Application of MoS2-FeS functional carrier loaded Ni single-atom catalysts on HER: first principle.
The stability of functional carriers single-atom catalysts can be effectively guaranteed by using stable mineral materials to support low dimensional catalytic materials. In this paper, the theoretical calculation of electrochemical hydrogen evolution reaction (HER) of the composite functional single-atom catalysts supported by single-atom Ni was carried out using first-principles method. And the original structure of MoS2,amorphous structure and S-vacancy structure are studied. Through the analysis and discussion of electronic properties, adsorption energy and active sites, it is found that Ni@Amorphous MoS2-FeS has excellent effect of hydrogen evolution in acidic environment, ΔGHis 0.312 eV, and the other two structures supporting Ni single-atom also have excellent HER properties in a wide range of pH. This design broadens the research idea of single-atom catalysts carriers and provides a new direction for the research and development of electrocatalytic materials.


Carboplatin as a radiation sensitizer in locally advanced cervical cancer: a pilot study.
Radiation therapy is the mainstay in treatment of locally advanced cervical carcinoma. Several chemotherapeutic agents have been used as radiation sensitizers in the treatment of cervical cancer in an effort to improve local response and survival. A prospective study was designed to evaluate carboplatin as a radiosensitizer in advanced cervical cancer. Standard radiotherapy techniques were used to treat patients with Stage IIA-IIIB cervical cancer. Intravenous carboplatin was administered twice weekly concurrent with external beam radiation. Of 22 evaluable patients, there were 19 complete responders of whom 15 remain alive: 11 patients were alive and disease free at last visit for a median duration of 15 months follow-up (range, 4-43 months) and 4 patients remain alive with disease for a median duration of 17 months (range, 3-55 months). Seven have died, one of whom was without evidence of disease. There were no treatment-related deaths and no grade 4 toxicity. The most significant adverse effect was hematologic resulting in four patients with grade 3 neutropenia or anemia. There were no fistulae or late gastrointestinal or genitourinary complications. This pilot study suggests that carboplatin administered with standard radiation is safe, well-tolerated, and thus may be useful as a radiation sensitizer in the treatment of locally advanced cervical cancer.


Acceptability, predictors and attitudes of Canadian women in labour toward point-of-care HIV testing at a single labour and delivery unit.
To assess attitudes and opinions surrounding point-of-care HIV testing among Canadian women, and to determine predictors for acceptance of testing. A survey assessing acceptability and attitudes toward rapid HIV testing was distributed on the labour and delivery unit in an academic hospital (St Michael's Hospital) in Toronto, Ontario, in 2011. Information collected included demographic data, health and pregnancy history, willingness to undergo rapid HIV testing while in labour and barriers to testing. Responses in 92 completed questionnaires were analyzed. The mean age of respondents was 32 years and all were HIV negative. Twelve percent of patients reported having at least one risk factor for HIV transmission. The study showed that only 59% of women were willing to be tested at the time of survey completion, and these women stated that they would accept saliva, urine or serum testing. If found to be positive, 96% would accept antiretroviral treatment and 94% would formula feed their infants. Of the 41% who were not willing to be tested, their reasons for refusal included "don't want to know" (39%) and being in "too much labour pain" (29%). Regardless of willingness to be tested, the most frequently cited barriers to testing were social stigma (64%) and reaction from partners (69%). Canadian women in labour were willing to undergo rapid HIV testing via urine, saliva or serum. If found to be positive, women were willing to undergo treatment and to formula feed to prevent mother-to-child transmission of HIV.


Localization of and immune response to the lipid-modified azurin of the pathogenic Neisseria.
The development of vaccines to prevent Neisseria infections has been impeded by antigenic diversity of most Neisseria surface components. The lipid-modified azurin (Laz), one of two distinct surface proteins recognized by the H.8 monoclonal antibody, is present in all pathogenic Neisseria. The mature protein has two domains; one contains an H.8 epitope and the other has extensive homology to azurins, a class of bacterial copper-binding proteins. The cellular location of Laz and the serum immune response to Lax were examined in patients with disseminated Neisseria infections. The data demonstrated that Laz is probably contained in the Neisseria outer membrane, although unlike most outer membrane proteins it is Sarkosyl soluble. By probing recombinant bacteriophages encoding the H.8 and azurin domains of Laz, results showed that whereas the H.8 epitope is immunogenic in patients with disseminated Neisseria infections, the azurin domain of Laz plays little role in eliciting an antibody response in these patients.


Transmission disequilibrium of polymorphic variants in the tryptophan hydroxylase-2 gene in children and adolescents with obsessive-compulsive disorder.
Dysfunction of the central serotonergic system has been implicated in the pathophysiology of obsessive-compulsive disorder (OCD). The genetic contribution to the development of OCD is particularly high in early-onset OCD. The aim of this study was to investigate the effect of polymorphic variants in the gene of the novel brain-specific tryptophan hydroxylase-2 (TPH2), the rate-limiting enzyme of serotonin (5-HT) synthesis in the brain, in OCD with disease onset in childhood and adolescence. We analysed two common single nucleotide polymorphisms (SNPs) of TPH2 in the putative transcriptional control region and in intron 2 of the TPH2 gene in a unique family-based sample of OCD patients with onset of the disease in childhood and adolescence comprising 71 complete, independent trios. The transmission disequilibrium test was used to determine transmission of alleles and haplotypes from parents to offspring. In this first study of TPH2 in OCD, analysis of the SNPs, rs4570625 and rs4565946, revealed a significant preferential transmission of haplotype G-C to children and adolescents with OCD. Moreover, a trend towards preferential transmission of the C allele of SNP rs4565946 to the patients was found. The genotype relative-risk estimate for homozygous C allele carriers of SNP rs4565946 was 2.58 (95% CI 0.98-6.82). In conclusion, the results link TPH2 variations to the pathogenesis of early-onset OCD and further support the aetiological relevance of 5-HT signalling in OCD.


Use of Tobacco Products, Alcohol, and Other Substances Among High School Students During the COVID-19 Pandemic - Adolescent Behaviors and Experiences Survey, United States, January-June 2021.
The COVID-19 pandemic has been associated with established risk factors for adolescent substance use, including social isolation, boredom, grief, trauma, and stress. However, little is known about adolescent substance use patterns during the pandemic. CDC analyzed data from the Adolescent Behaviors and Experiences Survey, an online survey of a probability-based, nationally representative sample of public- and private-school students in grades 9-12 (N = 7,705), to examine the prevalence of current use of tobacco products, alcohol, and other substances among U.S. high school students. Prevalence was examined by demographic characteristics and instructional models of the students' schools (in-person, virtual, or hybrid). During January-June 2021, 31.6% of high school students reported current use of any tobacco product, alcohol, or marijuana or current misuse of prescription opioids. Current alcohol use (19.5%), electronic vapor product (EVP) use (15.4%), and marijuana use (12.8%) were more prevalent than prescription opioid misuse (4.3%), current cigarette smoking (3.3%), cigar smoking (2.3%), and smokeless tobacco use (1.9%). Approximately one third of students who used EVPs did so daily, and 22.4% of students who drank alcohol did so ≥6 times per month. Approximately one in three students who ever used alcohol or other drugs reported using these substances more during the pandemic. The prevalence of substance use was typically higher among non-Hispanic American Indian or Alaska Native students, older students, and gay, lesbian, or bisexual students than among students of other racial or ethnic groups, younger students, and heterosexual students. The prevalence of alcohol use also was higher among non-Hispanic White students than those of other racial or ethnic groups. Students only attending school virtually had a lower prevalence of using most of the substances examined than did students attending schools with in-person or hybrid models. These findings characterizing youth substance use during the pandemic can help inform public health interventions and messaging to address these health risks during and after the COVID-19 pandemic.


Coagulation and fibrinolysis in diabetes.
The accelerated development of atherothrombotic cardiovascular disease in type 2 diabetes mellitus may be enhanced by the presence of a prothrombotic state. This prothrombotic state includes a diminished fibrinolytic capacity and an increased coagulability. Impaired fibrinolytic capacity appears to be a hallmark of the metabolic syndrome of type 2 diabetes and can be a direct consequence of visceral obesity. In addition, a chronic low inflammatory state with hyperinsulinemia and dyslipidemia may further influence the hemostatic balance. The characteristic dyslipidemia of type 2 diabetes, coined the atherogenic lipoprotein profile, with raised plasma levels of fasting and postprandial triglyceride lipoproteins, atherogenic low-density lipoproteins, and low high-density lipoproteins, is involved in promoting a hypercoagulable state. Lifestyle and pharmacologic interventions that reduce cardiovascular risk in the general population and that may improve the metabolic syndrome may also reduce the prothrombotic state.


Confined Pyrolysis within Metal-Organic Frameworks To Form Uniform Ru3 Clusters for Efficient Oxidation of Alcohols.
Here we report a novel approach to synthesize atomically dispersed uniform clusters via a cage-separated precursor preselection and pyrolysis strategy. To illustrate this strategy, well-defined Ru3(CO)12 was separated as a precursor by suitable molecular-scale cages of zeolitic imidazolate frameworks (ZIFs). After thermal treatment under confinement in the cages, uniform Ru3 clusters stabilized by nitrogen species (Ru3/CN) were obtained. Importantly, we found that Ru3/CN exhibits excellent catalytic activity (100% conversion), high chemoselectivity (100% for 2-aminobenzaldehyde), and significantly high turnover frequency (TOF) for oxidation of 2-aminobenzyl alcohol. The TOF of Ru3/CN (4320 h-1) is about 23 times higher than that of small-sized (ca. 2.5 nm) Ru particles (TOF = 184 h-1). This striking difference is attributed to a disparity in the interaction between Ru species and adsorbed reactants.


An in vitro oral biofilm model for comparing the efficacy of antimicrobial mouthrinses.
The ability of commercial mouthrinses to reduce total viable counts of mixed microbial populations was examined using a previously developed in vitro model of supragingival plaque. Exploratory experiments aimed at fine-tuning the model indicated that optimal correspondence between in vitro and clinical results for chlorhexidine-containing formulations were obtained at a saliva:medium ratio of 70:30 (v/v); moreover, expanding the microbial population from 5 bacterial species to 5 bacterial species + Candida albicans had no noticeable impact on overall results. The efficacies of 12 different mouthrinse proprietary products containing chlorhexidine, hexetidine, octenidine, Triclosan, plant extracts, or aminefluoride/stannous fluoride vis-à-vis biofilm clearance were compared. All mouthrinses promoted a statistically significant reduction in microbial load compared to distilled water. The herbal- and phenolic-based products were substantially less effective than most chlorhexidine-containing mouthrinses, or mouthrinses containing hexetidine or octenidine. No significant difference between the plaque-clearing plaque-clearing abilities of Listerine and Meridol was observed. This polyspecies biofilm model can be a valuable tool for preclinical testing of antiplaque formulations, particularly during the product development stage.


