Effects of in vitro and in vivo cytokine treatment, leucapheresis and irradiation on the function of human neutrophils: implications for white blood cell transfusion therapy.
Treatment of human polymorphonuclear leucocytes (PMNL) separated by density sedimentation (DS) from normal donors (PMNL-NL-DS) with interferon-gamma (IFN-gamma) + granulocyte colony-stimulating factor (G-CSF) lessens the damage caused by isolation and irradiation. We have studied granulocyte-macrophage colony-stimulating factor (GM-CSF) in this system, as well as the behaviour of PMNL collected by continuous flow leucapheresis (CFL) from donors treated with G-CSF (PMNL-GCSF-CFL). After isolation, PMNLs were treated with IFN-gamma + G-CSF, GM-CSF or IFN-gamma + G-CSF + GM-CSF, irradiated with 0 or 30 Gy and studied after 0 and 20 h in cell culture. All regimens reduced apoptosis of PMNL-NL-DS. Killing of Candida albicans by 20-h-old PMNL-NL-DS was best preserved by IFN-gamma + G-CSF treatment. A similar pattern of results was obtained for assays of PMNL-NL-DS chemotaxis and superoxide production. There was a consistent trend toward reduced function after irradiation in all assays. PMNL-GCSF-CFL less often demonstrated the morphological features of apoptosis, and this was further reduced by cytokine regimens containing IFN-gamma + G-CSF. In assays of C. albicans killing and chemotaxis, 20-h-old untreated PMNL-GCSF-CFL performed as well as freshly isolated PMNL-GCSF-CFL. PMNL-GCSF-CFL showed decay in CD11b (CR3), CD16 (Fc gamma III) and CD64 (Fc gamma R1) expression after 20 h in cell culture, but treatment with IFN-gamma + G-CSF preserved expression. There was a trend toward reduced function after radiation. Comparison of PMNL-GCSF separated by CFL and DS demonstrated that CFL itself is a strong inducer of the morphological features of apoptosis. This study shows that while separation by CFL, and irradiation are damaging to PMNLs, damage may be reduced by use of cytokines.


Incidence of Oral Lichen Planus in Perimenopausal Women: A Cross-sectional Study in Western Uttar Pradesh Population.
Hormonal fluctuations during menopause lead to endocrine changes in women, especially in their sex steroid hormone production. Studies have documented the role of estrogen and progesterone (Pg) on autoimmune disorders such as multiple sclerosis, systemic lupus erythematosus, and rheumatoid arthritis. Lichen planus (LP), an autoimmune disorder, seen frequently in perimenopausal women, may also get affected by sex steroid hormones, but no direct relationship has been established yet. The aim of this study is to find the incidence of oral LP (OLP) in perimenopausal women and evaluate the factors associated with it. This cross-sectional study was conducted over a period of 1 year. All the perimenopausal women (44.69 ± 3.79 years) who came to the dental outpatient department were evaluated for the presence of LP and various factors associated with it. Depression Anxiety Stress Scale-21 questionnaire was used for psychometric evaluation of perimenopausal women. According to our study, incidence of LP in postmenopausal women was 10.91%, which is higher than incidence of LP in general population, i.e., 0.5% to 2.0%. Incidence of LP increased with the severity of depression in perimenopausal women (P = 0.000). The incidence of OLP is higher in perimenopausal women than in general population and increases significantly with increase in the severity of depression. LP in perimenopausal women can be mediated by declined level of estrogen and Pg directly or indirectly through causing depression that can trigger LP.


Quantitative ultrasound method to detect and monitor laser-induced cavitation bubbles.
An ultrasound technique to measure the spatial and temporal behavior of the laser-induced cavitation bubble is introduced. The cavitation bubbles were formed in water and in gels using a nanosecond pulsed Nd:YAG laser operating at 532 nm. A focused, single-element, 25-MHz ultrasound transducer was employed both to detect the acoustic emission generated by plasma expansion and to acoustically probe the bubble at different stages of its evolution. The arrival time of the passive acoustic emission was used to estimate the location of the cavitation bubble's origin and the time of flight of the ultrasound pulse-echo signal was used to define its spatial extent. The results of ultrasound estimations of the bubble size were compared and found to be in agreement with both the direct optical measurements of the stationary bubble and the theoretical estimates of bubble dynamics derived from the well-known Rayleigh model of a cavity collapse. The results of this study indicate that the proposed quantitative ultrasound technique, capable of detecting and accurately measuring laser-induced cavitation bubbles in water and in a tissue-like medium, could be used in various biomedical and clinical applications.


Immunochemical and immunocytochemical studies of the C-propeptide of type II procollagen in chondrocytes of the growth plate.
The C-propeptide of type II procollagen has previously been implicated in cartilage calcification. To further characterize this propeptide, we have investigated its molecular status and intracellular distribution in bovine fetal growth plate chondrocytes, particularly within the calcifying zone, using cell isolation, Western blotting, and localization with immunofluorescence and immunogold techniques. We found that in all cells freshly isolated by collagenase digestion the C-propeptide was a component of type II pro-alpha chains. No free C-propeptide was detected intracellularly. In situ localization of the C-propeptide by immunostaining employing immunofluorescence revealed the presence of procollagen in most growth plate cells, staining being most intense in hypertrophic cells. In the latter, large dilations of the rough endoplasmic reticulum were observed. These were not found in proliferating cells and had an approximate diameter of 5 microns. With immunogold localization these, together with Golgi-derived secretory granules, stained for the C-propeptide. These combined results suggest that in all cells of the growth plate the C-propeptide is a constituent part of type II collagen pro-alpha chains, and that it is usually segregated in the rough endoplasmic reticulum at a time when, according to other studies, collagen synthesis ceases in the lower hypertrophic zone and calcification of the extracellular matrix ensues. This suggests that the intracellular translocation of type II collagen pro-alpha chains may change in hypertrophic cells at this time.


Thermoluminescent dosimeters for in vivo measurement of radiation exposure and related dose in mammography.
Most methods of radiation exposure evaluation in mammography concentrate on in vitro determination. One method has evolved using thermoluminescent dosimeters (TLDs) for in vivo determination, yet on a mail order basis. Presented here is the development of a procedure for preparing and using TLDs to measure entrance skin exposure (ESE) and mammographic unit output consistency that was adapted for implementation within a hospital setting. Using published correction factors and absorbed dose data, the estimated midbreast dose was calculated from the ESE obtained. A two-view examination resulted in an average ESE of 2198 mR per breast and an average midbreast dose of 177 mRad. This procedure is feasible for assessing ESE and dose in mammography.


Preparation of nano/submicrometer Ganoderma tsugae and its mutagenic potencies and cytotoxicity.
This study explored the feasibility of preparing nano/submicrometer particles from Ganoderma tsugae to enhance the contents of bioactive compounds and to assess its mutagenic potencies and cytotoxicity. Hot-water extract, a common product, was employed as a reference. After 3 h of media milling, almost all of the particles were smaller than 1 μm with a number-mean diameter of 0.11 μm. There were about 62% particles smaller than 0.1 μm in terms of number of particles. Scanning electron microscopy (SEM) confirmed the presence of particles at nano/submicrometer scale. The content of 1→3-β-D-glucan in nano/submicrometer G. tsugae was 3.5 times of that in hot-water extract. Both nano/submicrometer and hot-water extract G. tsugae exhibited no mutagenic potential to Salmonella Typhimurium tester strains. Cell toxicity test also confirmed the safety of both nano/submicrometer and hot-water extract G. tsugae. The effect of media milling on the structural change of hyphae was also discussed.


Jasmonate-Elicited Stress Induces Metabolic Change in the Leaves of Leucaena leucocephala.
The plant Leucaena leucocephala was exposed to four jasmonate elicitors, i.e., jasmonic acid (JA), methyl jasmonic acid (MeJA), jasmonoyl-l-isoleucine (JA-Ile) and 6-ethyl indanoyl glycine conjugate (2-[(6-ethyl-1-oxo-indane-4-carbonyl)-amino]-acetic acid methyl ester) (CGM). The treatment was to mimic the herbivores and wounding stresses. By using NMR spectroscopy along with chemometric analysis, including principal component analysis (PCA) and partial least squares discriminant analysis (PLS-DA), the changes of metabolites in the leaves of L. leucocephala were determined under the stress as induced by the four elicitors. The challenge of JA-Ile caused an accumulation of lactic acid (6), β-glucose (10), alanine (12), threonine (13), steroids (18), 3,4-dihydroxypyridine (19) and an unidentified compound 20. The chemometric analysis of the PCA and PLS-DA models indicated that the alternation of metabolites triggered by JA, MeJA, and CGM treatments were very minimum. In contrast, the treatment by JA-Ile could induce the most significant metabolic changes in the leaves. Moreover, there was very minimal new metabolite being detected in responding to the jasmonate-induced stresses. The results showed some metabolite concentrations changed after application of the elicitors, which may be related to a high level of tolerance to stress conditions as well as the strong ecological suitability of L. leucocephala.


Efficacy of etanercept in patients with AA amyloidosis secondary to rheumatoid arthritis.
The efficacy of biological therapies in rheumatoid arthritis (RA) is well known, but their hypothetical benefit in amyloid A (AA) amyloidosis secondary to RA still remains to be considered. We evaluated the efficacy and safety of etanercept in serum amyloid A (SAA) 1.3 allele Japanese patients with AA amyloidosis secondary to RA. Seven RA patients with histologically confirmed AA amyloidosis and renal involvement who were treated with etanercept were enrolled. They all had the SAA1.3 allele, which has been shown to be a risk factor not only for the association of AA amyloidosis but also for a poor prognosis in Japanese RA patients. Efficacy was assessed as a sustained decrease in RA inflammation and an amelioration of renal function. RA inflammation and AA amyloidosis were improved and stabilized after 43.4 +/- 16.5 weeks. At week 20 the number of tender (p = 0.017) and swollen (p = 0.017) joints, and levels of serum C-reactive protein (p = 0.018) and albumin (p = 0.045) had improved. The values for SAA, serum creatinine, calculated creatinine clearance, and proteinuria also ameliorated. No severe adverse events were observed. One patient eventually had to go on hemodialysis but her tolerance of etanercept remained stable. Etanercept can be used safely and effectively in AA amyloidosis secondary to RA with renal involvement, and is of clinical benefit in the short-term, even in patients on hemodialysis. It appears that SAA1.3 allele may be used as a clinical parameter for the introduction of etanercept in Japanese RA with AA amyloidosis.


