Trends in Sentinel Lymph Node Mapping and Adjuvant Therapy in Endometrial Carcinoma.
We analyzed 54,039 women with uterine cancer in the National Cancer Database from 2013 to 2014 including 38,453 (71.2%) who underwent lymphadenectomy, 1929 (3.6%) who underwent sentinel lymph node (SLN) mapping, and 13,657 (25.3%) who did not undergo nodal assessment. SLN mapping increased from 2.8% in 2013 to 4.3% in 2014 (P < 0.001). Patients treated in 2014 and those at community centers were more likely to undergo SLN biopsy, while women with advanced-stage disease, sarcomas, and grade 3 tumors were less likely to undergo SLN mapping (P < 0.05). There was no association between use of SLN biopsy and use of radiation (aRR = 0.92; 95% CI, 0.82-1.05).


Filamin A expression predicts early recurrence of hepatocellular carcinoma after hepatectomy.
Recurrence of hepatocellular carcinoma (HCC) after hepatectomy is very high. A predictive marker of early recurrence (ER) capable of personalizing follow-up and developing a new target therapy would be beneficial. The overexpression of Filamin-A (FLNA), a cytoskeleton protein with scaffolding properties, has recently been associated with progression in tumours. The aim of this study was to test the expression of FLNA in a cohort of patients operated for HCC. A retrospective cohort of patients who underwent hepatic resection at Humanitas Clinical and Research Center between January 2004 and December 2014 was analysed. FLNA was tested, using a tissue microarray, in the HCC and in the surrounding tissues. The endpoint was the role of FLNA expression in predicting ER of HCC after hepatectomy. Analyses were performed following the REMARK guidelines. A total of 113 patients were considered. FLNA was expressed only in the tumoral tissue. Several variables, including T stage, tumour number, tumour size, type of viral hepatitis, type of hepatectomy and intra and peritumoral immune-reactivity to FLNA were significantly associated with ER by univariate analysis. With multivariate analysis, only T stage (HR=2.108; P=.002), tumour number (HR=1.586; P=.023), intra-tumoral (HR=2.672; P<.001) and peritumoral immune-reactivity to FLNA (HR=2.569; P<.001), significantly correlated with ER. The logistic regression analysis revealed that advanced T stage (OR=2.985; P=.001), HCV-infection (OR=1.219; P=.008) and advanced tumour grading (OR=2.781; P=.002) were associated with intratumoral FLNA immune-reactivity. FLNA expression predicts recurrence of HCC after hepatectomy. This finding provides important insights that would help physicians to personalize follow-up strategies.


Silver Nanoparticles Reinforced (Poly-(l-lysine)/Hyaluronic Acid) Free-Standing Films: The Mechanical Strength and Antibacterial Activity.
Free-standing polyelectrolyte multilayer films which are composed of biomacromolecules, such as polysaccharides and/or polypeptides, have attracted numerous attentions in biomedical fields. However, the poor mechanical strength makes their future applications difficult. In the present work, we used the pH-amplified Poly-(l-lysine)/Hyaluronic acid (PLL/HA) film as the template and in situ synthesized silver nanoparticles (AgNPs) in a green way. It was confirmed that the size of AgNPs in the films was largely dependent on the loading method of Ag+ (pre-complex vs. post-loading). Meanwhile, the loading amount of AgNPs and their distribution in the films could be controlled by the films outermost layer (PLL vs. HA) as observed under electron microscopies. The reduced AgNPs were used here as both bactericidal agent and mechanical reinforcer. The anti-bacterial activity of the films with AgNPs was verified by the Kirby-Bauer assay, and film cytotoxicity was examined by MTT examination. The effects of AgNPs' amount, size and distribution on the mechanical properties of films were evaluated by both nanoindentation and micro tensile tests. The films embedded with AgNPs of smaller size and well-distribution throughout the films gained the maximal enhancement on mechanical strength and preserved acceptable cytocompatibility. The in situ UV reduction of silver nanoparticles in polyelectrolyte multilayer films with controllable internal structures could provide a facile way to ensure the films with enhanced mechanical properties as well as effective anti-bacterial and normal-cell-supporting capabilities.


The Oportunidades program's fortified food supplement, but not improvements in the home diet, increased the intake of key micronutrients in rural Mexican children aged 12-59 months.
Mexico's Oportunidades program provides conditional cash transfers, nutrition education, health services, and fortified food supplements for the young children of poor families. We have documented the effects of the program on growth and reduction of anemia. To better understand the impact pathways and disentangle the relative effects on dietary intake of the food supplements compared with other program components, we analyzed data from a randomized effectiveness evaluation of the Oportunidades program in rural children aged 12-59 mo. All Oportunidades beneficiaries received the cash transfers and the health and education components, but some children did not consume the supplements. The children's diet was evaluated using a single 24-h recall. The impact was estimated using multiple linear regression models with community-level random effects. Comparisons were made among children who received all the benefits of Oportunidades, including the fortified food supplement (SG), beneficiaries of the program who did not consume the food supplement (NSG), and the control group (CG). Relative to the NSG and CG, respectively, the SG consumed greater amounts of [mean (95% CI)]: energy, 94 (28, 160) and 111 (43, 180) kcal/d; iron, 7.6 (6.3, 8.9) and 7.7 (6.5, 9.0) mg/d; zinc, 7.5 (6.4, 8.6) and 7.6 (6.5, 8.7) mg/d; and vitamin A, 0.109 (0.071, 0.147) and 0.120 (0.080, 0.159) mg retinol equivalents/d. No differences were found between the NSG and CG (P > 0.05). To conclude, the Oportunidades program had a positive impact on the diet of children. The effects of the program on dietary intake resulted from the food supplement and not from improvements in the home diet. Our findings are useful for identifying which program components contributed to the effects on the nutritional status of children.


Three-dimensional core-shell ferromagnetic nanowires grown by focused electron beam induced deposition.
Functional nanostructured materials often rely on the combination of more than one material to confer the desired functionality or an enhanced performance of the device. Here we report the procedure to create nanoscale heterostructured materials in the form of core-shell nanowires by focused electron beam induced deposition (FEBID) technologies. In our case, three-dimensional (3D) nanowires (<100 nm in diameter) with metallic ferromagnetic cores of Co- and Fe-FEBID have been grown and coated with a protective Pt-FEBID shell (ranging 10-20 nm in thickness) aimed to minimize the degradation of magnetic properties caused by the surface oxidation of the core to a non-ferromagnetic material. The structure, chemistry and magnetism of nanowire cores of Co and Fe have been characterized in Pt-coated and uncoated nanostructures to demonstrate that the morphology of the shell is conserved during Pt coating, the surface oxidation is suppressed or confined to the Pt layer, and the average magnetization of the core is strengthened up to 30%. The proposed approach paves the way to the fabrication of 3D FEBID nanostructures based on the smart alternate deposition of two or more materials combining different physical properties or added functionalities.


Dermatopathic lymphadenopathy: a differential diagnosis of enlarged lymph nodes in uremic pruritus.
In end-stage renal disease patients, the incidence of both infections and malignancies is increased leading to a higher incidence of peripheral lymphadenopathy. In the present work we describe a rare but probably underdiagnosed cause for enlarged lymph nodes in uremic patients. A 43-year-old male patient was admitted to our hospital with inguinal lymphadenopathy and pruritus. He turned out to be uremic due to focal segmental glomerulosclerosis (creatinine 4.5 mg/dl, MDRD creatinine clearance 12 ml/min). Sonography revealed enlarged lymph nodes (up to 4 cm) with intact corticohilar border differentiation. After extirpation of an inguinal lymph node, histological examination established the diagnosis of dermatopathic lymphadenopathy. T cell lymphoma was excluded by PCR for T cell receptor-gamma rearrangements and subsequent GeneScan analysis. Intravenous fluid supplementation with subsequent decline of creatinine, UVB treatment, clemastine, and topical use of emollients led to a relief of the uremic pruritus and the lymph nodes' size normalized within 8 weeks. Dermatopathic lymphadenopathy refers to the reactive condition seen in lymph nodes that drain areas with disruption of the skin integrity, e.g. due to scratch marks. The present case report describes dermatopathic lymphadenopathy as a harmless cause of enlarged lymph nodes in uremic pruritus for the first time. This entity should be considered in the differential diagnosis of peripheral lymphadenopathy of unknown origin in patients with renal failure.


Adherence to Clinical Practice Guidelines during Dementia Work-Up in a Real-World Setting: A Study from the Registry of Dementias of Girona.
There are several position statements and clinical practice guidelines (CPG) for diagnosing dementia. Our aims were to evaluate the adherence to CPG among specialists in the 7 memory clinics included in the Registry of Dementias of Girona (ReDeGi), and to compare the results between 2007-2011 and 2012-2015. We also determined the time and number of visits required to achieve a diagnosis, the supplementary tests ordered, and the drugs prescribed according to dementia subtypes. Medical charts of a stratified random sample of 475 ReDeGi cases were reviewed. Basic dementia work-up was evaluated using as a reference evidence-based CPG. An Index of Adherence (AI) was calculated using the following items in the medical chart: cognitive symptomatology; functional disability evaluation; physical examination; neurological examination; psychiatric examination; brief cognitive examination; activities of daily living performance examination; blood test; structural neuroimaging (CT-scan or MRI). The mean AI to CPG among specialists was of 8.2 points, and it improved from 7.9 points in 2007-2011 to 8.5 points in 2012-2015 (Cohen's d = 0.46). A lower adherence was detected in the most severe cases. A dementia diagnosis required 3.5 visits, regardless of the subtype of dementia, although milder cases required more time, more visits, and more supplementary tests than severe cases. The adherence to CPG in the catchment area of the ReDeGi is high, and an epidemiological surveillance system such as the ReDeGi may help in improving it. Dementia guidelines should establish procedures adapted to clinical practice, with simplified recommendations for most severe cases.


[A brainstem variant of reversible posterior leukoencephalopathy syndrome (RPLS) presenting with visual disturbance].
A 40-year-old woman noticed blurred vision of the right eye. The optic disc edema of bilateral eyegrounds was noted, and brain MRI showed abnormal signals of the brainstem at a neurosurgical clinic. On her first visit, blood pressure was as remarkably high as 250/130 mmHg. Neurologically, only optic disc edema of bilateral eye-grounds was found. Both T2-weighted MRI and FLAIR showed hyperintense signal areas mainly from the ventral pons to medulla oblongata. These areas were not enhanced with gadolinium. About three weeks after the administration of an antihypertensive agent, brain MRI revealed no abnormal signal. About three months later, the blurred vision disappeared and ophthalmological abnormalities subsided. We diagnosed her with a brainstem variant of RPLS, presenting with visual disturbance caused by hypertensive retinopathy.