Hospital trends of admissions and procedures for acute leg ischaemia in England, 2000-2011.
Acute leg ischaemia (ALI) is a common vascular emergency for which new minimally invasive treatment options were introduced in the 1990s. The aim of this study was to determine recent hospital trends for ALI in England and to assess whether the introduction of the new treatment modalities had affected management. Routine hospital data covering ALI were provided by Hospital Episode Statistics for the years 2000 to 2011 and mortality data were obtained from the Office for National Statistics. All data were age standardised, reported per 100,000 of the population, and stratified by age band (60-74 years and ≥75 years) and sex. Hospital admissions have risen significantly from 60.3 to 94.3 per 100,000 of the population, with an average annual increase of 6.2% since 2003 (p<0.001). The rise was greater in the older age group (from 79.9 to 134.4 vs 49.3 to 73.0) and yet procedures for ALI have shown a significant decrease since 2000 from 14.3 to 12.4 per 100,000 (p=0.013), independent of age and sex. Open embolectomy of the femoral artery remains the most common procedure and the proportion of endovascular interventions showed only a small increase. Only a few deaths were attributed to ALI (range: 95-150 deaths per year). Hospital workload for ALI has increased, particularly since 2003, but this trend does not appear to have translated into increased endovascular or surgical activity.


Byssinosis and other respiratory ailments: a survey of 6,631 cotton textile employees.
A Pulmonary Function Survey involving a questionnaire and pulmonary function testing was carried out in 14 plants of a large cotton textile manufacturing corporation. The edited records of 6,631 employees were analyzed to help identify the prevalence and location of byssinosis and other respiratory ailments and to explore the environmental conditions associated with them. A majority of the complaints of byssinosis were found among the relatively small subset of employees located in the high dust work areas of opening, picking, and carding. Byssinosis was significantly associated with bronchitis. Smoking was significantly associated with byssinosis for employees in opening, picking, and carding. While 3% of the population had subjective symptoms (history) of byssinosis, 0.8% indicated both symptoms and objective sign by a 10% or greater drop during the working day of the one-second forced expiratory volume (FEV1). The techniques commonly used to predict FEV1 should employ race as a predictive factor.


Mutation-Associated Phenotypic Heterogeneity in Novel and Canonical PIK3CA Helical and Kinase Domain Mutants.
Phosphatidylinositol 3-kinase, catalytic subunit alpha (PIK3CA) is an oncogene often mutated in colorectal cancer (CRC). The contribution of PIK3CA mutations in acquired resistance to anti-epidermal growth factor receptor (EGFR) therapy is well documented, but their prognostic and predictive value remain unclear. Domain- and exon-specific mutations are implicated in either favorable or poor prognoses, but there is paucity in the number of mutations characterized outside of the mutational hotspots. Here, two novel non-hotspot mutants-Q661K in exon 13 and C901R in exon 19-were characterized alongside the canonical exon 9 E545K and exon 20 H1047R mutants in NIH3T3 and HCT116 cells. Q661K and E545K both map to the helical domain, whereas C901R and H1047R map to the kinase domain. Results showed variable effects of Q661K and C901R on morphology, cellular proliferation, apoptosis resistance, and cytoskeletal reorganization, with both not having any effect on cellular migration. In comparison, E545K markedly promoted proliferation, survival, cytoskeletal reorganization, migration, and spheroid formation, whereas H1047R only enhanced the first three. In silico docking suggested these mutations negatively affect binding of the p85 alpha regulatory subunit to PIK3CA, thereby relieving PIK3CA inhibition. Altogether, these findings support intra-domain and mutation-specific variability in oncogenic readouts, with implications in degree of aggressiveness.


Redefining the Molecular Interplay between Dimethyl Sulfoxide, Lipid Bilayers, and Dehydration.
The potentially damaging action of dimethyl sulfoxide (DMSO) on phospholipid bilayers remains a matter of controversy. We have conducted a series of long-scale molecular dynamics simulations of 1,2-dioleoyl-sn-glycero-3-phosphocholine (DOPC) bilayers at various levels of hydration in the presence of variable quantities of DMSO. These simulations provide evidence for a non-destructive dehydrating mechanism of action for DMSO on DOPC bilayers across a wide concentration range and levels of hydration. Specifically, under full- and low-hydration conditions, the bilayer underwent a minor lateral contraction, coinciding with surface dehydration in the presence of dilute DMSO solutions (XDMSO < 0.3). At higher DMSO concentrations, this bilayer structure was retained despite a progressive deterioration of the hydration structure at the interface. A similar convergence of bilayer structural properties was observed under dehydration conditions for 0.3 < XDMSO < 0.7. Destabilization occurred for dehydrated bilayers in the presence of XDMSO ≥ 0.7, suggesting the existence of a DMSO concentration and/or dehydration threshold. However, such DMSO concentrations far exceed those established as toxic to other cellular components. Our findings represent a computational model for DMSO-DOPC interactions that is consistent with a range of experimental characterizations, offering new molecular insights into the cryoprotective mechanisms of action of DMSO.


Inhibiting autophagy: a novel approach for the treatment of renal cell carcinoma.
The common clear cell subtype of renal cell carcinoma is associated with hereditary or acquired loss of function of the von Hippel-Lindau tumor suppressor, a key component in oxygen sensing, perpetuating a stressed state. Autophagy is primarily a highly conserved, catabolic process by which stressed cells shuttle damaged or effete organelles and proteins into autophagosomes for sequestration and digestion after fusion with lysosomes. Autophagy is directed by autophagy-related genes and is divided into 4 discrete steps: initiation, nucleation, maturation, and degradation. During early tumorigenesis, apoptosis is enhanced and autophagy is suppressed, allowing accumulation of mutations and emergence of genomic instability. Late, an "autophagic switch" occurs, promoting survival and limiting apoptosis. Compounds such as chloroquine and hydroxychloroquine that prevent acidification of the lysosomal compartment are the sole clinically available inhibitors of autophagy. Currently, there are more than 30 trials examining combinations of hydroxychloroquine with anticancer agents. The intricate effects of autophagy on the immune response complicate manipulation of autophagy as part of the antitumor strategy. Further understanding of basic mechanisms of renal cell carcinoma pathogenesis and of autophagy will enable development of the next generation of pharmacologic modulators of autophagy.


Sustaining a Pregnant Cadaver for the Purpose of Gestating a Fetus: A Limited Defense.
I argue that there are times it is morally permissible to keep a brain-dead pregnant woman on life support for the sole purpose of allowing her fetus to gestate until it is able to be born as healthy as possible. While a woman should not be kept on such support if she has clearly expressed that this would contradict her wishes, she may be kept on such support if she did not make her wishes known at all. Moreover, there are reasons why her family's wishes alone may not suffice to override the fetus' interest in continued existence. The most difficult case to assess is when the woman had previously made it known she would not want to be sustained on artificial life support, but was not explicit concerning whether she would maintain that stance in the event of her pregancy. Finally, I will show why my position is compatible with a pro-abortion-choice perspective.


Wavefunction in density functional theory embedding for excited states: which wavefunctions, which densities?
We present a detailed analysis of our recently proposed wavefunction in density functional theory method to include differential polarization effects through state-specific embedding potentials. We study methylenecyclopropene and acrolein in water by using several wavefunction approaches to validate the supermolecular reference and to assess their response to embedding. We find that quantum Monte Carlo, complete-active space second-order perturbation theory, and coupled cluster methods give very consistent solvatochromic shifts and a similar response to embedding. Our scheme corrects the excitation energies produced with a frozen environment, but the values are often overshot. To ameliorate the problem, one needs to use wavefunction densities to polarize the environment. The choice of the exchange-correlation functional in the construction of the potential has little effect on the excitation, whereas the approximate kinetic-energy functional appears to be the largest source of error.


A mitochondrial protein affects cell morphology, mitochondrial segregation and virulence in Leishmania.
The single mitochondrion of kinetoplastids divides in synchrony with the nucleus and plays a crucial role in cell division. However, despite its importance and potential as a drug target, the mechanism of mitochondrial division and segregation and the molecules involved are only partly understood. In our quest to identify novel mitochondrial proteins in Leishmania, we constructed a hidden Markov model from the targeting motifs of known mitochondrial proteins as a tool to search the Leishmania major genome. We show here that one of the 17 proteins of unknown function that we identified, designated mitochondrial protein X (MIX), is an oligomeric protein probably located in the inner membrane and expressed throughout the Leishmania life cycle. The MIX gene appears to be essential. Moreover, even deletion of one allele from L. major led to abnormalities in cell morphology, mitochondrial segregation and, importantly, to loss of virulence. MIX is unique to kinetoplastids but its heterologous expression in Saccharomyces cerevisiae produced defects in mitochondrial morphology. Our data show that a number of mitochondrial proteins are unique to kinetoplastids and some, like MIX, play a central role in mitochondrial segregation and cell division, as well as virulence.


Determination of in-process limits during parenteral solution manufacturing using Monte Carlo Simulation.
The purpose of this study is to utilize Monte Carlo Simulation methodology to determine the in-process limits for the parenteral solution manufacturing process. The Monte Carlo Simulation predicts the distribution of a dependable variable (such as drug concentration) in a naturally occurring process through random value generation considering the variability associated with the depended variable. The propagation of variation in drug concentration from batch to batch is cascading in nature during the following four formulation steps: 1) determination of drug raw material potency (or purity), 2) weighing of drug raw material, 3) measurement of batch volume, and 4) determination of drug concentration in the mix tank. The coefficients of variation for these four steps are denoted as CV1, CV2, CV3, and CV4, respectively. The Monte Carlo Simulation was performed for each of the above four cascading steps. The results of the simulation demonstrate that the in-process limits of the drug can be successfully determined using the Monte Carlo Simulation. Once the specification limits are determined, the Monte Carlo Simulation can be used to study the effect of each variability on the percent out of specification limits (OOL) for the in-process testing. Demonstrations were performed using the acceptance criterion of less than 5% of OOL batches, and the typical values of CV2 and CV3 being equal to 0.03% and 0.5%, respectively. The results show that for the in-process limits of +/- 1%, the values of CV1 and CV4 should not be greater than 0.1%. These assay requirements appear to be difficult to achieve for a given chemical analytical method. By comparison, for the In-process limits of +/- 4%, the requirements are much easier to achieve. The values of CV1 and CV4 should not be greater than 1.38%. In addition, the relationship between the percent OOL versus CV1 or CV4 is nonlinear per se. The number of OOL batches increases rapidly with increasing variability of CV1 or CV4.