Coupling of GnRH concentration and the GnRH receptor-activated gene program.
The initial waves of gene induction caused by GnRH in the LbetaT2 gonadotrope cell line have recently been identified using microarrays. We now investigate the relationship of the concentration of GnRH to the level of biosynthesis induced. Using an optimized custom cDNA microarray, we show that a large number of genes are induced in a concentration-dependent fashion. Detailed time course studies of the induction of six induced transcripts using quantitative real-time PCR suggest that the amplitude, but not the temporal pattern, depends on the concentration of GnRH. The early genes appear to show a delay in gene induction, followed by a linear phase of increase. The relationship of rate of synthesis and GnRH concentration was studied by mathematical modeling of the induction of two genes, gly96 and tis11. In both cases, only the rates of increase, but not the lag times, are influenced by the concentration of GnRH exposure. Western blot analyses for c-Jun and Egr1 show that the levels of nuclear protein for these transcription factors also depend on the concentration of GnRH. These studies indicate that, despite the complex signaling network connecting the receptor to the activated genes, the biosynthetic rate of RNA polymerase at induced genes is correlated with the concentration of GnRH at the GnRH receptor.


Simultaneous determination of phthalates and adipates in human serum using gas chromatography-mass spectrometry with solid-phase extraction.
A gas chromatography-mass spectrometry assay was developed and validated for the simultaneous determination of phthalates and adipates in human serum. The phthalates and adipates studied were dimethyl phthalate, diethyl phthalate, dibutyl phthalate, benzylbutyl phthalate, di-2-ethylhexyl phthalate, di-n-octyl phthalate, diethyl adipate, dibutyl adipate, diisobutyl adipate, bis(2-butoxyethyl) adipate and di-2-ethylhexyl adipate, with diisooctyl phthalate as internal standard. The extraction and cleaning up procedure was carried out with solid-phase extraction cartridges containing dimethyl butylamine groups, which showed extraction efficiencies over 88% for each analyte and the internal standard. The calibration curves obtained were linear with correlation coefficients greater than 0.98. For all analytes, the assay gave CV% values for intra-day precision from 4.9 to 13.3% and mean accuracy values from 91.4 to 108.4%, while inter-day precision was 5.2-13.4% and mean accuracy 91.0-110.2%. The limits of detection for the assay of phthalates and adipates were in the range 0.7-4.5 ng/mL. The method is simple, sensitive and accurate, and allows for simultaneous determination of nanogram levels of phthalates and adipates in human serum. It was successfully applied to an investigation on the level of phthalates and adipates in a non-occupationally exposed population.


COVID-19 Vaccine Acceptance, Trust in Vaccine, Anxiety Levels, and Related Factors in Turkish Society.
Vaccine acceptance and trust in vaccines pose a complex process affected by many factors. The present study was conducted to determine coronavirus disease 2019 (COVID-19) vaccine acceptance, trust in vaccines, anxiety levels, and related factors in Turkish society. The data of this cross-sectional and descriptive-correlational study were collected with the snowball method by using an online questionnaire throughout Turkey. The study was conducted between March 15 and April 3, 2021, with 3148 participants from 7 regions and 81 cities in Turkey. It was found that the participants accepted the vaccine at 72.8%, and the trust rate in the vaccine was 66.0%. It was also found that women, single participants, those who had immune system diseases, and with COVID-19 had higher Coronavirus Anxiety Scale scores at significant levels. According to Logistic Regression Analysis, gender, age, trust in the vaccine, perception of risk levels regarding COVID-19, and coronavirus anxiety levels are factors affecting the intentions of participants to accept/reject the vaccine. It was determined that male participants were more likely to accept the coronavirus vaccine (P = 0.028). It was found that health-care employees had higher trust in the coronavirus vaccine (P = 0.006) and acceptance rates (P = 0.010) at significant levels compared with the general population. The COVID-19 vaccine acceptance rate in Turkish society was found to be high, and the level of trust in vaccines and anxiety levels were above the moderate level.


Reduced tuberoinfundibular dopaminergic neuronal function in rats with in situ prolactin-secreting pituitary tumors.
Tuberoinfundibular dopaminergic (TIDA) neuronal function in rats with spontaneous or estrogen-induced prolactin- (PRL-)secreting pituitary tumors (prolactinomas) was studied by assaying dopamine (DA) concentration in pituitary stalk blood and electrically induced release of 3H-DA from the median eminence in vitro. Old rats with spontaneous prolactinomas showed enlarged and hemorrhagic pituitaries and elevated serum PRL levels. These rats had reduced DA in pituitary stalk blood, showed significantly lower response to the DA-releasing drug, nomifensine, and exhibited reduced electrically induced 3H-DA release from the median eminence in vitro, when compared to corresponding values in young and old rats without prolactinomas. The dopamine agonist piribedil failed to reduce electrically induced 3H-DA release by the superfused median eminence from old rats with prolactinomas, but not from old and young rats without prolactinomas. Old rats without prolactinomas also showed higher serum PRL values and pituitary weight than young rats without prolactinomas. However, stalk blood DA values before and after nomifensine, electrically induced 3H-DA release by the median eminence in vitro, and inhibition by piribedil of 3H-DA release in vitro were significantly lower in old rats without prolactinomas than in young rats without prolactinomas. Estrogen treatment of young ovariectomized rats for 5 months produced enlarged and hemorrhagic pituitaries and elevated serum PRL values, but reduced the content of stalk blood DA and electrically induced release of 3H-DA by the median eminence in vitro as compared with values in untreated young ovariectomized control rats. Estrogen-treated rats also showed no response to piribedil on in vitro 3H-DA release.(ABSTRACT TRUNCATED AT 250 WORDS)


Double jeopardy: Predictors of elevated lethality risk among intimate partner violence victims seen in emergency departments.
Many intimate partner homicide victims visit emergency departments (EDs) prior to their deaths, yet their lethality risk is not well understood. eHealth interventions for intimate partner violence (IPV) improve provider information, tailor care to victim need and link victims to services. We analyzed ED patients' lethality risk using one such intervention, Domestic Violence Report and Referral (DVRR). DVRR records were assessed for 263 female patients aged 16 and older seen for IPV at an urban, high-traffic, Northern California ED in 2014-15. Multiple linear regression was used to test the association of children's presence at home, pregnancy, age, and abuser-victim relationship with victim's lethality risk using the Danger Assessment (DA) score from the Lethality Risk Assessment for Intimate Partner Femicide. Differences in means were assessed using t- and F-tests. The mean DA score indicated high lethality risk, with a third of respondents (33.1%) reporting very high DA scores. Multiple linear regression models indicated that increasing victim age (β=0.20/year; 95% CI: 0.11-0.29), children's presence at home (β=2.61, 95% CI: 0.63-4.58), and perpetrator reported as dating partner (β=4.50, 95% CI: 1.62-7.38) or ex-partner (β=4.38, 95% CI: 1.10-7.66) were significantly associated with the DA score (p<0.05). Use of DA scores as ED risk assessment tools in response to IPV victimization could help hospital staff and IPV advocates direct resources toward highest-need patients, improving health outcomes without additional burden on hospitals. These results also foreground eHealth interventions' utility in linking providers and IPV advocates and reducing the risk of intimate partner homicide.


2p15-p16.1 microdeletion syndrome: molecular characterization and association of the OTX1 and XPO1 genes with autism spectrum disorders.
Reports of unrelated individuals with autism spectrum disorder (ASD) and similar clinical features having overlapping de novo interstitial deletions at 2p15-p16.1 suggest that this region harbors a gene(s) important to the development of autism. We molecularly characterized two such deletions, selecting two genes in this region, exportin 1 (XPO1) and orthodenticle homolog 1 (OTX1) for association studies in three North American cohorts (Autism Spectrum Disorder - Canadian American Research Consortium (ASD-CARC), New York, and Autism Genetic Resource Exchange (AGRE)) and one Italian cohort (Società Italiana per la Ricerca e la Formazione sull'Autismo (SIRFA)) of families with ASD. In XPO1, rs6735330 was associated with autism in all four cohorts (P<0.05), being significant in ASD-CARC cohorts (P-value following false discovery rate correction for multiple testing (P(FDR))=1.29 × 10(-5)), the AGRE cohort (P(FDR)=0.0011) and the combined families (P(FDR)=2.34 × 10(-9)). Similarly, in OTX1, rs2018650 and rs13000344 were associated with autism in ASD-CARC cohorts (P(FDR)=8.65 × 10(-7) and 6.07 × 10(5), respectively), AGRE cohort (P(FDR)=0.0034 and 0.015, respectively) and the combined families (P(FDR)=2.34 × 10(-9) and 0.00017, respectively); associations were marginal or insignificant in the New York and SIRFA cohorts. A significant association (P(FDR)=2.63 × 10(-11)) was found for the rs2018650G-rs13000344C haplotype. The above three SNPs were associated with severity of social interaction and verbal communication deficits and repetitive behaviors (P-values <0.01). No additional deletions were identified following screening of 798 ASD individuals. Our results indicate that deletion 2p15-p16.1 is not commonly associated with idiopathic ASD, but represents a novel contiguous gene syndrome associated with a constellation of phenotypic features (autism, intellectual disability, craniofacial/CNS dysmorphology), and that XPO1 and OXT1 may contribute to ASD in 2p15-p16.1 deletion cases and non-deletion cases of ASD mapping to this chromosome region.


Understanding the Role of Non-Coding RNAs in Bladder Cancer: From Dark Matter to Valuable Therapeutic Targets.
The mortality and morbidity that characterize bladder cancer compel this malignancy into the category of hot topics in terms of biomolecular research. Therefore, a better knowledge of the specific molecular mechanisms that underlie the development and progression of bladder cancer is demanded. Tumor heterogeneity among patients with similar diagnosis, as well as intratumor heterogeneity, generates difficulties in terms of targeted therapy. Furthermore, late diagnosis represents an ongoing issue, significantly reducing the response to therapy and, inevitably, the overall survival. The role of non-coding RNAs in bladder cancer emerged in the last decade, revealing that microRNAs (miRNAs) may act as tumor suppressor genes, respectively oncogenes, but also as biomarkers for early diagnosis. Regarding other types of non-coding RNAs, especially long non-coding RNAs (lncRNAs) which are extensively reviewed in this article, their exact roles in tumorigenesis are-for the time being-not as evident as in the case of miRNAs, but, still, clearly suggested. Therefore, this review covers the non-coding RNA expression profile of bladder cancer patients and their validated target genes in bladder cancer cell lines, with repercussions on processes such as proliferation, invasiveness, apoptosis, cell cycle arrest, and other molecular pathways which are specific for the malignant transformation of cells.