Biological Function of Ribosomal Protein L10 on Cell Behavior in Human Epithelial Ovarian Cancer.
Ribosomal protein L10 (RPL10) is one of large ribosomal proteins and plays a role in Wilms' tumor and premature ovarian failure. However, the function of RPL10 in human epithelial ovarian cancer (EOC) remains unknown. The purpose of this study was to examine the expression level and function of RPL10 in EOC. RPL10 protein expression was detected by immunohistochemistry and Western blot. The association RPL10 expression with clinical features was analyzed. Loss-of-function and gain-of-function approaches were applied in cellular assays, including cell viability, migration, invasion, and apoptosis. Our study demonstrated for the first time that RPL10 was upregulated in human EOC compared with normal ovarian tissues. Knockdown of RPL10 inhibited cell viability, migration, and invasion, and increased cell apoptosis. On the contrary, upregulation of RPL10 increased cell viability, migration, invasion, and decreased cell apoptosis. Furthermore, miR-143-3p regulated RPL10 expression. Our data indicate that RPL10 is a potential tissue biomarker of patients with EOC and may be a therapeutic target of ovarian cancer.


Strain-induced Stranski-Krastanov growth of Pd@Pt core-shell hexapods and octapods as electrocatalysts for methanol oxidation.
Bimetallic nanocrystals with a branched shape have received great interest as catalysts due to their unique structures and fascinating properties. However, the conventional synthetic approaches based on the island growth mode often lead to the dendritic nanostructures with inhomogeneous and uncontrolled branches. Here precise control over the number of branches has been realized in the deposition of Pt on Pd seeds through the Stranski-Krastanov growth mechanism. Based on such a growth mode, Pd@Pt core-shell hexapods and octapods have been generated by a seeded growth with Pd octahedra and cubes as the seeds, respectively. We found that Pt atoms are initially deposited on the side faces of Pd seeds through a layer-by-layer epitaxial growth in the presence of oleylamine (OAm), leading to a local strain focused at their corners. These strain-concentrated sites promote the subsequent island growth of Pt atoms at the corners of the Pd seeds, resulting in the Pd@Pt core-shell hexapods or octapods. Both the Pd@Pt core-shell hexapods and octapods exhibit the substantially enhanced catalytic properties in terms of activity and stability towards a methanol oxidation reaction (MOR) relative to the commercial Pt/C. Specifically, the Pd@Pt core-shell hexapods show the highest specific (1.97 mA cm-2) activity and mass activity (0.52 mA μgPt-1) for the MOR, which are 5.8 and 2.6 times higher than those of the commercial Pt/C, respectively. This enhancement can probably be attributed to their unique structures and the synergistic effect between Pt and Pd.


Effects of spinal stabilization exercises delivered using telerehabilitation on outcomes in patients with chronic neck pain: a randomized controlled trial.
When spinal stabilization exercises (SSE) are performed regularly, may provide benefits on outcome measures in chronic nonspecific neck pain (CNNP) patients. The pandemic has made it difficult for CNNP patients to access regular physiotherapy-exercise services. This study aims to compare telerehabilitation (TR) with face-to-face rehabilitation in CNNP. Neck Functional Capacity Evaluation Test (NFCET) results were the primary outcomes. Pain intensity (PI), disability, awareness, neck muscles architecture, andexercise satisfaction were the secondary outcomes. Patients were randomized into the TR group (TRG) (n = 15) and the control group (CG) (n = 16). Patients performed SSE 3 days a week, for 8 weeks. The TRG was instructed remotely while the CG was instructed in the clinic. After 8 weeks in both groups, NFCET values and neck awareness increased (p < 0.05), PI and disability decreased (p < 0.05). Muscle architecture improved in both groups (p < 0.05), except for the Right Sternocleidomastoideus in both groups and the Right Upper-Trapezius in TRG (p > 0.05). There was no difference between the groups for all variables and exercise satisfaction(p > 0.05). SSE for CNNP, whether supervised by therapists in the clinic or by telerehabilitation, was equally effective. NCT04691024.


Apoptosis repressor with caspase recruitment domain (ARC) promotes bone regeneration of bone marrow-derived mesenchymal stem cells by activating Fgf-2/PI3K/Akt signaling.
This study aims to investigate whether apoptosis repressor with caspase recruitment domain (ARC) could promote survival and enhance osteogenic differentiation of bone marrow-derived mesenchymal stem cells (BMSCs). The lentivirus transfection method was used to establish ARC-overexpressing BMSCs. The CCK-8 method was used to detect cell proliferation. The BD Pharmingen™ APC Annexin V Apoptosis Detection kit was used to detect cell apoptosis. The osteogenic capacity was investigated by OCN immunofluorescence staining, ALP analysis, ARS assays, and RT-PCR analysis. Cells were seeded into calcium phosphate cement (CPC) scaffolds and then inserted subcutaneously into nude mice and the defect area of the rat calvarium. Histological analysis was conducted to evaluate the in vivo cell apoptosis and new bone formation of the ARC-overexpressing BMSCs. RNA-seq was used to detect the possible mechanism of the effect of ARC on BMSCs. ARC promoted BMSC proliferation and inhibited cell apoptosis. ARC enhanced BMSC osteogenic differentiation in vitro. An in vivo study revealed that ARC can inhibit BMSC apoptosis and increase new bone formation. ARC regulates BMSCs mainly by activating the Fgf-2/PI3K/Akt pathway. The present study suggests that ARC is a powerful agent for promoting bone regeneration of BMSCs and provides a promising method for bone tissue engineering.


Bilateral Killian-Jamieson diverticula: a case report and literature review.
A Killian-Jamieson diverticulum is an outpouching from the lateral wall of the proximal cervical esophagus. These diverticula are rare and are distinct from the more commonly known Zenker's diverticulum. Literature regarding Killian-Jamieson diverticula and its suggested management is scarce. The present report describes a patient with symptomatic bilateral Killian-Jamieson diverticula. The patient had both diverticula excised and an esophagomyotomy performed. Following surgery, the patient's symptoms resolved and he recovered well. A literature review and discussion of the etiology, clinical presentation and radiographic findings of Killian-Jamieson diverticulum follow, as do recommendations for clinical management.


Detection of human coronavirus NL63, human metapneumovirus and respiratory syncytial virus in children with respiratory tract infections in south-west Sweden.
Two recently detected viruses, human metapneumovirus (hMPV) and coronavirus NL63 (HCoV-NL63), have been associated with acute respiratory tract infections, particularly in young children. This study investigated the frequency of hMPV and HCoV-NL63 infections in Swedish children by screening 221 nasopharyngeal aspirates, collected between November 2003 and May 2005, from 212 children attending the paediatric department of a county hospital in Sweden or submitted from local general practitioners. The samples were originally submitted to be tested for respiratory syncytial virus (RSV), and were examined retrospectively for hMPV and HCoV-NL63 by RT-PCR. Of the 212 patients, 101 were positive for RSV (48%), 22 (10%) were positive for hMPV, and 12 (6%) were positive for HCoV-NL63. The frequency of HCoV-NL63 infection increased from 1% in 2003-2004 to 10% in 2004-2005. Sequence analysis of parts of the coronavirus genomes showed considerable similarity to the HCoV-NL63 prototype sequence. The study demonstrated that HCoV-NL63 and hMPV occur in south-west Sweden with essentially the same frequency, seasonal distribution and clinical characteristics as have been reported in other countries.


Psychological couple-oriented interventions for patients with heart disease and their partners: a scoping review and guidelines for future interventions.
This scoping review aims to provide an accessible summary of available evidence on the efficacy of psychological couple-based interventions among patients with heart disease and their partners focusing on specific aspects and strategies by assessing different emotional and physical cardiac-related outcome measures. A literature search was performed in PubMed, Scopus, Medline, PsycINFO, and Web of Science databases using the keywords "heart diseases" and "couple-based intervention." A literature search using systematic methods was applied. Data were extracted to address the review aims and were presented as a narrative synthesis. The database search produced 11 studies. Psychological couple-based interventions varied in terms of the type of intervention, personnel, format (group or individual, phone or in person), number of sessions, and duration. Most of the contributions also lacked adequate details on the training of professionals, the contents of the interventions, and the theoretical models on which they were based. Finally, although partners were involved in all the treatment, in most studies, the psychological strategies and outcomes were focused on the patient. The variability of the psychological couple-based interventions of included studies represents a challenge in summarizing the existing literature. Regarding their impact, psychological interventions for patients with cardiovascular disease and their partners were found to moderately improve patients' and partners' outcomes.


Fracturing-Fluid Flowback Simulation with Consideration of Proppant Transport in Hydraulically Fractured Shale Wells.
Involving the fluid-particle hydrodynamic process and hydraulically created fracture network, fracturing-fluid flowback in hydraulically fractured shale wells is a complex transport behavior. However, there is limited research on investigating the influence of proppant transport on the fracturing-fluid flowback behavior and flowback data analysis. In this paper, a flowback model is developed to simulate the flowback behaviors of the carrying fluid and proppant from the recompacted fracture system in shale wells. The development of fluid pressure and proppant concentration profiles of the fractured shale well are presented. The fluid and proppant fluxes among the hydraulic primary fracture and the induced fracture are also calculated. The influences of proppant consideration or not, proppant density, proppant size, fracturing-fluid viscosity, and fracturing-fluid density on the flowback behavior are investigated. The simulation results are useful for fracturing-fluid optimization in the design phase. Finally, two field cases from the Longmaxi Formation, Southern Sichuan Basin, China are used for matching the actual flowback data with the model results. The results prove that the proppant transport has influence on the flowback behavior to some degree and should be considered in the flowback model for a rather elaborate flowback analysis and post-treatment fracture evaluation.


