin D deficiency might be a causal factor for myocardial diseases. Data from interventional trials, however, are rare and urgently needed to elucidate whether vitamin D supplementation is useful for the treatment of myocardial diseases. In our opinion, the current knowledge of the beneficial effects of vitamin D on myocardial and overall health strongly argue for vitamin D supplementation in all vitamin D-deficient patients with or at high risk for myocardial diseases.


Parental consent and adolescent risk behavior research.
To identify methodological issues related to the use of active or passive parental consent in school-based research on adolescent risk behavior research and to propose recommendations consistent with current legal and ethical standards in the United States. Review and synthesis of the professional literature related to adolescents and parental consent, federal regulations and guidelines in the United States, and the author's experience presenting these arguments and issues to institutional review boards and funding agencies for over 10 years. The procedures used for parental consent affect a study's participation rates, costs, and selection bias. When active parental consent is required, parental permission is typically obtained for only 30%-60% of students, compared to 93%-100% when passive consent is used. Extensive follow-up may result in 55%-100% of parents giving permission, but at significant cost (typically $20-$25 per student). Active consent results in the exclusion of minorities, students having problems in school, and students already engaged in or at risk for problem behaviors. Strong methodological reasons were identified for using passive parental consent procedures when possible. Current federal regulations include four areas for possible waiver or alterations in parental consent procedures, including the use of passive parental consent. Health researchers must understand the methodological, legal, and ethical issues related to parental consent to produce high-quality, valid research about adolescents and to provide evidence for laws, policies, and regulations.


A rare combination of atypical cerebral vascular anatomy.
A 57-year-old woman presented with neurologic deficits consistent with a cerebrovascular accident. Her workup demonstrated the simultaneous occurrence of three uncommon cerebrovascular congenital anomalies in a single patient: (1) persistent trigeminal artery, (2) persistent fetal origin of the posterior cerebral artery and (3) bilateral occurrence of the vertebral arteries terminating in the posterior inferior cerebellar arteries. These persistent fetal cerebrovascular anatomic variants are reviewed and the clinical relevance discussed.


Nurses' perceptions and experiences of initiating thrombolysis: a qualitative study.
Nurse-initiated thrombolysis has become established in some trusts for patients presenting to the accident and emergency department or coronary care unit with an acute myocardial infarction. A limited approach to the exploration of this multidimensional expansion in nursing practice is noted in the literature. The aims of this study were to explore the experiential dimensions of nurses who have initiated thrombolysis, if nurses perceive themselves prepared for the role, and whether they consider role expansion a positive or negative experience. A qualitative approach was used. The sample included 12 nurses organizationally sanctioned to autonomously administer a thrombolytic agent, who completed a self-administered, predominantly open-ended questionnaire. Data were analysed using the method described by Giorgi (1997). Two major themes emerged: 'perceived pressure to deliver best practice' and 'developing patient care within a holistic framework', these themes are discussed and underpinned with supporting narratives. Nurses initiating thrombolysis have a desire to engage with delivery of a treatment proven to have a positive impact on individual patient outcomes; they express an overwhelming desire 'to do good' for their patient. Despite struggling with the possibility of adverse patient outcomes, all the nurses felt that their experiences overall were positive and all supported this with examples of practice.


Psychological distress predicts the development of the metabolic syndrome: a prospective population-based study.
To examine prospectively the association of psychological distress with the development of the metabolic syndrome (MetS) and the potential influence of demographic characteristics, health behaviors, and inflammation in this association. A total of 466 (n = 185 males; 281 females) subjects, aged 36 to 56 years, and free of MetS at baseline, participated in a population-based study from 1997 to 1998 and again from 2004 to 2005. Mean observation time was 6.4 years. Various clinical, biochemical, and behavioral factors were measured at baseline, including assessment of psychological distress using the 12-item General Health Questionnaire. The development of MetS was measured at follow-up based on National Cholesterol Education Program criteria. Subjects with high psychological distress at baseline (General Health Questionnaire scores, 4-12) were more than twice as likely to develop MetS than those with low psychological distress (odds ratio, 2.18; 95% confidence interval, 1.30-3.64). Adjustments for 1) age, gender, and sociodemographic variables; 2) health behaviors (smoking, alcohol use, and leisure time physical activity); and 3) C-reactive protein in the analysis diminished the odds of developing MetS in the distressed group (odds ratio, 1.87; 95% confidence interval, 1.83 and 1.81, respectively); however, the association remained statistically significant (p = .025-.038). Psychological distress at baseline increases the risk of developing MetS during follow-up. This association remained robust after adjusting for age, gender, sociodemographic variables, baseline health behaviors, and C-reactive protein. These prospective findings are evidence of a significant association between psychological distress and the development of MetS.