Role of newly synthesized fibronectin in vascular smooth muscle cell migration on matrix-metalloproteinase-degraded collagen.
The migration of vascular smooth muscle cells (VSMC) is known to be a key process in the development of a number of vascular lesions, although the precise mechanisms involved have still to be elucidated. In the present study, the production of endogenous fibronectins by VSMC migrating across intact and matrix-metalloproteinase-degraded collagen type I has been explored. Cellular fibronectin seems to play a role in the enhanced migration seen when VSMC are exposed to degraded collagen and platelet-derived growth factor-BB. VSMC were found to synthesize both exon IIIA-containing fibronectin (which predominated) and exon IIIB-containing fibronectin. When these cells were exposed to substrates consisting of recombinant exon IIIA- or exon IIIB-containing fibronectin, rates of migration were not elevated above those seen with undegraded collagen. Endogenous fibronectin production may thus be necessary, but not sufficient, for VSMC migration over degraded collagenous substrates.


Risk of Depression in People With Human Immunodeficiency Virus: A Nationwide Population-based Matched Cohort Study.
Human immunodeficiency virus (HIV) infection is associated with depression. However, previous studies have not addressed familial factors. Nationwide, population-based, matched cohort study of people with HIV (PWH) in Denmark between 1995 and 2021 who were matched on sex and date of birth with a comparison cohort randomly selected from the Danish population. Family-related factors were examined by inclusion of siblings of those in the cohorts. We calculated hazard ratios (HRs) for depression, receipt of antidepressants, electroconvulsive therapy (ECT), and suicide, as well as the yearly proportions of study cohorts with psychiatric hospital contact due to depression and receipt of antidepressants from 10 years before to 10 years after study inclusion. We included 5943 PWH and 59 430 comparison cohort members. Median age was 38 years, and 25% were women. We observed an increased risk of depression, receipt of antidepressants, ECT, and suicide among PWH in the 2 first years of observation (HR, 3.3; 95% confidence interval [CI]: 2.5-4.4), HR, 3.0 (95% CI: 2.7-3.4), HR, 2.8 (95% CI: .9-8.6), and HR, 10.7 (95% CI: 5.2-22.2), thereafter the risk subsided but remained increased. The proportions of PWH with psychiatric hospital contact due to depression and receipt of antidepressants were increased prior to and especially after HIV diagnosis. Risk of all outcomes was substantially lower among siblings of PWH than among PWH (HR for receipt of antidepressants, 1.1; 95% CI: 1.0-1.2). PWH have an increased risk of depression. Family-related factors are unlikely to explain this risk.


Effect of Short Message Service on Management of Pulmonary Tuberculosis Patients in Anhui Province, China: A Prospective, Randomized, Controlled Study.
BACKGROUND To explore the significance of short message service (SMS) on the management of pulmonary tuberculosis (TB) patients in reinforcing the treatment adherence and health awareness, and provide scientific evidences for popularizing this model and formulating related polices and measures. MATERIAL AND METHODS Six counties (districts) were selected by stratified cluster sampling method, and randomly divided into control group and intervention group. Pulmonary TB patients eligible to the study criteria were included in the study. SMS management and regular education of core knowledge about pulmonary TB were carried out in SMS group patients. The conventional directly observed therapy (DOT) was carried out in control group. Data was collected by questionnaire method. RESULTS A total of 350 patients were included in the study, including 160 cases in the SMS group and 190 cases in the control group. There were 270 males (77.1%) and 80 females (22.9%). The treatment completion rate in SMS group (96.25%) was significantly higher than that in the control group (86.84%) (χ²=9.52, P=0.002). Both the interrupted treatment rate and the missed dose rate in the SMS group were significantly lower than those in the control group (χ²=10.41, P=0.001; χ²=28.54, P<0.001). After a period of treatment, the reexamination rate of SMS group patients was significantly higher than that in control group (except the reexamination rate after 5 months treatment). CONCLUSIONS The management of pulmonary TB patients by SMS can effectively reinforce the completed treatment rate of pulmonary TB patients and reduce their missed dose rate and interrupted treatment rate, and further enhance their reexamination awareness. Therefore, SMS on the management of patients may be a new promising therapeutic strategy for pulmonary TB.


[Ultrasonic diagnosis of tumors of the spleen].
Neoplasms of the spleen, either primary or secondary, are rare, and knowledge of them is insufficient. Actually, the spleen had been a difficult organ clinically to assess until the ultrasonic technique was introduced for medical diagnostic purposes. Nowadays, one can easily determine splenic size by using one of the largest cross sectional area of several ultrasonic scans taken parallel to the IXth ribs). Ultrasonic appearance of the spleens in the tomograms taken by our method is classified into three basic patterns. Splenotomograms of our own cases with diffuse and localized splenic tumors were shown in this study. Ultrasonic scanning of the spleen is a non-invasive and valuable diagnostic technique for estimation of its configuration and size, and for detection and some degree of tissue characterization of space occupying lesions. However, further extensive investigation is needed for more accurate tissue characterization of the splenic lesions.


The association between left ventricle diastolic dysfunction and endothelial dysfunction and the results of stress myocardial SPECT in asymptomatic patients with type 2 diabetes.
Diabetes mellitus is associated with a poor cardiovascular prognosis. Stress myocardial single-photon emission computed tomography (SPECT) reliably detects coronary ischaemia in asymptomatic patients. Our study aimed to evaluate the association between systolic and diastolic left ventricular function, left ventricular hypertrophy, endothelial function and the results of stress myocardial SPECT in 126 patients with type 2 diabetic patients with no cardiovascular symptoms. Thirty-three patients (26%) had abnormal SPECT results, 33 patients (26%) had intermediate (equivocal) results, and 60 patients (48%) had normal results. We found a significant association between an abnormal SPECT result, left ventricular diastolic dysfunction and impaired post-ischaemic dilatation of the brachial artery. No association was found between the SPECT result and systolic function and left ventricular hypertrophy, however. An abnormal SPECT result was significantly associated with left ventricular diastolic dysfunction and the deterioration of post-ischaemic dilatation of the brachial artery in asymptomatic patients with type 2 diabetes.


Aluminum tolerance mechanisms in Kenyan maize germplasm are independent from the citrate transporter ZmMATE1.
Aluminum (Al) toxicity on acid soils adversely affects maize yields, which can be overcome by combining soil amendments with genetic tolerance. In maize, ZmMATE1 confers Al tolerance via Al-activated citrate release, whereby citrate forms non-toxic complexes with Al3+ in the rhizosphere. Here, we investigated Al tolerance mechanisms in maize germplasm originated from Kenya based on quantitative trait loci (QTL) mapping. Five QTLs and four epistatic interactions explained ~51% of the phenotypic variation for Al tolerance. The lack of Al tolerance QTL on chromosome 6 and the much lower expression of ZmMATE1 in both Kenyan lines than in Cateto Al237, which donates the superior allele of ZmMATE1, strongly indicate that this gene does not play a significant role in Al tolerance in neither parent. In turn, maize homologs to genes previously implicated in Al tolerance in other species, ZmNrat1, ZmMATE3, ZmWRKY and ZmART1, co-localized with Al tolerance QTL and were more highly expressed in the parent that donate favorable QTL alleles. However, these candidate genes will require further studies for functional validation on maize Al tolerance. The existence of Al tolerance mechanisms independent from ZmMATE1 suggests it is possible to develop highly Al tolerant cultivars by pyramiding complementary Al tolerance genes in maize.


Dural puncture and subdural injection: a complication of lumbar transforaminal epidural injections.
Two cases are presented in which the complication of dural puncture is documented in the context of a lumbar transforaminal epidural steroid injection. The hazard of dural puncture during transforaminal epidural injections, the anatomy of the dural and thecal sac, the potential for subdural injections, and relevant literature are reviewed. Report of two cases. Lumbar transforaminal epidural steroid injections are a commonly employed procedure for the treatment of lumbar radiculopathy. The optimal target point lies at the "6 o' clock" position of the pedicle. Contrast is injected to confirm proper placement of the needle and correct flow of the medication through the epidural space. Despite apparent proper placement of the needle, a potential complication exists of puncturing the dura while performing this procedure. Spinal injectionists should recognize the subsequent contrast patterns associated with this complication. Subdural and intrathecal spread of contrast is rarely seen with transforaminal injections and thus can be easily overlooked. Becoming familiar with the images presented in these cases may help alert the interventionalist of a dural puncture, and thus avoid injection of medications into the intrathecal and subdural spaces.


Evaluation of technical quality of endodontic treatment--reliability of intraoral radiographs.
The purpose of this study was to evaluate: 1) the use of the conventional buccolingual radiographic projection for estimating the technical quality of endodontic treatment and 2) the effect of the surrounding tissues on these evaluations. The material consisted of three radiographs of each of 108 extracted roots: a clinical radiograph, an in vitro radiograph taken in the buccolingual projection, and an in vitro radiograph taken in the mesiodistal projection. The radiographs were analysed by two observers and consensus was reached and used in the analyses. The agreement between the two observers was good, but statistically significant differences were found between recordings of the seal in the clinical radiographs and the in vitro radiographs taken in the buccolingual projection. The length of the root filling in each of the three projections was interpreted to be the same, while both inadequate seal and visible lumen apical to the root filling were recorded less frequently in the clinical radiographs than in either of the two in vitro projections. This difference was most pronounced in molar teeth. It was concluded that the lengths of root fillings could be measured correctly in clinical radiographs. Due to the anatomy of root canals in incisors and canines, there was a risk of misinterpreting an inadequate seal as adequate in these teeth. The large amount of tissue surrounding molar teeth tended to cause an underregistration of both inadequate seal and lumen apical to the root fillings in these regions.