Is adenovirus a fetal pathogen?
The purpose of this study was to test the relationship between adenovirus genetic material in the amniotic fluid and adverse pregnancy outcome. This was a prospective, observational study of women who were referred in the second trimester of gestation for either genetic amniocentesis or evaluation of fetal malformation. A 2-mL aliquot of amniotic fluid was subjected to multiplex polymerase chain reaction for a panel of viruses that included adenovirus and human genome controls. Fetuses with an abnormal karyotype were excluded from analysis. The prevalence of adenovirus was similar in normal (39/652) and anomalous fetuses (23/364; chi(2) test, P=.376). There was significant seasonal variation in the prevalence in both normal and anomalous fetuses (chi(2) exact test, P<.001), but no significant difference between groups. The monthly proportion of patients who underwent amniocentesis remained constant throughout the year (mean, 8.3%; chi(2) test, P=.67). Central nervous system anomalies and echogenic liver foci were significantly more common among fetuses with positive amniotic fluid polymerase chain reaction results for adenovirus (P<.005, respectively). Adenovirus is found in a similar prevalence and seasonal variation in sonographically normal and abnormal pregnancies. Although a specific fetal presentation was not identified, echogenic liver lesions with or without hydrops and neural tube defects were significantly more common in the presence of adenovirus. The significance of these findings deserves further study.


Symptoms and signs in benign and malignant tumours of the breast.
The diagnostic distribution and the relation between diagnosis and symptoms, symptom duration, tumour site, tumour size and breast size were studied in 1 244 women with breast symptoms examined at a special breast tumour clinic. 9% of the women had cancer, 62% fibroadenosis and 6% fibroadenoma. In 18% no breast disease was found. A painful tumour was experienced by 19% of all women with breast cancer, but by 54% of breast cancer patients below 50 years of age. 50% of the patients with fibroadenosis had a painful tumour. This symptom was thus not a discriminating feature between cancer and fibroadenosis in younger women. The reason that most breast tumours, both benign and malignant, are located in the upper outer quadrant is not known. It has been proposed that this might be due to the larger volume of this quadrant as compared with the others. The present results contradict this view.


Personal exposure and long-term health effects in survivors of the union carbide disaster at bhopal.
Nine years after the Bhopal methyl isocyanate disaster, we examined the effects of exposures among a cross-section of current residents and a subset of those with persistent symptoms. We estimated individual exposures by developing exposure indices based on activity, exposure duration, and distance of residence from the plant. Most people left home after the gas leak by walking and running. About 60% used some form of protection (wet cloth on face, splashing water). Mean and median values of the exposure indices showed a declining trend with increasing distance from the plant. For those subjects reporting any versus no exposure, prevalence ratios were elevated for most respiratory and nonrespiratory symptoms. We examined exposure-response relationships using exposure indices to determine which were associated with health outcomes. The index total exposure weighted for distance was associated with most respiratory symptoms, one measure of pulmonary function in the cross-sectional sample [mid-expiratory flow (FEF)(25-75), p = 0.02], and two measures of pulmonary function in the hospitalized subset [forced expiratory volume (FEV)(1), p = 0.02; FEF(25-75), p = 0.08). Indices that correlated with FEV(1) and forced vital capacity in the hospitalized subset did not correlate with the cross-sectional sample, and most indices (except total exposure) that correlated with the hospitalized subset did not correlate with the cross-sectional sample. Incorporation of distance into every index increased the number of symptoms associated; an improvement was also noted in the strength of the association for respiratory symptoms, but not for pulmonary function. The sum of duration (p = 0.02) and total exposure (p = 0.03) indices independently demonstrated stronger associations with percent predicted FEF(25-75) than the distance variable (p = 0.04). The results show that total exposure weighted for distance has met the criteria for a successful index by being associated with most respiratory symptoms as well as FEF(25-75), features of obstructive airways disease.


High intake of alcohol is associated with newly diagnosed diabetes in 60 years old men and women.
Low or moderate alcohol intake has been found to be protective against the incidence of diabetes, while conflicting results have been found regarding high alcohol intake. This study aimed at evaluating the effect of alcohol intake on newly diagnosed diabetes among subjects aged 60 years in relation to anthropometric measurements, life-style and socio-economic factors. A population-based cross-sectional study of 4106 individuals, 1973 men and 2133 women, aged 60 years, in Stockholm County, Sweden. Medical history, socio-economic factors and life-style data were collected by a questionnaire and a medical examination including laboratory tests. High total intake of alcohol, i.e. >30 g/day vs. 0-30 g/day, was significantly noted more often in newly diagnosed diabetes in men (OR 2.72, 95% CI 1.70-4.34), even when adjusting for other factors, i.e. anthropometric measurements, life-style, socio-economic and dietary factors (adjusted OR 1.94, 95% CI 1.17-3.23); a high intake of spirits, i.e. >15 g/day vs. 0-15 g/day, was significantly more often observed among women (OR 3.97, 95% CI 1.50-10.50), however, it was not significant after adjustment (OR 2.23, 95% CI 0.67-7.42). High intake of alcohol among men was associated with increased risk of diabetes even when adjusting for other factors.


Emerging Chagas disease in Amazonian Brazil.
In the Amazon Basin, Trypanosoma cruzi infection is enzootic, involving a variety of wild mammals and at least 10 of the 16 reported silvatic triatomine bug species. Human cases of Chagas disease are increasing, indicating that the disease may be emerging as a wider public health problem in the region: 38 cases from 1969 to 1992, and 167 in the past eight years. This article reviews the status of Chagas disease in Amazonian Brazil, including known reservoirs and vectors, and the genetic diversity of T. cruzi. At least three subspecific groups of T. cruzi-T. cruzilZ1, T. cruziZ3 and T. cruziZ3/Z1 ASAT--are present. It appears that T. cruzil has an extant capacity for genetic exchange. Attention is also drawn to the risk of domestic endemicity, in addition to the tasks facing the disease control authorities.


Safety and efficiency of femoral artery access closure with a novel biodegradable closure device: a prospective single-centre pilot study.
Vascular closure devices can accelerate haemostasis after arteriotomy, but induce scarring. The aim of the study was to prospectively analyse the feasibility of a novel biodegradable arterial closure device (CD). Two hundred fifty-five patients (183 male; age 36-98 years) with an access vessel diameter >3 mm received the biodegradable CD after endovascular therapy. Technical success rate, time-to-haemostasis (TTH) and time-to-ambulation (TTA) were measured. Puncture site complications were categorized as minor (local hematoma, minor bleeding) or major (pseudoaneurysm, embolization, dissection, thrombotic occlusion, hematoma/major bleeding requiring surgery, access site infection). Technical success was achieved in 98.8 % (252 cases); device failure occurred in three cases (1.2 %). The average TTH and TTA were 11.3 ± 26.9 s and 73.0 ± 126.3 min. The major complication rate was 1.6 %, with three pseudoaneurysms and one retroperitoneal bleeding. The minor complication rate was 2.0 %, with five small hematomas. Neither cardiovascular risk factors nor access vessel characteristics had statistically significant influence on adverse events. Re-puncture was uncomplicated in 32 cases after 155.0 ± 128.8 days. Handling of the new biodegradable CD is safe. The complication rates are tolerably low and comparable to other CDs. Post-procedural sonography showed no significant palpable subcutaneous changes in the access site. • VCDs can increase time efficiency and patient comfort after intervention. • In this prospective single-centre-study, biodegradable CD was safe and easily applicable. • Its major and minor complication rates are comparable to other CDs. • Its mean time-to-haemostasis and time-to-ambulation were 11.3 ± 26.9 s and 73.0 ± 126.3 min. • Post-procedural sonography showed no significant palpable subcutaneous changes at the access site.


Does the Level of Transection of the Biliary Remnant Affect Outcome After Laparoscopic Kasai Portoenterostomy for Biliary Atresia?
We assessed postoperative outcome in relation to the level of transection of the biliary remnant at the time of laparoscopic Kasai portoenterostomy (LKP) in biliary atresia (BA) patients. The subjects for this study were 12 consecutive nonsyndromic type III BA patients who had LKP at our institute between 2009 and 2014. All LKPs were video recorded. Four board-certified pediatric surgeons assessed the level of transection of the biliary remnant and suturing during the anastomosis in each video blindly. A standard protocol was used for postoperative management. The level of transection was assessed as being shallow and suturing techniques as being identical in all. Although all cases achieved jaundice disappearance, 4 required liver transplantation (NNL group) for relapse of jaundice and 8 remain anicteric with native livers after mean follow-up of 4.6 years (NL group). Demographic data (birth weight, weight and age at LKP, duration from onset of symptoms to LKP, size of microbile ducts, and preoperative biochemical markers) were similar for both groups. The level of transection of the biliary remnant and suturing techniques would appear to not directly influence the outcome of LKP.


Ginkgo biloba induced malformations in mice.
To determine the gross structural malformations to the mice fetuses of the mothers given Ginkgo biloba during pregnancy. Experimental study. The Experimental Research Laboratory, University of Health Sciences, Lahore, from May 2006 to December 2006. The teratogenic effects of Ginkgo biloba extract (78 mg/kg/day and 100 mg/kg/day) dissolved in water were studied on the gross features of mice fetuses. Three groups (A, B and C) of 6 females each were mated with 2 males in two cages with 3:1 ratio of females to males. The first two groups (A and B) served as experimental and the third (C) was used as a control. Pregnancy was confirmed by a vaginal plug and gravid female mice (6) were separated from the males. Group A was treated with human therapeutic dose (78 ppm) while group B was given a high dose (100 ppm). Group C was given water only. Both experimental groups were given the drug orally throughout the gestational period. Result were compared using ANOVA with significance at p < 0.05. Forty-nine fetuses from B and C groups and 50 fetuses from A group were recovered. There was a significant (p < 0.05) decrease in weight and crown-rump length of fetuses in group B as compared to those from group A and C. Further, fetuses from groups A and C did not show any gross abnormalities, whereas those from group B exhibited a high frequency of malformations including round shaped eye and orbits, syndactyly, malformed pinnae, nostrils, lips and jaws. The results obtained substantiate the early finding that Ginkgo biloba can be teratogenic when given to pregnant mothers.