Harmonization of interpretative comments in laboratory hematology reporting: the recommendations of the Working Group on Diagnostic Hematology of the Italian Society of Clinical Chemistry and Clinical Molecular Biology (WGDH-SIBioC).
The goal of harmonizing laboratory testing is contributing to improving the quality of patient care and ultimately ameliorating patient outcome. The complete blood and leukocyte differential counts are among the most frequently requested clinical laboratory tests. The morphological assessment of peripheral blood cells (PB) through microscopic examination of properly stained blood smears is still considered a hallmark of laboratory hematology. Nevertheless, a variable inter-observer experience and the different terminology used for characterizing cellular abnormalities both contribute to the current lack of harmonization in blood smear revision. In 2014, the Working Group on Diagnostic Hematology of the Italian Society of Clinical Chemistry and Clinical Molecular Biology (WGDH-SIBioC) conducted a national survey, collecting responses from 78 different Italian laboratories. The results of this survey highlighted a lack of harmonization of interpretative comments in hematology, which prompted the WGDH-SIBioC to develop a project on "Harmonization of interpretative comments in the laboratory hematology report", aimed at identifying appropriate comments and proposing a standardized reporting system. The comments were then revised and updated according to the 2016 revision of the World Health Organization classification of hematologic malignancies. In 2016, the Working Group on Diagnostic Hematology of the Italian Society of Clinical Chemistry and Clinical Molecular Biology (WGDH SIBioC) published its first consensus based recommendation for interpretative comments in laboratory hematology reporting whit the purpose of evaluating comments and the aim to (a) reducing their overall number, (b) standardizing the language, (c) providing information that could be easily comprehended by clinicians and patients, (d) increasing the quality of the clinical information, and (e) suggesting additional diagnostic tests when necessary. This paper represents a review of the recommendations of the former document.


Enriching practice of dialectic behaviour therapy with the dynamic maturational model of attachment and adaptation.
The major challenge for a clinician is integration of the wisdom available in the wide range of therapeutic paradigms available. I have found the principles guiding dialectic behaviour therapy (DBT; see Miller, Rathus, & Linehan, 2007, for applying DBT to adolescents) extremely useful in my practice running a general adolescent unit; similarly, the understanding of the different information processing and learning principles associated with each of the Type A and C attachment strategies, as understood in dynamic maturational model (DMM), has guided me through the dark corners of treatment. Specifically, how does DMM inform practice of DBT? As a 'DBTer' might say, 'Where is the wisdom in both points of view?' Nevertheless, DMM is not primarily about treatment. It concerns how different ways of adapting to developmental contingencies bias perceptual propensities, and hence the information available for reflective brain function. Recognition of these twists to knowing what is going on can then be used to inform a variety of therapeutic approaches. The purpose of this article is to look for the signposts in DBT and DMM which together help navigate the comprehensive approach necessary in complicated therapy. In the process, hopefully some more general principles for addressing discomfited adolescents arise for informing future practice. Although many steer shy of using personality disorder diagnoses for adolescents, clinicians are nevertheless addressing, directly or indirectly, the personality development of all adolescents in treatment, regardless of their classical axis I diagnoses, including both those with developing emotional instability and a group of avoidant over-controlled adolescents, which in Norway is growing in prominence.


Improved semi-automated analysis of procainamide and N-acetyl procainamide utilizing a totally volatile mobile phase.
A semi-automated technique has been devised for the analysis of the antirhythmic drugs, procainamide (PA) and N-acetyl procainamide (NAPA) from human serum. Reverse-phase high-performance liquid chromatographic (HPLC) separations were performed by means of an autoinjector system in combination with microBondapak C18 column. A mobile phase containing only volatile buffers (e.g., triethylamine-acetic acid or N-ethyl morpholine-acetic acid) at apparent pH 5.3 was necessitated to prevent the buildup of salt residues on the valves and fittings within the autoinjector and high pressure pump. For HPLC analysis of these drugs, the within-run precision, as estimated by coefficient of variation analysis, was less than 9%. Comparable precision was shown for day-to-day variation in analysis. No interference was noted from 20 other substances, metabolites or drugs that might be present in the sera extracts. This semi automated procedure has been utilized successfully to quantitate over 200 patient sera on a bach or emergency basis.


Full model for reversible kinetics of lipase-catalyzed sugar-ester synthesis in 2-methyl 2-butanol.
A kinetic model derived from the ping-pong bi-bi reversible mechanism is proposed to described the acylation of glucose by lauric acid in 2-methyl 2-butanol mediated by Candida antarctica lipase at 60 degrees C. The model accounts for the effect of all four compounds in the reaction mixture, namely lauric acid, glucose, water, and lauroyl glucose ester. A supersaturated glucose solution was used to avoid limitations by glucose dissolution rate. Experiments with varied initial water content were performed to determine the effect of water on the initial reaction rate. The full time course of ester formation is described by five parameters: (a) three parameters evaluated from initial rate measurements; (b) the equilibrium constant, independently evaluated; and (c) one extra parameter fitted to the progress curve of ester formation. This reduced form of a full reversible kinetic model based on the ping-pong bi-bi mechanism is able to describe the complete course of lauroyl glucose ester synthesis. The proposed model provides a good fit for the experimental results.


Organic-Inorganic Phenolic/POSS Hybrids Provide Highly Ordered Mesoporous Structures Templated by High Thermal Stability of PS-b-P4VP Diblock Copolymer.
Anionic living polymerization was used to prepare a diblock copolymer of poly(styrene-b-4-vinyl pyridine) (PS-b-P4VP), and a phenolic resin with a double-decker silsesquioxane (DDSQ) cage structure was used to form a phenolic/DDSQ hybrid (PDDSQ-30 with 30 wt.% DDSQ). Strong intermolecular hydrogen bonding could be confirmed through the hydroxyl (OH) groups of PDDSQ hybrid with the pyridine group of the P4VP block in PDDSQ-30/PS-b-P4VP blends based on Fourier transform infrared spectroscopy analyses, where increasing PDDSQ concentrations resulted in a higher proportion of hydrogen-bonded pyridine groups. After thermal polymerization at 180 °C, the self-assembled structures of these PDDSQ/PS-b-P4VP blends were revealed by data from small-angle X-ray scattering (SAXS) and transmission electron microscopy (TEM), where the d-spacing increased with raising PDDSQ concentration. Because relatively higher thermal stability of the PDDSQ hybrid than pure phenolic resin and PS-b-P4VP template, we can obtain the long ranger order of mesoporous PDDSQ hybrids after removing the PS-b-P4VP template, which reveals the high surface area and high pore volume with cylindrical and spherical structures corresponding to the PDDSQ compositions that are rarely observed by using pure phenolic resin as the matrix and could be used in supercapacitor application.


Artemether-lumefantrine (six-dose regimen) for treating uncomplicated falciparum malaria.
The World Health Organization recommends artemether-lumefantrine for treating uncomplicated malaria. We sought evidence of superiority of the six-dose regimen over existing treatment regimens as well as its effectiveness in clinical situations. To evaluate the six-dose regimen of artemether-lumefantrine for treating uncomplicated falciparum malaria. We searched the Cochrane Infectious Diseases Group Specialized Register (April 2005), CENTRAL (The Cochrane Library Issue 1, 2005), MEDLINE (1966 to April 2005), EMBASE (1974 to April 2005), LILACS (1982 to April 2005), conference proceedings, and reference lists of articles. We also contacted experts in malaria research and the pharmaceutical company that manufactures artemether-lumefantrine. Randomized controlled trials comparing six doses of artemether-lumefantrine administered orally with standard treatment regimens (single drug or combination), or supervised with unsupervised treatment, for uncomplicated falciparum malaria. Two authors independently applied inclusion criteria to potentially relevant trials, assessed trial quality, and extracted data, including adverse events. Total failure by day 28 (day 42 for sulfadoxine-pyrimethamine and day 63 for mefloquine) was the primary outcome. Nine trials (4547 participants) tested the six-dose regimen. Total failure at day 28 for artemether-lumefantrine was lower when compared with amodiaquine (270 participants, 1 trial), amodiaquine plus sulfadoxine-pyrimethamine (507 participants, 1 trial), but not with chloroquine plus sulfadoxine-pyrimethamine (201 participants, 2 trials). In comparisons with artemisinin derivative combinations, artemether-lumefantrine performed better than amodiaquine plus artesunate (668 participants, 2 trials), worse than mefloquine plus artesunate (270 participants, 4 trials), and no differently to dihydroartemisinin-napthoquine-trimethoprim (89 participants, 1 trial). The six-dose regimen of artemether-lumefantrine appears more effective than antimalarial regimens not containing artemisinin derivatives.


Primary esophageal lymphoma in immunocompetent patients: Two case reports and literature review.
Primary lymphoma that involves the esophagus is very rare, with fewer than 30 cases reported in the English-language literature. Non-Hodgkin lymphoma accounts for most of the cases. Esophageal lymphomas have varied radiological appearances, which poses diagnostic difficulty. We report two cases of histopathologically confirmed primary diffuse large B-cell esophageal lymphoma and describe their radiological features, and briefly review the literature.


Development and evaluation of a soft wearable weight support device for reducing muscle fatigue on shoulder.
Compensating the weight of human limbs is important in reducing muscle fatigue experienced by manual laborers. In this study, a compact and lightweight soft wearable weight support device was developed and evaluated. The device supports gravitational force on the shoulder at any arm posture, although there are some limitations in its assistive performance. The device actuator consists of a cam-rod structure, a tendon-driven mechanism, and a rubber band. The desired assistive torque is translated to the shoulder joint along a tendon routing structure. Device performance was evaluated by measuring muscle activation in with-assist and without-assist conditions. Muscle activation on the deltoid was measured by surface electromyography. An experimental protocol consisting of a series of exercises was executed with six healthy subjects. The subjects raised and lowered their arm from 0 to 100 degrees for 30 times under eight conditions, which were combined with-assist and without-assist conditions, and holding the horizontal angle of the arm at 0, 30, 60, or 90 degrees against the sagittal plane. Surface electromyography data were pre-processed and analyzed using a root mean square method. When muscle fatigue occurs, the root mean square of the surface electromyography increases nonlinearly. This was calculated using the standard deviation of the root mean square. Three of six subjects showed decreased variation of the root mean square between the exercises in the with-assist condition. One subject's result was significantly reduced (by about 57.6%) in the with-assist condition. In contrast, two subjects did not show significant difference between measurements taken in the with-assist and without-assist conditions. One subject was dropped from the experiment because the device did not fit the subject's body. In conclusion, the effectiveness of the soft wearable weight support device in supporting shoulder movements was verified through the decreased variation of muscle activation.