Effect of Flexibility, Lipophilicity, and the Location of Polar Residues on the Passive Membrane Permeability of a Series of Cyclic Decapeptides.
Cyclic peptides have received increasing attention over the recent years as potential therapeutics for "undruggable" targets. One major obstacle is, however, their often relatively poor bioavailability. Here, we investigate the structure-permeability relationship of 24 cyclic decapeptides that share the same backbone N-methylation pattern but differ in their side chains. The peptides cover a large range of values for passive membrane permeability as well as lipophilicity and solubility. To rationalize the observed differences in permeability, we extracted for each peptide the population of the membrane-permeable conformation in water from extensive explicit-solvent molecular dynamics simulations and used this as a metric for conformational rigidity or "prefolding." The insights from the simulations together with lipophilicity measurements highlight the intricate interplay between polarity/lipophilicity and flexibility/rigidity and the possible compensating effects on permeability. The findings allow us to better understand the structure-permeability relationship of cyclic peptides and extract general guiding principles.


Review of Integrated Psychological Services in Primary Care.
Reviews the book, Integrated Psychological Services in Primary Care edited by William Scott Craig (see record 2016-01850-000). This book opens with an article by the editor, in which he outlines the behavioral health needs of primary care patients and the rationale behind integrating mental health services in primary care settings. Subsequent chapters address basic and practical information for a variety of practice locations, such as Patient Centered Medical Home clinics, the Veteran's Administration medical centers, and primary care settings where the concept of integrated health is new. This is an excellent primer for anyone planning to implement an integrated care program or for those considering moving from an independent practice, agency, or traditional health care/hospital environment into an integrated primary care environment. The authors' writing styles made difficult concepts easy to understand and their knowledge of the utility of integration was evident. (PsycINFO Database Record


An evaluation protocol of 'Replicability Model' project for detection and treatment of leprosy and related disability in Chhattisgarh, India.
People affected by leprosy are at increased risk of impairments and deformities from peripheral nerve damage. This mostly occurs if diagnosis and treatment is delayed and contributes to continued transmission within the community. Champa district of Chhattisgarh state in India is an endemic area with the highest national annual case detection and disability rates for leprosy. The Replicability Model is a system strengthening intervention implemented by the Leprosy Mission Trust India in Champa that aims to promote early diagnosis and treatment of leprosy, improve on-going management of the effects of leprosy and improve welfare for the people affected by leprosy. This protocol presents a plan to describe the overall implementation of the Replicability Model and describe the barriers and facilitators encountered in the process. We will also quantify the effect of the program on one of its key aims- early leprosy diagnosis. The replicability model will be implemented over four years, and the work described in this protocol will be conducted in the same timeframe. We have two Work Packages (WPs). In WP1, we will conduct a process evaluation. This will include three methods i) observations of replicability model implementation teams' monthly meetings ii) key informant interviews (n = 10) and interviews with stakeholders (n = 30) iii) observations of key actors (n = 15). Our purpose is to describe the implementation process and identify barriers and facilitators to successful implementation. WP2 will be a quantitative study to track existing and new cases of leprosy using routinely collected data. If the intervention is successful, we expect to see an increase in cases (with a higher proportion detected at an early clinical stage) followed by a decrease in total cases. This study will enable us to improve and disseminate the Replicability Model by identifying factors that promote success. It will also identify its effectiveness in fulfilling one of its aims: reducing the incidence of leprosy by finding and tracking cases at an earlier stage in the disease.


Short-term myocardial ischemia induces cardiac modified C-reactive protein expression and proinflammatory gene (cyclo-oxygenase-2, monocyte chemoattractant protein-1, and tissue factor) upregulation in peripheral blood mononuclear cells.
Prompt coronary thrombus resolution, reducing time of ischemia, improves cardiac recovery. The factors triggered by ischemia that contribute to the clinical outcome are not fully known. We hypothesize that unabated inflammation due to cardiac ischemia may be a contributing factor. As a proof-of-concept, we evaluated the effect of short-term myocardial ischemia on the local and systemic inflammatory response. Pigs underwent either 90-min mid-left anterior descending (LAD) coronary artery balloon occlusion (infarct size 25% +/- 1% left ventricle; 29% heart function deterioration) or a sham-operation procedure. Peri-infarcted and non-ischemic cardiac tissue was obtained for histopathologic, molecular and immunohistochemical analysis of inflammatory markers [interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), modified C-reactive protein (mCRP), and human alveolar macrophage-56 (HAM-56)]. Blood (femoral vein) was withdrawn prior to myocardial infarction (MI) induction (t = 0) and at 30 and 90 min to evaluate: (i) systemic cytokine levels (IL-6, TNF-alpha, CRP); (ii) proinflammatory gene and protein expression in peripheral blood mononuclear cells (PBMCs) of tissue factor (TF), cyclo-oxygenase-2 (Cox-2), monocyte chemoattractant protein-1 (MCP-1), and CRP; and (iii) platelet activation (assessed by perfusion studies and RhoA activation). Short-term ischemia triggered cardiac IL-6 and TNF-alpha expression, recruitment of inflammatory cells, and mCRP expression in infiltrated macrophages (P < 0.05 vs. t = 0 and sham). PBMC mRNA and protein expression of MCP-1, Cox-2 and TF was significantly increased by ischemia, whereas no differences were detected in CRP. Ischemia increased cardiac troponin-I, IL-6 and TNF-alpha systemic levels, and was associated with higher platelet deposition and RhoA activation (P < 0.001 vs. t = 0 and sham). Short-term myocardial ischemia, even without atherosclerosis, induces an inflammatory phenotype by inducing local recruitment of macrophages and systemic activation of mononuclear cells, and renders platelets more susceptible to activation.


Long-distance transport of neonates with transposition of the great arteries for the arterial switch operation: A 26-year Western Australian experience.
There is evidence that outcomes of complex paediatric cardiac procedures including the arterial switch operation (ASO) for transposition of the great arteries (TGA) are improved when performed at higher volume centres. While in utero transport for surgery is considered ideal, antenatal detection rates of TGA are low. Long-distance transport of post-natally diagnosed neonates has the potential to destabilise the patient's clinical condition. Since 1986, many neonates with TGA have been transported interstate from Perth to Melbourne or Brisbane for ASO surgery. The aim of this study was to review the Western Australian experience of interstate transport of newborns with TGA for ASO, noting transport complications and comparing the early mortality of these patients with published outcomes of the ASO from Royal Children's Hospital (RCH), Melbourne. In this retrospective cohort study, we reviewed the neonatal and cardiology databases and medical records to identify infants with TGA born between 1986 and 2011 and requiring ASO surgery during the neonatal period. Over 26 years, 80 neonates were transferred interstate for ASO surgery. Twelve infants required ventilation, 36 needed prostaglandin (prostaglandin E1) infusion and 3 inotropic support. There was no mortality during transport and there was a single early post-operative death. This early mortality of 1.2% compares favourably with the RCH mortality of 2.8% from a recently published review of early outcomes for ASO. When in utero transport is not possible, long-distance transport of neonates with TGA can be safely undertaken, with no evidence of increased transport mortality/ major morbidity or higher early surgical mortality.


Carotid flow rates and flow division at the bifurcation in healthy volunteers.
In nine healthy subjects, magnetic resonance imaging was used to measure blood flow waveforms in the common (CCA), internal (ICA) and external (ECA) carotid arteries. Useful data were acquired from 14 carotid arteries in total. Flow rates were determined from regions of interest placed over the arteries in CINE-phase contrast velocity encoded images. Use of a normalized cardiac cycle allowed the combination of flow waveforms from individuals. Time-averaged group mean flow rates were 6.16, 4.14 and 1.59 ml s(-1) for the CCA, ICA and ECA, respectively. Time-averaged values for the flow division ratios ICA/CCA, ECA/ICA and ECA/CCA were 0.70, 0.39 and 0.26, respectively. The data will be of use in future physiological studies and in computational modelling of carotid artery haemodynamics.


Vending Machines of Food and Beverages and Nutritional Profile of their Products at Schools in Madrid, Spain, 2014-2015.
Policies restricting access to sugary drinks and unhealthy foods in the school environment are associated with healthier consumption patterns. In 2010, Spain approved a Consensus Document regarding Food at Schools with nutritional criteria to improve the nutritional profile of foods and drinks served at schools. The objective of this study was to describe the frequency of food and drink vending machines at secondary schools in Madrid, the products offered at them and their nutritional profile. Cross-sectional study of a random sample of 330 secondary schools in Madrid in 2014-2015. The characteristics of the schools and the existence of vending machines were recorded through the internet and by telephone interview. The products offered in a representative sample of 6 vending machines were identified by in situ inspection, and its nutritional composition was taken from its labeling. Finally, the nutritional profile of each product was analyzed with the United Kingdom profile model, which classifies products as healthy and less healthy. The prevalence of vending machines was 17.3%. Among the products offered, 80.5% were less healthy food and drinks (high in energy, fat or sugar and poor in nutrients) and 10.5% were healthy products. Vending machines are common at secondary schools in Madrid. Most products are vending machines are still less healthy.


SIR2 modifies histone H4-K16 acetylation and affects superhelicity in the ARS region of plasmid chromatin in Saccharomyces cerevisiae.
The null mutation of the SIR2 gene in Saccharomyces cerevisiae has been associated with a series of different phenotypes including loss of transcriptional silencing, genome instability and replicative aging. Thus, the SIR2 gene product is an important constituent of the yeast cell. SIR2 orthologues and paralogues have been discovered in organisms ranging from bacteria to man, underscoring the pivotal role of this protein. Here we report that a plasmid introduced into sir2Delta cells accumulates more negative supercoils compared to the same plasmid introduced into wild-type (WT) cells. This effect appears to be directly related to SIR2 expression as shown by the reduction of negative supercoiling when SIR2 is overexpressed, and does not depend on the number or positioning of nucleosomes on plasmids. Our results indicate that this new phenotype is due to the lack of Sir2p histone deacetylase activity in the sir2Delta strain, because only the H4-K16 residue of the histone octamer undergoes an alteration of its acetylation state. A model proposing interference with the replication machinery is discussed.


Clinical Relevance of Intraperitoneal Pressure in Peritoneal Dialysis Patients.
Intraperitoneal pressure (IPP) in peritoneal dialysis (PD) increases in sitting and upright positions and is related to some individual characteristics. Adverse effects can appear with IPP > 20 cm H2O. Few studies about peritoneal transport or abdominal wall problems have directly measured IPP. We measured IPP in our prevalent PD patients to identify the clinical factors related to its variability and its possible association with peritoneal transport and abdominal wall complications. We performed a retrospective, observational study of our stable PD patients. Intraperitoneal pressure was measured using the Durand's method in supine, sitting, and upright position. Forty-nine patients were included, 70% males, mean age 61.1 ± 15 years, body mass index (BMI) 27.9 ± 5.2 kg/m2. The mean of supine IPP was 18.0 ± 4.4 cm H2O. Intraperitoneal pressure in sitting and upright positions were similar and higher than in supine. Supine IPP showed a positive correlation with BMI (p < 0.0005) and comorbidity (p < 0.05). A multivariate linear regression analysis showed that BMI and comorbidity (p < 0.005) had a positive correlation with IPP; time on PD and daily total ultrafiltration (UF) (p < 0.005) showed a negative correlation. Patients with an IPP ≥ 20 cm H2O had more hernias (35% vs 17%) and leakages (21% vs 8%) without statistical significance. Our supine IPPs were higher than others published in adults. Intraperitoneal pressure has an individual value associated with body size. Greater IPP was correlated with lower daily total UF and more hernias and leakages. The measurement of IPP is a simple technique and can help with PD prescription, especially in obese patients.