Improved Water Barrier Properties of Calcium Alginate Capsules Modified by Silicone Oil.
Calcium alginate films generally offer poor diffusion resistance to water. In this study, we present a technique for encapsulating aqueous drops in a modified calcium alginate membrane made from an emulsion of silicone oil and aqueous alginate solution and explore its effect on the loss of water from the capsule cores. The capsule membrane storage modulus increases as the initial concentration of oil in the emulsion is increased. The water barrier properties of the fabricated capsules were determined by observing the mass loss of capsules in a controlled environment. It was found that capsules made with emulsions containing 50 wt% silicone oil were robust while taking at least twice the time to dry completely as compared to capsules made from only an aqueous alginate solution. The size of the oil droplets in the emulsion also has an effect on the water barrier properties of the fabricated capsules. This study demonstrates a facile method of producing aqueous core alginate capsules with a modified membrane that improves the diffusion resistance to water and can have a wide range of applications.


[Pregnancy following prostaglandin F2 alpha treatment of tubal pregnancy].
We report on a successful pregnancy after prostaglandin F2 alpha treatment for tubal pregnancy. Laparoscopic instillation of prostaglandin F2 alpha was performed in 14 cases; we had to laparotomise in only 2 cases.


Combined antiviral effects of flavonoids and 5-ethyl-2'-deoxyuridine on the multiplication of herpesviruses.
The combined antiviral effects of quercetin, quercitrin and 5-ethyl-2'-deoxyuridine on the multiplication of herpes simplex virus type 1 (HSV-1) and pseudorabies virus were studied in vitro by the yield reduction test. Quercetin in combination with 5-ethyl-2'-deoxyuridine had an additive antiviral effect on either herpes-virus. The combined application of quercitrin and 5-ethyl-2'-deoxyuridine showed a synergic effect on pseudorabies virus.


Total body water reduction in subjects with chronic kidney disease on peritoneal dialysis is associated with a better hypertension control.
Hypertension is highly prevalent in patients with chronic kidney disease and hypervolemia is one of the principal causes. To evaluate the influence of the reduction of volemia on blood pressure as well as on echocardiographic parameters in patients on continuous ambulatory peritoneal dialysis. Twelve patients with no clinical evidence of hypervolemia were submitted to an increase in the rate of the dialysis with the purpose of reducing body weight by 5%. The volemia was evaluated by electrical bioimpedance and by ultrasound of the inferior cava vena (ICV). Blood pressure was measured by ambulatory blood pressure monitoring and cardiac function was evaluated by echocardiography both at baseline and 5 weeks after the intervention period. After the increase in the ultrafiltration, body weight, extracellular water and the inspiratory diameter of the ICV decreased significantly in parallel with a non-significant increase in the collapsing ICV index. Despite the reduction of anti-hypertensive drugs, systolic blood pressure during the sleep period decreased from 138.4 ± 18.6 to 126.7 ± 18.0 mmHg, the nocturnal blood pressure drop increased and the final systolic left ventricular diameter decreased significantly. Reduction of the volemia of patients on peritoneal dialysis, with no signs of hypervolemia, was associated with a better blood pressure control and with a decrease of the final systolic left ventricular diameter.


[Health-related quality of life in patients with chronic kidney disease].
Assessment of quality of life in patients with different degrees of chronic kidney disease is an important issue because of its impact on clinical decisions and financial resource management in the health-care system. The aim of this study was to assess whether a generic instrument like the SF-36 questionnaire is able to discriminate three different populations of patients with different degrees of renal disease (pre-ESRD, ESRD, TxR). Five hundred sixty-three patients from 12 Italian nephrology units completed the SF-36 scales by themselves. The results from these samples were compared with those from the general population. Univariate analysis and multivariate regression were used. The generic SF-36 questionnaire proved to be a powerful instrument to discriminate populations with different degrees of chronic renal failure. The quality of life of patients on dialysis is significantly worse than that of the normal population and other patients with less severe renal function impairment.


Chronic Disease Registries - Trends and Challenges.
This accompanying editorial is an introduction to the focus theme of "chronic disease registries - trends and challenges". A call for papers was announced on the website of Methods of Information in Medicine in April 2016 with submission deadline in September 2016. A peer review process was established to select the papers for the focus theme, managed by two guest editors. Three papers were selected to be included in the focus theme. Topics range from contributions to patient care through implementation of clinical decision support functionality in clinical registries; analysing similar-purposed acute coronary syndrome registries of two countries and their registry-to-SNOMED CT maps; and data extraction for speciality population registries from electronic health record data rather than manual abstraction. The focus theme gives insight into new developments related to disease registration. This applies to technical challenges such as data linkage and data as well as data structure abstraction, but also the utilisation for clinical decision making.


Ultra-low-dose radiotherapy for definitive management of ocular adnexal B-cell lymphoma.
The purpose of this study was to report the response to and toxicity of ultra-low-dose radiotherapy (RT) for B-cell ocular adnexal lymphoma (OAL). We conducted a retrospective review of patients with indolent B-cell and mantle cell OAL treated with 4 Gy to the orbit(s) in two 2-Gy fractions. Disease response was assessed clinically and/or radiographically at 2 to 4-month intervals after RT. Data collected included rates of overall response, complete response (CR), partial response (PR), and treatment-related toxic effects. Twenty-two patients (median age, 65 years) had the following histologic subtypes: mucosa-associated lymphoid tissue (MALT; 14 patients; 64%); follicular lymphoma (5 patients; 23%); mantle cell lymphoma (MCL; 2 patients; 9%); and unclassifiable (1 patient, 4%). The overall response rate was 100%; 19 patients (86%) had a CR and 3 patients (14%) had a PR. The only acute toxic effect was grade 1 dry eye syndrome in 1 patient. Ultra-low-dose RT in patients with OAL is associated with high response rates and minimal toxic effects, and is much shorter in duration and cost. © 2017 Wiley Periodicals, Inc. Head Neck 39: 1095-1100, 2017.


BOLD signal physiology: Models and applications.
The BOLD contrast mechanism has a complex relationship with functional brain activity, oxygen metabolism, and neurovascular factors. Accurate interpretation of the BOLD signal for neuroscience and clinical applications necessitates a clear understanding of the sources of BOLD contrast and its relationship to underlying physiology. This review describes the physiological components that contribute to the BOLD signal and the steady-state calibrated BOLD models that enable quantification of functional changes with a separate challenge paradigm. The principles derived from these biophysical models are then used to interpret BOLD measurements in different neurological disorders in the presence of confounding vascular factors related to disease.


Organotin compounds in seafood by ultrasonic assisted extraction and gas chromatography-triple quadrupole tandem mass spectrometry.
Although restricting environmental quality values for organotin compounds (OTs) are set by Directive 2013/39/EU of the European Parliament, marine environment remains being affected due to maritime circulation at global scale. Fish and seafood accumulate OTs, making fish and seafood consumption the main source of OTs in humans. Because of the fish and seafood matrices complexity and the required low limits of detection, a robust and fast procedure for the quantification of OTs in fish and seafood, using ultrasound-assisted extraction and gas chromatography-tandem mass spectrometry, was validated and applied. Detection (2.7 µg Sn kg-1) and quantification (8.0 µg Sn kg-1) limits, repeatability and intermediate precision (<10%), accuracy by analysing ERM®-CE477 Mussel Tissue and analytical recoveries (65-122%) were assessed. Multivariate analysis shown that the matrix effect for some OTs displayed good negative correlation with the fat and protein content. Health risk assessment of OTs intake revealed no serious risk for human consumption.


Arthroscopic Coracoid Bone Block for Posterior Glenohumeral Instability: Description of Surgical Technique and a Case Report.
This case report describes the surgical technique of posterior arthroscopic bone block using the coracoid graft to treat recurrent posterior dislocations and describes preliminary results. Performance of coracoid transfer as a graft for posterior arthroscopic bone block in one patient (two shoulders) with recurrent posterior glenohumeral instability refractory to clinical treatment for six months, excluding volition dislocation. The patient was followed up weekly for the first three weeks when the stitches were removed. Postoperative computed tomography was performed before the patient was authorized to practice contact and aquatic sports (3-4 months after surgery). Patient returned to previous activities without complaints or limitations. There were no neurovascular complications. The initial results using coracoid as a bone graft for posterior instability were positive, and the technique requires reproduction to investigate possible complications. To date, no study has been found in the literature that reports an open or arthroscopic coracoid bone block technique.


Results of the MITRA project: monitoring and intervention for the transportation of dangerous goods.
The objective of the MITRA (monitoring and intervention for the transportation of dangerous goods) project was to prototype a new operational system for monitoring the transportation of dangerous goods in Europe based on regional responsibilities. This concept, based on systems used in air traffic control, aims to provide civil security centres with real-time knowledge of the position and contents of dangerous vehicles circulating in their area of responsibility, and, in the event of a dangerous situation, to issue warnings, alerts and crisis management information, thereby allowing intervention teams to react immediately with maximum safety. The project was funded by the European Commission under the 6th Framework Programme (STREP--specific targeted research project--under the Information Society Technologies priority). It started on 1 September 2004 and ended on 31 October 2006. This paper presents the results of this project and the conclusions derived from the field tests carried out in Germany and in the French/Spanish border region in order to test the proposed operational system.


Potential variability of Leptospira serovars belonging to the same group.
3 clone strains of monjakov and pomona serovars were cultured with prolongation in a medium containing homologous immune sera. Separate subcultures were cloned in a solid medium, while isolated clones were typed in microagglutination test with whole and absorbed immune sera and in some cases in an absorption test. The results showed that the mutants of subcultures with the minimal and maximal time of contact with the immune serum turned out to differ greatly from each other in antigenic properties. While antigenic mutants of earlier subcultures were constantly connected with serovars of Pomona serogroup, mutants of subcultures adapted to immune serum were serologically more related to butembo serovar of Cynoptery serogroup. The results obtained showing potential variability of serovars belonging to Pomona serogroup could be significant from the viewpoint of classification and phylogeny of Leptospira.


Nanoparticle-mediated delivery of multinuclear platinum(IV) prodrugs with enhanced drug uptake and the activity of overcoming drug resistance.
Here, a nanoparticle-mediated delivery of multinuclear platinum(IV) prodrugs [biodegradable polymer-di-cisPt(IV)] for overcoming cisplatin drug resistance is reported. From the MTT assays, lower IC50 values of polymer-di-cisPt(IV) on A2780DDP cells than A2780 were observed with the lowest resistance factor of 0.7. Inductively coupled plasma mass spectroscopy results showed that more drugs were delivered into cancer cells and greater number of Pt-DNA adducts were formed with the use of the polymer-di-cisPt(IV) conjugate nanoparticles. By a mechanistic study with endocytosis inhibitors to treat A2780 cells, we proved that polymer-di-cisPt(IV) conjugate nanoparticles were internalized by the cancer cells through endocytosis rather than through passive diffusion or copper transporter 1-mediated active transportation. This well illustrates the way how the polymer-di-cisPt(IV) micelles overcome cisplatin resistance.