A supervision program for increasing functional activities for severely handicapped students in a residential setting.
This study was designed to increase the amount of time severely handicapped students living in a residential facility engaged in age-appropriate and functional activities. After a brief in-service training, a program involving instructions to supervisors and staff feedback was implemented in a multiple-baseline design across settings. Results showed that after the supervision program was implemented, the students' participation in activities increased. Further, these increases maintained when feedback was reduced from an average of 3 days a week during treatment, to once a month for a 5-month period.


Inhibitory effects of Stichopus japonicus extract on melanogenesis of mouse cells via ERK phosphorylation.
Stichopus japonicus has been used as a folk medicine and as an ingredient in traditional food in East Asian countries. In recent years, the bioactive compounds found in S. japonicus have been reported to possess efficacy in wound healing and may be of potential use in the cosmeceutical, pharmaceutical and biomedical industries. Although the components and their functions require further investigation, S. japonicus extracts exhibit anti‑inflammatory properties, and may be used for cancer prevention and treatment. Although several reports have examined different aspects of S. japo-nicus, the effects of S. japonicus extract on melanogenesis in the skin has not been reported to date. Therefore the present study aimed to investigate the effects of S. japonicus extract on melanogenesis. Treatment with a mixture of S. japonicus extracts (MSCE) reduced melanin synthesis and tyrosinase (TYR) activity in mouse melanocyte cells lines, B16F10 and Melan‑A. In addition, MSCE treatment reduced the protein expression levels of TYR, tyrosinase‑related protein‑1 and tyrosinase‑related protein‑2. The reduced protein levels may be the result of decreased microphthalmia‑associated transcription factor (MITF) expression, which is an important regulator of melanogenesis. The reduced expression level of MITF was associated with delayed phosphorylation of extracellular signal‑regulated kinase (ERK) induced by MSCE treatment. A specific MEK inhibitor, PD98059, significantly blocked MSCE‑mediated inhibition of melanin synthesis. In conclusion, these results indicate that MSCE may be useful as a potential skin‑whitening compound in the skin medical industry.


Leukotriene D4-induced vasoconstriction of coronary arteries in anaesthetized dogs.
We examined in pentobarbital-anaesthetized dogs, the effects of intracoronary leukotriene D4 (LTD4) on large vessel (circumflex artery) flow and diameter and on calculations of late diastolic and total coronary resistance. Heart rate, systolic and end-diastolic ventricular pressures and the dP/dt were the haemodynamic variables studied. The peripheral ECG was obtained in lead II. LTD4 (0.1-10 micrograms kg-1) reduced coronary diameter up to 12 +/- 3% (mean +/- s.e.m.). Coronary flow decreased in dose-dependent fashion up to 100%. Blood flow returned to control values within 3-15 min of LTD4 administration. Blood pressure, heart rate and ventricular pressure did not change while LV dP/dtmax fell and filling pressure increased. The sum of ST segments and R wave voltages of the ECG increased indicating transient myocardial ischaemia during LTD4-induced coronary blood flow cessation. Small vessel and total coronary resistance rose in a dose-dependent manner between 33-232% and 50-500%, respectively. Inhibition of cyclo-oxygenase enzyme (indomethacin, 5 mg kg-1, i.v.) and lipoxygenase enzymes (nafazatrom, 10 mg kg-1, i.d.) had no effect on LTD4-caused alterations in coronary flow, resistance and arterial diameter. Thus, in canine experiments the intracoronary administration of LTD4 can constrict coronary arteries--presumably large conductive vessels. This is independent of the cyclooxygenase and additional lipoxygenase metabolites of the arachidonic acid pathway other than LTD4. Therefore, the agent may contribute to cardiac dysfunction in coronary artery disease and spasm.


Malaria in Hubei Province, China: approaching eradication.
In the last six years, there has been a steady reduction of Plasmodium vivax malaria in Hubei Province with an API (annual parasite incidence) of 0.134 per thousand by 1992. This is especially so in the south, east, west and north-west parts of the province. Much of this reduction has been produced by a policy of repeated radical treatment in the non-malaria season. In the centre of Hubei, where Anopheles anthropophagus is the chief vector, malaria is still a problem. The key factors in destabilizing malaria are a sudden increase in the number of An. anthropophagus, introduction of non-immunes into the endemic area, and the village doctors' diminished interest in malaria surveillance activities. Impregnated bed nets are possibly the best strategy for reducing malaria, but where the prevalence is reduced to a sufficiently low level efficient case finding and detection are able to contain malaria and produce a continued reduction.


States of mind: emotions, body feelings, and thoughts share distributed neural networks.
Scientists have traditionally assumed that different kinds of mental states (e.g., fear, disgust, love, memory, planning, concentration, etc.) correspond to different psychological faculties that have domain-specific correlates in the brain. Yet, growing evidence points to the constructionist hypothesis that mental states emerge from the combination of domain-general psychological processes that map to large-scale distributed brain networks. In this paper, we report a novel study testing a constructionist model of the mind in which participants generated three kinds of mental states (emotions, body feelings, or thoughts) while we measured activity within large-scale distributed brain networks using fMRI. We examined the similarity and differences in the pattern of network activity across these three classes of mental states. Consistent with a constructionist hypothesis, a combination of large-scale distributed networks contributed to emotions, thoughts, and body feelings, although these mental states differed in the relative contribution of those networks. Implications for a constructionist functional architecture of diverse mental states are discussed.


Density functional theory study of the binding capability of tris(pyrazol-1-yl)methane toward Cu(I) and Ag(I) cations.
Density functional theory (DFT) has been used to look into the electronic structure of [M(tpm)]+ molecular ion conformers (M = Cu, Ag; tpm = tris(pyrazol-1-yl)methane) and to study the energetics of their interconversion. Theoretical data pertaining to the free tpm state the intrinsic instability of its kappa3-like conformation, thus indicating that, even though frequently observed, the kappa3-tripodal coordinative mode is unlikely to be directly achieved through the interaction of M(I) with the kappa3-like tpm conformer. It is also found that the energy barrier for the kappa2-[M(tpm)]+ --> kappa3-[M(tpm)]+ conversion is negligible. As far as the bonding scheme is concerned, the tpm --> M(I) donation, both sigma and pi in character, is the main source of the M(I)-tpm bonding, whereas back-donation from completely occupied M(I) d orbitals into tpm-based pi* levels plays a negligible role.


Infection related cerebral venous thrombosis.
The incidence of cerebral venous thrombosis (CVT) has dropped dramatically in recent years. In the past, before the introduction of antibiotics, infection was the main cause of CVT. But this is no longer true. Recently, the occurance of septic CVT is rare, which leads to an increased chance of misdiagnosis and treatment delay. Early suspicion and recognition is very crucial to improve mortality and morbidity rates of this potentially fatal disease. Intravenous, wide spectrum, antibiotics and early surgical drainage of the primary site of infection whenever possible are essential. Anticoagulation with intravenous heparin infusion and corticosteroids use are of uncertain benefit, although some reports have shown some favorable response.


Thromboprophylaxis with dabigatran leads to an increased incidence of wound leakage and an increased length of stay after total joint replacement.
Since the introduction of the National Institute for Health and Care Excellence (NICE) guidelines on thromboprophylaxis and the use of extended thromboprophylaxis with new oral agents, there have been reports of complications arising as a result of their use. We have looked at the incidence of wound complications after the introduction of dabigatran for thromboprophylaxis in our unit. We investigated the rate of venous thromboembolism and wound leakage in 1728 patients undergoing primary joint replacement, both before and after the introduction of dabigatran, and following its subsequent withdrawal from our unit. We found that the use of dabigatran led to a significant increase in post-operative wound leakage (20% with dabigatran, 5% with a multimodal regimen; p < 0.001), which also resulted in an increased duration of hospital stay. The rate of thromboembolism in patients receiving dabigatran was higher (1.3%) than in those receiving the multimodal thromboprophylaxis regimen, including low molecular weight heparin as an inpatient and the extended use of aspirin (0.3%, p = 0.047). We have ceased the use of dabigatran for thromboprophylaxis in these patients.


Light-induced retinal degeneration suppresses developmental progression of flip-to-flop alternative splicing in GluR1.
AMPA receptors are hetero-oligomers composed of subsets of four distinct subunits, termed GluR1, GluR2, GluR3, and GluR4. Using quantitative reverse transcription-PCR analysis, we have found that light-induced degeneration of rat retina dramatically suppresses developmental progression of the flip-to-flop alternative splicing switch of retinal GluR1 mRNA. When animals were raised under standard conditions of a 12 hr light/dark cycle (LD 12:12), the flop-to-flip ratio in GluR1 and GluR2 dramatically increased between postnatal day 10 (P10) and P28, and the ratios continued to increase gradually up to P84. When animals were raised in complete darkness, this increase was delayed in GluR1 between P21 and P42. In addition, the increase of the flop-to-flip ratio in GluR1 was strongly suppressed after P21 under conditions of continuous illumination from P2. This is significant because P21 is just after the eye opening and is the timing of the onset of light-induced retinal degeneration. This suppression of the increase of the flop-to-flip ratio was specific to GluR1 and was not observed in GluR2-4. Immunocytochemistry and immunoblot analysis suggested no changes in either the distribution or expression of GluR1 protein in the light-damaged retina measured at P84. When rats were raised under continuous illumination from P2 to P21 followed by LD 12:12 from P22 to P84, retinal degeneration did not progress after P22. In such animals the flop-to-flip ratio, once decreased to approximately 50% of the control (LD 12:12) at P21, was restored to the control level at P84. These findings demonstrate that developmental progression of the flip-to-flop exon switch in retinal GluR1 is affected by lighting conditions, and that light-induced retinal degeneration contributes to the mechanism of suppression of this splicing switch.


Liquid chromatography--mass spectrometric method combined with derivatization for determination of 1 alpha-hydroxyvitamin D(3) in human plasma.
A stable isotope dilution liquid chromatography-tandem mass spectrometric (LC-MS-MS) method for the determination of plasma 1 alpha-hydroxyvitamin D(3) [1 alpha(OH)D(3)] has been developed. The method employed derivatization, the reaction with 4-[2-(6,7-dimethoxy-4-methyl-3-oxo-3,4-dihydroquinoxalyl)ethyl]-1,2,4-triazoline-3,5-dione and acetylation, which significantly improved the ionization efficiency of 1 alpha(OH)D(3) with a detection limit of 6.3 fmol per injection. The plasma 1 alpha(OH)D(3) was extracted with acetonitrile, purified with disposable cartridges, derivatized and subjected to LC-MS-MS analysis using atmospheric pressure chemical ionization. The intra- and inter-assay coefficients of variation were below 10.6 and 4.7%, respectively, and the analytical recovery of 1 alpha(OH)D(3) was quantitative. The limit of quantitation was 25 pg/ml for a 1.0-ml plasma aliquot. The application of the developed method to the sample of a volunteer orally given 1 alpha(OH)D(3) was also described.