Effect of pulsed electromagnetic field therapy on the osteogenic and adipogenic differentiation of bone marrow mesenchymal stem cells.
We investigated the effects of pulsed electromagnetic fields (PEMFs) of 20 Hz/2 mT on the osteogenic and adipogenic differentiation of bone marrow stem cells (BMSCs). Sprague Dawley rat BMSCs were isolated and cultured in vitro. The BMSCs of the third passage were obtained and stimulated by PEMFs of 20 Hz/2 mT. The alkaline phosphatase (ALP) activity was measured according to the ALP assay kit manufacturer instructions, the BMSC osteogenic and adipogenic indicators were detected by semi-quantitative reverse transcription polymerase chain reaction (RT-PCR), and oil red O staining was used to observe the adipose-induced adipogenic differentiation of BMSCs. PEMFs of 20 Hz/2 mT significantly promoted the activity of ALP in the BMSCs (P < 0.01) and mRNA expression of osteogenic proteins (osteocalcin and osteopontin). The PEMFs inhibited the expression of adipogenic transcription factors such as adipokines and adipocyte-binding protein-2, and the adipogenic differentiation of BMSCs. PEMFs of 20 Hz/2 mT can promote osteogenic differentiation and inhibit adipogenic differentiation in BMSCs.


The rural tax: comprehensive out-of-pocket costs associated with patient travel in British Columbia.
A significant concern for rural patients is the cost of travel outside of their community for specialist and diagnostic care. Often, these costs are transferred to patients and their families, who also experience stress associated with traveling for care. We sought to examine the rural patient experience by (1) estimating and categorizing the various out of pocket costs associated with traveling for healthcare and (2) describing and measuring patient stress and other experiences associated with traveling to seek care, specifically in relation to household income. We have designed and administered an online, retrospective, cross-sectional survey seeking to estimate the out-of-pocket (OOP) costs and personal experiences of rural patients associated with traveling to access health care in British Columbia. Respondents were surveyed across five categories: Distance Traveled and Transportation Costs, Accommodation Costs, Co-Traveler Costs, Lost Wages, and Patient Stress. Bivariate relationships between respondent household income and other numerical findings were investigated using one-way ANOVA. On average, costs for respondents were $856 and $674 for transport and accommodation, respectively. Strong relationships were found to exist between the distance traveled and total transport costs, as well as between a patient's stress and their household income. Patient perspectives obtained from this survey expressed several related issues, including the physical and psychosocial impacts of travel as well as delayed or diminished care seeking. These key findings highlight the existing inequities between rural and urban patient access to health care and how these inequities are exacerbated by a patient's overall travel-distance and financial status. This study can directly inform policy related efforts towards mitigating the rural-urban gap in access to health care.