Explaining the specific heat of liquids based on instantaneous normal modes.
The successful prediction of the specific heat of solids is a milestone in the kinetic theory of matter due to Debye. No such success, however, has ever been obtained for the specific heat of liquids, which has remained a mystery for over a century. A theory of specific heat of liquids is derived here using a recently proposed analytical form of the vibrational density of states of liquids, which takes into account saddle points in the liquid energy landscape via the so-called instantaneous normal modes (INMs), corresponding to negative eigenvalues (imaginary frequencies) of the Hessian matrix. The theory is able to explain the typical monotonic decrease in specific heat with temperature observed in liquids in terms of the average INM excitation lifetime decreasing with T (in accordance with the Arrehnius law) and provides an excellent single-parameter fitting to several sets of experimental data for atomic and molecular liquids. It also correlates the height of the liquid energy barrier with the slope of the specific heat in the function of temperature in accordance with the available data. These findings demonstrate that the specific heat of liquids is controlled by the instantaneous normal modes, i.e., by localized unstable (exponentially decaying) vibrational excitations and provide the missing connection among anharmonicity, saddle points in the energy landscape, and the thermodynamics of liquids.


Host defenses in subcutaneous mycoses.
Subcutaneous mycoses include diverse clinical syndromes, characterized by invasion of the skin and subcutaneous tissue by saprobic fungi. Individuals living in rural areas constantly suffer lesions or trauma; however, only a few of them develop disease. In this contribution, we describe recent advances in the understanding of the virulence of these organisms, focusing on the most prevalent infections, sporotrichosis, chromoblastomycosis, and mycetoma. Although these infectious diseases are considered neglected tropical diseases, modern molecular techniques have been able to identify the etiologic agents and observe variations in the former monolithic concept of the species, which was based mostly on morphologic characteristics. The complete genetic characterization of the causative agents, along with that of their host, will help in the understanding of the factors on which the development of these infections depends.


Radio Frequency Identification Gate System to Identify Misused Personal Dosimeters.
The use of two personal dosimeters, one worn over and one worn under a protective apron, provides the best estimate of effective dose. However, inappropriate positioning of dosimeters is a common occurrence, resulting in abnormally high or low radiation exposure records. Although such incorrect positioning can be identified by radiation exposure records, doing so is time-consuming and labor-intensive for administrators. Therefore, a system that can identify incorrect locations of dosimeters without burdening administrators must be developed. In this study, we developed a radio frequency identification (RFID) gate system that can differentiate between two RFID-tagged dosimeters placed over and under a metal apron and identify misused dosimeters. To simulate the position of the RFID-tagged dosimeters, we designed four dosimeter-wearing classes, including "proper use" and three types of "misuse" (i.e., "reversed," "both under," and "both over"). When the system predicts "misuse" based on the tag reading, the worker is alerted with lights and alarms. The system performance was evaluated using a confusion matrix, with an overall accuracy of 97.75%, demonstrating high classification performance. The safety of the system against life support devices was also investigated, demonstrating that they were not affected by the electric field at 0.3 m or more from the antenna of the system under any transmit powers tested. This RFID gate system is highly capable of identifying incorrectly positioned dosimeters, enabling real-time monitoring of dosimeters to manage their positioning.


Epidemiology-based assessment of tumor marker overordering in breast cancer: an algorithm to examine different disease conditions.
Laboratory tests are frequently overused and have elevated inappropriateness rates. We previously developed a model to investigate the rate of utilization of tumor markers (TMs) in outpatients as an indirect indicator of inappropriateness. The model was based on the comparison between the number of actually ordered and expected tests, with the latter estimated on the basis of both epidemiological data and recommendations of available clinical practice guidelines.In this paper we propose an algorithm to distinguish prevalent cases without evidence of disease from those with metastatic spread, on the basis of both epidemiological and clinical information. The algorithm allows for a more precise prediction of the expected TM requests per year, to be compared with the actual number of requested TMs in order to assess possibly inappropriate overordering rates. Moreover, the implementation of the algorithm renders the epidemiologically based model more flexible to develop accurate indicators for appropriateness in the use of TMs in different stages of disease and for different clinical questions. A practical application with CA15.3 requests in breast cancer is presented.


Informatics. A subspecialty in pathology.
The emerging discipline of pathology informatics is reviewed, and its placement as a subspecialty within the broader field of pathology and laboratory medicine is proposed. Informatics concepts should guide the development of the next generation of laboratory information systems. Advanced laboratory systems will incorporate decision support leading to improvements in quality and in interpretive reporting providing support for clinical diagnosis and decision making. Training programs in pathology should take into account the need for expertise in informatics and develop fellowships in this area to adequately prepare junior faculty members for their future professional role.


Inflammatory cytokines IFN-gamma plus TNF-alpha induce regulated expression of CD80 (B7-1) but not CD86 (B7-2) on murine fibroblasts.
Optimal T cell activation requires signals delivered via both the TCR and the costimulatory receptors. Considerable experimental data now suggest that this costimulatory signal is generated predominantly by CD28 when engaged by its ligands CD80 (B7-1) and/or CD86 (B7-2). Whether T cell activation is controlled in part by regulated CD80 and/or CD86 expression has been incompletely explored. Here, we report that CD80 can be expressed constitutively by murine fibroblasts and up-regulated after treatment with IFN-gamma plus TNF-alpha. CD80 expression and function was confirmed by 1) Northern analysis, 2) specific immunoprecipitation of a approximately 69-kDa surface protein that comigrated with CD80 precipitated from CD80-transfected CHO cells, and 3) two independent assays for costimulation of Ag-specific T cell activation. Taken together, these observations suggest that CD28/CTLA-4 ligands are expressed on a wider variety of tissues than previously suspected and that their expression is dynamically regulated. Consequently, these results might explain previous observations that inflammatory cytokines can result in autoimmune responses.


Biomimetically synthesized silica-carbon nanofiber architectures for the development of highly stable electrochemical biosensor systems.
Biomimetically synthesized silica and conductive activated carbon nanofibers (CNFs) are used in a synergistic manner for the development of a novel electrochemical biosensor system. Poly(L-lysine) templated silica grows and encapsulates the CNF-immobilized enzyme generating a highly stabilizing nanostructured environment for the underlying protein. Concurrently, CNFs provide both the required surface area for the high-capacity enzyme immobilization required in biosensors as well as direct electron transfer to the inner platinum transducer. As a result, this silica/nanofiber superstructure is an ideal architecture for the development of electrochemical biosensor systems that can withstand exposure to extreme operational conditions, such as high temperatures or the presence of proteases. Acetylcholine esterase is used as the model catalyst and with the aid of spectroscopic data it is shown that the observed high operational stability of the biosensor is due to the direct interaction of the protein with the silica backbone, as well as due to the nanostructured enzyme confinement.


[The type of material primary hyperlipoproteinemia and newborn birth weight].
Twenty four cases of hyperlipoproteinemia were reported in the investigated group of 67 mother, which delivered behind 38 and 41 week of pregnancy newborns above 2500 g body mass. They were characterized as IIa and IV types according to the WHO classification. Fifteen mothers had HLP of IV type. The average delivery body mass of newborns of these mothers was 3550 g. Nine mothers had HLP of IIa type and these mothers delivered the lightest newborns, average delivery body mass was 3117 g while the average of with normolipidemia mothers was 3238 g. The chi 2 test indicated that the delivery body mass of the newborns is related to the type of hyperlipoproteinemia of mother (p < 0.05).


Transperitoneal laparoscopic pyelolithotomy after failed percutaneous access in the pediatric patient.
We present our experience with transperitoneal laparoscopic pyelolithotomy in pediatric patients in whom percutaneous renal access failed and the stone burden warranted open intervention. A transperitoneal laparoscopic approach was used for pyelolithotomy in 8 patients 3 months to 10 years old (mean age 4 years). Percutaneous access failed secondary to a nondilated system and/or an occluding lower pole calculus. Inclusion criteria were failed percutaneous access secondary to a nondilated system and/or stone occlusion of the lower pole system and failed shock wave lithotripsy or a stone burden of greater than 2.5 cm2. A posterior pelviotomy was made. Stones in the renal pelvis were removed with rigid graspers under direct laparoscopic vision. A flexible cystoscope was introduced through a port if caliceal stones were present. The renal pelvis was reconstructed. A watertight anastomosis was verified. Average operative time was 1.6 hours (range 0.8 to 2.3). Mean hospital stay was 2.15 days (range 2 to 3). A range of 1 to 3 stones (median of 1) were removed and the mean stone burden was 2.9 cm2. No intraoperative complications were noted. Stone analysis revealed 3 patients with calcium oxalate stones, 1 with a calcium phosphate stone and 4 with cysteine stones. There was 1 patient with stone recurrence at a mean followup of 12 months (range 3 to 20). Thus, the overall long-term stone-free rate was 87.5%. Transperitoneal laparoscopic pyelolithotomy is feasible when percutaneous access fails and open pyelolithotomy is considered due to a large stone burden.


Dental sleep medicine: coming of age.
Millions of people worldwide suffer diminished quality of life due to the effects of sleep-disordered breathing (snoring and obstructive sleep apnea). The worst cases can be life-threatening. Recently, the medical and dental professions have partnered to provide essential relief for many of those afflicted with this widespread malady. As medical sleep specialists reach out to include dentists on the "sleep team," it is incumbent on the dental professional to have sufficient education and training. Presently, there are a multitude of opportunities and venues available to the dentist who may have an interest in this burgeoning new field. However, caution is required during the learning experience because different sources of educational material may not be congruent with legal or professional ethics.