Haploid mouse embryonic stem cells: rapid genetic screening and germline transmission.
Most animal genomes are diploid, and mammalian development depends on specific adaptations that have evolved secondary to diploidy. Genomic imprinting and dosage compensation restrict haploid development to early embryos. Recently, haploid mammalian development has been reinvestigated since the establishment of haploid embryonic stem cells (ESCs) from mouse embryos. Haploid cells possess one copy of each gene, facilitating the generation of loss-of-function mutations in a single step. Recessive mutations can then be assessed in forward genetic screens. Applications of haploid mammalian cell systems in screens have been illustrated in several recent publications. Haploid ESCs are characterized by a wide developmental potential and can contribute to chimeric embryos and mice. Different strategies for introducing genetic modifications from haploid ESCs into the mouse germline have been further developed. Haploid ESCs therefore introduce new possibilities in mammalian genetics and could offer an unprecedented tool for genome exploration in the future.


Preparation of a Novel Formaldehyde-Free Impregnated Decorative Paper Containing MnO2 Nanoparticles for Highly Efficient Formaldehyde Removal.
The loading of catalytic manganese dioxide (MnO2) nanoparticles onto an impregnated decorative paper has been an effective method for the removal of indoor formaldehyde (HCHO) pollutants. However, its preparation can present numerous challenges, including instability in dipping emulsions and leaching. In this investigation, a novel and stable formaldehyde-free polyacrylate dipping emulsion containing MnO2 particles was prepared and then back-coated on a decorative paper. To improve the dispersion and fixation, the MnO2 was modified with silane. HCHO can undergo physical adsorption on the cellulosic fibers present in the paper, while it can also undergo chemical degradation into CO2 within the MnO2 groups. The silane not only enhanced the interfacial adhesion to a polyacrylate resin but also increased the interlayer distance, thereby creating a larger space for HCHO absorption. The impregnated decorative paper back-coated with 10 wt % of silane-modified MnO2 exhibited a removal efficiency of approximately 90% for HCHO at 20 °C. The removal rate further improved to approximately 100% when the temperature was increased to 60 °C. Moreover, it is worth noting that the release of volatile organic compounds was exceptionally minimal. Additionally, the particleboard bonded with this impregnated decorative paper exhibited an extremely low emission of HCHO, with a value that approached 0 mg·L-1. Furthermore, the bonding strength of the surface remained unaffected. Therefore, this study provides a simple and eco-friendly method for effectively removing HCHO, which can enhance indoor air quality.


Characteristics and outcomes of lung cancer in solid organ transplant recipients.
Lung cancer is the third most common malignancy that develops in patients following solid organ transplantation and is the leading cause of cancer deaths in the general population. The aims of this study are to examine the characteristics of patients who developed lung cancer following solid organ transplantation at our institution and to compare their outcomes to those of lung cancer patients without a history of transplant. We performed a single-institution retrospective study of 44 solid organ transplant recipients who developed lung cancer and compared their characteristics to a cohort of 74 lung cancer patients without a history of transplant. We performed propensity score weighted analyses to compare outcomes between the two groups, including a cox proportional hazards model of overall survival. 52 % of post-transplant patients who developed lung cancer were diagnosed with stage III or IV disease. In the propensity score weighted analysis that accounted for age at diagnosis, sex, lung cancer stage at diagnosis, Charlson comorbidity index score, and ECOG performance score, post-transplant patients were more likely to have squamous cell histology (p < 0.01) and had worse overall survival compared to the non-transplant cohort (HR = 1.88, 95 % CI 1.13-3.12, p = 0.02). The difference in survival remained significant after accounting for differences in lung cancer histology and treatment (HR = 2.40, 95 % CI 1.27-3.78, p < 0.01). When compared to non-transplant patients with lung cancer, post-transplant patients have worse overall survival after accounting for differences in age, sex, lung cancer stage, comorbidities, and performance status. This survival difference is not solely attributable to differences in tumor histology and treatments received. This may suggest that post-transplant malignancies are more aggressive and difficult to treat.


The quality of life of chronic epileptic patients in Ibadan, Nigeria.
Epilepsy is a disease that significantly impairs the quality of life of the sufferers. Measures of quality of life have been developed to assess the overall impact of management on the patients. While studies on quality of life have been previously carried out in Nigerians, a standardised and validated inventory has not been used for this purpose because these are just being developed. Thirty-two epileptics (24 males and 8 females) attending the Neurology clinic of the University College Hospital, Ibadan, were studied. Each subject had complete physical examination and elecroencephalography. A short screening quality of life questionnaire (QOLIE 10) was administered to the subjects during routine clinic visits. The commonest aspect of quality of life affected in the subjects was feeling of energy, which was impaired in 15 (46.8%) subjects. This was followed by memory problems in 11 (34.4%). Fear of experiencing the next seizure was reported by eight (25.8%) of subjects. Only five (16.7%) and three (10.3%) of the subjects respectively reported work and social limitations like attending social occasions. No subject reported difficulty with driving or operating machinery, or mental disturbances. Energy and memory deficits are the major problems affecting the quality of life of epileptics in this study. Most subjects did not consider physical and social limitations important.


Uricostatic and uricosuric effect of grapefruit juice in potassium oxonate-induced hyperuricemic mice.
The aim of this study was to examine the preventive action of grapefruit juice (GFJ) against potassium oxonate-induced hyperuricemic mice. The results showed that GFJ significantly (p < .05) inhibit the serum and hepatic xanthine oxidase enzyme, lower uric acid level, serum creatinine, uromodulin, and blood urea nitrogen levels to normal and lower inflammation related genes IL-1β, caspase-1, NLRP3, and ASC. Furthermore, histopathology analysis revealed that GFJ markedly improve the renal and intestinal morphology. The mRNA expression of urate transporter 1, glucose transporter 9 were downregulated, whereas ATP-binding cassette transporter (ABCG2) was upregulated in the GFJ-treated group. The results of immunohistochemistry revealed that the ABCG2 protein expression in the small and large intestine was significantly upregulated after the GFJ administration. These results suggested that GFJ can be used as a urate lowering agent and future mechanistic studies should be conducted. PRACTICAL APPLICATIONS: The results of current study indicated that utilization of GFJ as an anti-hyperuricemic agent for the treatment of hyperuricemia. This article will be very valuable for all those peoples which are directly or indirectly linked with this disease.


POSSIM: Parameterizing Complete Second-Order Polarizable Force Field for Proteins.
Previously, we reported development of a fast polarizable force field and software named POSSIM (POlarizable Simulations with Second order Interaction Model). The second-order approximation permits the speed up of the polarizable component of the calculations by ca. an order of magnitude. We have now expanded the POSSIM framework to include a complete polarizable force field for proteins. Most of the parameter fitting was done to high-level quantum mechanical data. Conformational geometries and energies for dipeptides have been reproduced within average errors of ca. 0.5 kcal/mol for energies of the conformers (for the electrostatically neutral residues) and 9.7° for key dihedral angles. We have also validated this force field by running Monte Carlo simulations of collagen-like proteins in water. The resulting geometries were within 0.94 Å root-mean-square deviation (RMSD) from the experimental data. We have performed additional validation by studying conformational properties of three oligopeptides relevant in the context of N-glycoprotein secondary structure. These systems have been previously studied with combined experimental and computational methods, and both POSSIM and benchmark OPLS-AA simulations that we carried out produced geometries within ca. 0.9 Å RMSD of the literature structures. Thus, the performance of POSSIM in reproducing the structures is comparable with that of the widely used OPLS-AA force field. Furthermore, our fitting of the force field parameters for peptides and proteins has been streamlined compared with the previous generation of the complete polarizable force field and relied more on transferability of parameters for nonbonded interactions (including the electrostatic component). The resulting deviations from the quantum mechanical data are similar to those achieved with the previous generation; thus, the technique is robust, and the parameters are transferable. At the same time, the number of parameters used in this work was noticeably smaller than that of the previous generation of our complete polarizable force field for proteins; thus, the transferability of this set can be expected to be greater, and the danger of force field fitting artifacts is lower. Therefore, we believe that this force field can be successfully applied in a wide variety of applications to proteins and protein-ligand complexes.


Self-templated formation of uniform NiCo2O4 hollow spheres with complex interior structures for lithium-ion batteries and supercapacitors.
Despite the significant advancement in preparing metal oxide hollow structures, most approaches rely on template-based multistep procedures for tailoring the interior structure. In this work, we develop a new generally applicable strategy toward the synthesis of mixed-metal-oxide complex hollow spheres. Starting with metal glycerate solid spheres, we show that subsequent thermal annealing in air leads to the formation of complex hollow spheres of the resulting metal oxide. We demonstrate the concept by synthesizing highly uniform NiCo2O4 hollow spheres with a complex interior structure. With the small primary building nanoparticles, high structural integrity, complex interior architectures, and enlarged surface area, these unique NiCo2O4 hollow spheres exhibit superior electrochemical performances as advanced electrode materials for both lithium-ion batteries and supercapacitors. This approach can be an efficient self-templated strategy for the preparation of mixed-metal-oxide hollow spheres with complex interior structures and functionalities.


Stepping Stones Triple P: an RCT of a parenting program with parents of a child diagnosed with an autism spectrum disorder.
Whilst the Triple P Positive Parenting Program has a large evidence base (Sanders, Clinical Child and Family Psychology Review 2:71-90, 1999; Sanders, Journal of Consulting and Clinical Psychology 68:624-640, 2000) and preliminary evidence indicates that Stepping Stones Triple P is also efficacious (Roberts, Journal of Clinical Child and Adolescent Psychology, 35(2):180-193, 2006), to date Stepping Stones has not been evaluated with the ASD population. Fifty-nine families with a child with ASD aged between 2 and 9 participated in this randomized controlled trial. The results demonstrate significant improvements in parental reports of child behaviour and parenting styles with the treatment effects for child behaviour, parental over reactivity and parental verbosity being maintained at follow-up 6 months later. Further, the results suggest significant improvements in parental satisfaction and conflict about parenting as well as a sleeper effect for parental efficacy. The results indicate that Stepping Stones Triple P is a promising intervention for parents of children with ASD. Limitations and future research are also addressed.