Neurohumoral mechanisms involved in the hypertensive response elicited by bilateral carotid occlusion in conscious intact or chronically sympathectomized rats.
Bilateral carotid occlusion (BCO) increases the sympathetic drive to the circulatory system in conscious intact rats, producing a hypertensive response characterized by two components, i.e., an initial peak followed by a sustained response of lower intensity. The neurohumoral mechanisms involved in the hypertensive response to BCO were evaluated in conscious intact (INTACT) or chronic guanethidine sympathectomized (SYMPX) rats. To accomplish this, the receptor antagonists, prazosin for alpha1-adrenergic receptor, losartan for AT1 angiotensin II receptor and [d(CH2)5Tyr(Me)AVP] for vascular V1 vasopressin receptor were used. A saline control group was studied as well. Conscious rats were equipped with cuffs around the common carotid arteries plus arterial and venous catheters. The results indicate that the sympathetic nervous system is the main mechanism controlling the basal arterial pressure in conscious INTACT rats, whereas in chronically SYMPX rats the renin-angiotensin system plays this role. In INTACT rats prazosin abolished the initial peak and blunted the sustained hypertensive response due to BCO, while the other antagonists exhibited no effect. SYMPX rats did not present the initial peak but displayed an enhanced sustained response, which was blunted by prazosin or the vasopressin antagonist. In conclusion, activation of the sympathetic drive is responsible for both the initial peak and the sustained hypertensive response due to BCO in conscious INTACT rats. On the other hand, vasopressin acting in concert with the sympathetic nervous system, plays a key role in the potentiation of the sustained hypertensive response due to BCO in conscious chronically SYMPX rats.


The validity of general cognitive ability predicting job-specific performance is stable across different levels of job experience.
Decades of research in industrial-organizational psychology have established that measures of general cognitive ability (g) consistently and positively predict job-specific performance to a statistically and practically significant degree across jobs. But is the validity of g stable across different levels of job experience? The present study addresses this question using historical large-scale data across 31 diverse military occupations from the Joint-Service Job Performance Measurement/Enlistment Standards Project (N = 10,088). Across all jobs, results of our meta-analysis find near-zero interactions between Armed Forces Qualification Test score (a composite of math and verbal scores) and time in service when predicting job-specific performance. This finding supports the validity of g for predicting job-specific performance even with increasing job experience and provides no evidence for diminishing validity of g. We discuss the theoretical and practical implications of these findings, along with directions for personnel selection research and practice. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


[Congenital Defect of the Left Pericardium with Spontaneous Pneumothorax;Report of a Case].
Congenital cardiac membrane deficiency is a relatively rare condition. Here, we report a case of congenital cardiac membrane deficiency that manifested as left spontaneous pneumothorax. A 72-year-old man was hospitalized for recurrence of the spontaneous pneumothorax. Computed tomography findings led us to suspect pericardial deficits, and the perioperative findings during thoracoscopic surgery for the pneumothorax confirmed complete absence of the left pericardium. We resected a lung cyst but did not treat the pericardial deficit. The patient's postoperative course was uneventful.


Freeze-fracture and immunomorphological analysis of spiral ganglion cells.
Freeze-fracture analysis of adult spiral ganglion cells of CBA/CBA mice revealed two types of membrane specializations. Most cells (type I) had a smooth surface and were surrounded by Schwann cells. Type II spiral ganglion cells showed numerous membrane specializations with well-delineated indentations similar to those previously found on hair cells adjacent to afferent and efferent nerve endings. Immunomorphological analysis (using well-defined monoclonal antibodies directed against different subclasses of intermediate filament proteins) revealed a unique co-expression of neurofilaments, vimentin and cytokeratins in spiral ganglion cells of 8- to 22-week human fetuses.


Exclusion of phlebotomine sand flies from inhabited areas by means of vertical mesh barriers.
Vector control constitutes an important component of integrated disease control campaigns. Source reduction is not an option for phlebotomine sand fly vectors of leishmaniasis, because larval breeding sites remain either unknown or inaccessible. Thus, all control efforts are directed against the adult sand flies, mostly attempting to limit their contact with humans. We describe experiments using an insecticide-treated vertical barrier to prevent sand flies from reaching inhabited areas of an agricultural settlement. A 400 meter long section of the peripheral fence of Kibbutz Sde Eliyahu, Jordan Valley, Israel was draped with a deltamethrin-impregnated net that is impenetrable to sand flies (polyester net, 450 holes/inch(2)). Sand flies were captured before and after construction of the barrier using CO(2)-baited CDC traps. Sand fly numbers, as monitored around three houses internal to the barrier, exhibited an 84.9% decrease once the barrier was erected (P=0.003). Concurrently, the neighboring control group of three houses, not protected by the barrier, exhibited a 15.9% increase in sand fly numbers (P=0.974). These results corroborate previous findings of field tests conducted on a smaller scale in an arid suburban setting. Campaigns for reducing the burden of sand fly bites and curtailing the transmission of leishmaniasis, should consider integrating vertical fine-mesh nets with other sand fly control measures.


Improving the Precision of Weak Measurements by Postselection Measurement.
Postselected weak measurement is a useful protocol for amplifying weak physical effects. However, there has recently been controversy over whether it gives any advantage in precision. While it is now clear that retaining failed postselections can yield more Fisher information than discarding them, the advantage of postselection measurement itself still remains to be clarified. In this Letter, we address this problem by studying two widely used estimation strategies: averaging measurement results, and maximum likelihood estimation, respectively. For the first strategy, we find a surprising result that squeezed coherent states of the pointer can give postselected weak measurements a higher signal-to-noise ratio than standard ones while all standard coherent states cannot, which suggests that raising the precision of weak measurements by postselection calls for the presence of "nonclassicality" in the pointer states. For the second strategy, we show that the quantum Fisher information of postselected weak measurements is generally larger than that of standard weak measurements, even without using the failed postselection events, but the gap can be closed with a proper choice of system state.


[Diagnosis and Treatment of Eosinophilic Esophagitis].
Eosinophilic esophagitis (EoE) is a chronic, immune/antigen-mediated esophageal disease characterized by symptoms of esophageal dysfunction and eosinophil-predominant inflammation. The diagnostic criteria for EoE have changed with our growing knowledge over the past two decades. Esophageal eosinophilia, which responds histologically to a proton pump inhibitor (PPI) is not a distinct disease but a subset of EoE. An endoscopic scoring system that relies on the assessment of exudates, rings, edema, furrows, and strictures is a useful tool for assessing endoscopic severity. PPIs are regarded as safe and effective first-line treatments for EoE. Oral topical corticosteroids or dietary therapy are also options for first-line treatment. Endoscopic dilation is effective for relieving the dysphagia symptoms of a patient with an esophageal stricture.


IDENTIFICATION OF BACTERIA IN BLOOD CULTURES FROM CLINICALLY ILL CAPTIVE ANTILLEAN MANATEES (TRICHECHUS MANATUS MANATUS).
Between September 2001 and March 2013, 62 bacterial cultures (37 aerobic and 25 anaerobic) were performed on 37 blood samples from 23 Antillean manatees ( Trichechus manatus manatus) that were kept in captivity at the Brazilian National Center for Research and Conservation of Aquatic Mammals (CMA) in Pernambuco (CMA-PE) and Alagoas (CMA-AL), Brazil. All of the animals sampled exhibited clinical signs at the time of sampling including abscesses (n = 8), debilitation and anorexia (n = 22), and profound lethargy-moribundity (n = 7). The 4 animals with profound lethargy-moribundity died shortly after sampling of unknown causes. Bacteria were isolated from 15/37 (40.5%) and aerobic blood cultures from 13/23 animals (56.5%). None of the anaerobic cultures were positive. Aeromonas caviae , Aeromonas hydrophila , Aeromonas sp., Escherichia coli , Leclercia adecarboxylata , Pantoea agglomerans , Pseudomonas aeruginosa , Pseudomonas stutzeri , Pseudomonas sp., Sphingomonas paucimobilis , coagulase-negative Staphylococcus, and Staphylococcus epidermidis were each found in only one animal; Staphylococcus spp. was found in two; and Vibrio fluvialis in four. Thirteen samples had only one bacteria isolated, one sample had two bacteria, and one sample had three bacteria isolated. Regarding sex, age group, and origin among the manatees examined, 54.5% (6/11) of the females, 58.3% (7/12) of the males, 40% (2/5) of the calves, 66.7% (8/12) of the juveniles, 50% (3/6) of the adults, 55.5% (10/18) at CMA-PE, and 60% (3/5) at CMA-AL were found to be positive for bacterial growth during at least one sampling time. All Antillean manatees were clinically ill. Regarding clinical signs, bacteria were found in 50% (11/22) of blood samples of the animals showing debilitation and anorexia, 1 of 8 (12.5%) of blood samples of the animals showing abscesses, and 3 of 7 (42.9%) of blood samples of the animals showing profound lethargy-moribundity.


[Polymorphism of porcine myostatin gene].
Myostatin(MSTN) gene is expressed specifically in developing and mature skeletal muscle, and the expression products of MSTN gene inhibits muscle growth and differentiation. The polymorphism of the porcine MSTN gene was researched by PCR-SSCP. The SSCP was found in the MSTN gene exon 2 and exon 3. It showed three genotypes (CC, CT, TT) in exon 2 and two genotypes (AG, GG) in exon 3 in Large White pigs. The relationship between polymorphism in exons 2 and 3 and productive performance was analysed. Variance analysis showed that there was no significant relationship between the polymorphism in exon 2 and productive performance. But t test showed that there was a significant relationship between the polymorphism in exon 3 and back fat thickness (P < 0.05), there was also a relationship between the polymorphism in exon 3 and lean meat percentage, but not significant (P > 0.05). The fragments with SSCP polymorphism in exon 2 and 3 were sequenced, the sequencing results showed that there were two single nucleotides mutation, i.e. A-->G at 1008 (exon 3) and G-->T at 480 (exon 2). Two mutations did not change the amino acid but brought an Apa I site in exon 3, and PCR-RFLP molecular marker technique was established with Apa I.