Infants' Motor Proficiency and Statistical Learning for Actions.
Prior research has shown that infants learn statistical regularities in action sequences better than they learn non-action event sequences. This is consistent with current theories claiming that the same mechanism guides action observation and action execution. The current eye-tracking study tested the prediction, based on these theories, that infants' ability to learn statistical regularities in action sequences is modulated by their own motor abilities. Eight- to eleven-month-old infants observed an action sequence containing two deterministic action pairs (i.e., action A always followed by action B) embedded within an otherwise random sequence. One pair was performed with a whole-hand grasp. The second pair was performed with a pincer grasp, a fine motor skill that emerges around 9 months of age. Infants were then categorized into groups according to which grasp was dominant in their motor repertoire. Predictive looks to correct upcoming actions during the deterministic pairs were analyzed to measure whether infants learned and anticipated the sequence regularities. Findings indicate that infants learned the statistical regularities: across motor groups, they made more correct than incorrect predictive fixations to upcoming actions. Overall, learning was not significantly modulated by their dominant grasping abilities. However, infants with a dominant pincer grasp showed an earlier increase in correct predictions for the pincer grasp pair and not the whole-hand grasp. Likewise, infants with a dominant whole-hand grasp showed an early increase in correct predictions for the pair performed with a whole-hand grasp, and not the pincer grasp. Together, these findings suggest that infants' ability to learn action sequences is facilitated when the observed action matches their own action repertoire. However, findings cannot be explained entirely by motor accounts, as infants also learned the actions less congruent with their own abilities. Findings are discussed in terms of the interplay between the motor system and additional non-motor resources during the acquisition of new motor skills in infancy.


Fixed Drug Eruption in an Epileptic Patient Previously Receiving Treatment With Phenytoin for Seven Years.
A 52-year-old African American female presented with severe left thigh pain of unknown etiology. She had a past medical history of generalized seizure disorder treated with phenytoin for 7 years without incident. During admission a nurse witnessed a seizure, and consequently loading and maintenance doses of phenytoin were administered to obtain a therapeutic serum concentration. The patient had a history of noncompliance with multiple subtherapeutic phenytoin levels. Subsequently, unifocal blue discolored spots appeared, progressing to a bullous component that was positive for skin sloughing. Drug-induced fixed drug eruption was diagnosed and attributed to phenytoin. Clinicians should be cognizant of drug-induced fixed drug eruption in patients just initiated and those receiving long-term treatment with phenytoin. The administration rate of phenytoin may be associated with the development of fixed drug eruption.


Bipolarolides A-G: Ophiobolin-Derived Sesterterpenes with Three New Carbon Skeletons from Bipolaris sp. TJ403-B1.
Bipolarolides A-G (1-7), seven novel ophiobolin-derived sesterterpenes with three new types of skeletons, were characterized from fungus Bipolaris sp. TJ403-B1. Their structures were determined via spectroscopic analyses, X-ray crystallography, and quantum chemical 13 C NMR and electronic circular dichroism (ECD) calculations. Compounds 1 and 2 were uniquely defined by a multicyclic caged oxapentacyclo[9.3.0.01,6 .05,9 .18,12 ]pentadecane-bridged system. Compounds 3 and 4 featured an unprecedented 5-5-5-5-fused core skeleton, while 3 also contained an unexpected C-3-C-14 oxygen bridge to construct the caged architecture. Compounds 5-7 form a new class of highly modified pentacyclic oxaspiro[4.4]nonane-containing sesterterpene-alkaloid hybrids. Their biosynthetic pathways and potential HMG-CoA reductase inhibitory and antimicrobial activities are also discussed.


Stem cells for the treatment of heart failure.
Stem cell-based therapy is currently tested in several trials of chronic heart failure. The main question is to determine how its implementation could be extended to common clinical practice. To fill this gap, it is critical to first validate the hypothesis that the grafted stem cells primarily act by harnessing endogenous repair pathways. The confirmation of this mechanism would have three major clinically relevant consequences: (i) the use of cardiac-committed cells, since even though cells primarily act in a paracrine manner, such a phenotype seems the most functionally effective; (ii) the optimization of early cell retention, rather than of sustained cell survival, so that the cells reside in the target tissue long enough to deliver the factors underpinning their action; and (iii) the reliance on allogeneic cells, the expected rejection of which should only have to be delayed since a permanent engraftment would no longer be the objective. One step further, the long-term objective of cell therapy could be to use the cells exclusively for producing factors and then to only administer them to the patient. The production process would then be closer to that of a biological pharmaceutic, thereby facilitating an extended clinical use.