Limb threatening neuropathic complications from ankle fractures in patients with diabetes.
Although less common than neuropathic (Charcot) deformities in feet, ankle deformities can occur and produce significant limb threatening complications after injury in patients with longstanding diabetes. A series of six such complications, including one that resulted in amputation and several near amputations, are presented. The authors' primary purpose is to alert or remind physicians and orthopaedic surgeons of the often unanticipated but significant complications of these rare and seemingly mild ankle injuries. A secondary purpose is to point out that complications may be avoided or mitigated with early stabilization and possibly with treatment of bone resorbing, inflammatory processes characteristic of neuroarthropathies.


Stress relaxation in polymer networks: equilibrium behavior and dynamics.
The elastic and relaxational properties of a polymer network have been calculated using a stress based formulation based on the Rouse mode expansion [W. L. Vandoolaeghe and E. M. Terentjev, J. Chem. Phys. 123, 34902 (2005)]. In this article, we propose an improved Rouse mode expansion incorporating appropriate boundary conditions. In contrast to the previous work, this improved formulation provides a smooth crossover from the classical equilibrium result of rubber elasticity to the shorter-time-scale Rouse relaxation of a polymer melt. Our results are compared with the classical phantom network approach in equilibrium, as well as both equilibrium and dynamic elongation experiments. The model captures the qualitative features of the data well and some of the quantitative aspects, such as the exponents seen in the dynamic modulus G(omega).


Community mental health services in transition: who is benefiting?
This study addresses four major questions about the delivery of community-based mental health services: Which target groups are benefiting from recent policy shifts? What services are expanding? What staffing changes are occurring? How are these changes being financed? Findings indicate that state policies are aiding chronically mentally ill clients, but that services for other important target groups are being reduced substantially.


Optimal bounds on the trapping constant and permeability of porous media.
We derive exact expressions for so-called "void" bounds on the trapping constant gamma and fluid permeability k for coated-sphere and coated-cylinder models of porous media. We find that in some cases the bounds are optimal. In these instances, exact expressions are obtained for the relevant length scale that arises in the void bounds, which depends on a two-point correlation function that characterizes the porous medium. This is the first time that model microstructures have been found that exactly realize bounds on either the trapping constant or fluid permeability.


Photo-Reconfigurable Azopolymer Etch Mask: Photofluidization-Driven Reconfiguration and Edge Rectangularization.
Directional photofluidization of azobenzene materials has provided unprecedented opportunities for the structural reconfiguration of circular holes, line gaps, ellipsoidal holes, and nanofunnel-shaped micro/nanoarchitectures. However, all the reconfigured structures have a parabolic or round wall due to the tendency of the photofluidized azobenezene materials to minimize the surface area, which limits their use as a reconfigurable etch-mask for the lithography process. In this work, a simple method is presented that can change the round walls of azopolymer architectures into rectangular walls, which is named rectangularization. By irradiating far-field light on reconfigured azopolymer in a conformal contact with a flat polydimethylsiloxane (PDMS) film, the round wall transforms to a rectangular one because the azopolymer adheres along the PDMS surface while being photofluidized. As a result, the rectangularization process creates a variety of structural features and sizes ranging from a few micrometers to 150 nm having a rectangular wall. By exploiting the rectangularization process, the concept of a photo-reconfigurable etch mask is achieved, which transfers the mask patterns to a silicon pattern with a high structural fidelity and imparts a considerable flexibility to the lithography process.


[Cerebral venous thrombosis as the presenting symptom of systemic lupus erythematosus].
Cerebral venous thrombosis (CVT) is an infrequent process in systemic lupus erythematosus. We report the case of a female patient whose initial manifestation of lupus was a CVT. A 30-year-old female who presented headaches and diminished visual acuity; on exploring the patient bilateral papilloedema was found. Magnetic resonance imaging revealed the presence of a venous thrombosis in the superior and transversal longitudinal sinus. Complementary explorations showed high levels of antinuclear antibodies with leukopenia and proteinuria. Antiphospholipid antibodies were negative. Following treatment with anticoagulants, the patient's condition improved both clinically and radiologically. Months later a biopsy was performed and revealed a grade IV diffuse glomerulonephritis. In systemic lupus erythematosus, phenomena such as CVT can be the initial form of presentation of the disease. The presence of antiphospholipid antibodies plays a partial role in CVT; other phenomena, such as inflammatory processes, should also be taken into account.


Intrahost mechanisms governing emergence of resistance-breaking variants of Potato virus Y.
The emergence of resistance breaking (RB) variants starting from the avirulent Potato virus Y NN strain (PVY(NN)) was analyzed after imposing different selective host constraints. Tobacco resistance to PVY(NN) is conferred by va in both NC745 and VAM genotypes, but VAM carries an extra resistance gene, va2. RB-variants emerged only in NC745 and unexpectedly accumulated higher in the original host, tobacco B21, than the parental PVY(NN). However, the recovery of RB-variants was interfered by PVY(NN) in mixed infections. Further analysis indicated that RB-variants also arose in tobacco VAM, but they were limited to subliminal local infections. Their inability to breakout was associated with absence of a mutational adaptation in the viral VPg gene, which implied a loss of fitness in tobacco B21. Altogether, the emergence of RB-variants was conditioned by inherited host constraints, interference by co-infecting avirulent virus genotypes, and fitness tradeoff of virus adaptations.


Hormonal control of serine dehydratase mRNA in primary cultures of adult rat hepatocytes.
The mechanism of hormonal induction of serine dehydratase [EC 184.108.40.206, SDH] was studied in primary cultures of adult rat hepatocytes by measuring the rates of syntheses of the enzyme protein and its translatable mRNA. The rate of synthesis of enzyme protein, measured as incorporation of [3H]leucine into the enzyme protein in hepatocytes, was increased 4-5 times by dexamethasone (Dex) plus glucagon. Neither hormone alone increased the rate. The increased rate induced by the two hormones was suppressed by insulin and epinephrine. The decay curves of [3H]leucine-labeled SDH showed that these hormones did not affect the rate of enzyme degradation. The level of translatable mRNA was determined by measuring cell-free synthesis of SDH in a reticulocyte lysate system. Dex plus glucagon increased the level of mRNA of SDH in hepatocytes. Insulin and epinephrine suppressed this increase without changing the rate of mRNA degradation. The level of mRNA changed in parallel with that of the rate of synthesis of the enzyme protein. These results suggest that these hormones regulate transcription of SDH, rather than its translation. After pretreatment of hepatocytes with Dex, further addition of glucagon caused more rapid induction of mRNA of SDH than addition of both hormones together. The effect of glucagon after pretreatment with Dex was inhibited by actinomycin D and alpha-amanitin, suggesting that glucagon does not affect post-transcription, but transcription per se. The requirement for both Dex and glucagon for induction of this enzyme is discussed in comparison with the requirements for either hormone alone for inductions of other gluconeogenic enzymes.


The effect of acute exercise on lymphocyte subsets, natural killer cells, proliferative responses, and cytokines in HIV-seropositive persons.
Eight healthy men infected with human immunodeficiency virus, type 1 (HIV) and eight HIV seronegative age- and sex-matched controls exercised on a bicycle ergometer (75% of VO2max, 1 h). The percentages of CD4+, CD4+45RA+, and CD4+45RO+ cells did not change, whereas the absolute number of CD4+ cells increased twofold during exercise and fell below prevalues 2 h after. The neutrophil count increase was more pronounced after exercise in the controls compared with in HIV-seropositive subjects. The percent CD16+ cells, and the natural killer (NK) and lymphokine activated killer (LAK) cell activity increased during exercise, but this increase was significantly less pronounced in the HIV-seropositive group. The results suggest that in response to physical stress, HIV-seropositive subjects have an impaired ability to mobilize neutrophils, NK and LAK cells to the blood. Furthermore, because the total number of CD4+ cells, but not the percentage of CD4+ cells, changed in response to exercise, this study further strengthens the idea that the percentage of CD4+ cells is preferable to the number of CD4+ cells in monitoring patients seropositive for HIV.


Surgical benefits of bidirectional knotless barbed sutures over conventional sutures for uterine repair during cesarean section-A meta-analysis of randomized controlled trials.
To analyze the surgical benefits of bidirectional knotless barbed suture (BS) compared with conventional sutures for uterine closure during cesarean section. The databases were searched using the following keywords: "Cesarean Section," "Uterine closure," "Barbed suture" and "Conventional suture." Randomized control trials reporting the comparison of bidirectional knotless BS with conventional sutures for closing uterine incision were included. The outcome measures were closing time of uterine incision, the number of additional hemostatic sutures used, blood loss parameters, and the total duration of surgery. A random or fixed-effects model was used to obtain the pooled estimates using the inverse variance method. The heterogeneity was assessed using the I2 test and the GRADE approach was used to assess the quality of evidence. Out of 15 full-text assessed, three randomized controlled trials were included. We observed significantly short uterine incision closure time with BS [standardised mean difference -1.51; 95% confidence interval (CI): -1.97, -1.06; I2=64%; GRADE approach evidence: Moderate], significantly lesser need of additional hemostatic sutures (risk ratio: 0.39; 95% CI: 0.28, 0.54; I2=0%; GRADE approach evidence: High) and significantly less blood loss during uterine incision closure [-0.47 (95% CI:-0.75, -0.19); I2 =0%; GRADE approach evidence: moderate]. with no significant difference in total blood loss, the need of blood transfusion, and total duration of surgery. The use of bidirectional knotless BS for uterine closure can reduce suturing time and the additional suture requirement.


Novel membrane-interactive ether lipid analogs that inhibit infectious HIV-1 production and induce defective virus formation.
A new class of membrane-active ether lipid (EL) analogs of platelet-activating factor were studied for in vitro anti-HIV-1 activity. Human T-cell (CEM-ss) monolayers or suspension cultures were used to determine effects of structural modifications of Type A phosphorus-containing and Type B nonphosphorus EL analogs on (a) the inhibitory concentration50 (IC50) for HIV-1 syncytial plaque formation and cell growth, and, (b) virus budding at the cell plasma membrane. Results indicate that representative Type A and Type B EL inhibit HIV-1 but not herpes simplex virus type 2 plaque formation when added before or up to 2 days after viral infection. Anti-HIV-1 activity does not involve direct inactivation of virus infectivity. Type A EL (IC50 range = 0.2-1.4 microM) with alkyoxy, alkylthio, or alkyamido substitution at glycerol position 1 and ethoxy or methoxy substitution at position 2, and Type B compounds (IC50 range = 0.33-0.63 microM) with an inverse choline or nitrogen heterocyclic substitution at position 3 have selective activity against HIV-1-infected T-cells. EL treatment of HIV-1-infected cells is associated with subsequent release of reverse transcriptase activity, but infectious virus production is inhibited with time after infection. Electron microscopic examination of HIV-1-infected and EL-treated cells revealed absence of detectable budding virus at the plasma membrane but presence of intracytoplasmic vacuolar virus particles. In summary, these data suggest that EL analogs are a novel class of agents that induce defective intracytoplasmic vacuolar HIV-1 formation in T-cells. Being membrane interactive, EL are ideally suited for combination chemotherapy with DNA-interactive anti-HIV nucleoside analogs.