AN INVESTIGATION OF VISION PROBLEMS AND THE VISION CARE SYSTEM IN RURAL CHINA.
This paper examines the prevalence of vision problems and the accessibility to and quality of vision care in rural China. We obtained data from 4 sources: 1) the National Rural Vision Care Survey; 2) the Private Optometrists Survey; 3) the County Hospital Eye Care Survey; and 4) the Rural School Vision Care Survey. The data from each of the surveys were collected by the authors during 2012. Thirty-three percent of the rural population surveyed self-reported vision problems. Twenty-two percent of subjects surveyed had ever had a vision exam. Among those who self-reported having vision problems, 34% did not wear eyeglasses. Fifty-four percent of those with vision problems who had eyeglasses did not have a vision exam prior to receiving glasses. However, having a vision exam did not always guarantee access to quality vision care. Four channels of vision care service were assessed. The school vision examination program did not increase the usage rate of eyeglasses. Each county-hospital was staffed with three eye-doctors having one year of education beyond high school, serving more than 400,000 residents. Private optometrists often had low levels of education and professional certification. In conclusion, our findings shows that the vision care system in rural China is inadequate and ineffective in meeting the needs of the rural population sampled.


Cytokine production induced by a 67-kDa fimbrial protein from Porphyromonas gingivalis.
Fimbriae have been reported to play an important role in the adherence of Porphyromonas gingivalis to oral surfaces and possibly in triggering host responses. P. gingivalis ATCC 33277 has two distinctly different fimbriae expressed on the cell surface. The 67-kDa fimbriae differ in size and antigenicity from the earlier reported FimA, a major 41-kDa fimbrial component of P. gingivalis. Expression of the 67-kDa fimbriae on the cell surface of a fimA mutant was investigated by electron microscopy. The 67-kDa fimbrial protein was purified from the fimA mutant by sonication, precipitation, and chromatography on a DEAE Sepharose CL-6B column. The N-terminal amino acid sequence of the 67-kDa fimbrillin was distinct from that of the 41-kDa fimbrillin. Moreover, we have found that the 67-kDa fimbrial protein from P. gingivalis ATCC 33277 induced IL-1alpha, IL-beta, IL-6 and TNFalpha cytokine expression in mouse peritoneal macrophages. These results suggest that P. gingivalis 67-kDa fimbriae may play a part in the inflammatory response during the development of periodontal diseases.


Spatio-temporal information analysis of event-related BOLD responses.
A new approach for analysis of event-related fMRI (BOLD) signals is proposed. The technique is based on measures from information theory and is used both for spatial localization of task-related activity, as well as for extracting temporal information regarding the task-dependent propagation of activation across different brain regions. This approach enables whole brain visualization of voxels (areas) most involved in coding of a specific task condition, the time at which they are most informative about the condition, as well as their average amplitude at that preferred time. The approach does not require prior assumptions about the shape of the hemodynamic response function (HRF) nor about linear relations between BOLD response and presented stimuli (or task conditions). We show that relative delays between different brain regions can also be computed without prior knowledge of the experimental design, suggesting a general method that could be applied for analysis of differential time delays that occur during natural, uncontrolled conditions. Here we analyze BOLD signals recorded during performance of a motor learning task. We show that, during motor learning, the BOLD response of unimodal motor cortical areas precedes the response in higher-order multimodal association areas, including posterior parietal cortex. Brain areas found to be associated with reduced activity during motor learning, predominantly in prefrontal brain regions, are informative about the task typically at significantly later times.


Sacral Stress Fractures: A Rare but Curable Cause of Back Pain in Athletes.
Stress fractures of the sacrum are an uncommon cause of low back and buttock pain in athletes. They have been described in a few case reports, with the injury occurring most often in female distance runners. Given the rarity of this condition, there is a general lack of awareness of this injury, which may lead to a missed or delayed diagnosis. Case series. Level 5. The 5 cases were identified by performing a medical records search within the practices of the senior authors over a 3-year period from January 2016 to December 2018. Three of 5 patients (1 male, 2 females) returned to regular activity after diagnosis and treatment. Two (1 male, 1 female) have yet to return to regular activity. Magnetic resonance imaging was the key modality in all diagnoses. All 3 female patients had components of the female athlete triad-menstrual irregularity, disordered eating, and decreased bone mineral density. A high index of suspicion is required to make the correct diagnosis and initiate treatment for this rare condition given its association with low body mass index, vitamin D insufficiency, disordered eating, and malabsorption disorders. Appropriate treatment includes rest from the causative activity, nutritional support, and biomechanical optimization. In severe, chronic, or recurrent cases, referral for nutritional counseling, hormonal replacement therapies, and mental health support may be necessary. Sacral stress fractures, though uncommon, should be included prominently in the differential diagnosis for runners with low back pain, especially if the athlete has a history of prior stress fracture or the female athlete triad.


Descriptive normative beliefs and the self-regulation in alcohol use among Slovak university students.
This study aims (i) to understand how descriptive normative beliefs (DNB) about typical students' alcohol use and self-regulation (SRG) are related to alcohol use (AU) by exploring the indirect effect of SRG on AU through DNB and (ii) to explore gender differences and the differences between universities in DNB, SRG and AU. The cross-sectional data were collected online from 817 Slovak university students from four universities (75.22% females; Mage = 19.61; SD = 1.42), who filled in the AUDIT-C items, items measuring the DNB about typical students' AU and SRG. T-tests, one-way Anova and structural equation modelling were used for data analysis. Gender differences in AU and DNB were found with males having higher levels of both AU and DNB. The tested model of AU fits the data well. A significant association was found between DNB and (i) AU (positive) and (ii) SRG (negative). The analysis confirmed the existence of an indirect effect of SRG on AU through DNB. The study contributes to research concerning AU by the way in which DNB and SRG are linked to AU among Slovak university students. The research findings can also be used in developing prevention and intervention programs.


Medium effects on zwitterionic-biradicaloid intermediates from two phenyl-alpha-oxoamides. Irradiations in fluid and solid protic media, neat solid phases, and the solid, smectic and isotropic phases of a completely saturated phosphonium salt at different temperatures.
The photochemical processes of two N,N-dialkyl phenyl-alpha-oxoamides, N,N-diisopropyl phenyl-alpha-oxoamide (1) and N,N-dibenzyl phenyl-alpha-oxoamide (2), are investigated at different temperatures in methanol and ethylene glycol (to probe the influences of H-bonding and viscosity), in the solid phase of D-sorbitol at room temperature (to compare with the results in the liquid alcohols and to assess the influence of a poorly organized "stiff" environment), in the neat solid phase (to probe the influence of well-ordered, "stiff" matrices), and in the solid, smectic A2 and isotropic phases of methyl-tris-tetradecylphosphonium tetrafluoroborate (1P14BF4) (to assess the ability of the intermediates to respond to subtle changes in the order and polarity of their local environments). From differences between the activation parameters for product pathways from irradiations in methanol and in 1P14BF4, we conclude that the zwitterionic pre-product intermediate from 1 is much more sensitive to the polarity, viscosity and order of its local environment than is the isomeric pre-product biradicaloid intermediate or either of the pre-product intermediates from 2. A very sensitive balance among the medium parameters, as well as internal steric and electronic factors of 1 and 2, controls the reactive pathways of the photochemically generated intermediates.


Development of a cross-polarization scattering system for the measurement of internal magnetic fluctuations in the DIII-D tokamak.
The design and performance of a new cross-polarization scattering (CPS) system for the localized measurement of internal magnetic fluctuations is presented. CPS is a process whereby magnetic fluctuations scatter incident electromagnetic radiation into a perpendicular polarization which is subsequently detected. A new CPS design that incorporates a unique scattering geometry was laboratory tested, optimized, and installed on the DIII-D tokamak. Plasma tests of signal-to-noise, polarization purity, and frequency response indicate proper functioning of the system. CPS data show interesting features related to internal MHD perturbations known as sawteeth that are not observed on density fluctuations.


C-reactive protein, early life stress, and wellbeing in healthy adults.
To determine whether C-reactive protein (CRP) can serve as a marker for alterations in immune function prior to the manifestation of significant psychiatric and medical disorders. Ninety-two healthy adults were recruited from the community and determined to be free of psychiatric or medical disorders. The concentration of plasma CRP from a single resting sample was examined in relation to current mental and physical health as well as to self-reported history of early life adversity. C-reactive protein showed a significant positive correlation with body mass index (BMI; r = 0.477, P < 0.001). Non-specific pain, fatigue, and lower overall quality of physical health were all associated with higher CRP concentrations (all P < 0.05 or P < 0.01), after controlling for effect of BMI and other relevant covariates. Subthreshold depression symptoms and other indices of mental/emotional wellbeing were not associated with CRP, nor was CRP significantly linked to any measures of early life adversity. Lower-quality physical health and wellbeing, but not the presence of mood/anxiety symptoms or early life stress (ELS), were significantly related to plasma CRP. Elevated CRP does not appear to be a fundamental consequence of ELS among healthy adults.


Effect of RNAi-mediated silencing of two Knickkopf family genes (LmKnk2 and LmKnk3) on cuticle formation and insecticide susceptibility in Locusta migratoria.
Knickkopf (Knk) proteins play crucial roles in the formation of insect cuticle. Recent studies in the holometabolous insect red flour beetle (Tribolium castaneum) have shown that three Knk genes encoding TcKnk, TcKnk2 and TcKnk3 play different but essential roles at different developmental stages and in different tissues. However, the functions of Knk genes had not been fully explored in hemimetabolous insects such as the migratory locust Locusta migratoria. We identified three transcripts of LmKnk-like genes LmKnk2 and LmKnk3 with the full-length cDNA sequences, which were named as LmKnk2, LmKnk3-FL and LmKnk3-5'. These three transcripts were highly expressed before molting and mainly expressed in the integument. Among these genes, silencing only LmKnk3-5' by RNA interference (RNAi) caused molting defects and high mortality of the locusts. Injection of dsLmKnk3-5' dramatically decreased chitin content, but did not affect cuticle laminar ultra-structures in the integument. After the knockdown of LmKnk3-5' transcript, lipid deposition on the cuticle surface was impeded, and locusts exhibited increased susceptibility to each of four insecticides in three different classes. However, no visible phenotypic changes were observed after LmKnk2 or LmKnk3-FL was silenced by RNAi. We demonstrate that LmKnk3-5' is essential for cuticle formation in L. migratoria. This contrasts the findings that the cognate protein in T. castaneum TcKnk3-5' is dispensable for cuticle formation and survival. Hence, we provide some evidence that the function of Knk-type proteins may be species-specific. We therefore think that LmKnk3-5' may be a good target for the application of RNAi-based technologies for species-specific insect pest management. © 2020 Society of Chemical Industry.