Treatment with B-type natriuretic peptide for chronic decompensated heart failure: insights learned from the follow-up serial infusion of nesiritide (FUSION) trial.
Several evidence-based treatment regimens are modestly effective in patients with moderately severe to severe heart failure, but truly effective therapies that improve symptoms, reduce hospitalizations, and extend meaningful survival do not exist for these patients. Only ventricular replacement therapy, with either heart transplantation or left ventricular assist devices, has been shown to significantly improve outcomes. Nesiritide, a recombinant B-type natriuretic peptide, is associated with significant reductions in filling pressure, with corresponding relief of symptoms, and diminished neurohormonal levels and has no inotropic effects and no evidence of proarrhythmia when given to patients with decompensated acute heart failure. Results of the Follow-Up Serial Infusion of Nesiritide (FUSION) trial suggest that a regimen incorporating nesiritide can be accomplished with a reasonable assurance of safety and tolerability; pre-study concerns regarding hypotension were not realized. A qualified look at outcomes data within FUSION I suggests that further study of this paradigm is reasonable, especially if the studied patient population includes patients with a low left ventricular ejection fraction and New York Heart Association (NYHA) class III disease with renal insufficiency, or patients with low left ventricular ejection fraction and NYHA class IV heart failure. Therefore, FUSION II, a double-blind, placebo-controlled trial, will randomly assign approximately 900 such patients to treatment with usual care plus nesiritide or usual care plus placebo and will use mortality/cardiorenal hospitalization as a composite end point. If positive data emerge from FUSION II that either confirm or strengthen the data in FUSION I, a new therapeutic option may be available for patients with chronic decompensated heart failure.


Microsatellite instability in hereditary and sporadic breast cancers.
Sporadic cancers and familial breast cancers are characterized by an increase in genetic instability. Little is known about whether mismatch repair defects accompany this genetic instability. We investigated invasive and/or in situ breast cancers from 30 women with deleterious BRCA1/2 mutations and unclassified variant BRCA1/2 alterations. Forty cases of sporadic breast cancers were also investigated, including 7 medullary carcinomas. Malignant and benign lesions were examined from all cases to better understand tumor progression. Automated immunohistochemistry, with antibodies directed against hMLH1 and hMSH2, was used to screen cases for possible mismatch repair defects. When loss of expression was noted, DNA ploidy was performed by cytomorphometry. DNA, after laser microdissection, was extracted from a majority of familial cases and their corresponding controls, and microsatellite instability analysis was performed. None of the familial or sporadic cases had loss of hMSH2 expression. All but one lesion, a DCIS arising in a deleterious BRCA2 mutation carrier, had loss of hMLH1 expression and a tetraploid profile by image cytomorphometry. There was no MSI in any explored lesions (n = 34), as determined by molecular analysis, including the DCIS with loss of hMLH1 expression. We conclude that DNA mismatch repair defects involving hMLH1 and hMSH2 underexpression are extremely rare events in sporadic and familial breast cancer. Mismatch repair gene mutations may be secondary random events in breast cancer progression.


Effectiveness and safety of acupuncture in treating sleep disturbance in dementia patients: A PRISMA-compliant systematic review and limitations of current evidence.
Dementia is of increasing importance, as it is a major public health problem worldwide. Sleep disturbance is common in dementia patients and may be associated with worse cognitive symptoms or behavioral and psychological symptoms of dementia. Non-pharmacological approaches, such as acupuncture, for treating this clinical condition are gaining importance. This study aimed to comprehensively search and analyze randomized controlled clinical trials (RCTs) of acupuncture in treating sleep disturbance or sleep disorders in dementia patients. A comprehensive search was conducted from 12 electronic databases on December 2, 2020. We included RCTs reporting the effectiveness and safety of acupuncture in treating sleep disorders or disturbance in dementia patients. The methodological quality of the included studies was assessed using the Cochrane Collaboration's risk-of-bias tool. Five articles with four original RCTs met the inclusion criteria. These studies reported clinical data suggesting that adjuvant acupuncture for hypnotics, and ear acupressure in dementia patients with sleep disorders or sleep disturbance may have clinical benefits in certain sleep-related parameters and total effective rate (TER). Only 1 study reported the safety profile of the intervention, and no acupuncture-related adverse reactions were reported. Some studies compared 2 kinds of acupuncture methods, and found that specific acupuncture methods were superior to conventional acupuncture in improving sleep-related parameters, cognitive function and TER. The methodological quality of the included clinical studies was not high. There were limited acupuncture studies on this topic. Given the number of studies included and their sample size, methodological quality, and heterogeneities, clinically relevant conclusions could not be drawn. Further clinical studies are needed in this field considering its urgency and importance.