High-frequency dual mode pulsed wave Doppler imaging for monitoring the functional regeneration of adult zebrafish hearts.
Adult zebrafish is a well-known small animal model for studying heart regeneration. Although the regeneration of scars made by resecting the ventricular apex has been visualized with histological methods, there is no adequate imaging tool for tracking the functional recovery of the damaged heart. For this reason, high-frequency Doppler echocardiography using dual mode pulsed wave Doppler, which provides both tissue Doppler (TD) and Doppler flow in a same cardiac cycle, is developed with a 30 MHz high-frequency array ultrasound imaging system. Phantom studies show that the Doppler flow mode of the dual mode is capable of measuring the flow velocity from 0.1 to 15 cm s(-1) with high accuracy (p-value = 0.974 > 0.05). In the in vivo study of zebrafish, both TD and Doppler flow signals were simultaneously obtained from the zebrafish heart for the first time, and the synchronized valve motions with the blood flow signals were identified. In the longitudinal study on the zebrafish heart regeneration, the parameters for diagnosing the diastolic dysfunction, for example, E/Em < 10, E/A < 0.14 for wild-type zebrafish, were measured, and the type of diastolic dysfunction caused by the amputation was found to be similar to the restrictive filling. The diastolic function was fully recovered within four weeks post-amputation.


Toward classification of BRCA1 missense variants using a biophysical approach.
Carriers of germ line mutations in breast cancer susceptibility gene BRCA1 have an increased risk of developing breast and ovarian cancers; missense mutations have, however, been difficult to assess for disease association. Here we have used a biophysical approach to classify these variants. We established an assay for measuring the thermodynamic stability of the BRCA1 BRCT domains and investigated the effects of 36 missense mutations. The mutations show a range of effects. Some do not change the stability, whereas others destabilize the protein by as much as 6 kcal mol(-1); one-third of the mutants could not be expressed in soluble form in Escherichia coli, and we conclude that these destabilize the protein by an even greater amount. We tested several computer algorithms for their ability to predict the mutant effects and found that by grouping them into two classes (destabilizing by less than or more than 2.2 kcal mol(-1)), the algorithms could predict the stability changes. Importantly, with the exception of the few mutants located in the binding site, none showed a significant reduction in affinity for phosphorylated substrate. These results indicate that despite very large losses in stability, the integrity of the structure is not compromised by the mutations. Thus, the majority of mutations cause loss of function by reducing the proportion of BRCA1 molecules that are in the folded state and increasing the proportion of molecules that are unfolded. Consequently, small molecule stabilization of the structure could be a generally applicable preventative therapeutic strategy for rescuing many BRCA1 mutations.


Effect of intraduodenal instillation of 1-phenyl-1-hydroxy-n-pentane on pancreatic exocrine secretions and immunoreactive secretion release in the rat.
Pancreatic juice flow and amylase output, and the concentrations of immunoreactive secretin in portal and peripheral blood were simultaneously determined in anesthetized rats in response to intraduodenal instillation of 1-phenyl-1-hydroxy-n-pentane (PHP), a phenyl carbinol derivative induced from one of the constituents of Curcuma. PHP stimulated both pancreatic juice flow and amylase output and increased portal and jugular plasma secretin levels in a dose-related fashion. During intraduodenal instillation of PHP the pH in the second portion of the duodenum remained consistently above 6.3. Infusion of cyclic somatostatin at a dose of 5 microgram/kg/h significantly suppressed the PHP-induced secretin release, though pancreatic flow rate and amylase output were only slightly and insignificantly suppressed. These observations suggest that PHP release secretin by an acid independent mechanism but also stimulates the exocrine pancreas by a mechanism independent of secretin.


Induction of cancer of the glandular stomach in rats by an extract of nitrite-treated fish.
Treatment of a homogenate of the mackerel fish Sanma hirakl with nitrite at pH 3 led to the development of direct-acting mutagenic activity for Salmonella typhlmurium TA-1535. Repeated gastric intubation three times/week for 6 months of an extract containing this mutagenic activity into noninbred Wistar rats led to the induction of tumors in 8 of 12 rats 12-18 months later. Adenomas and adenocarcinomas were found in the glandular stomach, squamous cell carcinoma was observed in the forestomach, and adenocarcinoma was found in the small intestine and pancreas. Furthermore, precancerous lesions (including intestinal metaplasia and glandular hyperplasia of the glandular stomach as well as squamous cell hyperplasia) were noted in virtually all of the animals at risk. No tumors were seen in 8 control rats given the untreated fish extract alone; 1 rat had glandular hyperplasia and intestinal metaplasia. Thus a mutagenic extract of nitrite-treated fish was demonstrated to induce, in the rat glandular stomach, cancers identical to gastric cancer observed in man. Preventive m:asures, including reduction of the intake of pickled foods and the year-round daily availability of foods containing vitamin C, are discussed.


Hepatitis B virus DNA quantitation and detection of core promoter, precore and polymerase mutations in chronic hepatitis B: evaluation and clinical usefulness of three new commercial assays.
HBV-DNA quantitation, the HBe antigen status and the appearance of mutations in the core promoter, precore and polymerase regions are important elements in the management of chronic HBV infection. We performed a technical evaluation of 3 new kits, affigene HBV VL, affigene HBV mutant VL and affigene HBV DE/3TC assays (Sangtec Molecular Diagnostics) in comparison with the Amplicor HBV Monitor assay (Manual Test, Roche), direct sequencing and direct sequencing/Inno-LIPA HBV DR (Innogenetics), respectively. We evaluated the clinical application of these tests in the management of patients with chronic (HBeAg positive) hepatitis B. Serial sera of 11 chronic HBeAg positive patients were studied before, during and after lamivudine/interferon treatment. HBV-DNA quantitation detected with affigene HBV VL showed a high correlation with the Amplicor HBV Monitor test (r=0.85). affigene HBV mutant VL (positions G1764A, G1896A) and affigene HBV DE/3TC (positions rtL180M, rtM204V/I) were able to detect a low presence of mutants in a mixed population (wild type and mutant) compared to direct sequencing and Inno-LIPA HBV DR, which identified only the dominant population. These three sensitive assays, performed with the same DNA extraction, give clinicians useful information for the management of chronic hepatitis B and for timing treatment.


Alcohol blunts pregnancy-mediated insulin resistance and reduces fetal brain glucose despite elevated fetal gluconeogenesis, and these changes associate with fetal weight outcomes.
Prenatal alcohol exposure (PAE) impairs fetal growth and neurodevelopment. Although alcohol is well known to alter metabolism, its impact on these processes during pregnancy is largely unexplored. Here, we investigate how alcohol affects maternal-fetal glucose metabolism using our established mouse binge model of PAE. In the dam, alcohol reduces the hepatic abundance of glucose and glycolytic intermediates, and the gluconeogenic enzymes glucose-6-phosphtase and phosphoenolpyruvate carboxykinase. Fasting blood glucose is also reduced. In a healthy pregnancy, elevated maternal gluconeogenesis and insulin resistance ensures glucose availability for the fetus. Glucose and insulin tolerance tests reveal that alcohol impairs the dam's ability to acquire insulin resistance. Alcohol-exposed dams have enhanced glucose clearance (p < .05) in early gestation, after just two days of alcohol, and this persists through late term when fetal glucose needs are maximal. However, maternal plasma insulin levels, hepatic insulin signaling, and the abundance of glucose transporter proteins remain unchanged. In the PAE fetus, the expression of hepatic gluconeogenic genes is elevated, and there is a trend for elevated blood and liver glucose levels. In contrast, fetal brain and placental glucose levels remain low. This reduced maternal fasting glucose, reduced hepatic glucose, and elevated glucose clearance inversely correlated with fetal body and brain weight. Taken together, these data suggest that alcohol blunts the adaptive changes in maternal glucose metabolism that otherwise enhance fetal glucose availability. Compensatory attempts by the fetus to increase glucose pools via gluconeogenesis do not normalize brain glucose. These metabolic changes may contribute to the impaired fetal growth and brain development that typifies PAE.


Comparison of the efficacy and tolerability of an angiotensin converting enzyme inhibitor (lisinopril) versus a calcium channel antagonist (diltiazem SR) in the treatment of moderate to severe hypertension.
One hundred and ten patients (mean age 50.6 years) with moderate to severe essential hypertension (DBP between 105 and 116 mmHg) were randomised to eight weeks of double-blind treatment with lisinopril (n = 56) or diltiazem SR (n = 54). Fourteen patients withdrew from therapy; six patients withdrew because of adverse events (lisinopril, n = 3; diltiazem SR, n = 1) and lack of BP control (lisinopril, n = 1; diltiazem SR, n = 1). Both monotherapies were titrated upward (lisinopril 20-40 mg daily, diltiazem SR 120-180 mg twice daily) to achieve an office DBP < 90 mmHg. Hydrochlorothiazide (HCTZ; 25 mg daily) was added to monotherapy after week 4 if patients did not reach the BP goal (i.e. non-responders). After four weeks of therapy, 72% of patients (74 of 103) were nonresponders. At eight weeks of therapy, 66 patients (lisinopril, n = 32; diltiazem SR, n = 34) had received HCTZ. At week 8, 53% of lisinopril and 36% of diltiazem SR patients met the response criteria. Mean office DBP decreased from baseline -18.1 +/- 8.6 mmHg for lisinopril patients and -15.9 +/- 10.1 mmHg for diltiazem SR patients at week 8. Lisinopril was as effective as diltiazem in reducing systolic and diastolic office BP at week 4 (p > 0.1). Likewise, at weeks 4 and 8, no statistically significant differences were detected between treatments (p > 0.05) for systolic and diastolic ambulatory BP averaged over 24 hours. Both treatments were well tolerated and showed important antihypertensive efficacy in patients with moderate to severe BP elevation.


SPECT/CT imaging of patella metastasis from a squamous carcinoma of the lung.
A 71-year-old man presented with a progressive right knee pain which persisted for 6 months and was not relieved by pain medications. He had a history of lung squamous carcinoma 1 year ago. X-ray and magnetic resonance imaging (MRI) revealed hyperostosis, degenerative changes, and occupancy lesions of the right patella. The patient underwent Tc methylene diphosphonate (Tc-MDP) bone scan and single photon emission tomography/computed tomography (SPECT/CT), which showed abnormal metabolism of the right patella with bone destruction and soft tissue swelling. Finally, patellectomy was taken and pathology confirmed patella metastasis from lung squamous carcinoma.