Variable confounding and the influence of non economic determinants on dental utilization for the elderly.
The purpose of this study is to test the hypothesis that variable confounding will cause discrepancies in dental utilization analysis and to determine the significance of gender, health status, and race on dental utilization by controlling for several predictor variables previously reported to be associated with dental care utilization. Results provide supporting evidence that discrepancies in dental utilization analysis can occur as a result of variable confounding. In addition, parameter estimates indicate that older women and white adults were more likely to visit a dental office than either older men or older blacks. On the other hand, older adults reported to be in poor health were no more likely to visit a dentist than older adults in excellent health.


Cardiac troponin I for predicting right ventricular dysfunction and intermediate risk in patients with normotensive pulmonary embolism.
Right ventricular dysfunction (RVD) and cardiac troponin I (cTnI) are important tools for risk stratification in pulmonary embolism (PE). We investigate the association of RVD and cTnI in normotensive PE patients and calculate a cTnI cut-off level for predicting RVD and submassive PE. Clinical, laboratory, radiological and echocardiagraphic data were analysed. Patients were categorised into groups with or without RVD and compared focussing on cTnI. Effectiveness of cTnI for predicting RVD and submassive PE was tested. One hundred twenty-nine normotensive PE patients, 71 with and 58 without RVD, were included. Patients with RVD were older (75.0 years (61.3/81.0) vs. 66.0 years (57.7/75.1), P = 0.019). cTnI (0.06 ng/ml (0.02/0.23) vs. 0.01 ng/ml (0.00/0.03), P < 0.0001) and D-dimer values (2.00 mg/l (1.08/4.05) vs. 1.23 mg/l (0.76/2.26), P = 0.016) were higher in PE with RVD. cTnI was associated with RVD (OR 3.95; 95 % CI 1.95-8.02, p = 0.00014). AUC for cTnI diagnosing RVD was 0.79, and for submassive PE0.87. Cut-off values for cTnI predicting RVD and submassive PE were 0.01 ng/ml, with a negative predictive value of 73 %. cTnI was positively correlated with age, D-dimer and creatinine. In normotensive PE patients, cTnI is helpful for risk stratification and excluding RVD. cTnI elevation is correlated with increasing age and reduced kidney function.


Instant noodle consumption is associated with cardiometabolic risk factors among college students in Seoul.
Increased consumption of instant noodles has recently been reported to be positively associated with obesity and cardiometabolic syndrome in South Korea, which has the highest per capita instant noodle consumption worldwide. This study aimed to investigate the association between instant noodle consumption and cardiometabolic risk factors among college students in Seoul. The study subjects consisted of 3,397 college students (1,782 male; 1,615 female) aged 18-29 years who participated in a health checkup. Information on instant noodle consumption was obtained from the participants' answers to a question about their average frequency of instant noodle intake over the 1 year period prior to the survey. Statistical analysis using a general linear model that adjusted for age, body mass index, gender, family income, health-related behaviors, and other dietary factors important for cardiometabolic risk, showed a positive association between the frequency of instant noodle consumption and plasma triglyceride levels, diastolic blood pressure, and fasting blood glucose levels in all subjects. Compared to the group with the lowest frequency of instant noodle intake (≤ 1/month), the odds ratio for hypertriglyceridemia in the group with an intake of ≥ 3/week was 2.639 [95% confidence interval (CI), 1.393-5.000] for all subjects, while it was 2.149 (95% CI, 1.045-4.419) and 5.992 (95% CI, 1.859-21.824) for male and female students, respectively. In female students, diastolic blood pressure was also higher among more frequent consumers of instant noodles. Our results suggest that frequent consumption of instant noodles may be associated with increased cardiometabolic risk factors among apparently healthy college students aged 18-29 years.


A new millennium for health care IT: the year 2000 conversion.
The new millennium. It means many things for many people, from astrologers to information technology (IT) professionals. But the latter, especially those in health care, have good reason to be concerned. Because for the majority of computer systems, January 1,2000, marks both the beginning of a new decade and total system chaos.


Effect of Warm Acupuncture Combined with Bone Marrow Mesenchymal Stem Cells Transplantation on Cartilage Tissue in Rabbit Knee Osteoarthritis.
The current study was designed to investigate the effect and underlying mechanism of warm acupuncture combined with bone marrow mesenchymal stem cells (BMSC) transplantation on cartilage tissue injury in rabbit knee osteoarthritis (KOA). In the study, 50 rabbits were randomly divided into 5 groups: blank group, KOA group, warm acupuncture group, BMSCs group, and warm acupuncture combined with BMSCs group. After warm acupuncture combined with BMSCs, the Modified Lequesne MG knee joint assessment scale was used to evaluate the degree of knee joint behavior, the Taiping Peng method generally observed the histomorphology changes of KOA rabbit cartilage, and hematoxylin-eosin staining, safranin O green staining, and toluidine blue staining were conducted to evaluate the extent of cartilage tissue pathology. Furthermore, transmission electron microscopy and TUNEL staining were used to observe cell apoptosis, and immunohistochemistry and qPCR analysis were used to detect the expression of apoptosis-related proteins and mRNA. Results showed that administration of warm acupuncture combined with BMSCs recovered the joint function and significantly decreased Lequesne MG score. The degree of cartilage tissue pathological damage has been improved, cartilage ultrastructure degeneration has recovered, peripheral blood vessels have mild edema, blood supply has gradually recovered, and even small amounts of red blood cells have appeared. In addition, warm acupuncture combined with BMSCs treatment suppressed chondrocyte apoptosis in rabbits with knee osteoarthritis by reduced TUNEL-positive chondrocytes and simultaneously reversed the mRNA expression of Bax, Bcl-2, and Caspase-3. These results indicate that warm acupuncture combined with BMSCs transplantation has a potential protective effect on rabbit KOA, which may be mediated by inhibiting chondrocyte apoptosis.


[Risk of community acquired pneumonia in patients with diabetes mellitus: Review].
The article for the first time provides a relatively comprehensive overview of the main aspects of the epidemiology and clinical features of infectious pathology, i.e., community-acquired pneumonia, as comorbid and aggravating conditions in patients with type 1 and type 2 diabetes mellitus. Risk factors and pathogenetic patterns of infectious processes development, as well as the special etiological role of pneumococcal infection in this group of patients, are considered. Particular attention is paid to the possibilities of and approaches to the primary prevention of vaccine-preventable infections as the causes of the development of community-acquired pneumonia and invasive diseases in patients with diabetes mellitus with a review of international studies, guidelines, and local experience data in pneumococcal infection immunization.


Visible Light-Induced Trifluoromethylation and Perfluoroalkylation of Cysteine Residues in Batch and Continuous Flow.
We report a visible light-induced trifluoromethylation and perfluoroalkylation for cysteine conjugation using Ru(bpy)3(2+) as photocatalyst and inexpensive RFI as coupling partner. The protocol allows the introduction of a variety of perfluoro alkyl groups (C1-C10) and a CF2COOEt moiety. The reaction is high yielding (56-94% yield) and fast (2 h in batch, 12 examples). Process intensification in a photomicroreactor accelerated the reaction (5 min reaction time) and increased the yields (8 examples). Quantum yield investigations support a radical chain mechanism.


Application of ultrasonography-elastography score to suspect porto-sinusoidal vascular disease in patients with portal vein thrombosis.
Porto-sinusoidal vascular disease (PSVD) and portal vein thrombosis (PVT) are causes of portal hypertension characterized respectively by an intrahepatic and a pre-hepatic obstacle to the flow in the portal system. As PVT may be a consequence of PSVD, in PVT patients at presentation, a pre-existing PSVD should be suspected. In these patients the identification of an underlying PSVD would have relevant implication regarding follow-up and therapeutic management, but it could be challenging. In this setting ultrasonography may be valuable in differential diagnosis. The aim of the study was to use ultrasonography to identify parameters to discriminate between PSVD and "pure" PVT and then to suspect PVT secondary to a pre-existing PSVD. Fifty-three patients with histologically proven PSVD and forty-eight patients affected by chronic PVT were enrolled and submitted to abdominal ultrasonography with elastography by acoustic radiation force impulse (ARFI). ARFI was higher and superior mesenteric vein (SMV) diameter was wider in PSVD patients than in PVT patients. Thus, a prognostic score was obtained as linear combinations of the two parameters with a good discrimination capacity between PSVD and PVT (the area under the curve = 0.780; 95% confidence interval: 0.690-0.869). A score based on ARFI and SMV diameter may be useful to suspect an underlying PSVD in patients with PVT and to identify a subgroup of patients to be submitted to liver biopsy.


A discrete event simulation for improving operating theatre efficiency.
Increasing demand in healthcare services has posed excessive burden on healthcare professionals and hospitals with finite capacity. Operating theatres are critical resources within hospitals that can become bottlenecks in patient flow during high demand conditions. There are substantial costs associated with running operating theatres that include keeping professional staff ready, maintaining operating theatres and equipment, environmental services and cleaning of operating theatres and recovery rooms, and these costs can increase if theatres are not used efficiently. In addition to cost, operating theatre inefficiency can result in surgery cancelations and delays, and eventually, poor patient outcomes, which can be exacerbated under the increase in demand. The allocation of surgeries to operating theatres is explored using a simulation model for patients admitted to inpatient beds and sent for surgery. We proposed a discrete event simulation (DES) to model incoming flow to operating theatres of a major metropolitan hospital. We assessed how changing the configuration of surgery at the target hospital affects Key Performance Indicators relating to theatre efficiency. In particular, the model was used to assess impacts of six different scenarios by defining new/hypothetical theatre case-mix, opening and closing times of theatres, turnaround (changeover) time, and repurposing the theatres. Target performance metrics included theatre utilisation, pre-operative length-of-stay, average reclaimable time, the percentage of total theatre time in a year that could be reclaimed, and patient waiting time. A web-based application was developed that allows testing user-defined scenarios and interactive analysis of the results. Extending the opening hours of operating theatres by 1 hour almost halved the number of deferred electives as well as over-run cases but at the expense of reduced theatre utilisation. A one-hour reduction in opening hours resulted in 10 times more deferred elective cases and a negligible increase in theatre utilisation. Reducing turnaround time by 50% had positive effects on theatre management: increased utilisation and less deferred and over-run elective cases. Pooling emergency theatres did not affect theatre utilisation but resulted in a considerable reduction in average wait time and the proportion of the delayed emergency cases. The developed DES-based simulation model of operating theatres along with the web-based user interface provided a useful interrogation tool for theatre management and hospital executive teams to assess new operational strategies. The next step is to embed simulation as ongoing practices in theatre planning workflow, allowing operational managers to use the model outputs to increase theatre utilisation, and reduce cancellations and schedule changes. This can support hospitals in providing services as efficiently and effectively as possible.