Metastatic Adenocarcinoma of the Prostate Presenting as Supraclavicular and Bulky Generalized Lymphadenopathy with a Benign Digital Rectal Exam.
A 63-year-old male presented with complaints of an enlarging left supraclavicular mass and weight loss. Computed tomography demonstrated a large retroperitoneal mass causing displacement of the adjacent organs, and moderate left hydroureteronephrosis. Multiple pulmonary nodules, lytic spinal lesions, and generalized lymphadenopathy including the left supraclavicular region were seen. Serum prostate-specific antigen level was 2064.0 ng/mL. Digital rectal exam revealed an enlarged prostate without nodularity. Biopsy of the supraclavicular node demonstrated prostatic adenocarcinoma. The diagnosis of lymphoma may be initially suggested, however, prostatic origin should be considered even when the prostate exam is not grossly abnormal.


A three-month physical training program improves cardiovascular autonomic function in patients with metabolic syndrome with and without diabetes - a pilot study.
Vascular complications and neuropathy may develop in the presence of metabolic syndrome. The aim of our study was to measure the cardiovascular autonomic function following physical training in patients with metabolic syndrome with and without diabetes. 56 patients with metabolic syndrome (32 men/24 women, 40 non-diabetic patients (NDMetS)/16 diabetic patients (DMetS) [mean ± SD]: age: 50.35 ± 8.03 vs. 56.8 ± 9.30 years, p=0.023; baseline BMI: 32.2 ± 7.03 vs. 32.8 ± 5.94 kg/m2, p=0.739) were involved in our study. All tests and measurements were carried out before and following a 3-month physical training period. Autonomic function was assessed by means of five standard cardiovascular reflex tests. ECG repolarization parameters, including short-term QT variability and stress-ECG were also measured. In the whole population, Valsalva-ratio (VR) and the autonomic score (AS) improved following training (VR: 1.49 ± 0.24 vs. 1.64 ± 0.34, p=0.001; AS: 2.05 ± 1.73 vs. 1.41 ± 1.36, p=0.015) accompanied by the significant decrease of the systolic (150.3 ± 16.12 vs. 134.1 ± 16.67 mmHg, p<0.001) and diastolic (90.64 ± 12.8 vs. 82.79 ± 11.1 mmHg, p<0.001) blood pressure. An improvement in VR was detected in NDMetS patients following training (1.51 ± 0.24 vs. 1.67 ± 0.31, p= 0.002). No significant changes could be detected in autonomic tests' results in the DMetS patient group following training. The applied exercise training program did not lead to significant changes in ECG repolarization. The stress-ECG test in the whole study population yielded a significant increase in the test duration (12.9 ± 3.76 vs. 15.1 ± 2.96 min, p<0.001) and in the test load (10.5 ± 2.78 vs. 11.6 ± 2.39 MET, p<0.001). The load capability improved significantly in both subgroups: 11.1 ± 2.04 vs. 12.1 ± 1.82, (p<0.001) and 9.0 ± 3.64 vs. 10.4 ± 3.05, (p=0.033) in subpopulations of NDMetS and DMetS, respectively. The DMetS patients achieved a significantly lower MET score at baseline (p=0.039) and following training (p=0.044) in comparison to the NDMetS patients. The three-month exercise program improved the Valsalva-ratio and the AN score in the MetS patients, that is potentially protective against cardiovascular events. The training had some beneficial effect on blood pressure and the results of the stress-ECG tests in both groups. The absence of significant change in the reflex tests in DMetS group reflects an impaired adaptation compared to the NDMestS group.


Identification of patients at risk from ischaemic complications.
Several risk factors for cardiovascular disease are discussed, including blood pressure, left ventricular hypertrophy, stress and smoking. Beta-blockers have a modest effect in reversing increased left ventricular mass, compared with angiotensin converting enzyme (ACE) inhibitors, although beta-blockers are as effective as ACE inhibitors in reducing posterior wall and interventricular septal thickness. Coronary events and many risk factors show a circadian rhythm. Beta-blockers can reduce the mid-morning (0700-1000 h) risk of ischaemic events and myocardial infarction. Catecholamine levels peak at 0700-1000 h, and catecholamine-induced myocardial necrosis can be significantly reduced by beta-blockade. Beta-blockers appear to be more effective than calcium antagonists in modifying the mid-morning vulnerable period and reducing the duration of ischaemia. However, the problems of using surrogate endpoints are discussed. In young to middle-aged hypertensives, beta-blockers are more effective in primary prevention of myocardial events than diuretics, though this is not the case for the elderly. Beta-blockers are also more effective than calcium antagonists in reducing morbidity and mortality after a myocardial infarction (i.e. secondary prevention). Patients with hypertension associated with ischaemic heart disease are most likely to get maximal benefit from treatment with beta-blockers.


Evaluation of a Proton Pump Inhibitor for Sleep Bruxism: A Randomized Clinical Trial.
Bruxism is a repetitive jaw-muscle activity characterized by clenching or grinding of the teeth and/or bracing or thrusting of the mandible. Recent advances have clarified the relationship between gastroesophageal reflux and sleep bruxism (SB). However, the influence of pharmacological elimination of gastric acid secretion on SB has not been confirmed. The authors aimed to assess the efficacy of a proton pump inhibitor (PPI) on SB and to examine the gastrointestinal (GI) symptoms and endoscopic findings of the upper GI tract in SB patients. The authors performed a randomized double-blind placebo-controlled crossover study at Kagoshima University Hospital. Twelve patients with polysomnography (PSG)-diagnosed SB underwent an assessment of GI symptoms using the frequency scale for the symptoms of gastroesophageal reflux disease (FSSG) and esophagogastroduodenoscopy. At baseline (i.e., before interventions), the mean frequencies of electromyography (EMG) bursts and rhythmic masticatory muscle activity (RMMA) episodes were 65.4 ± 49.0 bursts/h and 7.0 ± 4.8 episodes/h, respectively, and at least 1 RMMA episode with grinding noise was confirmed in all participants. The mean FSSG score was 8.4 ± 5.6, and 41.7% of patients were diagnosed with gastroesophageal reflux disease. Mild reflux esophagitis was confirmed in 6 patients. PSG, including EMG of the left masseter muscle and audio-video recording, was performed on days 4 and 5 of administration of 10 mg of the PPI (rabeprazole) or placebo. PPI administration yielded a significant reduction in the frequency of EMG bursts, RMMA episodes, and grinding noise. No significant differences were observed regarding the swallowing events and sleep variables. Since the clinical application of PPI for SB treatment should remain on hold at present, the results of this trial highlight the potential application of pharmacological gastroesophageal reflux disease treatment for SB patients. Larger scale studies are warranted to corroborate these findings. (UMIN Clinical Trials Registry: UMIN000004577).


Simulation of L/A control in fed-batch culture of baker's yeast.
L/A controllers have extended their use from continuous to fed-batch fermentation where the control is applied from the start of an initial batch phase. As opposed to proportional integral derivative (PID) controllers where even a startup procedure is recommended prior to fed-batch, the L/A controller is not upset by an early connection. It is easily retuned continuously by means of ethanol measurements and can cope with a large range of output conditions. The performance of an L/A algorithm, which uses biomass concentration as the controlled variable, is assessed through simulation. The self-contained algorithm is relatively simple with no greater intrinsic complexity than modern PID stand alone controllers.


Application of Machine Learning Technique to Distinguish Parkinson's Disease Dementia and Alzheimer's Dementia: Predictive Power of Parkinson's Disease-Related Non-Motor Symptoms and Neuropsychological Profile.
In order to develop a predictive model that can distinguish Parkinson's disease dementia (PDD) from other dementia types, such as Alzheimer's dementia (AD), it is necessary to evaluate and identify the predictive accuracy of the cognitive profile while considering the non-motor symptoms, such as depression and rapid eye movement (REM) sleep behavior disorders. This study compared Parkinson's disease (PD)'s non-motor symptoms and the diagnostic predictive power of cognitive profiles that distinguish AD and PD using machine learning. This study analyzed 118 patients with AD and 110 patients with PDD, and all subjects were 60 years or older. In order to develop the PDD prediction model, the dataset was divided into training data (70%) and test data (30%). The prediction accuracy of the model was calculated by the recognition rate. The results of this study show that Parkinson-related non-motor symptoms, such as REM sleep behavior disorders, and cognitive screening tests, such as Korean version of Montreal Cognitive Assessment, were highly accurate factors for predicting PDD. It is required to develop customized screening tests that can detect PDD in the early stage based on these results. Furthermore, it is believed that including biomarkers such as brain images or cerebrospinal fluid as input variables will be more useful for developing PDD prediction models in the future.


Effect of pentagastrin on gastric mucosal nucleic acid synthesis of fed guinea pigs.
In normally fed guinea pigs the effect of a sustained release pentagastrin preparation was studied on gastric mucosal weight, protein, DNA and RNA concentration and thymidine and uridine incorporation into DNA and RNA, respectively. Treatment with pentagastrin for 3 days significantly increased antral fundic mucosal DNA and RNA concentration and thymidine and uridine incorporation. It is concluded that pentagastrin stimulates gastric mucosal nucleic acid synthesis beyond the driving force elicited by food.


Reactive oxygen species production by quercetin causes the death of Leishmania amazonensis intracellular amastigotes.
The present study reports the mechanism of the antileishmanial activity of quercetin against the intracellular amastigote form of Leishmania amazonensis. Treatment with 1 reduced the infection index in L. amazonensis-infected macrophages in a dose-dependent manner, with an IC₅₀ value of 3.4 μM and a selectivity index of 16.8, and additionally increased ROS generation also in a dose-dependent manner. Quercetin has been described as a pro-oxidant that induces the production of reactive oxygen species, which can cause cell death. Taken together, these results suggest that ROS production plays a role in the mechanism of action of 1 in the control of intracellular amastigotes of L. amazonensis.