Modeling the potential impact of emerging innovations on achievement of Sustainable Development Goals related to maternal, newborn, and child health.
Innovations that improve the affordability, accessibility, or effectiveness of health care played a major role in the Millennium Development Goal achievements and will be critical for reaching the ambitious new Sustainable Development Goal (SDG) health targets. Mechanisms to identify and prioritize innovations are essential to inform future investment decisions. Innovation Countdown 2030 crowdsourced health innovations from around the world and engaged recognized experts to systematically assess their lifesaving potential by 2030. A health impact modeling approach was developed and used to quantify the costs and lives saved for select innovations identified as having great promise for improving maternal, newborn, and child health. Preventive innovations targeting health conditions with a high mortality burden had the greatest impact in regard to the absolute number of estimated lives saved. The largest projected health impact was for a new tool for small-scale water treatment that automatically chlorinates water to a safe concentration without using electricity or moving parts. An estimated 1.5 million deaths from diarrheal disease among children under five could be prevented by 2030 by scaling up use of this technology. Use of chlorhexidine for umbilical cord care was associated with the second highest number of lives saved. The results show why a systematic modeling approach that can compare and contrast investment opportunities is important for prioritizing global health innovations. Rigorous impact estimates are needed to allocate limited resources toward the innovations with great potential to advance the SDGs.


The first decade of the Massachusetts Tobacco Control Program.
This article provides a comprehensive overview of the first decade of the Massachusetts Tobacco Control Program (MTCP). Born after Massachusetts passed a 1992 ballot initiative raising cigarette excise taxes to fund the program, MTCP greatly reduced statewide cigarette consumption before being reduced to a skeletal state by funding cuts. The article describes the program's components and goals, details outcomes, presents a summary of policy accomplishments, and reviews the present status of MTCP in the current climate of national and state fiscal crises. The first decade of the MTCP offers many lessons learned for the future of tobacco control.


Ventricular repolarization abnormalities: the electrocardiographic track of cardiac tumoural involvement in an infant with tuberous sclerosis complex. A case report.
Primary cardiac tumours are rare in children. Against this backdrop, Doppler echocardiogram is the main diagnostic procedure, while electrocardiogram (ECG) usually plays a secondary role, by detecting tumoural consequences as cardiac arrhythmias and chambers overload. We describe a case where an electrocardiographic sign was the cornerstone to diagnosis and surveillance of an infant with a cardiac rhabdomyoma. A female infant was referred for cardiac evaluation to elucidate an electrocardiographic abnormality, detected during investigation of seizures. She had recently been diagnosed with epilepsy and was under three different anticonvulsants for appropriate control. Cardiovascular symptoms were absent. Skin inspection revealed hypochromic macules. Respiratory and cardiovascular examinations were normal, as well as laboratorial tests and chest radiography. Electrocardiogram (ECG) showed dome-shaped ST-segment elevation in V2 and V3. Transthoracic echocardiogram unveiled a single hyper-echogenic node (0.4 cm2) in the interventricular septum. Cardiac chambers had normal size and function and Doppler analysis was also normal. No specific medication was used to treat the tumour. During follow-up, she remained free of cardiac symptoms. Eighteen months after her first visit to the cardiologist, routine clinical assessment, ECG, and transthoracic Doppler echocardiogram normal results stated the spontaneous and complete involution of the tumoural lesion. Convex ST-segment elevation, generally related to myocardial injury, is unusual in paediatric patients. Once it occurs in asymptomatic individuals within this age bracket, exclusion of cardiac tumours is mandatory. However, data regarding the accuracy of such electrocardiographic marker in this clinical setting are still to be defined.


DNA alterations in human aberrant crypt foci and colon cancers by random primed polymerase chain reaction.
Colon cancers are the result of the accumulation of multiple genetic alterations. To evaluate the role genomic instability plays during tumor development, we compared DNA fingerprints of 44 aberrant crypt foci (ACF; the earliest identified neoplastic lesion in the colon), 23 cancers, and normal crypts generated by random primers with PCR. The PCR products, separated by PAGE and viewed after silver staining, demonstrate altered fingerprints for 23.3% of the ACF and 95.7% of the cancers. In this first study of human ACF with this approach, the finding of altered DNA fingerprints in these microscopic lesions suggests that genomic instability can occur very early in human colon tumorigenesis.


Hospitals and moral imperatives: hospital ethics.
... Because institutional ethics has been neglected, there is a tendency in our institutional life to apply moral principles with which we are familiar from our personal life. However, principles from individual ethics often distort institutional ethics. Ethical problems in the hospital are not exactly the same as ethical problems that arise when individual doctors treat individual patients. And when the problems are similar, the ethical principles by which we should resolve them are likely to be quite different. To begin to make a case for taking hospital ethics seriously, I briefly examine two familiar principles of individual doctor-patient ethics that look different, or should look different, in the setting of a hospital. I then discuss ethics committees -- one of the most important ways in which hospital ethics is put into practice.


Use of Electronic Medication Administration Records to Reduce Perceived Stress and Risk of Medication Errors in Nursing Homes.
Concerns have been raised about the effects of current medication administration processes on the safety of many of the aspects of medication administration. Keeping electronic medication administration records could decrease many of these problems. Unfortunately, there has not been much research on this topic, especially in nursing homes. A prospective case-control survey was consequently performed at two nursing homes; the electronic record system was introduced in one, whereas the other continued to use paper records. The personnel were asked to fill in a questionnaire of their perceptions of stress and risk of medication errors at baseline (n = 66) and 20 weeks after the intervention group had started recording medication administration electronically (n = 59). There were statistically significant decreases in the perceived risk of omitting a medication, of medication errors occurring because of communication problems, and of medication errors occurring because of inaccurate medication administration records in the intervention group (all P < .01 vs the control group). The perceived overall daily stress levels were also reduced in the intervention group (P < .05). These results indicate that the utilization of electronic medication administration records will reduce many of the concerns regarding the medication administration process.


Cancer mortality near Oak Ridge, Tennessee.
Oak Ridge, Tennessee, is the site of one of the two oldest nuclear facilities in the United States. Although precise records have not been maintained, low levels of radioactive products have been released into the environment since the facility began operation in World War II. Changes in age-adjusted cancer mortality rates for whites between the periods 1950-1952 and 1987-1989 were analyzed to assess whether these radioactive releases have had any adverse effects on the population living near Oak Ridge. Results indicate that the increases in the local area (under 100 miles from Oak Ridge) exceeded regional increases and far exceeded national increases. Within the region, increases were greatest in rural areas, in Anderson County (where Oak Ridge is located), in mountainous counties, and in the region downwind of Oak Ridge. Each of these findings suggest that low levels of radiation, ingested gradually by local residents, were a factor in the increases in local cancer death rates. Results indicate that more studies of this type are called for and that cessation of all future radioactive emissions from nuclear facilities should be considered.


Atmospheric Water Harvesting by Large-Scale Radiative Cooling Cellulose-Based Fabric.
Atmospheric water harvesting (AWH) has received tremendous interest because of population growth, limited freshwater resources, and water pollution. However, key challenges remain in developing efficient, flexible, and lightweight AWH materials with scalability. Here, we demonstrated a radiative cooling fabric for AWH via its hierarchically structured cellulose network and hybrid sorption-dewing mechanisms. With 8.3% solar absorption and ∼0.9 infrared (IR) emissivity, the material can drop up to 7.5 °C below ambient temperature without energy consumption via radiative cooling. Water adsorption onto the hydrophilic functional groups of cellulose is dominated by sorption at low relative humidity (RH) and dewing at high RH. The cellulose network provides desirable mechanical properties with entangled high-aspect-ratio fibers over tens of adsorption-extraction cycles. In the field test, the cellulose sample exhibited water uptake of 1.29 kg/kg at 80% RH during the night. The profusion of radiative cooling fabric features desirable cost effectiveness and allows fast deployment into large-scale AWH applications.


Cytoprotective Encapsulation of Individual Jurkat T Cells within Durable TiO2 Shells for T-Cell Therapy.
Lymphocytes, such as T cells and natural killer (NK) cells, have therapeutic promise in adoptive cell transfer (ACT) therapy, where the cells are activated and expanded in vitro and then infused into a patient. However, the in vitro preservation of labile lymphocytes during transfer, manipulation, and storage has been one of the bottlenecks in the development and commercialization of therapeutic lymphocytes. Herein, we suggest a cell-in-shell (or artificial spore) strategy to enhance the cell viability in the practical settings, while maintaining biological activities for therapeutic efficacy. A durable titanium oxide (TiO2 ) shell is formed on individual Jurkat T cells, and the CD3 and other antigens on cell surfaces remain accessible to the antibodies. Interleukin-2 (IL-2) secretion is also not hampered by the shell formation. This work suggests a chemical toolbox for effectively preserving lymphocytes in vitro and developing the lymphocyte-based cancer immunotherapy.


An accurate and fast alignment-free method for profiling microbial communities.
Determining abundances of microbial genomes in metagenomic samples is an important problem in analyzing metagenomic data. Although homology-based methods are popular, they have shown to be computationally expensive due to the alignment of tens of millions of reads from metagenomic samples to reference genomes of hundreds to thousands of environmental microbial species. We introduce an efficient alignment-free approach to estimate abundances of microbial genomes in metagenomic samples. The approach is based on solving linear and quadratic programs, which are represented by genome-specific markers (GSM). We compared our method against popular alignment-free and homology-based methods. Without contamination, our method was more accurate than other alignment-free methods while being much faster than a homology-based method. In more realistic settings where samples were contaminated with human DNA, our method was the most accurate method in predicting abundance at varying levels of contamination. We achieve higher accuracy than both alignment-free and homology-based methods.


[Influence of heart and brain disease on multifractal singularity spectrum of synchronous 12-lead ECG signals].
We analyzed the multifractal singularity spectrum of synchronous 12-lead ECG (electrocardiogram) signals from heart and brain disease patients, and found that multifractal curves of different leads do not overlap each other. After calculating the scope of the singularity strength, we noticed that the averages of scope are not the same in different subjects,and the dispersing degree is also different in someone's different leads. Both the deltaalpha, the average of the deltaalpha, and the dispersing degree deltaalpha (be defined as standard deviation) of the deltaalpha of every one's 12-lead ECG were computed. Then, a comparison was made between the spectrum of the healthy subjects and the heart disease patients. The results showed that their deltaalpha are close, but their deltaalpha are markedly different. Also the healthy subjects and brain disease patients were compared, we found that their deltaalpha are close, but their deltaalpha are markedly different. These indicate that the character of multifractal spectrum is controlled by both the neurosystem of body and the self-syntonic property of cardiac structures. Furthermore, the deltaalpha is related with the neuroautonomic control of people's body on the ECG, and the deltaalpha is related with the anisotropy of the heterogeneous tissue and the electric signal propagation in heart.