[Spatial variation of carbon density in Pinus massoniana forest in Jiangxi Province, China].
Carbon density is one of the important indicators for carbon sequestration capacity in forest ecosystems. The analysis of spatial variation in forest carbon density can provide scientific basis for management of forest carbon sink. We investigated the carbon density of Pinus massoniana forest in Jiangxi Province. Based on plot investigation and meaurement of sample carbon content, the spatial autocorrelation and distribution of carbon density were analyzed and explored respectively by using global Moran I, local Moran I and geostatistics. Results from the global Moran I showed that ecosystem carbon density had significant positive spatial autocorrelation and its autocorrelation decreased with the increase of distance. Ecosystem carbon density had no spatial autocorrelation when the distance exceeded 400 km. The spatial distribution of ecosystem carbon density changed from aggregated distribution to random distribution with the increase of distance. Results from the local Moran I showed that the local spatial distribution of ecosystem carbon density was not uniform, and the difference of local spatial distribution gradually increased with the increase of distance. The fitting results of semi-variogram models showed that the spherical model was the best fitting model for the estimation of ecosystem carbon density. The ratio of nugget to sill was 0.36, indicating mode-rate spatial correlation of carbon density. The ecosystem carbon density based on kriging spatial interpolation mainly concentrated in the range of 85.14-153.52 t·hm-2. The spatial distribution regularity was generally low in middle region and high in peripheral region, which was consistent with the terrain characteristics of the study area.


Effect of preoperative hemodynamic support on survival after cardiac transplantation.
The accessibility and success of cardiac transplantation promotes transplantation for a broad range of recipients, including those requiring intravenous inotropes or mechanical-assist devices. To determine if survival is dependent on preoperative requirements for hemodynamic support, we studied 230 patients who underwent transplant at the Loyola, Stanford, and UTAH programs from December 1, 1984 through November 30, 1986, and who were followed up for 34 months postoperatively. Group 1 (n = 132 of 230, 57%) patients required only oral medical therapy to maintain hemodynamic compensation; Group 2 (n = 69 of 230, 30%) patients were dependent on intravenous inotropic support; and Group 3 (n = 29 of 230, 13%) patients required mechanical assistance. Pretransplant characteristics showed that dilated cardiomyopathy was more common in Group 2 patients, and lower cardiac index and ejection fraction were more prevalent in Group 3 patients as expected. Although survival was lower in Group 3 only at 1 month (Group 1, 98.5%; Group 2, 92.8%; and Group 3, 86.2%; p less than 0.01), the survival advantage in Groups 1 and 2 was lost by 3 months, with 1-year survival rates of 88.6% in Group 1, 81.2% in Group 2, and 82.8% in Group 3. Allograft survival and cause of death were not different among the three groups. Acute rejection occurred at a lower monthly frequency in the first 4 months in Group 3 (Group 1, 0.47 +/- 0.03; Group 2, 0.47 +/- 0.05; and Group 3, 0.29 +/- 0.06; p less than 0.01), whereas infectious complications occurred at similar frequencies.(ABSTRACT TRUNCATED AT 250 WORDS)


The role of pneumolysin in the pathogenesis of Streptococcus pneumoniae infection.
In addition to being cytotoxic for eukaryotic cells, recent research has clearly indicated that pneumolysin at sub-cytolytic concentrations potentiates the proinflammatory activities of neutrophils and macrophages. Together these cytotoxic and proinflammatory activities of the toxin are likely to contribute to the virulence of the pneumococcus, particularly in facilitating adherence, invasion and dissemination of this important microbial pathogen. Pneumolysin-based vaccine strategies, although in the early stages of development and evaluation, show promise in reducing the severity of pneumococcal disease.


Comorbid autism spectrum disorder and anxiety disorders: a brief review.
Appearing in 40% of the cases of autism spectrum disorder (ASD), comorbid anxiety presents unique challenges for practitioners by amplifying problem behaviors such as social skills deficits, resistance to change and repetitive behaviors. Furthermore, comorbid ASD/anxiety strains familial relationships and increases parental stress. Research indicates that the neurobiological interactions between anxiety and ASD require comprehensive assessment approaches, modified cognitive behavioral therapy and carefully managed pharmacological interventions. Meta-analyses indicate that cognitive behavioral therapy with exposure is an effective treatment option when adequately accounting for social, familial and cognitive variables. The purpose of this focused review is to update readers on the latest research advances in comorbid ASD and anxiety, including prevalence, assessment, psychosocial and pharmacological treatment.


Hyaluronidase-like enzymes are a frequent component of venoms from theraphosid spiders.
Theraphosid spider venoms are extremely complex mixtures, composed mainly by low molecular compounds, peptides, and enzymes. The large size of these spiders and their ability to breed in captivity permits access to rather large amounts of venom and an easier venom extraction. In the present study, we conducted a comparative investigation about the content of hyaluronidase-like enzymes in the venoms from several theraphosid spiders, with a special focus on the Poecilotheria species, which are considered as underestimated theraphosids of medical importance. The following species were analyzed: Poecilotheria regalis, Poecilotheria ornata, Poecilotheria rufilata, Poecilotheria vittata, Bonnetina papalutlensis, Aphonopelma sp., Brachypelma smithi, Brachypelma epicureanum, Brachypelma boehmei, Grammostola porteri, Lasiodora klugi, Ceratogyrus darlingi, and Nhandu chromatus. The presence of hyaluronidase-like enzymes was evidenced in all venoms by a turbidimetric method and zymography. Several isoforms of acid-active hyaluronidase-like enzymes were detected in the venoms from Poecilotheria species. These results provide some biochemical characteristics of the high molecular mass proteins of the theraphosid venoms.


Double contrast small bowel follow-through with an acid-resistant effervescent agent.
A new technique was developed to achieve double contrast examinations in the small bowel without intubation. Effervescent granules and tablets were coated with an acid-resistant acrylic lacquer to provide selective enteric gas release. The coating thickness was 15% of dry weight for the granules and 1 to 4.5 mg/cm2 for the tablets. Fifty patients were examined using the method in a controlled study. All examinations were reviewed by two radiologists using a three-step quality score. The results were compared to 20 enteroclysis examinations. Image quality was better for the coated tablets compared with the granules (P < .01). The double-contrast small bowel follow-through (DC-SBFT) provided a better quality examination in the terminal small bowel than in the jejunum. Enteroclysis yielded better results for the jejunum, but was not superior in the terminal ileum. Average time of fluoroscopy was 477 seconds for the DC-SBFT (n = 50) compared with 952 seconds for patients receiving enteroclysis (n = 528). No side effects or adverse reactions occurred due to contrast media application. The results of this new method are preliminary, yet promising. For young patients and certain indications it may provide a less invasive alternative to enteroclysis.


Diabetes, hypertension, and renal insufficiency in post-myocardial infarction cardiovascular risk.
The prognosis for patients who suffer myocardial infarctions (MIs) is poor, with 22% of male and 46% of female survivors being disabled by heart failure within 6 years. Many well-established risk factors for increased morbidity and mortality post-MI are closely linked to the metabolic syndrome and associated with over-activation of the renin-angiotensin-aldosterone and sympathetic nervous systems. Results from numerous large-scale clinical endpoint trials have shown that blocking the deleterious effects of these systems with either an angiotensin-converting enzyme inhibitor or a beta-adrenoceptor antagonist significantly reduces the risk of mortality and cardiovascular events in post-MI patients. Results from 1 recent study of the beta-blocker, carvedilol, have shown further that these benefits extend to high-risk patients with either diabetes or hypertension.


Using artificial neural networks to predict impingement and dislocation in total hip arthroplasty.
Dislocation after total hip arthroplasty (THA) remains a major issue and an important post-surgical complication. Impingement and subsequent dislocation are influenced by the design (head size) and position (anteversion and abduction angles) of the acetabulum and different movements of the patient, with external extension and internal flexion the most critical movements. The aim of this study is to develop a computational tool based on a three-dimensional (3D) parametric finite element (FE) model and an artificial neural network (ANN) to assist clinicians in identifying the optimal prosthesis design and position of the acetabular cup to reduce the probability of impingement and dislocation. A 3D parametric model of a THA was used. The model parameters were the femoral head size and the acetabulum abduction and anteversion angles. Simulations run with this parametric model were used to train an ANN, which predicts the range of movement (ROM) before impingement and dislocation. This study recreates different configurations and obtains absolute errors lower than 5.5° between the ROM obtained from the FE simulations and the ANN predictions. The ROM is also predicted for patients who had already suffered dislocation after THA, and the computational predictions confirm the patient's dislocations. Summarising, the combination of a 3D parametric FE model of a THA and an ANN is a useful computational tool to predict the ROM allowed for different designs of prosthesis heads.


An investigation on the biodynamic foundation of a rat tail vibration model.
The objectives of this study are to examine the fundamental characteristics of the biodynamic responses of a rat tail to vibration and to compare them with those of human fingers. Vibration transmission through tails exposed to three vibration magnitudes (1 g, 5 g, and 10 g r.m.s.) at six frequencies (32 Hz, 63 Hz, 125 Hz, 160 Hz, 250 Hz, and 500 Hz) was measured using a laser vibrometer. A mechanical-equivalent model of the tail was established on the basis of the transmissibility data, which was used to estimate the biodynamic deformation and vibration power absorption at several representative locations on the tail. They were compared with those derived from a mechanical-equivalent model of human fingers reported in the literature. This study found that, similar to human fingers, the biodynamic responses of the rat tail depends on the vibration magnitude, frequency, and measurement location. With the restraint method used in this study, the natural frequency of the rat tail is in the range 161-368 Hz, which is mostly within the general range of human finger resonant frequencies (100-350 Hz). However, the damping ratios of the rat tail at the unconstrained locations are from 0.094 to 0.394, which are lower than those of human fingers (0.708-0.725). Whereas the biodynamic responses of human fingers at frequencies lower than 100 Hz could be significantly influenced by the biodynamics of the entire hand-arm system, the rat tail biodynamic responses can be considered independent of the rat body in the frequency range used in this study. Based on these findings it is concluded that, although there are some differences between the frequency dependences of the biodynamic responses of the rat tail and human fingers, the rat tail model can provide a practical and reasonable approach to examine the relationships between the biodynamic and biological responses at midrange to high frequencies, and to understand the mechanisms underlying vibration-induced finger disorders.