Effect of corrective stresses on rods in adult spinal deformity surgery-finite element analysis.
The incidence of rod fracture after corrective surgery for adult spinal deformity (ASD) is high. Although many reports have investigated the effects of rod bending considering postoperative body motion, and countermeasures, there are no reports investigating the effects during intraoperative correction. The purpose of this study was to investigate the effect of ASD correction on rods by using finite element analysis (FEA) based on the rod shape changes before and after spinal corrective fusion. Five ASD patients (mean age 73 years, all female) who underwent thoracic to pelvic fusion were included in this study. A 3D rod model was created using computer-aided design software from digital images of the intraoperatively bended rod and intraoperative X-ray images after corrective fusion. The 3D model of the bent rod was meshed by dividing each of the screw head intervals into 20 sections and cross-section of the rod into 48 sections. Two surgical fusion methods of stepwise fixation as the cantilever method and parallel fixation as the translational method were simulated to evaluate stress and bending moments on the rods during intraoperative correction. The stresses on the rods were 1500, 970, 930, 744, and 606 MPa in the five cases for stepwise fixation and 990, 660, 490, 508, and 437 MPa for parallel fixation, respectively, with parallel fixation having lower stresses in all cases. In all cases, maximum stress was found around the apex of the lumbar lordosis and near L5/S1. The bending moment was high around L2-4 in most cases. The external forces of intraoperative correction had the greatest effect on the lower lumbar region, especially around the apex of the lumbar lordosis.


Prevalence and management of pain, by race and dementia among nursing home residents: United States, 2004.
Data from the National Nursing Home Survey, 2004. About one-quarter of all nursing home residents reported or showed signs of pain. Nonwhite residents and residents with dementia were less likely to report or show signs of pain compared with white residents and residents without dementia. Nonwhite residents with dementia were least likely, and white residents without dementia were most likely to report or show signs of pain. Forty-four percent of nursing home residents with pain received neither standing orders for pain medication nor special services for pain management (i.e., appropriate pain management). Among residents with dementia and pain, nonwhite residents were more likely than white residents to lack appropriate pain management.


Using Patterns of Genetic Association to Elucidate Shared Genetic Etiologies Across Psychiatric Disorders.
Twin studies indicate that latent genetic factors overlap across comorbid psychiatric disorders. In this study, we used a novel approach to elucidate shared genetic factors across psychiatric outcomes by clustering single nucleotide polymorphisms based on their genome-wide association patterns. We applied latent profile analysis (LPA) to p-values resulting from genome-wide association studies across three phenotypes: symptom counts of alcohol dependence (AD), antisocial personality disorder (ASP), and major depression (MD), using the European-American case-control genome-wide association study subsample of the collaborative study on the genetics of alcoholism (N = 1399). In the 3-class model, classes were characterized by overall low associations (85.6% of SNPs), relatively stronger association only with MD (6.8%), and stronger associations with AD and ASP but not with MD (7.6%), respectively. These results parallel the genetic factor structure identified in twin studies. The findings suggest that applying LPA to association results across multiple disorders may be a promising approach to identify the specific genetic etiologies underlying shared genetic variance.


Pushing the limits of task difficulty for the right and left hands in manual aiming.
The effects of task difficulty on the performance of the two hands in right-handers were examined in a manual-aiming paradigm. In order to examine both simple and complex tasks, movement amplitude, cursor size, and target size were manipulated, resulting in eight different indices of difficulty (as defined by Fitts' Law). Kinematic parameters examined included reaction time, movement time, time to and time after peak velocity, peak velocity, and resultant accuracy. Analysis revealed no differential effects of task difficulty on the overall movement times of the two hands. These results are discussed in light of current theories of manual asymmetries.