Fine-scale genetic structure in a high dispersal capacity raptor, the Montagu's harrier (Circus pygargus), revealed by a set of novel microsatellite loci.
The Montagu's harrier (Circus pygargus) is a semi-colonial raptor species widely but patchily distributed across the Palearctic region with recorded cases of philopatry and presence of extra-pair copulation. In order to assess Montagu's harrier spatial genetic structure and contemporary gene flow, we developed 16 new microsatellite markers using 454 pyrosequencing. Genotypes of 117 chicks sampled in a 200 × 300 km farmland area in Central Western France were analyzed to characterize genetic polymorphism at each locus and regional and fine-scale genetic structure. Fourteen markers were found polymorphic, with a number of alleles ranging from 3 to 11. The expected and observed heterozygosities ranged from 0.36 to 0.856 and from 0.35 to 0.868, respectively. A single genetic unit was found at the regional scale with higher genetic similarity observed at a small spatial scale (up to 10 km). Our results are consistent with overall large-scale juvenile and adult dispersal together with small-scale male philopatry. Cross-species amplification of this set of microsatellites makers has been successful in two closely related harrier species: the marsh harrier (Circus aeruginosus) and the Hen harrier (Circus cyaneus) for which 14 and 12 markers were polymorphic, respectively. These new microsatellite markers could be used to study the population genetic structure, contemporary gene flow and parentage analyses in these three species and to conduct microsatellite-based demographic inferences on the Montagu's harrier.


Multistimuli Response Micro- and Nanolayers of a Coordination Polymer Based on Cu2 I2 Chains Linked by 2-Aminopyrazine.
A nonporous laminar coordination polymer of formula [Cu2 I2 (2-aminopyrazine)]n is prepared by direct reaction between CuI and 2-aminopyrazine, two industrially available building blocks. The fine tuning of the reaction conditions allows obtaining [Cu2 I2 (2-aminopyrazine)]n in micrometric and nanometric sizes with same structure and composition. Interestingly, both materials show similar reversible thermo- and pressure-luminescent response as well as reversible electrical response to volatile organic solvents such as acetic acid. X-ray diffraction studies under different conditions, temperatures and pressures, in combination with theoretical calculations allow rationalizing the physical properties of this compound and its changes under physical stimuli. Thus, the emission dramatically increases when lowering the temperature, while an enhancement of the pressure produces a decrease in the emission intensity. These observations emerge as a direct consequence of the high structural flexibility of the Cu2 I2 chains which undergo a contraction in CuCu distances as far as temperature decreases or pressure increases. However, the strong structural changes observed under high pressure lead to an unexpected effect that produces a less effective CuCu orbital overlapping that justifies the decrease in the intensity emission. This work shows the high potential of materials based on Cu2 I2 chains for new applications.


Factors related to rural general practitioners supervising general practice registrars in Australia: A national cross-sectional study.
General practice training in Australia is uniquely structured to allow half of all registrars to train in rural areas, in order to increase rural workforce development and access to rural primary care. There is, however, limited national-scale information about rural general practice supervisors who underpin the capacity for rural general practice training. The objective of this research was to explore the factors related to rural general practitioners (GPs) supervising general practice registrars. Results were obtained using multivariate analysis of the 2016 Medicine in Australia: Balancing Employment and Life survey data. Overall, 57.8% of rural GPs were supervising registrars. Supervising was strongly related to being Australian-trained, working in a larger practice, and supervising medical students and interns. Rural supervising capacity could be increased through supporting GPs in smaller practices to engage in supervision and maintaining the strong involvement of GPs in larger practices. Other important factors may include a greater number of Australian-trained graduates working in rural general practice and increased support for international medical graduates to Fellow and feel confident to supervise.


Locally recurrent penile apocrine carcinoma initially diagnosed as metastatic adenocarcinoma of colon.
Apocrine carcinoma is a rare malignant adnexal neoplasm. The differential diagnosis between apocrine carcinoma and cutaneous metastasis is often difficult. Here, we report a case of locally recurrent penile apocrine carcinoma initially diagnosed as metastatic adenocarcinoma of the colon. A 75-year-old man with a history of surgical resection due to sigmoid colon cancer and penile metastasis two years prior to this study presented with a nodule at the left penile base. He underwent a wide local resection of the penile mass under a suggested preoperative diagnosis of extra-mammary Paget's disease (EMPD) associated with previous sigmoid colon cancer. However, the previously and currently resected penile masses were identified as primary apocrine carcinoma upon hematoxylin and eosin (H&E) staining and immunohistochemical staining. Although the incidence is extremely rare, both clinicians and pathologists should be alert to the possibility of synchronous double primary apocrine carcinoma in cancer patients with malignant cutaneous lesions.


[Surface structure of the elementary bodies of Chlamydia].
The surface structure of chlamydial elementary bodies (strain PL-B577 causing enzootic abortion of ewes and strain CP-1 isolated from a patient with Reiter's syndrome), concentrated directly on the grid of an electron microscope, was studied by the method of negative staining. The surface of the cell wall of chlamydial elementary bodies in the preparations of crude cultures, not subjected to enzymatic purification, was formed by spherical subunits 4 nm in diameter. The surface of the cell wall of elementary bodies was found to have projections 10-20 nm long and 3-4 nm in diameter, as well as annular structures 15-22 nm in diameter in hexagonal arrangement, spaced at 45 nm and probably traversed by these projections. The number of such structures in a group was 12-15. These data correspond to the model representing the structure of the surface of chlamydiae, which was proposed by Matsumoto in 1979.


Synergistic effects between GM-CSF and G-CSF or M-CSF on highly enriched human marrow progenitor cells.
The human multilineage hematopoietic growth factor granulocyte-macrophage colony-stimulating factor (GM-CSF) induces multipotent, erythroid, and eosinophil colony formation from highly enriched normal bone marrow cells. We have examined the effects of GM-CSF combined with granulocyte-CSF (G-CSF) or macrophage-CSF (M-CSF) on the monolineage granulocytic, eosinophilic, and macrophage progenitor cells (CFU-G, CFU-Eo, and CFU-M) in accessory cell depleted marrow fractions. GM-CSF effects were assessed in direct comparison with those of interleukin-3 (IL-3) plus G-CSF or M-CSF. GM-CSF strongly synergized with G-CSF in the formation of granulocytic colonies with respect to number and size and enhanced the in vitro survival of CFU-G. More immature cells were present in colonies induced by the mixture of GM-CSF and G-CSF than by G-CSF alone. GM-CSF also synergized with M-CSF in the formation of macrophage colonies (number and size). The addition of G-CSF and M-CSF did not influence eosinophil colony formation induced by GM-CSF or IL-3. Experiments directly comparing GM-CSF and IL-3 revealed that the effects of GM-CSF on G and M colony-forming cells were significantly greater than those of IL-3. The potent positive effects between GM-CSF and G-CSF as well as between GM-CSF and M-CSF provide a powerful mechanism of amplification of granulopoiesis and monocytopoiesis.


Travel immunization update for older adults.
Older Americans are among the most widely traveled group in our society. Recent trends point to more international travel, more travel to Third World countries, and more travel by older adults with significant health problems. Regardless of the reason for travel, older adults need to plan for healthy travel. Primary care providers need to inquire at routine visits if patients have plans for international travel. If travel to other countries or regions is being considered, patients must be advised of the importance of early travel preparation. To begin with, older adults should be up to date on all routine immunizations. Those planning on international travel may need additional required and/or recommended immunizations, depending on the individual's health status, travel itinerary, length of stay, and health risks associated with destination sites. Primary care providers should be knowledgeable about travel medicine resources in the community to make referrals for travelers requiring additional immunizations and health information.


Serum resistin levels in children with primary snoring.
Primary Snoring (PS) has been positioned at the milder end of the Sleep-Disordered Breathing severity continuum characterized by snoring and it is usually underestimated. PS is defined as snoring without apnea, frequent arousals, or gas exchange abnormalities and recent studies demonstrated that children with PS have increased blood pressure and reduced arterial distensibility. The association between adipokines and SDB has been recently investigated, though most of the studies were focused on OSAS where intermittent hypoxia characterizing the disease may lead to an inflammatory cascade and to the release of several adipokines, contributing to oxidative stress. Resistin, initially described s an adipokine increasing insulin resistance, has been recently identified as a novel important member of the cytokine family involved in the regulation of inflammation. The aim of our study was to investigate circulating resistin levels in normal weight children with PS. Sixty-five children of normal weight aged between 4 and 14 years of age were selected for habitual snoring. Children with positive polysomnography were excluded from the study. Serum resistin levels were detected in all children with PS. Thirty-three healthy non-snorer children with similar age, sex and BMI were selected as a control group. A significantly higher level of resistin was observed in patients with PS compared to the control group (4.67±1.91 ng/ml vs 3.98±1.58 ng/ml; p<0.01). Patients with inconclusive pulse oximetry showed significantly higher resistin levels than those with negative recordings recordings (5.29±1.91 ng/ml vs 4.20±1.93 ng/ml; p<0.008). Moreover, there was a significant increasing trend between sieric adipokine level and the frequency of snoring (p<0.006). Our results suggest that systemic inflammation and oxidative stress may also play a significant role in the pathophysiology of PS.


Chloroplast envelope localization of EDS5, an essential factor for salicylic acid biosynthesis in Arabidopsis thaliana.
Chloroplasts are responsible for biosynthesis of salicylic acid (SA) an important signal molecule in plant immunity. EDS5 is a homolog of the MATE (multidrug and toxic compound extrusion) family of transporters, and is essential for SA biosynthesis. It has been speculated that EDS5 would be involved in the export of SA from chloroplasts. However, the subcellular localization of EDS5 remains largely uncharacterized. We demonstrate here that EDS5 is specifically localized to the chloroplast envelope membrane in Arabidopsis. In addition, we found that EDS5 is preferentially expressed in epidermal cells. These findings suggest that EDS5 is responsible for transport of SA from chloroplasts to the cytoplasm in epidermal cells.