Plasma and Nail Zinc Concentrations, But Not Hair Zinc, Respond Positively to Two Different Forms of Preventive Zinc Supplementation in Young Laotian Children: a Randomized Controlled Trial.
Plasma zinc concentrations (PZC) have been shown to significantly increase during zinc supplementation. This study investigated the effects of daily preventive zinc supplementation on hair and nail zinc concentrations compared with a control group. In a randomized controlled trial, 6- to 23-month-old children (n = 3407) in Lao PDR were randomly assigned to one of four groups and followed for ~ 36 weeks: daily preventive zinc dispersible tablet (7 mg/d; PZ), daily micronutrient powder (10 mg zinc/d; MNP), therapeutic zinc supplements for diarrhea treatment (20 mg/d for 10 days; TZ), or daily placebo powder (Control). Plasma, hair, and nail zinc concentrations were assessed in a sub-sample of participants (n = 457) at baseline and endline. At baseline, 75% of children had low PZC (< 65 μg/dL). At endline, geometric mean (95% CI) PZC were greater in the PZ and MNP groups compared with the TZ and control groups (P < 0.01), but hair zinc concentrations did not differ among groups (P = 0.99). Nail zinc concentrations were marginally higher in the PZ (115.8 (111.6, 119.9) μg/g) and the MNP (117.8 (113.3, 122.3) μg/g) groups than in the TZ group (110.4 (106.0, 114.8) μg/g; P = 0.055) at endline. This study does not support the use of hair zinc as a biomarker of zinc exposure in young children. However, it provides some evidence that zinc concentrations in nails may respond to supplemental zinc interventions and supports the need for collecting additional data on this emerging biomarker.


Compaction and multiple chain assembly of DNA with the cationic polymer poly(aluminum chloride) (PAC).
Assembly of DNA molecules by the addition of poly(aluminum chloride) (PAC) was studied. In the absence of PAC, electron microscopy indicated the formation of elongated coiled DNA molecules. In the presence of PAC, multiple doughnut-like structures, 8-15 nm thick, formed and fused together. When salt was added, the doughnut-like structures tended to be thinner and the morphology of the fused doughnuts became irregular. We obtained a view of a single DNA structure by fluorescent microscopy, which revealed that individual DNA molecules undergo a discrete transition from an elongated to compacted state with an increase in PAC concentration. Electron microscopic observation showed that a regular doughnut is the typical structure seen under low salt conditions. At high salt concentrations, the doughnut shape deformed, yielding results similar to those produced by the salt effect on DNA assembly at high DNA concentrations.


In-Hospital Cardiopulmonary Resuscitation of Patients With Human Immunodeficiency Virus Infection: A Population-Based Cohort Study of Epidemiology and Outcomes.
Marked improvements were realized in both short-term and long-term outcomes of human immunodeficiency virus (HIV)-infected patients following the introduction of combination antiretroviral therapy. However, the contemporary population-level patterns of in-hospital cardiopulmonary resuscitation (CPR) and the outcomes of HIV-infected patients were not systematically examined. We used the Texas Inpatient Public Use Data File to identify hospitalizations aged ≥ 18 years with and without HIV during 2009 - 2014, and those in each group who have undergone in-hospital CPR. Short-term survival (defined as absence of hospital mortality or discharge to hospice) following in-hospital CPR was examined. Multivariate logistic regression modeling was used to assess the prognostic impact of HIV infection following in-hospital CPR and predictors of short-term survival among HIV hospitalizations. In-hospital CPR was reported in 437 and 54,135 hospitalizations with and without HIV, respectively. The rates of in-hospital CPR (per 1,000 hospitalizations) were 4.4 and 4.1 among hospitalizations with and without HIV, respectively (P = 0.1659). The corresponding rates of in-hospital CPR among decedents were 11% and 11.8%, respectively (P = 0.1531). Crude short-term survival following in-hospital CPR among hospitalizations with and without HIV was 19% and 26.8%, respectively (P = 0.0003). The corresponding adjusted short-term survival between 2009 and 2014 rose from 14.2% to 27% (P = 0.0009 for trend) and from 25.5% to 28% (P < 0.0001 for trend). HIV infection was associated with lower odds of short-term survival following in-hospital CPR (adjusted odds ratio (aOR): 0.50, 95% confidence interval (95% CI): 0.39 - 0.65). Select comorbid conditions (congestive heart failure, aOR: 2.03, 95% CI: 1.20 - 2.46; cerebrovascular disease, aOR: 2.08, 95% CI: 1.15 - 3.75; and diabetes, aOR: 1.53, 95% CI 1.31 - 4.71) were the only independent predictors of short-term survival following in-hospital CPR among HIV hospitalizations. The rates of in-hospital CPR were similar among hospitalizations with and without HIV infection, with similar level of selectivity among decedents. Although HIV infection was associated with lower short-term survival following in-hospital CPR for the whole cohort, a dramatic improvement was observed during the study period among affected patients, with short-term survival rates becoming near-similar to those without HIV. Further studies are needed to identify modifiable factors to further improve the outcomes following in-hospital CPR among patients with HIV infection.


[A comparative study of postharvest fruit senescence in different litchi cultivars].
Among the 5 tested litchi (Litchi chinensis Sonn.) cultivars ("Huaizhi", "Guiwei", "Nuomici", "Hongmili" and "Shuijingqiu", "Nuomici" became deteriorated much faster than other cultivars while "Guiwei" fruit was the slowest in the rotting process (Fig. 1A). Fruit deterioration was accompanied by fruit desiccation (Fig. 2B), but the speed of water loss was not significantly correlated to fruit deterioration rate, indicating that it was not the key factor causing the difference in postharvest performance among cultivars. Fruit deterioration rate was significantly positively correlated to membrane leakage (Fig. 2A), suggesting the capacity to maintain membrane integrity is closely related to the shelflife of litchi. Skin browning potential, uronic acid concentration, degree of methylation of pectin and soluble Ca content in pericarp as well as total Ca content in the pulp were not significantly correlated with fruit deterioration. Content of structural Ca (water-insoluble but acetic acid-soluble calcium, membrane or wall-bound Ca), the major form of Ca in the pericarp, was negatively correlated to fruit deterioration rate (Fig. 2E). The results proved that differences in fruit desiccation rate, browning potential, Ca other than structural form were not the major cause leading to difference in postharvest performance among different cultivars. "Guiwei" being more tolerant to desiccation than other cultivars is likely associated its higher structural Ca concentration in the pericarp.


RAB3GAP1 and RAB3GAP2 modulate basal and rapamycin-induced autophagy.
Macroautophagy is a degradative pathway that sequesters and transports cytosolic cargo in autophagosomes to lysosomes, and its deterioration affects intracellular proteostasis. Membrane dynamics accompanying autophagy are mostly elusive and depend on trafficking processes. RAB GTPase activating proteins (RABGAPs) are important factors for the coordination of cellular vesicle transport systems, and several TBC (TRE2-BUB2-CDC16) domain-containing RABGAPs are associated with autophagy. Employing C. elegans and human primary fibroblasts, we show that RAB3GAP1 and RAB3GAP2, which are components of the TBC domain-free RAB3GAP complex, influence protein aggregation and affect autophagy at basal and rapamycin-induced conditions. Correlating the activity of RAB3GAP1/2 with ATG3 and ATG16L1 and analyzing ATG5 punctate structures, we illustrate that the RAB3GAPs modulate autophagosomal biogenesis. Significant levels of RAB3GAP1/2 colocalize with members of the Atg8 family at lipid droplets, and their autophagy modulatory activity depends on the GTPase-activating activity of RAB3GAP1 but is independent of the RAB GTPase RAB3. Moreover, we analyzed RAB3GAP1/2 in relation to the previously reported suppressive autophagy modulators FEZ1 and FEZ2 and demonstrate that both reciprocally regulate autophagy. In conclusion, we identify RAB3GAP1/2 as novel conserved factors of the autophagy and proteostasis network.


Preparation and antioxidant properties of selenium nanoparticles-loaded chitosan microspheres.
Selenium nanoparticles (SeNPs), as a special form of selenium (Se) supplement, have attracted worldwide attention due to their favorable properties and unique bioactivities. Herein, an eco-friendly and economic way to prepare stable SeNPs is introduced. SeNPs were synthesized in aqueous chitosan (CTS) and then embedded into CTS microspheres by spray-drying, forming selenium nanoparticles-loaded chitosan microspheres (SeNPs-M). The physicochemical properties including morphology, elemental state, size distribution and surface potential were investigated. Institute of Cancer Research mice were used as model animal to evaluate the bioactivities of SeNPs-M. Trigonal-phase SeNPs of ~35 nm were synthesized, and SeNPs-M physically embedding those SeNPs were successfully prepared. Amazingly, acute toxicity test indicated that SeNPs-M were much safer than selenite in terms of Se dose, with a LD50 of around 18-fold of that of selenite. In addition, SeNPs-M possessed powerful antioxidant activities, as evidenced by a dramatic increase of both Se retention and the levels of glutathione peroxidase, superoxide dismutase and catalase. The design of SeNPs-M can offer a new way for further development of SeNPs with a higher efficacy and better biosafety. Thus, SeNPs-M may be a potential candidate for further evaluation as an Se supplement with antioxidant properties and be used against Se deficiency in animals and human beings.


The application of serum cystatin C in estimating the renal function in women with preeclampsia.
Serum cystatin C (Cys-C) is known to reflect the glomerular filtration rate (GFR) more precisely in native kidney diseases and renal dysfunctions secondary to other diseases. This study investigated the serum Cys-C in estimating the renal function in preeclamptic women. A total of 96 patients with normal pregnancy (controls) and 48 cases of severe preeclampsia were recruited in this study. We measured the 24-hour creatinine clearance (CrCl), serum creatinine, Cys-C, uric acid (UA), and beta trace protein (BTP) concentrations on all the pregnant women in the second trimester and third trimester and in the postpartum of the patients with severe preeclampsia. Multiple comparisons and correlation analysis were used to analyze the indexes estimating the GFR. In the normal pregnancies, the concentrations of serum creatinine, UA, and BTP were significantly higher in the third trimester compared to the second trimester, however with no significant differences in the serum Cys-C levels. Comparison between the second and third trimester in patients with severe preeclampsia indicated that significant difference existed in the serum Cys-C, with higher concentration in third trimester. Correlation analyses demonstrated that significant negative correlations could be detected between Cys-C and 24-hour CrCl in the second trimester and third trimester of all the 144 pregnant women and in the postpartum of the patients with severe preeclampsia, and better correlations in normal participants than in participants with preeclampsia. Serum Cys-C seems to reflect the GFR precisely in women with severe preeclampsia and can be a good marker to monitor the renal function from antepartum to postpartum.