Impact of Western Bean Cutworm (Lepidoptera: Noctuidae) Infestation and Insecticide Treatments on Damage and Marketable Yield of Michigan Dry Beans.
The western bean cutworm, Striacosta albicosta (Smith) (Lepidoptera: Noctuidae), recently expanded its range from the western United States into the Great Lakes region of the United States and Canada, threatening eastern dry bean production. Our objectives were to better understand the relationship between cutworm infestation and damage in dry beans, and to determine the best method and timing of insecticide application to reduce pick. Infesting with at least one egg mass per 1.5 m, or as few as two larvae per 0.3 m, of row resulted in significantly more pod damage and pick than in uninfested plots. By 14 d after hatch, larvae were no longer on plants during the daytime; direct observations revealed that fifth instars climbed plants to feed between 2100 and 0600 hours, illustrating the impractically of using larval counts to make management decisions. There was a strong linear relationship between pod damage and percent pick, making scouting for pod damage a viable alternative to egg or larval scouting. Aldicarb soil insecticide or thiamethoxam-treated seed did not reduce cutworm damage. Instead, plots treated with these insecticides had significantly more pick than control plots, perhaps related to increased canopy growth or fewer natural enemies. The pyrethroid λ-cyhalothrin provided excellent control of cutworm when sprayed up to 18 d after infestation. Pick was similar among plots sprayed once up to 18 d after infestation or sprayed four separate times. In a field study, λ-cyhalothrin residue on field-treated foliage was 100% effective at controlling caterpillars up to 14 d after application.


Prehension of objects oriented in three-dimensional space.
When reaching for an object, the proximity of the object, its orientation, and shape should all be correctly estimated well before the hand arrives in contact with it. We were interested in the effects of the object's orientation on manual prehension. Subjects were asked to reach for an object at one of several possible orientations. We found that the trajectory of the hand and its rotation and opening were significantly affected by the object's orientation within the first half of the movement. We also detected a slight delay of the wrist relative to the forearm and a small bias of the orientation of the fingers' tips toward the orientation of the table on which the object lay. Finally, the aperture of the hand was proportional to the physical size of the object, which shows that size constancy was achieved from the variation of the object's orientation. Taken together, these results indicate that the three components of the movement - the transport, rotation, and opening of the hand - have access to a common visual representation of the object's orientation.


Effect of desuppression on nodular thyroid disease.
To ascertain the clinical effect of discontinuation of thyroxine (T4) suppression therapy in patients with solitary thyroid nodules or multinodular goiters (MNGs). After long-term T4 suppression therapy was discontinued (desuppression) in 63 patients (45 with solitary or dominant nodules and 18 with MNGs), we conducted a prospective follow-up for a mean of 18 months in an effort to detect any thyroid-related changes. A dominant nodule developed in 4 of 18 patients with MNGs. Fine-needle aspirations showed benign lesions in these four patients, but two were referred for thyroidectomy because of substantial nodule growth (both lesions proved to be benign). Of the 45 patients with solitary or dominant thyroid nodules, 4 were lost to follow-up, and 9 had clinically significant nodule enlargement and underwent thyroidectomy. One patient had clinically significant papillary carcinoma, and one had microscopic papillary carcinoma. These data on effect of discontinuation of T4 suppression therapy suggest that (1) about 20% of patients with MNGs will ultimately have thyroid nodule enlargement and (2) about 20% of patients with a solitary or dominant nodule will have nodule enlargement, of which approximately 20% will have papillary carcinoma.


A survey of specialized traumatic stress services in the United Kingdom.
Specialist care following psychological trauma in the UK has, since 2005, been governed by the National Institute for Health and Clinical Excellence (NICE) Guideline 26, for the treatment of post-traumatic stress disorder. NICE guidance states that the preferred first-line treatment is trauma-focused cognitive behavioural therapy that incorporates techniques of eye movement, desensitization and reprocessing. In light of this guidance, the rationale for this survey was to assess the nature and scope of services available in UK specialist trauma services and range of available therapeutic approaches delivered. Thirteen organizations responded to the survey. Ten were NHS services and three were non-statutory organizations. Professional positions were primarily populated by psychologists. The total number of referrals to UK specialist trauma services surveyed in the 12 months prior to the survey was 2041 with a mean of 157. Trauma-focused cognitive behavioural therapy was the most common therapeutic treatment, but person-centred therapy was found to have increased in availability within specialist trauma services. This arguably reflects the widening availability of person-centred therapy in the improving access to psychological therapies initiative and perhaps suggests some divergence from more uniform cognitive and behavioural approaches within NHS therapy services. Implications for practice are discussed.


The role of the prostaglandin D2 receptor, DP, in eosinophil trafficking.
Prostaglandin (PG) D2 is a major mast cell product that acts via two receptors, the D-type prostanoid (DP) and the chemoattractant receptor-homologous molecule expressed on Th2 cells (CRTH2) receptors. Whereas CRTH2 mediates the chemotaxis of eosinophils, basophils, and Th2 lymphocytes, the role of DP has remained unclear. We report in this study that, in addition to CRTH2, the DP receptor plays an important role in eosinophil trafficking. First, we investigated the release of eosinophils from bone marrow using the in situ perfused guinea pig hind limb preparation. PGD2 induced the rapid release of eosinophils from bone marrow and this effect was inhibited by either the DP receptor antagonist BWA868c or the CRTH2 receptor antagonist ramatroban. In contrast, BWA868c did not inhibit the release of bone marrow eosinophils when this was induced by the CRTH2-selective agonist 13,14-dihydro-15-keto-PGD2. In additional experiments, we isolated bone marrow eosinophils from the femoral cavity and found that these cells migrated toward PGD2. We also observed that BWA868c inhibited this response to a similar extent as ramatroban. Finally, using immunohistochemistry we could demonstrate that eosinophils in human bone marrow specimens expressed DP and CRTH2 receptors at similar levels. Eosinophils isolated from human peripheral blood likewise expressed DP receptor protein but at lower levels than CRTH2. In agreement with this, the chemotaxis of human peripheral blood eosinophils was inhibited both by BWA868c and ramatroban. These findings suggest that DP receptors comediate with CRTH2 the mobilization of eosinophils from bone marrow and their chemotaxis, which might provide the rationale for DP antagonists in the treatment of allergic disease.


New molecular insights into CETP structure and function: a review.
Cholesteryl ester transfer protein (CETP) is important clinically and is the current target for new drug development. Its structure and mechanism of action has not been well understood. We have combined current new structural and functional methods to compare with relevant prior data. These analyses have led us to propose several steps in CETP's function at the molecular level, in the context of its interactions with lipoproteins, e.g., sensing, penetration, docking, selectivity, ternary complex formation, lipid transfer, and HDL dissociation. These new molecular insights improve our understanding of CETP's mechanisms of action.


Can grief be a mental disorder? An online survey on public opinion in mainland China.
This study investigates Chinese people's opinions about the diagnosis of grief and the factors associated with their opinions. Among 1041 participants who completed the online survey, over half (56.5%) agreed that grief could be a mental disorder under certain circumstances, such as harm to self or others, functional impairment, and persistent grief. Primary reasons against the diagnosis were that grief is normal and its intensity decreases over time. A small proportion of opponents also expressed concerns about stigmatization resulting from labeling grief as being pathological. Younger, male, and full-time employed adults tended to support diagnosing grief as a mental disorder.


Mutations in TYROBP are not a common cause of dementia in a Turkish cohort.
Mutations in TYROBP and TREM2 have been shown to cause polycystic lipomembranous osteodysplasia with sclerosing leukoencephalopathy. Recently, variants in TREM2 were also associated with frontotemporal dementia and Alzheimer's disease. Given the functional proximity between these 2 genes, we investigated the genetic variation of TYROBP in a Turkish cohort of 103 dementia patients. No mutations or copy number variants predicted to be pathogenic were identified. These results indicate that mutations in TYROBP are not a common cause of dementia in this Turkish cohort.